〔丹〕司丞叔平生脚自踝以下常觉热,冬不可加绵于上,常自言曰∶我资禀壮不怕冷。予曰∶此足三阴虚,
宜断欲事以补养阴血,庶乎可免。笑而不答,年方十七,患痿,半年而死。
〔《千》〕手足烦者,小便三升,盆中温渍手足。
〔《灵》〕热厥,取足太阴、少阳,皆留之。(寒热病篇)
〔垣〕香港脚之疾,实水湿之所为也。盖湿之害人皮肉筋脉而属于下,然亦有二焉∶一则自外而感,一则自
内而致。其治法自应不同,故详而论之。其为病也,有证无名。香港脚之称,自晋苏敬始,关中河朔无有也。惟
南方地下水寒,其清湿之气中于人,必自足始。故经曰∶清湿袭虚,则病起于下。或者难曰∶今兹北方,其地
则风土高寒,其人则腠理致密,而复多此疾者,岂是地湿之气感之而为邪?答曰∶南方之疾,自外而感者也;
北方之疾,自内而致者也。何以言之?北方之人,常食 乳,又饮酒无节,过伤而不厌,且 乳之为物,其气
味则 乳,其形质则水也,酒醴亦然。人之水谷入胃,胃气蒸腾,其气与味宣之于经络,化之为血气,外荣四
末,内注五脏六腑,周而复始,以应刻数焉,是谓天地之纪,此皆元气充足,脾胃之气无所伤而然也。苟元气
不充,则胃气之本自弱,饮食既倍,则脾胃之气有伤,既不能蒸化所食之物,其气与味,亦不能宣畅旁通,其
水湿之性流下而致之,其自外而入者,止于下胫肿而痛,自内而致者,乃或至于手节也。经云∶足胫肿曰水,
太阴所至为重跗肿。此但言其自外者也。所治之法,前人方论备矣。自内而致者,治法则未有也。杨大受云∶
香港脚是为壅疾,治以宣通之剂,使气不能成壅也。壅既成而盛者,砭恶血而去其重势。经曰∶蓄则肿热,砭射
之后,以药治之。
按东垣论南方香港脚,外感清湿,作寒治;北方香港脚,内伤酒醴,作湿热治,此实发前人之未发者。以人
论之,不必以南北分寒热,凡外感寒湿者,皆属寒湿,不必南方为然;凡内伤酒醴者,皆属湿热,不必北
方为然;但随脉症及询其病之由来而施治可也。
〔《素》〕卧出而风吹之,血凝于肤者为痹,凝于脉者为泣,凝于足者为厥,此三者,血行而不得反其空,
故为痹厥也。(五脏生成篇)
冬苦病痹厥。(全文见五厥。)
〔垣〕孙真人云∶凡四时之中,皆不得久坐久立湿冷之地,亦不得因酒醉汗出,脱衣洗足,当风取凉,皆
成香港脚。若暑月久立湿冷之地者,则湿热之气,蒸人经络,病发必热,则四肢皆酸疼烦闷。若寒月久坐久立湿
冷之地者,则湿冷之气,上入经络,病发则四肢皆酷冷转筋。世有勤工力学之士,久坐久立于湿地,不得动静,
冷风来入经络,不觉成病也。若欲使之不成病者,初觉则灸患处二三十壮则愈,不复发热。黄帝云∶当风取凉,
醉以入房,能成此病。又云∶妇人产后取凉,多有此疾。深宜慎之。《内经》论南方者,其地下水土弱,雾露
之所蒸也,江东岭南,大率如此,春夏之交,山林蒸郁,风湿毒瓦斯为甚,足或感之,遂成瘴毒香港脚。其候则脚
先屈弱,渐至痹疼,胫微肿,小腹不仁,头痛烦心,痰壅吐逆,时作寒热,便溲不通,甚者攻心而势逼,治之
诚不可缓。支法存所以留意经方偏善此术者,岂非江右岭表此疾得之多欤?
《千》、《外台》、《总录》所录,皆谓南方卑湿雾露所聚之地,其民腠理疏,阳气不能外固,因而履之,则清
湿袭虚,病起于下,此因血虚气弱,受清湿之邪气,与血并行于肤腠,邪气盛,正气少,故血气涩,涩则痹,
虚则弱,故令痹弱也,后人名曰香港脚。《针经》云∶有道以来,有道以去。治之多以灸 为佳,以导引湿气外
出,及饮醪醴以通经散邪。所制之方,寒药少,热药多,多用麻黄、川乌、姜、附之属。《内经》云∶湿淫于
外,以苦发之。麻黄苦温,发之者也。川乌辛热,走而不能守,通行经络。姜、附辛甘大热,助阳退阴,亦能
散清湿之邪。又察足之三阴三阳,是何经络所起,以引用药为主治,更审六气中何气当之,治以佐使之药。孙
真人云∶医者意也,随时增损,初无定方,真知言哉。
〔《千》〕 风毒之气,入人体中,脉有三品,内外证候相似,但脉有异耳。若脉大而缓,宜服续命汤二剂,
立瘥。若风盛宜作越婢汤加白术二两。若脉浮大而紧转快,宜作竹沥汤。又云∶脉浮大而紧 ,此最恶脉也。
若细而 者,同是恶脉。浮大者病在外,沉细者病在内,治亦不同。病患脉微而弱,宜服风引汤,此人脉多是
因虚而得之。若大虚短气力乏,可间作补汤,随病冷热而用之。若未愈,更服竹沥汤即止。
〔《活》〕治香港脚属冷者,小续命汤煎成,旋入生姜自然汁服之,最快。(续命方见前中风门。)
〔仲〕越婢加白术汤。(见后痿厥门。)
〔《千》〕第一竹沥汤 治两脚痹弱或转筋,皮肉不仁,腹胀起如肿,按之不陷,心中恶,不欲食,或患冷方。
竹沥(五升) 甘草 蓁艽 葛根 黄芩 麻黄 防风 细辛 桂心 干姜(各一两) 防己 升麻(各
一两半) 茯苓(三两) 附子(二枚) 杏仁(五十枚)
上 咀,以水七升,合竹沥煮取三升,分三服,取汗。《千金冀方》无茯苓、杏仁,有白术一两。
第二大竹沥汤 治卒中风,口噤不能言,四肢纵缓,偏痹挛急,风经五脏,恍惚,恚怒无常,手足不随方。
竹沥(一升四合) 独活 芍药 防风 茵芋 甘草 白术 葛根 细辛 黄芩 芎 (各二两) 桂心
防己 人参
石膏 麻黄 生姜 茯苓(各一两) 乌头(一枚)
上 咀,竹沥每服四升,分六服,先未汗者取汗,一服相当即止。
第三竹沥汤 治风毒入人五脏,短气,心下甚热,手足烦疼,四肢不举,皮肉不仁,口噤不语方。
竹沥(一斗二升) 防风 茯苓 秦艽(各三两) 当归 黄芩(《千金翼》作白芍) 人参
芎(《千金》作防己) 细辛 桂心 甘草 升麻(《千金》作通草) 麻黄 白术(各二两)
附子(二枚) 蜀椒(一两) 葛根(五两) 生姜(八两)
上 咀,以竹沥煮取四升,分五服。初得病,即须摩风膏,日再,痹定止。(《千金翼》无麻黄、
蜀椒、生姜。)
风引汤
麻黄 石膏 独活 茯苓(各二两) 吴茱萸 附子 秦艽 细辛 桂心 人参 防风 芎 防己
甘草 干姜(以上各一两) 白术(三两) 杏仁(六十枚)
上 咀,以水一斗六升,煮取三升,分三服,取汗为度。
上六方表剂。
竹沥汤若不及热服,辄停在胸膈,更为人患。每服当使极热。若服竹沥汤得下者,必佳也。若加服数剂,
病及脉势未折而苦胀满者,可以大鳖甲汤下之。汤势尽而不得下,可以丸散助汤令下,下后更服竹沥汤,令脉
势折,将息料理乃佳。
大鳖甲汤 治脚弱风毒挛痹气上,及伤寒恶风湿毒,山水瘴气,热毒,四肢痹弱方。
鳖甲(二两) 防风 麻黄 白术 石膏 知母 升麻 茯苓 橘皮 芎 杏仁(去皮尖) 人参
半夏 当归 芍药 葳蕤 甘草 麦门冬(各一两) 羚羊角(六铢) 大黄(一两半) 犀角 雄黄 青木
香(各半两) 大枣(二十枚) 贝齿 乌头(七枚) 生姜(一两) 薤白(十四枚) 麝香(二铢) 赤
小豆(三合) 吴茱萸(五合)
上 咀,以水二斗,煮取四升,分六服,去渣,食前温服。如人行十里久,得下则止。一方用大黄半两,
煨,畏下可止用六铢。一方用羚羊角五钱,毒盛可用六铢。(胡治有山茱萸半升,《千金翼》无知母、
升麻、橘皮、芎 、人参、当归、葳蕤。)
上治寒湿属里。
〔仲〕乌头汤 治香港脚疼痛,不可屈伸。(方见历节注疼痛。)
〔《千》〕麻黄汤 治风恶毒瓦斯,脚弱无力,顽痹四肢不仁,失音不能言,毒瓦斯冲心。有人病者,但一病相当,
即服此第一服,次服第二、第三、第四方。
麻黄 大枣(二十枚) 茯苓(三两) 杏仁(三十枚) 防风 白术 当归 升麻 芎 芍药 黄芩
桂心 麦门冬 甘草(各二两)
上 咀,以水九升,清酒二升,合煮取二升半,分四服,日三夜一。覆令小汗,粉之,莫令见风。
第二服独活汤方。
独活(四两) 熟地(三两) 生姜(五两) 葛根 桂心 甘草 芍药 麻黄(各二两)
上 咀,以水八升,清酒二升,合煎取二升半,分四服,日三夜一。脚弱时忌瓠子、蕺菜,犯之一世治不愈。
第三兼补浓朴汤并治诸气咳嗽逆气呕吐方。
浓朴 芎 桂心 熟地 芍药 当归 人参(各二两) 黄 甘草(各三两) 吴茱萸(二升) 半夏(七两)
生姜(一斤)
上 咀,以水二斗,煮猪蹄一具,取汁一斗二升,去上肥,内入清酒三升,合煮,取三升,分四服。相去
如人行二十里久,更进服。
第四服风引独活汤兼补方。
独活(四两) 茯苓 甘草(各三两) 升麻(一两半) 人参 桂心 防风 芍药 当归 黄 干姜 附子(各
二两) 大豆(二升)
上 咀,以水九升,清酒三升,合煮三升半,分四服。相去如人行二十里久,更进服。
〔《本》〕益气血,补肝肾,祛风湿,壮脚膝,地黄丸。
熟地(一两) 牛膝 石斛(各三两) 肉苁蓉 茵芋 防风 川芎 桂心 五味子 附子 薏苡仁(各半两)
上为末,炼蜜丸,如桐子大。每服三四十丸,酒吞下,空心,食前服。
治腰脚走注痛,此是香港脚,宜薏苡丸。
薏苡仁 茵芋 白芍药 牛膝 川芎 防风 独活(各半两) 熟地 侧子(一枚) 桂心 橘红
上细末,炼蜜丸,如桐子大。每服三四十丸,酒下,食前,日三服。木瓜汤下亦得。
〔《三因》〕胜骏丸 治元气不足,真气虚弱,及诸虚寒湿气进袭,手足拳挛,脚指连脚面拘急,走注
疼痛,筋脉不伸,行步不随,常服益真气,壮筋骨,黑髭须,滑皮肤,及去一切足弱鹤膝风。
附子(一枚,炮,去皮脐) 当归(酒浸一宿) 天麻(酒浸) 牛膝(酒浸) 酸枣仁(炒)
熟地(酒浸) 防风(各二两) 木瓜(四两) 乳香(半两,别研) 全蝎(去毒,一两) 麝香(二钱,别研)
木香 没药(另研) 羌活 甘草(炙。各半两)
上件为细末,用生地黄三斤,洗净,研烂如泥,无灰酒四升,煮烂如膏,以前药匀和,杵令坚,每两作十
丸,每服用一丸,细嚼临睡酒下。如冬月无地黄,炼蜜丸,如桐子大,每服五十丸,盐汤下,酒亦可。服此
药五七日或半月,见效甚速,行履如飞,千里可至,故名胜骏。(一方加槟榔、萆 、苁蓉、破故纸、巴戟、
木瓜各一两,减当归、地黄各一两,尤妙。)
〔《云》〕苍术丸 治干湿香港脚,筋脉拘挛,疼痛不能行。
乳香 没药(各二两。另研) 牛膝 青盐(各半两) 熟艾(四钱) 川乌(三钱) 全蝎(炒,二钱)
苍术(米泔浸,炒,四两)
上为细末,共研药和匀。以木瓜一个,大者,切一头,留作盖,去穣,入上件药于内,将盖拴定,安木瓜
于黑豆中,蒸令极烂,取出去皮,连药研成膏,却入生苍术末拌匀,丸如桐子大,每服五十丸,空心木瓜汤
下,以温盐酒亦可,日三服。忌血与蒜。
〔《本》〕治腰脚筋骨酸无力,酒浸牛膝丸。
牛膝(三两,炙黄) 川椒(半两,去子并合口者) 附子(一两,炮去皮脐) 虎胫骨(真者半两,
醋炙黄)
上 咀,用生绢作袋,入药扎口,用煮酒一斗,春秋浸十日,夏浸七日,冬浸十四日,每日空心饮一大盏。
酒尽,出药为末,醋糊为丸。每服二十丸,空心,温酒盐汤任下。忌动风等物。
〔丹〕香港脚,须用提起其湿之在下者,药随气血用。
治肿痛方。
生地 黄柏(酒炒) 苍术(盐炒) 白术 防风 槟榔 川芎 犀角 甘草梢 木通 黄连
热加芩、连。痰加竹沥、姜汁。及时令热加石膏。大便秘加桃仁。小便涩加牛膝。
有食积流注者。
苍术 黄柏 防己 南星 川芎 白芷 犀角 槟榔
血虚加牛膝、龟板。有如常肿者,专主湿热。肥人加痰药。
一妇人足肿。
生地 黄柏 苍术 南星 牛膝(酒洗) 草龙胆 川芎
脚弱筋痛。
牛膝(二两) 白芍(一两半) 龟板(酒炙) 黄柏(炒,一两) 知母(炒,一两) 甘草(炙,半两)
上为末,酒糊为丸。
〔垣〕异法方宜论云∶北方者其地高陵居,风寒冷洌,其俗饮 酪而肉食。凡饮 酪,以饮多饮速者为能。
经云∶因而大饮则气逆。又云∶食入于阴,长气于阳。今乃反行阳道,是为逆也。夫乳酪醇酒者,湿热之物,
饮之属也。加以奉养太过,亦滋其湿。水性润下,气不能 ,故下疰于足陉,积久而作肿痛,此饮食下流之所
【丹溪】司丞叔平生双脚从脚踝以下常觉得热,冬天不能在脚上加棉袜,常自己说:“我体质强壮,不怕冷。”我说:“这是足三阴经虚损,应当断绝房事以补养阴血,或许可以免除祸患。”他笑着不回答,年仅十七岁,患了痿证,半年后死亡。
【《千金方》】手足烦热的,小便量多至三升,用温水浸泡手足。
【《灵枢》】热厥,取足太阴脾经、足少阳胆经的穴位,均留针。(见《寒热病篇》)
【《摘玄方》】产后手足冰冷逆乱:针刺肩井穴(可立即痊愈。)
【李东垣】香港脚这一疾病,实际上是水湿邪气造成的。大概湿气伤害人的皮肉筋脉而病位在下,然而也有两种情况:一种是从外感受,一种是从内生发。其治疗方法自然应该不同,所以详细论述它。这种病有症状而无正式病名。“香港脚”这个称呼,从晋代苏敬开始才有,关中、河朔地区是没有的。只有南方地下水寒冷,清湿之气侵入人体,必定从脚部开始。所以医经说:“清湿侵袭虚弱之处,则病起于下部。”有人辩难道:“如今北方,地势高寒,人的腠理致密,却还多有此病,难道是地湿之气感之而为邪吗?”回答说:“南方的病,是从外感受的;北方的病,是从内生发的。为什么这样说?北方的人,常吃乳酪,又饮酒无节制,过度损伤而不厌弃,况且乳酪这种东西,其气味是乳浊的,其形质是水,酒也是如此。人的水谷进入胃中,胃气蒸腾,其气与味宣散于经络,化生为气血,外荣养四肢末端,内灌注五脏六腑,周而复始,以应合刻漏计时,这叫做天地的大纪,这都是元气充足,脾胃之气没有受伤的缘故。如果元气不充盛,那么胃气的根本自会虚弱,饮食加倍,就会损伤脾胃之气,既然不能蒸化所吃的食物,其气与味,也不能宣畅旁通,其水湿的性质流注向下而导致发病,那些从外而入的,只限于小腿肿胀疼痛;从内生发的,甚至会导致手部关节病变。医经说:‘足胫肿胀叫水肿,太阴脾土所致的是足背沉重肿胀。’这只是说从外感受的情况。治疗的方法,前人的方论已经完备了。从内生发的,治疗方法还没有记载。杨大受说:‘香港脚是壅滞之疾,治疗用宣通的药剂,使气不能形成壅滞。’壅滞既成且严重的,用砭石刺破排出恶血以去除重势。医经说:‘蓄积则肿热,砭射之后,再用药物治疗。’
按语:东垣论述南方香港脚,因外感清湿,按寒证治疗;北方香港脚,因内伤酒醴,按湿热证治疗,这实在是阐发了前人未曾发表的观点。就人而论,不必以南北来分寒热,凡是外感寒湿的,都属于寒湿,不一定非要是南方才这样;凡是内伤酒醴的,都属于湿热,不一定非要是北方才这样;只要根据脉症并询问病因来施治就可以了。
【《素问》】睡觉出来被风吹,血液凝滞在皮肤的叫痹,凝滞在经脉的叫涩,凝滞在足部的叫厥,这三种情况,都是血行不畅而不能返回其空窍,所以称为痹厥。(见《五脏生成篇》)
【李东垣】孙真人说:凡是在四季之中,都不得久坐久立在湿冷的地方,也不得因为酒醉汗出,脱衣洗脚,当风取凉,这些都会导致香港脚。如果在暑月久立湿冷之地,那么湿热之气,蒸熏人的经络,发病必定发热,则四肢都酸疼烦闷。如果在寒月久坐久立湿冷之地,那么湿冷之气,上入经络,发病则四肢都酷冷转筋。世间有勤工力学之士,久坐久立于湿地,不得动静,冷风进入经络,不知不觉就成病了。如果想让他不成病,初觉时就在患处灸二三十壮就好了,不再发热。黄帝说:当风取凉,醉后行房,能造成此病。又说:妇人产后取凉,多有此病。深宜谨慎。《内经》论述南方的,那里地下水土弱,雾露蒸腾,江东岭南,大体如此,春夏之交,山林蒸郁,风湿毒瓦斯很严重,脚部如果感受了,遂成为瘴毒香港脚。其症状则是脚先屈弱,渐至痹疼,小腿微肿,小腹麻木不仁,头痛心烦,痰壅呕吐,时常发作寒热,大小便不通,严重的攻心而形势危急,治疗实在不可迟缓。支法存之所以留意经方偏善于此术者,岂不是因为江右岭表此地此病多得多的缘故吗?
《千金方》、《外台秘要》、《太平圣惠方》所记录的,都说南方是卑湿雾露聚集的地方,那里的百姓腠理疏松,阳气不能外固,因而踩踏,则清湿侵袭虚弱之处,病起于下部,这是因为血虚气弱,受清湿之邪气,与血并行于肤腠,邪气盛,正气少,所以血气涩滞,涩滞则痹,虚弱则弱,所以令痹弱也,后人名为香港脚。《针经》说:有道以来,有道以去。治疗多以灸法为佳,以导引湿气外出,以及饮醪醴以通经散邪。所制的方剂,寒药少,热药多,多用麻黄、川乌、姜、附子之类。《内经》说:湿淫于外,用苦味发散。麻黄苦温,是发散的。川乌辛热,走而不守,通行经络。姜、附子辛甘大热,助阳退阴,也能散清湿之邪。又察足之三阴三阳,是何经络所起,以引用药为主治,更审六气中何气当之,治以佐使之药。孙真人说:医者意也,随时增损,初无定方,真是知言啊。
【《千金方》】风毒之气,进入人体,脉象有三品,内外证候相似,但脉象有差异罢了。如果脉大而缓,宜服续命汤两剂,立即痊愈。如果风盛宜作越婢加白术汤加白术二两。如果脉浮大而紧转快,宜作竹沥汤。又说:脉浮大而紧,这是最恶的脉象。如果细而迟,同是恶脉。浮大的病在外,沉细的病在内,治疗也不同。病患脉微而弱,宜服风引汤,此人脉多是因为虚而得的。如果大虚短气力乏,可间作补汤,随病冷热而用之。如果未愈,再服竹沥汤即止。
【《活人书》】治疗香港脚属冷证的,小续命汤煎成,随即加入生姜自然汁服用,最快。(续命方见前中风门。)
【《千金方》】第一竹沥汤 治两脚痹弱或转筋,皮肉不仁,腹胀起如肿,按之不陷,心中恶,不欲食,或患冷方。
竹沥(五升) 甘草 秦艽 葛根 黄芩 麻黄 防风 细辛 桂心 干姜(各一两) 防己 升麻(各一两半) 茯苓(三两) 附子(二枚) 杏仁(五十枚)
以上切碎,用水七升,合竹沥煮取三升,分三次服,取汗。《千金翼方》无茯苓、杏仁,有一两白术。
第二大竹沥汤 治卒中风,口噤不能言,四肢纵缓,偏痹挛急,风经五脏,恍惚,恚怒无常,手足不随方。
竹沥(一升四合) 独活 芍药 防风 茵芋 甘草 白术 葛根 细辛 黄芩 川芎(各二两) 桂心 防己 人参 石膏 麻黄 生姜 茯苓(各一两) 乌头(一枚)
以上切碎,竹沥每服四升,分六次服,先未出汗者取汗,一服相当即止。
第三竹沥汤 治风毒入人五脏,短气,心下甚热,手足烦疼,四肢不举,皮肉不仁,口噤不语方。
竹沥(一斗二升) 防风 茯苓 秦艽(各三两) 当归 黄芩(《千金翼》作白芍) 人参 川芎(《千金》作防己) 细辛 桂心 甘草 升麻(《千金》作通草) 麻黄 白术(各二两) 附子(二枚) 蜀椒(一两) 葛根(五两) 生姜(八两)
以上切碎,以竹沥煮取四升,分五次服。初得病,即须摩风膏,日两次,痹定止。(《千金翼》无麻黄、蜀椒、生姜。)
风引汤
麻黄 石膏 独活 茯苓(各二两) 吴茱萸 附子 秦艽 细辛 桂心 人参 防风 川芎 防己 甘草 干姜(以上各一两) 白术(三两) 杏仁(六十枚)
以上切碎,用水一斗六升,煮取三升,分三次服,取汗为度。
以上六方为表剂。
竹沥汤若不及热服,辄停在胸膈,更为人患。每服当使极热。若服竹沥汤得下者,必佳也。若加服数剂,病及脉势未折而苦胀满者,可以用大鳖甲汤下之。汤势尽而不得下,可以用丸散助汤令下,下后更服竹沥汤,令脉势折,将息料理乃佳。
大鳖甲汤 治脚弱风毒挛痹气上,及伤寒恶风湿毒,山水瘴气,热毒,四肢痹弱方。
鳖甲(二两) 防风 麻黄 白术 石膏 知母 升麻 茯苓 橘皮 川芎 杏仁(去皮尖) 人参 半夏 当归 芍药 葳蕤 甘草 麦门冬(各一两) 羚羊角(六铢) 大黄(一两半) 犀角 雄黄 青木香(各半两) 大枣(二十枚) 贝齿 乌头(七枚) 生姜(一两) 薤白(十四枚) 麝香(二铢) 赤小豆(三合) 吴茱萸(五合)
以上切碎,用水二斗,煮取四升,分六次服,去渣,食前温服。如人行十里久,得下则止。一方用大黄半两,煨,畏下可止用六铢。一方用羚羊角五钱,毒盛可用六铢。(胡治有山茱萸半升,《千金翼》无知母、升麻、橘皮、川芎、人参、当归、葳蕤。)
以上治寒湿属里证。
【张仲景】乌头汤 治香港脚疼痛,不可屈伸。(方见历节注疼痛。)
【《千金方》】麻黄汤 治风恶毒瓦斯,脚弱无力,顽痹四肢不仁,失音不能言,毒瓦斯冲心。有人病者,但一病相当,即服此第一服,次服第二、第三、第四方。
麻黄 大枣(二十枚) 茯苓(三两) 杏仁(三十枚) 防风 白术 当归 升麻 川芎 芍药 黄芩 桂心 麦门冬 甘草(各二两)
以上切碎,用水九升,清酒二升,合煮取二升半,分四次服,日三夜一。覆令小汗,粉之,莫令见风。
第二服独活汤方。
独活(四两) 熟地黄(三两) 生姜(五两) 葛根 桂心 甘草 芍药 麻黄(各二两)
以上切碎,用水八升,清酒二升,合煎取二升半,分四次服,日三夜一。脚弱时忌瓠子、蕺菜,犯之一世治不愈。
第三兼补浓朴汤并治诸气咳嗽逆气呕吐方。
浓朴 川芎 桂心 熟地黄 芍药 当归 人参(各二两) 黄芪 甘草(各三两) 吴茱萸(二升) 半夏(七两) 生姜(一斤)
以上切碎,用水二斗,煮猪蹄一具,取汁一斗二升,去上肥,内入清酒三升,合煮,取三升,分四次服。相去如人行二十里久,更进服。
第四服风引独活汤兼补方。
独活(四两) 茯苓 甘草(各三两) 升麻(一两半) 人参 桂心 防风 芍药 当归 黄芪 干姜 附子(各二两) 大豆(二升)
以上切碎,用水九升,清酒三升,合煮三升半,分四次服。相去如人行二十里久,更进服。
【《本草》】益气血,补肝肾,祛风湿,壮脚膝,地黄丸。
熟地黄(一两) 牛膝 石斛(各三两) 肉苁蓉 茵芋 防风 川芎 桂心 五味子 附子 薏苡仁(各半两)
以上为末,炼蜜丸,如桐子大。每服三四十丸,酒吞下,空心,食前服。
治腰脚走注痛,此是香港脚,宜薏苡丸。
薏苡仁 茵芋 白芍药 牛膝 川芎 防风 独活(各半两) 熟地黄 侧子(一枚) 桂心 橘红
以上细末,炼蜜丸,如桐子大。每服三四十丸,酒下,食前,日三服。木瓜汤下亦得。
【《三因方》】胜骏丸 治元气不足,真气虚弱,及诸虚寒湿气进袭,手足拳挛,脚指连脚面拘急,走注疼痛,筋脉不伸,行步不随,常服益真气,壮筋骨,黑髭须,滑皮肤,及去一切足弱鹤膝风。
附子(一枚,炮,去皮脐) 当归(酒浸一宿) 天麻(酒浸) 牛膝(酒浸) 酸枣仁(炒) 熟地黄(酒浸) 防风(各二两) 木瓜(四两) 乳香(半两,别研) 全蝎(去毒,一两) 麝香(二钱,别研) 木香 没药(另研) 羌活 甘草(炙。各半两)
以上件为细末,用生地黄三斤,洗净,研烂如泥,无灰酒四升,煮烂如膏,以前药匀和,杵令坚,每两作十丸,每服用一丸,细嚼临睡酒下。如冬月无地黄,炼蜜丸,如桐子大,每服五十丸,盐汤下,酒亦可。服此药五七日或半月,见效甚速,行履如飞,千里可至,故名胜骏。(一方加槟榔、萆薢、苁蓉、破故纸、巴戟、木瓜各一两,减当归、地黄各一两,尤妙。)
【《云岐子》】苍术丸 治干湿香港脚,筋脉拘挛,疼痛不能行。
乳香 没药(各二两。另研) 牛膝 青盐(各半两) 熟艾(四钱) 川乌(三钱) 全蝎(炒,二钱) 苍术(米泔浸,炒,四两)
以上为细末,共研药和匀。以木瓜一个,大者,切一头,留作盖,去穣,入上件药于内,将盖拴定,安木瓜于黑豆中,蒸令极烂,取出去皮,连药研成膏,却入生苍术末拌匀,丸如桐子大,每服五十丸,空心木瓜汤下,以温盐酒亦可,日三服。忌血与蒜。
【《本草》】治腰脚筋骨酸无力,酒浸牛膝丸。
牛膝(三两,炙黄) 川椒(半两,去子并合口者) 附子(一两,炮去皮脐) 虎胫骨(真者半两,醋炙黄)
以上切碎,用生绢作袋,入药扎口,用煮酒一斗,春秋浸十日,夏浸七日,冬浸十四日,每日空心饮一大盏。酒尽,出药为末,醋糊为丸。每服二十丸,空心,温酒盐汤任下。忌动风等物。
治肿痛方。
生地黄 黄柏(酒炒) 苍术(盐炒) 白术 防风 槟榔 川芎 犀角 甘草梢 木通 黄连
热加芩、连。痰加竹沥、姜汁。及时令热加石膏。大便秘加桃仁。小便涩加牛膝。
有食积流注者。
苍术 黄柏 防己 南星 川芎 白芷 犀角 槟榔
一妇人足肿。
生地黄 黄柏 苍术 南星 牛膝(酒洗) 草龙胆 川芎
脚弱筋痛。
牛膝(二两) 白芍(一两半) 龟板(酒炙) 黄柏(炒,一两) 知母(炒,一两) 甘草(炙,半两)
以上为末,酒糊为丸。
【李东垣】异法方宜论云:北方者其地高陵居,风寒冷洌,其俗饮酪而肉食。凡饮酪,以饮多饮速者为能。经云:因而大饮则气逆。又云:食入于阴,长气于阳。今乃反行阳道,是为逆也。夫乳酪醇酒者,湿热之物,饮之属也。加以奉养太过,亦滋其湿。水性润下,气不能升,故下注于足陉,积久而作肿痛,此饮食下流之所
[Danxi] Si Chengshu felt heat in his feet from the ankles down throughout his life, and could not wear cotton socks on them in winter. He often said, "My constitution is strong, I am not afraid of cold." I said, "This is deficiency of the three Yin meridians of the foot (Taiyin Spleen, Shaoyin Kidney, Jueyin Liver). You should abstain from sexual activity to nourish Yin blood, perhaps this can be avoided." He smiled and did not answer. At the age of seventeen, he developed Wei syndrome (flaccidity syndrome) and died half a year later.
[Qianjin Fang] For those with vexing heat in the hands and feet, if urination volume reaches three sheng, soak the hands and feet in warm water.
[Lingshu] For Re Jue (Heat Jue), select points from the Foot Taiyin Spleen Meridian and Foot Shaoyang Gallbladder Meridian, and retain the needles. (See Chapter "Cold-Heat Diseases")
[Zhai Xuan Fang] For postpartum cold and reversed limbs: Needle Jianjing (GB21) [immediate cure].
[Li Dongyuan] The disease known as Hong Kong Jiao (Gout/Jiaogong) is actually caused by Water-Dampness pathogenic factors. Generally, Dampness harms the skin, flesh, sinews, and vessels, with the pathology located below. However, there are two types: one is contracted externally, and the other arises internally. Their treatment methods should naturally differ, so I will discuss them in detail. This disease has symptoms but no formal name. The term "Hong Kong Jiao" originated with Su Jing of the Jin Dynasty; it was unknown in Guanzhong and Heshuo regions. Only in the south, where underground water is cold, does the Clear-Dampness Qi invade the human body, starting from the feet. Thus, the classics state: "When Clear-Dampness attacks deficiency, the disease originates from below." Some might argue: "Nowadays, in the north, the terrain is high and cold, people's couli (pores/skin texture) are dense, yet they still suffer from this disease frequently. Is it really caused by local dampness?" The answer is: Southern diseases are contracted externally; Northern diseases arise internally. Why? People in the north often consume dairy products and drink alcohol without restraint, causing excessive damage. Dairy products have a milky odor and watery nature; wine is similar. When food and drink enter the stomach, Stomach Qi steams and vaporizes them. Their Qi and flavors diffuse into the meridians, transforming into Qi and Blood, which nourish the four extremities externally and irrigate the Zang-Fu organs internally, cycling continuously to correspond with timekeeping. This is called the Great Principle of Heaven and Earth. This occurs because Yuan Qi (Original Qi) is sufficient and Spleen-Stomach Qi is unharmed. If Yuan Qi is insufficient, the root of Stomach Qi becomes weak. With doubled food intake, Spleen-Stomach Qi is damaged. Unable to steam and transform ingested food, its Qi and flavors cannot diffuse smoothly. The nature of Water-Dampness flows downward, causing disease. Those contracting externally present only with lower leg swelling and pain; those arising internally may even affect hand joints. The classics say: "Swelling of the lower legs is Edema; what Taiyin causes is heavy swelling of the dorsum pedis." This refers only to external contraction. Treatment methods were well documented by predecessors. For internal origin, treatment methods were lacking. Yang Dashou said: "Hong Kong Jiao is a stagnation disease; treat with agents that promote circulation and unblocking, preventing Qi stagnation." If stagnation is severe, use Bian stone (bloodletting) to drain evil blood and reduce severe swelling. The classics say: "Accumulation causes swelling and heat; after Bian therapy, treat with herbs."
Commentary: Dongyuan discussed southern Hong Kong Jiao, caused by external Clear-Dampness, treating it as Cold; northern Hong Kong Jiao, caused by internal injury from wine/dairy, treating it as Damp-Heat. This truly elucidates insights previously unexpressed. Regarding individuals, one need not distinguish Cold/Heat by North/South. All cases of external Cold-Damp contraction belong to Cold-Damp, regardless of region; all cases of internal injury from wine/dairy belong to Damp-Heat, regardless of region. Treatment should be based on pulse and symptoms and inquiry into the disease's origin.
[Suwen] Sleeping and then being exposed to wind causes blood to coagulate in the skin (Bi syndrome), in the vessels (Qi stagnation/stasis), or in the feet (Jue syndrome). In these three cases, blood flow cannot return to its empty spaces (acupoints/vessels), hence Bi Jue. (See Chapter "Generation of Five Zang Organs")
Winter brings suffering from Bi Jue. (Full text see Five Jue chapter.)
[Li Dongyuan] Sun Simiao said: In all four seasons, one must not sit or stand for long periods in cold-damp places, nor strip naked to wash feet or cool off in the wind after drunken sweating. These habits cause Hong Kong Jiao. Standing long in cold-damp places during summer allows Damp-Heat Qi to steam the meridians, causing fever and soreness/irritability in all four limbs. Sitting/standing long in cold-damp places during winter allows Cold-Damp Qi to enter the meridians, causing extreme cold and convulsions in all four limbs. Scholars who work hard often sit/stand on wet ground without moving; cold wind enters the meridians unnoticed, causing disease. To prevent this, moxa 20-30 moxibustion sessions at the initial site upon first sensation will cure it, preventing fever. Huangdi said: Cooling off in the wind and having sex while drunk can cause this disease. Also: Women cooling off after childbirth often get this disease. Be very cautious. Suwen discusses the south: low land, weak soil/water, steaming fog/dew. Jiangdong and Lingnan are similar. In spring/summer transitions, mountain forests are humid/oppressive, making Wind-Damp-Toxic Qi severe. If the feet contract it, it becomes Miasma-Toxic Hong Kong Jiao. Symptoms: feet become weak/bent, progressing to Bi pain, slight calf swelling, numbness in lower abdomen, headache, irritability, phlegm obstruction, vomiting, alternating chills/fever, urinary/fecal retention. Severe cases attack the heart, requiring urgent treatment. Zhifacun paid attention to classical formulas for this skill, likely because this disease is prevalent in Jiangyou and Lingbiao regions.
Qianjin, Waitai, and Tonglu record that the south is low, damp, and foggy. People there have loose couli, and Yang Qi cannot secure the exterior. Walking on such ground allows Clear-Dampness to attack deficiency, originating below. This is due to Blood/Qi deficiency, allowing Clear-Dampness Evil to travel with Blood in the skin/couli. When Evil is strong and Righteous Qi weak, Blood/Qi becomes stagnant. Stagnation causes Bi; weakness causes frailty. Hence Bi-Weakness, later named Hong Kong Jiao. Zhenjing says: "There is a way in, there is a way out." Treatment favors moxibustion to guide Dampness out, and drinking wine to unblock meridians and scatter Evil. Formulas use few Cold herbs and many Hot herbs, mainly Ephedrae Herba (Mahuang), Aconiti Lateralis Radix Praeparata (Chuanwu), Ginger, and Aconiti Radix Praeparata (Fuzi). Suwen says: "For external Dampness excess, use Bitter herbs to disperse." Mahuang is Bitter-Warm, dispersing. Chuanwu is Pungent-Hot, moving without staying, unblocking meridians. Ginger/Fuzi are Pungent-Sweet-Greatly Hot, assisting Yang, retreating Yin, scattering Clear-Dampness. Observe which Foot Three Yin/Yang meridian is involved to guide herbs. Examine which of the Six Qi is dominant and use assistant/guide herbs. Sun Simiao said: "Medicine is intention; adjust according to time, no fixed formula." Truly wise words.
[Qianjin Fang] Wind-Toxic Qi entering the body presents with three pulse types, similar external/internal symptoms but different pulses. Large-slow pulse: take Xuming Tang (Two doses, immediate cure). Wind-excess: Yebip Decoction plus Baizhu (Two liang). Floating-large-tight-fast pulse: Zhuli Tang. Floating-large-tight pulse: worst pulse. Fine-slow pulse: also bad. Floating-large indicates exterior disease; sinking-fine indicates interior disease; treatments differ. Micro-weak pulse: Fengyin Tang (due to deficiency). Great deficiency/short breath/lack of strength: intermittent Tonifying Decoction, adjusted for Cold/Heat. If not cured, take Zhuli Tang to stop.
[Huo Ren Shu] For Cold-type Hong Kong Jiao, add fresh ginger juice to Xiaoxuming Tang when decocted. Fastest effect. (Xuming Formula see Stroke section earlier.)
[Zhang Zhongjing] Yebip Plus Baizhu Decoction. (See Wei Jue section later.)
[Qianjin Fang] First Zhuli Tang: Treats bilateral foot Bi-weakness or convulsions, insensitivity of skin/flesh, abdominal distension like swelling (non-pitting), nausea, anorexia, or cold patterns.
Zhuli (Bamboo Sap, 5 sheng), Gancao, Qinjiao, Gegen, Huangqin, Mahuang, Fangfeng, Xixin, Guixin, Ganjiang (each 1 liang), Fangji, Shengma (each 1.5 liang), Fuling (3 liang), Fuzi (2 pieces), Xingren (50 seeds).
Chop ingredients. Add 7 sheng water and Bamboo Sap. Decoct to 3 sheng. Divide into 3 doses. Induce sweating. Qianjin Yi Fang omits Fuling/Xingren, adds Baizhu (1 liang).
Second Zhuli Tang: Treats sudden wind-stroke, locked jaw unable to speak, flaccid limbs, hemiplegic spasms, Wind affecting Five Zang, confusion, erratic anger, limb paralysis.
Zhuli (1.4 sheng), Duhuo, Shaoyao, Fangfeng, Yinyu, Gancao, Baizhu, Gegen, Xixin, Huangqin, Xiong (Chuanxiong), Guixin, Fangji, Renshen, Shigao, Mahuang, Shengjiang, Fuling (each 1 liang), Wutou (1 piece).
Chop. Take 4 sheng Zhuli per dose, divided into 6 doses. Induce sweating if not already sweating. Stop when appropriate.
Third Zhuli Tang: Treats Wind-Toxin entering Five Zang, shortness of breath, intense heat in epigastrium, vexing pain in hands/feet, inability to lift limbs, skin/flesh insensitivity, locked jaw unable to speak.
Zhuli (1.2 dou), Fangfeng, Fuling, Qinjiao (each 3 liang), Danggui, Huangqin (Yi Fang: Baishao), Renshen, Xiong (Qianjin: Fangji), Xixin, Guixin, Gancao, Shengma (Qianjin: Tongcao), Mahuang, Baizhu (each 2 liang), Fuzi (2 pieces), Shujiao (1 liang), Gegen (5 liang), Shengjiang (8 liang).
Chop. Decoct with Zhuli to 4 sheng. Divide into 5 doses. Apply Mofeng Gao immediately upon onset, twice daily, stop when Bi resolves. (Yi Fang omits Mahuang, Shujiao, Shengjiang.)
Fengyin Tang
Mahuang, Shigao, Duhuo, Fuling (each 2 liang), Wuzhuyu, Fuzi, Qinjiao, Xixin, Guixin, Renshen, Fangfeng, Xiong, Fangji, Gancao, Ganjiang (each 1 liang), Baizhu (3 liang), Xingren (60 seeds).
Chop. Decoct with 1.6 dou water to 3 sheng. Divide into 3 doses. Stop when sweating occurs.
These six formulas are Exterior-releasing agents.
If Zhuli Tang is not taken hot, it stagnates in chest/diaphragm, causing more harm. Must be taken piping hot. If effective, good. If multiple doses fail to resolve pulse/pathology and patient suffers fullness/distension, use Da Biejia Tang to purge. If purgative fails, use pills/powders to assist. After purging, take Zhuli Tang again to resolve pulse pathology. Rest and care appropriately.
Da Biejia Tang: Treats foot weakness, Wind-Toxin spasms/Bi with Qi rising, cold-damage evil wind-damp-toxin, mountain/miasma qi, heat-toxin, limb Bi-weakness.
Biejia (2 liang), Fangfeng, Mahuang, Baizhu, Shigao, Zhimu, Shengma, Fuling, Ju Pi, Xiong, Xingren (dehusked/decored), Renshen, Banxia, Danggui, Shaoyao, Weirui, Gancao, Maidong (each 1 liang), Lingyangjiao (6 zhu), Dahuang (1.5 liang), Xijiao, Xionghuang, Qingmuxiang (each 0.5 liang), Dazao (20 pieces), Beichi, Wutou (7 pieces), Shengjiang (1 liang), Xiebai (14 pieces), Shexiang (2 zhu), Chixiaodou (3 he), Wuzhuyu (5 he).
Chop. Decoct with 2 dou water to 4 sheng. Divide into 6 doses. Strain. Warm take before meals. Walk ~1 li (500m); if purged, stop. Alternative: Dahuang 0.5 liang (roasted); if fear of purging, use 6 zhu. Alternative: Lingyangjiao 5 qian; if toxin severe, use 6 zhu. (Hu Zhi adds Shanzhuyu 0.5 sheng; Yi Fang omits Zhimu, Shengma, Ju Pi, Xiong, Renshen, Danggui, Weirui.)
These treat Interior Cold-Damp.
[Zhang Zhongjing] Wutou Tang: Treats Hong Kong Jiao pain, inability to bend/extend. (Formula see Lizhe Note Pain.)
[Qianjin Fang] Mahuang Tang: Treats Wind-Evil Toxic Qi, foot weakness/powerlessness, stubborn Bi, limb insensitivity, aphonia, Toxic Qi attacking heart. If a patient matches this pattern, take this First Dose, then Second, Third, Fourth.
Mahuang, Dazao (20 pieces), Fuling (3 liang), Xingren (30 seeds), Fangfeng, Baizhu, Danggui, Shengma, Xiong, Shaoyao, Huangqin, Guixin, Maidong, Gancao (each 2 liang).
Chop. Decoct with 9 sheng water + 2 sheng clear wine to 2.5 sheng. Divide into 4 doses. Day 3, Night 1. Cover to induce slight sweat. Dust powder. Avoid wind.
Second Dose: Duhuo Tang
Duhuo (4 liang), Shudi (3 liang), Shengjiang (5 liang), Gegen, Guixin, Gancao, Shaoyao, Mahuang (each 2 liang).
Chop. Decoct with 8 sheng water + 2 sheng clear wine to 2.5 sheng. Divide into 4 doses. Day 3, Night 1. Avoid Hu Zi (bottle gourd) and Jicai (fish mint) during foot weakness; consuming them makes the condition incurable for a lifetime.
Third Dose: Jianbu Houpo Tang & treats various Qi cough/reverse Qi/vomiting.
Houpo, Xiong, Guixin, Shudi, Shaoyao, Danggui, Renshen (each 2 liang), Huangqi, Gancao (each 3 liang), Wuzhuyu (2 sheng), Banxia (7 liang), Shengjiang (1 jin).
Chop. Decoct 1 pig trotter in 2 dou water to obtain 1.2 dou juice. Remove fat. Add 3 sheng clear wine. Decoct to 3 sheng. Divide into 4 doses. Advance dose after walking ~2 li (1km).
Fourth Dose: Fengyin Duhuo Tang & Tonifying Formula.
Duhuo (4 liang), Fuling, Gancao (each 3 liang), Shengma (1.5 liang), Renshen, Guixin, Fangfeng, Shaoyao, Danggui, Huangqi, Ganjiang, Fuzi (each 2 liang), Dadou (2 sheng).
Chop. Decoct with 9 sheng water + 3 sheng clear wine to 3.5 sheng. Divide into 4 doses. Advance dose after walking ~2 li (1km).
[Bencao] Nourishes Qi/Blood, tonifies Liver/Kidney, expels Wind-Damp, strengthens legs/knees. Dihuang Wan.
Shudi (1 liang), Niuxi, Shihu (each 3 liang), Rongzhu, Yinyu, Fangfeng, Chuanxiong, Guixin, Wuweizi, Fuzi, Yiyiren (each 0.5 liang).
Powder. Honey pills, size of wattle seeds. Take 30-40 pills with wine, fasting, before meals.
Treats migrating pain in waist/legs (Hong Kong Jiao). Use Yiyi Wan.
Yiyiren, Yinyu, Baishaoyao, Niuxi, Chuanxiong, Fangfeng, Duhuo (each 0.5 liang), Shudi, Cezi (1 piece), Guixin, Juhong.
Fine powder. Honey pills, size of wattle seeds. Take 30-40 pills with wine, before meals, 3 times/day. Papaya soup is also acceptable.
[Sanyin Fang] Shengjun Wan: Treats insufficient Yuan Qi, weak True Qi, invasion of deficiency-Cold-Damp, curled hands/feet, toe/instep spasm, migrating pain, sinew non-extension, gait disturbance. Regular use benefits True Qi, strengthens sinews/bones, darkens beard/hair, smooths skin, cures all foot weakness/Crane Knee Wind.
Fuzi (1 piece, processed, peeled/cored), Danggui (soaked in wine overnight), Tianma (wine-soaked), Niuxi (wine-soaked), Suanzaoren (fried), Shudi (wine-soaked), Fangfeng (each 2 liang), Mugua (4 liang), Ruxiang (0.5 liang, separately ground), Quanxie (venom removed, 1 liang), Shexiang (2 qian, separately ground), Muxiang, Moyao (separately ground), Qianghuo, Gancao (honey-fried, each 0.5 liang).
Fine powder. Wash 3 jin Shengdi, grind to mud. Cook with 4 sheng pure wine until paste-like. Mix with herbs, pound firm. Each liang makes 10 pills. Take 1 pill, chew finely, swallow with wine before sleep. Winter without Shengdi: honey pills, wattle seed size. Take 50 pills with salt water or wine. Effects seen in 5-7 days or half month; speed like flying, traveling 1000 li possible, hence named Shengjun. (Alternative adds Binglang, Biba, Congrong, Pugu Zhi, Bajitian, Mugua each 1 liang; reduces Danggui, Dihu each 1 liang; especially excellent.)
[Yunqizi] Cangzhu Wan: Treats Dry/Wet Hong Kong Jiao, sinew spasms, pain preventing walking.
Ruxiang, Moyao (each 2 liang, separately ground), Niuxi, Qingyan (each 0.5 liang), Shuai Ai (4 qian), Chuanwu (3 qian), Quanxie (fried, 2 qian), Cangzhu (rice water soaked, fried, 4 liang).
Fine powder. Mix evenly. Cut top off large Mugua, remove pulp, insert herbs, replace lid, tie. Steam in black soybeans until very soft. Peel, grind with herbs into paste. Add raw Cangzhu powder, mix. Pills, wattle seed size. Take 50 pills, fasting, with papaya soup or warm salt wine. 3 times/day. Avoid blood products and garlic.
[Bencao] Treats waist/leg bone/muscle soreness/weakness. Jiujin Niuxi Wan.
Niuxi (3 liang, honey-fried yellow), Chuanjiao (0.5 liang, de-seeded/de-closed), Fuzi (1 liang, processed peeled/cored), Hu Jinggu (real 0.5 liang, vinegar-fried yellow).
Chop. Place in raw silk bag. Soak in 1 dou boiled wine. Spring/Autumn 10 days, Summer 7 days, Winter 14 days. Drink 1 large cup fasting daily. When wine exhausted, dry herbs, powder, make pills with vinegar paste. Take 20 pills, fasting, with warm wine/salt water. Avoid Wind-moving foods.
[Danxi] Hong Kong Jiao requires lifting Dampness from below. Herbs follow Qi/Blood.
Formula for Swelling/Pain.
Shengdi, Huangbai (wine-fried), Cangzhu (salt-fried), Baizhu, Fangfeng, Binglang, Chuanxiong, Xijiao, Gancao Shao, Mutong, Huanglian.
Add Heat: Qin, Lian. Add Phlegm: Zhuli, Jiangzhi. Seasonal Heat: Shigao. Constipation: Taoren. Urinary difficulty: Niuxi.
With Food Stagnation/Migration.
Cangzhu, Huangbai, Fangji, Nanxing, Chuanxiong, Baizhi, Xijiao, Binglang.
Blood Deficiency: Add Niuxi, Guiban. Persistent swelling: Focus on Damp-Heat. Obese: Add Phlegm-resolving herbs.
Case: Woman with swollen foot.
Shengdi, Huangbai, Cangzhu, Nanxing, Niuxi (wine-washed), Caolongdan, Chuanxiong.
Foot Weakness/Sinus Pain.
Niuxi (2 liang), Baishao (1.5 liang), Guiban (wine-fried), Huangbai (fried, 1 liang), Zhimu (fried, 1 liang), Gancao (honey-fried, 0.5 liang).
Powder. Wine paste pills.
[Li Dongyuan] Yifa Fangyi Lun says: North is high/hilly, windy/cold. Custom is drinking dairy/meat. Drinking dairy: more and faster is better. Classics: "Drinking heavily causes Qi rebellion." Also: "Food enters Yin, grows Yang Qi." Now it goes contrary to Yang path, causing rebellion. Dairy/wine are Damp-Heat substances. Overindulgence nourishes Dampness. Water nature is moistening/downward; Qi cannot ascend. Thus, it sinks to foot creases, accumulating over time to cause swelling/pain. This is due to dietary flow downward...