【方歌】湿毒流注腿胫生,顶如牛眼漫肿形,紫轻黑重脓水渍,
寒湿暑热在腠凝。
【注】此证生于腿胫,流行不定,或发一、二处,疮顶形似牛
眼,根脚漫肿,轻则色紫,重则色黑,溃破脓水浸渍,
好肉破烂,日久不敛。由暴风疾雨,寒湿暑火,侵在腠
理,而肌肉为病也。初觉急服防风通圣散,加木瓜、牛
膝、防己、苍术消之;若腿胫至晚发热者,宜服当归拈
痛汤,加牛膝。外治初搽三妙散,肿痛全消,换搽轻粉
散敛之即效。若绕胫而发,即名瓜藤缠,结核数枚,日
久肿痛,腐烂不已,亦属湿热下注而成,治法同前。
方剂:轻粉散
组成:轻粉(一钱五分) 黄丹
黄柏 密陀僧
高末茶 乳香(各三钱)
麝香(五分)
共研末,先用葱熬汤洗患处,再搽此药。
【方歌】轻粉黄丹柏陀僧,末茶乳麝共研成,湿毒流注〔月廉〕
疮证,化腐除湿又止疼。
又方:防风通圣散(见头部秃疮)
当归拈痛汤(见股部腿游风)
三妙散(见腹部脐痈)
【方歌】肾气游风腿肚生,红肿如云火烘疼,证由肾火蕴于内,
膀胱气滞外受风。
【注】此证多生于肾虚之人。腿肚红肿,形如云片,游走不定
,痛如火烘,由肾火内蕴,外受风邪,膀胱气滞而成也
。初服紫苏流气饮,次服槟榔丸;外用豆腐研调黄柏末
,贴敷之甚效。
方剂:紫苏流气饮
组成:紫苏 黄柏
木瓜 槟榔
香附 陈皮
川芎 厚朴(姜炒)
白芷 苍术(米泔水浸,炒)
乌药 荆芥
防风 甘草
独活 枳壳(麸炒)
等分,姜三片,枣一枚,水煎服。
【方歌】紫苏流气柏瓜榔,香附陈芎厚芷苍,乌药荆防甘独枳,
肾气游风服最昌。
又方:槟榔丸
组成:槟榔 枳壳(麸炒,各二两)
木瓜(一两五钱) 木香(一两)
大黄(四两)
共研细末,炼蜜为丸,如梧桐子大。每服三十丸,
空心白滚汤送下,黄酒送下亦可。
【方歌】槟榔枳壳木瓜痛,木香大黄炼蜜丸,肾气游风红肿痛,
空心水送自然痊。
【方歌】湿毒流注发生于腿胫,疮顶形状像牛眼,周围弥漫性肿胀,颜色紫红较轻、黑色较重,溃破后脓水浸渍,好肉腐烂,日久难以愈合。这是由于暴风疾雨,寒湿暑热之邪侵袭腠理(皮肤与肌肉之间的间隙),导致肌肉发生病变。初起时急服防风通圣散,加入木瓜、牛膝、防己、苍术以消除病邪;若腿胫部位在傍晚发热,宜服用当归拈痛汤,加入牛膝。外治法初期搽涂三妙散,待肿痛完全消退后,更换为轻粉散搽涂以促进收敛,即可见效。若绕着小腿发作,即称为瓜藤缠,出现数个结节,日久肿痛,腐烂不止,这也属于湿热下注所致,治疗方法同上。
方剂:轻粉散
组成:轻粉(一钱五分)、黄丹、黄柏、密陀僧、高末茶、乳香(各三钱)、麝香(五分)。
共研为细末,先用葱熬汤清洗患处,再搽涂此药。
【方歌】轻粉、黄丹、黄柏、密陀僧,加上末茶、乳香、麝香共同研成粉末,治疗湿毒流注引起的阴囊疮证,具有化腐除湿又止痛的功效。
又一方:防风通圣散(见头部秃疮章节)
当归拈痛汤(见股部腿游风章节)
三妙散(见腹部脐痈章节)
【方歌】肾气游风发生于腿肚,红肿如云片状,如火烤般疼痛,病因是肾火蕴结于内,膀胱气机阻滞,外加风邪侵袭。
【注】此证多发生于肾虚之人。腿肚红肿,形状如云片,游走不定,疼痛如火烤,由肾火内蕴,外受风邪,膀胱气滞而成。初起服用紫苏流气饮,随后服用槟榔丸;外用豆腐研磨调匀黄柏末,贴敷患处,效果显著。
方剂:紫苏流气饮
组成:紫苏、黄柏、木瓜、槟榔、香附、陈皮、川芎、厚朴(姜炒)、白芷、苍术(米泔水浸泡,炒制)、乌药、荆芥、防风、甘草、独活、枳壳(麸炒)。
以上药材等分,加生姜三片、大枣一枚,水煎服。
【方歌】紫苏流气饮含黄柏、木瓜、槟榔,以及香附、陈皮、川芎、厚朴、白芷、苍术,还有乌药、荆芥、防风、甘草、独活、枳壳,治疗肾气游风服用最为适宜。
又一方:槟榔丸
组成:槟榔、枳壳(麸炒,各二两)、木瓜(一两五钱)、木香(一两)、大黄(四两)。
共研为细末,用炼蜜制成丸药,大小如梧桐子。每次服用三十丸,空腹时用白开水送服,用黄酒送服也可以。
[Formula Song] Damp-toxin flowing accumulation occurs on the lower legs and shins; the sore's apex resembles an ox eye with diffuse swelling. Purple color indicates mildness, black indicates severity; upon ulceration, pus exudes, healthy flesh rots, and healing is delayed for a long time. This arises from violent wind and rain, where cold-dampness and summer-heat invade the *Couli* (the interstitial spaces between skin and muscle), causing pathology in the muscles. At the initial stage, urgently administer Fangfeng Tongsheng San (Windproof Unblocking Hero Powder) added with Mugua (Papaya), Niuxi (Achyranthes Root), Fangji (Stephania Root), and Cangzhu (Atractylodes Rhizome) to eliminate the pathogen; if there is evening fever in the lower legs and shins, it is appropriate to take Danggui Nian Tong Tang (Angelica Relieving Pain Decoction) added with Niuxi. For external treatment, initially apply Sanmiao San (Three Marvels Powder); once swelling and pain completely subside, switch to applying Qingfen San (Calomel Powder) to promote healing, which will be effective. If it develops circumferentially around the shin, it is named Guatechan (Gourd Vine Wrapping), presenting with several nodules that swell, hurt, and rot continuously over time; this also results from damp-heat sinking downward, and the treatment method is the same as above.
Formula: Qingfen San (Calomel Powder)
Composition: Qinfen (Calomel, 1.5 qian), Huangdan (Lead Tetroxide), Huangbai (Phellodendron Bark), Mituosen (Litharge), Gaomo Cha (High-end Tea), Ruxiang (Frankincense) (each 3 qian), Shexiang (Musk) (0.5 qian).
Grind all into fine powder. First, wash the affected area with decoction of scallions, then apply this medicine.
[Formula Song] Calomel, Lead Tetroxide, Phellodendron Bark, and Litharge, mixed with tea, Frankincense, and Musk ground together, treat damp-toxin flowing accumulation causing scrotal sores, resolving decay, removing dampness, and relieving pain.
Another Formula: Fangfeng Tongsheng San (See Head Bald Sores section)
Danggui Nian Tong Tang (See Thigh Wandering Wind section)
Sanmiao San (See Abdominal Umbilical Carbuncle section)
[Formula Song] Kidney-Qi Wandering Wind arises in the calf; redness and swelling resemble cloud patches, painful as if roasted by fire. The syndrome is caused by Kidney Fire accumulating internally, Bladder Qi stagnation, and external invasion of Wind Pathogen.
[Annotation] This syndrome often occurs in individuals with Kidney Deficiency. The calves are red and swollen, shaped like cloud patches, wandering without fixed location, and painful as if roasted by fire. It is formed by internal accumulation of Kidney Fire, external invasion of Wind Pathogen, and Bladder Qi stagnation. Initially take Zisu Liuqi Yin (Perilla Moving Qi Drink), followed by Binglang Wan (Areca Nut Pill); externally, grind tofu and mix with Huangbai powder, apply as a poultice for significant effect.
Formula: Zisu Liuqi Yin (Perilla Moving Qi Drink)
Composition: Zisu (Perilla Leaf), Huangbai (Phellodendron Bark), Mugua (Papaya), Binglang (Areca Seed), Xiangfu (Cyperus Rhizome), Chenpi (Tangerine Peel), Chuanxiong (Sichuan Lovage Rhizome), Houpo (Magnolia Bark, stir-fried with ginger juice), Baizhi (Angelica Dahurica Root), Cangzhu (Atractylodes Rhizome, soaked in rice water, stir-fried), Wuyao (Lindera Root), Jingjie (Schizonepeta Spike), Fangfeng (Saposhnikovia Root), Gancao (Licorice Root), Duhuo (Angelica Pubescens Root), Zhike (Bitter Orange Fruit, stir-fried with bran).
Equal parts of each, add three slices of ginger and one jujube, decoct in water and take orally.
[Formula Song] Perilla Moving Qi Drink contains Phellodendron, Papaya, Areca Seed, Cyperus, Tangerine Peel, Sichuan Lovage, Magnolia Bark, Angelica Dahurica, Atractylodes, Lindera, Schizonepeta, Saposhnikovia, Licorice, Angelica Pubescens, and Bitter Orange; taking it for Kidney-Qi Wandering Wind is most auspicious.
Another Formula: Binglang Wan (Areca Nut Pill)
Composition: Binglang (Areca Seed), Zhike (Bitter Orange Fruit, stir-fried with bran, each 2 liang), Mugua (Papaya, 1.5 liang), Muxiang (Vladimiria Root, 1 liang), Dahuang (Rhubarb Root, 4 liang).
Grind into fine powder, make pills with refined honey, size of Sophora seeds. Take 30 pills per dose, swallowed with plain boiled water on an empty stomach; swallowing with yellow wine is also acceptable.
[Formula Song] Areca Seed, Bitter Orange, and Papaya relieve pain; Vladimiria and Rhubarb made into honey pills; for redness, swelling, and pain of Kidney-Qi Wandering Wind, taking them on an empty stomach with water leads to natural recovery.