香港脚有四，迟寒数热，浮滑者风，濡细者湿。
香港脚一证，经名厥，汉名缓风，宋齐后始名香港脚。陈无择谓风、寒、暑、湿四
邪皆能成。今历诊是证，成于寒湿者，十常八九。经曰∶清湿袭邪，病起于下，信
然哉。其始发也，甚微，发亦易解，故人常忽而不觉，觉亦不速治。及其深久，愈
发愈重，甚至痿痹不仁者有之，入腹冲心者有之，身命从此而殒，可哀也。足三阴、
三阳六经，皆有此证，而发于三阳者轻，三阴者重。以三阴属脏，经络居里，若非
脏气大虚，邪不易及。其证不论阴阳，初发时，大类伤寒，头痛发热，恶寒呕吐，
但足屈伸不能，或痛或红为异耳。在阳，多恶寒壮热头痛，或骨节痛，或呕吐渴烦，
或叫号谵语，或腿脚红紫极热，大肿大痛，手不可按，或顽痹麻木。患多在腿外廉
阳分。三阳经所过之处，面光泽，脉多浮。在阴，多恶寒，甚或厥逆，不发热或微
热，头不痛，或骨痛筋挛，或呕逆，或神昏沉默，或腹痛下利，或畏见光明，或大
小便闭，或心烦动悸，或小腹不仁，或冲胸闷乱。患处肿痛或不肿，或微赤而热，
或反极冷。患多在腿内廉阴分，三阴经所过之处，面青惨，脉多沉。此言阴阳之大
概。若细别之∶太阳则发热头痛恶寒，目眩项强，腰脊、身体及外踝后至小指外侧
皆痛。（宜仲景麻黄汤、桂枝汤、九味羌活汤、败毒散、集验麻黄左经汤之类。）阳明则翕翕发热，
口鼻干，善欠，腹胀，自髀、膝、膑、 外廉以下足跗中指内俱痛。（宜得效芎芷香苏散、大黄
左经汤之类。）少阳则往来寒热，口苦，胁痛，面垢，头目眩痛，腋下马刀肿痛，髀膝外至
及外踝诸指节皆痛。（宜小柴胡汤、半夏左经汤之类。）三阳并合为病，则憎寒壮热，自汗恶风，
或无汗恶寒，眩晕重着，关节掣痛，手足拘挛，疼痛冷痹，腰腿缓纵不随，心躁气
上，呕吐下利，其脉浮弦紧数。（宜大料神秘左经汤、加味败毒散之类。）太阴则腹满，胸膈痞，
舌系急，循 骨下股膝内前廉、内踝过核骨后廉足大指之端内侧皆痛。（宜胃苓汤、六物附
子汤之类。）少阴则腰脊痛，上冲胸咽，饥不能食，面黑，大小淋 ，善恐，小趾、足
心、内踝跟中、 内廉皆痛。（宜麻黄附子细辛汤、金匮八味丸之类。）厥阴则腰胁偏痛，脚挛急，
嗌干、呕逆、洞泄，足大趾连足趺上廉，上 至内廉，循股环阴，小腹夹脐诸处胀
痛。（宜茱萸木瓜汤、神应养真丹之类。）三阴并合为病，则四肢拘挛，上气喘满，小便闭涩，心
热烦闷，遍身浮肿，脚弱，缓纵不能行步。（宜加味败毒散、追毒汤之类。）以上六经受病，流
注自汗为风胜，（脉多浮滑，宜多羌活、独活、防风、桂枝。）无汗疼痛为寒胜（脉多迟，宜多桂
附姜辛。）热烦为暑胜，（脉多数，宜多黄芩、黄柏、木瓜、香薷。）重着肿满为湿胜。（脉多濡细，
宜多苍术、泽泻、薏苡、防己、茯苓。）至如防己、木瓜、米仁、槟榔、苍术、黄柏、肉桂、桂枝、
巴戟、葳蕤、木通、羌活、枳壳、泽泻、桑枝之类，各随其气所胜者而偏调之，证相宜者而倍用
之，又不可拘于一方也。东垣谓此疾，南方卑下，乃寒湿之邪外袭经络而成。如北
方地高，外鲜水湿，发此者皆内伤酒乳，湿热之邪下注也。故南则宜作寒湿治，北
则宜作湿热治。此虽发前人之未发，恐未必尽然也。南方固下，岂乏膏粱嗜酒之人？
北方固高，岂无践涉洗濯之事？是在圆机者，谨察证脉而分别之，斯善矣。
香港脚（一种以足部肿痛、麻木或痿弱为主要表现的疾病）有四种脉象：迟脉主寒，数脉主热，浮滑脉主风，濡细脉主湿。
香港脚这一病症，在经典医籍中称为“厥”，汉代称为“缓风”，直到宋代和齐代之后才被称为“香港脚”。陈无择认为，风、寒、暑、湿四种邪气都能导致此病。如今我诊治这类病症，由寒湿引起的，十有八九。医经说：“清冷潮湿之邪侵袭人体，疾病多起于下部。”这确实是真理。该病刚开始发作时，症状非常轻微，也很容易缓解，所以人们常常忽视而不觉察，即使察觉了也不及时治疗。等到病邪深入且病程长久后，病情会越来越重，甚至出现肢体痿废、痹痛、感觉丧失的情况，或者病邪入腹冲犯心脏的情况，生命因此终结，真是令人悲哀啊。足三阴经和足三阳经这六条经脉，都可能出现这种病症，但发于三阳经的较轻，发于三阴经的较重。因为三阴经属于脏，经络位置较深，如果不是脏气极度虚弱，邪气不容易侵犯到那里。这种病症不论属于阴证还是阳证，在初发时，大多类似伤寒，表现为头痛、发热、恶寒、呕吐，只是足部屈伸困难，或者疼痛、发红作为区别罢了。
属于阳证者，多表现为恶寒、高热、头痛，或者骨节疼痛，或者呕吐、口渴、烦躁，或者呼叫号哭、胡言乱语，或者腿脚红肿紫暗、极热、肿大剧痛、手不可触碰，或者顽固性痹痛、麻木。患病部位多在腿部外侧的阳分。在三阳经循行经过的地方，面色光泽，脉象多浮。
属于阴证者，多表现为恶寒，甚至四肢厥冷，不发热或仅有微热，头部不痛，或者骨痛、筋脉拘挛，或者呕吐逆气，或者神志昏迷、沉默寡言，或者腹痛、腹泻，或者害怕见到光亮，或者大小便闭塞，或者心烦悸动，或者小腹感觉迟钝，或者气逆胸闷混乱。患处可能肿痛也可能不肿，或者微红发热，或者反而极冷。患病部位多在腿部内侧的阴分，在三阴经循行经过的地方，面色青惨，脉象多沉。这是阴阳证的大致情况。如果仔细辨别：
太阳经受病，则发热、头痛、恶寒，目眩、项强，腰部、脊柱、身体以及外踝后至小指外侧皆痛。（适宜使用张仲景的麻黄汤、桂枝汤，九味羌活汤，败毒散，集验麻黄左经汤等方剂。）
阳明经受病，则翕翕发热（如羽毛覆盖般的发热），口鼻干燥，喜欢打哈欠，腹胀，从大腿、膝盖、髌骨外侧以下至足背、中指内侧全部疼痛。（适宜使用得效芎芷香苏散，大黄左经汤等方剂。）
少阳经受病，则往来寒热，口苦，胁痛，面部污垢，头目眩晕疼痛，腋下马刀侠瘿肿痛，大腿外侧至膝盖及外踝各指节皆痛。（适宜使用小柴胡汤，半夏左经汤等方剂。）
三阳经合并为病，则憎寒壮热，自汗恶风，或者无汗恶寒，眩晕沉重，关节牵掣疼痛，手足拘挛，疼痛冷痹，腰腿松弛无力不能随意运动，心中烦躁气上逆，呕吐腹泻，脉象浮弦紧数。（适宜使用大料神秘左经汤，加味败毒散等方剂。）
太阴经受病，则腹部胀满，胸膈痞塞，舌根紧急，沿胫骨下段、大腿内侧前缘、内踝后方至足大趾末端内侧皆痛。（适宜使用胃苓汤，六物附子汤等方剂。）
少阴经受病，则腰脊疼痛，气上冲胸咽，饥饿但不能进食，面色黑，小便淋沥不畅，容易恐惧，小趾、足心、内踝跟中、小腿内侧皆痛。（适宜使用麻黄附子细辛汤，金匮八味丸等方剂。）
厥阴经受病，则腰胁偏侧疼痛，脚部拘挛急迫，咽喉干燥，呕吐逆气，洞泄（严重腹泻），足大趾连足背上缘，上行至小腿内侧，沿大腿环绕阴器，小腹夹脐各处胀痛。（适宜使用茱萸木瓜汤，神应养真丹等方剂。）
三阴经合并为病，则四肢拘挛，上气喘满，小便闭涩，心中烦闷，遍身浮肿，脚部软弱，松弛无力不能行走。（适宜使用加味败毒散，追毒汤等方剂。）
以上六经受病，流注并伴有自汗的是风邪偏胜，（脉象多浮滑，适宜多用羌活、独活、防风、桂枝。）无汗疼痛的是寒邪偏胜，（脉象多迟，适宜多用桂枝、附子、干姜、细辛。）热烦的是暑邪偏胜，（脉象多数，适宜多用黄芩、黄柏、木瓜、香薷。）沉重肿胀的是湿邪偏胜，（脉象多濡细，适宜多用苍术、泽泻、薏苡仁、防己、茯苓。）至于像防己、木瓜、米仁（薏苡仁）、槟榔、苍术、黄柏、肉桂、桂枝、巴戟天、葳蕤（玉竹）、木通、羌活、枳壳、泽泻、桑枝等药物，各自根据气机偏胜的情况来侧重调理，证候相宜的药物加倍使用，又不可以拘泥于某一个固定方剂。李东垣认为此疾，南方地势低洼，是寒湿之邪外袭经络而成。如北方地势高，外部少有水湿，发作此病的都是内伤于酒乳，湿热之邪下注所致。所以南方应当按寒湿治疗，北方应当按湿热治疗。这虽然提出了前人未发的观点，恐怕未必完全正确。南方固然地势低下，难道缺乏嗜好膏粱厚味和饮酒的人吗？北方固然地势高，难道没有涉水洗涤的事情吗？关键在于圆融机变的大夫，谨慎诊察证候和脉象而分别对待，这才是好的治疗方法。
Hong Kong Foot (a disease characterized mainly by swelling, pain, numbness, or weakness of the feet) presents with four types of pulses: a slow pulse indicates Cold, a rapid pulse indicates Heat, a floating and slippery pulse indicates Wind, and a soft and thin pulse indicates Dampness.
This syndrome of Hong Kong Foot is named "Jue" in classic medical texts, called "Huan Feng" (Slow Wind) in the Han Dynasty, and was only referred to as "Hong Kong Foot" after the Song and Qi dynasties. Chen Wuyue stated that the four pathogenic factors of Wind, Cold, Summer-heat, and Dampness can all cause this condition. In my current clinical practice, eight or nine out of ten cases are caused by Cold-Dampness. The classics state: "Clear dampness invades the body, and diseases arise from below." This is indeed true. When the disease first begins, symptoms are very slight and easy to resolve; therefore, people often ignore it without noticing, and even if noticed, they do not treat it promptly. Once the pathogen penetrates deeply and the course becomes prolonged, the condition worsens progressively, potentially leading to flaccidity, bi-syndrome (painful obstruction), loss of sensation, or the pathogen entering the abdomen and rushing to the Heart, resulting in death. This is truly lamentable. All six meridians of the foot—Three Yin and Three Yang—can manifest this syndrome. However, those arising in the Three Yang meridians are mild, while those in the Three Yin meridians are severe. Since the Three Yin meridians belong to the Zang organs and their pathways are located internally, pathogens rarely reach them unless the Zang Qi is severely deficient. Regardless of whether the syndrome is Yin or Yang, at its onset, it largely resembles Taiyang Disease (Cold Damage), presenting with headache, fever, aversion to cold, and vomiting. The distinguishing features are the inability to flex and extend the feet, or pain and redness.
In Yang syndromes, there is often aversion to cold, high fever, and headache, or bone and joint pain, vomiting, thirst, and irritability, or shouting and delirium, or legs and feet becoming red, purple, extremely hot, swollen, and painfully tender to touch, or stubborn bi-syndrome with numbness. The affected area is mostly on the lateral aspect of the leg (Yang region). Along the pathways of the Three Yang meridians, the complexion is lustrous, and the pulse is mostly floating.
In Yin syndromes, there is often aversion to cold, or even cold extremities (Jue Ni), without fever or with only slight fever, no headache, or bone pain and tendon contraction, vomiting and counterflow qi, lethargy and silence, abdominal pain and diarrhea, fear of light, closure of urination and defecation, mental restlessness and palpitations, insensitivity in the lower abdomen, or chest oppression and mental confusion. The affected site may be swollen and painful or not swollen, slightly red and hot, or conversely extremely cold. The affected area is mostly on the medial aspect of the leg (Yin region). Along the pathways of the Three Yin meridians, the complexion is dark and sallow, and the pulse is mostly deep. These are the general characteristics of Yin and Yang syndromes. If distinguished in detail:
Taiyang Meridian involvement presents with fever, headache, aversion to cold, dizziness, stiff neck, and pain in the waist, spine, body, and from the lateral malleolus to the lateral side of the little toe. (Suitable formulas include Zhang Zhongjing's Mahuang Tang [Ephedra Decoction], Guizhi Tang [Cinnamon Twig Decoction], Jiuwei Qianghuo Tang [Nine-Ingredient Notopterygium Decoction], Baidu San [Decoction for Resolving Toxins], and Jiyan Mahuang Zuojing Tang [Collected Proven Ephedra Left-Meridian Decoction].)
Yangming Meridian involvement presents with mild fever (like feathers covering the body), dry mouth and nose, frequent yawning, abdominal distension, and pain from the thigh, knee, patella, lateral aspect downwards to the dorsum of the foot and the medial side of the middle toe. (Suitable formulas include Dexiao Xiong Zhi Xiang Su San [Effective Ligusticum, Angelica Dahurica, and Perilla Powder] and Dahuang Zuojing Tang [Rhubarb Left-Meridian Decoction].)
Shaoyang Meridian involvement presents with alternating chills and fever, bitter taste, hypochondriac pain, facial dirtiness, dizziness and painful eyes, swelling and pain of scrofula (Madao Xia Yi) in the axilla, and pain from the lateral thigh and knee to the various joints of the lateral malleolus. (Suitable formulas include Xiao Chaihu Tang [Minor Bupleurum Decoction] and Banxia Zuojing Tang [Pinellia Left-Meridian Decoction].)
Combined illness of the Three Yang meridians presents with aversion to cold and high fever, spontaneous sweating and aversion to wind, or anhidrosis and aversion to cold, dizziness and heaviness, pulling pain in joints, contracture of hands and feet, painful cold bi-syndrome, flaccidity and paralysis of waist and legs, mental agitation with rising qi, vomiting and diarrhea, with a floating, wiry, tight, or rapid pulse. (Suitable formulas include Da Liao Shenmi Zuojing Tang [Large-Dose Mysterious Left-Meridian Decoction] and Jia Wei Baidu San [Modified Decoction for Resolving Toxins].)
Taiyin Meridian involvement presents with abdominal fullness, chest and diaphragm stuffiness, tightness of the tongue root, and pain along the tibia, anterior-medial aspect of the thigh and knee, posterior-medial aspect of the medial malleolus, to the medial end of the big toe. (Suitable formulas include Weiling Tang [Stomach and Five Ingredients Decoction] and Liwu Fuzi Tang [Six-Ingredient Aconite Decoction].)
Shaoyin Meridian involvement presents with pain in the waist and spine, qi rushing up to the chest and throat, hunger but inability to eat, black complexion, dysuria, excessive fearfulness, and pain in the little toe, sole of the foot, medial malleolus, heel, and medial aspect of the leg. (Suitable formulas include Mahuang Fuzi Xixin Tang [Ephedra, Aconite, and Asarum Decoction] and Jingui Shiwu Wan [Eight-Ingredient Pill from the Golden Cabinet].)
Jueyin Meridian involvement presents with unilateral pain in the waist and hypochondrium, contracture of the feet, dry throat, vomiting and counterflow qi, profuse diarrhea, and distending pain in the upper lateral aspect of the big toe connected to the dorsum of the foot, ascending to the medial aspect of the leg, circling around the genitals along the thigh, and the areas beside the navel in the lower abdomen. (Suitable formulas include Zhuyu Mugua Tang [Cornus and Papaya Decoction] and Shenyang Zhenzhen Dan [Divine Response Nourishing True Pill].)
Combined illness of the Three Yin meridians presents with contracture of the four limbs, wheezing and chest fullness, closure and difficulty of urination, mental heat and irritability, generalized edema, weak feet, and flaccidity preventing walking. (Suitable formulas include Jia Wei Baidu San [Modified Decoction for Resolving Toxins] and Zhuidu Tang [Poison-Chasing Decoction].)
Regarding the above six meridians: Flowing fluids with spontaneous sweating indicate excess Wind (pulse mostly floating and slippery; suitable to increase usage of Qianghuo, Du Huo, Fang Feng, Guizhi). Anhidrosis with pain indicates excess Cold (pulse mostly slow; suitable to increase usage of Guizhi, Fuzi, Ganjiang, Xixin). Heat and irritability indicate excess Summer-heat (pulse mostly rapid; suitable to increase usage of Huangqin, Huangbai, Mugua, Xiangru). Heaviness and swelling indicate excess Dampness (pulse mostly soft and thin; suitable to increase usage of Cangzhu, Zexie, Yiyiren, Fangji, Fuling). As for herbs such as Fangji, Mugua, Yiyiren (Coix Seed), Binglang, Cangzhu, Huangbai, Rougui, Guizhi, Bajitian, Weirui (Polygonatum Odoratum), Mutong, Qianghuo, Zhike, Zexie, Sangzhi, etc., one should adjust the dosage according to which pathogenic factor is predominant and double the dose of herbs suitable for the specific syndrome, rather than being confined to a single formula. Li Dongyuan stated that this disease, due to the low-lying terrain of the South, is caused by external invasion of Cold-Dampness into the meridians. In contrast, the North has high terrain and little external water-dampness; thus, cases there are caused by internal injury from alcohol and dairy, with Damp-Heat sinking downward. Therefore, the South should be treated as Cold-Dampness, and the North as Damp-Heat. Although this viewpoint was novel, it may not be entirely accurate. Is it true that the South, despite being low-lying, lacks people who indulge in rich foods and alcohol? Is it true that the North, despite being high, lacks activities involving wading and washing? It depends on the skilled physician to carefully observe the signs and pulses and differentiate accordingly. This is the proper approach.