夫痈疽疮肿之所作也。皆五脏六腑蓄毒不流。则生（本作皆有。）矣。非独因荣卫壅塞而发者也。其行也有处。其
主也有归。假令发于喉舌者。心之毒也。发于皮毛者。发于肌肉者。脾之毒也。发于骨髓者。肾之毒也。（阙肝毒。）
发于下者阴中之毒也。发于上者。阳中之毒也。发于外者六腑之毒也发于内者。五脏之毒也故内曰坏。
外曰溃。上曰从。下曰逆。发于上者得之速。发于下者得之缓。感于六腑则易治感于五脏则难瘳也。又近
骨者多冷。近虚者多热近骨者久不愈。则化血成蛊。近虚者。久不愈。则传气成漏。成蛊。则多痒而少痛。或
先痒后痛。成漏。则多痛而少痒。或不痛。或不痒内虚外实者。多庠而少痛。外虚内实者。多痛而少痒。血不
止者则多死。脓疾溃者则多生。或吐逆无度。饮食不时。皆痈疽之使然也。种候万一（一作多。）端。要凭详。治疗
之法。列在后篇。
人之病。香港脚。与气脚之为异。何也谓人之喜怒忧思。寒热邪毒之气。自内而注入于脚。则名气脚也。风寒
暑湿邪毒之气。从外而入于脚膝。渐传于内。则名香港脚也。然内外皆以邪夺正故使人病形颇相类例。其
于治疗。亦有上下先后也。故分别其目。若一揆而不察其由。则无理致其瘳也。夫喜怒忧思寒热邪毒之
气。流入股节。或注于脚膝。其状类诸风。历节。偏枯。痈肿之证。但入于脚膝。则谓之气脚也。若从外而入于
足。从足而入脏者。乃谓之香港脚也。气脚者。先治内而次治外。香港脚者先治外而次治内。实者利之。虚者益
之。又人之病。香港脚多者何也。谓人之心肺二经。起于手。脾肾肝三经。起于足手则清邪中之。足则浊邪中
之。人身之苦者手足耳。而足则最重艰苦。故风寒暑湿之气。多中于足。以此香港脚之病多也。然而得之病
者。从渐而生疾。但始萌而不悟。悟亦不晓。医家不为香港脚。将为别疾。治疗不明。因循至大。身居危地。本从
微起。浸成巨候。流入脏腑。伤于四肢。头项。腹背也。而疾未甚。终不能知觉也。特因他而作。或如伤寒。或如
中暑。或腹背疼痛。或肢节不仁。或语言错乱。或精神昏昧。或时喘乏。或暴盲聋。或饮食不入。或脏腑不通。
或挛急不遂。或舒缓不收。或口眼牵搐。或手足颤掉。种种多状。莫有达者。故使愚俗束手受病。死无告陈。
仁者见之。岂不伤哉。今述始末。略示后学。请深消息。至如醉入房中。饱眠露下。当风取凉。对月贪欢。沐浴
未干。而熟睡。房室才罢而冲轩。久立于低湿。久伫于水涯。冒雨而行。渎寒而 。劳伤汗出。食饮悲生。犯诸
禁忌。因成疾矣。其于不正之气。中于上则害于头目。害于中则蛊于心腹。形于下则灾于腰脚。及于旁则
妨于肢节。千状万证。皆属于气脚。但起于脚膝。乃谓香港脚也。形候脉证。亦在详明。其脉浮而弦者。起于风。
濡而弱者。起于湿。洪而数者。起于热。迟而涩者。起于寒。滑而微者。起于虚。牢而坚者。起于实。在于上则由
于上。在于下则由于下。在于中则生于中。结而因气。散则因忧。紧则因怒。细则因悲。风者汗之而愈。湿者
温之而愈。热者解之而愈。寒者熨之而愈。虚者补之。实者泻之。气者流之。忧者宽之。怒者悦之。悲者和之。
能通此者。乃谓之良医。又香港脚之病传于心肾。则十死不治入心则恍惚忘谬。呕吐。食不入。眠不安宁。口
眼不定。左手寸口手脉乍大乍小乍有乍无者。是也入肾。则腰脚俱肿。小便不通。呻吟不绝。目额皆见黑
色。气时上冲胸腹而喘。其左手尺中脉绝者是也。切宜详审矣。
痈疽疮肿的发生，都是由于五脏六腑蓄积毒素、运行不畅所致。因此产生（原本文本作“皆有”）。这不仅仅是因为营卫之气壅塞而引发的。它们的发病部位有定处，主治脏腑有归属。假如发于喉舌的，是心的毒邪；发于皮毛和肌肉的，是脾的毒邪；发于骨髓的，是肾的毒邪。（原文缺肝毒部分）。发于身体下部的，是阴分的毒邪；发于身体上部的，是阳分的毒邪；发于体表的，是六腑的毒邪；发于体内的，是五脏的毒邪。所以，在体内称为“坏”，在体表称为“溃”，病势顺者为“从”，病势逆者为“逆”。发于上部的，发病迅速；发于下部的，发病缓慢。感受六腑之毒则容易治疗，感受五脏之毒则难以痊愈。另外，靠近骨节的病变多表现为寒证，体质虚弱部位的病变多表现为热证。靠近骨节且久不愈合的，会化血成蛊（一种积聚性疾病）；体质虚弱且久不愈合的，会传气成漏（瘘管）。形成蛊的，大多瘙痒而疼痛轻微，或者先痒后痛；形成漏的，大多疼痛而瘙痒轻微，或者不痛也不痒。内虚外实的，多瘙痒而疼痛轻微；外虚内实的，多疼痛而瘙痒轻微。血液不止的往往死亡，脓液通畅排出的往往生存。如果出现呕吐逆乱无度、饮食不时的情况，都是痈疽导致的后果。症状种类万一有一千种之多，关键在于详细诊察。治疗方法，列在后篇。
人的疾病中，香港脚（脚气病）与气脚的区别是什么？所谓气脚，是由于人的喜怒忧思等情志变化，以及寒热邪毒之气，从内部注入到脚部引起的。所谓香港脚，是风寒暑湿邪毒之气，从外部侵入脚膝，逐渐向内传变引起的。然而内外病因都是因为邪气夺走正气，所以使人患病，症状颇为相似。但在治疗上，也有上下先后的区别。所以要分别列出其条目，如果一概而论而不考察其缘由，就无法合理使其痊愈。那些喜怒忧思寒热邪毒之气，流入大腿关节，或注于脚膝，症状类似诸风、历节（关节疼痛变形）、偏枯（半身不遂）、痈肿等证候，但只要病位在于脚膝，就称为气脚。如果是从外部侵入足部，再由足部传入内脏的，才称为香港脚。治疗气脚，先治内部而后治外部；治疗香港脚，先治外部而后治内部。实证用通利法，虚证用补益法。
另外，为什么人的香港脚病较多呢？这是因为人心肺二经起于手部，脾肝肾三经起于足部。手接受清邪，足接受浊邪。人体辛苦劳作多在手足耳，而足部承受最重的艰苦，所以风寒暑湿之气，多侵袭足部。因此香港脚病较多。然而得此病的人，病情是逐渐产生的，刚开始萌芽时没有察觉，即使察觉了也不知晓。医生不把此病当作香港脚，而误认为是其他疾病，治疗不明确，因循拖延导致病情加重，人身处于危险境地。本从微小开始，逐渐发展成巨大病症，流入脏腑，损伤四肢、头项、腹背。此时疾病尚未严重，最终也不能被察觉。特别因为其他原因发作，有的像伤寒，有的像中暑，有的腹背疼痛，有的肢节麻木不仁，有的语言错乱，有的精神昏昧，有时气喘乏力，有的突然失明失聪，有的饮食不进，有的脏腑不通，有的拘挛急迫不能随意运动，有的松弛不收，有的口眼歪斜抽搐，有的手足颤抖，种种症状繁多，没有人能通达理解。所以使愚昧世俗之人束手受病，死时无处申诉。仁爱的人看到这种情况，难道不感到悲伤吗？现在叙述始末，略微展示给后学者，请深入思考。至于如醉酒后行房事，饱食后露天睡觉，当风取凉，对着月亮贪恋欢愉，沐浴后头发未干就熟睡，房事刚结束就乘车奔波，长久站立在低湿之地，长久停留在水边，冒雨行走，触犯寒冷而……劳伤出汗，饮食悲生（指因情绪悲伤影响饮食），违反各种禁忌，因而成为疾病。不正之气，侵袭上部则危害头目，侵袭中部则蛊惑心腹，表现于下部则灾害腰脚，波及旁边则妨碍肢节。千状万证，都属于气脚范畴，但起于脚膝，才称为香港脚。形态候脉证候，也在详细阐明之中。脉象浮而弦的，起于风邪；濡而弱的，起于湿邪；洪而数的，起于热邪；迟而涩的，起于寒邪；滑而微的，起于虚证；牢而坚的，起于实证。病在上部则由上部引起，病在下部则由下部引起，病在中部则生于中部。脉结滞是因气滞，脉散漫是因忧愁，脉紧是因愤怒，脉细是因悲伤。风邪用发汗法可愈，湿邪用温法可愈，热邪用解表清热法可愈，寒邪用熨法可愈。虚证用补法，实证用泻法，气滞用行气法，忧愁用宽慰法，愤怒用悦乐法，悲伤用调和法。能通晓这些道理的，才称之为良医。另外，香港脚病若传于心肾，则十死不治。传入心脏，则出现恍惚忘谬、呕吐、饮食不进、睡眠不安宁、口眼不定，左手寸口脉乍大乍小、乍有乍无，就是这种证候。传入肾脏，则腰脚俱肿、小便不通、呻吟不绝、目额皆见黑色、气时常上冲胸腹而喘，左手尺中脉绝，就是这种证候。切宜详细审察。
The occurrence of carbuncles, ulcers, sores, and swellings is due to the accumulation of toxins in the five zang organs and six fu organs, leading to stagnation. Thus, they arise (the original text reads "all exist"). This is not solely caused by the obstruction of Ying (Nutritive) and Wei (Defensive) Qi. Their manifestation has specific locations, and their governing organs have specific affiliations. For instance, those manifesting on the throat and tongue are due to heart toxins; those manifesting on the skin, hair, and muscles are due to spleen toxins; those manifesting in the bone marrow are due to kidney toxins. (The section on liver toxins is missing.) Those manifesting in the lower body are yin toxins; those manifesting in the upper body are yang toxins; those manifesting externally are fu organ toxins; those manifesting internally are zang organ toxins. Therefore, internal lesions are termed "huai" (destruction), external lesions are termed "kui" (ulceration), favorable progression is "cong" (following), and unfavorable progression is "ni" (rebellious). Lesions in the upper body develop rapidly, while those in the lower body develop slowly. Infections involving the six fu organs are easier to treat, whereas those involving the five zang organs are difficult to cure. Furthermore, lesions near bones often present with cold syndromes, while those in deficient areas often present with heat syndromes. If lesions near bones persist without healing, blood may transform into "gu" (a type of accumulation disease); if areas of deficiency persist without healing, qi may transmit to form "lou" (fistula). Conditions forming "gu" typically involve more itching and less pain, or itching preceding pain. Conditions forming "lou" typically involve more pain and less itching, or neither pain nor itching. Internal deficiency with external excess leads to more itching and less pain; external deficiency with internal excess leads to more pain and less itching. Unstoppable bleeding indicates a high mortality rate, while proper pus discharge indicates survival. Symptoms such as uncontrolled vomiting and irregular eating habits are all consequences of carbuncles and ulcers. The variety of symptoms can be countless, but the key lies in detailed examination. Treatment methods are listed in the subsequent chapters.
What is the difference between Hong Kong Jiao (Jiaqi/Foot Qi) and Qi Jiao in human diseases? Qi Jiao refers to conditions where emotional factors such as anger, joy, worry, and thought, along with pathogenic qi of cold, heat, and toxicity, enter from the interior and inject into the feet. Hong Kong Jiao refers to conditions where pathogenic qi of wind, cold, summer-heat, and dampness enters from the exterior into the feet and knees, gradually transmitting inward. However, both internal and external causes involve pathogens depriving the righteous qi, resulting in similar clinical manifestations. Nevertheless, treatment strategies differ regarding priority and sequence. Therefore, categories must be distinguished. If one treats them uniformly without investigating their origins, it will be impossible to achieve a rational cure. When pathogenic qi from emotions and temperature changes flows into the thigh joints or injects into the feet and knees, presenting symptoms similar to various wind syndromes, Li Jie (joint pain and deformity), Pian Ku (hemiplegia), and carbuncles/swellings, but located specifically in the feet and knees, it is termed Qi Jiao. If the pathogen enters from the exterior into the feet and then transmits from the feet to the viscera, it is termed Hong Kong Jiao. For treating Qi Jiao, address the interior first and the exterior second; for treating Hong Kong Jiao, address the exterior first and the interior second. Excess syndromes are treated with draining methods, and deficiency syndromes are treated with tonifying methods.
Furthermore, why are cases of Hong Kong Jiao more common? This is because the Heart and Lung meridians originate in the hands, while the Spleen, Kidney, and Liver meridians originate in the feet. The hands receive clear pathogens, while the feet receive turbid pathogens. Human physical hardship primarily falls upon the hands, feet, and ears, with the feet bearing the heaviest burden. Consequently, pathogenic qi of wind, cold, summer-heat, and dampness frequently attacks the feet. Thus, Hong Kong Jiao is prevalent. Patients suffering from this disease develop it gradually. Initially, when symptoms are subtle, they are unnoticed; even if noticed, they are misunderstood. Physicians may misdiagnose it as other ailments rather than Hong Kong Jiao, leading to unclear treatment and delayed care until the condition becomes severe, placing the patient in danger. Starting from minor issues, it progresses to major syndromes, invading the viscera and damaging the four limbs, head, neck, abdomen, and back. Even when the disease is not yet critical, it remains undetected. It may manifest due to other triggers, resembling Taiyang syndrome (Shanghan), heatstroke, abdominal and back pain, numbness in limbs and joints, disordered speech, mental confusion, occasional asthma and fatigue, sudden blindness or deafness, inability to eat, visceral blockage, spasms and inability to move freely, flaccidity and lack of control, facial deviation and twitching, or trembling of hands and feet. There are myriad complex presentations that few understand. Consequently, ignorant people suffer helplessly and die without recourse. Would not benevolent individuals find this tragic? I now narrate the beginning and end to briefly instruct future students; please reflect deeply. Causes include sexual intercourse after drunkenness, sleeping outdoors after full meals, cooling off in the wind, indulging in pleasure facing the moon, sleeping soundly before drying off after bathing, traveling immediately after intercourse, standing long in low-damp places, lingering by water edges, walking in rain, exposure to cold, sweating from overexertion, dietary issues arising from sorrow, and violating taboos, all leading to disease. Pathogenic qi attacking the upper part harms the head and eyes; attacking the middle part affects the heart and abdomen; manifesting in the lower part damages the waist and feet; spreading to the sides hinders the joints. Thousands of symptoms belong to Qi Jiao, but those originating in the feet and knees are specifically termed Hong Kong Jiao. Morphological signs and pulse patterns require detailed clarification. A floating and wiry pulse indicates wind origin; a soggy and weak pulse indicates dampness origin; a surging and rapid pulse indicates heat origin; a slow and choppy pulse indicates cold origin; a slippery and faint pulse indicates deficiency origin; a firm and hard pulse indicates excess origin. Disease in the upper part arises from the upper; disease in the lower part arises from the lower; disease in the middle part arises from the middle. Knotted pulses indicate qi stagnation; scattered pulses indicate sorrow; tight pulses indicate anger; thin pulses indicate grief. Wind pathogens are cured by inducing sweating; damp pathogens are cured by warming; heat pathogens are cured by resolving/clearing; cold pathogens are cured by moxibustion/warming compresses. Deficiency is treated by tonification, excess by purging, qi stagnation by moving qi, sorrow by comforting, anger by pleasing, and grief by harmonizing. One who masters these principles is called a good physician. Furthermore, if Hong Kong Jiao transmits to the Heart and Kidneys, ten out of ten cases are fatal. Transmission to the Heart presents as mental confusion, forgetfulness, vomiting, inability to eat, restless sleep, and instability of the mouth and eyes, accompanied by a cun position pulse at the left hand that fluctuates in size and presence. Transmission to the Kidneys presents as swelling of the waist and feet, urinary retention, incessant groaning, black discoloration of the eyes and forehead, qi rushing upward to the chest and abdomen causing asthma, and an absent chi position pulse at the left hand. Careful examination is essential.