敦疽多生足指疼，肿色红活出血脓，血燥精竭无败色，膏粱房劳脾肾经。
【注】此证多生于足指，而手指亦间有生者，由膏粱太过则损脾，房劳太过则伤肾；脾
既损则血生少，肾既伤则精必竭，更兼湿热壅盛而成。初起黄粟小 ，痛如汤泼火燃，其
色红活，肿无黑晕，溃破有脓，腐无败色，此属血脉未死之候。然此证虽无败色，亦由脏
腑发出，未可视为小毒也，法宜急服滋阴救燥、补血理脾之药。初服解毒济生汤、六味
地黄汤，溃服人参养荣汤、桂附地黄汤。外初宜蝌蚪拔毒散涂之，将溃贴蟾酥饼，兼贴
巴膏，溃腐之后，换搽生肌玉红膏生肌敛口。初终禁用灸法。患者宜清心寡欲调理，庶免变证。
\r敦疽图\p04-34a219.bmp\r
解毒济生汤（见脱疽）
六味地黄汤（见面部雀斑）
桂附地黄汤（见面部颊疡）
人参养荣汤 巴膏 生肌玉红膏（俱见溃疡门）
蝌蚪拔毒散（见肿疡门）
蟾酥饼（即蟾酥丸作饼。见疔疮门）
甲疽多因剔甲伤，甲长侵肉破成疮， 肉高突痛难忍，消瘀化 效非常。
【注】此证因割嵌指甲伤肉，或剔甲伤肉，或甲长侵肉，穿窄小靴鞋，以致甲旁 肿破
烂，时津黄水， 肉高突，疼痛难忍，不能着衣。原系好肉受伤，宜用盐汤烫洗，外敷
华佗累效散，白膏药盖贴， 肉消尽即愈。
\r甲疽图\p04-34a220.bmp\r
华佗累效散
乳香 砂（各一钱） 轻粉（五分） 橄榄核（烧，存性三枚） 黄丹（三分）
共研细末，香油调敷。
【方歌】华佗累效敷嵌甲，黄丹轻粉乳 砂，橄榄核烧同碾细，香油调浓患处搽。
白膏药（见溃疡门）
敦疽多生于足趾，伴有疼痛，肿胀部位颜色红活，溃破后流出脓血。若患者因血燥、精竭导致局部无败坏之色，其病因多与饮食肥甘厚味过度损伤脾脏、房事劳倦过度损伤肾脏有关。
【注】此证多见于足趾，手指间偶有发生。由于饮食过于肥甘厚味会损伤脾脏，房事过度会损伤肾脏；脾脏受损则血液生成不足，肾脏受伤则精气必然枯竭，再加上湿热邪气壅盛而发病。初起时出现如黄粟米大小的结节，疼痛剧烈如同被热水泼洒或烈火燃烧，患处颜色红活，肿胀周围无黑色晕圈，溃破后有脓液排出，腐肉无败坏之气，这属于血脉尚未坏死的表现。然而此证虽然表面没有败坏之色，实则由脏腑病变引发，不可视为轻微毒邪。治疗法则应当急服滋阴润燥、补血健脾的药物。初期服用解毒济生汤、六味地黄汤；溃破后服用人参养荣汤、桂附地黄汤。外治方面，初期宜涂抹蝌蚪拔毒散；即将溃破时贴敷蟾酥饼，并兼贴巴膏；溃烂腐肉之后，更换涂抹生肌玉红膏以促进肌肉生长和伤口愈合。全程禁用灸法。患者宜清心寡欲进行调理，以免产生变证。
甲疽多因修剪指甲时受伤所致，指甲过长侵入肉质导致破损成疮，增生之肉高突且疼痛难忍，采用消瘀化腐之法效果极佳。
【注】此证因切割嵌甲伤及肌肉，或修剪指甲伤及肌肉，或指甲过长侵入肌肉，以及穿着窄小靴鞋挤压，导致指甲旁肿胀破溃糜烂，时常渗出黄色液体，增生的肉芽高突，疼痛难以忍受，无法穿鞋着袜。原本是好肉受到外伤，适宜用盐水汤烫洗，外敷华佗累效散，再用白膏药覆盖贴敷，待增生肉芽消退后即可痊愈。
Dun Ju (Thick Abscess) often occurs on the toes with pain. The swelling is red and vibrant, discharging pus and blood upon rupture. If there is no foul odor or necrotic tissue due to blood dryness and essence depletion, the etiology is related to excessive consumption of rich foods damaging the Spleen and excessive sexual activity damaging the Kidney.
[Note] This condition mostly occurs on the toes, occasionally on the fingers. Excessive intake of rich and greasy food damages the Spleen; excessive sexual activity damages the Kidney. When the Spleen is damaged, blood production decreases; when the Kidney is injured, essence inevitably depletes. Combined with the accumulation of damp-heat, the disease manifests. Initially, small yellow millet-like nodules appear, with severe pain as if scalded by hot water or burned by fire. The color is red and vibrant, without black halos around the swelling. Upon rupture, pus is discharged, and the necrotic tissue shows no signs of putrefaction, indicating that the blood vessels have not yet died. However, although this condition lacks signs of putrefaction, it originates from internal organ dysfunction and should not be regarded as a minor toxicity. The treatment principle requires urgent administration of herbs that nourish Yin, rescue dryness, tonify blood, and regulate the Spleen. In the early stage, administer Jiedu Jisheng Tang (Detoxification and Life-Preserving Decoction) and Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill). After ulceration, administer Renshen Yangrong Tang (Ginseng Nourishing Harmony Decoction) and Guifu Dihuang Tang (Cinnamon Twig and Aconite Rehmannia Pill). Externally, in the early stage, apply Ketou Badu San (Tadpole Detoxifying Powder); just before ulceration, apply Chansu Bing (Toad Venom Cake) and simultaneously apply Bagao (Ba Paste). After ulceration and necrosis, switch to applying Shengji Yuhong Gao (Muscle-Regenerating Jade Red Ointment) to promote granulation and wound closure. Moxibustion is strictly prohibited throughout the course. Patients should maintain a clear mind and few desires for recuperation to avoid complications.
Jia Ju (Nail Fungus/Ingrown Nail Abscess) is mostly caused by injury during nail trimming. Overgrown nails invading the flesh cause ulcers. Hyperplastic tissue protrudes with unbearable pain; methods to resolve stasis and transform necrosis are highly effective.
[Note] This condition results from cutting ingrown nails injuring the flesh, trimming nails injuring the flesh, overgrown nails invading the flesh, or wearing tight boots/shoes, leading to swelling, rupture, and erosion beside the nail. It frequently oozes yellow fluid, with hyperplastic tissue protruding and unbearable pain, making it impossible to wear shoes or socks. Originally, healthy tissue is injured. It is suitable to wash with salt water solution, apply Huatuo Leixiao San (Huatuo’s Repeatedly Effective Powder) externally, and cover with Baigaoyao (White Plaster). Healing occurs once the hyperplastic tissue subsides.
Huatuo Leixiao San
Ruxiang (Frankincense), Sharen (Amomum Fruit) (1 qian each), Qingfen (Calomel), Ganlanhe (Olive Pit, burnt to retain its nature, 3 pieces), Huangdan (Lead Tetroxide) (0.3 fen).
Grind all into fine powder, mix with sesame oil, and apply to the affected area.
[Prescription Song] Huatuo’s repeatedly effective powder treats ingrown nails,
With lead tetroxide, calomel, frankincense, and amomum fruit.
Burn olive pits and grind them fine together,
Mix thickly with sesame oil and apply to the lesion.
Baigaoyao (White Plaster) (See Ulcer Section)