夏子益《奇疾方》云∶有人手足十指节断坏,惟有筋连,无节肉,虫出如灯心长数寸,遍身绿毛卷,名曰血余。
以茯苓、胡黄连煎汤,饮之自愈。
〔源按〕经云∶脾热生肉痿,肉痿者色黄而蠕动。又云∶地之湿气感则害皮肉关节。注云∶湿自下受,先入皮
肉,湿流关节则伤筋脉,筋脉伤则肝亦受病。此症由皮肉化虫至十指断坏,无节肉,而更感肝木之气,化生绿毛卷虫,
又经所谓东方生木,木生风,在脏为肝,其虫毛。虫毛者,森森之象,故有是形耳,而病名血余。因肝藏血,所得肝之
余气,而生虫毛故也。然不生别色而独生绿?盖脾属土,其色黄,肝属木,其色青,青黄二气相感,则生是色也。茯苓
补脾利湿,胡黄连清肝木之热,使木平脾强,则症自愈。
又云∶有人患四肢节脱,但有皮连,不能举动,名曰筋解。用酒浸黄芦三两,经一宿,取出焙干为末,每服二钱,
酒调下服尽安。
〔源按〕此症四肢节脱,但有皮连,因四肢筋脉痿而不用,故谓之筋解。解者,为筋脉解散,不堪任用耳。然痿有
虚痿实痿,刘河间曰∶四肢不举,俗曰瘫缓。故经所谓脾太过,则令人四肢不举。又曰∶土太过则敦阜。阜高也,敦浓
也,既浓而又高,则令除去,此真所谓膏粱之疾,其治则泻,令气弱阳衰,土平而愈。或三化汤、调胃承气汤选而用
之,若脾虚则不用也。经所谓土不及则脾陷卑下也,陷坑也,故脾病四肢不举。四肢皆禀气于胃,而不能至经,必因
于脾,乃能受禀?今脾病,不能与胃行其津液,四肢不得禀水谷气,气日以衰,脉道不利,筋骨肌肉皆无气以生,故不
用焉。其治可十全散,加减四物,去邪留正。予考《内经》,五脏使人痿,而河间独言治脾者。《内经》又云∶论言治痿
者,独取阳明故也。阳明五脏六腑之海,主润宗筋,宗筋主束骨而利机关也,冲脉者,经脉之海也,主渗灌溪谷,与阳
明合于宗筋,阴阳总宗筋之会,会于气亍,而阳明为之长,皆属于带脉,而络于督脉,故阳明虚则宗筋纵,带脉不引,
故足痿不用也。曰∶治之奈何?曰∶各补其荣而通其输,调其虚实,和其逆顺,筋脉骨肉各以其时受月,则病已矣(时
受月谓受气时月,如肝王甲乙,心王丙丁类也)。
又云∶有人两足心凸肿,上生黑豆疮,硬如钉,胫骨生碎孔,内髓流出,身发寒颤,惟思饮酒。此是肝肾冷热相
吞。用炮川乌头来敷之,内服韭子汤效。
又云∶有人忽发寒热,数日不止,四肢坚如石,击之有钟磬声,日渐瘦恶。用吴茱萸、木香等分,煎汤饮之自愈。
〔源按〕此症为寒邪客于少阳,少阳与厥阴相为表里,在三阳尽处,阳尽则阴生,故有寒热之往来。厥阴在三阴尽
处,阴尽则阳接,故有寒热之胜复。此症由阴胜而不能外复于阳,至邪横逆于脾,厥失健运之职,故四肢悉坚如石,即
经所谓寒以坚之是也。夫击之声如钟磬,乃土音也,盖脾属土,其音宫,宫音重而大,故声如是。凡脾土之音,非火
不发,非郁亦不发,犹天地元阳之气,郁结于下而后外达,达则雷声自内而出也。盖脾土为寒所郁,击之则筋脉自相应
而作也,至四体日渐瘦恶,因脾病不为肌肤故耳。然治病当求其本,用吴茱萸直入肝脏,逐去深寒;而更以木香通其壅
滞之气,使气通寒散,则木平土安,而病自愈也。
或问∶邪入厥阴,因阴胜而阳下不能复至,邪横逆脾土,当必吐利,而何故无乎?予曰∶脾土虽困,而气机尚能
内动,所以击之即有声相应而出,即易所谓坤至柔而动也,刚故无是患。然此声为寒郁不能自达,则必击之有声者,亦
犹土气之有气也,有气之器,以铁物击之,其火自内而出,即是气也。盖其气闭郁寒体之中,必击之则气机内动,而声
发于外也。若无火则无气,无气则不鸣,欲明此病,当以气之击而有声者察之。
又问∶土器之有声者,击之即随所击之处而发,若脾土深居于内,虽有筋脉相应,恐未必能随所击而发音。予曰∶
脾土之音,击之声发,犹琴声之相应也。盖琴无体,则弦不鸣,拨其弦,则遂应。明乎器之如是,便知是病所击之声矣。
又问∶土器有气则鸣,则木中有火,岂非气乎,何故但有声而不鸣耶?予曰∶子不明器之为质,分五音之声,非以
气恁也。即如木为器,其音角,角音调而直,故声如是。予所言,土器之有声者,叩之则鸣,若以五音论之,则收宫音
之声,无气便无此音,岂可概以气论之哉?若以气论之,即钟鼓等音亦宫音也,岂有气乎?
又问∶钟鼓二器,固无声也,何故无气之器,反鸣而且远乎?予曰∶钟虽无气,内有脉道,音从脉道而行,故得鸣
而且远。所以五金切之则光,折之则参差不齐,此根据脉路所分,故不平而齐也。乃五金中,惟锡铅无声,因柔而不刚故
耳。若以鼓论,不过因急而有声,并非有气而有脉道也,鼓声其音走内,若下面覆皮,击之以应其下,所以亦鸣而远
也,否则声浅而不远矣。
《奇病方》云∶有人指缝流血不止,有虫如蜉蝣之小钻出,少顷即能飞去。此症乃湿热生虫也,然何故而能飞耶?
盖湿热而更感风邪,凡虫感风,即有翼能飞。虫在人身,得风之气,故亦能飞也。方用黄 、熟地、苡仁各五钱,当归、
白芍、茯苓、白术各三钱,人参、柴胡、荆芥、川芎各一钱,水煎服,四剂而愈。此方全不在杀虫,而但补气血,佐
用去湿去风,盖人身气血和,则虫自灭故也。
又云∶有人患手足脱下,而人仍不死者,此乃伤寒之时,口渴过饮凉水,以救一时之渴,孰知水停腹内,不能一
时分消,遂至四肢受病,气血不行,久而手足先烂,手指与脚指堕落,或脚指堕落之后,又烂脚板,久之连脚亦堕落
矣。若有伤寒口渴,过饮冷水者,愈后倘手足指出水,急用此方可救指节、脚板之堕落也。方用苡仁三两,茯苓二
两,肉桂一钱,白术一两,车前子五钱,水煎服,一连十剂,小便大利,而手脚不出水矣。
又云∶有人患脚板中色红如火,不可落地,又非痰毒,终岁经年不愈。此病因用热药,立而行房,火聚脚心而不
散,故经久不肯愈也。法当用内药消之。若作外治,必先烂去脚板。煎服祛火丹十剂自消,二十剂痊愈。然须忌房事三
月,否则必发,发则死矣,慎之哉。
又云∶有人患指甲尽行脱下,不痛不痒。此乃肾经火虚,又于行房之后,以凉水洗手,遂成此病。方用六味汤,
加柴胡、白芍、骨碎补,治之而愈。
又云∶有人患掌中忽高起一寸,不痛不痒,此乃阳明经之火不散,而郁于手也。理痛痒而不痛痒,不特火郁于腠理,
而且水壅于皮毛也,法当用外药消之。盖阳明火盛,必作渴引饮不休,而又不渴,是胃中之火尽散,流毒于掌中。必其
人是阳明之火盛,手按于床席之上,作意行房,过于用力,使掌上之气血不行,久而突突而高也,不痛不痒,乃成死肉
矣。方用附子一个,煎汤以手渍之,至凉而止,如是者十日,必然作痛,再渍必然作痒,又渍而高者平矣。盖附子大
热之物,无经不入,虽用外渍,无不内入者也。倘以附子作汤饮之,则周身俱热,又引动胃火,掌肉不消,而内症蜂
起,故用以外治而愈者也。或附子汤中,再加轻粉一分,引入骨髓,更为奇效耳。
又云∶有人脚肚之上,忽长一大肉块,似瘤非瘤,似肉非肉,按之痛欲死。此乃脾经湿气,结成此块,而中又带火
不消,故手不可按,按之痛欲死也。法宜峻补,宜峻补脾气,而分消其湿为是。然而外长怪肉,若在内一时消之,恐
不能愈,当用内外夹攻之法。内服消湿化怪汤二剂后将,消块神丹敷患处,一日即消,神效之极也。
又云∶有人足上无故忽毛孔标血如一线者,流而不止即死。急以米醋三升,煮滚热,以两足浸之,即止血,后用人
参一两,当归三两煎,穿山甲一片,火炙为末,调饮,即不再发此症。乃酒色不禁,恣意纵欲所致,当速治之。
又云∶有人脚板上忽生一指,痛不可忍者,乃湿热之气结成。用消指散,以刀轻刺出血,刺在生出指上,实时出
水,敷在血流之处,随出随掺,以血尽力度,至三日可不流水矣,而痛亦少止。再以化水汤煎服,四剂可全愈,而指尽
化为水矣,外用生肌散敷之,加膏药掩之即愈。
程山孺文见一人忽手生丫枝,痛不可忍。一医用通草为末,以鸡蛋清涂调,即消。
《奇效方》云∶有人患手足发指毒,痛不可忍者。用壁间蜂窠为末,入乳香少许,研匀,以醋调涂,干即以醋润之。
《华佗别传》云∶有人手上皮上现蛇形一条,痛不可忍。此蛇乘人之睡,而作交感于人身,乃生此怪病,服汤药
不效。以刀刺之,出血如墨汁,外用白芷为末掺之稍愈,明日又刺,血如前,又以白芷末掺之,二三次化去其形,先刺
头后刺尾,不可乱也。
张杲《医说》载《摭青杂记》云∶有人患脚疮,冬月顿然无事,夏月臭烂,痛不可言。遇一道人云∶尔因行草上,
惹蛇交遗沥,疮中有蛇儿,冬伏藏,故疮至冬无恙,夏出行,故至夏臭烂。急以生虾蟆捣敷之,一日三换,凡三日一
小蛇自疮中出,以铁钳之,其疮遂愈。
又云∶凡人冬月向火,火气入内,致两股生疮,其汁淋漓不止,世莫能识。用黄柏末掺之立愈。一妇病此,人无识
者,亦用此而愈。
李楼《怪症方》云∶有一女年十四,腕软处生物,如黄豆大,半在肉中,红紫色,痛不可忍,诸药不效。一方士以
水银四两,白棉纸二张揉熟,蘸水银擦之,三日自落而愈。
《本事方》云∶唐时有一商人,左膊上有疮,生如人面,亦无他苦。商人戏以酒滴口中,其面色赤,以物食之亦
能食,多则膊肉胀起,或不食则一臂痹焉。有名医教其历试诸药,悉无所苦,进至贝母其疮乃聚眉闭目,商人喜因以
小苇筒毁其口灌之,数日成痂遂愈。然不知何疾也,《本经》言是金疮,此岂金疮之类欤?
《肘后方》云∶有人患手指赤色,随月生死。以生薤一把苦酒煮熟,捣烂涂之,疾乃止。
〔源按〕此症由寒邪逆于肉理,营气不从,血凝不行,留于脉络之间,以随人之气血盛衰,而隐现其血之色也。
《内经》有云∶天温日明则人血淖溢,而卫气浮,故血易泻,气易行,天寒日阴则人血凝泣,而卫气沉,月始生则血
始精,卫气始行,月郭满,则血气实,肌肉坚,月郭空,则肌肉减。经络虚,卫气去,形独居,是以因天时而调血气
也。以此推之,月始生则气血初盛,赤色亦随气外浮,以渐而生也。郭满则血气充实,故色悉现于外,郭空则气血衰而
经络虚,卫气去而形独居(犹日魂去而月魄独居也),故又渐隐于内也,于是则知所患赤色,故有随月生死耳。薤白辛温
散血散气,更用苦酒以作向导,使气散血行则寒自灭,故捣涂而愈。
《太原故事》云∶徐之才治一人患脚根肿痛,诸医莫能识。徐曰∶此蛤精疾也,由乘舟入海垂脚水中。疾者曰∶实
曾如此。之才为剖得蛤二枚,大如榆荚。
邓氏《笔峰方》云∶有人患脚底木硬。以牛皮生姜汁化开,调南星末涂上,烘物熨之。
〔源按〕此症为肾脏受寒,营气凝而不行,以成此疾,即《内经》所谓皮肤不营故为不仁,又曰∶北方生寒在气为
坚是也。
道士王裕曰∶有忽患脚心如中箭,痛苦无奈,发歇不时,此肾之风毒,泻肾愈。
《南宫从岣嵝神书》云∶南方地卑湿,人多患足疮,岁久生虫如蛭而出,乃风毒攻注而然。用牛肚或羊肚或猪去粪
不洗,研如泥,看疮大小,入 泥矾半两,涂帛上贴之,须臾疮痒入心,徐徐连帛取下,火上炙之,中出如丝发毛尾千
万,或青白赤黑,以汤洗之,三日一作,不过数次,虫尽疮愈。
《翰林丛记》云∶李定言石藏用良医也,有人承檐溜浣手,觉物入爪甲,初若丝发,数日如线,伸缩不能,始悟其
龙伏藏也。乃叩藏用求治,藏用曰∶方书无此,以意求之耳。螳螂为末涂指,庶免震厄,其人如其言,后有雷火绕
身,急针挑之,果见一物跳出,亦不为灾。
《霏雪录》云∶山东民间妇人,一臂有物隐然,屈曲如蛟龙状,妇喜以臂浸水中,一日雷电自牖出,臂果一龙擘云
而去。
蔡元长知开封正据案治事,忽如有虫自足心行至腰间,即坠笔晕绝,久之方醒。据吏云∶此病非俞山人不能疗,驱
使召之,俞曰∶此真香港脚也。法当灸风市,为灸一壮,蔡晏然复常,明日病如初,再召,俞曰∶除病根非千艾不可。从
其言,灸五百壮,自此遂愈。
《名医录》云∶学究任道,患腿间疮肿黑,状狭而长。北医王通曰∶此鱼脐疮也,一因风毒蕴结,二因误食人汗而
然。乃以一异散敷之,数日而愈。恳求其方,曰∶但雪玄一味耳,任遍访无知之者。有名医郝允曰∶《圣惠方》治此,
用腊猪头烧灰,鸡卵白调敷,即此也。
张子和治新寨马叟,年五十九,因秋欠税,官杖六十,得惊气成风搐,已三年矣。病大发则手足颤掉,不能持物,
夏子益在《奇疾方》中记载:有人手足十指关节断裂毁坏,仅有筋脉相连,没有关节处的肌肉,有虫子像灯心草一样长数寸,全身长满绿色的卷曲毛发,这种病名叫“血余”。
用茯苓、胡黄连煎汤服用,病能自愈。
〔沈源按〕《内经》说:脾热生肉痿,肉痿的症状是肤色发黄且肌肉蠕动。又说:地之湿气侵袭人体则伤害皮肉关节。注释说:湿邪从下部受入,先进入皮肉,湿气流注关节则损伤筋脉,筋脉受伤则肝脏也受累患病。此症由皮肉化生虫子导致十指断裂毁坏,无关节处肌肉,又感受肝木之气,化生出绿毛卷曲的虫子,这正是经文中所说的东方生木,木生风,在脏属肝,其虫为毛虫。所谓毛虫,呈现森然之象,所以有此形态,因此病名血余。因为肝藏血,所得肝之余气,而生出毛虫。然而为何不生其他颜色而独生绿色?大概脾属土,其色黄,肝属木,其色青,青黄二气相互感应,便生成这种颜色。茯苓补脾利湿,胡黄连清肝木之热,使木气平和脾气强健,则病症自愈。
又记载:有人患四肢关节脱位,仅有皮肤相连,不能活动,名叫“筋解”。用酒浸泡黄芦三两,经过一夜,取出焙干研为末,每次服用二钱,用酒调服,服完即安。
〔沈源按〕此症四肢关节脱位,仅有皮肤相连,是因为四肢筋脉痿废而不用,所以称为筋解。“解”的意思是筋脉解散,不堪任用。然而痿证有虚痿和实痿之分,刘河间说:四肢不能举动,俗称为瘫缓。所以经文所说脾太过,则令人四肢不能举动。又说:土太过则敦阜。阜是高耸的意思,敦是浓厚的意思,既浓厚又高耸,则需要去除,这真是所谓的膏粱之疾(饮食肥甘厚味所致的疾病),治疗应当泻下,令气弱阳衰,土气平和而痊愈。或者选用三化汤、调胃承气汤,若脾虚则不使用。经文所说土不及则脾陷卑下,即陷坑之意,所以脾病导致四肢不能举动。四肢都禀受胃气,但不能直达经脉,必须依赖脾,才能受纳禀受?如今脾病,不能与胃共同运行津液,四肢得不到水谷之气的滋养,气日渐衰弱,脉道不利,筋骨肌肉都没有气以生长,所以不能使用。治疗可用十全散,或加减四物汤,去邪留正。我考察《内经》,五脏都能使人发生痿证,而河间唯独强调治脾。《内经》又说:论言治痿者,独取阳明。阳明是五脏六腑之海,主要滋润宗筋,宗筋主要约束骨骼而利于关节运动。冲脉是经脉之海,主要渗透灌溉溪谷,与阳明合于宗筋,阴阳总汇于宗筋,会合于气街穴,而阳明为之长,都隶属于带脉,并联络于督脉,所以阳明虚则宗筋松弛,带脉不牵引,故足痿不能用。问:如何治疗?答:各补其荣穴而通其输穴,调其虚实,和其逆顺,筋脉骨肉各以其时受月(受气时月,如肝旺于甲乙日,心旺于丙丁日等),则病就好了。
又记载:有人两足心凸肿,上面生黑豆疮,硬如钉子,胫骨生碎孔,内部骨髓流出,身体发寒颤,只想饮酒。这是肝肾冷热相吞。用炮制的川乌头外敷,内服韭子汤有效。
又记载:有人忽然发作寒热,数日不止,四肢坚硬如石,敲击有钟磬声,日渐消瘦恶形。用吴茱萸、木香等分,煎汤服用自愈。
〔沈源按〕此症为寒邪客居于少阳,少阳与厥阴互为表里,在三阳经尽处,阳尽则阴生,所以有寒热往来。厥阴在三阴经尽处,阴尽则阳接,所以有寒热胜复。此症由阴胜而不能外复于阳,至邪气横逆于脾,厥阴失去健运之职,所以四肢全部坚硬如石,即经文所说的“寒以坚之”。敲击声音如钟磬,乃是土音,大概脾属土,其音为宫,宫音沉重宏大,所以声音如此。凡是脾土之音,非火不发,非郁亦不发,犹如天地元阳之气,郁结于下而后向外通达,通达则雷声自内而出。大概脾土被寒邪郁结,敲击则筋脉自然相应而发声,至于四肢日渐消瘦恶形,是因为脾病不能滋养肌肤的缘故。然而治病当求其本,用吴茱萸直入肝脏,驱逐深寒;再用木香疏通壅滞之气,使气通寒散,则木气平和土气安宁,而病自愈。
有人问:邪气进入厥阴,因阴胜而阳气下不能回复,邪气横逆脾土,应当必然呕吐腹泻,为何没有呢?我说:脾土虽然困顿,但气机尚能内部发动,所以敲击就有声音相应而出,即《易经》所说的坤至柔而动也刚,所以没有这种祸患。然而这种声音是因为寒郁不能自达,所以必须敲击才有声音,也如同土器中有气一样,有气的器皿,用铁物敲击,火自内而出,这就是气。大概气闭郁在寒体之中,必须敲击则气机内部发动,而声音发于外部。如果没有火就没有气,没有气就不鸣响,想要明白此病,应当以气击而有声来考察。
又问:土器有声者,敲击随即随所击之处而发出,若脾土深居于内,虽有筋脉相应,恐怕未必能随所击而发音。我说:脾土之音,敲击声音发出,犹如琴声相应。大概琴没有体,则弦不鸣,拨动其弦,则随即应和。明了器物是这样,便知道此病所击之声了。
又问:土器有气则鸣,则木中有火,难道不是气吗,为何只出声而不鸣响呢?我说:你不明白器物作为本质,区分五音之声,并非以气来凭借。就像木为器物,其音为角,角音调畅而直,所以声音如此。我所说的土器有声者,叩击则鸣,若以五音论之,则是收宫音之声,无气便无此音,岂可一概以气论之呢?若以气论之,即钟鼓等音也是宫音,难道有气吗?
又问:钟鼓二器,固然无声,为何无气之器,反而鸣响而且远呢?我说:钟虽无气,内有脉道,音从脉道而行,所以得鸣响而且远。所以五金切之则光亮,折之则参差不齐,这是根据脉路所分,所以不平而齐。乃五金之中,只有锡铅无声,因为柔软而不刚的缘故。若论鼓,不过是因急迫而有声,并非有气而有脉道,鼓声其音走内,若下面覆盖皮,敲击以应其下,所以也鸣响而且远,否则声音浅而不远。
《奇病方》记载:有人指缝流血不止,有虫子如蜉蝣般小钻出,片刻后就能飞去。此症乃湿热生虫,然而为何能飞呢?大概湿热更感风邪,凡虫感风,即有翼能飞。虫在人身,得风之气,所以也能飞。方用黄芪、熟地、薏苡仁各五钱,当归、白芍、茯苓、白术各三钱,人参、柴胡、荆芥、川芎各一钱,水煎服,四剂而愈。此方全不在杀虫,而只是补气血,佐用去湿去风,盖人身气血调和,则虫自灭的缘故。
又记载:有人患手足脱落,而人仍不死,这是伤寒之时,口渴过饮凉水,以救一时之渴,谁知水停腹内,不能一时分消,遂致四肢受病,气血不行,久而手足先烂,手指与脚趾堕落,或脚趾堕落之后,又烂脚板,久之连脚也堕落矣。若有伤寒口渴,过饮冷水者,愈后倘若手足指出水,急用此方可救指节、脚板的堕落。方用薏苡仁三两,茯苓二两,肉桂一钱,白术一两,车前子五钱,水煎服,一连十剂,小便大利,而手脚不出水了。
又记载:有人患脚板中色红如火,不可落地,又不是痰毒,终岁经年不愈。此病因用热药,立即行房事,火聚脚心而不散,所以经久不肯愈。法当用内药消之。若作外治,必先烂去脚板。煎服祛火丹十剂自消,二十剂痊愈。然而须忌房事三月,否则必发,发则死矣,慎之哉。
又记载:有人患指甲尽行脱下,不痛不痒。这是肾经火虚,又在行房之后,用凉水洗手,遂成此病。方用六味地黄汤,加柴胡、白芍、骨碎补,治之而愈。
又记载:有人患掌中忽然高起一寸,不痛不痒,这是阳明经之火不散,而郁于手。理痛痒而不痛痒,不仅是火郁于腠理,而且水壅于皮毛,法当用外药消之。大概阳明火盛,必然作渴引饮不休,而又不渴,是胃中之火尽散,流毒于掌中。必定其人阳明之火盛,手按于床席之上,刻意行房,过于用力,使掌上之气血不行,久而突突而高,不痛不痒,乃成死肉矣。方用附子一个,煎汤以手渍之,至凉而止,如是者十日,必然作痛,再渍必然作痒,又渍而高者平矣。盖附子大热之物,无经不入,虽用外渍,无不内入者也。倘若以附子作汤饮之,则周身俱热,又引动胃火,掌肉不消,而内症蜂起,故用以外治而愈者也。或在附子汤中,再加轻粉一分,引入骨髓,更为奇效耳。
又记载:有人脚肚之上,忽然长一大肉块,似瘤非瘤,似肉非肉,按之痛欲死。这是脾经湿气,结成此块,而中又带火不消,所以手不可按,按之痛欲死。法宜峻补,宜峻补脾气,而分消其湿为是。然而外长怪肉,若在内一时消之,恐不能愈,当用内外夹攻之法。内服消湿化怪汤二剂后将,消块神丹敷患处,一日即消,神效之极也。
又记载:有人足上无故忽然毛孔标血如一线者,流而不止即死。急以米醋三升,煮滚热,以两足浸之,即止血,后用人参一两,当归三两煎,穿山甲一片,火炙为末,调饮,即不再发此症。乃酒色不禁,恣意纵欲所致,当速治之。
又记载:有人脚板上忽然生一指,痛不可忍者,乃湿热之气结成。用消指散,以刀轻刺出血,刺在生出指上,实时出水,敷在血流之处,随出随掺,以血尽力度,至三日可不流水矣,而痛亦少止。再以化水汤煎服,四剂可全愈,而指尽化为水矣,外用生肌散敷之,加膏药掩之即愈。
程山孺文见一人忽然手生丫枝,痛不可忍。一医用通草为末,以鸡蛋清涂调,即消。
《奇效方》记载:有人患手足发指毒,痛不可忍者。用壁间蜂窠为末,入乳香少许,研匀,以醋调涂,干即以醋润之。
《华佗别传》记载:有人手上皮上现蛇形一条,痛不可忍。此蛇乘人之睡,而作交感于人身,乃生此怪病,服汤药不效。以刀刺之,出血如墨汁,外用白芷为末掺之稍愈,明日又刺,血如前,又以白芷末掺之,二三次化去其形,先刺头后刺尾,不可乱也。
张杲《医说》载《摭青杂记》云:有人患脚疮,冬月顿然无事,夏月臭烂,痛不可言。遇一道人说:你因行草上,惹蛇交遗沥,疮中有蛇儿,冬伏藏,故疮至冬无恙,夏出行,故至夏臭烂。急以生虾蟆捣敷之,一日三换,凡三日一小蛇自疮中出,以铁钳之,其疮遂愈。
又记载:凡人冬月向火,火气入内,致两股生疮,其汁淋漓不止,世莫能识。用黄柏末掺之立愈。一妇病此,人无识者,亦用此而愈。
李楼《怪症方》记载:有一女年十四,腕软处生物,如黄豆大,半在肉中,红紫色,痛不可忍,诸药不效。一方士以水银四两,白棉纸二张揉熟,蘸水银擦之,三日自落而愈。
《本事方》记载:唐时有一商人,左膊上有疮,生如人面,亦无他苦。商人戏以酒滴口中,其面色赤,以物食之亦能食,多则膊肉胀起,或不食则一臂痹焉。有名医教其历试诸药,悉无所苦,进至贝母其疮乃聚眉闭目,商人喜因以小苇筒毁其口灌之,数日成痂遂愈。然不知何疾也,《本经》言是金疮,此岂金疮之类欤?
《肘后方》记载:有人患手指赤色,随月生死。以生薤一把苦酒煮熟,捣烂涂之,疾乃止。
〔沈源按〕此症由寒邪逆于肉理,营气不从,血凝不行,留于脉络之间,以随人之气血盛衰,而隐现其血之色也。《内经》有云:天温日明则人血淖溢,而卫气浮,故血易泻,气易行,天寒日阴则人血凝泣,而卫气沉,月始生则血始精,卫气始行,月郭满,则血气实,肌肉坚,月郭空,则肌肉减。经络虚,卫气去,形独居,是以因天时而调血气也。以此推之,月始生则气血初盛,赤色亦随气外浮,以渐而生也。郭满则血气充实,故色悉现于外,郭空则气血衰而经络虚,卫气去而形独居(犹日魂去而月魄独居也),故又渐隐于内也,于是则知所患赤色,故有随月生死耳。薤白辛温散血散气,更用苦酒以作向导,使气散血行则寒自灭,故捣涂而愈。
《太原故事》记载:徐之才治一人患脚根肿痛,诸医莫能识。徐曰:此蛤精疾也,由乘舟入海垂脚水中。疾者曰:实曾如此。之才为剖得蛤二枚,大如榆荚。
邓氏《笔峰方》记载:有人患脚底木硬。以牛皮生姜汁化开,调南星末涂上,烘物熨之。
〔沈源按〕此症为肾脏受寒,营气凝而不行,以成此疾,即《内经》所谓皮肤不营故为不仁,又曰:北方生寒在气为坚是也。
道士王裕说:有忽然患脚心如中箭,痛苦无奈,发歇不时,此肾之风毒,泻肾愈。
《南宫从岣嵝神书》记载:南方地卑湿,人多患足疮,岁久生虫如蛭而出,乃风毒攻注而然。用牛肚或羊肚或猪去粪不洗,研如泥,看疮大小,入矾半两,涂帛上贴之,须臾疮痒入心,徐徐连帛取下,火上炙之,中出如丝发毛尾千万,或青白赤黑,以汤洗之,三日一作,不过数次,虫尽疮愈。
《翰林丛记》记载:李定言石藏用良医也,有人承檐溜浣手,觉物入爪甲,初若丝发,数日如线,伸缩不能,始悟其龙伏藏也。乃叩藏用求治,藏用曰:方书无此,以意求之耳。螳螂为末涂指,庶免震厄,其人如其言,后有雷火绕身,急针挑之,果见一物跳出,亦不为灾。
《霏雪录》记载:山东民间妇人,一臂有物隐然,屈曲如蛟龙状,妇喜以臂浸水中,一日雷电自牖出,臂果一龙擘云而去。
蔡元长知开封正据案治事,忽如有虫自足心行至腰间,即坠笔晕绝,久之方醒。据吏云:此病非俞山人不能疗,驱使召之,俞曰:此真香港脚也。法当灸风市,为灸一壮,蔡晏然复常,明日病如初,再召,俞曰:除病根非千艾不可。从其言,灸五百壮,自此遂愈。
《名医录》记载:学究任道,患腿间疮肿黑,状狭而长。北医王通曰:此鱼脐疮也,一因风毒蕴结,二因误食人汗而然。乃以一异散敷之,数日而愈。恳求其方,曰:但雪玄一味耳,任遍访无知之者。有名医郝允曰:《圣惠方》治此,用腊猪头烧灰,鸡卵白调敷,即此也。
张子和治新寨马叟,年五十九,因秋欠税,官杖六十,得惊气成风搐,已三年矣。病大发则手足颤掉,不能持物,
Xia Ziyi recorded in *Qi Ji Fang* (Strange Disease Formulas): There was a person whose ten fingers on hands and feet had broken joints, with only tendons connecting them, lacking the flesh at the joints. Worms emerged like rush pith, several inches long, and the whole body grew green curly hair. This disease is named "Xue Yu" (Blood Remnant).
Decocting Poria (Fuling) and Coptis Chinensis Rhizome (Huhuanglian) to drink will lead to self-healing.
[Shen Yuan's Note] The *Classic of Internal Medicine* (*Neijing*) states: Spleen heat generates muscle flaccidity (Rou Wei), and the symptom of muscle flaccidity is yellowish skin color with muscle twitching. It also states: Dampness from the earth, when it affects the human body, harms the skin, flesh, and joints. The annotation says: Dampness enters from the lower part, first entering the skin and flesh; if dampness flows into the joints, it damages the tendons and vessels; once the tendons and vessels are damaged, the Liver also suffers disease. This condition arises from flesh transforming into worms, causing the ten fingers to break and lack joint flesh, and further being affected by the Qi of Liver Wood, generating green-haired curly worms. This corresponds to the scripture saying that the East generates Wood, Wood generates Wind, and in the Zang organs, it belongs to the Liver, and its worm is the hairy worm. The so-called hairy worm presents a dense appearance, hence this form, thus the disease name "Xue Yu". Because the Liver stores Blood, obtaining the residual Qi of the Liver generates the hairy worm. However, why does it not generate other colors but exclusively green? Presumably, the Spleen belongs to Earth, its color is yellow; the Liver belongs to Wood, its color is blue-green. When the blue-green and yellow Qi interact, this color is generated. Poria tonifies the Spleen and promotes dampness drainage; Coptis Chinensis Rhizome clears the heat of Liver Wood, making the Wood Qi peaceful and the Spleen strong, thus the condition heals itself.
It is also recorded: A person suffered from dislocation of the joints of the four limbs, connected only by skin, unable to move. This is named "Jin Jie" (Tendon Dissolution). Soaking three taels of Phellodendron Bark (Huanglu) in wine for one night, taking it out, drying it over fire, grinding it into powder, taking two qian each time, mixed with wine and swallowed, brings peace upon completion.
[Shen Yuan's Note] In this condition, the joints of the four limbs are dislocated, connected only by skin, because the tendons and vessels of the four limbs are flaccid and unusable, hence called "Jin Jie". "Jie" means the tendons and vessels have dissolved and cannot be used. However, flaccidity has deficiency flaccidity and excess flaccidity. Liu Hejian said: Four limbs unable to move is commonly known as paralysis and laxity. Thus, the scripture says: If the Spleen is excessive, it causes people's four limbs to be unable to move. It also says: If Earth is excessive, it becomes Dun Fu (high and thick). Fu means high, Dun means thick. Since it is both thick and high, it must be removed. This is truly what is called the disease of rich food and fine drinks (Gao Liang Zhi Ji), and the treatment should be purging, making the Qi weak and Yang decline, until Earth Qi is peaceful and recovery occurs. One may select San Hua Tang or Tiao Wei Cheng Qi Tang for use; if the Spleen is deficient, do not use them. The scripture says: If Earth is insufficient, the Spleen sinks low, meaning a pit. Thus, Spleen disease causes four limbs to be unable to move. The four limbs all receive Qi from the Stomach, but cannot reach the meridians directly; they must rely on the Spleen to receive it. Now, due to Spleen disease, it cannot transport fluids together with the Stomach; the four limbs do not receive water and grain Qi, Qi declines daily, vessel pathways become unfavorable, sinews, bones, muscles, and flesh have no Qi to grow, hence they are unusable. Treatment can use Shi Quan San, or modified Si Wu Tang, eliminating evil while preserving righteousness. I examined the *Neijing*, which states that the five Zang organs can cause flaccidity, yet Hejian alone emphasizes treating the Spleen. The *Neijing* also says: Discussions on treating flaccidity emphasize solely selecting the Yangming. Yangming is the sea of the five Zang and six Fu organs, primarily moistening the Zong Jin (major tendons); Zong Jin primarily binds bones and facilitates joint movement. The Chong Mai (Penetrating Vessel) is the sea of the meridians, primarily seeping and irrigating the valleys, combining with Yangming at the Zong Jin. Yin and Yang converge at the Zong Jin, meeting at the Qichong point, with Yangming as their leader, all belonging to the Dai Mai (Belt Vessel), and connecting to the Du Mai (Governing Vessel). Thus, Yangming deficiency leads to Zong Jin laxity, and the Dai Mai fails to draw, resulting in foot flaccidity and inability to use. Question: How to treat? Answer: Tonify each Ying (Nutrient) point and unblock each Shu (Transport) point, regulate their deficiency and excess, harmonize their reversal and smooth flow. For sinews, vessels, bones, and flesh, treat according to their respective months of receiving Qi (e.g., Liver prospers on Jia/Yi days, Heart on Bing/Ding days), then the disease will end.
It is also recorded: A person had convex swelling on both soles of the feet, with black bean-like sores growing on top, hard as nails, fragmented holes in the tibia bone with marrow flowing out, shivering chills in the body, and only desiring to drink alcohol. This is the swallowing of cold and heat between the Liver and Kidney. Applying processed Sichuan Aconite Root (Chuan Wutou) externally and drinking Leek Seed Decoction internally is effective.
It is also recorded: A person suddenly developed alternating chills and fever that did not stop for several days, limbs hard as stone, producing bell and chime sounds when struck, gradually becoming emaciated and ugly. Equal parts of Evodia Fruit (Wuzhuyu) and Costus Root (Muxiang) decocted and drunk leads to self-healing.
[Shen Yuan's Note] This condition is caused by Cold Evil lodging in Shaoyang. Shaoyang and Jueyin are exterior-interior pairs. At the end of the Three Yang meridians, Yang ends and Yin begins, hence the alternating chills and fever. At the end of the Three Yin meridians, Yin ends and Yang connects, hence the victory and recurrence of chills and fever. This condition arises from Yin excess failing to return outward to Yang, leading to evil invading the Spleen horizontally. Jueyin loses its function of healthy transportation, so all four limbs become hard as stone, which is what the scripture calls "Cold solidifies." The sound of striking resembling bells and chimes is the Earth tone. Presumably, the Spleen belongs to Earth, its tone is Gong (Palace), which is heavy and grand, hence the sound. Any Spleen Earth tone requires Fire to emit, and requires stagnation to emit, just like the primal Yang Qi of heaven and earth, which is stagnant below and then reaches outward; when it reaches, thunder sounds from within. Presumably, Spleen Earth is depressed by Cold; striking causes the tendons and vessels to respond and make sound. As for the gradual emaciation of the four limbs, it is because Spleen disease fails to nourish the skin and flesh. However, treating disease requires seeking the root. Using Evodia Fruit to enter the Liver directly drives out deep Cold; using Costus Root to unblock stagnant Qi allows Qi to flow and Cold to scatter, making Wood peaceful and Earth secure, thus healing.
Someone asked: Evil enters Jueyin, due to Yin excess and Yang failing to return downward, evil invades Spleen Earth horizontally; there should surely be vomiting and diarrhea, why is there none? I say: Although Spleen Earth is troubled, its Qi mechanism can still move internally, so striking produces corresponding sound, as stated in the *I Ching*: Kun is extremely soft yet moves with strength, hence no such disaster. However, this sound exists because Cold depression prevents self-reach, so striking produces sound, similar to Earth vessels having Qi. An instrument with Qi, when struck with iron, fire emerges from within; this is Qi. Presumably, Qi is closed and depressed within the Cold body; striking activates the internal Qi mechanism, emitting sound externally. Without Fire, there is no Qi; without Qi, there is no ringing. To understand this disease, one should observe it through the analogy of Qi striking and producing sound.
Another question: Earth vessels with sound produce it immediately upon striking where hit. If Spleen Earth resides deeply inside, although tendons and vessels correspond, perhaps it cannot produce sound following the strike. I say: The sound of Spleen Earth upon striking is like the resonance of a lute. If a lute has no body, strings do not ring; plucking the string causes immediate response. Understanding instruments this way reveals the sound produced by striking this disease.
Another question: Earth vessels with Qi ring; thus, wood contains Fire, which is not Qi? Why does it only make sound without ringing? I say: You do not understand the instrument as substance, distinguishing the five tones, which are not based on Qi. For example, wood as an instrument has the tone Jue (Ang), which is melodious and straight, hence the sound. What I mean by Earth vessels having sound is that knocking produces ringing. If analyzed by five tones, it is the sound of Gong (Palace). Without Qi, there is no such tone; how can it generally be discussed as Qi? If discussed as Qi, then bells and drums are also Gong tones; do they have Qi?
Another question: Bells and drums naturally have no sound; why do Qi-less vessels ring loudly and far? I say: Although bells have no Qi, they have internal pulse pathways; sound travels along these pathways, hence ringing far. Thus, cutting metals makes them shiny; breaking them results in uneven edges, divided by pulse paths, hence uneven. Among the five metals, only Tin and Lead have no sound because they are soft and not rigid. Regarding drums, sound arises from urgency, not from Qi or pulse pathways. Drum sound travels inward; if covered with skin below, striking responds below, hence ringing far; otherwise, sound is shallow and not far.
*Qi Bing Fang* records: A person's finger webs bled incessantly, with small worms like mayflies drilling out, able to fly away shortly after. This condition is caused by Damp-Heat generating worms. But why can they fly? Presumably, Damp-Heat combined with Wind Evil. All worms sensing Wind gain wings and can fly. Worms in the human body obtain the Qi of Wind, hence they can also fly. The formula uses Astragalus Root (Huangqi), Prepared Rehmannia Root (Shudi), and Coix Seed (Yiren) each 5 qian; Angelica Sinensis Root (Danggui), White Peony Root (Baishao), Poria (Fuling), and Atractylodes Macrocephala Rhizome (Baizhu) each 3 qian; Ginseng (Renshen), Bupleurum Root (Chaihu), Schizonepeta Spike (Jingjie), and Ligusticum Chuanxiong Rhizome (Chuanxiong) each 1 qian. Decoct in water and take orally. Four doses cure it. This formula does not focus on killing worms but merely tonifying Qi and Blood, assisting with draining Dampness and expelling Wind. When human Qi and Blood are harmonious, worms extinguish themselves.
It is also recorded: A person suffered from falling off of hands and feet but remained alive. This occurred during a Typhoid Fever (Shanghan) episode; thirst led to excessive drinking of cold water to relieve temporary thirst. Who knew that water would stagnate in the abdomen, unable to dissipate quickly, causing disease in the four limbs, blocking Qi and Blood circulation. Over time, hands and feet rotted first, fingers and toes fell off. Or after toes fell off, the soles rotted. Eventually, even the feet fell off. If one has Typhoid Fever with thirst and drinks excessive cold water, and after recovery, fluid oozes from fingers and toes, urgently use this formula to save the finger joints and soles. The formula uses Coix Seed 3 liang, Poria 2 liang, Cinnamon Twig (Rougui) 1 qian, Atractylodes Macrocephala Rhizome 1 liang, Plantago Seed (Cheqianzi) 5 qian. Decoct in water and take orally for ten consecutive doses. With profuse urination, the oozing from hands and feet stops.
It is also recorded: A person suffered from red-hot soles of feet, unable to touch the ground, not phlegm-toxin, lasting years without healing. This condition resulted from using hot medicines and immediately engaging in sexual intercourse, causing Fire to gather in the soles and not dissipate, hence chronic non-healing. The method should use internal medicine to resolve it. If external treatment is used, the sole must rot away first. Decocting and drinking Qu Huo Dan (Fire-Quenching Pill) for ten doses resolves it spontaneously; twenty doses bring full recovery. However, sexual abstinence for three months is required; otherwise, it will recur, and recurrence leads to death. Be cautious.
It is also recorded: A person's fingernails all fell off, without pain or itching. This is due to deficient Fire in the Kidney Meridian, followed by washing hands with cold water after sexual intercourse, resulting in this disease. The formula uses Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), adding Bupleurum Root, White Peony Root, and Drynaria Rhizome (Gusuibu). Treatment leads to recovery.
It is also recorded: A person's palm suddenly rose one cun high, without pain or itching. This is Fire of the Yangming Meridian not dispersing, but stagnating in the hand. Addressing pain/itchlessness indicates not only Fire stagnating in the couli (interstices) but also Water obstructing the skin and hair. The method should use external medicine to resolve it. Presumably, Yangming Fire excess causes constant thirst and drinking; if not thirsty, it means Stomach Fire has dispersed, flowing poison into the palm. Likely, the person had Yangming Fire excess, pressed hands on the bed/mat, intentionally engaged in intercourse with excessive effort, causing Qi and Blood in the palm to stagnate. Over time, it bulged up, painless and itchless, becoming dead flesh. The formula uses one Aconite Lateralis Preparata Radix (Fuzi), decocted in water to soak the hand until cool, stopping. Doing this for ten days inevitably causes pain; soaking again causes itching; further soaking flattens the elevation. Presumably, Aconite is a great heat substance, entering no meridian it does not penetrate; even used externally, it enters internally. If taken as a decoction, the whole body heats up, stirring Stomach Fire, palm flesh does not resolve, and internal symptoms arise蜂起 (swarm up). Hence, external treatment achieves cure. Alternatively, adding one fen of Calomelas (Qingfen) to the Aconite decoction introduces it to the bone marrow, yielding miraculous effects.
It is also recorded: A large fleshy lump suddenly grew above the calf, looking like a tumor but not, like flesh but not, painful to touch. This is Spleen Meridian Dampness condensing into this lump, carrying Fire that does not dissipate, hence painful to touch. The method should strongly tonify, specifically tonifying Spleen Qi and dispersing Dampness. However, external strange flesh, if resolved internally instantly, may not heal. An internal-external attack method is needed. Internally take Xiao Shi Hua Guai Tang (Dampness-Dispersing Strange-Lump Resolving Decoction) for two doses, then apply Xiao Kuai Shen Dan (Lump-Resolving Divine Pill) to the lesion. It resolves in one day, extremely miraculous.
It is also recorded: Suddenly, blood spurts from pores on the foot like a thread, flowing incessantly leads to death. Urgently boil three sheng of rice vinegar until hot, soak both feet, stopping bleeding immediately. Then decoct one liang of Ginseng and three liang of Angelica Sinensis Root with one slice of Pangolin Scale (Shanjiapia), roasted and powdered, mixed with liquid and drunk. The condition never recurs. This is caused by unrestrained alcohol and sexual desire; treat urgently.
It is also recorded: A sudden finger-like growth appeared on the sole, unbearable pain, formed by Damp-Heat Qi condensation. Use Xiao Zhi San (Finger-Resolving Powder), lightly prick with a knife to bleed, pricking the grown finger. Fluids emerge immediately; apply to the bleeding area, sprinkling powder as fluid comes out, continuing until blood stops. After three days, fluid secretion ceases, and pain lessens. Then decoct and drink Hua Shui Tang (Water-Transforming Decoction) for four doses for full recovery, the finger transforms entirely into water. Externally apply Sheng Ji San (Flesh-Generating Powder) and cover with plaster for healing.
Cheng Shanru Wen saw a person suddenly grow a branch-like growth on the hand, unbearable pain. A doctor used Akebia Caulis (Tongcao) powder mixed with egg white applied, resolving it immediately.
*Qi Xiao Fang* records: A person suffered from toxic inflammation of hands and feet, unbearable pain. Use hornet nests from walls, powdered, add a little Frankincense (Ruxiang), grind evenly, mix with vinegar to apply. When dry, moisten with vinegar.
*Hua Tuo Bie Zhuan* records: A snake-shaped mark appeared on the skin of a hand, unbearable pain. This snake took advantage of sleep to interact with the body, causing this strange disease. Herbal decoctions were ineffective. Prick with a knife, bleeding like ink. Externally apply Angelica Dahurica Root (Baizhi) powder, slightly improving. Next day, prick again, blood as before, apply Baizhi powder again. Two or three times dissolve the shape. Prick head first, then tail, do not confuse.
Zhang Gao's *Yi Shuo* cites *Zhi Qing Za Ji*: A person suffered from foot sores, silent in winter, foul and rotten in summer, unbearable pain. Met a Daoist who said: You walked on grass, attracting snake mating residue; there are snake babies in the sore. They hide in winter, hence safe; they emerge in summer, hence rotten. Urgently crush fresh toad and apply, changing three times a day. Within three days, a small snake emerges from the sore; clamp it with iron tongs, the sore heals.
It is also recorded: Anyone warming by fire in winter, fire Qi enters internally, causing sores on both thighs, dripping fluid incessantly, unrecognized by the world. Apply Phellodendron Bark (Huangbai) powder, curing immediately. A woman suffered this, unrecognized by others, also cured by this.
Li Lou's *Guai Zheng Fang* records: A fourteen-year-old girl had a growth at the soft wrist, soybean-sized, half in flesh, red-purple, unbearable pain, all medicines ineffective. A practitioner used four liang of Mercury, rubbed with two sheets of white cotton paper, dipped in mercury and rubbed on it. It fell off naturally in three days, curing her.
*Benshi Fang* records: During the Tang Dynasty, a merchant had a sore on his left upper arm, growing like a human face, with no other suffering. The merchant jokingly dripped wine into its mouth; its face turned red. Feeding it objects, it could eat; too much caused arm swelling; not eating caused arm numbness. A famous doctor taught him to test various medicines; none caused harm. When administered Fritillaria Bulb (Beimu), the sore knit eyebrows and closed eyes. The merchant joyfully destroyed its mouth with a small reed tube and poured it in. Scabs formed in a few days, curing it. Unknown what disease it was; *Ben Jing* says it is a metal wound; is this a type of metal wound?
*Zhou Hou Bei Ji Fang* records: A person's fingers were red, rising and falling with the moon. Boil a handful of raw Scallion Bulb (Xie) in sour wine, mash and apply, the disease stops.
[Shen Yuan's Note] This condition is caused by Cold Evil reversing into the meat texture, Ying Qi not following, blood coagulating and not moving, remaining in the vessel pathways, appearing and disappearing with the rise and fall of human Qi and Blood, showing the color of blood. The *Neijing* says: When weather is warm and sunny, human blood overflows, and Wei Qi floats, so blood is easily discharged, Qi moves easily. When cold and cloudy, blood coagulates, Wei Qi sinks. When the moon begins to wax, blood becomes refined, Wei Qi begins to move. When the moon is full, Qi and Blood are substantial, muscles firm. When the moon wanes, muscles reduce. Meridians are empty, Wei Qi departs, form stands alone. Thus, adjust Qi and Blood according to heavenly timing. Inferring from this, when the moon begins to wax, Qi and Blood initially prosper, red color floats outward with Qi, gradually arising. When full, Qi and Blood are substantial, so color appears externally. When waning, Qi and Blood decline, meridians empty, Wei Qi departs, form stands alone (like Sun Soul departing and Moon Soul standing alone), so it gradually hides internally. Thus, knowing the afflicted red color rises and falls with the moon. Scallion Bulb is pungent and warm, dispersing blood and Qi; sour wine acts as a guide, allowing Qi to scatter and Blood to move, Cold extinguishes itself, hence mashing and applying cures.
*Taiyuan Gushi* records: Xu Zhicai treated a person with swollen and painful heels, unrecognized by other doctors. Xu said: This is a clam spirit disease, caused by dipping feet in seawater while boating. The patient said: Indeed, it happened so. Zhicai dissected and found two clams, size of elm seeds.
Deng's *Bifeng Fang* records: A person had wooden hardness on the soles. Melt cowhide with ginger juice, mix with Arisaema Rhizome (Nanxing) powder, apply, and iron with heated object.
[Shen Yuan's Note] This condition is Kidney Cold, Ying Qi coagulating and not moving, forming this disease, which is what the *Neijing* calls "skin not nourished leads to insensitivity," and also "North generates Cold, in Qi it is hardness."
Daoist Wang Yu said: Suddenly suffering from soles feeling like arrow strikes, unbearable pain, irregular onset, this is Kidney Wind-Toxin, draining the Kidney cures it.
*Nangong Cong Julou Shenshu* records: The South is low and damp; many suffer from foot sores, years later generating worms like leeches emerging, caused by Wind-Toxin attacking. Use beef tripe, sheep tripe, or pig tripe (without washing off feces), grind to mud. Depending on sore size, add half liang of Alum (Fan), apply on cloth and paste. Soon, sore itching enters the heart; slowly remove cloth with it, roast over fire. Thousands of silk-hair-like tails emerge, green, white, red, or black. Wash with water. Do this every three days, not exceeding several times; worms exhaust, sore heals.
*Hanlin Congji* records: Li Ding spoke of Shi Zangyong, a good doctor. Someone washed hands under eaves drip, felt something enter nail beds, initially like silk/hair, days later like a thread, unable to extend/retract, realized a dragon hid there. Knocked on Zangyong for treatment. Zangyong said: Medical books have no record, seek by intuition. Grind mantis into powder, apply to finger, hopefully avoiding lightning disaster. The person followed advice. Later, lightning fire surrounded body; urgently needle-picked, indeed saw an object jump out, no disaster ensued.
*Feixue Lu* records: A folk woman in Shandong had a hidden lump on one arm, curved like a dragon. She liked immersing her arm in water. One day, lightning came from window; indeed, a dragon split clouds and left from the arm.
Cai Yuanchang, Prefect of Kaifeng, was working at his desk when suddenly a bug crawled from sole to waist, dropping pen and fainting. Recovered after a long time. Clerk said: Only Scholar Yu can treat this. Summoned Yu. Yu said: This is true Hong Kong Foot (Gout/Cramp). Method: Moxibustion on Fengshi (GB31). One moxa cone applied, Cai returned to normal calmly. Next day, relapse. Summoned again. Yu said: Removing root requires thousand moxa cones. Followed advice, applied five hundred cones, healed since.
*Ming Yi Lu* records: Scholar Ren Dao suffered from black swollen sore between legs, narrow and long. Northern Doctor Wang Tong said: This is Fish Umbilicus Sore, caused by Wind-Toxin accumulation and accidental ingestion of human sweat. Applied Yi Yi San (Unique Powder), cured in days. Begged for formula. Said: Only Xue Xuan (Snow Black? likely referring to a specific ingredient or alias, context implies a single herb). Ren visited widely, none knew. Famous Doctor Hao Yun said: *Sheng Hui Fang* treats this with ash of cured pig head mixed with chicken egg white applied, which is it.
Zhang Zihe treated Old Ma of Xinzhai, age 59. Due to autumn tax arrears, beaten sixty times by officials, obtained shock Qi becoming wind convulsion, already three years. Severe attacks caused hand and foot trembling, unable to hold objects,