治香港脚,足胫肿痛,憎寒壮热。(香港脚自外感得者,山岗雨水,或履湿热之地。自
得者,生冷茶酒,油面湿热之毒。有湿有热。湿性下流,故注于足。湿热分争,湿胜则
热胜则壮热。有兼头痛诸证者,状类伤寒,但胫肿掣痛为异尔。此病忌用补剂及淋洗
热得补增剧也,亦不宜大泻,治之喜通而恶寒。若香港脚冲心,喘急不止,呕吐不休者
凌火故也。先痛而后肿者,气伤血也。先肿而后痛者,血伤气也。筋脉弛张肿痛者
气,宜利湿疏风。卷缩枯细,不肿而痛者,名干香港脚,即热也,宜润血清燥。)
防己 木通 槟榔 生地(酒洗) 川芎 白术(炒) 苍术(盐炒) 黄柏(酒炒) 甘
草梢 犀
小便赤
防己行水疗风,泻下焦之湿热。槟榔攻坚利水,坠诸药使下行。木通降心火,由小肠出。
草
由
治寒湿在脾,泄泻久不能愈者。
真茅山苍术(米泔浸一宿。切炒。如无。即以好白术代之。八两。)
破故纸(酒浸晒干炒) 白芍(炒黄四两) 浓朴(姜汁炒) 云苓(二两) 甘草(炙)
川椒(去
汤下七八十
(内经病机一十九条独遗燥气,他凡秋伤于燥,皆谓秋伤于湿。历代诸贤,随文作解,
弗察
于寒
肝木
纪
可
试观草木菁英可掬,一乘金气,勿焉改容,焦其上首,而燥气先伤上焦华盖,岂不明耶。详
此则病机之诸气 郁,皆属于肺,诸痿喘呕,皆属于上,二条明指燥病言矣。生气通天论,
秋伤于燥,上逆而咳,发为痿厥。燥病之要,一言而终。与病机二条,适相吻合矣。要知肺
气不燥,则诸气禀清肃之令,而周身四达,亦何致恚郁耶。诸痿喘呕之属于上者,上亦指肺,
不指心也。若统上焦心肺并言,则心病不主痿喘及呕也。惟肺燥甚,则肺叶痿而不用,肺气
逆而喘鸣,食难膈而呕出。三者皆燥证之极者也。经文原有逆秋气,则太阴不收,肺气焦满
之文,其可称为湿病乎?其左 胁痛,不能转侧,嗌干面尘,身无膏泽。足外反热,腰痛惊
骇筋挛。丈夫 疝,妇人少腹痛,目昧 疮,则燥病之本于肝,而散见不一者也。肝脏见燥
证,固当急救肝叶,勿令焦损。然清其肺金,除其燥本,尤为先务。若肺金自病,不及于肝
,即专力救肺,焦枯且恐立至,尚可分功缓图乎。)
治疗香港脚(下肢肿痛为主的疾病),足胫部肿胀疼痛,憎恶寒冷且高热。(香港脚若由外感引起,多因山岗雨水侵袭,或行走于湿热之地所致;若由内伤引起,多因过食生冷、茶酒及油腻面食等湿热毒邪所致。病机为既有湿又有热。湿性重浊趋下,故病邪注于足部。湿热相互搏争,湿邪偏胜则局部肿胀,热邪偏胜则壮热。若兼有头痛等症状,其表现类似伤寒,但区别在于足胫肿胀牵引作痛。此病忌用补益剂及淋洗热敷,因为遇热得补会使病情加重,也不宜使用峻猛泻下法,治疗原则喜通畅而恶寒凝。若香港脚之气上冲于心,出现喘息急促不止、呕吐不休者,乃水气凌犯心火所致。先痛后肿者,为气伤及血;先肿后痛者,为血伤及气。筋脉弛缓、张肿疼痛者,属气分病变,宜利湿疏风;若筋脉卷缩、枯细,不肿而痛者,名为干香港脚,即燥热之证,宜润血清燥。)
防己、木通、槟榔、生地(酒洗)、川芎、白术(炒)、苍术(盐炒)、黄柏(酒炒)、甘草梢、犀角。主治小便赤涩。
防己能行水利湿以疗风,泻除下焦之湿热。槟榔能攻坚利水,引诸药势下行。木通能降心火,使热邪从小肠排出。
真茅山苍术(米泔水浸泡一夜,切片炒制。若无,可用优质白术代替,用量八两)、破故纸(杜仲子,酒浸晒干炒)、白芍(炒至微黄,四两)、浓朴(厚朴,姜汁炒)、云苓(茯苓,二两)、甘草(炙)、川椒(去目及闭口者)。以上药材共研细末,汤送服七八十丸。
《内经》病机十九条中唯独遗漏了燥气,其他凡言“秋伤于燥”的,都解释为“秋伤于湿”。历代贤人随文作解,未能察觉……关于寒、肝木、纪、可……试看草木精华充盈,一旦遇到金气(秋季燥气),便立刻改变容颜,枯萎于顶部,可见燥气首先损伤上焦华盖(肺),这难道还不明显吗?详细考察这一点,则病机中“诸气膹郁,皆属于肺”、“诸痿喘呕,皆属于上”这两条,明确是指燥病而言。《生气通天论》说:“秋伤于燥,上逆而咳,发为痿厥。”燥病的要点,一言以蔽之,与病机两条完全吻合。要知道肺气若不燥,则诸气禀受清肃之令,周身通达,又何致恚怒郁结呢?所谓“诸痿喘呕之属于上者”,这里的“上”也是指肺,而非指心。如果统指上焦心肺而言,则心病并不主司痿、喘及呕。只有当肺燥极甚时,肺叶痿废不用,肺气上逆而喘鸣,食物难以下咽而格拒呕吐。这三者都是燥证的极端表现。经文原有“逆秋气,则太阴不收,肺气焦满”的文字,这怎能称为湿病呢?至于左胁痛,不能转侧,咽喉干燥,面色如尘,身体无光泽,足外侧反热,腰痛惊骇,筋脉拘挛,男子疝气,女子少腹痛,目视不明,生疮等,则是燥病源于肝,散见于各处的症状。肝脏见到燥证,固然应当急救肝叶,勿令焦损。然而清除肺金之燥,去除燥之本源,更是首要任务。若肺金自病,未波及于肝,即专力救肺,若不及时,焦枯之势恐怕立即到来,哪里还能分功缓图呢?)
Treats Hongjiao (a disease characterized by swelling and pain in the lower limbs), with swelling and pain in the shins and feet, aversion to cold, and high fever. (Hongjiao acquired from external contraction is caused by mountain rain or walking on damp-heat terrain; that acquired internally is due to the toxicity of damp-heat from consuming raw/cold foods, tea, alcohol, and oily/noodle-rich diets. The pathology involves both dampness and heat. Dampness has a downward nature, so it settles in the feet. When dampness and heat contend, excess dampness leads to swelling, while excess heat leads to high fever. If accompanied by headache and other symptoms, it resembles Taiyang disease (Taiyang syndrome), but differs in that the shins swell and pull with pain. This disease contraindicates tonifying agents and hot washing/bathing, as heat and tonification exacerbate the condition; severe purgation is also unsuitable. Treatment favors unblocking and avoids cold. If Hongjiao qi rushes to the heart, causing incessant panting and vomiting, this is due to water qi attacking heart fire. Pain preceding swelling indicates qi injury affecting blood; swelling preceding pain indicates blood injury affecting qi. Flaccid tendons and vessels with swelling and pain indicate qi involvement, suitable for promoting urination to drain dampness and dispersing wind. Contracted, withered, thin tendons without swelling but with pain are named Dry Hongjiao, representing dryness-heat, suitable for moistening blood and clearing dryness.)
Fangji (Stephaniae Tetrandrae Radix), Mutong (Akebiae Caulis), Binglang (Arecae Semen), Shengdi (Rehmanniae Radix Praeparata - washed with wine), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma - stir-fried), Cangzhu (Atractylodis Rhizoma - salt-stir-fried), Huangbai (Phellodendri Cortex - wine-stir-fried), Gancao Shao (Glycyrrhizae Radix et Rhizoma tip), Xijiao (Rhinocerotis Cornu). Indicated for red urine.
Fangji promotes water metabolism and treats wind, draining damp-heat from the Lower Jiao. Binglang breaks stagnation and promotes urination, directing the action of other herbs downward. Mutong descends Heart Fire, allowing it to exit via the Small Intestine.
Treats chronic diarrhea due to Cold-Dampness encumbering the Spleen that fails to resolve.
Zhen Maoshan Cangzhu (Maoshan Atractylodis Rhizoma - soaked in rice wash overnight, sliced and stir-fried. If unavailable, use high-quality Baizhu instead, 8 liang); Pogu Zhi (Euodiae Fructus / Psoraleae Fructus contextually often Euodiae here or similar warming herb, traditionally Psoraleae corylifolia in some contexts but "Pogu Zhi" usually refers to Psoraleae Fructus/Bu Gu Zhi, however text says "Pogu Zhi", likely a variant or typo for Bu Gu Zhi, assuming Psoraleae Fructus based on common pairing, but strictly translating name: Pogu Zhi) (soaked in wine, sun-dried, stir-fried); Baishao (Paeoniae Radix Alba - stir-fried until yellow, 4 liang); Nongpo (Magnoliae Officinalis Cortex - stir-fried with ginger juice); Yunling (Poria) (2 liang); Gancao (Glycyrrhizae Radix et Rhizoma - honey-fried); Chuanjiao (Zanthoxyli Pericarpium - remove seeds and closed ones). Take 70-80 pills with decoction.
The *Neijing* (Inner Canon) lists nineteen pathogenesis clauses but omits Dryness Qi. Other texts stating "Autumn injury by Dryness" interpret it as "Autumn injury by Dampness." Past sages interpreted according to the text without examining closely... regarding Cold, Liver Wood, Era, Can... Observe how the essence of grasses and trees is abundant; once encountering Metal Qi (Autumn Dryness), their appearance changes instantly, withering at the top, clearly showing that Dryness Qi first injures the Upper Jiao Huagai (Lung). Examining this detail, the clauses "All Qi stagnation and oppression belong to the Lung" and "All flaccidity, panting, and vomiting belong to the Upper" in the Pathogenesis explicitly refer to Dryness diseases. *Shengqi Tongtian Lun* states: "Injury by Autumn Dryness causes upward rebellion with cough, developing into flaccidity and厥 (Jue/counterflow)." The essence of Dryness disease is summarized in one phrase, aligning perfectly with the two pathogenesis clauses. It must be known that if Lung Qi is not dry, all Qi receives the clear and descending command, circulating throughout the body, avoiding resentment and stagnation. The "Upper" in "Flaccidity, panting, and vomiting belonging to the Upper" refers to the Lung, not the Heart. If speaking generally of the Upper Jiao Heart and Lung, Heart disease does not govern flaccidity, panting, or vomiting. Only when Lung Dryness is extreme do the lung lobes become flaccid and non-functional, Lung Qi rebels causing panting/wheezing, food cannot pass through the diaphragm causing vomiting. These three are extreme manifestations of Dryness syndromes. The scripture originally stated: "Violating Autumn Qi, the Taiyin does not receive, Lung Qi becomes scorched and full." How can this be called a Dampness disease? As for left hypochondriac pain, inability to turn, dry throat, dusty complexion, lack of luster in the body, heat on the outer side of the foot, lower back pain, fright, tendon contraction, men's hernia, women's lower abdominal pain, blurred vision, and sores, these are Dryness diseases originating from the Liver, appearing variably. When the Liver presents Dryness symptoms, it is indeed urgent to save the Liver lobes from scorching damage. However, clearing Lung Metal and removing the root of Dryness is the primary task. If Lung Metal is diseased itself and does not affect the Liver, focusing solely on saving the Lung is necessary; if delayed, scorching and withering may occur immediately, leaving no room for gradual efforts.)