（附论）
代指者先肿。 然痛。色不黯。缘爪甲边结脓。剧者爪皆脱落。此谓之代指病也。但得
一
端。故其指先肿热 痛。结聚成脓。甚则爪甲脱落。世或谓之沦指。又代甲。其实一也。此
病
方
漏芦汤（出圣济总录）
治代指。筋骨脏腑中。热 肿痛。
漏芦（去芦头） 升麻 大黄（锉炒） 黄芩（去黑心各一两） 玄参（三分） 上粗
捣筛。每服五
服。如利、去
蓝花汤（出圣济总录）
治代指肿痛。
蓝花 漏芦（去芦头） 大黄（锉炒） 升麻 黄芩（去黑心各一两） 上粗捣筛。每
服五钱。水
利、去芒硝
皂霜散
治恶指。
皂角 南星 拒霜叶 草乌 上等分为末。米醋调敷。留口出毒。
升麻汤（出圣济总录）
治代指虽无蕴毒。筋骨中热气尚盛。
升麻 甘草（各半两） 上细锉。以水二升煎。去滓。下芒硝末半两搅匀。温浸指上数
十遍。
栀子汤
治代指。
栀子仁 甘草（各一两） 上细锉。以水二升煎至一升半。去滓。令温浸指上。日三五
度瘥。
草硝散（出仁存方）
治代指结脓。指爪甲脱者。
上用甘草二两 咀。以水五升。煮取一升半渍之。一方用芒硝亦可。煎汤淋洗愈。
盐脂汤（出千金方）
治指痛欲脱。
上用猪脂和盐煮令稍热。纳指中一食久。住。千金翼加干姜。
酱蜜涂方（出千金方）
治代指掣痛。手足不可忍者。
酱汁（一合） 蜜（一两） 上和煎令沸。稍热敷日五七上即瘥。一方用酱水。
酱水渍方（出圣济总录）
治代指肿痛。
上取酱水一升。以盐半两和煎令沸。温浸患指。日三五度瘥。一方用酱水调蜜敷之。
地龙散（出仁存方）
治代指。手指甲头肿取肉刺。
上用地龙干者。不拘多少。捣罗为细散。以猪膏调敷患指。日三两上瘥。一方用泥敷之。
一
砂膏（出千金方）
治代指。
上以唾和白 砂。先搜面作碗子盛唾。次着 砂如枣许。以爪着指中。一日即瘥。
麻黄汤（出圣济总录）
治代指。
上用麻黄二两。去根锉。以水二升煎至一升半。去滓。温浸患指。日三五度瘥。
热蘸汤（出圣惠方）
治代指。为五脏气流注十二经脉。热冲手指。
上以热汤急蘸五七度。次以冷水浸之。又复如此三遍。涂羊胆即瘥。未成脓者。此方甚
效。
粟米粉
治代指发症。
上用粟米粉。不拘多少。在铁铛中熬赤。以众人唾调涂患指。
乌梅醋法（出仁斋直指方）
治代指。手指甲头肿取肉刺。
上用乌梅去肉壳。只用仁研细。米醋调得所。入指渍之。或和敷之。
治代指。手指忽肿痛不已者。名为代指。
上以毛杂黄土。作泥指五分浓。纳 灰中煨之。令热可忍。泥干即易。不过数度瘥。如
皮
又方（出肘后方）
治代指。
上刺指热饭中。二七遍。
又方（出千金方）
治代指。
上以麻沸汤渍之。
又方（出千金方）
治代指。
上取萎黄葱叶。煮沸渍之。
又方（出千金方）
治代指。
上以蜀椒四合。水一升。煮三沸渍之。
又方（出圣惠方）
治代指。
上先刺去脓血。炙鱼 皮令温。以缠裹固匝。痛止便愈。
又方（出传信适用方）
治代指。
上拒霜叶为末。加消风散调涂。自散其毒。
又方
治代指。
上以黑豆烂嚼敷之。或烧灰敷之亦可。
又方（出圣惠方）
治代指。
上用地榆二两细锉。以水三升煎至二升。去滓。温浸患指。冷即再暖。
又方（出圣惠方）
治代指发疣。
上用盐不拘多少。小便调涂患指上。以故帛裹之。一二日。铍针刺血。再涂即瘥。
又方（出圣济总录）
治代指。卒肿痛不可忍。
上用酒糟不拘多少。取昼夜裹之。
又方
上用酒糟不拘多少。以瓶子一枚。先装灰火了。入菌子于上。以纸裹瓶口。作一孔子。
将指头入熏疮。
又方（出肘后方）
治代指。甲头肿取肉刺。
上取土中蚯蚓和猪脂。捣如泥敷之。一方无猪脂。
又方（出肘后方）
上烧铁令热。勿令赤。以灼之。又炙指头痛处七壮愈。
治恶指入痈。
上用粪堆上蛴螬虫一个。截头。中一段安患处。以艾炙之。和面调围患处。
拔毒散（出卫生家宝方）
治毒疮生于手指。赤肿坚硬。俗呼为发指。彻疼痛不可忍者。
泥蜂窠（岩壁间采之） 乳香（少许研） 上为末。用酽米醋调涂之。干即再上醋。痛
立止。治恶指。俗云天蛇风。
蜈蚣（一条火上烧） 上以烟熏病指。一二次即安。
疗代指。（出本草）
以蜡、松胶相和。火炙。笼代指即瘥。
（附论）
代指病，起初表现为肿胀。随后出现疼痛，但肤色不暗。这是因为脓液积聚在指甲边缘所致。病情严重时，指甲会全部脱落。这被称为代指病。之所以称为“代”，是因为它只发生在手指的一端，所以手指先出现红肿热痛，结聚形成脓液，严重到一定程度时指甲就会脱落。世人有时称之为沦指，又或称为代甲，其实都是同一种病。
此病的方剂：
漏芦汤（出自《圣济总录》）
治疗代指病。针对筋骨脏腑中的热毒引起的肿痛。
药材：漏芦（去除芦头）、升麻、大黄（锉碎并炒制）、黄芩（去除黑心，各一两）、玄参（三分）。
用法：将上述药材粗捣筛成粉末。每次服用五钱（原文此处可能有脱字，通常指用水煎服），如果腹泻，则去掉芒硝。
蓝花汤（出自《圣济总录》）
治疗代指引起的肿痛。
药材：蓝花、漏芦（去除芦头）、大黄（锉碎并炒制）、升麻、黄芩（去除黑心，各一两）。
用法：将上述药材粗捣筛成粉末。每次服用五钱，用水煎煮。如果出现腹泻，则去掉芒硝。
皂霜散
治疗恶指病。
药材：皂角、南星、拒霜叶、草乌。
用法：将上述药材等分为末。用米醋调匀后敷于患处，留出指尖口以排出毒气。
升麻汤（出自《圣济总录》）
治疗代指病，虽然体内没有蕴积的毒邪，但筋骨中的热气仍然旺盛的情况。
药材：升麻、甘草（各半两）。
用法：将上述药材细切。用水二升煎煮，去渣。加入芒硝末半两搅匀。温热浸泡患指数十次。
栀子汤
治疗代指病。
药材：栀子仁、甘草（各一两）。
用法：将上述药材细切。用水二升煎至一升半。去渣。待温度适宜后浸泡患指。每天三到五次，痊愈为止。
草硝散（出自《仁存方》）
治疗代指病结脓，指甲脱落的情况。
用法：取甘草二两，切碎。用水五升，煮取一升半，用来浸泡患处。另一方法是用芒硝也可以。煎汤淋洗即可痊愈。
盐脂汤（出自《千金方》）
治疗手指疼痛欲脱落的情况。
用法：取猪脂和盐一起煮至稍热。将手指放入其中浸泡一顿饭的时间。停歇片刻。《千金翼方》中加干姜。
酱蜜涂方（出自《千金方》）
治疗代指引起的牵引性疼痛，手足疼痛难以忍受的情况。
药材：酱汁（一合）、蜂蜜（一两）。
用法：将两者混合煎至沸腾。稍凉后热敷，每天五到七次即可痊愈。另一方法是用酱水。
酱水渍方（出自《圣济总录》）
治疗代指引起的肿痛。
用法：取酱水一升，与半两盐混合煎至沸腾。温热浸泡患指。每天三到五次，痊愈为止。另一方法是用酱水调蜂蜜敷之。
地龙散（出自《仁存方》）
治疗代指病。手指指甲头部肿胀并长出肉刺的情况。
用法：取干燥的地龙，数量不限。捣罗成细散。用猪膏调匀后敷于患指。每天两到三次，痊愈为止。另一方法是用泥土敷之。
砂膏（出自《千金方》）
治疗代指病。
用法：用唾液调和硇砂。先在手掌中揉搓成碗状盛住唾液，然后放入如枣核大小的硇砂。用指甲按在手指患处。一天即可痊愈。
麻黄汤（出自《圣济总录》）
治疗代指病。
用法：取麻黄二两，去除根部锉碎。用水二升煎至一升半。去渣。温热浸泡患指。每天三到五次，痊愈为止。
热蘸汤（出自《圣惠方》）
治疗代指病。因五脏气流注十二经脉，热气冲撞手指所致。
用法：先用热汤急蘸手指五到七次。接着用冷水浸泡。如此反复三遍。涂上羊胆即可痊愈。尚未化脓者，此方非常有效。
粟米粉
治疗代指病引发的症状。
用法：取粟米粉，数量不限。在铁锅中熬至发红。用众人的唾液调匀涂抹于患指。
乌梅醋法（出自《仁斋直指方》）
治疗代指病。手指指甲头部肿胀并长出肉刺的情况。
用法：取乌梅，去除果肉和壳，只用果仁研细。用米醋调匀适度。将手指浸入其中，或者调和后敷之。
治代指。手指突然肿痛不止的，名为代指。
用法：用毛发混杂黄土，做成泥状，厚五分涂在手指上。放入灰烬中煨烤。令热度可忍受。泥干了就更换。不过几次即可痊愈。如果皮肤……（原文此处似有残缺，推测为继续处理或观察皮色变化）。
又方（出自《肘后方》）
治疗代指病。
用法：在手指上刺破，然后在热饭中按压二十一次。
又方（出自《千金方》）
治疗代指病。
用法：取萎黄的葱叶，煮沸后浸泡。
又方（出自《千金方》）
治疗代指病。
用法：取蜀椒四合，水一升，煮开三次后浸泡。
又方（出自《圣惠方》）
治疗代指病。
用法：先刺破排出脓血。炙烤鱼鳔皮使其温热，缠绕包裹固定。疼痛停止即愈。
又方（出自《传信适用方》）
治疗代指病。
用法：将拒霜叶研为末，加入消风散调匀涂抹。使毒气自行消散。
又方
治疗代指病。
用法：将黑豆烂嚼后敷之，或者烧成灰敷之亦可。
又方（出自《圣惠方》）
治疗代指病。
用法：取地榆二两细切。用水三升煎至二升。去渣。温热浸泡患指。冷了再加热。
又方（出自《圣惠方》）
治疗代指病引发的疣。
用法：取盐，数量不限。用小便调匀涂于患指上，用旧布包裹。一到两天后，用铍针刺破出血，再涂抹即可痊愈。
又方（出自《圣济总录》）
治疗代指病。突然肿痛难以忍受的情况。
用法：取酒糟，数量不限。昼夜包裹患处。
又方
用法：取酒糟，数量不限。用一个瓶子，先在瓶底装好灰火。将菌子放在上面，用纸包裹瓶口，钻一个小孔。将患指头伸入孔中熏蒸疮口。
又方（出自《肘后方》）
治疗代指病。指甲头部肿胀并长出肉刺。
用法：取土中的蚯蚓和猪脂，捣成泥状敷之。另一方法无猪脂也可。
又方（出自《肘后方》）
用法：烧铁使其发热，但不要烧红。用它灼烫患处。或者在手指疼痛处艾灸七壮即可痊愈。
治恶指入痈。
用法：取粪堆上的蛴螬虫一条，截去头部，取中间一段安放在患处。用艾条灸之。并用面粉调糊围在患处周围。
拔毒散（出自《卫生家宝方》）
治疗毒疮生于手指，赤肿坚硬，俗称为发指，彻骨疼痛难以忍受的情况。
药材：泥蜂窠（从岩壁间采集）、乳香（少许，研细）。
用法：将上述药材研为末。用浓米醋调匀涂抹。干了就再涂醋。疼痛立即停止。治疗恶指，俗称为天蛇风。
蜈蚣（一条，火上烧焦）
用法：用其烟雾熏烤病指。一到两次即可安宁。
(Attached Discussion)
Dai Zhi (Substitute Finger Disease), initially presents with swelling. Subsequently, pain occurs, but the skin color is not dark. This is due to pus accumulation at the edge of the nail. In severe cases, the nails may all fall off. This is referred to as Dai Zhi disease. It is called "Dai" (substitute/change) because it affects only one end of the finger; thus, the finger first exhibits redness, swelling, heat, and pain, which coagulate into pus, and in extreme cases, the nails detach. The world sometimes refers to this as Lun Zhi (Sunken Finger) or Dai Jia (Substitute Nail), but they are essentially the same condition.
Formulas for this disease:
Lou Lu Tang (Caulis Rhapontici Decoction) (from *Shengji Zonglu*)
Treats Dai Zhi. Addresses heat-toxin causing swelling and pain in the sinews, bones, zang-fu organs, and bowels.
Herbs: Caulis Rhapontici (Lou Lu, remove rhizome head), Cimicifugae Rhizoma (Sheng Ma), Radix et Rhizoma Rhei (Da Huang, cut and stir-fried), Radix Scutellariae (Huang Qin, remove black heart, each 1 liang), Radix Scrophulariae (Xuan Shen, 3 fen).
Usage: Coarsely grind and sieve the above herbs. Take 5 qian per dose. If diarrhea occurs, remove Mang Xiao (Mirabilite).
Lan Hua Tang (Indigo Flower Decoction) (from *Shengji Zonglu*)
Treats swelling and pain caused by Dai Zhi.
Herbs: Indigo Naturalis (Lan Hua), Caulis Rhapontici (Lou Lu, remove rhizome head), Radix et Rhizoma Rhei (Da Huang, cut and stir-fried), Cimicifugae Rhizoma (Sheng Ma), Radix Scutellariae (Huang Qin, remove black heart, each 1 liang).
Usage: Coarsely grind and sieve the above herbs. Take 5 qian per dose, decoct in water. If diarrhea occurs, remove Mang Xiao (Mirabilite).
Zao Shuang San (Gleditsia Sinensis Frost Powder)
Treats E Zhi (Malignant Finger).
Herbs: Fructus Gleditsiae Sinensis (Zao Jiao), Rhizoma Arisaematis (Nan Xing), Folium Hibisci Mutabilis (Ju Shuang Ye), Radix Aconiti Kusnezoffii (Caowu).
Usage: Grind the above herbs into powder in equal parts. Mix with rice vinegar and apply to the affected area, leaving the fingertip exposed to allow toxin discharge.
Sheng Ma Tang (Cimicifuga Decoction) (from *Shengji Zonglu*)
Treats Dai Zhi where, although there is no accumulated toxin internally, the heat qi in the sinews and bones remains vigorous.
Herbs: Cimicifugae Rhizoma (Sheng Ma), Radix Glycyrrhizae (Gan Cao, each half liang).
Usage: Finely cut the above herbs. Decoct in 2 sheng of water, strain. Add Ban Xia powder (Note: text says Mang Xiao/Mirabilite, likely typo in source or specific variation, usually Mang Xiao is used here) 0.5 liang, mix well. Warm-soak the affected finger dozens of times.
Zhi Zi Tang (Gardenia Decoction)
Treats Dai Zhi.
Herbs: Semen Gardeniae (Zhi Zi Ren), Radix Glycyrrhizae (Gan Cao, each 1 liang).
Usage: Finely cut the above herbs. Decoct in 2 sheng of water until reduced to 1.5 sheng. Strain. Soak the affected finger while warm. Do this 3-5 times daily until recovery.
Cao Xiao San (Licorice and Mirabilite Powder) (from *Ren Cun Fang*)
Treats Dai Zhi with pus formation and nail detachment.
Usage: Take 2 liang of Gan Cao (Licorice Root), cut into pieces. Decoct in 5 sheng of water until reduced to 1.5 sheng, and soak the affected area. Another method uses Mang Xiao (Mirabilite). Boil in water and wash/rinse until healed.
Yan Zhi Tang (Salt and Lard Decoction) (from *Qian Jin Fang*)
Treats finger pain threatening detachment.
Usage: Boar lard (Zhu Zhi) and salt are boiled until slightly hot. Immerse the finger for the duration of a meal. Pause briefly. *Qian Jin Yi Fang* adds dried ginger (Gan Jiang).
Jiang Mi Tu Fang (Sauce and Honey Paste Formula) (from *Qian Jin Fang*)
Treats Dai Zhi with pulling pain, unbearable in hands and feet.
Ingredients: Fermented Soybean Paste Juice (Jiang Zhi, 1 he), Honey (Mi, 1 liang).
Usage: Mix and boil until bubbling. Apply as a warm compress 5-7 times daily until healed. Another method uses sauce water.
Jiang Shui Ze Fang (Sauce Water Soaking Formula) (from *Shengji Zonglu*)
Treats swelling and pain of Dai Zhi.
Usage: Take 1 sheng of sauce water, mix with half a liang of salt, and boil. Warm-soak the affected finger 3-5 times daily until healed. Another method mixes sauce water with honey for application.
Di Long San (Earthworm Powder) (from *Ren Cun Fang*)
Treats Dai Zhi. Swelling at the fingernail tip with callus formation.
Usage: Use dry Di Long (Pheretima/Earthworm), amount不拘 (unrestricted). Grind into fine powder. Mix with boar lard (Zhu Gao) and apply to the affected finger 2-3 times daily until healed. Another method uses mud for application.
Sha Gao (Sal Ammoniac Ointment) (from *Qian Jin Fang*)
Treats Dai Zhi.
Usage: Mix Niao Sha (Sal Ammoniac) with saliva. First, knead the palm into a bowl shape to hold the saliva. Then place a date-sized piece of Niao Sha on it. Press with the fingernail onto the affected finger. Heal within one day.
Ma Huang Tang (Ephedra Decoction) (from *Shengji Zonglu*)
Treats Dai Zhi.
Usage: Take 2 liang of Ma Huang (Ephedra Herba), remove roots and cut. Decoct in 2 sheng of water until reduced to 1.5 sheng. Strain. Warm-soak the affected finger 3-5 times daily until healed.
Re Zhan Tang (Hot Dipping Decoction) (from *Sheng Hui Fang*)
Treats Dai Zhi caused by five zang organ qi flowing into the twelve meridians, with heat rushing to the fingers.
Usage: Quickly dip the finger in hot water 5-7 times. Then immerse in cold water. Repeat this cycle three times. Apply sheep gallbladder bile (Yang Dan) to heal. For cases where pus has not yet formed, this formula is very effective.
Su Mi Fen (Millet Flour)
Treats Dai Zhi presenting with symptoms.
Usage: Take Su Mi Fen (Setaria Italica Flour), amount unrestricted. Roast in an iron pan until red. Mix with saliva from multiple people and apply to the affected finger.
Wu Mei Cu Fa (Dark Plum Vinegar Method) (from *Ren Zhai Zhi Zhi Fang*)
Treats Dai Zhi. Swelling at the fingernail tip with callus formation.
Usage: Remove the flesh and shell of Wu Mei (Dark Plum), use only the kernel. Grind finely. Mix appropriately with rice vinegar. Soak the finger in it, or mix and apply.
Treatment for Dai Zhi: When fingers suddenly swell and hurt incessantly, it is named Dai Zhi.
Usage: Mix hair with yellow earth to make mud, apply thickness of 5 fen to the finger. Place in ashes and roast until tolerably hot. Replace when dry. Not more than a few times to heal. If the skin... (text fragment).
Another Formula (from *Zhou Hou Fang*)
Treats Dai Zhi.
Usage: Prick the finger, then press into hot rice 21 times (two sevens).
Another Formula (from *Qian Jin Fang*)
Treats Dai Zhi.
Usage: Soak in boiling water.
Another Formula (from *Qian Jin Fang*)
Treats Dai Zhi.
Usage: Take withered yellow scallion leaves, boil and soak.
Another Formula (from *Qian Jin Fang*)
Treats Dai Zhi.
Usage: Take 4 he of Shu Jiao (Sichuan Pepper), 1 sheng of water, boil three times and soak.
Another Formula (from *Sheng Hui Fang*)
Treats Dai Zhi.
Usage: First prick to drain pus and blood. Roast fish swim bladder skin until warm, wrap and bind tightly. Healing occurs when pain stops.
Another Formula (from *Chuan Xin Shi Yong Fang*)
Treats Dai Zhi.
Usage: Grind Ju Shuang Ye (Hibiscus Mutabilis Leaf) into powder, add Xiao Feng San (Wind-Expelling Powder) to mix and apply. Let the toxin disperse naturally.
Another Formula
Treats Dai Zhi.
Usage: Chew black beans until mushy and apply, or burn to ash and apply.
Another Formula (from *Sheng Hui Fang*)
Treats Dai Zhi.
Usage: Take 2 liang of Di Yu (Sanguisorba Root), cut finely. Decoct in 3 sheng of water until reduced to 2 sheng. Strain. Warm-soak the affected finger. Re-warm if it cools down.
Another Formula (from *Sheng Hui Fang*)
Treats Dai Zhi presenting with warts.
Usage: Take salt, amount unrestricted. Mix with urine to apply to the affected finger, wrap with old cloth. After 1-2 days, pierce with a bi needle to bleed, reapply to heal.
Another Formula (from *Shengji Zonglu*)
Treats Dai Zhi. Sudden severe swelling and pain unbearable.
Usage: Take wine lees (Jiu Zao), amount unrestricted. Wrap around the affected area day and night.
Another Formula
Usage: Take wine lees, amount unrestricted. Take one bottle, put hot ashes/fire inside first. Place mushrooms on top, cover bottle mouth with paper, make a small hole. Insert the finger tip into the hole to fumigate the sore.
Another Formula (from *Zhou Hou Fang*)
Treats Dai Zhi. Swelling at nail tip with callus.
Usage: Take earthworms from soil and boar lard, grind into mud and apply. Another method without boar lard.
Another Formula (from *Zhou Hou Fang*)
Usage: Heat iron until hot, but not red-hot. Cauterize the affected area. Or moxa 7 loads on the painful spot of the finger to heal.
Treatment for Malignant Finger entering carbuncle.
Usage: Take one Qi Chang (larva of beetle found on manure heap) from a manure pile, cut off the head, take the middle segment, place on the affected area. Moxa it. Surround the affected area with dough paste.
Ba Du San (Detoxifying Powder) (from *Wei Sheng Jia Bao Fang*)
Treats toxic sores on fingers, red, swollen, hard, commonly called Fa Zhi, with penetrating unbearable pain.
Herbs: Mud Wasp Nest (Ni Feng Ke, collected from rock walls), Frankincense (Ru Xiang, small amount, ground).
Usage: Grind into powder. Mix with strong rice vinegar to apply. When dry, reapply vinegar. Pain stops immediately. Treats Malignant Finger, commonly known as Tian She Feng (Heavenly Snake Wind).
Centipede (Wu Gong, one, roasted over fire)
Usage: Fumigate the diseased finger with its smoke. Once or twice brings relief.
Treating Dai Zhi. (from *Ben Cao*)
Usage: Mix wax and pine resin, heat over fire. Cover the Dai Zhi area to heal.