夫伤寒后香港脚者。此是风毒湿气滞于肾经。缘肾主腰膝。今肾既受湿。故脚弱而肿满。
即成香港脚也。又春夏之时。温湿之气搏于肾经。沉滞不散。两脚浮肿疼闷而热。其体性夙有
风毒。则风湿之气上冲心肺。即气闷而胸满。致于夭横。诊其左手尺脉当洪而数。是其候也。
若服药后。其脉沉而缓者。疾当愈也。活人书云。问伤寒头疼身热。百肢节疼痛。大便秘。
或呕逆。而脚屈弱者。此名香港脚也。伤寒只传足经。不传手经。地之寒暑风湿皆作蒸气。足
常履之。遂成香港脚。所以病证与伤寒相近。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。风者汗而愈。湿者温而愈。热者下而愈。寒者熨而愈。香港脚之
病。始得之不觉。因他病乃知。毒瓦斯入心。则小腹顽痹不仁。令人呕吐。死在朝夕矣。然终
是与伤寒不同者。孙真人云。卒起脚屈弱不能转动。有此为异耳。要之有香港脚之人。先从脚
起。或先患缓弱疼痹。寒气胜者为痛痹。有寒故也。或行起忽倒。或两胫肿满。亦有不肿者。
或脚膝枯细。或心中忪悸。或小腹不仁。病久入深。荣卫之行涩。致皮虚不荣。故为不仁。
不仁者。皮顽不知有无也。或举体转筋。或见食呕逆。恶闻食气。或胸满气急。或遍体酸痛
。皆香港脚候也。黄帝所谓缓风。寒湿痹是也。顽弱名缓风。疼痛为湿痹。痹者闭也。闭而不
仁。故曰痹。寒中三阳。所患必冷。越婢汤。小续命汤主之。小续命煎汤成。旋入生姜自然
汁最快。暑中三阳。所患必热。小续命汤去附子。减桂一半。大烦躁者。紫雪最良。大便秘
者。脾约丸。神功丸。五柔丸。大三腕散。木瓜散主之。香港脚之疾。皆由气实而死。终无一
人以服药致虚而殂者。头疼身热。肢节痛而脚屈弱者。是其人素有香港脚。此时发动也。脚肿
者。槟榔散主之。香港脚方论。千金外台最详。此不复叙。大抵越婢汤。小续命汤。薏苡仁酒
法。脾约丸。神功丸。皆要药也。仍针灸为佳。服补药与用汤淋洗者。皆医之大禁也。
方
槟榔散(出圣惠方)治伤寒后香港脚上攻。心腹妨闷。坐卧不安。
槟榔 羚羊角屑 木香(各三分) 郁李仁(半两汤浸去皮微炒) 吴茱萸(一分汤浸
七次
焙干微炒) 陈橘皮(三分汤浸去白瓤焙) 上为散。每服三钱。以水一中盏。煎至六分。
去
滓。不计时候。温服。
鳖甲散(出圣惠方)治伤寒后香港脚攻心闷乱。腹满如石。大小便涩。
鳖甲(三分涂醋炙微黄去裙 ) 木通(三分锉) 郁李仁(汤浸去皮尖微炒) 赤茯
苓(各
一两) 羚羊角屑 槟榔〔各三两(分)〕 上为散。每服四钱。以水一中盏。煎至六分。
去
滓。不计时候。温服。
木香散(出圣惠方)治伤寒后香港脚。心下痞坚。或时妨痛。不能下食。
木香 鳖甲(涂醋炙微黄去裙 ) 诃黎勒皮 槟榔 赤茯苓 郁李仁(汤浸去皮尖微
炒
各三分) 上为散。每服四钱。以水一中盏。煎至六分。去滓。不计时候。温服。
沉香散(出圣惠方)治伤寒后香港脚冲心。烦闷气促。脚膝酸疼。昏沉不利。
沉香(三分) 赤芍药(一两) 木通(三分锉) 紫苏茎叶(一两半) 槟榔(三分)
吴茱萸
(半两汤浸七次曝干微炒) 川朴硝(一两) 上为散。每服三钱。以水一中盏。入生姜半
分。
煎
半夏散(出圣惠方)治伤寒后香港脚。心烦满闷。不下饮食。呕逆痰唾。
半夏(汤洗七次去滑) 枳壳(麸炒去白瓤) 赤茯苓 前胡(去芦头) 木通(锉) 人
参
(去芦头各三分) 上为散。每服三钱。以水一中盏。入生姜半分。煎至六分。去滓。不计
时
候。
桑白皮散(出圣惠方)治伤寒后香港脚冲心。神识闷乱。
桑根白皮(锉) 木通(锉) 陈橘皮(汤浸去白瓤焙) 紫苏茎叶〔各二(三)两(分)〕
大
腹皮(一两锉) 上为散。每服半两。以水一大盏。入生姜半分。煎至五分。去滓。不计时
候。
温
羚羊角散(出圣惠方)治伤寒后香港脚。上冲心膈烦闷。
羚羊角屑〔二(一)两〕 旋复花(三分) 赤茯苓(一两) 黄芩(三分) 半夏(三
分汤洗
七次去滑) 陈橘皮(三分汤浸去白瓤焙) 槟榔(三分圣济方半两) 吴茱萸(半两汤洗
七次焙
干微炒) 上为散。每服四钱。以水一大盏。入生姜半分。煎至五分。去滓。不计时候。温
服。圣济方。每服五钱匕。水一盏半。入生姜一分。拍碎。同煎至七分。去滓。食前温服。
名羚羊角汤。
紫苏散(出圣惠方)治伤寒后香港脚冲心。心神烦乱。呕逆恶食。腰膝酸疼。
紫苏茎叶(一两) 木香(三分圣济方半两) 赤茯苓(三分圣济方半两) 沉香(一
两) 吴
茱萸(一分汤洗七次焙干微炒) 赤芍药(一两) 陈橘皮(三分汤浸去白瓤焙圣济方作一
分)
槟榔(三分锉圣济方作一分) 木通(一两锉) 上为散。每服三钱。以水一中盏。入生姜
半分。
煎
前胡散(出圣惠方)治伤寒后香港脚上攻。痰逆。头目旋闷。
前胡(一两去芦头) 半夏(汤洗七次去滑) 桂心 甘草(炙微赤锉) 陈橘皮(汤
浸去白
瓤焙) 大腹子〔各三两(分)〕 赤茯苓(一两半) 桑根白皮(一两半锉) 上为散。
每服四
钱。以水一大盏。入生姜半分。煎至五分。去滓。不拘时候。温服。
犀角散(出圣惠方)治伤寒后风毒香港脚。心膈壅闷。头旋目眩。
犀角屑(三分) 防风(去芦头) 羌活 秦艽(去苗各一两) 陈橘皮(一两汤浸去
白瓤焙)
桂心 大腹子(各三分) 牛膝〔一(半)两去苗〕 上为散。每服五钱。以水一中盏。入
生姜
半分。煎至五分。去滓。不计时候。温服。
赤茯苓散(出圣惠方)治伤寒后香港脚上攻。烦满。及脚膝疼肿。
赤茯苓 赤芍药(各一两) 枳壳(麸炒微黄去瓤) 大腹子(各三分) 桑根白皮(一
两半
锉) 紫苏茎叶(三分) 百合(三分) 川大黄(三分锉碎微炒) 甘草(半两炙微赤锉)
汉防
己(三分) 郁李仁(三分汤浸去皮尖微炒) 羚羊角屑(三分) 上为散。每服五钱。以
水一大
盏。入生姜半分。煎至五分。去滓。不计时候。温服。
柴胡散(出圣惠方)治伤寒后香港脚上攻。心胸烦闷。喘促食少。
柴胡(一两去苗) 旋复花 青橘皮(汤浸去白瓤焙各三分) 大腹子(三分) 马牙
硝(二
两) 甘草(半两炙微赤锉) 半夏(三分汤洗七次去滑) 桑根白皮(一两半锉) 紫苏
茎叶(三
分) 上为散。每服四钱。以水一大盏。入生姜半分。煎至五分。去滓。不计时候。温服。
又方(出圣惠方)
木香(三分) 槟榔(二分) 川朴硝(三分) 紫苏茎叶(半两) 枳实(半两麸炒
微黄) 上
为散。每服三钱。以水一中盏。入生姜半分。葱白三茎。煎至五分。去滓。不计时候。温服。
大黄丸(出圣惠方)治伤寒后香港脚并肾气上冲。
川大黄(一两锉碎微炒) 牛膝(三分去苗) 槟榔(一两) 枳壳(三分麸炒微黄去
瓤) 木
香(三分) 人参(三分去芦头) 郁李仁(一两汤浸去皮尖微炒) 桂心(三分) 前胡
(一两去
芦头) 上为末。炼蜜和捣三二百杵。丸如梧桐子大。每服食前。以温酒下三十丸。
木瓜丸(出圣惠方)治伤寒后香港脚久不瘥。心腹胀满。腿膝浮肿。胸膈妨闷。
木瓜(一两半干者) 桂心(半两) 沉香(一两) 柴胡(一两去苗) 槟榔(一两)
高良姜
(三分锉) 赤芍药(一两) 吴茱萸(三两汤浸七次曝干微炒) 浓朴(三分去粗皮涂生
姜汁炙
令香熟) 上为末。炼蜜和捣三二百杵。丸如梧桐子大。每服食前。以生姜汤下三十丸。
淋蘸方(出圣惠方)治伤寒后初觉香港脚。
薏苡仁根(三两) 蒴 枝(五两) 枳壳根(三两) 吴茱萸(一两) 上细锉。以
水三斗。
煎至二斗。去滓。入盐半合。浆水一碗看冷热淋脚。欲淋时蹋一新砖。勿令汤过脚面。旋旋
淋之。汤冷为度。后淋蘸脚了。以少生姜汁擦热脚心。
淋蘸方(出圣惠方)治伤寒后香港脚肿满不消。
蓖麻叶 枸杞根 葡萄蔓(各一两) 蒴 枝(七两锉) 羌活(一两) 本(一两)
吴茱
萸(半两) 杏仁(半两) 椒(一合) 青盐(一两) 上细锉。分为二剂。每剂用水二
斗。入连
须
槟榔散 治伤寒后香港脚攻心闷绝。
槟榔(锉) 木香(各一两) 郁李仁(微炒去皮) 桂(去粗皮各三分) 吴茱萸(汤
洗三次
焙干炒半两) 赤茯苓(去黑皮) 牛膝(去苗酒浸焙各三分) 上为细散。每服一钱半匕。
水
煎。食前。煎桑白皮、木通汤调下。日二服。
陈橘皮散 治伤寒后香港脚。胸中满腹闷。喘息促急。
陈橘皮(汤浸去白焙三分) 槟榔(锉一两) 桂(去粗皮三分) 牵牛子(微炒一两)
上为
细散。每服一(半)钱匕。食前。温酒调下。日二服。
茯苓汤 治伤寒后香港脚攻心闷乱。腹满如石。小便赤涩。
赤茯苓(去黑皮一两) 鳖甲(醋炙去裙 ) 郁李仁(微炒去皮) 木通(锉各三分)
上粗
捣筛。每服三钱匕。水一盏。煎至七分。去滓。食前温服。
半夏汤 治伤寒后香港脚。心烦满闷。不下饮食。呕逆多痰。
半夏(汤洗七次焙干) 枳壳(去瓤麸炒) 茯苓(去黑皮) 前胡(去芦头) 木通
(锉各三
分) 上粗捣筛。每服三钱匕。水一盏。入生姜一分。拍碎。同煎至半盏。去滓。食前温服。
赤小豆汤 治伤寒后香港脚。膝肿满。气急。大便秘涩。
赤小豆(半合) 桑根白皮(半两) 紫苏茎叶(一两) 槟榔(半两) 上锉三味如
麻豆大。
同赤小豆用水五盏。入生姜一分。拍碎。煎至二盏半。去滓。分两服。食前温服。
犀角散 治伤寒后香港脚。两胫肿满。心下烦闷。
犀角(镑一两) 槟榔(锉半两) 陈橘皮(汤浸去白焙三分) 细辛(去苗叶半两) 吴
茱萸
(汤洗三次焙干炒一分) 上为细末。每服一钱半匕。食前。生姜热酒调下。日二服。
吴茱萸散 治伤寒后香港脚。心腹妨闷胀痛。坐卧不安。
吴茱萸(汤洗三次焙干炒一分) 槟榔(锉) 当归(切焙) 木香 郁李仁(微炒去
皮各三
分) 上粗捣筛。每服三钱匕。用水一盏。煎至七分。去滓。食前温服。
大戟丸 治伤寒后香港脚攻心。腹胀硬。小便赤涩。
大戟(炒) 芫花(醋炒令焦) 苦葶苈(炒各半两) 续随子(去皮炒) 巴豆(去
皮心压去
油尽别净研各一分) 上为细末。入巴豆和研匀。炼蜜和丸如梧桐子大。每服三丸至五丸。
温米饮下。不计时候。
凡是伤寒病后出现的香港脚(一种以足胫肿重、软弱无力为主要表现的疾病),这是由于风毒湿气阻滞在肾经所致。因为肾主管腰部和膝盖,现在肾脏受到湿邪侵袭,所以双脚软弱且肿胀满闷,这就形成了香港脚。另外,在春夏季节,温湿之气搏结于肾经,沉滞不散,导致两脚浮肿、疼痛、烦闷且有热感。如果患者体质原本就有风毒,那么风湿之气就会上冲心肺,造成气闷和胸满,甚至导致突然死亡。诊察时,左手尺脉应当呈现洪大且数的特征,这就是其征候。如果服药后,脉象变得沉而缓,疾病很快就会痊愈。《活人书》说:问伤寒头疼身热,百肢节疼痛,大便秘结,或者呕吐逆气,而脚屈弱无力的,这名叫香港脚。伤寒只传变足部经脉,不传变手部经脉。地上的寒暑风湿都化作蒸气,脚经常踩踏接触这些地气,于是形成香港脚。所以病症表现与伤寒相近。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。风邪致病用发汗法可愈,湿邪致病用温法可愈,热邪致病用泻下法可愈,寒邪致病用熨法可愈。香港脚这种病,刚开始发作时并不觉得明显,往往因为其他疾病才知晓。如果毒瓦斯进入心脏,则小腹顽麻痹痛不知痛痒,令人呕吐,不久就会死亡。然而终究与伤寒不同的是,孙真人说,突然发生脚屈弱不能转动,这是它的特异之处。总之,患有香港脚的人,病势先从脚部发起,有的先患肢体缓弱疼痛麻木,寒气胜者为痛痹,因为有寒的缘故;有的行走时突然跌倒,或者两小腿肿胀满闷,也有不肿的;有的脚膝枯瘦细小,有的心中悸动不安,有的小腹感觉迟钝。病程久了深入体内,营卫运行涩滞,导致皮肤虚弱不能荣养,所以出现麻木不仁。所谓不仁,就是皮肤顽钝,不知有无触觉。有的全身转筋抽搐,有的见食物就呕吐逆气,厌恶闻食物的气味,有的胸满气急,有的遍体酸痛,这些都是香港脚的征候。黄帝所说的“缓风”,就是寒湿痹阻。身体顽弱称为缓风,疼痛称为湿痹。“痹”就是闭塞的意思,闭塞而不通故称痹。寒邪侵入三阳经,所患的病必定寒冷,可用越婢汤、小续命汤主治。小续命汤煎好药汁后,随即加入生姜自然汁效果最快。暑邪侵入三阳经,所患的病必定发热,用小续命汤去掉附子,减少桂枝一半用量。大烦躁者,紫雪最良。大便秘结者,脾约丸、神功丸、五柔丸、大三腕散、木瓜散主治。香港脚的疾病,都是因为气实而死,最终没有一个人因为服药导致虚损而死亡的。头疼身热,肢节痛而脚屈弱的,是这个人素来有香港脚,此时发作了。脚肿的,槟榔散主治。关于香港脚的方论,《千金方》和《外台秘要》记载得最详细,这里不再复述。大体上越婢汤、小续命汤、薏苡仁酒法、脾约丸、神功丸,都是重要的药物。仍然以针灸治疗为佳,服用补药和使用汤药淋洗,都是医家的重大禁忌。
方剂:
槟榔散(出自《圣惠方》):治疗伤寒后香港脚之气上攻,心腹妨闷,坐卧不安。
槟榔、羚羊角屑、木香(各三分)、郁李仁(半两,汤浸去皮微炒)、吴茱萸(一分,汤浸七次焙干微炒)、陈橘皮(三分,汤浸去白瓤焙)。以上研为散。每次服三钱,用水一中盏,煎至六分,去渣。不分时候,温服。
鳖甲散(出自《圣惠方》):治疗伤寒后香港脚攻心致闷乱,腹满如石,大小便涩滞。
鳖甲(三分,涂醋炙微黄去裙襕)、木通(三分锉)、郁李仁(汤浸去皮尖微炒)、赤茯苓(各一两)、羚羊角屑、槟榔(各三两)。以上研为散。每次服四钱,用水一中盏,煎至六分,去渣。不分时候,温服。
木香散(出自《圣惠方》):治疗伤寒后香港脚,心下痞坚,有时妨痛,不能进食。
木香、鳖甲(涂醋炙微黄去裙襕)、诃黎勒皮、槟榔、赤茯苓、郁李仁(汤浸去皮尖微炒,各三分)。以上研为散。每次服四钱,用水一中盏,煎至六分,去渣。不分时候,温服。
沉香散(出自《圣惠方》):治疗伤寒后香港脚冲心,烦闷气促,脚膝酸疼,昏沉不利。
沉香(三分)、赤芍药(一两)、木通(三分锉)、紫苏茎叶(一两半)、槟榔(三分)、吴茱萸(半两,汤浸七次曝干微炒)、川朴硝(一两)。以上研为散。每次服三钱,用水一中盏,入生姜半分,煎至六分,去渣。不分时候,温服。
半夏散(出自《圣惠方》):治疗伤寒后香港脚,心烦满闷,不下饮食,呕逆痰唾。
半夏(汤洗七次去滑)、枳壳(麸炒去白瓤)、赤茯苓、前胡(去芦头)、木通(锉)、人参(去芦头,各三分)。以上研为散。每次服三钱,用水一中盏,入生姜半分,煎至六分,去渣。不分时候,温服。
桑白皮散(出自《圣惠方》):治疗伤寒后香港脚冲心,神识闷乱。
桑根白皮(锉)、木通(锉)、陈橘皮(汤浸去白瓤焙)、紫苏茎叶(各二两或三两)、大腹皮(一两锉)。以上研为散。每次服半两,用水一大盏,入生姜半分,煎至五分,去渣。不分时候,温服。
羚羊角散(出自《圣惠方》):治疗伤寒后香港脚,上冲心膈烦闷。
羚羊角屑(一两或一两)、旋复花(三分)、赤茯苓(一两)、黄芩(三分)、半夏(三分,汤洗七次去滑)、陈橘皮(三分,汤浸去白瓤焙)、槟榔(三分,圣济方用半两)、吴茱萸(半两,汤洗七次焙干微炒)。以上研为散。每次服四钱,用水一大盏,入生姜半分,煎至五分,去渣。不分时候,温服。圣济方:每次服五钱匕,水一盏半,入生姜一分拍碎,同煎至七分,去渣,食前温服。名为羚羊角汤。
紫苏散(出自《圣惠方》):治疗伤寒后香港脚冲心,心神烦乱,呕逆恶食,腰膝酸疼。
紫苏茎叶(一两)、木香(三分,圣济方用半两)、赤茯苓(三分,圣济方用半两)、沉香(一两)、吴茱萸(一分,汤洗七次焙干微炒)、赤芍药(一两)、陈橘皮(三分,汤浸去白瓤焙,圣济方作一分)、槟榔(三分锉,圣济方作一分)、木通(一两锉)。以上研为散。每次服三钱,用水一中盏,入生姜半分,煎至六分,去渣。不分时候,温服。
前胡散(出自《圣惠方》):治疗伤寒后香港脚上攻,痰逆,头目旋闷。
前胡(一两去芦头)、半夏(汤洗七次去滑)、桂心、甘草(炙微赤锉)、陈橘皮(汤浸去白瓤焙)、大腹子(各三两或三分)、赤茯苓(一两半)、桑根白皮(一两半锉)。以上研为散。每次服四钱,用水一大盏,入生姜半分,煎至五分,去渣。不拘时候,温服。
犀角散(出自《圣惠方》):治疗伤寒后风毒香港脚,心膈壅闷,头旋目眩。
犀角屑(三分)、防风(去芦头)、羌活、秦艽(去苗,各一两)、陈橘皮(一两,汤浸去白瓤焙)、桂心、大腹子(各三分)、牛膝(一两或半两,去苗)。以上研为散。每次服五钱,用水一中盏,入生姜半分,煎至五分,去渣。不分时候,温服。
赤茯苓散(出自《圣惠方》):治疗伤寒后香港脚上攻,烦满,及脚膝疼肿。
赤茯苓、赤芍药(各一两)、枳壳(麸炒微黄去瓤)、大腹子(各三分)、桑根白皮(一两半锉)、紫苏茎叶(三分)、百合(三分)、川大黄(三分锉碎微炒)、甘草(半两炙微赤锉)、汉防己(三分)、郁李仁(三分,汤浸去皮尖微炒)、羚羊角屑(三分)。以上研为散。每次服五钱,用水一大盏,入生姜半分,煎至五分,去渣。不分时候,温服。
柴胡散(出自《圣惠方》):治疗伤寒后香港脚上攻,心胸烦闷,喘促食少。
柴胡(一两去苗)、旋复花、青橘皮(汤浸去白瓤焙,各三分)、大腹子(三分)、马牙硝(二两)、甘草(半两炙微赤锉)、半夏(三分,汤洗七次去滑)、桑根白皮(一两半锉)、紫苏茎叶(三分)。以上研为散。每次服四钱,用水一大盏,入生姜半分,煎至五分,去渣。不分时候,温服。
又一方(出自《圣惠方》):
木香(三分)、槟榔(二分)、川朴硝(三分)、紫苏茎叶(半两)、枳实(半两,麸炒微黄)。以上研为散。每次服三钱,用水一中盏,入生姜半分、葱白三茎,煎至五分,去渣。不分时候,温服。
大黄丸(出自《圣惠方》):治疗伤寒后香港脚并肾气上冲。
川大黄(一两,锉碎微炒)、牛膝(三分去苗)、槟榔(一两)、枳壳(三分,麸炒微黄去瓤)、木香(三分)、人参(三分去芦头)、郁李仁(一两,汤浸去皮尖微炒)、桂心(三分)、前胡(一两去芦头)。以上研为末,炼蜜和捣三二百杵,丸如梧桐子大。每次饭前,以温酒送下三十丸。
木瓜丸(出自《圣惠方》):治疗伤寒后香港脚久不愈,心腹胀满,腿膝浮肿,胸膈妨闷。
木瓜(一两半,干者)、桂心(半两)、沉香(一两)、柴胡(一两去苗)、槟榔(一两)、高良姜(三分锉)、赤芍药(一两)、吴茱萸(三两,汤浸七次曝干微炒)、浓朴(三分,去粗皮涂生姜汁炙令香熟)。以上研为末,炼蜜和捣三二百杵,丸如梧桐子大。每次饭前,以生姜汤送下三十丸。
淋蘸方(出自《圣惠方》):治疗伤寒后初觉香港脚。
薏苡仁根(三两)、蒴藋枝(五两)、枳壳根(三两)、吴茱萸(一两)。以上细锉,用水三斗,煎至二斗,去渣,入盐半合、浆水一碗,看冷热淋脚。欲淋时踏一新砖,勿令汤过脚面,缓缓淋之,汤冷为度。后淋蘸脚了,以少许生姜汁擦热脚心。
淋蘸方(出自《圣惠方》):治疗伤寒后香港脚肿满不消。
蓖麻叶、枸杞根、葡萄蔓(各一两)、蒴藋枝(七两锉)、羌活(一两)、本(一两)、吴茱萸(半两)、杏仁(半两)、椒(一合)、青盐(一两)。以上细锉,分为二剂。每剂用水二斗,入连须槟榔散治伤寒后香港脚攻心闷绝。
槟榔(锉)、木香(各一两)、郁李仁(微炒去皮)、桂(去粗皮,各三分)、吴茱萸(汤洗三次焙干炒半两)、赤茯苓(去黑皮)、牛膝(去苗酒浸焙,各三分)。以上为细散。每次服一钱半匕,水煎。食前,煎桑白皮、木通汤调下。日二服。
陈橘皮散 治伤寒后香港脚。胸中满腹闷,喘息促急。
陈橘皮(汤浸去白焙三分)、槟榔(锉一两)、桂(去粗皮三分)、牵牛子(微炒一两)。以上为细散。每次服半钱或一钱匕,食前,温酒调下。日二服。
茯苓汤 治伤寒后香港脚攻心闷乱,腹满如石,小便赤涩。
赤茯苓(去黑皮一两)、鳖甲(醋炙去裙襕)、郁李仁(微炒去皮)、木通(锉,各三分)。以上粗捣筛。每次服三钱匕,水一盏,煎至七分,去渣,食前温服。
半夏汤 治伤寒后香港脚,心烦满闷,不下饮食,呕逆多痰。
半夏(汤洗七次焙干)、枳壳(去瓤麸炒)、茯苓(去黑皮)、前胡(去芦头)、木通(锉,各三分)。以上粗捣筛。每次服三钱匕,水一盏,入生姜一分拍碎,同煎至半盏,去渣,食前温服。
赤小豆汤 治伤寒后香港脚,膝肿满,气急,大便秘涩。
赤小豆(半合)、桑根白皮(半两)、紫苏茎叶(一两)、槟榔(半两)。以上锉三味如麻豆大,同赤小豆用水五盏,入生姜一分拍碎,煎至二盏半,去渣,分两服,食前温服。
犀角散 治伤寒后香港脚,两胫肿满,心下烦闷。
犀角(镑一两)、槟榔(锉半两)、陈橘皮(汤浸去白焙三分)、细辛(去苗叶半两)、吴茱萸(汤洗三次焙干炒一分)。以上为细末。每次服一钱半匕,食前,生姜热酒调下。日二服。
吴茱萸散 治伤寒后香港脚,心腹妨闷胀痛,坐卧不安。
吴茱萸(汤洗三次焙干炒一分)、槟榔(锉)、当归(切焙)、木香、郁李仁(微炒去皮,各三分)。以上粗捣筛。每次服三钱匕,用水一盏,煎至七分,去渣,食前温服。
大戟丸 治伤寒后香港脚攻心,腹胀硬,小便赤涩。
大戟(炒)、芫花(醋炒令焦)、苦葶苈(炒,各半两)、续随子(去皮炒)、巴豆(去皮心压去油尽别净研,各一分)。以上为细末,入巴豆和研匀,炼蜜和丸如梧桐子大。每次服三丸至五丸,温米饮下,不计时候。
Hongjiao (a disease characterized by swelling and weakness of the lower legs) occurring after Shanghan (Cold Damage) is caused by wind-toxin and dampness stagnating in the Kidney Meridian. Since the Kidneys govern the waist and knees, when the Kidneys are affected by dampness, the feet become weak, swollen, and distended, thus forming Hongjiao. Furthermore, during spring and summer, warm and damp qi combats with the Kidney Meridian, sinking and stagnating without dispersing, causing both feet to swell, ache, feel stifled, and be hot. If the constitution inherently possesses wind-toxin, the wind-damp qi will rush upward to the Heart and Lungs, causing chest fullness and shortness of breath, potentially leading to sudden death. Upon diagnosis, the pulse at the left Chi position should be large (Hong) and rapid (Shu); this is its sign. If after taking medicine the pulse becomes deep (Chen) and slow (Huan), the illness will soon recover. The *Huoren Shu* states: regarding Shanghan with headache, fever, pain in all joints, constipation, or vomiting and reverse flow of qi, accompanied by weak and flexed feet, this is named Hongjiao. Shanghan transmits only through the Foot meridians, not the Hand meridians. The cold, heat, wind, and dampness on earth transform into vapor; as the feet constantly tread upon it, Hongjiao forms. Therefore, the symptoms resemble those of Shanghan. A pulse that is floating (Fu) and wiry (Xian) originates from Wind; one that is soggy (Ru) and weak (Ruo) originates from Dampness; one that is large (Hong) and rapid (Shu) originates from Heat; one that is slow (Chi) and choppy (Se) originates from Cold. Diseases caused by Wind are cured by sweating; those by Dampness by warming; those by Heat by purging downward; those by Cold by moxibustion or ironing therapy. Hongjiao often begins imperceptibly and is recognized only due to other illnesses. If the toxin enters the Heart, the lower abdomen becomes numb and insensible, causing vomiting, leading to death within a day or two. However, it ultimately differs from Shanghan. Sun Simiao said that sudden onset of foot weakness and inability to move is its distinctive feature. In summary, patients with Hongjiao always start with symptoms in the feet; some first experience flaccidity, weakness, pain, and numbness. When Cold predominates, it is termed Painful Bi (Tongbi) due to Cold. Some may suddenly fall while walking, or have swollen and distended calves, though some do not swell. Some have withered and thin feet and knees; some have palpitations; some have insensitivity in the lower abdomen. As the disease progresses deeply, Ying (Nutritive) and Wei (Defensive) Qi circulation becomes stagnant, causing the skin to become deficient and unable to nourish itself, resulting in numbness (Bu Ren). "Bu Ren" means the skin is callous and unaware of touch. Some experience whole-body spasms; some vomit upon seeing food or smelling it; some have chest fullness and急促 breathing; some have generalized soreness and pain. These are all signs of Hongjiao. What the Yellow Emperor called "Huan Feng" (Lax Wind) refers to Cold-Damp Bi obstruction. Flaccidity and weakness are called Huan Feng; pain is called Shi Bi (Damp Bi). "Bi" means closure; closed and insensible, hence Bi. When Cold invades the Three Yang meridians, the illness must be cold; Yuepi Tang (Curtain-Dispersing Decoction) and Xiao Xuming Tang (Minor Continuation of Life Decoction) are indicated. For Xiao Xuming Tang, adding fresh ginger juice immediately after decocting yields the best results. When Summer-Heat invades the Three Yang meridians, the illness must be hot; use Xiao Xuming Tang removing Fuzi (Aconite Root) and reducing Guizhi (Cinnamon Twig) by half. For severe restlessness, Zixue (Purple Snow) is best. For severe constipation, Piyue Wan (Spley-Restriction Pill), Shengong Wan (Divine Merit Pill), Wuro Wan (Five Softness Pill), Dasanwan San (Great Three-Wrist Powder), and Mugua San (Papaya Powder) are indicated. Hongjiao deaths result from Excess Qi; no one dies from deficiency caused by medication. Headache, fever, joint pain, and weak feet indicate an underlying Hongjiao now manifesting. For swollen feet, Binglang San (Areca Seed Powder) is indicated. Discussions on Hongjiao formulas are most detailed in *Qianjin Fang* and *Waitai Miyao*, so they are not repeated here. Generally, Yuepi Tang, Xiao Xuming Tang, Yiyiren Jiu method (Coix Seed Wine), Piyue Wan, and Shengong Wan are essential medicines. Acupuncture and moxibustion are preferred; taking tonics and using decoctions for washing are major medical taboos.
Formulas:
Binglang San (Areca Seed Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking upward, causing chest/abdominal oppression, restlessness.
Ingredients: Areca Seed, Antelope Horn Shavings, Costus Root (each 3 fen); Prunus Mume Seed (2.5 liang, soaked in water, peeled, lightly stir-fried); Evodia Fruit (1 fen, soaked in water seven times, dried, lightly stir-fried); Tangerine Peel (3 fen, soaked in water, white pith removed, dried). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water until 6 fen remains. Strain. Take warm at any time.
Biejia San (Turtle Shell Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking the Heart causing confusion, abdominal distension like stone, difficult urination/defecation.
Ingredients: Turtle Shell (3 fen, vinegar-fried until slightly yellow, skirt removed); Akebia Stem (3 fen, sliced); Prunus Mume Seed (soaked, peeled, pit removed, lightly stir-fried); Red Poria (each 1 liang); Antelope Horn Shavings; Areca Seed (each 3 liang). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 zhong zhan of water until 6 fen remains. Strain. Take warm at any time.
Muxiang San (Costus Root Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan, epigastric hardness/fullness, occasional pain, inability to eat.
Ingredients: Costus Root, Turtle Shell (vinegar-fried, skirt removed), Chebula Epicarps, Areca Seed, Red Poria, Prunus Mume Seed (soaked, peeled, pit removed, lightly stir-fried; each 3 fen). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 zhong zhan of water until 6 fen remains. Strain. Take warm at any time.
Chenxiang San (Agarwood Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan rushing to the Heart, causing stifling sensation, shortness of breath, sore/aching feet/knees, drowsiness.
Ingredients: Agarwood (3 fen); Red Peony Root (1 liang); Akebia Stem (3 fen, sliced); Perilla Stems/Leaves (1.5 liang); Areca Seed (3 fen); Evodia Fruit (0.5 liang, soaked in water seven times, dried, lightly stir-fried); Mirabilite (1 liang). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome until 6 fen remains. Strain. Take warm at any time.
Banxia San (Pinellia Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan, heart vexation/stifling, loss of appetite, vomiting/phlegm.
Ingredients: Pinellia Tuber (washed seven times in water to remove slipperiness); Bitter Orange (bran-fried, white pith removed); Red Poria; Peucedanum Root (radicle removed); Akebia Stem (sliced); Ginseng Radix (radicle removed; each 3 fen). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome until 6 fen remains. Strain. Take warm at any time.
Sangbaipi San (Mulberry Root Bark Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan rushing to the Heart, causing mental confusion.
Ingredients: Mulberry Root Bark (sliced); Akebia Stem (sliced); Tangerine Peel (soaked, white pith removed, dried); Perilla Stems/Leaves (each 2 or 3 liang); Areca Nut (1 liang, sliced). Process: Grind into powder. Dosage: 0.5 liang per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.
Lingyangjiao San (Antelope Horn Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan rushing to the Heart/Chest causing vexation.
Ingredients: Antelope Horn Shavings (1 liang or 1 liang); Inula Flower (3 fen); Red Poria (1 liang); Scutellaria Root (3 fen); Pinellia Tuber (3 fen, washed seven times); Tangerine Peel (3 fen, soaked, white pith removed, dried); Areca Seed (3 fen; *Shengji Fang* uses 0.5 liang); Evodia Fruit (0.5 liang, washed seven times, dried, lightly stir-fried). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time. (*Shengji Fang*: 5 qian bi per dose, 1.5 zhong zhan water, 1 fen Ginger smashed, decoct until 7 fen remains, take warm before meals. Named Lingyangjiao Tang.)
Zisu San (Perilla Leaf Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan rushing to the Heart, causing mental restlessness, vomiting, aversion to food, sore/aching waist/knees.
Ingredients: Perilla Stems/Leaves (1 liang); Costus Root (3 fen; *Shengji Fang* 0.5 liang); Red Poria (3 fen; *Shengji Fang* 0.5 liang); Agarwood (1 liang); Evodia Fruit (1 fen, washed seven times, dried, lightly stir-fried); Red Peony Root (1 liang); Tangerine Peel (3 fen, soaked, white pith removed, dried; *Shengji Fang* 1 fen); Areca Seed (3 fen, sliced; *Shengji Fang* 1 fen); Akebia Stem (1 liang, sliced). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome until 6 fen remains. Strain. Take warm at any time.
Qianhu San (Peucedanum Root Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking upward, phlegm reversal, dizzy head/eyes.
Ingredients: Peucedanum Root (1 liang, radicle removed); Pinellia Tuber (washed seven times); Cinnamon Bark; Licorice Root (honey-fried, slightly red, sliced); Tangerine Peel (soaked, white pith removed, dried); Areca Nut (each 3 liang or 3 fen); Red Poria (1.5 liang); Mulberry Root Bark (1.5 liang, sliced). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.
Xijiao San (Rhinoceros Horn Powder, from *Shenghui Fang*): Treats Wind-Toxin Hongjiao after Shanghan, chest/diaphragm oppression, dizziness, vertigo.
Ingredients: Rhinoceros Horn Shavings (3 fen); Saposhnikovia Root (radicle removed); Notopterygium Root; Gentian Macrophylla Root (radicle removed; each 1 liang); Tangerine Peel (1 liang, soaked, white pith removed, dried); Cinnamon Bark; Areca Nut (each 3 fen); Achyranthes Root (1 liang or 0.5 liang, radicle removed). Process: Grind into powder. Dosage: 5 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.
Chifuling San (Red Poria Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking upward, vexation/fullness, and sore/swollen feet/knees.
Ingredients: Red Poria; Red Peony Root (each 1 liang); Bitter Orange (bran-fried, slightly yellow, pith removed); Areca Nut (each 3 fen); Mulberry Root Bark (1.5 liang, sliced); Perilla Stems/Leaves (3 fen); Lily Bulb (3 fen); Rhubarb (3 fen, sliced, crushed, lightly stir-fried); Licorice Root (0.5 liang, honey-fried, slightly red, sliced); Stephania Root (3 fen); Prunus Mume Seed (3 fen, soaked, peeled, pit removed, lightly stir-fried); Antelope Horn Shavings (3 fen). Process: Grind into powder. Dosage: 5 qian per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.
Chaihu San (Bupleurum Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking upward, chest/heart vexation, panting, poor appetite.
Ingredients: Bupleurum Root (1 liang, radicle removed); Inula Flower; Green Tangerine Peel (soaked, white pith removed, dried; each 3 fen); Areca Nut (3 fen); Mirabilite (2 liang); Licorice Root (0.5 liang, honey-fried, slightly red, sliced); Pinellia Tuber (3 fen, washed seven times); Mulberry Root Bark (1.5 liang, sliced); Perilla Stems/Leaves (3 fen). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.
Another Formula (from *Shenghui Fang*):
Ingredients: Costus Root (3 fen); Areca Seed (2 fen); Mirabilite (3 fen); Perilla Stems/Leaves (0.5 liang); Immature Bitter Orange (0.5 liang, bran-fried, slightly yellow). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome and 3 stalks of Scallion White until 5 fen remains. Strain. Take warm at any time.
Dahuang Wan (Rhubarb Pill, from *Shenghui Fang*): Treats Hongjiao after Shanghan and Kidney Qi rushing upward.
Ingredients: Rhubarb (1 liang, sliced, crushed, lightly stir-fried); Achyranthes Root (3 fen, radicle removed); Areca Seed (1 liang); Bitter Orange (3 fen, bran-fried, slightly yellow, pith removed); Costus Root (3 fen); Ginseng Radix (3 fen, radicle removed); Prunus Mume Seed (1 liang, soaked, peeled, pit removed, lightly stir-fried); Cinnamon Bark (3 fen); Peucedanum Root (1 liang, radicle removed). Process: Grind into powder, mix with refined honey, pound 200-300 times, form pills like wu-tong seeds. Dosage: 30 pills before meals, taken with warm wine.
Mugua Wan (Papaya Pill, from *Shenghui Fang*): Treats chronic Hongjiao after Shanghan, abdominal distension, leg/knee edema, chest/diaphragm oppression.
Ingredients: Papaya (1.5 liang, dried); Cinnamon Bark (0.5 liang); Agarwood (1 liang); Bupleurum Root (1 liang, radicle removed); Areca Seed (1 liang); Galangal (3 fen, sliced); Red Peony Root (1 liang); Evodia Fruit (3 liang, soaked in water seven times, dried, lightly stir-fried); Magnolia Bark (3 fen, coarse bark removed, fried with ginger juice until fragrant). Process: Grind into powder, mix with refined honey, pound 200-300 times, form pills like wu-tong seeds. Dosage: 30 pills before meals, taken with Ginger Decoction.
Lin-Zhan Fang (Washing/Dipping Formula, from *Shenghui Fang*): Treats early-stage Hongjiao after Shanghan.
Ingredients: Coix Root (3 liang); Dioscorea Hypoglauca Branches (5 liang); Bitter Orange Root (3 liang); Evodia Fruit (1 liang). Process: Finely slice, decoct with 3 dou of water until 2 dou remains. Strain, add 0.5 he of salt and 1 bowl of sour rice water. Wash feet according to temperature. Stand on a new brick while washing; do not let water exceed the ankles. Wash slowly until cool. Afterward, rub the soles of the feet with a little Ginger Juice to generate heat.
Lin-Zhan Fang (Washing/Dipping Formula, from *Shenghui Fang*): Treats Hongjiao after Shanghan with persistent swelling/distension.
Ingredients: Castor Leaves; Goji Root Bark; Grape Vines (each 1 liang); Dioscorea Hypoglauca Branches (7 liang, sliced); Notopterygium Root (1 liang); Ligusticum Root (1 liang); Evodia Fruit (0.5 liang); Apricot Seeds (0.5 liang); Sichuan Pepper (1 he); Blue Vitriol/Salt (1 liang). Process: Finely slice, divide into two doses. Each dose decocted with 2 dou of water.
Binglang San (Areca Seed Powder): Treats Hongjiao after Shanghan attacking the Heart causing extreme stifling.
Ingredients: Areca Seed (sliced); Costus Root (each 1 liang); Prunus Mume Seed (lightly stir-fried, peeled); Cinnamon (coarse bark removed, each 3 fen); Evodia Fruit (washed three times in water, dried, stir-fried, 0.5 liang); Red Poria (black skin removed); Achyranthes Root (radicle removed, wine-soaked, dried, each 3 fen). Process: Grind into fine powder. Dosage: 1.5 qian bi per dose. Decoct in water. Before meals, take mixed with Sangbaipi-Mutong Decoction. Twice daily.
Chenju Pi San (Tangerine Peel Powder): Treats Hongjiao after Shanghan, chest fullness, abdominal oppression,急促 breathing.
Ingredients: Tangerine Peel (soaked, white pith removed, dried, 3 fen); Areca Seed (sliced, 1 liang); Cinnamon (coarse bark removed, 3 fen); Morning Glory Seeds (lightly stir-fried, 1 liang). Process: Grind into fine powder. Dosage: 0.5 or 1 qian bi per dose. Before meals, taken with warm wine. Twice daily.
Fuling Tang (Poria Decoction): Treats Hongjiao after Shanghan attacking the Heart causing confusion, abdominal distension like stone, red/scanty urine.
Ingredients: Red Poria (black skin removed, 1 liang); Turtle Shell (vinegar-fried, skirt removed); Prunus Mume Seed (lightly stir-fried, peeled); Akebia Stem (sliced, each 3 fen). Process: Coarsely crush and sieve. Dosage: 3 qian bi per dose. Decoct with 1 zhong zhan of water until 7 fen remains. Strain. Take warm before meals.
Banxia Tang (Pinellia Decoction): Treats Hongjiao after Shanghan, heart vexation/stifling, loss of appetite, vomiting/phlegm.
Ingredients: Pinellia Tuber (washed seven times, dried); Bitter Orange (pith removed, bran-fried); Poria (black skin removed); Peucedanum Root (radicle removed); Akebia Stem (sliced, each 3 fen). Process: Coarsely crush and sieve. Dosage: 3 qian bi per dose. Decoct with 1 zhong zhan of water plus 1 fen of Ginger Rhizome (smashed) until 0.5 zhong zhan remains. Strain. Take warm before meals.
Chixiaodou Tang (Adzuki Bean Decoction): Treats Hongjiao after Shanghan, knee swelling/distension, shortness of breath, constipation.
Ingredients: Adzuki Beans (0.5 he); Mulberry Root Bark (0.5 liang); Perilla Stems/Leaves (1 liang); Areca Seed (0.5 liang). Process: Slice the three herbs like hemp seeds. Decoct together with Adzuki Beans in 5 zhong zhan of water plus 1 fen of Ginger Rhizome (smashed) until 2.5 zhong zhan remains. Strain. Divide into two doses. Take warm before meals.
Xijiao San (Rhinoceros Horn Powder): Treats Hongjiao after Shanghan, swollen/distended calves, chest vexation.
Ingredients: Rhinoceros Horn (sliced, 1 liang); Areca Seed (sliced, 0.5 liang); Tangerine Peel (soaked, white pith removed, dried, 3 fen); Asarum Root (radicles/leaves removed, 0.5 liang); Evodia Fruit (washed three times, dried, stir-fried, 1 fen). Process: Grind into fine powder. Dosage: 1.5 qian bi per dose. Before meals, taken with hot Ginger-infused wine. Twice daily.
Wuzhuyu San (Evodia Fruit Powder): Treats Hongjiao after Shanghan, chest/abdominal oppression/pain, restlessness.
Ingredients: Evodia Fruit (washed three times, dried, stir-fried, 1 fen); Areca Seed (sliced); Angelica Sinensis Root (sliced, dried); Costus Root; Prunus Mume Seed (lightly stir-fried, peeled, each 3 fen). Process: Coarsely crush and sieve. Dosage: 3 qian bi per dose. Decoct with 1 zhong zhan of water until 7 fen remains. Strain. Take warm before meals.
Daji Wan (Kerria Root Pill): Treats Hongjiao after Shanghan attacking the Heart, abdominal hard distension, red/scanty urine.
Ingredients: Kerria Root (stir-fried); Genkwa Flower (vinegar-fried until charred); Lepidium Seeds (stir-fried; each 0.5 liang); Croton Seeds (peeled, stir-fried); Croton Seeds (peeled, heart removed, oil pressed out, finely ground; each 1 fen). Process: Grind into fine powder, mix with Croton, refine with honey, form pills like wu-tong seeds. Dosage: 3-5 pills, taken with warm rice drink. At any time.