疗此病,纵《明堂》无正文,但随所苦,火艾彻处,痛便消散,此不可知也(按∶程衍道本,知上补不字)。
又候灸疮瘥后,瘢色赤白,平复如本,则风毒尽矣。若色青黑者,风毒未尽,仍灸勿止,待肢体轻乃休矣。
(同上)
苏恭云∶若香港脚盛发时,自腰以上,并不得针灸,当引风气上则杀人。气歇以后,有余病者,灸无妨。唯
冬月得灸,春夏不可灸,自风市以下固宜佳耳。(同上)
又若胸中气散,而心下有脉洪大跳,其数向下分入两髀股内,令人心急忪悸者,宜以手按捻小腹下两旁,
接髀大斜文中,有脉跳动,盒饭文上,灸跳三七炷即定。灸毕皆须灸三里二十炷,以引其气下也。(同上)
《唐论》又若心胸气满,已灸身胫诸穴及服汤药,而气犹不可(程刻可改下),烦急欲死者,宜灸两足心
下当中陷
处各七炷,气即下。此穴尤为极要,而不可数灸,但极急乃灸七炷耳。凡灸不废汤药。药攻其内,灸泄其外,
譬如开门驱贼,贼则易出;若闭户逐之,贼无出路,当反害人耳。(同上)
调摄法 凡香港脚之病,极须慎房室,羊肉牛肉鱼蒜,蕺菜菘菜,蔓菁瓠子,酒面酥油乳糜,猪鸡鹅鸭,
有方用鲤鱼头,此等并切禁,不得犯之,并忌大怒。惟得食粳梁粟米,酱豉葱韭薤,椒姜橘皮。又不得食诸生
果子酸酢之食,犯者皆不可瘥。又大宜生牛乳、生栗子矣。(《千金》)(按∶又《食治》门中,引扁鹊云∶
患香港脚虚胀者,不得食甜瓠,其患永不除。)
苏∶生姜蒜豉当食大佳,不宜食面及羊肉萝卜蔓菁韭。酒醉房室,久立冷湿,船行水气,夏月屋中湿气热
气,劳剧哭泣忧愦,如此等类,好使气发也。(《外台》)
又第一忌嗔,嗔即心腹烦,烦即香港脚发。第二忌大语,大语即损肺,肺损亦发动。又不得露脚当风入水,
以冷水洗脚,脚胫尤不宜冷。(同上)
又昼日莫多卧,须力遨游,舒畅情性,以勿睡也。(同上)
又患香港脚,每旦早食任意饱,午后少食,日晚不食弥佳。(同上)(《宝鉴》此下曰∶恐伤脾胃营运之气,
失其常度。况夜食则血气壅滞而行阴道,愈增肿痛。)
唐∶若头面及项,少似热气上,即露背膊取冷,勿使腰肾冷,其背膊冷,极浓着衣,须如此将息必渐瘥。
若不解将息,立见危殆困笃,转加易发,至损性命。洗面及脚,皆须热汤,小添冷水洗之。又不得食酸饭,不用
乘马。若能步行,劳筋力,其香港脚自然渐瘥。(同上)
又凡香港脚病患不能永瘥,至春夏还复发动。夏时腠理
开,不宜卧睡,睡觉令人按挪,勿使邪气稽留,数劳动关节,常令通畅,此并养生之要,拒风邪法也。寻常有
力,每食后行五百步,罢倦即止,此脚中恶气随即下散,虽浮肿气不能上也。(同上)
患香港脚人,不可吃鲫鱼,甚验。(《琐碎录》)
治疗这种病,虽然《明堂》中没有明确的正文记载,但只要根据患者痛苦的地方,用艾火灸透患处,疼痛就会消散,这是显而易见的(按:程衍道本在此处补了一个“不”字)。
另外观察,如果灸疮愈合后,瘢痕颜色变为赤白,且皮肤平复如初,说明风毒已经排尽。如果瘢痕颜色呈青黑色,说明风毒尚未排尽,应继续施灸不停止,直到肢体感觉轻快才停止。
苏恭说:如果香港脚(足部湿邪引起的疾病)剧烈发作时,腰部以上部位都禁止针灸,因为若引风气上行会导致死亡。待气机平息后,若有残留病症,施灸无妨。只有冬季可以施灸,春夏季节不可施灸,从风市穴以下的部位适宜施灸。(同上)
另外,如果胸中气机涣散,而心下有脉搏洪大跳动,其脉数向下分入两腿大腿内侧,使人心中焦急惊恐悸动,应当用手按压揉捏小腹下两旁,连接到大腿外侧斜纹中间的位置,此处有脉搏跳动,应在该纹路上方施灸,灸七壮即可定惊。灸完后都必须再灸足三里穴二十壮,以引导气机下行。(同上)
《唐论》又说,如果心胸胀满,已经灸过身体和胫部的各个穴位并服用了汤药,但气机仍然不能下行,烦躁急迫欲死,应当灸两足心下方中间的凹陷处各七壮,气机即可下行。这个穴位尤为重要,但不能频繁施灸,只有在极度紧急时才灸七壮。凡是施灸都不废弃汤药。药物攻治内部,艾灸宣泄外部,就像开门驱赶贼人,贼人就容易出去;如果关着门追逐,贼人没有出路,反而会伤害主人。(同上)
调养方法:凡是患香港脚的人,非常需要谨慎房事,羊肉、牛肉、鱼、蒜、蕺菜、白菜、蔓菁、瓠子、酒、面、酥油、乳糜、猪、鸡、鹅、鸭等食物,虽然有方剂使用鲤鱼头,但这些都属于严格禁忌,不得触犯,并且要忌大怒。只可以吃粳米、高粱、粟米,以及酱、豉、葱、韭、薤、椒、姜、橘皮。又不能吃各种生果子及酸醋类的食物,触犯这些都不能痊愈。另外非常适合吃生牛奶、生栗子。(《千金方》)(按:另外《食治》门类中,引用扁鹊的话说:患香港脚虚胀的人,不能吃甜瓠,否则病情永远无法去除。)
苏敬说:生姜、蒜、豆豉应当多吃,很好;不宜吃面、羊肉、萝卜、蔓菁、韭菜。醉酒、行房、久站在冷湿之地、船行水气、夏季屋中的湿热之气、劳累过度、哭泣、忧愁烦闷,这些都会导致气机发动。(《外台秘要》)
另外第一忌讳发怒,发怒则心腹烦热,烦热则香港脚发作。第二忌讳大声说话,大声说话会损伤肺脏,肺脏受损也会诱发此病。又不能露脚对着风吹或下水,用冷水洗脚,小腿尤其怕冷。(同上)
另外白天不要多睡觉,必须尽力活动游玩,舒畅性情,避免嗜睡。(同上)
另外患香港脚的人,每天早晨吃饭可以任意吃饱,中午少吃,晚上不吃更好。(同上)(《宝鉴》在此之后说:恐怕损伤脾胃运化之气,失去常态。况且夜间进食会使血气壅滞而行于阴经,更加增加肿痛。)
唐代医家说:如果头面及颈部,稍微感到热气上冲,就露出背部取凉,不要让腰肾受冷,如果背膊冷,就要穿极厚的衣服,必须这样调养护理,病情才会逐渐好转。如果不加以调养护理,立刻会见危险困顿加重,转变加剧容易发病,甚至损害性命。洗脸和洗脚,都必须用热水,稍加冷水清洗。又不能吃酸饭,不要骑马。如果能步行,锻炼筋骨力量,香港脚自然会逐渐好转。(同上)
另外凡是香港脚病患者不能永久痊愈,到了春夏还会再次发作。夏天时腠理开泄,不适宜躺卧睡觉,醒来让人按摩推拿,不要让邪气滞留,多次活动关节,常令其通畅,这都是养生的关键,抵御风邪的方法。平时有力气的人,每顿饭后面行走五百步,疲倦了就停止,这样脚中的恶气随即向下消散,即使浮肿,气也不能上逆。(同上)
To treat this disease, although the *Mingtang* (Classic of Acupoints) lacks explicit text, simply applying moxibustion thoroughly to the area of suffering will cause the pain to dissipate; this is self-evident. (Note: The Cheng Yandao edition adds the character "bu" [not] here.)
Furthermore, observe that after the moxa blisters heal, if the scar color becomes red and white and the skin returns to its original state, the wind-toxin has been completely exhausted. If the color is blue-black, the wind-toxin is not yet exhausted; continue moxibustion without stopping until the limbs feel light, then cease.
Su Gong stated: When Hongjiaojiao (Gouty Arthritis/Edema of the lower limbs) flares up severely, acupuncture and moxibustion are forbidden on the upper body from the waist upwards, as drawing wind qi upward can be fatal. After the qi settles, if residual symptoms remain, moxibustion is permissible. Moxibustion should only be performed in winter, not in spring or summer; it is suitable for areas below the Fengshi acupoint.
Additionally, if the qi in the chest is scattered, but there is a surging, beating pulse under the heart that extends downward into the inner thighs, causing mental anxiety and palpitations, one should use the hand to press and knead the lower abdomen on both sides, connecting to the oblique lines on the outer thighs where the pulse beats. Apply moxibustion above this line for seven moxa cones (zhu), which will stabilize the condition. Afterward, moxibustion must also be applied to Zusanli (ST36) for twenty cones to guide the qi downward.
The *Tang Lun* further states: If there is fullness in the chest and heart, and even after moxibustion on various points of the body and shins and taking herbal decoctions, the qi still cannot descend, leading to extreme irritability and a desire to die, apply seven moxa cones to the central depression below each sole. This point is particularly crucial and should not be frequently moxibusted; only apply seven cones in extreme emergencies. In all cases of moxibustion, do not abandon herbal medicine. Herbs attack internally, while moxibustion vents externally; this is like opening the door to drive out thieves, making it easy for them to exit; if the door is closed while chasing, the thieves have no way out and may harm the owner instead.
Regulation Methods: Patients with Hongjiaojiao must strictly abstain from sexual activity. Foods such as mutton, beef, fish, garlic, Houttuynia (Jicai), Chinese cabbage, turnip (Manjinging), bottle gourd (Huzi), alcohol, wheat noodles, butter/ghee, milk porridge, pork, chicken, goose, and duck are strictly prohibited, although some formulas use carp heads. One must also avoid extreme anger. Suitable foods include japonica rice, sorghum, millet, soy sauce, fermented beans, green onion, leek, wild garlic (Xie), pepper, ginger, and tangerine peel. Do not consume raw fruits or sour/vinegar-based foods; violating these prohibitions prevents recovery. It is highly beneficial to consume raw cow's milk and raw chestnuts. (*Qianjin Fang*) (Note: Additionally, the *Food Therapy* section cites Bian Que stating that patients with Hongjiaojiao deficiency bloating must not eat sweet bottle gourd, otherwise the condition will never resolve.)
Su Jing stated: Ginger, garlic, and fermented soybeans are excellent to eat; however, wheat noodles, mutton, radish, turnip, and leeks should be avoided. Drunkenness, sexual intercourse, prolonged standing in cold/damp places, boat travel moisture, summer indoor heat/humidity, overexertion, crying, and worry/confusion all trigger the onset of qi disturbances. (*Waitai Miyao*)
First, avoid anger; anger causes heart/abdominal irritation, which triggers Hongjiaojiao. Second, avoid loud talking; loud talking damages the Lungs, and Lung damage also induces the disease. Do not expose the feet to wind or enter water, nor wash feet with cold water; the calves are especially susceptible to cold.
Do not sleep excessively during the day; engage in physical activity and leisure to soothe the temperament and avoid lethargy.
Patients with Hongjiaojiao should eat freely and fully at breakfast, eat less at lunch, and refrain from eating dinner, which is optimal. (*Baojian* adds: Fear of damaging the Spleen and Stomach's transportive qi, losing normal rhythm. Moreover, night eating causes blood and qi stagnation moving along yin meridians, increasing swelling and pain.)
Tang physicians stated: If slight heat rises to the head, face, and neck, expose the back to cool down, ensuring the kidneys/lower back do not get cold. If the back feels cold, wear very thick clothing. Such care will lead to gradual recovery. Without proper care, danger and severe illness will appear immediately, worsening rapidly and potentially endangering life. Wash face and feet with hot water, adding a little cold water. Do not eat sour food or ride horses. Walking and exercising muscles/tendons will naturally help Hongjiaojiao gradually improve.
Generally, Hongjiaojiao patients do not achieve permanent cure and relapse in spring/summer. In summer, when pores open, lying down/sleeping is inadvisable; upon waking, massage and knead to prevent pathogenic qi retention. Frequently move joints to keep them unobstructed; this is key to health preservation and resisting wind-pathogens. Those with strength should walk 500 steps after meals, stopping when tired; this disperses evil qi downward in the legs, preventing qi from rising even if edema exists.
Hongjiaojiao patients should not eat crucian carp; this is highly effective. (*Suosui Lu*)