详见热门病本不同例下
外台秘要云第一忌嗔嗔则心烦烦则香港脚发又禁大语大语则伤肺肺伤亦发动又不得露足当
风入
水以冷水洗足两脚胫尤不宜冷虽暑月常须着绵 至冬寒倍令两胫温暖微汗大佳根据此将息气渐
薄
损每至寅丑日割手足甲割少侵肉去气夏时腠理开不宜当风卧睡睡觉令人按挪勿令邪气稽留数
劳动关节常令通畅此并养生之要拒风邪之法也寻常有力每食后行三五百步疲倦便止脚中恶气
随即下散虽浮肿气不能上也
发明云第一凡酒及潼酪勿使过度过则损伤脾胃下疰于足胫 肿遂成香港脚第二欲不可纵嗜
欲则香港脚发凡饮食之后宜缓行如上法经云逸者行之又云病在脾忌温食饱食湿地濡衣
杨太受云香港脚之疾自古皆尚疏下为疾壅故也然不可太过太过则损伤脾胃使营运之气不能
上行反下注为香港脚也又不可不及不及则使气壅不得消散今立三方于后详虚实而用之
按三方医学发明谓导滞汤导引丸除湿丹例是也然亦大略言尔如香港脚在表在气血之分而疏下
之法可例用乎
活人书云凡香港脚服补药及用汤渫洗者皆医之大禁也发明谓此为南方外感湿气乘虚袭入为
肿痛而言非为北方内受湿气注下肿痛而言也盖湿气不能外达宜淋渫开导泄越其邪也
杨太受云香港脚是为壅疾治当以宣通之剂使气不能成壅也壅既成而盛者砭恶血而去其重势
经曰蓄则肿热砭射之也后以药治之
详见“热门病本不同例”一节。
《外台秘要》说:第一禁忌是发怒,发怒则心烦,心烦则香港脚发作;又禁止大声说话,大声说话则伤肺,肺受伤也会引发此病;又不让双脚暴露在风中或进入水中,用冷水洗脚,尤其是两小腿尤其不宜受冷。即使在暑热月份,也常须穿着丝绵衣物;到了冬季寒冷时,更要加倍使两小腿温暖,微微出汗最好。根据这些原则调养,气息逐渐淡薄减少。每逢寅日、丑日,修剪手脚指甲,稍微切入肉中,以去除邪气。夏季腠理开泄,不应当迎风卧睡,睡觉醒来让人按摩推拿,不要让邪气滞留。经常活动关节,常令其通畅,这都是养生的要领、抵御风邪的方法。平常身体有力的人,每顿饭后可行走三五百步,疲倦了就停止,脚中的恶气随即向下消散,即使出现浮肿,气也不能上逆。
《医学发明》说:第一,凡是酒及乳酪类食物不要过量,过量则损伤脾胃,湿气下注于足胫,肿胀遂形成香港脚。第二,房事不可放纵,嗜欲过度则香港脚发作。凡是饮食之后宜缓步行走,如上述方法。《内经》说:“安逸的病人应使之运动。”又说:“病在脾,忌食温热食物、饱食、穿潮湿衣服。”
杨太受说:香港脚之疾,自古以来都崇尚疏利通下之法,因为这是疾病壅滞的缘故。然而不可太过,太过则损伤脾胃,使营运之气不能上行,反而下注成为香港脚;也不可以不及,不及则使气机壅滞不得消散。现在立下三个方剂在后面,详细辨别虚实而使用它们。按这三个方剂,《医学发明》中称为导滞汤、导引丸、除湿丹,大抵就是这些例子。然而也只是大概而言,比如香港脚在表、在气血之分,疏下之法可以类推使用吗?
《活人书》说:凡是香港脚服用补药及使用汤药淋洗的,都是医家的重大禁忌。《医学发明》认为这是针对南方外感湿气乘虚袭入导致肿痛而言,并非针对北方内受湿气下注导致肿痛而言。盖因湿气不能向外透达,适宜用淋洗疏通开导,泄越其邪气。
杨太受说:香港脚属于壅滞之疾,治疗应当用宣通之剂,使气机不成壅滞。如果壅滞已经形成且势盛,应用砭石刺破排出恶血,以去除严重的病势。《内经》说:“蓄积则肿热,应用砭石射之。”之后再用药物进行治疗。
See the section "Example of Different Origins of Hot Diseases."
*Waitai Miyao* states: The first taboo is anger; anger causes mental restlessness, and mental restlessness triggers Hongjiaojiao (Gouty Arthritis). One must also avoid speaking loudly, as loud speech damages the Lung (Lung), and lung damage can also induce the disease. One should not expose the feet to wind or immerse them in water, nor wash the feet with cold water; especially, the calves are particularly unsuitable for cold exposure. Even during hot summer months, one should constantly wear silk floss garments; in winter cold, one must doubly ensure the warmth of the calves, with slight sweating being ideal. Based on these principles, regulate one's lifestyle so that qi gradually becomes thin and reduced. On every Yin and Chou days, trim the fingernails and toenails slightly into the flesh to expel pathogenic qi. In summer, when the cou li (pores/skin texture) are open, one should not sleep facing the wind. Upon waking from sleep, have someone massage and knead the body to prevent pathogenic qi from lingering. Frequently move the joints to keep them unobstructed; this is the essence of health preservation and a method to repel wind pathogens. Those with sufficient strength should walk three to five hundred steps after each meal and stop when tired; the evil qi in the feet will then dissipate downward, and even if edema occurs, the qi will not ascend.
*Mingyi Bielu* states: First, do not consume alcohol and dairy products (such as camel milk/cheese) excessively; excess damages the Spleen and Stomach, causing dampness to sink to the lower legs, resulting in swelling and forming Hongjiaojiao. Second, sexual desire should not be unrestrained; excessive lust induces Hongjiaojiao. After eating, one should walk slowly, as described above. The *Classic* says: "For those who are idle/languid, promote movement." It also says: "When the disease is in the Spleen, avoid warm foods, overeating, and wearing damp clothes."
Yang Taishou said: Since ancient times, the treatment of Hongjiaojiao has favored methods of draining and purging, because it is a disease of obstruction. However, one must not purge too heavily, as this damages the Spleen and Stomach, preventing the transporting and transforming qi from ascending, causing it to sink instead and become Hongjiaojiao. Conversely, one must not purge insufficiently, as this fails to resolve the qi obstruction. I now present three formulas below to be used according to detailed differentiation of deficiency and excess. According to *Mingyi Bielu*, these correspond to Daozhi Tang (Stagnation-Resolving Decoction), Daoyin Wan (Guiding and Leading Pill), and Chushi Dan (Dampness-Expelling Pellet). However, these are merely general examples. For instance, if Hongjiaojiao is at the exterior or involves the blood and qi levels, can the method of draining and purging be applied by analogy?
*Heren Shu* states: Taking tonifying medicines or using decoctions for washing/bathing in cases of Hongjiaojiao are major taboos for physicians. *Mingyi Bielu* clarifies that this prohibition applies to cases where external damp-heat invades due to deficiency, causing swelling and pain (typical of the South), rather than cases where internal dampness sinks downward causing swelling and pain (typical of the North). Since the dampness cannot reach the exterior, it is appropriate to use bathing and flushing to open, guide, and vent the pathogen.
Yang Taishou said: Hongjiaojiao is a disease of obstruction; treatment should employ agents that promote diffusion and unblocking to prevent qi from becoming obstructed. If obstruction has formed and is severe, one should use bian stone (stone lancet) to puncture and evacuate bad blood to remove the intense pathological condition. The *Classic* states: "Accumulation leads to swelling and heat; treat with bian stone." Subsequently, treat with herbal medicine.