严氏曰古无香港脚之说内经名厥两汉间名缓风宋齐之后谓之香港脚名虽不同其实一也初得不
觉因
他病乃始发或奄然大闷经三两日方觉之先从脚起或缓弱疼痹或行起忽倒或两胫肿满或足膝枯
细或心中忪悸或小腹不仁或举体转筋或见食吐逆恶闻食气或胸满气急或遍体酸疼此其候之不
同也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夫香港脚皆由肾虚而
生
然妇人亦病香港脚者必因血海虚乘七情遂成斯疾兼今妇人病此者众则知妇人以血海虚而得之与
男子肾虚类矣男女用药固无异但兼以治忧恚药无不效也须量人盛衰微加滋补不然则气血日衰
必使年年遇蒸热而作理之必然
陈无择曰香港脚不专主一气亦不专在一经故与中风寒暑湿为异耳兼有所杂生诸病未易分别
须寻
三阴三阳病所在后察脉虚实为治自汗走疰为风胜无汗药急掣痛为寒胜肿满重着为湿胜烦渴热
积为暑胜四气兼中者但推其多者为胜分其表里以施治也脉浮为风紧为寒缓细为湿洪数为热见
于诸阳在外宜发散沉而弦者亦为风沉而紧者为寒沉细为湿沉数为热见诸阴在内宜温利之若大
虚气之间作补汤随病冷热而用之千金方论但备诸证不说阴阳经络所受从何为治
按以上所言脉证但备四气而已至于肿 发疮泡为湿热热毒之胜肿而重者有湿痰胜或肿或
消兼气不升降诸例皆所未详陈云六经证见后各方下
严氏说：古代没有“香港脚”这一病名，《内经》中称之为“厥”，两汉时期称为“缓风”，宋齐之后才称为“香港脚”。名称虽然不同，但实质是一样的。初起时往往没有感觉，因为其他疾病而诱发，或者突然感到极度闷乱，经过两三天后才察觉。症状多从脚部开始，有的表现为迟缓无力、疼痛麻木；有的行走时突然跌倒；有的双侧小腿肿胀满闷；有的足膝枯瘦细小；有的心中悸动不安；有的小腹感觉迟钝或麻木；有的全身肌肉抽搐痉挛；有的见到食物就呕吐，厌恶食物的气味；有的胸膈满闷、气急；有的全身酸痛。这些就是其证候的不同表现。
其脉象浮而弦的，病因起于风邪；脉象濡而弱的，病因起于湿邪；脉象洪而数的，病因起于热邪；脉象迟而涩的，病因起于寒邪。大凡“香港脚”都是由肾虚而生成的。然而妇女也会患“香港脚”，必定是因为血海空虚，受到七情（喜、怒、忧、思、悲、恐、惊）刺激，从而形成这种疾病。如今妇女患此病者众多，可知妇女因血海空虚而患病，与男子因肾虚而患病是类似的。男女用药固然没有太大差异，但如果兼用治疗忧愤郁结的药物，没有不有效的。必须根据患者体质的强弱，稍加滋补，否则气血日渐衰败，必然导致每年遇到蒸腾炎热之时病情发作，这样处理是必然的结果。
陈无择说：“香港脚”不专门主责于某一种气，也不专门局限于某一经络，所以它与中风、伤寒、伤暑、伤湿有所不同。此外还夹杂产生各种其他疾病，不容易区分。必须寻找三阴三阳病所在的部位，然后察看病脉的虚实来施治。自汗、游走性疼痛的是风邪偏胜；无汗、服药后出现紧急掣痛的是寒邪偏胜；肿胀满闷、身体沉重着滞的是湿邪偏胜；烦躁口渴、热邪积聚的是暑邪偏胜。四种邪气兼夹其中时，只需推究哪一种邪气偏胜，分辨表里关系来实施治疗。脉象浮的属风，紧的属寒，缓细的属湿，洪数的属热。见于诸阳经在外的，适宜用发散法；沉而弦的也属风，沉而紧的属寒，沉细的属湿，沉数的属热。见于诸阴经在内的，适宜用温通利下的方法。如果脉象特别虚弱，气息微弱间歇发作，则服用补汤，根据病的寒热性质来选择使用。《千金方》论述了各种证候，但没有说明阴阳经络受邪的情况以及从何着手治疗。
按：以上所说的脉证，只备述了四气（风、寒、暑、湿）而已。至于肿胀、发疮泡，这是湿热、热毒偏胜的表现；肿胀且沉重的，有湿痰偏胜的情况；或者肿或者消，兼有气机升降失常的各种情况，上述例子都未曾详细记载。陈云指出，六经证候出现后，各方剂下还有具体论述。
Yan stated: In ancient times, there was no concept of "Hongxiangjiao" (Gouty Arthritis/Chronic Lower Limb Edema). The *Neijing* (Classic of Internal Medicine) referred to it as "Jue" (Reversal/Cold Extremities), the Han and Wei periods called it "Huanfeng" (Languid Wind), and after the Song and Qi dynasties, it was termed "Hongxiangjiao". Although the names differ, the essence is the same. Initially, there may be no sensation; it may be triggered by other illnesses or manifest suddenly as severe oppression and confusion, only becoming apparent after two or three days. Symptoms often start from the feet: some present with sluggish weakness, pain, and numbness; some experience sudden collapse while walking; some have bilateral swelling and fullness in the lower legs; some have withered and thin feet and knees; some suffer from palpitations; some have insensitivity or numbness in the lower abdomen; some experience generalized muscle spasms; some vomit upon seeing food and detest the smell of food; some have chest fullness and shortness of breath; some have generalized body aches. These are the different manifestations of the syndrome.
Regarding the pulse: floating and wiry indicates etiology originating from Wind; soggy and weak indicates etiology originating from Dampness; surging and rapid indicates etiology originating from Heat; slow and choppy indicates etiology originating from Cold. Generally, Hongxiangjiao arises from Kidney Deficiency. However, women also suffer from Hongxiangjiao, which must be due to the emptiness of the Blood Sea (Uterus/Menstrual system) combined with emotional disturbances (Seven Emotions), leading to this disease. Given that many women suffer from this condition nowadays, it can be known that women contracting it due to Blood Sea emptiness is similar to men contracting it due to Kidney Deficiency. The medication for men and women is fundamentally the same, but if combined with herbs treating sorrow and indignation (emotional stagnation), efficacy is invariably achieved. One must assess the patient's constitution and add mild tonification; otherwise, Qi and Blood will decline daily, inevitably causing recurrence during the steaming heat of summer. This management is inevitable.
Chen Wuyue stated: Hongxiangjiao is not exclusively governed by one type of pathogenic factor, nor is it confined to a single meridian; thus, it differs from Stroke, Cold Damage, Summerheat, and Dampness injury. Furthermore, various mixed diseases arise, making differentiation difficult. One must locate the involvement of the Three Yin and Three Yang meridians, then examine the pulse for deficiency or excess to guide treatment. Spontaneous sweating and migratory pain indicate Wind predominance; absence of sweating and urgent pulling pain after taking medicine indicate Cold predominance; swelling, fullness, and heaviness indicate Dampness predominance; irritability, thirst, and heat accumulation indicate Summerheat predominance. When the four pathogens are mixed, one should deduce which pathogen is predominant, differentiate between exterior and interior, and apply treatment accordingly. A floating pulse indicates Wind, tight indicates Cold, slow and fine indicates Dampness, and surging and rapid indicates Heat. When appearing in the Yang meridians (exterior), dispersing methods are appropriate. A deep and wiry pulse also indicates Wind; deep and tight indicates Cold; deep and fine indicates Dampness; deep and rapid indicates Heat. When appearing in the Yin meridians (interior), warming and purgative/drainage methods are appropriate. If the pulse is extremely deficient and Qi is intermittent and weak, decoctions for tonification should be used, selected according to the cold or heat nature of the disease. The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) lists various syndromes but does not explain the involvement of Yin-Yang meridians or how to initiate treatment based on them.
Commentary: The aforementioned pulse and syndrome descriptions merely cover the Four Qi (Wind, Cold, Summerheat, Dampness). Regarding swelling and blister formation, these are signs of excess Damp-Heat or Heat-Toxin. Swelling accompanied by heaviness suggests excess Damp-Phlegm. Cases where swelling comes and goes, combined with disorders of Qi ascending and descending, are not detailed in the previous examples. Chen noted that after the Six Meridian syndromes appear, specific formulas follow.