申斗垣曰∶脾主四肢，脾有湿热，则手足指腐烂成疳是也。如长夏六月间，湿
热盛而诸物腐焉。（《启玄》）
又曰∶宜服清脾胃、利湿热之剂。
澄曰∶此证指顶如泡，贯脓之后，破烂流水，当用燥湿生肌散干掺自效。
验方（《启玄》）
儿茶（五钱） 雄黄（一钱） 冰片（二分）
研细，米泔水洗净，搽之。
王肯堂曰∶代指者，先肿 热痛，色不黯，缘爪甲边结脓，剧者爪皆脱落。但
得一物冷药汁 渍之，佳。爪者，筋之余，筋赖血养，血热甚，注于指端，故手指肿
热，结聚成脓；甚则爪甲脱落。此证类于指疽，然无蕴毒，故色不黯，虽久亦不杀
人。（《准绳》）
\r代指\p04-a41a121.bmp\r
陈实功曰∶手指忽肿痛者，名为代指。（《正宗》）
薛立斋曰∶代指生指甲身之内，三四
日后，甲面上透一点黄色。初起先肿 热，疼痛应心，宜用甘草、朴硝各五钱，熬水
浸洗即瘥。如甲面透黄，即系内脓已成，但无门得泄；急用钱针在指甲身，就脓近处
挑一小孔，脓方得出，随后轻手挤尽余脓，用黄连膏贴之，易愈。若失治或敷凉药，以
致肌肉冰凝，脓毒浸淫好肉，爪甲溃空，必然脱落，宜用琥珀膏贴之，一两月收功。
申斗垣说：脾主司四肢，如果脾脏有湿热，就会导致手足指头腐烂，形成疳症。比如在长夏六月期间，湿热之气旺盛，各种物体都会腐败。（出自《启玄》）
顾世澄说：这种病症表现为指头顶端像水泡一样，化脓之后，患处破烂并流出液体，应当使用燥湿生肌散进行干撒，自然能够见效。
验方（出自《启玄》）
儿茶（五钱） 雄黄（一钱） 冰片（二分）
研磨成细粉，用米泔水洗净患处后涂抹。
王肯堂说：代指病，起初肿胀、发热、疼痛，颜色不暗紫，这是因为指甲边缘结脓，严重的会导致指甲全部脱落。只要用一种冷性药物的汁液浸泡患处，效果很好。指甲是筋的余气所化，筋依赖血液滋养，如果血热严重，热气灌注于手指末端，所以手指会肿胀发热，气血结聚而成脓；严重时指甲会脱落。此证类似于指疽，但是没有蕴积的毒邪，所以颜色不暗紫，即使病程长久也不会致死。（出自《准绳》）
陈实功说：手指突然发生肿痛的情况，称为代指。（出自《正宗》）
薛立斋说：代指生在指甲内部的肉里，三四天后，指甲面上透出一点黄色。初起时先出现肿胀、发热，疼痛感应到心脏部位，适宜使用甘草、朴硝各五钱，熬水浸泡清洗，即可痊愈。如果指甲面透出黄色，说明内部脓液已经形成，只是没有出口得以排出；急需用钱针在指甲身上，靠近脓液的地方挑一个小孔，脓液才能流出，随后轻轻手法挤尽剩余的脓液，使用黄连膏贴敷，容易愈合。如果延误治疗或者敷用凉药，导致肌肉冰冷凝固，脓毒侵蚀好肉，指甲溃烂变空，必然脱落，此时适宜使用琥珀膏贴敷，一两月左右可以收功。
Shen Douyuan stated: The Spleen governs the four limbs. If damp-heat resides in the Spleen, it leads to the rotting and ulceration of the fingers and toes, manifesting as gan (necrotic sores). For instance, during the late summer months (the sixth lunar month), when damp-heat is abundant, all organic matter tends to decay. (From *Qixuan*)
He further stated: It is appropriate to administer formulas that clear the Spleen and Stomach and promote the drainage of damp-heat.
Gu Shicheng stated: In this condition, the tip of the finger resembles a blister. After suppuration, the area becomes ulcerated and exudes fluid. One should apply Zaoshi Shengji San (Drying-Dampness and Muscle-Regenerating Powder) as a dry dusting, which will naturally yield effective results.
Verified Formula (From *Qixuan*)
*Calcariae Corii Elephanti* (Wucha, 儿茶) - 5 qian
*Realgar* (Xionghuang, 雄黄) - 1 qian
*Borneolum Syntheticum* (Bingpian, 冰片) - 2 fen
Grind into fine powder. Cleanse the affected area with rice-washing water (*Migan Shui*) and apply.
Wang Kentang stated: Dai Zhi (Substitute Finger Abscess) initially presents with swelling, heat, and pain, but the skin color remains non-darkened. This occurs because pus forms at the edge of the nail; in severe cases, the entire nail may fall off. Soaking the affected part in the juice of a single cold-natured herb yields good results. Nails are considered the surplus of tendons, and tendons rely on blood for nourishment. When blood heat is severe, it pours into the finger tips, causing swelling, heat, and the accumulation of pus in the digits; in extreme cases, the nails detach. This condition resembles Zhi Ju (Finger Carbuncle), but lacks accumulated toxic pathogens, hence the color does not darken, and even if prolonged, it is not fatal. (From *Zhunsheng*)
Chen Shigong stated: Sudden swelling and pain of the fingers is named Dai Zhi. (From *Zhengzong*)
Xue Lizhai stated: Dai Zhi originates within the flesh beneath the nail. After three or four days, a yellow spot appears on the nail surface. Initially, there is swelling, heat, and pain that radiates to the heart region. It is advisable to use 5 qian each of *Gancao* (Licorice Root) and *Puxiao* (Mirabilite), boil them in water, and soak/wash the area, which will lead to recovery. If a yellow spot appears on the nail surface, it indicates that internal pus has formed but lacks an outlet. Urgently, use a coin needle to pierce a small hole in the nail body near the pus to allow drainage. Subsequently, gently squeeze out any remaining pus, apply Huanglian Gao (Coptis Ointment), and healing will be rapid. If treatment is delayed or cold-natured medicines are applied, causing the muscle tissue to freeze and congeal, the pus and toxins will invade healthy flesh, leading to hollowing and inevitable shedding of the nail. In such cases, apply Hupo Gao (Amber Ointment); recovery can be expected within one to two months.
Verified Formula: Soak *Wumei* (Mume Fruit) in vinegar, grind it, and apply to the affected area for immediate cure.
Another Formula: Decoct *Mangxiao* (Mirabilite) in water to wash the area, allowing the abscess to rupture spontaneously.