牛角散（《正宗》）
牛角尖（烧灰） 松香 水龙骨 轻粉（各等分）
共研细末，牛骨髓调搽，虚弱者兼服十全大补汤。
又方 治脚后跟老皮肉痛起疽，破头成漏，久不收口，不能着地疼甚者。
用黄蜡、松香各一钱许化开，即投入水中取起，看漏口大小，用药为丸，塞住
漏眼，外用棉花裹脚，扎住勿动，十数日之间，漏干着地演试不痛，渐渐行动，漏内肉长，自将药顶出，功难尽述。
熏法（《金鉴》）。用瓦盆一个，内安新砖，砖上安放鸽粪，粪上合笊篱，以脚踏
在笊篱上，再以滚水从旁冲入蒸之，后渍
之，冷则易之，初起用之可消。
又法 新砖烧红，韭菜汁泼之，将病足踏于其上荡之，初起自消。
\r足跟疽\p04-a41a202.bmp\r
王肯堂曰∶足跟疽又名兔啮，其状若兔啮故名。属足太阳经，穴名申脉，在足
跟骨下，此处乃阴阳二跷发源之所，由脏腑积热所致。其毒深重，最忌毒药敷贴，若
紫陷麻木，神昏脉乱者不治，过时溃烂者，有妨饮食，二便不调，或涉房劳，怒气迷闷者死。（《准绳》）
薛立斋曰∶足跟乃督脉发源之所，肾经所过之地，若饮食起居失宜，亏损足三
阳经则成疮矣。若漫肿寒热，或体倦少食，属脾虚下陷也。施治之法，滋肝肾，扶脾胃为主。
冯鲁瞻曰∶妇人足跟足指肿痛，足心发热，皆因胎产经行，失于调摄，亏损足
三阴虚热所致。若肿痛或出脓，用六味地黄丸为主，佐以八珍汤；胃虚懒食，佐以
六君子汤；寒热内热，佐以逍遥散；晡热益甚，头目不清，佐以补中益气汤；凡发
热晡热内热，自汗盗汗等证，皆阴虚假热也。故丹溪谓火起九泉，阴虚之极也。足
跟乃督脉发源之所，肾经所过之地，诸骨承载之本，若不求其属，泛用寒凉，其为夭枉者多矣。（《锦囊》）
又曰∶男酒色过度者，多患此证。
汪省之曰∶啮疽属足太阳膀胱经，多血少气，生于脚跟申脉穴，又名足疽。如
初起赤肿有头可刺；黄白色脓可治。如初起便破，黑烂则凶，若不早治，令人足落不能生也。（《理例》）
又曰∶筋疽生两足后跟昆仑二穴，乃足太阳膀胱经，多血少气。初起三五日，皮
如虫蚀，过一年有虫内食其骨，骨粗脓多时凶，落虫如筋，头黄赤色，经年不瘥，名
曰痿漏，一名曲疽。如脓水不止，名曰冷疽，多死。
《心法》曰∶足跟疽生足跟，俗名脚挛根。此因脏腑积热，汗出涉水，远行伤筋
而成。初肿红紫疼痛，溃破脓水淋沥，状如兔咬。经云∶兔啮状如赤豆，深可至骨，
务须急治，迟则害人，盖谓毒之深恶也。属足太阳膀胱经，穴名申脉，即阳跷脉发源
之所，又乃肾经所过之路，疮口久溃不合，阳跷脉气不能冲发肾气，由此漏泄，以致
患者益虚。初起宜隔蒜片灸之，服仙方活命饮加肉桂、牛膝，溃后宜补中益气汤、人
参养荣汤、桂附地黄丸，随证滋补治之。（《金鉴》）
王海藏曰∶兔啮久不收敛，用盐汤洗之，白术研末撒之，两日一易，谨戒一切劳碌即效。
澄曰∶足跟疽多因汗足涉水，或远行有伤筋骨，或湿热流注而生。初起必痒，勿
视容易，可用艾灸，或因循十余日，脓血淋漓经年不敛，如痒以椒盐汤洗之。
牛角散（出自《外科正宗》）
牛角尖（烧成炭灰）、松香、水龙骨、轻粉（各取等量）
共同研磨成细末，用牛骨髓调和后涂抹患处。身体虚弱者同时服用十全大补汤。
另一方：治疗脚后跟老皮肉疼痛引发疽症，破溃形成瘘管，长期不愈合，无法着地且疼痛剧烈者。
取黄蜡、松香各约一钱，将其熔化，随即投入水中取出，根据瘘口的大小，将药物制成丸剂，塞入漏眼处。外用棉花包裹脚部，扎紧固定不动。十几天后，瘘管排干，着地试探不再疼痛，逐渐可以行走，瘘管内长出肌肉，药物自然被顶出，功效难以尽述。
熏蒸法（出自《医宗金鉴》）。用一个瓦盆，里面放置新砖，砖上安放鸽粪，粪上覆盖笊篱，人脚踏在笊篱上，再从旁边冲入滚水蒸汽熏蒸，熏蒸后用冷水浸泡，水冷则更换热水，初起时使用此法可使肿消。
另一种方法：将新砖烧红，泼上韭菜汁，将患足踏在上面震荡熏蒸，初起时即可消除。
足跟疽
王肯堂说：足跟疽又名兔啮，其形状像兔子咬伤，因此得名。归属于足太阳膀胱经，穴位名为申脉，位于足跟骨下方，此处是阴阳二跷脉发源的地方，由脏腑积热所致。毒气深重，最忌讳使用毒药敷贴。如果出现紫陷麻木、神志昏迷、脉象紊乱的情况，属于不治之症；如果过时溃烂，影响饮食，大小便不调，或者涉及房劳过度、怒气郁结闷绝的，会导致死亡。（出自《医学准绳六要》）
薛立斋说：足跟是督脉发源的地方，也是肾经经过的区域，如果饮食起居不当，亏损了足三阳经，就会形成疮疡。如果漫肿伴有寒热，或者身体疲倦、食欲减少，属于脾虚下陷。施治的方法，以滋补肝肾、扶持脾胃为主。
冯鲁瞻说：妇女足跟和足趾肿痛，足心发热，都是因为胎产或月经期间，失于调养，导致足三阴虚热所致。如果肿痛或出脓，以六味地黄丸为主，辅以八珍汤；胃虚食欲不振，辅以六君子汤；寒热内热，辅以逍遥散；傍晚发热加重，头目不清爽，辅以补中益气汤。凡是发热、傍晚发热、内热、自汗盗汗等症状，都是阴虚假热。所以丹溪说火起九泉，是阴虚到了极点。足跟是督脉发源的地方，肾经经过的区域，诸骨承载的根本，如果不求其所属经络根源，泛用寒凉药物，导致夭折枉死者很多。（出自《薛氏锦囊秘录》）
又说：男性因酒色过度的人，多患此证。
汪省之说：啮疽属于足太阳膀胱经，多血少气，生于脚跟申脉穴，又名足疽。如果初起时赤肿且有脓头，可以刺破；呈黄白色的脓液是可以治疗的。如果初起就破溃，黑烂则凶险，如果不尽早治疗，会导致足部脱落而不能存活。（出自《外科理例》）
又说：筋疽生在两足后跟昆仑二穴，属于足太阳膀胱经，多血少气。初起三五天，皮肤像虫蚀一样，过一年有虫在内部啃食骨头，骨头粗糙、脓多时凶险，掉落的虫像筋一样，头部黄红色，经年不愈，名叫痿漏，又名曲疽。如果脓水不止，名叫冷疽，大多死亡。
《医宗金鉴·外科心法要诀》说：足跟疽生在足跟，俗名脚挛根。这是因为脏腑积热，出汗后涉水，远行损伤筋骨而形成的。初起肿胀红紫疼痛，溃破后脓水淋漓，形状像兔子咬伤。经书说：兔啮形状像赤豆，深度可达骨骼，务必紧急治疗，迟则会害人，这是指毒气的深恶痛绝。归属于足太阳膀胱经，穴位名为申脉，即阳跷脉发源的地方，又是肾经经过的道路，疮口长期溃破不合，阳跷脉气不能冲发肾气，由此漏泄，导致患者更加虚弱。初起宜隔蒜片灸治，服用仙方活命饮加肉桂、牛膝；溃破后宜服用补中益气汤、人参养荣汤、桂附地黄丸，随证滋补治疗。（出自《医宗金鉴》）
王海藏说：兔啮长期不收敛，用盐汤清洗，白术研成末撒在患处，两天更换一次，谨戒一切劳累即刻见效。
顾世澄说：足跟疽多因出汗后涉水，或远行损伤筋骨，或湿热流注而生。初起必然瘙痒，不要视为容易之症，可用艾灸，如果拖延十余日，脓血淋漓经年不愈合，如瘙痒可用椒盐汤清洗。
Niujiao San (from *Waike Zhengzong*)
Horn of Ox, burnt to ash; Pine Rosin; Shuilonggu (Ligulum); Qingfen (Calomel) (each in equal parts).
Grind together into a fine powder. Mix with ox medulla (bone marrow) and apply topically. For those with deficiency, simultaneously administer Shiquan Dabu Tang (Ten Significant Tonifying Decoction).
Another prescription: Treats heel carbuncle arising from pain in old skin and flesh, which breaks down into a fistula, fails to heal for a long time, prevents standing on the ground, and causes severe pain.
Take approximately one qian of yellow wax and pine rosin, melt them, then immediately immerse in water and retrieve. According to the size of the fistula opening, form the medicine into pills and insert them into the fistula. Wrap the foot externally with cotton wool and bind it firmly without movement. Within ten days or so, the fistula will dry up, allowing the patient to stand and test without pain, gradually enabling walking. Flesh will grow inside the fistula, and the medication will be naturally pushed out. The efficacy is hard to fully describe.
Fumigation method (from *Yizong Jinjian*). Use one earthenware basin, place a new brick inside, put pigeon droppings on the brick, cover the droppings with a colander, step onto the colander with your feet, and pour boiling water from the side to generate steam for fumigation. Afterward, soak the foot. Replace with hot water when it cools. Using this at the initial stage can eliminate the swelling.
Another method: Heat a new brick until red-hot, splash it with leek juice, and tread the affected foot upon it to oscillate and fumigate. It will resolve spontaneously at the initial stage.
Heel Carbuncle (Zugen Ju)
Wang Kentang stated: Heel carbuncle is also known as "Rabbit Bite" (Tunie), named so because its appearance resembles a rabbit bite. It belongs to the Foot-Taiyang Bladder Meridian. The acupoint is Shenmai (BL62), located below the calcaneus. This area is the source of the Yin and Yang Qiao vessels. It is caused by accumulated heat in the zang-fu organs. The toxicity is deep and severe; applying toxic medicines topically is strictly contraindicated. If purple depression, numbness, coma, and chaotic pulse appear, it is incurable. If ulceration occurs late, affecting diet, causing irregular urination and defecation, or involving sexual exhaustion and anger-induced fainting, death ensues. (*Yixue Zhunsheng*)
Xue Lizhai stated: The heel is the source of the Du Mai (Governing Vessel) and the pathway of the Kidney Meridian. If diet and起居 (daily life) are improper, damaging the Three Foot-Yang meridians, sores will form. If there is diffuse swelling with cold and fever, or fatigue and poor appetite, it belongs to Spleen deficiency with sinking. The treatment principle focuses on nourishing the Liver and Kidneys and supporting the Spleen and Stomach.
Feng Luzhan stated: Swelling, pain, and heat in the sole of women's heels and toes are all due to postpartum or menstrual conditions where regulation was neglected, leading to deficiency-heat in the Three Foot-Yin meridians. If there is swelling, pain, or pus discharge, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) as the main formula, assisted by Bazhen Tang (Eight-Gentlemen Decoction). If stomach deficiency leads to reluctance to eat, assist with Liujunzi Tang (Six-Gentlemen Decoction). If there is alternating chills and fever with internal heat, assist with Xiaoyao San (Free and Easy Wanderer Powder). If evening tidal fever worsens with unclear head and eyes, assist with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). All symptoms such as fever, evening tidal fever, internal heat, spontaneous sweating, and night sweats are false heat due to yin deficiency. Therefore, Danxi said that fire rising from the nine springs indicates extreme yin deficiency. The heel is the source of the Du Mai and the pathway of the Kidney Meridian, the foundation bearing all bones. If one does not seek the root cause and indiscriminately uses cold-cooling herbs, many die prematurely. (*Xue Shi Jinnang*)
He also stated: Men who overindulge in alcohol and sex often suffer from this condition.
Wang Shengzhi stated: Nie Ju (Biting Carbuncle) belongs to the Foot-Taiyang Bladder Meridian, which has abundant blood but little qi. It arises at the Shenmai acupoint on the heel, also called Foot Ju. If initially red and swollen with a head, it can be pricked; if the pus is yellowish-white, it is treatable. If it breaks open immediately at the start, black and rotten, it is ominous. If not treated early, it may lead to the loss of the foot and death. (*Waike Lili*)
He also stated: Jin Ju (Sinew Carbuncle) arises at the Kunlun (BL57) acupoints on both heels, belonging to the Foot-Taiyang Bladder Meridian, which has abundant blood but little qi. In the first three to five days, the skin appears eroded like insect bites. After a year, worms internally consume the bone. When the bone becomes rough and pus is profuse, it is ominous. Worms falling out resemble sinews, with yellow-red heads. If not healing after years, it is called Weilou (Atrophy Fistula) or Qu Ju (Curved Carbuncle). If pus flows incessantly, it is called Leng Ju (Cold Carbuncle), and most patients die.
*Yizong Jinjian: Waike Xinfa Yaojue* states: Heel carbuncle arises on the heel, commonly called Jiaoluan Gen. This is caused by accumulated heat in the zang-fu organs, wading in water while sweating, or injuring sinews through long-distance walking. Initially, it swells, turns red-purple, and hurts. Upon ulceration, pus drips continuously, resembling a rabbit bite. The classics state: "Rabbit Bite resembles a red bean, deep enough to reach the bone." Urgent treatment is required; delay harms the patient, indicating the severity of the toxicity. It belongs to the Foot-Taiyang Bladder Meridian, specifically the Shenmai acupoint, the source of the Yang Qiao vessel, and the path of the Kidney Meridian. If the wound remains unhealed for a long time, the Qi of the Yang Qiao vessel cannot stimulate Kidney Qi, leading to leakage and further deficiency in the patient. At the initial stage, moxibustion with garlic slices is suitable; administer Xianfang Huoming Yin (Immortal Formula for Saving Lives Decoction) with Rougui (Cinnamon Bark) and Niuxi (Achyranthes Root). After ulceration, administer Buzhong Yiqi Tang, Renshen Yangrong Tang (Ginseng Nourishing Young and Virtuous Decoction), or Guifu Dihuang Wan (Cinnamon and Aconite Rehmannia Pill), tonifying according to the syndrome. (*Yizong Jinjian*)
Wang Haicang stated: For Tunie that fails to converge for a long time, wash with salt solution and sprinkle powdered Baizhu (Atractylodes Macrocephala Rhizome). Change every two days. Strictly avoid all labor for immediate effect.
Cheng stated: Heel carbuncle is mostly caused by wading in water after sweating, injuring sinews and bones through long walking, or damp-heat flowing and depositing. Initially, there must be itching; do not regard it as trivial. Moxibustion can be used. If delayed for more than ten days, with pus and blood dripping for years without healing, and if itchy, wash with pepper-salt solution.