自三里穴起至腓 止，一切痈疽疮毒，
皆汇于此部，以便检阅参治。
《鬼遗方》云∶三里两处起痈疽名三里发。初发如牛眼睛，青黑五七日，破穴出
黑血汁脓，肿攻膀肚连腿里，拘急冷痛，此因伤筋气劳力所成，宜用汤药注射，其外毒自平息矣。
《心法》曰∶三里发生膝眼下三寸外侧前廉两筋间。初肿形如牛眼，拘急冷痛，由
劳力致伤筋骨，郁热凝结而成，渐增肿痛，其色青黑，溃出紫血，次出稀脓，治同痈疽。（《金鉴》）
汪省之曰∶合阳疽，乃足太阳膀胱经湿热之毒，在膝下腿外侧。（《理例》）
《心法》曰∶香港脚疮生于膝之下，足之上，腿胫肿胖痒痛，破津黄水上结黄痂，皆
由湿热内搏，滞于肤腠，外为风乘，不得宣通，形类黄水疮，惟身体壮热，心神烦
躁，经久难瘥为异。（《金鉴》）
陈实功曰∶ 疮乃风热湿毒相聚而成也。外 多服四生丸，内 多服肾气丸。（《正宗》）
冯鲁瞻曰∶妇人两 生疮，或胎产调理失宜，伤损脾胃，或忧思郁怒，亏损肝
脾，以致湿热下注。外 属足三阳易治，内 属三阴难痊。若初起发肿赤痛，属湿毒
所乘，人参败毒散。若漫肿作痛，或不肿不痛，属脾虚湿热下注，补中益气汤，或
八珍汤加萆 、银花之类。若脓水淋沥，体倦少食，内热口干，属脾气虚弱，补中益
气汤加白茯苓、酒炒白芍。若午后发热体倦，属血虚，前汤加川芎、熟地，或六味
地黄丸。若肢体畏寒，饮食少思，脾肾虚寒，十全大补汤、八味地黄丸。色赤属热
毒易治，色黯属虚寒难治。（《锦囊》）
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周文采曰∶夫 疮者，皆由肾脏虚寒，风邪毒瓦斯外攻三里之旁，灌于阴交之侧，风
热毒瓦斯流注两脚生疮，肿烂疼痛臭秽，步履艰难。此疮生于 骨为重，以其骨上肉
少皮薄，故难易愈也。（《集验》）
申斗垣曰∶里 是足厥阴肝经，外 是足阳明胃经主之。（《启玄》）
又曰∶裙边疮是受裙边风所致，不戒房事，故久久不瘥。
又曰∶腿 生疮，最忌房事，犯之则渐渐开张腐臭，故有伤守疮之名，言其不
守禁忌也。今人因其搔痒，遂疑疮中惹指甲锋，名之曰伤手疮，实非也。
又曰∶裙边疮，即裤口风疮。
又曰∶裤口毒，生踝骨之上者是也。
《明医集》云∶一女子患 疮，百药罔效，每月医治新肉长满，忽疮中流血，三
日渐止，别无他苦，众医不识，或一医问曰∶月经如期否？女曰∶已一年不至矣。医
遂用引血归经药服之月余，外以生肌膏丹收口而愈。此乃抑郁损伤肝脾，错经之证，
所以引血归经，归故道而疮自愈矣。
《心法》曰∶外 属足三阳经，湿热结聚而成，早治易于见效。内 属足三阴经，
湿兼血分虚热而成，且 骨皮肉浇薄，难得见效，极其缠绵。（《金鉴》）
蒋示吉曰∶ 疮红者多热，肿者多湿，痒者多风，痛者属实，早宽而暮肿者属气
虚下陷。初起者风热湿毒为多，日久者下陷湿热为胜。（《说约》）
从足三里穴开始，直到腓骨部位为止，这一区域发生的一切痈疽疮毒，都汇集记载于此部，以便于查阅和参考治疗。
《鬼遗方》说：在双侧足三里处发生的痈疽，称为“三里发”。初起时像牛的眼睛一样，呈现青黑色，经过五到七天后，破溃流出黑血、汁液和脓液，肿胀攻冲至膀胱腹部并牵连腿部内部，出现拘挛紧急、冷痛的症状。这是由于损伤筋气、过度劳累所致，适宜使用汤药内服或注射治疗，体表的毒邪自然就会平息。
《医宗心法》说：“三里发”发生在膝盖下方三寸外侧前缘两条筋之间。初起肿胀形状像牛眼睛，伴有拘挛紧急、冷痛，是由于劳力导致筋骨受伤，郁热凝结而成，逐渐增加肿痛，颜色变为青黑，溃破后流出紫血，随后流出稀薄的脓液，治疗方法与一般痈疽相同。（出自《医宗金鉴》）
汪省之说：合阳疽，是足太阳膀胱经湿热之毒蕴结所致，病位在膝盖下方的腿外侧。（出自《理例》）
《医宗心法》说：香港脚疮生于膝盖以下、足部以上的小腿胫骨部位，表现为小腿肿胀、肥胖、瘙痒疼痛，破溃后渗出黄水并结成黄色痂皮。这都是由于湿热内盛搏结，停滞于皮肤纹理之间，外部又受风邪侵袭，导致气血不得宣通，形态类似黄水疮，但不同的是身体壮热、心神烦躁，经久难以痊愈。（出自《医宗金鉴》）
陈实功说：臁疮乃是由风热湿毒相聚而成。体表症状多者，宜多服用四生丸；体内症状多者，宜多服用肾气丸。（出自《外科正宗》）
冯鲁瞻说：妇女两小腿生疮，或因胎产调理不当，损伤脾胃；或因忧思郁怒，亏损肝脾，导致湿热下注。小腿外侧属于足三阳经，容易治疗；小腿内侧属于足三阴经，难以痊愈。如果初起时红肿疼痛，属于湿毒所乘，用人参败毒散。如果漫肿作痛，或者不肿不痛，属于脾虚湿热下注，用补中益气汤，或八珍汤加萆薢、金银花等药物。如果脓水淋漓不尽，身体疲倦、食欲减退、内热口干，属于脾气虚弱，用补中益气汤加白茯苓、酒炒白芍。如果午后发热、身体疲倦，属于血虚，在前一方基础上加川芎、熟地黄，或用六味地黄丸。如果肢体畏寒、饮食减少，属于脾肾虚寒，用十全大补汤、八味地黄丸。疮色红赤属热毒，容易治疗；疮色暗黯属虚寒，难以治疗。（出自《锦囊秘录》）
周文采说：臁疮，皆由肾脏虚寒，风邪毒瓦斯向外攻冲至足三里旁边，灌注于阴交穴一侧，风热毒瓦斯流注于双脚生疮，导致肿胀腐烂、疼痛且有臭秽气味，行走困难。这种疮生在胫骨上为重证，因为该处骨头上方肌肉少、皮肤薄，所以难以愈合。（出自《集验方》）
申斗垣说：小腿内侧属于足厥阴肝经，小腿外侧属于足阳明胃经主治。（出自《启玄微旨》）
他又说：裙边疮是由于受到裙边风邪所致，如果不节制房事，所以久久不能痊愈。
他又说：小腿生疮，最忌讳房事，如果犯忌，则疮口渐渐张开、腐烂发臭，因此有“伤守疮”的名称，意思是说不遵守禁忌。现在的人因为患者搔痒，便怀疑是疮中被指甲锋刃划伤，称之为“伤手疮”，这实际上是不对的。
他又说：裤口毒，是指生在踝骨上方的疮。
《明医集》记载：有一个女子患臁疮，各种药物都没有效果，每个月治疗时新肉长满，忽然疮中流血，三天后停止，没有其他痛苦，众医生不认识病情。有一位医生问：“月经按时来潮吗？”女子说：“已经一年没来了。”医生于是使用引血归经的药物服用一个多月，外用生肌膏丹收敛伤口而痊愈。这是因抑郁损伤肝脾，导致经血错行（非经期出血）的证候，所以用引血归经的方法，使血液回归正道，疮口也就自愈了。
《医宗心法》说：小腿外侧属于足三阳经，由湿热结聚而成，早期治疗容易见效。小腿内侧属于足三阴经，由湿兼血分虚热而成，且胫骨处皮肉浇薄，难得见效，病程极其缠绵。（出自《医宗金鉴》）
蒋示吉说：臁疮发红者多属热，肿胀者多属湿，瘙痒者多属风，疼痛者属实证，早晨减轻傍晚肿胀者属气虚下陷。初起时多为风热湿毒，日久则以下陷湿热为主。（出自《说约》）
From the Zusanli (ST36) acupoint down to the fibula region, all carbuncles, ulcers, sores, and toxic eruptions occurring in this area are compiled here for easy reference and treatment consultation.
The *Guiyi Fang* states: Carbuncles and ulcers arising at both Zusanli points are named "Sanli Fa" (Eruption of Sanli). Initially, they resemble a cow's eye, appearing blue-black. After five to seven days, they rupture, discharging black blood, serum, and pus. The swelling attacks the bladder and abdominal regions, extending into the legs, accompanied by stiffness, coldness, and pain. This condition is caused by injury to the sinews and qi due to labor and exertion. It is appropriate to use decoctions administered orally or injected; the external toxicity will naturally subside.
The *Xinfa* states: "Sanli Fa" occurs three cun below the knee on the lateral anterior edge, between the two tendons. Initially, the swelling resembles a cow's eye, with stiffness, coldness, and pain. It results from injury to sinews and bones due to physical labor, leading to the condensation of stagnant heat. The swelling and pain gradually increase, the color turns blue-black, and upon ulceration, purple blood is discharged, followed by thin pus. The treatment is the same as for general carbuncles and ulcers. (From *Yizong Jinjian*)
Wang Shengzhi stated: Heyang Ju (Abscess of Heyang) is caused by damp-heat toxin in the Foot-Taiyang Bladder Meridian, located on the lateral side of the leg below the knee. (From *Lili*)
The *Xinfa* states: Hongxiangjiao Chuang (Hongxiangjiao Sore) arises below the knee and above the foot, on the tibia. Symptoms include swelling, obesity, itching, and pain in the lower leg. Upon rupture, yellow fluid oozes out and forms a yellow crust. These conditions arise from internal stagnation and binding of damp-heat, obstructing the skin and interstices, compounded by external wind invasion, preventing free circulation. The morphology resembles Huangshui Chuang (Yellow Water Sore), but differs in that the patient suffers from high fever, mental restlessness, and a chronic course difficult to cure. (From *Yizong Jinjian*)
Chen Shigong stated: Lian Chuang (Shin Ulcer) is formed by the gathering of wind-heat and damp-toxin. For cases with predominant external symptoms, Sibao Wan (Four Generations Pill) should be taken frequently; for cases with predominant internal symptoms, Shenqi Wan (Kidney Qi Pill) should be taken frequently. (From *Zhengzong*)
Feng Luzhan stated: Women developing sores on both lower legs may do so due to improper regulation after childbirth or pregnancy, damaging the Spleen and Stomach; or due to worry, thought, depression, and anger, injuring the Liver and Spleen, causing damp-heat to sink downward. Sores on the outer leg belong to the Foot-Yangming and Foot-Taiyang meridians (part of the Three Yang meridians) and are easier to treat; sores on the inner leg belong to the Foot-Yin meridians (Three Yin meridians) and are harder to cure. If the sore initially presents with redness, swelling, and pain, it is caused by damp-toxin; Ren Shen Bai Du San (Ginseng Decoction for Resisting Toxicity) is indicated. If there is diffuse swelling and pain, or no swelling and no pain, it is due to Spleen deficiency with sinking damp-heat; Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) or Bazhen Tang (Eight Treasures Decoction) added with Biba (Dioscorea Hypoglauca) and Yinhua (Honeysuckle Flower) is indicated. If pus and water drip continuously, accompanied by fatigue, poor appetite, internal heat, and dry mouth, it indicates Spleen Qi deficiency; Buzhong Yiqi Tang added with Baifuling (Poria with White Ginseng) and Jiuchaobaishao (White Peony Root stir-fried with wine) is indicated. If there is afternoon fever and fatigue, it indicates Blood deficiency; add Chuanxiong (Szechwan Lovage Rhizome) and Shudi (Prepared Rehmannia Root) to the previous formula, or use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). If there is aversion to cold in the limbs and poor desire for food, it indicates Spleen and Kidney deficiency-cold; Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) or Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) is indicated. Red color indicates heat-toxin and is easy to treat; dark color indicates deficiency-cold and is hard to treat. (From *Jinnang*)
Zhou Wencai stated: Lian Chuang (Shin Ulcer) is all caused by Kidney deficiency-cold, where wind-pathogen and toxic vapors attack externally near Zusanli, pouring into the side of Yinjiao. Wind-heat toxic vapors flow into both feet, causing sores, swelling, rotting, pain, and foul odor, making walking difficult. This type of sore occurring on the tibia bone is considered severe because there is little muscle and thin skin above the bone, making it difficult to heal. (From *Jiyan*)
Shen Douyuan stated: The inner aspect of the lower leg is governed by the Foot-Jueyin Liver Meridian, while the outer aspect is governed by the Foot-Yangming Stomach Meridian. (From *Qixuan*)
He further stated: Qunbian Chuang (Skirt-Hem Sore) is caused by wind from the skirt hem. If sexual intercourse is not abstained from, it persists for a long time without healing.
He further stated: Leg sores strictly forbid sexual intercourse. Violating this leads to gradual opening of the wound, rotting, and foul odor, hence the name "Shangshou Chuang" (Injured Guard Sore), implying a failure to observe taboos. Some people today, seeing the itching, suspect the sore was scratched by fingernails and call it "Shangshou Chuang," which is incorrect.
He further stated: Qunbian Chuang is the same as Kukou Fengchuang (Pantleg Wind Sore).
He further stated: Kukou Du (Pantleg Toxin) refers to sores arising above the malleolus.
*Mingyi Ji* records: A woman suffered from Lian Chuang (Shin Ulcer) with no effect from various medicines. Each month, new flesh would grow over the wound, but suddenly blood would flow from the sore, stopping after three days with no other discomfort. Many doctors could not identify the condition. One doctor asked, "Does your menstruation come on schedule?" The woman replied, "It has been absent for one year." The doctor then administered herbs to guide blood back to its normal pathway for over a month, and applied external Jisheng Gao Dan (Flesh-Generating Paste and Pills) to close the wound, resulting in a cure. This was a syndrome of Liver and Spleen injury due to depression, causing abnormal uterine bleeding (misdirected menstruation). By guiding the blood back to its proper channel, the sore healed spontaneously.
The *Xinfa* states: Sores on the outer leg belong to the Foot-Yangming and Foot-Taiyang meridians, formed by the accumulation of damp-heat; early treatment yields quick results. Sores on the inner leg belong to the Foot-Yin meridians, formed by dampness combined with Blood deficiency-heat. Moreover, the skin and flesh over the tibia are thin, making it difficult to see results, and the course is extremely lingering. (From *Yizong Jinjian*)
Jiang Shiji stated: Red Lian Chuang indicates Heat; swollen ones indicate Dampness; itchy ones indicate Wind; painful ones indicate Excess. Those that improve in the morning and swell in the evening indicate Qi deficiency with sinking. Early stages are mostly due to wind-heat-damp-toxin; long-standing stages are dominated by sinking damp-heat. (From *Shuoyue*)