\r足心痈\p04-a41a196.bmp\r
《鬼遗方》云∶两脚心发彻骨者不治，如脚心微皮破，不至深发，脓不多者可治。
王肯堂曰∶足心发毒肿痛，亦名涌泉疽，俗名病穿板，又名穿窟天 ，属少阴
肾经虚损所致。宜十全大补汤、八味地黄汤，大剂，不问昼夜投之，溃烂呕逆迷闷，脉微代者死。（《准绳》）
冯鲁瞻曰∶脚心发，毒浅者可治，毒深者不治。（《锦囊》）
申斗垣曰∶脚心痈，乃心肾二经湿毒流注，发于足心。（《启玄》）
又曰∶脚底穿心疔，又名井泉疽，乃肾经外感风邪，湿毒流于脚底，久则穿烂，遂成漏证。
《心法》曰∶涌泉疽，乃足少阴肾经虚损，兼湿热下注而成，生足心涌泉穴故名。
若十四日内即溃，脓浅则为痈，犹为可救，悉照痈疽施治，外用神灯照法。若虚甚脓
迟十全大补汤，溃后八味地黄丸；若黑陷不疼，二十一日之内，不溃脓者为疽，属阴败之证难救。（《金鉴》）
《心法》曰∶田螺 多生足掌，而手掌罕见，由脾经湿热下注，外寒闭塞，或因
热体涉水，湿冷之气蒸郁而成。初生形如豆粒，黄 闷胀，硬疼不能着地，连生数
，皮浓难于自破，传度三五成片，湿烂甚则足跗俱肿，寒热往来，治宜苦参、菖
蒲、野艾熬汤热洗，次用线针将 挑破，放出臭水，加味太乙膏贴之，再将 皮剪去，
宜用石膏、轻粉等分，研末撒之，仍以膏贴，更有经年不愈者，系下部湿寒，以金
匮肾气丸常服甚效。（《金鉴》）
陈实功曰∶田螺 ，乃脾经风湿攻注，多生手足，忽如火烧，随生紫白黄 ，不
久渐大，胀痛不安，用针挑破，泄去毒水，太乙膏盖。如挑破又生者，须服解毒泻脾汤。（《正宗》）
足心痈
《鬼遗方》记载：双脚脚心部位发病，若深入骨骼者无法治愈；如果仅是脚心表皮轻微破损，未深入内部，且脓液不多者可以治愈。
王肯堂说：脚心部位发毒肿痛，也称为涌泉疽，俗称“病穿板”，又名“穿窟天”，属于少阴肾经虚损所致。适宜使用十全大补汤、八味地黄汤，大剂量服用，不分昼夜给药。如果出现溃烂、呕吐逆气、神志昏迷闷乱，脉象微弱或出现代脉者，预后不良致死。（出自《医学准绳六要》）
冯鲁瞻说：脚心发病，毒邪浅表者可治，毒邪深重者不可治。（出自《锦囊秘录》）
申斗垣说：脚心痈，是心肾二经的湿毒流注，发生在脚心部位。（出自《外科启玄》）
他又说：脚底穿心疔，又名井泉疽，是由于肾经外感风邪，湿毒流注于脚底，日久导致腐烂，最终形成漏证（瘘管）。
《医宗金鉴·外科心法要诀》记载：涌泉疽，是由于足少阴肾经虚损，兼有湿热下注而成，生于足心涌泉穴处，因此得名。如果在十四天内即溃破，脓液浅表则为痈，尚属可救，完全按照痈疽的方法施治，外用神灯照法。如果正气极虚导致脓液生成迟缓，用十全大补汤；溃破后服用八味地黄丸；如果疮色黑陷且不疼痛，二十一天内不溃破出脓者为疽，属于阴寒败坏之证，难以救治。（出自《医宗金鉴》）
《医宗金鉴·外科心法要诀》又记载：田螺疮多生于足掌，手掌罕见，这是由于脾经湿热下注，外加寒邪闭塞，或者因身体发热时涉水，湿冷之气蒸郁而成。初生时形状如豆粒，黄色，感觉闷胀，坚硬疼痛不能着地，连续生长数个，皮厚难以自行破裂，蔓延三五成片，湿气糜烂严重时足背也会肿胀，伴有寒热往来症状。治疗宜用苦参、石菖蒲、野艾熬汤热敷清洗，随后用线针将患处挑破，放出臭水，加味太乙膏贴敷。再将表皮剪去，宜用石膏、轻粉各等分，研成粉末撒在患处，仍用膏药贴敷。更有常年不愈者，属于下部湿寒，常服金匮肾气丸非常有效。（出自《医宗金鉴》）
陈实功说：田螺疮，是脾经风湿攻注所致，多生于手足，突然感觉如火烧般，随即生出紫、白、黄色的疱，不久逐渐变大，胀痛不安。用针挑破，泄去毒水，用太乙膏覆盖。如果挑破后又复发，必须服用解毒泻脾汤。（出自《外科正宗》）
Abscess of the Sole of the Foot
*Gui Yi Fang* (The Book of Ghosts' Remnants) states: If an eruption occurs on both soles and penetrates to the bone, it is incurable. However, if only the skin on the sole is slightly broken, without deep involvement, and with little pus, it is treatable.
Wang Kentang stated: Eruptions causing swelling and pain in the sole are also known as Yongquan Ju (Abscess at Yongquan point), commonly called "Bing Chuan Ban" (Disease Penetrating the Board), or "Chuan Ku Tian". These conditions result from deficiency and exhaustion of the Shaoyin Kidney Meridian. It is appropriate to administer Shiquan Dabu Tang (Decoction for Ten Complete Tonifications) and Bawei Dihuang Tang (Eight-Ingredient Rehmannia Decoction) in large doses, day and night. If ulceration, vomiting, retrograde qi, coma, or confusion occurs, accompanied by a faint or intermittent pulse, death ensues. (From *Yixue Zhunsheng*)
Feng Luzhan stated: Eruptions on the sole are treatable if the pathogenic factor is superficial, but incurable if it is deep. (From *Jinnang*)
Shen Douyuan stated: An abscess on the sole is caused by the flow and accumulation of damp-toxin from the Heart and Kidney meridians, manifesting on the sole. (From *Waike Xuanyuan*)
He further stated: A Ding (hard nodule) piercing the heart on the sole, also known as Jingquan Ju, results from external wind-pathogens affecting the Kidney meridian, with damp-toxin flowing to the sole. Over time, this leads to rotting and eventually forms a fistula. (From *Jin Jian*)
*Xin Fa* (Essentials of Medical Methods) states: Yongquan Ju arises from deficiency and exhaustion of the Foot-Shaoyin Kidney Meridian, combined with damp-heat sinking downward. It is named after its location at the Yongquan acupoint on the sole. If it ulcerates within fourteen days and the pus is shallow, it is classified as an abscess (Yong) and remains salvageable; treatment should follow standard protocols for abscesses and carbuncles, with external application of the Shen Deng Zhao method. If deficiency is severe and pus formation is delayed, use Shiquan Dabu Tang; after ulceration, administer Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pills). If the lesion appears black, sunken, and painless, and fails to ulcerate within twenty-one days, it is classified as a carbuncle (Ju), indicating a syndrome of Yin collapse that is difficult to save. (From *Yi Zong Jin Jian*)
*Xin Fa* further states: Tialuo Chuang (Clam-shaped Sores) mostly occur on the sole, rarely on the palm. They arise from damp-heat sinking due to Spleen meridian dysfunction, blocked externally by cold pathogens, or resulting from wading in water while the body is hot, causing damp-cold qi to steam and stagnate. Initially, they resemble bean grains, appearing yellow, feeling stifled and swollen, hard, painful, and making weight-bearing impossible. Multiple lesions may grow together, forming clusters of three to five. The skin is thick and difficult to rupture spontaneously. If dampness causes severe erosion, the dorsum of the foot may also swell, accompanied by alternating chills and fever. Treatment should involve boiling Kushen (Sophora Root), Changpu (Acorus Rhizome), and Ye Ai (Wild Mugwort) for hot washing. Subsequently, puncture the lesion with a thread needle to drain foul fluid, apply Jiawei Taiyi Gao (Modified Taiyi Plaster), trim the necrotic skin, and sprinkle a powder made of equal parts Shigao (Gypsum Fibrosum) and Qingfen (Calomel). Cover with plaster again. For cases persisting for years, attributed to damp-cold in the lower part, regular administration of Jinkui Shenqi Wan (Kidney Qi Pill from the Golden Cabinet) is highly effective. (From *Yi Zong Jin Jian*)
Chen Shigong stated: Tialuo Chuang is caused by wind-dampness attacking and accumulating in the Spleen meridian. It mostly occurs on the hands and feet, suddenly feeling like burning fire. Purple, white, or yellow blisters appear and gradually enlarge, causing distending pain and discomfort. Puncture with a needle to drain toxic fluid and cover with Taiyi Gao. If lesions recur after puncture, one must administer Jiedu XiPi Tang (Detoxifying and Draining Spleen Decoction). (From *Waike Zhengzong*)