鱼肚毒,生于小腿肚上,属足少阴与足太阳二经。初起憎寒壮热,烦躁,结肿 痛。皆
由肾经素亏、膀胱湿热下注而成。宜服清利湿热、凉血和营之剂;成脓后,即宜刺破,勿使
毒瓦斯蔓延,致久难收口;虚,则以补剂托之。
如小腿肚漫肿坚硬下塌,紫暗 痛者,即名腓 疽。穿溃后,出稠脓兼血者为
顺,出清水者为凶。初服仙方活命饮,或萆 化毒汤;溃后,宜八珍汤、十全大补之属,
补其气血。
黄鳅痈,生于小腿肚里侧,又名胫阴疽,由肝脾二经湿热凝结而成。微红微肿,坚硬如
石,三、四寸许,痛楚难禁。如期溃出稠脓者,吉;如溃流污水败酱者,凶。治同痈疽。
跗阴疽,生内踝上三寸,初生小泡,疼痛日增,坚硬赤肿,渐如鸡卵,破流血水。系三
阴交会、湿热积聚而成。治同痈疽。但三阴交系纯阴之穴,收敛迟缓,调理不可不慎。
接骨发,生于小腿肚之下,胫骨与足后跟骨相接处,故名之。此属膀胱经湿热凝结而成
。初如核桃,坚硬漫肿,色红、急胀、微疼,脓宜速溃,迟则脓毒损筋,筋脉既伤,腿缺踵
行。踵行者,不能全足踏地,惟恃足指着力而行也。治同痈疽。
(附∶穿拐痰、驴眼毒)
外踝疽,即脚拐毒,俗名穿拐毒,属足三阳经脉络也。由湿热下注、血凝气滞而成。初
起外踝 肿,疼痛彻骨,举动艰难,寒热往来。如有红晕者,宜服荆防败毒散加牛膝,脓熟
针之,后兼用托补法。若其皮色不变而漫肿无头者,此名穿拐痰,由三阴亏损、寒湿注聚阻
络所致;幼儿因先后天不足而发。初起宜温通,溃后宜补托。第此证属虚,每难速效。
内踝疽,生两足内踝近腕之处,足三阴经脉络也。有由湿热下注而成者,亦有由寒湿凝
聚而成者。证形同前,治法亦可通用。其有肿甚,串及外踝,后俱穿溃腐烂如 疮,四围紫
黑,时流毒水,或淌臭脓,名曰驴眼毒,俗名夹棍疮也。由脾经湿毒流滞而成。亦有HT
伤,或毒蚊虼蚤咬伤而起者,最难收功。掺以珍珠散,贴以白玉膏,内服萆 化毒汤,或五
苓、四妙等。
鱼肚毒,生长在小腿肚部位,归属于足少阴经和足太阳经。初起时憎寒壮热(恶寒与高热并见),烦躁不安,局部结块肿胀疼痛。这都是由于肾经素来亏虚、膀胱湿热下注所致。适宜服用清利湿热、凉血和营的方剂;脓液形成后,应立即刺破排脓,防止毒气蔓延,导致伤口久不愈合;若患者体质虚弱,则用补益剂托毒外出。
如果小腿肚漫肿坚硬且向下塌陷,颜色紫暗疼痛,这就称为腓疽。溃破后,流出稠厚脓液兼带血液的为顺证,流出清水的为逆证。初期服用仙方活命饮,或萆薢化毒汤;溃破后,适宜使用八珍汤、十全大补汤之类,以补益气血。
黄鳅痈,生长在小腿肚内侧,又名胫阴疽,由肝脾二经湿热凝结而成。局部微红微肿,坚硬如石,大小约三、四寸,疼痛剧烈难以忍受。如期溃破流出稠厚脓液的为吉兆;如果溃破后流出污水败酱样的液体,则为凶兆。治疗方法同痈疽一般。
跗阴疽,生长在内踝上三寸处,初起时有小水泡,疼痛日益加重,局部坚硬赤肿,逐渐增大如鸡蛋,破溃后流血水。这是由于三阴经交会之处,湿热积聚而成。治疗方法同痈疽一般。但三阴交穴属于纯阴之穴,收敛迟缓,调理时不可不慎。
接骨发,生长在小腿肚下方,胫骨与足后跟骨相接的地方,因此得名。这属于膀胱经湿热凝结而成。初起时像核桃一样,坚硬漫肿,颜色发红,急胀微疼,脓液应当迅速溃破,如果迟缓,脓毒会损伤筋脉,一旦筋脉受伤,腿部将缺失脚跟行走的功能。所谓“踵行者”,是指不能完全用脚掌着地,只能依靠脚趾着力行走。治疗方法同痈疽一般。
外踝疽,即脚拐毒,俗名穿拐毒,归属于足三阳经脉络。由湿热下注、血凝气滞而成。初起时外踝肿胀,疼痛彻骨,举动艰难,寒热往来。如果有红晕的,适宜服用荆防败毒散加牛膝,脓熟后针刺排脓,之后兼用托补法。如果皮色不变而漫肿无头的,这叫穿拐痰,由三阴亏损、寒湿注聚阻络所致;幼儿因先天后天不足而发病。初起宜温通,溃破后宜补托。只是此证属虚证,往往难以速效。
内踝疽,生长在两足内踝近脚踝处,归属于足三阴经脉络。有的由湿热下注而成,有的由寒湿凝聚而成。证候形态与前文相同,治疗方法也可通用。其中肿胀严重,串及外踝,后来都溃烂腐烂如疮疡,四周紫黑,时常流出毒水,或淌出臭脓,名叫驴眼毒,俗名夹棍疮。由脾经湿毒流滞而成。也有因跌打损伤,或被毒蚊虼蚤咬伤而引发的,最难收功。外用珍珠散掺敷,贴白玉膏,内服萆薢化毒汤,或五苓散、四妙丸等。
Yudu poison (Fish-belly Poison) arises on the calf muscle, belonging to the Foot Shaoyin and Foot Taiyang meridians. In the initial stage, it presents with aversion to cold accompanied by high fever (Zenghan Zhuangre), irritability, and localized induration, swelling, and pain. This is caused by a pre-existing deficiency of the Kidney meridian and the downward pouring of damp-heat from the Bladder meridian. It is appropriate to administer formulas that clear and drain damp-heat, cool the blood, and harmonize the Ying (Nutritive) level. Once suppuration occurs, it should be punctured immediately to prevent the spread of toxic heat, which would otherwise lead to prolonged non-healing of the wound; if the patient is deficient, tonifying agents should be used to expel the toxin.
If the calf exhibits diffuse swelling, hardness, sinking depression, purple-dark discoloration, and pain, it is named Feiju (Calf Carbuncle). After ulceration, the discharge of thick pus mixed with blood indicates a favorable prognosis (Shun), whereas the discharge of clear water indicates an unfavorable prognosis (Xiong). In the initial stage, Xianfang Huoming Yin (Immortal Life Elixir) or Bixie Huadu Tang (Dioscorea Hypoglauca Decoction for Resolving Toxins) may be taken; after ulceration, Bazhen Tang (Eight-Treasure Decoction) or Shiquan Dabu Tang (Ten Complete Great Tonification Decoction) are suitable to tonify Qi and Blood.
Huiqiu Yong (Yellow Eel Abscess) arises on the medial side of the calf, also known as Jingyin Ju (Tibia-Yin Carbuncle), resulting from the coagulation of damp-heat in the Liver and Spleen meridians. The area is slightly red and swollen, hard as stone, approximately 3–4 cun in size, with unbearable pain. If it ulcerates as scheduled and discharges thick pus, it is auspicious; if it discharges foul water resembling spoiled sauce, it is ominous. The treatment is the same as for general abscesses and carbuncles.
Fuyin Ju (Foot-Yin Carbuncle) arises three cun above the medial malleolus. Initially, small blisters appear, with pain increasing daily. The area becomes hard, red, and swollen, gradually enlarging to the size of a chicken egg, and upon rupture, bleeds bloody fluid. This is caused by the accumulation of damp-heat at the intersection of the Three Yin meridians. The treatment is the same as for general abscesses and carbuncles. However, Sanyinjiao (SP6) is a point of pure Yin nature, where convergence is slow; therefore, regulation must be handled with caution.
Jiegu Fa (Bone-Fusing Nodule) arises below the calf, at the junction of the tibia and the calcaneus, hence its name. This results from the coagulation of damp-heat in the Bladder meridian. Initially, it resembles a walnut, being hard and diffusely swollen, with red coloration, acute distension, and slight pain. Suppuration should occur rapidly; if delayed, the pus and toxins will damage the sinews. Once the sinews are injured, the leg loses the ability to walk using the heel. "Heel-walking" refers to the inability to place the entire sole flat on the ground, relying solely on the toes for weight-bearing. The treatment is the same as for general abscesses and carbuncles.
(Attachment: Chuangui Tan, Luyan Du)
Waihui Ju (Lateral Malleolus Carbuncle), also known as Jiaogai Du, commonly called Chuangui Du, belongs to the collaterals of the Foot Yangming, Foot Taiyang, and Foot Shaoyang meridians. It is caused by the downward pouring of damp-heat, leading to blood stasis and Qi stagnation. In the initial stage, there is swelling of the lateral malleolus, pain penetrating to the bone, difficulty in movement, and alternating chills and fever. If there is a red halo, Jingfang Baidu San (Aucklandia and Saposhnikovia Powder to Defeat Toxins) with added Niuxi (Achyranthes Root) is appropriate. Once the pus is ripe, it should be punctured, followed by the application of supportive and tonifying methods. If the skin color remains unchanged with diffuse swelling and no head, this is named Chuangui Tan (Lateral Malleolus Phlegm), caused by the deficiency of the Three Yin meridians and the accumulation of cold-dampness obstructing the collaterals; it occurs in young children due to congenital and acquired insufficiency. In the initial stage, warming and unblocking methods are indicated; after ulceration, supportive and tonifying methods are used. However, since this condition is deficient in nature, rapid efficacy is often difficult to achieve.
Neihui Ju (Medial Malleolus Carbuncle) arises near the ankle joint on the medial side of both feet, belonging to the collaterals of the Foot Three Yin meridians. Some cases result from the downward pouring of damp-heat, while others result from the coagulation of cold-dampness. The clinical presentation is similar to the aforementioned conditions, and the treatment methods can be generally applied. In cases where swelling is severe and spreads to the lateral malleolus, followed by ulceration and rotting like sores, with surrounding purple-black discoloration, frequent discharge of toxic fluid, or oozing of foul-smelling pus, it is named Luyan Du (Donkey-Eye Poison), commonly known as Jiagun Chuang (Clamping Stick Sore). This is caused by the flow and stagnation of damp-toxin from the Spleen meridian. It may also arise from traumatic injury or bites from poisonous mosquitoes, midges, or fleas, making it difficult to heal. External application of Zhenzhu San (Pearl Powder) and Bayu Gao (White Jade Ointment) is recommended, along with internal administration of Bixie Huadu Tang (Dioscorea Hypoglauca Decoction for Resolving Toxins), Wuling San (Five-Ingredient Powder with Poria), or Simiao Wan (Four Marvels Pill).