（附烂腿）
薛立斋治一妇人，患 疮，因步履劳动，复恶寒发热，倦怠懒食，而疮出血。此元气虚，而不能
摄血归经也，用补中益气汤而愈。
陶九成曰∶辛酉夏，余足疡发于外 ，初甚微，其后浸淫涉秋徂冬，不良于行。凡敷膏濯之剂，
尝试略尽，痛痒杂作，大妨应酬。一日，友人俞和父过见，怪其蹒跚，举以告之。和父笑曰∶吾能三
日已此疾，法当先以淡齑水涤疮口， 干，次用《局方》驻车丸研极细，加乳香少许，干糁之，无不
立效。如其说用之，数日良愈。盖驻车丸本治血痢滞下，而此疮亦由气血凝滞所成也。（《齐东野语》）
张子和治小渠袁三，因被盗受惊仆，伤其两 外 ，作疮，数年不已，脓水常涓涓然，但饮冷则
疮间冷水浸淫而出，延为湿疮。张曰∶尔中焦当有绿水二三升，涎数掬。袁曰∶何也？曰∶当被盗时
感惊气入腹，惊则胆伤，足少阳经也，兼两外 皆少阳之部。此胆之甲木受邪，甲木色青，当有绿水。
少阳在中焦如沤，既伏惊，涎在中焦，饮冷水，咽为惊涎所阻，水随经而旁入疮中，故饮水则疮中水
出。乃上涌寒痰，汗如流水，次下绿水，果二三升，一夕而痂干矣。
薛立斋治一室女，年十七，腿外 忽肿起一红点，作痒，搔破，日日鲜血如注，及飞出小虫甚多。
审其由，每先寒热，两耳下或结核，盖外 耳下，俱属胆经。胆为肝之腑，肝主风热生虫，血得风而
妄行，肝火旺而血出，其肝胆阴阳俱虚矣。凡病虚则补其母，用六味丸，滋肾水以生肝木，四物加柴
胡、山栀、钩藤，生肝血以抑风热而痊。
陈湖陆懋诚，素因阴虚，过饮入房，发热腿痛似 疮。用发表之剂，两腿肿黯，热气如雾，欲发
痉，脉皆洪数，两尺尤大。此属足三阴虚，酒湿所乘，元气损而邪益甚耳。用十全大补加山药、山萸、
附子，一剂脉症顿退。去附子，又二剂全愈。
李绛记武元衡相国在西川，且苦胫疮， 痛不可堪，百医无效。及到京城，呼供奉石礞等数人疗
治，无益。有厅吏上此方，用之便瘥。其方云∶疗多年恶疮，百方不瘥，或痛 走注不已者，并烂捣
马齿苋敷上，不过三两度愈。（李绛兵部手集）
章宇泰传治 疮方，六郎乳母试之神效。松香一两，轻粉三钱，乳香五钱，细茶五钱，四味共打
成膏。先将葱头、花椒煎汤，熏洗净，用布摊膏，浓贴患处，以绢缚定，黄水流尽，烂肉生肌。（《广
笔记》）
陈仪部年逾五十，两 生疮，日久不愈，饮食失节，或劳苦，或服渗利消毒之剂，愈甚。脾脉大
而无力，此脾虚而无湿热也。以补中益气汤，数剂少愈。更以六君子汤加苍术、升麻、神曲，治之而
愈。尝治下部生疮 痛，或发寒热，或香港脚肿痛，以人参败毒散加槟榔、苏木、苍术、黄柏并效。久
不愈者，以四生散治之。愈后，以补肾丸补之，庶不再发矣。
王洪绪治马悠也，右足背连小腿转弯处，初因汤毒而成烂腿，三十余年，其肿如斗，孔可容拳，
有时出血，以布团填塞，否则空痛。时年七十有四，令以老蟾破腹，身刺数孔，以肚杂填患孔，蟾身
覆之。早晚煎葱椒汤，温洗一次，以蟾易贴。用醒消丸，早晚二服。三日后取地丁、大力鲜草，捣烂
填孔，外贴乌金膏，日服醒消丸。其四围硬块出水处，以嫩膏加五味散敷。其发痒者，以白花膏贴。
内有硬块如石者，以生商陆捣烂涂孔内。出
血时，先以参三七末糁之，然后填药。如此二十余日，肿退痒止，块平，黑肉渐红活，孔亦收浅，止
以草填，日以五宝散糁，仍贴乌金膏。因老人精神不衰，饮食不减，始终不用补而收功。
蒋仲芳治胡明甫，年五十余，患 疮三载，沿皮瘙痒，微肿，色紫黑，用膏药盖之，则流水，鞋
袜尽湿，去膏药即又燥烈，痒痛难忍。此湿热下流也，人但知燥湿清热解毒，而不知湿热之原，从脾
家下陷耳。遂用补中益气汤升举其气，更加黄柏清热，苍术燥湿，茯苓、泽泻利水。盖治湿不利小便，
非其治也。外用陈锻石调侧柏汁，以燥湿散瘀清热，稍加火酒为从治。敷之，明日疮干，数日而愈。
（外治法妙）
（附：烂腿）
薛立斋治疗一位妇人，患有疮疡，因行走劳累后，又出现恶寒发热、疲倦乏力、食欲不振的症状，且疮口出血。这是元气虚弱，不能统摄血液回归经脉所致，使用补中益气汤而痊愈。
陶九成说：辛酉年夏天，我的脚部外侧发生溃疡，起初很轻微，后来逐渐蔓延，直到秋冬季节，导致行走不便。凡是涂抹膏药或清洗的药物，几乎都尝试遍了，疼痛和瘙痒交替发作，严重妨碍日常应酬。一天，友人俞和父来访，见其步履蹒跚，便将此病告知他。俞和父笑着说：“我能三天治好这个病。方法应当先用淡盐水洗涤疮口，待干燥后，再用《局方》中的驻车丸研磨成极细粉末，加入少许乳香，干撒在疮面上，没有不立即见效的。”按照他的说法使用，几天后便大愈。因为驻车丸原本用于治疗血痢和滞下（痢疾），而这个疮疡也是由气血凝滞所形成的。（出自《齐东野语》）
张子和治疗小渠村的袁三，因被盗贼惊吓跌倒，伤了足部外侧，形成疮疡，数年不愈，脓水常滴滴流出，只要喝冷水，疮口中就会渗出冷水，进而演变为湿疮。张子和说：“你中焦应该有绿水二三升，涎沫几捧。”袁三问：“为什么？”张子和说：“在被盗受惊时，惊气进入腹部，惊恐损伤胆腑，足少阳经也受影响，加上两足外侧都是少阳经的部位。这是胆的甲木受到邪气侵袭，甲木色青，所以会有绿水。少阳在中焦如同沤泡（发酵过程），既然潜伏了惊气，涎沫就在中焦，饮用冷水时，咽下的水被惊涎阻塞，水液顺着经络旁流入疮中，所以喝水时疮中就有水流出。”于是用涌吐法吐出寒痰，出汗如流水般，接着排出绿水，果然有二三十升，一夜之间疮痂就干了。
薛立斋治疗一位十七岁的少女，腿部外侧突然肿起一个红点，感到瘙痒，抓破后，每天鲜血如注，甚至飞出很多小虫。审察病因，每次发病前先有寒热症状，两耳下方或有结核（肿块），因为腿外侧和耳下方都属于胆经。胆是肝的腑，肝主风热生虫，血遇风则妄行，肝火旺盛导致出血，这说明肝胆阴阳都虚了。凡是大病虚损则补其母脏，使用六味地黄丸，滋补肾水以生养肝木；配合四物汤加柴胡、山栀、钩藤，生养肝血以抑制风热而痊愈。
陈湖人陆懋诚，素来阴虚，房事过度并饮酒，出现发热腿痛类似疮疡的症状。医生使用发表（解表）药物，导致双腿肿胀发暗，热气如雾笼罩，想要发生痉病，脉象都洪大数急，两尺脉尤其大。这属于足三阴经虚损，被酒湿所乘，元气受损而邪气更加猖獗。使用十全大补汤加山药、山萸肉、附子，一剂药后脉症顿时减退。去掉附子，再服两剂完全痊愈。
李绛记载武元衡宰相在西川时，苦于胫疮，疼痛难以忍受，众多医生无效。到了京城，召供奉石礞等人数人治疗，也无益处。有一位厅吏献上此方，使用后便痊愈。该方说：治疗多年的恶疮，百方无效，或者疼痛游走不止的，以及烂腿，将马齿苋捣烂敷在上面，不过两三次就能痊愈。（出自《李绛兵部手集》）
章宇泰传授治疗疮疡的方子，六郎的乳母试用神效。松香一两，轻粉三钱，乳香五钱，细茶五钱，四味药共同打成膏。先将葱头、花椒煎汤，熏洗疮口干净，用布摊开药膏，厚贴患处，用绢布绑紧，待黄水流尽，新肉生长。（出自《广笔记》）
陈仪部年过五十，两腿生疮，日久不愈，饮食不节制，或劳累辛苦，或服用渗利消毒的药物，病情反而加重。脾脉大而无力，这是脾虚而没有湿热。用补中益气汤，几剂后稍有好转。再用六君子汤加苍术、升麻、神曲，治疗而痊愈。曾经治疗下部生疮疼痛，或发寒热，或香港脚（脚气）肿痛，用人参败毒散加槟榔、苏木、苍术、黄柏都有效。久治不愈的，用四生散治疗。痊愈后，用补肾丸补益，以防复发。
王洪绪治疗马悠也，右足背连小腿转弯处，起初因烫伤而成烂腿，三十多年，肿胀如斗，孔洞可容拳头，有时出血，用布团填塞，否则空洞疼痛。当时七十四岁，让人剖开老蟾蜍腹部，在身上刺几个孔，用蟾蜍内脏填入患孔，蟾蜍身体覆盖在上面。早晚煎葱椒汤，温洗一次，更换蟾蜍贴敷。服用醒消丸，早晚各一次。三天后取地丁草、牛蒡鲜草，捣烂填入孔内，外贴乌金膏，日服醒消丸。其四周硬块出水处，用嫩膏加五味散敷贴。发痒的，用白花膏贴敷。内有硬块如石的，用生商陆捣烂涂在孔内。出血时，先撒参三七末，然后填药。如此二十多天，肿胀消退，瘙痒停止，硬块平复，黑肉渐变红润，孔洞也变浅，只用草填塞，每日撒五宝散，仍贴乌金膏。因为老人精神不衰，饮食不减，始终不用补益药而收功。
蒋仲芳治疗胡明甫，年五十多岁，患疮三年，沿皮肤瘙痒，微肿，颜色紫黑，用膏药覆盖，则流水，鞋袜全湿，去掉膏药就又干燥烈性，痒痛难忍。这是湿热下流所致。人们只知道燥湿清热解毒，却不知道湿热的根源是从脾家下陷引起的。于是用补中益气汤升举其气，再加黄柏清热，苍术燥湿，茯苓、泽泻利水。大概治疗湿邪如果不通利小便，就不是正确的治疗方法。外用煅牡蛎调侧柏汁，以燥湿散瘀清热，稍加烧酒作为从治（反佐）。敷上后，第二天疮口干燥，几天后痊愈。（外治法妙）
(Attached: Ulcerated Leg)
Xue Lizhai treated a woman suffering from sores. After walking and exerting herself, she developed aversion to cold, fever, fatigue, anorexia, and bleeding from the sores. This was due to deficiency of Yuan Qi (Primordial Qi), which failed to control blood within the vessels. She was cured using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
Tao Jiu Cheng stated: "In the summer of Xinyou year, an ulcer developed on my foot. Initially slight, it gradually spread through autumn into winter, impairing my gait. I tried nearly all ointments and washes, but pain and itching alternated, severely hindering social engagements. One day, my friend Yu Hefu visited, noticed my limping, and I told him of my ailment. He smiled and said, 'I can cure this in three days. First, wash the sore with weak salt water. Once dry, grind Zhuche Wan (Stop Dysentery Pill) from *Jufang* (Formulas of the Imperial Pharmacy) into a fine powder, add a little Ruxiang (Frankincense), and sprinkle it dry onto the wound; it will be effective immediately.' Following his advice, I recovered well in a few days. Zhuche Wan is originally used for bloody dysentery and tenesmus; this sore was also caused by stagnation of Qi and Blood." (*Qidong Yeyu*)
Zhang Zihe treated Yuan San from Xiaoqu Village, who, after being robbed and frightened into falling, injured the lateral aspect of both feet, resulting in sores that did not heal for years. Pus and fluid dripped constantly. Drinking cold water caused cold fluid to seep from the sores, eventually developing into damp sores. Zhang Zihe said, "You likely have two or three sheng [approx. 2-3 liters] of green fluid and several handfuls of saliva/phlegm in your Middle Jiao." Yuan San asked why. Zhang replied, "When frightened by the robbery, the shock qi entered the abdomen. Fright injures the Gallbladder, which corresponds to the Foot Shaoyang channel. Additionally, the lateral aspects of both feet are areas of the Shaoyang channel. The Jia Wood of the Gallbladder has been invaded by pathogenic factors. Since Jia Wood is associated with the color green, there is green fluid. The Shaoyang in the Middle Jiao acts like fermentation. Having harbored shock qi, phlegm resides in the Middle Jiao. When drinking cold water, the swallowed water is blocked by the shock-phlegm, and the water follows the channels laterally into the sores. Hence, drinking causes water to exit the sores." He then induced vomiting to expel cold phlegm, sweating profusely, followed by the discharge of green fluid, totaling two or three sheng. By that night, the sores had scabbed over.
Xue Lizhai treated a seventeen-year-old maiden whose lateral leg suddenly swelled with a red spot causing itching. Upon scratching, fresh blood flowed heavily, and many small insects flew out. Investigating the cause, she experienced chills and fever beforehand, with nodules sometimes appearing below both ears. Both the lateral leg and area below the ears belong to the Gallbladder channel. The Gallbladder is the Fu organ of the Liver; the Liver governs wind-heat and generates parasites. Blood flows recklessly when exposed to wind; excessive Liver fire causes bleeding, indicating deficiency of both Yin and Yang in the Liver and Gallbladder. For deficiency diseases, tonify the mother organ. He used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to nourish Kidney Water to generate Liver Wood, combined with Siwu Tang (Four Substance Decoction) plus Chaihu (Bupleurum), Shanzhi (Gardenia), and Gouteng (Uncaria) to nourish Liver blood, suppress wind-heat, and achieve recovery.
Lu Maocheng from Chenhu, constitutionally Yin-deficient, indulged in sexual activity and alcohol, developing fever and leg pain resembling sores. Physicians used diaphoretic (releasing the exterior) agents, causing both legs to swell and darken, with heat rising like fog, approaching spasms. The pulse was surging and rapid, especially at the Chi positions (Kidney pulse). This indicated deficiency of the Three Yin channels of the Foot, exacerbated by dampness from alcohol, damaging Yuan Qi while pathogens intensified. He prescribed Shiquan Dabu Tang (Ten Significant Tonifying Decoction) plus Shanyao (Dioscorea), Shanyuzhizi (Cornus), and Fuzi (Aconite). After one dose, symptoms and pulse subsided significantly. Removing Fuzi, he administered two more doses, resulting in complete recovery.
Li Jiang recorded that Chancellor Wu Yuanheng, stationed in Xichuan, suffered from shin sores with unbearable pain, unresponsive to many physicians. Upon arriving in the capital, imperial attendants Shi Meng and others were summoned but provided no benefit. A hall clerk presented a prescription, which cured him. The formula stated: "For chronic malignant sores unresponsive to hundreds of remedies, or those with wandering pain, or ulcerated legs, crush fresh Machixian (Purslane) and apply externally. It heals in two or three applications." (*Li Jiang Bingbu Shouji*)
Zhang Yutai transmitted a prescription for sores, tested effectively by the wet nurse of Sixth Lang. Songxiang (Rosin) 1 liang, Qingfen (Calomel) 3 qian, Ruxiang (Frankincense) 5 qian, Xicha (Fine Tea) 5 qian. These four ingredients are processed into an ointment. First, decoct Congtou (Green Onion Bulb) and Huajiao (Sichuan Pepper), fumigate and wash the sore clean. Spread the ointment thickly on cloth, apply to the affected area, bind with silk, drain yellow fluid until new flesh grows. (*Guang Biji*)
Minister Chen, over fifty, had sores on both legs that persisted for a long time. Irregular diet, labor, or use of draining/detoxifying agents worsened the condition. The Spleen pulse was large but forceless, indicating Spleen deficiency without damp-heat. He used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); after several doses, slight improvement occurred. Then, Liujunzi Tang (Six Gentlemen Decoction) plus Cangzhu (Atractylodes), Shengma (Cimicifuga), and Shenqu (Medicated Leaven) was used to cure him. He also treated lower body sores with pain, chills/fever, or Hongjiaojiao (Charley Horse/Foot Rot) swelling using Renshen Baidu San (Ginseng Detoxification Powder) plus Binglang (Areca Seed), Sumu (Sappan Wood), Cangzhu, and Huangbai (Phellodendron), all effective. For chronic cases, Six Raw Ingredients Powder (Sisheng San) was used. Post-recovery, Bushen Wan (Tonify Kidney Pill) was taken to prevent recurrence.
Wang Hongxu treated Ma Youye, whose right dorsum of the foot connected to the calf bend had become an ulcerated leg due to scalding, persisting for thirty years. Swelling was bowl-sized, with a hole large enough for a fist, occasionally bleeding, requiring cloth packing to avoid empty pain. At seventy-four, he instructed opening an old toad's belly, piercing its body, filling the wound hole with toad viscera, and covering it with the toad's body. Morning and evening, wash with warm Scallion and Pepper decoction once, replacing the toad. Take Xingxiao Wan (Awaken Elimination Pill) twice daily. After three days, apply crushed fresh Dideng (Viola) and Dali (Arctium) herbs into the hole, externally paste Wujin Gao (Black Gold Ointment), continue Xingxiao Wan. For hard masses weeping around the periphery, apply Nengao (Young Ointment) plus Wuwei San (Five Spice Powder). For itching, apply Baihua Gao (White Flower Ointment). For stone-hard internal masses, apply raw Shanglu (Morphoea) crushed into the hole. When bleeding, first dust with Sanqifen (Notoginseng powder), then pack medicine. After twenty-plus days, swelling receded, itching stopped, masses flattened, black flesh turned reddish, and the hole shallowed. Only grass was used for packing, dusted daily with Wubao San (Five Treasures Powder), still pasting Wujin Gao. Because the elderly patient retained spirit and appetite, no tonics were used throughout, yet success was achieved.
Jiang Zhongfang treated Hu Mingfu, over fifty, suffering from sores for three years. Itching along the skin, slight swelling, purple-black color. Covering with plaster caused weeping, soaking shoes and socks; removing the plaster caused dryness and intense itching/pain. This was downward flow of damp-heat. People only know to dry dampness and clear heat/toxicity, unaware that the source of damp-heat sinks from the Spleen. Thus, Buzhong Yiqi Tang was used to raise Qi, plus Huangbai (Phellodendron) to clear heat, Cangzhu (Atractylodes) to dry dampness, Fuling (Poria) and Zexie (Alisma) to promote urination. Treating dampness without promoting urination is incorrect. Externally, Duanshi (Calcined Oyster Shell) mixed with Cebaiye juice (Biota Tops) was applied to dry dampness, dissipate stasis, and clear heat, with a little Huojiu (Burnt Wine) as a guiding agent. Applied, the sore dried the next day and healed in several days. (Excellent External Treatment Methods)