一钱,豆淋酒调,仍用川椒、香白芷、草乌煎汤洗。香港脚隐痛,行步艰辛,用平胃散加赤曲同煎服最
妙,鸡鸣散亦佳。香港脚有壅者,加减槟榔汤。无壅者,牛膝汤,
川牛膝、(酒洗)、白茯苓(去皮)、人参(去芦)各一两,当归(去芦)半两,为细末。每服三钱,空
心、温酒调服。香港脚两胫肿满,是为壅疾,南方多见,两足粗大,与疾偕老者,初起当以重剂宣通壅
滞,或砭恶血而去其重势,后以药治。经曰∶蓄则肿热,砭射之也。
【渫洗】《活人书》云∶凡脚
气服补药,及用汤渫洗,皆医之大禁也,为南方外感湿气,乘虚袭人为肿痛而言,非为北方内受湿气,
注下肿痛而言也。盖湿气不能外达,宜淋渫开导泄越其邪,名曰导气除湿汤。
《外台》云∶第一忌嗔,嗔则心烦,烦则香港脚发。第二禁大语,大语则伤肺,肺伤亦发动。又不
得露足,当风入水,以冷水洗脚,两脚胫尤不宜冷,虽暑月常须着绵裤,至冬寒倍令两胫温暖,得微
汗大佳。根据此将息,气渐薄损,每至寅丑日割手足甲,割少侵肉去气。夏时腠理开,不宜当风
卧睡,睡觉令人按 ,勿使邪气稽留,数劳动关节,常令通畅,此并养生之要,拒风邪之法也。寻常
有力,每食后行三五百步,疲倦便止,脚中恶气随即下散,虽浮肿气不能上也。凡治此疾,每旦早饭
任意饱食,午饭少食,晚饭不食弥佳。恐伤脾胃营运之气,失其天度。况夜食
则血气壅滞,而阴道愈增肿痛矣。第一凡饮食酒及潼酪勿使过度,过则伤损脾胃,下注于足胫跗肿,
遂成脚疾。第二欲不可纵,嗜欲多则香港脚发。凡饮食之后,宜缓行二三百步,不至汗出觉困则止,如
此则不能成壅也。经云∶逸者行之。又云∶病湿痹,忌温食饱食,湿地濡衣。
【诊】脉浮弦为虚,濡细为湿,洪数为热,迟涩为寒,微滑为虚,牢坚为实。浮为表,沉为里,
沉弦为风,沉紧为寒,沉细为湿,沉数为热。结因气,散因忧,紧因怒,细因悲。入心则恍惚谬妄,
呕吐食不入,眠不安,脉左寸乍大乍小乍无者不治。入肾则腰脚皆肿,小便不通,呻吟,口额黑,冲
胸而喘,左尺绝者不治。但见心下急,气喘不停,或自汗数出,或乍寒乍热,其脉促短而数,呕吐不
止者死。
一钱,用豆淋酒调服,同时使用川椒、香白芷、草乌煎汤洗脚。香港脚(足部肿痛之疾)隐痛,行走艰难,用平胃散(燥湿运脾,行气和胃的方剂)加赤曲同煎服用最好,鸡鸣散(治疗脚气的方剂)也很好。香港脚有壅滞症状的,用加减槟榔汤。没有壅滞症状的,用牛膝汤,由川牛膝(经酒洗)、白茯苓(去皮)、人参(去芦头)各一两,当归(去芦头)半两,研为细末。每次服用三钱,空腹时温酒调服。香港脚导致两小腿肿胀满闷,这是壅滞之疾,南方多见,两脚粗大,与疾病共存直至老去的,初起应当用重剂宣通壅滞,或者用砭石刺破排出恶血以去除严重的病势,之后再用药物治疗。医经说:气血蓄积则肿胀发热,应用砭石刺射放血。
【渫洗】《活人书》说:凡是脚气病服用补药,以及用汤药渫洗(浸泡清洗),都是医家的重大禁忌,这是针对南方外感湿气,乘虚侵袭人体导致肿痛而言的,并非针对北方内受湿气,注下导致肿痛而言的。大概湿气不能向外发散,适宜淋渫开导,泄越其邪气,名为导气除湿汤。
《外台秘要》说:第一忌发怒,发怒则心烦,心烦则香港脚发作。第二禁大声说话,大声说话则伤肺,肺受伤也会诱发此病。又不得露出双脚,当风或入水,用冷水洗脚,两脚胫尤其不宜冷,即使在暑月也常须穿着棉裤,到了冬季寒冷更要让两胫温暖,得到微微出汗最好。根据这些调养方法,气逐渐薄损,每逢寅日、丑日割手足指甲,割时稍微侵入肉中去气。夏季腠理(皮肤纹理及汗孔)开放,不应当当风卧睡,睡觉醒来让人按摩穴位,不要让邪气稽留,多次活动关节,常令通畅,这都是养生的关键,抵御风邪的方法。平常有力气的人,每顿饭后面行走三五百步,疲倦就停止,脚中的恶气随即向下消散,即使浮肿气也不能上逆。凡是治疗这种病,每天早晨早饭任意吃饱,午饭少吃,晚饭不吃更好。恐怕损伤脾胃营运之气,失去自然规律。况且夜间进食则血气壅滞,而阴道的肿痛更加严重了。第一,凡饮食酒及潼酪(乳製品)不要过度,过度则损伤脾胃,下注于足胫跗肿,遂成脚疾。第二,房事不可放纵,嗜欲多则香港脚发作。凡饮食之后,宜缓行二三百步,不出汗不觉困倦就停止,如此则不能形成壅滞。医经说:安逸者行之(运动)。又说:患湿痹,忌温食饱食,湿地濡衣。
【诊】脉浮弦为虚证,濡细为湿证,洪数为热证,迟涩为寒证,微滑为虚证,牢坚为实证。浮脉主表,沉脉主里,沉弦为风邪,沉紧为寒邪,沉细为湿邪,沉数为热邪。结脉因气郁所致,散脉因忧思所致,紧脉因愤怒所致,细脉因悲伤所致。病邪入心则恍惚谬妄,呕吐食物不入,睡眠不安,脉象左寸忽大忽小忽无的属不治之症。病邪入肾则腰脚皆肿,小便不通,呻吟,口额发黑,冲胸而喘,左尺脉绝的属不治之症。只要见到心下急迫,气喘不停,或自汗数出,或乍寒乍热,其脉促短而数,呕吐不止的属死症。
One qian, mixed with Doulin Jiu (Soybean Dripping Wine) for oral administration; simultaneously, wash the feet with a decoction of Chuanjiao (Zanthoxylum Bungeanum Fruit), Xiangbaizhi (Angelica Dahurica Root), and Caowu (Aconitum Carmichaelii Lateral Root). For Hongxiangjiao (Gouty Arthritis/Foot Qi) presenting with hidden pain and difficulty in walking, Pingwei San (Calm the Stomach Powder) combined with Chiqu (Red Fermented Rice) and decocted together is most effective; Jiming San (Rooster Crow Decoction) is also excellent. For Hongxiangjiao with stagnation (Yong), use Jiabian Binglang Tang (Modified Areca Seed Decoction). For cases without stagnation, use Niuxi Tang (Achyranthes Root Decoction), composed of Chuanniuxi (Achyranthes Bidentata Root, washed with wine), Baifuling (Poria Cocos, peeled), Renshen (Ginseng Root, de-gubbed) each at one liang, and Danggui (Angelica Sinensis Root, de-gubbed) at half a liang, ground into fine powder. Take three qian per dose, administered orally with warm wine on an empty stomach. When Hongxiangjiao causes swelling and fullness in both calves, it is termed a disease of stagnation (Yong), common in the South, where both feet become enlarged and persist until old age. In the initial stage, heavy doses should be used to unblock stagnation, or bi-stone therapy should be employed to drain evil blood and remove severe pathogenic factors, followed by herbal treatment. The Classics state: "Accumulation leads to swelling and heat; treat with bi-stone puncture."
[Washing] The *Huoren Shu* (Book of Living People) states: "For any case of Jiaoqi (Foot Qi/Gout), taking tonifying medicines and using hot water washing are major taboos among physicians." This warning applies to cases in the South where external dampness invades the body due to deficiency, causing swelling and pain, not to cases in the North where internal dampness descends, causing swelling and pain. Generally, if dampness cannot diffuse outward, it is appropriate to use washing to guide and open the pathways, draining and venting the pathogen, named Daoqi Chushi Tang (Guide Qi and Remove Dampness Decoction).
The *Waitai Miyao* (Essential Prescriptions Worth a Thousand Gold for Emergencies) states: "First, avoid anger; anger causes mental agitation, which triggers Hongxiangjiao. Second, forbid loud talking; loud talking damages the Lung, and Lung damage also induces the disease. Do not expose the feet; do not sit in the wind, enter water, or wash feet with cold water. The calves especially must not be kept cold. Even in summer, cotton pants should always be worn. In winter, keep the calves extra warm. Obtaining slight sweating is highly beneficial. Following these regimens, the pathogenic qi gradually diminishes. On days corresponding to Yin and Chou, trim the fingernails and toenails slightly penetrating the flesh to expel qi. In summer, when pores are open, do not sleep facing the wind. Upon waking, have someone massage acupoints to prevent pathogenic qi from lingering. Frequently move the joints to maintain patency. These are essential for health preservation and resisting wind pathogens. Those with normal strength should walk 300-500 steps after each meal, stopping when tired. The evil qi in the feet will then dissipate downward, preventing even edema from rising. In treating this disease, eat freely and fully for breakfast every morning, eat less for lunch, and fasting for dinner is best. One must fear damaging the Spleen and Stomach's transporting and transforming qi, losing natural rhythm. Moreover, night eating causes blood and qi stagnation, increasing swelling and pain in the Yin channels. First, do not overconsume alcohol and dairy products (Tongluo); excess damages the Spleen and Stomach, leading to downward pouring into the calves and dorsum of the feet, resulting in foot diseases. Second, do not indulge in sexual desires; excessive lust triggers Hongxiangjiao. After meals, walk slowly for 200-300 steps, stopping before sweating or feeling fatigued; thus, stagnation will not form. The Classics say: 'Move those who are sedentary.' It also says: 'In cases of damp Bi syndrome, avoid warm/heavy foods and wet clothing.'"
[Diagnosis] A floating and wiry pulse indicates deficiency; a soggy and fine pulse indicates dampness; a surging and rapid pulse indicates heat; a slow and choppy pulse indicates cold; a faint and slippery pulse indicates deficiency; a deep, firm, and hard pulse indicates excess. Floating pulses indicate exterior conditions; sinking pulses indicate interior conditions. Deep and wiry indicates Wind; deep and tight indicates Cold; deep and fine indicates Dampness; deep and rapid indicates Heat. Knotted pulses arise from Qi stagnation; scattered pulses arise from Worry; tight pulses arise from Anger; fine pulses arise from Grief. If the pathogen enters the Heart, there is mental confusion and delirium, vomiting with inability to retain food, and restless sleep. If the left Cun pulse fluctuates between large, small, and absent, it is untreatable. If the pathogen enters the Kidney, both waist and feet swell, urination is obstructed, groaning occurs, the mouth and forehead turn black, chest distension with wheezing appears, and if the left Chi pulse is absent, it is untreatable. If one observes urgency below the heart, ceaseless wheezing, frequent spontaneous sweating, alternating chills and fever, a hurried, short, and rapid pulse, and ceaseless vomiting, death ensues.