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Hong Kong Jiao (Gouty Arthritis / Podagra) refers to swelling and pain in the legs and feet. The region of the legs and feet is governed by the three Yin meridians: Liver, Spleen, and Kidney. The meridians of these three Yin channels originate from the middle toe. If one washes their feet while exposed to wind, or if sweat is exposed to wind after perspiration, Wind Pathogen invades the body and disturbs Qi upward, hence the name "Hong Kong Jiao." This condition often begins imperceptibly and manifests due to other illnesses. For instance, if there is redness and swelling of the legs and feet, accompanied by aversion to cold and fever, with a floating, wiry, and rapid pulse, this indicates that the patient has previously harbored Damp-Heat and Wind pathogens, and subsequently suffered from strenuous labor or running, combined with dietary stagnation. Consequently, the Qi of water and grain sinks into the extreme Yin region, forming this syndrome. Treatment should initially employ Chai Ge Er Miao Tang (Bupleurum and Pueraria Two Marvels Decoction) to disperse exterior pathogens, followed by formulas that broaden the middle jiao and resolve stagnation, ensuring recovery. In cases of constipation, purgative methods should be applied.

Regarding white swelling without redness, the presentation can be differentiated into Cold-Damp, Wind-Damp, and Phlegm-Damp patterns.
Cold-Damp pattern presents with a deep, fine, and slow pulse, often caused by sitting or lying on damp ground, or wading in water during cold months. The Damp Pathogen remains at the exterior and has not yet constrained into Heat. It is suitable to use Bu Zhong Tang (Tonify the Middle Decoction) added with Gui Zhi (Cinnamon Twig) and Du Huo (Angelica Pubescens). If Cold constrains into Heat over time, it can no longer be treated as Cold-Damp.
Wind-Damp pattern presents with a floating, wiry, fine, and slightly rapid pulse. Wind damages the Qi level but has not entered the Ying (Nutritive) level, resulting in white swelling without redness. Treatment focuses on dispersion; Shu Feng Sheng Shi Tang (Dispel Wind and Overcome Damp Decoction) should be used.
If the pulse is wiry and rapid, with white swelling but no redness, this belongs to Phlegm-Damp. Chai Chen Si Miao Tang (Bupleurum and Chenpi Four Marvels Decoction) is appropriate, and it should not be treated merely as Dampness.

There is also Dry Hong Kong Jiao, characterized by no swelling or redness, only deep bone soreness and pain. The severity varies. Mild cases involve slight pain with a floating, wiry, fine, and slightly rapid pulse, treated with Shu Feng Sheng Shi Tang. Severe cases present with aversion to cold, fever, a floating, wiry, and urgent pulse, and unbearable pain, also caused by the sinking of Water and Grain Qi. Chai Ge Er Miao Tang is indicated. If residual pathogens remain, Chu Shi Yang Rong Tang (Remove Damp and Nourish Blood Decoction) may be used. If fluid oozes from the toes, although caused by Damp-Heat, Wind must also be considered. Treatment should primarily nourish blood and remove dampness, with minor additions of Fang Feng (Saposhnikovia Root) and Du Huo.

For pain in the heel, which often relates to Yin deficiency or Yin pathology, Liu Wei Wan (Six-Ingredient Rehmannia Pill) added with Yi Yi Ren (Coix Seed), Mu Gua (Chaenomeles Fruit), Du Zhong (Eucommia Bark), and Wu Qia Pi (Acanthopanax Bark) is effective.

Chai Ge Er Miao Tang (Bupleurum and Pueraria Two Marvels Decoction)
Ingredients: Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Ban Xia (Pinelliae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chi Shao (Paeoniae Radix Rubra), Gan Ge (Puerariae Lobatae Radix), Cang Zhu (Atractylodis Rhizoma), Huang Bai (Phellodendri Cortex), Hou Po (Magnoliae Officinalis Cortex), Shan Zha (Crataegi Fructus), Mu Gua (Chaenomelis Fructus), Bing Lang (Arecae Semen).
Note: This formula is derived from the Hernia Gate section, removing Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Xiang Fu (Cyperi Rhizoma), and adding Mu Gua and Bing Lang.

Shu Feng Sheng Shi Tang (Dispel Wind and Overcome Damp Decoction)
Ingredients: Zi Su (Perillae Folium), Gan Ge, Chai Hu, Chuan Xiong, Chen Pi (Citri Reticulatae Pericarpium), Ban Xia, Qian Hu (Peucedani Radix), Yi Yi Ren (Coicis Semen), Mu Gua, Xu Duan (Dipsaci Radix), Zhi Ke (Aurantii Fructus Immaturus), Xiang Fu, Huang Qin.

Chai Chen Si Miao Tang (Bupleurum and Chenpi Four Marvels Decoction)
Ingredients: Chai Hu, Huang Qin, Ban Xia, Gan Cao, Chen Pi, Bai Fu Ling (Poria), Cang Zhu, Huang Bai, Fang Feng, Jin Yin Hua (Lonicerae Japonicae Flos), Bei Mu (Fritillariae Thunbergii Bulbus), Hua Fen (Trichosanthis Radix), Shan Zhi (Gardeniae Fructus).

Chu Shi Yang Rong Tang (Remove Damp and Nourish Blood Decoction)
Ingredients: Dang Gui (Angelicae Sinensis Radix), Chuan Xiong, Bai Shao (Paeoniae Radix Alba), Shu Di Huang (Rehmanniae Radix Preparata), Huang Qin, Zhi Mu (Anemarrhenae Rhizoma), Mu Gua, Yi Yi Ren, Xu Duan, Wu Qia Pi, Niu Xi (Achyranthis Bidentatae Radix), Du Zhong, Che Qian Zi (Plantaginis Semen), Du Huo, Fang Feng, Qin Jiao (Gentianae Macrophyllae Radix).