Library

The knee joint swells alone, resembling the shape of a crane's knee; this is caused by the Wind, Cold, and Dampness (Feng, Han, Shi) stagnating in the lower limbs. After completing the administration of Wuji San (Five Accumulations Powder), applying White Mustard Seed (Baijiezi) externally, and using modified Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) yields excellent results, effectively warming and unblocking the meridians.

The origin of Hongxiangjiao (Foot Qi / Beriberi) can be traced to the *Neijing* (Classic of Internal Canon), which states: "When Heat dominates, the earth becomes hot; when Wind dominates, the earth shakes; when Dampness dominates, the earth becomes muddy; when Cold dominates, the earth cracks." Although the Qi of Cold, Heat, Wind, and Dampness originates from Heaven, it enters into the Earth. Consequently, human feet tread upon the ground and often suffer from their toxicity. If the condition starts from the feet and gradually invades the lower abdomen, and severely attacks the chest and heart, failure to treat it urgently will lead to death. This is because the meridians of the Zang organs—specifically the Spleen, Liver, and Kidney—ascend from the toes to the abdomen. However, the manifestations differ between Dry and Wet types: In Wet Hongxiangjiao, both feet swell, or sores form below with oozing fluid, requiring Jiming San (Crowing Rooster Powder). In Dry Hongxiangjiao, the calves do not swell but present with numbness, cramping, or flaccidity due to Blood deficiency combined with Damp-Heat; Siwu Tang (Four Substances Decoction) added with Niuxi (Achyranthes Root), Duhuo (Angelica Pubescens), Cangzhu (Atractylodes Rhizome), and Zexie (Alisma Rhizome) is indicated. For Heat patterns, add Huangbai (Phellodendron Bark), Zhimu (Anemarrhena Rhizome), and Ychen (Artemisia Capillaris); for Cold patterns, add Ganjiang (Dried Ginger), Fuzi (Aconite Lateral Root), Wuzhuyu (Evodia Fruit), and Rougui (Cinnamon Bark). Both conditions are termed Yong Ji (Obstructive Diseases) and should not be tonified abruptly. If accompanied by wheezing and shortness of breath, or insensitivity in the lower abdomen, fearing cardiac attack, the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) recommends Shenqi Wan (Kidney Qi Pill). Since this condition presents with external swelling, it is categorized under Exterior Syndromes.

Swelling of the feet arises from Dampness; do not hesitate to use Jiming San. (For Dry Hongxiangjiao, characterized by numbness and cramping without swelling), Siwu Tang added with Cangzhu and Zexie is suitable, while Shenqi Wan can calm rebellious Qi and prevent disaster.

In Summerheat syndromes presenting with thirst, vexation, dark urine, fever, and a洪 (Surging) yet empty pulse, mild cases are termed Shangshu (Summerheat Injury). Liuyi San (Six-to-One Powder) is used to cleanse Heat Qi, excreting it via urination. If Summerheat is closed and depressed without sweating, Xiangsu Yin (Perilla and Eupatorium Drink) must be used to disperse Yang Qi, penetrating from top to bottom, resolving the exterior and promoting diuresis to achieve cure. Severe cases are named Zhongshu (Heat Stroke), characterized by extreme thirst and profuse sweating, treated primarily with Baihu Tang (White Tiger Decoction) plus Renshen (Ginseng Root). If sweating occurs followed by fever but cold feet, this indicates Summerheat complicated by Dampness, treated with Baihu Jia Cangzhu Tang (White Tiger Decoction plus Atractylodes). If heat stroke causes coma and unconsciousness, or if latent Summerheat with food stagnation leads to vomiting and diarrhea, use Banxia (Pinellia Tuber) 4 qian, Fuling (Poria) and Gancao (Licorice Root) 2 qian each, powdered, mixed with a little fresh ginger juice, and administered with boiled water. Later in summer, excessive cooling often leads to Cold Damage diseases, which should be treated according to Cold Damage protocols. Moreover, during summer months, Yin Cold lurks internally; for vomiting and diarrhea, Lizhong Tang (Regulate the Middle Decoction) is applicable in six or seven out of ten cases. Severe cases require Tongmai Sini Tang (Unblock the Pulse Four Reversal Decoction). If vomiting and diarrhea are accompanied by thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated.

(Interpretation of Classic Texts) The *Cizhi Lun* (Treatise on Acupuncture and Vitality) states: "Qi deficiency with body heat results from Summerheat injury." The *Shengqi Tongtian Lun* (Treatise on Vital Energy Connecting to Heaven) states: "Due to Summerheat, there is sweating; vexation leads to panting and fullness, while quietness leads to excessive talking; the body feels like burning charcoal, and heat dissipates with sweating." Zhang Zhongjing stated: "Empty pulse with body heat results from Summerheat injury."