脉
香港脚之脉，其状有四∶浮弦为风，宜汗；濡弱湿气，宜渗；迟涩因寒，宜温；洪数为热，宜下。微
滑者虚，牢坚者实。结则因气，散则因忧，紧则因怒，细则因悲。
病
夫香港脚者，古谓之缓风，又谓之厥者，是古今之异名也。有干、湿之分，其脚肿者，名湿香港脚；其不
肿者，名干香港脚。由脾胃两经虚弱，行动坐卧之间，为风寒暑湿之气所侵，或内因饮食浓味所伤，致湿热下
注而成。如得之不便觉，乃因他病发动而知，先从
脚起，或先缓弱痹，或行起忽倒，或两胫肿满，或足膝枯细，或心下松悸，或小腹不仁，大小便涩，或
举体转筋，骨节酸痛，或恶闻食气，见食吐逆，或胸满气急，憎寒壮热，状似伤寒，是其候也。
或经一旬，或半月复作，渐而至于足筋肿大如瓜瓠者。
治
治之之法，用苍术、白术以治其湿，黄芩、黄拍、知母以治其热，当归、芍药、生地黄以调其血，木瓜、
槟榔以调其气，羌活、独活以利关节而散风湿，兼用木通、防己、牛膝引诸药下行，及消肿去湿，以为此证
之大法矣。兼用针HT 导引其湿热之气外出也。东垣曰∶湿淫所胜，治以苦温，以苦辛发之，透关节，胜
湿为佐，以苦寒泄之，流湿清热为臣。故立当归拈痛汤治之，其效捷于影响，学人更宜详究焉。
一、凡脚肿，名湿香港脚，用五积散加槟榔、木瓜、青藤、穿山甲。
一、凡足疼痛，皮不肿赤，筋不拘急，遇夜则痛甚，此是气虚，而血不荣也。宜十全大补汤，加牛膝、
木瓜、槟榔、石南藤、五加皮、没药、川乌之类，或四斤丸。若两膝赤肿，强急作热而掣痛，两总
筋拘急，此血热也，宜人参败毒散加赤芍药、大黄，利气丸下之。
一、凡香港脚上攻，胸膈闷满，大便不通，宜三和散。
一、凡香港脚攻注，大小便不通，用水中大螺蛳三个，以盐一小撮，和壳生捣烂，
置两脐下一寸三分，用帛紧紧系之，立通神效。
一、凡两膝肿痛，脚胫枯细，名曰鹤膝风，以四物汤加黄
、人参、白术、附子、牛膝、杜仲、防风、羌活、甘草。又宜五积散加松节、林节。
方
羌活导滞汤 治香港脚初发，一身俱痛，或肢节肿痛，便溺阻
隔，先用此药导之，后用当归拈痛散以彻其邪。
羌活（二钱） 独活（二钱） 当归（二钱） 防己（一钱五分） 大黄（四钱） 枳实（炒，一钱）
上锉一剂，水煎，空心服。
当归拈痛散 治湿热香港脚为病，四肢骨节烦痛，肩背沉重，胸胁不利，兼遍身疼痛，下注足
胫肿痛，脚膝生疮赤肿，及内外生疮，脓水不绝，或痒或痛，并宜服之。
羌活（一钱） 人参 苦参 升麻 葛根 防风 苍术（米泔浸炒，各四
分） 甘草（炙） 黄芩（酒炒） 茵陈（酒洗，各一钱） 当归（酒洗） 猪苓 泽泻 知
母（去毛，酒浸） 白术（各五分）
上锉一剂，水煎，空心服。
神仙飞步丸（云林制）〔批〕（按此方治香港脚因湿热者） 治脚膝疼痛。
当归（一两） 川芎（八钱） 白芍（一两五钱） 生地黄（一两） 黄柏（酒炒，二两）
知母（一两） 苍术（一两） 牛膝（一两） 木瓜（一两） 杜仲（一两） 薏苡仁（一两） 防
风（七钱） 防己（七钱） 威灵仙（七钱） 羌活（七钱） 桃仁（七钱） 红花（七钱） 黄连
（酒炒，一两） 肉桂（三钱） 黄芩（酒炒，一两） 陈皮（一两） 半夏（姜汁炒，一两） 白茯苓（一两）
上为末，酒糊为丸，如梧桐子大。每服六七十丸，空心盐汤下。
五积交加酒（云林制） 治诸湿足膝麻木，冷痹缓弱，及腰痛，香港脚下虚之疾。
白芷 陈皮 浓朴 枳壳 桔梗 川芎 白芍 苍术 当归 茯苓 半夏 官桂 干姜 麻黄 甘草
小茴（酒炒） 牛膝（酒洗） 杜仲（酒炒） 大附子（制） 川乌 吴茱萸 槟榔 木瓜 草果
砂仁 破故纸（酒炒） 羌活 葫芦巴 威灵仙（各等分）
上共合一斤，用陈酒十壶，姜十斤，枣十格，瓦罐炊熟，每日空心温服。
趁痛散（秘方） 治湿气攻注腰脚痛，行步少力。
当归（酒洗，二两） 肉桂（二两） 玄胡索（二两） 萆 （二两） 没药（二两） 杜
仲（酒炒，一两五钱）
上为末，每服三钱，空心温酒下。
芙蓉丸（魏宪副传） 治脚腿疼痛，一服即愈。
哑芙蓉 乳香 没药 孩儿茶 鹿茸（去毛，酒蒸） 官桂 玄胡索（酒浸微炒） 乌药（炙）
陈皮 五加皮 粉草（炙，各等分）
上为末，面糊为丸。每服二钱，酒煎葛根汤，临卧，出微汗。
换脚丸（秘方） 治肾虚，下注脚膝，或当风取凉，冷气所乘，沉重少力，移步迟缓，筋脉挛痛不
能屈伸，脚心隐痛，有碍履地，大治干、湿香港脚，赤肿痛楚，发作无时，呻吟难忍，气满喘急，举步
艰难，面色黧黑，传送秘涩并治。
当归 天麻 防风 羌活 石南藤 萆 （炙） 石斛（去根） 黄 肉桂 大附子（炮） 南星
续断 薏苡仁（各一两） 苍术（米泔浸，一两五钱） 川牛膝（一两，酒洗） 木瓜（四两） 槟榔（五钱）
上为末，面糊丸，如梧桐子大。每服五十丸，空心酒下，或木瓜汤下，日二服。
二仙丹（刘夷门传）〔批〕（按此方治香港脚因寒湿者） 治脚疾，肿痛拘挛。
川牛膝 威灵仙（各等分）
上为细末，炼蜜为丸，如梧子大。每服五十丸，空心酒下，白滚汤亦可，忌茶。
追风通气散 治香港脚，加槟榔、木瓜、穿山甲，水煎服。
治妇人香港脚，一月一次，足下浮肿，手肢拘挛不伸，头疼心
痛，吐痰胀满，下元湿热带下，行步艰辛。
当归 川芎 白术 茯苓 陈皮 香附 木瓜 槟榔 白芷 天麻 牛膝 甘草
上锉一剂，生姜煎服。
Pulse Diagnosis
The pulse manifestations of Hongxiangjiao (Jiaogi disease, commonly known as beriberi or gouty arthritis in ancient texts) present four main patterns: A floating and wiry pulse indicates wind pathogen invasion, suitable for diaphoresis (sweating method); a soggy and weak pulse indicates dampness retention, suitable for diuresis (damp-draining method); a slow and choppy pulse indicates cold stagnation, suitable for warming the interior; a surging and rapid pulse indicates heat excess, suitable for purgation. A slightly slippery pulse suggests deficiency, while a firm and hard pulse indicates excess. A knotted pulse is often due to qi stagnation; a scattered pulse is often due to excessive worry; a tight pulse is often due to anger; a thin pulse is often due to sorrow.
Symptoms
Hongxiangjiao was historically referred to as "Huanfeng" (Slow Wind) or "Jue" (Reversal/Cold Extremities), reflecting different nomenclatures across eras. It is categorized into dry and wet types: swelling of the feet defines Wet Hongxiangjiao, while non-swelling defines Dry Hongxiangjiao. This condition arises from weakness in the Spleen and Stomach meridians, where external pathogens such as wind, cold, summerheat, and dampness invade during daily activities like sitting, lying, walking, or standing. Alternatively, internal injury from rich and heavy dietary habits leads to damp-heat sinking downward. Initially asymptomatic, it may be discovered only when triggered by other illnesses. Symptoms typically begin in the feet, manifesting as flaccidity, weakness, or numbness; sudden collapse while walking; bilateral swelling of the shins; withered and thin foot and knee muscles; palpitations in the epigastrium; insensitivity in the lower abdomen; difficult urination and defecation; generalized muscle spasms; bone and joint soreness; aversion to food odors; nausea and vomiting upon seeing food; chest fullness and shortness of breath; aversion to cold accompanied by high fever, resembling Taiyang disease (Exterior Syndrome). These are the characteristic signs. The condition may recur after ten days or half a month, progressively leading to significant swelling of the foot tendons resembling gourds.
Treatment Principles
The general treatment principle involves using Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) to resolve dampness; Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), and Zhimu (Anemarrhenae Rhizoma) to clear heat; Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), and Shengdihuang (Rehmanniae Radix) to regulate blood; Mugua (Chaenomelis Fructus) and Binglang (Arecae Semen) to regulate qi; Qianghuo (Notopterygii Rhizoma et Radix) and Duhuo (Angelicae Pubescentis Radix) to unblock joints and dispel wind-dampness; combined with Mutong (Akebiae Caulis), Fangji (Stephaniae Tetrandrae Radix), and Niuxi (Achyranthis Bidentatae Radix) to guide herbs downward, reduce swelling, and drain dampness. Additionally, acupuncture and Dao Yin (therapeutic exercises) should be employed to expel damp-heat. Li Dongyuan stated: "When dampness prevails excessively, treat with bitter-warm agents; use bitter-pungent agents to disperse and penetrate the joints; employ bitter-cold agents to purge and drain dampness while clearing heat." Thus, Danggui Nian Tong San (Danggui Pain-Relieving Powder) was formulated, showing rapid efficacy. Scholars are advised to study this thoroughly.
1. For cases with foot swelling (Wet Hongxiangjiao), use Wuji San (Five Accumulations Powder) supplemented with Binglang (Arecae Semen), Mugua (Chaenomelis Fructus), Qingteng (Uncariae Ramulus cum Uncis), and Chuanshanjia (Manis Squama).
2. For foot pain without skin redness or swelling, and without tendon spasm, but worsening at night, this indicates Qi deficiency failing to nourish Blood. Use Shiquan Dabu Tang (Ten Significant Tonifying Decoction) supplemented with Niuxi (Achyranthis Bidentatae Radix), Mugua (Chaenomelis Fructus), Binglang (Arecae Semen), Shinanteng (Acanthopanacis Senticosi Caulis), Wujapi (Acanthopanacis Cortex), Moyao (Myrrha), and Chuanwu (Aconiti Radix Preparata), or Sijin Wan (Four Jin Pill). If both knees are red, swollen, hot, stiff, and painful with traction, and the major tendons are spasmodic, this indicates Blood Heat. Use Renshen Baidu San (Ginseng Detoxification Powder) supplemented with Chishaoyao (Paeoniae Radix Rubra) and Dahuang (Rhei Radix et Rhizoma), followed by Liqi Wan (Qi-Regulating Pill) to purge.
3. For Hongxiangjiao attacking upward causing chest and diaphragm fullness and constipation, use Sanhe San (Three Harmonizations Powder).
4. For Hongxiangjiao attack with obstruction of urination and defecation, take three freshwater snails, mix with a pinch of salt, crush them raw including the shells, apply to one cun three fen below both umbilicus points, and bind tightly with cloth. This provides immediate and miraculous relief.
5. For bilateral knee swelling and pain with withered shins, termed Hexikeng Feng (Crane Knee Wind), use Siwu Tang (Four Substances Decoction) supplemented with Huangqi (Astragali Radix), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuzi (Aconiti Lateralis Radix Preparata), Niuxi (Achyranthis Bidentatae Radix), Duzhong (Eucommiae Cortex), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), and Gancao (Glycyrrhizae Radix et Rhizoma). Also suitable is Wuji San (Five Accumulations Powder) supplemented with Songjie (Pinus Joint) and Linjie (likely referring to a specific bark or joint herb).
Formulas
Qianghuo Daoshi Tang (Notopterygium Guiding Stagnation Decoction): Treats early-stage Hongxiangjiao with whole-body pain or joint swelling/pain, and urinary/fecal obstruction. Use this first to guide out stagnation, then follow with Danggui Nian Tong San (Danggui Pain-Relieving Powder) to eliminate pathogens.
Ingredients: Qianghuo (2 qian), Duhuo (2 qian), Danggui (2 qian), Fangji (1.5 qian), Dahuang (4 qian), Zhishi (stir-fried, 1 qian).
Preparation: Coarsely powder one dose, decoct in water, and take on an empty stomach.
Danggui Nian Tong San (Danggui Pain-Relieving Powder): Treats Hongxiangjiao caused by damp-heat, featuring vexing pain in limbs and joints, heaviness in shoulders and back, stiffness in chest and hypochondrium, generalized body pain, damp-heat sinking causing shin/foot swelling, sores on feet/knees with redness/swelling, internal/external sores with continuous pus discharge, itching or pain.
Ingredients: Qianghuo (1 qian), Renshen, Kushen, Shengma, Gegen, Fangfeng, Cangzhu (soaked in rice wash water and stir-fried, each 0.4 qian), Gancao (honey-fried), Huangqin (wine-fried), Yichen (wine-rinsed, each 1 qian), Danggui (wine-rinsed), Zhuling, Zexie, Zhimu (de-haired, wine-soaked), Baizhu (each 0.5 qian).
Preparation: Coarsely powder one dose, decoct in water, and take on an empty stomach.
Shenxian Feibu Wan (Immortal Fast-Walking Pill) [Note: For Hongxiangjiao due to damp-heat]: Treats foot and knee pain.
Ingredients: Danggui (1 liang), Chuanxiong (8 qian), Baishao (1.5 liang), Shengdihuang (1 liang), Huangbai (wine-fried, 2 liang), Zhimu (1 liang), Cangzhu (1 liang), Niuxi (1 liang), Mugua (1 liang), Duzhong (1 liang), Yiyiren (1 liang), Fangfeng (7 qian), Fangji (7 qian), Weilingxian (7 qian), Qianghuo (7 qian), Taoren (7 qian), Honghua (7 qian), Huanglian (wine-fried, 1 liang), Rougui (3 qian), Huangqin (wine-fried, 1 liang), Chenpi (1 liang), Banxia (fried with ginger juice, 1 liang), BaiFuling (1 liang).
Preparation: Grind into powder, make pills with wine paste, size of Sophora seeds. Take 60-70 pills per dose on an empty stomach with salt water.
Wuji Jiaojia Jiu (Five Accumulations Mixed Wine) [Yunlin Formula]: Treats numbness and cold bi syndrome in feet/knees due to dampness, weakness, lower back pain, and deficiency-type Hongxiangjiao.
Ingredients: Baizhi, Chenpi, Houpo, Zhiqiao, Jiegeng, Chuanxiong, Baishao, Cangzhu, Danggui, Fuling, Banxia, Guanzi Gui, Ganjiang, Mahuang, Gancao, Xiaohui (wine-fried), Niuxi (wine-rinsed), Duzhong (wine-fried), Dafuzi (prepared), Chuanwu, Wuzhuyu, Binglang, Mugua, Caoguo, Sharen, Pogostemon (wine-fried), Qianghuo, Hutulu, Weilingxian (equal parts).
Preparation: Combine one jin of herbs, cook in ten pots of aged wine with ten jin of ginger and ten grids of dates in a clay pot until cooked. Take warm on an empty stomach daily.
Chentong San (Pain-Chasing Powder) [Secret Recipe]: Treats waist and foot pain caused by dampness attack and lack of strength in walking.
Ingredients: Danggui (wine-rinsed, 2 liang), Rougui (2 liang), Yanhusuo (2 liang), Bibi (2 liang), Moyao (2 liang), Duzhong (wine-fried, 1.5 liang).
Preparation: Grind into powder. Take 3 qian per dose on an empty stomach with warm wine.
Furong Wan (Hibiscus Pill) [Transmitted by Vice Minister Wei Xian]: Treats leg and foot pain; effective after one dose.
Ingredients: Ya Furong, Ruxiang, Moyao, Haiercha, Lurong (de-haired, steamed with wine), Guanzi Gui, Yanhusuo (soaked in wine and lightly fried), Wuyao (roasted), Chenpi, Wujapi, Fugan (roasted, equal parts).
Preparation: Grind into powder, make pills with flour paste. Take 2 qian per dose with wine-decocted Gegen Tang before bed, aiming for slight sweating.
Huanjiao Wan (Foot-Replacing Pill) [Secret Recipe]: Treats Kidney deficiency with damp-heat sinking to feet/knees, or cold invasion from exposure to wind/coolness. Symptoms include heaviness, weakness, slow movement, tendon spasms preventing flexion/extension, dull pain in soles hindering walking. Effective for dry/wet Hongxiangjiao, red/swollen/painful attacks, irregular timing, unbearable groaning, chest fullness, panting, difficulty walking, dark complexion, and constipation.
Ingredients: Danggui, Tianma, Fangfeng, Qianghuo, Shinanteng, Bibi (roasted), Shihu (roots removed), Huangqi, Rougui, Dafuzi (pounded), Nanxing, Xuduan, Yiyiren (each 1 liang), Cangzhu (rice wash soaked, 1.5 liang), Chuan Niuxi (1 liang, wine-rinsed), Mugua (4 liang), Binglang (5 qian).
Preparation: Grind into powder, make pills with flour paste, size of Sophora seeds. Take 50 pills per dose on an empty stomach with wine or Mugua decoction, twice daily.
Erxian Dan (Two Immortals Elixir) [Transmitted by Liu Yimen] [Note: For Hongxiangjiao due to cold-damp]: Treats foot diseases with swelling, pain, and spasms.
Ingredients: Chuan Niuxei, Weilingxian (equal parts).
Preparation: Grind into fine powder, make pills with refined honey, size of Sophora seeds. Take 50 pills per dose on an empty stomach with wine or plain boiled water. Avoid tea.
Zhuifeng Tongqi San (Wind-Chasing Qi-Unblocking Powder): Treats Hongxiangjiao. Add Binglang (Arecae Semen), Mugua (Chaenomelis Fructus), and Chuanshanjia (Manis Squama). Decoct in water and take.
Indication for Women: Monthly recurrence of Hongxiangjiao, foot edema, limb spasms preventing extension, headache, heart pain, phlegm expectoration, abdominal distension, lower jiao damp-heat with leukorrhea, and difficult walking.
Ingredients: Danggui, Chuanxiong, Baizhu, Fuling, Chenpi, Xiangfu, Mugua, Binglang, Baizhi, Tianma, Niuxi, Gancao.
Preparation: Coarsely powder one dose, decoct with fresh ginger and take.