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Discussion: Examining various classic prescriptions, there are often discussions on "leg weakness" (Jiao Ruo), but ancient people rarely suffered from this disease. Since the southward migration during the Yongjia era, scholar-officials and nobles have frequently encountered this illness.
In the Lingnan and Jiangdong regions, individuals such as Zhi Facun and Daoist Master Yang paid attention to classic prescriptions and were particularly skilled in this art; many prominent families of the Jin Dynasty were saved and treated through them, none without relying on these two gentlemen. Furthermore, between the Song and Qi dynasties, a Buddhist monk named Deep Master Shishidao compiled old prescriptions from Zhi Facun and others into thirty volumes, with nearly one hundred formulas dedicated to leg weakness alone.
During the Wei and Zhou dynasties, this disease was apparently non-existent, so Yao Gong's *Ji Yan* did not emphasize it, and Xu Wang's compilation did not take it seriously. Specifically, due to the tripartite division of power, inconsistent customs and teachings, uneven frost and dew, and unequal cold and heat, people in Guanxi and Hebei were unfamiliar with this disease. Since the founding of the Great Tang, the world has been unified. The southernmost lands are critical strategic points, garrisoned by troops unaccustomed to the local climate, who all succumbed to this illness. Recently, even scholar-officials in the Central Plains, though not traveling to the Jiangnan region, have contracted it while residing locally. This is indeed caused by the homogenization of wind and qi across the realm and the equality of material classes in the present era. However, this disease initially manifests starting from the feet, followed by swelling of the shins, which contemporary people call "Hong Xiang Jiao" (Cantonese Foot / Gouty Arthritis). Deep Master stated: "Leg weakness" conveys its meaning. Deep Master narrated over eighty precise and essential formulas for leg weakness used by Zhi Facun, Yong Ping Shan Fu, Shi Lian, Fan Zuyao, Huang Su, etc.; yet students finding them rather cumbersome, it is merely a collection of formulas, offering no clear guidance for emergency rescue. Now, I select only those that have proven effective through experience, to prepare for emergencies, omitting the rest.

Discussion on why the disease originates in the feet. Question: Wind-toxin affects humans everywhere, why does it specifically target the feet? Answer: Humans have five zang organs; the meridians of the Heart and Lung originate in the ten fingers of the hands; the meridians of the Liver, Kidney, and Spleen originate in the ten toes of the feet. Wind-toxin arises from the earth. The cold, heat, wind, and dampness of the earth transform into vapors; since the feet constantly tread upon them, wind-toxin must first affect the feet. If untreated for a long time, it spreads to the four limbs, abdomen, back, head, and neck. Initially imperceptible, it is only recognized when stagnation becomes entrenched. The Classics state: this is known as sequential transmission or intermittent transmission.

Discussion on whether symptoms are immediately apparent upon contraction. All Hong Xiang Jiao diseases are caused by contracting wind-toxin. Upon contracting this disease, symptoms are rarely immediately apparent. It often triggers only after another illness occurs. One might suddenly feel severe oppression, unable to rise for two or three days before realizing the condition. Many mediocre physicians fail to recognize this disease, treating it arbitrarily as other ailments, leading inevitably to death; thus, this disease is often unrecognized. In its early stages, symptoms are subtle; diet, play, and strength remain normal. The only anomaly is the sudden onset of foot weakness and inability to move. As the Yellow Emperor said: this is "Luan Feng Bi" (Flaccid Wind Bi Syndrome).

Discussion on the manifestations of wind-toxin. Some patients feel no abnormality in their feet, yet suffer from pain in the head, neck, arms, and shoulders; some feel no discomfort elsewhere, yet their heart, abdomen, and internal organs are troubled. When wind-toxin attacks, some may vomit upon seeing food or detest the smell of food; some may experience abdominal pain and diarrhea; some may suffer from constipation and difficulty in urination or defecation; some may feel palpitations in the chest, aversion to light; some may suffer from mental confusion, forgetfulness, and disordered speech; some may have high fever and headache; some may feel extreme cold and painful irritability; some may experience muscle spasms; some may swell, others not; some may have numbness and paralysis in the legs; some may experience flaccidity and loss of motor control; some may suffer from joint contractions; some may have insensitivity in the lower abdomen. These are all manifestations of Hong Xiang Jiao, also referred to as signs of Wind-Toxin Hong Xiang Jiao. These signs are difficult to discern and require careful observation; otherwise, the key to treatment will be missed. Once the disease is established, it is difficult to treat, including in women. Women who cool themselves during spring and summer after childbirth are prone to contracting this toxin and should exercise great caution. Symptoms include stifling heat, pulling pain, palpitations, irritability, vomiting, and rising qi. Additionally, feeling cold and stuffiness below the navel, discomfort, and dribbling urine, differing from one's usual state, are signs of Jiao Qi (Foot Qi). Flaccidity is called Huan Feng (Flaccid Wind); pain is called Shi Bi (Damp Bi).

Discussion on the causes of the disease. Throughout the four seasons, one should not stand or sit for long periods in wet and cold places. One should not remove clothes, boots, or socks to cool off in the wind after drinking to intoxication and sweating; doing so leads to Hong Xiang Jiao. Sitting or standing for long periods in wetlands during hot months allows damp-heat qi to steam into the meridians, causing the disease to manifest with heat, soreness, and irritability in the four limbs. Sitting or standing for long periods in wet and cold places during cold months allows cold-damp qi to enter the meridians, causing the disease to manifest with extreme cold and spasms in the four limbs. Contracting it by cooling off in the wind causes the disease to manifest with numbness and paralysis of the skin and flesh, moving gradually upward toward the head. On ordinary days, if sudden intense heat makes endurance difficult, one must not abruptly seek cold relief for pleasure, nor endure sudden extreme cold; both cause illness. Diligent scholars who focus entirely on their work, sitting or standing for long periods in wetlands without moving, allow cold wind to strike and enter the meridians, unknowingly contracting the disease. Thus, wind-toxin may first affect the ten fingers of the hands and feet. With sweat pores open and interstices loose, wind strikes like an urgent arrow, possibly first affecting the sole of the foot, the dorsum of the foot, or the areas above and below the knee. To prevent the disease, moxibustion should be applied immediately at the site of initial sensation, twenty to thirty moxa cones; this cures it and prevents recurrence. The Yellow Emperor said: cooling off in the wind and engaging in sexual activity after drunkenness can cause this disease.

Discussion on Cold and Heat differences. Question: Why do some cases present with cold and others with heat? Answer: The feet have three Yin and three Yang meridians. Cold attacking the three Yang meridians results in cold pathology; heat attacking the three Yin meridians results in heat pathology. Hence, there are differences in exterior/interior and cold/heat. Heat is treated with cold medicines; cold is treated with hot medicines, adjusted according to judgment. The Spleen affected by Yang-toxin becomes hot and numb; the Kidney affected by Yin-dampness becomes cold and bi-syndrome.

Discussion on subsequent diseases arising from Hong Xiang Jiao. Even if suffering from Hong Xiang Jiao, if mineral drugs (Ru Shi) trigger reactions, one must take mineral-suppressing medicines. For subsequent diseases arising from Hong Xiang Jiao, appropriate medicines should be matched. If urination is difficult, use Zhu Ling (Polyporus), Fu Ling (Poria), and other diuretics; if stool is extremely hard, use Wu Rou Ma Ren Wan (Five-Kernel Hemp Seed Pill) and similar formulas; if the whole body is swollen and edematous, use water-draining formulas from the relevant section. Other conditions follow this pattern, with no further restrictions.

Discussion on urgency of treatment. Whenever slight abnormalities in symptoms are felt, one must be greatly alarmed and resolve to treat urgently without delay. If delayed, qi rises into the abdomen, causing swelling or non-swelling, fullness and rebellion in the chest and hypochondrium, and breathing difficulties with qi rising to the shoulders. In acute cases, death follows swiftly; in less acute cases, death occurs within days. Urgent treatment is imperative. If the epigastrium feels urgent with continuous panting, spontaneous sweating, alternating chills and fever, a rapid and short pulse, and incessant vomiting, death is certain.

Discussion on Excess/Deficiency and suitability of medication. All Hong Xiang Jiao diseases lead to death due to qi excess; no one dies from deficiency caused by medication. Therefore, patients with Jiao Qi must not undergo strong tonification, nor strong purgation. One must not fear deficiency to the point of refusing necessary decoctions; those who do will die untreatable.

Discussion on visitors asking about illness. Many relatives, friends, and acquaintances visit sick patients to inquire about their condition. These visitors, having experienced nothing and read no prescriptions, boast of their knowledge and pretend to be wise, discussing heterodox theories. They claim it is deficiency or excess, wind or gu-poison, water or phlegm, spreading confused and erroneous statements. This disrupts the patient's mind, leaving them unsure of what is true. Delays occur, time waits for no one, and disaster ensues as everyone scatters. Therefore, one needs good people and excellent famous doctors who understand the depth of the disease, explore medical texts, study past and present, and clearly comprehend matters. Treating without such expertise greatly harms human life. Pitying the multitude who act thus, I explain each point clearly, detailing the causes and manifestations, so future patients may read this to protect themselves. If any symptom matches, one must urgently treat according to the formula, ignoring outsiders' opinions to avoid regret. Focus solely on the formula's intent; do not trust other words to mislead yourself. I once composed Dong Qing Jian (Asparagus Decoction) for someone (see Volume 12, Gallbladder Section, named Tian Men Dong Jian). This formula is highly effective for Hong Xiang Jiao; patients must use it.

Discussion on Pulse Diagnosis. Although Hong Xiang Jiao presents variably, pulse diagnosis is crucial. Pulses in the three positions must not contradict the four seasons to be auspicious; those contradicting the four seasons should not be treated. Other details follow the *Mai Jing* (Pulse Classic) and are not repeated here. Patients who are originally black and thin are easier to treat; those who are fat, fleshy, red, or white are difficult to cure. Black-skinned people tolerate wind and dampness; red/white-skinned people do not tolerate wind. Thin people have firm flesh; fat people have soft flesh. Soft flesh indicates deep disease involvement and difficulty in cure.

Discussion on Swelling vs. Non-Swelling. People suffering from Hong Xiang Jiao for a long time may not realize the distinction. Later, triggered by another illness, after treatment improves, they may directly suffer from vomiting and recurring foot weakness. Upon examination, I diagnosed it as Hong Xiang Jiao. The patient said: "I have never had swollen feet in my life; why is it called Hong Xiang Jiao?" Refusing to take decoctions. Another physician thought it was a mineral reaction. Hesitating, the patient died within ten days. Thus, Hong Xiang Jiao should not always be judged by swelling; some swell, some do not. Those with numbness and insensitivity in the lower abdomen often do not have swollen feet. If numbness in the lower abdomen is followed by vomiting within three to five days, it is called "Hong Xiang Jiao entering the Heart," and death is imminent within dawn and dusk. Hong Xiang Jiao reaching the Heart is difficult to treat because Kidney Water overcomes Heart Fire.

Discussion on Precautions. Hong Xiang Jiao requires strict avoidance of sexual activity, mutton, beef, fish, garlic, jiu cai (Chinese chives), song cai (Napa cabbage), man jing (Turnip), hu zi (Gourd), wine, noodles, butter, milk porridge, pork, chicken, goose, duck. Although some formulas use carp heads, these items are strictly forbidden. Anger must also be avoided. Only rice, millet, soybean paste, green onions, leeks, wild garlic, pepper, ginger, and tangerine peel are permitted. Raw fruits and sour/vinegar foods must not be eaten; violating this prevents recovery. Fresh cow's milk and fresh chestnuts are highly recommended.

Discussion on Recovery Time for Effective Treatment. Many die unjustly from Hong Xiang Jiao. Briefly, there are three types of unjust death: 1. Delayed recognition; 2. Pride and arrogance; 3. Indecision and doubt. These three represent the color of unjust death. Thus, truly good doctors are rare in the world. Even if good doctors exist, few patients have the spiritual capacity to accept treatment. Like a thoroughbred without Bo Le, or Confucius without disciples, unjust deaths are common. If a patient has the capacity to accept treatment and follows the method, I can cure them permanently within ten days. Without this capacity, treatment is unnecessary; even if attempted, recovery is unlikely. This applies to all diseases, not just Hong Xiang Jiao. Good medicine and advice are available, but one cannot force compliance. Methods are for believers, not for the doubtful.

Discussion on Moxibustion. For Hong Xiang Jiao, upon initial foot weakness, apply moxibustion quickly and take Zhu Li Tang (Bamboo Juice Decoction). After moxibustion, take Ba Feng San (Eight-Wind Powder); all recover. Treat urgently. If one moxas but does not take powder, or takes powder but does not moxa, half recover, half die. Even those who recover may relapse in one to two years. Upon sensation, follow this method for quick moxibustion and powder intake; ten out of ten heal. Though mild cases may not seem severe initially, improper treatment leaves the root intact, eventually leading to death. Precision is vital. First moxa Feng Shi (GB31), then Fu Tu (ST32), then Du Bi (ST35), then Xi Yan (EX-LE5), then Zu San Li (ST36), then Shang Lian (ST37), then Xia Lian (ST38), then Jue Gu (GB39). Eight points are moxaed.
1. Feng Shi (GB31): Patient stands upright, arms hanging down, fingers covering thighs. Point is at the center of the middle finger touching the large tendon on the thigh. Moxa 100 cones; more is acceptable. Mild cases: no less than 100; severe cases: 500-600 per point. Do not moxa all at once; divide into three sessions.
2. Fu Tu (ST32): Patient sits cross-legged. Place hand on bent knee. Point is level with the knee cap, on the side. Moxa 100 cones, or 50.
3. Du Bi (ST35): At the outer edge of the patella, level with the bone. Press to find the joint gap. Alternatively, below the knee, near the outer three bones, press while moving the foot to find the hollow. Moxa 50 cones, up to 100.
4. Xi Yan (EX-LE5): In the depressions on both sides below the knee cap.
5. Zu San Li (ST36): One fu (hand breadth) below the knee joint, outside the tibia. Or three cun below. Measure using the patient's hand. Moxa 100 cones.
6. Shang Lian (ST37): One fu below Zu San Li, outside the tibia. Moxa 100 cones.
7. Xia Lian (ST38): One fu below Shang Lian, outside the tibia. Moxa 100 cones.
8. Jue Gu (GB39): One fu above the lateral malleolus, or four cun.
For all these points, do not moxa all cones at once; daily moxibustion over three days to complete the count is best. Moxa one foot if one foot is diseased, both if both are. Leg weakness usually affects both feet. Another method: if feet feel bad, moxa Zu San Li and Jue Gu on each side. Four points total, quantity depending on severity. Generally, even mild cases require no less than 100 cones. If not cured, proceed to next points; more is better. Some say Jue Gu is most important. If leg weakness is not treated immediately and enters the abdomen, causing abdominal distension and rising qi, major moxibustion is needed along all transport points and joints of the abdomen and back, plus Ba Feng San. Often recovers. Joint methods are in Volume 29. If disease enters abdomen and patient cannot endure pain, moxa chest, heart, abdomen, and foot points; some recover.
Measurement of "Fu": Cover hand, extend four fingers horizontally across the middle joint of the fingers constitutes one fu. There are two types; for leg weakness, use four fingers as one fu, following Zhi Facun's old method.
Points: Liang Qiu (ST34), Du Bi (ST35), Zu San Li (ST36), Shang Lian (ST37), Xia Lian (ST38), Jie Xi (ST41), Tai Chong (LR3), Yang Ling Quan (GB34), Jue Gu (GB39), Kun Lun (BL60), Yin Ling Quan (SP9), San Yin Jiao (SP6), Zu Tai Yin (Spleen Meridian), Fu Liu (KI7), Ran Gu (KI2), Yong Quan (KI1), Cheng Shan (BL57), Shu Gu (BL65). These eighteen points. Old methods often moxa Bai Hui (GV20) and Feng Fu (GV16). In recent times, moxaing Shu and Mu points of the five zang and six fu organs causes qi to rise upward, so this method is not adopted unless qi does not rise. For critical cases fearing non-recovery, all points must be moxaed.
At the tips of the ten toes, one fen away from the nail, there are eight points on both feet, called "Ba Chong" by Cao Shi, very effective for descending qi. The toe tips are called "Qi Duan", moxa 3 cones daily, a great secret. Ba Chong can be moxaed with 7 cones daily. Stop when qi descends. Unless deeply knowledgeable, do not moxa others. Be cautious. Moxa cones for Ba Chong must be small.

Discussion on Decoction Types. Wind-toxin enters the body; pulses have three grades. Exterior and interior signs are similar, but pulses differ.
If pulse is floating, large, and slow, take Xuming Tang (Continuing Life Decoction) for two doses; should recover.
If wind is prevalent, use Yebipi Tang (Yi Yi Decoction modified) adding 4 liang of Bai Zhu (Atractylodes Macrocephala Rhizome).
If pulse is floating, large, tight, and rapid, use Zhu Li Tang (Bamboo Juice Decoction).
If pulse is faint and weak, use Feng Yin Tang (Wind-Guiding Decoction); this pulse often arises from deficiency.
If severely deficient with shortness of breath and lack of strength, use Tonifying Decoction intermittently, adjusting for cold/heat. If not cured, take Zhu Li Tang again.
If pulse is floating, large, tight, and rapid, this is the worst of the three grades. If sinking, fine, and rapid, this is equally bad. Floating/large indicates exterior disease; sinking/fine indicates interior disease. Treatment is similar, adjusted by judgment.
If appearance is okay but limbs are not yet weak, qi rising leads to death within days. Such pulses are fatal; none survive. Urgently take Zhu Li Tang, one dose daily. Ensure continuous administration; do not leave gaps of half a day. This decoction contains much bamboo juice; if not taken piping hot, it stays in the chest/heart, causing harm. Take it very hot. If Zhu Li Tang passes down, it is excellent.
If three doses of Zhu Li Tang are taken and disease/pulse persist with bloating, use Da Bie Jia Tang (Large Turtle Shell Decoction) to purge. If pills assist the decoction to pass, continue. After purging, resume Zhu Li Tang until pulse缓和 and breath stabilizes, then stop. San Shi Er Wu Ba Feng San (Thirty-Two Ingredient Eight-Wind Powder) is good.
Upon initial disease, apply Ye Ge Gao (Wild Vine Paste) twice daily until numbness and weakness resolve.
If Zhu Li Tang reduces pulse to normal, strength returns to legs, but walking is still impossible, wait for full physical strength, then gradually walk. Severe cases may need six months before assisted walking.
Once pulse and internal state improve, diligently take Ba Feng San. Do not add other treatments just because walking is impaired; it may not help and could cause harm. Do not use Ye Ge Gao on vulgar people.
Some fear Zhu Li Tang damages waist and feet; do not treat them. Know this method; these patients lack the capacity for treatment, illustrating "not speaking to the doubtful."
There are three versions of Zhu Li Tang; mild cases use the first, severe cases use the latter sequentially.
This wind-toxin transfers between patients. Use Xiao Jin Ya San (Small Gold Tooth Powder) prophylactically; apply a little to nostrils and ear gates. Sick people and the newly deceased tend to transfer toxin to healthy people; take it. Apply to nose/ears before approaching the dying or examining the sick. Carry a square-inch scoop in a crimson bag on the left arm for men, right for women. Start with small amounts of toxin dispersion. (Jin Ya San formula in Volume 14, Gallbladder Section).
Patients should only drink Chi Xiao Dou San (Red Bean Powder). In winter, take Ce Zi Jin Ya Jiu Xu Ming Tang (Side-Seed Gold Tooth Wine Continuing Life Decoction).
Treating wind-toxin: Early stage resembles epidemic toxic disease, with floating/slow pulse that does not become rapid; this is untreatable. Death in days or ten days, or confusion, jaundice, spots, red eyes, or genital ulceration indicate acute contraction.
First take one dose of Xuming Tang, then purge with Gegen Tang (Kudzu Decoction) or Mahuang Tang (Ephedra Decoction). If this fails, give Xuming Tang two to three more doses; must recover.
This disease is extremely urgent; keep decoctions continuous. Half-day gaps kill. (Xuming Tang formula in Volume 10, Various Winds Section).