【歌】香港脚多因清湿致，风寒暑挟须分异。浮弦之脉挟于风，濡从湿兮数从暑。挟于寒者脉必迟，得病必
从足上起。头痛身热肢节疼，人皆误作伤寒治。但看足膝多不仁，或软或肿或疼痹。呕逆便秘体转筋，胸膈痞
满心中悸。此病根从湿上来，治湿当分南北地。
【论】夫香港脚，始受于湿，复挟风、寒、暑热之邪而成。故先起于腿足，必脚屈弱而举体转筋，肢节疼
而足 肿，小腹不仁，心中悸动，胸满便涩。但发热头痛身疼之候，绝似伤寒，人多误治，故仲景以香港脚为类
伤寒证，另立篇目以别之。丹溪云∶香港脚多从于湿，而有湿热、湿寒、风湿之别，食积流注之因。罗谦甫云∶
南北香港脚，受病不同，南方地土卑湿，清湿袭虚而病起于下，此南方香港脚从外受也。北方地高陵居无湿，其俗
饮潼乳酒面，以饮多快食为能，或奉养太过，亦滋其湿，水性润下，气不能拘，故下注于足，而成肿痛，此北
方香港脚之从内受也。学人当推究所因而治之。
谨按∶前证乃肾火挟湿见于皮肉，红肿如云痕，或隐见
红色，按之热且痛是也。红肿自足起，渐行至股，其势必上升，升至心者不治，急宜治之，勿令上升为妙。
【脉】香港脚之脉，其状有四∶浮弦为风，濡弱湿气，迟涩因寒，洪数热郁。风寒热温，热下寒熨。
湿
湿胜者，足重痛，或胫肿，防己饮或除湿丹。湿胜心下痞满，开结导饮丸。（二方俱见前湿证。）
防己饮
治湿香港脚神效。
白术（一钱，炒） 木通（八分） 防己（八分） 槟榔（八分） 川芎（八分） 甘草梢（七分） 犀
角（一钱） 苍术（炒，一钱） 黄柏（酒炒，一钱） 生地黄（酒炒，一钱）
水煎热服。
挟寒
挟寒湿者，六物附子汤、五积散、（方见中寒。）健步丸。（方见腰痛。）
六物附子汤
附子（四钱） 肉桂（四钱） 防己（四钱） 白术（炒，三钱） 茯苓（三钱） 甘草（炙，二钱）
每半两，姜煎服。
挟热
挟湿热者，走痛，当归拈痛汤。湿热甚，大便不通，大黄左经汤或羌活导滞汤。
当归拈痛汤
当归（酒洗，一钱） 白术（炒，一钱） 苍术（米泔浸，晒干，炒，一钱） 黄芩（酒炒，一
钱） 羌活（一钱二分） 防风（去芦，一钱） 泽泻（去毛，八分） 猪苓（八分） 茵陈（一钱） 干葛
（一钱） 苦参（一钱） 人参（六分） 知母（六分）
升麻（一钱） 甘草（六分）
上锉，作一帖，水二钟，煎八分，空心热服。
大黄左经汤
细辛（八分） 茯苓（七分，去皮） 羌活（一钱，去芦） 大黄（煨，二钱） 甘草（炙，六分） 前
胡（七分） 枳壳（炒，七分） 浓朴（姜炒，八分） 黄芩（炒，一钱） 杏仁（十四粒，去皮、尖）
姜、枣水煎服。
羌活导滞汤
羌活（半两，去芦） 独活（半两，去芦） 防己（二钱） 当归（二钱） 大黄（酒蒸，一两） 枳
实（炒，二钱）
每七钱，水煎服。
挟风
挟风者，麻黄左经汤。风湿痹痛足弱，独活寄生汤，（方见腰痛。）或半夏左经汤。
麻黄左经汤
麻黄（去节，一钱） 细辛（一钱） 干葛（一钱） 白术（四分） 茯苓（八分） 防己（一钱） 肉
桂（七分） 羌活（去芦，一钱） 防风（去芦，一钱） 甘草（六分）
姜、枣水煎服。
半夏左经汤
半夏（一钱） 干葛（一钱） 细辛（一钱） 白术（炒，四分） 麦门冬（八分） 白茯苓（八分）
桂枝（八分） 防风（去芦，八分） 干姜（五分） 黄芩（炒，七分） 小草（六分） 柴胡（八分） 甘草
（炙，六分）
姜三片，枣二枚，水煎服。
食积
食积流注于下作香港脚，苍术防己丸。食不消，胸痞痛者，开结导饮丸。
苍术防己丸
苍术（一两，炒） 防己（一两） 黄柏（一两，酒炒） 南星（八钱，姜制） 川芎（五钱） 白芷
（一两） 犀角（一两） 槟榔（八钱）
肥人加贝母（一两，去心） 橘皮（一两，去白）
末之，酒糊丸如梧桐子大，每七十丸，空心白汤下。
开结导饮丸
白术（一两，炒） 橘皮（一两） 泽泻（一两，去毛） 茯苓（一两，去皮） 神曲（炒，一两） 麦芽
（炒，一两） 半夏（一两，姜制） 枳壳（炒，半两） 巴豆霜（半两） 青皮（半两，炒） 干姜（半两）
末之，蒸饼糊丸如梧子大，每七十丸，空心白汤下。
[Song] Hongjiaojiao (a disease characterized by swelling and heaviness of the lower legs and weakness) is mostly caused by cold-dampness. If complicated by Wind, Cold, or Summerheat, differentiation is required. A floating and wiry pulse indicates complication with Wind; a soggy pulse indicates complication with Dampness; a rapid pulse indicates complication with Summerheat. When complicated by Cold, the pulse must be slow, and the disease inevitably starts from the feet and moves upward. Symptoms include headache, fever, and pain in the limbs and joints; people often mistakenly treat it as Taiyang Disease (diseases caused by pathogenic factors attacking the Taiyang meridian). However, if one observes that the feet and knees are mostly numb, or soft, swollen, or painful and bi-syndrome-like, accompanied by vomiting, constipation, muscle spasms, chest and diaphragm fullness, and palpitations. The root of this disease lies in Dampness rising; treating Dampness requires distinguishing between Southern and Northern geographical regions.
[Dissertation] As for Hongjiaojiao, it initially suffers from Dampness, then becomes complicated by Wind, Cold, Summerheat, and Heat pathogens. Therefore, symptoms first arise in the legs and feet, inevitably manifesting as flexion weakness of the feet, whole-body spasms, limb joint pain, foot swelling, numbness in the lower abdomen, palpitations, chest fullness, and difficult defecation. Although there are signs of fever, headache, and body pain that closely resemble Taiyang Disease, people often misdiagnose and mistreat it. Thus, Zhang Zhongjing classified Hongjiaojiao as a "Taiyang-like" syndrome and established a separate chapter to distinguish it. Zhu Danxi stated: Hongjiaojiao mostly stems from Dampness, with distinctions among Damp-Heat, Damp-Cold, Wind-Damp, and causes such as food stagnation and flowing accumulation. Luo Qianfu said: The causes of Hongjiaojiao differ between the North and South. In the South, the land is low and damp; cold-dampness attacks deficiency, so the disease arises from below. This is Hongjiaojiao contracted externally in the South. In the North, the land is high, and people live on hills without dampness. Their custom involves drinking turbid milk, wine, and eating noodles, regarding large intake and hearty eating as capable. Or, excessive nourishment also generates Dampness. Water nature is moist and downward; Qi cannot restrain it, so it flows down to the feet, resulting in swelling and pain. This is Hongjiaojiao contracted internally in the North. Students should investigate the cause and treat accordingly.
Note: The aforementioned syndrome is Kidney Fire complicated by Dampness appearing in the skin and flesh, presenting as redness and swelling like cloud marks, or faintly visible redness, which feels hot and painful upon pressure. The redness and swelling start from the feet and gradually move up to the thighs. The pathological trend inevitably rises; if it reaches the Heart, it is incurable. Urgent treatment is needed to prevent the pathogen from rising, which is the best approach.
[Pulse Diagnosis] The pulse manifestations of Hongjiaojiao have four types: Floating and wiry indicate Wind; soggy and weak indicate Dampness; slow and choppy indicate Cold; surging and rapid indicate Heat stagnation. For Wind-Cold and Warm-Heat, the method of "heat applied below and cold applied above" (or adjusting warmth/coolness based on cold/heat nature) is used.
If Dampness prevails, causing heavy and painful feet or swollen shins, Fangji Yin or Chushi Dan may be used. If Dampness prevails causing epigastric fullness and stuffiness, Kaijie Daoyin Wan is used. (Both formulas are seen in the previous Dampness syndrome section.)
Fangji Yin
Treats Dampness-induced Hongjiaojiao with miraculous effect.
Baizhu (1 qian, stir-fried) Mutong (8 fen) Fangji (8 fen) Binglang (8 fen) Chuanxiong (8 fen) Gancao Shao (7 fen) Xijiao (1 qian) Cangzhu (stir-fried, 1 qian) Huangbai (wine-stir-fried, 1 qian) Sheng Dihuang (wine-stir-fried, 1 qian)
Decoct in water and take hot.
Complicated by Cold
For cases complicated by Cold-Dampness, Liwu Fuzi Tang, Wuji San (formula seen in Middle Cold section), or Jianbu Wan (formula seen in Lower Back Pain section) are used.
Liwu Fuzi Tang
Fuzi (4 qian) Rougui (4 qian) Fangji (4 qian) Baizhu (stir-fried, 3 qian) Fuling (3 qian) Gancao (honey-fried, 2 qian)
Take half liang per dose, decoct with ginger.
Complicated by Heat
For cases complicated by Damp-Heat, if pain migrates, Danggui Niantong Tang is used. If Damp-Heat is severe with constipation, Dahuang Zuojing Tang or Qianghuo Daozhi Tang is used.
Danggui Niantong Tang
Danggui (wine-washed, 1 qian) Baizhu (stir-fried, 1 qian) Cangzhu (soaked in rice water, dried, stir-fried, 1 qian) Huangqin (wine-stir-fried, 1 qian) Qianghuo (1.2 qian) Fangfeng (deprived of radicle, 1 qian) Zexie (deprived of hairs, 8 fen) Zhuling (8 fen) Yichen (1 qian) Gange (1 qian) Kushen (1 qian) Renshen (6 fen) Zhimu (6 fen) Shengma (1 qian) Gancao (6 fen)
Coarsely crush, make one dose, add two zhong of water, decoct to eight parts, take hot on an empty stomach.
Dahuang Zuojing Tang
Xixin (8 fen) Fuling (7 fen, deprived of peel) Qianghuo (1 qian, deprived of radicle) Dahuang (roasted, 2 qian) Gancao (honey-fried, 6 fen) Qianhu (7 fen) Zhiqiao (stir-fried, 7 fen) Houpo (ginger-stir-fried, 8 fen) Huangqin (stir-fried, 1 qian) Xingren (14 grains, deprived of peel and tip)
Decoct with ginger and jujube in water.
Qianghuo Daozhi Tang
Qianghuo (half liang, deprived of radicle) Duohuo (half liang, deprived of radicle) Fangji (2 qian) Danggui (2 qian) Dahuang (wine-steamed, 1 liang) Zhishi (stir-fried, 2 qian)
Take 7 qian per dose, decoct in water.
Complicated by Wind
For cases complicated by Wind, Mahuang Zuojing Tang is used. For Wind-Damp bi-syndrome causing foot weakness, Duhuo Jisheng Tang (formula seen in Lower Back Pain section) or Banxia Zuojing Tang may be used.
Mahuang Zuojing Tang
Mahuang (deprived of nodes, 1 qian) Xixin (1 qian) Gange (1 qian) Baizhu (4 fen) Fuling (8 fen) Fangji (1 qian) Rougui (7 fen) Qianghuo (deprived of radicle, 1 qian) Fangfeng (deprived of radicle, 1 qian) Gancao (6 fen)
Decoct with ginger and jujube in water.
Banxia Zuojing Tang
Banxia (1 qian) Gange (1 qian) Xixin (1 qian) Baizhu (stir-fried, 4 fen) Maimendong (8 fen) Bai Fuling (8 fen) Guizhi (8 fen) Fangfeng (deprived of radicle, 8 fen) Ganjiang (5 fen) Huangqin (stir-fried, 7 fen) Xiaocao (6 fen) Chaihu (8 fen) Gancao (honey-fried, 6 fen)
Add three slices of ginger and two jujubes, decoct in water.
Food Stagnation
When food stagnation flows downward causing Hongjiaojiao, Cangzhu Fangji Wan is used. If food is not digested and there is epigastric fullness and pain, Kaijie Daoyin Wan is used.
Cangzhu Fangji Wan
Cangzhu (1 liang, stir-fried) Fangji (1 liang) Huangbai (1 liang, wine-stir-fried) Nanxing (8 qian, ginger-processed) Chuanxiong (5 qian) Baizhi (1 liang) Xijiao (1 liang) Binglang (8 qian)
For obese persons, add Beimu (1 liang, deprived of heart) and Chenpi (1 liang, deprived of white pith).
Grind into powder, make pills with wine paste, size of paulownia seeds. Take 70 pills per dose, swallow with plain warm water on an empty stomach.
Kaijie Daoyin Wan
Baizhu (1 liang, stir-fried) Chenpi (1 liang) Zexie (1 liang, deprived of hairs) Fuling (1 liang, deprived of peel) Shenqu (stir-fried, 1 liang) Maiya (stir-fried, 1 liang) Banxia (1 liang, ginger-processed) Zhiqiao (stir-fried, half liang) Badoushuang (half liang) Qingpi (half liang, stir-fried) Ganjiang (half liang)
Grind into powder, make pills with steamed cake paste, size of paulownia seeds. Take 70 pills per dose, swallow with plain warm water on an empty stomach.