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Hongjiao (a disease characterized by swelling and weakness of the lower legs) occurring after Shanghan (Cold Damage) is caused by wind-toxin and dampness stagnating in the Kidney Meridian. Since the Kidneys govern the waist and knees, when the Kidneys are affected by dampness, the feet become weak, swollen, and distended, thus forming Hongjiao. Furthermore, during spring and summer, warm and damp qi combats with the Kidney Meridian, sinking and stagnating without dispersing, causing both feet to swell, ache, feel stifled, and be hot. If the constitution inherently possesses wind-toxin, the wind-damp qi will rush upward to the Heart and Lungs, causing chest fullness and shortness of breath, potentially leading to sudden death. Upon diagnosis, the pulse at the left Chi position should be large (Hong) and rapid (Shu); this is its sign. If after taking medicine the pulse becomes deep (Chen) and slow (Huan), the illness will soon recover. The *Huoren Shu* states: regarding Shanghan with headache, fever, pain in all joints, constipation, or vomiting and reverse flow of qi, accompanied by weak and flexed feet, this is named Hongjiao. Shanghan transmits only through the Foot meridians, not the Hand meridians. The cold, heat, wind, and dampness on earth transform into vapor; as the feet constantly tread upon it, Hongjiao forms. Therefore, the symptoms resemble those of Shanghan. A pulse that is floating (Fu) and wiry (Xian) originates from Wind; one that is soggy (Ru) and weak (Ruo) originates from Dampness; one that is large (Hong) and rapid (Shu) originates from Heat; one that is slow (Chi) and choppy (Se) originates from Cold. Diseases caused by Wind are cured by sweating; those by Dampness by warming; those by Heat by purging downward; those by Cold by moxibustion or ironing therapy. Hongjiao often begins imperceptibly and is recognized only due to other illnesses. If the toxin enters the Heart, the lower abdomen becomes numb and insensible, causing vomiting, leading to death within a day or two. However, it ultimately differs from Shanghan. Sun Simiao said that sudden onset of foot weakness and inability to move is its distinctive feature. In summary, patients with Hongjiao always start with symptoms in the feet; some first experience flaccidity, weakness, pain, and numbness. When Cold predominates, it is termed Painful Bi (Tongbi) due to Cold. Some may suddenly fall while walking, or have swollen and distended calves, though some do not swell. Some have withered and thin feet and knees; some have palpitations; some have insensitivity in the lower abdomen. As the disease progresses deeply, Ying (Nutritive) and Wei (Defensive) Qi circulation becomes stagnant, causing the skin to become deficient and unable to nourish itself, resulting in numbness (Bu Ren). "Bu Ren" means the skin is callous and unaware of touch. Some experience whole-body spasms; some vomit upon seeing food or smelling it; some have chest fullness and急促 breathing; some have generalized soreness and pain. These are all signs of Hongjiao. What the Yellow Emperor called "Huan Feng" (Lax Wind) refers to Cold-Damp Bi obstruction. Flaccidity and weakness are called Huan Feng; pain is called Shi Bi (Damp Bi). "Bi" means closure; closed and insensible, hence Bi. When Cold invades the Three Yang meridians, the illness must be cold; Yuepi Tang (Curtain-Dispersing Decoction) and Xiao Xuming Tang (Minor Continuation of Life Decoction) are indicated. For Xiao Xuming Tang, adding fresh ginger juice immediately after decocting yields the best results. When Summer-Heat invades the Three Yang meridians, the illness must be hot; use Xiao Xuming Tang removing Fuzi (Aconite Root) and reducing Guizhi (Cinnamon Twig) by half. For severe restlessness, Zixue (Purple Snow) is best. For severe constipation, Piyue Wan (Spley-Restriction Pill), Shengong Wan (Divine Merit Pill), Wuro Wan (Five Softness Pill), Dasanwan San (Great Three-Wrist Powder), and Mugua San (Papaya Powder) are indicated. Hongjiao deaths result from Excess Qi; no one dies from deficiency caused by medication. Headache, fever, joint pain, and weak feet indicate an underlying Hongjiao now manifesting. For swollen feet, Binglang San (Areca Seed Powder) is indicated. Discussions on Hongjiao formulas are most detailed in *Qianjin Fang* and *Waitai Miyao*, so they are not repeated here. Generally, Yuepi Tang, Xiao Xuming Tang, Yiyiren Jiu method (Coix Seed Wine), Piyue Wan, and Shengong Wan are essential medicines. Acupuncture and moxibustion are preferred; taking tonics and using decoctions for washing are major medical taboos.

Formulas:
Binglang San (Areca Seed Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking upward, causing chest/abdominal oppression, restlessness.
Ingredients: Areca Seed, Antelope Horn Shavings, Costus Root (each 3 fen); Prunus Mume Seed (2.5 liang, soaked in water, peeled, lightly stir-fried); Evodia Fruit (1 fen, soaked in water seven times, dried, lightly stir-fried); Tangerine Peel (3 fen, soaked in water, white pith removed, dried). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water until 6 fen remains. Strain. Take warm at any time.

Biejia San (Turtle Shell Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking the Heart causing confusion, abdominal distension like stone, difficult urination/defecation.
Ingredients: Turtle Shell (3 fen, vinegar-fried until slightly yellow, skirt removed); Akebia Stem (3 fen, sliced); Prunus Mume Seed (soaked, peeled, pit removed, lightly stir-fried); Red Poria (each 1 liang); Antelope Horn Shavings; Areca Seed (each 3 liang). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 zhong zhan of water until 6 fen remains. Strain. Take warm at any time.

Muxiang San (Costus Root Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan, epigastric hardness/fullness, occasional pain, inability to eat.
Ingredients: Costus Root, Turtle Shell (vinegar-fried, skirt removed), Chebula Epicarps, Areca Seed, Red Poria, Prunus Mume Seed (soaked, peeled, pit removed, lightly stir-fried; each 3 fen). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 zhong zhan of water until 6 fen remains. Strain. Take warm at any time.

Chenxiang San (Agarwood Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan rushing to the Heart, causing stifling sensation, shortness of breath, sore/aching feet/knees, drowsiness.
Ingredients: Agarwood (3 fen); Red Peony Root (1 liang); Akebia Stem (3 fen, sliced); Perilla Stems/Leaves (1.5 liang); Areca Seed (3 fen); Evodia Fruit (0.5 liang, soaked in water seven times, dried, lightly stir-fried); Mirabilite (1 liang). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome until 6 fen remains. Strain. Take warm at any time.

Banxia San (Pinellia Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan, heart vexation/stifling, loss of appetite, vomiting/phlegm.
Ingredients: Pinellia Tuber (washed seven times in water to remove slipperiness); Bitter Orange (bran-fried, white pith removed); Red Poria; Peucedanum Root (radicle removed); Akebia Stem (sliced); Ginseng Radix (radicle removed; each 3 fen). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome until 6 fen remains. Strain. Take warm at any time.

Sangbaipi San (Mulberry Root Bark Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan rushing to the Heart, causing mental confusion.
Ingredients: Mulberry Root Bark (sliced); Akebia Stem (sliced); Tangerine Peel (soaked, white pith removed, dried); Perilla Stems/Leaves (each 2 or 3 liang); Areca Nut (1 liang, sliced). Process: Grind into powder. Dosage: 0.5 liang per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.

Lingyangjiao San (Antelope Horn Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan rushing to the Heart/Chest causing vexation.
Ingredients: Antelope Horn Shavings (1 liang or 1 liang); Inula Flower (3 fen); Red Poria (1 liang); Scutellaria Root (3 fen); Pinellia Tuber (3 fen, washed seven times); Tangerine Peel (3 fen, soaked, white pith removed, dried); Areca Seed (3 fen; *Shengji Fang* uses 0.5 liang); Evodia Fruit (0.5 liang, washed seven times, dried, lightly stir-fried). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time. (*Shengji Fang*: 5 qian bi per dose, 1.5 zhong zhan water, 1 fen Ginger smashed, decoct until 7 fen remains, take warm before meals. Named Lingyangjiao Tang.)

Zisu San (Perilla Leaf Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan rushing to the Heart, causing mental restlessness, vomiting, aversion to food, sore/aching waist/knees.
Ingredients: Perilla Stems/Leaves (1 liang); Costus Root (3 fen; *Shengji Fang* 0.5 liang); Red Poria (3 fen; *Shengji Fang* 0.5 liang); Agarwood (1 liang); Evodia Fruit (1 fen, washed seven times, dried, lightly stir-fried); Red Peony Root (1 liang); Tangerine Peel (3 fen, soaked, white pith removed, dried; *Shengji Fang* 1 fen); Areca Seed (3 fen, sliced; *Shengji Fang* 1 fen); Akebia Stem (1 liang, sliced). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome until 6 fen remains. Strain. Take warm at any time.

Qianhu San (Peucedanum Root Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking upward, phlegm reversal, dizzy head/eyes.
Ingredients: Peucedanum Root (1 liang, radicle removed); Pinellia Tuber (washed seven times); Cinnamon Bark; Licorice Root (honey-fried, slightly red, sliced); Tangerine Peel (soaked, white pith removed, dried); Areca Nut (each 3 liang or 3 fen); Red Poria (1.5 liang); Mulberry Root Bark (1.5 liang, sliced). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.

Xijiao San (Rhinoceros Horn Powder, from *Shenghui Fang*): Treats Wind-Toxin Hongjiao after Shanghan, chest/diaphragm oppression, dizziness, vertigo.
Ingredients: Rhinoceros Horn Shavings (3 fen); Saposhnikovia Root (radicle removed); Notopterygium Root; Gentian Macrophylla Root (radicle removed; each 1 liang); Tangerine Peel (1 liang, soaked, white pith removed, dried); Cinnamon Bark; Areca Nut (each 3 fen); Achyranthes Root (1 liang or 0.5 liang, radicle removed). Process: Grind into powder. Dosage: 5 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.

Chifuling San (Red Poria Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking upward, vexation/fullness, and sore/swollen feet/knees.
Ingredients: Red Poria; Red Peony Root (each 1 liang); Bitter Orange (bran-fried, slightly yellow, pith removed); Areca Nut (each 3 fen); Mulberry Root Bark (1.5 liang, sliced); Perilla Stems/Leaves (3 fen); Lily Bulb (3 fen); Rhubarb (3 fen, sliced, crushed, lightly stir-fried); Licorice Root (0.5 liang, honey-fried, slightly red, sliced); Stephania Root (3 fen); Prunus Mume Seed (3 fen, soaked, peeled, pit removed, lightly stir-fried); Antelope Horn Shavings (3 fen). Process: Grind into powder. Dosage: 5 qian per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.

Chaihu San (Bupleurum Powder, from *Shenghui Fang*): Treats Hongjiao after Shanghan attacking upward, chest/heart vexation, panting, poor appetite.
Ingredients: Bupleurum Root (1 liang, radicle removed); Inula Flower; Green Tangerine Peel (soaked, white pith removed, dried; each 3 fen); Areca Nut (3 fen); Mirabilite (2 liang); Licorice Root (0.5 liang, honey-fried, slightly red, sliced); Pinellia Tuber (3 fen, washed seven times); Mulberry Root Bark (1.5 liang, sliced); Perilla Stems/Leaves (3 fen). Process: Grind into powder. Dosage: 4 qian per dose. Decoct with 1 da zhan of water plus 0.5 fen of Ginger Rhizome until 5 fen remains. Strain. Take warm at any time.

Another Formula (from *Shenghui Fang*):
Ingredients: Costus Root (3 fen); Areca Seed (2 fen); Mirabilite (3 fen); Perilla Stems/Leaves (0.5 liang); Immature Bitter Orange (0.5 liang, bran-fried, slightly yellow). Process: Grind into powder. Dosage: 3 qian per dose. Decoct with 1 zhong zhan of water plus 0.5 fen of Ginger Rhizome and 3 stalks of Scallion White until 5 fen remains. Strain. Take warm at any time.

Dahuang Wan (Rhubarb Pill, from *Shenghui Fang*): Treats Hongjiao after Shanghan and Kidney Qi rushing upward.
Ingredients: Rhubarb (1 liang, sliced, crushed, lightly stir-fried); Achyranthes Root (3 fen, radicle removed); Areca Seed (1 liang); Bitter Orange (3 fen, bran-fried, slightly yellow, pith removed); Costus Root (3 fen); Ginseng Radix (3 fen, radicle removed); Prunus Mume Seed (1 liang, soaked, peeled, pit removed, lightly stir-fried); Cinnamon Bark (3 fen); Peucedanum Root (1 liang, radicle removed). Process: Grind into powder, mix with refined honey, pound 200-300 times, form pills like wu-tong seeds. Dosage: 30 pills before meals, taken with warm wine.

Mugua Wan (Papaya Pill, from *Shenghui Fang*): Treats chronic Hongjiao after Shanghan, abdominal distension, leg/knee edema, chest/diaphragm oppression.
Ingredients: Papaya (1.5 liang, dried); Cinnamon Bark (0.5 liang); Agarwood (1 liang); Bupleurum Root (1 liang, radicle removed); Areca Seed (1 liang); Galangal (3 fen, sliced); Red Peony Root (1 liang); Evodia Fruit (3 liang, soaked in water seven times, dried, lightly stir-fried); Magnolia Bark (3 fen, coarse bark removed, fried with ginger juice until fragrant). Process: Grind into powder, mix with refined honey, pound 200-300 times, form pills like wu-tong seeds. Dosage: 30 pills before meals, taken with Ginger Decoction.

Lin-Zhan Fang (Washing/Dipping Formula, from *Shenghui Fang*): Treats early-stage Hongjiao after Shanghan.
Ingredients: Coix Root (3 liang); Dioscorea Hypoglauca Branches (5 liang); Bitter Orange Root (3 liang); Evodia Fruit (1 liang). Process: Finely slice, decoct with 3 dou of water until 2 dou remains. Strain, add 0.5 he of salt and 1 bowl of sour rice water. Wash feet according to temperature. Stand on a new brick while washing; do not let water exceed the ankles. Wash slowly until cool. Afterward, rub the soles of the feet with a little Ginger Juice to generate heat.

Lin-Zhan Fang (Washing/Dipping Formula, from *Shenghui Fang*): Treats Hongjiao after Shanghan with persistent swelling/distension.
Ingredients: Castor Leaves; Goji Root Bark; Grape Vines (each 1 liang); Dioscorea Hypoglauca Branches (7 liang, sliced); Notopterygium Root (1 liang); Ligusticum Root (1 liang); Evodia Fruit (0.5 liang); Apricot Seeds (0.5 liang); Sichuan Pepper (1 he); Blue Vitriol/Salt (1 liang). Process: Finely slice, divide into two doses. Each dose decocted with 2 dou of water.

Binglang San (Areca Seed Powder): Treats Hongjiao after Shanghan attacking the Heart causing extreme stifling.
Ingredients: Areca Seed (sliced); Costus Root (each 1 liang); Prunus Mume Seed (lightly stir-fried, peeled); Cinnamon (coarse bark removed, each 3 fen); Evodia Fruit (washed three times in water, dried, stir-fried, 0.5 liang); Red Poria (black skin removed); Achyranthes Root (radicle removed, wine-soaked, dried, each 3 fen). Process: Grind into fine powder. Dosage: 1.5 qian bi per dose. Decoct in water. Before meals, take mixed with Sangbaipi-Mutong Decoction. Twice daily.

Chenju Pi San (Tangerine Peel Powder): Treats Hongjiao after Shanghan, chest fullness, abdominal oppression,急促 breathing.
Ingredients: Tangerine Peel (soaked, white pith removed, dried, 3 fen); Areca Seed (sliced, 1 liang); Cinnamon (coarse bark removed, 3 fen); Morning Glory Seeds (lightly stir-fried, 1 liang). Process: Grind into fine powder. Dosage: 0.5 or 1 qian bi per dose. Before meals, taken with warm wine. Twice daily.

Fuling Tang (Poria Decoction): Treats Hongjiao after Shanghan attacking the Heart causing confusion, abdominal distension like stone, red/scanty urine.
Ingredients: Red Poria (black skin removed, 1 liang); Turtle Shell (vinegar-fried, skirt removed); Prunus Mume Seed (lightly stir-fried, peeled); Akebia Stem (sliced, each 3 fen). Process: Coarsely crush and sieve. Dosage: 3 qian bi per dose. Decoct with 1 zhong zhan of water until 7 fen remains. Strain. Take warm before meals.

Banxia Tang (Pinellia Decoction): Treats Hongjiao after Shanghan, heart vexation/stifling, loss of appetite, vomiting/phlegm.
Ingredients: Pinellia Tuber (washed seven times, dried); Bitter Orange (pith removed, bran-fried); Poria (black skin removed); Peucedanum Root (radicle removed); Akebia Stem (sliced, each 3 fen). Process: Coarsely crush and sieve. Dosage: 3 qian bi per dose. Decoct with 1 zhong zhan of water plus 1 fen of Ginger Rhizome (smashed) until 0.5 zhong zhan remains. Strain. Take warm before meals.

Chixiaodou Tang (Adzuki Bean Decoction): Treats Hongjiao after Shanghan, knee swelling/distension, shortness of breath, constipation.
Ingredients: Adzuki Beans (0.5 he); Mulberry Root Bark (0.5 liang); Perilla Stems/Leaves (1 liang); Areca Seed (0.5 liang). Process: Slice the three herbs like hemp seeds. Decoct together with Adzuki Beans in 5 zhong zhan of water plus 1 fen of Ginger Rhizome (smashed) until 2.5 zhong zhan remains. Strain. Divide into two doses. Take warm before meals.

Xijiao San (Rhinoceros Horn Powder): Treats Hongjiao after Shanghan, swollen/distended calves, chest vexation.
Ingredients: Rhinoceros Horn (sliced, 1 liang); Areca Seed (sliced, 0.5 liang); Tangerine Peel (soaked, white pith removed, dried, 3 fen); Asarum Root (radicles/leaves removed, 0.5 liang); Evodia Fruit (washed three times, dried, stir-fried, 1 fen). Process: Grind into fine powder. Dosage: 1.5 qian bi per dose. Before meals, taken with hot Ginger-infused wine. Twice daily.

Wuzhuyu San (Evodia Fruit Powder): Treats Hongjiao after Shanghan, chest/abdominal oppression/pain, restlessness.
Ingredients: Evodia Fruit (washed three times, dried, stir-fried, 1 fen); Areca Seed (sliced); Angelica Sinensis Root (sliced, dried); Costus Root; Prunus Mume Seed (lightly stir-fried, peeled, each 3 fen). Process: Coarsely crush and sieve. Dosage: 3 qian bi per dose. Decoct with 1 zhong zhan of water until 7 fen remains. Strain. Take warm before meals.

Daji Wan (Kerria Root Pill): Treats Hongjiao after Shanghan attacking the Heart, abdominal hard distension, red/scanty urine.
Ingredients: Kerria Root (stir-fried); Genkwa Flower (vinegar-fried until charred); Lepidium Seeds (stir-fried; each 0.5 liang); Croton Seeds (peeled, stir-fried); Croton Seeds (peeled, heart removed, oil pressed out, finely ground; each 1 fen). Process: Grind into fine powder, mix with Croton, refine with honey, form pills like wu-tong seeds. Dosage: 3-5 pills, taken with warm rice drink. At any time.