立斋曰∶肾藏风,属肾虚,风邪乘于 胫,以致皮肤如癣,或渐涎上腿,久则延及遍身
。外证则搔痒成疮,脓水淋漓,眼目昏花。内证则口燥舌干,腰腿倦怠,吐痰发热,盗汗体
疲。治法∶用六味丸为主,佐以四生散。若脾胃虚弱者,用补中益气汤为主,佐以六味丸、四生散为善。
钦天薛循斋,年六十有一,两 患之,脓水淋漓,发热吐痰,四年矣。此肾脏风证也,
与六味丸、四生散而瘥。年余复作,延及遍身,日晡益甚,痰渴盗汗,唇舌生疮,两目昏赤
,皆肾经虚火而水泛为痰也,用加减八味丸而愈。三年后,小便淋沥,茎中涩痛,此思色精
不出而内败也,用前丸,及补中益气汤加麦冬、五味而愈。(薛按)
一、凡肾囊湿痒,抓破成疮,俗名肾上风也。外治之法,但以黄丹、枯矾、生牡蛎,共为末
,搽擦即愈。或以蛇床子同白矾煎汤洗之,亦可。
立斋曰∶ 疮,生于两 ,初起赤肿,久而腐溃,或浸淫瘙痒,破而脓水淋漓。盖因饮
食起居,亏损肝肾,或因阴火下流,外邪相搏而致。外 ,属足三阳湿热,可治。内 ,属
足三阴虚热,难治。若初起恶寒壮热, 肿作痛者,属湿热,用槟苏散。若漫肿作痛,或不
肿不痛者,属阴虚,用补阴八珍汤。若脓水淋漓,体倦食少,内热口干者,属脾虚,用补中
益气汤加茯苓、酒炒白芍药。若午后热,或作痛,头目不清者,属阴水,前汤加酒炒黑黄柏
,及六味地黄丸。若午后发热,至子时方止,是血虚,前汤加芎、归、熟地。若郁结伤脾而
甚者,用归脾汤加柴胡、山栀。若怒动肝火而甚者,用补中益气汤加川芎、山栀、黄芩。若
内热口干,肢体倦怠,或痰涎上升,或口舌生疮,属脾肾虚热,用六味地黄丸、补中益气汤
。若患处黑黯,肢体畏寒,饮食少思,属脾肾虚败,用八味地黄丸。若误用攻伐,复损胃气
,绝其化源,治亦难矣。
鸿胪翟少溪,两 生疮,渐至遍身发热,吐痰,口燥咽干,盗汗心烦,溺赤足热,日
晡益甚,形体日瘦,此肾经虚火也。用六味丸,不一月,诸证悉退,三月元气平复。
陈湖陆懋诚,素因阴虚,过饮入房,发热腿痛似 疮。用发表之剂,两腿肿黯,热气如
雾,欲发痉,脉皆洪数,两尺尤大。余曰∶属足三阴虚,酒湿所乘,元气损而邪益甚耳。用
十全大补加山药、山茱萸、附子,一剂脉证顿退,却去附子,又二剂全愈。(薛按)
Xue Lizhai stated: Kidney wind (Feng Chuang caused by kidney deficiency) belongs to kidney deficiency, where wind pathogenic factors invade the shank (lower leg), causing the skin to resemble tinea or gradually secreting fluid onto the legs. If prolonged, it spreads over the entire body. External manifestations include itching leading to sores, dripping with pus and fluid, and blurred vision. Internal manifestations include dry mouth and tongue, fatigue in the waist and legs, expectoration of phlegm with fever, night sweats, and physical exhaustion. Treatment method: Use Liuwei Wan (Six-Ingredient Pill with Rehmannia) as the principal formula, assisted by Sisheng San (Four-Generation Powder). If the spleen and stomach are weak, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) as the principal formula, assisted by Liuwei Wan and Sisheng San, which is advisable.
Xue Xunzhai, an official at the Bureau of Astronomy, was sixty-one years old when he suffered from this condition in both legs, with dripping pus and fluid, fever, and expectoration for four years. This was a kidney wind syndrome. He was treated with Liuwei Wan and Sisheng San and recovered. More than a year later, it recurred and spread to the entire body, worsening in the late afternoon, accompanied by excessive phlegm, thirst, night sweats, sores on the lips and tongue, and redness and blurriness in both eyes. All these were due to deficient fire in the kidney meridian causing water flooding and transforming into phlegm. He was cured using Jiaban Bawei Wan (Modified Eight-Ingredient Pill). Three years later, he experienced dribbling urination and涩 pain (astringent pain) in the urethra. This was due to longing for sexual activity without emission, leading to internal deterioration. He was cured using the aforementioned pill along with Buzhong Yiqi Tang added with Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Fruit). (Commentary by Xue)
1. Whenever the scrotum is damp and itchy, and scratching breaks the skin causing sores, it is commonly known as "Wind above the Kidney" (Shen Shang Feng). For external treatment, simply use Huangdan (Lead Monoxide), Kufan (Alum), and Sheng Muli (Raw Oyster Shell), grind them together into powder, and apply it to the affected area for immediate healing. Alternatively, washing with a decoction of Shechuangzi (Cnidium Fruit) and Baifan (Alum) is also effective.
Xue Lizhai stated: Chan Sores (Chan Chuang) arise between the two thighs. Initially, they present with redness and swelling; if prolonged, they become ulcerated and putrid, or spread with itching, breaking open to drip pus and fluid. This is generally caused by improper diet and lifestyle damaging the liver and kidneys, or by yin fire flowing downward and combing with external pathogens. External chan sores belong to damp-heat in the three yang meridians of the foot and are treatable. Internal chan sores belong to deficient heat in the three yin meridians of the foot and are difficult to treat. If initially there is aversion to cold and high fever, with swelling and pain, it belongs to damp-heat, and Bing Su San should be used. If there is diffuse swelling and pain, or no swelling and no pain, it belongs to yin deficiency, and Buyin Bazhen Tang should be used. If there is dripping pus and fluid, physical fatigue, poor appetite, internal heat, and dry mouth, it belongs to spleen deficiency, and Buzhong Yiqi Tang added with Fuling (Poria) and Jiuchao Baishaoyao (White Peony Root stir-fried with wine) should be used. If there is fever in the afternoon, or pain, and unclear head and eyes, it belongs to insufficient yin water, and the aforementioned decoction added with Jiuchao Hei Huangbai (Phellodendron Bark stir-fried with wine and charred), along with Liuhuang Diwan (Six-Ingredient Rehmannia Pill), should be used. If there is fever in the afternoon that stops only at midnight, it is blood deficiency, and the aforementioned decoction added with Chuanxiong (Szechuan Lovage Rhizome), Danggui (Angelica Sinensis), and Shudi (Prepared Rehmannia Root) should be used. If depression damages the spleen severely, Guipi Tang should be used added with Chaihu (Bupleurum Root) and Shanzhi (Gardenia Fruit). If anger stirs up liver fire severely, Buzhong Yiqi Tang added with Chuanxiong, Shanzhi, and Huangqin (Scutellaria Root) should be used. If there is internal heat and dry mouth, limb fatigue, rising phlegm-saliva, or sores in the mouth and tongue, it belongs to spleen and kidney deficient heat, and Liuhuang Diwan and Buzhong Yiqi Tang should be used. If the affected area is dark black, limbs fear cold, and there is little desire for food, it belongs to spleen and kidney failure, and Bawei Diwan (Eight-Ingredient Rehmannia Pill) should be used. If attacking and purging drugs are mistakenly used, further damaging stomach qi and cutting off the source of transformation, treatment becomes difficult.
Zhai Shaoxi, an official at the Court of State Ceremonial, developed chan sores in both thighs, which gradually led to whole-body fever, expectoration, dry mouth and throat, night sweats, irritability, red urine, hot feet, worsening in the late afternoon, and daily emaciation. This was deficient fire in the kidney meridian. He was treated with Liuwei Wan. Within less than a month, all symptoms subsided, and within three months, his primordial qi recovered balance.
Lu Maocheng from Chenhu, who had always suffered from yin deficiency, indulged excessively in alcohol and sexual intercourse, resulting in fever and leg pain resembling chan sores. After using diaphoretic agents, his legs became swollen and dark, heat rose like fog, and he was on the verge of developing spasms. His pulse was surging and rapid, especially prominent in the chi positions at both wrists. I said: This belongs to deficiency of the three yin meridians of the foot, compounded by dampness from alcohol, where primordial qi is damaged and pathogens become more severe. He was treated with Shiquan Dabu Tang added with Shanyao (Dioscorea Rhizome), Shanzhuyu (Cornus Fruit), and Fuzi (Aconite Lateral Root). After one dose, the pulse and symptoms suddenly receded. Fuzi was then removed, and after two more doses, he fully recovered. (Commentary by Xue)