分，煎至六分去滓，不计时候温服。（《圣惠》）又治妇人香港脚忽发，冲心闷乱，四肢烦疼，犀角散，于本方
去沉香、木通、诃黎勒、吴茱萸，加犀角、赤茯苓、木香、红蓝花。（按∶此二方俱去芍药为宜。又木香散方
中用紫雪。）
沉香降气汤，患香港脚人，毒瓦斯上冲，心腹坚满，肢体浮肿者，尤宜服之。（《和剂》）（方见《诸气》中）
崔氏疗香港脚，毒遍内外，烦热，口中生疮者方。服紫雪，强人服如两枣大，弱者减之，和水服，当利热毒。
（《外台》）（按∶又引苏恭同）紫雪方，鉴真云∶若香港脚冲心，取一小两和水饮之。（《医心》）大烦躁者，
紫雪最良。（《活人书》）（按∶此本于《伤寒括要》。）
茱萸散，治香港脚心闷不通，及干霍乱等方。
炼成朴硝（一斤） 茱萸末（八两）
上相和捣罗调匀，以不津瓷器贮之，凡患服一匙匕。（《千金月令》）
三将军丸，治香港脚入腹冲心，大便不通。
吴茱萸（去皮枝汤泡） 宣木瓜（去穣） 川大黄（等分）
上为细末，米糊丸，绿豆大，每服五十丸，粳米枳壳煎汤吞下。未应，加丸数再服，以通为度。（《澹寮》）
（按∶此方本出《续易简方后集》。）
搜风丸，治香港脚肿痛，大便不通。
大黄（半两） 槟榔（半两） 枳实（半两） 黑牵牛（一两生）
上为末，糊丸如梧子大，每服五十丸，饭汤下，食前。（《仁存孙氏方》）
若香港脚之患，入腹冲心，或见呕逆之证，无法可疗，《千金》以大黄利之。大黄性寒，病既深入，必难导
达，是速其呕吐也。不若用养正丹或黑锡丹、来复丹之类，煎降气
汤咽下。更须多服，以大便通利为度。香港脚无补法，此有利性，即非补药，服之无疑。（《易简》）（养正丹、
黑锡丹方见《中风》中，降气汤即苏子降气汤。）
甘草汤，治脚弱，举身洪肿，胃反，食谷吐逆，胸中气结不安而寒热，下痢不止，小便难。
甘草 人参（各一两） 半夏（一升） 桂心 蜀椒（各三两） 小麦（八合） 大枣（二十枚） 生姜
（八两） 吴茱萸（二升）
上九味 咀，以水一斗三升，煮小麦取一斗，去小麦，内诸药，煮取三升，分为六服。（《千金》）又半
夏汤，治香港脚上入腹，腹急上冲胸，气急欲绝。于本方去小麦、大枣、生姜、吴茱萸，加干姜、细辛、附子，
咀，以水一斗，煮取三升，分为三服。初稍稍进，恐气冲上格塞不得下，少少服，通其气耳。（按∶此二方
无类可属，盖其意主在温散，而上冲呕逆一时或有宜此者，仍附于兹。先教谕尝用《千金》治痰饮半夏汤，半
夏、生姜、附子、吴茱萸四味方，以治冲心危证，大奏奇验，即此方之单捷者也。《千金》又有紫苏子汤，治
脚弱上气，《和剂》苏子降气汤是，然卢祖常论之曰∶香港脚初发，早服亦可成功，若曰入腹攻胃冲心，略难觊
效云云。此言信然，今仍举其方于咳嗽中，兹不录入。）
内疏缓治诸方 治香港脚春夏防发，宜服此疏风调气槟榔散方。
槟榔（一两） 独活（半两） 赤茯苓（半两） 枳壳（一两麸炒微黄去瓤） 羚羊角屑（半两） 沉香
（半两） 川大黄（一两锉碎微炒） 芎 （半两） 甘草（半两炙微赤锉）
上件药捣，粗罗为散，每服四钱，以水一中盏，入生姜半分，煎至六分，去滓，食前温服。（《圣惠》）
三和散，治香港脚上攻，胸腹满闷，大便不通。（《和
剂》）《究原方》治香港脚发肿，大便涩气满，《局方》三和散，加大黄煎服。（《万安》）香港脚稍愈，可服沉
香三和散，不特愈时服之，病香港脚常服尤妙。（《经验良方》）
木瓜散，治香港脚冲心，胸膈痞滞烦闷得效方。
大腹（一个） 紫苏（一分） 干木瓜（一分） 甘草（一分炙） 木香（一分） 羌活（一分）
上件药细锉为饮子，分作三服，每服用水一升，同煎至三合，通口服之。（《传家秘宝》）《活人》大腹
用皮。《奇效》木瓜汤，于活人方中，加茯苓、陈皮。
轻者与香苏散，加干木瓜、槟榔、生姜煎服，然后随证治之。（《管见良方》）
《和剂方》香苏散，加槟榔、木瓜，名槟苏散，治风湿脚痛，疏通气道。
紫苏 香附子（各二两） 陈皮 甘草 槟榔 木瓜（各一两）
上 咀，每服四钱，水一盏，姜葱煎服。（《大成》）《经验良方》槟苏散，凡觉香港脚初发，先服此药，
去风湿及损郁气脉，多服不伤人（即本方）。大便秘滞，加大黄二钱半。《济生》槟榔汤，治一切脚痛，顺气
防壅，于本方加五加皮。如大便秘结，虚弱者加枳实，壮盛者加大黄。
钝斋彭先生传神效槟苏散，治香港脚如神。
槟榔（三钱） 苏叶梗 防风 羌活 当归 木瓜（各二钱） 乳香 没药（各一钱半）
上为末，分二服，每服姜葱各五，酒二碗，煎八分，入片糖一指大（《试效要方》砂糖一片，如指大）溶
化，热空心服，酒随量饮，醉为度。绵被盖脚痛处，待药力寻到痛处，汗出避风，以有汗为愈。（《普济良方》）
主香港脚大便涩方。
大黄（五两） 大麻仁（三两熟研）
上捣罗大黄为末，和麻仁以蜜为丸，酒下五丸，渐加至十五、二十丸，微利为度。气胀手脚肿，加槟榔一
两，人参末一两。（《千金月令》）
渗利涤泻诸方 崔氏疗香港脚遍身肿方。
大豆（三大升以水一斗煮取五升去豆） 桑根白皮（一握切） 槟榔（二七枚碎） 茯苓（二两切）
上四味，将三物以前豆汁浸经宿，煮取二升，绞去滓，添酒二合内药中，随多少服之。或不利即更服，利
多量减服之。（《外台》）又文仲疗香港脚满，小便少者，于本方去茯苓。若冷胀，加吴茱萸二升，生姜二两。
《圣济》治一切风毒香港脚软脚等，黑豆饮，于本方去茯苓，加郁李仁。
苏恭防己汤，主通身体满，小便涩，上气，上下痰水。不能食，食则胀者方。
桑白皮（五两切） 大豆（五升以水三斗并桑白皮煮取一斗去滓） 防己 橘皮 赤茯苓 麻黄（去节各三两）
生姜（五两） 旋复花（一两） 杏仁（八十枚去尖皮两仁碎） 紫苏茎叶（二两切）
上十味切，以前件药汁煮取三升，去滓分为三服，身弱者分为五服，相去六七里久，微覆，当大汗，小便
利，肿气消下。冷多，加茱萸四两，热多，加玄参四两。忌酢物。（《外台》）
唐风引汤，疗痹满上气，遍身胀，膝疼，并去风湿痛方。
大豆（三升） 附子（三两炮） 枳实（炙） 泽泻 橘皮（各四两） 甘草（炙） 茯苓 防风（各二两）
上八味切，以水二斗，酒二升，煮大豆取一斗，去滓内药，煮取三升，分三服，三剂肿消，去大豆、泽泻，
更服三剂瘥。（同上）
治湿香港脚，通身浮肿，小便不利，气壅烦闷，腹胁连膀胱虚胀，上气喘促，坐卧不得、宜服汉防己散方。
汉防己（三分） 桑根白皮（一两锉） 泽泻（半两） 赤茯苓（半两） 木通（三分锉） 郁李仁
（三分汤浸去皮尖微炒） 猪苓（三分去黑皮） 槟榔（一两） 紫苏茎叶（一两）
上件药捣，粗罗为散，每服四钱，以水一中盏，入生姜半分，煎至六分，去滓不计时候温服。（《圣惠》）
又治香港脚肿满，小便不利，喘促不食，汉防己散，于本方去泽泻、郁李仁。
治香港脚，大小便秘涩，膀胱气壅，攻心腹妨闷，宜服泽泻散方。
泽泻（三分） 赤茯苓（三分） 枳壳（三分麸炒微黄去瓤） 木通（一两锉） 猪苓（一两去黑皮）
槟榔（一两） 牵牛子（二两微炒）
上件药捣，细罗为散，每服用水煎生姜葱白汤，调下二钱，日二三服，以利为度。（同上）
《近效》疗香港脚冲心，肺气气急，及水气卧不得，立验方。
曹州葶苈子（四分，好者纸上熬令紫色，别捣如膏，纸裹，两瓦子合，床脚下压去油。） 杏仁（四分，去
尖皮两仁，切碎，纸上熬令黄，捣如膏。） 甘草（四分炙） 海蛤（四分别研如面） 郁李仁（四分去皮尖
如麻子仁别捣） 汉防己（五分） 吴茱萸（二分） 槟榔仁（六分） 大黄（七分）
上九味捣筛为散，合研令调和，取蒸饼中枣膏二分去皮，搅和白蜜少许，更于臼中捣一千二百杵方止，空
腹一服十五丸，如梧子，渐渐加至下泄为度。服良久，待丸散后可食。（《外台》）
崔氏疗香港脚，及腰肾膀胱宿水，及痰饮，桃花散方。
收桃花阴干，量取一大升，但随虚满，不须按捺，捣为散，纱罗下之，温清酒和，一服令尽，通利为度。
（同上）
滋养诸方 三阴受寒湿，着于脚膝上，枯瘦色淡，小腹不仁，腹急疼痛，上气喘急，八味丸加沉香。
（《医通》）
治肝肾风虚气弱，脚膝不可践地，腰脊疼痛，风毒流 下经，行止艰难，小便余沥，思仙续断丸。
思仙木（即杜仲也，去皮锉，炒令黑，五两。） 五加皮 防风（去叉股） 薏苡仁 羌活（洗去土）
川续断（洗锉焙干） 牛膝（洗锉焙，酒浸一宿，再焙，各三两。） 萆 （四两） 生干地黄（五两）
上细末，好酒三升，化青盐三两，用大木瓜半斤，去皮子，以盐酒煮木瓜成膏和杵，丸如桐子大，每服五
十丸，空心食前，温酒盐汤下。膏子少，益以酒糊。（《本事》）《鸡峰》思仙丸，于本方加干蝎、天麻、白
术。《和剂》思仙续断丸，于本方去五加皮、羌活、地黄，加川乌头。
去风，补血益气，壮筋骨，强脚力，虎骨酒。
虎胫骨（真者酒浸酥炙） 萆 牛膝（洗净锉焙酒浸一宿再焙） 仙灵脾 薏苡仁 熟干地黄（酒洗九
蒸九曝焙干秤各二两）
上细锉，绢袋盛，浸酒二斗，饮了一盏，入酒一盏，可得百日。妇人去牛膝。（《本事》）（按∶《千金》
虎骨酒，单用一味）
四斤丸，治体虚气弱，风寒湿毒客于经络，血脉凝滞，腰腿沉重，筋骨缓弱，四肢酸疼，麻痹不仁，间或
肿痒，脚膝无力，隐痛拘挛，不能履地，一切久新诸肿香港脚悉治之。
宣州木瓜（去穣切焙干） 牛膝（去芦切） 苁蓉（洗净切焙） 天麻（去芦细锉各一斤）
以上四味，如前修事了，用无灰酒五升浸，春秋各五日，夏三日，冬十日足，取出焙干，再入虎骨一两，
附子二
两炮去皮脐。
上同为细末，用浸前药酒，打面糊为丸，如梧桐子大，每服三五十丸，空心煎木瓜酒下，或盐汤吞下，食
前服。（《和剂》）《叶氏》增添四斤丸，于本方（虎骨八两，余同）去附子，加没药四两，川乌头四两，炼
蜜和丸。《杨氏》五斤丸。于《叶氏》方加山药。《济生续方》加味四斤丸，于《叶氏》方加乳香。（《三因》
加味四斤丸，见《痿》门）
湿热香港脚治方 中书粘合公，年四旬有余，躯干魁梧。丙辰春，从征至扬州北之东武隅，香港脚忽作，
遍身肢体微肿，其痛手不能近，足胫尤甚，履不任穿，跣以骑马，控两镫而以竹器盛之，以困急来告。予思
《内经》有云饮发于中， 肿于上。又云诸痛为实，血实者宜决之。以三棱针数刺其肿上，血突出高二尺余，
渐渐如线，流于地约半升许，其色紫黑，顷时肿消痛减，以当归拈痛汤重一两半服之，是夜得睡，明日再服而
愈。（《宝鉴》）（按∶《类案》引东垣有廉平章治验，与此相近，不录）
当归拈痛汤，治湿热为病，肢体烦疼，肩背沉重，胸膈不利，下疰于胫，肿痛不可忍。
甘草（炙） 茵陈蒿（酒炒） 酒黄芩 羌活（各半两） 防风 知母（酒洗） 猪苓（去皮） 泽泻
当归身（各三钱） 苦参（酒洗）
升麻 黄芩（炒） 人参 葛根 苍术（各二钱） 白术（一钱半）
上 咀，每服一两，水二盏半，先以水拌湿，候少时煎至一盏，去渣温服食前，待少时美膳压之。（同上）
（按∶此方亦出《兰室秘藏》。《统旨》曰∶北方香港脚，古虽原其情，而治法无所见，惟罗氏尝以当归拈痛汤
治之，上下分消其湿，使壅滞之气得宣通也。）
灸法 凡香港脚，初得脚弱，使速灸之，并服竹沥汤，灸
讫可服八风散，无不瘥者，惟急速治之。若人但灸而不能服散，服散而不灸，如此者半瘥半死。虽得瘥者，或
至一二年复更发动。觉得便根据此法速灸之及服散者，治十十愈。此病轻者，登时虽不即恶，治之不当，根源不
除，久久期于杀人，不可不精以为意。初灸风市，次灸伏兔，次灸犊鼻，次灸膝两眼，次灸三里，次灸上廉，
次灸下廉，次灸绝骨。（《千金》）（原有详说宜考。又曰∶既得病后，毒瓦斯外满，则灸泄其气。）
崔氏∶若香港脚上入少腹，少腹不仁，即服张仲景八味丸，仍灸三里、绝骨。若脚数转筋，灸承山。若脚胫
内稍不仁，灸三阴交。（《外台》）
苏∶诸毒瓦斯所攻，攻内则心急闷，不疗至死。若攻外，毒出皮肤则不仁，不仁者膏摩之差。若未出皮肤，
在荣卫刺痛者，随痛处急宜灸三五炷即瘥，不必要在孔穴也。远方无药物处，急宜灸之，腹背手足诸要穴，皆能
Decoct until the liquid reduces to six-tenths, remove the dregs, and take warm at any time. (From *Shenghui Fang*) Also treats sudden onset of Hongxiangjiao (Gouty Arthritis) in women, with toxic qi rushing to the heart causing chest oppression and confusion, and severe pain in the four limbs. Use Xijiao San (Rhinoceros Horn Powder). Modify the base formula by removing Chenxiang (Aquilaria Wood), Mutong (Akebia Stem), Helile (Chebula Fruit), and Wuzhuyu (Evodia Fruit); add Xijiao (Rhinoceros Horn - *Note: substitute with Buffalo Horn in modern practice*), Chifuling (Red Poria), Muxiang (Costus Root), and Honglanhua (Carthamus Flower). (Note: It is appropriate to remove Shaoyao (Peony Root) in both these formulas. Additionally, Zixue (Purple Snow) is used in the Muxiang San formula.)
Chenxiang Jiangqi Tang (Agarwood Qi-Descending Decoction) is especially suitable for patients suffering from Hongxiangjiao (Gouty Arthritis) where toxic vapors rush upward, causing hardness and fullness in the heart and abdomen, and edema of the limbs. (From *Heji Jufang*) (See formula in *Zhuqi* chapter)
Cui Shi’s prescription for treating Hongxiangjiao (Gouty Arthritis) where toxicity pervades the interior and exterior, accompanied by vexatious heat and sores in the mouth. Administer Zixue (Purple Snow). For robust individuals, administer an amount the size of two dates; reduce for weaker individuals. Mix with water and swallow. This should promote the purgation of heat and toxins. (From *Waitai Mi Yao*) (Note: Su Gong agrees with this view). Regarding the Zixue (Purple Snow) formula, Jianzhen stated: If Hongxiangjiao (Gouty Arthritis) attacks the heart, take one liang of Zixue mixed with water and drink it. (From *Ishin Hokan*) For severe restlessness, Zixue (Purple Snow) is most effective. (From *Huo Ren Shu*) (Note: This originates from *Shanghan Kuayao*.)
Zhuyu San (Evodia Powder) treats Hongxiangjiao (Gouty Arthritis) with chest oppression and blockage, as well as Gan Huoluan (Dry Cholera).
Refined Poxiao (Mirabilite) (one jin) Zhuyu powder (eight liang)
Mix and grind together into a uniform powder. Store in a non-porous ceramic vessel. Take one chi bi (spoonful) when ill. (From *Qianjin Yueling*)
San Jiangjun Wan (Three Generals Pill) treats Hongxiangjiao (Gouty Arthritis) entering the abdomen and attacking the heart, with constipation.
Wuzhuyu (Evodia Fruit) (peeled, branches removed, soaked in decoction) Xuan Mugua (Chaenomeles Fruit) (pulp removed) Chuan Dahuang (Rhubarb Root) (equal parts)
Grind into fine powder. Form pills using rice paste, sized like mung beans. Take fifty pills per dose, swallowed with a decoction of Jingmi (Japonica Rice) and Zhike (Bitter Orange). If ineffective, increase the number of pills and take again. Stop when bowel movement is unobstructed. (From *Danliao Fang*) (Note: This formula originally comes from *Xu Yijian Fang Houji*.)
Soufeng Wan (Wind-Searching Pill) treats Hongxiangjiao (Gouty Arthritis) with swelling and pain, and constipation.
Dahuang (Rhubarb Root) (half liang) Binglang (Areca Seed) (half liang) Zhishi (Immature Bitter Orange) (half liang) Hei Qianniu (Black Morning Glory Seed) (one liang, raw)
Grind into powder. Form pills using paste, sized like sophora seeds. Take fifty pills per dose, before meals, with rice soup. (From *Ren Cun Sun Shi Fang*)
If Hongxiangjiao (Gouty Arthritis) enters the abdomen and attacks the heart, or presents with vomiting and counterflow qi, and no other method works, *Qianjin Fang* uses Dahuang (Rhubarb Root) to purge. Dahuang (Rhubarb Root) is cold in nature. Since the disease has penetrated deeply, it will be difficult to guide out, which may accelerate vomiting. It is better to use Yangzheng Dan (Nourish Righteousness Pill), Heixi Dan (Black Tin Pill), or Laifu Dan (Revive Life Pill), taken down with a decoction of Jiangqi Tang (Qi-Descending Decoction). More doses are required until the bowels move freely. There is no tonifying method for Hongxiangjiao (Gouty Arthritis); these formulas have purgative properties and are not tonics. There is no doubt about their use. (From *Yijian Fang*) (Yangzheng Dan and Heixi Dan formulas are seen in the *Zhongfeng* chapter; Jiangqi Tang is Suzi Jiangqi Tang.)
Gancao Tang (Licorice Decoction) treats weak feet, generalized severe edema, stomach reversal with food regurgitation, chest qi stagnation with anxiety and alternating chills and fever, persistent diarrhea, and difficult urination.
Gancao (Licorice Root) Renshen (Ginseng Root) (each one liang) Banxia (Pinellia Tuber) (one sheng) Guixin (Cinnamon Twig) Shujiao (Sichuan Pepper) (each three liang) Xiaomai (Common Wheat Grain) (eight he) Dazao (Jujube Fruit) (twenty pieces) Shengjiang (Fresh Ginger) (eight liang) Wuzhuyu (Evodia Fruit) (two sheng)
Chop the nine ingredients. Add ten dou three sheng of water. First decoct Xiaomai (Common Wheat Grain) until one dou remains. Remove the wheat, add the remaining herbs, and decoct to obtain three sheng of liquid. Divide into six doses. (From *Qianjin Fang*) There is also Banxia Tang (Pinellia Decoction) for treating Hongxiangjiao (Gouty Arthritis) ascending into the abdomen, abdominal tightness rushing up to the chest, and suffocating shortness of breath. Modify the base formula by removing Xiaomai (Common Wheat Grain), Dazao (Jujube Fruit), Shengjiang (Fresh Ginger), and Wuzhuyu (Evodia Fruit); add Ganjiang (Dried Ginger), Xixin (Asarum Root), and Fuzi (Aconite Lateral Root). Chop and add ten sheng of water. Decoct to obtain three sheng. Divide into three doses. Initially, advance slowly. Fear that qi rushing upward may cause obstruction preventing downward flow; take small amounts to unblock the qi. (Note: These two formulas do not fit neatly into categories; their intent is primarily warming and dispersing, which may be suitable for sudden upper-rushing vomiting and counterflow qi. They are attached here. The former Instructor once used *Qianjin Fang*’s Banxia Tang for Phlegm-Fluids, specifically the four-ingredient formula of Banxia (Pinellia Tuber), Shengjiang (Fresh Ginger), Fuzi (Aconite Lateral Root), and Wuzhuyu (Evodia Fruit), to treat critical cases of heart-attacking pathogens, achieving miraculous results. This is a simplified version of this formula. *Qianjin Fang* also has Zisuzi Tang (Perilla Seed Decoction) for weak feet and rebellious qi, which is the Suzi Jiangqi Tang (Perilla Seed Qi-Descending Decoction) of *Heji Jufang*. However, Lu Zuchang commented: Early administration upon initial onset of Hongxiangjiao (Gouty Arthritis) can succeed; however, if it has entered the abdomen, attacked the stomach, and rushed to the heart, efficacy is hard to expect. This statement is credible. Therefore, its formula is listed under Cough here and not included in this section.)
Internal Draining and Slow Treatment Formulas To prevent the recurrence of Hongxiangjiao (Gouty Arthritis) in spring and summer, it is advisable to take this wind-dispersing and qi-regulating Binglang San (Areca Powder).
Binglang (Areca Seed) (one liang) Duhuo (Angelica Pubescens Root) (half liang) Chifuling (Red Poria) (half liang) Zhike (Bitter Orange) (one liang, bran-fried until slightly yellow, pulp removed) Lingyangjiaoxie (Antelope Horn Fragments) (half liang) Chenxiang (Aquilaria Wood) (half liang) Chuan Dahuang (Rhubarb Root) (one liang, chopped and lightly fried) Xiong (Ligusticum Rhizome) (half liang) Gancao (Licorice Root) (half liang, honey-fried until slightly red and chopped)
Crush the above herbs and sieve coarsely. Take four qian per dose. Add one zhong zhan (approx. 200ml) of water and half fen of Shengjiang (Fresh Ginger). Decoct to six-tenths. Remove dregs and take warm before meals. (From *Shenghui Fang*)
Sanhe San (Harmonizing Powder) treats Hongxiangjiao (Gouty Arthritis) attacking upward, causing chest and abdominal fullness and constipation. (From *Heji Jufang*) *Jiuyuan Fang* treats Hongxiangjiao (Gouty Arthritis) with swelling, constipation, and qi fullness. *Ju Fang*’s Sanhe San (Harmonizing Powder) adds Dahuang (Rhubarb Root) for decoction. (From *Wan An Fang*) After Hongxiangjiao (Gouty Arthritis) subsides slightly, Chenxiang Sanhe San (Agarwood Harmonizing Powder) can be taken. Not only is it useful during remission, but regular long-term use for Hongxiangjiao (Gouty Arthritis) is particularly excellent. (From *Jingyan Liangfang*)
Mugua San (Chaenomeles Powder) treats Hongxiangjiao (Gouty Arthritis) attacking the heart, with chest and diaphragm stuffiness and vexation.
Dafu (Areca Nut Peel) (one piece) Zisu (Perilla Leaf) (one fen) Gan Mugua (Dried Chaenomeles Fruit) (one fen) Gancao (Licorice Root) (one fen, honey-fried) Muxiang (Costus Root) (one fen) Qianghuo (Notopterygium Rhizome) (one fen)
Finely chop the above herbs to make a tea. Divide into three doses. For each dose, use one sheng of water and decoct together until three ge remain. Drink all at once. (From *Chuanjia Mibao*) *Huo Ren Shu* specifies using Dafu Pi (Areca Nut Peel). *Qixiao Liangfang* Mugua Tang (Chaenomeles Decoction) adds Fuling (Poria) and Chenpi (Tangerine Peel) to the *Huo Ren Shu* formula.
For mild cases, use Xiangsu San (Perilla Powder) adding Gan Mugua (Dried Chaenomeles Fruit), Binglang (Areca Seed), and Shengjiang (Fresh Ginger) for decoction, then treat according to symptoms. (From *Guanjian Liangfang*)
*Heji Jufang* Xiangsu San (Perilla Powder) added with Binglang (Areca Seed) and Mugua (Chaenomeles Fruit) is named Bing Su San (Areca-Perilla Powder), treating wind-damp foot pain and unblocking the qi mechanism.
Zisu (Perilla Leaf) Xiangfu (Cyperus Rhizome) (each two liang) Chenpi (Tangerine Peel) Gancao (Licorice Root) Binglang (Areca Seed) Mugua (Chaenomeles Fruit) (each one liang)
Chop. Take four qian per dose. Add one zhan of water, ginger, and scallion. Decoct and take. (From *Yixue Dacheng*) *Jingyan Liangfang* Bing Su San (Areca-Perilla Powder): Whenever Hongxiangjiao (Gouty Arthritis) is first felt, take this medicine first to dispel wind-damp and resolve stagnant qi and vessels. Long-term use does not harm the body (this is the base formula). For constipation, add Dahuang (Rhubarb Root) two qian half. *Jisheng Fang* Binglang Tang (Areca Decoction) treats all foot pains, regulates qi and prevents congestion. Add Wujia Pi (Eleutherococcus Bark) to the base formula. For constipation, add Zhishi (Immature Bitter Orange) for the weak, and Dahuang (Rhubarb Root) for the robust.
Mr. Dunzhai Peng transmitted the Spirit-Efficient Bing Su San (Areca-Perilla Powder), treating Hongxiangjiao (Gouty Arthritis) miraculously.
Binglang (Areca Seed) (three qian) Suye Geng (Perilla Leaf and Stem) Fangfeng (Saposhnikovia Root) Qianghuo (Notopterygium Rhizome) Danggui (Angelica Sinensis Root) Mugua (Chaenomeles Fruit) (each two qian) Ruxiang (Olibanum) Moyao (Myrrh) (each one qian half)
Grind into powder. Divide into two doses. For each dose, use five slices each of ginger and scallion, and two bowls of wine. Decoct to eight-tenths. Add a finger-sized piece of rock sugar (*Shixiao Yaofang* records a slice of white sugar, finger-sized) until dissolved. Take hot on an empty stomach. Drink wine according to tolerance, stopping at drunkenness. Cover the painful foot area with a cotton quilt. Wait for the medicinal power to reach the pain site, induce sweating, and avoid wind. Recovery is indicated by sweating. (From *Puji Liangfang*)
Main Formula for Hongxiangjiao (Gouty Arthritis) with Constipation.
Dahuang (Rhubarb Root) (five liang) Dama Ren (Hemp Seed) (three liang, cooked and ground)
Grind Dahuang (Rhubarb Root) into powder. Mix with Hemp Seed. Form pills with honey. Take five pills with wine. Gradually increase to fifteen or twenty pills. Stop when slight purgation occurs. For qi distension and swollen hands/feet, add Binglang (Areca Seed) one liang and Renshen (Ginseng Root) powder one liang. (From *Qianjin Yueling*)
Draining and Purging Formulas Cui Shi’s formula for treating Hongxiangjiao (Gouty Arthritis) with generalized swelling.
Da Dou (Soybean) (three large sheng, decocted in ten dou of water to yield five sheng, remove beans) Sanggen Baipi (Mulberry Root Bark) (one handful, chopped) Binglang (Areca Seed) (fourteen pieces, crushed) Fuling (Poria) (two liang, chopped)
Take the last three herbs and soak them overnight in the soybean decoction obtained above. Decoct to obtain two sheng. Strain to remove dregs. Add two he of wine to the medicine. Take according to the degree of illness. If urine output is insufficient, take again. If purgation is excessive, reduce the dose. (From *Waitai Mi Yao*) Wen Zhong’s treatment for Hongxiangjiao (Gouty Arthritis) with fullness and scanty urination: Remove Fuling (Poria) from the base formula. For cold-type distension, add Wuzhuyu (Evodia Fruit) two sheng and Shengjiang (Fresh Ginger) two liang. *Shengji Zonglu* Black Bean Drink for all wind-toxin Hongxiangjiao (Gouty Arthritis) and soft legs: Remove Fuling (Poria) from the base formula and add Yuliren (Apricot Kernel-like seed of Prunus armeniaca var. ansu? No, Yu Li Ren is Prunus japonica seed) Yu Li Ren.
Su Gong’s Fangji Tang (Podophyllotoxin Decoction) treats generalized body fullness, scanty urination, rebellious qi, phlegm-fluids above and below. Inability to eat, bloating after eating.
Sangbaipi (Mulberry Root Bark) (five liang, chopped) Da Dou (Soybean) (five sheng, decocted with Sangbaipi (Mulberry Root Bark) in three dou of water to yield one dou, strain) Fangji (Stephania Root) Ju Pi (Tangerine Peel) Chifuling (Red Poria) Mahuang (Ephedra Herb) (decocted nodes removed, each three liang) Shengjiang (Fresh Ginger) (five liang) Xuanjinhua (Inula Flower) (one liang) Xingren (Apricot Seed) (eighty pieces, tips and skins removed, double kernels crushed) Zisu Jingye (Perilla Stem and Leaf) (two liang, chopped)
Chop the ten ingredients. Decoct using the previously prepared liquid to yield three sheng. Strain and divide into three doses. For weak bodies, divide into five doses. Wait six or seven li (approx. 3-4 km) apart. Cover slightly. Expect profuse sweating, free urination, and reduction of edema and qi. For cold predominance, add Zhuyu (Cornus Fruit) four liang. For heat predominance, add Xuanshen (Scrophularia Root) four liang. Avoid vinegar. (From *Waitai Mi Yao*)
Tang Fengyin Tang (Tang Wind-Guiding Decoction) treats bi-syndrome with fullness and rebellious qi, generalized swelling, knee pain, and dispelling wind-damp pain.
Da Dou (Soybean) (three sheng) Fuzi (Aconite Lateral Root) (three liang, processed) Zhishi (Immature Bitter Orange) (roasted) Zexie (Alisma Rhizome) Ju Pi (Tangerine Peel) (each four liang) Gancao (Licorice Root) (roasted) Fuling (Poria) Fangfeng (Saposhnikovia Root) (each two liang)
Chop the eight ingredients. Add two dou of water and two sheng of wine. Decoct Da Dou (Soybean) to yield one dou. Strain and add other herbs. Decoct to yield three sheng. Divide into three doses. After three doses, swelling subsides. Remove Da Dou (Soybean) and Zexie (Alisma Rhizome). Take another three doses for cure. (Same source)
For damp-type Hongxiangjiao (Gouty Arthritis) with generalized edema, difficult urination, qi stagnation with vexation, false distension of abdomen/flanks extending to bladder, shortness of breath, inability to sit or lie down, Han Fangji San (Han Fangji Powder) is suitable.
Han Fangji (Stephania Tetrandra Root) (three fen) Sanggen Baipi (Mulberry Root Bark) (one liang, chopped) Zexie (Alisma Rhizome) (half liang) Chifuling (Red Poria) (half liang) Mutong (Akebia Stem) (three fen, chopped) Yuliren (Prunus japonica Seed) (three fen, soaked in water, skin and tip removed, lightly fried) Zhuling (Polyporus) (three fen, black skin removed) Binglang (Areca Seed) (one liang) Zisu Jingye (Perilla Stem and Leaf) (one liang)
Crush the above herbs and sieve coarsely. Take four qian per dose. Add one zhong zhan of water and half fen of Shengjiang (Fresh Ginger). Decoct to six-tenths. Remove dregs and take warm at any time. (From *Shenghui Fang*)
Also for Hongxiangjiao (Gouty Arthritis) with swelling and fullness, difficult urination, panting, and anorexia: Han Fangji San (Han Fangji Powder), modify by removing Zexie (Alisma Rhizome) and Yuliren (Prunus japonica Seed).
For Hongxiangjiao (Gouty Arthritis) with constipation of both large and small bowels, bladder qi stagnation, attacking heart/abdomen with oppression: Zexie San (Alisma Powder) is suitable.
Zexie (Alisma Rhizome) (three fen) Chifuling (Red Poria) (three fen) Zhike (Bitter Orange) (three fen, bran-fried until slightly yellow, pulp removed) Mutong (Akebia Stem) (one liang, chopped) Zhuling (Polyporus) (one liang, black skin removed) Binglang (Areca Seed) (one liang) Qianniu Zi (Morning Glory Seed) (two liang, lightly fried)
Crush the above herbs and sieve finely. For each dose, decoct Shengjiang (Fresh Ginger) and Congbai (Scallion White) in water, mix with two qian of powder. Take two to three times daily. Stop when purged. (Same source)
*Jin Xiao Fang* treating Hongxiangjiao (Gouty Arthritis) attacking the heart, lung qi urgency, and fluid retention preventing lying down, with immediate effect.
Caozhou Tinglizi (Descurainia Seed) (four fen, select good quality, roast on paper until purple, grind separately into paste, wrap in paper, press between two tiles under bed leg to remove oil.) Xingren (Apricot Seed) (four fen, remove tips/skins/double kernels, chop, roast on paper until yellow, grind into paste.) Gancao (Licorice Root) (four fen, roasted) Hai Ge (Clam Shell) (four fen, grind separately into powder) Yuliren (Prunus japonica Seed) (four fen, remove skin/tip, grind separately like hemp seed) Han Fangji (Stephania Tetrandra Root) (five fen) Wuzhuyu (Evodia Fruit) (two fen) Binglang Ren (Areca Seed Kernel) (six fen) Dahuang (Rhubarb Root) (seven fen)
Grind the nine ingredients into powder. Mix thoroughly. Take two fen of paste from steamed dough (jujube paste), remove skin, stir with a little white honey. Pound in mortar for 1200 strikes. Take fifteen pills on an empty stomach, sized like sophora seeds. Gradually increase until purgation occurs. After some time, wait for pills/powder to digest before eating. (From *Waitai Mi Yao*)
Cui Shi’s Taohua San (Peach Blossom Powder) for Hongxiangjiao (Gouty Arthritis), old water in waist/kidneys/bladder, and phlegm-fluids.
Collect peach blossoms and dry in shade. Measure one large sheng. Grind into powder according to the degree of fullness, without pressing. Sieve through gauze. Mix with warm/clear wine. Take one dose completely. Stop when purged. (Same source)
Nourishing Formulas When Cold-Damp invades the Three Yin meridians, settling in the feet and knees, causing emaciation and pale complexion, numbness in the lower abdomen, abdominal tightness and pain, rebellious qi and shortness of breath: Ba Wei Wan (Eight-Ingredient Pill) added with Chenxiang (Aquilaria Wood). (From *Yitong*)
For Liver-Kidney wind-deficiency and weak qi, inability to walk due to weak feet/knees, back/spine pain, wind-toxin flowing down meridians, difficulty walking, dribbling urine: Six Immortals Xuduan Wan (Six Immortals Teasel Pill).
Six Immortals Wood (Du Zhong / Eucommia Bark) (peel, chop, roast until black, five liang.) Wujia Pi (Eleutherococcus Bark) Fangfeng (Saposhnikovia Root) (remove forked roots) Yiyiren (Coix Seed) Qianghuo (Notopterygium Rhizome) (wash dirt off) Chuan Xuduan (Teasel Root) (wash, chop, bake dry) Niuxi (Achyranthes Root) (wash, chop, bake, soak in wine overnight, bake again, each three liang.) Bibo (Dioscorea Hypoglauca Rhizome) (four liang) Sheng Gan Di Huang (Rehmannia Root) (five liang)
Grind into fine powder. Use three sheng of good wine to dissolve three liang of Green Salt. Take half a jin of large Mugua (Chaenomeles Fruit), peel and remove seeds. Boil Mugua (Chaenomeles Fruit) in salt-wine until it becomes a paste. Mix with powder and pound into pills sized like paulownia seeds. Take fifty pills on an empty stomach before meals, with warm wine-salt water. If paste is insufficient, add wine paste. (From *Benshi Fang*) *Jifeng Puji Fang* Six Immortals Pill adds Gan Xie (Dried Scorpion), Tianma (Gastrodia Rhizome), and Baizhu (Atractylodes Macrocephala Rhizome) to the base formula. *Heji Jufang* Six Immortals Xuduan Wan removes Wujia Pi (Eleutherococcus Bark), Qianghuo (Notopterygium Rhizome), and Di Huang (Rehmannia Root), adding Chuan Wu Tou (Aconitum Carmichaelii Lateral Root).
Dispelling wind, nourishing blood, benefiting qi, strengthening sinews and bones, strengthening legs: Tiger Bone Wine.
Hu Jing Gu (Tiger Tibia Bone) (authentic, soaked in wine, roasted with butter) Bibo (Dioscorea Hypoglauca Rhizome) Niuxi (Achyranthes Root) (wash, chop, bake, soak in wine overnight, bake again) Xianling Pi (Epimedium Leaf) Yiyiren (Coix Seed) Shu Gan Di Huang (Prepared Rehmannia Root) (wine-washed, nine-steamed nine-dried, baked dry, weighed, each two liang)
Finely chop. Place in silk bag. Soak in two dou of wine. Drink one zhan. Refill with one zhan of wine. Lasts for one hundred days. Remove Niuxi (Achyranthes Root) for women. (From *Benshi Fang*) (Note: *Qianjin Fang* Tiger Bone Wine uses only one ingredient.)
Si Jin Wan (Four-Jin Pill) treats weakness of body and qi, wind-cold-damp-toxin lodging in collaterals, blood stasis, heavy waist/legs, weak sinews/bones, soreness/pain in four limbs, numbness, occasional swelling/itching, weak feet/knees, dull pain/spasms, inability to walk. Treats all chronic/new swellings and Hongxiangjiao (Gouty Arthritis).
Xuan Zhou Mugua (Chaenomeles Fruit) (remove pulp, slice, bake dry) Niuxi (Achyranthes Root) (remove rootlets, slice) Rongrong (Cistanche Stem) (wash, slice, bake) Tianma (Gastrodia Rhizome) (remove rootlets, finely chop, each one jin)
Process the above four ingredients as before. Soak in five sheng of pure wine. Spring/Autumn: 5 days. Summer: 3 days. Winter: 10 days. Take out, bake dry. Add Hu Gu (Tiger Bone) one liang and Fuzi (Aconite Lateral Root) two liang (processed, peel/navel removed).
Grind together into fine powder. Use the wine used for soaking to make wheat paste pills, sized like sophora seeds. Take thirty to fifty pills on an empty stomach with Mugua (Chaenomeles Fruit) wine decoction, or swallow with salt water. Take before meals. (From *Heji Jufang*) *Ye Shi* Enhanced Four-Jin Pill: From base formula (Hu Gu (Tiger Bone) eight liang, others same), remove Fuzi (Aconite Lateral Root), add Moyao (Myrrh) four liang and Chuan Wu Tou (Aconitum Carmichaelii Lateral Root) four liang. Mix with refined honey for pills. *Yang Shi* Five-Jin Pill: Add Shanyao (Dioscorea Rhizome) to *Ye Shi* formula. *Jisheng Xufang* Modified Four-Jin Pill: Add Ruxiang (Olibanum) to *Ye Shi* formula. (*Sanyin Fang* Modified Four-Jin Pill is seen in *Wei* chapter.)
Treatment for Damp-Heat Hongxiangjiao (Gouty Arthritis): Zhongshu Zhanhe Gong, over forty years old, tall and sturdy. In spring of Bingchen year, campaigning north of Yangzhou to Dongwu Yu, Hongxiangjiao (Gouty Arthritis) suddenly occurred. Generalized slight swelling of limbs, pain too severe to touch, worse in calves/shins. Unable to wear shoes. Rode horse barefoot, holding stirrups with bamboo container. Reported distress. I recalled *Neijing*: "Fluid retention originates internally, edema manifests externally." And: "All pain is excess; for blood excess, lancing is appropriate." Used San Leng Needle to lance the swollen area multiple times. Blood spurted out over two chi high, then flowed like a thread, about half a sheng onto the ground, dark purple/black color. Swelling and pain subsided immediately. Took Dang Gui Nian Tong Tang (Angelica Pain-Relieving Decoction) weighing one liang half. Slept that night. Took again next day and recovered. (From *Baojian*) (Note: *Lei An* cites Dong Yuan’s case of Marshal Lianping, similar, not recorded.)
Dang Gui Nian Tong Tang (Angelica Pain-Relieving Decoction) treats diseases caused by damp-heat: vexatious pain in limbs, heaviness in shoulders/back, chest/diaphragm discomfort, sinking into calves, unbearable swelling/pain.
Gancao (Licorice Root) (roasted) Yinchen Hao (Artemisia Capillaris Herb) (wine-fried) Jiu Huang Qin (Scutellaria Root) Qianghuo (Notopterygium Rhizome) (each half liang) Fangfeng (Saposhnikovia Root) Zhi Mu (Anemarrhena Rhizome) (wine-washed) Zhuling (Polyporus) (skin removed) Zexie (Alisma Rhizome) Dang Gui Shen (Angelica Sinensis Root Body) (each three qian) Kushen (Sophora Root) (wine-washed) Shengma (Cimicifuga Rhizome) Huang Qin (Scutellaria Root) (fried) Renshen (Ginseng Root) Gegen (Pueraria Root) Cang Zhu (Atractylodes Lancea Rhizome) (each two qian) Bai Zhu (Atractylodes Macrocephala Rhizome) (one qian half)
Chop. Take one liang per dose. Add two and a half zhan of water. Moisten with water first, let sit briefly, then decoct to one zhan. Strain and take warm before meals. Follow with a good meal shortly after. (Same source) (Note: This formula also appears in *Lanshi Micang*. *Tongzhi* states: Northern Hongxiangjiao (Gouty Arthritis), although ancient texts explored its nature, treatment methods were lacking. Only Luo Shi used Dang Gui Nian Tong Tang (Angelica Pain-Relieving Decoction) to treat it, draining dampness from above and below, allowing stagnant qi to circulate.)
Moxibustion Method For any Hongxiangjiao (Gouty Arthritis), upon initial onset of weak feet, moxibustion should be performed immediately, along with taking Zhuli Tang (Bamboo Juice Decoction). After moxibustion, Bafeng San (Eight-Wind Powder) can be taken. All recover, provided treatment is rapid. If one only moxibusticates without taking powder, or takes powder without moxibustication, the result is half-recovery, half-death. Even if recovered, relapse may occur within one to two years. Those who follow this method of rapid moxibustication and powder-taking will see ten cures out of ten. Mild cases, though not immediately dangerous, if treated improperly without removing the root cause, will eventually lead to death. Precision is essential. Initial moxibustication points: Fengshi, Futu, Dubi, Xi Yan (Two Eyes of Knee), Zusanli, Shanglian, Xialian, Jiexu. (From *Qianjin Fang*) (Original detailed explanation should be verified. Also says: After disease onset, if toxic vapors fill the exterior, moxibustication vents the qi.)
Cui Shi: If Hongxiangjiao (Gouty Arthritis) ascends to the lower abdomen causing numbness, take Zhang Zhongjing’s Ba Wei Wan (Eight-Ingredient Pill) and moxibusticate Zusanli and Jiexu. If feet frequently cramp, moxibusticate Chengshan. If inner calf is slightly numb, moxibusticate Sanyinjiao. (From *Waitai Mi Yao*)
Su: Attacks by various toxic vapors: if attacking interior, causes heart anxiety/oppression, untreated leads to death. If attacking exterior, toxin emerges in skin causing numbness; numbness improves with ointment massage. If toxin has not emerged in skin but causes stabbing pain in Ying and Wei levels, apply three to five moxa cones immediately at the painful spot. Specific acupoints are not strictly necessary. In remote areas without medicine, urgent moxibustication is required. Important points on abdomen, back, hands, and feet are all effective...