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The deficiency of Yuan Qi (Original Qi) in the lower jiao, combined with external pathogenic invasion, leads to this disease caused by wind-cold-damp-heat. It may also arise from carbuncles, accumulations, or liuzhu (a chronic suppurative condition). If the pathogen enters the abdomen and attacks the heart, it is difficult to save. There is a formula named Cangzhu Jianbu Tang (Cangzhu Walking-Strengthening Decoction), composed of Qingpi (Green Tangerine Peel), Chenpi (Aged Tangerine Peel), Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Gualou (Trichosanthis Fructus), Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Huangbai (Phellodendri Cortex), Lian (Coptidis Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Zhuling (Polyporus), Niuxi (Achyranthis Bidentatae Radix), Longdancao (Gentianae Radix), and Binglang (Arecae Semen). If the left chi pulse does not respond, the disease is hard to cure; if the cunkou pulse is irregular, do not treat. For women with swollen, sore, numb, and painful feet, use Shengdihuang, Chuanxiong, Cangzhu, Huangbai, Huangqin, Niuxi, Honghua (Carthami Flos), and Caolongdancao, decocted and taken before meals for effect.

Differentiation:
Swelling of both calves indicates damp-type Hongxiangjiao (Hongxiangjiao refers to beriberi/foot qi disease); use Danggui Niantong Tang (Danggui Pain-Withdrawing Decoction) or Wuji San (Five Accumulations Powder), adding Binglang, Mugua (Chaenomelis Fructus), Qingteng (Sinomenii Caulis), and Chuanshanjia (Manis Squama). Dry Hongxiangjiao presents with withered and thin foot-knees; use Shiquan Dabu Tang (Ten Significant Tonifying Decoction), adding Niuxi, Mugua, Shinanteng (Acanthopanacis Senticosi Caulis), Wujiaopi (Acanthopanacis Cortex), Moyao (Myrrha), and Chuanwu (Aconiti Radix).

Binglang San (Arecae Semen Powder): This powder contains abundant Xiangsu San ingredients, plus Gancao (Licorice Root), Chenpi, half portions of Binglang and Mugua. Decoct with Shengjiang (Fresh Ginger) and Congbai (Scallion White) to treat Hongxiangjiao; how effective is it in dispelling wind-damp?

Danggui Niantong Tang: Treats damp-type Hongxiangjiao, joint pain, carbuncles, etc.
Qianghuo, Yinchern, Gancao, Ling are each 1 qian; Gui, Zhi, Ze, Mi, Zhu Ling are each 5 fen; Fangfeng, Cangzhu, Sheng, Ge are each 4 fen; Ren Shen and Kushen are also included. First line drugs 1 qian each, second line 5 fen each, last two lines 4 fen each.

Fangji Yin (Fangji Decoction): Fangji, Bai, Cang, Baizhu, Binglang, Shengdi, Chuanxiong, Moyao, Xi Xiao, Cao Shao, Tong, Lian. Dosages vary (7, 5, 3 fen respectively). Add Huangqin for internal heat; add Shigao (Gypsum Fibrosum) for severe heat or summer heat; add Taoren (Persicae Semen) for constipation; add Niuxi, Mugua, Yiyiren (Coicis Semen) for dysuria; add Weilingxian (Salviae Miltiorrhizae Radix et Rhizoma - *Note: Standard is Clematidis Radix* Salviae Miltiorrhizae is Danshen, but Weilingxian is Clematis root. WHO term: Clematis Root) for arm pain; add Dancao (Gentianae Radix) for hypochondriac pain; add Chuanbi (Dioscoreae Hypoglaucae Rhizoma) for severe wind; add Mugua for severe damp; add Shanzha, Shenqu, Maiya for food stagnation. If foot qi attacks the heart, combine with Siwu Tang (Four Substances Decoction); for obese patients, add phlegm-resolving herbs.

Jianbu Wan (Walking-Strengthening Pill): Shengdihuang, Chenpi, Baishao each 1.5 liang; Cangzhu, Guiwei (Angelicae Sinensis Radix Tail) each 1 liang; Niuxi, Tiaohuangqin (Scutellariae Radix), Wuzhuyu (Evodiae Fructus) each 5 qian. Make pills with Da Zhengbing (Large Steamed Dough Ball) size of Wuzi (Chinese Wolfberry). Take 80 pills with a decoction of Baizhu and Mutong (Akebiae Caulis) before meals.

Wuji San (see Cold Damage section), Shiquan Dabu Tang (see Consumption section).

Single Prescriptions:
For swollen and cramped feet: Weilingxian, Chuan Niuxi, equal parts powdered, honey-pilled like Wuzi, taken with wine on an empty stomach. Avoid tea.
For damp-heat pain: Melt 1 jin of lead in a pot, pour in wine, drink it; foot pain will stop. Severe cases take three doses.

Additional Remarks:
The Spleen governs the four limbs. Failure to control rich, greasy foods, tea, alcohol, and wheat/rice products leads to stagnation generating heat. Heat flows to the feet, and combined with mountainous dampness or wading through water/rain, the feet are first affected. Damp-heat interacts, causing foot diseases. Initially, there is aversion to cold and fever, resembling Shanghan (Cold Damage), but only the calves are red/swollen or tendons cramp/painful. Mild cases stay in the feet; severe cases enter the yin meridians, reach the Small Intestine, pass through the hypochondrium to the head; even more severe, Hongxiangjiao attacks the heart, and mis-treatment causes immediate death. Mild cases first dispel cold; severe cases clear heat, assisted by damp-draining and descending herbs. Unless the feet/knees are withered/thin and the onset is slow, do not abruptly use Qi-tonifying herbs.

Shenxiao Zhujiu Fang (Divine Effect Boiled Wine Recipe): Wujiaopi 3 liang, Xuan Mugua 3 liang. Use 3 large pots of non-ashy wine. Put herbs in a small porcelain bottle, crush them, place in the bottle. Sit the bottle in a boiling water bath. Boil wine several times, remove, cool overnight. Drink 6-7 cups on an empty stomach.

For foot tendon spasms: Grate garlic on the soles of the feet until warm; it heals immediately.

Treating Hongxiangjiao: An ancient story tells of an official who, in intense summer heat, placed a cloth bag under a stove fire and stepped his feet on it. Asked about it, he said he had old foot qi disease. He recently got a prescription: put 2-3 jin of Chuanjiao (Sichuan Pepper) in a loose cloth bag, step barefoot on it. The pepper's heat dispels cold and heat. Years later, his cured friends shared it with relatives/friends, all effective. Later, adding broken Binglang and hot Aiye (Artemisiae Argyi Folium), each one-third part, was also wonderful. Truly a good prescription.