香港脚之名，起自后代，其顽麻肿痛者，则经所谓痹厥也。痿软不收者，则经所谓痿厥也。其冲心
者，则经所谓厥逆也。东垣云∶香港脚之疾，实水湿之所为也。盖湿之害人皮肉筋脉而属于下，然亦有
二焉。一则自外而感，一则自内而致，其治法自应不同，故详而论之。其为病也，有证无名。香港脚之
称，自晋苏敬始，关中河朔无有也。惟南方地下水寒，其清湿之气中于人，必自足始，故经曰清湿袭
虚，则病起于下。或者难曰，今兹北方，其地则风土高寒，其人则腠理致密，而复多此疾者，岂是地
湿之气感之而为耶？答曰，南方之疾自外而感者也，北方之疾自内而致者也。
何以言之？北方之人常食潼乳，又饮酒无节，过伤而不厌，且潼乳之为物，其气味则潼乳，其形质则
水也，酒醴亦然。人之水谷入胃，胃气蒸腾，其气与味宣之于经络，化之为血气，外荣四末，
内注五脏六腑，周而复始，以应刻数焉，是谓天地之纪。此皆元气充足，脾胃之气无所伤而然也。苟
元气不充，则胃气之本自弱，饮食既倍，则脾胃之气有伤，既不能蒸化所食之物，其气与味，亦不能
宣畅旁通，其水湿之性，流下而致之。其自外而入者，止于下胫肿而痛，自内而致者，乃或至于手节
也。经云∶足胫肿曰水。太阴所至，为重 肿。此但言其自外者也。所治之法，前人方论备矣。自内
而致者，治法则未有也。杨大受云∶香港脚是为壅疾，治以宣通之剂，使气不能成壅也。壅既成而盛者，
砭恶血而去其重势。经曰∶蓄则肿热，砭射之，后以药治之。按东垣论南方香港脚，外感清湿作寒治；
北方香港脚，内伤酒乳作湿热治。此实前人之未发者。后学泥之，遂成南北二派，互相诋毁。南毁北者
曰，彼所论乃北方病也，彼所治乃北方法也，不可施于南。北毁南者曰，彼所论乃南方病也，彼所治
乃南方法也，不可施于北。呜呼，立论之始，不究《内经》首尾所言，辄创其
名，以致后人守其说者，知其一不知其二，故相乖迕若此。夫《素》、《灵》诸篇，上穷天文，下究
地理，中知人事之变，叠出不一书者，为天地以二气食于人，而人以六经三阴三阳上奉之，是故三阴
三阳，亦是在人之六经气也，内以养于脏腑，壮精神，运水谷，以为生化百骸之用。及乎天地六气一
有不正则变，变则袭人身形之虚，入客以为病者，谓之外邪。若人之三阴三阳一有不正则变，变则淫
为病者，谓之内邪。二者皆得致周身之百病。况足之六经，皆起于脚五趾，行过于腿膝，上属脏腑，
统身半以下气血之营运，故外入之邪客之，则壅闭其经气，凝泣其络血。若人气内注之邪，着而留之，
则亦必如外邪壅闭气血者无异也。及其冲痛痿痹厥逆之状，亦无异也。于是皆以香港脚名也。此四方之
所同，今乃以南方者，止中外邪之湿，北方者，止中内注之湿，岂理也哉。然北方纵无地之卑湿，其
在践雨露，履汗袜，洗濯足，皆湿也。与夫脱卸靴履，汗出而风吹之，而血凝于足者，宁不与南方地
之湿同类，尽属外中者乎。南方虽无潼乳之湿，其在酒食，与脏腑所伤，津液水谷停积之湿而下注者，
宁不与北方潼乳同类，尽属内注者乎。能达此理，第恐自责辨邪之不易，奚暇相毁哉。《千金》云∶
凡香港脚之病，始起甚微，多不令人识也。
食饮嬉戏，气力如故，惟卒起脚屈弱不能动，有此为异耳。凡香港脚之候，或见食呕吐，憎闻食臭，或
有腹痛下利，或大小便闭涩不通，或胸中冲悸，不欲见光明，或精神昏愦，或喜迷忘，语言错乱，或
壮热头痛，或身体极冷疼烦，或觉转筋，或肿或不肿，或 腿顽痹，或时缓纵不随，或复百节挛急，
或小腹不仁，此皆香港脚状貌也。方书以肿者为湿香港脚，不肿者为干香港脚。不问久近干湿及属何经，并
可用除湿汤加木瓜、槟榔、白芷各半钱，或芎芷香苏散加赤芍药、萆 各半钱，仍吞木瓜丸。香港脚发
动，两足痛不可忍者，五积散加全蝎三五个，入酒煎。香港脚发动，必身痛发热，大类伤寒，若卒起脚
弱，或少腹不仁，或举体转筋，或见食呕逆，或两胫赤肿，盒饭作香港脚治。干者，于前二药中，或更
加莱菔子炒研半钱。湿者，于前二药中加青橘皮十数片。《千金》云∶若脉大而缓，宜服续命汤二剂
立瘥。（活人云∶香港脚属冷者，小续命汤煎成，旋入生姜自然汁，服之最快。）若风盛，宜作越婢汤
加白术二两。若脉浮大而紧转 ，宜作竹沥汤。（此最恶脉，细而 亦恶。）脉微而弱，宜服风引汤。
此人脉多是因虚而得之。若大虚短气力乏，可间作补汤，随病冷热而用之。若未愈，更服竹沥汤即止。
竹沥汤若不及热服，辄停在胸膈，更为人患，每服当使极热。若服竹沥汤得下者必佳也。
若加服数剂，病及脉势未折，而苦胀满者，可以大鳖甲汤下之。汤势尽而不得下，可以丸药助
汤令下，下后更服竹沥汤，令脉势折，将息料理乃佳。东垣云∶《外台》所录，皆谓南方卑湿雾露所
聚之地，其民腠理疏，阳气不能外固，因而履之则清湿袭虚，病起于下，此因血虚气弱，受清湿之邪
气，与血并行于肤腠，邪气盛，正气少，故血气涩；涩则痹，虚则弱，故令痹弱也。后人名曰香港脚。
初觉即灸患处二三十壮，以导引湿气外出，及饮醪醴，以通经散邪。所制之方，寒药少，热药多，多
用麻黄、川乌、姜、附之属。《内经》云∶湿淫于外，以苦发之。麻黄苦温，发之者也。川乌辛热，
走而不守，通行经络。姜、附辛甘大热，助阳退阴，亦能散清湿之邪。又察足之三阴三阳，是何经络
所起，以引用药为主治，更审六气中何气当之，治以佐使之药。按前廉为阳明，宜以白芷、升麻、葛
根为引用。后廉为太阳，宜以羌活、防风为引用。外廉为少阳，宜以柴胡为引用。内廉为厥阴，宜以
青皮、吴茱萸、川芎为引用。内前廉为太阴，宜以苍术、白芍药为引用。风胜者，自汗走注，其脉浮
而弦，宜发散，越婢加术汤。寒胜者，无汗挛急掣痛，其脉迟而涩，宜温熨，
酒浸牛膝丸。湿胜者，肿痛重着，其脉濡而细，宜分渗，除湿汤。暑胜者，烦渴热积，其脉洪而数，
宜清利，清暑益气汤。若四气兼见，但推其多者为胜，分其表里以施治也。太阳经香港脚病者，头痛目
眩，项强，腰脊身体经络，外踝之后，循京骨至小指外侧皆痛，宜随四时之气发散而愈，麻黄左经汤。
阳明经香港脚病者，翕翕寒热，呻欠，口鼻干，腹胀，髀膝膑中循 外 ，下足跗，入中趾内间皆痛，
宜随四时气微利之，大黄左经汤。少阳经香港脚病者，口苦上喘，胁痛面垢，体无光泽，头目皆痛，缺
盆并腋下如马刀肿，自汗振寒发热，胸中胁肋髀膝、外至 绝骨外踝，及诸节指皆痛，宜随四气和解
之，半夏左经汤。三阳并合香港脚病者，憎寒壮热，自汗恶风，或无汗恶寒，晕眩重着，关节掣痛，手
足拘挛疼痛，冷痹，腰腿缓纵不随，心躁气上，呕吐下利，其脉必浮弦紧数，宜大料神秘左经汤，加
味败毒散。太阴经香港脚病者，腹满，夹咽连舌系急，胸膈痞满，循 骨下股膝内前廉、内踝，过核骨
后，连足大趾之端内侧皆痛，宜六物附子汤。少阴经香港脚病者，腰脊痛，小趾之下连足心，循内踝，
入跟中，上 内，出 中，内廉股肉皆痛，上冲胸咽，饥不能食，面黑，小便淋闭，咳唾不已，善恐，
心惕惕如将捕之，小腹不仁者难治。四气偏胜，
各随其气所中轻重而温之，宜八味丸。厥阴经香港脚病者，腰胁偏疼，从足大趾连足趺，上廉上 ，至
内廉，循股环阴，抵小腹夹脐，诸处胀痛，两脚挛急，嗌干，呕逆洞泄，各随四气所中轻重而调之，
神应养真丹。三阴并合香港脚，四肢拘挛，上气喘满，小便秘涩，心热烦闷，遍身浮肿，脚弱缓纵不能
行步，宜追毒汤。以上六经受风寒暑湿流注，自汗为风胜，无汗疼痛为寒胜，热烦为暑胜，重着肿满
为湿胜，各随其气所胜者而偏调之，不可拘于一方也。湿热为病，肢节烦疼，肩背沉重，胸膈不利，
兼遍身疼痛，流注手足，足胫肿痛不可忍者，当归拈痛汤主之。本草十剂云∶宣可去壅，通可去滞。
《内经》云∶湿淫所胜，治以苦温。羌活苦辛，透关节胜湿，防风甘辛温，散经络中留湿，故以为君。
水性润下，升麻、葛根苦辛平，味之薄者，阴中之阳，引而上行，以苦发之也。白术苦甘温，和平除
湿，苍术体轻浮，气力雄壮，能除肤腠间湿，故以为臣。夫血壅而不流则为痛，当归身辛温以散之，
使血气各有所归，人参、甘草甘温，补脾养正气，使苦药不能伤脾胃。仲景云∶湿热相合，肢节烦疼，
苦参、黄芩、知母、茵陈苦寒，乃苦以泄之者也。凡酒制炒，以为因用。治湿不利小便，非其治也。
猪苓甘温平，泽泻咸平，淡以渗之，又能导其留饮，故
以为佐。气味相合，上下分流其湿，使壅滞之气得宣通也。杨大受谓香港脚之疾，自古皆尚疏下，为疾
壅故也。然不可太过，太过则损伤脾胃，使营运之气不能上行，反下注为香港脚，又不可不及，不及则
使壅气不能消散。今立三方于后，详虚实而用之。香港脚初发，一身尽痛，或肢节肿痛，便溺阻隔，先
以羌活导滞汤导之，后用当归拈痛汤除之。饮食不消，心下痞闷者，开结导饮丸。治廉平章年三十八，
身体充肥，香港脚始发，头面浑身肢节微肿，皆赤色，足胫赤肿，痛不可忍，不敢扶策，手着皮肤其痛
转甚，昼夜苦楚，此以北土高寒，故多饮酒，积久伤脾，不能运化，饮食下流之所致。投以当归拈痛
汤一两二钱，其痛减半，再服肿痛悉除，止有左手指末微赤肿，以三棱针刺爪甲端，多出黑血，赤肿
全去。不数日，因食湿面，肢体觉痛，再以枳实大黄汤治之。夫香港脚之疾，皆水湿之为也。面滋其湿，
血壅而不行，故肢节烦疼。经云∶风胜湿，羌活辛温，透关节去湿，故以为主。血留而不能行则痛，
当归之辛温，散壅止痛，枳实之苦寒，治痞消食，故以为臣。大黄苦寒，以导面之湿热，并治诸老血
留结，取其峻 ，故以为使也。服后利下两行，痛止。控涎丹加胭脂一钱，槟榔、木瓜各一两，卷柏
半两，先以盐水煮半日，次日白水煮半日，
同前药为丸。每三十丸加至四五十丸，利下恶物立效。《衍义》云∶有人嗜酒，日须五七十杯，后患
香港脚甚危，或教以巴戟半两，糯米同炒，米微转色，不用米，大黄一两，锉炒，同为末，熟蜜为丸。
温水下五七十丸，仍禁酒遂愈。肾脏风壅积，腰膝沉重，威灵仙末，蜜和丸，如桐子大。酒下八十丸，
平明微利恶物如青脓桃胶，即是风毒。香港脚多属肺气。经云∶肺病者，汗出，尻阴股膝、髀 足皆
痛，故戴人治香港脚用涌法者，良由此也。又《千金方》多汗之者，亦泻肺之意也。古方用紫苏陈皮生姜
汤，调槟榔末服之，于疏通肺气为佳。《三因》十全丹、续断丸、薏苡仁酒、虎骨酒，皆药性平良，
病患下虚而无实积者，可以常服。
【香港脚冲心】丹溪用四物汤加炒柏，以附子末津调敷涌泉穴以艾灸，
泄引其热下行。《金匮》八味丸，治香港脚上攻入少腹不仁。以上虚者宜之。槟榔为末，童便调服。三
脘散、大腹子散、桑白皮散、薏苡仁散，以上实者宜之。犀角散，热者宜之。茱萸木瓜汤、沉香散，
无热者宜之。
【香港脚上气喘息】紫苏叶三两，桑白皮锉炒二两，前胡去芦一两， 咀，每服八钱，水
二盏半，槟榔二枚，杏仁去皮尖二十枚，生姜五片，煎至一盏，温服无时。香港脚喘急，此系入腹，宜
苏子降气汤，仍佐以养正丹或四磨饮。香港脚迫肺，令人喘嗽，宜小青龙汤，
每服入槟榔一钱煎服。
【香港脚呕逆恶心】宜八味平胃散，加木瓜一钱。畏食者，宜生料平胃散，加
木瓜一钱。二证并可用半夏散、橘皮汤。
【小便不通】用生料五苓散一帖，除湿汤一帖，加木瓜二
钱重，分二服。
【大便不通】羌活导滞汤。
【大小便俱不通】槟榔丸，或五苓散和复元通气散。
【发热不退】者，败毒散加木瓜一钱，或用败毒散、五积散各半帖和匀，名交加散，更加木瓜一钱。
若久履湿，而得两脚或肿或疮，五苓散或和气饮，加木瓜、萝卜子各半钱，大黄一钱。香港脚日久，脚
胫枯细，或寒或热，或疼或痒，或一脚偏患软弱 曳，状如偏风者，宜小续命汤加木瓜，或独活寄生
汤、附子八味汤，吞活络丹、虎骨四斤丸之类。
【香港脚生疮】肿痛，心神烦热，犀角散。香港脚腿腕生
疮，用鹿茸丸、芎归散。香港脚生疮肿痛，用漏芦、白蔹、槐白皮、五加皮、甘草各七钱半，蒺藜子二
两， 咀，水煎去渣，看冷热于无风处淋洗之。香港脚，跟注一孔，深半寸许，每下半日痛异常，此乃
香港脚注成漏，以人中白于火上 ，中有水出，滴入疮口。
【脚心痛者】，宜大圣散二钱重，入木瓜末
The name "Hong Kong Jiao" (Hong Kong Foot / Gouty Arthritis) originated in later dynasties. Cases presenting with stubborn numbness, swelling, and pain correspond to what the Classics call *Bi Jue* (Painful Obstruction and Cold Reversal). Cases presenting with flaccidity and weakness correspond to what the Classics call *Wei Jue* (Flaccidity and Cold Reversal). Cases where the pathogen rushes upward to affect the heart correspond to what the Classics call *Jue Ni* (Cold Reversal). Li Dongyuan stated: The disease of Hong Kong Jiao is actually caused by water-dampness. Generally, dampness harms the skin, flesh, sinews, and vessels, and its location is often in the lower body. However, there are two origins. One is contracted from the exterior, and the other is generated from within; therefore, the treatment methods should naturally differ. Thus, I will discuss them in detail. This disease has symptoms but lacked a specific name initially. The term "Hong Kong Jiao" began with Su Jing of the Jin Dynasty and was not used in the Guan Zhong and He Shuo regions. Only in the south, where underground water is cold, does the clear-cold damp qi invade the human body, starting necessarily from the feet. Hence, the Classics say: "When clear-cold dampness attacks deficiency, the disease arises from below." Some might question: Now in the north, the terrain is high and cold, people's cou li (pores/skin texture) are dense, yet this disease is common. Is it truly caused by ground dampness? The answer is: Southern diseases are contracted from the exterior, while northern diseases are generated from within.
Why is this so? People in the north frequently consume Tong Ru (a type of milk product), drink alcohol without restraint, and harm themselves excessively without tiring of it. Moreover, Tong Ru, in terms of taste, resembles milk, and in terms of substance, resembles water; wine is similar. When food and drink enter the stomach, stomach qi steams and vaporizes them. Their qi and flavor spread through the meridians, transform into blood and qi, nourish the four extremities externally, and irrigate the five zang and six fu organs internally, cycling endlessly to correspond with time cycles. This is called the Great Principle of Heaven and Earth. This occurs because yuan qi (original qi) is sufficient, and spleen-stomach qi is undamaged. If yuan qi is insufficient, the root of stomach qi becomes weak. With doubled dietary intake, spleen-stomach qi is damaged. Unable to steam and transform ingested food, their qi and flavor cannot circulate freely. The nature of water-dampness flows downward, causing the disease. Exterior invasion results only in swelling and pain of the lower legs; internal generation can even affect the hand joints. The Classics state: "Swelling of the feet and shins is called Water Disease." When Taiyin pathology reaches an extreme, severe edema occurs. This refers only to exterior contraction. Previous physicians' formulas and theories for treatment were comprehensive. However, treatment methods for internal generation were lacking. Yang Dashou said: Hong Kong Jiao is a disease of stagnation/obstruction. It should be treated with agents that promote circulation and unblocking, preventing qi from becoming stagnant. If stagnation is already severe, use bian stone (lithotripsy/acupuncture tool) to puncture and expel evil blood to reduce the intense pathogenic factor. The Classics say: "Accumulation leads to swelling and heat; treat with bian stone puncture, then follow with herbal medicine." According to Li Dongyuan's discussion, southern Hong Kong Jiao, caused by external contraction of clear-cold dampness, is treated as a cold syndrome; northern Hong Kong Jiao, caused by internal injury from alcohol and dairy, is treated as a damp-heat syndrome. This was an insight previously undeveloped. Later scholars stuck to these views, forming Northern and Southern schools that disparaged each other. The Southern school criticized the Northern school saying: "Their theory discusses northern diseases, and their methods apply only to the north, not the south." The Northern school criticized the Southern school saying: "Their theory discusses southern diseases, and their methods apply only to the south, not the north." Alas! At the inception of these theories, if one had not investigated the entirety of the *Neijing* (Inner Canon), but instead arbitrarily created names, it led later followers who adhered to these theories to know only one side and not the other, resulting in such mutual contradiction. The *Suwen* and *Lingshu* chapters explore astronomy above, geography below, and human affairs in between, presenting varied scenarios repeatedly. This is because Heaven and Earth feed humans with yin and yang qi, and humans respond to Heaven and Earth via the Six Meridians (Three Yin and Three Yang). Thus, the Three Yin and Three Yang are also the qi of the Six Meridians in the body, internally nourishing the zang-fu organs, strengthening spirit, transforming water and grain, and serving the function of generating the hundred bones. When any of the Six Qi of Heaven and Earth becomes irregular and changes, it invades the deficiencies in the human form, lodging as a pathogen, which is called an External Evil. If any of the human Three Yin and Three Yang becomes irregular and changes, it overflows and becomes a pathogen, which is called an Internal Evil. Both can cause all kinds of diseases in the body. Furthermore, the six meridians of the foot all originate at the five toes, pass through the legs and knees, connect upward to the zang-fu organs, and govern the circulation of qi and blood in the lower half of the body. Therefore, when external pathogens lodge, they obstruct meridian qi and congeal collateral blood. If internal pathogens lodge and remain, they are no different from external pathogens obstructing qi and blood. Consequently, the manifestations of rushing pain, flaccidity, obstruction, and reversal are also identical. Thus, all are named "Hong Kong Jiao." This is common to all four directions. To now claim that southern cases involve only external dampness and northern cases involve only internal dampness is unreasonable. Although the north lacks low-lying dampness, walking in rain/dew, wearing sweaty socks, and washing feet all introduce dampness. Taking off boots/shoes after sweating and being exposed to wind causes blood coagulation in the feet; is this not similar to southern ground dampness, belonging entirely to external invasion? Although the south lacks the dampness of Tong Ru, dampness from alcohol/food damage, or fluid/grain accumulation in the zang-fu flowing downward—is this not similar to northern Tong Ru, belonging entirely to internal generation? Understanding this principle, one would likely blame oneself for the difficulty in distinguishing evils, rather than having time to disparage others. The *Qianjin Fang* states: All Hong Kong Jiao diseases begin very subtly, often unrecognized. Diet, play, and strength remain normal; the anomaly is sudden onset of foot flexion weakness and immobility. Symptoms of Hong Kong Jiao include: vomiting upon seeing food, aversion to food odors, abdominal pain with diarrhea, constipation or difficult urination/defecation, chest palpitations/rushing sensation, aversion to light, mental confusion, forgetfulness, disordered speech, high fever with headache, extreme body cold/pain/agitation, muscle twitching/cramping, swelling or non-swelling, leg numbness/obstruction, intermittent flaccidity/incoordination, joint spasms, insensitivity of the lower abdomen. These are all appearances of Hong Kong Jiao. Medical texts classify swollen cases as Damp Hong Kong Jiao and non-swollen cases as Dry Hong Kong Jiao. Regardless of duration, dryness/moisture, or meridian involvement, one may use Chu Shi Tang (Dampness-Removing Decoction) plus Mugua (Papaya), Binglang (Areca Seed), and Baizhi (Angelica Dahurica), each 0.5 qian; or Xiong Zhi Xiang Su San plus Chishao (Red Peony Root) and Bixie (Dioscorea Hypoglauca Rhizome), each 0.5 qian, taken together with Mugua Wan (Papaya Pill). For acute Hong Kong Jiao with unbearable foot pain, use Wu Ji San (Five Accumulations Powder) plus 3-5 Quanxie (Scorpion), decocted in wine. Acute Hong Kong Jiao presents with body pain and fever, resembling Typhoid (Shanghan). If sudden foot weakness, lower abdominal insensitivity, generalized cramping, vomiting upon seeing food, or red swollen calves occur, treat as Hong Kong Jiao. For dry types, add 0.5 qian of fried and powdered Lefuzi (Radish Seed) to the previous formulas. For damp types, add 10+ slices of Qingjupi (Green Tangerine Peel). The *Qianjin Fang* states: If the pulse is large and slow, administer Xuming Tang (Continuing Life Decoction) for two doses for immediate recovery. (Huoren Shu says: For cold-type Hong Kong Jiao, add fresh ginger juice to Xiao Xuming Tang immediately after decoction for fastest effect.) If wind is predominant, use Yeshi Tang (Yi Ma Decoction) plus 2 liang of Baizhu (Atractylodes Macrocephala Rhizome). If the pulse is floating, large, tight, and turning choppy, use Zhuli Tang (Bamboo Juice Decoction). (This is the worst pulse; fine and choppy is also bad.) If the pulse is faint and weak, use Fengyin Tang (Wind-Guiding Decoction). This patient's pulse is likely due to deficiency. If severely deficient with shortness of breath and fatigue, administer Bu Tang (Tonifying Decoction) intermittently, choosing based on cold/heat. If unresolved, take Zhuli Tang again. Zhuli Tang must be taken piping hot; otherwise, it stagnates in the chest/diaphragm and causes further harm. If taking Zhuli Tang results in bowel movement, it is excellent. If several doses fail to reduce the disease/pulse intensity and bloating persists, use Da Biejia Tang (Large Turtle Shell Decoction) to purge. If the liquid decoction fails to produce evacuation, use pills to assist the decoction. After evacuation, resume Zhuli Tang to subdue the pulse intensity, followed by proper care. Li Dongyuan stated: The *Waitai Mi Yao* records that the south is low, damp, and foggy. People there have loose cou li, and yang qi cannot secure the exterior. Walking in such conditions allows clear-cold dampness to attack deficiency, causing disease from below. This is due to blood deficiency and qi weakness, allowing clear-cold dampness to travel with blood in the skin/flesh. Excess evil and deficient righteous qi cause blood/qi stagnation; stagnation leads to Bi, deficiency leads to weakness, hence Bi-weakness. Later people named this Hong Kong Jiao. Upon initial sensation, moxa 20-30 cones on the affected area to guide dampness out, and drink Lao Li (fermented rice wine) to unblock meridians and scatter evil. Formulas prepared contain few cold herbs and many warm herbs, mostly Mahuang (Ephedra), Chuanwu (Aconitum Carmichaelii), Ginger, and Fuzi (Prepared Aconite). The *Neijing* states: "For dampness overflowing externally, use bitter [herbs] to disperse." Mahuang is bitter-warm and disperses. Chuanwu is acrid-hot, moving and unrestrictive, circulating meridians. Ginger and Fuzi are acrid-sweet and greatly warm, assisting yang, retreating yin, and scattering clear-cold dampness. Observe which of the foot's three yin/yang meridians originates where, using guiding herbs as main treatments. Assess which of the six qi is dominant, treating with assistant/herb-guiding medicines. Anterior aspect is Yangming: use Baizhi, Shengma (Cimicifuga Rhizome), Gegen (Pueraria Lobata Root) as guides. Posterior aspect is Taiyang: use Qianghuo (Notopterygium Rhizome), Fangfeng (Saposhnikovia Root) as guides. Lateral aspect is Shaoyang: use Chaihu (Bupleurum Root) as guide. Medial aspect is Jueyin: use Qingpi (Aurantii Fructus Immaturus Pericarpium), Wuzhuyu (Evodia Fruit), Chuanxiong (Ligusticum Chuanxiong Rhizome) as guides. Anterior-medial aspect is Taiyin: use Cangzhu (Atractylodes Lancea Rhizome), Baishao (White Peony Root) as guides. Wind excess: spontaneous sweating, wandering pain, floating-choppy pulse; disperse with Yeshi Jia Zhu Tang. Cold excess: no sweating, spasmodic pulling pain, slow-choppy pulse; warm with Jiu Jin Niuxi Wan (Wine-Soaked Achyranthes Pill). Damp excess: swelling, pain, heaviness, soggy-thin pulse; separate and渗 (percolate) with Chu Shi Tang. Summerheat excess: irritability, thirst, heat accumulation, surging-numerous pulse; clear and benefit with Qingshu Yiqi Tang. If four qi combine, identify the predominant one, distinguish interior/exterior, and treat accordingly. Taiyang Meridian Hong Kong Jiao: headache, dizziness, stiff neck, pain along waist/spine/body meridians, posterior lateral malleolus, Jinggu point to little toe lateral side; resolve by dispersing according to seasons, use Mahuang Zuojing Tang. Yangming Meridian Hong Kong Jiao: mild chills/fever, groaning/yawning, dry mouth/nose, abdominal distension, pain along thigh/knee/patella lateral side, dorsum of foot, medial middle toe; mildly purge according to seasons, use Dahuang Zuojing Tang. Shaoyang Meridian Hong Kong Jiao: bitter taste, panting, hypochondriac pain, dirty face, dull complexion, head/eye pain, scrofula-like swelling in supraclavicular/axillary areas, spontaneous sweating/chills/fever, pain in chest/hypochondrium/thigh/knee/lateral fibula/lateral malleolus/joints/fingers; harmonize according to four qi, use Banxia Zuojing Tang. Combined Three Yang Hong Kong Jiao: aversion to cold/high fever, spontaneous sweating/aversion to wind, or no sweating/aversion to cold, dizziness/heaviness, joint pulling pain, limb spasm/pain, cold Bi, flaccid waist/legs, restlessness/rising qi, vomiting/diarrhea, floating-choppy-tight-numerous pulse; use large dose Shenmi Zuojing Tang plus Jiawei Baidu San. Taiyin Meridian Hong Kong Jiao: abdominal fullness, throat/tongue tie tightness, chest/diaphragm stuffiness, pain along shin/thigh/knee medial anterior aspect/medial malleolus/posterior calcaneus/medial big toe tip; use Liuwu Fuzi Tang. Shaoyin Meridian Hong Kong Jiao: waist/spine pain, pain from little toe sole through medial malleolus/heel/calf popliteal fossa/medial thigh, rushing to chest/throat, hunger without appetite, black face, difficult/blocked urination, persistent coughing/sputum, fearfulness, heart palpitations like being hunted, lower abdominal insensitivity (difficult to treat). For four qi bias, warm according to severity, use Bawei Wan. Jueyin Meridian Hong Kong Jiao: unilateral waist/hypochondriac pain, from big toe dorsum up calf to medial aspect, circling genitals to lower abdomen/navel, distending/painful everywhere, bilateral leg spasms, dry throat, vomiting/loose stools; regulate according to four qi severity, use Shenyang Zhen Dan. Combined Three Yin Hong Kong Jiao: limb spasms, upper asthma/fullness, difficult urination, heart heat/irritability, generalized edema, weak/flaccid legs unable to walk; use Zhuidu Tang. For the above six meridians affected by wind/cold/summerheat/damp: spontaneous sweating indicates wind excess; no sweating/pain indicates cold excess; heat/irritability indicates summerheat excess; heaviness/swelling indicates damp excess. Adjust according to the predominant qi; do not stick to one formula. Damp-heat disease: joint pain, heavy shoulders/back, chest discomfort, generalized pain flowing to limbs, unbearable swollen/painful calves; principal formula Dangni Tongtong Tang. *Bencao Shiji* states: "Xuan [disperse] removes obstruction; Tong [unblock] removes stasis." *Neijing* states: "For excessive dampness, treat with bitter-warm." Qianghuo is bitter-acrid, penetrating joints and overcoming dampness; Fangfeng is sweet-acrid-warm, dispersing retained dampness in meridians; thus they are Sovereign herbs. Water nature is moistening and downward; Shengma and Gegen are bitter-acrid-neutral, thin-flavored, yang within yin, guiding upward, dispersing with bitterness. Baizhu is bitter-sweet-warm, peacefully removing dampness; Cangzhu is light-floating, strong qi, removing dampness in skin/flesh; thus they are Minister herbs. Blood stagnation causes pain; Danggui Shen is acrid-warm to disperse, returning blood/qi to their sources; Renshen and Gancao are sweet-warm, tonifying spleen and nurturing righteous qi, preventing bitter herbs from damaging spleen/stomach. Zhang Zhongjing stated: "Damp-heat combined causes joint pain." Kushen, Huangqin, Zhimu, Yinchen are bitter-cold, draining with bitterness. All are processed with wine/frying for use. Treating dampness without promoting urination is not the correct treatment. Zhuling is sweet-warm-neutral; Zexie is salty-neutral; bland herbs percolate dampness and guide retained fluids; thus they are Assistant herbs. Flavors combine to drain dampness up/down, allowing stagnant qi to circulate. Yang Dashou said: Since ancient times, Hong Kong Jiao treatment favored purgatives due to obstruction. However, do not overdo it; excess damages spleen/stomach, preventing ascending qi, causing downward flow (Hong Kong Jiao). Do not underdo it; insufficiency fails to dissipate stagnant qi. Here are three formulas, used after assessing deficiency/excess. Initial Hong Kong Jiao with whole-body pain or joint swelling/blockage of urine/stool: first guide with Qianghuo Daozhi Tang, then eliminate with Dangni Tongtong Tang. Indigestion, epigastric stuffiness: Kaijie Daoyin Wan. Case: Lian Pingzhang, age 38, obese, initial Hong Kong Jiao, slight swelling/redness of head/face/limbs, red swollen calves, unbearable pain, unable to bear touch, day/night suffering. Due to northern cold climate, heavy drinking, long-term spleen damage, failure to transform, dietary fluids flowing down. Administered 1.2 liang Dangni Tongtong Tang; pain halved. Second dose eliminated swelling/pain. Left finger tips slightly red/swollen; pricked nail beds with Sanleng needle, expelled much black blood, redness/swelling gone. Few days later, ate wet noodles, limb pain returned; treated with Zhishi Dahuang Tang. Hong Kong Jiao is caused by water-dampness. Noodles increase dampness, blood stagnates, causing joint pain. Classics: "Wind overcomes dampness." Qianghuo is acrid-warm, penetrating joints to remove dampness (Sovereign). Blood retention causes pain; Danggui is acrid-warm, dispersing stagnation/pain (Minister). Zhishi is bitter-cold, treating stuffiness/digestion (Minister). Dahuang is bitter-cold, guiding noodle-damp-heat and old blood stasis, using its harsh action (Envoy). After taking, two bowel movements occurred, pain stopped. Kongxian Dan plus 1 qian Yanzhi (Rouge/Cinnabar substitute?), 1 liang Binglang, 1 liang Mugua, 0.5 liang Juanbai. Boil in salt water for half a day, then plain water for half a day next day. Mix with previous herbs to make pills. Start with 30 pills, increase to 40-50. Evacuating foul matter brings immediate relief. *Yanyi* states: Someone drank 50-70 cups daily, developed critical Hong Kong Jiao. Advice: 0.5 liang Bajitian (Morinda Officinalis Root) stir-fried with glutinous rice until rice changes color (discard rice). 1 liang Dahuang chopped and stir-fried. Powder together, make pills with honey. Take 50-70 pills with warm water, abstain from alcohol. Cured. Kidney wind obstruction, heavy waist/knees: Weilingxian (Clematis Root) powder, honey pills, size of paulownia seeds. Take 80 pills with wine. Next morning, slight evacuation of foul matter like green pus/peach gum indicates wind-toxin. Hong Kong Jiao often relates to Lung qi. Classics: "Lung disease patients sweat, pain in buttocks/genitals/thighs/knees/calves/feet." Thus Dai Ren used Yongfa (inducing vomiting/emetic therapy) for Hong Kong Jiao, for this reason. *Qianjin Fang* often uses sweating to vent lung qi. Ancient formula: Zisu Chenpi Jiangsheng Tang mixed with Binglang powder to soothe lung qi. *Sanyin* Shiquan Dan, Xuduan Wan, Yiyiren Wine, Hugujia Four-Jin Pill are mild/good herbs, suitable for regular use in patients with lower deficiency and no excess accumulation.
[Hong Kong Jiao Rushing to Heart] Zhu Danxi used Siwu Tang plus fried Huangbai (Phellodendron Bark), applied Fuzi powder mixed with saliva to Yongquan (KI1) acupoint, moxibusted to drain heat downward. *Jinkui Yaolue* Bawei Wan treats Hong Kong Jiao rushing to lower abdomen with insensitivity. Suitable for upper deficiency. Binglang powder mixed with child's urine. Sanwan San, Dafuzi San, Sangbaipi San, Yiyiren San suitable for excess. Xijiao San suitable for heat. Zhuyu Mugua Tang, Chenxiang San suitable for no heat.
[Hong Kong Jiao Upward Qi/Asthma] Zisu Ye (Perilla Leaf) 3 liang, Sangbaipi (Morus Alba Root Bark) cut/fried 2 liang, Qianhu (Peucedanum Root) de-rhizome 1 liang. Coarsely powder. Take 8 qian per dose, with 2.5 cups water, 2 Binglang seeds, 20 Xingren (Apricot Seed) peeled/cored, 5 Ginger slices. Decoct to 1 cup, take warm anytime. Hong Kong Jiao asthma/wheezing, pathogen enters abdomen: Su Zi Jiangqi Tang, assisted by Yangzheng Dan or Simo Yin. Hong Kong Jiao pressing on Lung, causing asthma/cough: Xiao Qinglong Tang, add 1 qian Binglang per dose.
[Hong Kong Jiao Vomiting/Nausea] Bayi Pingwei San plus 1 qian Mugua. For those fearing food: Shengliao Pingwei San plus 1 qian Mugua. Both conditions can use Banxia San or JuPi Tang.
[Urinary Retention] One dose of Shengliao Wuling San, one dose of Chu Shi Tang, plus 2 qian Mugua, divided into two doses.
[Fecal Impaction] Qianghuo Daozhi Tang.
[Both Urinary and Fecal Obstruction] Binglang Wan, or Wuling San mixed with Fuyuan Tongqi San.
[Persistent Fever] Baidu San plus 1 qian Mugua, or equal parts Baidu San and Wuji San mixed, named Jiajiao San, plus 1 qian Mugua. If long-term exposure to dampness causes swollen/ulcerated feet: Wuling San or Heqi Yin, plus 0.5 qian Mugua, 0.5 qian Luobozǐ (Radish Seed), 1 qian Dahuang. Chronic Hong Kong Jiao with thin/dry calves, cold/heat, pain/itch, or unilateral weakness resembling hemiplegia: Xiao Xuming Tang plus Mugua, or Duhuo Jisheng Tang, Fuzi Bawei Tang, swallowed with Huoluo Dan or Hugujia Sijin Wan.
[Hong Kong Jiao Ulcers] Swelling/pain, heart-mind heat/restlessness: Xijiao San. Ankle ulcers: Lurong Wan, Xiong Gui San. Ulcers with swelling/pain: Loulu, Bailian, Huaibaipi, Wujapi, Gancao (each 0.75 qian), Jili Zi (2 liang). Coarsely powder, decoct in water, strain. Wash wound at appropriate temperature in windless place. Hong Kong Jiao heel fistula (half cun deep), severe pain every afternoon/evening: Hong Kong Jiao transformed into fistula. Calcine Renzhongbai (Human Tooth Ash) over fire until water appears, drip into wound.
[Plantar Pain] Dasheng San 2 qian, mixed with Mugua powder.