《灵枢》曰∶发于胫,名曰兔啮。其状如赤豆至骨,急治之,不急治害人也。
或间∶足小肚内侧,微红微肿,坚硬如石三四寸许,痛楚难禁,何如?曰∶此名黄
鳅痈。属足太阴与足厥阴二经湿热,又积愤所致。宜服五香汤、流气饮,加牛膝、木瓜、
防己、黄柏。壮实者,一粒金丹下之,或万病解毒丹。不足者,十全大补汤加牛膝、木
瓜。若过时溃出清水,虚火上升,呕吐不食者不治。
《鬼遗》云∶三里两处起痈疽,初发如牛眼睛青黑,便五七日破穴,出黑血汁,脓肿
攻膀肚连腿里,拘急冷疼,此因伤筋气劳力所成。宜用汤药注射其外,毒自平息矣。
《鬼遗》云∶两脚接骨,近上膀肚下一处,起丹疽,如胡桃大,硬如物打磕之状,不苦
疼,但肿急胀,虑其损筋,亦须早出脓毒,可保平安也。
《鬼遗》云∶垂珠左右两处起痈为骗马坠。初起大小不定,此处微实皮肉薄,纹紧,口
亦难合。疮初起,宜以消散药贴令内消,此处亦易成漏疮。唯宜消散之,硬即恐缓慢难
为功矣。又云∶交HT 一处,近棱在线亦为骗马坠,防漏,(俗名跨马痈是也。)
或问∶足肚之下结块,长二三寸许,寒热大作,饮食不进何如?日;此名青蛇便。属
足少阴与足太阳经,由肾经虚损,湿热下注所致。头向上者难治。头向下者刺出恶血,服
活命饮加木瓜、牛膝、黄柏,或乌金散、紫金丹选用。老弱之人,呕吐腹胀,神昏脉躁
者死。
青蛇便生小膀上下,头生望上攻,走入腹者,不可治。头生向下,尾在上即为顺可
治也。急服二十六味托里散;外用神方铁箍散,姜汁、陈醋、猪胆同调敷之。上望下赶,
蛇头上用三棱针,针入二寸出黑紫血,出针急下保生散,用纸捻蘸药送入。
The *Ling Shu* states: When a carbuncle occurs on the lower leg, it is named "Rabbit Bite" (Tubi). Its appearance resembles a red bean extending deep to the bone; it must be treated urgently. If not treated promptly, it will endanger life.
A question was raised: On the medial side of the calf, there is slight redness and swelling, hardness like stone for about three or four cun, with unbearable pain. What is this? The answer is: This is named "Yellow Loach Abscess" (Huangqiu Yong). It belongs to damp-heat in the Foot-Taiyin Spleen and Foot-Jueyin Liver meridians, caused by accumulated resentment and anger. It is suitable to take Wuxiang Tang (Five Fragrances Decoction) or Liqi Yin (Flowing Qi Drink), added with Xuexi (Radix Achyranthis Bidentatae), Mugua (Fructus Chaenomelis), Fangji (Radix Stephaniae Tetrandrae), and Huangbai (Cortex Phellodendri). For those with strong constitutions, Yili Jindan (One Pill Golden Elixir) can be used to purge toxins, or Wanbing Jiedu Dan (Ten Thousand Diseases Detoxifying Pill). For those with deficient constitutions, Shiquan Dabu Tang (Decoction for Complete Great Tonification) added with Xuexi and Mugua is appropriate. If it ulcerates late and discharges clear fluid, with rising deficiency fire, vomiting, and inability to eat, it is incurable.
The *Gui Yi Ke* states: When carbuncles and sores arise at both sides of the Zusanli point, initially appearing dark green-black like an ox's eye, they break open after five to seven days, discharging black bloody pus. The abscess attacks the bladder and abdomen, extending into the legs, causing spasms, cold pain, and stiffness. This is formed due to injury to the sinews and qi from labor and overexertion. It is suitable to apply herbal decoctions externally to inject or wash the area, allowing the toxin to subside naturally.
The *Gui Yi Ke* states: At one location near the upper part of the calf, below the ankle joint on both feet, a Dan Ju (erysipelas-like sore) arises, the size of a walnut, hard as if beaten by an object. It does not cause severe pain but presents with urgent swelling and distension. One should worry about damage to the sinews; it is necessary to discharge the pus and toxin early to ensure safety.
The *Gui Yi Ke* states: When sores arise at the left and right sides of the scrotal pendulum, it is called "Pian Ma Zhui" (Deceiving Horse Fall). Initially, the size varies. The skin here is thin yet firm, with tight texture, and the wound mouth is difficult to close. At the initial stage, it is suitable to apply dissipating medicines topically to resolve it internally. This location is also prone to forming fistulas. Only dissipating methods are suitable; if it becomes hard, progress may be slow and ineffective. It further states: At the Huiyin point, near the perineal raphe, it is also called Pian Ma Zhui. Prevention of fistula formation is required (commonly known as Cross-Horse Carbuncle).
A question was asked: A mass forms below the calf, about two or three cun long, accompanied by severe chills and fever, and loss of appetite. What is this? The answer is: This is named "Green Snake Urination" (Qingshe Bian). It belongs to the Foot-Shaoyin Kidney and Foot-Taiyang Bladder meridians, caused by Kidney meridian deficiency and downward pouring of damp-heat. Those with the head pointing upward are difficult to treat. Those with the head pointing downward should have pricked to release foul blood, followed by taking Huoming Yin (Life-Saving Drink) added with Mugua, Xuexi, and Huangbai, or alternatively selecting Wu Jin San (Black Gold Powder) or Zi Jin Dan (Purple Gold Pill). For elderly and weak individuals presenting with vomiting, abdominal distension, confusion, and rapid/irregular pulse, the prognosis is fatal.
When Qingshe Bian arises above or below the calf, if the head grows upward attacking into the abdomen, it is incurable. If the head grows downward and the tail is upward, it is considered a favorable progression and is treatable. Urgently take Ershiliu Wei Tuoli San (Twenty-Six Ingredient Interior-Supporting Powder); externally apply Shenfang Tiegu San (Divine Formula Iron-Fence Powder) mixed with ginger juice, aged vinegar, and pig bile. The treatment principle is "directing upwards towards downwards" (guiding the toxin downward). Use a three-edged needle on the snake's head, inserting two cun deep to discharge black-purple blood. After removing the needle, immediately administer Bao Sheng San (Life-Preserving Powder), using a paper twist dipped in medicine to guide the intake.