香港脚证状固多,但当以脉诊分其阴阳,使无差互。所谓脉浮为风,紧为寒,缓细为湿,
洪数为热,见于诸阳病在外,宜发散之愈;沉而弦者亦为风,沉而紧者为寒,沉细为湿,沉
数为热,见诸阴病在里,宜温利之愈;外证自汗走疰为风胜,无汗疼痛挛急为寒胜,肿满重
着为湿胜,烦渴热顽为暑胜。四气兼有,但推其多者为胜。治之,当以诸证互辨而分表里,
寒则温之,热则寒之,在表则散,在里则下,若太虚气乏,间作补汤,随病冷热而用之,不
可拘不得服补药。
病者头痛,目脱项强,腰脊连体枢、循髀外出外踝之后,循京骨至小指外侧皆痛者,乃
足太阳膀胱经为风寒暑湿流注。自汗者为风胜,无汗疼痛为寒胜,热顽为暑胜,重着肿满为
湿胜,诸经皆当如此推。凡太阳经宜随四气发散愈。
治风寒暑湿流注足太阳经,手足挛痹,行步艰难,憎寒发热,无汗恶寒,
或自汗恶风,头疼眩晕,腰重,关节痛。
麻黄(去节) 干葛 细辛 白术(切,米泔浸) 茯苓 防己 桂心(不见火) 羌活 防
风甘草(炙,各等分)
上为粗末。每服四钱,水二盏,姜三片,枣一个,煎七分,去滓,空腹服。自汗,去麻
黄,加桂、芍药;重着,加术、橘皮;无汗,减桂,加杏仁、泽泻。所加并等分。
香港脚(足部肿胀疼痛之病)的症状表现固然繁多,但应当通过脉诊来区分其阴阳属性,以免出现差错混淆。所谓脉象浮取主风邪,紧脉主寒邪,缓细脉主湿邪,洪数脉主热邪;这些脉象若出现在诸阳经的病证中且病位在外,适宜采用发散法治疗即可痊愈;脉象沉取而弦者亦主风邪,沉取而紧者主寒邪,沉细脉主湿邪,沉数脉主热邪;这些脉象若出现在诸阴经的病证中且病位在里,适宜采用温通利下法治疗即可痊愈;外在症状中,自汗且病情游走不定者为风邪偏胜,无汗且疼痛拘挛紧急者为寒邪偏胜,肿胀沉重困着者为湿邪偏胜,烦躁口渴、身体灼热顽麻者为暑邪偏胜。这四种邪气可能同时存在,只需推断其中哪一种邪气占优势即可。治疗时,应当综合各种证候相互辨析以分清表里,寒证则用温法,热证则用清法,病在表则用解表散邪法,病在里则用攻下法;如果患者正气极度虚弱、气血匮乏,可间歇性地使用补益方剂,根据病证的寒热性质灵活选用,不可固执地认为不能服用补药。
患者出现头痛,眼球突出感或目睛不适,项部僵硬,腰部脊柱连接躯干枢纽处,沿大腿外侧下行至外踝后方,再沿京骨穴行至小指外侧均疼痛的,这是足太阳膀胱经受风寒暑湿邪气流注所致。有自汗症状的是风邪偏胜,无汗且疼痛的是寒邪偏胜,身体灼热顽麻的是暑邪偏胜,沉重困着且肿胀满闷的是湿邪偏胜,其他经络的病证也都应当如此推演判断。凡是足太阳经的病证,适宜根据四种邪气的性质采用发散法治疗即可痊愈。
治疗风寒暑湿邪气流注于足太阳经,导致手足拘挛麻痹,行走困难,怕冷发热,无汗且恶寒,或者自汗且恶风,头痛眩晕,腰部沉重,关节疼痛。
处方:麻黄(去除节)、干葛、细辛、白术(切片,用米泔水浸泡)、茯苓、防己、桂心(不经过火烤)、羌活、防风、甘草(炙制),以上药材各等分。
将上述药材捣成粗末。每次服用四钱,加水两盏,生姜三片,大枣一个,煎煮至剩余七分药液,滤去药渣,空腹服用。若有自汗症状,去掉麻黄,加入桂枝、芍药;若身体沉重困着,加入白术、橘皮;若无汗,减少桂枝用量,加入杏仁、泽泻。所加入的药材均为等分。
Hongjiao (a disease characterized by swelling and pain in the feet) symptoms are indeed numerous, but one must distinguish between Yin and Yang through pulse diagnosis to avoid errors and confusion. A floating pulse indicates Wind, a tight pulse indicates Cold, a slow and fine pulse indicates Dampness, and a surging and rapid pulse indicates Heat; when these pulses appear in diseases of the Yang meridians with pathology located externally, resolution via dispersing methods is appropriate for recovery. A deep and wiry pulse also indicates Wind, a deep and tight pulse indicates Cold, a deep and fine pulse indicates Dampness, and a deep and rapid pulse indicates Heat; when these pulses appear in diseases of the Yin meridians with pathology located internally, warming and purging methods are appropriate for recovery. In external manifestations, spontaneous sweating and migratory afflictions indicate predominance of Wind; absence of sweating, pain, and spasmodic stiffness indicate predominance of Cold; swelling, fullness, heaviness, and stagnation indicate predominance of Dampness; irritability, thirst, heat, and stubborn numbness indicate predominance of Summerheat. These four pathogens may coexist, but one should deduce which pathogen is predominant. Treatment requires mutual differentiation of various syndromes to distinguish between exterior and interior: Cold syndromes are treated with warming methods, Heat syndromes with cooling methods, exterior conditions with dispersing methods, and interior conditions with purging methods. If the patient suffers from extreme deficiency and lack of Qi, tonifying decoctions may be administered intermittently, applied flexibly according to the cold or heat nature of the disease; one must not rigidly adhere to the notion that tonifying medicines cannot be taken.
If the patient experiences headache, protrusion or discomfort of the eyes, neck stiffness, pain connecting the waist and spine to the body's pivot, extending along the lateral thigh to the posterior aspect of the lateral malleolus, then along the Jinggu point to the lateral side of the little toe, this indicates that the Foot-Taiyang Bladder Meridian is subjected to the flow and injection of Wind, Cold, Summerheat, and Dampness. Spontaneous sweating indicates predominance of Wind; absence of sweating and pain indicate predominance of Cold; stubborn heat indicates predominance of Summerheat; heaviness, swelling, and fullness indicate predominance of Dampness. All other meridians should be analyzed in this manner. Diseases of the Taiyang Meridian are generally suitable for resolution via dispersing methods according to the nature of the four pathogens.
To treat the flow and injection of Wind, Cold, Summerheat, and Dampness into the Foot-Taiyang Meridian, causing spasmodic paralysis of the hands and feet, difficulty walking, aversion to cold with fever, absence of sweating with aversion to cold, or spontaneous sweating with aversion to wind, headache with vertigo, heavy sensation in the waist, and joint pain.
Prescription: Ephedrae Herba (Mahuang, 麻黄) [remove nodes], Puerariae Radix (Gegen, 干葛), Asari Radix (Xixin, 细辛), Atractodis Rhizoma (Baizhu, 白术) [sliced, soaked in rice wash water], Poria (Fuling, 茯苓), Stephaniae Tetrandrae Radix (Fangji, 防己), Cinnamomi Ramulus (Guixin, 桂心) [not roasted over fire], Notopterygii Rhizoma et Radix (Qianghuo, 羌活), Saposhnikoviae Radix (Fangfeng, 防风), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted], all in equal proportions.
Grind the above ingredients into a coarse powder. For each dose of 4 qian, add 2 zhan of water, 3 slices of ginger, and 1 jujube. Decoct until 0.7 parts remain, filter out the dregs, and take on an empty stomach. If there is spontaneous sweating, remove Ephedrae Herba (Mahuang, 麻黄) and add Cinnamomi Ramulus (Guizhi, 桂枝) and Paeoniae Radix Alba (Shaoyao, 芍药); if there is heaviness and stagnation, add Atractodis Rhizoma (Baizhu, 白术) and Citri Reticulatae Pericarpium (Chenpi, 橘皮); if there is no sweating, reduce the amount of Cinnamomi Ramulus (Guizhi, 桂枝) and add Armeniaci Semen Amarum (Xingren, 杏仁) and Alismatis Rhizoma (Zexie, 泽泻). The added ingredients should be in equal proportions.