[总诀]足居下部肾之分,又属阳明灌大筋。寒热肿疼根据法治,总于胃肾问原因。
脚冷厥逆,或兼下利清谷者,脾肾之虚寒也,宜加味四逆汤。
干姜(二钱) 附片(三钱) 甘草(二钱) 白术(三钱) 茯苓(三钱)
歌曰∶洞泻脾虚肾亦虚,阳微足冷厥难舒。
茯苓术草和中胃,姜附回阳暖气嘘。
脚发热厥,夜睡不欲被复者,肾中真阴虚也。宜六味地黄丸。
熟地(五钱) 山萸(三钱) 山药(四钱) 茯苓(三钱) 丹皮(三钱) 泽泻(三钱)
歌曰∶夜中足热肾阴亏,苓地山萸泽泻宜。
山药滋阴当重用,再加凉血牡丹皮。
脚跗肿大,青白如蚕明亮者,寒湿之气注也。宜神仙鸡鸣散。
吴萸(二钱) 苍术(二钱) 紫苏(二钱) 生姜(三钱) 苡仁(三钱) 木瓜(二钱) 陈皮(二
钱) 槟榔(一钱) 桔梗(二钱) 云苓(三钱)
歌曰∶脚肿皮光白似蚕,吴萸苍术苡瓜探。
槟榔陈桔姜苏入,除湿云苓性要参。
(伯未按∶当在五更时冷服,故名“鸡鸣”。)
脚跗赤肿,以及生疮溃烂者,湿热之下注也,宜苍术知母汤。
苍术(二钱) 知母(三钱) 白术(二钱) 云苓(二钱) 黄芩(二钱) 白芍(二钱) 续断(二
钱) 秦皮(二钱) 茵陈(二钱) 桑皮(二钱) 地骨皮(二钱) 甘草(一钱) 防己(一钱五分)
歌曰∶足跟赤肿或生疮,二术三皮知芍匡。
苓续茵陈防己入,枯芩甘草共清凉。
脚痛瘦削,无论干枯发热者,肝肺之痿弱也。宜去痿治血汤。
生地(三钱) 当归(三钱) 元参(二钱) 白芍(二钱) 杏仁(二钱) 丹皮(二钱) 麦冬(三
钱) 知母(二钱) 胆草(二钱) 秦艽(二钱)
歌曰∶脚疼瘦削属痿痹,药用元参归地施。
杏芍麦冬知共胆,秦艽再入牡丹皮。
妇人脚心疼痛,如刀锥刺者,少阴经瘀血也。宜仲景温经汤。
当归(三钱) 白芍(二钱) 阿胶(二钱) 川芎(一钱) 桂枝(二钱) 丹皮(三钱) 麦冬(四
钱) 半夏(二钱) 人参(二钱) 吴萸(一钱)
甘草(一钱) 生姜(三片)
歌曰∶脚底烦疼痛似锥,妇人瘀血用丹皮。
归芎胶芍同姜桂,参草吴萸冬夏施。
【总诀】足部位于身体下部,归属于肾脏的分管区域,同时也属于阳明经灌注大筋的部位。对于寒、热、肿、痛等症状,应依据相应的法则进行治疗,其根本原因总在于胃和肾。
脚部发冷且四肢厥逆,或者兼有腹泻排出未消化食物的症状,这是脾肾阳虚寒盛的表现,适宜使用加味四逆汤。
干姜(二钱) 附片(三钱) 甘草(二钱) 白术(三钱) 茯苓(三钱)
歌诀说:洞泄(严重腹泻)因脾虚且肾亦虚,阳气微弱导致足冷厥逆难以舒展。
茯苓、白术、甘草调和中焦脾胃,干姜、附子回阳救逆使暖气通畅。
脚部发热且四肢厥逆,夜间睡眠时不想盖被子的,这是肾中真阴亏损的表现。适宜使用六味地黄丸。
熟地(五钱) 山萸肉(三钱) 山药(四钱) 茯苓(三钱) 丹皮(三钱) 泽泻(三钱)
歌诀说:夜间足部发热因肾阴亏虚,茯苓、地黄、山萸肉、泽泻适宜使用。
山药滋阴应当重用,再加入凉血的牡丹皮。
脚背肿大,皮肤青白光亮如蚕腹般的,是寒湿之气侵袭所致。适宜使用神仙鸡鸣散。
吴茱萸(二钱) 苍术(二钱) 紫苏(二钱) 生姜(三钱) 薏苡仁(三钱) 木瓜(二钱) 陈皮(二钱) 槟榔(一钱) 桔梗(二钱) 云苓(茯苓)(三钱)
歌诀说:脚肿皮肤光亮白似蚕腹,用吴茱萸、苍术、薏苡仁、木瓜探寻病机。
加入槟榔、陈皮、桔梗、生姜、紫苏,除湿需参悟云苓的药性。
(伯安按语:应当在五更天时冷服,所以名叫“鸡鸣”。)
脚背赤红肿胀,以及生疮溃烂的,是湿热下注所致,适宜使用苍术知母汤。
苍术(二钱) 知母(三钱) 白术(二钱) 云苓(二钱) 黄芩(二钱) 白芍(二钱) 续断(二钱) 秦皮(二钱) 茵陈(二钱) 桑白皮(二钱) 地骨皮(二钱) 甘草(一钱) 防己(一钱五分)
歌诀说:足跟赤红肿胀或生疮,苍术、白术及三种皮类药配合知母、白芍来匡正。
茯苓、续断、茵陈、防己加入,枯芩(黄芩)与甘草共同起到清凉作用。
脚部疼痛且肌肉消瘦,无论是否干枯发热的,这是肝肺痿弱的表现。适宜使用去痿治血汤。
生地(三钱) 当归(三钱) 元参(玄参)(二钱) 白芍(二钱) 杏仁(二钱) 丹皮(二钱) 麦冬(三钱) 知母(二钱) 胆草(龙胆草)(二钱) 秦艽(二钱)
歌诀说:脚疼消瘦属于痿痹,药用玄参、当归、地黄施用。
杏仁、白芍、麦冬、知母配合胆草,秦艽再加入牡丹皮。
妇人脚心疼痛,像刀锥刺一样的,是少阴经瘀血阻滞。适宜使用张仲景的温经汤。
当归(三钱) 白芍(二钱) 阿胶(二钱) 川芎(一钱) 桂枝(二钱) 丹皮(三钱) 麦冬(四钱) 半夏(二钱) 人参(二钱) 吴茱萸(一钱)
甘草(一钱) 生姜(三片)
歌诀说:脚底烦扰疼痛似锥刺,妇人瘀血使用牡丹皮。
当归、川芎、阿胶、白芍同生姜、桂枝一起,人参、甘草、吴茱萸、麦冬、半夏施用。
[General Principle] The feet are located in the lower part of the body, belonging to the domain of the Kidney (Shen), and also belong to the area where the Yangming channel irrigates the large sinews. For symptoms of cold, heat, swelling, and pain, treatment should follow appropriate principles; the root causes generally lie in the Stomach (Wei) and Kidney.
Coldness and reversal cold (Jue Ni) of the feet, or accompanied by clear undigested food in diarrhea, indicate deficiency-cold of the Spleen and Kidney. Jiawei Sini Tang (Modified Four Reversal Decoction) is indicated.
Dried Ginger (Qian), Prepared Aconite Root (San Qian), Licorice Root (Er Qian), Atractylodes Macrocephala Rhizome (San Qian), Poria (San Qian).
The song states: Profuse diarrhea due to Spleen deficiency and concurrent Kidney deficiency; weak Yang leads to cold feet and difficult-to-relieve reversal cold.
Poria, Atractylodes Macrocephala, and Licorice harmonize the Middle Jiao Stomach; Dried Ginger and Aconite restore Yang, allowing warm Qi to circulate.
Heat sensation in the feet with reversal cold, and a desire not to cover oneself during night sleep, indicates deficiency of True Yin in the Kidney. Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is indicated.
Prepared Rehmannia Root (Wu Qian), Cornus Fruit (San Qian), Dioscorea Rhizome (Si Qian), Poria (San Qian), Moutan Cortex (San Qian), Alisma Rhizome (San Qian).
The song states: Heat in the feet at night due to Kidney Yin deficiency; Poria, Rehmannia, Cornus, and Alisma are suitable.
Dioscorea nourishes Yin and should be used in heavy doses; add Moutan Cortex to cool the blood.
Swelling of the dorsum of the foot, with skin appearing bluish-white and bright like a silkworm's belly, indicates invasion by Cold-Dampness. Shenxian Jiming San (Immortal Chicken-Crowing Powder) is indicated.
Evodia Fruit (Er Qian), Atractylodes Lancea Rhizome (Er Qian), Perilla Leaf (Er Qian), Fresh Ginger (San Qian), Coix Seed (San Qian), Chaenomelis Fructus (Er Qian), Tangerine Peel (Er Qian), Areca Seed (Yi Qian), Platycodon Root (Er Qian), Poria (San Qian).
The song states: Foot swelling with smooth white skin resembling a silkworm; explore with Evodia, Atractylodes, Coix, and Chaenomeles.
Add Areca Seed, Tangerine Peel, Platycodon, Fresh Ginger, and Perilla; deeply understand the nature of Poria for removing dampness.
(Ber An's Note: It should be taken cold during the fifth watch (3-5 AM), hence the name "Chicken-Crowing".)
Redness and swelling of the dorsum of the foot, along with sores and ulceration, indicates downward pouring of Damp-Heat. Cangzhu Zhimu Tang (Atractylodes and Anemarrhena Decoction) is indicated.
Atractylodes Lancea Rhizome (Er Qian), Anemarrhena Rhizome (San Qian), Atractylodes Macrocephala Rhizome (Er Qian), Poria (Er Qian), Scutellaria Root (Er Qian), White Peony Root (Er Qian), Dipsacus Root (Er Qian), Bark of Chinese Privet (Er Qian), Yarrow Herb (Er Qian), Mulberry Root Bark (Er Qian), Phellodendron Bark (Er Qian), Licorice Root (Yi Qian), Stephania Tetrandra Stem (Yi Qian Wu Fen).
The song states: Redness and swelling of the heel or formation of sores; corrected by the two Atractolodeses, three barks, Anemarrhena, and White Peony.
Poria, Dipsacus, Yarrow, and Stephania are added; Scutellaria and Licorice jointly provide cooling effects.
Foot pain with muscle wasting, whether dry or hot, indicates weakness and flaccidity of the Liver and Lung. Quwei Zhixue Tang (Remove Flaccidity and Regulate Blood Decoction) is indicated.
Rehmannia Root (San Qian), Angelica Sinensis Root (San Qian), Scrophularia Root (Er Qian), White Peony Root (Er Qian), Apricot Seed (Er Qian), Moutan Cortex (Er Qian), Ophiopogon Tuber (San Qian), Anemarrhena Rhizome (Er Qian), Gentian Root (Er Qian), Kochia Flower (Er Qian).
The song states: Foot pain and wasting belong to flaccidity and bi-syndrome; use Scrophularia, Angelica, and Rehmannia.
Apricot Seed, White Peony, Ophiopogon, and Anemarrhena combined with Gentian; Kochia Flower and Moutan Cortex are added again.
Pain in the sole of the foot in women, feeling like stabbing with knives or awls, indicates blood stasis in the Shaoyin channel. Zhang Zhongjing's Wenjing Tang (Warm the Menses Decoction) is indicated.
Angelica Sinensis Root (San Qian), White Peony Root (Er Qian), Donkey-Hide Gelatin (Er Qian), Ligusticum Chuanxiong Rhizome (Yi Qian), Cinnamon Twig (Er Qian), Moutan Cortex (San Qian), Ophiopogon Tuber (Si Qian), Pinellia Tuber (Er Qian), Ginseng Root (Er Qian), Evodia Fruit (Yi Qian).
Licorice Root (Yi Qian), Fresh Ginger (Three slices).
The song states: Irritating pain in the sole like an awl; for women's blood stasis, use Moutan Cortex.
Angelica, Ligusticum, Donkey-Hide Gelatin, and White Peony together with Fresh Ginger and Cinnamon Twig; Ginseng, Licorice, Evodia, Ophiopogon, and Pinellia are administered.