【方歌】附阴疽发内踝上，初如红粟日增疼，坚硬赤肿渐如卵，
三阴交会湿热凝。
【注】此证生于内踝骨之上三寸，初如红粟，疼痛日增，坚硬
赤肿，渐如鸡卵，系三阴交会湿热积聚而成。始终内、
外治法，俱按痈疽肿疡、溃疡门。但三阴交系纯阴之穴
，收敛迟缓，调养不可不慎。
【方歌】内外踝疽湿寒成，血涩气滞阻于经，三阳外侧三阴里，
初用宣通蒜灸灵。
【注】此二证生两足踝近腕之处，在内踝者名走缓，又名鞋带
疽；在外踝者名脚拐毒。着内踝骨，属三阴经脉络也；
外踝骨，属三阳经脉络也。俱由湿寒下注，血涩气阻而
成。其坚硬漫肿，皮色不变，时时隐痛，难于行立者，
初服疮科流气饮加牛膝、木瓜、防己以宣通之，外用蒜
片灸法以消之。发三阴经者，服内托黄耆汤；发三阳经
者，服内托羌活汤。若虚弱将欲作脓，跳痛无时者，俱
服十全大补汤，外敷乌龙膏。其肿溃治法，俱按痈疽肿
疡、溃疡门。
方剂：疮科流气饮（见背部附骨疽）
内托黄耆汤（见股部附骨疽）
内托羌活汤（见臀部上马痈）
十全大补汤（见溃疡门）
乌龙膏（见肿疡门）
【方歌】穿踝疽由脾湿寒，里发串外踝骨间，有头属阳阴闷肿，
溃出清水废疾缠。
【注】此证由脾经湿寒下注，血涩气阻而成。先从里踝骨发起
，串及外踝，致令里外通肿，以有头为阳，易破；若惟
闷肿无头为阴，难溃。其证初起寒热往来，有红晕兼有
热也，宜服荆防败毒散；皮色不变者，服万灵丹。其余
肿溃治法，俱同内、外二踝疽。若溃出清水，或投方不
应，缠绵日久者，必成废疾，难治。
方剂：荆防败毒散（见项部脑疽）
万灵丹（见肿疡门）
【方歌】附阴疽发作于内踝上方，起初像红色的粟米，每日疼痛加剧，肿块坚硬、发红肿胀，逐渐变得像鸡蛋一样大，这是由于足三阴经交会处湿热凝聚所致。
【注】此病证生于内踝骨上方三寸处，起初像红色的粟米，疼痛日益加重，肿块坚硬、发红肿胀，逐渐变得像鸡卵一样大，这是由足三阴经交会处的湿热积聚而形成的。其治疗始终遵循痈疽肿疡（未溃破的疮疡）和溃疡（已溃破的疮疡）章节的方法。但三阴交穴属于纯阴之穴，收敛愈合迟缓，调养时不可不谨慎。
【方歌】内外踝疽由湿寒邪气形成，导致血液涩滞、气机阻滞于经络中，外踝位于三阳经外侧，内踝位于三阴经内侧，初起时使用宣通气血的蒜灸法效果灵验。
【注】这两种病证生于双脚踝靠近脚腕的部位，在内踝者名为“走缓”，又名“鞋带疽”；在外踝者名为“脚拐毒”。病变附着于内踝骨，属于足三阴经的脉络；附着于外踝骨，属于足三阳经的脉络。均因湿寒之邪下注，导致血液涩滞、气机阻滞而形成。表现为肿块坚硬、漫无边际地肿胀，皮肤颜色不变，时常出现隐隐作痛，难以行走站立者，初起服用疮科流气饮，并加入牛膝、木瓜、防己以宣通气血，外用蒜片灸法以消除病灶。发于足三阴经者，服用内托黄芪汤；发于足三阳经者，服用内托羌活汤。若患者体质虚弱，脓液即将形成，出现无休止的跳痛者，均服用十全大补汤，外部敷贴乌龙膏。其消肿溃破后的治法，均参照痈疽肿疡、溃疡章节。
方剂：疮科流气饮（见背部附骨疽章节）
内托黄芪汤（见股部附骨疽章节）
内托羌活汤（见臀部上马痈章节）
十全大补汤（见溃疡门章节）
乌龙膏（见肿疡门章节）
【方歌】穿踝疽由脾经湿寒引起，病邪从内部发起串连至外踝骨之间，有脓头属阳证，表现为阴闷性肿胀，溃破后流出清水，会导致残疾纠缠不休。
【注】此病证由脾经湿寒之邪下注，导致血液涩滞、气机阻滞而形成。先从内踝骨发起，串连波及外踝，致使里外通体肿胀。如果有脓头则属阳证，容易破溃；如果仅有闷胀肿胀而无脓头则属阴证，难以溃破。此病初起时有寒热往来症状，若有红晕兼有热感，适宜服用荆防败毒散；若皮肤颜色不变，则服用万灵丹。其余消肿溃破后的治法，均与内、外踝疽相同。若溃破后流出清水，或投用方药无效，缠绵日久者，必然成为废疾，难以治愈。
方剂：荆防败毒散（见项部脑疽章节）
万灵丹（见肿疡门章节）
[Verse] Fuyin Ju (Abscess of the Inner Ankle) arises above the medial malleolus. Initially, it resembles a red millet grain, with pain increasing daily. The swelling becomes hard, red, and swollen, gradually enlarging to the size of an egg. This is caused by the condensation of damp-heat at the intersection of the three Yin meridians.
[Note] This condition occurs three cun above the medial malleolus. Initially resembling a red millet grain, the pain increases day by day, and the swelling becomes hard, red, and enlarged, eventually reaching the size of a chicken egg. It is formed by the accumulation of damp-heat at the intersection of the three Yin meridians. The treatment throughout follows the protocols for Tumors and Ulcers (Yong Ju) in the sections on Swelling Sores (Zhongyang) and Ulcers (Kuiyang). However, Sanyinjiao (SP6) is a pure Yin acupoint, and healing/convergence is slow; care must be taken during convalescence.
[Verse] Swellings of the inner and outer ankles are caused by damp-cold. Blood stasis and Qi stagnation obstruct the meridians. The three Yang meridians are on the lateral side, while the three Yin meridians are on the medial side. Initially, use garlic moxibustion to promote circulation and unblock obstructions, which yields effective results.
[Note] These two conditions arise near the ankle joint of both feet. The one on the medial ankle is called Zouhuan (Wandering Slowness) or Xiedai Ju (Shoelace Abscess); the one on the lateral ankle is called Jiaoguai Du (Ankle Deformity Toxin). Lesions adhering to the medial malleolus belong to the network vessels of the three Yin meridians; those adhering to the lateral malleolus belong to the network vessels of the three Yang meridians. Both result from the downward pouring of damp-cold, leading to blood stasis and Qi obstruction. Manifestations include hard, diffuse swelling, unchanged skin color, occasional dull pain, and difficulty in walking or standing. Initially, administer Chuangke Liuqi Yin (Surgeon's Flow-Qi Decoction) added with Niuxi (Achyranthes Root), Mugua (Chaenomeles Fruit), and Fangji (Stephania Root) to promote circulation and unblock obstructions. Externally, apply garlic slice moxibustion to resolve the swelling. For cases arising in the three Yin meridians, administer Neituo Huangqi Tang (Internal Support Astragalus Decoction); for cases arising in the three Yang meridians, administer Neituo Qianghuo Tang (Internal Support Notopterygium Decoction). If the patient is weak and pus is about to form, characterized by ceaseless throbbing pain, administer Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) and externally apply Wulong Gao (Black Dragon Ointment). The methods for reducing swelling and managing ulcers follow the protocols in the sections on Swelling Sores and Ulcers.
Formulas: Chuangke Liuqi Yin (see Back Bone-Adhering Abscess section); Neituo Huangqi Tang (see Thigh Bone-Adhering Abscess section); Neituo Qianghuo Tang (see Buttock Shangma Carbuncle section); Shiquan Dabu Tang (see Ulcer Section); Wulong Gao (see Swelling Sore Section).
[Verse] Chuanhu Ju (Penetrating Ankle Abscess) is caused by spleen damp-cold. The pathogen originates internally and penetrates between the bones of the inner and outer ankles. Having a head indicates a Yang syndrome, presenting as stifling swelling; upon ulceration, clear fluid drains out, entangling the patient with disability.
[Note] This condition is caused by the downward pouring of damp-cold from the Spleen meridian, resulting in blood stasis and Qi obstruction. It initiates from the inner ankle bone, spreads to the outer ankle, causing swelling throughout the inner and outer regions. Having a head indicates a Yang syndrome, which is easy to ulcerate; having only stifling swelling without a head indicates a Yin syndrome, which is difficult to ulcerate. At the onset, there may be alternating chills and fever. If there is a red halo accompanied by heat, Jingfang Baidu San (Jingjie and Fangfeng Detoxifying Powder) is suitable; if the skin color remains unchanged, Wanling Dan (Myriad Spirits Pill) should be administered. The remaining methods for reducing swelling and managing ulcers are identical to those for inner and outer ankle abscesses. If clear fluid drains after ulceration, or if the prescribed formulas are ineffective and the condition lingers for a long time, it will inevitably become a debilitating disease, which is difficult to treat.
Formulas: Jingfang Baidu San (see Neck Brain Carbuncle section); Wanling Dan (see Swelling Sore Section).