治脚弱,举体痹不仁,热毒瓦斯入脏,胸中满塞不通,食即呕吐方。
独活 麻黄 犀角(各三两,一方用羚羊角) 半夏(一升) 大枣 乌梅(各二十枚)
桂
心鳖甲 升麻 橘皮 枳实 甘草 吴茱萸 大黄(各一两) 生姜 石膏(各六两) 贝
齿
(七枚)
上十七味 咀,以水一斗四升,煮取四升,分五服,日三夜二,不瘥至三剂必瘥。
治香港脚初发,从足起至膝胫骨肿痛者方∶
取蜱麻叶切捣蒸薄裹之,日二三易即消,蜱麻子似牛蜱虫故名蜱麻也,若冬月无蜱麻取
蒴根捣研,和酒糟三分根一分,合蒸热,及热封裹肿上,如前法,日二即消。亦治不仁顽
痹(此方非汤,不当见此,然以前后三方俱出苏长史,更不分出。)
若肿毒已入 至小腹胀,小便涩少者方∶
取乌特牛尿一升,一服,日二,取消乃止。(《千金翼》云,羸瘦人二分尿一分牛乳合
煮,乳浮结乃服之。)
若肿已消仍有此候者,急服此汤方(苏长史方神验∶)
麻黄 射干 人参 茯苓 防己 前胡 枳实(各二两) 半夏 犀角 羚羊角 青木
香
橘皮 杏仁 升麻(各一两) 生姜(五两) 独活(三两) 吴茱萸(一升)
上十七味 咀,以水一斗二升,煮取四升,分五服,相去二十里久,中间进少粥,以
助胃气。此汤两日服一剂,取病气退乃止,以意消息之。若热盛喘烦者,加石膏六两、生麦
冬一升,去吴茱萸。若心下坚加鳖甲一两。
夫香港脚之病,先起岭南,稍来江东,得之无渐。或微觉疼痹,或两胫肿满,或行起涩弱
,或上入腹不仁,或时冷热,小便秘涩,喘息气冲喉,气急欲死,食呕不下,气上逆者,皆
其候也,若觉此证先与犀角旋复花汤方(方列后。)
治疗脚弱(下肢痿软无力),全身麻木不仁,热毒之气侵入脏腑,胸中胀满堵塞不通,进食后即呕吐的方剂。
独活、麻黄、犀角(各三两,另一版本用羚羊角)、半夏(一升)、大枣、乌梅(各二十枚)、桂心、鳖甲、升麻、橘皮、枳实、甘草、吴茱萸、大黄(各一两)、生姜、石膏(各六两)、贝齿(七枚)。
以上十七味药,切碎,用水一斗四升,煎煮至四升,分五次服用,白天服三次,夜间服两次,若未痊愈,再服三剂必定痊愈。
治疗香港脚(脚气病)初发,从足部起直至膝胫骨肿痛者的方剂:
取蓖麻叶切碎捣烂,蒸熟后薄敷患处,每天更换二三次即可消肿。蓖麻子形状像牛身上的蜱虫,所以叫蓖麻。如果在冬季没有蓖麻,可取蒴藋根捣碎研细,按三份根一份酒糟的比例混合,蒸热后趁热敷裹在肿胀处,方法同上,每天两次即可消肿。此方也治疗麻木顽痹(此方并非汤剂,不应出现在此处,但因为前三个方子都出自苏长史,故不再单独分出。)
如果肿毒已经深入至小腹胀痛,小便涩滞量少者的方剂:
取特等公牛尿一升,一次服用,每天两次,直到小便通畅为止。(《千金翼方》记载,身体消瘦的人将两份尿与一份牛奶混合煎煮,待牛奶表面结成浮皮时服用。)
如果肿胀已经消退但仍有上述症状者,急服此汤剂方(苏长史的方子非常灵验):
麻黄、射干、人参、茯苓、防己、前胡、枳实(各二两)、半夏、犀角、羚羊角、青木香、橘皮、杏仁、升麻(各一两)、生姜(五两)、独活(三两)、吴茱萸(一升)。
以上十七味药,切碎,用水一斗二升,煎煮至四升,分五次服用,每次服药间隔约相当于行走二十里的时间,中间喝少量米粥,以辅助胃气。此汤剂两天服用一剂,直到病气退去才停止,根据病情灵活调整。如果热盛喘促烦躁者,加石膏六两、生麦冬一升,去掉吴茱萸。如果心下坚硬者,加鳖甲一两。
大凡香港脚(脚气病)这种病,最初起源于岭南地区,后来逐渐传到江东,得病没有明显的渐进过程。有的轻微感到疼痛麻木,有的两小腿肿胀满闷,有的行走起步时涩滞软弱,有的病邪上行入腹导致腹部麻木不仁,有的时而怕冷时而发热,小便便秘涩滞,喘息气冲喉咙,气急欲死,饮食呕吐不下,气机上逆者,都是其症状表现。如果感觉到这些证候,先给予犀角旋复花汤方(方剂列在后面)。
Treatment for Jiaoruo (lower limb flaccidity and weakness), generalized numbness and insensitivity, heat-toxic qi invading the Zang organs, chest fullness and blockage preventing free flow, and vomiting immediately after eating.
Duohuo (Angelicae Pubescentis Radix), Mahuang (Ephedrae Herba), Xijiao (Rhinocerotis Cornu) [Note: Rhinoceros horn is banned; modern substitutes like Buffalo Horn Shuiniujiao are used clinically], Banxia (Pinelliae Rhizoma), Dazao (Ziziphi Jujubae Fructus), Wumei (Mume Fructus) (each 3 liang, another version uses Lingyangjiao [Capricornis Cornu]); Guixin (Cinnamomi Ramulus et Cortex interior), Biejia (Testudinis Carapax et Plastrum), Shengma ( Cimicifugae Rhizoma), Juapi (Citri Reticulatae Pericarpium), Zhishi (Aurantii Fructus Immaturus), Gancao (Glycyrrhizae Radix et Rhizoma), Wu Zhu Yu (Evodiae Fructus), Dahuang (Rhei Radix et Rhizoma) (each 1 liang); Shengjiang (Zingiberis Rhizoma Recens), Shigao (Gypsum Fibrosum) (each 6 liang); Beichi (Concha Meretricis et Cyclinae) (7 pieces).
The above seventeen ingredients are coarsely crushed. Decoct with 14 sheng of water until 4 sheng remains. Divide into five doses. Administer three times during the day and twice at night. If not cured, administer up to three courses (ji) until cure is achieved.
Formula for early-stage Hongjiao (Beriberi/Foot Qi), characterized by swelling and pain starting from the feet and extending to the knees and shins:
Take Bi Ma Ye (Ricini Folium), cut and crush, steam, and apply thinly to the affected area. Change two to three times daily until swelling subsides. Bi Ma Zi (Ricini Semen) resembles the tick on cattle, hence the name "Bi Ma" (Castor Bean). In winter, if Bi Ma is unavailable, use Suo Gen (Ammanni Radix or similar local root, often identified as *Abutilon* or *Sida* roots in historical contexts, here referred to as Suo root), crush and grind. Mix three parts root with one part wine lees (Jiu Zao). Steam until hot and apply while warm to the swollen area, as described above. Apply twice daily until swelling subsides. This formula also treats numbness and stubborn bi-syndrome (This formula is not a decoction and arguably should not appear here, but since the preceding three formulas are all from Chancellor Su, they are not separated out.)
Formula for cases where swelling/toxin has progressed to lower abdominal distension and scanty, difficult urination:
Take urine from a prime bull (Wute Niu Niao), 1 sheng per dose. Take twice daily. Discontinue once urination becomes smooth. (*Qianjin Yifang* notes: For emaciated persons, mix two parts urine with one part cow's milk, boil together until a scum forms on the surface, then consume.)
If swelling has subsided but these symptoms persist, urgently administer this decoction (Chancellor Su’s formula is highly effective):
Mahuang (Ephedrae Herba), Shegan (Belamcandae Rhizoma), Renshen (Ginseng Radix), Fuling (Poria), Fangji (Stephaniae Tetrandrae Radix), Qianhu (Peucedani Radix), Zhishi (Aurantii Fructus Immaturus) (each 2 liang); Banxia (Pinelliae Rhizoma), Xijiao (Rhinocerotis Cornu), Lingyangjiao (Capricornis Cornu), Qingmuxiang (Aucklandiae Radix), Juapi (Citri Reticulatae Pericarpium), Xingren (Prunus Armeniacae Semen Amarum), Shengma (Cimicifugae Rhizoma) (each 1 liang); Shengjiang (Zingiberis Rhizoma Recens) (5 liang), Duohuo (Angelicae Pubescentis Radix) (3 liang), Wu Zhu Yu (Evodiae Fructus) (1 sheng).
The above seventeen ingredients are coarsely crushed. Decoct with 12 sheng of water until 4 sheng remains. Divide into five doses. The interval between doses should be approximately the time it takes to walk 20 li. During this interval, consume a small amount of rice porridge to support Stomach Qi. This decoction is administered over two days per course (ji). Continue until pathogenic qi recedes, adjusting according to clinical judgment. If heat is excessive with panting and irritability, add Shigao (Gypsum Fibrosum) 6 liang and Sheng Maidong (Ophiopogonis Radix) 1 sheng, and remove Wu Zhu Yu (Evodiae Fructus). If there is hardness below the heart (epigastrium), add Biejia (Testudinis Carapax et Plastrum) 1 liang.
Generally, Hongjiao (Foot Qi/Beriberi) originated in the Lingnan region and later spread to Jiangdong. Onset is often insidious. Symptoms may include mild pain and numbness, swelling and fullness in both calves, difficulty initiating gait with weakness, upward invasion causing abdominal numbness, alternating chills and fever, constipation and difficult urination, wheezing with qi rushing to the throat, severe dyspnea feeling like suffocation, inability to keep food down due to vomiting, and rebellious qi rising. These are all characteristic signs. If these syndromes are perceived, first administer the Xijiao Xuanfuhua Tang (Rhino Horn and Inula Flower Decoction) (formula listed below).