狐尿刺生手足间，闷肿 痛红紫斑，螳螂精尿流积毒，误触肌肤痛不眠。
【注】此证《大成》书名狐狸刺，《外台》、《总录》二书名狐尿刺。由螳螂盛暑交媾，
精汁染于诸物，干久有毒，人手足误触之，则成此患。初起红紫斑点，肌肤干燥，闷肿
痛，不眠，十日后腐开，疮口日宽。内宜服黄连解毒汤，外以蒲公英连根浓煎温洗，若
得鲜蒲公英，捣汁涂患处更佳。盖螳螂又名野狐鼻涕，此证取名。盖本于此。将溃治法，
按痈疽溃疡门
\r狐尿刺图\p04-34a172.bmp\r
黄连解毒汤（见耳部黑疔）
鹅掌风生掌心间，皮肤燥裂紫白斑，杨梅余毒血燥热，兼受风毒凝滞源。
【注】此证生于掌心，由生杨梅余毒未尽，又兼血燥，复受风毒，凝滞而成。初起紫白
斑点，叠起白皮，坚硬且浓，干枯燥裂，延及遍手。外用二矾散洗之，三油膏擦之，内
用祛风地黄丸料，加土茯苓、白鲜皮、当归为佐，作丸服之其效。若年久成癣难愈。又
有不因杨梅后，无故掌心燥痒起皮，甚则枯裂微痛者，名掌心风。由脾胃有热，血燥生
风，血不能荣养皮肤而成。宜服祛风地黄丸，外用润肌膏，久久擦之即愈。
\r鹅掌风图\p04-34a173.bmp\r
祛风地黄丸
生地 熟地（各四两） 白蒺藜 川牛膝（酒洗，各三两） 知母 黄柏 枸杞子（各二两） 菟丝
子（酒制） 独活（各一两）
共研末，炼蜜和丸，如梧桐子大。每服三钱，黄酒送下，夏月淡盐汤下。
【方歌】祛风地黄除血热，鹅掌风生服即瘥，知柏蒺藜牛膝菟，独杞同研炼蜜和。
二矾散
白矾 皂矾（各四两） 儿茶（五钱） 侧柏叶（八两）
水十碗，煎数滚听用。先以桐油搽患处，再用纸捻桐油浸透，火点向患处熏片时；次
用前汤，乘热贮净木桶内，手架桶上，以布将手连桶口盖严，汤气熏手勿令泄气；待微
热将汤倾入盆内，蘸洗良久，一次即愈。七日切不可见水。
【方歌】二矾掌起紫白斑，矾与儿茶柏叶煎，先以桐油搽患处，油捻燃熏后洗痊。
三油膏
牛油 地沥青 香油 银朱（各一两） 官粉 麝香（研细、各二钱）
将三油共合火化，入黄蜡一两，溶化尽离火；再入朱、麝、官粉等末，搅匀成膏。搽
患处，火烘之，以油干滋润为度。
【方歌】三油膏润鹅掌风，初斑渐裂燥痒攻，牛柏香油朱粉麝，蜡熬擦患火上烘。
润肌膏（见头部白屑风）
狐尿刺生于手足之间，表现为闷胀、肿胀、疼痛、发红及出现紫黑色斑点。此病由螳螂在盛夏交配时排出的精液积聚成毒，人体手足误触其毒物后，导致肌肤受损，疼痛剧烈以致无法入睡。
【注释】此证在《外科大成》中称为“狐狸刺”，在《外台秘要》和《医宗金鉴·外科心法要诀》（简称《总录》）中称为“狐尿刺”。病因是螳螂在盛暑时节交媾，其精汁沾染在各类物体上，干燥日久产生毒性，人手足误触后即引发此病。初起时可见红紫色斑点，肌肤干燥，伴有闷肿疼痛，导致失眠；十日后疮面溃烂腐坏，疮口日渐扩大。内治宜服用黄连解毒汤，外用蒲公英连根浓煎，趁温热清洗患处；若能获得新鲜蒲公英，捣取汁液涂抹患处效果更佳。盖因螳螂又名“野狐鼻涕”，此病因此得名，本源于此说法。对于即将溃破时的治疗方法，参照痈疽溃疡门的相关记载。
狐尿刺图\p04-34a172.bmp\r
鹅掌风生于掌心部位，表现为皮肤干燥开裂，出现紫白色斑点。此病多因患杨梅疮（梅毒）后余毒未尽，加之血燥生热，又兼受风毒侵袭，致使气血凝滞所致。初起时可见紫白斑点，层层叠起白色皮屑，质地坚硬且增厚，干枯枯燥并发生裂口，病情可蔓延至整个手掌。外治可用二矾散清洗患处，再用三油膏擦拭；内服祛风地黄丸的方药，加入土茯苓、白鲜皮、当归作为辅助药物，制成丸剂服用，疗效显著。若病程长久演变为癣症，则难以治愈。此外，还有并非因杨梅疮后遗症引起，而是无故出现掌心干燥瘙痒、脱皮，甚至干枯开裂伴轻微疼痛者，称为“掌心风”。此乃因脾胃有热，血燥生风，血液不能濡养皮肤所致。适宜服用祛风地黄丸，外用润肌膏，长期擦拭即可痊愈。
鹅掌风图\p04-34a173.bmp\r
祛风地黄丸
生地 熟地（各四两） 白蒺藜 川牛膝（酒洗，各三两） 知母 黄柏 枸杞子（各二两） 菟丝子（酒制） 独活（各一两）
共研为细末，用炼蜜调和制成丸剂，大小如梧桐子。每次服用三钱，用黄酒送服，夏季用淡盐汤送服。
【方歌】祛风地黄除血热，鹅掌风生服即瘥，知柏蒺藜牛膝菟，独杞同研炼蜜和。
二矾散
白矾 皂矾（各四两） 儿茶（五钱） 侧柏叶（八两）
用水十碗，煮沸数次备用。先用桐油涂抹患处，再用纸捻浸透桐油，点燃后向患处熏烤片刻；接着用前述药汤，趁热存入干净的木桶中，将手架在桶口上方，用布将手连同桶口严密遮盖，利用药气熏蒸双手，切勿漏气；待药汤微温时，将其倒入盆中，浸泡洗手良久，一次即可痊愈。七日内切不可接触生水。
【方歌】二矾掌起紫白斑，矾与儿茶柏叶煎，先以桐油搽患处，油捻燃熏后洗痊。
三油膏
牛油 地沥青 香油 银朱（各一两） 官粉 麝香（研细，各二钱）
将三种油共同加热熔化，加入一两黄蜡，完全溶化后离火；再加入朱砂、麝香、官粉等粉末，搅拌均匀制成膏状。涂抹于患处，用火烘烤，以油干滋润为度。
Fox Urine Thorn (Hú Niào Cì) arises between the hands and feet, presenting with stifling swelling, pain, redness, and purple-black macules. This condition is caused by the accumulation of toxic fluid from mantises mating in midsummer; when human hands or feet accidentally touch these contaminated objects, the skin is damaged, causing severe pain that prevents sleep.
[Note] In *Waike Dacheng* (Comprehensive Treatise on Surgery), this condition is named "Fox Thorn" (Hú Lí Cì); in *Waitai Miyao* (Essential Prescriptions of the Imperial Library) and *Zonglu* (General Records), it is named "Fox Urine Thorn" (Hú Niào Cì). The etiology involves mantises copulating during the height of summer, their seminal fluid staining various objects, which becomes toxic after drying for a long time. Accidental contact by human extremities induces this disease. Initially, red-purple spots appear, the skin is dry, accompanied by stifling swelling and pain leading to insomnia. After ten days, the lesion ulcerates and necrotizes, with the wound widening daily. Internal treatment should involve taking Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity). Externally, prepare a strong decoction of Dandelion (Taraxaci Herba) including roots, and wash the affected area while warm. If fresh Dandelion is available, crushing it to extract juice for application yields better results. The name derives from the fact that the mantis is also known as "Wild Fox Nasal Discharge," hence the nomenclature. For management prior to ulceration, refer to the section on Ulcerative Sores and Carbuncles.
Fox Urine Thorn Image \p04-34a172.bmp\r
Huanglian Jiedu Tang (See Black Boil of the Ear Section)
Goose Palm Wind (É Zhǎng Fēng) arises in the palm, characterized by dry, cracked skin presenting with purple and white macules. This condition often results from residual toxins of Yangmei Chuang (Syphilitic Chancre) not fully cleared, combined with blood dryness generating heat, and further complicated by wind-toxin invasion, leading to qi and blood stagnation. Initially, purple-white spots appear, with layers of white scales rising, becoming hard and thickened, dry, brittle, and fissured, potentially spreading across the entire hand. Externally, wash the affected area with Er Fan San (Two Alum Powder) and apply San You Gao (Three Ointment). Internally, use the formula for Qufeng Dihuang Wan (Wind-Expelling Rehmannia Pill) modified with Tufuling (Smilacis Glabrae Rhizoma), Baixianpi (Dictamni Cortex), and Danggui (Angelicae Sinensis Radix) as adjuvants, processed into pills for administration, which proves effective. If the condition persists for years and evolves into tinea (xuǎn), it becomes difficult to cure. Additionally, there are cases not resulting from syphilis sequelae, where the palm inexplicably becomes dry, itchy, and scaly, progressing to dry cracking with mild pain, termed "Palm Wind" (Zhǎng Xīn Fēng). This is due to heat in the spleen and stomach, blood dryness generating wind, and blood failing to nourish the skin. It is suitable to take Qufeng Dihuang Wan externally with Runji Gao (Moisturizing Skin Ointment), applying it over time until healing occurs.
Goose Palm Wind Image \p04-34a173.bmp\r
Qufeng Dihuang Wan (Wind-Expelling Rehmannia Pill)
Shengdi (Rehmanniae Radix Recens) and Shudi (Rehmanniae Radix Preparata) (each 4 liang), Bajieli (Tribuli Fructus), Chuan Niuxi (Achyranthis Bidentatae Radix, washed in wine) (each 3 liang), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Gouqizi (Lycii Fructus) (each 2 liang), Tusizi (Cuscutae Semen, prepared in wine), Du Huo (Angelicae Pubescentis Radix) (each 1 liang).
Grind all ingredients into fine powder, mix with refined honey to form pills the size of sophora seeds. Take 3 qian per dose, administered with yellow wine; in summer, administer with light salt water.
[Pill Formula Song] Qufeng Dihuang clears blood heat, Goose Palm Wind heals upon ingestion, Zhi Mu, Huang Bai, Ji Li, Niu Xi, Tu Si Zi, Du Huo and Gou Qi are ground together and mixed with refined honey.
Er Fan San (Two Alum Powder)
Baifan (Alumen) and Zaofan (Melanterite) (each 4 liang), Ercha (Catechu) (5 qian), Ce Baiye (Biota Top Swath Leaf) (8 liang).
Boil in ten bowls of water until simmering several times, then set aside. First, apply Tung Oil (Verniciae Folii Oleum) to the affected area. Then, soak a paper wick in tung oil, ignite it, and fumigate the affected area for a period. Next, pour the aforementioned hot decoction into a clean wooden bucket. Place hands over the bucket opening, cover tightly with cloth to prevent steam leakage, and fumigate the hands with the medicinal vapor. When the liquid cools slightly, pour it into a basin and soak/wash the hands for an extended period; one session may suffice. Strictly avoid contact with plain water for seven days.
[Pill Formula Song] Two Alums treat purple-white spots on palms, Alum, Catechu, and Biota leaves are boiled, first apply tung oil to the lesion, fumigate with oiled wick before washing cures.
San You Gao (Three Ointment)
Niuyou (Bovis Caudalis Adipis), Diqingli (Bitumen), Xiangyou (Sesame Oil), Yinzhu (Cinnabar) (each 1 liang), Guanfen (Lead Carbonate), Shexiang (Moschus, finely ground) (each 2 qian).
Melt the three oils together over fire, add 1 liang of Beeswax (Cera Flava), dissolve completely, then remove from heat. Add powders of Cinnabar, Moschus, and Lead Carbonate, stir evenly to form an ointment. Apply to the affected area and bake with fire until the oil dries but the skin remains moist.
[Pill Formula Song] San You Gao moisturizes Goose Palm Wind, initial spots gradually crack with dry itching, Beef fat, Biota, Sesame oil, Cinnabar, Powder, Moschus, wax boiled applied to lesion baked on fire.
Runji Gao (Moisturizing Skin Ointment) (See White Scale Wind of the Head Section)