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。
\r附阴疽图\p04-34a207.bmp\r
内外踝疽湿寒成，血涩气滞阻于经，三阻外侧三阴里，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。
盖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 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。其肿溃法，俱按痈疽肿疡，溃疡门。
\r内踝疽 外踝疽图\p04-34a208.bmp\r
疮科流气饮（见背部痰注发）
内托黄 汤（见股部附骨疽）
内托羌活汤（见臀部上马痈）
十全大补汤（见肿疡门）
乌龙膏（见肿疡门）
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。
\r穿踝疽图\p04-34a209.bmp\r
荆防败毒散（见项部脑疽）
万灵丹（见肿疡门）
附阴疽发生在内踝上方，初起时像红色的粟米，疼痛每日增加，患处坚硬、发红、肿胀，逐渐变得像鸡蛋一样大，这是由于三阴经交会处湿热凝聚所致。
【注】此证生在内踝骨上方三寸处，初起时像红色的粟米，疼痛每日加重，患处坚硬、发红、肿胀，逐渐变得像鸡卵一样大，是由三阴经交会处湿热积聚而成。治疗始终遵循痈疽肿疡和溃疡章节的方法。但三阴交穴属于纯阴之穴，气血收敛迟缓，调养不可不谨慎。
内外踝疽由湿寒之邪形成，导致血液涩滞、气机阻滞于经络中。病变位于外侧的为三阳经所主，位于内侧的为三阴经所主。初起时使用宣通之法，配合蒜片灸法疗效显著。
【注】这两种证候生于两足踝关节靠近手腕（此处指脚踝）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”。因为内踝骨属于三阴经脉络，外踝骨属于三阳经脉络。二者均由湿寒之邪下注，导致血行涩滞、气机阻滞而成。其表现为患处坚硬、弥漫性肿胀，皮色不变，时常隐痛，难以行走站立。初起时内服疮科流气饮加牛膝、木瓜、防己，以宣通气血；外用蒜片灸法以消散肿块。发于三阴经者，服用内托黄芪汤；发于三阳经者，服用内托羌活汤。若患者体虚且即将化脓，出现无休止的跳痛者，均服用十全大补汤，外敷乌龙膏。其消肿溃破的方法，均参照痈疽肿疡、溃疡章节。
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。有头者属阳，表现为闷肿；溃破后流出清水，会导致残疾缠身。
【注】此证由脾经湿寒之邪下注，导致血行涩滞、气机阻滞而成。先从内踝骨发起，串连至外踝，导致内外连通肿胀。若有头者为阳证，容易破溃；若仅闷肿而无头者为阴证，难以溃破。此证初起时有寒热往来，若有红晕兼有热感者，宜服用荆防败毒散；若皮色不变者，服用万灵丹。其余消肿溃破的治疗方法，均与内、外踝疽相同。若溃破后流出清水，或投药无效，病程缠绵日久者，必然成为废疾，难以治愈。
Fu Yin Ju (Attached Yin Abscess) occurs above the medial malleolus. Initially, it resembles a red millet grain, with pain increasing daily. The area 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 arises three cun above the medial malleolus. Initially resembling a red millet grain, the pain increases daily, and the area becomes hard, red, and swollen, eventually resembling a chicken egg. It is formed by the accumulation of damp-heat at the intersection of the three yin meridians. Throughout the treatment, whether internal or external, the methods for abscesses (Yong Ju), swelling ulcers (Zhong Yang), and ulcerated wounds (Kui Yang) are followed. However, Sanyinjiao (SP6, Three Yin Intersection) is a pure yin acupoint where qi and blood converge slowly; therefore, nursing care must be cautious.
Nei Wai Huai Ju (Medial and Lateral Malleolus Abscesses) are caused by damp-cold, leading to sluggish blood flow and qi stagnation obstructing the meridians. Lesions on the lateral side belong to the yang meridians, while those on the medial side belong to the yin meridians. Initially, use promoting circulation methods combined with garlic moxibustion for effective results.
[Note] These two conditions occur near the ankle joints of both feet. The one on the medial malleolus is named "Zou Huan" (Walking Slowness) or "Xie Dai Ju" (Shoelace Abscess); the one on the lateral malleolus is named "Jiao Guai Du" (Ankle Deformity Toxin). This is because the medial malleolus belongs to the network vessels of the three yin meridians, and the lateral malleolus belongs to the network vessels of the three yang meridians. Both are caused by the downward pouring of damp-cold, resulting in sluggish blood and obstructed qi. Their manifestations include hardness, diffuse swelling, unchanged skin color, occasional dull pain, and difficulty in walking or standing. Initially, administer Chuang Ke Liu Qi Yin (Wound Department Flow-Qi Decoction) added with Niuxi (Achyranthis Bidentatae Radix), Mugua (Chaenomelis Fructus), and Fangji (Stephaniae Tetrandrae Radix) to promote circulation; externally apply garlic slice moxibustion to dissipate the swelling. For cases involving the three yin meridians, administer Nei Tuo Huang Qi Tang (Internal Support Astragalus Decoction); for cases involving the three yang meridians, administer Nei Tuo Qiang Huo Tang (Internal Support Notopterygii Decoction). If the patient is weak and pus is about to form, presenting with ceaseless throbbing pain, administer Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) and externally apply Wu Long Gao (Black Dragon Ointment). The methods for reducing swelling and inducing suppuration follow the sections on Zhong Yang (Swelling Ulcer) and Kui Yang (Ulcerated Wound).
Chuan Huai Ju (Piercing Ankle Abscess) is caused by spleen damp-cold. The pathogen originates internally and spreads between the bones of the medial and lateral malleoli. Cases with a head belong to yang and present as stifling swelling; upon suppuration, clear fluid is discharged, leading to chronic disability.
[Note] This condition is caused by the downward pouring of spleen meridian damp-cold, resulting in sluggish blood and obstructed qi. It initially arises from the medial malleolus and spreads to the lateral malleolus, causing swelling connecting the inside and outside. Having a head indicates a yang pattern, which is easy to rupture; only stifling swelling without a head indicates a yin pattern, which is difficult to rupture. Initially, the condition presents with alternating chills and fever. If there is a red halo accompanied by heat, Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction for Overcoming Toxins) should be administered; if the skin color remains unchanged, Wan Ling Dan (Myriad Spirits Pill) should be administered. The remaining methods for reducing swelling and inducing suppuration are the same as those for medial and lateral malleolus abscesses. If clear fluid is discharged after rupture, or if the prescribed formulas are ineffective and the condition lingers for a long time, it will inevitably become a chronic disability and be difficult to treat.