治风寒湿痹，皮肉不仁，骨髓疼痛，不可忍者。
天雄（炮，去皮脐，一两） 附子（炮，去皮脐，一两） 官桂（去皮，一两半） 干
姜（炮，二两） 防风（去叉，三两）
上为细末，炼蜜和丸，如梧桐子大，每服二十丸，食前用温酒送下。
治风寒湿痹留着不去，四肢痒麻，拘挛浮肿。
赤茯苓（去皮） 桑白皮（各二两） 防己 官桂（去皮） 川芎
芍药 麻黄（去根节，先煮，掠去沫，焙干） 当归（以上各一两半） 甘草（炙，三
两）
上 咀，每服六钱，水二盏，枣三枚，去核煎至一盏，去滓，空心临睡服。如欲出汗，
服药了以生姜热粥投之，汗出慎外风。一方去防己，用防风。
夫香港脚者，有南北之分。孙真人云∶凡四时之中，皆不得久坐久立湿冷之地，亦不得因
酒醉而为脱衣跣足，当风取凉，皆成香港脚。若暑月久坐久立湿冷之地者，则湿冷之气蒸人经
络，病发必热而四肢酸疼，烦闷；若寒月久坐久立湿冷地者，则湿冷之气上入经络，病发则
四肢皆为转筋。世有勤工学之士，久坐久立于湿地，冷风来入经络，不觉成病也。《内经》
曰∶当风取凉，醉以入房，能成此疾也。东垣云∶《千金》《外台》《总录》所录，皆系南
方卑湿，雾露所聚之地。其民腠理疏，阳气不能外固，因而履之，则清湿袭虚，病起于下。
此由血气衰弱，受清湿之邪气，与血并行肤腠，邪气盛，正气少，故血气涩。涩则痹，虚则
弱，故令痹弱也，后人名曰香港脚。《针经》云∶有道以来，有道以去，治之多以艾 为佳，
以导引湿气出外，及饮醪醴以通经散邪。所制之方，寒药少，热药多，用麻黄川乌姜附之属
。《内经》云∶湿淫于内，以苦发之，麻黄苦温，发散者也，川乌辛热，走而不能守，通行
经络，姜附辛甘大热，助阳退阴，亦散清热之邪。又察足之三阴三阳 ，是何经络所起，以
引用药为主治。更审六气，何气客之，治以佐使之药。《医学发明》曰∶《异法方宜论》云
，北方者，其地高陵，居风寒冰冽，其俗饮 酪而肉食。凡饮 酪者，以饮多速饮为能。经
曰∶因而大饮则气逆。又云∶食入于阴，行气为阳，乃反阴道是为逆也。夫乳酪醇酒者，湿
热之物，饮之属也。加以奉养太过，亦滋其湿，水性润下，气不能煦，故下注于足胫，积久
而成肿满疼痛。此饮食下流之所致也。《通评虚实论》曰∶谷入多而气少，湿居下也，况
酪醇酒之湿热蓄于谷者也？《至真要大论》云∶太阴之胜，火气内菀，流散于外，足胫 肿
，饮发于中， 肿于下，此之谓也。故饮入于胃，游溢精气，上输于脾，脾气散精，上归于
肺，通调水道，下输膀胱，水精四布，五经并行，合于四时五脏阴阳，揆度以为常也。若饮
食自倍，脾胃乃伤，则胃气不能施行，脾气不能四布，故下流乘其肝肾，湿流于足胫，加之
房事不节，阳虚阴盛，遂成香港脚。孙真人云∶古人少有此疾，自永嘉南渡，衣冠之人多有之。
亦此意也。东垣云∶夫香港脚之疾，实水湿之所为也。盖湿之害人皮肉筋脉而属于下，然亦有
二焉∶一则自外而感，一则自内而致。南方之疾，自外而感者也。北方之疾，自内而致者也
。其治法自应不同，故诸公详析而论之。严氏曰∶古无香港脚之说，《内经》名厥，两汉名缓
风，后谓之香港脚，名虽不同，其实一也。初得不觉，因他病乃始发，或奄然大闷，经三两日
方觉之，先从脚起，或缓弱疼痹，或行起忽倒，或两胫肿满，或足膝枯细，或心中忪悸，或
小腹不仁，或举体转筋，或见食吐逆，恶闻食气，或胸满气急，或遍体酸疼，此其候之不同
也，其脉浮而弦者起于风，濡而弱者起于湿，洪而数者起于热，迟而涩者起于寒。凡此皆由
肾虚而生。然妇人亦病香港脚者，必因血海虚，乘七情，遂成斯疾。且妇人病此者众，皆因血
海虚而得之，与男子肾虚相类矣。男女用药固无异，但兼以治忧恚之药，无不效也。须量人
盛衰，微加滋补，不然则气血日衰，必使年年遇蒸热而作，理之必然，陈无择曰∶香港脚不专
主一气，亦不专在一经，故与中风寒暑湿为异耳。兼有所杂生诸病，未易分别，须寻三阴三
阳病所在后，察脉虚实为治。《发明》曰∶《内经》论南方者，其地下，水土弱，雾露之所
聚也。江东岭南，大率如此。春夏之交，山川蒸菀，风湿毒瓦斯为甚，感之遂成瘴毒香港脚。《
外台秘要》云∶第一忌嗔，嗔则心烦，烦则香港脚发。又禁大语，大语则伤肺，肺伤亦发动。
又不得露足当风，冷水洗足，虽夏月常须闭护，慎之慎之，《发明》曰∶第一凡酒及 酪勿
使过度，过度则损伤脾胃，下注于足胫 肿，遂成香港脚。第一欲不可纵，嗜欲则香港脚发。凡
饮食之后宜缓行，经云∶逸者行之。又云∶病在脾，忌温食饱食，湿地濡衣。杨大受云∶脚
气之疾，自古皆当疏下，为疾壅故也。然不可太过，则损伤脾胃，使营运之气，不能上行，
反下注为香港脚也。又不可不及，不及则使气壅不得消散，立方于后，详虚实而用之。羌活导
滞汤、导水丸、除湿丹，此药如香港脚在表在气血之分而疏下，随宜而用之。《活人书》云∶
凡香港脚服补药及用汤渫洗者，皆医之大禁也。杨大受云∶香港脚是为壅疾，当以宣通之剂，使
气不能成壅也，壅既成而盛者，砭恶血而去其重势。经曰∶蓄则肿热，砭射之也。夫前代各
人所论，其香港脚所感不一，有在表而得之，有在气血之分而得之，或从风寒暑湿得之，或因
虚实而得之，在乎医者诊视果决而治之。
治疗风寒湿邪侵袭经络导致的痹证，表现为皮肤肌肉麻木不仁，骨髓深处疼痛，痛苦难以忍受。
天雄（炮制，去皮和脐部，一两） 附子（炮制，去皮和脐部，一两） 官桂（去皮，一两半） 干姜（炮制，二两） 防风（去除叉枝，三两）
以上药物研成细末，用炼蜜调和制成丸药，大小如梧桐子，每次服用二十丸，饭前用温酒送服。
治疗风寒湿邪滞留体内不去，导致四肢瘙痒麻木，筋脉拘挛浮肿。
赤茯苓（去皮） 桑白皮（各二两） 防己 官桂（去皮） 川芎 芍药 麻黄（去除根节，先煎煮，撇去浮沫，焙干） 当归（以上药材各一两半） 甘草（炙，三两）
以上药物切碎，每次取六钱，加水两盏，去核的大枣三枚，煎煮至一盏水，滤去药渣，空腹及睡前服用。如果希望发汗，服药后喝生姜热粥以助汗出，出汗后注意避免外风侵袭。另一配方去掉防己，改用防风。
所谓香港脚（脚气病），有南方和北方的区别。孙思邈说：四季之中，都不应长时间坐或站在潮湿寒冷的地方，也不应在醉酒时脱衣赤脚，迎风乘凉，这些都会导致香港脚。如果在暑天长时间坐或站在潮湿寒冷的地方，湿冷之气会熏蒸人的经络，发病时必然发热且四肢酸痛、烦闷；如果在寒天长时间坐或站在潮湿寒冷的地方，湿冷之气会上入经络，发病时四肢都会发生转筋（抽筋）。世间那些勤奋读书的士人，因久坐久立于湿地，冷风侵入经络，不知不觉就形成了疾病。《黄帝内经》说：迎风乘凉，醉酒后行房事，能形成这种疾病。李东垣说：《千金方》《外台秘要》《太平圣惠方总录》中记载的，都是指南方低洼潮湿、雾露聚集的地方。那里的百姓腠理疏松，阳气不能在外固护，因此接触湿气，清湿之邪侵袭虚处，疾病起于下部。这是由于血气衰弱，受到清湿邪气的侵袭，邪气与血液并行于皮肤腠理之间，邪气盛而正气少，所以气血运行涩滞。涩滞则形成痹证，虚弱则身体软弱，所以称为痹弱，后人称之为香港脚。《灵枢·针经》说：有道路来就有道路去，治疗多用艾灸为佳，以引导湿气排出体外，并饮用醪醴（米酒）以疏通经络、驱散邪气。所制定的方剂，寒性药少，热性药多，使用麻黄、川乌、干姜、附子之类的药物。《黄帝内经》说：湿邪淫溢于内，应用苦味药发散，麻黄味苦性温，具有发散作用；川乌味辛性热，走窜而不能守静，通行经络；干姜、附子味辛甘大热，助阳退阴，也能驱散清热之邪。另外观察足部的三阴经和三阳经，是哪条经络起始受病，以此作为引经药的主治方向。再审视六气，是何种邪气客居，用佐使药进行治疗。《医学发明》说：《素问·异法方宜论》提到，北方地区地势高陵，居住在此的人常受风寒冰冽之苦，习俗是饮用乳酪和食用肉类。凡是饮用乳酪的人，以多喝速饮为能事。经书说：因此大量饮水会导致气机上逆。又说：食物进入阴分，化生阳气运行，反而违背了阴道的规律，这就是逆。乳酪和醇酒属于湿热之物，饮用它们属于“饮”类。加上供养太过，也会滋生湿气，水性润下，阳气不能温煦，所以湿气下注于足胫，积久而成肿胀疼痛。这是饮食下流所致。《素问·通评虚实论》说：谷食摄入多而正气少，湿气居于下部，何况乳酪醇酒的湿热蓄积在谷食之中呢？《素问·至真要大论》说：太阴湿土胜复之时，火气郁结在内，流散于外，导致足胫肿胀，水饮发于中，水肿在下，说的就是这种情况。所以水饮进入胃中，游溢精气，上输于脾，脾气散布精微，上归于肺，通调水道，下输膀胱，水精四布，五经并行，符合四时五脏阴阳的规律，以此作为常态。如果饮食加倍，脾胃就会受伤，那么胃气不能施行，脾气不能四布，所以下流侵犯肝肾，湿气流注于足胫，再加上房事不节制，阳虚阴盛，于是形成香港脚。孙思邈说：古人很少有这种病，自从永嘉南渡以来，士大夫阶层中多有此病。也是这个意思。李东垣说：香港脚这种疾病，确实是水湿造成的。大概湿气伤害人的皮肉筋脉而病位在下，然而也有两种情况：一种是从外部感受，一种是从内部产生。南方的疾病，是从外部感受的。北方的疾病，是从内部产生的。治疗方法自然应该不同，所以各位医家详细分析并论述了这一点。严用和说：古代没有香港脚的说法，《黄帝内经》称为厥，两汉时期称为缓风，后来称为香港脚，名称虽然不同，实质是一样的。刚得病时不觉察，因为其他疾病才发作，或者突然感到极度烦闷，经过两三天才察觉，病先从脚起，有的缓慢虚弱疼痛麻木，有的行走时突然跌倒，有的双小腿肿胀，有的足膝枯瘦细小，有的心中悸动不安，有的小腹麻木不仁，有的全身抽筋，有的见食呕吐逆反，厌恶闻食物的气味，有的胸满气急，有的遍体酸痛，这些是症状的不同表现。其脉象浮而弦的起于风邪，濡而弱的起于湿邪，洪而数的起于热邪，迟而涩的起于寒邪。凡此种种皆由肾虚而生。然而妇女也患香港脚的，必定是因为血海空虚，受到七情刺激，于是形成此病。况且妇女患此病者众多，都是因为血海空虚而得的，与男子的肾虚相似。男女用药固然没有不同，但兼用治疗忧恚的药物，没有不有效的。必须衡量人体的盛衰，稍微加以滋补，否则气血日渐衰弱，必然导致每年遇到蒸热天气就发作，这是理所当然的。陈无择说：香港脚不专门主于一气，也不专门局限于一经，所以与中风、寒、暑、湿有所不同。兼有其他杂病产生，不容易分别，必须寻找三阴三阳病所在的部位后，观察脉象虚实进行治疗。《医学发明》说：《黄帝内经》论述南方地区，地势低下，水土薄弱，是雾露聚集的地方。江东、岭南地区，大体如此。春夏之交，山川湿热郁蒸，风湿毒瓦斯严重，感之遂成瘴毒香港脚。《外台秘要》说：第一忌讳发怒，发怒则心烦，心烦则香港脚发作。又禁止大声说话，大声说话则伤肺，肺伤也会诱发此病。又不能露出双脚当风，或用冷水洗脚，即使在夏天也必须小心保护，慎之又慎。《医学发明》说：第一，酒及乳酪不要过度饮用，过度则损伤脾胃，湿气下注于足胫肿胀，遂成香港脚。第二，性欲不可放纵，嗜欲则香港脚发作。凡饮食之后宜缓步慢行，经书说：安逸的人应当运动。又说：病在脾，忌温食饱食，忌穿潮湿的衣服。杨大受说：脚气病，自古以来都应当采用疏下法治疗，因为疾病壅滞的缘故。然而不可太过，否则会损伤脾胃，使营运之气不能上行，反而下注成为香港脚。也不可不及，不及则使气机壅滞不得消散，立方如下，根据虚实情况选用。羌活导滞汤、导水丸、除湿丹，这些药适用于香港脚在表、在气血分的情况，通过疏下法治疗，随宜选用。《伤寒百问歌》（活人书）说：凡香港脚服用补药及使用汤药淋洗的，都是医家的重大禁忌。杨大受说：香港脚是壅滞之疾，应当用宣通的药剂，使气机不成壅滞。如果壅滞已经形成且势盛，需用砭石刺破排出恶血以去除重势。经书说：气血蓄积则肿热，需用砭石刺射治疗。前代各位医家所论述的，香港脚的感受途径不一，有的在表而得之，有的在气血之分而得之，或从风寒暑湿得之，或因虚实而得之，关键在于医者诊视果决并正确治疗。
To treat Bi syndrome (obstructive syndrome) caused by Wind-Cold-Dampness, characterized by insensitivity of the skin and flesh, severe pain in the bone marrow that is unbearable.
Tianxiong (Radix Aconiti Kusnezoffii Preparata, processed, peel and umbilicus removed, 1 liang) Fuzi (Radix Aconiti Lateralis Preparata, processed, peel and umbilicus removed, 1 liang) Guigui (Cortex Cinnamomi Preparata, peel removed, 1.5 liang) Ganjiang (Rhizoma Zingiberis Preparata, processed, 2 liang) Fangfeng (Radix Saposhnikoviae, remove forked branches, 3 liang)
Grind the above into a fine powder, mix with refined honey to make pills, size of Sophora japonica seeds. Take 20 pills per dose, administered before meals with warm wine.
To treat Wind-Cold-Dampness lingering in the body without dispersal, causing itching and numbness in the four limbs, spasms, and edema.
Chifuling (Poria cocos with Red Peel, peel removed) Sangbaipi (Cortex Mori Radicis, each 2 liang) Fangji (Radix Stephaniae Tetrandrae) Guigui (Cortex Cinnamomi Preparata, peel removed) Chuanxiong (Rhizoma Chuanxiong) Shaoyao (Radix Paeoniae Alba seu Rubra) Mahuang (Herba Ephedrae, remove roots and joints, decoct first, skim off foam, dry by baking) Danggui (Radix Angelicae Sinensis, each of the above 1.5 liang) Gancao (Radix Glycyrrhizae Preparata, honey-fried, 3 liang)
Cut the above ingredients coarsely. For each dose, take 6 qian, add two zhan of water and three dates (pitted), decoct until one zhan remains, filter out the dregs, and take on an empty stomach and before sleep. If sweating is desired, after taking the medicine, drink hot porridge with ginger to induce sweat; be careful to avoid external wind after sweating. Another prescription removes Fangji and uses Fangfeng instead.
Regarding Hong Kong Jiao (Jiaogqi / Foot Qi disease), there is a distinction between the South and the North. Sun Simiao stated: In all four seasons, one must not sit or stand for long periods in damp and cold places, nor should one strip naked and barefoot to cool off in the wind while drunk. All these actions can lead to Hong Kong Jiao. If one sits or stands for long periods in damp and cold places during the summer months, the damp-cold qi steams through the meridians, causing the disease to manifest with fever, soreness and pain in the four limbs, and restlessness. If one sits or stands for long periods in damp and cold places during the winter months, the damp-cold qi enters the meridians from above, causing the disease to manifest with spasms (charley horse) in the four limbs. Scholars who study diligently often sit or stand for long periods on wet ground; when cold wind enters the meridians unnoticed, the disease forms. The *Neijing* states: Cooling off in the wind and engaging in sexual activity after drunkenness can cause this disease. Li Dongyuan stated: The records in *Qianjin Fang*, *Waitai Miyao*, and *Zonglu* refer to southern regions that are low-lying and damp, where fog and dew accumulate. The people there have loose interstices (couli), and their Yang qi cannot secure the exterior. Consequently, when they encounter dampness, clear-damp pathogens attack the deficiency, and the disease arises from below. This is due to weakened blood and qi, which are invaded by clear-damp pathogens. The pathogens run parallel with the blood in the skin and interstices. When pathogens are strong and healthy qi is weak, blood and qi become stagnant. Stagnation leads to Bi syndrome, and weakness leads to debility, hence it is called "Bi Ruo" (Bi and Weakness), later named Hong Kong Jiao. The *Zhenjing* (Needling Classic) states: What has come by a path can go by a path. Treatment mostly favors moxibustion to guide dampness outwards, and drinking Lao Li (fermented rice wine) to unblock meridians and scatter pathogens. The prescribed formulas contain few cold-natured herbs and many hot-natured ones, using herbs such as Mahuang, Chuanwu, Jiang, and Fu. The *Neijing* states: When dampness overflows internally, use bitter herbs to disperse them. Mahuang is bitter and warm, possessing dispersing properties; Chuanwu is acrid and hot, moving freely but not retaining, unblocking the meridians; Jiang and Fu are acrid, sweet, and greatly hot, assisting Yang and retreating Yin, also scattering heat-clearing pathogens. Furthermore, observe which of the Foot Three Yin and Three Yang meridians is affected, using this as the guiding herb for treatment. Examine the Six Qi to determine which pathogen is invading, and treat with assistant and envoy herbs. *Yixue Faming* states: The *Yifang Fangyi Lun* chapter of the *Neijing* mentions that in the North, the terrain is high and hilly, and the inhabitants live in cold, windy, and icy conditions, with customs involving drinking milk curds and eating meat. Those who drink milk curds do so quickly and in large amounts. The classics state: Drinking excessively causes Qi to rebel upwards. It also says: Food enters the Yin, transforms into Qi and moves as Yang, thereby reversing the course of Yin. Milk curds and strong wine are damp-heat substances; drinking them belongs to the category of "drinks." Coupled with excessive nourishment, this generates dampness. Water nature flows downward; if Yang Qi fails to warm, dampness sinks to the lower legs, accumulating over time to form swelling, fullness, and pain. This results from dietary fluids flowing downward. The *Tongping Xuushi Lun* states: When grain intake is high but Qi is low, dampness resides below. How much more so when the damp-heat of milk curds and strong wine accumulates within the grain? The *Zhiyun Yao Da Lun* states: When Taiyin wins, Fire Qi stagnates internally and flows outward, causing swelling of the lower legs, fluid retention internally, and edema below. This is what is meant. Thus, when drinks enter the Stomach, their essence floats and overflows, uploading to the Spleen. The Spleen scatters the essence, sending it up to the Lung. The Lung regulates the water passages, downloading to the Bladder. Water essence distributes in all directions, running through the Five Meridians, conforming to the Yin-Yang of the Four Seasons and Five Zang organs, serving as the norm. If food and drink double, the Spleen and Stomach are injured. Then Stomach Qi cannot perform its functions, and Spleen Qi cannot distribute in all directions, so it flows downward, attacking the Liver and Kidney. Dampness flows to the lower legs. Added to irregular sexual activity, leading to Yang deficiency and Yin excess, Hong Kong Jiao is formed. Sun Simiao said: Ancients rarely had this disease; since the southward migration during the Yongjia era, many among the gentry suffered from it. This is also the meaning. Li Dongyuan said: Hong Kong Jiao is truly caused by water and dampness. Generally, dampness harms the skin, flesh, tendons, and vessels, with the pathology located below. However, there are two types: one contracted externally, and one generated internally. Southern diseases are contracted externally. Northern diseases are generated internally. Their treatments should naturally differ, which is why various experts analyzed and discussed them in detail. Yan Shi said: There was no concept of Hong Kong Jiao in ancient times. The *Neijing* called it Jue, the Two Han dynasties called it Huan Feng (Sluggish Wind), and later it was called Hong Kong Jiao. Although the names differ, the essence is the same. Initially, there is no sensation; it manifests only due to other illnesses, or suddenly becomes extremely stifling, becoming apparent after two or three days. It starts from the feet. Symptoms may include slow weakness, pain, and numbness; sudden collapse while walking; swelling of both calves; withered and thin foot and knees; palpitations; insensitivity of the lower abdomen; whole-body spasms; vomiting upon seeing food or aversion to the smell of food; chest fullness and shortness of breath; or generalized soreness and pain. These are the different manifestations. Pulse floating and wiry indicates origin from Wind; pulse soggy and weak indicates origin from Damp; pulse surging and rapid indicates origin from Heat; pulse slow and choppy indicates origin from Cold. All these arise from Kidney deficiency. However, women also suffer from Hong Kong Jiao, necessarily due to emptiness of the Blood Sea (Chong and Ren meridians), compounded by emotional disturbances, leading to this disease. Moreover, many women suffer from this because of Blood Sea emptiness, similar to Kidney deficiency in men. The medication for men and women is fundamentally the same, but adding herbs to treat sorrow and resentment ensures efficacy. One must assess the person's strength and weakness, adding slight tonification; otherwise, Qi and blood will decline daily, inevitably causing recurrence every year during hot and humid weather, which is logical. Chen Wuyue said: Hong Kong Jiao does not focus solely on one Qi, nor is it confined to one meridian, thus differing from Zhong Feng (Wind Stroke), Cold, Summerheat, and Dampness. When complicated by various other diseases, it is difficult to distinguish; one must locate the disease in the Three Yin and Three Yang meridians, then examine the pulse for deficiency or excess to guide treatment. *Faming* states: The *Neijing* discusses the South as having low terrain, weak water and soil, and accumulation of fog and dew. Jiangdong and Lingnan areas are generally like this. During the transition of Spring and Summer, mountains and rivers steam with damp-heat, making Wind-Damp toxic vapors severe; contracting this leads to Miasma-Toxic Hong Kong Jiao. *Waitai Miyao* states: First, avoid anger. Anger causes heart vexation; vexation triggers Hong Kong Jiao attacks. Second, avoid loud talking. Loud talking injures the Lung; Lung injury also triggers the disease. Third, do not expose feet to wind or wash them with cold water. Even in summer, one must keep them protected. Be very cautious. *Faming* states: First, do not consume alcohol and milk curds excessively. Excess damages the Spleen and Stomach, causing dampness to sink to the lower legs and swell, forming Hong Kong Jiao. Second, do not indulge in desires. Indulgence triggers Hong Kong Jiao attacks. After eating, one should walk slowly. The classics say: Those who are idle should move. It also says: When the disease is in the Spleen, avoid warm foods, overeating, and wearing damp clothes. Yang Dashou said: Since ancient times, Jiaogqi (Foot Qi) has always been treated with purgative methods because of the obstruction. However, it must not be too aggressive, as this damages the Spleen and Stomach, preventing the transport and transformation Qi from ascending, causing it to sink downward and become Hong Kong Jiao. Nor should it be insufficient; insufficiency leaves Qi obstructed and unable to dissipate. The following formulas are provided, to be used according to deficiency or excess: Qianghuo Daozhi Tang, Daoshui Wan, Chushi Dan. These medicines are used for purgation when Hong Kong Jiao is at the surface or in the Qi and Blood levels, applied as appropriate. *Huren Shu* states: Using tonic medicines or herbal baths for Hong Kong Jiao are major prohibitions for physicians. Yang Dashou said: Hong Kong Jiao is an obstructive disease; it should be treated with dispersing and unblocking agents to prevent Qi obstruction. If obstruction is already established and severe, use Bian stone (lithotripsy/bleeding therapy) to drain evil blood and reduce the severe condition. The classics state: Accumulation leads to swelling and heat; use Bian stone to pierce and drain. The discussions by predecessors vary regarding the etiology of Hong Kong Jiao: some contract it at the surface, some in the Qi and Blood levels, some from Wind, Cold, Summerheat, and Dampness, and some from deficiency or excess. It depends on the physician's decisive diagnosis and treatment.