下元气弱因感受，风寒湿热成斯疾，疮积流注亦有之，入腹攻心定难救，总有苍术健步
汤，青陈苍白术瓜当，生地柏连防己入，猪牛龙胆纳槟榔。左尺不应病难全，寸口无常君莫
治，妇人足肿酸麻痛，生地川芎苍柏星，牛膝红花草龙胆，食前煎服便能行。
辨证
两胫肿胀为湿香港脚 宜当归拈痛汤，或五积散，加槟榔、木瓜、青藤、穿山甲。足膝枯
细为干香港脚，宜十全大补汤，加牛膝、木瓜、石南藤、五加皮、没药、川乌。
槟榔散 槟苏散内香苏多，甘草陈皮槟瓜半，和姜葱煎服治香港脚，风湿驱除效若何。
当归拈痛汤 治湿香港脚及骨节疼痛，疮毒等症。
拈痛羌茵甘草苓，归知泽米共猪苓，防风苍术加升葛，还有人参并苦参。首句各一钱，
次句各五分，下二句各四分是也。
防己饮 防己柏苍并白术，槟榔生地川芎没，犀屑草梢通与连，七五三分次第及。内热，
加芩；热甚及暑天，加石膏；大便秘，加桃仁；小便涩，加牛膝、木瓜、薏苡仁；臂痛，加
威灵仙；胁痛，加胆草；风甚，加川萆 ；湿甚，加木瓜；食积甚，加山楂、神曲、麦芽。
足气冲心，合四物汤，肥人宜加痰药。
健步丸 生地 陈皮 白芍各一两半 苍术 归尾各一两 牛膝 条芩 吴茱萸各五钱
大
蒸饼，丸如梧子。白术、木通各一钱，煎汤，食前送下八十丸。
五积散（见中寒） 十全大补汤（见捞瘵）
单方
治脚肿拘挛 威灵仙、川牛膝，等分为末，炼蜜丸如梧子，空心酒下。忌茶。治湿热
痛铅一斤，入锅熬化，将酒冲入，止饮酒痛自止。至重者三服。
余论
脾主四肢，油腻浓味，茶酒面食，不能节制。郁而生热，热流于足，而山岚卑湿，涉水
冒雨，足先受之，湿热相搏，足疾生矣。其初起时，恶寒发热，状若伤寒，惟足胫红肿，或
筋挛痛，此为别耳。轻者只于足痛，重者由足入阴，抵小肠，历胁肋上于头，又重者香港脚冲
心，误治立死。轻者先散其寒，重者退其热，佐以渗湿下行之药。苟非足膝□细，势来缓者，
断不可骤用补气药。
治湿神效煮酒方 五加皮三两，宣木瓜三两，用无灰酒三大壶，入小瓷瓶内，将药 咀，
亦入瓶内，将坐，放滚汤锅中，酒数沸，取出，冷一宿，空心饮六七杯。
治脚转筋 急将大蒜磨脚心，令偏热，即瘥。
治香港脚 昔人见一缙绅，于剧暑时，置一布囊下用炉火，以足 上。叩之∶则云旧有脚
气疾。近得一方，用川椒二三斤，实于疏布囊中，跣足踏上，因椒气惟热，辟去寒热也。越
数年间，其疾疗后传知亲，知无不效者。后又有加破开槟榔并热艾，各三分之一亦妙，真良
方也。
下焦元气虚弱，又感受外邪，风寒湿热之邪侵袭身体而引发此病；疮毒积聚、流注（一种慢性化脓性疾病）也可能导致此症。若病邪入腹攻心，则定难救治。总有一方名为苍术健步汤，由青皮、陈皮、苍术、白术、瓜蒌、当归、生地黄、黄柏、黄连、防己、猪苓、牛膝、龙胆草、槟榔组成。若左尺脉不应指，说明病情难以痊愈；寸口脉象无常，医生切勿轻易施治。对于妇人足部肿胀、酸痛、麻木、疼痛，可用生地黄、川芎、苍术、黄柏、黄芩、牛膝、红花、草龙胆，饭前煎服即可见效。
辨证：
两小腿肿胀属于湿性香港脚（脚气病），适宜用当归拈痛汤，或五积散，加槟榔、木瓜、青风藤、穿山甲。足膝干枯细瘦属于干性香港脚，适宜用十全大补汤，加牛膝、木瓜、石南藤、五加皮、没药、川乌。
槟榔散：槟榔散内含有香苏散成分较多，加上甘草、陈皮、半量的槟榔和木瓜，配合生姜、葱白煎服治疗香港脚，驱除风湿的效果如何呢？
当归拈痛汤：治疗湿性香港脚及骨节疼痛、疮毒等症状。
方中羌活、茵陈、甘草、茯苓各一钱，当归、知母、泽泻、粳米、猪苓各五分，防风、苍术、升麻、葛根各四分，还有人参、苦参。首句药物各一钱，次句药物各五分，下二句药物各四分。
防己饮：防己、黄柏、苍术、白术、槟榔、生地黄、川芎、没药、犀角屑、甘草梢、木通、黄连，剂量依次为七分、五分、三分等。若内热，加黄芩；热甚及暑天，加石膏；大便秘结，加桃仁；小便涩滞，加牛膝、木瓜、薏苡仁；手臂疼痛，加威灵仙；胁肋疼痛，加龙胆草；风邪甚，加川萆薢；湿邪甚，加木瓜；食积甚，加山楂、神曲、麦芽。若足气冲心，合用四物汤，肥胖者宜加化痰药。
健步丸：生地黄、陈皮、白芍各一两半，苍术、当归尾各一两，牛膝、黄芩、吴茱萸各五钱。以大蒸饼为丸，如梧桐子大小。用白术、木通各一钱煎汤，饭前送服八十丸。
单方：
治疗脚肿拘挛：威灵仙、川牛膝，等分为末，炼蜜为丸如梧桐子大，空腹时酒送服。忌饮茶。
治疗湿热痛：铅一斤，放入锅中熬化，将酒冲入，饮酒后脚痛自止。重症者服用三次。
余论：
脾主四肢，若不能节制油腻浓味、茶酒面食，郁而生热，热流于足，加之山岚卑湿、涉水冒雨，足部先受邪，湿热相搏，足疾便产生了。初起时，恶寒发热，状若伤寒，只是足胫红肿，或筋挛痛，这是区别所在。轻者仅在足部疼痛，重者由足入阴经，抵小肠，经过胁肋上至头部，更重者香港脚冲心，误治立即死亡。轻者先散其寒，重者退其热，佐以渗湿下行的药物。如果不是足膝干枯细瘦、病势缓慢的情况，绝对不可骤用补气药。
治湿神效煮酒方：五加皮三两，宣木瓜三两，用无灰酒三大壶，装入小瓷瓶内，将药材切碎，也放入瓶内，将瓶子坐放在滚汤锅中，酒煮沸数次，取出，冷却一夜，空腹饮用六七杯。
治疗香港脚：古人见一位官员，在酷暑时节，放置一个布袋在下面用炉火烘烤，将脚踩在上面。询问他，他说旧有脚气疾。最近得到一方，用川椒二三斤，装入疏布囊中，赤脚踩上去，因为椒气温热，能辟去寒热。过了几年，他的病治愈后传授给亲友，没有不有效的。后来又有加入破开的槟榔和热艾，各占三分之一，也很奇妙，真是良方。
The deficiency of Yuan Qi (Original Qi) in the lower jiao, combined with external pathogenic invasion, leads to this disease caused by wind-cold-damp-heat. It may also arise from carbuncles, accumulations, or liuzhu (a chronic suppurative condition). If the pathogen enters the abdomen and attacks the heart, it is difficult to save. There is a formula named Cangzhu Jianbu Tang (Cangzhu Walking-Strengthening Decoction), composed of Qingpi (Green Tangerine Peel), Chenpi (Aged Tangerine Peel), Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Gualou (Trichosanthis Fructus), Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Huangbai (Phellodendri Cortex), Lian (Coptidis Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Zhuling (Polyporus), Niuxi (Achyranthis Bidentatae Radix), Longdancao (Gentianae Radix), and Binglang (Arecae Semen). If the left chi pulse does not respond, the disease is hard to cure; if the cunkou pulse is irregular, do not treat. For women with swollen, sore, numb, and painful feet, use Shengdihuang, Chuanxiong, Cangzhu, Huangbai, Huangqin, Niuxi, Honghua (Carthami Flos), and Caolongdancao, decocted and taken before meals for effect.
Differentiation:
Swelling of both calves indicates damp-type Hongxiangjiao (Hongxiangjiao refers to beriberi/foot qi disease); use Danggui Niantong Tang (Danggui Pain-Withdrawing Decoction) or Wuji San (Five Accumulations Powder), adding Binglang, Mugua (Chaenomelis Fructus), Qingteng (Sinomenii Caulis), and Chuanshanjia (Manis Squama). Dry Hongxiangjiao presents with withered and thin foot-knees; use Shiquan Dabu Tang (Ten Significant Tonifying Decoction), adding Niuxi, Mugua, Shinanteng (Acanthopanacis Senticosi Caulis), Wujiaopi (Acanthopanacis Cortex), Moyao (Myrrha), and Chuanwu (Aconiti Radix).
Binglang San (Arecae Semen Powder): This powder contains abundant Xiangsu San ingredients, plus Gancao (Licorice Root), Chenpi, half portions of Binglang and Mugua. Decoct with Shengjiang (Fresh Ginger) and Congbai (Scallion White) to treat Hongxiangjiao; how effective is it in dispelling wind-damp?
Danggui Niantong Tang: Treats damp-type Hongxiangjiao, joint pain, carbuncles, etc.
Qianghuo, Yinchern, Gancao, Ling are each 1 qian; Gui, Zhi, Ze, Mi, Zhu Ling are each 5 fen; Fangfeng, Cangzhu, Sheng, Ge are each 4 fen; Ren Shen and Kushen are also included. First line drugs 1 qian each, second line 5 fen each, last two lines 4 fen each.
Fangji Yin (Fangji Decoction): Fangji, Bai, Cang, Baizhu, Binglang, Shengdi, Chuanxiong, Moyao, Xi Xiao, Cao Shao, Tong, Lian. Dosages vary (7, 5, 3 fen respectively). Add Huangqin for internal heat; add Shigao (Gypsum Fibrosum) for severe heat or summer heat; add Taoren (Persicae Semen) for constipation; add Niuxi, Mugua, Yiyiren (Coicis Semen) for dysuria; add Weilingxian (Salviae Miltiorrhizae Radix et Rhizoma - *Note: Standard is Clematidis Radix* Salviae Miltiorrhizae is Danshen, but Weilingxian is Clematis root. WHO term: Clematis Root) for arm pain; add Dancao (Gentianae Radix) for hypochondriac pain; add Chuanbi (Dioscoreae Hypoglaucae Rhizoma) for severe wind; add Mugua for severe damp; add Shanzha, Shenqu, Maiya for food stagnation. If foot qi attacks the heart, combine with Siwu Tang (Four Substances Decoction); for obese patients, add phlegm-resolving herbs.
Jianbu Wan (Walking-Strengthening Pill): Shengdihuang, Chenpi, Baishao each 1.5 liang; Cangzhu, Guiwei (Angelicae Sinensis Radix Tail) each 1 liang; Niuxi, Tiaohuangqin (Scutellariae Radix), Wuzhuyu (Evodiae Fructus) each 5 qian. Make pills with Da Zhengbing (Large Steamed Dough Ball) size of Wuzi (Chinese Wolfberry). Take 80 pills with a decoction of Baizhu and Mutong (Akebiae Caulis) before meals.
Wuji San (see Cold Damage section), Shiquan Dabu Tang (see Consumption section).
Single Prescriptions:
For swollen and cramped feet: Weilingxian, Chuan Niuxi, equal parts powdered, honey-pilled like Wuzi, taken with wine on an empty stomach. Avoid tea.
For damp-heat pain: Melt 1 jin of lead in a pot, pour in wine, drink it; foot pain will stop. Severe cases take three doses.
Additional Remarks:
The Spleen governs the four limbs. Failure to control rich, greasy foods, tea, alcohol, and wheat/rice products leads to stagnation generating heat. Heat flows to the feet, and combined with mountainous dampness or wading through water/rain, the feet are first affected. Damp-heat interacts, causing foot diseases. Initially, there is aversion to cold and fever, resembling Shanghan (Cold Damage), but only the calves are red/swollen or tendons cramp/painful. Mild cases stay in the feet; severe cases enter the yin meridians, reach the Small Intestine, pass through the hypochondrium to the head; even more severe, Hongxiangjiao attacks the heart, and mis-treatment causes immediate death. Mild cases first dispel cold; severe cases clear heat, assisted by damp-draining and descending herbs. Unless the feet/knees are withered/thin and the onset is slow, do not abruptly use Qi-tonifying herbs.
Shenxiao Zhujiu Fang (Divine Effect Boiled Wine Recipe): Wujiaopi 3 liang, Xuan Mugua 3 liang. Use 3 large pots of non-ashy wine. Put herbs in a small porcelain bottle, crush them, place in the bottle. Sit the bottle in a boiling water bath. Boil wine several times, remove, cool overnight. Drink 6-7 cups on an empty stomach.
For foot tendon spasms: Grate garlic on the soles of the feet until warm; it heals immediately.
Treating Hongxiangjiao: An ancient story tells of an official who, in intense summer heat, placed a cloth bag under a stove fire and stepped his feet on it. Asked about it, he said he had old foot qi disease. He recently got a prescription: put 2-3 jin of Chuanjiao (Sichuan Pepper) in a loose cloth bag, step barefoot on it. The pepper's heat dispels cold and heat. Years later, his cured friends shared it with relatives/friends, all effective. Later, adding broken Binglang and hot Aiye (Artemisiae Argyi Folium), each one-third part, was also wonderful. Truly a good prescription.