《心法》曰∶敦疽多生于足指，而手指亦间有生者，此由膏梁太过则损脾，房劳
太甚则损肾，脾既损则血生少，肾既伤则精必竭，更兼湿热壅盛而成。初起黄粟小
泡，痛如汤泼火燃，其色红活，肿无黑晕，溃破有脓，腐无败色，此属血脉未死之候，
然此证虽无败色，亦由脏腑发出，未可视为小毒也。急宜内服滋阴救燥，补血理脾
之药，清心寡欲调理，庶无变证。（《金鉴》）
又曰∶首尾禁用灸法。
王肯堂曰∶青蛇头又名指风毒，生足大指节上，乃毒蛇所处之地，人不知觉，早
起经过，染受毒瓦斯，故生此毒。初起状如汤泼火烧，痛不可忍，内毒滋甚，憎寒壮
热，四肢酸痛，后则 肉突出，痛如刀割，用人龙散敷之， 肉自缩，轻者经旬匝月，
重者二三月不收功，溃败筋骨，多有之矣。（《准绳》）
人龙散 蛇头 肉突出 人龙即蛔虫，人吐出者更佳，厕中者亦可用，一条。
雄黄二钱，同捣烂敷 肉上，实时 肉缩进，肿消痛止而愈。
\r厉痈\p04-a41a198.bmp\r
王肯堂曰∶厉痈发于足傍，其状不大。初从小指发，急治去之；其状黑者不可消，
辄益不治，百日死。（《准绳》）
《心法》曰∶《灵枢》云∶发于足上下，名曰四淫；发于足傍，名曰厉痈。不急治
之，俱百日死。此二证俱由足三阴经亏损，为疽者重，若兼足三阳经湿热下注而成痈
者轻，若红肿疼痛，溃后有脓，腐脱无黑气侵漫，属湿热偏胜，顺证易治。若微红
微肿，溃出脓水，属阴气凝结，不能化脓，险证难治。若黑暗漫肿，痛不溃脓，烦热
作渴，小水淋漓，为阴败恶证属逆。四淫无边沿，厉痈类敦疽，首尾宜壮脾滋水，或
可成功，若妄用苦寒克伐之药，多致不救。（《金鉴》）
《医宗心法》说：敦疽多发生在足趾，手指间偶尔也有发生的。这是由于饮食过于肥甘厚味损伤了脾脏，房事过度损伤了肾脏。脾脏受损则血液生成减少，肾脏受伤则精气必然枯竭，再加上湿热邪气壅盛而形成。初期出现像黄米大小的水泡，疼痛如同热水浇泼、烈火燃烧，颜色红活，肿胀处没有黑色晕圈，破溃后有脓液，腐烂处没有败坏的颜色，这属于血脉尚未死亡的征象。然而此证虽然无败坏之色，也是由脏腑病变发出，不可视为小毒。应当紧急内服滋阴润燥、补血健脾的药物，并清心寡欲进行调理，这样才可能避免病情变化。（出自《医宗金鉴》）
又说：治疗全过程禁用灸法。
王肯堂说：青蛇头又名指风毒，生长在足大脚趾节上，这里是毒蛇出没的地方，人们不知觉，早起经过时沾染了毒气，所以生出这种毒疮。初期症状如同热水浇泼、烈火燃烧，疼痛难以忍受，体内毒气滋长严重，恶寒高热，四肢酸痛，后来肌肉突出，疼痛如刀割，用人龙散外敷，突出的肌肉自然收缩，轻者经过十天到一个月，重者两三个月才能见效，导致筋骨溃败的情况有很多。（出自《医学准绳六要》）
人龙散配方：蛇头疮肌肉突出。人龙即蛔虫，从人口中吐出的更佳，厕所中的也可以使用，用一条。雄黄二钱，一同捣烂敷在突出的肌肉上，立刻肌肉缩回，肿胀消退疼痛停止而痊愈。
厉痈
王肯堂说：厉痈发于脚旁，形状不大。初期从小脚趾开始发作，应紧急治疗去除；如果形状发黑则无法消除，若继续不加治疗，一百天后会死亡。（出自《医学准绳六要》）
《医宗心法》说：《灵枢经》记载：发于足上下方的，名叫四淫；发于脚旁的，名叫厉痈。如果不紧急治疗，这两种病证都会在一百天后致死。这两种证候都是由足三阴经亏损引起的，表现为疽的较重，如果兼有足三阳经湿热下注而形成痈的较轻。如果红肿疼痛，溃破后有脓液，腐肉脱落且没有黑色气体侵漫，属于湿热偏胜，是顺证，容易治疗。如果微红微肿，溃破流出脓水，属于阴气凝结，不能化脓，是险证，难治。如果黑暗漫肿，疼痛但不溃破流脓，伴有烦热口渴，小便淋漓不尽，这是阴气败坏的恶证，属于逆证。四淫没有明显的边缘界限，厉痈类似敦疽，从头到尾应该采用壮脾滋肾的方法，或许可以成功，如果妄用苦寒攻伐的药物，大多会导致无法救治。（出自《医宗金鉴》）
*The Xin Fa (Core Methods)* states: Dun Ju (Dun Carbuncle) mostly occurs on the toes, and occasionally on the fingers. This is caused by excessive consumption of rich and sweet foods damaging the Spleen, and excessive sexual activity damaging the Kidney. Once the Spleen is damaged, blood production decreases; once the Kidney is injured, essence inevitably exhausts. Furthermore, it forms due to the accumulation and excess of Damp-Heat. Initially, small yellow millet-like blisters appear, with pain like being scalded by hot water or burned by fire. The color is vibrant red, swelling has no black halo, and upon ulceration, there is pus without foul discoloration. This indicates that the blood vessels have not yet died. However, although this condition lacks signs of tissue necrosis, it originates from internal Zang-Fu organs and should not be regarded as a minor toxicity. It is urgent to internally administer herbs that nourish Yin and rescue dryness, tonify blood, and regulate the Spleen, along with regulating lifestyle by reducing desires and calming the mind, so as to prevent complications. (*Yi Zong Jin Jian*)
It also states: Moxibustion is strictly contraindicated throughout the course of treatment.
Wang Kentang states: Qing She Tou (Green Snake Head), also known as Zhi Feng Du (Finger Wind Toxicity), arises on the joint of the big toe. This is an area where venomous snakes reside. People are unaware of it, and upon passing by early in the morning, they contract toxic vapors, thus generating this toxicity. Initially, the appearance is like being scalded by hot water or burned by fire, with unbearable pain. Internal toxicity proliferates severely, accompanied by aversion to cold and high fever, and soreness and pain in the four limbs. Later, flesh protrudes, with pain like knife cutting. Applying Ren Long San externally causes the protruding flesh to retract spontaneously. Mild cases may take ten days to a month, while severe cases may take two to three months to show results, often leading to the destruction of muscles and bones. (*Yi Xue Zhun Sheng*)
**Ren Long San Formula**: For protruding flesh in snake-head carbuncles. "Ren Long" refers to Ascaris lumbricoides (Roundworm); those vomited out by humans are better, but those found in toilets can also be used. Use one worm. Mix with 2 qian of Xiong Huang (Realgar), pound into a paste, and apply to the protruding flesh. The flesh will immediately retract, swelling will subside, pain will cease, and recovery will occur.
Li Yong (Malignant Ulcer)
Wang Kentang states: Li Yong arises on the side of the foot, with a shape that is not large. It initially starts from the little toe and must be treated urgently to remove it; if the shape turns black, it cannot be resolved. If left untreated, death will occur within one hundred days. (*Yi Xue Zhun Sheng*)
*The Xin Fa* states: *Ling Shu* says: Eruptions on the upper and lower parts of the foot are named Si Yin (Four Licentious Ones); eruptions on the side of the foot are named Li Yong. If not treated urgently, both conditions result in death within one hundred days. Both these conditions are caused by the deficiency of the Three Yin Meridians of the Foot. Those manifesting as Ju (Deep Abscesses) are severe; those formed by Damp-Heat pouring downward from the Three Yang Meridians of the Foot manifesting as Yong (Superficial Abscesses) are milder. If there is redness, swelling, and pain, with pus after ulceration, and the slough falls off without black gas infiltration, it belongs to excess Damp-Heat, representing a favorable syndrome (Shun Zheng) that is easy to treat. If there is slight redness and swelling, with purulent discharge after ulceration, it belongs to the coagulation of Yin Qi, inability to generate pus, representing a dangerous syndrome (Xian Zheng) that is difficult to treat. If there is dark blackness and diffuse swelling, pain without ulceration or pus, accompanied by irritability, heat, thirst, and dribbling urination, it is a malignant syndrome of Yin collapse, representing an adverse syndrome (Ni Zheng). Si Yin has no distinct borders, while Li Yong resembles Dun Ju. Throughout the treatment, methods to strengthen the Spleen and nourish Water (Kidney) should be used, which may achieve success. If bitter-cold draining drugs are recklessly used, most cases will become incurable. (*Yi Zong Jin Jian*)