江南扬州府江都、甘泉、仪征三县妇女香港脚，始自康熙五十年间，从前并无此
证。此乃得于阴阳错谬之 气，非上古男妇湿热壅肿五痹之香港脚也。其感受也，皆
由于富贵之家，性情骄傲，稍不如意，恚怒易生，安享太过，饮食无节，伤饥失饱，
喜飧生冷。亦有女子婚姻愆期，经事骤闭，或配非其偶，抑郁不舒，肝气凝结，脾气
郁滞，是以肝脾两伤，肝血日亏，肝气日
增，肝气日增，肝无血养，筋脉拘挛，脾气日困，胃阳不振，脾失健运，湿热渐生，
肚口不宽，加之饮食非时，七情自戕。初见证也，月事不调，肚口作痛，呕吐酸水，
绿水痰涎，身体大腿作酸，小腿渐痛，脐下或左或右，必有或长或圆气块作梗，拍
拍跳动，由上而下，觉肚口稍宽，则疼痛至足胫，趺口热如火烙；再则痛至足指，指
甲缝中痛如针刺，日夜喊叫，欲生不可，欲死不能，忽而足痛稍定，则肚口依然胀闷，
甚则面色呈青，目睛倒视，胸前非重手按捺，男子脚跟 住，则昏厥不省人事，两
足非妇女替换揉搓，不能少定痛楚，更有四肢搐搦，头项动摇，昏厥僵仆，有一二
时而苏，或半日而苏者，无论体之强弱，但能清饿七日，其痛渐定，亦有十四朝，二
十一朝，始能渐定者，此又在医之用药善与不善，及病家妄与粥汤，吊住邪气之所
致也。考香港脚之论，古时有干香港脚、湿香港脚之称。干香港脚，其痛也足胫趺指干瘦，疼
痛无汗；湿香港脚，其痛也足胫趺指红肿，疼痛有汗，足指缝中流水。今扬地俗呼亦有
公母之称，公香港脚其痛也肿而色白，治之纵愈，不能望其生育，因其血气大亏，经
必过期而至，悭涩无多；母香港脚其痛也肿而色红，其热如烙，经多先期而至，治之
如法，尚可望其生育。大势皆由肝脾素亏，邪由虚召，施治之法，因风寒而发者，但
散风寒，因暑湿而发者，但清暑湿，因饮食生冷而发者，但温中化滞，因气恼恚怒
而发者，但平肝散郁，如法治之，先分其势，其发必轻，但病者当平时无病须作有
病想，服丸药，每早以养血调经、宁神散郁为主。如调经养血丸、河车大造丸、益
母八珍丸、香附女金丹、益气养荣丸之类。盖阴药多滞，每早服之，取其阳中之阳，易
于消化，每晚以健脾和胃为主，如加味六君子丸、加味异功散、水叠资生丸、和胃
健脾丸之类，择而用之，俱宜水法叠作小丸，盖水叠细丸，入胃即化，夜乃阴中之
阴，即胃脘新进饮食，亦可借以消化，三年之内勿令间断，其患自可永除。仍须病
人改换性情，节戒口味，慎之又慎，此治香港脚之大法也。惜乎扬城妇女，香港脚相延
四五十年，病家极受痛楚，呼天抢地，医家惟知检查历朝各家五痹香港脚诸方施治，
无非防己、木瓜、秦艽、萆 、威灵仙、桂枝、桑枝、苍术、浓朴、乌药、槟榔、黄
柏、千年健、钻地风、 草、五加皮、海桐皮、降香节、肉桂、附子、乳香、没药、
虎骨、青皮等味，一派损脾伐肝，破气伤阴之品，舍此之外，技已穷矣。所以然者，
医家认定湿热，先横一香港脚上冲，厥逆无救之害于胸中，惟以赶其下趋为第一策，罔
顾病患之正气。殊不知其病始于肝脾两虚，厥气上犯胸膈胀闷，骤用攻伐峻利之药，逐
其下行，岂知正气与邪气俱陷，譬夫盗贼入门，自应开门逐贼，今将盗贼赶入呆巷，
无门可遁，其势不得钻墙挖壁，夺径而逃。其如妇女十指甲中，无缝可逃，是以两足
十指胀痛有如针挖，更有过投以上诸药，正气大伤，仓廪空虚，正不敌邪，邪气得以
肆横，下既无门可遁，直冲而上，鲜有不一冲而丧其生者。至于体实者，七日渐安，
体虚者，十四日始宁，更有极虚者，二十一日始安，其故何也？斯证即如伤寒，六
日传遍，邪气已衰，七日天地之气来复，凝结之气随天地之气来复而解自愈，原非医
者追赶药力，能令七日自愈耳，此又无怪乎医者之误。当初此证初行之时，医家原
无头绪，亦不知此为阴阳错谬之 ，亦不知妇女感受之由，考诸方书五痹香港脚门中，
要不过以上诸药投之，不效，只嫌病大药轻，惟有多加分两，别无他法，执而不移，
任其痛楚，七日自愈，在病家延请群医而用药立方，大概不过如此，亦遂信而不疑，
竟至无救，亦不过委之香港脚上冲，本无可救之术。扬城妇女四五十年，罹此夭折死
而不悟，良可悲也。是以有斯证，服斯药者，初起尚轻，再发即重，三发愈危，竟
有数发而死者多矣。岂知秦汉以来，历朝所着方书，有曰缓风，有曰弱脚，有曰脚
气，所立之方，皆治普天下男妇风寒湿热五痹香港脚之方，并非治扬郡江、甘、仪三
邑妇女感受阴阳错谬之诊气，而成脚痛之方也。况古时男女朴实者多，地土本浓，今
扬郡水土本薄，知识易开，禀受本弱，兼之娇养性成，安逸太过，情性乖张，喜餐
生冷，非暴躁恚怒，即沉默内郁，肝脾气郁，经事不调，犯此弊端，方成此病。况
古人虽有先见之明，洞窥脏腑，恐未能数千年前，即逆料我朝扬郡江、甘、仪三邑
妇女，将来数千年后必有感此错谬异气而成此香港脚，遂留诸方治之耶！即使果有先
见之神明，何不标明某方治男妇五痹香港脚，某方留治扬郡江、甘、仪三邑妇女香港脚耶！
且江、甘、仪三邑妇女香港脚现证情形，不特苏松、常镇、江淮各郡并无此证，即扬
属高邮、宝应、兴化、泰州，邻邑妇女，亦未闻有此异证也。至谓扬郡地处卑湿，其
湿热郁于肌表者，疮疥极多，湿热壅于肠胃者，肿满颇众，兼亦有男妇湿热下注腿
膝，红肿光亮，破流脂水，至晚下淋，胫趺胀痛者，然其初起，决不由肚口作痛，其
红肿胀痛，亦不似此等热如火烙，痛如刀绞之惨，若执古方施治，何异抱薪救焚。施
治之法，亦有用防己、木瓜、秦艽、五加皮、海桐皮、海风藤、川萆 、苍术、黄
柏、浓朴等味而愈者，此男妇脾土高阜，膏粱曲 ，蕴结有余之湿热，用之偶有效耳。
若以之治男妇脾土卑监，饮食不运，化为不足之湿热，用之则非徒无益，而反有增
剧之害也。澄每叹扬郡男妇，饮食不调，喜餐生冷，脾胃潮湿，精神如旧而胸膈不宽，
舌有潮胎，不思饮食，不饮茶汤。竟有三四十日不进粥汤，大便不行，腹内肠鸣，时
或泄气，仍可应酬嬉戏者，投以苍、朴、香、砂、姜、桂、萸、附等剂，其病渐愈，汤
药服之已多，但能进食，即止煎剂。数月之后，其病又作，形证既同，医家照前苍
朴混投，而病家因前功既建，视苍、朴如参、苓，亦坚信而不疑，殊不知脾为万物
之母，胃为水谷之海，初病脾土壅遏，非苍、朴不足以平胃土，胃土既平，则万物
发生，此至理也。医者病者未悉治农之理，高者平之，洼者培之，土地既平之后，必
如农夫垦田，调其灌溉，滋之培之，然后能发生五谷，万物资生。今医者病者，第
以平胃为治湿之金丹，日事苍朴平胃，是将可耕之田，平而又平，渐平成一聚水之
深塘，但有水液痰涎，未有不归之脾胃虚虚之祸，可无戒哉！澄意治斯证者，高阜
自应平胃，卑监惟宜健脾，轻者消补兼施，重者补火生土，非姜附理中汤，即桂附六
君子，病愈之后，六君子丸、加味异功丸、金匮肾气丸、七味地黄丸、归芍六君子丸、
水叠资生丸，按证施用，自可永除脾胃湿热之患矣。澄因侨居扬郡，诊视既久，妇
女香港脚及男妇湿热之证极多，每见妇女香港脚，悲痛号呼，披头散发，抽掣切牙，殊
令人惊心惨目，是以悉心审察病情，探本寻源，另开生面，投之药剂，无不旋愈。始
知前医未识病由，妄投攻下，以致病家戕其生者，不可胜数。今澄既已获效于前，不
敢秘其法而不传，爰特增此门，质诸高明君子，凡我同道诊视此等证候，务循此法，
不至仍前错误，则不但病者受福，即司医者亦可种德于无穷矣。谨论。
香港脚之患，多患于富贵之家，而经纪小户从无香港脚可见。富贵之家奉养太过，安
逸过甚，以日继夜，以夜继日，贪顽则当食不餐，爱者则啖之无厌，稍有怫郁则恚
怒频生，语言微犯则含蓄不释，是以肝脾受伤，易于感召也。至于经纪小户，妇女
非勤于针工，即劳于操作，便得菜饭充肠，一衫蔽体，既无分外之求，更无奢靡之想，
筋骨虽劳，气血反畅，藜藿充饥，脾无壅滞，纵有湿热相干，轻则生疮患疥，甚则
腿脚红肿而已，香港脚之邪未能干犯也。且妇女香港脚一染，先从胸膈胀闷，肚口作痛，
呕吐痰涎绿水，胸前有埂，按之搏手，渐则腰腿酸痛，由上而下，痛至足胫趺指，则
胸膈渐宽，倏然腿脚疼痛稍减，胸膈渐加胀闷，或则上攻，或则下注，其患俨如竹
夫人肚中球子，滚上滚下，胸膈稍宽脚下必痛，脚下稍定胸膈必胀，甚则混投粥饭
油汤，邪气上冲，一冲即厥，屡厥必死。所以香港脚上攻，胸前要人重手紧按，竟有要
男子双脚 踏胸前乳侧，方免昏厥。香港脚下注两足，必要二人揉搓摸抚，昼夜不停，
更有遍身酸痛，要人揉搓，俨如和面，加之煎汤调药需人，岂知昼夜灯烛炭火，延
医拯救，一人有病，十人服侍，刻无宁晷，且恐病患生气，多方先意承志，要一奉十，
犹以为未足，若非富贵之家，焉得有如许之人服侍，如许之钱措办，假使贫穷小户，
一夫一妇，翁姑年老，子女幼小之家，患此不特服侍无人，日食尚且不敷，凭何措
此靡费，再加昏厥，翁姑夫婿何以堪此。澄所谓阴阳错谬之异气者，未尝不因人而召
之也。所谓江、甘、仪三邑妇女香港脚，乃阴阳错谬之 气者，凡患香港脚，亲戚妇女
探视，偶坐病患床沿，即可传染而成，香港脚之异所以为异耳。每见婆有香港脚，其媳
亦然；母有香港脚，其女亦然；姊有香港脚，其妹亦然；妯有香港脚，其娌亦然。传染者固
多，不传染者亦复有之。
妇女香港脚，有一种滴酒不可饮者，有一种平时戒饮，惟举发时非酒不能稍定其
痛，竟有饮烧酒者，想来酒能乱性昏神，不过一醉神昏，即不知锥痛矣。
凡患香港脚痛止，忌人问其仍痛与否，但遇有问之者，痛必复作。
凡患香港脚，最忌人谈说他人香港脚，但闻此语，其病必发，此乃肝虚胆怯所致耳。
凡患香港脚妇女，清饿以痛止胸宽为率，痛止只宜吃水煮饭汤，渐渐吃汤饭，不可
先进粥汤糕汤，庶免胸膈胀闷，缠绵时日。
凡患香港脚平时当忌食物∶
鲥鱼 黄鱼 鱼 虾子 虾油 螃
蟹 鲤鱼 猪首 公鸡 鹅 鸭蛋 鲜菌 香蕈 磨菇 黄瓜 番瓜 面筋 蒲菜 芫荽 茄
子香瓜 荠菜 菜 茨菰 蚕豆 黄豆 糟菜 腐乳 酱瓜 韭菜 苣蒿 鲜笋 火酒 杂酒 粘
食面食 变蛋 虾米 苔干 黄鲳 豌豆头 豌豆 芋子 菱角 御米 萝卜 石
耳木耳 鲜蛏 河歪 蛤蜊 滴醋 鸡蛋 汤圆 羊肉 驴肉 芹菜 菠菜 团圆饼 西瓜
凡妇女香港脚，举发时忌闻香气，凡安息、芸香、苍术均不可焚烧。
凡妇女香港脚，原不必限定七日始定，但发于月经后者为日必多，发于月经前者，只
要经水一通，其邪随经自解，其痛易定，可见是肝脾遏郁，气凝血滞。
凡妇女香港脚，发后宜静养调理，须戒房事一月。
凡妇女有香港脚者，将临月事之前，忌食生萝卜、西瓜、桃子、杏子、李子、生藕、荸荠、柿子、柿饼等物。
凡妇女香港脚，呕吐痰涎绿水，不得食核桃、叭嗒杏、落花生、松子，此四物有油，皆呕家所忌。
凡妇女香港脚，平时宜戒暴怒郁闷，必须自惜身命，改换性情，无病时作有病想，方能不发。
双钩藤钩祛风舒筋，香港脚定痛圣药，宜多用。
【背景信息】
书名：疡医大全 作者：顾世澄 朝代：清 章节：添加江苏扬州府江、甘、仪三邑妇女香港脚门主论 类别：医论
江南扬州府江都、甘泉、仪征三县的妇女患香港脚（一种以足胫肿痛为特征的疾病），始于康熙五十年间，此前并没有这种病症。这是由于阴阳错乱之气所致，并非上古时期男女因湿热壅盛导致的五痹（风、寒、湿、热、燥五种痹证）类型的香港脚。其致病原因，多发生在富贵人家，这些人性格骄傲，稍有不如意就容易愤怒，生活过于安逸，饮食没有节制，饥饱不均，喜欢吃生冷食物。也有女子婚期延误，月经突然闭止，或者配偶不当，心情抑郁不畅，导致肝气凝结，脾气郁滞，从而造成肝脾两伤。肝血日渐亏损，肝气日渐亢盛；肝气亢盛则无血滋养，导致筋脉拘挛；脾气日渐困顿，胃阳不振，脾失健运，湿热逐渐产生。肚口（心窝部）不宽舒，加上饮食不按时，七情（喜、怒、忧、思、悲、恐、惊）自我伤害。初起时表现为月经不调，肚口疼痛，呕吐酸水或绿色痰涎，身体和大腿酸痛，小腿逐渐疼痛，脐下左侧或右侧必有长短不一或圆形的肿块堵塞感，拍之有跳动声，由上而下蔓延，感觉肚口稍宽舒，则疼痛传至足胫，足背热如火烙；进而疼痛传至脚趾，指甲缝中痛如针刺，日夜喊叫，求生不得，求死不能。有时足痛稍定，则肚口依然胀闷，甚至面色发青，眼睛上视，胸前若非重手按压，男子用脚跟住，就会昏厥不省人事；双足若非妇女轮流揉搓，就不能稍微缓解疼痛。更有甚者四肢抽搐，头项动摇，昏厥僵仆，有的过一两个时辰苏醒，有的半天才苏醒。无论体质强弱，只要能禁食七天，疼痛逐渐平息；也有十四天、二十一天才开始逐渐平息的。这又取决于医生用药是否得当，以及病家错误地给予粥汤，吊住了邪气所致。
考察香港脚的论述，古时有干香港脚和湿香港脚之称。干香港脚，其疼痛部位足胫、足背、脚趾干枯消瘦，疼痛无汗；湿香港脚，其疼痛部位足胫、足背、脚趾红肿，疼痛有汗，脚趾缝中流水。如今扬州地方俗呼也有公母之分。公香港脚，其疼痛肿胀且颜色白，治疗即使痊愈，也不能指望生育，因为其气血大亏，月经必定过期而至，量少涩滞；母香港脚，其疼痛肿胀且颜色红，热如火烙，月经先期而至，治疗若合乎法度，尚有望生育。大势皆由肝脾素来亏虚，邪气因虚而召致。施治之法，因风寒引发的，只散风寒；因暑湿引发的，只清暑湿；因饮食生冷引发的，只温中化滞；因气恼愤怒引发的，只平肝散郁。如法治疗，先分其势，发作必然轻微。但病人平时无病时要当作有病想，服用丸药，每早以养血调经、宁神散郁为主，如调经养血丸、河车大造丸、益母八珍丸、香附女金丹、益气养荣丸之类。因为阴药多滋腻滞碍，每早服用取其“阳中之阳”的特性，易于消化；每晚以健脾和胃为主，如加味六君子丸、加味异功散、水叠资生丸、和胃健脾丸之类，择而用之，都宜用水泛法制成小丸。因为水泛细丸入胃即化，夜间乃阴中之阴，即使是胃脘新进饮食，也可借以消化。三年之内不可间断，病患自然可永除病痛。仍须病人改变性情，节制口味，慎之又慎，这是治疗香港脚的大法。
可惜扬州城妇女患香港脚延续四五十年，病家极受痛苦，呼天抢地，医家只知道检查历朝各家关于五痹香港脚的诸方施治，无非是防己、木瓜、秦艽、萆薢、威灵仙、桂枝、桑枝、苍术、厚朴、乌药、槟榔、黄柏、千年健、钻地风、草薢、五加皮、海桐皮、降香节、肉桂、附子、乳香、没药、虎骨、青皮等药物，这是一派损伤脾胃、伐害肝脏、破气伤阴的药物，除此之外，医术已穷尽。之所以这样，是因为医家认定是湿热，先在胸中横亘着香港脚上冲、厥逆无救的危害，只把使其向下趋行为第一策略，不顾病人的正气。殊不知此病始于肝脾两虚，厥气上犯胸膈胀闷，骤用攻伐峻利的药物，驱逐其下行，岂知正气与邪气一起陷入，譬如盗贼进门，自应开门逐贼，现在将盗贼赶入死胡同，无路可逃，其势不得不钻墙挖壁，夺路而逃。无奈妇女十个脚趾甲中，无缝可逃，所以两足十指胀痛有如针挖。更有过量投以上诸药，正气大伤，仓廪空虚，正不敌邪，邪气得以肆虐横行，下既无门可遁，直冲而上，很少有不一冲而丧命的。至于体质实者，七日渐安；体质虚者，十四日始宁；更极虚者，二十一日始安，这是什么缘故呢？此证就像伤寒，六日传遍，邪气已衰，七日天地之气来复，凝结之气随天地之气来复而解自愈，原本不是医者追赶药力能令七日自愈的，这又难怪医者的误治。当初此证初行时，医家原无头绪，也不知此为阴阳错谬之气，也不知妇女感受的原因，考证诸方书五痹香港脚门中，要不过是以上诸药投之，不效，只嫌病重药轻，只是多加分量，别无他法，固执不移，任其痛苦，七日自愈。在病家延请群医而用药立方，大概不过如此，也遂信而不疑，竟至无救，也不过归结为香港脚上冲，本无可救之术。扬州城妇女四五十年，罹此夭折死而不悟，实在可悲。因此有此证，服此药者，初起尚轻，再发即重，三发愈危，竟有数发而死者多矣。岂知秦汉以来，历朝所著方书，有曰缓风，有曰弱脚，有曰脚气，所立之方，都是治普天下男女风寒湿热五痹香港脚的方子，并非治扬州郡江都、甘泉、仪征三邑妇女感受阴阳错谬之气而成脚痛的方子。况且古时男女朴实者多，地土本浓，今扬州郡水土本薄，知识易开，禀受本弱，加之娇养性成，安逸太过，情性乖张，喜餐生冷，非暴躁愤怒，即沉默内郁，肝脾气郁，经事不调，犯此弊端，方成此病。况且古人虽有先见之明，洞窥脏腑，恐未能数千年前，即逆料我朝扬州郡江都、甘泉、仪征三邑妇女，将来数千年后必有感此错谬异气而成此香港脚，遂留诸方治之耶！即使果有先见之神明，何不标明某方治男女五痹香港脚，某方留治扬州郡江都、甘泉、仪征三邑妇女香港脚耶！且江都、甘泉、仪征三邑妇女香港脚现证情形，不特苏州、松江、常州、镇江、江淮各郡并无此证，即扬州属高邮、宝应、兴化、泰州，邻邑妇女，亦未闻有此异证也。至于说扬州郡地处卑湿，其湿热郁于肌表者，疮疥极多，湿热壅于肠胃者，肿满颇众，兼亦有男女湿热下注腿膝，红肿光亮，破流脂水，至晚下淋，胫足胀痛者，然其初起，决不由肚口作痛，其红肿胀痛，亦不似此等热如火烙，痛如刀绞之惨，若执古方施治，何异抱薪救焚。施治之法，也有用防己、木瓜、秦艽、五加皮、海桐皮、海风藤、川萆薢、苍术、黄柏、厚朴等味而愈者，这是男女脾土高阜，膏粱曲蘖，蕴结有余之湿热，用之偶有效耳。若以之治男女脾土卑监，饮食不运，化为不足之湿热，用之则非徒无益，而反有增剧之害也。
顾世澄常叹扬州郡男女，饮食不调，喜餐生冷，脾胃潮湿，精神如旧而胸膈不宽，舌有潮苔，不思饮食，不饮茶汤。竟有三四十日不进粥汤，大便不行，腹内肠鸣，时或泄气，仍可应酬嬉戏者，投以苍术、厚朴、香附、砂仁、生姜、肉桂、山茱萸、附子等剂，其病渐愈，汤药服之已多，但能进食，即止煎剂。数月之后，其病又作，形证既同，医家照前苍术、厚朴混投，而病家因前功既建，视苍术、厚朴如人参、茯苓，亦坚信而不疑，殊不知脾为万物之母，胃为水谷之海，初病脾土壅遏，非苍术、厚朴不足以平胃土，胃土既平，则万物发生，此至理也。医者病者未悉治农之理，高者平之，洼者培之，土地既平之后，必如农夫垦田，调其灌溉，滋之培之，然后能发生五谷，万物资生。今医者病者，第以平胃为治湿之金丹，日事苍术、厚朴平胃，是将可耕之田，平而又平，渐平成一聚水之深塘，但有水液痰涎，未有不归之脾胃虚虚之祸，可无戒哉！顾世澄意治斯证者，高阜自应平胃，卑监惟宜健脾，轻者消补兼施，重者补火生土，非姜附理中汤，即桂附六君子，病愈之后，六君子丸、加味异功丸、金匮肾气丸、七味地黄丸、归芍六君子丸、水叠资生丸，按证施用，自可永除脾胃湿热之患矣。顾世澄因侨居扬州郡，诊视既久，妇女香港脚及男女湿热之证极多，每见妇女香港脚，悲痛号呼，披头散发，抽掣切牙，殊令人惊心惨目，是以悉心审察病情，探本寻源，另开生面，投之药剂，无不旋愈。始知前医未识病由，妄投攻下，以致病家戕其生者，不可胜数。今顾世澄既已获效于前，不敢秘其法而不传，爰特增此门，质诸高明君子，凡我同道诊视此等证候，务循此法，不至仍前错误，则不但病者受福，即司医者亦可种德于无穷矣。谨论。
香港脚之患，多患于富贵之家，而经纪小户从无香港脚可见。富贵之家奉养太过，安逸过甚，以日继夜，以夜继日，贪顽则当食不餐，爱者则啖之无厌，稍有怫郁则恚怒频生，语言微犯则含蓄不释，是以肝脾受伤，易于感召也。至于经纪小户，妇女非勤于针工，即劳于操作，便得菜饭充肠，一衫蔽体，既无分外之求，更无奢靡之想，筋骨虽劳，气血反畅，藜藿充饥，脾无壅滞，纵有湿热相干，轻则生疮患疥，甚则腿脚红肿而已，香港脚之邪未能干犯也。且妇女香港脚一染，先从胸膈胀闷，肚口作痛，呕吐痰涎绿水，胸前有埂，按之搏手，渐则腰腿酸痛，由上而下，痛至足胫趺指，则胸膈渐宽，倏然腿脚疼痛稍减，胸膈渐加胀闷，或则上攻，或则下注，其患俨如竹夫人肚中球子，滚上滚下，胸膈稍宽脚下必痛，脚下稍定胸膈必胀，甚则混投粥饭油汤，邪气上冲，一冲即厥，屡厥必死。所以香港脚上攻，胸前要人重手紧按，竟有要男子双脚踩踏胸前乳侧，方免昏厥。香港脚下注两足，必要二人揉搓摸抚，昼夜不停，更有遍身酸痛，要人揉搓，俨如和面，加之煎汤调药需人，岂知昼夜灯烛炭火，延医拯救，一人有病，十人服侍，刻无宁晷，且恐病患生气，多方先意承志，要一奉十，犹以为未足，若非富贵之家，焉得有如许之人服侍，如许之钱措办，假使贫穷小户，一夫一妇，翁姑年老，子女幼小之家，患此不特服侍无人，日食尚且不敷，凭何措此靡费，再加昏厥，翁姑夫婿何以堪此。顾世澄所谓阴阳错谬之异气者，未尝不因人而召之也。所谓江都、甘泉、仪征三邑妇女香港脚，乃阴阳错谬之气者，凡患香港脚，亲戚妇女探视，偶坐病患床沿，即可传染而成，香港脚之异所以为异耳。每见婆有香港脚，其媳亦然；母有香港脚，其女亦然；姊有香港脚，其妹亦然；妯有香港脚，其娌亦然。传染者固多，不传染者亦复有之。
妇女香港脚，有一种滴酒不可饮者，有一种平时戒饮，惟举发时非酒不能稍定其痛，竟有饮烧酒者，想来酒能乱性昏神，不过一醉神昏，即不知锥痛矣。
凡患香港脚痛止，忌人问其仍痛与否，但遇有问之者，痛必复作。
凡患香港脚，最忌人谈说他人香港脚，但闻此语，其病必发，此乃肝虚胆怯所致耳。
凡患香港脚妇女，清饿以痛止胸宽为率，痛止只宜吃水煮饭汤，渐渐吃汤饭，不可先进粥汤糕汤，庶免胸膈胀闷，缠绵时日。
凡患香港脚平时当忌食物：鲥鱼、黄鱼、鱼虾、虾子、虾油、螃蟹、鲤鱼、猪首、公鸡、鹅、鸭蛋、鲜菌、香蕈、磨菇、黄瓜、番瓜、面筋、蒲菜、芫荽、茄子、香瓜、荠菜、菜茨菰、蚕豆、黄豆、糟菜、腐乳、酱瓜、韭菜、苣蒿、鲜笋、火酒、杂酒、粘食面食、变蛋、虾米、苔干、黄鲳、豌豆头、豌豆、芋子、菱角、御米、萝卜、石耳木耳、鲜蛏、河歪、蛤蜊、滴醋、鸡蛋、汤圆、羊肉、驴肉、芹菜、菠菜、团圆饼、西瓜。
凡妇女香港脚，举发时忌闻香气，凡安息、芸香、苍术均不可焚烧。
凡妇女香港脚，原不必限定七日始定，但发于月经后者为日必多，发于月经前者，只要经水一通，其邪随经自解，其痛易定，可见是肝脾遏郁，气凝血滞。
凡妇女香港脚，发后宜静养调理，须戒房事一月。
凡妇女有香港脚者，将临月事之前，忌食生萝卜、西瓜、桃子、杏子、李子、生藕、荸荠、柿子、柿饼等物。
凡妇女香港脚，呕吐痰涎绿水，不得食核桃、叭嗒杏、落花生、松子，此四物有油，皆呕家所忌。
凡妇女香港脚，平时宜戒暴怒郁闷，必须自惜身命，改换性情，无病时作有病想，方能不发。
双钩藤钩祛风舒筋，香港脚定痛圣药，宜多用。
[Background Information]
Book: Yangyi Quanquan (Complete Book of Surgeons)
Author: Gu Shicheng
Dynasty: Qing
Chapter: Main Discussion on Hong Kong Foot in Women of Jiangdu, Ganquan, and Yizheng Counties, Yangzhou Prefecture, Jiangsu Province
Category: Medical Treatise
Women in Jiangdu, Ganquan, and Yizheng counties of Yangzhou Prefecture in the Jiangnan region suffered from "Hong Kong Foot" (a disease characterized by swelling and pain in the lower legs and feet), starting around the 50th year of the Kangxi reign. Before this, such a condition did not exist. This ailment is caused by chaotic Qi of Yin and Yang, and it is not the same as the "Hong Kong Foot" associated with the Five Bi syndromes (Wind, Cold, Dampness, Heat, and Dryness obstruction syndromes) caused by damp-heat accumulation in men and women in ancient times. The cause of infection lies mostly in wealthy families whose members are proud in temperament, prone to anger at minor inconveniences, overly comfortable in life, irregular in diet, alternating between hunger and overeating, and fond of raw and cold foods. Some women suffer from delayed marriage, sudden cessation of menstruation, or unsuitable marital matches, leading to depression and emotional stagnation. This causes Liver Qi to knot and Spleen Qi to stagnate, injuring both the Liver and Spleen. Liver Blood declines daily, while Liver Qi becomes excessive; excessive Liver Qi lacks nourishment from Blood, leading to spasms and contracture of tendons and vessels. Spleen Qi becomes increasingly fatigued, Stomach Yang fails to thrive, and the Spleen loses its ability to transport and transform, gradually generating Damp-Heat. The epigastric region feels tight and uncomfortable. Combined with irregular eating habits and self-harm through the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright), the initial symptoms include irregular menstruation, epigastric pain, vomiting of sour water or green phlegm-saliva, soreness in the body and thighs, and gradual pain in the calves. There is often a blocking sensation of masses of varying lengths or shapes below the umbilicus, either on the left or right, which pulsates upon palpation. The pain spreads downwards; when the epigastric region feels slightly relieved, pain reaches the shins and dorsum of the foot, feeling hot like a brand. Subsequently, pain reaches the toes, with needle-like pain in the nail beds, causing day-and-night screaming, unable to live nor die. Sometimes foot pain subsides slightly, but the epigastric region remains distended and stuffy, sometimes turning the face blue and eyes rolling back. Unconsciousness may occur unless heavy pressure is applied to the chest, or a man presses his heels against it. Both feet require constant rubbing by women to alleviate pain. In severe cases, there are limb convulsions, head and neck trembling, fainting, and collapse. Recovery may take one to two hours or half a day. Regardless of constitution, if the patient fasts for seven days, pain gradually subsides; some take fourteen or twenty-one days. This depends on the appropriateness of the doctor's prescription and the family's mistake of giving porridge, which traps the pathogenic factor.
Historically, Hong Kong Foot was classified into Dry and Wet types. Dry Hong Kong Foot presents with dry, emaciated shins, dorsum, and toes, with pain but no sweat. Wet Hong Kong Foot presents with red, swollen shins, dorsum, and toes, with pain, sweat, and fluid oozing from toe webs. In Yangzhou, it is colloquially divided into Male and Female types. Male Hong Kong Foot involves swelling with white coloration; even if cured, fertility is unlikely due to severe depletion of Qi and Blood, resulting in delayed, scanty menstruation. Female Hong Kong Foot involves swelling with red coloration and burning heat; menstruation occurs early. If treated correctly, fertility can be expected. Generally, the root cause is inherent deficiency of the Liver and Spleen, allowing pathogens to enter due to deficiency. Treatment should address the specific trigger: disperse Wind-Cold if triggered by Wind-Cold; clear Summer-Heat-Dampness if triggered by Summer-Heat-Dampness; warm the Middle and resolve stagnation if triggered by raw/cold food; soothe the Liver and dissipate depression if triggered by anger. By addressing the pattern first, attacks will be milder. Patients should maintain a mindset of being ill even when well, taking pills in the morning focused on nourishing Blood, regulating menstruation, calming the Spirit, and dissipating depression, such as Tiaojing Yangxue Wan, Heche Dazao Wan, Yimu Bazhen Wan, Xiangfu Nv Jindan, or Yiqi Yangrong Wan. Since Yin-nourishing herbs can be cloying, morning doses leverage their "Yang within Yang" nature for easier digestion. Evening doses focus on strengthening the Spleen and harmonizing the Stomach, using formulas like Jiawei Liujunzi Wan, Jiawei Yigong San, Shuidie Zisheng Wan, or Hewei Jianpi Wan, preferably prepared as small water-pellets that dissolve quickly in the stomach during the night (Yin time). Consistent use for three years can permanently eliminate the disease. Patients must also change their temperament and dietary habits.
Regrettably, for forty to fifty years, women in Yangzhou have suffered from this, crying out in agony. Doctors have blindly applied ancient formulas for Five Bi Hong Kong Foot, using herbs like Fangji, Mugua, Qinjiao, Bixie, Weilingxian, Guizhi, Sangzhi, Cangzhu, Houpo, Wuyao, Binglang, Huangbai, Qiannianjian, Zuandifeng, Caoxie, Wujiapi, Haitongpi, Jiangxiangjie, Rougui, Fuzi, Ruxiang, Moyao, Hugu, and Qingpi. These are largely damaging to the Spleen and Liver, breaking Qi and injuring Yin, leaving doctors with few other options. This error stems from doctors fixating on Damp-Heat and the fear of "Hong Kong Foot rushing upward" causing fatal厥逆 (rebellious Qi and cold extremities). They prioritize forcing the pathogen downward, ignoring the patient's Righteous Qi. However, the disease originates from Liver-Spleen deficiency and rebellious Qi attacking the chest. Using harsh purgatives to force downward movement traps both Righteous Qi and Pathogenic Qi, akin to chasing thieves into a dead end, forcing them to escape violently. With nowhere to go in the ten toes, pain becomes excruciating. Overuse of these drugs damages Righteous Qi further, leading to empty "granaries" (digestive system), where Pathogenic Qi runs rampant upward, often fatally. Those with strong constitutions may recover in seven days; weak ones in fourteen; extremely weak in twenty-one. This mirrors the Six Meridian transmission of Shanghan (Cold Damage), where recovery coincides with the restoration of Heaven and Earth Qi, not merely drug efficacy. Early doctors lacked direction, misdiagnosed the cause as chaotic Yin-Yang Qi, and relied on increasing dosages of ineffective ancient formulas. They attributed death to "rushing upward," deeming it incurable. Many died without understanding the true cause. Since the Qin and Han dynasties, texts referred to conditions as Huanfeng, Ruojiao, or Jiaoqi, treating general Wind-Cold-Damp-Heat Bi syndromes, not this specific epidemic affecting women in Yangzhou. Ancient people were simpler, lived in richer soils, and had stronger constitutions. Yangzhou's soil is thin, people are more sensitive, weaker, pampered, comfort-seeking, emotionally volatile, and eat raw/cold foods, leading to Liver-Spleen stagnation. Ancients could not have predicted this specific demographic and environmental combination millennia later. If they had, they would have specified distinct formulas. This condition is unique to these three counties; neighboring areas do not report it. While Yangzhou is damp, causing skin sores or gastrointestinal bloating, or damp-heat descending to legs (red, swollen, weeping), these do not start with epigastric pain or the intense burning pain seen here. Applying ancient formulas is like adding fuel to fire. Some recover with Fangji, Mugua, etc., because they have excess Damp-Heat from rich diets. But applying this to those with deficient Damp-Heat due to poor Spleen function worsens the condition.
Gu Shicheng observes that Yangzhou residents eat poorly, favoring raw/cold foods, leading to Spleen-Stomach dampness. Even after fasting for weeks with no bowel movements, they may still socialize. Prescriptions with Cangzhu, Houpo, Xiangfu, Sharen, Jiang, Rougui, Yuzhu, and Fuzi help. Once eating resumes, decoctions stop. Relapses occur, and doctors repeat the same formulas, which patients trust blindly. However, the Spleen is the mother of all things, and the Stomach is the sea of grain and water. Initially, Cangzhu and Houpo are needed to level the obstructed Spleen Earth. Once leveled, growth can occur. Doctors and patients fail to understand agricultural principles: leveling high ground and filling low ground, then irrigating to grow crops. Constantly using Cangzhu and Houpo to "level the Stomach" turns fertile land into a stagnant pond, leading to Spleen-Stomach deficiency. Gu Shicheng proposes: for high/robust patterns, level the Stomach; for low/deficient patterns, strengthen the Spleen. Mild cases need simultaneous resolving and tonifying; severe cases need warming Fire to generate Earth, using Lizhong Tang with Ginger and Aconite, or Liujunzi Tang with Cinnamon and Aconite. Post-recovery, use Liujunzi Wan, Jiawei Yigong Wan, Jin Gui Shen Qi Wan, Qiwei Dihuang Wan, Guishao Liujunzi Wan, or Shuidie Zisheng Wan according to the pattern to permanently resolve Spleen-Stomach Damp-Heat. Having practiced in Yangzhou, Gu has seen many cases. Women scream, tear their hair, and grind their teeth. By investigating the root, he developed new methods that cure rapidly. Previous doctors misused purgatives, killing many. Now sharing this method to prevent future errors and accumulate virtue.
Hong Kong Foot affects the wealthy, not the working class. The wealthy are overfed, idle, irregular in eating, emotionally repressed or angry, injuring the Liver and Spleen. Working-class women labor, eat simple food, have unobstructed Qi and Blood, and thus resist the pathogen. When infected, symptoms start with chest oppression, epigastric pain, vomiting green phlegm, and a hard mass in the chest. Pain moves down to the legs; as leg pain increases, chest relief occurs, and vice versa, like a ball rolling in a bamboo tube. Mismanagement with greasy foods causes upward rushing of pathogenic Qi, leading to fainting and death. Severe cases require heavy pressure on the chest or men stepping on it to prevent fainting, and constant rubbing of feet. It requires extensive care, impossible for poor families. The "chaotic Yin-Yang Qi" is attracted by individual constitution. Transmission occurs among close female relatives (mother-daughter, sisters, sisters-in-law), though not always. Alcohol may temporarily numb pain but is generally contraindicated. Asking about pain triggers recurrence. Discussing the disease triggers attacks due to Liver deficiency and Gallbladder timidity. Fasting until pain stops and chest opens is key; resume with rice water, avoiding porridge initially. Dietary taboos include fish, shellfish, poultry, eggs, mushrooms, cucumbers, melons, gluten, cilantro, eggplant, beans, fermented products, garlic, chives, bamboo shoots, alcohol, sticky foods, preserved eggs, shrimp, kelp, yellow pomfret, peas, taro, water chestnuts, poppy seeds, radish, fungus, clams, vinegar, tangyuan, lamb, donkey meat, celery, spinach, round cakes, and watermelon. Avoid incense (Benzoin, Rue, Atractylodes) during outbreaks. Recovery time varies; post-menstrual onset lasts longer, while pre-menstrual onset resolves quickly with menstruation, indicating Liver-Spleen stagnation. Rest and abstinence from sex for one month are required. Avoid raw radish, watermelon, peaches, apricots, plums, lotus root, persimmons before menstruation. Avoid oily nuts (walnuts, almonds, peanuts, pine nuts) if vomiting green fluid. Maintain emotional stability and a "sick mindset" when well to prevent recurrence. Uncaria rhynchophylla (Gouteng) dispels Wind and relaxes tendons, serving as a holy medicine for pain relief; use generously.