陈实功曰∶穿踝疽即脚拐毒，乃足三阴经湿热下流，停滞而成。初起内踝肿痛
彻骨，举动艰难，甚则串及外踝通肿。此证若不早治，因循必成废疾。（《正宗》）
又曰∶大法，初起宜荆防败毒散加牛膝，胀者针之，玉红膏敛之，虚者补之。
《心法》曰∶穿踝疽乃脾经寒湿下注，血涩气阻而成。先从内踝骨发起，串及外
踝，至蚀里外，通肿不红，以有头为阳，易破易治，若只闷肿无头为阴，难溃难愈。如
初起寒热往来，有红晕兼有热也，宜荆防败毒散，皮色不变者，宜万灵丹，其余悉同痈疽治法。（《金鉴》）
又曰∶内踝疽生两足内踝近腕之处，属三阴经脉络也。由湿寒下注，血涩气阻而
成。其坚硬漫肿，皮色不变，时时隐痛，难于行走，初宜疮科流气饮加牛膝、木瓜、防
己宣通之，外以蒜灸消散，已成服内托黄 汤，若虚弱者将欲作脓，跳痛者十全大补汤，外敷乌龙膏。
又曰∶穿踝疽，内踝疽，外踝疽，若溃出清水，或投方不应，缠绵日久者，必成废疾，难治。
澄曰∶内踝疽即鞋带疽，属足三阴经脉络，外踝疽即脚拐毒，足三阳经脉络，皆
生两足踝近腕之处，俱由寒湿下注，血涩气阻而成，初宜隔蒜艾灸。
澄曰∶脾经湿毒，流滞足胫骨，烂如 疮，四边紫黑，时流毒水，或淌臭脓，名
曰驴眼疮，俗名夹棍疮，因其疼痛难堪，故名之也。亦有碰伤而成，亦有毒蚊蛇蚤咬伤而起，最难收功。
陈实功说：穿踝疽就是脚拐毒，是由于足三阴经的湿热下注，停滞积聚而形成的。初起时内踝肿痛，痛感直达骨骼，行动困难，严重时肿胀会蔓延至外踝，导致整个脚踝通肿。这个病症如果不尽早治疗，拖延下去必然会导致残疾。（《外科正宗》）
又说：一般的治疗原则是，初起宜用荆防败毒散加牛膝，肿胀明显者针刺放血，溃后使用玉红膏收敛生肌，体虚者予以补益。
《医宗金鉴·外科心法要诀》说：穿踝疽是由于脾经寒湿下注，导致血行涩滞、气机阻滞而形成的。病势先从内踝骨处发起，蔓延至外踝，直至腐蚀内外，整体肿胀但不发红。如果有脓头属于阳证，容易破溃且容易治疗；如果只有闷肿没有脓头属于阴证，难以溃破且难愈。如果初起时有寒热往来，伴有红晕说明兼有热邪，宜用荆防败毒散；皮色不变者，宜用万灵丹，其余治疗方法均同痈疽的一般治法。（《医宗金鉴》）
又说：内踝疽生于两脚内踝靠近脚踝关节之处，归属于足三阴经的脉络。由湿寒之邪下注，导致血行涩滞、气机阻滞而形成。患处坚硬漫肿，皮色不变，时常隐隐作痛，行走困难。初起宜用疮科流气饮加牛膝、木瓜、防己以宣通气血，外用隔蒜灸以消散肿块；成脓期服用内托黄芪汤；若体质虚弱即将化脓，或出现跳痛者，服用十全大补汤，外用乌龙膏敷贴。
又说：穿踝疽、内踝疽、外踝疽，如果溃破后流出清水，或者用药无效，病程缠绵日久者，必然导致残疾，难以治愈。
顾世澄说：内踝疽即鞋带疽，归属于足三阴经脉络；外踝疽即脚拐毒，归属于足三阳经脉络。两者都生于双脚踝部靠近脚踝关节的地方，都是由寒湿之邪下注，导致血行涩滞、气机阻滞而形成的，初起适宜采用隔蒜艾灸的方法。
顾世澄说：脾经湿毒流滞于足胫骨部位，皮肤腐烂如同浅表溃疡，四周呈紫黑色，时常流出毒水，或淌出臭脓，名叫驴眼疮，俗称夹棍疮，因为其疼痛难以忍受，所以得名。也有因碰撞受伤而形成的，也有因毒蚊、蛇、蚤叮咬引起的，最难收口愈合。
Chen Shigong stated: Chuanhuai Ju (Penetrating Ankle Carbuncle), also known as Jiaoguai Du (Ankle Swelling Poison), is caused by damp-heat flowing downward and stagnating in the Foot Three Yin Meridians. Initially, there is swelling and pain at the medial malleolus that penetrates to the bone, making movement difficult; in severe cases, the swelling spreads to the lateral malleolus, causing total ankle edema. If this condition is not treated early, neglect will inevitably lead to disability. (*Waike Zhengzong*)
He further stated: The general treatment principle is that for initial onset, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction) with additional Achyranthes Root should be used; if there is distension, acupuncture should be employed; after ulceration, Yuhong Gao (Jade Red Ointment) should be applied to promote healing; for deficiency patterns, tonification should be provided.
*Yizong Jinjian: Waikexinfa Yaojue* stated: Chuanhuai Ju is formed by cold-dampness descending from the Spleen Meridian, leading to sluggish blood flow and obstructed Qi. The pathology originates from the medial malleolus and spreads to the lateral malleolus, eventually eroding both inside and out, resulting in diffuse swelling without redness. The presence of a head indicates a Yang pattern, which is easy to suppurate and treat; diffuse swelling without a head indicates a Yin pattern, which is difficult to suppurate and heal. If chills and fever occur alternately at the onset with a red halo, it indicates heat accumulation, and Jingfang Baidu San is appropriate; if the skin color remains unchanged, Wanling Dan (Ten Thousand Spirits Pill) is appropriate; other treatments follow standard abscess and carbuncle protocols. (*Yizong Jinjian*)
It further stated: Neihuai Ju (Medial Malleolus Carbuncle) arises near the ankle joint on the inner side of both feet, belonging to the Foot Three Yin Meridians. It is caused by cold-dampness descending, leading to sluggish blood and obstructed Qi. The area is hard and diffusely swollen, with normal skin color, intermittent dull pain, and difficulty walking. Initially, Chuangke Liuqi Yin (Dermatological Flowing Qi Decoction) with additional Achyranthes Root, Chaenomeles Fruit, and Stephania Root should be used to promote circulation; externally, garlic moxibustion should be applied to dissipate the swelling. Once suppuration occurs, Neituo Huangqi Tang (Internal Support Astragalus Decoction) should be taken. For patients with weakness approaching suppuration or experiencing throbbing pain, Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) should be administered, with Wulong Gao (Black Dragon Ointment) applied externally.
It further stated: For Chuanhuai Ju, Neihuai Ju, and Waihuai Ju (Lateral Malleolus Carbuncle), if clear fluid oozes from the ulcer, or if prescribed formulas are ineffective and the disease lingers for a long time, it will inevitably result in disability and is difficult to cure.
Gu Shicheng stated: Neihuai Ju, also known as Xiedai Ju (Shoelace Carbuncle), belongs to the Foot Three Yin Meridians; Waihuai Ju, also known as Jiaoguai Du, belongs to the Foot Three Yang Meridians. Both arise near the ankle joints of both feet and are caused by cold-dampness descending, leading to sluggish blood and obstructed Qi. Initial treatment should involve garlic moxibustion.
Gu Shicheng stated: When damp-toxin from the Spleen Meridian stagnates in the tibia region, the skin rots like superficial ulcers, with purple-black edges, frequently discharging toxic fluid or foul pus. This is named Lvyan Chuang (Donkey Eye Ulcer), commonly known as Jiagun Chuang (Pillory Ulcer), named so because the pain is unbearable. It may also result from trauma or bites from poisonous insects, snakes, or fleas, and is extremely difficult to heal.