《医宗金鉴》云∶青腿牙疳，此证自古方书罕载，其名仅传。雍正年间北路随营
医官陶麟起颇得其详，略云∶军中凡病腿肿色青者，其上必发牙疳；凡病牙疳腐血
者，其下必发青腿。二者相因而至，推其原皆因上为阳火炎炽，下为阴寒闭郁，以
至阴阳上下不交，各自为寒为热，各为凝结而生此证也。相近内地间亦有之，边外
虽亦有，不甚多，惟内地民众初赴边外，得此证者十之八九。盖中国之人，本不耐边
外苦寒风冷，况坐卧湿地，故寒湿之痰生于下，致腿膝青肿，其病形如云片，色似
乌茄，肉体顽硬，所以步履艰难也。又缘边外缺少五谷，多食牛羊等肉，其肥腻腥
膻，瘀滞于胃，毒火上熏，致生牙疳，牙龈腐烂出血。若穿腮破唇，腐烂色黑，即
为危候。边外相传有令服马乳之法，麟初到军营诊视青腿牙疳之证，亦仅以马乳。阅
历既久，因悟其马脑之温，不如易之马乳，为效倍速，令患者服之，是夜即能发出，诸
证减矣。盖脑为诸阳之首，其性温暖，且能流通故耳，兼服活络流气饮，加味二妙
汤，宣其气血，通其经络，使毒不得凝结，外用砭法，令恶血流出以杀毒势，更以牛
肉片贴敷以拔积毒，不数日而愈。盖黑血出则阴气外泄，阳气即随阴气而下降，两
相交济，上下自安矣。由是习为成法，其中活者颇多。因不敢自私，着之于书，以公于世。
又曰∶形气衰败，饮食不思者，不治。牙齿俱落，紫黑血流，腐溃秽臭者，不治。
腿大肿腐烂，或细而干枯者，不治。
《医宗金鉴》记载：青腿牙疳这一病证，自古以来的医书中很少记载，其名称仅流传下来。雍正年间，北路随营医官陶麟起对此病了解得非常详细，大致说：军队中凡是出现腿部肿胀且颜色发青的病症，患者上部必定并发牙疳；凡是患有牙疳并伴有腐烂出血症状的，其下部必定并发青腿。这两种病症相互关联而同时发生，推究其根源，都是因为上部阳火炽盛，下部阴寒闭郁，导致阴阳之气上下不能交通，各自形成寒热之邪，进而凝结产生此病。在靠近内地的地方也有此病，边塞之外虽然也有，但数量不多，只有内地民众初次前往边塞之外时，得此病的占十之八九。大概是因为中国人本来就不适应边塞外面苦寒风冷的环境，加上坐卧在潮湿的土地上，所以寒湿之痰生成于下部，导致腿膝部位青肿，病状形状像云片一样，颜色像乌茄子，肌肉皮肤坚硬顽固，因此行走困难。又因为边塞之外缺少五谷杂粮，人们多吃牛羊等肉类，这些食物肥腻腥膻，瘀滞于胃中，毒火上熏，导致生出牙疳，牙龈腐烂出血。如果发展到穿腮破唇，腐烂处颜色发黑，就是危重的征候。边塞之外相传有让患者服用马奶的方法，陶麟起初到军营诊治青腿牙疳的病证时，也仅仅使用马奶。经过长时间的阅历观察，他领悟到马脑的温性作用，不如改用马奶，疗效加倍迅速，让患者服用后，当天晚上就能使毒气发出，各种症状减轻。大概是因为脑为诸阳之首，其性质温暖，且能流通的缘故，（后来）兼服活络流气饮、加味二妙汤，以宣通气血，疏通经络，使毒邪不得凝结，外用砭法，让恶血流出以杀灭毒势，再用牛肉片贴敷以拔出积存的毒邪，不出几天就能痊愈。大概是因为黑血排出则阴气外泄，阳气随即随着阴气而下降，两者相互交济，上下自然安宁了。从此这成为固定的治疗方法，其中治愈的人很多。因为不敢独自占有，便将其著录在书中，公之于世。又说：形体正气衰败，不想饮食的，属于不治之症。牙齿全部脱落，流出紫黑色血液，腐烂溃烂且有秽臭气味的，属于不治之症。腿部严重肿胀腐烂，或者细小干枯的，属于不治之症。
*Yi Zong Jin Jian* (Golden Mirror of Medicine) states: Qing Tui Ya Gan (Green Leg and Gum Gangrene), this syndrome is rarely recorded in ancient medical texts, with its name merely passed down. During the Yongzheng reign, Tao Linqi, a military physician attached to the northern route camp, understood its details quite well. He briefly stated: In the army, whenever patients suffer from leg swelling with a bluish color, they must simultaneously develop Ya Gan (Gum Gangrene) above; whenever patients suffer from Ya Gan with rotting blood, they must simultaneously develop Qing Tui (Green Leg) below. These two conditions arise mutually and concurrently. Tracing their origin, it is all due to Yang Fire blazing excessively above and Yin Cold closing and stagnating below, leading to a failure of Yin and Yang Qi to interact between upper and lower parts. Each generates cold or heat independently, condensing to produce this syndrome. It also occurs in areas near the interior regions. Although it exists outside the borderlands, it is not very common. However, among the populace from the interior who first go to the borderlands, eight or nine out of ten contract this syndrome. This is because people from China are inherently不耐 (not resistant to) the bitter wind and cold of the borderlands. Moreover, sitting and sleeping on damp ground causes Phlegm of Cold-Dampness to generate in the lower part, resulting in bluish swelling of the legs and knees. The lesion resembles cloud patches, the color resembles that of an eggplant, the flesh becomes hard and stubborn, making walking difficult. Furthermore, due to the scarcity of grains outside the borders, people consume much beef and mutton. The greasy, fishy, and muttony nature of these foods causes stasis in the Stomach, with Toxic Fire steaming upward, leading to Ya Gan (Gum Gangrene), where gums rot and bleed. If it progresses to perforating the cheeks and lips, with blackish rotting tissue, it indicates a critical prognosis. Outside the borders, there is a tradition of administering Horse Milk (Equus caballus milk). When Tao Linqi first arrived at the military camp to treat Qing Tui Ya Gan, he initially used only Horse Milk. After extensive experience, he realized that the warming property of Horse Brain was inferior to Horse Milk, which yielded twice as fast results. Upon instructing patients to take it, the toxins were expelled that very night, and various symptoms subsided. This is likely because the brain is the head of all Yang meridians, possessing a warm nature and facilitating circulation. Subsequently, Huoluo Liuqi Yin (Circulating-Activating Decoction for Unblocking Collaterals) and Jia Wei Er Miao Tang (Modified Two-Awesome Decoction) were added to promote Qi and Blood circulation, unblock meridians, and prevent toxin condensation. Externally, Bian Fa (Scarification Therapy) was used to let evil blood flow out to kill the toxic pathogen, followed by applying slices of beef to draw out accumulated toxins. Within a few days, recovery occurred. Essentially, when black blood is discharged, Yin Qi leaks outward, and Yang Qi descends following Yin Qi. The two interact harmoniously, bringing peace to both upper and lower parts. Thus, it became a standard method, saving many lives. Not daring to keep it private, he recorded it in a book to share with the world. He further stated: Cases where physical constitution and Zheng Qi (Upright Qi) are exhausted, and there is no desire for food, are incurable. Cases where all teeth fall out, purple-black blood flows, and the tissue rots with a foul odor are incurable. Cases where the legs are massively swollen and rotting, or thin and dry/withered, are incurable.