凡脚 及曲 中痒,搔则黄汁出,名风疽。治之方。以青竹筒一枚,径一寸半,长
三尺,当中着大豆一升,以糠、马屎二物烧为火,当竹筒中烧之,以器承两头取汁。先
以泔清和盐,热洗疮了,即涂豆汁,不过三度极效。
又方 嚼胡麻敷。以绵裹之,日一易,神良。
防风汤 治风毒中人,留血脉不散,与荣卫相搏,结成风疽。身体烦热,昏冒肿痛。
防风(去叉) 柴胡(去苗) 白芷 木通(锉) 当归(切,焙) 羌活(去芦) 麻黄
(去根节,煎掠去沫,焙) 附子(炮,去皮脐) 桔梗(炒) 甘草(炙,各一两)
上锉如麻豆大。每服五钱,水一盏半,煎至八分去滓。食后临卧各一服;如欲出汗,空
心并两服,后以热姜稀粥投,盖覆取汗,慎外风。
海桐皮散浸酒方 治热毒风结成疽,肿痛不得安。
海桐皮 五加皮(各锉) 独活(去芦) 薏苡仁(炒) 防风(去叉) 干蝎(炒) 杜
仲(去粗皮) 牛膝(去苗,酒浸,各一两) 生地黄(焙,三两)
上 咀,生绢囊贮,以好酒一斗五升,浸瓷瓶中密封,秋夏三日,春冬七日取。食前,
温酒三合或四五合,不拘时。甚者,常气相续。
《灵枢》云,发于足上下,名曰四淫。其状大痈,不急治之,百日死。发于足傍,名
曰厉痈。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。
〔薛〕 脚发之证,属足三阴经,精血亏损,或足三阳经湿热下注。若色赤肿痛而溃
脓者,属湿热下注,为可治。若色微赤微肿,而脓清者,属精血亏损,为难治。若黑黯不
肿痛,不溃脓,烦热作渴,小便淋漓者,阴败末传,恶证也,为不治。其法湿热下注者,
先用隔蒜灸,活命饮以解壅毒,次服益气汤、六味丸以补精气。若色黯不痛者,着肉灸,桑
枝灸以行壅滞助阳气,更用十全大补汤、八味丸壮脾胃,滋化源,多有复生者。若专治
其疮,复伤元气,吾未见其生者。 阁老靳介庵,脚指缝作痒出水,肿 脚面,敷止痒
之药不应,服除湿之剂益甚。予以为阴虚湿热下注,用六味地黄丸、补中益气汤愈。
大参李北溪,左足赤肿作痛,此足三阳经湿热下注。先用隔蒜灸,活命饮一剂,其痛顿
止,灸患处出水,赤肿顿消,次用托里消毒散四剂,灸患处出脓而愈。 儒者杨举元患
此,微肿痛,微赤 ,此足三阴经,阴虚湿热下注。用隔蒜灸,托里散而起发,用十全
大补汤而脓成,又与加减八味丸料,百剂而敛。一儒者患此,肿硬色白,两月余矣,此
足三阴经亏损,为外寒所侵,用大防风汤及十全大补,兼服而消。后场屋不利,饮食劳
倦,前症复作,盗汗内热,饮食不化,便滑肌瘦,此脾土虚寒而命门火不能相生,用八
味丸、益气汤百余剂,喜其年壮得愈。 一男子,脚心发热,作渴引饮,或用四物,芩、
连、黄柏、知母辈。腹痛作呕,烦热大渴,此足三阴亏损,前药复伤脾胃也。先用六君加
炮姜,数剂而脾胃醒,再用补中益气加茯苓、半夏而脾胃健,乃以加减八味丸,兼服半载
而愈。 一儒者,脚心发热作痒,以滚汤浸渍,溃而出水,肌体骨立,作渴吐痰,此脾
肾虚而水泛为痰也。服益气汤、六味丸年余,元气复而诸证愈。 少宗伯顾东江,面黧作
渴。予曰∶此肾经亏损,当滋化源,以杜后患。彼虽然之,而终不服,次年九月,内左
足面患疽,色黯不痛,脚腿沉重,用隔蒜灸三十余壮,足腿即轻,疮出血水,数日而消。
疮色仍黯,时公将北行,贺万寿。予诊之曰∶脾脉衰惫,阳气虚极,不宜远行,公曰∶予
得梦屡验,向梦群仙待我,此寿征也。至河驿聚仙堂病笃,叹曰∶立斋岂能留我?果卒
于此,亦异数也。
凡是脚部及膝盖弯曲处瘙痒,抓挠后有黄色汁液流出,称为风疽。治疗此病的方剂:取一根青竹筒,直径一寸半,长三尺,在竹筒中间放入一升大豆,用糠和马粪两种燃料在竹筒下方燃烧,用容器承接竹筒两头流出的汁液。先用淘米水加盐,加热后清洗疮口,然后涂抹豆汁,不超过三次即可见效。
又一方:嚼碎胡麻敷于患处。用棉布包裹,每天更换一次,效果极佳。
防风汤:治疗风毒侵入人体,滞留血脉不散,与营卫之气相搏结,形成风疽。症状表现为身体烦热、头昏目眩、肿痛。
药物组成:防风(去叉)、柴胡(去苗)、白芷、木通(锉碎)、当归(切片,焙干)、羌活(去芦头)、麻黄(去根节,煎煮时撇去浮沫,焙干)、附子(炮制,去皮脐)、桔梗(炒)、甘草(炙,各一两)。
将上述药材锉成如麻豆大小的颗粒。每次服用五钱,加水一盏半,煎至八分,去渣。饭后和临睡前各服一次;如果想要发汗,空腹时将两服药一起服用,随后喝热姜稀粥,盖被取汗,注意避免受外风侵袭。
药物组成:海桐皮、五加皮(各锉碎)、独活(去芦头)、薏苡仁(炒)、防风(去叉)、干蝎(炒)、杜仲(去粗皮)、牛膝(去苗,酒浸,各一两)、生地黄(焙干,三两)。
将药材切碎,装入生绢袋中,用优质酒一斗五升浸泡在瓷瓶中并密封,夏秋季节浸泡三天,冬春季节浸泡七天取出。饭前温服三合或四五合,不拘时间。病情严重者,可连续服用。
《灵枢》记载,生于足上下方的,名为四淫。其状为大痈,若不紧急治疗,百日死亡。生于足旁的,名为厉痈。其状不大,初起从小指开始,需紧急治疗去除。
如果疮色发黑,不能消散反而增大,不治疗则百日死亡。
〔薛己〕 脚发的病症,属于足三阴经,因精血亏损,或足三阳经湿热下注所致。若颜色红赤、肿痛且溃破流脓的,属于湿热下注,为可治之症。若颜色微红微肿,且脓液清稀的,属于精血亏损,为难治之症。若颜色黑黯、不肿痛、不溃破流脓,伴有烦热口渴、小便淋漓不尽的,是阴气败坏末期传变而来的恶证,属不治之症。对于湿热下注者,先用隔蒜灸法,服用活命饮以解壅滞之毒,接着服用益气汤、六味丸以补益精气。若颜色黑黯且不痛的,用着肉灸、桑枝灸以疏通壅滞、助长阳气,再用十全大补汤、八味丸壮脾胃、滋生化之源,多有康复者。若只治疗疮疡,反而损伤元气,我未见有能存活者。
阁老靳介庵,脚趾缝瘙痒出水,肿胀至脚面,敷止痒药无效,服除湿剂反而加重。我认为这是阴虚湿热下注,用六味地黄丸、补中益气汤治愈。
大参李北溪,左足红赤肿胀疼痛,这是足三阳经湿热下注。先用隔蒜灸,服用一剂活命饮,疼痛立刻停止,灸患处出水,红赤肿胀立刻消退,接着服用托里消毒散四剂,灸患处出脓而痊愈。
儒者杨举元患此病,轻微肿痛,微红,这是足三阴经阴虚湿热下注。用隔蒜灸,托里散促使疮势起发,用十全大补汤使脓液生成,又给予加减八味丸料,服用百剂后收敛愈合。
一位儒者患此病,肿胀坚硬色白,已两个多月,这是足三阴经亏损,被外寒侵袭,用大防风汤及十全大补汤兼服而消散。后来科举不利,饮食劳倦,前症复发,出现盗汗内热、饮食不化、便溏肌瘦,这是脾土虚寒而命门火不能相生,用八味丸、益气汤百余剂,庆幸他年轻力壮得以痊愈。
一名男子,脚心发热,口渴引饮,有人用四物汤及黄芩、黄连、黄柏、知母等药。导致腹痛呕吐,烦热大渴,这是足三阴经亏损,前面的药物再次损伤了脾胃。先用六君子汤加炮姜,数剂后脾胃功能恢复,再用补中益气汤加茯苓、半夏使脾胃强健,然后服用加减八味丸,兼服半年而愈。
一位儒者,脚心发热作痒,用滚水浸渍,溃破出水,形体消瘦如骨立,口渴吐痰,这是脾肾虚而水泛为痰。服用益气汤、六味丸一年多,元气恢复诸证痊愈。
少宗伯顾东江,面色黧黑作渴。我说:这是肾经亏损,应当滋生化源,以杜绝后患。他虽然口头答应,但最终不服药,次年九月,左侧足面患疽,颜色黑黯不痛,腿脚沉重,用隔蒜灸三十多壮,腿脚即感轻快,疮口出血水,数日后消退。但疮色仍黑黯,当时公将要北上贺万寿。我诊脉说:脾脉衰惫,阳气极度虚弱,不宜远行。他说:我做梦屡次应验,先前梦见群仙待我,这是长寿的征兆。到了河驿聚仙堂病重,感叹道:立斋怎能留住我?果然死于此地,也是奇事。
Whenever the feet and the popliteal fossa (area behind the knee) itch, and scratching produces yellow exudate, it is called Wind Abscess (Feng Ju). The treatment formula: Take one green bamboo tube, one and a half cun in diameter and three chi long. Place one sheng of soybeans in the middle of the tube. Burn rice bran and horse manure as fuel beneath the tube to distill the juice, collecting the liquid from both ends of the tube with vessels. First, wash the sore with warm water mixed with salt and lye (fermented rice water), then apply the bean juice. It will be extremely effective within no more than three applications.
Another prescription: Chew sesame seeds and apply them to the affected area. Wrap with cotton cloth, changing once daily; this is highly effective.
Fangfeng Tang (Saposhnikovia Decoction): Treats wind-toxin invading the human body, stagnating in the blood vessels without dispersing, clashing with Ying-Wei (Nutritive and Defensive Qi), resulting in the formation of Wind Abscess. Symptoms include bodily restlessness and heat, dizziness, swelling, and pain.
Ingredients: Fangfeng (Saposhnikovia Radix, fork removed), Chaihu (Bupleuri Radix, sprouts removed), Baizhi (Angelicae Dahuricae Radix), Mutong (Akebiae Caulis, chopped), Danggui (Angelicae Sinensis Radix, sliced, dried by heat), Qianghuo (Notopterygii Rhizoma et Radix, rhizome removed), Mahuang (Ephedrae Herba, roots and nodes removed, boiled to skim foam, dried), Fuzi (Aconiti Lateralis Radix Praeparata, processed, skin and navel removed), Jiegeng (Platycodonis Radix, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 1 liang).
Crush the above herbs into pieces the size of hemp seeds. For each dose, take 5 qian, add 1.5 sheng of water, decoct until reduced to 0.8 sheng, then strain. Take one dose after meals and one before bed; if sweating is desired, take both doses on an empty stomach, followed by hot ginger thin gruel, cover with blankets to induce sweating, and strictly avoid exposure to external wind.
Haitongpi San Soaked Wine Prescription: Treats heat-toxin and wind clumping to form abscesses, causing painful swelling and discomfort.
Ingredients: Haitongpi (Pseudosasa Caulis), Wujia Pi (Acanthopanacis Cortex, each chopped), Duhuo (Angelicae Pubescentis Radix, rhizome removed), Yiyiren (Coicis Semen, stir-fried), Fangfeng (Saposhnikovia Radix, fork removed), Ganxie (Scorpio, stir-fried), Duzhong (Eucommiae Cortex, rough bark removed), Niuxi (Achyranthis Bidentatae Radix, sprouts removed, soaked in wine, each 1 liang), Shengdihuang (Rehmanniae Radix, dried by heat, 3 liang).
Chop the herbs, store in a raw silk bag, and soak in 1.5 dou of good wine in a porcelain bottle, sealed tightly. In autumn and summer, soak for three days; in spring and winter, soak for seven days, then retrieve. Before meals, take 3 or 4-5 he of warm wine, at any time. For severe cases, take continuously.
The *Ling Shu* states: When occurring above and below the foot, it is called Si Yin (Four Licentiousnesses). Its appearance is a large carbuncle; if not treated urgently, death occurs within one hundred days. When occurring on the side of the foot, it is called Li Yong (Malignant Carbuncle). Its appearance is not large, initially starting from the little toe; treat urgently to remove it. If the lesion appears black, it cannot dissipate and will increase; if untreated, death occurs within one hundred days.
[Xue Ji] The syndrome of Jiao Fa (Foot Erysipelas/Carbuncle) belongs to the Foot Three Yin Meridians, caused by deficiency of essence and blood, or damp-heat pouring downward from the Foot Three Yang Meridians. If the color is red, swollen, painful, and suppurates, it belongs to damp-heat pouring downward and is treatable. If the color is slightly red and slightly swollen, with clear pus, it belongs to deficiency of essence and blood and is difficult to treat. If the color is dark/black, without swelling or pain, without suppuration, accompanied by irritability, heat, thirst, and dribbling urination, it is a malignant sign indicating terminal failure of Yin, which is incurable. For damp-heat pouring downward, first use Garlic-Separated Moxibustion, then administer Huoming Yin (Life-Saving Decoction) to resolve toxic stagnation, followed by Yiqi Tang (Qi-Boosting Decoction) and Liuwei Wan (Six-Ingredient Pill with Rehmannia) to tonify essence and qi. If the color is dark and painless, use Flesh-Adhering Moxibustion and Mulberry Branch Moxibustion to unblock stagnation and assist yang qi, further using Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) and Bawei Wan (Eight-Ingredient Pill) to strengthen the spleen and stomach and nourish the source of transformation; many recover. If one only treats the sore while damaging the healthy qi, I have never seen survival.
Grand Secretary Jin Jian'an had itching and weeping between his toes, swelling to the dorsum of the foot. Topical anti-itch medicines were ineffective, and damp-draining agents worsened the condition. I diagnosed it as yin-deficiency with damp-heat pouring downward and cured him with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) and Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction).
Grand Councilor Li Beixi had red, swollen, and painful left foot, due to damp-heat pouring downward in the Foot Three Yang Meridians. He first received Garlic-Separated Moxibustion and one dose of Huoming Yin, which immediately stopped the pain. Moxibustion on the lesion produced exudate, and the redness and swelling subsided instantly. He then took four doses of Tuoli Xiaodu San (Interior-Supporting Toxin-Resolving Powder); moxibustion on the lesion produced pus, leading to recovery.
Scholar Yang Juyuan suffered from this, with slight swelling, pain, and redness, due to yin-deficiency and damp-heat pouring downward in the Foot Three Yin Meridians. He used Garlic-Separated Moxibustion and Tuoli San (Interior-Supporting Powder) to promote maturation, Shiquan Dabu Tang to generate pus, and Jiabian Bawei Wan (Modified Eight-Ingredient Pill) material, taking over a hundred doses until healing.
Another scholar suffered from this, with hard, white swelling for over two months, due to deficiency of the Foot Three Yin Meridians invaded by external cold. He used Da Fangfeng Tang (Major Saposhnikovia Decoction) and Shiquan Dabu Tang concurrently, leading to resolution. Later, due to examination failures, dietary irregularities, and fatigue, the previous symptoms recurred with night sweats, internal heat, indigestion, loose stools, and emaciation. This indicated spleen-earth deficiency-cold and mingmen fire failing to generate support. He took Bawei Wan and Yiqi Tang for over a hundred doses; fortunately, being young, he recovered.
A man suffered from heat in the soles of his feet and excessive thirst. Others prescribed Siwu Tang (Four-Substance Decoction) along with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), and Zhimu (Anemarrhenae Rhizoma). This led to abdominal pain, vomiting, irritability, heat, and extreme thirst. This was deficiency of the Foot Three Yin Meridians, and the previous medicines further damaged the spleen and stomach. He first took Liujun Zi Tang (Six-Gentlemen Decoction) with Paojiang (Prepared Ginger) for several doses to restore spleen-stomach function, then Buzhong Yiqi Tang with Fuling (Poria) and Banxia (Pinelliae Rhizoma) to strengthen the spleen and stomach, followed by Jiabian Bawei Wan (Modified Eight-Ingredient Pill) taken concurrently for half a year until recovery.
A scholar suffered from heat and itching in the soles of his feet. He soaked them in boiling water, causing ulceration and weeping. His body became emaciated ("standing like bones"), with thirst and expectoration. This was spleen-kidney deficiency with water overflowing to form phlegm. He took Yiqi Tang and Liuwei Wan for over a year; his healthy qi recovered, and all symptoms resolved.
Vice Minister Gu Dongjiang had a sallow complexion and thirst. I said: "This is kidney meridian deficiency; you should nourish the source of transformation to prevent future complications." Although he agreed verbally, he ultimately did not take medicine. In September of the following year, he developed an abscess on the dorsum of his left foot, dark in color and painless, with heavy legs. He underwent over thirty moxa cones of Garlic-Separated Moxibustion, after which his legs felt lighter, and the sore bled fluid, resolving in a few days. However, the sore remained dark. At that time, he was preparing to travel north to congratulate the Emperor's birthday. I examined his pulse and said: "The spleen pulse is weak and exhausted, and yang qi is extremely deficient; long-distance travel is inadvisable." He replied: "My dreams have often come true; previously I dreamed of immortals awaiting me, which is a sign of longevity." He fell critically ill at Hexi Juxiantang and sighed: "Can Lizhai keep me alive?" He indeed died there, which was also an extraordinary event.