〔丹〕痛风论 气行脉外，血行脉内，昼行阳二十五度，夜行阴二十五度，此平人之造化
也。得寒则行迟而不及，得热则行速而太过。内伤于七情，外伤于六气，则气血之运或迟或
速，而疾作矣。彼痛风者，大率因血受热，已自沸腾，其后涉于冷水，或立湿地，或扇风取
凉，或坐卧当风，寒凉外搏，热血得寒，污浊凝涩，所以作痛，夜则痛甚，行于阴也。治法
以辛热之剂，流散寒湿，发腠理。其血得行，与气相和，其病自安。然亦有数种，治法各异
，谨书一二，以证予言。一治东阳傅丈腿痛，一治朱宅阃内痛挛，一治邻鲍子痢后风，皆数
十帖半年安（详见后丹溪先治内热条）。或问∶比见邻人，用草药研酒饮之，不过数帖，
亦有安者，如子之言，类皆经久取效，无乃太缓乎？予曰∶此劫病草药，石上采丝为之君，
过山龙等佐之，皆性热而燥者，不能养阴，却能燥湿。病之浅者，湿疾得燥则开，热血得热
则行，亦可取效。彼病深而血少者，愈劫愈虚，愈劫愈深，若朱之病是也。子以我为迂缓乎
！（朱之病，即朱阃挛痛医十月不应，而丹溪起之也）
潜行散 治痛风。黄柏一味，酒浸焙干，为末。生姜汁和酒调服，必兼四物等汤相间服之妙。
二妙散 治筋骨疼痛因湿热者。如有气加气药；如血虚加补血药；如痛甚以姜汁热辣服之。
黄柏（炒） 苍术（炒制，去皮）
上为粗末。生姜研入，汤煎沸，调服。此二物皆有雄壮之气，如表实气实者，少酒佐
之。一法，二妙为君，加甘草、羌活各二钱，陈皮、芍药各一钱，酒炒威灵仙半钱，为末服之佳。
一男子，家贫多劳，秋凉忽浑身发热，两臂膊及腕，两足及胯，皆疼痛如锻，昼轻夜剧
。医与风药则愈痛，与血药则不效，惟待毙而已。予脉之，两手俱涩而数，右甚于左。问其
饮食，则如平时。形瘦则如削尽，盖大痛而瘦，非病也。用苍术一钱半，酒黄柏一钱半，生
附一片，生甘草三分，麻黄五分，研桃仁九个，作一帖煎，入姜汁些少令辣，热服。至四帖
后，去附子，加牛膝一钱。至八帖后，来告急云∶气上喘促不得睡，痛似微减。此时昏黑不
能前去诊视，予意其血虚，因服麻黄过剂，阳虚被发动而上奔，当与补血镇坠带味酸之药以
收之。遂以四物汤加川芎、芍药、人参二钱，五味子十二粒，作一帖。与二帖服之，喘促随
定，是夜遂安。三日脉之，数减大半，涩脉如旧。问其痛，则曰不减，然呻吟之声却无。察
其起居，则疲弱无力，病患却自谓不弱。遂以四物汤加牛膝、白术、人参、桃仁、陈皮、甘
草、槟榔，入姜三片煎服。如此药与五十帖而安。一月后，因负重担，痛复作，饮食亦少，
再与此药，每帖加黄 三分，又二十帖方全愈。东阳傅丈，年逾六十，性急作劳，患两腿痛
，动作则痛甚。予视之曰∶此兼虚证，当补血虚，病自安。遂与四物汤加桃仁、陈皮、牛膝
、生甘草，煎入生姜，研潜行散，热饮，三四十帖而安。
何县长，年四十余，形瘦性急，因作劳背疼，臂痛，骨节疼，足心发热，可与四物汤。
带热，下大补丸，保和丸共六十粒，食前服。
妇人脚疼，脚怕冷，夜剧日轻。
生地 白芍 归尾（各五钱） 黄柏（炒） 黄芩 白术 陈皮（各三钱） 牛膝（二钱） 苍术（三钱）
甘草梢（一钱）
上分六帖，煎服。食前热饮之。
邻人鲍子，年二十余，因患血痢，用涩药取效。后患痛风，号叫撼邻里。予视之曰∶此
恶血入经络证，血受湿热，久为凝浊，所下未尽，留滞隧道，所以作痛，经久不治，恐成枯
细。遂与四物汤、桃仁、红花、牛膝、黄芩、陈皮、甘草，煎生姜汁，研潜行散，入少酒饮
之，数十帖。又与刺委中，出黑血近三合而安。
痢后风，系血入腑腑，下未尽，复还经络，不得行故也。松明节一两，以乳香一钱，炒
焦存性，苍术一两，紫葳一两半，甘草半两，黄柏一两，桃仁去皮不去尖一两，俱为末。每
服三钱，生姜同杵细，水荡起二三沸服。
朱宅阃内，年三十，食味甚浓，性亦躁急，患痛风挛缩数月，医不应。予视之曰∶此挟
痰与气症，当和血疏痰导气，病自安。遂以潜行散，入生甘草、牛膝、枳壳、通草、陈皮、
桃仁、姜汁煎饮半年而安。
陆郎左腿HT 骨旧痛，小便赤少，此积忧痰涎所为。
白术 枳壳 赤芍（一钱） 条芩 连翘 通草 甘草梢（三分）
六安人脚HT 骨痛。
苍术 白术 陈皮 芍药（三分） 木通（二钱） 甘草（五分）
分四帖煎下大补丸四十粒。
上丹溪治痛风法，主于血热、血虚、血污，或挟痰，皆不离四物、潜行、黄柏、牛膝、
生甘草、桃仁、陈皮、苍术、生姜汁，而随症加减，发前人之所未发，医世俗之所不医，其
有功于世也大矣。
〔《本》〕王检正患鼻额间痛，或麻痹不仁，如是数年。忽一日，连口唇颊车发际皆痛，
不开口，虽言语饮食，亦妨，在额与颊上常如糊，手触之则痛。予作足阳明经络受风毒，传
入经络，血凝滞而不行，故有此症。或者以排风、小续命、透髓丹之类与之，皆不效。制此
犀角升麻汤赠之，数日而愈。
犀角（一两一钱） 升麻 防风 羌活（各三两） 川芎 白附 白芷 黄芩（各半两） 甘草（一分）
上粗末。每服四大钱，水一盏半，煎至八分，去渣，通口食后服，临卧一服，日三四服
。足阳明，胃也。经云∶肠胃为市。又云∶阳明多血多气。
胃之中，腥膻五味，无所不纳，如市廛无所不有也。六经之中，血气俱多，腐熟
饮食，故饮食之毒，聚于胃。此方以犀角为主，解饮食之毒也。阳明经络环唇挟舌，起于鼻
合中，循颊车上耳前，过客主人，循发际至额颅。王公所患，皆一经络也，故以升麻
佐之。余药皆涤除风热，升麻、黄芩，专入胃经，稍通者自能晓。
〔海〕四物苍术各半汤 治肢肿，不能举动。四物汤、苍术各半两，同煎服效（与活血丹相表里）。
活血丹 与四物苍术各半汤相表里，治遍身骨节疼痛如神。
熟地黄（三两） 当归 白术 白芍 续断 人参（各一两）
上细末。酒糊丸，如桐子大。
〔东垣〕苍术复煎散 治寒湿相合，脑户痛，恶寒，项筋脊强，肩背胛卵痛，膝膑痛，无
力行步，能食，身沉重，其脉沉缓洪上急。
苍术（四两，水二碗煎至二大盏，去渣，入下药） 羌活（一钱） 升麻 柴胡 本 泽泻
白术（各五分） 黄柏（三分） 红花（少许）
上为粗末。用苍术汤二盏，煎至一大盏，去渣温服，空心，微汗为效。忌酒面。
缓筋汤 治目如火肿痛，两足及伏兔骨筋痛，膝少力，身重腰痛，夜恶寒痰嗽，项颈筋
骨皆急痛，目多眵泪，食不下。
羌活（二钱） 独活（二钱） 本（三分） 麻黄（三分） 苏木（一分） 升麻（三分） 甘草（炙，二分） 草
蔻（三分） 生地 黄芩 黄柏（各三分） 苍术（五分） 归身（三分） 柴胡（三分） 熟地（二分） 生甘草根
（二分）
上为粗末。都作一服，水二盏，煎至一盏，去渣热服，食远。
〔仲〕桂枝芍药知母汤 〔河间〕防风汤。（以上二方治痛风神妙，并见行痹表条）
〔世〕治痛风。
草乌（四两，去尖） 木鳖子（三两，去壳） 自然铜（一两， ） 香白芷（三两） 没药（二两，另研）
南星（二两） 威灵仙（二两） 地龙（三两）
糊为丸。每服十五粒。
〔罗〕活血应痛丸 治风湿客于肾经，血脉凝滞，腰背肿疼，不能转侧，皮肤不仁，遍身
麻木，上攻头目虚肿，耳内常鸣，下注脚膝重痛少力，行履艰难，项背拘急，不得舒畅。常
服和血脉，壮筋骨，使气脉宣通。
狗脊（去毛，六两） 苍术（泔浸一宿，十两） 香附（炒，十二两） 陈皮（九两） 没药（一两二钱）
草乌（二两半，炮） 威灵仙（三两）
上为细末，酒煮面糊为丸，如桐子大。每服十五丸，温酒或热汤送下，不拘时候。久服
。忌桃李雀鸽诸血物。
〔丹〕八珍汤 治一切痛风，香港脚头风。
乳香 没药 代赭石 穿山甲（生用，三钱） 川乌（不去皮尖，生用，一两） 草乌（不去皮
尖，生用，五钱） 羌活（半两） 全蝎（二十一个，用头尾全者）
上醋糊丸，如桐子大。每服十一丸。
〔罗〕乌灵丸 治久患风寒，麻木痛，行步艰难。
五灵脂（二两） 川乌（一两，炮，去皮脐）
上为细末。酒煮面糊为丸，如桐子大。每服十丸，加至五十丸，空心温酒下。忌一切冷物。
史丞相遇仙方 治诸般痛风，手足艰难，筋骨疼痛，口眼 斜，言语謇涩。
附子（炮，去皮脐） 川乌（炮，去皮脐） 当归（酒浸，焙） 川芎 羌活 肉苁蓉（酒浸
，炮） 杜仲（去皮，炒去丝，姜汁制） 黄 白蒺藜（炒，去刺） 白术 人参 川牛膝（酒
浸，焙去芦） 防风 天麻（去苗） 白茯苓 萆 狗脊（炒，去毛） 续断 独活 肉桂（去
粗皮） 赤芍（各一两） 虎胫骨 （二两半，酥炙）
上二十二味，切细，以生绢袋盛之，用无灰酒浸，密封瓶口，春三日，夏二日，秋七日
，冬十日，取出晒，焙干为末，酒糊丸，如桐子大。用浸药酒一盏，送下五十丸，空心服。
忌生冷油腻豆腐面食发风之物。
〔世〕五加皮酒 治风湿遍身疼痛，俗名痛风，或肿或瘫，或香港脚不能步履者。
用五加皮，不拘多少，入白曲内，同酿白酒饮之，或入在曲内，造好酒尤妙。
〔丹〕治环跳痛不已，防生附骨痈方。以苍术佐黄柏之辛，行以青皮，冬加桂枝，夏加黄
芩；体虚者，加杜仲、牛膝，以甘草为使，大料煎入酒。深者恐术、柏、桂枝十数帖发不动
，以少麻黄一二帖又不动者，恐痈将成。撅地成坑，以火 红，沃以小便，赤体坐其上，以
被席围抱下体，使热蒸腠理间，血气畅而愈。
时行热毒，攻手足大痛欲死，作地坑，深三尺，可容则止。却烧令热，以酒沃之，乘热
着履，坐其上，包裹勿泄气，立安。若手痛者，暖酒浸之。（《伤寒类要》）
〔《衍》〕用三升醇酒，拌蚕屎五升，甑蒸热，于暖室中铺于油单上，令患风冷气闭及近
感痈风人，就所患一边卧着温热处，浓盖覆，汗出为度。若虚人，须在左右防大热昏冒，仍
令头面壅覆。未全愈，间再作。
〔《外》〕治风痛肿，白虎病。以三年酽醋五升，热煎三四沸，切葱白二三升，煮一沸滤
出。布帛热裹，当病上熨之，瘥为度。
〔《灵》〕寒痹之为病也，留而不去，时痛而皮不仁。黄帝曰∶刺寒痹内热奈何？伯高答
曰∶刺布衣者，以火淬之，刺大人者，以药熨之。黄帝曰∶药熨奈何？伯高答曰∶用醇酒二
十斤，蜀椒一升，干姜一斤，桂心一斤，凡四种，皆 咀渍酒中，用绵絮一斤，细白布
四丈，并纳酒中，置酒马矢 中，盖封涂，勿使泄。五日五夜，出布绵絮曝干之，干复
渍，以尽其汁。每渍必 其日，乃出干之，并用滓与绵絮复布为复巾，长六七尺，为六
七巾，则用之，生桑炭炙巾，以熨寒痹所刺之处，令热入至于病所，寒，复炙巾以熨之，三
十遍而止。汗出，以巾拭其身，亦三十遍而止。起步内中，无见风，每刺必熨，如此病已矣
。此所谓内热也。（内，音纳。寿夭刚柔篇）
〔罗〕拈痛散 治肢节疼痛，熨烙药。
羌活 独活 细辛 肉桂 防风 白术 良姜 麻黄（不去节） 天麻（去苗） 川乌（生
，去皮） 吴茱萸 乳香（研） 小椒（去目） 全蝎（生） 当归（各一两） 川姜（五钱） 葛根（一两）
上为粗末。入乳香研匀，每抄药一十钱，甚者十五钱，同细盐一升，炒令极热，绢袋盛
熨烙痛处，不拘早晚频用，药冷再炒一次，用毕甚妙。
〔仲〕妇人六十二种风，及腹中血气刺痛，红蓝花酒主之。
用红蓝花一味，以酒一大升，煎减半，顿服一半，顷之，再服。
〔《济》〕虚骨丸 治经络凝滞，骨节疼痛，筋脉挛急，遇阴寒愈痛。
乳香 没药（各另研） 赤芍 熟地 虎胫骨（酥炙黄） 当归（各一两） 血竭（五钱）
上为末。用木瓜一枚，切破去子，入乳香末在内，以麻线缠定，勿令透气，好酒六升煮
，酒尽取木瓜，去皮研和泥，更入熟蜜少许，杵和为丸，如桐子大。每服五十丸。病在上食
后，在下食前温酒下。
〔罗〕木瓜虎骨丸 治风寒湿合而成痹，脚重不仁，疼痛少力，足下瘾痛，不能踏地，脚
膝筋拳，不能屈伸，及项背拘急，手足无力，耳内蝉鸣，头眩目运诸证。香港脚行步艰难，并皆治之。
木瓜 麒麟竭（研） 虎胫骨（酒炙） 木香 自然铜（醋淬七次） 枫香脂 龟板（醋炙）
骨碎补（去毛） 甜瓜子 桂皮 当归 没药（各一两） 乳香（研，半两） 地龙（去土） 安息香（
重汤酒煮入药，各二两）
上件十五味，除没药外，为细末，拌匀，酒面糊为丸，如桐子大。每服三十丸，温酒送
[Dan] Discourse on Gout (Tongfeng)
Qi circulates outside the vessels, and blood circulates inside the vessels. During the day, it circulates in the Yang twenty-five times; at night, it circulates in the Yin twenty-five times. This is the natural transformation of a healthy person. When exposed to cold, circulation slows down and fails to reach its destination; when exposed to heat, circulation speeds up and becomes excessive. Internal injury from the Seven Emotions (Qing), or external injury from the Six Evils (Qi), causes the movement of Qi and Blood to be either slow or fast, leading to the onset of disease. Those suffering from gout generally occur because the blood has been heated and is already boiling. Subsequently, wading into cold water, standing on damp ground, fanning oneself for coolness, or sitting/lying in the wind allows cold and chill to attack externally. The hot blood, encountering cold, becomes turbid, coagulated, and stagnant, thus causing pain. The pain is worse at night because the pathogen travels through the Yin. The treatment method involves using acrid-hot preparations to disperse cold-dampness and open the interstices (Couli). Once the blood can circulate and harmonize with Qi, the disease will naturally resolve. However, there are several types, each requiring different treatments. I carefully record a few cases to verify my words. One case treats the leg pain of Elder Fu from Dongyang; one treats the painful spasms of the lady in the Zhu household; one treats the post-dysentery wind syndrome of neighbor Bao’s son. All were cured after dozens of doses over half a year (see details below under Danxi's section on treating internal heat first). Someone asked: "Recently I saw a neighbor use herbal medicine ground into wine and drunk. After only a few doses, they were also relieved. Your statements suggest that such methods take a long time to be effective. Is this not too slow?" I replied: "These herbs that forcibly suppress the disease, taking 'Shishang Caisi' as the sovereign herb, assisted by 'Guoshanlong', etc., are all acrid-hot and drying in nature. They cannot nourish Yin but can dry Dampness. For superficial diseases, Damp-illnesses open when dried, and hot blood moves when heated, so they can achieve efficacy. But for those with deep-seated disease and deficient Blood, each suppression makes them more deficient, and each suppression drives the pathogen deeper, as was the case with Patient Zhu. Do you consider me too pedantic and slow!" (Patient Zhu refers to the lady in the Zhu household whose spasmodic pain had not responded to treatment for ten months until Danxi cured her.)
Qianxing San (Secretly Moving Powder)
Indications: Gout.
Composition: Huangbai (Phellodendri Cortex) alone, soaked in wine, baked dry, and ground into powder.
Usage: Mix with fresh ginger juice and wine to take orally. It is excellent to alternate this with Siwu Tang (Four Substances Decoction).
ErMiao San (Two Marvels Powder)
Indications: Pain in sinews and bones caused by Damp-Heat.
Modifications: If Qi stagnation is present, add Qi-regulating herbs; if Blood deficiency is present, add Blood-nourishing herbs; if pain is severe, take hot and spicy with ginger juice.
Composition: Huangbai (Phellodendri Cortex) (stir-fried); Cangzhu (Atractylodis Rhizoma) (stir-fried, skin removed).
Preparation: Grind into coarse powder. Add freshly crushed ginger, decoct in water until boiling, strain, and take. These two herbs possess vigorous Qi. For patients with exterior excess and Qi excess, assist with a small amount of wine.
Alternative Method: Use ErMiao San as the sovereign herb, add Gancao (Glycyrrhizae Radix et Rhizoma) and Qianghuo (Notopterygii Rhizoma et Radix) 2 qian each, Chenpi (Citri Reticulatae Pericarpium) and Shaoyao (Paeoniae Radix) 1 qian each, and Jiuniu Weilingxian (Salviae Miltiorrhizae Radix stir-fried with wine) 0.5 qian. Grind into powder and take.
Case 1: A man, poor and overworked, suddenly developed generalized fever upon the cooling of autumn. His arms, wrists, feet, and hips all hurt as if forged. The pain was mild during the day and severe at night. Treatment with Wind-dispelling herbs worsened the pain; treatment with Blood-invigorating herbs was ineffective. He seemed destined to die. I palpated his pulse: both hands were choppy (Se) and rapid (Shuo), more pronounced on the right than the left. Regarding his diet, it was normal. His body was emaciated, as if stripped bare. Great pain leads to emaciation; this is not merely an illness. Prescription: Cangzhu 1.5 qian, Jiu Huangbai (Wine-processed Phellodendri Cortex) 1.5 qian, Sheng Fuzi (Raw Aconiti Lateralis Radix) 1 slice, Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) 3 fen, Mahuang (Ephedrae Herba) 5 fen, and 9 crushed Tao Ren (Persicae Semen). Decoct as one dose. Add a little ginger juice to make it spicy, and take hot. After four doses, remove Fuzi and add Niu Xi (Achyranthis Bidentatae Radix) 1 qian. After eight doses, he urgently reported: "Qi rushes upward causing panting and inability to sleep; pain seems slightly reduced." At this time, it was dark, and I could not visit to examine him. I surmised that due to Blood deficiency, the overdose of Mahuang had stimulated deficient Yang to rush upward. I should provide Blood-nourishing, heavy-settling, and sour-flavored herbs to gather and restrain it. Thus, I prescribed Siwu Tang (Four Substances Decoction) added with Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix), Renshen (Ginseng Radix) 2 qian, and Wuweizi (Schisandrae Fructus) 12 grains. Decoct as one dose. After taking two doses, the panting stabilized, and he slept peacefully that night. Three days later, I palpated his pulse: the rapidity decreased by more than half, but the choppy pulse remained unchanged. Asking about the pain, he said it had not decreased, yet there was no groaning sound. Observing his daily life, he was fatigued and weak, though he claimed he was not weak. Thus, I prescribed Siwu Tang (Four Substances Decoction) added with Niu Xi (Achyranthis Bidentatae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix), Tao Ren (Persicae Semen), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), and Binglang (Arecae Semen). Add three slices of ginger, decoct, and take. After fifty doses of this prescription, he recovered. One month later, due to carrying heavy loads, the pain recurred, and his appetite decreased. I gave him the same prescription again, adding Huangqi (Astragali Radix) 3 fen per dose. After another twenty doses, he was fully cured.
Case 2: Elder Fu from Dongyang, over sixty years old, impatient and overworked, suffered from bilateral leg pain, which worsened with movement. I examined him and said: "This involves deficiency syndromes. You must nourish Blood deficiency, and the disease will resolve." I prescribed Siwu Tang (Four Substances Decoction) added with Tao Ren (Persicae Semen), Chenpi (Citri Reticulatae Pericarpium), Niu Xi (Achyranthis Bidentatae Radix), and Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma). Decoct with fresh ginger, grind Qianxing San (Secretly Moving Powder), mix, and drink hot. After thirty to forty doses, he recovered.
Case 3: County Magistrate He, over forty years old, thin and impatient, suffered from back pain, arm pain, joint pain, and heat in the soles of his feet due to overwork. Prescribe Siwu Tang (Four Substances Decoction). Take with Da Bu Wan (Great Tonifying Pill) and Bao He Wan (Preserve Harmony Pill), sixty pills total, taken before meals.
Case 4: Woman with foot pain, fear of cold in the feet, worse at night and lighter during the day.
Composition: Shengdi (Rehmanniae Radix), Baishao (Paeoniae Radix Alba), Guiwei (Angelicae Sinensis Radix tail) (each 5 qian); Huangbai (Phellodendri Cortex) (stir-fried), Huangqin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 3 qian); Niu Xi (Achyranthis Bidentatae Radix) (2 qian); Cangzhu (Atractylodis Rhizoma) (3 qian); Gancao Shao (Glycyrrhizae Radix et Rhizoma tip) (1 qian).
Preparation: Divide into six doses, decoct, and take. Drink hot before meals.
Case 5: Neighbor Bao’s son, over twenty years old, had previously treated bloody dysentery with astringent herbs with success. Later, he developed gout, screaming and shaking neighbors. I examined him and said: "This is a syndrome of foul blood entering the collaterals. The blood has been affected by Damp-Heat, becoming turbid and coagulated over time. The downward discharge was incomplete, leaving stagnation in the tunnels (vessels/collaterals), thus causing pain. If not treated for a long time, it may become withered and thin." I prescribed Siwu Tang (Four Substances Decoction) added with Tao Ren (Persicae Semen), Honghua (Carthami Flos), Niu Xi (Achyranthis Bidentatae Radix), Huangqin (Scutellariae Radix), Chenpi (Citri Reticulatae Pericarpium), and Gancao (Glycyrrhizae Radix et Rhizoma). Decoct with ginger juice, grind Qianxing San (Secretly Moving Powder), add a little wine, and drink. After dozens of doses, I also performed acupuncture at Weizhong (BL40), drawing out nearly three he of black blood, after which he recovered.
Post-dysentery Wind Syndrome: This occurs when blood enters the fu organs, the downward discharge is incomplete, and it returns to the collaterals, unable to circulate.
Prescription: Songmingjie (Pinus Resin Node) 1 liang, Xuruxiang (Boswelliae Resin) 1 qian (stir-fried until carbonized but retaining nature), Cangzhu (Atractylodis Rhizoma) 1 liang, Ziwei (Bignoniae Caulis) 1.5 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 0.5 liang, Huangbai (Phellodendri Cortex) 1 liang, Taoren (Persicae Semen) peeled but tips retained 1 liang. All ground into powder. Take 3 qian per dose, crush with fresh ginger, decoct in water for two or three boils, and take.
Case 6: Lady in the Zhu household, thirty years old, accustomed to rich flavors, impatient temperament, suffered from gouty contraction for several months without response to medical treatment. I examined her and said: "This involves Phlegm and Qi disorders. Harmonize Blood, dissipate Phlegm, and guide Qi, and the disease will resolve." I prescribed Qianxing San (Secretly Moving Powder) added with Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Niu Xi (Achyranthis Bidentatae Radix), Zhike (Aurantii Fructus Immaturus), Tongcao (Tetrapanacis Medulla), Chenpi (Citri Reticulatae Pericarpium), Tao Ren (Persicae Semen), and ginger juice. Decoct and drink. After half a year, she recovered.
Case 7: Young Master Lu, old pain in the left leg fibula (HT bone - likely typo for 髀骨 or similar, context implies lower limb bone), scanty red urine. This is caused by accumulated worry and Phlegm-fluids.
Composition: Baizhu (Atractylodis Macrocephalae Rhizoma), Zhike (Aurantii Fructus Immaturus), Chishao (Paeoniae Radix Rubra) (1 qian); Tiao Qin (Scutellariae Radix), Lianqiao (Forsythiae Fructus), Tongcao (Tetrapanacis Medulla), Gancao Shao (Glycyrrhizae Radix et Rhizoma tip) (3 fen).
Case 8: Person from Lu'an, pain in the foot fibula (HT bone).
Composition: Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Shaoyao (Paeoniae Radix) (3 fen); Mutong (Akebiae Caulis) (2 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (5 fen).
Preparation: Divide into four doses, decoct, and take with forty Da Bu Wan (Great Tonifying Pills).
Summary of Danxi’s Methods for Treating Gout:
The main focus is on Blood Heat, Blood Deficiency, Blood Stasis/Turbidity, or involvement of Phlegm. All methods revolve around Siwu Tang (Four Substances Decoction), Qianxing San (Secretly Moving Powder), Huangbai (Phellodendri Cortex), Niu Xi (Achyranthis Bidentatae Radix), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Tao Ren (Persicae Semen), Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma), and Jiangzhi (Fresh Ginger Juice), with modifications according to symptoms. This reveals what predecessors had not yet discovered and treats what secular physicians do not treat. Its contribution to the world is immense.
[Ben] Wang Jianzheng suffered from pain between the nose and forehead, or numbness and insensitivity, for several years. Suddenly one day, the pain extended to the lips, jaw angle, and hairline. He could not open his mouth; speaking and eating were obstructed. The area on the forehead and cheeks felt like paste, and touching it caused pain. I diagnosed this as Wind-Toxin affecting the Foot-Yangming Meridian, transmitting into the collaterals, causing blood stagnation and obstruction, hence these symptoms. Others prescribed Paifeng San (Wind-Expelling Powder), Xiao Xuming San (Small Continuation of Life Powder), or Tou Sui Dan (Marrow-Penetrating Pill), but none were effective. I prepared this Xijiao Shengma Tang (Rhinoceros Horn and Cimicifugae Decoction) and gifted it to him. He recovered in a few days.
Composition: Xijiao (Rhinocerotis Cornu) (1 liang 1 qian); Shengma (Cimicifugae Rhizoma), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix) (each 3 liang); Chuanxiong (Ligustici Chuanxiong Rhizoma), Baifu (Bletillae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Huangqin (Scutellariae Radix) (each 0.5 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (1 fen).
Preparation: Coarse powder. Take 4 da qian per dose, decoct in 1.5 sheng of water until 0.8 sheng remains, strain, and take orally after meals. Take one dose before bed, 3-4 times a day.
Foot-Yangming corresponds to the Stomach. The Classics state: "The intestines and stomach are like a market." Also: "Yangming has abundant Blood and Qi."
Inside the stomach, all flavors are accepted, just as a market has everything. Among the Six Meridians, Yangming has the most Blood and Qi, responsible for rotting and ripening food. Therefore, toxins from food accumulate in the Stomach. This formula uses Xijiao (Rhinoceros Horn) as the sovereign herb to resolve food toxins. The Yangming meridian encircles the lips,夹 (flanks) the tongue, originates at the nose, meets in the middle, follows the cheekbone to the front of the ear, passes through Guest Master (ST4), and follows the hairline to the forehead. The areas Wang Gong suffered from all belong to one meridian, hence Shengma (Cimicifugae Rhizoma) is used as an assistant. Other herbs clear Wind-Heat. Shengma and Huangqin specifically enter the Stomach meridian; those slightly knowledgeable will understand.
[Hai] Siwu Cangzhu Geban Tang (Siwu and Cangzhu Half-Half Decoction)
Indications: Limb swelling, inability to move.
Composition: Siwu Tang (Four Substances Decoction) and Cangzhu (Atractylodis Rhizoma) 0.5 liang each. Decoct together and take. Effective (Corresponds to Huoxue Dan).
Huoxue Dan (Blood-Invigorating Pill)
Indications: Corresponds to Siwu Cangzhu Geban Tang. Treats generalized joint pain effectively.
Composition: Shudihuang (Rehmanniae Radix Praeparata) (3 liang); Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baishao (Paeoniae Radix Alba), Xuduan (Dipsaci Radix), Renshen (Ginseng Radix) (each 1 liang).
Preparation: Fine powder. Make pills with wine paste, size of wutong seeds.
[Dongyuan] Cangzhu Fujian San (Cangzhu Double-Decoction Powder)
Indications: Combination of Cold-Dampness, headache at Naohu (GV17), aversion to cold, stiffness of neck and spine, pain in shoulders, back, scapula, testicles, knee caps, inability to walk due to weakness, ability to eat, heaviness of body, pulse is deep, slow, and full at the upper position.
Composition: Cangzhu (Atractylodis Rhizoma) (4 liang, decoct in 2 bowls of water until 2 large cups remain, discard dregs, add following herbs); Qianghuo (Notopterygii Rhizoma et Radix) (1 qian); Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Bencao (Ligustici Wallichii Rhizoma), Zexie (Alismatis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 5 fen); Huangbai (Phellodendri Cortex) (3 fen); Honghua (Carthami Flos) (a little).
Preparation: Coarse powder. Use 2 cups of Cangzhu decoction, simmer until 1 cup remains, strain, and take warm on an empty stomach. Mild sweating indicates efficacy. Avoid alcohol and wheat products.
Huanjin Tang (Relaxing Sinews Decoction)
Indications: Eyes swollen and painful like fire, pain in sinews of both feet and Futu (ST32) bone, weakness in knees, heaviness of body, lower back pain, aversion to cold and phlegm-cough at night, acute pain in neck and back sinews/bones, excessive eye discharge and tearing, inability to eat.
Composition: Qianghuo (Notopterygii Rhizoma et Radix) (2 qian), Duhuo (Angelicae Pubescentis Radix) (2 qian), Bencao (Ligustici Wallichii Rhizoma) (3 fen), Mahuang (Ephedrae Herba) (3 fen), Sumu (Sappan Lignum) (1 fen), Shengma (Cimicifugae Rhizoma) (3 fen), Gancao (Glycyrrhizae Radix et Rhizoma) (roasted, 2 fen), Cao Kou (Amomi Fructus Rotundus) (3 fen), Shengdi (Rehmanniae Radix), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex) (each 3 fen), Cangzhu (Atractylodis Rhizoma) (5 fen), Guishen (Angelicae Sinensis Radix root portion) (3 fen), Chaihu (Bupleuri Radix) (3 fen), Shudi (Rehmanniae Radix Praeparata) (2 fen), Sheng Gancao Gen (Raw Glycyrrhizae Radix et Rhizoma root) (2 fen).
Preparation: Coarse powder. Combine as one dose, decoct in 2 cups of water until 1 cup remains, strain, and take hot far from meals.
[Zhongjing] Guizhi Shaoyao Zhimu Tang (Cinnamon Twig, Peony, and Anemarrhena Decoction) [Hejian] Fangfeng Tang (Saposhnikovia Decoction). (The above two formulas are miraculous for treating gout, see the section on Xingbi Exterior Syndromes).
[Shi] Treating Gout.
Caowu (Aconiti Kusnezoffii Radix) (4 liang, remove tips); Mugua Zi (Momordicae Semen) (3 liang, remove shell); Ziran Tong (Pyritum) (1 liang); Xiang Baizhi (Angelicae Dahuricae Radix) (3 liang); Moyao (Boswelliae Resin) (2 liang, separately ground); Nanxing (Arisaematis Rhizoma) (2 liang); Weilingxian (Syneilesidis Rhizoma) (2 liang); Dilong (Pheretima) (3 liang).
Make pills with paste. Take 15 pills per dose.
[Luo] Huoxue Yingtong Wan (Blood-Invigorating Pain-Relieving Pill)
Indications: Wind-Dampness invading the Kidney Meridian, blood vessel stagnation, swelling and pain in waist and back, inability to turn, skin insensitivity, generalized numbness, upward attacking causing head/eye puffiness, constant tinnitus, downward pouring causing heavy pain and weakness in feet/knees, difficulty walking, neck/back stiffness, inability to feel comfortable. Regular use harmonizes blood vessels, strengthens sinews and bones, and promotes free flow of Qi and vessels.
Composition: Gouji (Cibotii Rhizoma) (remove hair, 6 liang); Cangzhu (Atractylodis Rhizoma) (soaked in rice water overnight, 10 liang); Xiangfu (Cyperi Rhizoma) (roasted, 12 liang); Chenpi (Citri Reticulatae Pericarpium) (9 liang); Moyao (Boswelliae Resin) (1 liang 2 qian); Caowu (Aconiti Kusnezoffii Radix) (2.5 liang, processed); Weilingxian (Syneilesidis Rhizoma) (3 liang).
Preparation: Fine powder. Make pills with wine-boiled flour paste, size of wutong seeds. Take 15 pills per dose, with warm wine or hot water, anytime. Long-term use. Avoid peaches, plums, sparrows, pigeons, and other blood-producing foods.
[Dan] Bazhen Tang (Eight Treasures Decoction)
Indications: All types of gout, Hong Kong Foot (Gouty Arthritis), Toufeng (Head Wind).
Composition: Xuruxiang (Boswelliae Resin), Moyao (Boswelliae Resin), Daizheshi (Haematitum), Chuanshanjia (Manis Squama) (raw, 3 qian), Chuanwu (Aconiti Radix) (skin and tips not removed, raw, 1 liang), Caowu (Aconiti Kusnezoffii Radix) (skin and tips not removed, raw, 5 qian), Qianghuo (Notopterygii Rhizoma et Radix) (0.5 liang), Quanxie (Scorpio) (21 pieces, using whole heads and tails).
Preparation: Vinegar paste pills, size of wutong seeds. Take 11 pills per dose.
[Luo] Wuling Wan (Black Spirit Pill)
Indications: Long-standing Wind-Cold, numbness and pain, difficulty walking.
Composition: Wulingzhi (Trogopterori Faeces) (2 liang); Chuanwu (Aconiti Radix) (1 liang, processed, remove skin and navel).
Preparation: Fine powder. Make pills with wine-boiled flour paste, size of wutong seeds. Take 10 pills per dose, increasing to 50 pills, with warm wine on an empty stomach. Avoid all cold foods.
Shi Chengxiang Yuxian Fang (Official Shi’s Encounter with Immortals Formula)
Indications: Various types of gout, difficulty in hands and feet, sinew and bone pain, facial paralysis (mouth/eye deviation), slurred speech.
Composition: Fuzi (Aconiti Lateralis Radix Praeparata) (processed, remove skin and navel); Chuanwu (Aconiti Radix) (processed, remove skin and navel); Danggui (Angelicae Sinensis Radix) (wine-soaked, baked); Chuanxiong (Ligustici Chuanxiong Rhizoma); Qianghuo (Notopterygii Rhizoma et Radix); Rongcunrong (Cynomorii Herba) (wine-soaked, processed); Duzhong (Eucommiae Cortex) (remove skin, roast to remove silk, process with ginger juice); Huangqi (Astragali Radix); Bajieli (Tribuli Fructus) (roasted, remove spines); Baizhu (Atractylodis Macrocephalae Rhizoma); Renshen (Ginseng Radix); Chuan Niuxi (Achyranthis Bidentatae Radix) (wine-soaked, baked, remove radicle); Fangfeng (Saposhnikoviae Radix); Tianma (Gastrodiae Rhizoma) (remove sprouts); Baifuling (Poria) (not specified type, assume Fu Ling); Bibi (Dioscoreae Hypoglaucae Rhizoma); Gouji (Cibotii Rhizoma) (roasted, remove hair); Xuduan (Dipsaci Radix); Duhuo (Angelicae Pubescentis Radix); Rougui (Cinnamomi Cortex) (remove rough bark); Chishao (Paeoniae Radix Rubra) (each 1 liang); Hujinggu (Pantheris Tibiae) (2.5 liang, roasted with butter).
Preparation: Cut the 22 ingredients finely, place in a raw silk bag, soak in unadulterated wine, seal tightly. Spring: 3 days; Summer: 2 days; Autumn: 7 days; Winter: 10 days. Remove, sun-dry, bake dry, grind into powder. Make pills with wine paste, size of wutong seeds. Take 50 pills with one cup of the medicinal wine on an empty stomach. Avoid raw, cold, greasy, tofu, wheat/noodle foods, and wind-aggravating substances.
[Shi] Wujia Pi Jiu (Acanthopanacis Bark Wine)
Indications: Rheumatic pain throughout the body, commonly known as gout, or swelling, paralysis, or Hong Kong Foot making walking impossible.
Usage: Use Wujia Pi (Acanthopanacis Cortex) in any quantity, add to Baiqu (White Qu), ferment with white wine to drink. Or add to Qu to brew good wine, which is even better.
[Dan] Formula to Treat Persistent Huantiao (GB30) Pain and Prevent Ossified Abscess.
Use Cangzhu (Atractylodis Rhizoma) to assist Huangbai (Phellodendri Cortex)'s acridity, move with Qingpi (Citri Reticulatae Pericarpium), add Guizhi (Cinnamomi Ramulus) in winter, add Huangqin (Scutellariae Radix) in summer. For deficient bodies, add Duzhong (Eucommiae Cortex) and Niu Xi (Achyranthis Bidentatae Radix), use Gancao (Glycyrrhizae Radix et Rhizoma) as envoy. Decoct heavily with wine. If the condition is deep and Ten doses of Cangzhu, Huangbai, and Guizhi fail to move it, or one or two doses of Mahuang (Ephedrae Herba) fail to move it, suspect an abscess is forming. Dig a pit in the ground, heat it red with fire, pour urine on it, sit naked on it, wrap the lower body with blankets/sheets to keep heat steaming the interstices, promoting smooth Qi and Blood flow for recovery.
For epidemic heat-toxin attacking hands and feet causing severe pain almost fatal: Dig a pit 3 chi deep, large enough to sit in. Heat it, pour wine on it, put on shoes, sit on it, wrap tightly to prevent gas leakage. Immediate relief. If hand pain, soak in warm wine. (From Shanghan Leyao).
[Yan] Use 3 sheng of pure wine, mix with 5 sheng of silkworm feces, steam in a steamer until hot. Spread on an oil sheet in a warm room. Let patients with wind-cold qi closure or recent gout infection lie on the warm side, cover thickly, until sweating occurs. For deficient persons, guard against overheating and fainting on both sides, still covering head and face. Repeat occasionally if not fully cured.
[Wai] Treating Wind-Pain Swelling, Baihu Disease (Gout).
Use 5 sheng of strong vinegar aged three years, boil for three or four boils. Add 2-3 sheng of chopped green onion whites, boil once, strain. Wrap in hot cloth, apply as a hot compress to the diseased area until healed.
[Ling] Hanbi (Cold Bi) disease lingers and does not go away, causing intermittent pain and skin insensitivity. Yellow Emperor asked: How to puncture Cold Bi to introduce heat? Bo Gao answered: For commoners, use fire quenching; for nobles, use medicated hot compress. Yellow Emperor asked: How to medicate? Bo Gao answered: Use 20 jin of pure wine, 1 sheng of Shujiao (Sichuan Pepper), 1 jin of Ganjiang (Zingiberis Rhizoma), 1 jin of Guixin (Cinnamomi Cortex). All four chopped and soaked in wine. Use 1 jin of cotton wadding and 4 zhang of fine white cloth, put them in the wine. Place the wine in horse manure heat, cover and seal tightly to prevent leakage. After five days and nights, take out the cloth and wadding, dry them in the sun, then soak again until all juice is extracted. Each soaking must wait for the appropriate day, then dry. Use the dregs, wadding, and repeated cloth to make towels, 6-7 chi long, seven towels in total. Use them. Heat the towels with live mulberry charcoal, apply to the punctured sites of Cold Bi, letting heat penetrate to the disease site. When cool, reheat and apply again. Stop after thirty repetitions. Wipe sweat with the towel, also thirty times. Walk indoors, avoid wind. Puncture and compress every time. Thus the disease ends. This is called "Internal Heat". (Nei sounds like Na. Chapter: Shou Yao Gang Rou).
[Luo] Niantong San (Pain-Lifting Powder)
Indications: Joint pain, hot compress herb.
Composition: Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Xixin (Asari Radix et Rhizoma), Rougui (Cinnamomi Cortex), Fangfeng (Saposhnikoviae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Liangjiang (Galangal Rhizoma), Mahuang (Ephedrae Herba) (do not remove joints), Tianma (Gastrodiae Rhizoma) (remove sprouts), Chuanwu (Aconiti Radix) (raw, remove skin), Wuzhuyu (Evodiae Fructus), Xuruxiang (Boswelliae Resin) (ground), Xiaojiao (Zanthoxyli Pericarpium) (remove eyes), Quanxie (Scorpio) (raw), Danggui (Angelicae Sinensis Radix) (each 1 liang); Chuanjiang (Zingiberis Officinalis Rhizoma) (5 qian); Gegen (Puerariae Lobatae Radix) (1 liang).
Preparation: Coarse powder. Mix evenly with Xuruxiang. Take 10 qian of herb (15 qian for severe cases), stir-fry with 1 sheng of fine salt until extremely hot. Place in a silk bag and apply as a hot compress to the painful area. Use frequently regardless of morning or evening. Re-fry when cool. Very effective after use.
[Zhongjing] Women's 62 Types of Wind, and stabbing pain in abdomen from Blood-Qi: Honglanhua Jiu (Red Blue Flower Wine) governs.
Usage: Use Honglanhua (Carthami Flos) alone, decoct in 1 da sheng of wine until half remains. Take half at once, then take the rest shortly after.
[Ji] Xugu Wan (Empty Bone Pill)
Indications: Collateral stagnation, joint pain, sinew/tendon spasm, worsening pain in Yin-Cold.
Composition: Xuruxiang (Boswelliae Resin), Moyao (Boswelliae Resin) (separately ground); Chishao (Paeoniae Radix Rubra), Shudi (Rehmanniae Radix Praeparata), Hujinggu (Pantheris Tibiae) (roasted with butter until yellow), Danggui (Angelicae Sinensis Radix) (each 1 liang); Xuexie (Dracaenae Sangue) (5 qian).
Preparation: Powder. Take one Papaya (Mugua), cut open, remove seeds, put Xuruxiang powder inside, tie tightly with hemp thread to prevent air entry. Boil in 6 sheng of good wine. When wine is exhausted, take out papaya, remove skin, grind into mud. Add a little ripe honey, pound into pills, size of wutong seeds. Take 50 pills per dose. For upper body disease, take after meals; for lower body disease, take before meals with warm wine.
[Luo] Mugua Hugu Wan (Papaya and Tiger Bone Pill)
Indications: Bi syndrome formed by combination of Wind-Cold-Dampness, heavy and insensitive feet, pain with weakness, hidden pain under feet, inability to step on ground, curling of foot/knee sinews, inability to flex/extend, neck/back stiffness, weakness in hands/feet, cicada-like tinnitus, dizziness, vertigo. Also treats Hong Kong Foot and difficulty walking.
Composition: Mugua (Chaenomelis Fructus); Qilinjie (Dracaenae Sangue) (ground); Hujinggu (Pantheris Tibiae) (wine-roasted); Muxiang (Aucklandiae Radix); Ziran Tong (Pyritum) (quenched in vinegar seven times); Fengxiangzhi (Liquidambaris Resina); Guiban (Testudinis Carapax et Plastrum) (vinegar-roasted); Gusui Bu (Drynariae Rhizoma) (remove hair); Tianguazi (Benincasae Semen); Guipi (Cinnamomi Cortex); Danggui (Angelicae Sinensis Radix); Moyao (Boswelliae Resin) (each 1 liang); Xuruxiang (Boswelliae Resin) (ground, 0.5 liang); Dilong (Pheretima) (remove soil); Anshixiang (Styrax) (boiled in wine over double boiler and added to medicine, each 2 liang).
Preparation: The fifteen ingredients, except Moyao, ground into fine powder, mixed well. Make pills with wine-flour paste, size of wutong seeds. Take 30 pills per dose, with warm wine.