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[Prescription Verse] Xiyong (abscess of the knee) presents with redness, swelling, heat, and pain; Diju (a type of yin-type carbuncle arising from muscles and bones) is swollen but not red. Softness indicates a favorable prognosis, while hardness indicates an unfavorable one. This is caused by pathogenic factors invading the Spleen, Kidney, and Liver meridians.

[Annotation] Xiyong arises at the knee, characterized by redness, swelling, heat, and pain, belonging to excess patterns of Qi and Blood. Diju also arises at the knee, appearing swollen like an abscess but without color change, accompanied by alternating chills and fever, belonging to deficiency patterns of Qi and Blood. Local softening indicates a favorable course, whereas hardness like stone indicates an unfavorable course. The Classics state: "The small gatherings of flesh are called Xi." Xi refers to the two elbows, two knees, and four wrists. Diseases of the Spleen often occur in the Xi areas; when the Kidney has pathogenic factors, their Qi tends to remain in both knees; diseases of the tendons all belong to the joints, as tendons are the surplus of the Liver, thus they also belong to the Liver. Therefore, diseases in the Xi areas result from pathogenic factors invading through the Spleen, Kidney, and Liver meridians. Treatment always follows internal and external methods, categorized according to the sections on abscesses and sores during the swelling stage and ulceration stage. Only when both knees are affected simultaneously does it constitute a fatal syndrome that cannot be treated.

[Prescription Verse] Xiyanfeng (wind-damp bi syndrome at the knee eye acupoint) arises at the Guiyan point, causing pain like needle insertion accompanied by swelling. It is caused by deficiency in the Lower Jiao allowing invasion of wind, cold, and dampness, leading to impaired flexion and extension, which responds well to warming and dispersing therapies.

[Annotation] This condition arises at the Xiyan acupoint, also known as the Guiyan acupoint, located in the depressions between the bones below the knee. Due to inherent deficiency in the Lower Jiao, external pathogens easily invade. Initially, there is hidden pain at the Xiyan; if Wind predominates, the pain migrates unpredictably; if Cold predominates, the pain feels like needle insertion; if Dampness predominates, visible swelling appears externally. Inability to flex but ability to extend indicates disease in the tendons; inability to extend but ability to flex indicates disease in the bones; restricted movement signifies deep-seated cold and chronic cold conditions, requiring careful differentiation during clinical practice. Initially, administer Wanling Dan to warm and disperse, stopping the pain; subsequently, administer Duhuo Jisheng Tang to promote circulation and tonify. For slow responses, combine with fire-needle therapy at the Xiyan acupoint, a method of transforming heavy treatment into light treatment. Unilateral knee involvement is mild; bilateral knee involvement is severe. If the left knee heals and then the right knee becomes diseased, or vice versa, it is named Guoxifeng (Knee-Crossing Wind), which is a dangerous syndrome, treated similarly to the above.

Formula: Duhuo Jisheng Tang
Composition: Du Huo (Radix Angelicae Pubescentis), Ren Shen (Radix Ginseng), Sang Ji Sheng (Herba Taxilli) [if authentic is unavailable, substitute with Chuan Xu Duan (Radix Dipsaci)], Fu Ling (Poria), Chuan Xiong (Rhizoma Chuanxiong) [washed with wine], Fang Feng (Radix Saposhnikoviae), Gui Xin (Cortex Cinnamomi), Du Zhong (Cortex Eucommiae) [stir-fried with ginger juice, remove silk fibers], Niu Xi (Radix Achyranthis Bidentatae), Qin Jiao (Radix Gentianae Macrophyllae), Xi Xin (Herba Asari) [each 1.5 qian], Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Paeoniae Alba) [stir-fried with wine], Shu Di Huang (Radix Rehmanniae Praeparata), Gan Cao (Radix Glycyrrhizae) [each 1 qian]. Add five slices of Sheng Jiang (Rhizoma Zingiberis Recens), two zhong of water, decoct until seven parts remain, take before meals.

[Prescription Verse] Duhuo Jisheng Tang treats deficiency of the Liver and Kidney, where cold and dampness lodge in the knee causing swelling and pain. It contains Ren Shen, Fu Ling, Si Wu Tang (Four Substances Decoction), plus Fang Feng, Gui Xin, Du Zhong, Niu Xi, Qin Jiao, Gan Cao, and Xi Xin, which are appropriate for use.

Another Formula: Wanling Dan (see section on Swelling Stage Sores)