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[Prescription Verse] Elephant-knee disease (He Xi Feng) presents with swelling at the knee, while the upper and lower limbs become emaciated due to deficiency of the Foot Three Yin meridians. Wind, cold, and dampness pathogens enter when the body's defensive qi is deficient. Pain and aversion to cold indicate an excess of wind; muscle spasms and contracture indicate an excess of wind; flaccidity and weakness indicate an excess of dampness.

[Annotation] This condition is also known as You Xi Feng (Wandering Knee Wind) or Gu Chui Feng (Drum-Beating Wind). When it occurs after dysentery, it is called Li Feng (Dysentery Wind). Unilateral occurrence is mild, while bilateral occurrence is the most severe. After prolonged neglect, the knee becomes swollen and enlarged, while the thighs and calves above and below become emaciated. This disease arises from deficiency in the Foot Three Yin meridians (Liver, Spleen, Kidney), allowing wind, cold, and dampness pathogens to invade due to this deficiency.

Deep, hidden pain in the knee accompanied by aversion to cold indicates an excess of cold. Urgency and contracture of the tendons indicate an excess of wind. Flaccidity and lack of strength indicate an excess of dampness.

In the initial stage, the swelling feels soft like cotton, the skin color remains unchanged, and there is no redness or heat. However, pain increases daily. Whether unilateral or bilateral, it is appropriate to administer Wu Ji San (Five Accumulations Powder) to induce sweating. Subsequently, Wan Ling Dan (Ten Thousand Spirits Pill) should be taken for warm dispersion, and Wai Fu Hui Yang Yu Long Gao (Restore Yang Jade Dragon Ointment) applied externally. Regularly take Huan Gu Dan (Bone-Replacing Pill) or Yi Qi Wan (Yi Qi Pill) to expel the pathogens. If the condition persists without subsiding and shows signs of impending ulceration, Du Huo Ji Sheng Tang (Angelica Pubescens Decoction for Sustaining the Parasites) or Da Fang Feng Tang (Great Saposhnikovia Decoction) should be taken to tonify and warm. Add Ru Xiang (Frankincense) if pain is severe.

After ulceration, if white serous fluid frequently oozes out, and although the superficial skin is necrotic, pain and swelling persist, corrosive medicines must not be used. Instead, take Fu Rong Ye (Hibiscus Leaf) and Ju Hua Ye (Chrysanthemum Leaf), five qian each, grind them into powder, mix evenly with barley rice paste, and apply as a poultice to relieve pain. Alternatively, steam tofu dregs until hot, shape into a cake, and apply to the affected area, which is also effective. This condition belongs to the refractory category among external diseases, making recovery difficult.

Formula: Huan Gu Dan (Bone-Replacing Pill)
Composition: Cang Zhu (Atractylodis Rhizoma, 4 liang), Gou Qi (Lycii Fructus, 2.5 liang), Qie Gen (Solanis Lycopersici Caulis, washed, 2 liang), Dang Gui (Angelicae Sinensis Radix), Niu Xi (Achyranthis Bidentatae Radix), Bai Gui Ban (Testudinis Carapax et Plastrum), Fang Feng (Saposhnikoviae Radix), Qin Jiao (Gentianae Macrophyllae Radix), Du Huo (Angelicae Pubescentis Radix), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Can Sha (Bombyx Batryticatus), Song Jie (Pinus Massoniana Node), Hu Gu (Pantheris Os, prepared with butter, each 1 liang).

Soak all ingredients in wine, dry them, grind into fine powder, and make pills using wine paste, sized like paulownia seeds. Take three qian per dose, administered with plain boiled water before meals.

[Prescription Verse] Huan Gu Dan contains Dang Gui, Niu Xi, Gou Qi, Cang Zhu; Gui Ban, Fang Feng, Qin Jiao, Du Huo, Bi Xie, Qiang Huo; Can Sha, Song Jie, Qie Gen, Hu Gu. It is most effective for treating He Xi Feng (Elephant-knee disease).

Another Formula: Yi Qi Wan (Yi Qi Pill)
Composition: Yi Qi (Scorpio [Quanchexie], i.e., fresh Scorpius, one piece), Bai Zhi (Angelicae Dahuricae Radix), Gui Xin (Cinnamomi Cortex), An Xi Xiang (Benzoinum), A Wei (Ferulae Resina) (the above four are stir-fried with child's urine and wine). Wei Ling Xian (Salviae Miltiorrhizae Radix et Rhizoma - *Note: WHO standard usually maps Wei Ling Xian to Salviae Miltiorrhizae or sometimes Cistanches, but traditionally Clematis; here adhering to common TCM context often implying Clematis root in older texts, but WHO term is Salviae Miltiorrhizae Radix et Rhizoma? No, Wei Ling Xian is Clematis Root. WHO Term: Clematis Root.* Correction: Wei Ling Xian (Clematis Root)), Bai Fu Zi (Typhonii Rhizoma), Dang Gui (Angelicae Sinensis Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Tao Ren (Persicae Semen), Niu Xi (Achyranthis Bidentatae Radix), Bei Lou Lu (Euphorbiae Pekinensis Radix), Di Gu Pi (Lycii Cortex), Bai Shao (Paeoniae Radix Alba, stir-fried with wine, each 1 liang), Ru Xiang (Olibanum), Mo Yao (Myrrha) (the latter two are stir-fried with child's urine and wine).

Grind all into powder, make pills using refined honey, sized like paulownia seeds. Take three qian per dose, administered with warm wine on an empty stomach.

[Prescription Verse] Yi Qi Wan treats He Xi Feng (Elephant-knee disease); Bai Zhi, Gui Xin, An Xi Xiang, A Wei, Wei Ling Xian; Bai Fu Zi, Dang Gui, Qiang Huo, Tao Ren, Ru Xiang, Mo Yao; combined with Niu Xi, Lou Lu, Di Gu Pi, Bai Shao, formed with honey.

Other Formulas:
Wu Ji San (Five Accumulations Powder) (See Internal Abscess section, Kidney Abscess)
Da Fang Feng Tang (Great Saposhnikovia Decoction) (See Thigh section, Bone-Attached Carbuncle)
Wan Ling Dan (Ten Thousand Spirits Pill), Hui Yang Yu Long Gao (Restore Yang Jade Dragon Ointment) (See Ulcerated Disease Section)
Du Huo Ji Sheng Tang (Angelica Pubescens Decoction for Sustaining the Parasites) (See this section, Knee Eye Wind)