论曰∶《内经》曰，风寒湿三气杂至，合而为痹。又曰∶以春遇此者为筋痹。其状拘急
，屈而不伸是也。筋痹不已，复感于邪，内舍于肝，是为肝痹。其状夜卧则惊，饮多数小便
，上为引如怀。盖淫气乏竭，痹聚在肝。治法以筋痹为先，筋痹既平，则邪弗入于肝矣。
治筋风，四肢挛痹。天麻丸方
天麻（二两） 苦参（三两） 细辛（去苗叶二两） 菖蒲（二两） 牛膝（去苗，酒
浸，
焙二两） 赤箭（二两） 附子（炮裂，去皮脐一两） 地榆（二两） 人参（二两） 芎
（一两） 桂（去粗皮一两半） 木香（一两） 陈橘皮（汤浸，去白，焙干一两半） 当
归（切，
焙） 赤芍药 酸枣仁（微炒） 威灵仙（去土） 本（去苗土） 防风（去叉，锉） 独
活（去芦
头）各二两
上二十味，捣罗为细末，炼蜜和杵为丸，如梧桐子大。每服温酒下二十丸，日二服，加
至三十丸。
治筋痹，以筋虚为风所伤，故筋挛缩，腰背不伸，强直时痛。牛膝汤方。
牛膝（去苗，酒浸，锉，焙） 防风（去叉） 丹参 前胡（去芦头各二两） 石斛（去
根二
两半） 杜仲（去粗皮，涂酥炙，锉） 秦艽（去苗土） 续断（各一两半） 陈橘皮（汤
去白
各一两
上一十味，除大麻仁外，粗捣筛。每服五钱匕，水一盏半，煎五七沸，别下麻仁末一钱
匕，煎至一盏，去滓，空腹服，日二。
治筋痹肢体拘急，不得伸展。独活散方。
独活（去芦头三两） 附子（炮裂，去皮脐） 薏苡仁 苍耳 防风（去叉） 蔓荆实 芎
上一十味，捣罗为细散。每服一钱匕，空腹以温酒调下，日二。
治肝痹多惊悸，神思不安。茯神散方。
茯神（去木） 酸枣仁（微炒） 黄 （锉） 人参各一两 熟干地黄（焙） 远志（去
心） 五
味子（各半两） 白茯苓（去黑皮一两） 丹砂（别研半两）
上九味，除丹砂外，捣罗为散，入丹砂末，再研匀。每服一钱匕，以温酒调下，不计时
候。
治肝痹两胁下满，筋急不得太息，疝瘕四逆，抢心腹痛，目不明。补肝汤方。
白茯苓（去黑皮一两二钱） 乌头（四枚炮裂，去皮脐） 蕤仁（研） 柏子仁（研） 防
风（去
叉） 细辛（去苗叶各二两） 山茱萸 桂（去粗皮三分） 甘草（炙，锉半两）
上九味，锉如麻豆，入研药拌匀。每服五钱匕，水一盏半，入大枣二枚（劈开），同煎
数
沸，去滓，取一盏服，不计时。
治肝虚气痹，两胁胀满，筋脉拘急，不得喘息，四肢少力，眼目不明。细辛汤方。
细辛（去苗叶） 防风（去叉） 白茯苓（去黑皮） 柏子仁（研） 桃仁（汤浸去皮
尖、双仁，
麸炒微黄） 山茱萸 甘草（炙，锉各三分） 蔓荆实 枳壳（去瓤，麸炒各半两）
上九味，粗捣筛。每服三钱匕，水一盏，大枣三枚（劈破），同煎数沸，去滓，取七分
温
服，不计时候。
治肝痹头目昏塞，四肢不利，胸膈虚烦。防风汤方。
防风（去叉）一两 芎 黄 （锉） 五味子 人参 茯神（去木） 独活（去芦头）
羚羊
角（镑屑） 前胡（去芦头）各三分 细辛（去苗叶） 酸枣仁（微炒） 甘草（炙）各半
两
上一十二味，粗捣筛。每服三钱匕，水一盏，大枣三枚（劈破），同煎，取七分，去滓
温
服，不计时候。
治筋痹多悲思，颜色苍白，四肢不荣，诸筋拘挛，伸动缩急，腹中转痛。五加皮酒方。
五加皮 枳刺（炒） 猪椒根皮（各八两） 丹参（八两） 桂（去粗皮三两） 当归
（切，
焙三两） 甘草（炙） 天雄（炮裂，去皮脐） 秦椒（去闭口及目，炒出汗） 白藓皮 木
通（锉
各四两
上一十五味，锉如麻豆大，以夹绢囊盛贮，清酒三斗渍之，春夏三四宿，秋冬六七宿。
初服二三合，稍加，以知为度。
Discussion states: The *Huangdi Neijing* (Yellow Emperor's Inner Canon) asserts that Wind, Cold, and Dampness pathogenic factors invade the body simultaneously and combine to form Bi syndrome (Obstruction syndrome). It further states that encountering these factors in spring results in Jin Bi (Sinew Bi). Its manifestations include stiffness and spasm of the sinews, with flexion but inability to extend. If Jin Bi persists without resolution and is re-exposed to pathogens, the evil qi moves inward and resides in the Liver, constituting Gan Bi (Liver Bi). Symptoms include nocturnal startle during sleep, polydipsia with frequent urination, and a pulling sensation in the upper body resembling pregnancy. This occurs because excessive pathogenic qi leads to exhaustion, and Bi accumulation gathers in the Liver. The treatment principle prioritizes treating Jin Bi first; once Jin Bi is resolved, the pathogen will not enter the Liver.
Formula for Tianma Wan (Gastrodia Pill), treating Jin Feng (Wind affecting sinews) characterized by limb spasms and numbness:
Tianma (Rhizoma Gastrodiae, 2 liang), Kushen (Cortex Sophorae Flavescentis Radicis, 3 liang), Xixin (Herba Asari, de-radicle and leaves, 2 liang), Changpu (Rhizoma Acori Tatarinowii, 2 liang), Niuxi (Radix Achyranthis Bidentatae, de-radicle, wine-soaked, dried, 2 liang), Chijian (Rhizoma Angelicae Dahuricae, 2 liang), Fuzi (Radix Aconiti Lateralis Preparata, cracked by frying, skin and umbilicus removed, 1 liang), Diyü (Radix Sanguisorbae, 2 liang), Renshen (Radix Ginseng, 2 liang), Xiong (Radix Chuanxiong, 1 liang), Gui (Ramulus Cinnamomi, bark removed, 1.5 liang), Muxiang (Radix Aucklandiae, 1 liang), Chenjupi (Pericarpium Citri Reticulatae, soaked in water, white pith removed, dried, 1.5 liang), Danggui (Radix Angelicae Sinensis, sliced, dried), Chishao (Radix Paeoniae Rubra), Suanzaoren (Semen Ziziphi Spinosae, lightly fried), Weilingxian (Herba Clematidis, soil removed), Ben (Rhizoma Ligustici Wallichii, de-radicle and soil), Fangfeng (Radix Saposhnikoviae, forked parts removed, cut), Duhuo (Rhizoma et Radix Angelicae Pubescentis, rhizome head removed) each 2 liang.
The above twenty ingredients are crushed, sifted into fine powder, mixed with refined honey, pounded into pills the size of wutong seeds. Take 20 pills with warm wine per dose, twice daily; dosage may increase to 30 pills.
Formula for Niuxi Tang (Achyranthes Decoction), treating Jin Bi where deficient sinews are injured by wind, causing sinew contraction, inability to extend waist and back, stiffness, and intermittent pain:
Niuxi (Radix Achyranthis Bidentatae, de-radicle, wine-soaked, cut, dried), Fangfeng (Radix Saposhnikoviae, forked parts removed), Danshen (Radix Salviae Miltiorrhizae), Qianhu (Radix Peucedani, de-rhizome head) each 2 liang, Shihu (Caulis Dendrobii, de-roots, 2.5 liang), Duzhong (Cortex Eucommiae, coarse bark removed, coated with butter, roasted, cut), Qinjiao (Radix Gentianae Macrophyllae, de-radicle and soil), Xuduan (Radix Dipsaci, 1.5 liang each), Chenjupi (Pericarpium Citri Reticulatae, water-washed, white pith removed, 1 liang).
The above ten ingredients, except Dama Ren (Semen Cannabis Indicae), are coarsely crushed and sieved. Take 5 qianbi per dose with 1.5 zhan of water, boil for 5-7 boils, add 1 qianbi of crushed Mahren powder, boil until reduced to 1 zhan, strain, and take on an empty stomach, twice daily.
Formula for Duhuo San (Angelica Pubescens Powder), treating Jin Bi with limb stiffness and inability to extend:
Duhuo (Rhizoma et Radix Angelicae Pubescentis, de-rhizome head, 3 liang), Fuzi (Radix Aconiti Lateralis Preparata, cracked by frying, skin and umbilicus removed), Yiyiren (Semen Coicis), Cang'er (Fructus Xanthii), Fangfeng (Radix Saposhnikoviae, forked parts removed), Manjingzi (Fructus Viticis Negundo), Xiong (Radix Chuanxiong).
The above ten ingredients are crushed and sifted into fine powder. Take 1 qianbi per dose, mixed with warm wine on an empty stomach, twice daily.
Formula for Fushen San (Poria with Wood Powder), treating Gan Bi with frequent palpitations and mental unrest:
Fushen (Sclerotium Poriae Cum Radix, wood removed), Suanzaoren (Semen Ziziphi Spinosae, lightly fried), Huangqi (Radix Astragali Membranacei, cut), Renshen (Radix Ginseng) each 1 liang, Shugan Dihuang (Radix Rehmanniae Preparata, dried), Yuanzhi (Radix Polygalae, heart removed), Wuweizi (Fructus Schisandrae Chinensis) each 0.5 liang, Bai Fuling (Poria, black skin removed, 1 liang), Dansha (Cinnabaris, separately ground, 0.5 liang).
The above nine ingredients, excluding Dansha, are crushed and sifted into powder. Mix in Dansha powder and grind evenly. Take 1 qianbi per dose, mixed with warm wine, at any time.
Formula for Bugan Tang (Tonify Liver Decoction), treating Gan Bi with fullness under both hypochondria, sinew stiffness preventing deep breathing, hernia and masses, cold limbs, Qi rushing to cause abdominal pain, and blurred vision:
Bai Fuling (Poria, black skin removed, 1.2 qian), Wutou (Radix Aconiti Kusnezoffii, four pieces, cracked by frying, skin and umbilicus removed), Ruiren (Semen Pruni Armeniacae, ground), Baiziren (Semen Platycladi, ground), Fangfeng (Radix Saposhnikoviae, forked parts removed), Xixin (Herba Asari, de-radicle and leaves) each 2 liang, Shanzhuyu (Fructus Corni Officinalis), Gui (Ramulus Cinnamomi, bark removed, 3 fen), Gancao (Radix Glycyrrhizae Uralensis, roasted, cut, 0.5 liang).
The above nine ingredients are cut like hemp beans and mixed with ground herbs. Take 5 qianbi per dose with 1.5 zhan of water and two split jujubes, boil briefly, strain, take 1 zhan, at any time.
Formula for Xixin Tang (Asarum Decoction), treating Liver deficiency and Qi Bi with hypochondriac distension, sinew stiffness preventing breathing, limb weakness, and blurred vision:
Xixin (Herba Asari, de-radicle and leaves), Fangfeng (Radix Saposhnikoviae, forked parts removed), Bai Fuling (Poria, black skin removed), Baiziren (Semen Platycladi, ground), Taoren (Semen Persicae, soaked in water, peel and tips removed, bran-roasted until slightly yellow), Shanzhuyu (Fructus Corni Officinalis), Gancao (Radix Glycyrrhizae Uralensis, roasted, cut) each 3 fen, Manjingzi (Fructus Viticis Negundo), Zhike (Fructus Aurantii, pulp removed, bran-roasted) each 0.5 liang.
The above nine ingredients are coarsely crushed and sieved. Take 3 qianbi per dose with 1 zhan of water and three split jujubes, boil briefly, strain, take 7/10 portion warm, at any time.
Formula for Fangfeng Tang (Saposhnikovia Decoction), treating Gan Bi with dizziness and head heaviness, limb dysfunction, chest diaphragm deficiency irritability:
Fangfeng (Radix Saposhnikoviae, forked parts removed, 1 liang), Xiong (Radix Chuanxiong), Huangqi (Radix Astragali Membranacei, cut), Wuweizi (Fructus Schisandrae Chinensis), Renshen (Radix Ginseng), Fushen (Sclerotium Poriae Cum Radix, wood removed), Duhuo (Rhizoma et Radix Angelicae Pubescentis, de-rhizome head), Lingyangjiao (Cornu Saigae Tataricae, shaved flakes), Qianhu (Radix Peucedani, de-rhizome head) each 3 fen, Xixin (Herba Asari, de-radicle and leaves), Suanzaoren (Semen Ziziphi Spinosae, lightly fried), Gancao (Radix Glycyrrhizae Uralensis, roasted) each 0.5 liang.
The above twelve ingredients are coarsely crushed and sieved. Take 3 qianbi per dose with 1 zhan of water and three split jujubes, boil, reduce to 7/10, strain, take warm, at any time.
Formula for Wujia Pi Jiu (Acanthopanax Bark Wine), treating Jin Bi with excessive sadness, pale complexion, malnourished limbs, sinew spasms, difficulty extending or contracting, and abdominal shifting pain:
Wujia Pi (Cortex Acanthopanacis Senticosi), Zhici (Spina Gleditsiae Sinensis, fried), Zhu Jiaogenpi (Cortex Zanthoxyli Radicis, 8 liang each), Danshen (Radix Salviae Miltiorrhizae, 8 liang), Gui (Ramulus Cinnamomi, bark removed, 3 liang), Danggui (Radix Angelicae Sinensis, sliced, dried, 3 liang), Gancao (Radix Glycyrrhizae Uralensis, roasted), Tianxiong (Radix Aconiti Lateralis Preparata, cracked by frying, skin and umbilicus removed), Qinjiao (Pericarpium Zanthoxyli, remove closed mouth and eyes, fried until sweat appears), Baixianpi (Cortex Dictamni Dasycarpi), Mutong (Caulis Akebiae Trifoliatae, cut) each 4 liang.
The above fifteen ingredients are cut like hemp beans, placed in a silk bag, and soaked in 3 dou of clear wine. Soak for 3-4 nights in spring/summer, 6-7 nights in autumn/winter. Start with 2-3 he doses, gradually increasing until effective.