论曰内经谓结阳者肿四肢，夫热胜则肿，而四肢为诸阳之本，阳结于外，不得行于阴，
则热
故为
治结阳四肢肿满，热菀不散，犀角汤方
犀角（镑屑） 玄参 连翘 柴胡（去苗各半两） 升麻 木通（锉各三分） 沉香（锉）
檀
香（锉） 射干（去毛） 甘草（炙锉各一分） 芒硝 麦门冬（去心各一两）
上一十二味，粗捣筛，每服五钱匕，水二盏，煎至一盏，去滓食后温服，日三。
治结阳气壅，四肢肿热，大小便秘涩。木香丸方
木香 芎 羌活（去芦头） 桂（去粗皮各二两） 大黄（锉如半栗大醋炒紫色） 槟
榔（
煨） 郁李仁（汤浸去皮研如膏各四两）
上七味，先以六味捣罗为末，入郁李仁再研匀，炼蜜和丸，梧桐子大，每服二十丸，或
三十丸，生姜汤下，空腹临卧各一服。
治四肢肿热，气脉壅滞。防己丸方
防己（锉三两） 牛膝（去苗酒浸焙） 薏苡仁（炒） 生干地黄（焙） 枳壳（去瓤
麸炒各二
两） 芍药（去土锉） 槟榔（煨锉各二两一分） 茯神（去木一两） 桂（去粗皮一两一
分） 麦
门冬（去心） 木香（各一两半） 大黄（锉如半栗子大醋炒紫色三两）
上一十二味，捣罗为细末，炼蜜和丸，梧桐子大，每食后生姜汤下三十丸。
治热菀四肢，肿实不散，令人气壅。白藓皮散方
白藓皮 黄芩（去黑心） 升麻 玄参 白蒺藜（微炒去刺） 桔梗（去芦头炒） 防
风（去
叉） 前胡（去芦头） 百合 甘草（炙） 栀子仁 茯神（去木各半两） 马牙硝（一两）
麦门
冬（去心一两半）
上一十四味，捣罗为细散，每服三钱匕，食后薄荷汤调下。
治热毒流于四肢，肿痛不消。升麻汤方
升麻 大黄（锉如半栗大醋炒紫色各二两） 前胡（去芦头） 栀子仁 射干（去毛炙
各一
两半） 黄芩（去黑心） 犀角（镑屑各一两） 豉（炒半升） 羚羊角（镑屑半两）
上九味，粗捣筛，每服三钱匕，水一盏半，煎至一盏，去滓食后温服，日三。
It is stated in the discussion: The *Neijing* (Classic of Internal Medicine) mentions that when Yang Qi (Yang energy) becomes knotted in the Yang meridians, it results in swelling of the four limbs. This occurs because excessive heat leads to swelling, and the four limbs are the root of all Yang meridians. If Yang Qi knots externally and cannot circulate into the Yin, heat accumulates, thus causing these symptoms.
The Xijiao Tang (Rhinoceros Horn Decoction) treats swelling and fullness of the four limbs due to knotted Yang Qi, as well as persistent accumulation of heat.
Ingredients: Xijiao (Horn of Rhinoceros, sliced or powdered), 0.5 liang; Xuanshen (Radix Scrophulariae), 0.5 liang; Lianqiao (Fructus Forsythiae), 0.5 liang; Chaihu (Radix Bupleuri, stems removed), 0.5 liang; Shengma (Rhizoma Cimicifugae), 3 fen; Mutong (Caulis Akebiae, chopped), 3 fen; Chenxiang (Lignum Aquilariae Resinatum, chopped); Tanxiang (Santalum Album, chopped); Shegan (Rhizoma Belamcandae, hairs removed); Gancao (Radix Glycyrrhizae, roasted and chopped), each 1 fen; Mangxiao (Natrii Sulfas), 1 liang; Maimendong (Radix Ophiopogonis, heart removed), 1 liang.
Preparation: Coarsely crush and sieve the above twelve ingredients. For each dose, take 5 qianbi (approx. 5-7 grams), add 2 zhan (approx. 400 ml) of water, decoct until 1 zhan remains. Strain and take warm after meals, three times daily.
The Muxiang Wan (Aquilaria Pill) treats knotted Yang Qi with qi stagnation, resulting in swollen, hot four limbs, and constipation with difficult urination and defecation.
Ingredients: Muxiang (Radix Aucklandiae), 2 liang; Xiong (Radix Ligustici Chuanxiong), 2 liang; Qianghuo (Rhizoma et Radix Notopterygii, rhizome removed), 2 liang; Gui (Ramulus Cinnamomi, bark removed), 2 liang; Dahuang (Radix et Rhizoma Rhei, chopped to size of half a chestnut, stir-fried with vinegar until purple), 4 liang; Binglang (Semen Arecae, baked), 4 liang; Yuliren (Semen Pruni Persicae, soaked in hot water, skin removed, ground into paste), 4 liang.
Preparation: First, crush and sieve the first six ingredients into powder. Add the Yuliren paste and grind evenly. Mix with refined honey to form pills the size of a paulownia seed. Take 20 or 30 pills per dose, administered with ginger decoction, once on an empty stomach and once before sleep.
The Fangji Wan (Stephania Pill) treats swollen and hot four limbs with stagnant qi and vessels.
Ingredients: Fangji (Radix Stephaniae Tetrandrae, chopped), 3 liang; Niuxi (Radix Achyranthis Bidentatae, stems removed, wine-soaked and dried); Yiyiren (Semen Coicis, fried); Shengdihuang (Radix Rehmanniae Recens, dried); Zhike (Fructus Aurantii, albedo removed, bran-roasted), each 2 liang; Shaoyao (Radix Paeoniae Alba, cleaned and chopped); Binglang (Semen Arecae, baked and chopped), each 2.1 liang; Fushen (Poria cum Radice Pinelliae, wood removed), 1 liang; Gui (Ramulus Cinnamomi, bark removed), 1.1 liang; Maimendong (Radix Ophiopogonis, heart removed); Muxiang (Radix Aucklandiae), each 1.5 liang; Dahuang (Radix et Rhizoma Rhei, chopped to size of half a chestnut, stir-fried with vinegar until purple), 3 liang.
Preparation: Crush and sieve the above twelve ingredients into fine powder. Mix with refined honey to form pills the size of a paulownia seed. Take 30 pills after meals with ginger decoction.
The Baixianpi San (Dictamnus Powder) treats heat accumulation in the four limbs, solid swelling that does not dissipate, leading to qi stagnation.
Ingredients: Baixianpi (Cortex Dictamni), 0.5 liang; Huangqin (Radix Scutellariae, black heart removed), 0.5 liang; Shengma (Rhizoma Cimicifugae), 0.5 liang; Xuanshen (Radix Scrophulariae), 0.5 liang; Baijili (Fructus Tribuli, lightly fried and thorns removed), 0.5 liang; Jiegeng (Radix Platycodonis, rhizome removed and fried), 0.5 liang; Fangfeng (Radix Saposhnikoviae, forks removed), 0.5 liang; Qianhu (Radix Peucedani, rhizome removed), 0.5 liang; Baihe (Bulbus Lilii), 0.5 liang; Gancao (Radix Glycyrrhizae, roasted), 0.5 liang; Zhizi (Fructus Gardeniae), 0.5 liang; Fushen (Poria cum Radice Pinelliae, wood removed), 0.5 liang; Mayaxiao (Natrii Sulfas crystallized), 1 liang; Maimendong (Radix Ophiopogonis, heart removed), 1.5 liang.
Preparation: Crush and sieve the above fourteen ingredients into fine powder. Take 3 qianbi per dose, mixed with mint decoction after meals.
The Shengma Tang (Cimicifuga Decoction) treats heat-toxin flowing into the four limbs, causing swelling and pain that do not subside.
Ingredients: Shengma (Rhizoma Cimicifugae), 2 liang; Dahuang (Radix et Rhizoma Rhei, chopped to size of half a chestnut, stir-fried with vinegar until purple), 2 liang; Qianhu (Radix Peucedani, rhizome removed), 1.5 liang; Zhizi (Fructus Gardeniae), 1.5 liang; Shegan (Rhizoma Belamcandae, hairs removed and roasted), 1.5 liang; Huangqin (Radix Scutellariae, black heart removed), 1.5 liang; Xijiao (Horn of Rhinoceros, sliced or powdered), 1 liang; Chi (Faba Fabae Fermentata, fried), 0.5 sheng; Lingyangjiao (Cornu Saigae Tataricae, sliced or powdered), 0.5 liang.
Preparation: Coarsely crush and sieve the above nine ingredients. For each dose, take 3 qianbi, add 1.5 zhan of water, decoct until 1 zhan remains. Strain and take warm after meals, three times daily.