论曰∶风寒湿三气杂至，合而为痹，以至阴遇此者则为肌痹。其状皮肤弗营，肌肉 浓
而不仁是也。
治肌肉 痹，肢体怠堕缓弱，恶风头疼，舌本强，言语謇涩。天麻丸方。
天麻 独活（去芦头各一两） 人参 防风（去叉各三分） 附子（炮裂，去皮脐） 桂
（去
粗皮） 麻黄（去根节各一两） 细辛（去苗叶） 当归（切，焙） 白术 羚羊角（镑屑）
芎
醋拌，炒令
黄） 白僵蚕（微炒各三分） 牛黄（研） 麝香（研各一分） 乌蛇肉（酒浸，去皮骨，
酥炒令黄
一两） 丹砂（别研半两） 龙脑（别研一分）
上二十三味，除四味别研外，捣罗为末，入所研药拌匀，再罗，炼蜜和杵三五百下，丸
如梧桐子大。每服温酒下十丸至十五丸，不计时服。
治肌痹淫淫，如鼠走四体，津液脱，腠理开，汗大泄，为脾风。风气藏于皮肤，肉色败
，鼻见黄色，止汗通肉解痹。麻黄汤方。
麻黄（去根节，煎，掠去沫，焙干） 枳实（去瓤，麸炒微黄） 细辛（去苗叶） 白
术防
风（去叉各三两） 附子（炮裂，去皮脐四两） 甘草（炙，锉二两） 桂（去粗皮二两） 石
膏（
碎八两） 当归（切，焙） 芍药（各二两）
上一十一味，锉如麻豆。每服五钱匕，水一盏半，入生姜半分（切），煎至一盏，去滓
温
服，不计时候。
治肌痹津液开泄，时复不仁，或四肢急痛。西州续命汤方。
麻黄（去根节，煎，掠去沫，焙干） 当归（切，焙） 石膏（碎各二两） 芎 桂
（去粗
皮） 甘草（炙） 黄芩（去黑心） 防风（去叉） 芍药（各一两） 杏仁（汤浸去皮尖、
双仁，
炒四十枚）
上一十味，粗捣筛。每服四钱匕，水一盏，入生姜一枣大（切），煎至六分，去滓温服，
不计时候。
治肌痹淫淫如虫行，或腠理开疏，汗出，皮肤肉色不泽，唇鼻黄。细辛汤方。
细辛（去苗叶） 防风（去叉） 白术 附子（炮裂，去皮脐） 桂（去粗皮各一两） 石
膏（
碎） 麻黄（去根节，煎，掠去沫，焙干各二两） 枳实（去瓤，麸炒微黄） 甘草（炙，
锉各
半两） 黄 当归（切，焙各一两）
上一十一味，锉如麻豆。每服四钱匕，水一盏，入生姜五片，煎至七分，去滓温服，不
计时候。
Commentary states: The three pathogenic factors of Wind, Cold, and Dampness mix together to combine and cause Bi syndrome (Obstruction Syndrome). If encountered by the "Zhi Yin" (Extreme Yin constitution or timing), it manifests as Ji Bi (Muscle Bi). Its presentation involves skin lacking nourishment and circulation, with muscles presenting numbness and lack of sensation.
For treating Muscle Bi with symptoms of limb fatigue, flaccidity, weakness, aversion to wind, headache, stiffness of the tongue root, and slurred speech, use Tianma Wan Formula.
Tianma (Gastrodiae Rhizoma)
Duhuo (Angelicae Pubescentis Radix) [remove rhizome head, each 1 liang]
Renshen (Ginseng Radix et Rhizoma)
Fangfeng (Saposhnikoviae Radix) [remove forked branches, each 3 qian]
Fuzi (Aconiti Lateralis Radix Praeparata) [pao processed until cracked, remove skin and umbilical scar]
Guizhi (Cinnamomi Ramulus) [remove rough bark]
Mahuang (Ephedrae Herba) [remove roots and nodes, each 1 liang]
Xixin (Asari Radix et Rhizoma) [remove seedlings and leaves]
Danggui (Angelicae Sinensis Radix) [slice, dry-roast]
Baizhu (Atractylodis Macrocephalae Rhizoma)
Lingyangjiao (Saigae Tataricae Cornu) [shave into flakes]
Chuanxiong (Ligustici Chuanxiong Rhizoma) [mix with vinegar, stir-fry until slightly yellow]
Baijiangcan (Bombyx Batryticatus) [lightly stir-fry, each 3 qian]
Niuhuang (Bovis Calculus) [crush/grind]
Shexiang (Moschus) [crush/grind, each 1 fen]
Wushe Rou (Zaocys Flesh) [soak in wine, remove skin and bones, stir-fry with su (animal fat) until yellow, 1 liang]
Dansha (Cinnabaris) [separately grind, half liang]
Longnao (Borneolum Syntheticum) [separately grind, 1 fen]
Take the above twenty-three medicinal materials. Except for four that are separately ground, crush and sieve the rest into powder. Mix with the previously ground medicines evenly, sieve again, blend with refined honey, and pound/trample three to five hundred times. Form pills the size of Sophora japonica seeds. Take ten to fifteen pills per dose with warm wine, at any time.
For treating Ji Bi with sensations like mice running through the four limbs, depletion of body fluids, open couli (pores/skin texture), and profuse sweating, which constitutes Pi Feng (Spleen Wind) where Wind Qi hides in the skin, muscle color deteriorates, and the nose appears yellow. This formula aims to stop sweating, unblock collaterals, and resolve Bi obstruction. Use Mahuang Tang Formula.
Mahuang (Ephedrae Herba) [remove roots and nodes, decoct, skim off foam, dry-roast]
Zhishi (Aurantii Fructus Immaturus) [remove pith, stir-fry with bran until slightly yellow]
Xixin (Asari Radix et Rhizoma) [remove seedlings and leaves]
Baizhu (Atractylodis Macrocephalae Rhizoma)
Fangfeng (Saposhnikoviae Radix) [remove forked branches, each 3 liang]
Fuzi (Aconiti Lateralis Radix Praeparata) [pao processed until cracked, remove skin and umbilical scar, 4 liang]
Gancao (Glycyrrhizae Radix et Rhizoma) [zhi processed, cut into small pieces, 2 liang]
Guizhi (Cinnamomi Ramulus) [remove rough bark, 2 liang]
Shigao (Gypsum Fibrosum) [crushed, 8 liang]
Danggui (Angelicae Sinensis Radix) [slice, dry-roast]
Shaoyao (Paeoniae Radix Alba/Rubra) [each 2 liang]
Take the above eleven medicinal materials, cut into pieces the size of hemp seeds. Take five qianbi per dose, add one and a half sheng of water, add half a qianbi of Shengjiang (Zingiberis Rhizoma Recens) [sliced], decoct until one sheng remains, strain, and take warm, at any time.
For treating Ji Bi with leakage of body fluids, occasional numbness, or acute pain/stiffness in the four limbs, use Xizhou Xuming Tang Formula.
Mahuang (Ephedrae Herba) [remove roots and nodes, decoct, skim off foam, dry-roast]
Danggui (Angelicae Sinensis Radix) [slice, dry-roast]
Shigao (Gypsum Fibrosum) [crushed, each 2 liang]
Chuanxiong (Ligustici Chuanxiong Rhizoma)
Guizhi (Cinnamomi Ramulus) [remove rough bark]
Gancao (Glycyrrhizae Radix et Rhizoma) [zhi processed]
Huangqin (Scutellariae Radix) [remove black heart/core]
Fangfeng (Saposhnikoviae Radix) [remove forked branches]
Shaoyao (Paeoniae Radix Alba/Rubra) [each 1 liang]
Xingren (Armeniacae Semen Amarum) [soak in hot water, remove skin and tips, discard double kernels, stir-fry, 40 units]
Take the above ten medicinal materials, coarsely crush and sieve. Take four qianbi per dose, add one sheng of water, add Shengjiang (Zingiberis Rhizoma Recens) [sliced, size of a jujube], decoct until six-tenths remain, strain, and take warm, at any time.
For treating Ji Bi with sensations like insects crawling, or loose couli with sweating, dull skin and muscle color, and yellow lips and nose, use Xixin Tang Formula.
Xixin (Asari Radix et Rhizoma) [remove seedlings and leaves]
Fangfeng (Saposhnikoviae Radix) [remove forked branches]
Baizhu (Atractylodis Macrocephalae Rhizoma)
Fuzi (Aconiti Lateralis Radix Praeparata) [pao processed until cracked, remove skin and umbilical scar]
Guizhi (Cinnamomi Ramulus) [remove rough bark, each 1 liang]
Shigao (Gypsum Fibrosum) [crushed]
Mahuang (Ephedrae Herba) [remove roots and nodes, decoct, skim off foam, dry-roast, each 2 liang]
Zhishi (Aurantii Fructus Immaturus) [remove pith, stir-fry with bran until slightly yellow]
Gancao (Glycyrrhizae Radix et Rhizoma) [zhi processed, cut into small pieces, each half liang]
Huangqi (Astragali Radix)
Danggui (Angelicae Sinensis Radix) [slice, dry-roast, each 1 liang]
Take the above eleven medicinal materials, cut into pieces the size of hemp seeds. Take four qianbi per dose, add one sheng of water, add five slices of Shengjiang (Zingiberis Rhizoma Recens), decoct until seven-tenths remain, strain, and take warm, at any time.