论曰∶《内经》谓风寒湿三气杂至，合而为痹。又曰∶以冬遇此者为骨痹。骨痹不已，
复感于邪，内舍于肾，是为肾痹。其证善胀，尻以代踵，脊以代头。盖肾者胃之关，关门不
利，则胃气不行，所以善胀，筋骨拘迫，故其下挛急，其上蜷屈，所以言代踵代头也。
治肾脏虚乏，久感寒湿，因而成痹。补损益气。远志丸方。
远志（去心） 山芋 肉苁蓉（去皴皮，酒浸，切，焙） 牛膝（去苗，酒浸，切，焙
各一
两） 石斛（去根） 天雄（炮裂，去皮脐） 巴戟天（去心） 人参 山茱萸 泽泻 菟
丝子（酒
浸一宿，别捣） 茯神（去木） 覆盆子 续断 生干地黄（焙） 桂（去粗皮） 鹿茸（酒
炙，去
毛） 甘草（炙，锉） 附子（炮裂，去皮脐） 牡丹皮 白茯苓（去黑皮） 五味子 杜
仲（去粗
皮，炙，锉各一分） 蛇床子 楮实（微炒） 黄 （各一两）
上二十六味，捣罗为末，炼蜜和捣数百下，丸如梧桐子大。每服空心温酒下二十丸，加
至三十丸。
治肾脏虚冷，邪气乘虚，身体冷痹不仁，手足牵强，举动艰难；或肌肉 动，引腰脊及
左右偏急，不能饮食；或因房室发动。防风丸方。
防风（去叉） 白茯苓（去黑皮） 细辛（去苗叶） 白术 附子（炮裂，去皮脐） 桂
（去粗
皮） 泽泻（各半两） 甘草（炙，锉） 紫菀（去苗） 芍药 牛膝（去苗，酒浸，切，
焙） 栝
蒌根（各三分） 山茱萸 熟干地黄（焙） 半夏（汤洗七遍去滑，焙） 独活（去芦头） 山
芋
（各一分）
上一十八味，捣罗为末，炼蜜为丸，如梧桐子大。每日空腹温酒下十丸，日再服。未瘥
更加丸数，此药宜久服。
治肾脏中风湿，腰痛、脚膝偏枯，皮肤 痹。语声謇涩，两耳虚鸣，举体乏力，面无颜
色，志气不乐，骨节酸疼。茵芋散方。
茵芋（去茎） 杜仲（去粗皮，炙，锉） 石南 石龙芮 羊踯躅（微炒） 麝香（研）
狗脊
（去毛） 当归（锉，炒） 干蝎（微炒） 桑螵蛸（微炒） 菖蒲（各半两） 赤箭 独
活（去芦
头） 附子（炮裂，去皮脐） 天雄（炮裂，去皮脐） 甘菊花 牛膝（去苗，酒浸，切，
焙） 木
香
上二十一味，捣罗为散。每服二钱匕，食前温酒调下，日再服。
治肾脏中风，脚膝麻痹，腰背强直、疼痛，言语不利，面色萎黑，肌体羸瘦。白附子丸
方。
白附子（炮裂） 干蝎（微炒） 防风（去叉） 天麻 天雄（炮裂，去皮脐） 黄
（锉） 萆
独活（去芦头） 丹参 当归（锉，炒） 肉苁蓉（去皴皮，酒浸一宿，焙） 海桐皮
（锉） 补
骨脂 仙灵脾（各三分） 白花蛇（酒浸，去皮、骨，炙） 桂（去粗皮） 安息香 牛膝
（去
苗，酒浸，切，焙各一两） 雄黄（研，水飞过） 麝香（研各半两）
上二十味，捣罗为末，炼蜜和捣三五百下，丸如梧桐子大。每服三十丸，空心温酒下，
日再服。
治肾脏气虚，外邪杂至，脚膝缓弱，腰脊不可转侧，日加疼痹。石龙芮汤方。
石龙芮 独活（去芦头） 防风（去叉） 茯神（去木） 杜仲（去粗皮，炙，锉） 萆
丹
参羌活（去芦头） 五味子 细辛（去苗叶） 牛膝（酒浸，切，焙） 当归（锉，炒） 人
参（各
三分） 天雄（炮裂，去皮脐） 麻黄（去根节，煎，掠去沫，焙） 桂（去粗皮各一两） 枳
壳
（去瓤，麸炒半两）
上一十七味，锉如麻豆。每服四钱匕，水一盏，入生姜五片，同煎至六分。去滓温服，
不计时候。
治肾虚中风湿，腰脚缓弱，顽痹不仁，颜色苍黑，语音混浊，志意不定，头目昏，腰背
强痛，四肢拘急，体重无力。麻黄汤方。
麻黄（去根节，煎，掠去沫，焙） 羌活（去芦头） 桂（去粗皮） 附子（炮裂，去
皮脐）
侧子（炮裂，去皮脐各一两） 防己 当归（锉，炒） 海桐皮 牛膝（酒浸，切，焙） 甘
菊花
羚羊角（镑） 茵芋（去茎） 五加皮（各三分） 甘草（炙，锉半两） 防风（去叉） 白
术（各
三两
上一十六味，锉如麻豆。每服四钱匕，水一盏，入生姜五片，同煎至七分，去滓温服，
不计时候。
治肾气虚冷，复感寒湿为痹。牛膝酒方。
牛膝 秦艽（去苗土） 芎 防风（去叉） 桂（去粗皮） 独活（去芦头） 丹参 白
茯苓
（去黑皮各二两） 杜仲（去粗皮，锉，炒） 附子（炮裂，去皮脐） 石斛（去根） 干
姜（炮）
麦门冬（去心） 地骨皮（各一两半） 五加皮（五两） 薏苡仁（一两） 大麻子（炒半
两）
上一十七味，锉切如麻豆，以生绢袋盛，酒一斗浸，春夏三日，秋冬五日。每服半盏，
空心温服，日再。
Commentary states: The *Neijing* (Inner Canon) asserts that wind, cold, and dampness pathogenic factors mix and invade together, combining to form Bi syndrome (obstruction syndrome). It further states: contracting these pathogens in winter results in Bone Bi. If Bone Bi is not resolved and the body is re-exposed to pathogens, the pathogens move inward and lodge in the Kidney, which is termed Kidney Bi. Clinical manifestations include frequent abdominal distension, walking with the buttocks replacing the heels (indicating severe lower limb contracture preventing upright posture), and the spine replacing the head (indicating severe spinal deformity). This is because the Kidney serves as the gate of the Stomach; if this gate is obstructed, Stomach Qi cannot circulate freely, leading to frequent distension. Due to the constraint and compression of sinews and bones, the lower limbs become cramped and the upper body curls up, hence the description of "heels replaced by buttocks" and "head replaced by spine."
Treatment for Kidney deficiency and exhaustion, where long-term exposure to cold and dampness leads to Bi syndrome. The therapeutic method is tonification and replenishing Qi. Yuanzhi Wan (Polygala Pill) Formula:
Polygalae Radix (Yuanzhi, 远志) [removed heart]
Dioscoreae Rhizoma (Shanyu, 山芋)
Cynomorii Fructus (Roucongrong, 肉苁蓉) [removed wrinkled skin, soaked in wine, sliced, dried]
Achyranthis Bidentatae Radix (Niuxi, 牛膝) [removed sprouts, soaked in wine, sliced, dried] each 1 liang
Dendrobii Caulis (Shihu, 石斛) [removed roots]
Aconiti Kusnezoffii Radix (Tianxiong, 天雄) [processed until cracked, removed skin and navel]
Morinda Officinalis Radix (Bajitian, 巴戟天) [removed heart]
Ginseng Radix et Rhizoma (Renshen, 人参)
Corni Fructus (Shanzhuyu, 山茱萸)
Alismatis Rhizoma (Zexie, 泽泻)
Cuscutae Semen (Tusizi, 菟丝子) [soaked in wine overnight, separately pounded]
Poria (Fushen, 茯神) [removed wood]
Rubi Fructus (Fupenzi, 覆盆子)
Dipsaci Radix (Xuduan, 续断)
Rehmanniae Radix Preparata (Shengganshengdi, 生干地黄) [dried]
Cinnamomi Ramulus (Guizhi, 桂枝) [removed rough bark]
Cervi Cornu Pantotrichum (Lurong, 鹿茸) [wine-fried, hair removed]
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted, chopped]
Aconiti Lateralis Radix Preparata (Fuzi, 附子) [processed until cracked, removed skin and navel]
Moutan Cortex (Mudanpi, 牡丹皮)
Poria (Baifuling, 白茯苓) [removed black skin]
Schisandrae Fructus (Wuweizi, 五味子)
Eucommiae Cortex (Duzhong, 杜仲) [removed rough bark, roasted, chopped]
Cnidii Fructus (Shechuangzi, 蛇床子)
Broussonetiae Fructus (Chushi, 楮实) [lightly stir-fried]
Astragali Radix (Huangqi, 黄芪) [each 1 liang]
The above twenty-six ingredients are crushed, sifted into powder, mixed with refined honey, and pounded for hundreds of strokes to form pills the size of paulownia seeds. Take 20 pills on an empty stomach with warm wine; dosage may be increased to 30 pills.
Treatment for Kidney deficiency and cold, where pathogenic factors take advantage of deficiency to invade, causing cold Bi with numbness and insensitivity of the body, pulling stiffness of hands and feet, and difficulty in movement; or muscle twitching pulling on the waist, spine, and lateral tendons causing cramping, inability to eat; or triggered by sexual activity. Fangfeng Wan (Saposhnikovia Pill) Formula:
Saposhnikoviae Radix (Fangfeng, 防风) [removed forked branches]
Poria (Baifuling, 白茯苓) [removed black skin]
Asari Radix et Rhizoma (Xixin, 细辛) [removed sprouts and leaves]
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术)
Aconiti Lateralis Radix Preparata (Fuzi, 附子) [processed until cracked, removed skin and navel]
Cinnamomi Ramulus (Guizhi, 桂枝) [removed rough bark]
Alismatis Rhizoma (Zexie, 泽泻) [each ban liang]
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted, chopped]
Asteris Radix (Ziwan, 紫菀) [removed sprouts]
Paeoniae Radix Alba (Shaoyao, 芍药)
Achyranthis Bidentatae Radix (Niuxi, 牛膝) [removed sprouts, soaked in wine, sliced, dried]
Trichosanthis Radix (Gualougen, 栝楼根) [each 3 fen]
Corni Fructus (Shanzhuyu, 山茱萸)
Rehmanniae Radix Preparata (Shuganshengdi, 熟干地黄) [dried]
Pinelliae Rhizoma (Banxia, 半夏) [washed seven times in water to remove slipperiness, dried]
Angelicae Pubescentis Radix (Duohuo, 独活) [removed rhizome head]
Dioscoreae Rhizoma (Shanyu, 山芋) [each 1 fen]
The above eighteen ingredients are crushed, sifted into powder, and made into pills with refined honey, sized like paulownia seeds. Take 10 pills on an empty stomach with warm wine, twice daily. If symptoms persist, increase the number of pills; this medicine is suitable for long-term use.
Treatment for Wind-Damp invading the Kidney, causing lower back pain, hemiplegia or local paralysis of legs and knees, skin numbness. Hoarse voice, tinnitus in both ears, general weakness, pale complexion, low mood, and soreness/pain in bone joints. Yinyu San (Ilex Dispersion) Formula:
Ilex Cassine Cortex (Yinyu, 茵芋) [removed stems]
Eucommiae Cortex (Duzhong, 杜仲) [removed rough bark, roasted, chopped]
Rhododendri Daurici Folium (Shinan, 石南)
Batrachospermum (Shilongrui, 石龙芮)
Daphne Genkwa Flower (Yangzhizhu, 羊踯躅) [lightly stir-fried]
Moschus (Shexiang, 麝香) [ground]
Dryopteris Crassirhizoma (Gouji, 狗脊) [hair removed]
Angelicae Sinensis Radix (Danggui, 当归) [chopped, stir-fried]
Scorpio (Ganxie, 干蝎) [lightly stir-fried]
Mantis Oötheca (Sangpiaoxiao, 桑螵蛸) [lightly stir-fried]
Acori Tatarinowii Rhizoma (Changpu, 菖蒲) [each ban liang]
Araliae Radix (Chijian, 赤箭 - Tianma)
Angelicae Pubescentis Radix (Duohuo, 独活) [removed rhizome head]
Aconiti Lateralis Radix Preparata (Fuzi, 附子) [processed until cracked, removed skin and navel]
Aconiti Kusnezoffii Radix (Tianxiong, 天雄) [processed until cracked, removed skin and navel]
Chrysanthemi Flos (Ganjuhua, 甘菊花)
Achyranthis Bidentatae Radix (Niuxi, 牛膝) [removed sprouts, soaked in wine, sliced, dried]
Costi Radix (Muxiang, 木香)
The above twenty-one ingredients are crushed and sifted into a powder. Take 2 qianbi before meals, mixed with warm wine, twice daily.
Treatment for Wind striking the Kidney, causing numbness and paralysis of legs and knees, stiffness and pain in lower back, dysarthria, sallow and dark complexion, emaciation. Baifu Zi Wan (Hydrocotyl Pill) Formula:
Typhonii Rhizoma (Baifuzi, 白附子) [processed until cracked]
Scorpio (Ganxie, 干蝎) [lightly stir-fried]
Saposhnikoviae Radix (Fangfeng, 防风) [removed forked branches]
Gastrodiae Rhizoma (Tianma, 天麻)
Aconiti Kusnezoffii Radix (Tianxiong, 天雄) [processed until cracked, removed skin and navel]
Astragali Radix (Huangqi, 黄芪) [chopped]
Dioscoreae Hypoglaucae Rhizoma (Bixie, 萆薢)
Angelicae Pubescentis Radix (Duohuo, 独活) [removed rhizome head]
Salviae Miltiorrhizae Radix (Danshen, 丹参)
Angelicae Sinensis Radix (Danggui, 当归) [chopped, stir-fried]
Cynomorii Fructus (Roucongrong, 肉苁蓉) [removed wrinkled skin, soaked in wine overnight, dried]
Spatholobi Caulis (Haitongpi, 海桐皮) [chopped]
Psoraleae Fructus (Buguzhi, 补骨脂)
Epimedii Folium (Xianlinpi, 仙灵脾) [each 3 fen]
Bungarus Parvus (Baihuashe, 白花蛇) [soaked in wine, skin and bones removed, fried]
Cinnamomi Ramulus (Guizhi, 桂枝) [removed rough bark]
Styrax (Anxixiang, 安息香)
Achyranthis Bidentatae Radix (Niuxi, 牛膝) [removed sprouts, soaked in wine, sliced, dried] each 1 liang
Realgar (Xionghuang, 雄黄) [ground, wet-panned]
Moschus (Shexiang, 麝香) [ground] each ban liang
The above twenty ingredients are crushed, sifted into powder, mixed with refined honey, and pounded for three to five hundred strokes to form pills the size of paulownia seeds. Take 30 pills on an empty stomach with warm wine, twice daily.
Treatment for Kidney Qi deficiency, mixed external pathogens invading, flaccidity and weakness of legs and knees, inability to turn the waist and spine, worsening pain and Bi obstruction daily. Shilongrui Tang (Batrachospermum Decoction) Formula:
Batrachospermum (Shilongrui, 石龙芮)
Angelicae Pubescentis Radix (Duohuo, 独活) [removed rhizome head]
Saposhnikoviae Radix (Fangfeng, 防风) [removed forked branches]
Poria (Fushen, 茯神) [removed wood]
Eucommiae Cortex (Duzhong, 杜仲) [removed rough bark, roasted, chopped]
Dioscoreae Hypoglaucae Rhizoma (Bixie, 萆薢)
Salviae Miltiorrhizae Radix (Danshen, 丹参)
Notopterygii Rhizoma et Radix (Qianghuo, 羌活) [removed rhizome head]
Schisandrae Fructus (Wuweizi, 五味子)
Asari Radix et Rhizoma (Xixin, 细辛) [removed sprouts and leaves]
Achyranthis Bidentatae Radix (Niuxi, 牛膝) [soaked in wine, sliced, dried]
Angelicae Sinensis Radix (Danggui, 当归) [chopped, stir-fried]
Ginseng Radix et Rhizoma (Renshen, 人参) [each 3 fen]
Aconiti Kusnezoffii Radix (Tianxiong, 天雄) [processed until cracked, removed skin and navel]
Ephedrae Herba (Mahuang, 麻黄) [removed root and nodes, decocted, scum removed, dried]
Cinnamomi Ramulus (Guizhi, 桂枝) [removed rough bark] each 1 liang
Aurantii Fructus (Zhike, 枳壳) [pulp removed, bran-fried] ban liang
The above seventeen ingredients are chopped like hemp seeds. Take 4 qianbi, add one sheng of water and five slices of fresh ginger, decoct until reduced to six parts. Strain and take warm, at any time.
Treatment for Kidney deficiency with Wind-Damp invasion, flaccidity and weakness of waist and legs, stubborn numbness and insensitivity, dark complexion, turbid voice, unstable will, dizziness and blurred vision, stiff and painful lower back, cramped limbs, heavy body and weakness. Mahuang Tang (Ephedra Decoction) Formula:
Ephedrae Herba (Mahuang, 麻黄) [removed root and nodes, decocted, scum removed, dried]
Notopterygii Rhizoma et Radix (Qianghuo, 羌活) [removed rhizome head]
Cinnamomi Ramulus (Guizhi, 桂枝) [removed rough bark]
Aconiti Lateralis Radix Preparata (Fuzi, 附子) [processed until cracked, removed skin and navel]
Aconiti Lateralis Radix Preparata (Cezi, 侧子) [processed until cracked, removed skin and navel] each 1 liang
Stephaniae Tetrandrae Radix (Fangji, 防己)
Angelicae Sinensis Radix (Danggui, 当归) [chopped, stir-fried]
Spatholobi Caulis (Haitongpi, 海桐皮)
Achyranthis Bidentatae Radix (Niuxi, 牛膝) [soaked in wine, sliced, dried]
Chrysanthemi Flos (Ganjuhua, 甘菊花)
Antilopis Cornu (Lingyangjiao, 羚羊角) [sliced]
Ilex Cassine Cortex (Yinyu, 茵芋) [removed stems]
Acanthopanacis Cortex (Wujiaopi, 五加皮) [each 3 fen]
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted, chopped] ban liang
Saposhnikoviae Radix (Fangfeng, 防风) [removed forked branches]
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) [each 3 liang]
The above sixteen ingredients are chopped like hemp seeds. Take 4 qianbi, add one sheng of water and five slices of fresh ginger, decoct until reduced to seven parts. Strain and take warm, at any time.
Treatment for Kidney Qi deficiency and cold, re-exposed to cold and dampness forming Bi syndrome. Niuxi Jiu (Achyranthus Wine) Formula:
Achyranthis Bidentatae Radix (Niuxi, 牛膝)
Gentianae Macrophyllae Radix (Qinjiao, 秦艽) [removed sprouts and soil]
Ligustici Chuanxiong Rhizoma (Xiong, 川芎)
Saposhnikoviae Radix (Fangfeng, 防风) [removed forked branches]
Cinnamomi Ramulus (Guizhi, 桂枝) [removed rough bark]
Angelicae Pubescentis Radix (Duohuo, 独活) [removed rhizome head]
Salviae Miltiorrhizae Radix (Danshen, 丹参)
Poria (Baifuling, 白茯苓) [removed black skin] each 2 liang
Eucommiae Cortex (Duzhong, 杜仲) [removed rough bark, chopped, stir-fried]
Aconiti Lateralis Radix Preparata (Fuzi, 附子) [processed until cracked, removed skin and navel]
Dendrobii Caulis (Shihu, 石斛) [removed roots]
Zingiberis Rhizoma Preparatum (Ganjiang, 干姜) [processed]
Ophiopogonis Radix (Mendong, 麦门冬) [removed heart]
Lygodii Radix (Digupi, 地骨皮) [each 1.5 liang]
Acanthopanacis Cortex (Wujiaopi, 五加皮) 5 liang
Coicis Semen (Yiyiren, 薏苡仁) 1 liang
Cannabis Fructus (Damaizi, 大麻子) [stir-fried] ban liang
The above seventeen ingredients are chopped like hemp seeds, placed in a raw silk bag, and soaked in one dou of wine. Soak for three days in spring/summer, five days in autumn/winter. Take half a zhan on an empty stomach, warm, twice daily.