论曰∶《内经》谓人有身寒，汤火不能热，浓衣不能温，然不冻栗。是人者，素肾气胜，
以水为事，太阳气衰，肾脂枯不长，一水不能胜两火。肾者水也，而生于骨，肾不荣则髓不
能满，故寒甚至骨也。所以不能冻栗者，肝，一阳也；心，二阳也；肾，孤脏也，一水不能
胜二火，故不能冻栗。病名曰骨痹，是人当挛节也。夫骨者肾之余，髓者精之所充也。肾水
流行，则髓满而骨强。迨夫天癸亏而凝涩，则肾脂不长；肾脂不长，则髓涸而气不行，骨乃
痹而其证内寒也。虽寒不为冻栗，则以肝心二气为阳火，一水不能胜之，特为骨寒而已，外
证当挛节，则以髓少而筋燥，故挛缩而急也。
补骨髓，治寒湿。肉苁蓉丸方。
肉苁蓉（酒浸，切，焙一两） 獭肝（一具涂酥炙，切） 柴胡（去苗） 秦艽（去苗
土各三
分） 巴戟天（去心） 黄 （锉各一两） 人参（半两） 白茯苓（去黑皮三分） 熟干
地黄（切，
焙半两） 泽泻 附子（炮裂，去皮脐各三分） 远志（去心一两） 山芋 蒺藜子（炒去
角各半
两） 石斛（去根三分） 浓朴（去粗皮，姜汁炙） 五味子 桂（去粗皮） 桃仁（汤浸
去皮尖、
双仁，炒，别研） 丁香 木香（各半两） 当归（切，焙三分） 芍药 陈橘皮（汤浸去
白，焙）
赤石脂 槟榔 白术 干姜（炮） 郁李仁（汤浸去皮尖，炒，研） 甘草（炙，锉） 牡
丹皮 蜀
椒（去目并闭口者，炒出汗） 山茱萸 芎 牡蛎（炒各半两）
上三十五味，捣研为末，再和匀炼蜜，和杵数百下，丸如梧桐子大。每服温酒下三十丸
，不拘时，日三服。
治肾虚骨痹，肌体羸瘦，腰脚酸痛，饮食无味，小便滑数。石斛丸方。
石斛（去根） 牛膝（酒浸，切，焙） 续断（各三分） 菟丝子（酒浸，别捣） 石
龙芮（炒）
桂（去粗皮各一两） 肉苁蓉（酒浸，切，焙三分） 鹿茸（去毛，酥炙一两） 杜仲（去
粗皮，
炙，锉） 白茯苓（去黑皮） 熟干地黄（切，焙各三分） 附子（炮裂，去皮脐一两） 巴
戟天（去
心半两） 防风（去叉三分） 桑螵蛸（炙） 芎 （各半两） 山茱萸（三分） 覆盆子
（半两）
补骨脂（微炒） 荜澄茄（各三分） 五味子（半两） 泽泻（一两） 沉香 香子（微
炒各三分）
薏苡仁（炒一两）
上二十五味，捣罗为末，炼蜜和杵数百下，丸如梧桐子大。每服空心以温酒下三十丸，
日二服。
治肾虚骨痹，面色萎黑，足冷耳鸣，四肢羸瘦，脚膝缓弱，小便滑数。补肾熟干地黄丸
方。
熟干地黄（切，焙） 肉苁蓉（酒浸，切，焙） 磁石（ ，醋淬各二两） 山茱萸（三
分） 桂
（去粗皮） 附子（炮裂，去皮脐各一两） 山芋（三分） 牛膝（酒浸，切，焙一两） 石
南白
茯苓（去黑皮） 泽泻 黄 （锉各三分） 鹿茸（去毛，酥炙二两） 五味子（三分） 石
斛（去
根，锉一两） 覆盆子 远志（去心各三分） 补骨脂（微炒一两） 萆 （锉） 巴戟天
（去心各
三分） 杜仲（去粗皮，炙，锉一两） 菟丝子（二两酒浸，别捣） 白龙骨（一两）
上二十三味，捣罗为末，炼蜜和杵数百下，丸如梧桐子大。每服空心以温酒下三十丸，
日三服。
治肾脏中风寒湿成骨痹，腰脊疼痛，不得俯仰，两脚冷 ，缓弱不遂，头昏耳聋，语音
混浊，四肢沉重。附子独活汤方。
附子（炮裂，去皮脐） 独活（去芦头各一两） 防风（去叉） 芎 丹参 萆 菖
蒲（各
半两） 天麻 桂（去粗皮各一两） 黄 （半两） 当归（切，焙一两） 细辛（去苗叶）
山茱
萸白术 甘菊花 牛膝（酒浸，切，焙） 枳壳（去瓤，麸炒） 甘草（炙，锉各半两）
上一十八味，锉如麻豆。每服三钱匕，以水一盏，生姜三片，煎至七分，去滓，不计时
候温服。
治肾脏气虚，骨痹缓弱，腰脊酸痛，脐腹虚冷，颜色不泽，志意昏愦。鹿茸天麻丸方。
鹿茸（去毛，酥炙二两） 天麻（一两半） 附子（炮裂，去皮脐） 巴戟天（去心） 菖
蒲（各
一
（酒浸，切，
焙） 天雄（炮裂，去皮脐） 独活（去芦头） 丹参 当归（切，焙） 杜仲（去粗皮，
炙，锉）
（各一两） 肉苁蓉（酒浸，切，焙一两半） 磁石（ ，醋淬，细研，水飞过一两）
上一十七味，捣罗为末，炼蜜和匀，捣三五百下，丸如梧桐子大。每服二十丸，加至三
十丸，空心及晚食前以温酒下。
治肾脏久虚，骨疼腰痛足冷，少食无力。肾沥汤方。
磁石（ ，醋淬二两） 肉苁蓉（酒浸，切，焙） 黄 人参 白茯苓（去黑皮） 芎
桂（去粗皮） 菖蒲 当归（切，焙） 熟干地黄（切，焙） 石斛（去根） 覆盆子 干
姜（炮）
附子（炮裂，去皮脐） 五味子（各一两）
上一十五味，锉如麻豆。每服三钱匕，用羊肾一只，去脂膜，先用水二盏，煮肾取汁一
盏，去肾入药末，煎至七分，去滓温服，空心、日午、夜卧共三服。
Commentary states: The *Neijing* (Inner Canon) mentions that some individuals experience body coldness that cannot be warmed by hot water or fire, nor by thick clothing, yet they do not shiver from the cold. Such persons typically have an excess of Kidney Qi in their constitution, engage in work involving water, leading to a decline in Taiyang (Greater Yang) channel Qi. Consequently, Kidney essence dries up and fails to nourish the bones; a single source of Water (Kidney) cannot overcome two sources of Fire (Liver and Heart). The Kidney belongs to Water and governs the bones, generating marrow. When the Kidney fails to nourish, marrow cannot fill the bones, resulting in cold penetrating deep into the bones. The reason for not shivering is that the Liver represents one Yang, and the Heart represents two Yangs; the Kidney is the solitary Zang organ. A thin layer of Water cannot defeat the two fires of the Liver and Heart; thus, although there is cold, there is no shivering. This disease is named Bone Bi (Bone Obstruction), and such patients should exhibit joint contracture. Bones are the surplus of Kidney Qi, and marrow is filled with Jing (Essence). When Kidney Water circulates smoothly, marrow fills and bones become strong. However, when Tian Gui (Heavenly Nectar/Reproductive Essence) becomes deficient and stagnant, Kidney fat fails to grow; as Kidney fat does not grow, marrow dries up and Qi circulation ceases, causing bone obstruction with internal cold symptoms. Although cold exists without shivering, it is because the Qi of the Liver and Heart constitutes Yang Fire, which the thin Kidney Water cannot overcome; this results merely in bone cold. Externally, the manifestation is joint contracture due to insufficient marrow causing dry tendons, leading to contraction and tension.
[Formula] Rongrong Wan (Cistanche Pill) for tonifying marrow and treating Cold-Dampness.
Rongrong (Cistanches Herba, soaked in wine, sliced, dried, 1 liang); Tagan (Leporis Hepat, one piece, coated with butter, roasted, sliced); Chaihu (Bupleuri Radix, removed seedlings); Qinjiao (Gentianae Macrophyllae Radix, removed seedlings and soil, 3 fen each); Bajitian (Morindae Officinalis Radix, removed heart); Huangqi (Astragali Membranacei Radix, crushed, 1 liang each); Renshen (Ginseng Radix, 0.5 liang); Baifuling (Poria, removed black skin, 3 fen); Shugan Dihuang (Prepared Rehmanniae Radix, sliced, dried, 0.5 liang); Zexie (Alismatis Rhizoma); Fuzi (Aconiti Lateralis Radix Praeparata, cracked by frying, removed skin and umbilicus, 3 fen each); Yuanzhi (Polygalae Radix, removed heart, 1 liang); Shanyu (Dioscoreae Rhizoma); Jili (Tribuli Fructus, fried, removed spines, 0.5 liang each); Shihu (Dendrobii Caulis, removed roots, 3 fen); Houpo (Magnoliae Officinalis Cortex, removed rough bark, roasted with ginger juice); Wuweizi (Schisandrae Fructus); Gui (Cinnamomi Ramulus, removed rough bark); Taoren (Persicae Semen, soaked in hot water, removed skin and tips, double-kernel ones discarded, fried, separately ground); Dingxiang (Syzygii Flos); Muxiang (Aucklandiae Radix, 0.5 liang each); Danggui (Angelicae Sinensis Radix, sliced, dried, 3 fen); Shaoyao (Paeoniae Radix); Chenpi (Citri Reticulatae Pericarpium, soaked in hot water, removed white pith, dried); Chishizhi (Halloysit Rubrum); Binglang (Arecae Semen); Baizhu (Atractylodis Macrocephalae Rhizoma); Ganjiang (Zingiberis Rhizoma, fried); Yuliren (Pruni Semen, soaked in hot water, removed skin and tips, fried, ground); Gancao (Glycyrrhizae Radix et Rhizoma, roasted, crushed); Mudanpi (Moutan Cortex); Shujiao (Zanthoxyli Pericarpium, removed eyes and closed-mouth ones, fried until sweat appears); Shanzhuyu (Corni Fructus); Xiong (Ligustici Chuanxiong Rhizoma); Moli (Ostreae Concha, fried, 0.5 liang each).
The above thirty-five ingredients are pounded and ground into powder, mixed evenly, combined with refined honey, and pounded hundreds of times to form pills the size of Sophora seeds. Take thirty pills per dose with warm wine, at any time, three times daily.
[Xu He Shi] Shi Hu Wan (Dendrobium Pill) for treating Kidney Deficiency Bone Bi, emaciation, soreness and pain in waist and legs, loss of taste, and frequent slippery urination.
Shihu (Dendrobii Caulis, removed roots); Niuxi (Achyranthis Bidentatae Radix, soaked in wine, sliced, dried); Xuduan (Dipsaci Radix, 3 fen each); Tusizi (Cuscutae Semen, soaked in wine, separately ground); Shilongru (Ranunculi Ternati Herba, fried); Gui (Cinnamomi Ramulus, removed rough bark, 1 liang each); Rongrong (Cistanches Herba, soaked in wine, sliced, dried, 3 fen); Lurong (Cervi Cornu Pantotrichum, removed hair, roasted with butter, 1 liang); Duzhong (Eucommiae Cortex, removed rough bark, roasted, crushed); Baifuling (Poria, removed black skin); Shugan Dihuang (Prepared Rehmanniae Radix, sliced, dried, 3 fen each); Fuzi (Aconiti Lateralis Radix Praeparata, cracked by frying, removed skin and umbilicus, 1 liang); Bajitian (Morindae Officinalis Radix, removed heart, 0.5 liang); Fangfeng (Saposhnikoviae Radix, removed forked root, 3 fen); Sangpiaoxiao (Mantidis Oötheca, roasted); Xiong (Ligustici Chuanxiong Rhizoma, 0.5 liang each); Shanzhuyu (Corni Fructus, 3 fen); Fupenzi (Rubiae Fructus, 0.5 liang); Buguzhi (Psoraleae Fructus, slightly fried); Bidengqie (Schisandrae Fructus, 3 fen each); Wuweizi (Schisandrae Fructus, 0.5 liang); Zexie (Alismatis Rhizoma, 1 liang); Chenxiang (Aquilariae Lignum Resinatum); Xiangzi (Litseae Fructus, slightly fried, 3 fen each); Yiyiren (Coicis Semen, fried, 1 liang).
The above twenty-five ingredients are pounded and sieved into powder, combined with refined honey, and pounded hundreds of times to form pills the size of Sophora seeds. Take thirty pills per dose on an empty stomach with warm wine, twice daily.
[Bu Shen Shu Gan Di Huang Wan] Tonify Kidney Prepared Rehmannia Pill for treating Kidney Deficiency Bone Bi, sallow dark complexion, cold feet, tinnitus, emaciated limbs, weak knees and feet, and frequent slippery urination.
Shugan Dihuang (Prepared Rehmanniae Radix, sliced, dried); Rongrong (Cistanches Herba, soaked in wine, sliced, dried); Cishi (Magnetitum, calcined, quenched in vinegar, 2 liang each); Shanzhuyu (Corni Fructus, 3 fen); Gui (Cinnamomi Ramulus, removed rough bark); Fuzi (Aconiti Lateralis Radix Praeparata, cracked by frying, removed skin and umbilicus, 1 liang each); Shanyu (Dioscoreae Rhizoma, 3 fen); Niuxi (Achyranthis Bidentatae Radix, soaked in wine, sliced, dried, 1 liang); Shinanbai (Acanthopanacis Cortex); Baifuling (Poria, removed black skin); Zexie (Alismatis Rhizoma); Huangqi (Astragali Membranacei Radix, crushed, 3 fen each); Lurong (Cervi Cornu Pantotrichum, removed hair, roasted with butter, 2 liang); Wuweizi (Schisandrae Fructus, 3 fen); Shihu (Dendrobii Caulis, removed roots, crushed, 1 liang); Fupenzi (Rubiae Fructus); Yuanzhi (Polygalae Radix, removed heart, 3 fen each); Buguzhi (Psoraleae Fructus, slightly fried, 1 liang); Bixie (Dioscoreae Hypoglaucae Rhizoma, crushed); Bajitian (Morindae Officinalis Radix, removed heart, 3 fen each); Duzhong (Eucommiae Cortex, removed rough bark, roasted, crushed, 1 liang); Tusizi (Cuscutae Semen, 2 liang, soaked in wine, separately ground); Bailonggu (Fossilia Ossis Mastodi, 1 liang).
The above twenty-three ingredients are pounded and sieved into powder, combined with refined honey, and pounded hundreds of times to form pills the size of Sophora seeds. Take thirty pills per dose on an empty stomach with warm wine, three times daily.
[Fuzi Duhuo Tang] Aconite and Angelica Pubescens Decoction for treating Bone Bi caused by Wind-Cold-Dampness invading the Kidney, with pain in the lower back and spine, inability to bend or stretch, cold and weak paralyzed legs, dizziness, deafness, turbid speech, and heavy limbs.
Fuzi (Aconiti Lateralis Radix Praeparata, cracked by frying, removed skin and umbilicus); Duhuo (Angelicae Pubescentis Radix, removed rhizome head, 1 liang each); Fangfeng (Saposhnikoviae Radix, removed forked root); Xiong (Ligustici Chuanxiong Rhizoma); Danshen (Salviae Miltiorrhizae Radix et Rhizoma); Bixie (Dioscoreae Hypoglaucae Rhizoma); Changpu (Acori Tatarinowii Rhizoma, 0.5 liang each); Tianma (Gastrodiae Rhizoma); Gui (Cinnamomi Ramulus, removed rough bark, 1 liang each); Huangqi (Astragali Membranacei Radix, 0.5 liang); Danggui (Angelicae Sinensis Radix, sliced, dried, 1 liang); Xixin (Asari Radix et Rhizoma, removed seedlings and leaves); Shanzhuyu (Corni Fructus); Baizhu (Atractylodis Macrocephalae Rhizoma); Ganhua Ju (Chrysanthemi Flos); Niuxi (Achyranthis Bidentatae Radix, soaked in wine, sliced, dried); Zhike (Aurantii Fructus, removed pulp, stir-fried with bran); Gancao (Glycyrrhizae Radix et Rhizoma, roasted, crushed, 0.5 liang each).
The above eighteen ingredients are crushed like hemp seeds. Take three qian bi per dose, add one zhan of water and three slices of fresh ginger, decoct until seven-tenths remain, strain, and take warm at any time.
[Lurong Tianma Wan] Deer Horn and Gastrodia Pill for treating Kidney Qi Deficiency, Bone Bi with weakness, soreness and pain in the lower back and spine, deficiency-cold in the umbilical and abdominal region, lackluster complexion, and mental confusion.
Lurong (Cervi Cornu Pantotrichum, removed hair, roasted with butter, 2 liang); Tianma (Gastrodiae Rhizoma, 1.5 liang); Fuzi (Aconiti Lateralis Radix Praeparata, cracked by frying, removed skin and umbilicus); Bajitian (Morindae Officinalis Radix, removed heart); Changpu (Acori Tatarinowii Rhizoma, 1 liang each); Rongrong (Cistanches Herba, soaked in wine, sliced, dried); Tianxiong (Aconiti Radix, cracked by frying, removed skin and umbilicus); Duhuo (Angelicae Pubescentis Radix, removed rhizome head); Danshen (Salviae Miltiorrhizae Radix et Rhizoma); Danggui (Angelicae Sinensis Radix, sliced, dried); Duzhong (Eucommiae Cortex, removed rough bark, roasted, crushed) (1 liang each); Rongrong (Cistanches Herba, soaked in wine, sliced, dried, 1.5 liang); Cishi (Magnetitum, calcined, quenched in vinegar, finely ground, washed with water, 1 liang).
The above seventeen ingredients are pounded and sieved into powder, mixed evenly with refined honey, and pounded three to five hundred times to form pills the size of Sophora seeds. Take twenty pills per dose, increasing to thirty pills, on an empty stomach and before evening meal with warm wine.
[Shen Li Tang] Kidney Filtrate Decoction for treating long-standing Kidney Deficiency, bone pain, lumbar pain, cold feet, poor appetite, and fatigue.
Cishi (Magnetitum, calcined, quenched in vinegar, 2 liang); Rongrong (Cistanches Herba, soaked in wine, sliced, dried); Huangqi (Astragali Membranacei Radix); Renshen (Ginseng Radix); Baifuling (Poria, removed black skin); Xiong (Ligustici Chuanxiong Rhizoma); Gui (Cinnamomi Ramulus, removed rough bark); Changpu (Acori Tatarinowii Rhizoma); Danggui (Angelicae Sinensis Radix, sliced, dried); Shugan Dihuang (Prepared Rehmanniae Radix, sliced, dried); Shihu (Dendrobii Caulis, removed roots); Fupenzi (Rubiae Fructus); Ganjiang (Zingiberis Rhizoma, fried); Fuzi (Aconiti Lateralis Radix Praeparata, cracked by frying, removed skin and umbilicus); Wuweizi (Schisandrae Fructus, 1 liang each).
The above fifteen ingredients are crushed like hemp seeds. Take three qian bi per dose, use one sheep kidney, remove the fat membrane, first boil the kidney in two zhan of water to obtain one zhan of juice, remove the kidney, add the herbal powder, decoct until seven-tenths remain, strain, and take warm. Take three times daily: on an empty stomach, at noon, and before sleep.