此证多生于手足掌心，或腰腿臂下伸缩动处，疼如痛风，漫肿无头，其色淡红，憎寒发
热，
汗之，敷赤豆散。如表解，则用加味解酲汤少加乳香、没药消之，溃后亦然。贴洞天膏。
一由感受天地不正之厉气，壅遏肌表，宜用不换金正气散煎送五通丸，发汗解表，外
敷冲和散。表退而作脓，溃者，内托散、醒消丸主之。贴洞天膏。
按《幼科铁镜》，痛风之证即痼发也。其书云∶四肢上或身上一处肿痛或移动他处，色
红参差
如下体加牛膝各一钱，煎服，数剂即愈。（按此方甚佳，但遇好饮酒者患此去桂枝易白芷。）
曾医邑痒生方相幼子，左手右足各曲贴肉处痛曲不伸，用前方，煎服五剂愈。如大人须
用酒煮，每夜尽量饮，每味一两五钱，煮酒五、六斤，饮毕即愈。此予创方，屡效不爽。
加味解酲汤
葛根（三钱） 茯苓（二钱） 木香（五分） 砂仁（一钱） 人参（一钱） 白术（生） 陈皮
神曲 （炒） 猪苓 泽泻（各一钱五分）
上水煎二次服。（一方有枳 子以解酒毒。）
赤豆散
赤小豆，上一味磨粉葱汁调敷。（此方治一切痈毒以鸡子清调或醋调俱妙，又用敷 腮
神效。）
不换金正气散（见后瘴疽。）
五通丸（通用五十。）
散消饮（通用十一。）
千金内托散（通用三十八。）
醒消丸（通用四十七。）
洞天膏（通用七十六。）
This condition mostly occurs on the palms of the hands and feet, or in areas where the waist, legs, and arms flex and extend. The pain resembles that of *Tongfeng* (Gout), with diffuse swelling lacking a distinct head, and the color is pale red. It is accompanied by aversion to cold and fever. Treatment involves inducing sweating and applying Chidou San externally. If the exterior syndrome resolves, Jiawei Jiecheng Tang is used with small amounts of Rushi (Frankincense) and Moyao (Myrrh) to dissipate the swelling; this approach remains the same after ulceration. Dongtian Gao is applied as a plaster.
Another etiology involves contracting pathogenic miasma from heaven and earth, which obstructs the muscle surface. In such cases, Buhuanjin Zhengqi San should be decocted to administer Wutong Wan orally, aiming to induce sweating and release the exterior, while Chonghe San is applied externally. Once the exterior syndrome recedes and suppuration begins, or if ulceration has occurred, Qiantuo San and Xingxiao Wan are the primary treatments. Dongtian Gao is also applied.
According to *Youke Tieming*, the condition known as Tongfeng is identical to Gufa. The book states: "Swelling and pain occur on the limbs or a specific area of the body, potentially migrating to other locations, with colors appearing unevenly red." If the lower body is affected, add Niuxi (Achyranthes Root) at 1 qian each, decoct and take orally; recovery occurs within a few doses. (Note: This prescription is excellent, but for patients who enjoy alcohol, replace Guizhi with Baizhi.)
I once treated the young son of Fang Xiang, a provincial school scholar, who suffered from pain in the fleshy aspects of his left hand and right foot, preventing extension after flexion. Using the aforementioned prescription, five doses were decocted and administered, resulting in a cure. For adults, the herbs must be decocted in wine. The patient should drink as much as possible each night. Each herb is used at 1.5 liang, decocted in 5–6 jin of wine. Recovery follows immediately upon completion. This is a formula I created, which has proven consistently effective.
Jiawei Jiecheng Tang (Modified Decoction to Resolve Intoxication)
Gegen (Puerariae Lobatae Radix, 3 qian) Fuling (Poria, 2 qian) Muxiang (Aucklandiae Radix, 0.5 fen) Sharen (Amomi Fructus Rotundus, 1 qian) Renshen (Ginseng Radix et Rhizoma, 1 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, raw) Chenpi (Citri Reticulatae Pericarpium) Shenqu (Massa Medicata Fermentata, stir-fried) Zhuling (Polyporus, 1.5 qian each) Zexie (Alismatis Rhizoma, 1.5 qian each)
Decoct these ingredients in water twice and take orally. (Another version includes Zhizi Zi [Ardisiae Fructus] to resolve alcohol toxicity.)
Chidou San (Red Bean Powder)
Chixiaodou (Vigna angularis Seed). Grind the single ingredient into powder and apply externally mixed with Congbai juice (Scallion White Juice). (This formula is effective for all types of carbuncles and sores; mixing with Egg White [Jiziqing] or Vinegar [Cu] is also excellent. Applying it to the cheeks yields miraculous results.)
Buhuanjin Zhengqi San (See the section on Zhangju later.)
Wutong Wan (General Formula No. 50)
Sanxiao Yin (General Formula No. 11)
Qianjin Neituo San (General Formula No. 38)
Xingxiao Wan (General Formula No. 47)
Dongtian Gao (General Formula No. 76)