〔大〕夫妇人体虚，受风邪之气，随血而行，或淫溢皮肤，卒然掣痛，游走无有常
处，故名为走疰也。加减小续命汤主之。
〔薛〕东垣云∶若人身体沉重，走疰疼痛，此湿热相搏，或风热郁而不得伸，附着
于有形也。是证多因饮食起居失节，或因七情劳役失宜，脾胃亏损，腠理不密，外邪所
侵，以致内热晡热，自汗盗汗，或经候不调，饮食不甘。治法∶湿热肿痛者，清燥汤，（杂病
伤暑。）兼痰，佐以二陈汤。（杂病痰饮。）肝火作痛者，加味逍遥散。脾郁作痛者，加味归脾
汤。血虚作痛者，四物汤。气虚作痛者，四君子汤。气血俱虚者，八珍汤。俱加羌活、川
芎。月经先期而痛者，加味逍遥散。头眩倦怠而痛者，补中益气汤。大抵按之痛甚者，病
气实。按之痛缓者，元气虚。劳役而痛者，亦元气虚也。饮食失宜而痛者，脾气虚也。恼
怒而痛者，肝火盛也。若昼轻而夜重者，血分病也。一妇人历节发热作渴，饮食少思，月
经过期，其脉举之洪大，按之微细，用附子八物汤四剂而痛止，用加味逍遥而元气复，用
六味丸而月经调。一妇人体肥胖，素有热，月经先期，患痛风，下体微肿，痛甚则小便
频数，身重脉缓，此风湿血虚有热，用羌活胜湿汤二剂，肿痛渐愈。用清燥汤数剂，小
便渐清。用加味逍遥散，内热渐愈，又为饮食停滞，发热仍痛，面目浮肿，用六君加柴
胡、升麻而愈。又因怒气。小腹痞闷，寒热呕吐，用前药加山栀、木香而安。惟小腹下
坠，似欲去后，此脾气下陷，用补中益气而愈。后因劳役怒气，作呕吐痰，遍身肿痛，经
行寒热，此肝木侮脾土，用六君加柴胡、山栀，肿痛呕吐悉退，后用补中益气而安。
一妇人饮食少思，畏风寒，患痛风呕吐寒热，脉弦紧，用附子八物汤而四肢痛愈，用独活
寄生汤而腰痛渐痊。惟两膝肿痛，用大防风汤而痛渐愈，用归脾、逍遥而元气复。
没药散 治妇人血风走疰，肢节疼痛，发时来往不定。
没药（另研） 乳香（另研） 芎 当归（炒，去芦） 桂心 漏芦（去芦） 木香（各半两）
白芷 琥珀（另研） 地龙（去土，微炒，各七钱半） 安息香（另研） 麝香（另细研，各二钱半）
为细末，入研药拌匀。每服一钱，温酒调下，不拘时。
琥珀散 治妇人血风走疰疼痛，来往疼痛。
琥珀（另研） 当归（去芦） 牛膝（酒浸） 羌活（去芦） 川大黄（锉、微炒，各七钱半）
桂心（一两） 没药（另研） 血竭（另研） 干漆（炒烟尽） 玄胡索 防风（去芦） 羚羊角屑（各半两）
上为细末，每服二钱，温酒调下，不拘时日，进二服。
虎骨散 治妇人血风走疰疼痛，痛不可忍。
虎胫骨（二两，酥炙） 干蝎（炒） 琥珀（另研，各半两） 当归（炒） 威灵仙 牛膝（酒浸）
羌活（去芦） 桂心（各一两） 漏芦（去芦） 芎 没药（另研，各七钱半）
上为细末，每服二钱，温酒调下，不拘时候，日进二服。
雄黄散 治妇人血风走疰疼痛。
雄黄（研，水飞） 血竭（另研） 赤箭 侧子（炮，去皮脐） 桂心 没药（另研） 木香
白芥子 地龙（炒去土） （各半两，生用） 麝香（二钱半，另研） 乌蛇（二两，酒浸去皮骨，
炒微黄）
上为细末，入研药更研令匀，每服二钱，热酒调下，不拘时候，日进二服。
漏芦散 治妇人血风走疰，疼痛无有常处。
漏芦 当归 牛膝（各三分） 桂心 地龙（去土） 防风 羌活 白芷 没药（研）
甜瓜子（各半两） 虎胫骨（酥炙） 败龟板（醋炙，各一两）
上为细末，每服二钱，热酒调下，无时。
四生丸（见前。）
麝香丸 治白虎历节，诸风疼痛，游走不定，状如虫啮，昼静夜剧，及一切手足不
测疼痛。
大八角川乌头（三枚，去皮尖，生用） 生全蝎（二十个） 生黑豆（二十粒） 生地龙（去土，
半两）
为细末，入麝香一字，同研停，糯米糊为丸，如绿豆大。每服七丸，甚者十丸，夜
卧令膈空，温酒吞下，微出冷汗一身便瘥。许学士云∶予得此方，凡是历节及不测疼痛，一
二服便瘥。在歙州日，有一贵家妇人，遍身走注疼痛，至夜则发，如虫啮其肌，多作鬼
邪治。予曰∶此正历节病也，三服效。
芍药知母汤 （《三因》）治诸肢节疼痛，身体 羸，脚肿如脱，头眩短气，温温欲吐。
桂心 知母 防风（各四两） 芍药 麻黄（去根节） 甘草（各三两） 附子（二两，炮）
上 咀，每服四钱，水一盏半，生姜五片，煎七分，去滓空心服。一方有白术、川
芎、杏仁、半夏。
附子八物汤 治风历节疼痛，四肢如锤锻不可忍。
附子 干姜 芍药 茯苓 人参 甘草 桂心（各三两） 白术（四两）
上 咀，每服四大钱，水二盏，煎七分，去滓食前服。一方去桂，用干地黄二两。
独活寄生汤（方见杂病腰痛。）
小续命汤 治白虎历节，痛不可忍。（方见杂病中风。）
〔陈〕一妇人先自两足踝骨痛不可忍，次日流上于膝，三日流于髀骨，甚疼，至于
肩，肩流于肘，肘流于后溪。或如锤锻，或如虫窜，痛不可忍，昼静夜剧，服诸药无效。
召仆诊之，六脉紧。予曰∶此真历节证也，非解散之药不能愈，但用小续命汤，一剂而痊。
又邓安人夏月亦病历节，痛不可忍，诸药无效。召仆诊之，人迎与心脉虚，此因中暑
而得，合先服酒蒸黄连丸，众医莫不笑。用此药服一帖即愈，自后与人良验。
治妇人血风走疰，腰膝骨节疼痛不可忍。
附子（生） 薰陆香 杏仁（研） 桂心 当归 芸苔子 芫花 巴豆（去皮，各一两）
松脂（一两半）
上为细末，熔黄蜡五两，搅和诸药，捏作片子，包裹痛处，立效。
又方
芫花 桂心（各一两） 汉椒（二两） 桑根白皮（三两） 芸苔子 柳 屑（各五两）
上为细末，用醋一升拌和，蒸令热，用青布裹熨痛处，冷即更入醋蒸用之。
治妇人血风走疰，腰胯脚膝疼痛。
天仙子 川乌头（生） 附子（生，各一两）
上为细末，以酒煎成膏，摊于帛上，敷贴痛处，多年者不过三上效。
[Da] Women with a deficient constitution are susceptible to wind-pathogenic qi, which travels along with the blood. It may overflow into the skin and subcutaneous tissue, causing sudden pulling pain that migrates without a fixed location; hence it is named "Zou Zhu" (migrating bi-syndrome). It is primarily treated with Jiawei Xiao Xu Ming Tang (Modified Minor Continuation Life Decoction).
[Xue] Li Dongyuan stated: If a person suffers from heavy body sensation and Zou Zhu pain, this indicates a struggle between damp-heat, or wind-heat stagnation failing to disperse, adhering to the physical form. This syndrome often arises from irregular diet and lifestyle, or improper management of the seven emotions and overexertion, leading to Spleen-Stomach deficiency. The interstices (Cou Li) become loose, allowing external pathogens to invade, resulting in internal heat, afternoon fever, spontaneous sweating, or night sweats, irregular menstruation, and poor appetite. Treatment methods: For damp-heat swelling and pain, use Qing Zao Tang (Clear Dryness Decoction); if accompanied by phlegm, assist with Er Chen Tang (Two Aged Medicines Decoction); for pain due to Liver Fire, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder); for pain due to Spleen Qi Stagnation, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction); for pain due to Blood Deficiency, use Si Wu Tang (Four Substances Decoction); for pain due to Qi Deficiency, use Si Jun Zi Tang (Four Gentlemen Decoction); for combined Qi and Blood Deficiency, use Ba Zhen Tang (Eight Treasures Decoction). All these formulas should be supplemented with Qiang Huo (Notopterygii Rhizoma et Radix) and Chuan Xiong (Chuanxiong Rhizoma). For early menstruation with pain, use Jiawei Xiaoyao San; for dizziness, fatigue, and pain, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Generally, pain exacerbated by pressure indicates excess pathogenic factors, while pain relieved by pressure indicates deficiency of Yuan Qi (Original Qi). Pain triggered by overexertion also indicates Yuan Qi deficiency. Pain caused by improper diet indicates Spleen Qi deficiency. Pain triggered by anger indicates excessive Liver Fire. Pain that is mild during the day and severe at night indicates a disorder of the Blood level.
Case 1: A woman suffered from joint disease (Li Jie) with fever and thirst, reduced appetite, and delayed menstruation. Her pulse was surging and large when lifted, but fine and subtle when pressed. After four doses of Fuzi Bawu Tang (Aconite Eight-Ingredient Decoction), the pain ceased. After taking Jiawei Xiaoyao San, her Original Qi recovered. After taking Liuwei Wan (Six-Ingredient Pill with Rehmannia), her menstruation regulated.
Case 2: Another woman was obese and had inherent heat, with early menstruation. She developed gout-like symptoms with slight swelling in the lower limbs. Severe pain was accompanied by frequent urination, heaviness, and a slow pulse. This indicated Wind-Dampness with Blood Deficiency and Heat. After two doses of Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness), the swelling and pain gradually subsided. After several doses of Qing Zao Tang, urination cleared. Jiawei Xiaoyao San resolved the internal heat. Later, due to food stagnation, fever and pain recurred with facial edema. She was cured with Liujun Zi Tang (Six Gentlemen Decoction) plus Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma). Anger later caused abdominal distension, chills, fever, and vomiting. Adding Zhi Zi (Gardeniae Fructus) and Mu Xiang (Aucklandiae Radix) to the previous formula brought stability. However, a sensation of rectal tenesmus indicated Spleen Qi sinking, which was cured by Buzhong Yiqi Tang. Later, overexertion and anger caused vomiting of phlegm, generalized swelling and pain, and chills/fever during menstruation. This indicated Liver Wood insulting Spleen Earth. Liujun Zi Tang plus Chai Hu and Zhi Zi resolved the symptoms, followed by Buzhong Yiqi Tang for recovery.
Case 3: A woman with poor appetite and aversion to wind/cold suffered from gout with vomiting, chills, and fever, and a string-tight pulse. Fuzi Bawu Tang cured the limb pain, and Duhuo Jisheng Tang (Angelica Pubescens and Dorstenia Decoction) cured the lower back pain. However, knee swelling and pain persisted until Da Fangfeng Tang (Major Saposhnikovia Decoction) helped, after which Guipi Tang and Xiaoyao San restored her Qi.
Moyao San (Myrrh Powder): Treats women's Blood-Wind Zou Zhu, joint pain, with attacks occurring intermittently.
Ingredients: Moyao (Myrrha, separately ground), Ruxiang (Olibanum, separately ground), Chuanxiong, Danggui (Angelicae Sinensis Radix, stir-fried, de-gorged), Guixin (Cinnamomi Ramulus), Loulu (Euphorbiae Humifusae Radix, de-gorged), Muxiang (Aucklandiae Radix) (each 0.5 liang); Baizhi (Angelicae Dahuricae Radix), Hupo (Succinum, separately ground), Dilong (Pheretima, de-soil, lightly stir-fried) (each 0.75 liang); Anshixiang (Styrax, separately ground), Shexiang (Moschus, finely separately ground) (each 0.25 liang).
Preparation and Administration: Grind into fine powder, mix with separately ground ingredients. Take 1 qian per dose, mixed with warm wine, at any time.
Hupo San (Succinum Powder): Treats women's Blood-Wind Zou Zhu pain, with intermittent pain.
Ingredients: Hupo (Succinum, separately ground), Danggui (Angelicae Sinensis Radix, de-gorged), Niuxi (Achyranthis Bidentatae Radix, soaked in wine), Qianghuo (Notopterygii Rhizoma et Radix, de-gorged), Chuan Huanglian (Rhizoma Coptidis - *Note: Text says Chuan Dahuang, usually Rheum Palmatum* - Rhizoma et Radix Rhei, crushed, lightly stir-fried), Guixin (Cinnamomi Ramulus) (each 0.75 liang); Guixin (Cinnamomi Ramulus) (1 liang); Moyao (Myrrha, separately ground), Xuexie (Draconis Sanguis, separately ground), Ganqi (Caulis Cissampi, stir-fried until smoke ceases), Yanhusuo (Corydalis Rhizoma), Fangfeng (Saposhnikoviae Radix, de-gorged), Lingyangjiaoxie (Saigae Tataricae Cornu) (each 0.5 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with warm wine, at any time, twice daily.
Hugu San (Tiger Bone Powder): Treats women's Blood-Wind Zou Zhu pain, unbearable pain.
Ingredients: Hujinggu (Os Tigridis Tibia, roasted with butter) (2 liang), Ganxie (Scorpio, stir-fried), Hupo (Succinum, separately ground) (each 0.5 liang); Danggui (Angelicae Sinensis Radix, stir-fried), Weilingxian (Salviae Miltiorrhizae Radix et Rhizoma - *Note: Usually Salvia Chinensis*, here likely Clematidis Radix et Rhizoma based on context of wind-damp*), Niuxi (Achyranthis Bidentatae Radix, soaked in wine), Qianghuo (Notopterygii Rhizoma et Radix, de-gorged), Guixin (Cinnamomi Ramulus) (each 1 liang); Loulu (Euphorbiae Humifusae Radix, de-gorged), Chuanxiong, Moyao (Myrrha, separately ground) (each 0.75 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with warm wine, at any time, twice daily.
Xionghuang San (Realgar Powder): Treats women's Blood-Wind Zou Zhu pain.
Ingredients: Xionghuang (Realgar, ground, water-leveled), Xuexie (Draconis Sanguis, separately ground), Chijian (Gastrodiae Rhizoma), Cezi (Aconiti Lateralis Radix Praeparata, processed, peel and navel removed), Guixin (Cinnamomi Ramulus), Moyao (Myrrha, separately ground), Muxiang (Aucklandiae Radix), Baijiezi (Sinapis Semen), Dilong (Pheretima, stir-fried, de-soil) (each 0.5 liang, raw); Shexiang (Moschus, 0.25 liang, separately ground); Wushe (Bungarus multicinctus, soaked in wine, skin and bones removed, lightly stir-fried) (2 liang).
Preparation and Administration: Grind into fine powder, mix thoroughly with separately ground ingredients. Take 2 qian per dose, mixed with hot wine, at any time, twice daily.
Loulu San (Euphorbia Humifusa Powder): Treats women's Blood-Wind Zou Zhu, pain without fixed location.
Ingredients: Loulu (Euphorbiae Humifusae Radix), Danggui (Angelicae Sinensis Radix), Niuxi (Achyranthis Bidentatae Radix) (each 3 fen); Guixin (Cinnamomi Ramulus), Dilong (Pheretima, de-soil), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Baizhi (Angelicae Dahuricae Radix), Moyao (Myrrha, ground), Tianguaizi (Trichosanthis Semen) (each 0.5 liang); Hujinggu (Os Tigridis Tibia, roasted with butter), Baiguiban (Testudinis Carapax et Plastrum, vinegar-roasted) (each 1 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with hot wine, at any time.
Sisheng Wan (Four Generations Pill) (See previous section).
Shexiang Wan (Moschus Pill): Treats Baihu Lijie (White Tiger Arthralgia), various wind-pain, migrating pain resembling insect bites, worse at night than day, and all unexplained extremity pains.
Ingredients: Da Bajiao Chuan Wutou (Aconitum Carmichaelii Radix Preparata - *Text specifies raw, large star-shaped*) (3 pieces, peel tip, raw), Sheng Quanxie (Scorpio, raw) (20), Sheng Heidou (Sojae Semen Nigrum, raw) (20), Sheng Dilong (Pheretima, de-soil) (0.5 liang).
Preparation and Administration: Grind into fine powder, add one "zi" amount of Shexiang (Moschus), grind together uniformly, bind with glutinous rice paste into pills the size of mung beans. Take 7 pills per dose, 10 for severe cases. Take before sleep with an empty stomach, swallowed with warm wine. Recovery occurs when a slight cold sweat breaks out over the body. Scholar Xu stated: I obtained this prescription; for Lijie and unexplained pains, one or two doses bring cure. In Shenzhou, a noblewoman suffered from generalized migrating pain, worsening at night as if insects bit her muscles, often treated as ghost evil. I said: This is precisely Lijie disease; three doses will be effective.
Shaoyao Zhimu Tang (Peony and Anemarrhena Decoction) (From *San Yin Fang*): Treats pain in all joints, emaciation, swollen feet feeling like they are falling off, dizziness, shortness of breath, and nausea.
Ingredients: Guixin (Cinnamomi Ramulus), Zhimu (Anemarrhenae Rhizoma), Fangfeng (Saposhnikoviae Radix) (each 4 liang); Shaoyao (Paeoniae Radix Alba), Mahuang (Ephedrae Herba, remove roots and joints), Gancao (Glycyrrhizae Radix et Rhizoma) (each 3 liang); Fuzi (Aconiti Lateralis Radix Praeparata) (2 liang, processed).
Preparation and Administration: Cut into small pieces. Take 4 qian per dose, with 1.5 cups of water and 5 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct to 0.7 cup, strain, and take on an empty stomach. Another version includes Baizhu (Atractylodis Macrocephalae Rhizoma), Chuanxiong, Xingren (Armeniacae Semen Amarum), Banxia (Pinelliae Rhizoma).
Fuzi Bawu Tang (Aconite Eight-Ingredient Decoction): Treats wind-Lijie pain, unbearable pain in limbs as if hammered.
Ingredients: Fuzi (Aconiti Lateralis Radix Praeparata), Jiangtang (Zingiberis Rhizoma), Shaoyao (Paeoniae Radix Alba), Fuling (Poria), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Guixin (Cinnamomi Ramulus) (each 3 liang); Baizhu (Atractylodis Macrocephalae Rhizoma) (4 liang).
Preparation and Administration: Cut into small pieces. Take 4 da-qian per dose, with 2 cups of water, decoct to 0.7 cup, strain, and take before meals. Another version removes Guixin and uses Dihuang (Rehmanniae Radix) 2 liang.
Duhuo Jisheng Tang (Angelica Pubescens and Dorstenia Decoction) (Formula seen in Miscellaneous Diseases Lower Back Pain section).
Xiao Xu Ming Tang (Minor Continuation Life Decoction): Treats Baihu Lijie, unbearable pain. (Formula seen in Miscellaneous Diseases Stroke section).
[Chen] A woman initially suffered unbearable pain in both ankle bones. The next day, the pain migrated to the knees; on the third day, to the thigh bones, very painful, then to the shoulders, elbows, and Houxi acupoint. The pain felt like hammering or insect crawling, unbearable, worse at night than day. Various medicines failed. Upon examination, the six pulses were tight. I said: This is true Lijie syndrome, not resolvable by dispersing herbs alone, but Xiao Xu Ming Tang will cure it in one dose.
Another case: Lady Deng also suffered from Lijie in summer, unbearable pain, medicines failed. Examination showed Renying and Xin pulses were deficient, indicating heatstroke. She should first drink Jiuzheng Huanglian Wan (Wine-steamed Coptis Pills). Other doctors laughed. One dose cured her, and it proved effective subsequently.
External application for women's Blood-Wind Zou Zhu, unbearable pain in waist, knees, and joints:
Ingredients: Fuzi (Aconiti Lateralis Radix, raw), Xunluxiang (Olibanum), Xingren (Armeniacae Semen Amarum, ground), Guixin (Cinnamomi Ramulus), Danggui (Angelicae Sinensis Radix), Yuntaizi (Brassicae Napus Semen), Yuanhua (Genkwa Flos), Badou (Crotonis Fructus, peel removed) (each 1 liang); Songzhi (Pini Resina) (1.5 liang).
Preparation and Administration: Grind into powder, melt 5 liang of Huangla (Beeswax), mix with herbs, mold into patches, apply to painful area. Immediate effect.
Another formula:
Ingredients: Yuanhua (Genkwa Flos), Guixin (Cinnamomi Ramulus) (each 1 liang); Hanjiao (Zanthoxyli Pericarpium) (2 liang), Sanggenbaipi (Mori Cortex) (3 liang), Yuntaizi (Brassicae Napus Semen), Liuxie (Salicis Cortex/Calamus) (each 5 liang).
Preparation and Administration: Grind into powder, mix with 1 sheng of Cu (Vinegar), steam until hot, wrap in green cloth, and compress/foment the painful area. When cool, re-steam with vinegar.
External plaster for women's Blood-Wind Zou Zhu, pain in waist, hips, legs, and knees:
Ingredients: Tianxianzi (Hyoscyami Semen), Chuan Wutou (Aconiti Radix, raw), Fuzi (Aconiti Lateralis Radix, raw) (each 1 liang).
Preparation and Administration: Grind into powder, decoct with wine to make a paste, spread on silk, and apply to the painful area. Chronic cases resolve within three applications.