历节，即行痹、痛痹之属，唐人或谓之白虎病，宋人则联称为白虎历节风，又称之痛风，而元以降，专用
其名矣。倘经久不愈者，多变鹤膝风，而痢后风亦为其类证，仍并合为篇。
源候总说 历节风之状，短气自汗出，历节疼痛不可忍，屈伸不得是也。由饮酒腠理开，汗出当风所
致也，亦有血气虚受风邪而得之者。风历关节, 与血气相搏交攻，故疼痛，血气虚则汗也，风冷搏于筋则不可
屈伸，为历节风也。（《病源论》）
《近效》论白虎病者，大都是风寒暑湿之毒，因虚所致，将摄失理，受此风邪，经脉结滞，血气不行，蓄
于骨节之间，或在四肢，肉色不变，其病昼静而夜发，发即彻髓酸疼不歇，其病如虎之啮，故名曰白虎之病也。
（《外台》）（按∶《圣惠》同，作白虎风。）
夫历节，疼痛不可屈伸，身体 羸，其肿如脱，其痛如掣，流注骨节，短气自汗，头眩温温欲吐者，皆以
风湿寒相搏而成。其痛如掣者为寒多，肿满如脱者为湿多，历节黄汗出者为风多。顾《病源》所载，饮酒当风，
汗出入水，遂成斯疾。原其所因，虽涉风湿寒，又有饮酒之说，自属不内外因，亦有不能饮酒而患此者，要当
推求所因，分其先后轻重为治。久而不治，令人骨节蹉跌，变为癫病，不可不知。（《三因》）（按∶久而不
治云云，本出《千金》，然癫病可疑，当考。）
痛风即《内经》风寒湿三气杂至，合而为痹也。虽言寒为痛痹；然三者皆能作痛，但寒胜者痛甚如掣，湿
者痛着如
肿，风者其痛行动无常处。悉因凝滞之痹，与流行荣卫真气相击搏，则作痛痹，若不搏其流行出入之道，则
不痛，但痿痹耳。（《推求师意》）
病属血分 痛风者，大率因血得热，已自沸腾，其后或涉冷水，或立湿地，或扇取凉，或卧当风，寒
凉外搏，热血得寒，汗浊凝涩，所以作痛，夜则痛甚，行于阴也。治法以辛热之剂，流散寒湿，开发腠理，其
血得行，与气相和，其病自安。然亦有数种治法稍异，谨书一二，以证予言。东阳傅文年逾六十，性急作劳，
患两腿痛甚，动则甚痛。予视之曰∶此兼虚证，当补血温血，病当自安。遂与四物汤，加桃仁、陈皮、牛膝、
生甘草煎，入生姜，研潜行散，热饮，三四十帖而安。又朱宅阃内，年近三十，食味甚浓，性躁急，患痛风，
挛缩数月，医祷不应。予视之曰∶此挟痰与气证，当和血疏气导痰。病自安。遂以潜行散入生甘草、牛膝、炒
枳壳、通草、陈皮、桃仁、姜汁煎服，半年而安。又邻鲍六，年二十余，因患血痢，用涩药取效，后患痛风，
叫号撼邻。予视之曰∶此恶血入经络证，血受湿热，久必凝浊，所下未尽，留滞隧道，所以作痛，经久不治，
恐成偏枯。遂与四物汤，加桃仁、红花、牛膝、黄芩、陈皮、生甘草煎，入生姜，研潜行散，入少酒饮之，
数十帖，又与刺委中，出黑血近三合而安。（《格致余论》）
病有因中暑 邓安人夏月亦病历节，痛不可忍，诸药不效，召仆诊之，人迎与心脉虚，此因中暑而得
之，合先服酒蒸黄连丸（黄连一味，酒蒸为丸），众医莫不笑，用此药服一帖即愈，自后与人良验。（《妇人
良方》）
证治诸说 大都痛痹之证，多有昼轻而夜重者，正阴邪之在阴分也。其有遇风雨阴晦而甚者，此正阴
邪侮阳之证
也。或得暖遇热而甚者，此湿热伤阴之火证也。若筋脉拘滞，伸缩不利者，此血虚血燥证也，非养血养气不可。
（《景岳》）
两手十指，一指疼了一指疼，疼后又肿，骨头里痛，膝痛，左膝痛了右膝痛，发时多则五日，少则三日，
昼轻夜重，痛时觉热，行则痛轻，肿却重。解云∶先血后气，乃先痛后肿，形伤气也。（《纲目》引东）
如两腿自膝以下，或时内热，或骨中觉热，或有一点酸痛热者何？此血热也。但是风病，其血必热，惟其
血热，故风寒之气一袭，则外寒束内而作痛。（《慈航》）
白虎历节证，宜与小续命汤，兼以活络丹（用南星、草乌、川乌、地龙、乳香、没药）。若身体麻木者，
亦可服。麝香丸亦妙。（《管见》）
治法当以温药解其风寒湿之毒，或用和平，则独活寄生汤辈可也。（《直指》）
筋骨疼痛，俗呼为痛风，或痛而游走无定，俗呼为走注风，并宜乌药顺气散和煎服元通气散，咽地仙丹
（《和剂》经进地仙丹是）或青龙丸（见《济生》）。未效，用大防风汤，或五积散调乳香末。有痛风而痛有
常处，其痛处赤肿灼热，或浑身壮热，此欲成风毒，宜败毒散。（《要诀》）
痛风脉浮紧，头痛恶寒发热，为新受之邪，宜五积散。治风先治血，血行风自灭，宜四物汤加生黄 、防
风、桂枝、秦艽、桑枝、红花、炙甘草主之。痛风久不能愈，必大补气血，以为胜邪之本，切不可徒用风药，
宜十全大补汤，诸药各一钱，加真桑寄生三钱为君，再加附子、防风、竹沥、生姜汁为佐使。（《时方妙用》）
鹤膝风 （此证治方，多可通治历节，故并列在后款。）
肘膝肿痛，臂 细小，名曰鹤膝风，以其象鹤膝之形而名之也。或止有两膝肿大，皮肤拘挛，不能屈伸， 腿
枯细，俗谓之鼓槌风，要皆不过风寒湿之流注而作病也。（《医统》）（按∶鼓槌风亦出《奇效》，当考所本。）
鹤膝风，乃足三阴亏损之症。初起寒热交作时，亦宜五积散加牛膝、红花，或万灵丹发汗俱可。如汗后，
肿痛仍不消减，此阴寒深伏，以大防风汤温暖经络，重者兼灸膝眼二穴，敷以琥珀膏，亦可渐渐取效。又如以
上之法俱不效者，终成痼疾，不必强药消之，只宜先天大造丸、史国公酒药，每常服之，终年亦可转重就轻，
移步行履，尚可图也。（《外科正宗》）（按∶万灵丹、大造丸等，当就本书而考。）
鹤膝风者，即风寒湿之痹于膝者也。如膝骨日大，上下肌肉日枯细者，且未可治其膝，先养血气，俾肌肉
渐荣后治其膝可也。此与治左右半身偏枯之证大同，夫既偏枯矣，急溉其未枯者，然后既枯者得以通气而复荣。
倘不知从气引血、从血引气之法，但用麻黄、防风等散风之套药，鲜有不全枯而速死者。故治鹤膝风而亟攻其
痹，必并其足痿而不用矣。比而论之，其治法不益明乎。（《法律》）
古方治小儿鹤膝风，用六味地黄丸，加鹿茸、牛膝共八味，不治其风，其意最善。盖小儿非必为风寒湿所
痹，多因先天所禀，肾气衰薄，阴寒凝聚于腰膝而不解，从外可知其内也。故以六味丸补肾中之水，以鹿茸补
肾中之火，以牛膝引至骨节而壮其裹撷之筋，此治本不治标之良法也，举此为例而推之。（同上）
鹤膝风者，胫细而膝肿是也。经云∶膝者筋之府，屈伸不能，行则偻附，筋将惫矣。治宜去风顺气，活血
壮筋，十
全大补加杜仲、牛膝、羌活，或五积散加松节。血少虚寒而痛者，四物加荆芥、牛膝，送活络丹。气血流动，
更服八味丸加鹿茸、牛膝调理，正气旺而患自除矣。（《医通》）
鹤膝风与附骨疽，俱肾虚者多患之，因真气衰弱，邪气得以深袭，前人用附子者，以温补肾气，又能行药
势，散寒邪也。故体虚之人，为冷气所袭，经久不消，阴极生阳。寒化为热而溃也。若误用寒凉，必成废疾，
或挛曲偏枯，或痿弱不起，或坚硬如石为石疽，或日久始溃，皮肉俱腐为缓疽，下部道远，非桂、附不能下达
也。况肾主骨，而臀以下俱属肾，非桂、附不能入其经而宣行也。（《锦囊》）（按∶此说，《汇补》引薛氏，
当考。）
痢后风 （宜参后大防风汤） 痢后偏生痛脚风，一般五积自能攻，于中去却麻黄味，酒煮多多服见功。
（《澹轩》）
痢后风，因痢后下虚，不善调将，或多行，或房劳，或感外邪，致两脚双软，若痛若痹，遂成风痢（风痢
当易位）。独活寄生汤，吞虎骨四斤丸，或用大防风汤，或多以生樟，即骨碎补，俗呼为胡孙姜，三分之一，
同研取汁，酒解服，外以杜仲、牛膝、杉木节、白芷、南星、萆 煎汤熏洗。（《要诀》）
血痢止早，恶血留于经络，作痛甚者，四物加桃仁、红花、牛膝、黄芩、陈皮、甘草煎，生姜汁研潜行散
入少酒饮之，多服自验，于委中刺黑血妙（按∶此说本出丹溪）。凡久痢后，两脚酸软痛，或膝肿如鼓槌，此
亡阴也，宜以芎、归、熟地等补血药治之，自愈。挟气虚者，加参、 。挟风湿者，加羌活、防风、白芷之类。
切不可纯作风治而用风药，反燥其血，终不能愈。（《六要》）
类证 （宜参身体痛） 附骨疽与白虎飞尸、历节风皆相
类，历节则走注不定，白虎飞尸痛浅，按之则便，附骨疽痛深，按之无益。（《三因》）
大抵骨节疼痛，加寒热发肿块者，是湿痰流注经络，与痛风同治法，若医迟不散，则成脓矣，外用敷药。
（《回春》）
妇人少年虚弱少气，骨节间疼痛，或于他处疼痛，是气痛，非风湿也，逍遥加川芎、香附、乌药、木香。
（《阶梯》）
驱邪诸方 防己汤，治风历节，四肢疼痛，如槌锻不可忍者方。
防己 茯苓 白术 桂心 生姜（各四两） 乌头（七枚） 人参（二两） 甘草（三两）
上八味 咀，以苦酒一升，水一斗，煮取三升半，一服八合，日三夜一，当觉焦热痹忽忽然，慎勿怪也。
若不觉，复合服，以觉乃止。凡用乌头皆去皮，熬令黑乃堪用，不然至毒人，宜慎之。（《翼》不用苦酒）
（《千金》）《圣济》白术汤（主治同），于本方去茯苓、乌头，加附子、当归、芍药。
治湿风体痛欲折，肉如锥刀所刺方。
附子 干姜 芍药 茯苓 人参 甘草 桂心（各三两） 白术（四两）
上八味 咀，以水八升，煮取三升，日三服。一方去桂，用干地黄二两。（《千金》）《三因》附子八物
汤，治风历节，四肢疼痛，如槌锻不可忍（即本方）。《杨氏》名渗湿汤（宜参《中湿》）。
治历节风，周身百节疼痛，腰脚痿弱，防风汤方。
防风（去叉二两） 白术（一两） 白藓皮（二两） 桂（去粗皮一两三分） 黄 （锉二两） 薏苡仁
（炒三两）
上六味粗捣筛，每服四钱匕，水一盏半，生姜三片，煎至一盏，去滓温服，日三夜一。（《圣济》）
《疡医大全》鹤膝风神方，于本方去白术、白藓皮，加川萆 、牛膝、秦艽。
大枣汤，治历节疼痛方。
大枣（十五枚） 黄 （四两） 附子（一枚） 生姜（二两） 麻黄（五两） 甘草（一尺）
上六味 咀，以水七升，煮取三升，服一升，日三服。（《千金》）
逐风毒，石膏汤方。
石膏（鸡子大三枚） 麻黄（三两） 杏仁（四十枚） 鸡子（二枚） 甘草（一尺）
上五味 咀，以水三升，破鸡子内水中，烊令相得，内药煮取一升服之，覆取汗。汗不出，烧石熨取汗出。
（同上）
治历节风，日夜疼痛，黄 汤方。
黄 （四两） 防风（去叉） 附子（炮裂去皮脐各一两半） 芎 （一两） 麻黄（去根节煎掠去沫焙
五两） 当归（焙一两） 甘草（炙锉半两） 芍药（一两）
上八味，锉如麻豆，每服五钱匕，水一盏半，入枣二枚去核，生姜一分擘碎，煎至一盏，去滓温服，空心
日午夜卧各一。（《圣济》）
小续命汤，大治白虎历节，痛不可忍。有一妇人，先自两足踝骨痛不可忍，次日流上于膝，一二日流于解
骨，甚流至于肩，肩流于肘，肘流于后溪，或如槌锻，或如虫啮，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。但用小续命汤二剂而效。（《妇
人良方》）（按∶痛风用小续命，本出《是斋》。）
四肢疼痛不可忍，生五积加川羌活、川独活，穿山甲制过，随痛处所向，取甲烧炒存性，入煎，临熟入麝
香。（《永类》）
一人贫劳，秋深浑身发热，手足皆疼如锻，日轻夜重，服风药愈痛，气药不效，脉涩而数。用苍术、酒黄
柏各一钱半，生附一片，生甘草三分，麻黄五分，研桃仁九个，煎入姜汁令辣，热服。四帖，去附，加牛膝一
钱。八帖后，痛略减。（《丹溪》）（节录）
温经活血诸方 治历节风，骨节疼痛，四肢微肿，行立无力，宜服赤芍药散方。
赤芍药（二两） 附子（一两炮裂去皮脐） 桂心（二两） 芎 （一两） 当归（二两） 汉防己
（一两） 萆 （一两锉） 桃仁（半两汤浸去皮尖双仁麸炒微黄） 海桐皮（一两）
上件药捣筛为散，每服五钱，以水一大盏，入生姜半分，煎至五分去滓，于食前温服。（《圣惠》）
独活寄生汤，最治历节风，近人用之甚效，亦治腰背痛及香港脚流注。（《三因》）（方见《腰痛》门）
大防风汤，祛风顺气，活血脉，壮筋骨，除寒湿，逐冷气。（《和剂》此下曰∶又治患痢后脚痛痪弱，不
能行履，名曰痢风。或两膝肿大痛，髀胫枯腊，但存皮骨，拘挛 卧，不能屈伸，名曰鹤膝风。）善法寺僧如
Lijie (Joint-Traveling Pain) belongs to the category of Xingbi (Wandering Bi Syndrome) and Tongbi (Painful Bi Syndrome). In the Tang Dynasty, it was sometimes called Baihu Bing (White Tiger Disease), while in the Song Dynasty, it was collectively referred to as Baihu Lijie Feng (White Tiger Joint-Traveling Wind), also known as Tongfeng (Gout/Wind-Pain). Since the Yuan Dynasty, the specific term "Lijie" has been exclusively used. If the condition persists for a long time without cure, it often transforms into He Xi Feng (Crane Knee Wind), and Feng Zhenghou Li (Wind after Dysentery) is also considered a related syndrome; therefore, they are combined in this chapter for discussion.
*Summary from "Zhu Bing Yuan Hou Lun" (Source of All Diseases):*
The manifestations of Lijie Feng include shortness of breath, spontaneous sweating, severe joint pain that is unbearable, and inability to flex or extend. This is caused by drinking alcohol which opens the Couli (skin pores), followed by wind invasion during sweating. It can also result from deficiency of Blood and Qi leading to susceptibility to Wind pathogen. The Wind traverses the joints, clashing with Blood and Qi, causing pain; deficiency of Blood and Qi leads to sweating, and Cold-Wind clashing with tendons causes stiffness and inability to move. This constitutes Lijie Feng. (From *Bing Yuan Lun*)
*Discussion on White Tiger Disease from "Jin Xiao Fang":*
Generally, White Tiger Disease is caused by the toxicity of Wind, Cold, Summer-heat, and Dampness due to deficiency. Improper care leads to the invasion of these Wind pathogens, causing stagnation in the meridians and obstruction of Blood and Qi flow, which accumulates between bone joints or in the limbs. The skin color remains unchanged. The disease is quiet during the day but flares up at night. Upon onset, there is unceasing deep bone soreness and pain, feeling as if bitten by a tiger, hence the name White Tiger Disease. (From *Waitai Mibi*) (Note: *Taiping Shenghui Fang* states the same, calling it Baihu Feng.)
Regarding Lijie, symptoms include unbearable pain preventing flexion and extension, emaciation, swelling sensation as if dislocated, pulling pain, pathogen flowing into joints, shortness of breath, spontaneous sweating, dizziness, and nausea. These are all caused by the clashing of Wind, Dampness, and Cold. Pulling pain indicates excess Cold; swelling and fullness indicate excess Dampness; yellow sweat indicates excess Wind. Reviewing *Bing Yuan Lun*, drinking in the wind and entering water while sweating causes this disease. Although the etiology involves Wind, Dampness, and Cold, the mention of drinking classifies it partly under "Neither Internal nor External Causes" (dietary/lifestyle factors). Some who do not drink also suffer from this. One must investigate the specific cause and treat according to priority and severity. Untreated for a long time, it causes joint deformation and may transform into Dian Bing (epilepsy or mental disorder), which must be noted. (From *Sanyin Fang*) (Note: The phrase "untreated for a long time..." originates from *Qianjin Fang*, but the claim about Dian Bing warrants verification.)
Tongfeng corresponds to the "Bi Syndrome" described in *Neijing* as the mixture of Wind, Cold, and Dampness. Although Cold is said to cause Painful Bi, all three can cause pain: Cold dominance causes severe pulling pain; Dampness dominance causes fixed pain with swelling; Wind dominance causes wandering pain. All result from stagnant Bi clashing with circulating Ying and Wei Qi. If the pathway is not blocked, there is no pain, only Wei Bi (Flaccidity Bi). (From *Tuiqiu Shi Yi*)
[Pathology Belongs to Blood Level]
Tongfeng generally occurs when Blood becomes hot and boils, followed by exposure to cold water, damp ground, fans, or drafts. External Cold clashes with hot Blood, causing turbid sweat to coagulate and obstruct, resulting in pain, which worsens at night due to Yin influence. Treatment uses acrid-hot herbs to disperse Cold-Dampness, open Couli, allow Blood to circulate, and harmonize with Qi. However, methods vary slightly.
Case 1: Fu Wen from Dongyang, over 60, impatient and overworked, suffered severe leg pain worsening with movement. Diagnosed as deficiency, treated with Siwu Tang (Four Substances Decoction) plus Tao Ren (Peach Kernel), Chen Pi (Tangerine Peel), Niu Xi (Achyranthes Root), and raw Gan Cao (Licorice), decocted with fresh ginger, mixed with Qianxing San, taken hot. Cured after 30-40 doses.
Case 2: A woman in the Zhu household, nearly 30, rich diet, irritable, suffered Tongfeng with contracture for months. Diagnosed as Phlegm and Qi stagnation, treated with Qianxing San plus raw Gan Cao, Niu Xi, Chao Zhi Ke (Stir-fried Bitter Orange), Tong Cao (Tetrapanax Pith), Chen Pi, Tao Ren, and ginger juice. Cured after half a year.
Case 3: Neighbor Bao Liu, over 20, had bloody dysentery treated with astringents, later developed Tongfeng with loud cries. Diagnosed as Evil Blood in collaterals, Blood affected by Damp-Heat, stagnating in tunnels. Treated with Siwu Tang plus Tao Ren, Hong Hua (Safflower), Niu Xi, Huang Qin (Scutellaria), Chen Pi, raw Gan Cao, ginger, and Qianxing San with wine. After dozens of doses, bloodletting at Weizhong (BL40) released nearly 3 he of dark blood, curing him. (From *Gezhi Yulun*)
[Caused by Summer-heat]
Lady Deng suffered Lijie in summer with unbearable pain, unresponsive to drugs. Pulse at Renying (ST9) and Heart was deficient. Diagnosed as caused by Summer-heat. Prescribed Jiu Zheng Huanglian Wan (Alcohol-steamed Coptis Pill). Doctors mocked it, but one dose cured her. (From *Furen Liangfang*)
[Various Views on Diagnosis and Treatment]
Generally, Painful Bi is lighter by day and heavier by night, indicating Yin pathogen in Yin aspect. Worsening in rainy/dark weather indicates Yin pathogen harassing Yang. Worsening with warmth/heat indicates Fire syndrome damaging Yin due to Damp-Heat. Stiff tendons and vessels indicate Blood deficiency and dryness, requiring nourishment of Blood and Qi. (From *Jingyue Quanshu*)
Pain moving from finger to finger, swelling after pain, deep bone pain, knee pain alternating sides, worse at night, feeling heat during pain, lighter when walking but heavy when swollen. Explanation: Pathology starts in Blood then Qi; form injury affects Qi. (From *Bencao Gangmu* citing Dongyuan)
Internal heat or bone heat in lower legs below knees indicates Blood Heat. In Wind diseases, Blood is always hot; external Cold binding internal Heat causes pain. (From *Cihang*)
For Baihu Lijie, Xiaoxuming Tang (Minor Continuation of Life Decoction) is suitable, combined with Huoluo Dan (Meridian-Unblocking Pill) containing Nanxing (Arisaema), Caowu (Processed Aconitum Ferox), Chuanwu (Processed Aconitum Carmerichanii), Dilong (Earthworm), Ruxiang (Frankincense), Moyao (Myrrh). Also suitable for numbness. Shexiang Wan (Musk Pill) is also excellent. (From *Guanjian*)
Treatment should use warm herbs to resolve Wind-Cold-Damp toxicity, or mild formulas like Duhuo Jisheng Tang (Angelica Pubescens and Hosta Root Decoction). (From *Zhizhi Fang*)
For bone/joint pain (Tongfeng) or wandering pain (Zouzhufeng), use Wuyao Shunqi San (Noble Magnolia Bark Qi-Regulating Powder) mixed with Yuantong Qisan, swallowing Dixian Dan or Qinglong Wan. If ineffective, use Dafangfeng Tang (Great Wind-Expelling Decoction) or Wujisan (Five Accumulations Powder) mixed with Ruxiang powder. If pain is fixed, red, swollen, hot, or accompanied by high fever, suspect Wind-Toxin; use Baidu San (Eliminate Toxin Powder). (From *Yijue*)
If Tongfeng pulse is floating-tight with headache, aversion to cold, and fever, indicating recent invasion, use Wujisan. "Treating Wind requires treating Blood first; when Blood moves, Wind extinguishes." Use Siwu Tang plus Sheng Huang Qi (Raw Astragalus), Fangfeng (Saposhnikovia), Guizhi (Cinnamon Twig), Qinjiao (Gentiana Macrophylla), Sangzhi (Mulberry Twig), Honghua, and Zhi Gan Cao (Honey-fried Licorice). For chronic Tongfeng, strongly tonify Qi and Blood as the root to overcome pathogens; avoid using only Wind-expelling herbs. Use Shiquan Dabu Tang (Complete Great Tonifying Decoction) with Sangjisheng (Taxillus) as chief herb, plus Fuzi (Aconite), Fangfeng, Zhuli (Bamboo Juice), and Shengjiang Jiang (Ginger Juice) as assistants. (From *Shifang Miaoyong*)
He Xi Feng (Crane Knee Wind)
(This condition's treatments largely apply to Lijie, so listed here.)
Swelling and pain in elbows/knees with thin arms/thighs is He Xi Feng, named for its resemblance to a crane's knee. Or only knees swell with tight skin and immobility, with thin calves,俗称 Drumstick Wind. These are all caused by Wind-Cold-Damp accumulation. (From *Yitong*) (Note: Drumstick Wind also appears in *Qixiao Liangfang*.)
He Xi Feng results from deficiency of the Three Yin Meridions of the Foot. Early stage with alternating chills/fever can use Wujisan plus Niu Xi and Honghua, or Wanling Dan (Ten Thousand Spirits Pill) to induce sweat. If swelling/pain persists after sweating, indicating deep-seated Yin-Cold, use Dafangfeng Tang to warm meridians. Severe cases add moxibustion at Xiyang (EX-LE5) and application of Hupo Gao (Amber Plaster). If ineffective, it becomes chronic; forceful elimination is futile. Instead, use Xiantian Dazao Wan (Pre-heaven Great Creation Pill) or Shiguo Gong Wine regularly. Over a year, severity may decrease, allowing mobility. (From *Waike Zhengzong*) (Note: Verify sources for Wanling Dan, etc.)
He Xi Feng is Wind-Cold-Damp Bi in the knee. If knee bone enlarges and muscles waste, do not treat the knee immediately. First nourish Blood and Qi to restore muscle fullness, then treat the knee. Similar to treating hemiplegia: irrigate the healthy side first to restore Qi/Blood flow to the wasted side. Using only dispersing herbs like Mahuang (Ephedra) and Fangfeng without guiding Qi/Blood will lead to total wasting and rapid death. Thus, aggressive treatment of Bi in He Xi Feng causes foot flaccidity. The method is clear by comparison. (From *Yilv*)
Ancient prescriptions for pediatric He Xi Feng use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) plus Lurong (Deer Antler) and Niu Xi. Not directly treating Wind, this approach is wise. Children often suffer from congenital Kidney Qi deficiency rather than external Wind-Cold-Damp. Yin-Cold condenses in waist/knees. Liuwei Dihuang Wan tonifies Kidney Water; Lurong tonifies Kidney Fire; Niu Xi guides to joints and strengthens tendons. This treats the root, not the branch. (Same source)
He Xi Feng is thin shins with swollen knees. Classics state: "Knee is the house of tendons; inability to flex/extend or walk upright indicates tendon exhaustion." Treatment should dispel Wind, regulate Qi, invigorate Blood, and strengthen tendons. Use Shiquan Dabu Tang plus Duzhong (Eucommia), Niu Xi, Qianghuo (Notopterygium); or Wujisan plus Songjie (Pine Node). For Blood deficiency/Cold pain, Siwu Tang plus Jingjie (Schizonepeta), Niu Xi, delivering Huoluo Dan. After Qi/Blood circulation, regulate with Bawei Wan (Eight-Ingredient Pill) plus Lurong and Niu Xi. Strong Zheng Qi eliminates disease. (From *Yitong*)
He Xi Feng and Fusgu Ju (Bone-Adhering Abscess) are common in Kidney deficiency. Weak Zheng Qi allows deep pathogen invasion. Ancient doctors used Fuzi to warm Kidney Qi, promote drug action, and scatter Cold. In weak bodies, Cold Qi lingers, Yin extreme generates Yang, Cold turns to Heat, leading to ulceration. Misusing Cold herbs causes disability, contracture, hemiplegia, flaccidity, Stone Abscess, or Slow Abscess. Lower body pathology requires Guizhi/Fuzi to reach the meridians. Kidney governs bones; buttocks/lower limbs belong to Kidney; only Guizhi/Fuzi can enter these meridians. (From *Jinnang*) (Note: Cited from Xue's view in *Huibu*.)
Li Hou Feng (Wind after Dysentery)
(Refer to Dafangfeng Tang below.)
Post-dysentery unilateral leg pain/wind can be treated with Wujisan, removing Mahuang, decocted in wine. (From *Danxuan*)
Li Hou Feng results from post-dysentery lower deficiency, poor care, overexertion, sexual indulgence, or external invasion, causing soft, painful/numb legs, forming Feng Li. Treat with Duhuo Jisheng Tang, swallow Hubu Sijin Wan (Tiger Bone Four Jin Pill), or use Dafangfeng Tang. Alternatively, use raw Zhangnao (Camphor) or Gusuibu (Drynaria,俗称 Monkey Ginger), grind with juice, take with wine. External wash with Duzhong, Niu Xi, Shanmujie (Thuja twig), Baizhi (Angelica Dahurica), Nanxing, Biboa (Dioscorea Hypoglauca). (From *Yijue*)
If bloody dysentery stopped too early, Evil Blood remains in collaterals causing severe pain. Use Siwu Tang plus Tao Ren, Honghua, Niu Xi, Huang Qin, Chen Pi, Gan Cao, decocted with ginger juice and Qianxing San with wine. Bloodletting at Weizhong is effective. (Note: Originates from Danxi.) For chronic dysentery with soft/painful legs or drumstick-like knee swelling, this is Yin depletion. Treat with Xiong Gui Shudi (Angelica, Ligusticum, Rehmannia) to tonify Blood. Add Renshen/Atractylodes for Qi deficiency; Qianghuo/Fangfeng/Baizhi for Wind-Damp. Do not treat purely as Wind disease with dispersing herbs, as they dry Blood and prevent cure. (From *Liuyao*)
Similar Syndromes
(Refer to Body Pain.)
Fusgu Ju, Baihu Feishi, and Lijie Feng are similar. Lijie wanders; Baihu Feishi pain is superficial, relieved by pressure; Fusgu Ju pain is deep, unaffected by pressure. (From *Sanyin Fang*)
Generally, joint pain with chills/fever and masses indicates Wet-Phlegm flowing into collaterals, treated like Tongfeng. Delayed treatment leads to suppuration; use external applications. (From *Huichun*)
Young women with Qi deficiency suffering joint or other pains have Qi Pain, not Wind-Damp. Use Xiaoyao San plus Chuanxiong, Xiangfu, Wuyao, Muxiang. (From *Jieti*)
Formulas for Expelling Pathogens
**Fangji Tang**: Treats Wind-Lijie, limb pain unbearable as if hammered.
Ingredients: Fangji (Stephania), Fuling (Poria), Baizhu (Atractylodes), Guixin (Cinnamon Heart), Shengjiang (Fresh Ginger) [4 liang each]; Wutou (Aconite Lateralis Radix Preparata) [7 pieces]; Renshen (Ginseng) [2 liang]; Gancao (Licorice) [3 liang].
Method: Cut herbs. Boil with Kujiu (Bitter Wine) 1 sheng and Water 1 dou until 3.5 sheng remain. Take 8 ge three times daily and once at night. Sensation of burning/relief is expected. If no effect, repeat. Use roasted black Wutou. (From *Qianjin Yi* / *Qianjin Fang*; *Shengji* omits Kujiu). *Shengji* Baizhu Tang modifies this by removing Fuling/Wutou, adding Fuzi, Danggui, Shaoyao.
**Formula for Wet-Wind Body Pain**:
Ingredients: Fuzi (Prepared Aconite), Ganjiang (Dried Ginger), Shaoyao (Peony), Fuling, Renshen, Gancao, Guixin [3 liang each]; Baizhu [4 liang].
Method: Cut. Boil in 8 sheng Water to 3 sheng. Take three times daily. Alternative: Remove Guixin, add Sheng Dihuang 2 liang. (From *Qianjin Fang*). *Sanyin Fang* calls this Fuzi Bayi Tang.
**Fangfeng Tang**: Treats Lijie Feng, whole-body joint pain, weak waist/legs.
Ingredients: Fangfeng (Saposhnikovia) [2 liang], Baizhu [1 liang], Baixianpi (Dictamnus Bark) [2 liang], Gui (Cinnamon) [1.3 liang], Huangqi (Astragalus) [2 liang], Yiyiren (Coix Seed) [3 liang, stir-fried].
Method: Coarsely crush. Take 4 qianbi with 1.5 sheng Water, 3 slices Ginger. Decoct to 1 sheng. Take warm three times daily, once at night. (From *Shengji*). *Yangyi Daquan* formula for He Xi Feng removes Baizhu/Baixianpi, adds Chuan Biboa, Niu Xi, Qinjiao.
**Dazao Tang**: Treats Lijie pain.
Ingredients: Dazao (Jujube) [15 pieces], Huangqi [4 liang], Fuzi [1 piece], Shengjiang [2 liang], Mahuang (Ephedra) [5 liang], Gancao [1 chi].
Method: Cut. Boil in 7 sheng Water to 3 sheng. Take 1 sheng three times daily. (From *Qianjin Fang*)
**Shigao Tang**: Expels Wind-Toxin.
Ingredients: Shigao (Gypsum) [size of 3 large eggs], Mahuang [3 liang], Xingren (Apricot Seed) [40 pieces], Ji Zi (Chicken Egg) [2], Gancao [1 chi].
Method: Cut. Boil in 3 sheng Water. Break eggs into water, melt together, add herbs, boil to 1 sheng. Take. Cover to induce sweat. If no sweat, apply hot stones. (Same source)
**Huangqi Tang**: Treats Lijie Feng, day/night pain.
Ingredients: Huangqi [4 liang], Fangfeng, Paolu Fuzi [1.5 liang each], Chuanxiong [1 liang], Mahuang [5 liang], Danggui [1 liang], Zhi Gancao [0.5 liang], Shaoyao [1 liang].
Method: Cut like hemp seeds. Take 5 qianbi with 1.5 sheng Water, 2 dates, 1 part Ginger. Decoct to 1 sheng. Take warm on empty stomach, midnight, and before sleep. (From *Shengji*)
**Xiaoxuming Tang**: Greatly treats Baihu Lijie, unbearable pain. Case: Woman with ankle pain spreading to knees, ankles, shoulders, elbows, posterior stream points. Pain like hammering/biting, worse at night. Pulses tight. Diagnosed as true Lijie. Cured with 2 doses of Xiaoxuming Tang. (From *Furen Liangfang*; Note: Originates from *Shizhai*).
**Formula for Unbearable Limb Pain**:
Use Sheng Wujisan plus Chuan Qianghuo, Chuan Duhuo. Processed Shanzhujia (Pangolin Scale), burned to retain nature, added to decoction near end with Shexiang (Musk). (From *Yonglei*)
**Case**: Poor, overworked man, late autumn fever, limb pain like hammering, worse at night. Wind herbs worsened pain; Qi herbs failed. Pulse choppy-rapid. Used Cangzhu, Jiu Huangbai [1.5 qian each], Raw Fuzi [1 slice], Raw Gancao [3 fen], Mahuang [5 fen], Tao Ren [9 grains]. Decoct with spicy ginger juice, take hot. 4 doses, remove Fuzi, add Niu Xi [1 qian]. 8 doses, pain reduced. (From *Danxi Xinfa*)
**Warm Meridians and Invigorate Blood Formulas**
**Chishaoyao San**: Treats Lijie Feng, joint pain, slight limb swelling, weakness.
Ingredients: Chishaoyao (Red Peony Root) [2 liang], Fuzi [1 liang], Guixin [2 liang], Chuanxiong [1 liang], Danggui [2 liang], Han Fangji [1 liang], Biboa [1 liang], Tao Ren [0.5 liang], Haitongpi (Sarcandaa Bark) [1 liang].
Method: Crush/sift. Take 5 qian with 1 da sheng Water, 0.5 part Ginger. Decoct to 0.5 sheng. Take warm before meals. (From *Shenghui Fang*)
**Duhuo Jisheng Tang**: Best for Lijie Feng, highly effective recently. Also treats low back pain and Hong Kong Foot (Gouty Arthritis) flow. (From *Sanyin Fang*; Formula see "Low Back Pain" section)
**Dafangfeng Tang**: Dispels Wind, regulates Qi, invigorates Blood, strengthens sinews/bones, removes Cold-Damp, expels Cold Qi. (From *Heji Ju Fang*): Also treats post-dysentery leg pain/weakness (Li Feng) or swollen knees with wasted thighs/calves (He Xi Feng). Monk Ru of Shanfa Temple...