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Crane's Knee Wind (He Xi Feng)

Wang Kentang stated: Swelling and pain in both knees, with the thighs gradually becoming thinner, is called Crane's Knee Wind, also known as Drumstick Wind. It arises from internal dampness, or occurs after dysentery leading to leg weakness and inability to walk, a condition named Dysentery Wind. Alternatively, it may result from residual toxins of Cold Damage (Shanghan) failing to be dispersed, where wind-cold-damp pathogens knot in the meridians, causing blood vessels to stagnate, resulting in contracted tendons and thinner thighs; this belongs to the Foot Shaoyang and Foot Yangming meridians. (*Zhunsheng*)

Furthermore, he stated: Swelling and pain above the knee have various causes and must be distinguished carefully. If both knees are swollen inside and out, with pain like being bitten by a tiger, alternating chills and fever, thinning thighs, and increasingly swollen knees, it is named Crane's Knee Wind. Immediate garlic-separated moxibustion should be applied, and Da Fangfeng Tang (Great Prevention Decoction) with added Rhizoma Costi (Ruxiang, 乳香) should be taken to relieve pain and relax tendons. However, if pain in only one knee radiates up and down, with slight swelling and mild redness, it is named Knee Wandering Wind (Xi You Feng). Swelling and pain on both sides of the knee, accompanied by aversion to cold and high fever, worsening day and night, with the swollen area too painful to touch, is named Eye of the Knee Toxin (Xi Yan Du). Swelling and pain above the kneecap is named Knee Carbuncle (Xi Yong). (*Zhunsheng*)

Furthermore, he stated: At the inner side of the knee near the crease, tubercles appear with swelling and pain; if the nodule is long and shaped like a fish, it is named Upper Water Fish (Shang Shui Yu).

Chen Shigong stated: Crane's Knee Wind is a syndrome of deficiency in the Three Yin meridians, with slender lower legs but swollen knee joints, resembling the knee of a crane walking. Initially, there are alternating chills and fever, and sweating therapy is appropriate. If swelling and pain persist after sweating, it indicates deep-seated yin-cold; Da Fangfeng Tang (Great Prevention Decoction) should be used to warm the meridians. In severe cases, moxibustion at the two Xianyan points (Knee Eye acupoints) combined with topical application of Hupo Gao (Amber Ointment) can gradually yield results. If these treatments fail, it becomes a chronic disease; rather than forcing resolution, continuous intake of Xiantian Dazao Wan (Premature Creation Pill) and Shi Guogong Medicinal Wine may alleviate severity and restore mobility. (*Zhengzong*)

Master Qi stated: This illness arises from standing in dampness and engaging in sexual intercourse immediately, allowing water qi to penetrate clothing, thus causing this disease. (*Milu*)

Li Ziyong stated: For Crane's Knee Wind, ancients often used Da Fangfeng Tang (Great Prevention Decoction), combining qi- and blood-invigorating herbs, because the pathology resides in the lower jiao yin aspect. Removing blood herbs, as Master Qi suggested, suits the initial stage; however, for chronic cases, ancient formulas should not be discarded.

Feng Luzhan stated: Persistent swelling and pain in the knees may develop into Crane's Knee Wind, characterized by swollen knees like crane feet and thin calves, with a wiry and tight pulse. This is caused by deficiency-cold and dampness flowing into the Three Yin meridians. People often mistakenly diagnose it as damp-heat, leading to suppuration and severe depletion of qi and blood, rendering it incurable. One should know that this condition, along with Gu Ben Ju (Bone-Attached Abscess), is common in those with kidney deficiency. Due to weakened true qi, pathogens invade deeply. Ancients used Fuzi (Aconite Root) to warm and tonify the Kidney meridian and to promote the action of other herbs to disperse cold. Thus, in weak individuals invaded by cold air, prolonged non-resolution leads to extreme yin generating yang, transforming cold into heat and causing ulceration. Misuse of cold-cooling herbs will inevitably lead to disability, such as contracture, hemiplegia, paralysis, hardness like stone (Stone Ju), or slow ulceration with rotting flesh (Slow Ju). The lower body is distant; only Cinnamon Twig (Guizhi, 桂枝) and Aconite Root (Fuzi, 附子) can reach it. Moreover, the Kidney governs bones, and the area below the buttocks belongs to the Kidney; only Cinnamon Twig and Aconite Root can enter its meridians and circulate effectively. (*Jinnang*)

*Ke Fa Liang Gui* states: Drumstick Crane's Knee Wind arises from internal dampness. Since the feet and knees belong to the Liver, wind-cold-damp in the Liver obstructs blood flow, accumulating in the knees. Blood in the lower thighs flows out without returning, becoming thinner and colder with contracted tendons; blood in the upper thighs accumulates without dispersing, becoming more swollen and hot with wasting muscles. If the source is from flowing injection (Liu Zhu), condensed flesh will rot, and rotting flesh will corrode bone; once bone corrodes, even immortals cannot cure it, resulting in intractable disability. While the skin is intact, muscle is not yet dead; urgently apply Yulong Gao (Jade Dragon Ointment) mixed with hot wine to the upper leg above the knee to restore yang qi and stop bone pain. Apply Chonghe Gao (Harmony Ointment) to the cold areas of the upper leg to guide qi and blood to flow downward through the vessels. Apply Yulong Gao (Jade Dragon Ointment) to the joint connection to guide the vessels and disperse accumulated yin qi. Internally take Zhui Feng Wan (Wind-Chasing Pill) with added Rhizoma Costi (Ruxiang, 乳香) and Resina Commiphorae (Moyao, 没药); all cases will heal.

It further states: For all conditions involving damp-phlegm, damp-heat, or stagnant blood in the joints, where flow is obstructed, efficacy cannot be achieved without pungent-warm herbs to open the interstices, unblock the collaterals, and harmonize qi and blood. People fear the toxicity of Aconite Root (Fuzi, 附子) and refuse to take it. However, processed with child's urine, what toxicity remains? Moreover, it is stopped once the disease is cured and not taken continuously; why worry? The Classics say: "Use the appropriate medicine for the disease." Therefore, Da Fangfeng Tang (Great Prevention Decoction) and Huoluo Dan (Meridian-Activating Pill) are effective for Hong Kong Foot (Charcot Joint/Gout) and Crane's Knee Wind.

Zhenren Zhang stated: This disease arises from engaging in sexual intercourse while standing, allowing wind-damp to invade both knees. However, treatment does not focus on the Kidneys; healing qi alone suffices, and specific treatment for wind-damp is unnecessary. (*Liangfang Buyi*)

*Xinfa* states: Crane's Knee Wind is also named Wandering Knee Wind or Drumstick Wind. Cases arising after dysentery are Dysentery Wind. Unilateral occurrence is mild; bilateral is most severe. After ulceration, white fluid discharges, and floating skin remains swollen and painful. Corrosive medicines should not be used. Instead, use five qian each of Hibiscus Leaf (Furong Ye, 芙蓉叶) and Chrysanthemum Leaf (Juhua Ye, 菊花叶), ground into powder, mixed with barley water, and applied topically to relieve pain. Alternatively, steamed tofu dregs molded into cakes can be applied. This condition is a difficult-to-treat failure among external diseases, making recovery very hard.