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Tang suffered from Hongxiangjiao (a chronic condition characterized by swelling and pain in the feet), a lingering ailment rooted in Damp-Heat. Coinciding with the plum rain season of early summer, continuous rainfall and humid heat prevailed. The tongue coating was grayish-yellow, appetite was poor with no sense of hunger, and medications should avoid heavy, greasy substances because the Spleen dislikes Dampness. Considering her advanced age and deficient pulses of the Liver and Kidney, accompanied by alternating cold and fever, swollen feet, leukorrhea, lower back pain, and hypochondriac pain radiating from left to right such that she cannot lie on her side, this indicates concurrent disease of the Yangwei Vessel and Dai Vessel. Treatment should focus on the collaterals, assisted by regulating Spleen-Yang. Following the method of ancient Yinzi formulas, heavy/turbid medicines are administered in a clear/light manner. Prescription: Shudi Tan (Charred Rehmanniae Radix, 1.5 qian), Shayuanzi (Astragali Complanati Semen, stir-fried with salt water), Gouqizi (Lycii Fructus, roasted, each 2 qian), Niuxi (Achyranthis Bidentatae Radix, stir-fried with wine into charcoal), Guixu (Radix Angelicae Sinensis Pinnula, mixed with wine, each 1 qian), ShaRen Qiao (Amomi Fructus Pericarpium, 8 fen), Fuling (Poria), Yiyiren (Coicis Semen), Sheng Duzhong (Eucommiae Cortex, raw), Sangjisheng (Taxilli Herba), Xuduan (Dipsaci Radix, each 2 qian), Nuodaogenxu (Oryza Sativa Rootlet, 1 liang). After one dose, pain ceased; after two doses, appetite improved; long-term use reduced the frequency of Hongxiangjiao attacks.

(Attached: Xiyoubing [Wandering Knee Wind], Xiyan Du [Knee Eye Toxicity], Xi Yong [Knee Abscess])
The knee is the mansion of sinews. If flexion and extension are difficult, both knees are congested and swollen, painful internally and externally, with thin calves and thick knees resembling a crane's knee, it is named He Xin Feng (Crane Knee Wind). This is mostly caused by deficiency of the three Yin meridians of the foot, allowing Wind pathogen to invade. Treatment involves invigorating blood and nourishing sinews, while addressing Wind-Damp. Use Shiquan Dabu Tang (Decoction for Ten Complete Tonifications) added with Duzhong, Niuxi, Qianghuo, and Duhuo. In the initial stage with diffuse swelling without redness and difficulty in movement, apply Cong Yun (Scallion Moxibustion) to resolve internally, or Garlic-separated moxibustion, and orally administer Dafangfeng Tang (Great Wind-Expelling Decoction). Acupuncture needle insertion is strictly contraindicated. Alternatively, grind aged Mustard Seed (Jiezi) into fine powder, mix with juice of scallion and ginger and white honey, and apply topically. After one fu period (approx. 2 hours), blisters form on the affected area; when blisters dry and skin peels off, self-healing occurs. If cold and fever occur simultaneously, use Wuji Jiaozao San (Five Accumulations Mixed Powder) added with Wuyao and Jiangcan. If skin color remains unchanged but the thigh is diffusely swollen, use Shenxiao San (Miraculous Effect Powder). If there is rootless deficient fire causing sudden fever, use Shiquan Dabu Tang. For blood-deficiency fever with red face, large pulse, and thirst, use Danggui Buxue Tang (Decoction for Nourishing Blood with Danggui). For yin-deficiency emaciation with fever, use Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia). If complicated by Damp-Heat, use Canggui Wan (Cassia Twig Pill) or Ermiao San (Two Marvels Powder). If due to Wind-Damp, use Huangu Dan (Bone-Changing Elixir) or Sanxi Tang (Dispersing Knee Decoction). If invaded by Water-Damp, use Zhengxi Tang (Steaming Knee Decoction). For poor appetite and sallow complexion, use Liujunzi Tang (Six Gentlemen Decoction). For insufficiency of Middle Qi, use Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting Qi). For difficulty in flexion and extension, use Huoluo Dan (Collateral-Activating Pill). For suppuration and ulceration, use Dafangfeng Tang. For clear pus with non-regenerating muscle, or dizziness with phlegm expectoration, use Bawei Dihuang Wan (Eight-Ingredient Pill with Rehmannia) added with Lurong (Deer Antler Velvet) and Niuxi. For gradual development of Crane Knee Wind from weak legs, use Duhuo Jisheng Tang (Decoction for Expelling Wind-Damp and Nourishing Liver and Kidney). If only one knee pulls with pain, not significantly swollen above and below but slightly red, it is named Xiyoubing (Wandering Knee Wind). Use Fangtong Tongsheng San (Wind-Penetrating Supreme Survival Powder) added with Mugua and Niuxi, or Huangu Dan. If swelling and pain occur on both sides of the knee, with aversion to cold and high fever, where the swollen area cannot be touched, it is named Xiyan Du (Knee Eye Toxicity). Use Shengjin Dan (Supreme Gold Elixir) or Xianfang Huoming Yin (Immortal Formula for Preserving Life Decoction) added with Niuxi. If swelling and pain occur on the kneecap, also with chills and fever, it is named Xi Yong (Knee Abscess). Treatment is the same as above.

*Yitong* states: Women suffering from Crane Knee Wind often have liver and spleen damage due to depression and anger, followed by Wind pathogen invasion. Initially, limb sinew spasms may occur, with knees gradually enlarging and calves thinning, resembling a crane's knee. Cases with high, red, and painful swelling are easy to treat; those with diffuse, non-red, and painless swelling are difficult. Ulceration with thick pus within two to three months is easy to treat; ulceration with clear pus after half a year is difficult. Misuse of purgatives further damages Yuan Qi, making treatment particularly difficult. The primary approach should be consolidating Yuan Qi. For poor diet and fatigue, use Liujunzi Tang. For afternoon fever, internal heat, and alternating cold and fever, use Xiaoyao San (Free and Easy Wanderer Powder). For fever and aversion to cold, use Shiquan Dabu Tang. For palpitations and insomnia, use Guipi Tang (Spleen-Restoring Decoction). For delayed menstruation, use Buzhong Yiqi Tang. For early menstruation, use Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder). For kidney yin deficiency, use Liuwei Dihuang Wan. After ulceration, it is essential to strongly tonify the Spleen and Stomach. If pain persists after pus discharge, or if there is chills, fever, and irritability/thirst, these belong to Qi and Blood deficiency; treatment should focus on tonification using Bazhen Tang (Eight Treasures Decoction).

Pediatric Crane Knee Wind is mostly due to congenital weakness of Kidney Qi, with Yin-Cold condensing in the waist and knees. Ancient formulas use Liuwei Wan (Six-Ingredient Pill) to tonify Kidney Water, and Lurong (Deer Antler Velvet) to guide the medicine to the bone joints to strengthen interior Yang; this is an excellent method for treating the root.

Yu Jiayan stated: Crane Knee Wind is Bi syndrome of Wind, Cold, and Damp obstructing the knee. As the knee bones enlarge daily and upper/lower muscles atrophy daily, one should not treat the knee first. Instead, nourish Qi and Blood to allow muscles to gradually become robust, then treat the knee. This is largely similar to treating Pian Ku (hemiplegia); urgently irrigate the parts not yet atrophied to restore Qi and Blood circulation and robustness. If this is not done, and only Wind-dispelling drugs like Mahuang (Ephedrae Herba) and Fangfeng (Saposhnikoviae Radix) are used, few cases will avoid total atrophy. Therefore, treating Crane Knee Wind by urgently attacking the Bi obstruction will inevitably lead to foot flaccidity and inability to use the limbs.