Library

Chen Linchuan stated: Whenever there is headache, feverish body, pain in the limbs and joints, constipation, or vomiting with weakness and flexion of the feet, this is Hongxiangjiao (Gouty Arthritis). For mild cases, Xiangsu San (Perilla and Cyperus Powder) can be administered with added Mu Gua (Chaenomeles Fruit), Bing Lang (Areca Seed), and Sheng Jiang (Fresh Ginger Decoction), followed by treatment according to the specific syndrome. It must be known that patients with Hongxiangjiao typically develop symptoms starting from the feet. Manifestations may include initial flaccidity, weakness, pain, and numbness; sudden collapse while walking; bilateral swelling and fullness of the shins; emaciation of the feet and knees; palpitations in the heart region; insensitivity in the lower abdomen; skin induration with loss of pain sensation; generalized muscle spasms; nausea and vomiting upon seeing food or smelling food odors; chest fullness and shortness of breath; or generalized soreness and pain throughout the body. All these are signs of Hongxiangjiao. This corresponds to what the Yellow Emperor described as "Huan Feng Shi Bi" (Flaccid Wind-Damp Bi Syndrome). Flaccidity and weakness constitute Huan Feng (Flaccid Wind), while pain constitutes Shi Bi (Damp Bi). If Cold pathogen invades the Three Yang meridians, the afflicted area will necessarily feel cold; Xiao Xuming Tang (Minor Continuation of Life Decoction) is the primary formula. (It is best to add fresh ginger juice after decoction.) If Summerheat pathogen invades the Three Yin meridians, the afflicted area will necessarily feel hot; Xiao Xuming Tang should be used without Fu Zi (Aconite Lateral Root) and with Gui Zhi (Cinnamon Twig) reduced by half. For severe restlessness, Zi Xue (Purple Snow) is most effective. If Zi Xue is unavailable, Bai He (Lily Bulb) and Bo He (Mint) decocted in cold water for administration is also excellent. For constipation, Pi Yue Wan (Spley-Restriction Pill), Ma Ren Wan (Hemp Seed Pill), or San He San (Three Harmonies Powder) are indicated. Acupuncture and moxibustion are highly recommended. Taking tonifying medicines and washing the affected parts with medicated decoctions are strictly prohibited by physicians.

Women's Hongxiangjiao differs from men's. In men, it arises from Kidney deficiency allowing Wind-Damp to invade. In women, it results from Qi deficiency in the Bao Luo (Uterine Collaterals) allowing Wind-Toxin to bind. Since the Bao Luo is affiliated with the Kidney, and the Kidney governs the waist and feet, and the meridians of the Liver, Spleen, and Kidney all originate at the ten toes of the feet, when the Zang-Fu organs are deficient, Wind pathogen first lodges in the feet, ascending from below and disturbing Qi, hence the name Hongxiangjiao. These conditions arise from physical weakness, exposure to wind while cooling off, prolonged sitting in damp lowlands, postpartum overexertion, or anger and sorrow injuring the Liver, leading to Heart Qi deficiency and obstruction of menstruation. Due to deficiency allowing Wind-Toxin to enter the sinews and bones, skin becomes insensitive, sinews and bones ache, limbs become immobile, sinews and vessels spasm, sometimes with cold pain, sometimes with swelling, sometimes with numbness and weakness in both feet, sometimes with generalized spasms, dizziness, irritability, vomiting upon seeing food, mental confusion, joint pain, dark yellow urine, and constipation. For such syndromes, treating women's Hongxiangjiao differs from men's due to Qi and Blood disharmony and injuries related to pregnancy, childbirth, etc. Thus, the treatment for widows and nuns differs from that for ordinary wives, which illustrates this principle.

[Xue Ji] Yan Yonghe stated: The aforementioned syndrome is often unnoticed initially and manifests due to other illnesses, starting from the feet. Symptoms may include flaccidity, weakness, numbness, and pain preventing walking; bilateral shin swelling; small feet and knees; palpitations; abdominal insensitivity; generalized spasms; nausea upon seeing food; chest fullness and shortness of breath; and generalized soreness. A floating and wiry pulse indicates Wind; a soggy and weak pulse indicates Damp; a surging and rapid pulse indicates Heat; a slow and choppy pulse indicates Cold. In men, it stems from Kidney Qi depletion; in women, from Blood Sea deficiency caused by emotional disturbances. I suggest that if the Three Yin meridians of the foot are deficient, use Hai Shao Dan (Restore Youth Pill) [see Miscellaneous Diseases: Deficiency and Emaciation]. If Spleen Qi is deficient and cold, use Ba Wei Wan (Eight-Ingredient Pill) [see Miscellaneous Diseases: Deficiency and Emaciation]. If food stagnation causes soreness and distension in the buttocks and thighs with edema and pain, indicating Spleen Qi sinking, use Liu Jun Zi Tang (Six Gentlemen Decoction) [see Miscellaneous Diseases: Deficiency and Emaciation], adding minor amounts of Chai Hu (Bupleurum Root) and Sheng Ma (Cimicifuga Rhizome); if ineffective, Ba Wei Wan is required. If fever, thirst, irregular menstruation, and leg weakness occur, indicating Blood deficiency and Fire dryness in the Three Yin meridians of the foot, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and Ba Wei Wan together. People in the West are prone to this condition due to a diet rich in dairy, causing Spleen and Stomach stagnation and shin/foot swelling. In the South, it occurs due to rich foods causing Damp-Heat pouring downward. Hence ancients called it "Yong Ji" (Stagnant Disease), using formulas that mostly promote circulation and dispersal. However, if caused by excessive sexual activity damaging the Three Yin meridians, treatment should focus on consolidating the root. Therefore, Liu Wu Fu Zi (Six-Ingredient Aconite) type formulas are sacred remedies for Yuan Qi (Original Qi) deficiency and internal invasion of Cold pathogen.

Da Fu Pi San (Betel Nut Peel Powder): Treats Wind-Toxin Hongxiangjiao in women, characterized by vexatious pain in limbs and joints, mental confusion, and dizziness. Suitable for all such cases.
Ingredients: Da Fu Pi (Areca Peel), Sang Bai Pi (Mulberry Root Bark), Mu Tong (Akebia Stem), Qiang Huo (Notopterygium Rhizome), Chi Shao Yao (Red Peony Root), Jing Jie (Schizonepeta Spike), Du Huo (Angelica Pubescens Root), Qing Ju Pi (Green Tangerina Peel), Gan Mu Gua (Dried Chaenomeles Fruit) - each 1 liang; Zhi Ke (Bitter Orange Fruit), Zi Su Ye (Perilla Leaf) - each 2 liang.
Preparation: Coarsely crush ingredients. Take 8 qian per dose, decoct with 1.5 zhans of water, 5 slices of Fresh Ginger, and 7 cun of Scallion White until reduced to 1 zhan. Strain and take warm before meals.

Zi Su Yin (Perilla Decoction): Treats Wind-Toxin Hongxiangjiao in women, featuring epigastric fullness, phlegm-fluid retention, anorexia, heavy and swollen feet.
Ingredients: Zi Su Ye (Perilla Leaf), Mu Tong (Akebia Stem), Hui Xiang (Fennel Fruit), Sang Gen Bai Pi (Mulberry Root Bark), Du Huo (Angelica Pubescens Root), Qiang Huo (Notopterygium Rhizome), Gan Mu Gua (Dried Chaenomeles Fruit), Qing Ju Pi (Green Tangerina Peel), Zhi Gan Cao (Prepared Licorice Root), Da Fu Pi (Areca Peel), Zhi Ke (Bitter Orange Fruit), Jing Jie (Schizonepeta Spike).
Preparation: Coarsely crush ingredients. Take 8 qian per dose, decoct with 1.5 zhans of water, 5 slices of Fresh Ginger, and one stem of Scallion White with roots until reduced to 1 zhan. Strain and take warm at any time, twice daily.

Si Bai San (Four Whites Powder): Treats Blood deficiency with fever in men and women, night sweats, anorexia, emaciated limbs, sinew spasm, and foot pain preventing standing/walking.
Ingredients: Huang Qi (Astragalus Root), Hou Po (Magnolia Bark), Yi Zhi Ren (Alpinia Oxyphylla Fruit), Chen Pi (Tangerina Peel), Huo Xiang (Pogostemon Herb), Bai Bian Dou (White Hyacinth Bean), Bai Zhu (Atractylodes Macrocephala Rhizome), Bai Fu Ling (Poria), Bai Dou Kou (Cardamom Seed), Ren Shen (Ginseng Root), Zhi Gan Cao (Prepared Licorice Root), Tian Tai Yu Dao (Tiantai Litsea Rhizome), Shao Yao (Peony Root), Tan Xiang (Sandalwood Wood), Chen Xiang (Aquilaria Resin).
Preparation: Grind into fine powder. Take 3 qian per dose, decoct with 1 zhan of water, 3 slices of Fresh Ginger, and one Jujube until reduced to 0.7 zhan. Take warm, twice daily. If other symptoms subside but foot spasm/pain persists, treat with Cang Zhu Wan.

Cang Zhu Wan (Atractylodes Macrocephala Pill): Greatly treats Dry and Damp Hongxiangjiao, sinew spasm and pain, inability to walk, and tonifies the lower body.
Ingredients: Ru Xiang (Olibanum), Mo Yao (Myrrha) - each 2 qian (separately ground); Chuan Niu Xi (Cyathula Root), Qing Yan (Blue Salt) - each 0.5 liang (ground); Shu Ai Ye (Prepared Mugwort Leaf) - 4 qian (processed with rice paste, ground); Quan Xie (Scorpion) - 1 qian (fried, ground); Chuan Wu Tou (Aconitum Carmichaelii Lateral Root) - 3 qian (processed, skin/navel removed).
Preparation: Grind herbs into fine powder, mix with separately ground resins. Cut top off one large Mu Gua (Chaenomeles), remove pulp, insert herbs, replace lid, secure, and steam in Black Soybeans until very soft. Remove skin, grind herb-melon mixture into paste, mix with sufficient raw Cang Zhu (Atractylodes Macrocephala Rhizome) powder. Form pills like paulownia seeds. Take 50 pills per dose, fasting, with Mu Gua soup or warm salt wine, three times daily. Avoid blood products and garlic.

Discussions on other syndromes are detailed in the Miscellaneous Diseases section.