张涣云∶缘禀受肾气不足者，气血未荣，脚指拳缩无力，不能伸展。海桐皮散主之。
海桐皮散 治脚拳不展。
海桐皮 当归（汤洗，焙干） 牡丹皮 熟地黄 牛膝（酒浸，焙。各一两） 山茱萸 补骨脂
（各半两）
上为细末，每服一钱，水八分，入葱白二寸，煎至五分，去滓，温服，食前。
《圣惠》儿在胞，母脏腑有积冷，为风邪所乘，生后、肾气不足，气血未荣，故脚指
拳缩不展。
宜当归散
当归（焙） 麻黄（去根节。各半两） 羌活 酸枣仁（微炒） 人参 杜仲（微炙） 桂心
（各二钱半）
上为细末。每服一钱，水一小盏，姜少许，姜五分，量儿大小，乳前分减服。
干地黄丸
生地黄 郁李仁（汤浸，去皮尖微炒。各半两） 牛膝 防风 桂心 海桐皮 羌活 白茯
苓薏苡仁（各二钱半）
上为末，蜜丸，如绿豆。乳前、温酒下七丸；量儿加减。
〔曾〕肝者，东方青龙木也，其动则应于风，病则主惊骇。诸热引肝风，有风则
生痰，有痰亦作搐，小儿惊风之际，手足动掣，当听其自定，然后疗之，免生异证，
或父母见其病势可畏，从而按伏之，岂知筋者、肝之合也，临病发时，若按束其手
足，则筋不舒伸，遂至经络为风所闭，终为废人。《内经》曰∶顽弱名缓风，疼重名
湿痹，又有四肢痿痹不仁，致手足稍胀痛不堪忍者，此风毒之气使然，故传曰∶风
淫末疾是也。凡小儿心悸不常，及遍身肿痛，或手足不随，此为惊瘫候也，若治之
稍迟，至臂、腕、膝、胫、骨节之间，流结顽核，或膝大而肿，肉消骨露，如鹤膝
之状，或为瘫为疖，此名鹤膝候也。以上形证，并宜发汗为先，使腠理开通，则风
热可除，有湿亦去，用百解散和 咀五苓散倍加麻黄，水姜葱煎服，微得汗为度，
或以麻黄汤发散尤佳，次防己汤、祛风散及独活汤加桑寄生投服，并防风汤或黑虎
丹、作小丸子间服，使风不生而痰不作，则其疾易愈。若为痈为疖疼重者，用黑牵
牛半生半炒，略研碎，前无灰酒调下五苓散，以除流注之寒湿，则肿毒可消。如大
腑闭而不通，此是风热内蕴，其右腮红紫，及右手三部脉浮而实滑，宜五和汤，或
当归散、枳壳丸治之。其加减之法，尤在临机审处，若泥一方，非良医也。前证，
更宜间服排风汤。
〔薛〕鹤膝风者，其腿渐细，其膝愈粗，状如鹤膝，是以名之。此因禀肾经不足，
外邪所乘而患之，初则膝内作痛，外色不变，伸屈艰难，若一二月间， 肿色赤而
作脓者可治。肿硬色白而不作脓者难治。初起者用大防风汤为主，佐以益气养荣汤。
脓成者用补中益气汤为主，佐以大防风汤。切勿用十宣、流气、等药，若不溃、不
敛，或发热等证者，须调补脾胃为善，否则必变败证矣。
大防风汤 治鹤膝风，肿痛不消，或溃而不敛。
附子（炮） 牛膝（酒炒。各一钱） 白术 羌活 人参 防风（各二钱） 杜仲
（去皮，姜制） 川芎 肉桂（去皮） 黄 （炒） 熟地黄（自制） 芍药（炒，各一钱五分）
甘草（一钱）
上，每服三五钱，水煎，仍量儿大小用之。
独活寄生汤
独活 桑寄生 杜仲（炒） 细辛 牛膝（酒炒去土） 秦艽 茯苓 白芍药（炒） 桂心 川
芎防风 甘草 人参 熟地黄 当归（各等分）
上，每服二三钱，水煎，空心，乳母同服。
益气养荣汤（瘰 ） 百解散（惊） 五苓散（惊） 麻黄汤（伤寒）
防己汤 治感冒风湿之气失于解表，流注两足，疼痛至两膝，浮肿不能屈伸，传成
瘫痪。
防己（去黑皮） 麻黄（去节存根，功全表里，锉碎，汤泡，滤过，焙干用） 薄桂（去粗皮。各半两）
赤芍药 赤茯苓（去皮） 苍术（米泔水浸一宿，去粗皮，滤，锉片，火炒至微黄。各一两） 甘草
（炙，七钱半）
上件， 咀。每服二钱，水一盏，姜二片，葱一根，煎七分，空心热服。或入
薤白同煎。
祛风散 治卒暴中风，不能言全，口眼 斜，惊瘫搐掣，痰实烦躁，神昏有热，
睡卧不稳。
防风（去芦） 南星（生用） 甘草（生用） 半夏（制） 黄芩（各一两）
上碎。每服二钱，水一盏半，姜三片，慢火煎七分，不拘时、温服。
独活汤 治惊瘫鹤膝及中风湿，日久致腰背手足疼痛，昼轻夜重，及四肢痿痹不仁。
川独活（黄色、如鬼眼者佳，半两） 当归（酒洗） 白术 黄 （蜜水涂炙） 薄桂（去粗皮）
川牛膝（酒洗，各二钱半） 甘草（炙，三钱）
上件， 咀。每服二钱，水一盏，姜二片，薤白一根，煎七分，空心热服，或无时。
防风汤（惊）
黑虎丹 治诸般风证。
草乌（去黑皮，一两生用） 川乌（去黑皮，生用） 甘草（各七钱半） 麻黄（不去根节）
甘松 熟干地黄（净洗） 藿香叶 白芷 油烟墨（烧存性） 猪牙皂荚 川芎 当归 何首乌
南星（生用） 僵蚕（去丝） 赤小豆 羌活 白胶香 木鳖子（去油。各半两）
上件，锉碎，或焙或晒，研为细末，糯米粉煮糊丸，麻仁大。每服三十丸至五
十丸，或七十丸，稍空心，用淡姜汤下。儿小者，丸作粟谷大，治法如前。
五和汤（热） 当归散（热） 枳壳丸（大便秘）
排风汤 治中风狂言，失音不语，精神昏困，惊瘫鹤膝等证，及肿疾才愈后偶感外
风，满面遍体虚浮，并宜可服。
白藓皮 白术 白芍药 薄桂（去粗皮） 防风（去芦） 川芎 当归（酒洗） 杏仁（汤泡，
去皮尖） 甘草（炙。各半两） 川独活 麻黄（去根节） 白茯苓（去皮。各七钱半）
上，每服二钱，水一盏，姜二片，煎七分，无时温服。
Zhang Huan stated: Due to insufficient congenital kidney qi, the qi and blood fail to flourish and nourish, resulting in toes curled into fists, weakness, and inability to extend. The primary treatment is Haitongpi San (Sea Poplar Bark Powder).
Haitongpi San: Treats toes curled and unable to extend.
Ingredients: Haitongpi (Bark of Tinospora sinensis), Danggui (Radix Angelicae Sinensis) (washed with decoction, dried by baking), Mudanpi (Cortex Moutan Radicis), Shudihuang (Prepared Rhizoma Rehmanniae), Niuxi (Radix Achyranthis Bidentatae) (soaked in wine, dried by baking, each 1 liang), Shanzhuyu (Fructus Corni Officinalis), Buguzhi (Fructus Psoraleae) (each 0.5 liang).
Preparation and Administration: Grind the above ingredients into a fine powder. Take 1 qian per dose, add 8 fen of water, insert 2 cun of scallion white (Rhizoma Allii Fistulosi), decoct until 5 fen of liquid remains, filter off the dregs, take warm, before meals.
The *Shenghui Fang* records: While in the womb, if the mother's zang-fu organs have accumulated cold pathogens, after birth the infant is susceptible to wind pathogens, leading to insufficient kidney qi and lack of qi and blood nourishment, thus causing toes to curl and not extend.
Danggui San (Angelica Sinensis Powder) is suitable.
Ingredients: Danggui (Radix Angelicae Sinensis) (baked), Mahuang (Herba Ephedrae) (remove roots and nodes, each 0.5 liang), Qianghuo (Rhizoma et Radix Notopterygii), Suanzaoren (Semen Ziziphi Spinosae) (lightly stir-fried), Renshen (Radix Ginseng), Duzhong (Cortex Eucommiae Ulmoidis) (lightly roasted), Guixin (Cinnamomi Cortex) (each 2.5 qian).
Preparation and Administration: Grind the above ingredients into a fine powder. Take 1 qian per dose, add one small cup of water, a little ginger, decoct to 5 fen, adjust dosage according to the child's age, take in divided doses before breastfeeding.
Gan Dihuang Wan (Raw Rehmannia Pill):
Ingredients: Shengdihuang (Radix Rehmanniae Recens), Yuliren (Semen Pruni Armeniacae) (soaked in decoction, remove skin and tips, lightly stir-fried, each 0.5 liang), Niuxi (Radix Achyranthis Bidentatae), Fangfeng (Radix Saposhnikoviae), Guixin (Cinnamomi Cortex), Haitongpi (Caulis Tinosporae), Qianghuo (Rhizoma et Radix Notopterygii), Baifuling (Poria), Yiyiren (Semen Coicis) (each 2.5 qian).
Preparation and Administration: Grind the above ingredients into a fine powder, make pills with honey the size of mung beans. Take 7 pills before breastfeeding with warm rice wine; adjust dosage according to the child's condition.
Zeng's view: The Liver corresponds to the Azure Dragon of the East and Wood element; its movement responds to Wind, and disease manifests primarily as fright and terror. Various heat pathogens draw out Liver Wind; when there is Wind, Phlegm is generated, and when there is Phlegm, spasms occur. During pediatric convulsions (Jing Feng), when hands and feet twitch and jerk, one should allow them to settle naturally before treating, to avoid generating other complications. If parents, fearing the severity of the illness, forcibly press and restrain the child, they do not realize that tendons are the exterior correspondence of the Liver. When symptoms flare up, restraining the limbs prevents tendons from relaxing and extending, ultimately causing meridians to be blocked by Wind, leading to permanent disability. The *Neijing* states: Weakness is called Huan Feng (Sluggish Wind); pain and heaviness are called Shi Bi (Damp Bi). There are also cases of flaccid paralysis and numbness of the four limbs, causing unbearable slight swelling and pain in hands and feet; this is caused by Wind-Toxin Qi. Hence it is said: "Wind excess leads to diseases of the extremities." Whenever children have palpitations and restlessness, or generalized swelling and pain, or inability to move hands and feet voluntarily, this is a sign of Jing Tan (Fright Paralysis). If treatment is delayed, pathogens flow into the joints of arms, wrists, knees, and shins, forming hard nodules, or causing knee swelling with muscle wasting and exposed bones resembling a crane's knee, or developing into paralysis or sores, this is called He Xi Hou (Crane Knee Syndrome). For these presentations, sweating therapy should be used first to open the pores, thereby eliminating Wind-Heat and Dampness. Use Baijie San (Hundred-Resolving Powder) combined with Wu Ling San (Five-Ingredient Powder with Poria), adding extra Mahuang (Herba Ephedrae), decocted with water, ginger, and scallion, aiming for mild sweating. Alternatively, Mahuang Tang (Ephedra Decoction) for dispersal is even better. Subsequently, use Fangji Tang (Stephania Decoction), Qufeng San (Wind-Expelling Powder), or Duhuo Tang (Angelicae Pubescentis Decoction) plus Sangjisheng (Taxilli Cacumen). One may also use Fangfeng Tang (Saposhnikoviae Decoction) or Heihu Dan (Black Tiger Pill), made into small pills taken intermittently, so that Wind does not arise and Phlegm is not produced, facilitating recovery. If presenting as abscesses or sores with severe pain, use Heiqianniu (Radix et Rhizoma Stemonae) (half raw, half stir-fried), slightly crushed, taken with Wuling San (Five-Ingredient Powder with Poria) mixed in non-ash wine to eliminate flowing Cold-Dampness, resolving swelling and toxicity. If stool is closed and unpassable, this indicates internal accumulation of Wind-Heat, with red-purple right cheek and floating, solid, slippery pulses on the right hand three positions; use Hewa Tang (Five-Harmonizing Decoction), or Danggui San (Angelica Sinensis Powder), or Zhike Wan (Citrus Aurantium Pill). The method of modification depends on clinical judgment; sticking rigidly to one formula is not the way of a good physician. For the aforementioned conditions, Paifeng Tang (Wind-Expelling Decoction) should also be taken intermittently.
Xue's view: He Xi Feng (Crane Knee Wind) refers to legs gradually thinning while knees become increasingly thick, resembling a crane's knee, hence the name. This occurs due to congenital insufficiency of Kidney Meridian Qi, invaded by external pathogens. Initially, there is pain inside the knee with no change in external color, and difficulty in flexion and extension. If within one or two months the swelling becomes red and suppurates, it is treatable. If swollen, hard, white, and non-suppurating, it is difficult to treat. In early stages, Da Fangfeng Tang (Major Saposhnikoviae Decoction) is the main formula, assisted by Yiqi Yangrong Tang (Qi-Nourishing and Blood-Supplementing Decoction). If pus has formed, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is the main formula, assisted by Da Fangfeng Tang (Major Saposhnikoviae Decoction). Do not use drugs like Shixuan or Liqi; if there is no ulceration, no healing, or fever, one must regulate and tonify the Spleen and Stomach, otherwise it will inevitably turn into a critical failure syndrome.
Da Fangfeng Tang (Major Saposhnikoviae Decoction): Treats He Xi Feng, where swelling and pain do not subside, or ulcers fail to heal.
Ingredients: Fuzi (Prepared Radix Aconiti Lateralis Preparata), Niuxi (Radix Achyranthis Bidentatae) (stir-fried with wine, each 1 qian), Baizhu (Rhizoma Atractylodis Macrocephalae), Qianghuo (Rhizoma et Radix Notopterygii), Renshen (Radix Ginseng), Fangfeng (Radix Saposhnikoviae) (each 2 qian), Duzhong (Cortex Eucommiae Ulmoidis) (peeled, processed with ginger), Chuanxiong (Rhizoma Chuanxiong), Rougui (Cortex Cinnamomi) (peeled), Huangqi (Radix Astragali Membranacei) (stir-fried), Shudihuang (Prepared Rhizoma Rehmanniae) (homemade), Shaoyao (Radix Paeoniae Alba) (stir-fried, each 1.5 qian), Gancao (Radix Glycyrrhizae Uralensis) (roasted, 1 qian).
Preparation and Administration: Take 3-5 qian per dose, decoct in water, adjusting dosage according to the child's age.
Duhuo Jisheng Tang (Angelicae Pubescentis and Taxillus Decoction):
Ingredients: Duhuo (Radix et Rhizoma Angelicae Pubescentis), Sangjisheng (Taxilli Cacumen), Duzhong (Cortex Eucommiae Ulmoidis) (stir-fried), Xixin (Herba Asari), Niuxi (Radix Achyranthis Bidentatae) (wine-stir-fried, cleaned), Qinjiao (Radix Gentianae Macrophyllae), Fuling (Poria), Baishaoyao (Radix Paeoniae Alba) (stir-fried), Guixin (Cinnamomi Cortex), Chuanxiong (Rhizoma Chuanxiong), Fangfeng (Radix Saposhnikoviae), Gancao (Radix Glycyrrhizae Uralensis), Renshen (Radix Ginseng), Shudihuang (Prepared Rhizoma Rehmanniae), Danggui (Radix Angelicae Sinensis) (equal parts).
Preparation and Administration: Take 2-3 qian per dose, decoct in water, take on an empty stomach; the nursing mother takes it simultaneously.
Yiqi Yangrong Tang (Qi-Nourishing and Blood-Supplementing Decoction) (treats Scrofula); Baijie San (Hundred-Resolving Powder) (treats Convulsions); Wu Ling San (Five-Ingredient Powder with Poria) (treats Convulsions); Mahuang Tang (Ephedra Decoction) (treats Cold Damage).
Fangji Tang (Stephania Decoction): Treats contraction of Wind-Damp pathogens, failure to resolve via sweating, flowing into both legs, causing pain extending to both knees, edema preventing flexion and extension, progressing to paralysis.
Ingredients: Fangji (Radix Stephaniae Tetrandrae) (remove black skin), Mahuang (Herba Ephedrae) (remove nodes, keep roots for full surface-interior effect, crush, soak in water, filter, bake dry), Bo Gui (Thin Cinnamon Bark) (remove rough bark, each 0.5 liang), Chishao Yao (Radix Paeoniae Rubra), Chi Fuling (Red Poria) (remove skin), Cangzhu (Rhizoma Atractylodis Lanceae) (soak in rice wash water overnight, remove rough skin, filter, slice, stir-fry over fire until slightly yellow, each 1 liang), Gancao (Radix Glycyrrhizae Uralensis) (roasted, 7.5 qian).
Preparation and Administration: Crush the above ingredients. Take 2 qian per dose, add one cup of water, two slices of ginger, one stalk of scallion, decoct to 7 fen, take hot on an empty stomach. Or decoct together with Xiebai (Bulbus Allii Macrostemonis).
Qufeng San (Wind-Expelling Powder): Treats sudden stroke, inability to speak fully, facial deviation, fright paralysis, spasms, phlegm-fullness, irritability, mental confusion with heat, and restless sleep.
Ingredients: Fangfeng (Radix Saposhnikoviae) (remove rhizome stump), Nanxing (Rhizoma Arisaematis Cum Bile) (raw), Gancao (Radix Glycyrrhizae Uralensis) (raw), Banxia (Rhizoma Pinelliae Preparatum) (processed), Huangqin (Radix Scutellariae Baicalensis) (each 1 liang).
Preparation and Administration: Crush the above ingredients. Take 2 qian per dose, add one and a half cups of water, three slices of ginger, decoct slowly over low heat to 7 fen, take warm at any time.
Duhuo Tang (Angelicae Pubescentis Decoction): Treats fright paralysis, crane knee, and Wind-Damp invasion causing chronic pain in waist, back, hands, and feet, lighter by day and heavier by night, as well as flaccid paralysis and numbness of the four limbs.
Ingredients: Chuan Duhuo (Radix et Rhizoma Angelicae Pubescentis) (yellow, resembling a ghost's eye is best, 0.5 liang), Danggui (Radix Angelicae Sinensis) (wine-washed), Baizhu (Rhizoma Atractylodis Macrocephalae), Huangqi (Radix Astragali Membranacei) (brush with honey water and roast), Bo Gui (Thin Cinnamon Bark) (remove rough bark), Chuan Niuxi (Radix Achyranthis Bidentatae) (wine-washed, each 2.5 qian), Gancao (Radix Glycyrrhizae Uralensis) (roasted, 3 qian).
Preparation and Administration: Crush the above ingredients. Take 2 qian per dose, add one cup of water, two slices of ginger, one stalk of Xiebai, decoct to 7 fen, take hot on an empty stomach or at any time.
Fangfeng Tang (Saposhnikoviae Decoction) (treats Convulsions).
Heihu Dan (Black Tiger Pill): Treats various Wind syndromes.
Ingredients: Caowu (Radix Aconiti Kusnezoffii) (remove black skin, 1 liang raw), Chuanwu (Radix Aconiti Carminelii) (remove black skin, raw), Gancao (Radix Glycyrrhizae Uralensis) (each 7.5 qian), Mahuang (Herba Ephedrae) (do not remove roots and nodes), Gansong (Nardostachys Radix et Rhizoma), Shugan Dihuang (Dried Prepared Rhizoma Rehmanniae) (cleanly washed), Huoxiangye (Perilla Folium), Baizhi (Radix Angelicae Dahuricae), Youyan Mo (Lampblack), Zhuyazaojiao (Fructus Gleditsiae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Danggui (Radix Angelicae Sinensis), Heshouwu (Radix Polygoni Multiflori), Nanxing (Rhizoma Arisaematis Cum Bile) (raw), Jiangcan (Bombyx Batryticatus) (remove silk), Chixiaodou (Semen Phaseoli Angularis), Qianghuo (Rhizoma et Radix Notopterygii), Baijiaoxiang (Olibanum), Mugua Zi (Semen Momordicae) (remove oil, each 0.5 liang).
Preparation and Administration: Crush the above ingredients, bake or sun-dry, grind into fine powder, make pills with glutinous rice paste the size of hemp seeds. Take 30-50 pills, or 70 pills, slightly on an empty stomach, with light ginger soup. For infants, make pills the size of millet grains, treatment method as above.
Hewa Tang (Five-Harmonizing Decoction) (treats Heat); Danggui San (Angelica Sinensis Powder) (treats Heat); Zhike Wan (Citrus Aurantium Pill) (treats Constipation).
Paifeng Tang (Wind-Expelling Decoction): Treats stroke with delirious speech, loss of voice, mental fatigue, fright paralysis, crane knee, and post-swelling residual external Wind invasion causing generalized puffiness of face and body. Suitable for all these conditions.
Ingredients: Baixianpi (Cortex Dictamni Radicis), Baizhu (Rhizoma Atractylodis Macrocephalae), Baishaoyao (Radix Paeoniae Alba), Bo Gui (Thin Cinnamon Bark) (remove rough bark), Fangfeng (Radix Saposhnikoviae) (remove rhizome stump), Chuanxiong (Rhizoma Chuanxiong), Danggui (Radix Angelicae Sinensis) (wine-washed), Xingren (Semen Pruni Armeniacae) (soak in water, remove skin and tips), Gancao (Radix Glycyrrhizae Uralensis) (roasted, each 0.5 liang), Chuan Duhuo (Radix et Rhizoma Angelicae Pubescentis), Mahuang (Herba Ephedrae) (remove roots and nodes), Baifuling (Poria) (remove skin, each 7.5 qian).
Preparation and Administration: Take 2 qian per dose, add one cup of water, two slices of ginger, decoct to 7 fen, take warm at any time.