Library

Phlegm encases the interior; since phlegm does not dissipate, food also fails to digest. Thus, some remain trapped in the middle for several years, retaining their original state, a fact unknown to people. The area of both hypochondria is the residence of Liver Wood (Liver system). When phlegm and food accumulate within, symptoms resembling malaria naturally arise, with alternating chills and fever, appearing similar to Consumption (Lao Zai, a chronic wasting disease often involving the lungs). If treated as Consumption, the shock qi (Jing Qi) will not be resolved, and the phlegm and food will remain unchanged; how can the disease be cured? The treatment method should open up the shock qi and descend the phlegm and food; a disease lasting several years can be eliminated in one day.

Prescribe Shijing Tang (Decoction for Resolving Shock) for treatment.
Bai Shao (Radix Paeoniae Alba, 1 liang), Dang Gui (Radix Angelicae Sinensis, 5 qian), Qing Mu Xiang (Radix Aucklandiae, 3 qian), Da Huang (Radix et Rhizoma Rhei, 3 qian), Zhi Shi (Fructus Aurantii Immaturus, 1 qian), Bai Jie Zi (Semen Mustardae, 3 qian), Fu Ling (Poria, 3 qian), Zhi Ke (Pericarpium Citri Reticulatae Viride, 1 qian), Gan Cao (Radix Glycyrrhizae, 5 fen), Mai Ya (Fructus Hordei Germinatus, 1 qian), Shan Zha (Fructus Crataegi, 10 pieces).
Decoct in water and take orally. After one dose, the phlegm and food are completely discharged; no further doses are needed.
This formula eliminates phlegm and descends food, acting specifically between the two hypochondria, opening the shock qi, thus achieving miraculous results.
For this condition, Yixiaosan (Formula for Easy Dissipation) is also effective.
Shan Zha (Fructus Crataegi, 3 qian), Mai Ya (Fructus Hordei Germinatus, 3 qian), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1 liang), Bie Jia (Carapax et Plastrum Testudinis, 1 liang), Fu Ling (Poria, 3 qian), Ban Xia (Rhizoma Pinelliae, 3 qian), Fu Zi (Radix Aconiti Lateralis Preparata, 1 slice).
Decoct in water and take orally.

Some people experience gradual thinning of the lower legs and swelling of the knees, with soreness and pain deep in the bones, and gradual emaciation of the body. People mistake this for Crane’s Knee Wind (He Xi Feng); who would know it is due to Water-Dampness invading the bones?
Bone is the hardest tissue, and Dampness seems unlikely to penetrate deeply, so why does it enter the knee? This results from standing/walking combined with sexual intercourse. Whenever one engages in intercourse, the sinews and bones are labored. After ejaculation, the Marrow (Sui) becomes empty; when Marrow is empty, Bone is empty, and pathogenic factors take advantage of this emptiness to invade directly. The knee is where sinews and bones connect; bone remains static while the knee moves. Movement allows change, whereas stillness does not. What cannot change wastes away, while what can change swells. Although the disease originates from Kidney Essence deficiency, treatment must absolutely not focus solely on the Kidneys, because the pathogen involved is Dampness. Dampness is a Yin pathogen; Yin pathogens must be dispelled by Yang Qi. Kidney Essence is Yin Water. Tonifying Essence makes Essence abundant; Yin combines with Yin, leaving no opportunity for struggle. Without struggle, how can the pathogen be expelled? Therefore, one should not tonify Essence but rather tonify Qi. Prescribe Zhengxi Tang (Decoction for Steaming the Knees):
Sheng Huang Qi (Radix Astragali, 8 liang), Jin Chai Shi Hu (Caulis Dendrobii Nobiles, 2 liang), Yi Yi Ren (Semen Coicis, 2 liang), Rou Gui (Cortex Cinnamomi, 3 qian). Decoct in water to yield two bowls. Drink one bowl first, then cover oneself with blankets and lie down. When one feels the urge to sweat, drink the second bowl. Both feet will become hot as fire. Strictly avoid sitting up; allow sweating to proceed until sweat flows out below the Yongquan point (KI-1). Only then may the blankets be slowly removed; otherwise, under no circumstances should they be removed. One dose eliminates most of the disease; a second dose cures it completely.
This formula tonifies Qi somewhat aggressively. However, if Qi is not vigorous, it cannot circulate throughout the body. Even with herbs that promote diuresis and strengthen the knees, they ultimately cannot penetrate the site invaded by the pathogen to expel it. Merely greatly tonifying Qi without adding the acrid-warm nature of Rou Gui means Cold-Dampness wrapped around the knee cannot break through to the marrow to induce profuse sweating. As for not treating Wind at all, it is because there is no Wind pathogen originally. If treated as Wind, Qi is further depleted, making efficacy impossible.
For this condition, Jiawei Guizhi Tang (Modified Cinnamon Twig Decoction) is also excellent.
Huang Qi (Radix Astragali, 3 liang), Rou Gui (Cortex Cinnamomi, 3 qian), Po Gu Zhi (Fructus Psoraleae, 2 qian), Niu Xi (Radix Achyranthis Bidentatae, 3 qian). Decoct in water and take orally. Profuse sweating like rain will occur after administration; two doses result in cure.

There are two types of Crane’s Knee Wind: one originates from Water-Dampness invading the bone, and the other from Wind-Dampness invading the bone. Chen Shiduo here only discusses Water-Dampness invading the bone, omitting Wind-Dampness invading the bone. Generally, in Water-Dampness diseases, the bones feel heavy and difficult to move; in Wind-Dampness conditions, the bones feel light and mobile. The soreness and pain are similar in both. However, there are subtle differences in pain: Water-Dampness pain is fixed in one location and does not migrate, whereas Wind-Dampness pain migrates without a fixed position. Treatment should not merely address Wind-Dampness; use Sanxi Tang (Decoction for Scattering the Knees).
Huang Qi (Radix Astragali, 5 liang), Fang Feng (Radix Saposhnikoviae, 3 qian), Rou Gui (Cortex Cinnamomi, 5 qian), Fu Ling (Poria, 1 liang). Decoct in water and take orally. After ingestion, cover oneself with blankets and lie down, allowing sweat to occur without panic. The more sweat produced, the faster the disease resolves.
Huang Qi traditionally has an antagonistic relationship with Fang Feng, yet combining them enhances efficacy. I frequently use Huang Qi, worrying that patients may find it hard to tolerate; adding Fang Feng allows it to move Qi within the context of tonifying the Middle Jiao. With the acrid-dispersing property of Rou Gui, Yang Qi is guided to reach the deepest Yin levels. Together with Fu Ling entering the Bladder, Water-Dampness pathogens are drained. Attacking internally and externally simultaneously—draining water internally and inducing sweating externally—how could Wind-Dampness fail to resolve? Although profuse sweating might cause fear of Yang Collapse (Wang Yang), using dispersing herbs to induce sweating might be concerning. Here, however, we use Huang Qi to tonify Qi to induce sweating; this releases Pathogenic Sweat (Xie Han) rather than damaging Healthy Sweat (Zheng Han). Pathogenic Sweat can lead to Yang collapse, but Healthy Sweat actually benefits Yang. Thus, full efficacy is achieved in two doses.
For this condition, Yishu Fangsang Tang (Coix Seed, Atractylodes, Saposhnikovia, and Mulberry Leaf Decoction) is also effective.
Fang Feng (Radix Saposhnikoviae, 3 qian), Sang Ye (Folium Mori, 2 liang), Chen Pi (Pericarpium Citri Reticulatae, 1 qian), Po Gu Zhi (Fructus Psoraleae, 2 qian), Yi Yi Ren (Semen Coicis, 1 liang), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1 liang). Decoct in water and take orally. Profuse sweating must occur for recovery; only one dose is needed.