眼胞属脾，脾气呆钝，湿痰浊气上升，滞于膜里，眼胞痰瘤数年，日渐肿大下垂，将来
定须外溃，宜和荣化痰泄浊。
川芎 当归 南星 桃仁 清半夏 僵蚕 茯苓 陈皮 海藻 大贝 元参 姜
痰瘤渐松，前方加白芥子、毛茨菇、荸荠。
脾肚发外，溃烂势大，当以托里。
当归 甘草 连翘 银花 大贝 花粉 黄 赤芍 陈皮 绿豆
脉来左部细弦，右部沉涩，荣血不足，肝气不强，脾气不利，气血与汁沫凝结肠外，结
为肠覃，状如怀子。幸月事仍以时来，法宜养荣，兼流气化凝治之。
淮牛膝 丹参 川楝子 桃仁 青皮 上肉桂 当归 乌药 香附 延胡 瓦楞子 降香片
胃脘痈硬于右，呼吸转侧不能已，半月余，势将外溃，宜理气化痰。
炙甲片 制半夏 延胡 赤芍 生首乌 白茯苓 陈皮 青皮
舌根痈硬痛，大便闭，通降法。
生军 牛蒡子 姜蚕 赤勺 连翘 橘红 风化硝 元参 薄荷 竹叶
鹤膝风肿痛稍减，宗原治法。
当归 没药 川黄柏 桂枝 淮牛膝 苡米 五加皮 独活 丝瓜络 苍术 川萆 茄皮 桑枝
鹤膝风症，前贤以足三阴亏损，风寒湿三气袭于经隧，其治皆以辛温开发，宣通经络。
予谓又有不然。若肝肾阴亏，夹湿热者，岂可以辛温例治，如的系三气杂成，宗右法。又有
湿痹一症，与鹤膝风相似，不可不明辨也。痹则两膝肿痛，或足踝不肿，虽三月五月之久而
腿肉不消，筋脉不拘，鹤膝则二月后大肉枯细，屈不能伸，以此为辨。而治法亦殊。痹症
属实，鹤膝夹虚，有单有双，如肝肾阴亏，阳明湿热下注，膝肿热痛。若进辛温，是助其热，亏
其阴，必致肿溃为败症。始宜通络利湿，继以养阴清络。若初起肿痛，按之不热，虽寒热者
以万灵丹汗之，用独活渗湿汤、防己桂枝汤。日久腿足枯细者，古之大防风汤、胜骏丸、三
痹汤等方选用。脉见细数，虽风寒湿之症，过饵温热，恐湿寒化热，亦致酿脓。凭脉用药，认
症分湿与热，最为的当。至外治者诸方，详载于后。
一方通络利湿汤 治鹤膝肿热作痛。
大豆卷 防己 赤芍 秦艽 川牛膝 川萆 干地龙 归须 黄柏 白茄根 桑枝
二方养阴清络饮 治鹤膝肿热日久，夜分痛甚者。
炙鳖甲 秦艽 黄柏 炙龟板 地龙 川石斛 独活 赤芍 川牛膝 当归 川萆 苡米仁 桑枝
三方独活汤 治鹤膝风因风寒湿。初起肿痛寒热者。
独活 防风 苍术 黄柏 当归 秦艽 防己 萆 赤芍 川牛膝
四方防己桂枝汤 治寒湿鹤膝初起，肿痛无热者。
桂枝 川萆 独活 秦艽 川牛膝 白茄根 木防己 赤芍 苍术 炙没药 全当归 炒桑枝
五方防风汤 治三阴不足，风邪乘之，两膝作痛，膝肿而腿细。
潞党参 黄 熟地 木防风 怀牛膝 熟附子 甘草 羌活 川芎 生白术 全当归 川杜仲 桑枝
六方独活寄生汤 治肝肾虚，风湿入络，足膝掣痛痹。
独活 云茯苓 防风 大生地 桑寄生 细辛 秦艽 川芎 大白芍 桂心 人参 杜仲 当归 怀牛膝 生甘草
七方三因胜骏丸 治鹤膝风，膝肿腿细，手足寒挛，走注疼痛，三阴不足，寒湿气侵者。
熟地 附片 当归 苁蓉 破故纸 苍术 全蝎 槟榔 怀牛膝 萆 乳香 木香 射干 炙没药
木瓜 防风 天麻 枣仁 川羌活 巴戟肉
上药为末，烂蜜法丸。
八方三痹汤 治寒湿痛痹，膝踝肿胀，三阴不足。
川芎 当归 白芍 生地 防风 秦艽 黄 茯苓 炙甘草 牛膝 独活 川杜仲 桂心 细辛 羌活
续断 党参
九方史国公药酒 治手足拘掣，半身不遂，或腿膝痹痛，鹤膝等症。养血祛风，壮骨，健脾渗湿。
羌活（二两） 防风（二两） 白术（二两） 当归（二两） 川萆 （二两） 杜仲（二两） 松节
（二两） 虎骨（二两） 杞子（二两） 蚕沙（二两） 秦艽（四两） 鳖甲（二两） 茄根（八两）
苍耳（四两） 川牛膝（二两）
上药用好陈酒三十斤煮服。
外治丹散
洪宝丹 治膝盖肿痛而热，皮色不变，用葱汤调敷。
地骨皮散 治鹤膝肿热痛甚者，用车前子草打汁调敷。
冲和膏 治膝肿而潮热者，用醋调敷。
鹤膝散 治鹤膝因受风湿肿者。
白芷（四两） 陈酒（二十两）
煎稠去渣，以笔醮酒涂。
香桂散 此散治一切风寒湿气，筋骨疼痛。温经通络，掺膏药上贴之。
生附子（二钱） 麝香（二分） 川乌（二钱） 细辛（二钱） 木香（二钱） 炙没药（二钱）
肉桂（二钱） 草乌（二钱） 丁香（二钱） 樟冰（二钱）
共为细末，随症听用。
The eyelids (eyelid) belong to the Spleen. If the Spleen Qi is sluggish and dull, damp-phlegm and turbid qi ascend, stagnating in the membrane spaces, causing phlegm tumors in the eyelids for several years. These gradually enlarge and droop, and will inevitably ulcerate externally in the future. It is appropriate to harmonize Ying (Nutritive) blood, resolve phlegm, and drain turbidity.
Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Pinelliae Tuber Preparatum (Nanxing), Peach Kernel (Taoren), Pinelliae Tuber Preparatum (Qingbanxia), Bombyx Batryticatus (Jiangcan), Poria (Fuling), Citrus Reticulata Pericarpium (Chenpi), Sargassum (Haizao), Fritillariae Bulbus (Dabei), Scrophulariae Radix (Yuan Shen), Fresh Ginger (Sheng Jiang).
As the phlegm tumor gradually loosens, add White Mustard Seed (Baijiezi), Smilax Glabra Rhizome (Mao Cigu), and Dioscorea esculenta Tuber (Biqi) to the previous prescription.
Abdominal distension resembling a spleen (Spleen Belly) erupts externally with severe ulceration; one should employ methods to support the interior and expel pus.
Angelicae Sinensis Radix (Danggui), Licorice Root (Gancao), Forsythiae Fructus (Lianqiao), Lonicerae Japonicae Flos (Yinhua), Fritillariae Bulbus (Dabei), Trichosanthis Radix (Huafen), Astragali Radix (Huang), Red Peony Root (Chishao), Citrus Reticulata Pericarpium (Chenpi), Mung Bean (Lv Dou).
The pulse is fine and wiry on the left side, and deep and choppy on the right side. Ying blood is insufficient, Liver Qi is weak, and Spleen Qi is obstructed. Qi and blood condense with fluid foam outside the intestines, forming a mass known as Changtan (intestinal polyp/tumor), resembling pregnancy. Fortunately, menstruation still occurs on time. The treatment method should nourish Ying blood while promoting Qi movement to resolve stagnation.
Achyranthes Bidentatae Radix (Huainiuxi), Salviae Miltiorrhizae Radix (Danshen), Toosendan Fructus (Chuanlianzi), Peach Kernel (Taoren), Green Tangerine Peel (Qingpi), Cinnamon Bark (Shang Rougui), Angelicae Sinensis Radix (Danggui), Linderae Radix (Wuyao), Cyperi Rhizoma (Xiangfu), Corydalis Rhizoma (Yanhu), Arca Shell (Walengzi), Aquilaria Lignum Resinatum (Xiangjiang Pian).
An abscess in the epigastrium is hard on the right side, causing pain during respiration and turning of the body, persisting for over half a month, and is likely to ulcerate externally. Regulating Qi and resolving phlegm is indicated.
Prepared Pangolin Scales (Zhijia Pian), Prepared Pinelliae Tuber (Zhibanxia), Corydalis Rhizoma (Yanhu), Red Peony Root (Chishao), Polygoni Multiflori Preparati Radix (Sheng Shouwu), Poria (Baifuling), Citrus Reticulata Pericarpium (Chenpi), Green Tangerine Peel (Qingpi).
An abscess at the root of the tongue is hard and painful, accompanied by constipation. A descending and unblocking method is used.
Rhubarb Root and Rhizome (Sheng Jun), Achyranthes Bidentatae Radix (Niubangzi), Bombyx Batryticatus (Jiangcan), Red Peony Root (Chishao), Forsythiae Fructus (Lianqiao), Tangerine Peel (Juhong), Efflorescence of Natrii Sulfas (Fenghua Xiao), Scrophulariae Radix (Yuan Shen), Mentha Haplocalyx (Bohe), Bamboo Leaves (Zhuye).
Swelling and pain from Elephant Foot Disease (He Xi Feng) have slightly decreased. Follow the original treatment method.
Angelicae Sinensis Radix (Danggui), Myrrha (Moyao), Phellodendri Cortex (Chuan Huangbai), Cinnamon Twig (Guizhi), Achyranthes Bidentatae Radix (Huainiuxi), Coix Seed (Yimi), Eucommiae Cortex (Wujia Pi), Angelicae Pubescentis Radix (Duhuo), Luffa Fruit Fiber (Sigualuo), Atractylodis Macrocephalae Rhizome (Cangzhu), Dioscoreae Hypoglaucae Rhizoma (Chuan Bi), Eggplant Skin (Qiepi), Mulberry Twig (Sangzhi).
Regarding Elephant Foot Disease (He Xi Feng), ancient sages believed it was caused by deficiency of the three Yin meridians of the foot, with wind-cold-dampness invading the collaterals. Their treatments all focused on acrid-warm dispersal to unblock the meridians.
I hold a different view. If there is Liver-Kidney Yin deficiency complicated by damp-heat, can one simply use acrid-warm methods? If it is indeed caused by the mixture of wind-cold-dampness, follow the method described above. Additionally, there is a condition called Damp Bi Syndrome, which resembles Elephant Foot Disease and must be clearly distinguished. Damp Bi presents with swelling and pain in both knees, or non-swollen ankles. Even after months, the thigh muscles do not waste, and tendons are not contracted. In contrast, Elephant Foot Disease shows significant wasting of the thigh muscles after two months, with inability to extend the knee. This is the basis for differentiation, and their treatments differ significantly. Damp Bi is an excess syndrome, whereas Elephant Foot Disease involves deficiency. It can be unilateral or bilateral. If Liver-Kidney Yin deficiency leads to damp-heat pouring downward into the Yangming meridian, causing swollen, hot, and painful knees, using acrid-warm herbs would exacerbate heat and damage Yin, leading to ulceration and failure. Initially, one should unblock collaterals and promote diuresis to remove dampness, followed by nourishing Yin and clearing collaterals. If swelling and pain occur initially without heat upon pressure, even with chills and fever, Wan Ling Dan can be used to induce sweating, along with Duhuo Shen Shi Tang or Fangji Guizhi Tang. For cases where legs and feet become emaciated over time, ancient formulas such as Da Fangfeng Tang, Shengjun Wan, or Sanbi Tang may be selected. If the pulse is fine and rapid, although the condition is wind-cold-damp, excessive use of warm-hot herbs may transform cold-damp into heat, potentially leading to suppuration. Medication based on pulse diagnosis and accurate symptom differentiation between damp and heat is most appropriate. External treatment formulas are detailed below.
Formula 1: Tongluo Lishi Tang (Unblock Collaterals and Drain Dampness Decoction), treating Elephant Foot Disease with swelling, heat, and pain.
Sojae Semen Praeparatum (Dayanjiao), Stephaniae Tetrandrae Radix (Fangji), Red Peony Root (Chishao), Gentianae Macrophyllae Radix (Qinjiao), Cyathulae Officinalis Radix (Chuan Niuxi), Dioscoreae Hypoglaucae Rhizoma (Chuan Bi), Pheretima (Gan Dilong), Radix Angelicae Sinensis Caulis (Guixu), Phellodendri Cortex (Huangbai), Solani Tuberosi Radix (Bai Qiegen), Mulberry Twig (Sangzhi).
Formula 2: Yangyin Qingluo Yin (Nourish Yin and Clear Collaterals Infusion), treating Elephant Foot Disease with prolonged swelling, heat, and severe pain at night.
Testudinis et Testudin Carapax et Plastrum Zhitianjia, Gentianae Macrophyllae Radix (Qinjiao), Phellodendri Cortex (Huangbai), Chelonis Carapax et Plastrum Zhiguiban, Pheretima (Dilong), Dendrobii Caulis (Chuanshihu), Angelicae Pubescentis Radix (Duhuo), Red Peony Root (Chishao), Cyathulae Officinalis Radix (Chuan Niuxi), Angelicae Sinensis Radix (Danggui), Dioscoreae Hypoglaucae Rhizoma (Chuan Bi), Coix Seed (Yimi), Mulberry Twig (Sangzhi).
Formula 3: Duhuo Tang (Angelica Pubescens Decoction), treating Elephant Foot Disease caused by wind-cold-dampness, presenting with initial swelling, pain, and chills/fever.
Angelicae Pubescentis Radix (Duhuo), Saposhnikoviae Radix (Fangfeng), Atractylodis Rhizome (Cangzhu), Phellodendri Cortex (Huangbai), Angelicae Sinensis Radix (Danggui), Gentianae Macrophyllae Radix (Qinjiao), Stephaniae Tetrandrae Radix (Fangji), Dioscoreae Hypoglaucae Rhizoma (Bi Xie), Red Peony Root (Chishao), Cyathulae Officinalis Radix (Chuan Niuxi).
Formula 4: Fangji Guizhi Tang (Stephania and Cinnamon Twig Decoction), treating early-stage cold-damp Elephant Foot Disease with swelling and pain but no heat.
Cinnamon Twig (Guizhi), Dioscoreae Hypoglaucae Rhizoma (Chuan Bi), Angelicae Pubescentis Radix (Duhuo), Gentianae Macrophyllae Radix (Qinjiao), Cyathulae Officinalis Radix (Chuan Niuxi), Solani Tuberosi Radix (Bai Qiegen), Aristolochiae Radix (Mufangji), Red Peony Root (Chishao), Atractylodis Rhizome (Cangzhu), Myrrha Zhituoyao, Whole Angelicae Sinensis Radix (Quandanggui), Fried Mulberry Twig (Chaosangzhi).
Formula 5: Fangfeng Tang (Saposhnikovia Decoction), treating insufficiency of the three Yin meridians with wind pathogen invasion, causing knee pain, knee swelling, and thin legs.
Codonopsis Radix (Ludangshen), Astragali Radix (Huang), Prepared Rehmanniae Radix (Shudi), Saposhnikoviae Radix (Mufangfeng), Huai Achyranthes Radix (Huainiuxi), Prepared Aconiti Lateralis Radix (Shufuzi), Licorice Root (Gancao), Notopterygii Rhizoma et Radix (Qianghuo), Chuanxiong Rhizome (Chuanxiong), Atractylodis Macrocephalae Rhizome (Sheng Baizhu), Whole Angelicae Sinensis Radix (Quandanggui), Eucommiae Cortex (Chuan Duzhong), Mulberry Twig (Sangzhi).
Formula 6: Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction), treating Liver-Kidney deficiency with wind-damp invading collaterals, causing pulling pain and bi syndrome in feet and knees.
Angelicae Pubescentis Radix (Duhuo), Cloud Poria (Yun Fuling), Saposhnikoviae Radix (Fangfeng), Large Rehmanniae Radix (Da Shengdi), Taxilli Herba (Sangjisheng), Asari Radix et Rhizoma (Xixin), Gentianae Macrophyllae Radix (Qinjiao), Chuanxiong Rhizome (Chuanxiong), Large White Peony Root (Da Baishao), Cinnamon Heart (Guixin), Ginseng Radix (Renshen), Eucommiae Cortex (Duzhong), Angelicae Sinensis Radix (Danggui), Huai Achyranthes Radix (Huainiuxi), Raw Licorice Root (Sheng Gancao).
Formula 7: San Yin Shengjun Wan (Three Causes Victory Pill), treating Elephant Foot Disease with knee swelling and thin legs, cold and contracted hands and feet, migrating pain, insufficiency of the three Yin meridians, and invasion of cold-dampness.
Prepared Rehmanniae Radix (Shudi), Prepared Aconite Slice (Fupian), Angelicae Sinensis Radix (Danggui), Cynomorii Fructus (Congrong), Psoraleae Fructus (Poguzhi), Atractylodis Rhizome (Cangzhu), Whole Scorpion (Quanxie), Areca Seed (Binglang), Huai Achyranthes Radix (Huainiuxi), Dioscoreae Hypoglaucae Rhizoma (Bixie), Frankincense (Ruxiang), Aquilaria Wood (Muxiang), Belamcanda Rhizome (Shegan), Myrrha Zhituoyao, Papaw Fruit (Mugua), Saposhnikoviae Radix (Fangfeng), Gastrodia Rhizome (Tianma), Ziziphus Seed (Zaoren), Chuanxiong Rhizome (Chuan Qianghuo), Morinda Officinalis Root Bark (Bajirou).
Grind the above herbs into powder and make pills with thick honey.
Formula 8: Sanbi Tang (Three Obstructions Decoction), treating cold-damp painful bi syndrome with knee and ankle swelling, and insufficiency of the three Yin meridians.
Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), White Peony Root (Baishao), Rehmanniae Radix (Shengdi), Saposhnikoviae Radix (Fangfeng), Gentianae Macrophyllae Radix (Qinjiao), Astragali Radix (Huang), Poria (Fuling), Prepared Licorice Root (Zhigancao), Achyranthes Radix (Niuxi), Angelicae Pubescentis Radix (Duhuo), Eucommiae Cortex (Chuan Duzhong), Cinnamon Heart (Guixin), Asari Radix et Rhizoma (Xixin), Notopterygii Rhizoma et Radix (Qianghuo), Dipsacus Radix (Xuduan), Codonopsis Radix (Dangshen).
Formula 9: Shi Guogong Yao Jiu (Minister Shi’s Medicinal Wine), treating hand and foot contraction, hemiplegia, leg and knee bi pain, Elephant Foot Disease, etc. It nourishes blood, dispels wind, strengthens bones, and strengthens the spleen to drain dampness.
Notopterygii Rhizoma et Radix (Qianghuo, 2 liang), Saposhnikoviae Radix (Fangfeng, 2 liang), Atractylodis Macrocephalae Rhizome (Baizhu, 2 liang), Angelicae Sinensis Radix (Danggui, 2 liang), Dioscoreae Hypoglaucae Rhizoma (Chuan Bi, 2 liang), Eucommiae Cortex (Duzhong, 2 liang), Pine Joint (Songjie, 2 liang), Tiger Bone (Hugu, 2 liang), Lycii Fructus (Qizi, 2 liang), Bombyx Faeces (Cansha, 2 liang), Gentianae Macrophyllae Radix (Qinjiao, 4 liang), Testudinis et Testudin Carapax et Plastrum (Biejia, 2 liang), Eggplant Root (Qiegen, 8 liang), Xanthii Fructus (Canger, 4 liang), Cyathulae Officinalis Radix (Chuan Niuxi, 2 liang).
Decoct the above herbs in 30 jin of aged wine and consume.
External Treatments:
Hongbao Dan (Red Treasure Powder), treating knee swelling and pain with heat but unchanged skin color. Mix with green onion decoction for topical application.
Digupi San (Ground Tree Bark Powder), treating severe swelling, heat, and pain in Elephant Foot Disease. Mix with juice from Plantago asiatica herb (Cheqianzi Cao) for topical application.
Chonghe Gao (Harmony Ointment), treating knee swelling with tidal fever. Mix with vinegar for topical application.
Hexi San (Elephant Knee Powder), treating Elephant Foot Disease caused by wind-dampness swelling.
Angelica Dahurica Root (Baizhi, 4 liang), Aged Wine (Chenjio, 20 liang).
Boil until thick, strain, and apply with a brush dipped in the liquid.
Xianggui San (Fragrant Cinnamon Powder), this powder treats bone and joint pain caused by all types of wind-cold-dampness. It warms meridians and unblocks collaterals; sprinkle onto plasters for application.
Prepared Aconite Root (Sheng Fuzi, 2 qian), Moschus (Shexiang, 2 fen), Aconitum Kusnezoffii Root (Chuanwu, 2 qian), Asari Radix et Rhizoma (Xixin, 2 qian), Aquilaria Wood (Muxiang, 2 qian), Myrrha Zhituoyao (Zhi Moyao, 2 qian), Cinnamon Bark (Rougui, 2 qian), Aconitum Carmichaelii Root (Caowu, 2 qian), Clove (Dingxiang, 2 qian), Camphor (Zhangbing, 2 qian).
Grind into fine powder and use according to symptoms.