脉∶痛风沉弦，肝肾被湿；少阴弱浮，风血掣急；或涩而小，酒后风袭；风寒湿气，合而为痹，浮涩而紧，
三脉乃备。
痛风者，遍身骨节走注疼痛也。谓之白虎历节风，都是血气、风湿、痰火，皆令作痛。或劳力，寒水相搏；
或酒色醉卧，当风取凉；或卧卑湿之地；或雨、汗湿衣蒸体而成。痛风在上者，多属风；在下者，多属湿。治
用活血疏风、消痰去湿，羌活汤加减。凡治痛风，用苍术、羌活、酒芩三味散风行湿之妙药耳。
遍身骨节疼痛者，皆是血气、风湿、痰火也。
羌活汤 治痛风症。
羌活 苍术（米泔浸） 黄芩（酒炒） 当归 芍药（炒） 茯苓（去皮） 半夏（姜汁炒） 香附（各一
钱半） 木香（另研） 陈皮（各七分） 甘草（三分）
上锉一剂，姜三片，水煎服。风痛加防风；湿痛加苍术；热痰痛倍酒芩、栝蒌、枳实、竹沥；血虚痛加生
地黄；上痛加白芷、威灵仙；下痛加黄柏、牛膝；痛甚加乳香；发热加柴胡；小水短涩加木通，手臂痛加薄桂。
凡骨节疼痛，
如寒热发肿块者，是湿痰流注经络，与痛风同治法。若医迟不散，则成脓矣，外用敷药。一切痛风，肢节痛者，
痛属火，肿属湿，不可食肉。肉属阳火，能助火，食则下有遗溺，内有痞块，虽油炒热物鱼面，切以戒之。所
以膏粱之人，多食煎炒、炙爆、酒肉热物蒸脏腑，所以，患痛风、恶毒、痈疽者最多。肥人多是湿痰，瘦人多是
痰火。
遍身壮热、骨节疼痛者，是风寒也。
解表升麻汤 治遍身壮热、骨节疼痛。
柴胡 升麻 本 羌活 防风 麻黄 苍术 陈皮 甘草 当归
上锉一剂，姜葱水煎，热服，出微汗。
遍身疼痛属虚寒者，宜温散也。
加味五积散 治四肢骨节痛，因虚寒者宜之。
当归 川芎 白芍（酒炒） 陈皮 半夏（姜炒） 苍术（米泔浸） 茯苓（去皮） 浓朴（姜汁炒）
羌活 独活 枳壳（麸炒） 桔梗 白芷（各八分） 干姜 肉桂 麻黄 甘草（各五分） 穿山甲（随所痛取
甲，烧灰一钱）
上锉一剂，生姜三片、枣一枚、麝香少许，水煎温服。
乳香定痛丸 治诸风，遍身骨节疼痛，或腿膝痛及筋骨风。
苍术（米泔浸，二两） 川乌（泡去皮） 当归 川芎（各一两） 乳香 没药（各三钱） 丁香（五分）
上为细末，枣肉为丸，如梧桐子大。每服五六十丸，黄酒送下。
遍身疼痛属湿痰者，宜除湿化痰也。
清湿化痰汤 治周身、四肢骨节走注疼痛，牵引胸背，亦作寒热喘咳烦闷，或作肿块，痛难转侧，或四
肢麻痹不仁，
或背心一点如冰冷，脉滑，乃是湿痰流注经络关节不利故也。
南星（姜制） 半夏（姜制） 陈皮 茯苓（去皮） 苍术（米泔浸） 羌活 片芩（酒炒） 白芷
白芥子（各一钱） 甘草（三分） 木香（五分，另研）
上锉一剂，入竹沥、姜汁同服。骨体痛甚及有肿块作痛者，名曰痰块，加乳香、没药、海石、朴硝；头项
痛加川芎、威灵仙；手臂痛加薄桂，引南星等药至痛处；脚痛加牛膝、黄柏、防己、龙胆草、木瓜。
遍身走痛，日轻夜重者，是血虚也。
硫经活血汤 治遍身走痛如刺，左足痛尤甚。左属血，多因酒色损伤，筋脉虚空，被风寒湿热感于内，
热包于寒，则痛伤筋络，是以昼轻夜重。宜以疏经活血行湿。此非白虎历节风也。
当归（酒洗，一钱二分） 白芍（酒炒，钱半） 生地（酒洗） 苍术（米泔浸） 牛膝（去芦，酒洗）
陈皮（去白） 桃仁（去皮，煎炒） 威灵仙（酒洗，各一钱） 川芎草（六分） 汉防己（酒洗） 羌活
防风（去芦） 白芷（各六分） 龙胆草（六分） 茯苓（去皮，七分） 甘草（四分）
上锉一剂，生姜三片，水煎，空心温服。忌生冷湿物。有痰加南星、半夏各一钱；如身上及臂痛加薄桂三
分；如下体并足痛加木瓜、木通。盐炒黄柏、薏苡仁各一钱；如气虚加人参、白术、龟板各七分；如血虚倍四
物汤，以姜汁酒浸炒，用红花一钱。
肢节肿痛者，肿是湿、痛是火也。
灵仙除痛饮 治诸节肿痛，痛属火、肿属湿，兼受风寒而发动于经络之中，湿热流注于肢节之间而无
已也。
麻黄 赤芍（各一钱） 防风 荆芥 羌活 独活 白芷 苍术 威灵仙 片黄芩 枳实 桔梗 葛根
川芎（各五钱） 归尾 升麻 甘草（各三分）
上锉一剂，水煎服。在下焦加酒炒黄柏；妇人加红花；肿多加槟榔、大腹皮、泽泻、没药。一云脉涩数者，
有瘀血，宜桃仁、红花、芍、归及酒大黄微利之。
四肢百节痛如虎咬者，名白虎历节风也。
舒筋立安散 治四肢百节疼痛。
防风 羌活 独活 茯苓（去皮） 川芎 白芷 生地 苍术（米泔浸） 红花 桃仁（去皮）
南星（姜炒） 陈皮 半夏（姜炒） 白芍（去芦） 威灵仙 牛膝（去芦） 木瓜 防己 酒芩 连翘 木通
龙胆草 附子（少许） 甘草
上锉剂，水煎，入姜汁、竹沥。腹痛甚加乳香、没药为末调服。
独活寄生汤 治白虎历节风神效。（方见中湿门。）
两手疼痛、麻痹者，是风痰也。治两手疼痛麻木∶当归 川芎 白芷 片芩（酒炒） 黄连 羌活 苍术
（米泔制） 防风 桔梗 南星（姜制） 半夏（姜汁炒） 桂枝 甘草
上锉，生姜煎服。
两足疼痛麻木者，是湿热也。治两足疼痛麻木∶当归 白芍（酒炒） 白术（去芦） 苍术（米泔浸）
半夏（姜炒） 陈皮 茯苓（去皮） 黄柏（酒炒） 威灵仙 川牛膝（去芦酒洗） 桃仁（去皮） 红花 甘草
上锉剂，生姜五片，水煎，入竹沥服。
加味二妙丸 治两足麻木疼痛，如火之热。（方见香港脚。）
一切筋骨疼痛者，宜外贴也。
神应膏 治骨节疼痛。
乳香 没药（各一两为末） 皮胶（三两） 生姜（二斤，取自然汁） 先将生姜汁以砂锅内煎数沸，入
皮胶化开，将锅取下坐灰上，方入乳、没末，搅匀成膏。用不见烟的狗皮摊膏药，贴患处。仍用鞋底炙热，时
时在膏药上运动熨之神效。勿犯铁器。
一妇人，遍身作痛，筋骨尤甚，不能屈伸，口干目赤头眩，痰壅胸膈不利，小便赤短，夜间殊甚，遍身作
痒如虫行，此属肝肾气虚而热也。用六味丸料加山栀、柴胡而愈。（方见补益。）
一风湿相搏，一身尽痛者，补中益气汤加羌活、升麻、防风、 本、苍术治之。如病去再服，以消风药损
人元气而益其病也。（方见补益。）
太仆睛岩张公，每患天阴则遍身痛如锥刺，已经数年。予诊左脉微数，右脉洪数，乃血虚有湿热也。以当
归拈痛汤加生地黄、白芍、黄柏，去人参，数剂而痊。
脉象：痛风脉象沉弦，是肝肾被湿邪所困；少阴脉弱而浮，是风邪与血虚导致筋脉拘急抽搐；或者脉涩且小，多见于酒后受风侵袭。风寒湿三气，合而为痹证，若见浮、涩、紧三种脉象，则痛风的脉象特征便完备了。
所谓痛风，是指全身骨节游走性疼痛。称为白虎历节风，其病因都是由于气血失调、风湿侵袭、痰火内蕴，从而导致疼痛。或因劳累用力，寒水之气相搏结；或因饮酒纵欲后醉卧，迎风取凉；或睡在低洼潮湿之地；或因雨淋、汗湿衣物蒸熏身体而形成。痛风病位在上部的，多属于风邪致病；在下部的，多属于湿邪致病。治疗应采用活血疏风、消痰去湿的方法，用羌活汤加减。凡治疗痛风，主要使用苍术、羌活、酒炒黄芩这三味药，它们是疏散风邪、祛除湿气的妙药。
羌活汤：治疗痛风症。
组成：羌活、苍术（米泔水浸泡）、黄芩（酒炒）、当归、芍药（炒）、茯苓（去皮）、半夏（姜汁炒）、香附（各一钱半）、木香（另研细末）、陈皮（各七分）、甘草（三分）。
用法：以上药材锉碎为一剂，加生姜三片，水煎服。风痛明显者加防风；湿痛明显者加苍术；热痰痛者加倍使用酒炒黄芩，并加栝蒌、枳实、竹沥；血虚痛者加生地黄；上部疼痛加白芷、威灵仙；下部疼痛加黄柏、牛膝；疼痛剧烈者加乳香；发热者加柴胡；小便短赤涩痛者加木通；手臂疼痛加薄桂（肉桂的一种）。
凡是骨节疼痛，伴有寒热发作及肿块形成的，这是湿痰流注于经络，与痛风采用相同的治疗方法。如果医生延误治疗，肿块不散，就会化脓，此时应外用敷药。所有痛风引起的肢节疼痛，痛属火邪，肿属湿邪，不可食用肉类。肉属阳火，能助长火邪，吃了会导致下焦遗尿，体内形成痞块。即使是经过油炒的热物、鱼面等，也必须严格禁忌。因此，饮食膏粱厚味的人，多吃煎炒、炙爆、酒肉等热物，会蒸熏脏腑，所以患痛风、恶毒疮疡、痈疽的人最多。肥胖之人多患湿痰，消瘦之人多患痰火。
解表升麻汤：治疗全身壮热、骨节疼痛。
组成：柴胡、升麻、藁本、羌活、防风、麻黄、苍术、陈皮、甘草、当归。
用法：以上药材锉碎为一剂，加生姜、葱白，水煎，趁热服用，以微微出汗为度。
加味五积散：治疗四肢骨节疼痛，因虚寒所致者适宜使用。
组成：当归、川芎、白芍（酒炒）、陈皮、半夏（姜炒）、苍术（米泔水浸泡）、茯苓（去皮）、浓朴（姜汁炒）、羌活、独活、枳壳（麸炒）、桔梗、白芷（各八分）、干姜、肉桂、麻黄、甘草（各五分）、穿山甲（根据疼痛部位选取甲片，烧成灰一钱）。
用法：以上药材锉碎为一剂，加生姜三片、大枣一枚、少许麝香，水煎，温服。
乳香定痛丸：治疗各种风邪引起的全身骨节疼痛，或腿膝疼痛及筋骨风痛。
组成：苍术（米泔水浸泡，二两）、川乌（炮制去皮）、当归、川芎（各一两）、乳香、没药（各三钱）、丁香（五分）。
用法：以上药材研为细末，用枣肉制成丸药，如梧桐子大小。每次服用五六十丸，用黄酒送服。
清湿化痰汤：治疗周身、四肢骨节游走性疼痛，牵引胸背，也出现寒热、喘咳、烦闷，或形成肿块，疼痛难以转侧，或四肢麻木不仁，或背心一点感觉像冰冷一样，脉滑，这是由于湿痰流注经络关节不利所致。
组成：南星（姜制）、半夏（姜制）、陈皮、茯苓（去皮）、苍术（米泔水浸泡）、羌活、片芩（酒炒）、白芷、白芥子（各一钱）、甘草（三分）、木香（五分，另研细末）。
用法：以上药材锉碎为一剂，加入竹沥、姜汁同服。骨体疼痛严重及有肿块作痛的，名为痰块，加乳香、没药、海浮石、朴硝；头项疼痛加川芎、威灵仙；手臂疼痛加薄桂，以引导南星等药到达疼痛部位；脚痛加牛膝、黄柏、防己、龙胆草、木瓜。
硫经活血汤：治疗全身游走性疼痛如针刺感，左足疼痛尤为严重。左侧属血，多因酒色损伤，导致筋脉空虚，被风寒湿热之邪内侵，热包于寒中，则损伤筋络而痛，因此白天轻晚上重。宜用疏经活血行湿的方法治疗。这不是白虎历节风。
组成：当归（酒洗，一钱二分）、白芍（酒炒，一钱半）、生地（酒洗）、苍术（米泔水浸泡）、牛膝（去芦头，酒洗）、陈皮（去白）、桃仁（去皮，煎炒）、威灵仙（酒洗，各一钱）、川芎草（六分）、汉防己（酒洗）、羌活、防风（去芦头）、白芷（各六分）、龙胆草（六分）、茯苓（去皮，七分）、甘草（四分）。
用法：以上药材锉碎为一剂，加生姜三片，水煎，空腹温服。忌食生冷湿物。有痰者加南星、半夏各一钱；如身上及手臂疼痛加薄桂三分；如下体及足部疼痛加木瓜、木通、盐炒黄柏、薏苡仁各一钱；如气虚加人参、白术、龟板各七分；如血虚加倍使用四物汤，用姜汁酒浸炒，加红花一钱。
灵仙除痛饮：治疗诸节肿痛，痛属火、肿属湿，兼受风寒而在经络中发动，湿热流注于肢节之间而无休止。
组成：麻黄、赤芍（各一钱）、防风、荆芥、羌活、独活、白芷、苍术、威灵仙、片黄芩、枳实、桔梗、葛根、川芎（各五钱）、归尾、升麻、甘草（各三分）。
用法：以上药材锉碎为一剂，水煎服。病位在下焦的加酒炒黄柏；妇女加红花；肿胀多加槟榔、大腹皮、泽泻、没药。另一种说法认为脉涩数的，有瘀血，宜用桃仁、红花、芍药、当归及酒大黄轻微通便泄下。
舒筋立安散：治疗四肢百节疼痛。
组成：防风、羌活、独活、茯苓（去皮）、川芎、白芷、生地、苍术（米泔水浸泡）、红花、桃仁（去皮）、南星（姜炒）、陈皮、半夏（姜炒）、白芍（去芦头）、威灵仙、牛膝（去芦头）、木瓜、防己、酒芩、连翘、木通、龙胆草、附子（少许）、甘草。
用法：以上药材锉碎为一剂，水煎，加入姜汁、竹沥。腹痛严重者加乳香、没药研末调服。
两手疼痛、麻木的，是风痰所致。治疗两手疼痛麻木：当归、川芎、白芷、片芩（酒炒）、黄连、羌活、苍术（米泔水制）、防风、桔梗、南星（姜制）、半夏（姜汁炒）、桂枝、甘草。
用法：以上药材锉碎，生姜煎服。
两足疼痛、麻木的，是湿热所致。治疗两足疼痛麻木：当归、白芍（酒炒）、白术（去芦头）、苍术（米泔水浸泡）、半夏（姜炒）、陈皮、茯苓（去皮）、黄柏（酒炒）、威灵仙、川牛膝（去芦头酒洗）、桃仁（去皮）、红花、甘草。
用法：以上药材锉碎为一剂，加生姜五片，水煎，加入竹沥服用。
加味二妙丸：治疗两足麻木疼痛，如火灼热般。（方剂见“香港脚”门。）
一切筋骨疼痛者，宜外贴膏药治疗。
神应膏：治疗骨节疼痛。
组成：乳香、没药（各一两研为细末）、皮胶（三两）、生姜（二斤，取自然汁）。
制作与用法：先将生姜汁在砂锅内煎煮数沸，放入皮胶使其溶化，将锅取下放在灰烬上保温，再放入乳香、没药细末，搅拌均匀成膏。用不见烟火的狗皮摊涂膏药，贴于患处。仍需用鞋底烤热，时常在膏药上运动熨烫，效果神奇。切勿接触铁器。
有一位妇人，全身疼痛，筋骨尤其严重，不能屈伸，口干目赤头晕，痰壅胸膈不利，小便赤短，夜间特别严重，全身瘙痒如虫行，这属于肝肾气虚而有热。用六味丸料加山栀、柴胡而痊愈。（方剂见“补益”门。）
一位患者风湿相搏，全身尽痛，用补中益气汤加羌活、升麻、防风、藁本、苍术治疗。如病愈后再服用，是为了消除风药损伤人体元气从而加重病情的弊端。（方剂见“补益”门。）
太仆睛岩张公，每逢天阴就遍身疼痛如锥刺，已经数年。我诊察其左脉微数，右脉洪数，认为是血虚有湿热。用当归拈痛汤加生地黄、白芍、黄柏，去掉人参，服用数剂后痊愈。
Pulse: In gout, a deep and wiry pulse indicates dampness affecting the Liver and Kidney; a weak and floating pulse in the Shaoyin position suggests wind and blood deficiency causing spasms and urgency in the tendons; or a choppy and small pulse, often seen after alcohol consumption with wind invasion. Wind, cold, and dampness combine to form Bi syndrome (painful obstruction); when floating, choppy, and tight pulses are present together, the pulse characteristics of gout are complete.
Gout refers to wandering pain throughout the bone joints. It is also called "White Tiger Arthritis" (Baihu Lijie Feng). The causes include disturbances of Qi and Blood, wind-damp invasion, and phlegm-fire accumulation, all leading to pain. Etiologies include physical exertion combined with cold-water exposure; drunken sleep exposed to wind while cooling off; sleeping in low, damp places; or body steaming from rain and sweat-soaked clothes. Gout located in the upper body is mostly due to wind; in the lower body, it is mostly due to dampness. Treatment involves invigorating blood, dispersing wind, resolving phlegm, and eliminating dampness, using Qianghuo Tang (Notopterygium Decoction) with modifications. Generally, treating gout relies on three excellent herbs for dispersing wind and drying dampness: Cangzhu (Atractylodis Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), and Jiuhuangqin (Scutellariae Radix fried with wine).
Wandering pain in all bone joints is caused by disturbances of Qi and Blood, wind-dampness, and phlegm-fire.
Qianghuo Tang (Notopterygium Decoction): Treats gout symptoms.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Cangzhu (Atractylodis Rhizoma soaked in rice water), Huangqin (Scutellariae Radix fried with wine), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix stir-fried), Fuling (Poria sliced), Banxia (Pinelliae Rhizoma fried with ginger juice), Xiangfu (Cyperi Rhizoma, each 1.5 qian), Muxiang (Aucklandiae Radix, ground separately), Chenpi (Citri Reticulatae Pericarpium, each 0.7 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 0.3 fen).
Usage: Decoct one dose with three slices of fresh ginger in water. For wind-pain, add Fangfeng (Saposhnikoviae Radix); for damp-pain, add Cangzhu; for heat-phlegm pain, double the amount of Jiuhuangqin and add Gualou (Trichosanthis Fructus), Zhishi (Aurantii Fructus Immaturus), and Zhuli (Bambusae Caulis in Taeniam). For blood-deficiency pain, add Shengdihuang (Rehmanniae Radix); for upper pain, add Baizhi (Angelicae Dahuricae Radix) and Weilingxian (Saposhnikoviae Radix); for lower pain, add Huangbai (Phellodendri Cortex) and Niuxi (Achyranthis Bidentatae Radix); for severe pain, add Ruxiang (Olibanum); for fever, add Chaihu (Bupleuri Radix); for scanty and difficult urination, add Mutong (Akebiae Caulis); for arm pain, add Bo Gui (Cinnamomi Ramulus).
For bone joint pain accompanied by chills, fever, and swelling masses, this is damp-phlegm flowing into the collaterals, treated similarly to gout. If treatment is delayed and the mass does not dissipate, it will suppurate; external applications should be used. In all cases of gout with limb joint pain, pain belongs to fire, and swelling belongs to dampness. Meat should be avoided as it is yang-fire and can exacerbate fire, leading to enuresis and internal stagnation masses. Even oily, fried foods, fish, and noodles must be strictly prohibited. Therefore, those who consume rich foods often suffer from gout, malignant sores, and carbuncles due to frying, roasting, and alcohol steaming the viscera. Obese people tend to have damp-phlegm; thin people tend to have phlegm-fire.
Generalized high fever and bone joint pain indicate wind-cold.
Jiebiao Shengma Tang (Surface-Resolving Cimicifugae Decoction): Treats generalized high fever and bone joint pain.
Ingredients: Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), Bencao (Ligustici Rhizoma et Radix), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Mahuang (Ephedrae Herba), Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Danggui (Angelicae Sinensis Radix).
Usage: Decoct one dose with fresh ginger and scallions in water, take hot, aiming for a slight sweat.
Generalized pain belonging to deficiency-cold should be treated with warming and dispersing methods.
Jiawei Wuji San (Modified Five Accumulations Powder): Treats limb bone joint pain caused by deficiency-cold.
Ingredients: Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba fried with wine), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma fried with ginger juice), Cangzhu (Atractylodis Rhizoma soaked in rice water), Fuling (Poria sliced), Houpo (Magnoliae Officinalis Cortex fried with ginger juice), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Zhiqiao (Aurantii Fructus fried with bran), Jiegeng (Platycodonis Radix), Baizhi (Angelicae Dahuricae Radix, each 0.8 fen), Ganjiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), Mahuang (Ephedrae Herba), Gancao (Glycyrrhizae Radix et Rhizoma, each 0.5 fen), Chuanshanjia (Manis Squama, burned to ash, 1 qian according to painful area).
Usage: Decoct one dose with three slices of fresh ginger, one jujube, and a little Moschus in water, take warm.
Ruxiang Dingtong Wan (Frankincense Pain-Calming Pill): Treats various wind conditions causing whole-body bone joint pain, leg/knee pain, and tendon-bone wind pain.
Ingredients: Cangzhu (Atractylodis Rhizoma soaked in rice water, 2 liang), Chuanwu (Aconiti Radix Praeparata, peeled), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma, each 1 liang), Ruxiang (Olibanum), Moyao (Myrrhae Resina, each 3 qian), Dingxiang (Caryophylli Flos, 0.5 fen).
Usage: Grind into fine powder, make pills with jujube flesh, size of Sophora japonica seeds. Take 50-60 pills per dose with yellow wine.
Generalized pain belonging to damp-phlegm should be treated with drying dampness and resolving phlegm.
Qingshi Huatan Tang (Drying-Dampness Resolving-Phlegm Decoction): Treats wandering pain in the whole body and limb joints, radiating to chest and back, accompanied by chills/fever, wheezing/cough, irritability, or swelling masses, difficulty turning, numbness in limbs, or a cold sensation at the back, with a slippery pulse. This is due to damp-phlegm flowing into collaterals and joints causing obstruction.
Ingredients: Nanxing (Arisaematis Rhizoma prepared with ginger), Banxia (Pinelliae Rhizoma prepared with ginger), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria sliced), Cangzhu (Atractylodis Rhizoma soaked in rice water), Qianghuo (Notopterygii Rhizoma et Radix), Pianqin (Scutellariae Radix fried with wine), Baizhi (Angelicae Dahuricae Radix), Baijiezi (Sinapis Semen, each 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.3 fen), Muxiang (Aucklandiae Radix, 0.5 fen, ground separately).
Usage: Decoct one dose with Zhuli (Bambusae Caulis in Taeniam) and Jiangzhi (Zingiberis Juice). For severe bone/joint pain and painful masses (called Phlegm Masses), add Ruxiang (Olibanum), Moyao (Myrrhae Resina), Haishi (Calcium Carbonatum), and Poxiao (Natrii Sulfas). For head/neck pain, add Chuanxiong (Ligustici Chuanxiong Rhizoma) and Weilingxian (Saposhnikoviae Radix); for arm pain, add Bo Gui (Cinnamomi Ramulus) to guide the herbs; for foot pain, add Niuxi (Achyranthis Bidentatae Radix), Huangbai (Phellodendri Cortex), Fangji (Stephaniae Tetrandrae Radix), Longdancao (Gentianae Radix), and Mugua (Chaenomelis Fructus).
Wandering pain that is lighter during the day and heavier at night indicates blood deficiency.
Liujing Huoxue Tang (Meridian-Regulating Blood-Invigorating Decoction): Treats whole-body wandering stabbing pain, worse in the left foot. The left relates to blood; this is often due to damage from alcohol and sex, causing empty tendons/vessels invaded internally by wind-cold-damp-heat. Heat enveloping cold damages tendons/collaterals, causing day-light/night-heavy pain. Treatment involves regulating meridians, invigorating blood, and moving dampness. This is not White Tiger Arthritis.
Ingredients: Danggui (Angelicae Sinensis Radix wine-washed, 1.2 qian), Baishao (Paeoniae Radix Alba fried with wine, 1.5 qian), Shengdi (Rehmanniae Radix Preparata wine-washed), Cangzhu (Atractylodis Rhizoma soaked in rice water), Niuxi (Achyranthis Bidentatae Radix de-rooted, wine-washed), Chenpi (Citri Reticulatae Pericarpium peeled), Taoren (Persicae Semen peeled, fried), Weilingxian (Saposhnikoviae Radix wine-washed, each 1 qian), Chuanxiongcao (Ligustici Chuanxiong Rhizoma, 0.6 fen), Hanfangji (Stephaniae Tetrandrae Radix wine-washed), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix de-rooted), Baizhi (Angelicae Dahuricae Radix, each 0.6 fen), Longdancao (Gentianae Radix, 0.6 fen), Fuling (Poria sliced, 0.7 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 0.4 fen).
Usage: Decoct one dose with three slices of fresh ginger in water, take warm on an empty stomach. Avoid raw/cold/damp foods. Add Nanxing (Arisaematis Rhizoma) and Banxia (Pinelliae Rhizoma) 1 qian each if phlegm is present; add Bo Gui (Cinnamomi Ramulus) 0.3 fen for body/arm pain; add Mugua (Chaenomelis Fructus) and Mutong (Akebiae Caulis) for lower body/foot pain; add Yanhuangbai (Phellodendri Cortex salt-fried) and Yiyiren (Coicis Semen) 1 qian each; add Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Guiban (Testudinis Carapax et Plastrum) 0.7 fen each for Qi deficiency; double Siwu Tang (Four Substances Decoction) for blood deficiency, fried with ginger juice and wine, add Honghua (Carthami Flos) 1 qian.
Swelling and pain in joints: swelling is dampness, pain is fire.
Lingxian Chutong Yin (Weilingxian Pain-Relieving Drink): Treats joint swelling and pain where pain is fire and swelling is dampness, triggered by wind-cold in collaterals, with continuous flow of damp-heat into joints.
Ingredients: Mahuang (Ephedrae Herba), Chishao (Paeoniae Radix Rubra, each 1 qian), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Baizhi (Angelicae Dahuricae Radix), Cangzhu (Atractylodis Rhizoma), Weilingxian (Saposhnikoviae Radix), Pianhuangqin (Scutellariae Radix), Zhishi (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Gegen (Puerariae Lobatae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma, each 5 qian), Guiwei (Angelicae Sinensis Radix tail), Shengma (Cimicifugae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, each 0.3 fen).
Usage: Decoct one dose in water. For lower jiao, add Jiuhuangbai (Phellodendri Cortex fried with wine); for women, add Honghua (Carthami Flos); for more swelling, add Binglang (Arecae Semen), Dafupi (Tsaoko Pericarpium), Zexie (Alismatis Rhizoma), and Moyao (Myrrhae Resina). Alternatively, if pulse is choppy and rapid indicating blood stasis, use Taoren (Persicae Semen), Honghua (Carthami Flos), Shaoyao (Paeoniae Radix), Danggui (Angelicae Sinensis Radix), and Jiuda Huang (Rhei Radix et Rhizoma fried with wine) to mildly purge.
Pain in four limbs and hundred joints like being bitten by a tiger is named White Tiger Arthritis (Baihu Lijie Feng).
Shujin Li'an San (Tendon-Relaxing Immediate Peace Powder): Treats pain in four limbs and hundred joints.
Ingredients: Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fuling (Poria sliced), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Shengdi (Rehmanniae Radix Preparata), Cangzhu (Atractylodis Rhizoma soaked in rice water), Honghua (Carthami Flos), Taoren (Persicae Semen peeled), Nanxing (Arisaematis Rhizoma fried with ginger), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma fried with ginger juice), Baishao (Paeoniae Radix Alba de-rooted), Weilingxian (Saposhnikoviae Radix), Niuxi (Achyranthis Bidentatae Radix de-rooted), Mugua (Chaenomelis Fructus), Fangji (Stephaniae Tetrandrae Radix), Jiuqin (Scutellariae Radix fried with wine), Lianqiao (Forsythiae Fructus), Mutong (Akebiae Caulis), Longdancao (Gentianae Radix), Fuzi (Aconiti Lateralis Radix Praeparata, a little), Gancao (Glycyrrhizae Radix et Rhizoma).
Usage: Decoct one dose in water, add Jiangzhi (Zingiberis Juice) and Zhuli (Bambusae Caulis in Taeniam). If abdominal pain is severe, add Ruxiang (Olibanum) and Moyao (Myrrhae Resina) ground and mixed.
Duhuo Jisheng Tang (Angelica Pubescens and Sangjisheng Decoction): Highly effective for White Tiger Arthritis. (See "Zhongshi" section.)
Pain and numbness in both hands indicate wind-phlegm. Treatment for hand pain/numbness: Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Pianqin (Scutellariae Radix fried with wine), Huanglian (Coptidis Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Cangzhu (Atractylodis Rhizoma treated with rice water), Fangfeng (Saposhnikoviae Radix), Jiegeng (Platycodonis Radix), Nanxing (Arisaematis Rhizoma prepared with ginger), Banxia (Pinelliae Rhizoma fried with ginger juice), Guizhi (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma).
Usage: Decoct with fresh ginger.
Pain and numbness in both feet indicate damp-heat. Treatment for foot pain/numbness: Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba fried with wine), Baizhu (Atractylodis Macrocephalae Rhizoma de-rooted), Cangzhu (Atractylodis Rhizoma soaked in rice water), Banxia (Pinelliae Rhizoma fried with ginger juice), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria sliced), Huangbai (Phellodendri Cortex fried with wine), Weilingxian (Saposhnikoviae Radix), Chuan Niuxi (Achyranthis Bidentatae Radix de-rooted, wine-washed), Taoren (Persicae Semen peeled), Honghua (Carthami Flos), Gancao (Glycyrrhizae Radix et Rhizoma).
Usage: Decoct one dose with five slices of fresh ginger in water, add Zhuli (Bambusae Caulis in Taeniam).
Jiawei Ermiao Wan (Modified Two Marvels Pill): Treats foot numbness and pain feeling like burning heat. (See "Hongjiaojiao" section.)
For all tendon-bone pain, external application is suitable.
Shenying Gao (Divine Response Plaster): Treats bone joint pain.
Ingredients: Ruxiang (Olibanum), Moyao (Myrrhae Resina, each 1 liang ground), Pijiao (Colla Corii Asini, 3 liang), Shengjiang (Zingiberis Rhizoma Recens, 2 jin, juice extracted).
Preparation: Boil ginger juice in a clay pot, dissolve Pijiao (Colla Corii Asini), remove from heat and place on ashes, add Ruxiang (Olibanum) and Moyao (Myrrhae Resina) powder, stir into a paste. Spread on dog skin (smoke-free) to make plaster, apply to affected area. Heat shoe soles and frequently iron over the plaster for miraculous effect. Do not touch iron.
A woman suffered whole-body pain, especially in tendons/bones, unable to bend/stretch, dry mouth, red eyes, dizziness, phlegm obstructing chest/diaphragm, scanty dark urine, worse at night, itching all over like insects crawling. This was Liver/Kidney Qi deficiency with heat. Treated with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) formula plus Zhizi (Gardeniae Fructus) and Chaihu (Bupleuri Radix), cured. (See "Buyi" section.)
A patient with wind-damp combining causing whole-body pain was treated with Buzhong Yiqi Tang (Tonify Middle Augment Qi Decoction) plus Qianghuo (Notopterygii Rhizoma et Radix), Shengma (Cimicifugae Rhizoma), Fangfeng (Saposhnikoviae Radix), Bencao (Ligustici Rhizoma et Radix), and Cangzhu (Atractylodis Rhizoma). Continue taking after illness resolves to counteract the Qi-depleting nature of wind-dispersing herbs. (See "Buyi" section.)
Taipu Zhang Yan's Lord Zhang suffered whole-body stabbing pain like needles whenever cloudy, for years. Pulse: left slightly rapid, right large and rapid. Diagnosis: Blood deficiency with damp-heat. Treated with Danggui Niantong Tang (Angelica Regulating-Pain Decoction) plus Shengdi (Rehmanniae Radix Preparata), Baishao (Paeoniae Radix Alba), Huangbai (Phellodendri Cortex), removing Renshen (Ginseng Radix). Cured after several doses.