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，或发热等症者，须
调补脾胃为善，否则必变败症矣。
一小儿九岁，患此作痛，用葱熨法及大防风汤，肿起色
赤，用仙方活命饮、补中益气汤间服，肿渐消；又以独活寄生汤与补中益气汤间服；二三日，用葱熨一次，至两月余而
消。
一小儿患此，大溃不敛，体倦食少，口干发热，日晡尤甚，此脾气虚甚也，用补中益气汤五剂，以补元气，乃用大
防风汤一剂，以治其疮，如是月余，诸症悉退，遂用十全大补汤，佐以大防风汤而敛。
一小儿患此，溃而不敛，不时寒热，小便赤涩，此血气虚也，用十全大补汤加麦门冬、五味，诸症顿退，乃去桂，
令常服；佐以和血定痛丸而愈。
一女子左腿作痛，服流气饮之类，左膝肿硬，头晕吐痰，余谓此鹤膝风也，其脉弦数而无力，乃禀赋肝脾肾三经之
症，此形气病气俱虚者，当先调脾胃为主。不信，仍攻邪气，诸症蜂起，余先用五味异功散加升麻、干姜、肉桂，脾气
稍健，又用异功散、八珍汤而溃；却间服大防风汤、地黄丸而痊。
一小儿两膝渐肿，敷服皆消毒之药，足颈赤肿，此禀父肾气不足，用地黄丸、八珍汤而消。若用流气、败毒等药，
必致不起。
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。
益气养荣汤 治气血虚弱，四肢颈项等处患肿，不问肿溃，日久不敛，俱宜服之。
人参 茯苓 陈皮 贝母 香附（炒） 当归（酒洗） 川芎 黄
（炒） 熟地黄（自制） 芍药（炒。各一钱） 甘草（炙） 桔梗（各五分） 白术（炒） 柴胡（六分）
上每服二三钱，姜水煎。
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 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。
八珍汤（方见发热不止）
十全大补汤（方见便痈）
补中益气汤（方见肌肉不生）
和血定痛丸
葱熨法（二方见流注）
鹤膝风，其腿部逐渐变细，膝盖却越发粗大，形状像鹤的膝盖，因此得名。这是因为先天禀赋中肾经精气不足，外邪乘虚侵袭而患病。初期表现为膝盖内部疼痛，外部颜色没有变化，但伸屈活动困难。如果在发病一两个月后，肿胀处颜色发红并化脓的，可以治疗；如果肿胀坚硬、颜色发白且不化脓的，则难以治疗。初起阶段，以大防风汤为主方，辅以益气养荣汤。脓液已经形成的，以补中益气汤为主方，辅以大防风汤，切勿使用十宣散、流气饮等攻伐药物。如果疮口不溃破也不收敛，或者出现发热等症状，应当调理补益脾胃为最佳策略，否则必然转变为败症（危重病症）。
有一个九岁的小儿患此病且疼痛，采用葱熨法及大防风汤治疗，肿胀消退后颜色转红，于是交替服用仙方活命饮和补中益气汤，肿胀逐渐消退；之后又交替服用独活寄生汤与补中益气汤；每隔两三天用一次葱熨法，经过两个多月才痊愈。
另一个小儿患此病，疮口大溃而不收敛，身体疲倦、食欲减退、口干发热，且在下午申时（日晡）症状尤为严重，这是脾气极度虚弱的表现。先用补中益气汤五剂以补益元气，再用大防风汤一剂以治疗疮疡，如此经过一个多月，所有症状全部消退，最后改用十全大补汤为主，佐以大防风汤，使疮口愈合。
还有一个小儿患此病，溃破后不收敛，时常出现寒热往来，小便赤涩，这是气血虚弱的表现。使用十全大补汤加入麦门冬、五味子，诸症迅速消退，随后去掉肉桂，让患儿长期服用；同时佐以和血定痛丸而痊愈。
一个女子左腿疼痛，服用了流气饮之类的药物，导致左膝肿胀坚硬，伴有头晕、吐痰。我认为这是鹤膝风，脉象弦数但无力，属于先天禀赋不足导致的肝、脾、肾三经病变，且形体之气与病气均虚弱，应当首先以调理脾胃为主。患者不信从，仍然继续攻伐邪气，导致各种症状蜂拥而起。我先用五味异功散加入升麻、干姜、肉桂，待脾气稍健运后，又用异功散、八珍汤使疮疡溃破；期间间服大防风汤、地黄丸而痊愈。
一个小儿双膝逐渐肿胀，敷药和内服皆为消毒之药，导致足踝部红肿，这是由于禀受父亲的肾气不足所致，用地黄丸、八珍汤治疗后肿胀消退。如果继续使用流气饮、败毒散等药物，必然导致死亡。
大防风汤：治疗鹤膝风，肿痛不消，或溃破后不收敛。
附子（炮制）、牛膝（酒炒，各一钱）、白术、羌活、人参、防风（各二钱）、杜仲（去皮，姜汁制）、川芎、肉桂（去皮）、黄芪（炒）、熟地黄（自制）、芍药（炒，各一钱五分）、甘草（一钱）。
以上药材每次服用三至五钱，水煎，并根据儿童年龄大小酌情调整用量。
益气养荣汤：治疗气血虚弱，四肢、颈部等处发生肿胀，无论是否溃破，日久不收敛者，都适宜服用。
人参、茯苓、陈皮、贝母、香附（炒）、当归（酒洗）、川芎、黄芪（炒）、熟地黄（自制）、芍药（炒，各一钱）、甘草（炙）、桔梗（各五分）、白术（炒）、柴胡（六分）。
以上药材每次服用二至三钱，加生姜和水煎服。
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、桂心、川芎、防风、甘草、人参、熟地黄、当归（各等分）。
以上药材每次服用二至三钱，水煎，空腹服用，乳母同服（若患儿由哺乳母亲喂养）。
八珍汤（方剂见“发热不止”章节）
十全大补汤（方剂见“便痈”章节）
补中益气汤（方剂见“肌肉不生”章节）
和血定痛丸
葱熨法（方剂见“流注”章节）
He Xi Feng (Crane's Knee Wind) is characterized by the gradual thinning of the legs and the increasing swelling of the knees, resembling a crane's knee, hence its name. This condition arises from congenital insufficiency of the Kidney Meridian (Kidney Channel), allowing external pathogenic factors to invade. Initially, there is pain inside the knee with no change in external color, but difficulty in flexion and extension. If, within one or two months, the swelling becomes red and suppurates (forms pus), it is treatable; if the swelling is hard, white in color, and does not suppurate, it is difficult to treat. In the early stage, Da Fang Feng Tang (Great Wind-Expelling Decoction) should be used as the principal formula, assisted by Yi Qi Yang Rong Tang (Qi-Nourishing and Blood-Supplementing Decoction). When pus has formed, Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction) should be the principal formula, assisted by Da Fang Feng Tang. One must strictly avoid using Shi Xuan San (Ten Acupoints Powder) or Liu Qi Yin (Flowing-Qi Decoction) and other purgative drugs. If the sore does not ulcerate nor heal, or if symptoms such as fever occur, it is best to regulate and tonify the Spleen and Stomach; otherwise, it will inevitably transform into Bai Zheng (Decadent Syndrome/Critical Condition).
A nine-year-old child suffered from this condition with pain. After applying Cong Yun Fa (Scallion Moxibustion/Warming Method) and administering Da Fang Feng Tang, the swelling subsided and turned red. Subsequently, Xian Fang Huo Ming Yin (Immortal Formula for Reviving Life) and Bu Zhong Yi Qi Tang were administered alternately, causing the swelling to gradually disappear. Later, Du Huo Ji Sheng Tang (Angelica Pubescens and Taxillus Decoction) was alternated with Bu Zhong Yi Qi Tang. With one application of Cong Yun Fa every two or three days, the condition resolved after more than two months.
Another child suffered from this condition with large ulcers that failed to heal, accompanied by fatigue, poor appetite, dry mouth, and fever, which was particularly severe during the Shen hour (3-5 PM). This indicated extreme deficiency of Spleen Qi. Five doses of Bu Zhong Yi Qi Tang were first used to tonify Yuan Qi (Primal Qi), followed by one dose of Da Fang Feng Tang to treat the sore. After about a month, all symptoms receded. Finally, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) was used as the principal formula, assisted by Da Fang Feng Tang, leading to healing.
A third child suffered from this condition with ulcers that failed to heal, intermittent chills and fever, and dark, scanty urination. This indicated deficiency of Qi and Blood. Shi Quan Da Bu Tang was administered with added Mai Men Dong (Ophiopogon Tuber) and Wu Wei Zi (Schisandra Fruit), causing immediate relief of symptoms. Cinnamon Bark (Rou Gui) was then removed, and the patient was instructed to take it regularly. The child recovered with the assistance of He Xue Ding Tong Wan (Blood-Harmonizing and Pain-Relieving Pill).
A young woman experienced pain in her left leg. After taking Liu Qi Yin-like formulas, her left knee became swollen and hard, accompanied by dizziness and expectoration. I diagnosed this as He Xi Feng. Her pulse was wiry, rapid, and forceless, indicating a condition involving the Liver, Spleen, and Kidney meridians due to congenital insufficiency, where both physical constitution and pathogenic qi were deficient. Treatment should primarily focus on regulating the Spleen and Stomach. She did not believe this and continued to attack the pathogenic qi, resulting in a multitude of symptoms. I first used Wu Wei Yi Gong San (Five-Ingredient Extraordinary Efficacy Powder) augmented with Sheng Ma (Cimicifuga Rhizome), Gan Jiang (Dried Ginger), and Rou Gui (Cinnamon Bark). Once Spleen Qi improved slightly, Yi Gong San and Ba Zhen Tang (Eight-Treasure Decoction) were used to promote ulceration. During this period, Da Fang Feng Tang and Di Huang Wan (Rehmannia Pill) were taken intermittently, leading to recovery.
A child had gradually swelling knees. After applying and ingesting detoxifying medicines, the ankles became red and swollen. This was due to insufficient Kidney Qi inherited from the father. It resolved with Di Huang Wan and Ba Zhen Tang. Had Liu Qi Yin or Bai Du San (Defeat-Toxin Powder) been used, it would have resulted in death.
Da Fang Feng Tang: Treats He Xi Feng with persistent swelling and pain, or ulcers that fail to heal.
Fu Zi (Prepared Aconite Root), Niu Xi (Achyranthes Root, wine-fried) [1 qian each]; Bai Zhu (Atractylodes Macrocephala Rhizome), Qiang Huo (Notopterygium Rhizome), Ren Shen (Ginseng Root), Fang Feng (Saposhnikovia Root) [2 qian each]; Du Zhong (Eucommia Bark, peeled and ginger-processed), Chuan Xiong (Ligusticum Rhizome), Rou Gui (Cinnamon Bark, peeled), Huang Qi (Astragalus Root, fried), Shu Di Huang (Prepared Rehmannia Root), Shao Yao (Peony Root, fried) [1.5 qian each]; Gan Cao (Licorice Root) [1 qian].
Take 3-5 qian per dose, decoct in water, and adjust dosage according to the child's age.
Yi Qi Yang Rong Tang: Treats Qi and Blood deficiency causing swelling in limbs, neck, etc., whether ulcerated or not, especially when long-standing and unhealed.
Ren Shen, Fu Ling (Poria), Chen Pi (Tangerine Peel), Bei Mu (Fritillaria Bulb), Xiang Fu (Cyperus Rhizome, fried), Dang Gui (Angelica Sinensis Root, wine-washed), Chuan Xiong, Huang Qi, Shu Di Huang, Shao Yao [1 qian each]; Gan Cao (Honey-fried Licorice), Jie Geng (Platycodon Root) [0.5 qian each]; Bai Zhu (Fried Atractylodes), Chai Hu (Bupleurum Root) [0.6 qian].
Take 2-3 qian per dose, decoct with fresh ginger and water.
Du Huo Ji Sheng Tang:
Du Huo (Angelica Pubescens Root), Sang Ji Sheng (Taxillus Branch), Du Zhong (fried), Xi Xin (Asarum Root), Niu Xi (wine-fried, cleaned), Qin Jiao (Gentiana Macrophylla Root), Fu Ling, Bai Shao Yao (White Peony Root), Gui Xin (Cinnamon Twig Heart), Chuan Xiong, Fang Feng, Gan Cao, Ren Shen, Shu Di Huang, Dang Gui [Equal parts].
Take 2-3 qian per dose, decoct in water, take on an empty stomach. If the patient is breastfed, the mother should also take it.
Ba Zhen Tang (See "Unremitting Fever" chapter)
Shi Quan Da Bu Tang (See "Anal Abscess" chapter)
Bu Zhong Yi Qi Tang (See "Failure of Muscle Regeneration" chapter)
He Xue Ding Tong Wan
Cong Yun Fa (See "Liuzhu/Flowing Deposit" chapter)