关节剧疼历节风，方书五积散神功，若投温燥还增病，干葛冬藤（金银花，一名忍冬藤）羊
藿（淫羊藿）充（叶天士《本草经解》注云∶淫羊藿浸酒治偏枯。
痹者，风、寒、湿三气合成为病，痛中带麻也。然三气之中，以湿为主，宜二陈汤加苍
术、白术、防风治之，又可借用历节风治法。《金匮》黄 五物汤治血痹，然亦痹症属虚者
之通剂，服二十余剂必效。
（经义）《素问·痹论》曰∶“风、寒、湿三气合而为痹也。其风气胜者为行痹，寒气胜者
为痛痹，湿气胜者为着痹。”《灵枢·周痹篇》曰∶“周痹者，在于血脉之中，随脉以上，
随脉以下，不能左右，各当其所。”后贤用黑大豆水浸罨出芽一斤，晒干炒香熟为末，酒调
一钱，日三服。又《痹论》曰∶“胞痹者，少腹膀胱按之内痛，若沃以汤涩于小便，上为清
涕。肠痹者，数饮而出不得，中气喘争，时发飧泄。”又曰∶“阳气多，阴气少，病气胜，
阳遭阴，故为热痹。”
闭（痹者，闭也）而为痛痹斯名，五积（散）温通（通则不痛）古法程，二术二陈祛湿外，黄 五物
汤妙而精。
鹤膝风者，胫细而膝肿是也。为风、寒、湿三气合痹于膝而成。宜借用痹症，历节风方
法。如初起用白芥子研末，以姜、葱汁调涂，一伏时患处起泡，泡干起皮自愈。虚弱者，宜
十全大补汤，加附子、防风、牛膝、杜仲、独活主之。此证属于三阴，三阳虽曰主内，而风
、寒、湿皆自外来，故列于表症。
关节剧烈疼痛的历节风，方书中记载五积散具有神奇功效，但如果误用温燥药物反而会加重病情。可用干葛、冬藤（金银花，又名忍冬藤）、羊藿（淫羊藿）等药充数。（叶天士在《本草经解》中注释说：淫羊藿浸酒可治疗偏枯。）
痹症，是由风、寒、湿三种邪气结合而成的疾病，疼痛时伴有麻木感。然而在这三种邪气中，以湿气为主，适宜使用二陈汤加入苍术、白术、防风来治疗，也可以借用治疗历节风的方法。《金匮要略》中的黄芪桂枝五物汤用于治疗血痹，但这也是治疗属于虚证的痹症的通用方剂，服用二十多剂必定见效。
（经典理论依据）《素问·痹论》说：“风、寒、湿三种邪气结合而形成痹症。风气偏胜的叫行痹，寒气偏胜的叫痛痹，湿气偏胜的叫着痹。”《灵枢·周痹篇》说：“周痹，位于血脉之中，随着经脉上下移动，不能左右扩散，各自停留在其所在的部位。”后世医家使用黑大豆用水浸泡至发芽一斤，晒干炒香熟后研为粉末，用酒调服一钱，每日三次服用。又《痹论》说：“胞痹，表现为少腹膀胱部位按压时内部疼痛，像被热水浇烫一样，小便涩滞不畅，上部出现清涕。肠痹，表现为多次饮水却排尿困难，腹部气喘争鸣，时常发生完谷不化的泄泻。”又说：“阳气多，阴气少，病气盛，阳遭受阴邪侵袭，所以形成热痹。”
闭（痹即闭塞之意）塞不通而形成的疼痛称为痛痹，这是命名的由来。五积散温通经络（通则不痛），是古代的法度程式。除了苍术、白术和二陈汤祛除湿气外，黄芪桂枝五物汤精妙而精细。
鹤膝风，是指小腿纤细而膝盖肿胀的症状。这是由于风、寒、湿三种邪气合而为痹，阻滞于膝盖所致。适宜借用治疗痹症和历节风的方法。如果初起，可用白芥子研末，用姜汁、葱汁调和涂抹，经过一个时辰（两小时）患处起泡，泡干脱皮后即可自愈。身体虚弱者，适宜使用十全大补汤，加入附子、防风、牛膝、杜仲、独活来主治。此证归属于三阴经，虽然三阳经主内，但风、寒、湿皆从外来，所以将其列在表症之中。
Lijie Feng (Joint Pain Wind), characterized by severe joint pain, is said to have miraculous efficacy with Wuji San (Five Accumulations Powder) in medical texts. However, if warm and drying agents are administered, the disease will worsen. One may use Gan Ge (Puerariae Radix), Dong Teng (Lonicerae Japonicae Caulis, also known as Jin Yin Hua / Honeysuckle Stem), and Yang Huo (Epimedii Folium, i.e., Horny Goat Weed) as substitutes. (Ye Tianshi noted in *Bencao Jing Jie* that Epimedii Folium soaked in wine treats hemiplegia.)
Bi Syndrome (Obstruction Syndrome) is a disease caused by the combination of Wind, Cold, and Dampness pathogens; it presents with pain accompanied by numbness. Among these three pathogens, Dampness is predominant. It is appropriate to treat it with Er Chen Tang (Two-Aged Decoction) added with Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Fang Feng (Saposhnikoviae Radix). Alternatively, the treatment method for Lijie Feng can be borrowed. Huang Qi Wu Wu Tang (Astragalus Five-Ingredient Decoction) from *Jin Gui Yao Lue* is used to treat Blood Bi (Blood Obstruction Syndrome); however, it is also a general formula for Bi syndromes belonging to deficiency patterns. Taking it for more than twenty doses will surely yield results.
(Classical Theory Basis) *Su Wen: Bi Lun* states: "The combination of Wind, Cold, and Dampness forms Bi Syndrome. When Wind predominates, it is called Xing Bi (Wandering Bi); when Cold predominates, it is called Tong Bi (Painful Bi); when Dampness predominates, it is called Zhuo Bi (Fixed Bi)." *Ling Shu: Zhou Bi Pian* states: "Zhou Bi (General Bi) resides within the blood vessels, moving up and down along the meridians, unable to spread left or right, staying where it is." Later scholars used one jin (approx. 500g) of black soybeans soaked in water until sprouted, dried, roasted until fragrant, and ground into powder. Mixed with wine, one qian (approx. 3.7g) is taken orally three times daily. Furthermore, *Bi Lun* states: "Bao Bi (Bladder Bi) manifests as internal pain upon pressing the lower abdomen and bladder area, feeling as if scalded by hot water, with difficult and scanty urination, and clear nasal discharge above. Chang Bi (Intestinal Bi) manifests as frequent drinking but inability to urinate, abdominal distension and borborygmus, and occasional stool containing undigested food." It also states: "When Yang qi is abundant and Yin qi is scarce, pathogenic qi prevails; Yang encounters Yin, thus forming Re Bi (Hot Bi)."
Bi (meaning obstruction) leads to pain, hence named Tong Bi (Painful Bi). Wuji San (Five Accumulations Powder) warms and unblocks (when unblocked, there is no pain), following ancient methods. Besides Cang Zhu, Bai Zhu, and Er Chen Tang removing Dampness, Huang Qi Wu Wu Tang (Astragalus Five-Ingredient Decoction) is exquisite and refined.
He Xi Feng (Crane Knee Wind) refers to thin calves and swollen knees. It is formed by Wind, Cold, and Dampness combining to cause Bi obstruction in the knee. It is appropriate to borrow methods for treating Bi syndrome and Lijie Feng. If in the early stage, Bai Jie Zi (Sinapis Semen) can be ground into powder, mixed with Ginger Juice and Scallion Juice, and applied topically. After one fu shi (approx. 2 hours), blisters will form on the affected area; once the blisters dry and peel off, it will heal spontaneously. For those with weakness, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) added with Fu Zi (Aconiti Lateralis Radix Praeparata), Fang Feng (Saposhnikoviae Radix), Niu Xi (Achyranthis Bidentatae Radix), Du Zhong (Eucommiae Cortex), and Du Huo (Angelicae Pubescentis Radix) should be used. This condition belongs to the Three Yin meridians. Although the Three Yang meridians govern the interior, Wind, Cold, and Dampness all come from outside, so it is listed among exterior syndromes.