〔仲〕诸肢节疼痛,身体 羸,脚肿如脱,头眩短气,兀兀欲吐,桂枝芍药知母汤主之。
桂枝(四两) 芍药(三两) 甘草(二两) 麻黄(二两) 生姜(五两) 白术(五两) 知母(四两) 防风(四两) 附子(二两,炮)
上以水七升,煮取二升,温服七合,日三服。
病历节不可屈伸,疼痛,乌头汤主之。
麻黄 芍药 黄 (各三两) 甘草(炙) 川乌(五枚 咀。以蜜二升,煎取一升,即去乌头)
上五味 咀。以水三升,煮取一升,去渣,纳蜜再煎,服七合,不时尽服之。
〔河〕防风汤 治行痹走注无定。
防风 甘草 当归 赤茯苓(去皮) 杏仁(去皮,炒熟) 桂(以上各一两) 黄芩 秦艽
葛根(各三钱) 升麻(去节,半两)
上为末。服五钱,水酒各二盏,枣三枚,姜五片,煎至一盏,去渣,温服。
〔《本》〕治湿伤肾,肾不养肝,肝自生风,遂成风湿,流注四肢筋骨,或入左肩
,肌肉疼痛,渐入左指中,薏苡仁散。
薏苡仁(一两) 当归 小川芎 干姜 茵芋 甘草 官桂 川乌 防风 人参 羌活 白
术麻黄 独活(各半两)
上为细末。每服二钱,空心临卧酒调下,日三服。
治白虎历节诸风疼痛,游走无定,状如虫啮,昼静夜剧,及一切手足疼痛,麝香丸。
川乌(大八角者,三个,用生) 全蝎(二十一个,生用) 黑豆(二十一个,生用) 地龙(半两)
上为细末。入麝香半字同研匀,糯米糊为丸,如绿豆大。每服七丸,甚者十丸,夜卧令
膈空,温酒下,微出冷汗一身,便瘥。予得此方,凡得历节及不测疼痛,一二服便瘥。在歙
州日,有一贵家妇人,遍身走注疼痛,至夜则发,如虫啮其肌,多作鬼邪治。予曰,此正历
节病也,三服愈(歙,尸叶切)。
〔丹〕龙虎丹 治走注疼痛,或麻木不遂,或半身疼痛。
草乌 苍术 白芷(各一两)
上研为末,水拌发热过,再入乳香二钱,当归、牛膝各半两,酒糊丸,如弹子大。酒化下。
〔无〕附子八物汤 治历节风,四肢疼痛,如锤锻,不可忍。
附子(炮,去皮脐) 干姜(炮) 芍药 茯苓 半夏 桂心(各三两) 白术(四两) 人参(三两)
上锉散。每服四钱,水二盏,煎至七分,去渣,食前服。
〔丹〕痛风走注疼痛。
黄柏(酒炒) 苍术(酒炒,各二钱)
上作一服,煎就,调酒威灵仙末、羚羊角灰,臣苍术,佐芥子,使用姜一片,入药末一
钱,擂碎,以前药再温服。
〔东)和血散痛汤 治两手十指,一指疼了一指疼,疼后又肿,骨头里痛,膝痛,左膝痛
了右膝痛,发时多则五日,少则三日,昼轻夜重,痛时觉热,行则痛轻,肿却重。解云,先
血后气,乃先痛后肿,形伤气也。
羌活身 升麻 麻黄(去节,各钱半) 桃仁(十个) 柴胡(二钱) 红花(一分) 归身(一分) 防风
(一钱) 甘草(炙,二分) 独活(五分) 猪苓(五分) 黄柏(一钱) 防己(六分) 知母(酒,一钱) 黄连(
酒)
上 咀。分作四服,每服水一大盏,煎至一半,去渣,空心热服。
〔罗〕真定府张大,素好嗜酒,五月间病手指节肿痛,屈伸不利,膝髌亦然,心下痞满,
身体沉重,不欲饮食,食即欲吐,面色痿黄,精神减少。至六月间,求予治之。诊其脉沉而
缓,缓者脾也。《难经》云∶俞主体重节痛。俞者,脾之所主,四肢属脾。盖其人素饮酒,
加之时助,湿气大胜,流于四肢,故为肿痛。《内经》云∶诸湿肿满,皆属脾土。仲景云∶
湿流关节,肢体烦痛,此之谓也。宜以大羌活汤主之。《内经》云∶湿淫于内,治以苦温,
以苦发之,以淡渗之。又云∶风胜湿。羌活、独活苦温,透关节而胜湿,故以为君。升麻苦
平,威灵仙、苍术、防风苦辛温发之者也,故以为臣。血壅而不流则痛,当归辛温以散之。
甘草甘温益气,泽泻咸平,茯苓甘平,导湿而利小便,以淡渗之。使气味相合,上下分散其
湿也。
羌活 升麻(各一钱) 独活(七分) 苍术 防风 甘草 威灵仙 茯苓 当归 泽泻(各半两)
上锉作一服。水二盏,煎至一盏,温服,食前一服,食后一服。忌酒、面、生冷、硬物。
〔《本》〕麻黄汤 治历节。
麻黄(一两) 羌活(一两) 黄芩(三分) 细辛 黄 (各五钱)
上为粗末。每服五钱,水二盏,煎至八分,去渣,温服,接续三四日。有汗慎风。
治风热成历节,攻手指,作赤肿麻木,其则攻肩背两膝,遇暑热或大便秘即作,牛蒡子散。
牛蒡子 新豆豉(炒) 羌活(各三两) 生地(二两半) 黄 (一两半)
上为细末。汤调二钱服,空心食前,日三服。此病胸膈生痰,久则赤肿,附着肢节,久
久不退,遂成疠风。此孙真人预戒也,宜早治之。
〔河〕大豆 散 治周痹注五脏留滞,胃中结聚。益气出毒,润泽皮毛,补肾。
用大豆 一升,炒香熟,为末。每服半钱,温酒调下,空心加至一钱,日三服。(本
草云∶大豆消瘀血,破妇人恶血,治热痹筋挛膝痛。古人多用酒沃豆 取汗,盖表药也)
〔无〕控涎丹 凡人忽胸背手脚颈项腰胯隐痛不可忍,连筋骨牵引钓痛,坐卧不宁,时时
走易不定。俗医不晓,谓之走注,便用风药及针灸,皆无益。又疑是风毒结聚,欲为痈疽,
乱投药帖,亦非也。此乃是痰涎伏在心膈上下,变为疾。或令人头痛不可举,或神思昏
多睡,或饮食无味,痰唾稠粘,夜间喉中如锯声,口流唾涎,手脚重,腿冷,痹气不通,
误认为瘫痪,亦非也。凡有此疾,但用是药,不过数服,其疾如失。
甘遂(去心) 紫大戟(去皮) 白芥子(真者,各等分)
上为末,煮糊丸,如桐子大。晒干,临卧,淡姜汤或熟水下五、七丸至十丸。痰猛气实
,加丸数不妨,其效如神。
〔《千》〕犀角汤 治热毒流入四肢,历节肿痛。
犀角(二两) 羚羊角(一两) 前胡 黄芩 栀子仁 射干 大黄 升麻(各四两) 豉(一升)
上九味, 咀。每服五钱,水二盏,煎服。
〔《本》〕茵芋丸 治历节肿满疼痛。
茵芋 朱砂 薏苡仁(各一两) 牵牛(一两半) 郁李仁(半两)
上细末,炼蜜杵丸,如桐子大,轻粉滚为衣。每服十丸至十五丸,或二十丸,五更温水
下,到晚未利,可二三服,快利为度,白粥将息。
〔子和〕治一税官,风寒湿痹,腰脚沉重浮肿,夜则痛甚,两足恶寒,经五六月间,犹绵
胫,靴足膝,皮肤少有跣露,则冷风袭之,流入经络,其病转剧,走注上下,往来无定,其
痛极处,便挛急而肿起,肉色不变,腠理如虫行。每遇风冷,病必转增,饮食减,肌体瘦乏
,须人扶,稍能行立。所服者,乌、附、姜、桂种种燥热。燔针着灸,莫知其数,前后三年
不愈。一日予脉之,其两手皆沉滑有力,先以导水丸、通经散各一服,是夜泻三十余行,痛
减半,渐服赤茯苓汤、川芎汤、防风汤,此三方在《宣明论》中治痹方是也,日三服,煎七
八钱 然汗出。余又作玲珑灶法熏蒸,血热必增剧,诸汗法古方多有之,惟以吐
发汗者,世罕知之。故予尝曰∶吐法兼汗,良以此夫。
〔《千》〕治游风,行走无定,或如盘大,或加瓯,或着腹背,或着臂,或着脚,悉主之。
海藻 茯苓 防风 独活 附子 白术(各三两) 大黄(五两) 鬼箭羽 当归(各二两) 上
九味, 咀。以水二斗,渍五日,初服二合,渐加,以知为度。
〔丹〕控涎散 治身及胁走痛,痰挟死血。加桃仁泥丸,治走注疼痛。
威灵仙(一钱) 川芎(七钱) 栀子(炒,一钱) 当归(一钱) 肉桂(一分) 苍术(一钱) 桃仁(七个)
甘草(五分)
上用生姜五片,水二盏,煎半干,入童便半盏,竹沥半盏,沸热服。忌肉面鸡。
定痛方 治一切风湿痹痛。
乳香 没药 地龙(去土) 木鳖(去皮) 金星石 五灵脂
上等分蜜丸,如弹子大。每服一丸,临卧酒下。
〔《外》〕治历节诸风,百节酸疼不可忍。用松脂三十斤,炼四、五十遍,以炼酥三升,
温和松脂三升,熟搅令极调匀,每旦空腹以酒服方寸匕,日二服,数日。食面粥为佳,慎勿
食血腥生冷 物果子。百日瘥。
松节酒 治历节风,四肢疼痛。
松节二十斤,酒五斗,渍三七日,服一合,日五六服。(丹溪云∶松属金,能渗血中之湿)
〔《千》〕松叶酒 治历节。
松叶三十斤,酒二石五斗,渍三七日,服一合,日服五六度。
寒走注疼痛治法及热走注疼痛治法,并见表寒表热条。
〔垣〕∶身体沉重,走注疼痛,湿热相搏,而风热郁不得伸,附着于有形也,宜苍术、黄柏
之类。
〔李绛〕《兵部手集》方。治臂胫痛,不计深浅皆效。用虎胫骨二大两,粗舂熬黄,羚羊
角一大两,屑,新芍药二大两,细切。三物以无灰酒浸之,春夏七日,秋冬倍日,每旦空腹
饮一杯。冬月速要服,即以银器物盛,火炉中暖养之,三两日即可服也。
〔《经》〕治风毒,骨髓疼痛。芍药二分,虎骨一具,涂酥炙黄,槌碎,绢袋盛,用清酒
三升,渍五日,每服二合,日三服。
〔《圣》〕治历节风,百节疼痛,不可忍。用虎头骨一具,涂酥炙黄,槌碎,绢袋盛,用
清酒二斗,浸五宿,随性多少,缓饮之妙。
〔《灵》〕黄帝问于岐伯曰∶周痹之在身也,上下移徙随脉,其上下左右相应,间不容空
,愿闻此痛,在血脉之中邪,将在分肉之间乎?何以致是?其痛之移也,间不及下针,其搐痛
之时,不及定治,而痛已止矣,何道使然,愿闻其故?岐伯答曰∶此众痹也,非周痹也。黄
帝曰∶愿闻众痹。岐伯曰∶此各在其处,更发更止,更居更起,以右应左,以左应右,非能
周也,更发更休也。帝曰∶善。此痛安生?何因而有名?岐伯曰∶风寒湿气客于外分肉之间,
迫切而为沫,沫得寒则聚,聚则排分肉而分裂也。分裂则痛,痛则神归之,神归之则热,热
则痛解,痛解则厥,厥则它痹发,发则如是。此内则不在脏,而外未发于皮,独居分肉之间
,真气不能周,故命曰周痹(周痹当作众痹,夫周痹邪在分肉血脉,今云邪独居分肉之间而
命曰周痹者,是众痹之误为周痹也明矣。神归之则热,热则痛解者,所谓更止更居也。痛解
则厥,厥则它痹发者,所谓更发更起也。自黄帝曰善,此痛安生,至此一百十四字,原误在
后刺其下以脱之上,今移于此)。黄帝曰∶善。刺之奈何?岐伯曰∶刺此者,痛虽已止,必刺
其处,勿令复起。帝曰∶善。愿闻周痹如何?岐伯曰∶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。黄帝曰∶刺之奈何?岐伯曰∶痛从上下者,先刺其下以过
之,后刺其上以脱之。痛从下上者,先刺其上以过之,后刺其下以脱之。故刺痹者,必先切
循其下之六经,视其虚实,及大络之血结而不通,及虚而脉陷空者而调之,熨而通之,其
坚,转引而行之。帝曰∶善。余已得其意矣(周痹篇。大络血结不通为实,脉陷空为
虚。“过”字一作“遏”,下同)
按∶缪刺论云∶凡痹往来行无常处者,在分肉之间,痛而刺之,以月死生为数。用
针者,随气盛衰,以为 数。针过其日数则脱气,不及日数则气不泻,左刺右,右刺左
,病已止,不已复刺之如法。月生一日一 二日二 ,渐多之,十五日十五
,十六日十四 ,渐少之。
详此亦刺众痹于所痛之法,当与前众痹法相参用之。
刺五脏六腑痹法,见诸痹条。
〔《千》〕治历节,但于痛处,灸三七壮,佳。
〔《怪》〕白虎历节风痛∶两踝尖(在内外两踝尖灸之)。浑身疼痛,往来上下无常∶阳辅。
如足跟不得履地∶风池。如膝盖肿起∶曲池(一寸半),阳陵泉(一寸半)。
〔《心》〕妇人四旬,因小产成病,百节痛,无常处,卧床不起,八字(五分),环跳(四寸半)
,五枢(三寸半),曲池、液门(各寸半),绝骨(二寸半)。如脊背痛者,人中、大椎节下(各五分),委
中(七分见血立效)。
〔无〕附骨疽,与白虎飞尸历节皆相类。历节痛则走注不定,白虎飞尸痛浅按之则便止,
附骨疽痛深按之亦无益。又一说,白虎飞尸亦能作脓,着骨而生,及其腐渍,碎骨出尽,方
愈。如是则附骨与白虎飞尸同是一病,但浅深不同耳。
〔仲〕寸口脉沉而弱,沉即主骨,弱即主筋,沉即为肾,弱即为肝,汗出入水中,如水伤
心,历节黄汗出,故曰历节。少阴脉浮而弱,弱则血不足,浮则为风,风血相搏,则疼痛如
掣。盛人脉涩小,短气自汗出,历节疼不可屈伸,此皆饮酒汗出当风所致。
【张仲景】各个关节疼痛,身体消瘦羸弱,脚部肿胀得像要脱离身体一样,头晕目眩,呼吸短促,恶心欲吐,用桂枝芍药知母汤主治。
桂枝(四两) 芍药(三两) 甘草(二两) 麻黄(二两) 生姜(五两) 白术(五两) 知母(四两) 防风(四两) 附子(二两,炮制)
以上药物用水七升,煮取药液二升,温服七合,每日服用三次。
患历节病(一种以关节剧烈疼痛、变形为特征的疾病),关节僵硬不能屈伸,疼痛剧烈,用乌头汤主治。
麻黄 芍药 黄芪(各三两) 甘草(蜜炙) 川乌(五枚,捣碎。用蜂蜜二升,煎取一升,随即去掉川乌)
以上五味药捣碎。用水三升,煮取一升,去渣,加入蜂蜜再煎,服七合,随时服完。
【刘河间】防风汤,治疗行痹(风湿之邪游走不定引起的痹证),疼痛走注无定处。
防风 甘草 当归 赤茯苓(去皮) 杏仁(去皮,炒熟) 桂枝(以上各一两) 黄芩 秦艽 葛根(各三钱) 升麻(去芦头,半两)
以上药物研为细末。每次服五钱,加水、酒各二盏,大枣三枚,生姜五片,煎至一盏,去渣,温服。
【《本草》】治疗湿邪损伤肾脏,肾气不足不能滋养肝脏,肝气自生风邪,遂成风湿,流注于四肢筋骨,或者侵入左肩,肌肉疼痛,逐渐蔓延到左手指中,用薏苡仁散治疗。
薏苡仁(一两) 当归 小川芎 干姜 茵芋 甘草 官桂 川乌 防风 人参 羌活 白术 麻黄 独活(各半两)
以上药物研为细末。每次服二钱,空腹及睡前用酒调服,每日三次。
治疗白虎历节风(形容疼痛如虎咬,游走不定)等各种风邪疼痛,游走无定处,感觉像虫子啃咬,白天安静晚上加重,以及一切手足疼痛,用麝香丸治疗。
川乌(大八角形的,三个,生用) 全蝎(二十一个,生用) 黑豆(二十一个,生用) 地龙(半两)
以上药物研为细末。加入麝香半字共同研磨均匀,用糯米糊制作成丸,大小如绿豆。每次服七丸,严重的服十丸,夜间睡觉时保持膈部空虚,用温酒送下,全身微微出冷汗,病就好了。我得到这个方子后,凡是遇到历节病和不明的疼痛,一二服就能痊愈。在歙州时,有一位贵妇,全身游走性疼痛,到了夜晚发作,像虫子啃咬她的肌肉,很多人当作鬼邪来治。我说,这正是历节病,服三剂就好了。(歙,读音同“叶”)。
【朱丹溪】龙虎丹,治疗走注疼痛,或者麻木不遂,或者半身疼痛。
草乌 苍术 白芷(各一两)
以上药物研为细末,用水拌和发热后,再加入乳香二钱,当归、牛膝各半两,用酒糊制作成丸,大小如弹子。用酒化开送服。
【王好古】附子八物汤,治疗历节风,四肢疼痛,像被锤打锻造一样,难以忍受。
附子(炮制,去皮脐) 干姜(炮制) 芍药 茯苓 半夏 桂心(各三两) 白术(四两) 人参(三两)
以上药物切碎成散剂。每次服四钱,水二盏,煎至七分,去渣,饭前服用。
【朱丹溪】痛风走注疼痛。
黄柏(酒炒) 苍术(酒炒,各二钱)
以上作为一服,煎好后,调入酒威灵仙末、羚羊角灰,以苍术为主药,芥子为辅佐药,放入一片生姜,将药末一钱擂碎,用前面的药液再次温服。
【李东垣】和血散痛汤,治疗两手十个手指,这一个疼完那一个疼,疼后又肿胀,骨头里疼痛,膝盖疼痛,左膝疼完右膝疼,发作时多则五天,少则三天,白天轻晚上重,疼痛时感觉发热,行走时疼痛减轻,但肿胀沉重。注解说,先伤血后伤气,是先痛后肿,形体受伤导致气机阻滞。
羌活 升麻 麻黄(去节,各钱半) 桃仁(十个) 柴胡(二钱) 红花(一分) 归身(一分) 防风(一钱) 甘草(蜜炙,二分) 独活(五分) 猪苓(五分) 黄柏(一钱) 防己(六分) 知母(酒浸,一钱) 黄连(酒浸)
以上药物捣碎。分成四服,每服用水一大盏,煎至一半,去渣,空腹热服。
【罗谦甫】真定府的张大,平时喜欢喝酒,五月间发病,手指关节肿痛,屈伸不利,膝盖髌骨也这样,心下部痞塞胀满,身体沉重,不想饮食,吃了就想吐,面色萎黄,精神减少。到了六月间,求我治疗。诊察他的脉象沉而缓,缓脉主脾。《难经》说:俞穴主体重节痛。俞穴是脾所主的,四肢属于脾。大概是因为这个人平时饮酒,加上时令湿气相助,湿气大胜,流注于四肢,所以出现肿痛。《内经》说:各种湿邪导致的肿胀痞满,都归属于脾土。张仲景说:湿邪流注关节,肢体烦痛,说的就是这个情况。适宜用大羌活汤主治。《内经》说:湿邪淫溢于内,用苦温药治疗,用苦味发散它,用淡味渗利它。又说:风能胜湿。羌活、独活味苦性温,能透达关节而胜湿,所以作为君药。升麻味苦性平,威灵仙、苍术、防风味辛苦性温,能发散湿邪,所以作为臣药。血液壅滞而不流通就会疼痛,当归味辛性温以消散它。甘草味甘性温以益气,泽泻味咸性平,茯苓味甘性平,引导湿邪并通利小便,用淡味渗利它。使药气味相合,上下分散湿邪。
羌活 升麻(各一钱) 独活(七分) 苍术 防风 甘草 威灵仙 茯苓 当归 泽泻(各半两)
以上药物切碎作为一服。水二盏,煎至一盏,温服,饭前一服,饭后一服。忌食酒、面食、生冷、硬物。
【《本草》】麻黄汤,治疗历节病。
麻黄(一两) 羌活(一两) 黄芩(三分) 细辛 黄芪(各五钱)
以上药物研为粗末。每次服五钱,水二盏,煎至八分,去渣,温服,连续服用三四天。有汗者慎避风寒。
治疗风热形成的历节病,侵袭手指,发红肿胀麻木,严重时侵袭肩背和两膝,遇到暑热或大便秘结时就发作,用牛蒡子散治疗。
牛蒡子 新豆豉(炒) 羌活(各三两) 生地(二两半) 黄芪(一两半)
以上药物研为细末。开水调服二钱,空腹饭前服用,每日三次。这个病胸膈生痰,久了就发红肿胀,附着在肢节上,久久不退,遂成疠风。这是孙真人预先告诫的,应该早治。
【刘河间】大豆散,治疗周痹(疼痛沿经脉上下移动的痹证)注于五脏留滞,胃中结聚。益气排毒,润泽皮毛,补肾。
用大豆一升,炒香熟,研为细末。每次服半钱,温酒调服,空腹加至一钱,每日三次。(《本草》说:大豆能消瘀血,破妇人恶血,治疗热痹筋挛膝痛。古人多用酒浇豆子取汗,这属于表药)
【王好古】控涎丹,凡人忽然胸背手脚颈项腰胯隐痛不可忍受,牵连筋骨牵引钓痛,坐卧不宁,时时游走不定。俗医不懂,称之为走注,就用风药及针灸,都没有益处。又怀疑是风毒结聚,想要成为痈疽,乱投药贴,也不对。这其实是痰涎伏在心膈上下,变为疾症。或者让人头痛不能举,或者神志昏沉多睡,或者饮食无味,痰唾稠粘,夜间喉中像锯声,口流唾涎,手脚沉重,腿冷,痹气不通,误认为瘫痪,也不对。凡是有这种疾症,只要用这个药,不过几服,疾症就像消失了一样。
甘遂(去心) 紫大戟(去皮) 白芥子(真品,各等分)
以上药物研为末,煮糊制作成丸,大小如梧桐子。晒干,临睡前,用淡姜汤或温水送服五、七丸至十丸。痰盛气实的人,增加丸数不妨碍,其效果如神。
【《千金方》】犀角汤,治疗热毒流入四肢,历节肿痛。
犀角(二两) 羚羊角(一两) 前胡 黄芩 栀子仁 射干 大黄 升麻(各四两) 豆豉(一升)
以上九味药,捣碎。每次服五钱,水二盏,煎服。
【《本草》】茵芋丸,治疗历节肿满疼痛。
茵芋 朱砂 薏苡仁(各一两) 牵牛(一两半) 郁李仁(半两)
以上研为细末,炼蜜杵丸,大小如梧桐子,轻粉滚为衣。每次服十丸至十五丸,或二十丸,五更时用温水送下,到晚未通便,可服二三服,以痛快排便为度,用白粥调养。
【张子和】治疗一个税务官员,风寒湿痹,腰脚沉重浮肿,夜间疼痛加剧,两足怕冷,经过五六个月,还穿着厚棉裤,靴子套在膝盖上,皮肤很少有裸露的地方,一旦冷风吹袭,流入经络,病情转剧,走注上下,往来无定,疼痛最厉害的地方,就痉挛肿胀起来,肉色不变,腠理像虫行。每次遇到风冷,病情必定加重,饮食减少,肌体瘦乏,需要人搀扶,稍微能行走站立。所服用的,都是乌头、附子、干姜、桂枝种种燥热药物。烧针着灸,不知有多少次,前后三年不愈。一天我诊察他的脉,两手都沉滑有力,先用导水丸、通经散各一服,当晚腹泻三十多次,疼痛减半,渐渐服用赤茯苓汤、川芎汤、防风汤,这三个方子在《宣明论》中治疗痹证的方子里,每日三次,煎七八钱,然后出汗。我又做玲珑灶法熏蒸,血热必然加剧,各种发汗的古方多有提及,只有用吐法发汗的,世人很少知道。所以我曾说:吐法兼有汗法的作用,确实如此。
【《千金方》】治疗游风,行走无定处,或者像盘子大,或者像碗大,或者附着在腹背,或者附着在手臂,或者附着在脚,全部主治。
海藻 茯苓 防风 独活 附子 白术(各三两) 大黄(五两) 鬼箭羽 当归(各二两)
以上九味药,捣碎。用水二斗,浸泡五天,初服二合,逐渐增加,以见效为度。
【朱丹溪】控涎散,治疗身体及胁肋走痛,痰挟死血。加入桃仁泥丸,治疗走注疼痛。
威灵仙(一钱) 川芎(七钱) 栀子(炒,一钱) 当归(一钱) 肉桂(一分) 苍术(一钱) 桃仁(七个) 甘草(五分)
以上用生姜五片,水二盏,煎至半干,加入童便半盏,竹沥半盏,煮沸热服。忌食肉、面、鸡。
定痛方,治疗一切风湿痹痛。
乳香 没药 地龙(去土) 木鳖(去皮) 金星石 五灵脂
以上等分,蜜丸,大小如弹子。每次服一丸,临睡前用酒送下。
【《外台秘要》】治疗历节诸风,百节酸疼不可忍受。用松脂三十斤,炼制四五十遍,用炼酥三升,温和松脂三升,熟搅令极调匀,每天早晨空腹用酒服方寸匕,每日两次,持续数日。吃面条粥为佳,千万不要吃血腥生冷瓜果。百日痊愈。
松节酒,治疗历节风,四肢疼痛。
松节二十斤,酒五斗,浸泡三七天,服一合,每日五六服。(丹溪说:松属金,能渗血中之湿)
【《千金方》】松叶酒,治疗历节病。
松叶三十斤,酒二石五斗,浸泡三七天,服一合,每日服五六次。
寒性走注疼痛治法及热性走注疼痛治法,并见表寒表热条。
【李东垣】身体沉重,走注疼痛,湿热相搏,而风热郁结不得伸展,附着于有形之物,适宜用苍术、黄柏之类。
【李绛】《兵部手集》方。治疗臂胫痛,不论深浅都有效。用虎胫骨二大两,粗舂熬黄,羚羊角一大两,锉屑,新芍药二大两,细切。三物用无灰酒浸泡,春夏七天,秋冬加倍天数,每天早晨空腹喝一杯。冬天急着要服,就用银器盛放,火炉中暖养,三两日即可服用。
【《经》】治疗风毒,骨髓疼痛。芍药二分,虎骨一具,涂酥炙黄,槌碎,绢袋盛,用清酒三升,浸泡五天,每次服二合,每日三次。
【《圣济总录》】治疗历节风,百节疼痛,不可忍受。用虎头骨一具,涂酥炙黄,槌碎,绢袋盛,用清酒二斗,浸泡五宿,随性情多少,缓缓饮之妙。
【《灵枢》】黄帝问岐伯说:周痹在身上,上下移动跟随经脉,其上下左右相应,间隙不容空隙,请问这种痛,是在血脉之中呢,还是在分肉之间?怎么导致这样的?它的痛移动,来不及下针,抽搐疼痛的时候,来不及确定治疗,痛已经停止了,什么道理使得这样,请问其中的缘故?岐伯回答说:这是众痹,不是周痹。黄帝说:请问众痹。岐伯说:这各自在它的部位,更发更止,更居更起,以右应左,以左应右,不能周身,更发更休。帝说:好。这种痛怎么产生?什么因缘有名?岐伯说:风寒湿气客于外分肉之间,迫切而为沫,沫得寒则聚,聚则排分肉而分裂也。分裂则痛,痛则神归之,神归之则热,热则痛解,痛解则厥,厥则它痹发,发则如是。这在内不在脏,在外未发于皮,独居分肉之间,真气不能周,所以命曰周痹(周痹应当作众痹,夫周痹邪在分肉血脉,今云邪独居分肉之间而命曰周痹者,是众痹之误为周痹也明矣。神归之则热,热则痛解者,所谓更止更居也。痛解则厥,厥则它痹发者,所谓更发更起也。自黄帝曰善,此痛安生,至此一百十四字,原误在后刺其下以脱之上,今移于此)。黄帝说:好。怎么刺?岐伯说:刺此者,痛虽已止,必刺其处,勿令复起。帝说:好。请问周痹如何?岐伯说: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。黄帝说:怎么刺?岐伯说:痛从上下者,先刺其下以过之,后刺其上以脱之。痛从下上者,先刺其上以过之,后刺其下以脱之。故刺痹者,必先切循其下之六经,视其虚实,及大络之血结而不通,及虚而脉陷空者而调之,熨而通之,其坚,转引而行之。帝说:好。我已得其意了(周痹篇。大络血结不通为实,脉陷空为虚。“过”字一作“遏”,下同)。
按:缪刺论说:凡是痹症往来行无常处者,在分肉之间,痛而刺之,以月死生为数。用针者,随气盛衰,以为次数。针过其日数则脱气,不及日数则气不泻,左刺右,右刺左,病已止,不已复刺之如法。月生一日一,二日二,渐多之,十五日十五,十六日十四,渐少之。
详察此也是刺众痹于所痛之法,应当与前众痹法参合使用。
刺五脏六腑痹法,见诸痹条。
【《怪奇方》】白虎历节风痛:两踝尖(在内外两踝尖灸之)。浑身疼痛,往来上下无常:阳辅。如足跟不得履地:风池。如膝盖肿起:曲池(一寸半),阳陵泉(一寸半)。
【《心》】妇人四十岁,因小产成病,百节痛,无常处,卧床不起,八字(五分),环跳(四寸半),五枢(三寸半),曲池、液门(各寸半),绝骨(二寸半)。如脊背痛者,人中、大椎节下(各五分),委中(七分见血立效)。
【王好古】附骨疽,与白虎飞尸历节皆相类。历节痛则走注不定,白虎飞尸痛浅按之则便止,附骨疽痛深按之亦无益。又一说,白虎飞尸亦能作脓,着骨而生,及其腐溃,碎骨出尽,方愈。如是则附骨与白虎飞尸同是一病,但浅深不同耳。
【张仲景】寸口脉沉而弱,沉即主骨,弱即主筋,沉即为肾,弱即为肝,汗出入水中,如水伤心,历节黄汗出,故曰历节。少阴脉浮而弱,弱则血不足,浮则为风,风血相搏,则疼痛如掣。盛人脉涩小,短气自汗出,历节疼不可屈伸,此皆饮酒汗出当风所致。
[Zhongjing] Pain in various joints, emaciation of the body, swelling of the feet as if detached, dizziness, shortness of breath, nausea and desire to vomit; Guizhi Shaoyao Zhimu Tang (Cinnamon Twig, Peony, and Anemarrhena Decoction) is the primary treatment.
Guizhi (Cinnamon Twig, 4 liang), Shaoyao (Peony Root, 3 liang), Gancao (Licorice Root, 2 liang), Mahuang (Ephedra Herb, 2 liang), Shengjiang (Fresh Ginger, 5 liang), Baizhu (Atractylodes Rhizome, 5 liang), Zhimu (Anemarrhena Rhizome, 4 liang), Fangfeng (Saposhnikovia Root, 4 liang), Fuzi (Prepared Aconite Root, 2 liang, processed).
Take the above herbs, add seven sheng of water, boil to obtain two sheng of decoction, take warm, seven ge per dose, three times a day.
For Lijie disease (Joint Bi syndrome characterized by severe pain and deformity) with stiffness preventing flexion and extension, and severe pain, Wutou Tang (Aconite Decoction) is the primary treatment.
Mahuang (Ephedra Herb), Shaoyao (Peony Root), Huangqi (Astragalus Root) (each 3 liang), Gancao (Licorice Root, honey-fried), Chuanwu (Chuanwu Aconite, 5 pieces, crushed. Boil with two sheng of honey until one sheng remains, then remove the Chuanwu).
Crush the above five herbs. Add three sheng of water, boil to obtain one sheng, strain, add honey, and simmer again. Take seven ge, consume at any time.
[Hewen] Fangfeng Tang (Saposhnikovia Decoction) treats Xingbi (Wandering Bi syndrome with migrating pain).
Fangfeng (Saposhnikovia Root), Gancao (Licorice Root), Danggui (Angelica Sinensis), Chi Fuling (Red Poria, peeled), Xingren (Apricot Seed, peeled and stir-fried), Guizhi (Cinnamon Twig) (each 1 liang), Huangqin (Scutellaria Root), Qinjiao (Gentiana Macrophylla Root), Gegen (Pueraria Root) (each 3 qian), Shengma (Cimicifuga Rhizome, de-stalked, 0.5 liang).
Grind into fine powder. Take 5 qian, with two zhan of water and wine, three jujubes, and five slices of ginger. Decoct to one zhan, strain, and take warm.
[Bencao] Treats kidney injury by dampness, where kidney fails to nourish liver, leading to internal wind generation, resulting in Wind-Dampness flowing into the four limbs' sinews and bones, or invading the left shoulder, causing muscle pain that gradually spreads to the left fingers. Yiyiren San (Coix Seed Powder) is used.
Yiyiren (Coix Seed, 1 liang), Danggui (Angelica Sinensis), Xiao Chuanxiong (Small Ligusticum Rhizome), Ganjiang (Dried Ginger), Yinyu (Berberis Stem), Gancao (Licorice Root), Guanzi Gui (Cassia Bark), Chuanwu (Chuanwu Aconite), Fangfeng (Saposhnikovia Root), Renshen (Ginseng Root), Qianghuo (Notopterygium Rhizome), Baizhu (Atractylodes Rhizome), Mahuang (Ephedra Herb), Duhuo (Angelica Pubescens Root) (each 0.5 liang).
Grind into fine powder. Take 2 qian, mixed with wine on an empty stomach and before sleep, three times a day.
Treats Baihu Lijie Feng (White Tiger Joint Bi with migrating pain feeling like insect bites, quiet by day and worse by night) and all hand/foot pain. Shexiang Wan (Musk Pill) is used.
Chuanwu (Chuanwu Aconite, large octagonal shape, 3 pieces, raw), Quanxie (Whole Scorpion, 21 pieces, raw), Heidou (Black Soybean, 21 pieces, raw), Dilong (Earthworm, 0.5 liang).
Grind into fine powder. Add Banzi (half zi) of Shexiang (Musk), grind evenly. Form pills with glutinous rice paste, size of mung beans. Take 7 pills (10 for severe cases) before bed with empty diaphragm, using warm wine. Mild cold sweat over the body indicates recovery. I obtained this formula; for Lijie or unexplained pain, one or two doses bring relief. In Shenzhou, a noblewoman had whole-body migrating pain, worsening at night like insect bites, treated as ghost evil. I diagnosed it as Lijie; three doses cured her. (Shen pronunciation: Ye).
[Dani] Longhu Dan (Dragon-Tiger Pill) treats migrating pain, numbness and paralysis, or half-body pain.
Caowu (Caowu Aconite), Cangzhu (Atractylodes Lancea Rhizome), Baizhi (Angelica Dahurica Root) (each 1 liang).
Grind into powder, mix with water until hot, add Rushan (Frankincense Resin, 2 qian), Danggui (Angelica Sinensis, 0.5 liang), Niuxi (Achyranthes Root, 0.5 liang). Form pills with wine paste, size of bullet. Dissolve in wine and take.
[Wugou] Fuzi Bawu Tang (Aconite Eight-Ingredient Decoction) treats Lijie Feng, limb pain like hammering, unbearable.
Fuzi (Prepared Aconite Root, peeled), Ganjiang (Dried Ginger, processed), Shaoyao (Peony Root), Fuling (Poria), Banxia (Pinellia Tuber), Guixin (Cinnamon Bark) (each 3 liang), Baizhu (Atractylodes Rhizome, 4 liang), Renshen (Ginseng Root, 3 liang).
Cut into fragments. Take 4 qian, two zhan of water, decoct to 0.7 portion, strain, take before meals.
[Dani] Tongfeng (Gout) with migrating pain.
Huangbai (Phellodendron Bark, wine-fried), Cangzhu (Atractylodes Lancea Rhizome, wine-fried) (each 2 qian).
As one dose, decoct well, mix with Jiulingxian (Clematis Root) powder in wine, Lingyangjiao (Antelope Horn) ash. Cangzhu is the sovereign herb, Mustard Seed (Jiezi) is the assistant. Add one slice of ginger, grind 1 qian of herb powder, and re-warm with the decoction to take.
[Dongyuan] Hexue Santong Tang (Harmonize Blood and Disperse Pain Decoction) treats ten fingers, pain moving from one to another, followed by swelling, deep bone pain, knee pain (left then right), lasting 3-5 days, lighter by day, heavier by night, feeling hot during pain, walking relieves pain but swelling feels heavy. Explanation: Blood injury precedes Qi injury, hence pain precedes swelling; form injury affects Qi.
Qianghuo (Notopterygium Rhizome), Shengma (Cimicifuga Rhizome), Mahuang (Ephedra Herb, de-stalked) (each 1.5 qian), Taoren (Peach Kernel, 10 pieces), Chaihu (Bupleurum Root, 2 qian), Honghua (Carthamus Flower, 1 fen), Guishen (Angelica Sinensis Root tip, 1 fen), Fangfeng (Saposhnikovia Root, 1 qian), Gancao (Licorice Root, honey-fried, 2 fen), Duhuo (Angelica Pubescens Root, 5 fen), Zhuling (Polyporus, 5 fen), Huangbai (Phellodendron Bark, 1 qian), Fangji (Stephania Root, 6 fen), Zhimu (Anemarrhena Rhizome, wine, 1 qian), Huanglian (Coptis Rhizome, wine).
Crush. Divide into four doses. Each dose with one large zhan of water, decoct to half, strain, take hot on an empty stomach.
[Luo] Zhang Da from Zhengding Prefecture, loved alcohol. In May, finger joints swelled and hurt, stiff, knees similar, epigastric fullness, heavy body, anorexia, nausea after eating, sallow complexion, low spirit. In June, sought my treatment. Pulse was deep and slow; slow indicates Spleen. *Nanjing* states: Shu points govern weight and joint pain. Shu points are governed by Spleen; four limbs belong to Spleen. Due to chronic drinking and seasonal dampness, dampness overwhelmed and flowed to limbs, causing swelling and pain. *Neijing* states: All dampness, swelling, and fullness belong to Spleen Earth. Zhongjing states: Dampness flowing to joints causes limb pain. Use Da Qianghuo Tang (Great Notopterygium Decoction). *Neijing* states: For internal dampness, treat with bitter-warm, disperse with bitter, drain with bland. Wind overcomes dampness. Qianghuo and Duhuo are bitter-warm, penetrating joints to overcome dampness (Sovereign). Shengma is bitter-neutral; Weilingxian (Clematis Root), Cangzhu (Atractylodes Lancea Rhizome), Fangfeng (Saposhnikovia Root) are bitter-pungent-warm dispersants (Ministers). Blood stasis causes pain; Danggui (Angelica Sinensis) is pungent-warm to disperse. Gancao (Licorice Root) is sweet-warm to tonify Qi; Zexie (Alisma Rhizome) is salty-neutral; Fuling (Poria) is sweet-neutral; they guide dampness and promote urination (Drain). Combined, they disperse dampness up and down.
Qianghuo (Notopterygium Rhizome), Shengma (Cimicifuga Rhizome) (each 1 qian), Duhuo (Angelica Pubescens Root, 7 fen), Cangzhu (Atractylodes Lancea Rhizome), Fangfeng (Saposhnikovia Root), Gancao (Licorice Root), Weilingxian (Clematis Root), Fuling (Poria), Danggui (Angelica Sinensis), Zexie (Alisma Rhizome) (each 0.5 liang).
Cut into fragments. One dose, two zhan of water, decoct to one zhan, take warm. One dose before meal, one after. Avoid alcohol, wheat, raw/cold, hard foods.
[Bencao] Mahuang Tang (Ephedra Decoction) treats Lijie.
Mahuang (Ephedra Herb, 1 liang), Qianghuo (Notopterygium Rhizome, 1 liang), Huangqin (Scutellaria Root, 3 fen), Xixin (Asarum Root), Huangqi (Astragalus Root) (each 5 qian).
Grind to coarse powder. Take 5 qian, two zhan of water, decoct to 0.8 portion, strain, take warm, continuously for 3-4 days. Avoid wind if sweating.
Treats Wind-Heat forming Lijie, attacking fingers causing red swelling and numbness, later shoulders/back/knees, triggered by heat or constipation. Niubangzi San (Arctium Seed Powder) is used.
Niubangzi (Arctium Fruit), Xin Douchi (New Fermented Soybean), Qianghuo (Notopterygium Rhizome) (each 3 liang), Shengdi (Rehmannia Root, 2.5 liang), Huangqi (Astragalus Root, 1.5 liang).
Grind to fine powder. Mix with hot water, take 2 qian, empty stomach before meals, three times daily. Phlegm in chest/diaphragm leads to red swelling attaching to joints, becoming Leprosy if prolonged. Sun Simiao warned early treatment is needed.
[Hewen] Dadou San (Soybean Powder) treats Zhou Bi (Circular Bi) stagnating in five zang organs and stomach accumulation. Tonifies Qi, expels toxins, moistens skin/hair, tonifies Kidney.
Use one sheng of soybeans, stir-fry until fragrant, grind to powder. Take 0.5 qian with warm wine, empty stomach increase to 1 qian, three times daily. (*Bencao*: Soybeans resolve blood stasis, treat Heat Bi with tendon spasms/knee pain. Ancients used wine-soaked beans to induce sweating, a surface-releasing method).
[Wugou] Kongxian Dan (Control Phlegm Fluid Pill) treats sudden hidden pain in chest/back/limbs/neck/waist, radiating to sinews/bones, restlessness, migrating pain. Lay doctors mistake it for Wanzhu (migrating pain) and use wind-dispelling drugs/acupuncture, which are useless. They may suspect Wind-Toxin abscess and apply plasters, also wrong. This is Phlegm-Fluid lodged above/below diaphragm causing disease. Symptoms: headache, lethargy, loss of taste, thick saliva, sawing sound at night, drooling, heavy limbs, cold legs, blocked Bi Qi, mistaken for paralysis. Using this drug cures it in a few doses.
Gansui (Kansui Root, de-heart), Zijda Ji (Purple Euphorbia Root, de-skin), Baijiezi (White Mustard Seed, authentic) (equal parts).
Grind to powder, form pills with boiled paste, size of tung seeds. Dry. Take 5-10 pills before bed with light ginger soup or warm water. For strong phlegm/excess Qi, increase dosage. Effect is miraculous.
[Qianjin] Xijiao Tang (Rhinoceros Horn Decoction) treats Heat-Toxin flowing to four limbs, Lijie swelling/pain.
Xijiao (Rhinoceros Horn - *Note: Substitute with Water Buffalo Horn in modern practice*), Lingyangjiao (Antelope Horn), Qianhu (Peucedanum Root), Huangqin (Scutellaria Root), Zhizi Ren (Gardenia Seed), Shegan (Belamcanda Rhizome), Dahuang (Rhubarb Root), Shengma (Cimicifuga Rhizome) (each 4 liang), Chi (Fermented Soybean, 1 sheng).
Nine ingredients, crush. Take 5 qian, two zhan of water, decoct and take.
[Bencao] Yinyu Wan (Berberis Pill) treats Lijie swelling/fullness/pain.
Yinyu (Berberis Stem), Zhusha (Cinnabar), Yiyiren (Coix Seed) (each 1 liang), Qianniu (Morning Glory Seed, 1.5 liang), Yuliren (Bush Cherry Seed, 0.5 liang).
Fine powder, honey pills, size of tung seeds, coated with Qingfen (Calomel). Take 10-15 (or 20) pills at dawn with warm water. If no bowel movement by evening, take 2-3 more. Stop when loose stool occurs. Maintain with white rice porridge.
[Zihe] Treating a tax official with Wind-Cold-Damp Bi, heavy/swollen waist/legs, worse at night, cold feet. After 5-6 months, wore thick cotton pants/boots to avoid wind entering meridians, worsening condition with migrating pain, spasms/swelling at peak pain, normal skin color, bug-like sensation in pores. Cold worsens symptoms, appetite drops, emaciation, needs support. Took many hot/dry drugs (Wutou, Fuzi, Ganjiang, Guizhi) and moxibustion for 3 years without cure. Pulse: deep, slippery, forceful both hands. First, Daoshui Wan (Water-Guiding Pill) and Tongjing San (Meridian-Unblocking Powder), one dose each. That night, >30 stools, pain halved. Then gradually took Chifuling Tang (Red Poria Decoction), Chuanxiong Tang (Ligusticum Decoction), Fangfeng Tang (Saposhnikovia Decoction) from *Xuanning Lun*. Three times daily, decoct 7-8 qian, inducing sweat. Also used Linglong Zao fumigation. Blood heat exacerbates; ancient sweat methods exist, but vomiting-induced sweating is rare. Vomiting combines with sweating effect.
[Qianjin] Treats You Feng (Wandering Wind), migrating pain, size of plate/bowl, on abdomen/back/arms/legs.
Haizao (Sargassum Thallus), Fuling (Poria), Fangfeng (Saposhnikovia Root), Duhuo (Angelica Pubescens Root), Fuzi (Prepared Aconite Root), Baizhu (Atractylodes Rhizome) (each 3 liang), Dahuang (Rhubarb Root, 5 liang), Guijianyu (Arrowwood Branch), Danggui (Angelica Sinensis) (each 2 liang).
Nine ingredients, crush. Soak in two dou of water for 5 days. Start with 2 he, increase gradually until effective.
[Dani] Kongxian San (Control Phlegm Fluid Powder) treats body/flank migrating pain, Phlegm with dead blood. Add Taoren Mud (Peach Kernel Paste) pill for migrating pain.
Weilingxian (Clematis Root, 1 qian), Chuanxiong (Ligusticum Rhizome, 7 qian), Zhizi (Gardenia Seed, fried, 1 qian), Danggui (Angelica Sinensis, 1 qian), Rougui (Cinnamon Bark, 1 fen), Cangzhu (Atractylodes Lancea Rhizome, 1 qian), Taoren (Peach Kernel, 7 pieces), Gancao (Licorice Root, 5 fen).
Five slices of ginger, two zhan of water, decoct until half dry. Add half zhan of child's urine, half zhan of bamboo sap. Boil hot and take. Avoid meat, wheat, chicken.
Dingtong Fang (Definitive Pain Formula) treats all Wind-Damp Bi pain.
Ruxiang (Frankincense Resin), Moyao (Myrrh Resin), Dilong (Earthworm, de-soil), Mubie (Momordica Seed, de-skin), Jin Xingshi (Venus Stone), Wulingzhi (Trogopterus Dung).
Equal parts, honey pills, size of bullets. Take one pill before bed with wine.
[Waitai] Treats Lijie Wind, unbearable joint soreness. Use 30 jin of Songzhi (Pine Resin), refined 40-50 times. Mix with 3 sheng of refined butter and 3 sheng of refined pine resin, stir well. Take one fangcun bi (square inch spoonful) with wine on empty stomach morning, twice daily. Eat noodles/porridge. Avoid raw/cold/fish/meat/fruits. Cure in 100 days.
Songjie Jiu (Pine Node Wine) treats Lijie Feng, limb pain.
20 jin Pine Nodes, 5 dou Wine. Soak 21-30 days. Take 1 he, 5-6 times daily. (Danyu: Pine belongs to Metal, drains dampness from blood).
[Qianjin] Songye Jiu (Pine Needle Wine) treats Lijie.
30 jin Pine Needles, 2.5 shi Wine. Soak 21-30 days. Take 1 he, 5-6 times daily.
Cold/Warm migrating pain treatments see Table Cold/Table Heat sections.
[Yuan]: Heavy body, migrating pain, Damp-Heat conflict, Wind-Heat depression attaching to form. Use Cangzhu (Atractylodes Lancea Rhizome), Huangbai (Phellodendron Bark).
[Lijiang] *Bingbu Shouji* formula. Arm/shin pain, effective regardless of depth. Hu Jinggu (Tiger Tibia Bone, 2 da liang, pounded/cooked yellow), Lingyangjiao (Antelope Horn, 1 da liang, powdered), Xin Shaoyao (Fresh Peony Root, 2 da liang, sliced). Soak in pure wine: Spring/Summer 7 days, Autumn/Winter double. Drink one cup empty stomach morning. Winter: warm in silver vessel over fire for 2-3 days before taking.
[Jing]: Treats Wind-Toxin, bone marrow pain. Shaoyao (Peony Root, 2 fen), Hugu (Tiger Bone, 1 set, butter-coated, roasted yellow, crushed, silk bag). Soak in 3 sheng clear wine for 5 days. Take 2 he, three times daily.
[Shengji]: Treats Lijie Feng, unbearable joint pain. Tiger Head Bone (1 set, butter-coated, roasted yellow, crushed, silk bag). Soak in 2 dou clear wine for 5 nights. Drink slowly according to tolerance.
[Lingshu]: Yellow Emperor asked Qibo: Zhou Bi migrates along meridians, corresponding left/right, no gap. Is it in blood vessels or between muscles? Why? Pain moves too fast for acupuncture. Qibo: This is Zhong Bi (Multiple Bi), not Zhou Bi. Zhong Bi occurs locally, alternating onset/rest, left-right correspondence, not circulating. Cause: Wind-Cold-Damp in intermuscular spaces condenses into foam; cold gathers foam, pressing/splitting muscles causing pain. Pain draws Shen (Spirit/Mind); Shen generates heat; heat resolves pain; resolution leads to Jue (Cold/Stagnation); Jue triggers other Bi. It is not in Zang, not on Skin, but in intermuscular space, blocking True Qi circulation, hence called Zhou Bi (Correction: Text implies Zhong Bi misnamed Zhou Bi here). Acupuncture: Even if pain stops, needle the site to prevent recurrence. Zhou Bi is in blood vessels, following meridians up/down, not left/right. Treatment: If pain moves down, needle below first to block, then above to release. If up, needle above first to block, then below to release. Always palpate six meridians, assess deficiency/excess, blood stasis in collaterals, or sunken pulses. Adjust, warm, guide.
Note: *Mi C Lun* states: For Bi migrating without fixed location, needle in intermuscular space based on moon phases. Left needle right, right needle left. Stop when cured. Moon waxing: increase needles daily (1st day 1, 15th day 15). Moon waning: decrease. This method applies to Zhong Bi.
See Zhu Bi section for Five Zang/Six Fu Bi acupuncture.
[Qianjin]: Treat Lijie, moxa 37-77 moxibullae on painful spots.
[Guaiqi]: Baihu Lijie Feng pain: Liang Huai Jian (Ankle tips). Whole body migrating pain: Yangfu (GB38). Heel cannot touch ground: Fengchi (GB20). Knee swelling: Quchi (LI11), Yanglingquan (GB34).
[Xin]: Woman, 40, post-miscarriage, joint pain migrating, bedridden. Bazhui (GV19), Huantiao (GB30), Wushu (GB27), Quchi (LI11), Yemen (SJ2), Juegu (GB39). Back pain: Renzhong (GV26), Dazhui (GV14), Weizhong (BL40, bleed for immediate effect).
[Wugou): Fugu Ju (Bone-abscess Abscess) resembles Baihu Feishi Lijie. Lijie pain migrates; Feishi pain superficial stops on pressure; Fugu Ju pain deep unaffected by pressure. Feishi may suppurate, rot bone, heal when bone fragments exit. Same disease, different depth.
[Zhongjing]: Cun Kou pulse deep and weak. Deep governs bone/Kidney; Weak governs sinew/Liver. Sweat exposure to water damages Heart. Lijie with yellow sweat. Shao Yin pulse floating and weak. Weak means blood deficiency; Floating means Wind. Wind-Blood conflict causes tearing pain. Full-figured person with choppy/small pulse, shortness of breath, spontaneous sweat, Lijie stiffness: caused by drinking and sweating into wind.