虚人痹者，小续命汤（见中风）加减∶风胜倍防风，寒胜倍附子，湿胜倍防己，皮痹
加黄 或桂枝皮，脉痹加姜黄或红花，肌痹加葛根或白芷，筋痹加羚羊角或续
断，骨痹加虎骨或狗脊，有汗减麻黄，便溏减防己，寒胜减黄芩加干姜，热胜减
附子加石膏。壮者增味五痹汤∶风痹以羌、防为主，寒痹麻黄、附子为主，湿痹防
己、羌活为主，皮、脉等五痹，加药照前条。三痹通用木通，不见水者二两，以长
流水二碗，煎一碗，热服取微汗。（昔有人梦得此方而痹痛愈，此谓通则不痛也。）不愈再三
服，视所胜，照前方加味。（不得过三钱。）三痹汤、独活寄生汤，并治各痹久不已，乘虚
入脏。五苓散（见伤湿）。加附子治胞痹，加苍术治肠痹。气虚麻木，黄 益气汤。冷痹，
（身寒无热，四肢厥冷。）蠲痹汤。热痹，（身热如火。）升阳散火汤（见劳倦）加犀角、
羚羊角。又行痹，
黄、苍术各酒炒二钱，姜一片煎，调威灵仙（酒炒）末，羚羊角灰，芥子末，温
服。走注与历节不同，历节是支节疼痛，未必行也，今将治走注诸方开后∶如意通
圣散、虎骨散、桂心散、仙灵脾散、没药散、小乌犀丸、没药丸、虎骨丸、十生丹、
骨碎补丸、定痛丸、八神丹、一粒金丹、乳香应痛丸。外贴，用牛皮胶一两，水熔
成膏，芸薹子、安息香、川椒、附子，各半两，为细末，和贴。亦有痰涎走注，变
生诸疾，但察并非风寒湿外感，而忽然肢体上下走易作痛，神昏多睡，或饮食无味，
痰唾稠粘，夜间喉有痰声者是也，但用控涎丹（见痰）。数服即愈。
痛痹。上部痛∶羌活、桂枝皮、桔梗、威灵仙，臂痛加桑枝、姜黄。下
部痛∶牛膝、防己、木通、黄柏，加乌、附以引经。关节痛∶穿山甲、虎骨、松节。
上部肿痛∶五积散（见中寒）、乌药顺气散，加姜葱发汗。下部肿痛∶五苓散、（见伤湿。）
八正散（见淋）、大橘皮汤（见肿胀），加灯心、竹叶利小便。肿而大便不通；大柴
胡汤（见疟）、防
风通圣散（见中风）。筋痛∶缓筋汤。浑身筋骨痛∶立效散，觉冷者甘草附子汤，觉热
者当归拈痛汤。（见身体痛。）历节肿痛∶犀角汤，再服茵芋丸。肢节痛∶大羌活汤。外
用熨法∶三年酽醋五升，煎三四沸，入葱白二三升，再煎一沸滤出，布裹乘热
熨之。又方∶芫花、桑白、川椒，各二钱，桂心一两，柳蛀五钱，麦麸一升，醋炒
热，青布裹熨。樟木屑一斗，滚水泡熏洗，勿令气入眼。着痹∶白米半碗，薏苡仁
数钱，生川乌末四钱，熬粥，宜稀薄，下姜汁、蜜各二三茶匙，空心啜之。然非有
风，川乌不宜用。张子和以苦剂吐去湿痰，次用白术、茯苓，寒加附、姜煎服。
着痹∶大概气必虚，四君子（见气）为主，加去邪之品。
身体虚弱而患痹证的患者，使用小续命汤（见中风章节）进行加减：风邪偏盛者加倍使用防风；寒邪偏盛者加倍使用附子；湿邪偏盛者加倍使用防己；皮痹加黄芪或桂枝皮；脉痹加姜黄或红花；肌痹加葛根或白芷；筋痹加羚羊角或续断；骨痹加虎骨或狗脊；有汗者减少麻黄用量；大便溏泄者减少防己用量；寒邪偏盛者减少黄芩并加入干姜；热邪偏盛者减少附子并加入石膏。
体质壮实者使用增味五痹汤：风痹以羌活、防风为主药；寒痹以麻黄、附子为主药；湿痹以防己、羌活为主药；皮、脉等五种痹证，加药参照前一条规定。三种痹证通用木通，取不见水的木通二两，用长流水两碗，煎至一碗，趁热服用以取得微汗。（过去有人梦见得到此方后痹痛痊愈，这叫做“通则不痛”。）如果无效可再次服用，根据邪气偏盛的情况，参照前方加味。（木通用量不得超过三钱。）三痹汤、独活寄生汤，均用于治疗各种痹证日久不愈，病邪乘虚侵入脏腑的情况。五苓散（见伤湿章节）。加入附子治疗胞痹，加入苍术治疗肠痹。气虚导致的麻木，使用黄芪益气汤。冷痹（身体寒冷无发热，四肢厥冷），使用蠲痹汤。热痹（身体发热如火），使用升阳散火汤（见劳倦章节）加入犀角、羚羊角。
另外，行痹，使用黄芪、苍术各酒炒二钱，生姜一片煎煮，调入威灵仙（酒炒）末、羚羊角灰、芥子末，温服。走注（疼痛游走不定）与历节不同，历节是关节肢体疼痛，未必游走，现将治疗走注的各方列于后：如意通圣散、虎骨散、桂心散、仙灵脾散、没药散、小乌犀丸、没药丸、虎骨丸、十生丹、骨碎补丸、定痛丸、八神丹、一粒金丹、乳香应痛丸。外用贴敷，用牛皮胶一两，加水熔化成药膏，芸薹子、安息香、川椒、附子，各半两，研为细末，调和后贴敷。也有因痰涎走注，变生各种疾病，只要观察并非风寒湿外感引起，而是突然肢体上下游走作痛，神志昏沉嗜睡，或饮食无味，痰唾稠粘，夜间喉咙有痰鸣声的，只需用控涎丹（见痰章节）。服用数次即可痊愈。
痛痹。上部疼痛：羌活、桂枝皮、桔梗、威灵仙，手臂疼痛加桑枝、姜黄。下部疼痛：牛膝、防己、木通、黄柏，加入乌头、附子以引经。关节疼痛：穿山甲、虎骨、松节。上部肿痛：五积散（见中寒章节）、乌药顺气散，加入生姜、葱白发汗。下部肿痛：五苓散（见伤湿章节）、八正散（见淋章节）、大橘皮汤（见肿胀章节），加入灯心草、竹叶以利小便。肿胀且大便不通：大柴胡汤（见疟疾章节）、防风通圣散（见中风章节）。筋痛：缓筋汤。浑身筋骨痛：立效散，感觉冷的用甘草附子汤，感觉热的用当归拈痛汤（见身体痛章节）。历节肿痛：犀角汤，再服用茵芋丸。肢节痛：大羌活汤。外用熨法：三年陈醋五升，煎煮三四沸，加入葱白二三升，再煎一沸滤出，用布包裹趁热熨烫患处。又一方：芫花、桑白皮、川椒，各二钱，桂心一两，柳蛀五钱，麦麸一升，用醋炒热，用青布包裹熨烫。樟木屑一斗，用滚水泡熏洗，不要让蒸汽进入眼睛。
着痹（重着不移）：白米半碗，薏苡仁数钱，生川乌末四钱，熬粥，宜稀薄，加入姜汁、蜂蜜各二三茶匙，空腹饮用。然而如果没有风邪，不宜使用川乌。张子和用催吐剂吐出湿痰，随后使用白术、茯苓，寒邪加附子、生姜煎服。
For patients with Bi syndrome (Bi Syndrome, a condition characterized by pain and stiffness in the muscles, joints, and meridians due to the obstruction of Qi and Blood) who are deficient in constitution, Xiao Xuming Tang (Small Continuation of Life Decoction) (see Stroke section) is used with modifications: if Wind pathogen predominates, double the amount of Fangfeng (Saposhnikovia Root); if Cold pathogen predominates, double the amount of Fuzi (Aconite Lateral Root Prepared); if Dampness pathogen predominates, double the amount of Fangji (Stephania Root); for Pi Bi (Skin Bi), add Huangqi (Astragalus Root) or Guizhi Pi (Cinnamon Twig Bark); for Mai Bi (Vessel Bi), add Jianghuang (Turmeric Rhizome) or Honghua (Carthamus Flower); for Ji Bi (Muscle Bi), add Gegen (Pueraria Root) or Baizhi (Angelica Dahurica Root); for Jin Bi (Tendon Bi), add Lingyangjiao (Antelope Horn) or Xuduan (Dipsacus Root); for Gu Bi (Bone Bi), add Hugutou (Tiger Bone) or Gouji (Cibotium Rhizome); if there is sweating, reduce the amount of Mahuang (Ephedra Stem); if loose stools occur, reduce the amount of Fangji; if Cold predominates, reduce Huangqin (Scutellaria Root) and add Ganjiang (Zingiber Rhizome Dried); if Heat predominates, reduce Fuzi and add Shigao (Gypsum Fibrosum).
For those with robust constitutions, Zengwei Wubi Tang (Modified Five-Bi Decoction) is used: for Feng Bi (Wind Bi), Qianghuo (Notopterygium Root) and Fangfeng are the principal herbs; for Han Bi (Cold Bi), Mahuang and Fuzi are the principal herbs; for Shi Bi (Damp Bi), Fangji and Qianghuo are the principal herbs; for the five types of Bi involving skin and vessels, add herbs according to the previous rule. Tongcao (Akebia Caulis) is commonly used for all three types of Bi; use two liang of Tongcao that has not been in water, decoct with two bowls of running water until one bowl remains, and take hot to induce slight sweating. (In the past, someone dreamed of obtaining this prescription and their Bi pain was cured; this illustrates the principle that "if there is free flow, there is no pain.") If ineffective, administer again, adding ingredients based on the predominant pathogen as per the previous formula. (The dosage of Tongcao must not exceed three qian.) Sanbi Tang (Three-Bi Decoction) and Duhuo Jisheng Tang (Angelica Pubescens and Dicksonia Root Decoction) are both used to treat chronic Bi syndromes that have not resolved, where pathogens enter the Zang-Fu organs due to deficiency. Wuling San (Five-Ingredient Powder with Poria) (see Damp Injury section). Add Fuzi to treat Bao Bi (Bladder Bi); add Cangzhu (Atractylodes Rhizome) to treat Chang Bi (Intestinal Bi). For numbness caused by Qi deficiency, Huangqi Yiqi Tang (Astragalus Qi-Supplementing Decoction) is used. For Leng Bi (Cold Bi) (characterized by cold body without fever and cold extremities), Juanbi Tang (Expel Bi Decoction) is used. For Re Bi (Heat Bi) (characterized by body heat like fire), Shengyang Sanhuo Tang (Raise Yang and Disperse Fire Decoction) (see Fatigue section) with Xijiao (Rhinoceros Horn) and Lingyangjiao is used.
Additionally, for Xing Bi (Wandering Bi), use Huangqi and Cangzhu, each fried in wine, two qian; decoct with one slice of ginger, and mix with Wei Lingxian (Syneilesis Aconitum Root) powder (fried in wine), Lingyangjiao ash, and Jiezi (Mustard Seed) powder; take warm. Zouzhu (Wandering Pain) differs from Lijie (Joint Pain); Lijie involves pain in the limbs and joints but does not necessarily wander. The following prescriptions for treating Zouzhu are listed: Ruyi Tongsheng San, Hugutou San, Guixin San, Xianlingpi San, Moyao San, Xiao Wuxi Wan, Moyao Wan, Hugutou Wan, Shisheng Dan, Gusuibu Wan, Dingtong Wan, Bashen Dan, Yili Jin Dan, Ruxiang Yingtong Wan. For external application, use Niujiaojiao (Ox Hide Glue) one liang, melt with water into a paste; mix with Yuntaizi (Rapeseed), Anshixiang (Benzoin), Chuanjiao (Sichuan Pepper), and Fuzi, each half liang, ground into fine powder, and apply. There are also cases where Phlegm-Fluid wanders, causing various diseases; if it is observed that it is not due to external Wind-Cold-Dampness, but rather sudden wandering pain throughout the body, mental confusion and excessive sleepiness, loss of taste, thick sticky saliva, and phlegm sounds in the throat at night, only Kongyan Dan (Control Phlegm-Eflux Pill) (see Phlegm section) should be used. Several doses will lead to recovery.
Tong Bi (Painful Bi). Upper body pain: Qianghuo, Guizhi Pi, Jiegeng (Platycodon Root), Wei Lingxian; for arm pain, add Sangzhi (Mulberry Twig) and Jianghuang. Lower body pain: Niuxi (Achyranthes Root), Fangji, Tongcao, Huangbai (Phellodendron Bark); add Wu Tou (Aconite Root) and Fuzi to guide the herbs. Joint pain: Chanshanjia (Pangolin Scales), Hugutou, Songjie (Pine Node). Upper body swelling and pain: Wuji San (Five Accumulations Powder) (see Middle Cold section), Wuyao Shunqi San; add Shengjiang (Fresh Ginger) and Congbai (Green Onion White) to induce sweating. Lower body swelling and pain: Wuling San (see Damp Injury section), Bazheng San (Eight-Ingredient Corrective Powder) (see Stranguria section), Da Jupi Tang (Large Tangerine Peel Decoction) (see Swelling section); add Dengxincao (Juncus Maritimus Pith) and Zhuye (Bamboo Leaf) to promote urination. Swelling with constipation: Dachaihu Tang (Major Bupleurum Decoction) (see Malaria section), Fangfeng Tongsheng San (Windproof and Supreme Unblocking Powder) (see Stroke section). Sinew pain: Huanjin Tang (Relax Sinew Decoction). Whole-body bone and sinew pain: Lixiao San; if feeling cold, use Gancao Fuzi Tang (Licorice and Aconite Decoction); if feeling hot, use Danggui Niantong Tang (Angelica Relieving Pain Decoction) (see Body Pain section). Lijie swelling and pain: Xijiao Tang; follow with Yin Yu Wan. Limb joint pain: Da Qianghuo Tang. External moxibustion/warming method: Use five sheng of three-year-old strong vinegar, boil for three or four boils, add two or three sheng of green onion white, boil once more, strain, wrap in cloth, and apply hot compress. Another method: Yuanhua (Genkwa Flower), Sangbaipi (Mulch Bark), Chuanjiao, each two qian; Guixin (Cinnamon Bark) one liang; Liu Zhu (Willow Borer) five qian; wheat bran one sheng; stir-fry with vinegar until hot, wrap in blue cloth, and apply hot compress. One dou of camphor wood shavings, soak and fumigate/wash with boiling water; do not let the steam enter the eyes.
Zhuo Bi (Heavy Bi): Half a bowl of white rice, several qian of Yiyiren (Coix Seed), four qian of raw Chuanwu (Aconitum Carmichaelii Lateral Root Prepared) powder; cook into porridge, which should be thin; add two or three tea spoons each of Jiangzhi (Ginger Juice) and honey; drink on an empty stomach. However, if there is no Wind pathogen, Chuanwu should not be used. Zhang Hezi used emetics to expel Damp-Phlegm, followed by Baizhu (Atractylodes Macrocephala Rhizome) and Fuling (Poria), adding Fuzi and Shengjiang for decoction if Cold is present.
Zhuo Bi: Generally, Qi is deficient; Si Junzi Tang (Four Gentlemen Decoction) (see Qi Deficiency section) is the main formula, added with herbs to dispel pathogens.