论曰肉极病本于脾脏中风，脾主肌肉，风邪中脾，则令肌肉极而生病，所谓肉极者，令
人羸瘦无润泽，饮食不生肌肤是也，然肉有虚极，有实极，有极实热，有极虚寒，皆由脾感
风邪，若阴动则伤寒，寒为虚，虚则体重怠惰，四肢不欲举，不嗜饮食，食即咳，咳即右胁
下痛，阴阴引肩背，不可以动转，名曰厉风，若阳动则伤热，热为实，实则体上如鼠走，唇
口坏，皮肤色变，身体津液脱，腠理开，汗大泄，名曰恶风，治法实则泻之，虚则补之，当
治其微，若甚则皮肤不通，外不得泄，致太阴气绝而肉先死者，则不可救也。
治肉极虚寒，脾咳右胁下痛，阴阴引肩背痛，不可以动，动则咳，脾胀满，留饮痰癖，
大小便不利，少腹切痛，膈上寒，半夏汤方
半夏（汤洗去滑焙三两） 白术 赤茯苓（去黑皮） 人参 甘草（炙锉） 附子（炮
裂去皮
上八味，粗捣筛，每用五钱匕，水一盏半，入生姜半分拍碎，煎至一盏，去滓分温二服
治肉极皮肤不通，表实里虚，外不得泄，腰脚疼痛，独活散方
独活（二两） 当归（一两半） 白茯苓（一两半去皮） 干姜（一两炮裂锉） 人参
（一两去
去皮脐） 甘草（半
上十二味，捣筛为散，每服四钱匕，水一盏，入大豆半合，煎至五分，去滓食后温服。
治肉极肌肉变色，舌强阴缩，及腰脚疼弱，防风散方
防风（一两半去芦头） 独活（一两半） 白茯苓（一两半） 人参（一两去芦头） 干
姜（一两炮裂锉） 附子（半两炮裂去皮脐） 五加皮（一两） 甘草（一两炙微赤锉） 当
归（一两）
上一十一味，捣筛为散，每服四钱匕，水酒各半盏，煎至六分，去滓食前温服。
治肉极虚寒，四肢怠惰，或咳引胁肋，心下坚满痛，不嗜饮食，手足厥冷，忧恚思虑，
人参丸方
人参（一两一分） 附子（炮裂去皮脐三分） 干姜（炮三分） 远志（去心半两） 蜀
椒（去
苗叶半两）
治肉极实热，肌痹淫淫，如鼠走身上，津液脱，腠理开，汗大泄，为脾风，风气客于皮
肤肉色变，变则鼻见黄色，宜止汗解风痹，麻黄汤方
麻黄（去根节） 枳实（去瓤麸炒） 防风 白术 细辛（去苗叶一两） 石膏（碎四
两） 附
上九味，锉如麻豆，每服五钱匕，水一盏半，生姜一分拍碎，煎至一盏，去滓空腹温
服，日午夜卧再服。
治肉极实热，津液脱，腠理开，汗大泄，下焦痿弱，越婢汤方
麻黄（去根节三分） 石膏（碎三两） 甘草（炙锉一两） 附子（炮裂去皮脐一两）
上四味，锉如麻豆，每服五钱匕，水一盏半，生姜半分拍碎，枣两枚劈破，煎至一盏，
去滓空腹日午夜卧温服。
治肉极实热，身上如鼠走，或风痹唇口坏，皮肤色变，石楠散方
石楠（一两） 山芋（二两） 天雄（炮裂去皮脐） 桃花 菊花 甘草（炙锉各半两）
黄
蕤（一两
上一十二味，捣罗为散，每服二钱匕，空腹温酒调下，夜卧再服。
治肉极实热，肌肤淫淫如鼠走，津液开泄汗出，或痹不仁，四肢急痛，西州续命汤方
麻黄（去根节一两半） 当归（切焙） 石膏（碎各一两） 芎 （半两） 桂（去粗
皮） 甘草
双仁研十五枚）
上一十味，除杏仁外，粗捣筛和匀，每服五钱匕，水一盏半，生姜一分拍碎，煎至一盏，
去滓空腹温服，日晚再服。
治肉极虚羸，寒气所加，体重怠惰，四肢不举，肢节疼痛，饮食减少，坐卧不安，枸杞
汤方
枸杞 黄 （锉炒） 附子（炮裂去皮脐各二两） 芎 人参 芍药 茯神（去木） 甘
草
一两半）
上一十二味，锉如麻豆，每服五钱匕，用水一盏半，入生姜五片，煎取八分，去滓温
论述说：肉极病的根源在于脾脏受风邪侵袭。脾主司肌肉，风邪中伤脾脏，就会导致肌肉极度病变而引发疾病。所谓肉极，是指使人身体消瘦、缺乏润泽，饮食无法转化为肌肤营养。然而，肉极有虚极和实极之分，也有极实热和极虚寒之别，这些皆因脾感受风邪所致。如果阴气发动则损伤寒气，寒邪导致虚证，虚证表现为身体沉重、倦怠懒惰，四肢不想抬起，没有食欲，进食后就会咳嗽，咳嗽时右胁下疼痛，隐隐牵引肩背部，不能活动转动，这种病症名叫厉风。如果阳气发动则损伤热气，热邪导致实证，实证表现为身体感觉像老鼠爬行一样窜动，嘴唇口腔溃烂，皮肤颜色改变，身体津液耗脱，腠理（毛孔）开张，大汗淋漓，这种病症名叫恶风。治疗原则是实证用泻法，虚证用补法，应当在病情轻微时治疗。如果病情严重到皮肤闭塞不通，邪气外不得宣泄，导致太阴经气绝断而肌肉先坏死的，就不可救治了。
治疗肉极虚寒证，症见脾咳、右胁下痛、隐隐牵引肩背痛、不能活动、活动则咳嗽、脾脏胀满、停饮痰癖、大小便不利、少腹剧烈疼痛、膈上寒冷，使用半夏汤方。
药材：半夏（用汤洗去滑腻，焙干，三两）、白术、赤茯苓（去掉黑皮）、人参、甘草（炙过并锉碎）、附子（炮裂，去皮）。
以上八味药，粗捣筛碎，每次取五钱匕，加水一盏半，放入生姜半分拍碎，煎煮至一盏，去渣滓，分两次温服。
治疗肉极皮肤闭塞不通，表实里虚，邪气外不得宣泄，腰脚疼痛，使用独活散方。
药材：独活（二两）、当归（一两半）、白茯苓（一两半，去皮）、干姜（一两，炮裂锉碎）、人参（一两，去芦头）、甘草（半两，炙）。
以上十二味药，捣筛成散剂，每次服用四钱匕，加水一盏，放入大豆半合，煎煮至五分，去渣滓，饭后温服。
治疗肉极肌肉变色，舌体僵硬、阴部收缩，以及腰脚疼痛无力，使用防风散方。
药材：防风（一两半，去芦头）、独活（一两半）、白茯苓（一两半）、人参（一两，去芦头）、干姜（一两，炮裂锉碎）、附子（半两，炮裂去皮脐）、五加皮（一两）、甘草（一两，炙微赤锉碎）、当归（一两）。
以上十一味药，捣筛成散剂，每次服用四钱匕，用水和酒各半盏，煎煮至六分，去渣滓，饭前温服。
治疗肉极虚寒证，症见四肢倦怠懒惰，或咳嗽牵引胁肋，心下坚硬胀满疼痛，没有食欲，手足厥冷，忧愤思虑过度，使用人参丸方。
药材：人参（一两一分）、附子（炮裂去皮脐，三分）、干姜（炮制，三分）、远志（去心，半两）、蜀椒（去目及枝叶，半两）。
（注：原文此处未详述制法，通常此类丸剂需炼蜜为丸。）
治疗肉极实热证，症见肌痹如鼠走窜身上，津液耗脱，腠理开张，大汗淋漓，此为脾风，风气客于皮肤导致肉色改变，变色则鼻部呈现黄色，宜止汗解风痹，使用麻黄汤方。
药材：麻黄（去根节）、枳实（去瓤麸炒）、防风、白术、细辛（去苗叶，一两）、石膏（碎，四两）、附子（炮裂去皮脐）。
以上九味药，锉碎如麻豆大小，每次服用五钱匕，加水一盏半，生姜一分拍碎，煎煮至一盏，去渣滓，空腹温服，夜间午夜卧时再服一次。
治疗肉极实热证，症见津液耗脱，腠理开张，大汗淋漓，下焦痿弱无力，使用越婢汤方。
药材：麻黄（去根节，三分）、石膏（碎，三两）、甘草（炙锉，一两）、附子（炮裂去皮脐，一两）。
以上四味药，锉碎如麻豆大小，每次服用五钱匕，加水一盏半，生姜半分拍碎，大枣两枚劈破，煎煮至一盏，去渣滓，空腹及夜间午夜卧时温服。
治疗肉极实热证，症见身上如鼠走窜，或风痹导致唇口溃烂，皮肤颜色改变，使用石楠散方。
药材：石楠（一两）、山芋（二两）、天雄（炮裂去皮脐）、桃花、菊花、甘草（炙锉，各半两）、黄芩（一两）、蕤仁（一两）。
以上十二味药，捣罗成散剂，每次服用二钱匕，空腹用温酒调服，夜间卧时再服一次。
治疗肉极实热证，症见肌肤如鼠走窜，津液开泄出汗，或痹证麻木不仁，四肢急痛，使用西州续命汤方。
药材：麻黄（去根节，一两半）、当归（切焙）、石膏（碎，各一两）、川芎（半两）、桂枝（去粗皮）、甘草（炙）、杏仁（双仁研十五枚）。
以上十味药，除杏仁外，粗捣筛匀，每次服用五钱匕，加水一盏半，生姜一分拍碎，煎煮至一盏，去渣滓，空腹温服，日晚再服。
治疗肉极虚羸，寒气侵袭，身体沉重倦怠，四肢不能抬起，肢节疼痛，饮食减少，坐卧不安，使用枸杞汤方。
药材：枸杞、黄芪（锉炒）、附子（炮裂去皮脐，各二两）、川芎、人参、芍药、茯神（去木）、甘草（炙，一两半）。
以上十二味药，锉碎如麻豆大小，每次服用五钱匕，用水一盏半，放入生姜五片，煎取八分，去渣滓温服。
Discussion states: The root of the disease "Rou Ji" (Extreme Muscle Disorder) lies in the Spleen organ being invaded by Wind pathogen. The Spleen governs the muscles; when Wind pathogen strikes the Spleen, it causes extreme pathological changes in the muscles, leading to disease. What is called "Rou Ji" refers to a condition causing emaciation and lack of luster, where food intake fails to nourish the flesh and skin. However, Rou Ji can be classified into Extreme Deficiency and Extreme Excess, as well as Extreme Heat and Extreme Cold. All these arise from the Spleen contracting Wind pathogen. If Yin dynamics activate, it injures with Cold, resulting in a Deficiency syndrome characterized by heavy body, lethargy, reluctance to lift the limbs, anorexia, coughing after eating, pain under the right hypochondrium radiating faintly to the shoulder and back upon coughing, and inability to move or turn. This condition is named Li Feng (Severe Wind). If Yang dynamics activate, it injures with Heat, resulting in an Excess syndrome characterized by a sensation on the body like mice running, ulceration of lips and mouth, alteration of skin color, depletion of body fluids, opening of Cou Li (pores), and profuse sweating. This condition is named E Feng (Aversion to Wind). The treatment principle is to drain for Excess and tonify for Deficiency, treating while the condition is mild. If the condition becomes severe such that the skin becomes blocked, preventing external release, leading to the exhaustion of Taiyin Qi and necrosis of the muscle first, it is incurable.
To treat Rou Ji with Cold-Deficiency, presenting with Spleen cough, pain under the right hypochondrium radiating faintly to the shoulder and back, immobility, coughing upon movement, Spleen distension, retained fluid and phlegm masses, difficulty in urination and defecation, severe lower abdominal pain, and cold above the diaphragm, use Ban Xia Tang (Pinellia Decoction).
Herbs: Ban Xia (Pinelliae Rhizoma, washed with decoction to remove slipperiness, dried, 3 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chi Fu Ling (Poria cum Rhus, black peel removed), Ren Shen (Ginseng Radix et Rhizoma), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Fu Zi (Prepared Aconiti Lateralis Radix, cracked, peel removed).
The above eight herbs are coarsely crushed and sifted. Each dose uses 5 qian bi, added with 1.5 zhan of water and 0.5 fen of crushed Sheng Jiang (Zingiberis Rhizoma Recens), decocted until 1 zhan remains. Strain and take warm in two doses.
To treat Rou Ji with blocked skin, Exterior Excess and Interior Deficiency, inability to release externally, and pain in waist and legs, use Du Huo San (Angelicae Pubescentis Powder).
Herbs: Du Huo (Angelicae Pubescentis Radix, 2 liang), Dang Gui (Angelicae Sinensis Radix, 1.5 liang), Bai Fu Ling (Poria, 1.5 liang, peel removed), Gan Jiang (Zingiberis Rhizoma, 1 liang, cracked and crushed), Ren Shen (Ginseng Radix et Rhizoma, 1 liang, radix tip removed), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 0.5 liang).
The above twelve herbs are crushed and sifted into powder. Each dose is 4 qian bi, added with 1 zhan of water and 0.5 he of soybeans, decocted until 0.5 fen remains. Strain and take warm after meals.
To treat Rou Ji with altered muscle color, stiff tongue, retraction of genitals, and weak pain in waist and legs, use Fang Feng San (Saposhnikoviae Powder).
Herbs: Fang Feng (Saposhnikoviae Radix, 1.5 liang, radix tip removed), Du Huo (Angelicae Pubescentis Radix, 1.5 liang), Bai Fu Ling (Poria, 1.5 liang), Ren Shen (Ginseng Radix et Rhizoma, 1 liang, radix tip removed), Gan Jiang (Zingiberis Rhizoma, 1 liang, cracked and crushed), Fu Zi (Prepared Aconiti Lateralis Radix, 0.5 liang, cracked, peel and umbilicus removed), Wu Jia Pi (Cortex Acanthopanacis, 1 liang), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 1 liang, slightly reddened and crushed), Dang Gui (Angelicae Sinensis Radix, 1 liang).
The above eleven herbs are crushed and sifted into powder. Each dose is 4 qian bi, added with half a zhan of water and half a zhan of wine, decocted until 0.6 fen remains. Strain and take warm before meals.
To treat Rou Ji with Cold-Deficiency, presenting with lethargic limbs, cough radiating to costal regions, hardness and fullness/pain below the heart, anorexia, cold extremities, and excessive worry/contemplation, use Ren Shen Wan (Ginseng Pill).
Herbs: Ren Shen (Ginseng Radix et Rhizoma, 1 liang 1 fen), Fu Zi (Prepared Aconiti Lateralis Radix, cracked, peel and umbilicus removed, 3 fen), Gan Jiang (Zingiberis Rhizoma, processed, 3 fen), Yuan Zhi (Polygalae Radix, heart removed, 0.5 liang), Shu Jiao (Zanthoxyli Pericarpium, eyes and leaves removed, 0.5 liang).
To treat Rou Ji with Excess-Heat, presenting with My Bi (Muscle Bi) with sensations like mice running on the body, depletion of fluids, open Cou Li, and profuse sweating, identified as Pi Feng (Spleen Wind), where Wind pathogen lodges in skin altering flesh color, turning the nose yellow. It is suitable to stop sweating and resolve Wind-Bi, using Ma Huang Tang (Ephedra Decoction).
Herbs: Ma Huang (Ephedrae Herba, roots and joints removed), Zhi Shi (Immature Bitter Orange Fruit, pulp and bran removed, stir-fried), Fang Feng (Saposhnikoviae Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Xi Xin (Asari Radix et Rhizoma, seedlings and leaves removed, 1 liang), Shi Gao (Gypsum Fibrosum, crushed, 4 liang), Fu Zi (Prepared Aconiti Lateralis Radix, cracked, peel and umbilicus removed).
The above nine herbs are crushed like hemp seeds. Each dose is 5 qian bi, added with 1.5 zhan of water and 1 fen of crushed Sheng Jiang (Zingiberis Rhizoma Recens), decocted until 1 zhan remains. Strain and take warm on an empty stomach, then again at midnight before sleep.
To treat Rou Ji with Excess-Heat, presenting with depletion of fluids, open Cou Li, profuse sweating, and weakness in the Lower Jiao, use Yue Bi Tang (Leaping Spider Decoction).
Herbs: Ma Huang (Ephedrae Herba, roots and joints removed, 3 fen), Shi Gao (Gypsum Fibrosum, crushed, 3 liang), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 1 liang), Fu Zi (Prepared Aconiti Lateralis Radix, cracked, peel and umbilicus removed, 1 liang).
The above four herbs are crushed like hemp seeds. Each dose is 5 qian bi, added with 1.5 zhan of water, 0.5 fen of crushed Sheng Jiang (Zingiberis Rhizoma Recens), and two broken Da Zao (Jujubae Fructus), decocted until 1 zhan remains. Strain and take warm on an empty stomach and at midnight before sleep.
To treat Rou Ji with Excess-Heat, presenting with sensations like mice running on the body, or Wind-Bi causing lip/mouth ulceration and altered skin color, use Shi Nan San (Forsythia Leaf Powder).
Herbs: Shi Nan (Foliium Nandinae, 1 liang), Shan Yu (Dioscoreae Rhizoma, 2 liang), Tian Xiong (Aconiti Kusnezoffii Radix, cracked, peel and umbilicus removed), Tao Hua (Persicae Flos), Ju Hua (Chrysanthemi Flos), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 0.5 liang each), Huang Qin (Scutellariae Radix, 1 liang), Rui Ren (Buckthorn Seed, 1 liang).
The above twelve herbs are pounded and sieved into powder. Each dose is 2 qian bi, taken warm with wine on an empty stomach, then again at night before sleep.
To treat Rou Ji with Excess-Heat, presenting with skin sensations like mice running, fluid leakage and sweating, or Bi numbness and impotence, acute pain in limbs, use Xi Zhou Xu Ming Tang (Xizhou Life-Prolonging Decoction).
Herbs: Ma Huang (Ephedrae Herba, roots and joints removed, 1.5 liang), Dang Gui (Angelicae Sinensis Radix, cut and dried), Shi Gao (Gypsum Fibrosum, crushed, 1 liang each), Xiong Qiong (Ligustici Chuanxiong Rhizoma, 0.5 liang), Gui Zhi (Cinnamomi Ramulus, coarse bark removed), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Xing Ren (Prunus Armeniaca Semen, double-kernel, 15 grains ground).
The above ten herbs, excluding Xing Ren, are coarsely crushed and mixed evenly. Each dose is 5 qian bi, added with 1.5 zhan of water and 1 fen of crushed Sheng Jiang (Zingiberis Rhizoma Recens), decocted until 1 zhan remains. Strain and take warm on an empty stomach, then again in the evening.
To treat Rou Ji with Emaciation due to Cold pathogen invasion, presenting with heavy body, lethargy, inability to lift limbs, joint pain, reduced diet, and restlessness in sitting or lying, use Gou Qi Tang (Lycium Decoction).
Herbs: Gou Qi (Lycii Fructus), Huang Qi (Astragali Radix, crushed and stir-fried), Fu Zi (Prepared Aconiti Lateralis Radix, cracked, peel and umbilicus removed, 2 liang each), Xiong Qiong (Ligustici Chuanxiong Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Shao Yao (Paeoniae Radix), Fu Shen (Poria with Pine Root, wood removed), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 1.5 liang).
The above twelve herbs are crushed like hemp seeds. Each dose is 5 qian bi, added with 1.5 zhan of water and five slices of Sheng Jiang (Zingiberis Rhizoma Recens), decocted until 0.8 fen remains. Strain and take warm.