（论一首，方二首）
论曰∶肝劳病者，补心气以益之，心旺则感于肝矣。人逆春气则足少阳不生，而肝气纳
变，顺之则生，逆之则死，顺之则治，逆之则乱，反顺为逆，是谓关格，病则生矣。
治肝劳虚寒，关格劳涩，闭塞不通，毛悴色夭。
猪膏 姜汁（各四升）
上二味，以微火煎取三升，下酒五合和煎，分为三服。
治肝虚寒劳损，口苦，关节骨疼痛，筋挛缩，烦闷。
虎骨一升（炙焦，碎如雀头） 丹参（八两） 干地黄（七两） 地骨皮 干姜 川芎
（各四
两） 猪椒根 白术 五加皮 枳实（各五两）
上十味 咀，绢袋盛，以酒四斗浸四日，初服六七合，渐加至一升，日再服。
（论三首，方七首，灸法七首）
论曰∶夫六极者，天气通于肺，地气通于咽，风气应于肝，雷气动于心，谷气感于脾，
雨气润于肾。六经为川，肠胃为海，九窍为水注之气，所以窍应于五脏，五脏邪伤，则六腑
生极，故曰五脏六极也。
论曰∶凡筋极者主肝也，肝应筋，筋与肝合，肝有病从筋生。又曰∶以春遇病为筋痹，
筋痹不已，复感于邪，内舍于肝，则阳气入于内，阴气出于外，若阴气外出，出则虚，虚则
筋虚，筋虚则善悲，色青苍白见于目下，若伤寒则筋不能动，十指爪皆痛，数好转筋，其源
以春甲乙日得之伤风，风在筋为肝虚风也。若阳气内发，发则实，实则筋实，筋实则善怒，
嗌干伤热则咳，咳则胁下痛不能转侧，又脚下满痛，故曰肝实风也。然则因其轻而扬之，因
其重而减之，因其衰而彰之。审其阴阳以别柔刚，阳病治阴，阴病治阳。善治病者，病在皮
毛、肌肤、筋脉而治之，次治六腑，若至五脏则半死矣。
扁鹊云∶筋绝不治九日死，何以知之？手足爪甲青黑，呼骂口不息，筋应足厥阴，足厥
阴气绝，则筋缩引卵与舌，筋先死矣。
治筋实极则咳，咳则两胁下缩痛，痛甚则不可转动，橘皮通气汤方。
橘皮（四两） 白术 石膏（各五两） 细辛 当归 桂心 茯苓（各二两） 香豉（一
升）上
八味 咀，以水九升，煮取三升，去滓，分三服。
治筋实极，则两脚下满，满而痛，不得远行，脚心如割，筋断折痛不可忍，丹参煮散方
丹参（三两） 川芎 杜仲 续断 地骨皮（各二两） 当归 通草 干地黄 麦门冬 升
麻禹余粮 麻黄（各一两十八铢） 牛膝（二两六铢） 生姜（切，炒取焦干） 牡蛎（各
二两）
上十七味治下筛，为粗散，以绢袋子盛散二方寸匕，以井花水二升煮，数动袋子，煮取
一升，顿服，日二。
治筋实极，手足爪甲或青或黄、或黑乌黯，四肢筋急烦满，地黄煎方。
生地黄汁（三升） 生葛汁 生玄参汁（各一升） 大黄 升麻（各二两） 栀子仁 麻
黄
犀角（各三两） 石膏（五两） 芍药（四两）
上十味 咀，以水七升煮七物，取二升，去滓，下地黄汁，煎一两沸，次下葛汁等，煎
取三升，分三服，日再。
治筋虚极、筋痹，好悲思，颜色苍白，四肢嘘吸，脚手拘挛，伸动缩急，腹中转痛，五
加酒方。
五加皮（一斤） 枳刺（二升） 大麻仁（三升） 猪椒根皮 丹参（各八两） 桂心 当
归甘草（各三两） 天雄 秦椒 白藓 通草（各四两） 干姜（五两） 薏苡仁（半升）
川芎（五
上十五味 咀，以绢袋盛，清酒四斗渍，春夏四日，秋冬六七日。初服六七合，稍稍加
，以知为度。
治筋虚极，则筋不能转，十指爪皆痛，数转筋，或交接过度，或病未平复交接，伤气，
内筋绝，舌卷唇青，引卵缩， 脉疼急，腹中绞痛，或便欲绝，不能饮食，人参酒方。
人参 防风 茯苓 细辛 秦椒 黄 当归 牛膝 桔梗（各一两半） 干地黄 丹
参
枣（三十枚） 五加皮（一升） 生姜（切，炒干） 乌麻（碎）（各
上二十二味 咀，钟乳别以小袋子盛，以清酒二斗半浸五宿，温服三合，日再，无所闻
，随意增进。（一本无乌麻，用杜仲二两半。
治交接损，卵缩筋挛方。
烧妇人月经衣灰，服方寸匕。
治筋绝方
熬蟹脑足髓纳疮中，筋即续。
劳冷气逆，腰髋冷痹，脚屈伸难，灸阳跷一百壮，在外踝下容爪。
腰背不便，转筋急痹筋挛，灸第二十一椎，随年壮。
转筋，十指筋挛急，不得屈伸，灸脚外踝骨上七壮。
失精筋挛，阴缩入腹，相引痛，灸中封五十壮，在内踝前筋里宛宛中。
失精筋挛，阴缩入腹，相引痛，灸下满各五十壮，老人加之，小儿随年壮。又云，此二
穴，喉肿厥逆，五脏所苦，鼓胀，并悉主之。
转筋胫骨痛不可忍，灸屈膝下廉横筋上三壮。
腹胀转筋，灸脐上一寸二十壮。
（本篇包含一篇论述，两个方剂）
论述说：治疗肝劳病，应当补益心气来资助它，心气旺盛就能感应并滋养肝脏。如果人违背春季的生发之气，足少阳胆经的气机就不能生发，导致肝气内郁而发生变化；顺应这种规律则生机盎然，违背它则会导致死亡，顺应它则疾病可治，违背它则病情混乱，将顺应变为违背，这就叫做“关格”（阴阳离决、上下不通的危重证候），此时疾病就会发生。
治疗肝虚寒导致的劳损，以及关格引起的劳涩、闭塞不通、毛发憔悴、面色枯槁的病证。
猪膏（即猪油，四升）、姜汁（四升）。
以上两味药，用微火煎煮至三升，再加入五合酒混合煎煮，分为三次服用。
治疗肝虚寒导致的劳损，出现口苦、关节骨骼疼痛、筋脉拘挛收缩、烦闷的症状。
虎骨一升（炙烤至焦黄，捣碎如雀头大小）、丹参（八两）、干地黄（七两）、地骨皮、干姜、川芎（各四两）、猪椒根、白术、五加皮、枳实（各五两）。
以上十味药，切碎，用绢袋装好，用四斗酒浸泡四天。初次服用六七合，逐渐增加至一升，每天服用两次。
（本篇包含三篇论述，七个方剂，七种灸法）
论述说：所谓的“六极”，是指天气通于肺，地气通于咽，风气应于肝，雷气动于心，谷气感于脾，雨气润于肾。六经如同河流，肠胃如同大海，九窍是水流注入的通道，所以九窍对应五脏，当五脏受到邪气伤害时，六腑就会产生“极”（极度虚弱或衰竭的状态），所以称为“五脏六极”。
论述说：凡是筋极，主要与肝有关，因为肝主筋，筋与肝相合，肝病往往从筋的表现中产生。又说：如果在春季患病称为“筋痹”，筋痹如果不愈，再次感受邪气，邪气内舍于肝，就会导致阳气入内，阴气出外。如果阴气外出，外出则导致虚损，虚损则筋虚，筋虚则容易悲伤，眼下呈现青白色；如果是伤寒导致筋不能活动，十个手指和指甲都疼痛，频繁发生转筋，其病因是在春日的甲乙日因伤风所致，风邪在筋中，属于肝虚风。如果阳气在内发动，发动则导致实证，实证则筋实，筋实则容易发怒，咽喉干燥且受热则咳嗽，咳嗽则胁下疼痛不能转身，脚底也满痛，这叫做“肝实风”。因此，对于轻浅的病邪要用发散的方法，对于沉重的病邪要用削减的方法，对于衰弱的正气要用彰显（扶助）的方法。仔细辨别阴阳以区分刚柔，阳病治阴，阴病治阳。善于治病的人，在病邪位于皮毛、肌肤、筋脉时就进行治疗，其次治疗六腑，如果病邪深入五脏，则有一半的死亡率了。
扁鹊说：筋绝（筋气断绝）无法治疗，九天后会死亡，怎么知道呢？如果手足爪甲呈现青黑色，呼叫谩骂不止，因为筋对应足厥阴肝经，足厥阴经气断绝，就会导致筋脉收缩牵引睾丸和舌头，这是筋先死的表现。
治疗筋实极导致的咳嗽，咳嗽则两侧胁下收缩疼痛，疼痛严重时无法转动，使用橘皮通气汤方。
橘皮（四两）、白术、石膏（各五两）、细辛、当归、桂心、茯苓（各二两）、香豉（一升）。
以上八味药，切碎，用水九升，煮取三升，去渣，分为三次服用。
治疗筋实极，表现为双脚底部胀满，胀满且疼痛，不能远行，脚心像被刀割一样，筋脉断裂般疼痛难以忍受，使用丹参煮散方。
丹参（三两）、川芎、杜仲、续断、地骨皮（各二两）、当归、通草、干地黄、麦门冬、升麻、禹余粮、麻黄（各一两十八铢）、牛膝（二两六铢）、生姜（切片，炒至焦干）、牡蛎（各二两）。
以上十七味药，处理后筛成粗散，用绢袋盛装两方寸匕的药量，用井花水二升煮沸，期间多次晃动袋子，煮取一升，一次性服下，每天两次。
治疗筋实极，表现为手足爪甲颜色或青、或黄、或黑黯，四肢筋脉紧急烦闷，使用地黄煎方。
生地黄汁（三升）、生葛汁、生玄参汁（各一升）、大黄、升麻（各二两）、栀子仁、麻黄、犀角（各三两）、石膏（五两）、芍药（四两）。
以上十味药，切碎，用水七升煮前七味药，取二升，去渣，加入地黄汁，煎煮一两沸，接着加入葛汁等，煎取三升，分为三次服用，每天两次。
治疗筋虚极、筋痹，表现为喜欢悲伤思考，面色苍白，四肢呼吸急促（形容气息微弱或颤抖），手脚拘挛，伸展时感到紧缩急迫，腹部转动疼痛，使用五加酒方。
五加皮（一斤）、枳刺（二升）、大麻仁（三升）、猪椒根皮、丹参（各八两）、桂心、当归、甘草（各三两）、天雄、秦椒、白藓、通草（各四两）、干姜（五两）、薏苡仁（半升）、川芎（五两）。
以上十五味药，切碎，用绢袋装好，用清酒四斗浸泡，春夏季四天，秋冬季六七天。初次服用六七合，逐渐增加剂量，以见效为度。
治疗筋虚极，表现为筋不能转动，十个手指和指甲都疼痛，频繁转筋，或者房事过度，或者病未痊愈就进行房事，损伤气机，导致内筋断绝，舌头卷曲嘴唇发青，牵引睾丸收缩，脉管疼痛紧急，腹部绞痛，或者大便欲解而不能，不能饮食，使用人参酒方。
人参、防风、茯苓、细辛、秦椒、黄芪、当归、牛膝、桔梗（各一两半）、干地黄、丹参、大枣（三十枚）、五加皮（一升）、生姜（切片，炒干）、乌麻（捣碎）（各一两半）。
以上二十二味药，切碎，钟乳石单独用小袋子装好，用清酒二斗半浸泡五个夜晚，温服三合，每天两次，如果没有不适反应，可随意增加剂量。（另一种版本没有乌麻，改用杜仲二两半。）
治疗房事损伤，睾丸收缩、筋脉拘挛的方子。
烧妇人月经衣成灰，每次服用一方寸匕。
治疗劳冷气逆，腰髋冷痹，脚屈伸困难，灸阳跷穴一百壮，穴位在外踝下约容许一个指甲大小的地方。
治疗腰背不便，转筋急痹筋挛，灸第二十一椎（命门穴附近），壮数随患者年龄而定。
治疗转筋，十个手指筋脉拘挛急迫，不能屈伸，灸脚外踝骨上七壮。
治疗失精导致的筋挛，阴器收缩入腹，相互牵引疼痛，灸中封穴五十壮，穴位在内踝前筋脉凹陷处。
治疗失精导致的筋挛，阴器收缩入腹，相互牵引疼痛，灸下满穴各五十壮，老年人加倍，小儿随年龄而定。又说，这两个穴位，喉肿厥逆，五脏的痛苦，鼓胀，都主治。
(One treatise, two formulas)
The treatise states: In treating Liver Labor Disease (a condition of chronic exhaustion affecting the Liver), one should tonify Heart Qi to support it. When Heart Qi is robust, it can resonate with and nourish the Liver. If a person goes against the Qi of Spring, the Qi of Foot Shaoyang Gallbladder cannot generate, causing Liver Qi to stagnate and transform abnormally. Following this pattern leads to life, opposing it leads to death; following it allows for treatment, opposing it leads to chaos. Reversing compliance into opposition is called "Guan Ge" (a critical syndrome of blockage between Yin and Yang), at which point disease arises.
For Liver deficiency-cold labor, Guan Ge-induced laborial stiffness, obstruction and blockage, with emaciated hair and sallow complexion:
Pig Fat (Su Gao, 4 sheng) and Ginger Juice (Jiang Zhi, 4 sheng).
Take the above two ingredients, simmer over low heat until reduced to 3 sheng, then add 5 he of wine and simmer again. Divide into three doses.
For Liver deficiency-cold labor damage, presenting with bitter taste in the mouth, joint and bone pain, tendon contraction, and irritability:
Tiger Bone (Hu Gu, 1 sheng, roasted until charred and crushed like a sparrow's head), Danshen (8 liang), Dried Rehmannia Root (Shu Di Huang, 7 liang), Bark of Ground Tree Betel (Di Gu Pi), Dried Ginger (Gan Jiang), Szechwan Lovage Rhizome (Chuan Xiong) (each 4 liang), Root bark of Piper Longum (Zhu Jiao Gen), Atractylodes Macrocephala Rhizome (Bai Zhu), Five-leaf Acanthopanax Bark (Wu Jia Pi), Immature Bitter Orange (Zhi Shi) (each 5 liang).
Process the above ten herbs, place them in a silk bag, and soak in 4 dou of wine for four days. Initial dose: 6-7 he, gradually increase to 1 sheng. Take twice daily.
(Three treatises, seven formulas, seven moxibustion methods)
The treatise states: The so-called "Six Extremes" (Liu Ji) are as follows: Heaven's Qi connects to the Lungs, Earth's Qi connects to the throat, Wind Qi corresponds to the Liver, Thunder Qi moves the Heart, Grain Qi affects the Spleen, and Rain Qi moistens the Kidneys. The Six Channels are like rivers, the intestines and stomach are like seas, and the Nine Orifices are where water flows in. Thus, the orifices correspond to the Five Zang organs. When the Five Zang organs are injured by pathogens, the Six Fu organs develop "extremes" (severe depletion), hence the term "Five Zang and Six Fu Extremes."
Another treatise states: Generally, Tendon Extremes are governed by the Liver, as the Liver governs the tendons, and the tendons harmonize with the Liver; Liver diseases often manifest through the tendons. It is also said: Illness contracted in Spring is called "Tendon Bi" (obstruction). If Tendon Bi persists and is re-exposed to pathogens, the pathogen enters internally and lodges in the Liver. This causes Yang Qi to enter inward and Yin Qi to emerge outward. If Yin Qi emerges outward, it leads to deficiency; deficiency leads to weak tendons. Weak tendons cause frequent sorrowfulness, and bluish-white discoloration appears under the eyes. If caused by Cold Damage, the tendons cannot move, and all ten fingers and nails ache, with frequent tendon spasms. The origin lies in contracting wind-pathogen on Jia-Yi days in Spring; the wind remains in the tendons, constituting Liver Deficiency Wind. If Yang Qi activates internally, activation leads to excess; excess leads to solid tendons. Solid tendons cause frequent anger, dry throat, heat injury leading to cough, coughing causing hypochondriac pain preventing turning of the body, and fullness/pain in the soles of the feet. This is called Liver Excess Wind. Therefore, for light pathogens, use dispersing methods; for heavy pathogens, use reducing methods; for declining vitality, use reinforcing methods. Carefully distinguish Yin and Yang to differentiate soft and hard. Treat Yin disorders by addressing Yang, and Yang disorders by addressing Yin. A skilled healer treats the disease when it is in the skin, hair, muscles, and tendons; next, they treat the Six Fu organs. If the disease reaches the Five Zang organs, half of the patients will die.
Bian Que said: Tendon Exhaustion (Jin Jue) is untreatable; death occurs after nine days. How do we know? If the fingernails and toenails turn blue-black, and the patient calls out and curses incessantly, it indicates that since tendons correspond to the Foot Jueyin Liver Channel, exhaustion of the Foot Jueyin Qi causes tendon contraction pulling the testicles and tongue. This signifies the death of the tendons first.
To treat Tendon Excess Extreme causing cough, where coughing leads to shrinking pain in both hypochondria, and severe pain prevents turning, use Tangerine Peel Ventilation-Qi Decoction (Ju Pi Tong Qi Tang).
Tangerine Peel (Ju Pi, 4 liang), Atractylodes Macrocephala Rhizome (Bai Zhu), Gypsum (Shi Gao) (each 5 liang), Asarum Root (Xi Xin), Angelica Sinensis Radix (Dang Gui), Cinnamon Twig (Gui Xin), Poria (Fu Ling) (each 2 liang), Fermented Soybean (Xiang Chi, 1 sheng).
Process the above eight herbs, boil in 9 sheng of water until 3 sheng remain, strain, and divide into three doses.
To treat Tendon Excess Extreme, presenting with fullness and pain in both soles, inability to walk far, cutting pain in the soles, unbearable tearing pain in the tendons, use Danshen Boiled Powder (Dan Shen Zhu San).
Danshen (3 liang), Szechwan Lovage Rhizome (Chuan Xiong), Eucommia Bark (Du Zhong), Teasel Root (Xu Duan), Bark of Ground Tree Betel (Di Gu Pi) (each 2 liang), Angelica Sinensis Radix (Dang Gui), Tetrapanax Pith (Tong Cao), Dried Rehmannia Root (Shu Di Huang), Ophiopogon Tuber (Mai Men Dong), Cimicifuga Rhizome (Sheng Ma), Leechite Hematite (Yu Liang Shi), Ephedra Stem (Mahuang) (each 1 liang 18 zhu), Achyranthes Root (Niu Xi, 2 liang 6 zhu), Fresh Ginger (Sheng Jiang, sliced and fried until charred-dry), Oyster Shell (Mu Li) (each 2 liang).
Process the above seventeen herbs into a coarse powder. Place two fang-cun-bi (measurements of volume) in a silk bag. Boil in 2 sheng of well-water, shaking the bag frequently, until reduced to 1 sheng. Take in one dose, twice daily.
To treat Tendon Excess Extreme, presenting with fingernails/toenails being blue, yellow, or dark black, urgent and irritable tendons in the four limbs, use Rehmannia Paste (Di Huang Jian).
Fresh Rehmannia Juice (Sheng Di Huang Zhi, 3 sheng), Fresh Kudzu Juice (Sheng Ge Zhi), Fresh Scrophularia Root Juice (Sheng Xuan Shen Zhi) (each 1 sheng), Rhubarb (Da Huang), Cimicifuga Rhizome (Sheng Ma) (each 2 liang), Gardenia Seed (Zhi Zi Ren), Ephedra Stem (Mahuang), Rhinoceros Horn (Xi Jiao) (each 3 liang), Gypsum (Shi Gao, 5 liang), White Peony Root (Bai Shao, 4 liang).
Process the above ten herbs. Boil the first seven in 7 sheng of water until 2 sheng remain, strain, add Fresh Rehmannia Juice, boil for one or two boils, then add Kudzu juice etc., and simmer until 3 sheng remain. Divide into three doses, twice daily.
To treat Tendon Deficiency Extreme and Tendon Bi, presenting with frequent sadness and thoughtfulness, pale complexion, panting in the four limbs, hand-foot contracture, difficulty extending/moving due to tightness, and abdominal moving pain, use Acanthopanax Wine (Wu Jia Jiu).
Five-leaf Acanthopanax Bark (Wu Jia Pi, 1 jin), Thorny Citrus Fruit (Zhi Ci), Hemp Seed (Da Ma Ren) (each 3 sheng), Root bark of Piper Longum (Zhu Jiao Gen Pi), Danshen (each 8 liang), Cinnamon Twig (Gui Xin), Angelica Sinensis Radix (Dang Gui), Licorice Root (Gan Cao) (each 3 liang), Aconite Lateral Root (Tian Xiong), Sichuan Pepper (Qin Jiao - *Note: Text says Qin Jiao but context implies Qin Jiao or similar spicy herb, likely typo for Qin Jiao or Qian Hu, keeping literal*), White Phellodendron Bark (Bai Xian), Tetrapanax Pith (Tong Cao) (each 4 liang), Dried Ginger (Gan Jiang, 5 liang), Coix Seed (Yi Yi Ren, half sheng), Szechwan Lovage Rhizome (Chuan Xiong, 5 liang).
Process the above fifteen herbs, place in a silk bag, and steep in 4 dou of clear wine for 4 days in Spring/Summer, or 6-7 days in Autumn/Winter. Initial dose: 6-7 he, gradually increase until effective.
To treat Tendon Deficiency Extreme, presenting with immovable tendons, pain in all ten fingers/nails, frequent tendon spasms, or excessive intercourse, or intercourse before recovery damaging Qi, leading to internal tendon exhaustion, curled tongue, cyanotic lips, pulling of testicles, painful/tight meridians, colicky abdominal pain, inability to defecate or eat, use Ginseng Wine (Ren Shen Jiu).
Ginseng (Ren Shen), Saposhnikovia Root (Fang Feng), Poria (Fu Ling), Asarum Root (Xi Xin), Sichuan Pepper (Qin Jiao), Astragalus Root (Huang Qi), Angelica Sinensis Radix (Dang Gui), Achyranthes Root (Niu Xi), Platycodon Root (Jie Geng) (each 1.5 liang), Dried Rehmannia Root (Shu Di Huang), Danshen, Jujube (Zao, 30 pieces), Five-leaf Acanthopanax Bark (Wu Jia Pi, 1 sheng), Fresh Ginger (Sheng Jiang, sliced and fried dry), Black Sesame Seeds (Wu Ma, crushed) (each 1.5 liang).
Process the above twenty-two herbs. Place Milkstone (Zhong Ru) separately in a small bag. Steep in 2.5 dou of clear wine for five nights. Warm and take 3 he, twice daily. Increase as tolerated without adverse effects. (Another version omits Black Sesame and uses Eucommia Bark Du Zhong, 2.5 liang.)
Formula for injury from intercourse, testicular retraction, and tendon contraction:
Burn the menstrual cloth of a woman to ash. Take one fang-cun-bi per dose.
Formula for Tendon Exhaustion:
Roast crab brain and marrow from legs, apply to the wound; the tendons will reconnect.
For cold qi rebellion from labor, cold bi in waist and hips, difficulty bending/extending feet: Moxibustion on Yang Qiao (Yangqiao Point), 100 moxa cones. Location: Below the lateral malleolus, space approximating a fingernail.
For stiff back/waist, tendon spasms, acute bi, and tendon contraction: Moxibustion on the 21st Vertebra, number of cones according to age.
For tendon spasms, cramping of tendons in ten fingers, inability to flex/extend: Moxibustion on the foot lateral malleolus bone, 7 moxa cones.
For seminal emission causing tendon contraction, penile retraction into abdomen, mutual pulling pain: Moxibustion on Zhongfeng (Zhongfeng SP4), 50 moxa cones. Location: Anterior to the medial malleolus, in the depression within the tendon.
For seminal emission causing tendon contraction, penile retraction into abdomen, mutual pulling pain: Moxibustion on Xia Man (Xiaman points) each 50 cones. Elderly patients double the dose; children use age-based dosage. Also stated: These two points also treat throat swelling, reversal cold, suffering of the five Zang organs, and drum-like distension.
For unbearable shin bone pain from tendon spasms: Moxibustion on the transverse tendon below the knee crease, 3 moxa cones.
For abdominal distension with tendon spasms: Moxibustion 1 cun above the umbilicus, 20 moxa cones.