肢节走痛。内经谓之贼风。后人谓之痛风。又谓之白虎历节风。宜审其寒热而治之。
脉宜浮数。 忌虚弱。
痛风。脉浮紧。头痛恶寒发热。为新受之邪。宜
五积散。（四十二）
治风先治血。血行风自灭。宜
四物汤。加生黄 防风桂枝秦艽桑枝红花炙草主之。（九）
痛风久不能愈。必大补气血。以为胜邪之本。切不可徒用风药。宜
十全大补汤诸药。各一钱。加真桑寄生三钱为君。再加附子防风竹沥生姜汁为佐
使。（十一）
痛风久不愈。以痛久必入络也。诸方俱宜加入金银花木通红花钩钩藤刺蒺藜之类。
○又痛久则郁。郁而泻热。热则生痰。必加入制南星半夏栝蒌根黄柏贝母竹沥姜汁之类。○
又桑寄生虎骨。俱为要药。以桑为箕星之精。风从虎之义也。○久服辛热之药不效者。宜用
玉竹黑芝麻直僵蚕生 归须菊花蒺藜阿胶炙草之类。为柔润熄肝风法也。
痹者。闭也。风寒湿杂至。合而为痹。与痛风相似。但风则阳受之。痹则阴受之。虽内
经痹论。风气胜者为行痹。寒气胜者为痛痹。湿气胜者为着痹之分。而深究其源。自当以寒
与湿为主。盖以风为阳邪。寒与湿为阴邪。阴主闭。闭则郁滞而为痛。是痹不外寒与湿。而
寒与湿亦必假风以为之帅。寒曰风寒。湿曰风湿。此三气杂合之说也。内经寿天刚柔篇曰。
在阳者命曰风。在阴者命曰痹。以此分别。则两症自不混治矣。若胸痹及脏腑诸痹。又当别
论。医门法律。分别甚详。宜参阅之。
一痹症之实者。宜
五积散。（四十二）
一金匮治血痹。脉阴阳俱微。寸口关上微。尺中小紧。外症身体不仁。如风痹状。用黄
五物汤。黄 芍药桂枝各二钱。生姜六钱。大枣四枚。水煎服。一日三服。愚谓为痹症属
虚者之总方。
肢体关节游走性疼痛。《内经》称之为贼风。后人称之为痛风。又称之为白虎历节风。应当辨别其寒热属性而进行治疗。
脉象宜见浮数。忌见虚弱之脉。
痛风，脉象浮紧，伴有头痛、恶寒、发热，这是新近感受的外邪。适宜使用五积散。（第四十二条）
治疗风病首先要调理血液，血液运行通畅则风邪自然消除。适宜使用四物汤。加入生黄芪、防风、桂枝、秦艽、桑枝、红花、炙甘草来主治。（第九条）
痛风日久不能痊愈，必须大补气血，作为战胜病邪的根本。切不可单纯使用祛风药物。适宜使用十全大补汤诸药，每味药各一钱，加入真桑寄生三钱作为君药。再加入附子、防风、竹沥、生姜汁作为佐使药。（第十一条）
痛风日久不愈，是因为疼痛日久必然深入络脉。各种方剂都适宜加入金银花、木通、红花、钩藤、刺蒺藜之类的药物。
○另外，疼痛日久则会产生郁滞，郁滞化热，热盛则生痰。必须加入制南星、半夏、栝楼根、黄柏、贝母、竹沥、姜汁之类的药物。○
○另外，桑寄生和虎骨，都是重要的药物。因为桑树是箕星精气所化，老虎象征风的含义。○
○长期服用辛热药物无效者，适宜使用玉竹、黑芝麻、直僵蚕、当归须、菊花、蒺藜、阿胶、炙甘草之类的药物。这是柔润以平息肝风的方法。
痹证，就是闭塞的意思。风、寒、湿三种邪气杂合而至，结合而成痹证。与痛风相似。但风邪侵犯阳分，痹邪侵犯阴分。虽然《内经·痹论》中有风气偏胜的称为行痹，寒气偏胜的称为痛痹，湿气偏胜的称为着痹的区别，但如果深究其根源，自然应当以寒和湿为主。因为风属于阳邪，寒和湿属于阴邪。阴主闭塞，闭塞则气机郁滞而产生疼痛。所以痹证不外乎寒和湿，而寒和湿也必定借助风邪作为先导。寒称为风寒，湿称为风湿。这就是这三种邪气杂合的说法。《内经·寿天刚柔篇》说：“在阳分的叫做风，在阴分的叫做痹。”以此加以区分，那么这两种病症自然不会混淆治疗了。至于胸痹以及脏腑的各种痹证，又应当另外讨论。《医门法律》中区分得非常详细，适宜参阅。
《金匮要略》治疗血痹，脉象阴阳俱微，寸口和关上脉微，尺中脉稍紧，外症身体麻木不仁，像风痹的样子。使用黄芪桂枝五物汤。黄芪、芍药、桂枝各二钱，生姜六钱，大枣四枚，水煎服。一日服用三次。我认为这是治疗痹症属虚证的总方。
Painful wandering movement of the limbs and joints. The *Neijing* (Classic of Internal Medicine) refers to this as "Zei Feng" (Thieving Wind). Later generations call it "Tongfeng" (Gout/Arthralgia), also known as "Baihu Lijie Feng" (White Tiger Joint Pain Wind). One should examine its cold or heat nature and treat accordingly.
The pulse should be floating and rapid. A weak pulse is contraindicated.
In Tongfeng, if the pulse is floating and tight, accompanied by headache, aversion to cold, and fever, it indicates newly acquired pathogenic factors. It is suitable to use Wuji San (Five Accumulations Powder). (Article 42)
To treat wind disorders, one must first regulate the blood; when blood flows freely, wind extinguishes itself. It is suitable to use Siwu Tang (Four Substances Decoction). Add Sheng Huangqi (Raw Astragali Radix), Fangfeng (Saposhnikoviae Radix), Guizhi (Cinnamomi Ramulus), Qinjiao (Gentianae Macrophyllae Radix), Sangzhi (Mori Ramulus), Honghua (Carthami Flos), and Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) to govern it. (Article 9)
If Tongfeng persists for a long time without healing, one must greatly tonify Qi and Blood as the foundation for overcoming the pathogen. One must absolutely avoid using only wind-dispelling drugs. It is suitable to use Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction). Each herb in the formula at 1 qian, with Zhen Sangjisheng (True Taxilli Fructus) at 3 qian as the sovereign drug. Additionally add Fuzi (Aconiti Lateralis Radix Praeparata), Fangfeng, Zhuli (Bambusa Textilis Caulis Sap), and Jiangzhi (Zingiberis Recensis Juice) as minister and guide drugs. (Article 11)
If Tongfeng persists for a long time without healing, it is because prolonged pain inevitably enters the collaterals. Various formulas are suitable for adding herbs such as Jinyinhua (Lonicerae Japonicae Flos), Mutong (Akebiae Trifolata Caulis), Honghua, Gouteng (Uncariae Ramulus cum Uncis), and Ciji Li (Tribuli Fructus).
○ Furthermore, prolonged pain leads to stagnation; stagnation transforms into heat; heat generates phlegm. One must add herbs such as Zhi Nanting (Prepared Arisaematis Rhizoma), Banxia (Pinelliae Rhizoma), Gualou Gen (Trichosanthis Radix), Huangbai (Phellodendri Cortex), Beimu (Fritillariae Bulbus), Zhuli, and Jiangzhi. ○
○ Additionally, Sangjisheng and Hugu (Bone of Panthera tigris) are both essential medicines. This is because mulberry is the essence of the Ji Star, and the tiger symbolizes wind. ○
○ For those who have taken acrid-hot medicines for a long time without effect, it is suitable to use Yuzhu (Polygonati Odorati Rhizoma), Heimaazi (Sesami Fructus Niger), Zhijiangcan (Silkworm), Danggui Xu (Radix Angelicae Sinensis Caulis), Juhua (Chrysanthemi Flos), Jili, Ejiao (Colla Corii Asini), and Zhi Gancao. This constitutes the method of moistening and nourishing to extinguish Liver Wind.
Bi Syndrome (Obstruction Syndrome) means closure. Wind, Cold, and Dampness arrive together and combine to form Bi Syndrome. It is similar to Tongfeng. However, Wind affects Yang aspects, while Bi affects Yin aspects. Although the *Neijing · Bi Lun* distinguishes between Xing Bi (Wandering Bi) where Wind prevails, Tong Bi (Painful Bi) where Cold prevails, and Zhuo Bi (Fixed Bi) where Dampness prevails, upon deep investigation of their source, one should naturally prioritize Cold and Dampness. This is because Wind is a Yang pathogen, while Cold and Dampness are Yin pathogens. Yin governs closure; closure leads to stagnation and thus pain. Therefore, Bi Syndrome is essentially Cold and Dampness, and Cold and Dampness must borrow Wind as their commander. Cold is called Wind-Cold, Dampness is called Wind-Dampness. This is the theory of the mixture of these three qi. The *Neijing · Shoutian Gangrou Pian* states: "In Yang, it is named Wind; in Yin, it is named Bi." By distinguishing in this way, the two syndromes will not be treated confusingly. As for Xiong Bi (Chest Bi) and various organ Bi syndromes, they should be discussed separately. *Yimen Falü* (Medical Laws and Principles) distinguishes them in great detail; reference is recommended.
For excess-type Bi Syndromes, it is suitable to use Wuji San. (Article 42)
The *Jinkui Yaolue* treats Blood Bi, where the pulse is micro in both Yin and Yang positions, micro at Cun and Guan, and slightly tight at Chi. Externally, the body feels numb and insensible, resembling Wind-Bi. Use Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction). Huangqi, Shaoyao, and Guizhi each at 2 qian, Shengjiang at 6 qian, Dazao at 4 pieces. Decoct in water and take orally. Three doses per day. I consider this the general formula for deficiency-type Bi Syndromes.