【歌】遍体烦疼曰痛风，湿痰风热苦相攻。或因血弱寒凝涩，流注浑身骨节中。
【论】夫痛风者，遍身骨节走痛是也，古人谓之白虎历节风。大率因血受热已自沸腾，或涉冷受湿取凉，
热血得寒则污浊凝涩，不得营运，所以作痛。夜痛甚者，行于阴分也。亦有阴湿与痰流注为痛者，有因痰与热
者。盖肥人多是湿痰流注经络，瘦人多是血虚与热。大法以行气流湿疏风，导滞血，养新血，降阳升阴。治有
先后，须验肿与不肿，及上下部分，引而导之。
痰
因痰者，二陈汤加酒芩、羌活、南星、苍术、竹沥、姜汁。（方见痰证。）湿痰痛风，酒 、酒威灵
仙、苍术、羌活、甘草、干姜、陈皮、芍药。痰挟死血，一身走痛者，控涎丹。（方见胁痛。）
湿
因湿者，二术加羌活、白芷、黄柏、防风、竹沥、姜汁，
或二妙散。（方见香港脚。）肢节肿痛，脉滑，苍术、南星、木香、枳壳、槟榔、防己、黄柏。风湿相搏痛者，
甜瓜子丸。
甜瓜子丸
干木瓜（两半） 威灵仙（两半） 甜瓜子（二两，炒黄） 川乌（炮，五钱）
末之，酒糊丸桐子大，每三十丸，酒下。
血虚（附死血）
血虚痛，芎归汤加桃仁、红花、薄桂、威灵仙，取横行手膊。（方见头痛。）肢节肿痛，脉涩，死血
也，四物汤加桃仁、红花。（方见血证。）寒湿相搏，血郁经络作痛者，麒麟竭散。
麒麟竭散
血竭（六钱） 乳香（六钱） 没药（六钱） 白芍药（六钱） 当归（六钱） 水蛭（二钱，炒焦） 麝
香（二钱） 虎胫骨（酥炙，五钱）
末之，每服三钱，食前酒调下。
风热
风者，小续命汤去附子，加羌活、防风、酒炒黄芩。在上，威灵仙、桂枝；在下，牛膝、防己、黄柏。
（方见中风。）湿热，当归拈痛汤。（方见香港脚。）瘦人肢痛，血虚火盛也，四物汤加黄芩、黄柏、羌活、防
风、柴胡。（方见血证。）
【歌诀】全身广泛性疼痛称为痛风，这是湿邪、痰浊、风邪和热邪相互攻冲所致。有时是因为血气虚弱、寒邪凝滞导致气血运行涩滞，流注于全身的骨节之中。
【论述】所谓痛风，是指全身骨节游走性疼痛的症状，古人称之为“白虎历节风”。大体上是因为血液受热而沸腾，或者因接触寒冷、感受湿气、贪凉取冷，使得热血遇到寒邪后变得污浊凝滞，无法正常营运，从而产生疼痛。夜间疼痛加剧的，说明病邪行于阴分。也有因为阴湿与痰浊流注经络而引起疼痛的，还有因为痰与热相结引起的。一般来说，肥胖的人多因湿痰流注经络，消瘦的人多因血虚兼有内热。治疗的大法在于行气以祛湿、疏风、导滞化瘀、滋养新血、降阳升阴。治疗需分先后顺序，必须观察是否有肿胀，以及病变部位在上半身还是下半身，从而引导药力到达病所。
因痰浊引起的：使用二陈汤加酒炒黄芩、羌活、天南星、苍术、竹沥、姜汁。（方剂见痰证章节。）若是湿痰型痛风，可用酒浸白术、酒浸威灵仙、苍术、羌活、甘草、干姜、陈皮、芍药。若痰浊夹杂死血（瘀血），导致全身游走性疼痛，用控涎丹。（方剂见胁痛章节。）
因湿邪引起的：使用二术（苍术、白术）加羌活、白芷、黄柏、防风、竹沥、姜汁，或者使用二妙散。（方剂见香港脚章节。）若肢节肿痛，脉象滑，可用苍术、天南星、木香、枳壳、槟榔、防己、黄柏。若风湿相搏引起的疼痛，用甜瓜子丸。
甜瓜子丸
干木瓜（一两半） 威灵仙（一两半） 甜瓜子（二两，炒至微黄） 川乌（炮制，五钱）
研为细末，用酒糊制作成梧桐子大小的丸剂，每次服用三十丸，温酒送下。
血虚（附带死血/瘀血）
因血虚引起的疼痛，用芎归汤加桃仁、红花、薄桂（肉桂）、威灵仙，取其药性横行于手臂。（方剂见头痛章节。）若肢节肿痛，脉象涩，属于死血（瘀血），用四物汤加桃仁、红花。（方剂见血证章节。）若寒湿相搏，血郁积在经络引起疼痛，用麒麟竭散。
麒麟竭散
血竭（六钱） 乳香（六钱） 没药（六钱） 白芍药（六钱） 当归（六钱） 水蛭（二钱，炒焦） 麝香（二钱） 虎胫骨（酥炙，五钱）
研为细末，每次服用三钱，饭前用酒调服。
风热
因风邪引起的，用小续命汤去掉附子，加羌活、防风、酒炒黄芩。病位在上部的，加威灵仙、桂枝；病位在下部的，加牛膝、防己、黄柏。（方剂见中风章节。）湿热引起的，用当归拈痛汤。（方剂见香港脚章节。）消瘦之人肢体疼痛，是血虚火旺所致，用四物汤加黄芩、黄柏、羌活、防风、柴胡。（方剂见血证章节。）
[Verse]
Generalized pain throughout the body is termed *Tongfeng* (Gout). It arises from the mutual assault of Dampness, Phlegm, Wind, and Heat. Sometimes it is due to Blood deficiency and Cold coagulation causing stagnation, flowing into the bone joints throughout the body.
[Dissertation]
*Tongfeng* (Gout) refers to wandering pain in the bone joints throughout the body; in ancient times, it was called "White Tiger Li Jie Feng" (White Tiger Wandering Joint Wind). Generally, it occurs because the Blood has been heated to a state of boiling, or due to exposure to cold, dampness, or seeking coolness. When hot Blood encounters Cold, it becomes turbid and stagnant, failing to circulate normally, thus causing pain. Pain that worsens at night indicates the pathogen is traversing the Yin aspect. There are also cases where Yin-Dampness and Phlegm flow into the meridians causing pain, or where Phlegm and Heat combine. Typically, obese individuals suffer from Damp-Phlegm flowing into the meridians, while thin individuals suffer from Blood deficiency with internal Heat. The general treatment principle involves promoting Qi circulation to resolve Dampness, dispersing Wind, guiding out stagnation and blood stasis, nourishing new Blood, descending Yang, and ascending Yin. Treatment must follow a sequence, requiring examination of whether swelling is present and whether the lesion is located in the upper or lower parts, thereby guiding the therapeutic action accordingly.
**Due to Phlegm:**
For cases caused by Phlegm, use *Erchen Tang* (Two-Cured Decoction) plus Jiuhuangqin (Scutellariae Radix fried with wine), Qianghuo (Notopterygii Rhizoma et Radix), Nanting (Arisaematis Tuber processed), Cangzhu (Atractylodis Rhizoma), Zhuli (Bambusae Caulis in Succedaneum), and Jiangzhi (Zingiberis Rhizoma Juice). (Formula see Chapter on Phlegm Syndrome.) For Damp-Phlegm *Tongfeng*, use Jiuzhuru (Atractylodis Rhizoma soaked in wine), Jiuwanglingxian (Salviae Miltiorrhizae soaked in wine), Cangzhu, Qianghuo, Gancao (Glycyrrhizae Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Shaoyao (Paeoniae Radix Alba). If Phlegm clots with Dead Blood (Blood Stasis) causing wandering pain throughout the body, use *Kongxian Dan* (Control Fluid Pellets). (Formula see Chapter on Hypochondriac Pain.)
**Due to Dampness:**
For cases caused by Dampness, use Erzhu (Cangzhu and Baizhu) plus Qianghuo, Baizhi (Angelicae Dahuricae Radix), Huangbai (Phellodendri Cortex), Fangfeng (Saposhnikoviae Radix), Zhuli, and Jiangzhi, or use *Ermiao San* (Two-Awesome Powder). (Formula see Chapter on Hong Kong Foot / Podagra.) If there is swelling and pain in the limb joints with a slippery pulse, use Cangzhu, Nanting, Muxiang (Aucklandiae Radix), Zhike (Aurantii Fructus Immaturus), Binglang (Arecae Semen), Fangji (Stephaniae Tetrandrae Radix), and Huangbai. For pain caused by Wind-Dampness interlocking, use *Tianguazi Wan* (Sweet Melon Seed Pills).
**Tianguazi Wan**
Gan Mugua (Chaenomelis Fructus, 1.5 liang), Weilingshen (Salviae Miltiorrhizae, 1.5 liang), Tianguazi (Benincasae Semen, 2 liang, stir-fried until yellow), Chuanwu (Aconiti Radix Praeparata, 5 qian).
Grind into fine powder, mix with wine paste to form pills the size of tung tree seeds. Take 30 pills each time, washed down with wine.
**Blood Deficiency (Including Dead Blood/Stasis)**
For pain due to Blood deficiency, use *Xionggui Tang* (Ligusticum and Angelica Decoction) plus Taoren (Persicae Semen), Honghua (Carthami Flos), Bao Gui (Cinnamomi Ramulus), and Weilingshen, utilizing their property to travel horizontally along the arms. (Formula see Chapter on Headache.) If there is swelling and pain in the limb joints with a choppy pulse, this indicates Dead Blood (Blood Stasis); use *Siwu Tang* (Four Substances Decoction) plus Taoren and Honghua. (Formula see Chapter on Blood Syndromes.) For pain caused by Cold-Dampness interlocking and Blood depression in the meridians, use *Qilinjie San* (Kirin Blood Powder).
**Qilinjie San**
Xuejie (Dracaenae Sangue, 6 qian), Ruxiang (Olibanum, 6 qian), Moyao (Myrrha, 6 qian), Baishaoyao (Paeoniae Radix Alba, 6 qian), Danggui (Angelicae Sinensis Radix, 6 qian), Shuizhi (Hirudo, 2 qian, stir-fried until scorched), Shexiang (Moschus, 2 qian), Hu Jinggu (Pantheris Tibia prepared with butter, 5 qian).
Grind into fine powder. Take 3 qian each time, mixed with wine before meals.
**Wind-Heat**
For cases caused by Wind, use *Xia Xuming Tang* (Minor Xu Ming Decoction) minus Fuzi (Aconiti Lateralis Radix Praeparata), plus Qianghuo, Fangfeng, and Jiuchao Huangqin (Scutellariae Radix fried with wine). For lesions in the upper part, add Weilingshen and Guizhi (Cinnamomi Ramulus); for lesions in the lower part, add Niuxi (Achyranthis Bidentatae Radix), Fangji, and Huangbai. (Formula see Chapter on Stroke.) For Damp-Heat, use *Danggui Niang Tong Tang* (Angelica Relieving Pain Decoction). (Formula see Chapter on Hong Kong Foot.) For limb pain in thin individuals, which is due to Blood deficiency and flourishing Fire, use *Siwu Tang* plus Huangqin, Huangbai, Qianghuo, Fangfeng, and Chaihu (Bupleuri Radix). (Formula see Chapter on Blood Syndromes.)