房弟 胫膝痛肿,流走不定,筋惕足酸,风湿久痹,都从热化矣。古谓风从阳受,痹从阴受。始由络痹
失宣,十数年忽止忽发。今秋痛自右移左,行立颇难,阴络受病。诊脉下元先虚,搜理络邪,宜兼滋化源,为
有年阴虚痹症治法。熟地(水煮)、杞子、当归、牛膝、茯苓、木瓜、威灵仙、桑寄生、玉竹、独活、杜仲(生)、
薏苡、地骨皮同熬膏,以虎胫骨胶收,开水化服,痛止。
族某 水湿与气互搏,走注上下表里经络不定。其走注处必略肿,肤热如芒刺,前自耳项,直下胸乡,
走肠,别注茎囊;后自背膂,走腰注臀,行髀膝,至右 ,肿重。手按不即起,口燥咽痛,溺少便艰,
此湿饮为风气鼓动,溢于支络,游走升降,肠腑郁痹,针刺罔效。治用表里宣泄。杏仁、石膏、山栀、赤苓、
木通、秦艽、黑豆皮、大腹皮、黄柏(酒炒),二服痹痛减,二便爽。再用宣理行痹。钩藤、薏苡(各三钱)、
山栀、杏仁、车前(各一钱)、茯苓、腹皮、川楝子、桑寄生(各二钱)、牛膝、狗脊、防己(各钱半),
四服诸症平。再去牛膝、狗脊、川楝等,加神曲、半夏、椒目以运水湿,而肿退。
张 长夏历节痛痹,身重肢软,风湿淫注,血脉失于宣通,治用驱风逐湿,通调血脉。独活、川乌(制)、
当归、牛膝(蒸)、姜黄、威灵仙、防己、松节、乳香、桑枝寻骨风,水酒各半煎,外用风药煎汤熏洗而康。
族女 风湿走注,骨节痛痹,四肢筋掣,脉沉,由产后血虚留邪。当归、木瓜、秦艽、杞子、钩藤、茯苓、
牛膝、薏苡、蚕砂、姜黄、桑枝,外用防风、 、苍耳子、菖蒲根、葱、姜煎汤,浴取汗,六七次痛止如常。
房姓患者的弟弟,小腿和膝盖疼痛肿胀,疼痛部位游走不定,筋脉跳动,足部酸软。这是风湿之邪长期痹阻,都已转化为热证。古人说风邪从阳分受邪,痹证从阴分受邪。起初是由络脉痹阻、气机失于宣通所致,十几年来忽发忽止。今年秋季,疼痛从右侧转移到左侧,行走站立都很困难,说明阴络受了病邪。诊察脉象显示下元(肾与命门)先虚,治疗应搜剔络脉中的邪气,并兼补化源(脾胃及肾精生化之源),这是针对多年阴虚痹症的治疗方法。用熟地黄(水煮)、枸杞子、当归、牛膝、茯苓、木瓜、威灵仙、桑寄生、玉竹、独活、杜仲(生用)、薏苡仁、地骨皮一同熬制成膏,用虎胫骨胶收膏,开水冲服,疼痛停止。
同族某患者,水湿之气与正气相互搏结,在上下表里的经络中流注不定。其流注的部位必然略微肿胀,皮肤发热如芒刺扎一般,从前面的耳后颈部,直下至胸部,流注于肠道,另流注于阴茎和阴囊;后面的从背部脊柱,流注于腰部臀部,经过大腿膝盖,到达右腿(此处原文可能有缺字或指代特定部位,依文意理解为下肢关节),肿胀沉重。用手按压凹陷不能立即恢复,口干咽痛,小便少且排便困难。这是湿饮被风气鼓动,溢出于支络,游走升降,导致肠腑郁滞痹阻,针刺无效。治疗采用表里宣泄法。用杏仁、石膏、山栀、赤茯苓、木通、秦艽、黑豆皮、大腹皮、黄柏(酒炒),服用两剂后痹痛减轻,大小便通畅。再用宣理行痹法。用钩藤、薏苡仁(各三钱)、山栀、杏仁、车前子(各一钱)、茯苓、腹皮、川楝子、桑寄生(各二钱)、牛膝、狗脊、防己(各钱半),服用四剂后诸症平息。再去掉牛膝、狗脊、川楝子等药,加入神曲、半夏、椒目以运化水湿,从而消肿。
张某,长夏季节患历节痛痹,身体沉重,四肢软弱,风湿之邪淫溢流注,血脉失去宣通,治疗采用驱风逐湿、通调血脉的方法。用独活、川乌(制)、当归、牛膝(蒸)、姜黄、威灵仙、防己、松节、乳香、桑枝、寻骨风,用水和酒各一半煎煮,外用风药煎汤熏洗而痊愈。
同族女性,风湿流注,骨节疼痛痹阻,四肢筋脉抽搐,脉象沉,这是由于产后血虚留邪所致。用当归、木瓜、秦艽、枸杞子、钩藤、茯苓、牛膝、薏苡仁、蚕砂、姜黄、桑枝,外用防风、(此处原文可能有缺字,通常指白芷或其他祛风药,依原文保留空缺或略过)、苍耳子、菖蒲根、葱、姜煎汤,洗浴取汗,六七次后疼痛停止如常。
The younger brother of the Fang family presented with pain and swelling in the shins and knees, with migratory pain that did not stay in one place, twitching of the tendons, and soreness in the feet. This is a chronic Bi syndrome (obstruction syndrome) caused by Wind-Dampness, which has transformed into Heat. Ancient texts state that Wind is received from the Yang aspect, while Bi is received from the Yin aspect. Initially, it was due to obstruction in the collaterals and failure of Qi mechanism to circulate freely, causing intermittent attacks for over ten years. In this autumn, the pain migrated from the right side to the left, making walking and standing difficult, indicating disease in the Yin collaterals. The pulse diagnosis revealed deficiency in the Lower Yuan (Kidney and Mingmen). The treatment should search out and eliminate pathogenic factors in the collaterals, while simultaneously nourishing the source of transformation (the Spleen-Stomach and Kidney essence), which is the therapeutic method for chronic Yin-deficiency Bi syndrome. Prepared as a paste using Shu Di Huang (Rehmanniae Radix Praeparata, boiled), Gou Qi Zi (Lycii Fructus), Dang Gui (Angelicae Sinensis Radix), Niu Xi (Achyranthis Bidentatae Radix), Fu Ling (Poria), Mu Gua (Chaenomelis Fructus), Wei Ling Xian (Clematidis Radix et Rhizoma), Sang Ji Sheng (Taxilli Herba), Yu Zhu (Polygonati Odorati Rhizoma), Du Huo (Angelicae Pubescentis Radix), Du Zhong (Eucommiae Cortex, raw), Yi Yi Ren (Coicis Semen), and Di Gu Pi (Lycii Cortex), collected with Hu Jing Gu Jiao (Colla Cornu Tigris), taken dissolved in hot water, resulting in cessation of pain.
A certain member of the same clan had Water-Dampness and Qi fighting each other, flowing through the meridians above and below, interior and exterior without fixed location. The areas where it flowed were slightly swollen, with skin feeling hot like needle pricks. Anteriorly, it moved from behind the ears and neck, straight down to the chest, flowing into the intestines, and separately into the penis and scrotum; posteriorly, it moved from the dorsal spine, flowing into the waist and buttocks, passing through the thighs and knees, reaching the right leg, with heavy swelling. Pressing with hand left an indentation that did not immediately rebound. There was dry mouth, sore throat, scanty urination, and difficult defecation. This was caused by Damp-Fluids being stirred by Wind, overflowing into the branch collaterals, wandering up and down, causing stagnation and obstruction in the Intestine-Fu organs. Acupuncture was ineffective. Treatment used exterior-interior releasing methods: Xing Ren (Armeniacae Semen Amarum), Shi Gao (Gypsum Fibrosum), Shan Zhi (Gardeniae Fructus), Chi Ling Shen (Poria cum Rubro), Mu Tong (Akebiae Caulis), Qin Jiao (Gentianae Macrophyllae Radix), Hei Dou Pi (Sojae Semen Nigrum Testa), Da Fu Pi (Arecae Pericarpium), and Huang Bo (Phellodendri Cortex, wine-fried). After two doses, Bi pain decreased, and urination and defecation became smooth. Then, a method to promote circulation and treat moving Bi was used: Gou Teng (Uncariae Ramulus cum Uncis), Yi Yi Ren (each 3 qian), Shan Zhi, Xing Ren, Che Qian Zi (each 1 qian), Fu Ling, Fu Pi, Chuan Lian Zi, Sang Ji Sheng (each 2 qian), Niu Xi, Gou Ji, Fang Ji (each 1.5 qian). After four doses, all symptoms subsided. Niu Xi, Gou Ji, and Chuan Lian Zi were removed, and Shen Qu, Ban Xia, and Jiao Mu were added to transform Water-Dampness, leading to reduction of swelling.
Zhang suffered from Li Jie (interjoint) painful Bi during the long summer, with heavy body and soft limbs. Wind-Dampness excessively flooded and injected, causing blood vessels to lose free circulation. Treatment used dispelling Wind and expelling Dampness, and unblocking and regulating blood vessels. Du Huo, Chuan Wu (prepared), Dang Gui, Niu Xi (steamed), Jiang Huang (Curcumae Longae Rhizoma), Wei Ling Xian, Fang Ji, Song Jie (Pinus Massoniana Node), Ru Xiang (Olibanum), Sang Zhi (Mori Ramulus), and Xun Gu Feng (Sarcandrae Herba) were decocted in half water and half wine. Externally, Wind-dispelling herbs were decocted for fumigation and washing, leading to recovery.
A female member of the same clan had Wind-Dampness flowing through, causing painful Bi in bone joints, spasms of tendons in the four limbs, and a deep pulse. This was due to pathogenic factors remaining after postpartum Blood deficiency. Dang Gui, Mu Gua, Qin Jiao, Gou Qi Zi, Gou Teng, Fu Ling, Niu Xi, Yi Yi Ren, Can Sha (Bombyx Batryticatus), Jiang Huang, and Sang Zhi were used. Externally, Fang Feng (Saposhnikoviae Radix), Cang Er Zi (Xanthii Fructus), Chang Pu (Acori Tatarinowii Rhizoma), Cong Bai (Allii Fistulosi Bulbus), and Sheng Jiang (Zingiberis Rhizoma Recens) were decocted for bathing to induce sweating. After six or seven times, pain ceased and normalcy returned.