李 左臂自肩以下骨节大痛，经所谓寒胜则痛也。来势甚骤，若游走上下骨骱，即俗谓白虎历节风。
痛如虎咬，刻不可忍，此非厉剂不除，投以川乌头炮去脐皮、草乌头炮去皮，姜汁制、松节油，一剂，服后饮
酒以助药势达病所。夜半身麻汗出，平旦而病若失矣。此仿活络丹法。
张 五旬外，左臂素患肿痛，因涉江受风，一夜，全身麻痹，脉虚濡，此真气虚而风湿为病，乃痱中根萌
也。经曰∶营虚则不仁，卫虚则不用。营卫失调，邪气乘虚袭入经络，蠲痹汤主之，数服而效。《准绳》云，
凡风痹偏枯，未有不因真气不周而病者。治不用黄 为君，人参、归、芍为臣，桂枝、钩藤、荆沥、竹沥、姜汁
为佐。徒杂乌、附、羌活以涸营而耗卫，未之能愈也。严氏蠲痹汤用黄 、炙草以实卫，当归、白芍活血以
调营，羌、防除湿疏风，姜黄理血中滞气，入手足而驱寒湿，用酒和服，专借以行药力也。
王 伤酒涉水，湿袭阴络，右腿痹痛，由髀骨直至委中穴。参用三痹汤内服，桂心、茯苓、牛膝、杜仲、
白术、苍术、当归、独活、桑枝煎汤。外用防风、桂枝、木瓜、当归、 、葱白煎汤熏洗，汗出为度。夫
湿痹重着，今腿痛已定，通移膝胫，仍以逐湿通痹法治。川乌、桂心、独活、牛膝、虎胫骨、归尾、没药，以溺
少加茯苓、车前子。二服，兼用洗药，痛止能行。数十日内，戒酒肉风冷劳动。
王氏女 风寒湿合而成痹，蕴邪化热，蒸于经络，四肢痹痛，筋骨不舒。盖邪中于经为痹，中于络为痿。
《金匮》云∶经热则痹，络热则痿，倘经腑治失宣通，延为痿 。杏仁、滑石、石膏、赤苓、威灵仙、蚕砂、
薏仁，数服痛减，乃用白术、薏仁、茯苓、桂枝、片姜黄、钗斛、归身、玉竹、五加皮、桑枝煎汤，数十服肢体
活动。又服丸剂平补肝肾，步履如常。
族妇 右臂痛手不能举，此为肢痹。用舒筋汤。片姜黄、当归、羌活、炙草、姜渣、海桐皮，加桂枝，四
五服渐瘳。凡筋得
寒则急，得热则纵， 短为拘，弛长为痿。风寒湿三气杂至合而成痹。风胜为行痹，寒胜为痛痹，湿胜为着痹，
宜宣风逐寒燥湿，兼通络。如臂痛，服舒筋汤，必腋下 汗出，则邪不滞于筋节，而拘急舒矣。如气虚加参、
，血虚加地、芍，肩背加羌活、狗脊、鹿胶，腰脊加杜仲、独活、沙苑子，臂指加姜黄、桂枝，骨节加油松
节、虎膝，下部加牛膝、薏苡、五加皮、虎胫骨，经络加桑寄生、威灵仙、钩藤。久而不痊，必有湿痰败血瘀
滞经络，加桂心、胆星、川乌、地龙、红花、桃仁以搜逐之。
王有年，盛暑脉沉缓，身半以下酸
痛，胫膝无汗，手足不温，便艰梦泄，皆湿热壅阻致痹，先通其壅。
用蒸牛膝、当归、秦艽、川芎、玉竹、杏仁、陈皮、淡苁蓉。二服便润，去苁蓉、杏仁，专理经络湿邪，
加桂枝、桑寄生、独活、薏苡、杜仲、熟地（炒）。十数服全瘳。
李姓患者：左臂从肩部以下骨节剧烈疼痛，正如《内经》所说“寒邪偏胜则导致疼痛”。发病非常急骤，如果疼痛在上下关节间游走不定，就是民间所说的“白虎历节风”。疼痛如同被老虎咬噬，片刻难以忍受，这种病症非用猛烈药性不能祛除。处方使用炮制去脐皮的川乌头、炮制去皮的草乌头（用姜汁炮制）、松节油，服用一剂后，饮酒以助药力直达病所。夜间半身麻木并出汗，天亮时病痛仿佛消失了一样。此法仿照活络丹的方义。
张姓患者：五十多岁，左臂素来患有肿痛，因渡江受风，一夜之间全身麻痹，脉象虚软无力。这是真气虚弱而风湿之邪致病，乃是中风（痱中）的萌芽。经书说：“营气虚则感觉迟钝（不仁），卫气虚则运动障碍（不用）。”营卫失调，邪气乘虚侵袭经络，主用蠲痹汤治疗，服用数剂后见效。《准绳》说，凡是风痹或偏枯，没有不是因为真气运行不畅而致病的。治疗应以黄芪为君药，人参、当归、白芍为臣药，桂枝、钩藤、荆沥、竹沥、姜汁为佐药。如果只杂乱地使用乌头、附子、羌活等药，会使营血枯竭、卫气耗散，是无法治愈的。严氏蠲痹汤使用黄芪、炙甘草来充实卫气，当归、白芍活血以调和营气，羌活、防风除湿疏风，姜黄调理血中的滞气，作用于手足以驱除寒湿，用药酒送服，专门借酒力来推动药力运行。
王姓患者：饮酒过量且涉水，湿气侵袭阴络，右腿痹痛，从大腿骨一直延伸到委中穴。参用三痹汤内服，药物包括桂心、茯苓、牛膝、杜仲、白术、苍术、当归、独活、桑枝煎汤。外用防风、桂枝、木瓜、当归、细辛、葱白煎汤熏洗，以出汗为度。湿痹的特点是沉重固定，现在腿部疼痛已经稳定，并向膝盖和小腿转移，仍然采用祛湿通痹的方法治疗。处方用川乌、桂心、独活、牛膝、虎胫骨、当归尾、没药，因为尿少，加茯苓、车前子。服用两剂，同时使用外洗药，疼痛停止并能行走。数十日内，戒除酒肉及风寒劳累。
王氏女子：风寒湿三气结合而成痹证，蕴积的邪气化热，蒸灼于经络，导致四肢痹痛，筋骨舒展不利。大概邪气侵入经脉称为痹，侵入络脉称为痿。《金匮要略》说：“经脉有热则成痹，络脉有热则成痿。”如果经脉和腑气的治疗失去了宣通，拖延下去会发展为痿证。处方用杏仁、滑石、石膏、赤茯苓、威灵仙、蚕砂、薏苡仁，服用数剂后疼痛减轻，接着改用白术、薏苡仁、茯苓、桂枝、片姜黄、石斛、当归身、玉竹、五加皮、桑枝煎汤，服用数十剂后肢体活动自如。又服用丸剂平补肝肾，步履恢复正常。
族中妇人：右臂疼痛，手不能举起，这属于肢痹。使用舒筋汤。药物包括片姜黄、当归、羌活、炙甘草、姜渣、海桐皮，加入桂枝，服用四五剂后逐渐痊愈。大凡筋脉遇到寒冷就会收缩紧急，遇到热就会松弛延长，短缩为拘挛，松弛延长为痿废。风寒湿三气杂合而至结合而成痹证。风邪偏胜称为行痹，寒邪偏胜称为痛痹，湿邪偏胜称为着痹。适宜宣散风邪、驱逐寒邪、燥湿，兼以通络。如手臂疼痛，服用舒筋汤，必须腋下出汗，这样邪气就不会滞留在筋节，拘急就能舒缓。如果气虚加人参、黄芪，血虚加熟地、白芍，肩背疼痛加羌活、狗脊、鹿角胶，腰脊疼痛加杜仲、独活、沙苑子，手臂手指疼痛加姜黄、桂枝，骨节疼痛加油松节、虎膝（代用品），下部疼痛加牛膝、薏苡仁、五加皮、虎胫骨，经络阻滞加桑寄生、威灵仙、钩藤。如果久治不愈，必定有湿痰、败血瘀滞经络，加桂心、胆南星、川乌、地龙、红花、桃仁以搜剔驱逐。
王有年：盛夏时节脉象沉缓，身体下半部酸痛，小腿膝盖无汗，手足不温暖，大便困难，梦中遗精，这些都是湿热壅阻导致痹证，先要疏通其壅滞。处方用蒸牛膝、当归、秦艽、川芎、玉竹、杏仁、陈皮、淡苁蓉。服用两剂后大便通畅，去掉苁蓉、杏仁，专门调理经络湿邪，加桂枝、桑寄生、独活、薏苡仁、杜仲、熟地黄（炒）。服用十数剂后完全康复。
Patient Li: Severe pain in the bone joints of the left arm from the shoulder downwards, as stated in the *Classic of Internal Medicine*: "Excess Cold leads to pain." The onset was sudden. If the pain wanders up and down through the joints, it is commonly known as "White Tiger Arthritis" (Baihu Lijie Feng). The pain is like being bitten by a tiger, unbearable for even a moment; such a condition cannot be cured without potent agents. A prescription was administered consisting of Chuanwu Tou (Sichuan Aconite Root, processed to remove umbilicus and skin), Caowu Tou (Wild Aconite Root, processed to remove skin, treated with ginger juice), and Songjie You (Pine Joint Oil). After one dose, wine was consumed to assist the medicinal force in reaching the disease site. At night, numbness and sweating occurred on half of the body; by dawn, the illness seemed to have vanished. This method imitates the formula of Huoluo Dan (Activate Collaterals Pill).
Patient Zhang: Over fifty years old, suffering from chronic swelling and pain in the left arm. After crossing a river and being exposed to wind, he experienced total body paralysis overnight. His pulse was deficient and soggy (Xu Ru). This indicates deficiency of True Qi with pathogenic Wind-Dampness, which is the root germination of Feizhong (Apoplexy/Flaccidity). The Classics state: "Deficiency of Ying [Nutritive] Qi leads to insensibility (Bu Ren); deficiency of Wei [Defensive] Qi leads to inability to move (Bu Yong)." Disharmony of Ying and Wei allows pathogens to invade the collaterals due to deficiency. The primary treatment was Juanbi Tang (Eliminate Bi Decoction), which proved effective after several doses. *Zhunsheng* states: "All cases of Wind-Bi or hemiplegia arise from the failure of True Qi to circulate freely." Treatment should use Huangqi (Astragalus Root) as the Sovereign herb, Renshen (Ginseng Root), Danggui (Angelica Sinensis Root), and Baishao (White Peony Root) as Ministers, Guizhi (Cinnamon Twig), Gouteng (Uncaria Rhynchophylla), Jingli (Liquidambar Resin solution), Zhuli (Bamboo Sap), and Jiangzhi (Ginger Juice) as Assistants. Merely mixing Wutou (Aconite Root), Fuzi (Prepared Aconite Root), and Qianghuo (Notopterygium Root) would deplete Ying and consume Wei, failing to cure the disease. Yan's Juanbi Tang uses Huangqi and Zhi Gancao (Honey-fried Licorice Root) to solidify Wei, Danggui and Baishao to invigorate blood and harmonize Ying, Qianghuo and Fangfeng (Saposhnikovia Root) to drain dampness and disperse wind, Jianghuang (Turmeric Rhizome) to regulate stagnant Qi in the blood, acting on the limbs to drive out Cold-Dampness. It is taken with wine to specifically borrow the wine's power to propel the medicinal efficacy.
Patient Wang: Excessive alcohol consumption combined with wading in water caused Dampness to invade the Yin collaterals. He suffered from Bi pain in the right leg, extending from the thigh bone directly to Weizhong BL-40. Internally, Sanbi Tang (Triple Deficiency Bi Decoction) was used, decocted with Guixin (Cinnamon Bark), Fuling (Poria), Niuxi (Achyranthes Root), Duzhong (Eucommia Bark), Baizhu (Atractylodes Macrocephala Rhizome), Cangzhu (Atractylodes Rhizome), Danggui (Angelica Sinensis Root), Duhuo (Angelica Pubescens Root), and Sangzhi (Mulberry Twig). Externally, a decoction of Fangfeng (Saposhnikovia Root), Guizhi (Cinnamon Twig), Mugua (Chaenomeles Fruit), Danggui (Angelica Sinensis Root), Xixin (Asarum Root), and Congbai (Scallion White) was used for fumigation and washing, stopping when sweating occurred. Damp-Bi is characterized by heaviness and fixed location. Now that the leg pain has stabilized and shifted to the knee and shins, the treatment remains focused on draining Dampness and unblocking Bi. The prescription included Chuanwu (Sichuan Aconite Root), Guixin (Cinnamon Bark), Duhuo (Angelica Pubescens Root), Niuxi (Achyranthes Root), Hu Jinggu (Tiger Tibia Bone - substitute required), Dangguiwei (Angelica Sinensis Tail), Moyao (Myrrh). Due to scanty urination, Fuling (Poria) and Cheqianzi (Plantago Seed) were added. After two doses, combined with external washes, the pain ceased and walking resumed. For dozens of days, alcohol, meat, wind, cold, and labor were avoided.
Ms. Wang: Wind, Cold, and Dampness combined to form Bi syndrome. The accumulated pathogens transformed into Heat, steaming the collaterals, causing Bi pain in the four limbs and stiffness in sinews and bones. Generally, pathogens entering the meridians constitute Bi, while those entering the collaterals constitute Wei (Flaccidity). *Jingui Yaolue* states: "Heat in the meridians leads to Bi; heat in the collaterals leads to Wei." If the treatment of meridians and fu-organs fails to promote free circulation, it may prolong into Wei syndrome. The initial prescription included Xingren (Apricot Seed), Huashi (Talcum), Shigao (Gypsum), Chiling (Red Poria), Weilingxian (Syringa Root), Can Sha (Silkworm Frass), and Yiren (Coix Seed). After several doses, pain decreased. Subsequently, Baizhu (Atractylodes Macrocephala Rhizome), Yiren (Coix Seed), Fuling (Poria), Guizhi (Cinnamon Twig), Pian Jianghuang (Turmeric Rhizome), Chaihu (Dendrobium Stem - note: text says 钗斛, likely Dendrobium), Dangguishen (Angelica Sinensis Head), Yuzhu (Polygonatum Rhizome), Wujiapi (Acanthopanax Bark), and Sangzhi (Mulberry Twig) were decocted. After dozens of doses, limb movement normalized. Finally, pills were taken to gently tonify Liver and Kidney, restoring normal gait.
Clan Woman: Pain in the right arm preventing elevation, classified as Zhibi (Limb Bi). Shujin Tang (Relax Sinews Decoction) was used. Ingredients included Pian Jianghuang (Turmeric Rhizome), Danggui (Angelica Sinensis Root), Qianghuo (Notopterygium Root), Zhi Gancao (Honey-fried Licorice Root), Jiangzha (Ginger Residue), Haitongpi (Piliostigma Bark), plus Guizhi (Cinnamon Twig). After four or five doses, gradual recovery occurred. Generally, sinews contract and become tight when cold, and relax and lengthen when hot. Shortening constitutes Ju (Cramp/Tetany), while relaxation and lengthening constitute Wei (Flaccidity). Wind, Cold, and Dampness mixed together form Bi. Excess Wind constitutes Xingbi (Wandering Bi), excess Cold constitutes Tongbi (Painful Bi), and excess Dampness constitutes Zhuobi (Fixed Bi). Treatment should disperse Wind, expel Cold, dry Dampness, and unblock collaterals. For arm pain, taking Shujin Tang must result in sweating under the axilla; thus, pathogens will not stagnate in the sinew joints, and cramping will relieve. If Qi deficiency, add Renshen (Ginseng Root) and Huangqi (Astragalus Root); if Blood deficiency, add Shudi (Rehmannia Root) and Baishao (White Peony Root); for shoulder/back pain, add Qianghuo (Notopterygium Root), Gouji (Dogspine Herb), and Lu Jiao Jiao (Deer Antler Glue); for waist/spine pain, add Duzhong (Eucommia Bark), Duhuo (Angelica Pubescens Root), and Shayuanzi (Astragalus Complanatus Seed); for arm/finger pain, add Jianghuang (Turmeric Rhizome) and Guizhi (Cinnamon Twig); for joint pain, add Songjie (Pine Joint) and Hu Xi (Tiger Knee - substitute); for lower body pain, add Niuxi (Achyranthes Root), Yiyi (Coix Seed), Wujiapi (Acanthopanax Bark), and Hu Jinggu (Tiger Tibia Bone); for meridian obstruction, add Sangjisheng (Taxillus Branch) and Weilingxian (Syringa Root). If chronic and unhealed, there must be Damp-Phlegm and ruined blood stasis obstructing collaterals; add Guixin (Cinnamon Bark), Dansheng (Arisaema with Bile), Chuanwu (Sichuan Aconite Root), Dilong (Earthworm), Honghua (Safflower), and Taoren (Peach Kernel) to search out and expel them.
Wang Nian: In midsummer, the pulse was deep and slow. Acidic pain below the waist, no sweat in calves and knees, cold hands and feet, difficult defecation, and nocturnal emission. All these indicate Bi caused by Damp-Heat obstruction. First, unblock the stagnation. Prescription: Zheng Niuxi (Steamed Achyranthes Root), Danggui (Angelica Sinensis Root), Qin Jiao (Gentiana Macrophylla Root), Chuanxiong (Ligusticum Rhizome), Yuzhu (Polygonatum Rhizome), Xingren (Apricot Seed), Chenpi (Citrus Peel), Dan Congrong (Cistanche Stem). After two doses, stool became moist. Cistanche and Apricot Seed were removed. Focus shifted to regulating meridian Dampness, adding Guizhi (Cinnamon Twig), Sangjisheng (Taxillus Branch), Duhuo (Angelica Pubescens Root), Yiyi (Coix Seed), Duzhong (Eucommia Bark), and Shudi (Prepared Rehmannia Root, stir-fried). After more than ten doses, full recovery was achieved.