一人遍体疼痛，尻体皆肿，足膝挛急。李曰∶此寒伤荣血，脉筋为之引急，《内经》所谓痛痹也。用乌药
顺气散，七剂而减。更加白术、桂枝，一月而愈。
冯楚瞻治李相国（讳）之芳，当耿逆之变，勤劳军旅，左臂强硬作痛，上不能至头，下不能抚背，医与驱风活
络不效，且大便圆如弹子。以书有粪如羊矢者不治，深以为忧。诊之，六脉大而迟缓无神，知为中气久虚，荣
卫不能遍及肢末，乃有偏枯之象。至其大便，亦由中气不足，命门火衰，以致营运不健，转输迟滞，糟粕不能
连接直下，犹蜣 之转丸，故圆而且大，非若关格之病，津液燥槁，肠胃窄细，致黑小如羊粪者。然宜空心服
八味加牛膝、杜仲，以培其本；食远以加减归脾，加甜薄桂，以壮其标。元阳得旺，则营运健而大便自调；气
血既充，则肢节和而臂强自愈矣。如法而痊，精神更倍。
卢不远治张二如病，脊膂痛，艰于起拜，形伛偻，楚甚。脉之以为精虚，须龟鹿四仙膏一大剂，服三月方
可愈。彼不信，越三年，再求治，用四仙膏一料，佐以透冰丹二十粒，全愈。或问故，曰∶此房后风入髓中也，
骨气不精，故屈伸不利，用透冰以祛肾风，用四仙以填骨髓，病去精满，百体从合矣。顾渠三年之中，未尝不
服补精血祛风邪之药。不知药不可笼统而用，须精专，必使之填髓入骨中，透风自骨出，斯为合法耳。
孙文垣治程参军，年六十四，向以乏嗣，服下元药太多，冬月单 立溪边，督工受寒，致筋骨疼痛，肩井、
缺盆、脚膝、跟踝及骨节动处，皆红肿而痛，卧床三年。或认为虚、为寒、为风、为湿，百治不效，腿间大肉
尽消，惟骨节合处肿大而痛。脉之弦涩有力，知为湿热痰火被寒气凝滞，固涩经络也。所喜目中精神尚在，胃
气未全损。其小便在器，少顷则澄结为砂，色红而浊。两膝下及脚趾，皆生大疮，疮靥如靴钉状，皆由向服春
方所致。为先逐经络凝滞，然后健脾消痰，俾新痰不生，血气日长，后以补剂收功，斯得也。以新取威灵仙一
斤，装新竹筒中，入烧酒二斤，塞筒口，刮去青皮，重汤煮三炷官香为度，取出晒干为末，用竹沥打糊为丸桐
子大，早晚酒送一钱，日服二次。五日后，大便去稠粘痰积半桶，肿痛减大半。改以人参、石斛、苍术、黄柏、
薏仁、苍耳子、牛膝、乌药叶、龟板、红花、犀角、木通，煎服二十帖，又用前末药服三日，又下痰积如前之
半。仍以前药服半月，又服末药三日，腹中痰渐少。乃以虎骨、晚蚕砂、苍术、黄柏、丹参、杜仲、牛膝茎叶、
薏仁、红花、五加皮、苍耳子、龟板，酒打糊为丸梧子大，每空心服七八十丸，外以丹溪保和丸，食后服，半
年全愈。
孙质庵患痛风，两手自肩 （巨骨下臂 上。）及曲池，（肘弯处三里上。）以至手梢，两足自膝及跟尻，
肿痛更甚，痛处热，（火流注也。）饮食少，伏褥者三年。脉之皆弦细而数，面青，（肝色。）肌瘦，（火多。）
大小腿肉皆瘦削。（三阴虚损。）曰∶此得之禀气弱，下虚多内以伤其阴也。燕地多寒，今血虚则筋失养，故
荣不荣于中，气为寒束，百骸拘挛，故卫不卫于外，是名周痹。治当养血舒筋，疏湿润燥，使经络通畅。待痛
止，即以大补阴血之剂，实其下元。先与
五加皮、苍术、黄柏、苍耳子、当归、红花、薏仁、羌活、防风、秦艽、紫荆皮，二十剂，筋渐舒，肿渐消，
痛减大半。更以生地、龟板、牛膝、苍术、黄柏、晚蚕砂、苍耳子、薏仁、海桐皮、当归、秦艽，三十剂，肿
痛全减。戒之曰∶难足而易败者，阴也。须痛绝酒色，以固根本，斯刀圭可恃。乃用仙茅为君，杞子、牛膝、
鹿胶、虎骨、人参为臣，熟地、黄柏、晚蚕砂、茯苓、苍耳子为佐，桂心、秦艽、泽泻为使。蜜丸，服百日腿
肉长充，精神复旧。
俞东扶曰∶此案论治处方俱精当，叶案有蓝本于此者。
薛立斋治一男子，先腿肿，后四肢皆痛，游走不定，至夜益甚，服除湿败毒之剂不应。诊其脉滑而涩，此
湿痰浊血为患。以二陈汤加苍术、羌活、桃仁、红花、牛膝、首乌，治之而愈。凡湿痰湿热，或死血流注关节，
非辛温之剂，开发腠理，流通隧道，使气行血和，焉能得愈？
一男子肢节肿痛，脉迟而数，此湿热之症。以荆防败毒散加麻黄，二剂痛减半。以槟榔败毒散，四剂肿亦
消。更以四物汤加二术、牛膝、木瓜，数剂而愈。
一妇人两腿作痛，时亦走痛，气短自汗，诸药不应。诊之，尺脉弦缓，此寒湿流注肾经也，以附子六物汤
治之而愈。但人谓附子有毒，多不肯服。若用童便炮制，何毒之有？况不常服，何足为虑？薛中气不足，以补
中益气汤加附子，服之三年，何见其毒也？经云∶有是病，用是药。
冯楚瞻治唐某，患左足左手骨节疼痛，势如刀割，旦夕呼号，既而移至右手右足皆遍矣。或用祛风活络之
剂不效。见其口燥咽干，误作流火，投以凉剂，幸而吐出。神气疲困，六脉洪弦，此气血久虚，筋骨失养，将
成瘫痪之候。惟宜大用熟地、当归、白芍，养血为君；银花、秦艽，少借风势以达药力于筋骨为臣；牛膝、续
断、杜仲，以调筋骨为佐；更用桂枝、松节，以鼓舞药性，横行于两臂为引；再用参、术以固中培元。调理半
月，渐瘳。后以生脉饮，送八味丸加牛膝、杜仲、鹿茸、五味子各四五钱，日中仍服前剂，始能步履。更以大
补气血，强筋壮骨之药，以收全功。未几，其室人因日夜忧劳，亦患是症，六脉沉微，右手足疼痛，既而不流
于左，而竟攻之于里，胸脘痞闷恶心，疼痛欲绝。知为内伤日久，寒邪不为外达，直中阴分，宜急温之。以人
参、白术各五钱，肉桂、附子各二钱，浓煎，徐徐温服。次日脉少起，胸中病痛闷大减，身有微热，左亦略疼，
此阳气还表，寒邪欲外散之机也。照方再服，内症渐平。惟手足之痛尚在，然亦不甚，以参、术补中为君，归、
芍养血为臣，杜仲、续断、牛膝、秦艽、桂枝，舒筋活络为佐，全愈。夫痛风止有五痹，皮痹、脉痹、肌痹、
骨痹、筋痹，未闻有脏腑之痹也。然经曰∶寒气胜者为痛痹。又曰∶其留连筋骨间者疼久，其留皮肤间者易已，
其入脏者死。可不慎欤！
薛立斋治一妇人，肢节作痛，不能转侧，恶风寒，自汗盗汗，小便短，虽夏亦不去衣，其脉浮紧。此风寒
客于太阳经，用甘草附子汤，一剂而瘥。
一妇人月经不调，且素有痛风，遇劳必作，用众手重按稍止。此气血俱虚，用十全大补加独活而痛痊。用
六味丸、逍遥散而经调。
一妇人肢体作痛，面色萎黄，时或赤白，发热恶寒，吐泻食少，腹痛胁胀，月经不时，或如崩漏，或痰盛
喘嗽，头目眩痛，或五心烦热，口渴饮汤，或健忘惊悸，盗汗无寐等症，卧床年许。悉属肝脾亏损，气血不足
所致，用十全大补、加味归脾兼服月余，诸症悉痊。
张仲景治妇人六十二种风，及腹中血气刺痛，以红蓝花酒主之。红花一味，以酒一大碗，煎减半，顿服一
半，顷之再服。
喻嘉言治张令施弟伤寒坏症，两腰偻废，彻夜痛叫，百治不效。脉亦平顺无患，其痛则比前大减。曰∶病
非死症，但恐成废人矣。此症之可转移处，全在痛如刀刺，尚有邪正互争之象。若全不痛，则邪正混为一家，
相安于无事矣。今痛觉大减，实有可虑。病者曰∶此身既废，命安从活？不如速死。欲为救全，而无治法。谛
思良久，谓热邪入两腰，血脉久闭，不能复出，止有攻散一法。而邪入既久，正气全虚，攻之必不应。乃以桃
仁承气汤，多加肉桂、附子，二大剂与服，服后既能强起，再仿前意为丸，服至旬余全安。此非昔人之已试，
一时之权宜也，然有自来矣。仲景于结胸症有附子泻心汤一法，原是附子与大黄同用。但在上之症气多，故以
此法泻心。然在下之症多血，独不可仿其意，而合桃仁、肉桂，以散腰间血结乎！后江古生乃弟伤寒，两腰偻
废痛楚，不劳思索，径用此法，二剂而愈。
陈洪章治沈沃田，年七十余，左臂及指拘挛不能伸舒，食减神惫。或谓老人虚弱，用补剂以致日甚。陈诊
之，曰∶此由风湿邪郁胸脾，波及四肢。用二陈汤加芒硝、砂仁，以薏苡仁三两煎汁煎药，连服四剂，病去大
半。去硝，仍用二陈，又服六剂而全愈。（沃田手札新案。）
立斋治一妇人，肢节肿痛，胫足尤甚，时或自汗，或头痛。此太阳经湿热所致，用麻黄左金汤，二剂而愈。
昔有人患足痹者，趁舟，见舟中一袋，以足倚之，比及登岸，足以善步。及询袋中何物，乃木瓜也。（《本草
备要》。）
王执中云∶有贵人手中指挛，已而无名指亦挛，医为灸肩 、曲池、支沟而愈。支沟在腕后三寸。或灸风
池，多有不灸支沟，或灸合谷云。
李景中中丞，传筋骨疼甚如夹板状，痛不可忍者，将骡子修下蹄爪，烧灰存性，研末，或酒，或白汤，调
服立愈。（《广笔记》。）
雄按∶此方治 疮久不愈者甚效。干者麻油调敷，湿者糁之。
马元仪治陈氏妇，患痛痹，手足螈 ，周身尽痛，不能转侧，口干躁烦。脉之弦数兼涩，此阳明津液不足，
则生热，热极则生风。手足螈 者，风淫末疾也；口干烦躁者，火邪内炽也。惟专滋阳明，不治风而风自息，
不治痛而痛自除矣。用生首乌一两，生地五钱，黄连、黄芩、秦艽、半夏曲、枳壳、桔梗各一钱，四剂症减六
七，又数剂而痊。
张氏子周身掣痛，头不可转，手不能握，足不能运，如是者半月矣。诊之，两脉浮虚。浮虽风象，而内痛
者，脉亦浮而无力。以脉参症，当是劳倦伤中，阳明不治之候也。阳明者，五脏六腑之海，束筋骨而利机关，
不治则气血不荣，十二经脉无所禀受而不用矣。卫中空虚，荣行不利，故相搏而痛也。法当大补阳明气血，不
与风寒湿成痹者同。用人参二钱，黄 、当归各三钱，炙甘草、桂枝、红花各五分，秦艽一钱。两剂脉和而能
转侧，去桂枝、加白术、肉桂、杞子、熟地等，调理半月而安。夫病有虚实不同，治法因之而异。风寒湿所致
者，气滞于内而为痹、邪踞于表而为痛，病之实者也。阳明中虚所致者，血不养筋而为痛，气虚于内而不运，
病之虚者也。其实者急在邪气，去之不速，留则生变也；其虚者急在正气，补之不早，愈久愈剧也。凡病皆然，
不独此也。书之以为见病治病者鉴。
袁某患痛痹，身及手足掣痛，彻夜不得安卧，发热口燥，胸满中痛，两脉弦，右关独大，此胃热壅闭，为
阳明内实症也。阳明之气，不能充灌周身，十二经脉不得流利，故肢体不能自如。（ 按∶此与上条一虚一实，
恰是对面。此类观之，最足启发心思增识力。）以调胃承气加黄连、秦艽，一剂大便得通，再剂症减六七。改
用清胃和中之剂，调理而愈。
吴汉章痛风发热，神昏妄言见鬼，手足螈 ，大便不行。此胃津伤而肝木生火，内炽则便闭神昏，外攻则
发热身痛也。法当滋其内，则火自息，风自除，痛自止矣。用生首乌、蒌仁、黄连、知母、枳壳、桔梗、桂枝、
秦艽，一剂渐减。但心神不安，如在舟车云雾中，不能自主，改用人参、炙草、生地、麦冬、远志、枣仁、
茯神、贝母、橘红、羚羊角，三剂，再与归脾汤，调理数日而安。
杜汉飞患周身流走作肿，手不能握，足不能履，已三月。脉之浮大而数，发热口干。此阴虚生内热，热胜
则生风，风性善行，伤于筋脉，则纵缓不收，逆于肉理，则攻肿为楚也。用生地五钱，酒炒芩、连各一钱，红
花五分，盖苦以胜热，辛以散风也。二剂得酣睡，数剂而诸苦若失。
治臂腿之间，忽一两点痛若着骨不可忍。芫花根，研为细末，米醋调，随大小敷之立效。医云∶此陶成一
医者方，曾以治一妇人产后得此疾者，良验。但敷贴不住，须以纸花覆其上，用白绢札定也。（《百乙方》。）
立斋治徐工部宜人，先两膝痛，后至遍身骨节皆痛，脉迟缓，投羌活胜湿汤及荆防败毒散加渗湿药不应，
次以附子八物汤，一剂痛悉退，再服而愈。若脉洪数而痛者，宜服人参败毒散。
张子和治一税官，病风寒湿痹，腰脚沉重浮肿，夜则痛甚，两足恶寒，经五六月间，犹棉缠靴足。腰膝皮
肤，少有跣露，则冷风袭之，流入经络，其痛转剧，走注上下，往来无定，其痛极处，便拥急而肿起，肉色不
变，腠理间如虫行。每遇风冷，病必转增，饮食转减，肢体瘦乏，须人扶掖，犹能行立。所服者，乌、附、姜、
桂，种种燥热，燔针着灸，莫知其数，前后三年不愈。一日命张脉之，其两手皆沉滑有力。先以导水丸、通经
散各一服，是夜泻二十余行，痛减过半。渐服赤茯苓汤、川芎汤、防风汤。此三方在《宣明论》中，治痹方是
也。日三服，煎七八钱， 然汗出，又作玲珑灶法熏蒸。若热病反剧，诸汗法古方亦多有之，惟以吐发汗者，
世罕知之。故尝曰∶吐法兼汗，良以此夫。
一人全身疼痛，臀部及身体肿胀，足膝拘挛紧急。李中梓说：这是寒邪损伤了营血，导致脉管筋脉牵引拘急，《内经》所说的痛痹。使用乌药顺气散，服用七剂后症状减轻。再加白术、桂枝，一个月后痊愈。
冯楚瞻治疗李相国（名）之芳，正值耿精忠叛乱之时，他在军旅中辛勤劳苦，左臂僵硬作痛，上不能举过头顶，下不能抚摸背部，医生给予驱风活络的药物无效，且大便呈圆形如弹子大小。因为医书上有“粪便像羊屎一样”属于不治之症的记载，他深感忧虑。诊察发现，六脉大而迟缓且无神，知道是脾胃之气长期虚弱，营卫之气不能遍及四肢末端，所以呈现出类似偏枯的症状。至于他的粪便，也是由于中气不足，命门火衰，导致运化功能不健，传导迟滞，糟粕不能连接直下，就像蜣螂转丸一样，所以圆而且大，并非关格病那种津液干枯、肠胃狭窄细小，导致黑小如羊粪的情况。然而应当空腹服用八味丸加牛膝、杜仲，以培补根本；饭后服用加减归脾汤，加甜薄桂，以强壮标症。元阳旺盛，则运化健旺而大便自然调畅；气血充盈，则肢节调和而手臂僵硬自愈。按照这个方法痊愈，精神比之前加倍好。
卢不远治疗张二如的病，脊背疼痛，难以起身拜倒，身形佝偻，非常痛苦。诊脉认为是精髓亏虚，需要一大剂龟鹿四仙膏，服用三个月才可以痊愈。他不相信，过了三年，再来求治，用了四仙膏一料，佐以透冰丹二十粒，完全痊愈。有人问原因，他说：这是房事后风邪侵入髓海，骨气不精，所以屈伸不利，用透冰丹来祛除肾风，用四仙膏来填补骨髓，病去精满，百体自然和谐。只是这三年中，他并非没有服用补精血祛风邪的药物。不知道用药不可笼统使用，必须精准专一，务必使药物填补髓海进入骨骼，让风邪从骨中透出，这才是合法的治疗。
孙文垣治疗程参军，六十四岁，向来因为没有子嗣，服用了太多温补下元的药物，冬天独自站在溪边监督工程受寒，导致筋骨疼痛，肩井、缺盆、脚膝、跟踝以及骨节活动处，都红肿而痛，卧床三年。有人认为是虚证、寒证、风证、湿证，各种治疗都无效，大腿肌肉全部消瘦，只有骨节连接处肿大而痛。诊脉弦涩有力，知道是湿热痰火被寒气凝滞，固涩经络所致。庆幸的是眼中精神尚在，胃气未完全受损。他的尿液在容器中，片刻后沉淀结为砂状，颜色红而浑浊。两膝下及脚趾，都生大疮，疮痂像靴钉形状，这都是先前服用春方导致的。先驱逐经络中的凝滞，然后健脾消痰，使新痰不生，血气日渐增长，最后用补剂收功，这样才行。取新鲜威灵仙一斤，装入新竹筒中，加入烧酒二斤，塞住筒口，刮去青皮，隔水煮沸至燃烧三炷官香的时间为止，取出晒干研末，用竹沥打糊做成梧桐子大小的丸药，早晚用酒送服一钱，每天服用两次。五天后，排出粘稠痰积半桶，肿痛减少大半。改为用人参、石斛、苍术、黄柏、薏仁、苍耳子、牛膝、乌药叶、龟板、红花、犀角、木通煎服二十帖，又用前面的药末服用三天，又排出痰积如前的一半。仍然以前药服用半个月，又服末药三天，腹中痰渐少。然后用虎骨、晚蚕砂、苍术、黄柏、丹参、杜仲、牛膝茎叶、薏仁、红花、五加皮、苍耳子、龟板，酒打糊做成梧桐子大小的丸药，每次空腹服用七八十丸，外用丹溪保和丸，饭后服用，半年后完全痊愈。
孙质庵患痛风，两手从肩髃穴（巨骨下臂臑上）及曲池穴（肘弯处三里上），直到手指梢，两足从膝盖到脚跟臀部，肿痛更严重，痛处发热（这是火邪流注），饮食减少，卧床三年。诊脉皆弦细而数，面色青（肝色），肌肉消瘦（火多），大小腿肉皆瘦削（三阴虚损）。说：这是由于禀赋气弱，下元虚损过多内伤其阴。燕地多寒，现在血虚则筋失养，所以营气不能在内部荣养，气为寒邪束缚，百骸拘挛，所以卫气不能在外部护卫，这叫周痹。治疗应当养血舒筋，疏湿润燥，使经络通畅。待疼痛停止，立即以大补阴血的药剂，充实下元。先给五加皮、苍术、黄柏、苍耳子、当归、红花、薏仁、羌活、防风、秦艽、紫荆皮，二十剂，筋逐渐舒展，肿逐渐消退，痛减少大半。再用生地、龟板、牛膝、苍术、黄柏、晚蚕砂、苍耳子、薏仁、海桐皮、当归、秦艽，三十剂，肿痛全减。告诫他说：阴精难足而易败。必须戒绝酒色，以巩固根本，这样医术才能依靠。于是用仙茅为君药，枸杞子、牛膝、鹿胶、虎骨、人参为臣药，熟地、黄柏、晚蚕砂、茯苓、苍耳子为佐药，桂心、秦艽、泽泻为使药。蜜丸，服用一百天腿肉长充，精神恢复旧观。
俞东扶说：此案论述治疗和处方都非常精当，叶天士的医案有以此为蓝本的。
薛立斋治疗一名男子，先腿肿，后四肢皆痛，游走不定，到了夜里更加严重，服用除湿败毒的药物无效。诊脉滑而涩，这是湿痰浊血为患。用二陈汤加苍术、羌活、桃仁、红花、牛膝、首乌，治疗而愈。凡是湿痰湿热，或死血流注关节，非辛温的药物，开发腠理，流通隧道，使气行血和，怎么能痊愈？
一名男子肢节肿痛，脉迟而数，这是湿热之症。用荆防败毒散加麻黄，二剂痛减半。用槟榔败毒散，四剂肿也消。再用四物汤加二术、牛膝、木瓜，数剂而愈。
一名妇人两腿作痛，有时也游走作痛，气短自汗，各种药物无效。诊察，尺脉弦缓，这是寒湿流注肾经，用附子六物汤治疗而愈。只是人们说附子有毒，大多不肯服用。如果用童便炮制，有什么毒呢？况且不常服用，有什么可担忧的？薛立斋中气不足，用补中益气汤加附子，服用三年，哪里见到毒性呢？经文说：有是病，用是药。
冯楚瞻治疗唐某，患左足左手骨节疼痛，势如刀割，早晚呼号，随后移至右手右足皆遍。或用祛风活络的药物无效。见其口燥咽干，误作流火，投以凉剂，幸而吐出。神气疲困，六脉洪弦，这是气血久虚，筋骨失养，将要成为瘫痪的征候。只宜大用熟地、当归、白芍，养血为君药；银花、秦艽，少借风势以达药力于筋骨为臣药；牛膝、续断、杜仲，以调筋骨为佐药；再用桂枝、松节，以鼓舞药性，横行于两臂为引经药；再用参、术以固中培元。调理半月，逐渐好转。后用生脉饮，送服八味丸加牛膝、杜仲、鹿茸、五味子各四五钱，日中仍服前剂，才能步履。再用大补气血，强筋壮骨的药，以收全功。不久，他的妻子因日夜忧劳，也患此症，六脉沉微，右手足疼痛，随后不流于左，而竟攻之于里，胸脘痞闷恶心，疼痛欲绝。知道是内伤日久，寒邪不为外达，直中阴分，宜急温之。用人参、白术各五钱，肉桂、附子各二钱，浓煎，徐徐温服。次日脉稍起，胸中病痛闷大减，身有微热，左亦略疼，这是阳气还表，寒邪欲外散之机。照方再服，内症渐平。惟手足之痛尚在，然亦不甚，以参、术补中为君药，归、芍养血为臣药，杜仲、续断、牛膝、秦艽、桂枝，舒筋活络为佐药，全愈。夫痛风只有五痹，皮痹、脉痹、肌痹、骨痹、筋痹，没听说过有脏腑之痹。但经文说：寒气胜者为痛痹。又说：其留连筋骨间者疼久，其留皮肤间者易已，其入脏者死。能不谨慎吗！
薛立斋治疗一名妇人，肢节作痛，不能转侧，恶风寒，自汗盗汗，小便短，虽夏天也不脱衣服，其脉浮紧。这是风寒客于太阳经，用甘草附子汤，一剂而愈。
一名妇人月经不调，且素有痛风，遇劳必发作，用手重按稍止。这是气血俱虚，用十全大补汤加独活而痛痊。用六味丸、逍遥散而经调。
一名妇人肢体作痛，面色萎黄，时而赤白，发热恶寒，吐泻食少，腹痛胁胀，月经不时，或如崩漏，或痰盛喘嗽，头目眩痛，或五心烦热，口渴饮汤，或健忘惊悸，盗汗无寐等症，卧床年许。悉属肝脾亏损，气血不足所致，用十全大补汤、加味归脾汤兼服月余，诸症悉痊。
张仲景治疗妇人六十二种风，及腹中血气刺痛，用红蓝花酒主治。红花一味，用酒一大碗，煎至减半，顿服一半，一会儿再服另一半。
喻嘉言治疗张令施的弟弟伤寒坏症，两腰偻废，彻夜痛叫，各种治疗无效。脉象平顺无患，其痛比前大减。说：病不是死症，但恐怕成为废人。此症的可转移之处，全在痛如刀刺，尚有邪正互争的现象。若全不痛，则邪正混为一党，相安无事。现在痛觉大减，实在令人担忧。病人说：这身子既然废了，命从哪里活？不如速死。想要救全，却没有治法。深思良久，说热邪进入两腰，血脉久闭，不能复出，只有攻散一法。而邪入既久，正气全虚，攻之必然不应。于是用桃仁承气汤，多加肉桂、附子，两大剂与服，服后既能强起，再仿前意为丸，服用十余天全安。这不是前人已经试过的，也不是权宜之计，然而自有渊源。张仲景对于结胸症有附子泻心汤一法，原是附子与大黄同用。但在上的症气多，所以以此法泻心。然而在下的症多血，难道不可以仿其意，而合桃仁、肉桂，以散腰间血结吗？后来江古生的弟弟伤寒，两腰偻废痛楚，不需思索，直接用此法，二剂而愈。
陈洪章治疗沈沃田，七十多岁，左臂及手指拘挛不能伸舒，食减神惫。有人说老人虚弱，用补剂以致日益加重。陈诊察说：这是由风湿邪郁胸脾，波及四肢。用二陈汤加芒硝、砂仁，用薏苡仁三两煎汁煎药，连服四剂，病去大半。去掉芒硝，仍用二陈汤，又服六剂而全愈。（沈沃田手札新案。）
薛立斋治疗一名妇人，肢节肿痛，胫足尤其严重，时而自汗，时而头痛。这是太阳经湿热所致，用麻黄左金汤，二剂而愈。
过去有人患足痹，乘船时，看见船中有一袋，用脚倚靠它，等到上岸，脚能好走路。及询问袋中何物，原来是木瓜。（《本草备要》。）
王执中说：有位贵人手中指挛急，随后无名指也挛急，医生灸肩髎、曲池、支沟而愈。支沟在腕后三寸。或者灸风池，大多不灸支沟，或者灸合谷。
李景中丞，传筋骨疼甚如夹板状，痛不可忍，将骡子修下的蹄爪，烧灰存性，研末，或用酒，或用白开水，调服立愈。（《广笔记》。）
雄按：此方治疗瘭疮久不愈者很有效。干的用麻油调敷，湿的用粉撒之。
马元仪治疗陈氏妇，患痛痹，手足抽搐，周身尽痛，不能转侧，口干躁烦。诊脉弦数兼涩，这是阳明津液不足，则生热，热极则生风。手足抽搐，是风淫末疾；口干烦躁，是火邪内炽。只专滋阳明，不治风而风自息，不治痛而痛自除矣。用生首乌一两，生地五钱，黄连、黄芩、秦艽、半夏曲、枳壳、桔梗各一钱，四剂症减六七，又数剂而痊。
张氏儿子周身掣痛，头不可转，手不能握，足不能运，如此半月了。诊察，两脉浮虚。浮虽是风象，但内痛者，脉也浮而无力。以脉参症，应当是劳倦伤中，阳明不治的征候。阳明是五脏六腑之海，束筋骨而利机关，不治则气血不荣，十二经脉无所禀受而不用。卫中空虚，荣行不利，所以相搏而痛。法当大补阳明气血，不与风寒湿成痹者相同。用人参二钱，黄芪、当归各三钱，炙甘草、桂枝、红花各五分，秦艽一钱。两剂脉和而能转侧，去桂枝、加白术、肉桂、杞子、熟地等，调理半月而安。病有虚实不同，治法因之而异。风寒湿所致者，气滞于内而为痹、邪踞于表而为痛，病的实证。阳明中虚所致者，血不养筋而为痛，气虚于内而不运，病的虚证。其实者急在邪气，去之不速，留则生变；其虚者急在正气，补之不早，愈久愈剧。凡病皆然，不独此也。写下来作为见病治病者的借鉴。
袁某患痛痹，身及手足掣痛，彻夜不得安卧，发热口燥，胸满中痛，两脉弦，右关独大，这是胃热壅闭，为阳明内实症。阳明之气，不能充灌周身，十二经脉不得流利，故肢体不能自如。（按：此与上条一虚一实，恰是对面。此类观之，最足启发心思增识力。）用调胃承气加黄连、秦艽，一剂大便得通，再剂症减六七。改用清胃和中之剂，调理而愈。
吴汉章痛风发热，神昏妄言见鬼，手足抽搐，大便不行。这是胃津伤而肝木生火，内炽则便闭神昏，外攻则发热身痛。法当滋其内，则火自息，风自除，痛自止。用生首乌、蒌仁、黄连、知母、枳壳、桔梗、桂枝、秦艽，一剂渐减。但心神不安，如在舟车云雾中，不能自主，改用人参、炙草、生地、麦冬、远志、枣仁、茯神、贝母、橘红、羚羊角，三剂，再与归脾汤，调理数日而安。
杜汉飞患周身流走作肿，手不能握，足不能履，已三月。诊脉浮大而数，发热口干。这是阴虚生内热，热胜则生风，风性善行，伤于筋脉，则纵缓不收，逆于肉理，则攻肿为楚。用生地五钱，酒炒芩、连各一钱，红花五分，盖苦以胜热，辛以散风。二剂得酣睡，数剂而诸苦若失。
治疗臂腿之间，忽然一两点痛若着骨不可忍。芫花根，研为细末，米醋调，随大小敷之立效。医生说：这是陶成一医者方，曾以治一妇人产后得此疾者，良验。但敷贴不住，须以纸花覆其上，用白绢扎定。（《百乙方》。）
薛立斋治疗徐工部宜人，先两膝痛，后至遍身骨节皆痛，脉迟缓，投羌活胜湿汤及荆防败毒散加渗湿药无效，次以附子八物汤，一剂痛悉退，再服而愈。若脉洪数而痛者，宜服人参败毒散。
张子和治疗一名税官，病风寒湿痹，腰脚沉重浮肿，夜间则痛甚，两足恶寒，经过五六月间，还用棉缠靴足。腰膝皮肤，稍有裸露，则冷风袭之，流入经络，其痛转剧，走注上下，往来无定，其痛极处，便拥急而肿起，肉色不变，腠理间如虫行。每遇风冷，病必转增，饮食转减，肢体瘦乏，须人扶掖，犹能行立。所服的，乌头、附子、姜、桂，种种燥热，燔针着灸，不知其数，前后三年不愈。一日让张脉诊，其两手皆沉滑有力。先用导水丸、通经散各一服，当晚泻二十余行，痛减过半。渐服赤茯苓汤、川芎汤、防风汤。此三方在《宣明论》中，治痹方是也。日三服，煎七八钱，濈然汗出，又作玲珑灶法熏蒸。若热病反剧，诸汗法古方亦多有之，惟以吐发汗者，世罕知之。所以常说：吐法兼汗，良由此。
A man suffered from pain throughout his body, swelling of the buttocks and body, and spasm and tightness of the feet and knees. Li Zhongzi said: This is cold pathogen damaging the Ying Blood (nutritive blood), causing the vessels and sinews to be pulled and tightened, as described in the *Neijing* as Painful Bi Syndrome (痛痹). He used Wuyao Shunqi San (Wuyao Qi-Regulating Powder), and after seven doses, the symptoms decreased. White Atractylodes Rhizome (Baizhu) and Cinnamon Twig (Guizhi) were added, and he recovered after one month.
Feng Chuzhan treated Li Xiangguo (courtesy name) Zhifang, during the rebellion of Geng Jingzhong. Having labored hard in the military campaigns, his left arm was stiff and painful, unable to reach above his head or touch his back. Physicians had given wind-dispelling and collateral-unblocking remedies without effect, and his stool was round like a bullet. Because medical texts state that "stool like sheep dung" indicates an untreatable condition, he was deeply worried. Upon examination, the six pulses were large, slow, and lacking spirit, indicating long-standing deficiency of Middle Qi (Spleen/Stomach Qi), with Ying and Wei (nutritive and defensive) Qi unable to reach the extremities, presenting a picture similar to hemiplegia. As for his stool, it was due to insufficient Middle Qi and decline of Mingmen Fire (Gate of Life fire), leading to poor transportation and transformation, sluggish conduction, and waste material failing to descend smoothly, much like a dung beetle rolling a ball; thus it was round and large, unlike Guan Ge syndrome where dry fluids and narrow intestines cause black, small, sheep-dung-like stools. However, he should take Bawei Wan (Eight-Ingredient Pill) with Achyranthes Root (Niuxi) and Eucommia Bark (Duzhong) on an empty stomach to nourish the root; and Jiajian Guipi Tang (Modified Return to the Spleen Decoction) with Sweet Thin Cinnamon (Tian Bo Gui) after meals to strengthen the branch. When Yuan Yang (Primal Yang) flourishes, transportation becomes robust and bowel movements normalize; when Qi and Blood are充盈 (abundant), joints harmonize and arm stiffness heals spontaneously. Following this method, he recovered, with his spirit doubling.
Lu Buyuan treated Zhang Erru's illness: spinal pain, difficulty rising and bowing, a hunched posture, and severe discomfort. Pulse diagnosis indicated Essence deficiency, requiring a large dose of Guilu Sixian Gao (Turtle-Deer Four Immortals Paste), taken for three months for recovery. He did not believe it. Three years later, he sought treatment again. Lu used one dose of Sixian Gao assisted by Twenty grains of Toubing Dan (Ice-Penetrating Pill), resulting in complete recovery. When asked why, Lu said: This is Wind entering the Marrow after sexual intercourse, with unrefined Bone Qi, causing limited flexion and extension. Toubing Dan dispels Kidney Wind, while Sixian Gao fills the Marrow. With the disease gone and Essence full, the whole body harmonizes. Although he took tonifying Essence-Blood and dispelling Wind medicines during these three years, he did not know that medicines must not be used indiscriminately but must be precise and specific, penetrating the Marrow and bones to expel Wind from the bone, which is the correct method.
Sun Wen yuan treated Commander Cheng, aged 64. Previously, due to childlessness, he had taken too many drugs tonifying the Lower Yuan (Kidney). In winter, standing alone by a stream supervising work, he caught cold, resulting in bone and tendon pain. The Jianjing, Quepen, knees, ankles, and moving joints all became red, swollen, and painful, confining him to bed for three years. Some considered it Deficiency, Cold, Wind, or Dampness; hundred treatments failed. The thigh muscles wasted away completely, only the joint connections remained swollen and painful. Pulse was wiry, choppy, and forceful, indicating Damp-Heat, Phlegm, and Fire stagnated by Cold, obstructing the collaterals. Fortunately, the spirit in the eyes remained, and Stomach Qi was not fully damaged. His urine, upon standing in the vessel, precipitated into sand-like sediment, red and turbid. Large sores appeared below both knees and on the toes, scabs resembling boot nails, caused by previous intake of Spring Formulas. First, clear the stagnation in the collaterals, then strengthen the Spleen and resolve Phlegm, preventing new Phlegm formation, allowing Qi and Blood to grow daily, and finally use tonics to conclude treatment. Take one jin of fresh Clematis Root (Weilingxian), pack it in a new bamboo tube, add two jin of distilled spirits, seal the mouth, scrape off the green skin, boil in water until three incense sticks have burned, take out, dry, and powder. Make pills the size of paulownia seeds using Bamboo Sap paste. Take one qian with wine morning and evening, twice daily. After five days, half a bucket of sticky Phlegm accumulation was passed in stool, and swelling/pain reduced by more than half. Switch to decoction of Ginseng, Dendrobium, Atractylodes, Phellodendron, Coix Seed, Xanthium, Achyranthes, Wu Yao Leaf, Turtle Shell, Safflower, Rhinoceros Horn (substitute available), and Akebia Decoction for twenty doses, plus three days of the previous powder, passing another half bucket of Phlegm. Continue the decoction for half a month, plus three days of powder, reducing abdominal Phlegm. Then use Tiger Bone, Late Silkworm Sand, Atractylodes, Phellodendron, Salvia, Eucommia, Achyranthes Stem/Leaf, Coix Seed, Safflower, Five-finger Tree Bark, Xanthium, and Turtle Shell, made into paulownia-seed-sized pills with wine paste. Take 70-80 pills on an empty stomach, and externally take Danxi Baohe Wan after meals. Fully recovered in half a year.
Sun Zhi'an suffered from Gout. Both hands from Jianyu (below Giant Bone, above Arm Muscle) and Quchi (at elbow bend, above Sanli) to finger tips, and both feet from knees to heels/buttocks, had severe swelling and pain, with heat at the painful sites (Fire flowing and depositing), reduced diet, and confinement to bed for three years. Pulses were wiry, thin, and rapid. Face was blue (Liver color), muscles emaciated (Excess Fire), and calf/thigh muscles wasted (Three Yin deficiency). He said: This stems from weak constitution, excessive internal injury to Yin due to Lower Yuan deficiency. Yan region is cold; now Blood deficiency causes Sinews to lose nourishment, so Ying does not nourish internally, and Qi is bound by Cold, causing ten bones to spasm, so Wei does not protect externally. This is called Zhou Bi (General Bi). Treatment should nourish Blood and relax Sinews, disperse Dampness and moisten Dryness, unblocking collaterals. Once pain stops, immediately use major Yin-Blood tonics to fill the Lower Yuan. First give Tenaceous Bark, Atractylodes, Phellodendron, Xanthium, Angelica, Safflower, Coix Seed, Notopterygium, Saposhnikovia, Gentian, Red Bauhinia Bark for twenty doses. Sinews relaxed, swelling subsided, pain reduced by half. Then use Rehmannia, Turtle Shell, Achyranthes, Atractylodes, Phellodendron, Late Silkworm Sand, Xanthium, Coix Seed, Japanese Privet Vine, Angelica, Gentian for thirty doses, swelling and pain completely reduced. Advised: Yin is hard to fill but easy to damage. Must abstain from alcohol and sex to consolidate the root, so medicine can rely on it. Used Curculigo as Sovereign, Goji Berry, Achyranthes, Deer Glue, Tiger Bone, Ginseng as Ministers, Prepared Rehmannia, Phellodendron, Late Silkworm Sand, Poria, Xanthium as Assistants, Cinnamon Heart, Gentian, Alisma as Envoys. Honey pills, taken for 100 days, leg muscles filled, spirit restored.
Yu Dongfu said: This case discusses treatment and prescription with precision; Ye Tianshi's cases have this as a blueprint.
Xue Lizhai treated a man who first had leg swelling, then pain in all four limbs, wandering and worse at night. Dampness-clearing and toxin-resolving agents failed. Pulse slippery and choppy, indicating Damp-Phlegm and turbid Blood pathology. Used Erchen Tang with Atractylodes, Notopterygium, Peach Kernel, Safflower, Achyranthes, Polygonum, cured. For Damp-Phlegm/Damp-Heat or dead blood depositing in joints, non-pungent-warm agents are needed to open pores, unblock tunnels, move Qi and harmonize Blood to achieve cure.
A man had limb joint swelling and pain, pulse slow and rapid, indicating Damp-Heat syndrome. Used Jingfang Baidu San plus Ephedra; pain halved in two doses. Used Binglang Baidu San; swelling resolved in four doses. Then Siwu Tang with Two Atractolodes, Achyranthes, Quince; cured in several doses.
A woman had leg pain, sometimes wandering, shortness of breath, spontaneous sweating; various drugs failed. Pulse chi wiry and slow, indicating Cold-Damp flowing into Kidney Meridian. Used Fuzi Liuwu Tang; cured. People say Fuzi is toxic and refuse it. If processed with Child's Urine, what toxicity remains? Besides, infrequent use poses no worry. Xue Lizhai had Middle Qi deficiency, took Buzhong Yiqi Tang plus Fuzi for three years; where was the toxicity seen? Classic says: Have the disease, use the drug.
Feng Chuzhan treated Tang Mou, suffering bone/joint pain in left foot/hand, knife-like, crying day and night, spreading to right hand/foot. Wind-dispelling agents failed. Dry mouth/throat misdiagnosed as Flowing Fire, cooled with cold meds, vomited. Spirit exhausted, pulses洪 wiry, indicating long Qi/Blood deficiency, malnourished sinews/bones, impending paralysis. Use large amounts of Prepared Rehmannia, Angelica, White Peony to nourish Blood as Sovereign; Honeysuckle, Gentian to borrow Wind momentum to deliver drug power to sinews/bones as Minister; Achyranthes, Teasel Root, Eucommia to regulate sinews/bones as Assistant; Cinnamon Twig, Pine Joint to stimulate drug nature, traveling horizontally in arms as Guide; Ginseng, Atractylodes to secure Middle and nourish Origin. Regulated for half a month, gradually improved. Later, Shengmai Yin delivered with Bawei Wan plus Niuxi, Duzhong, Deer Antler, Schisandra (4-5 qian each), still taking previous formula at noon, could walk. Then major Qi/Blood tonics, strong sinews/bones to finish. Soon, his wife, worried day/night, got same disease, pulses deep minute, right hand/foot pain, then attacking interior, chest/epigastrium stuffy, nausea, extreme pain. Internal injury long-standing, Cold not exteriorly expelled, directly striking Yin division, urgent warming needed. Ginseng, Atractylodes 5 qian each, Cinnamon, Aconite 2 qian each, strong decoction, warm sip. Next day pulse rose slightly, chest pain/stuffiness greatly reduced, slight fever, left slightly painful, Yang returning to surface, Cold dispersing outward. Repeat formula, internal symptoms calmed. Hand/foot pain remained but mild. Ginseng/Atractylodes secure Middle as Sovereign, Angelica/Peony nourish Blood as Minister, Eucommia, Teasel, Achyranthes, Gentian, Cinnamon relax sinews/unblock collaterals as Assistant, fully cured. Gout only has Five Bi: Skin, Vessel, Muscle, Bone, Sinew Bi; no Zang-Fu Bi heard of. But Classic says: Cold dominance is Painful Bi. Also: Lingering in sinews/bones causes long pain; skin resolves easily; entering Zang is fatal. Be careful!
Xue Lizhai treated a woman, limb joint pain, inability to turn, aversion to wind/cold, spontaneous/drenching night sweats, short urination, refusing clothes even in summer, pulse floating tight. Wind-Cold invading Taiyang Meridian. Used Gancao Fuzi Tang; cured in one dose.
A woman with irregular menstruation and chronic gout, triggered by labor, relieved by heavy pressure. Qi/Blood deficiency. Used Shiquan Dabu Plus Du Huo for pain; Liuwei Wan, Xiaoyao San for menstruation.
A woman with limb pain, sallow complexion, alternating red/white, fever/aversion to cold, vomiting/diarrhea/poor appetite, abdominal/flank distension, irregular menses (flooding/spotting), profuse phlegm/wheezing, dizziness/headache, five-palm heat, thirst for hot drinks, forgetfulness/startle, night sweats/insomnia, bedridden for a year. All due to Liver/Spleen damage, Qi/Blood insufficiency. Used Shiquan Dabu + Jiawei Guipi Tang for over a month; all symptoms cured.
Zhang Zhongjing treated women with sixty-two types of Wind and stabbing abdominal blood/Qi pain, using Honglanhua Jiu (Red Blue Flower Wine). One ingredient, Safflower, boiled in one bowl of wine to half, drink half at once, then the rest shortly after.
Yu Jiayan treated Zhanglingshi's brother with damaged Shaoyang/Shao Yin from Cold Damage, lumbar flexion disability, screaming all night, hundred treatments failed. Pulse smooth/safe, pain greatly reduced. Disease not fatal, but fear of becoming disabled. Transferability lies in knife-like stabbing pain, showing Evil/Righteous struggle. No pain means Evil/Righteous merged. Great reduction in pain is worrying. Patient: Body disabled, how live? Better die fast. Want to save, no method. Thought long: Heat Evil entered lumbar, blood vessels closed long, cannot exit, only attack/scatter method. Long-standing Evil, Righteous totally deficient, attacking won't work. Used Taoren Chengqi Tang, adding large amounts of Cinnamon, Aconite, two large doses. Could rise strongly after. Made pills following previous intent, taken over ten days, fully safe. Not just past trial, nor temporary expedient, but has origin. Zhongjing for Jie Xiong (Chest Binding) has Fuzi Xiexin Tang, Aconite + Rhubarb together. Upper diseases mostly Qi, so use to drain Heart. Lower diseases mostly Blood, why not imitate intent, combine Taoren, Cinnamon to scatter waist blood knot? Later Jiang Gusheng's brother Cold Damage, lumbar flexion disability/pain, no thought, directly used this method, two doses cured.
Chen Hongzhang treated Shen Wotian, 70+, left arm/fingers spasmodic unable to extend, reduced food/exhausted spirit. Some said old age weakness, tonics worsened it. Chen diagnosed: Wind-Damp evil stagnant in Chest/Spleen, affecting four limbs. Used Erchen Tang + Mirabilite, Amomum, decocted with 3 liang Coix Seed juice, four doses, illness largely gone. Remove Mirabilite, continue Erchen, six doses, fully cured. (Wotian's handwritten notes.)
Xue Lizhai treated a woman, limb joint swelling/pain, shins/feet especially, spontaneous sweating/headache. Taiyang Meridian Damp-Heat. Used Mahuang Zuojin Tang, two doses cured.
Once someone with foot Bi took a boat, saw a bag, leaned foot on it. On shore, foot walked well. Asked contents, it was Quince. (*Bencao Bei Yao*).
Wang Zhizhong said: Noble person's middle finger spasmed, then ring finger. Physician moxed Jianliao, Quchi, Zhigou; cured. Zhigou is 3 cun behind wrist. Or mox Fengchi, often not Zhigou, or Hegu.
Li Jingzhong transmitted bone/tendon pain like clamped board, unbearable. Roasted donkey hoof claws to ash, powdered, taken with wine or water, instantly cured. (*Guang Biji*).
Xiong Note: This formula very effective for stubborn ulcers. Dry ones mixed with sesame oil applied; wet ones dusted.
Ma Yuanyi treated Mrs. Chen, Painful Bi, limb convulsions, whole body pain, unable to turn, dry mouth/restless. Pulse wiry/rapid/choppy, Yangming fluid deficiency generates Heat, extreme Heat generates Wind. Limb convulsions are Wind attacking extremities; dry mouth/restlessness is Fire Evil blazing internally. Only specifically nourish Yangming, do not treat Wind but Wind self-extinguishes, do not treat pain but pain self-removes. Use Raw Fleeceflower Root 1 liang, Raw Rehmannia 5 qian, Coptis, Scutellaria, Gentian, Fermented Pinellia, Aurantium, Platycodon 1 qian each. Four doses, symptoms reduced 60-70%, several more doses cured.
Zhang's son whole body pulling pain, head cannot turn, hand cannot grasp, foot cannot move, half a month. Pulse floating/deficient. Floating is Wind image, but internal pain also floating/weak. Pulse matches symptom: Labor/Fatigue injuring Middle, Yangming failure. Yangming is Sea of Five Zang/Six Fu, binds sinews/bones, benefits joints. Failure means Qi/Blood not nourishing, twelve meridians lack source/use. Wei empty, Ying flow unfavorable, fighting causing pain. Method: Major tonify Yangming Qi/Blood, different from Wind/Cold/Damp Bi. Ginseng 2 qian, Astragalus, Angelica 3 qian each, Roasted Licorice, Cinnamon Twig, Safflower 0.5 qian each, Gentian 1 qian. Two doses pulse harmonious, can turn. Remove Cinnamon, add Atractylodes, Cinnamon Bark, Goji, Prepared Rehmannia, regulate half month, safe. Diseases differ in deficiency/excess, methods vary. Wind/Cold/Damp: Qi stagnation internal = Bi, Evil occupying exterior = Pain, Excess type. Yangming Middle deficiency: Blood not nourishing sinews = Pain, Qi deficiency internal = non-movement, Deficiency type. Excess: Urgent to remove Evil, slow removal leads to change. Deficiency: Urgent to tonify Righteous, late tonification worsens over time. All diseases like this, not just this. Written as warning for treating disease by disease.
Yuan Mou Painful Bi, body/limbs pulling pain, sleepless all night, fever/dry mouth, chest full/middle pain, pulses wiry, right Guan particularly large, Stomach Heat blocking, Yangming Interior Excess. Yangming Qi cannot irrigate body, twelve meridians not smooth, limbs immobile. (Note: Contrasts with above, one deficiency one excess. Observing such cases inspires mind/knowledge.) Use Tiaowei Chengqi + Coptis, Gentian. One dose stool passes, two doses symptoms reduce 60-70%. Switch to Clear Stomach/Harmonize Middle agent, regulate, cured.
Wu Hanshang Gout fever, confusion/hallucinations, limb convulsions, constipation. Stomach fluid injured, Liver Wood generates Fire, internal blazing causes constipation/confusion, external attacking causes fever/body pain. Method: Nourish inside, Fire self-extinguishes, Wind self-removes, pain self-stops. Raw Fleeceflower, Trichosanthes Seed, Coptis, Anemarrhena, Aurantium, Platycodon, Cinnamon Twig, Gentian. One dose gradually reduces. But heart spirit uneasy, like in boat/clouds, uncontrollable. Switch Ginseng, Roasted Licorice, Raw Rehmannia, Ophiopogon, Polygala, Ziziphus Seed, Poria, Fritillaria, Tangerina Peel, Antelope Horn. Three doses, then Guipi Tang, regulate few days, safe.
Du Hanfei Whole body wandering swelling, hand cannot grasp, foot cannot step, three months. Pulse floating/large/rapid, fever/dry mouth. Yin deficiency generates internal Heat, Heat dominance generates Wind, Wind moves well, injures sinews/collaterals, flaccid/uncontrolled, reverses into flesh, attacks swelling/pain. Raw Rehmannia 5 qian, Wine-fried Scutellaria/Coptis 1 qian each, Safflower 0.5 fen. Bitter wins Heat, Pungent scatters Wind. Two doses sound sleep, several doses suffer lost.
Treatment for sudden sharp bone-deep pain in arm/leg. Genkwa Root, fine powder, rice vinegar mix, apply size appropriate, instant effect. Doctor says: Tao Chengyi's formula, treated postpartum woman effectively. But plaster doesn't stick, cover with paper flower, tie with white silk. (*Bai Bai Fang*).
Xue Lizhai treated Ministry Official Xu's wife, knee pain first, then whole body joint pain, pulse slow/slow, Qianghuo Shengshi Tang + Jingfang Baidu San + Damp-draining ineffective. Then Fuzi Bawu Tang, one dose pain retreated, two doses cured. If pulse large/rapid/pain, Renshen Baidu San suitable.
Zhang Zihe treated Tax Official, Wind/Cold/Damp Bi, heavy/swollen waist/legs, night pain severe, feet afraid of cold, five-six months, wrapped legs in boots. Waist/knee skin exposed to cold wind, flows into collaterals, pain worsens, wanders up/down,不定, extreme pain swells quickly, skin color unchanged, pores feel like insects walking. Every Wind/Cold, illness increases, diet decreases, limbs thin/weak, needs support, can walk/stand. Took Aconite, Ginger, Cinnamon, various hot/dry, burning needles, moxa, countless, three years uncured. One day Zhang pulsed, both hands deep/slipping/forceful. First Daoshui Wan, Tongjing San each one dose, that night diarrhea 20+ times, pain reduced half. Gradually Chi Fuling Tang, Chuanxiong Tang, Fangfeng Tang. These three in *Xuanming Lun*, Bi formulas. Three times daily, decoct 7-8 qian, profuse sweating, also Linglong Zao fumigation. If heat illness worsens, many ancient sweat methods exist, but vomiting inducing sweat rarely known. So said: Vomiting combined with sweating, good because of this.