大意
痛风即内经痛痹也。因气血亏损。湿痰浊血。流滞经络。注而为病。或客四肢。或客腰背百节。走痛攻刺。如
风之善动。故曰痛风。（汇补）
内因
热盛则痛。湿胜则肿。（经文）大率痰火多痛。风湿多肿。内因六欲七情。或病后亡津。血热沸腾。亦必外感六
淫。而后骨节钻痛。久则手足蜷挛。外因涉冷坐湿当风。亦必血热而凝滞污浊。所以作痛。甚则身体块瘰。
痛必夜甚者。血行于阴也。（丹溪）
外候
轻则骨节疼痛。走注四肢。难以转移。肢节或红或肿。甚则遍体瘰块。或肿如匏。或痛如掣。昼静夜剧。以其
痛循历节。曰历节风。甚如虎咬。曰白虎风。（丹溪）
痛分肥瘦
瘦人多阴虚火旺。血不荣筋。肥人多风湿生痰。流注经络。（丹溪）
上下昼夜
上体。宜祛风豁痰。散热微汗。下体。宜流湿行气。和血舒风。阴虚则脉弦散。而重在夜。阳虚则脉虚大。而重
在昼。（三锡）
脉法分辨
寸口脉沉而弦。或六脉涩小。皆为痛风。因火作痛。口干燥渴。脉来洪数。因湿作痛。恶心肿满。脉必沉滑。湿
热相兼者。身重而痛。脉必沉濡而带数急。血虚痛者。四肢软弱。而痛甚于夜。脉来芤大无力。血瘀痛者。隐
隐然痛在一处而不移。脉现涩滞。（汇补）
证候分辨
凡流走不定。久则变成风毒。痛入骨髓。不移其处。或痛处肿热。或浑身壮热。若劳役而痛者。元气虚也。恼
怒而痛者。肝火盛也。阴寒而痛者。湿郁也。饮食失宜而痛者。脾郁也。大约按之痛甚者。邪气实。按之痛缓
者。正气虚。又肿满重着者。湿也。面红掣痛汗黄者。风也。肩背头项不可回顾者。风入太阳而气郁也。小便
数而欠呻者。肺气郁热也。臂髀腰脚骨热肿痛。行步艰难者。湿热成痹也。面赤尿赤者。暑湿相搏也。结阳
肢肿。大便秘结者。热毒流注也。肢节掣痛。小筋急痹者。寒也。初起眩晕。自汗。肢节胸胁刺痛者。气也。痛从
背起至胸胁者。思虑伤心也。初起胸满呕吐者。食积也。髀枢左右一点痛起。延至膝 肿大。恶寒。夜剧者。
痰也。四肢历节走痛。气短脉沉者。留饮也。遍身痒痛如虫啮。遇痒即食。不致频啮者。虫也。亦有气血两虚。
阴火作痛者。既属虚症。而似实症。最宜详辨。（汇补）
痢后作痛
有血痢兜早。恶血留于经络作痛者。此瘀血也。有痢久两脚酸软疼痛。或膝肿如鼓捶。此亡阴也。血瘀逐
瘀。阴虚补阴。切不可兼用风药。反燥其血。若足膝枯细而肿大者。名鹤膝风症。（汇补）
痛风禁忌
肉属阳。性能助火。如素多痰火而痛者。因少水不能灭盛火。若食浓味。必加燥渴。上为痞闷。下必遗溺。故禁之。
治分始末
初起因风湿热者。当流动机关。不可遽补。病久则宜消瘀血。养新血。兼理痰火。则血自活。气自和。痛无不
愈。久不止者。间用升降之剂。或专主补脾。如久病及亡血产后。俱不可纯用风药燥血。如年高举动则筋
痛者。是血不能养筋。名曰筋枯。难治。（汇补）
用药
主以四物汤。加秦艽、桑枝、红花、桂枝。上痛。加羌活、灵仙。下痛。加萆 、防己、木通、牛膝。湿痰。加南
星、半夏。血瘀。加桃仁、红花、牛膝。湿热。加苍术、黄柏。气虚。加参、 。血虚。加龟板、牛膝。如周身关节痛。
逢阴寒则发者。为湿郁。用二陈汤。加苍术、白术。风毒痛。用败毒散治之。鹤膝风。用大防风汤。
【附鬼箭辨】
俗以遍身作痛。呼为鬼箭。夫鬼神无形。乌能有箭。所以然者。其人卫气空虚。腠理不密。贼风乘虚而入。客
于经络。荣卫不通则痛。南人称为鬼箭。北人称为羊毛疔。就其痛处按之。用针挑出。形如羊毛。故名。南人
亦就此毛为箭。其实闭塞结硬之络脉也。若真以为箭为疔。不亦冤乎。世之治此者。或挑以泄其气。或燃
麻油灯以粹之。或用艾叶温散。锻石炒熨。或用白芥子调之外敷。或用金银花内服取效。从无一定之方。
尝见挑时暂快。过则依然。甚至挑断络脉。终成痿废。良可惜哉。（汇补）
痛风选方
丹溪方 治气血两虚。浊痰阴火痛风。
人参 山药 海石 南星（各二两） 白术 熟地 黄柏（酒炒） 龟板（炙各二两） 干姜（炮） 锁阳（各五
钱）
酒糊丸。
丹溪曰。肢节肿痛。痛属火。肿属湿。盖为阴寒所郁而发动于经络之中。湿热流注于肢节之内。先宜微汗以散之。
麻黄（上） 赤芍（上） 防风（中） 荆芥（中） 羌活（中） 独活（中） 白芷（中）
桔梗（中） 葛根（中） 川芎（中） 甘草（下） 归尾（下） 升麻（下）
妇人。加酒红花。肿甚。加槟榔、腹皮、泽泻。更加没药一钱定痛。尤妙。下焦。加酒炒黄柏。脉涩滞。有
瘀血者。加桃仁、红花、川芎、当归。甚者。加大黄微利之。
加味二妙丸 治两足湿热疼痛。或如火燎。从足跗热气。渐至腰胯。或麻痹痿软。
苍术（上） 黄柏（中） 牛膝（下） 归尾（下） 防己（下） 萆 （下） 龟板（下）
酒糊丸。
蠲痹汤 治风痰湿火。郁于四肢。手足顽痹。
黄 羌活 赤芍 姜黄 当归（各一钱半） 甘草（五分）
姜枣煎。
大防风汤
人参（上） 附子（下） 白术（上） 羌活（上） 川芎（中） 防风（上） 甘草（上） 牛膝（下） 当归
（上） 黄 （上） 白芍（上） 杜仲（上） 生地 生姜
附俗用鬼箭方
用木龙藤子。名鬼馒头。焙干酒服。或用羌活、防风、木瓜、钩藤。同煎服。
又用五灵脂、红花。酒煎服。亦妙。
大意
痛风即《内经》中所说的痛痹。这是由于气血亏损，导致湿痰和浊血流滞于经络，注入体内而发病。病邪或停留在四肢，或停留在腰背及全身关节，疼痛游走不定、如针刺般剧烈，像风一样善于变动，所以称为痛风。（出自《证治汇补》）
内因
热盛则引起疼痛，湿胜则引起肿胀。（经文）大抵痰火多导致疼痛，风湿多导致肿胀。内因方面，六欲七情失调，或病后津液耗损，导致血热沸腾，也必然伴随外感六淫邪气，才会出现骨节钻心的疼痛。日久则手足蜷曲挛缩。外因方面，若涉水坐湿、当风受冷，也必然导致血热凝滞、污浊不通，从而产生疼痛。严重时身体会出现瘰疬肿块。疼痛多在夜间加重，是因为血液在夜间行于阴分。（出自朱丹溪）
外候
轻症表现为骨节疼痛，游走于四肢，难以移动。肢节有时发红或肿胀，严重时全身出现瘰疬肿块，有的肿胀像葫芦，有的疼痛像牵掣。白天安静，夜间加剧。因为疼痛沿着各个关节游走，称为历节风；疼痛剧烈如虎咬，称为白虎风。（出自朱丹溪）
痛分肥瘦
瘦人多阴虚火旺，血液不能濡养筋脉；肥人多风湿生痰，流注于经络。（出自朱丹溪）
上下昼夜
上部的疼痛，宜祛风豁痰，散热并微发汗；下部的疼痛，宜利湿行气，调和血脉、舒散风邪。阴虚者脉象弦散，且疼痛重在夜间；阳虚者脉象虚大，且疼痛重在白天。（出自三锡）
脉法分辨
寸口脉沉而弦，或六脉涩小，都是痛风的脉象，这是因火邪作痛，伴有口干燥渴，脉象洪数。因湿邪作痛，伴有恶心、肿胀满闷，脉象必沉滑。湿热相兼者，身体沉重而痛，脉象必沉濡且带数急。血虚作痛者，四肢软弱，且夜间疼痛更甚，脉象芤大无力。血瘀作痛者，隐隐作痛固定在一处不移，脉象现涩滞。（出自《证治汇补》）
证候分辨
凡是疼痛游走不定，日久则变成风毒，疼痛深入骨髓，固定不移。或者疼痛部位红肿发热，或者全身壮热。如果是劳累后疼痛，是元气虚弱；恼怒后疼痛，是肝火旺盛；遇阴寒而疼痛，是湿邪郁结；饮食不当而疼痛，是脾土郁结。大约按压时疼痛加剧的，是邪气实；按压时疼痛缓解的，是正气虚。又有肿胀满重着感的，是湿邪；面红、掣痛、汗黄的是风邪；肩背头项不能回顾的，是风邪侵入太阳经且气机郁结；小便频数且欠伸打哈欠的，是肺气郁热；手臂、大腿、腰部、脚部骨节热肿疼痛，行走困难的，是湿热成痹；面赤尿赤的，是暑湿相搏；结阳导致肢体肿胀，大便秘结的，是热毒流注；肢节掣痛，小筋拘急痹阻的，是寒邪；初起眩晕、自汗、肢节胸胁刺痛的是气滞；疼痛从背部起至胸胁的是思虑伤心；初起胸满呕吐的是食积；髀枢左右一点痛起，延至膝盖肿大，恶寒，夜间加剧的是痰饮；四肢历节游走疼痛，气短脉沉的是留饮；遍身痒痛如虫咬，遇痒即进食（此处原文可能有误，通常指皮肤瘙痒或有异物感），不致频繁叮咬的是虫积。也有气血两虚，阴火作痛的，既属于虚证，又类似实证，最宜详细辨别。（出自《证治汇补》）
痢后作痛
有患血痢后，恶血留滞于经络而作痛的，这是瘀血。有痢疾日久，两脚酸软疼痛，或膝盖肿胀如鼓槌状的，这是亡阴。血瘀者逐瘀，阴虚者补阴，切不可兼用风药，否则反会燥伤其血。如果足膝枯细而肿大，名为鹤膝风症。（出自《证治汇补》）
痛风禁忌
肉类属阳，性能助火。如素来多痰火而疼痛者，是因为少水不能灭盛火，若食用浓味厚腻之物，必然加重燥渴，上则痞闷，下则遗尿，故应禁忌。
治分始末
初起因风湿热所致者，应当流通机关，不可急于进补。病久则宜消除瘀血，滋养新血，兼理痰火，则血自活，气自和，疼痛无不痊愈。久治不愈者，间或使用升降之剂，或专主补脾。如久病及亡血、产后，都不可纯用风药燥血。如年高举动则筋痛者，是血不能养筋，名为筋枯，难治。（出自《证治汇补》）
用药
主方以四物汤为基础，加秦艽、桑枝、红花、桂枝。上部疼痛，加羌活、威灵仙；下部疼痛，加萆薢、防己、木通、牛膝。湿痰，加南星、半夏；血瘀，加桃仁、红花、牛膝；湿热，加苍术、黄柏；气虚，加人参、黄芪；血虚，加龟板、牛膝。如周身关节痛，逢阴寒则发作的，为湿郁，用二陈汤加苍术、白术。风毒痛，用败毒散治疗。鹤膝风，用大防风汤。
【附鬼箭辨】
世俗之人将遍身作痛称为“鬼箭”。鬼神无形，怎么会有箭呢？之所以这样叫，是因为其人卫气空虚，腠理不密，贼风乘虚而入，客居于经络，营卫不通则痛。南方人称为鬼箭，北方人称为羊毛疔。就在疼痛处按压，用针挑出形如羊毛的东西，故名。南方人也就此毛视为箭，其实那是闭塞结硬的络脉。如果真以为是箭或疔，岂不是冤枉吗？世间治疗此病的人，有的挑刺以泄其气，有的燃麻油灯熏灼，或用艾叶温散，锻石炒熨，或用白芥子调敷外用，或用金银花内服取效，从无一定之方。我曾见挑刺时暂时痛快，过后依然如故，甚至挑断络脉，终成痿废，实在可惜。（出自《证治汇补》）
痛风选方
丹溪方：治疗气血两虚，浊痰阴火痛风。
人参、山药、海浮石、天南星（各二两）、白术、熟地黄、黄柏（酒炒）、龟板（炙，各二两）、干姜（炮）、锁阳（各五钱）。
用酒糊为丸。
丹溪说：肢节肿痛，痛属火，肿属湿。大概是被阴寒所郁而发动于经络之中，湿热流注于肢节之内。先宜微汗以散之。
麻黄（上焦）、赤芍（上焦）、防风（中焦）、荆芥（中焦）、羌活（中焦）、独活（中焦）、白芷（中焦）、桔梗（中焦）、葛根（中焦）、川芎（中焦）、甘草（下焦）、当归尾（下焦）、升麻（下焦）。
妇人，加酒红花。肿甚，加槟榔、腹皮、泽泻。再加没药一钱以定痛，尤其奇妙。下焦病变，加酒炒黄柏。脉涩滞，有瘀血者，加桃仁、红花、川芎、当归。甚者，加大黄轻微通便。
加味二妙丸：治疗两足湿热疼痛，或如火燎，从足跗热气，渐至腰胯，或麻痹痿软。
苍术（上焦）、黄柏（中焦）、牛膝（下焦）、当归尾（下焦）、防己（下焦）、萆薢（下焦）、龟板（下焦）。
用酒糊为丸。
蠲痹汤：治疗风痰湿火，郁于四肢，手足顽痹。
黄芪、羌活、赤芍、姜黄、当归（各一钱半）、甘草（五分）。
加生姜、大枣煎服。
大防风汤
人参（上焦）、附子（下焦）、白术（上焦）、羌活（上焦）、川芎（中焦）、防风（上焦）、甘草（上焦）、牛膝（下焦）、当归（上焦）、黄芪（上焦）、白芍（上焦）、杜仲（上焦）、生地黄、生姜。
附俗用鬼箭方
用木龙藤子，名鬼馒头，焙干后用酒送服。或用羌活、防风、木瓜、钩藤，同煎服。
又用五灵脂、红花，酒煎服，也很好。
General Principles
Gout (Tongfeng) is the same as Painful Bi Syndrome (Tongbi) described in the *Neijing*. It arises from deficiency of Qi and Blood, leading to the stagnation of Damp-Phlegm and turbid blood within the meridians, which then invade the body. The pathogenic factors may lodge in the four limbs or in the waist, back, and all joints, causing wandering pain and stabbing sensations that move like wind; hence it is called Gout (Tongfeng). (From *Zhengzhi Huibu*)
Internal Causes
Excess Heat causes pain, while excess Dampness causes swelling. (Classic Text) Generally, Phlegm-Fire tends to cause pain, whereas Wind-Dampness tends to cause swelling. Internally, imbalances in the six desires and seven emotions, or loss of body fluids after illness leading to boiling Blood-Heat, must be accompanied by external contraction of the Six Evils before drilling bone-joint pain occurs. Over time, this leads to curling and contracture of the hands and feet. Externally, exposure to cold, sitting on dampness, or facing the wind also causes Blood-Heat to coagulate and stagnate with turbidity, resulting in pain. In severe cases, lumps and nodules appear on the body. Pain worsening at night occurs because Blood circulates in the Yin during the night. (Zhu Danxi)
External Manifestations
In mild cases, there is bone-joint pain wandering through the limbs, making movement difficult. The joints may be red or swollen. In severe cases, lumps and nodules cover the whole body; some swell like gourds, others feel like pulling or tearing. The condition is quiet during the day but severe at night. Because the pain follows the joints sequentially, it is called Li-Jie Feng (Wandering Joint Wind); if the pain is severe like a tiger bite, it is called Bai-Hu Feng (White Tiger Wind). (Zhu Danxi)
Differentiation by Body Constitution
Thin people often have Yin Deficiency with Fire Hyperactivity, where Blood fails to nourish the sinews. Fat people often have Wind-Dampness generating Phlegm, which flows into the meridians. (Zhu Danxi)
Upper/Lower and Day/Night Differentiation
For upper body pain, one should dispel Wind, resolve Phlegm, clear Heat, and induce slight sweating. For lower body pain, one should promote Dampness drainage, move Qi, harmonize Blood, and soothe Wind. Yin Deficiency presents with wiry and scattered pulses, with pain predominating at night. Yang Deficiency presents with deficient and large pulses, with pain predominating during the day. (San Xi)
Pulse Diagnosis and Differentiation
A Cun Kou pulse that is deep and wiry, or six pulses that are choppy and small, all indicate Gout caused by Fire, accompanied by dry mouth and thirst, with a flooding and rapid pulse. Pain caused by Dampness, accompanied by nausea, swelling, and fullness, presents with a deep and slippery pulse. When Dampness and Heat combine, the body feels heavy and painful, with a deep, soggy, yet rapid and urgent pulse. Pain due to Blood Deficiency involves weak limbs and worse pain at night, with a knotted, large, and forceless pulse. Pain due to Blood Stasis involves dull, fixed pain in one location without migration, presenting with a choppy and stagnant pulse. (*Zhengzhi Huibu*)
Syndrome Differentiation
When pain wanders不定ly, it eventually transforms into Wind-Toxin, penetrating the bone marrow and becoming fixed in one place. Alternatively, the painful area may be swollen and hot, or the whole body may have high fever. Pain triggered by overwork indicates Deficiency of Yuan Qi. Pain triggered by anger indicates Excess Liver Fire. Pain triggered by Yin-Cold indicates Dampness Depression. Pain triggered by improper diet indicates Spleen Depression. Generally, pain exacerbated by pressure indicates Excess Pathogen; pain relieved by pressure indicates Deficiency of Healthy Qi. Swelling, fullness, and heaviness indicate Dampness. Red face, pulling pain, and yellow sweat indicate Wind. Inability to turn the head, neck, shoulders, or back indicates Wind invading the Taiyang meridian with Qi depression. Frequent urination with yawning indicates Lung Qi depression with Heat. Heat, swelling, pain, and difficulty walking in arms, thighs, waist, and legs indicate Bi Syndrome formed by Damp-Heat. Red face and red urine indicate Summerheat-Dampness conflict. Yang knotting causing limb swelling with constipation indicates Flowing Heat-Toxin. Pulling pain in joints with acute spasm of small tendons indicates Cold. Initial dizziness, spontaneous sweating, and stabbing pain in limbs, chest, and ribs indicate Qi Stagnation. Pain starting from the back extending to the chest and ribs indicates Heart injury from excessive thinking. Initial chest fullness and vomiting indicate Food Retention. A single point of pain starting around the hip joint, extending to knee swelling, with aversion to cold and worsening at night, indicates Phlegm. Wandering pain in all limbs, shortness of breath, and deep pulse indicate Retained Fluids. Whole-body itching and pain like insect bites, where eating relieves the itch temporarily without frequent biting, indicates Parasites. There are also cases of dual Qi and Blood Deficiency with Yin Fire causing pain; although belonging to Deficiency syndromes, they mimic Excess syndromes and require careful differentiation. (*Zhengzhi Huibu*)
Pain After Dysentery
Some patients suffer pain after bloody dysentery due to evil blood remaining in the meridians; this is Blood Stasis. Some patients suffer soreness, weakness, and pain in both legs after prolonged dysentery, or knees swelling like drumsticks; this is Loss of Yin. For Blood Stasis, promote blood circulation; for Yin Deficiency, tonify Yin. One must not simultaneously use Wind-dispelling herbs, as they will dry the blood. If the legs and knees become emaciated yet swollen, it is named Crane-Knee Wind Syndrome. (*Zhengzhi Huibu*)
Contraindications for Gout Treatment
Meat is Yang in nature and promotes Fire. For those prone to Phlegm-Fire pain, where insufficient Water cannot extinguish blazing Fire, consuming rich flavors will exacerbate dryness and thirst, causing upper epigastric fullness and lower urinary incontinence; thus, meat should be avoided.
Treatment According to Stage
In the initial stage caused by Wind, Dampness, and Heat, one should unblock the joints and avoid sudden tonification. In chronic stages, one should eliminate Blood Stasis, nourish new Blood, and regulate Phlegm-Fire; then Blood will flow freely, Qi will harmonize, and pain will heal. For persistent cases, occasionally use ascending-descending agents, or focus on tonifying the Spleen. In cases of long-term illness, blood loss, or postpartum states, do not use purely Wind-dispelling herbs to dry the blood. For elderly patients whose sinews hurt upon movement, this is Blood failing to nourish sinews, named Sinew Withering, which is difficult to treat. (*Zhengzhi Huibu*)
Medication
The main formula is Si Wu Tang (Four Substances Decoction), added with Qin Jiao (Gentian Root), Sang Zhi (Mulberry Twig), Hong Hua (Safflower), and Gui Zhi (Cinnamon Twig). For upper pain, add Qiang Huo (Notopterygium Rhizome) and Ling Xian (Spirit Nettle Stem). For lower pain, add Bi Xie (Dioscorea Hypoglauca Rhizome), Fang Ji (Stephania Root), Mu Tong (Akebia Stem), and Niu Xi (Achyranthes Root). For Damp-Phlegm, add Nan Xing (Arisaema Rhizome) and Ban Xia (Pinellia Tuber). For Blood Stasis, add Tao Ren (Peach Kernel), Hong Hua (Safflower), and Niu Xi (Achyranthes Root). For Damp-Heat, add Cang Zhu (Atractylodes Rhizome) and Huang Bo (Phellodendron Bark). For Qi Deficiency, add Ren Shen (Ginseng Root) and Huang Qi (Astragalus Root). For Blood Deficiency, add Gui Ban (Tortoise Shell) and Niu Xi (Achyranthes Root). For whole-body joint pain triggered by Yin-Cold, indicating Dampness Depression, use Er Chen Tang (Two Aged Herbs Decoction) added with Cang Zhu (Atractylodes Rhizome) and Bai Zhu (Atractylodes Macrocephala Rhizome). For Wind-Toxin pain, use Bai Du San (Detoxification Powder). For Crane-Knee Wind, use Da Fang Feng Tang (Great Saposhnikovia Decoction).
[Appendix: Discussion on "Ghost Arrow"]
Laypeople call widespread body pain "Ghost Arrow." Since ghosts and gods are formless, how can they have arrows? The reason for this name is that the person has deficient Wei Qi (Defensive Qi) and loose interstices, allowing Rogue Wind to enter vacuously and lodge in the meridians. When Ying and Wei Qi fail to circulate smoothly, pain results. Southerners call this Ghost Arrow, while Northerners call it Wool Carbuncle (Yang Mao Ding). By pressing the painful area and picking with a needle, one extracts something resembling wool, hence the name. Southerners also regard this hair as an arrow; in reality, it is a blocked and hardened collateral vessel. To truly consider it an arrow or carbuncle would be unjust. Treatments in the world vary: some puncture to drain Qi, some fumigate with burning hemp oil lamps, some warm-disperse with Mugwort leaves, some apply heated iron filings, some apply white mustard seed externally, or take Honeysuckle internally for effect. There is no fixed formula. I have seen cases where puncture brings temporary relief, but symptoms return later; even severing collaterals can lead to flaccidity and paralysis, which is truly pitiable. (*Zhengzhi Huibu*)
Selected Formulas for Gout
Danxi Formula: Treats Gout caused by dual Qi and Blood Deficiency, turbid Phlegm, and Yin Fire.
Ren Shen (Ginseng Root), Shan Yao (Dioscorea Rhizome), Hai Shi (Floating Stone), Nan Xing (Arisaema Rhizome) [2 liang each]; Bai Zhu (Atractylodes Macrocephala Rhizome), Shu Di Huang (Prepared Rehmannia Root), Huang Bo (Phellodendron Bark, wine-fried), Gui Ban (Tortoise Shell, roasted) [2 liang each]; Gan Jiang (Dried Ginger, processed), Suo Yang (Cynomorium Stem) [5 qian each].
Make pills using wine paste.
Danxi stated: Limb-joint swelling and pain; pain belongs to Fire, swelling belongs to Dampness. This is generally caused by Yin-Cold depression activating within the meridians, with Damp-Heat flowing into the joints. Initially, induce slight sweating to disperse it.
Ma Huang (Ephedra Herb - Upper Jiao), Chi Shao (Red Peony Root - Upper Jiao), Fang Feng (Saposhnikovia Root - Middle Jiao), Jing Jie (Schizonepeta Spike - Middle Jiao), Qiang Huo (Notopterygium Rhizome - Middle Jiao), Du Huo (Angelica Pubescens Root - Middle Jiao), Bai Zhi (Angelica Dahurica Root - Middle Jiao), Jie Geng (Platycodon Root - Middle Jiao), Ge Gen (Kudzu Root - Middle Jiao), Chuan Xiong (Ligusticum Rhizome - Middle Jiao), Gan Cao (Licorice Root - Lower Jiao), Gui Wei (Salvia Root Tip - Lower Jiao), Sheng Ma (Cimicifuga Rhizome - Lower Jiao).
For women, add wine-treated Hong Hua (Safflower). For severe swelling, add Bing Lang (Areca Seed), Fu Pi (Citrus Peel), and Ze Xie (Alisma Rhizome). Add 1 qian Mo Yao (Myrrh) to stop pain, which is excellent. For Lower Jiao issues, add wine-fried Huang Bo (Phellodendron Bark). For choppy pulses indicating Blood Stasis, add Tao Ren (Peach Kernel), Hong Hua (Safflower), Chuan Xiong (Ligusticum Rhizome), and Dang Gui (Angelica Sinensis Root). In severe cases, add Da Huang (Rhubarb Root) to mildly purge.
Jia Wei Er Miao Wan (Modified Two Marvels Pill): Treats Damp-Heat pain in both feet, feeling like fire burning, with heat rising from the instep to the waist and hips, or numbness and flaccidity.
Cang Zhu (Atractylodes Rhizome - Upper Jiao), Huang Bo (Phellodendron Bark - Middle Jiao), Niu Xi (Achyranthes Root - Lower Jiao), Gui Wei (Salvia Root Tip - Lower Jiao), Fang Ji (Stephania Root - Lower Jiao), Bi Xie (Dioscorea Hypoglauca Rhizome - Lower Jiao), Gui Ban (Tortoise Shell - Lower Jiao).
Make pills using wine paste.
Juan Bi Tang (Dispel Bi Decoction): Treats Wind-Phlegm-Dampness-Fire郁 (depressed) in the four limbs, causing stubborn Bi syndrome in hands and feet.
Huang Qi (Astragalus Root), Qiang Huo (Notopterygium Rhizome), Chi Shao (Red Peony Root), Jiang Huang (Turmeric Rhizome), Dang Gui (Angelica Sinensis Root) [1.5 qian each], Gan Cao (Licorice Root) [0.5 qian].
Decoct with Ginger and Jujube.
Da Fang Feng Tang (Great Saposhnikovia Decoction)
Ren Shen (Ginseng Root - Upper Jiao), Fu Zi (Aconite Lateral Root - Lower Jiao), Bai Zhu (Atractylodes Macrocephala Rhizome - Upper Jiao), Qiang Huo (Notopterygium Rhizome - Upper Jiao), Chuan Xiong (Ligusticum Rhizome - Middle Jiao), Fang Feng (Saposhnikovia Root - Upper Jiao), Gan Cao (Licorice Root - Upper Jiao), Niu Xi (Achyranthes Root - Lower Jiao), Dang Gui (Angelica Sinensis Root - Upper Jiao), Huang Qi (Astragalus Root - Upper Jiao), Bai Shao (White Peony Root - Upper Jiao), Du Zhong (Eucommia Bark - Upper Jiao), Sheng Di Huang (Rehmannia Root - Unspecified), Sheng Jiang (Fresh Ginger).
Attached Folk Formula for Ghost Arrow
Use Mu Long Teng Zi (Seeds of *Sinomenium acutum* vine), named Gui Man Tou, dried over roasting and taken with wine. Or decoct Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root), Mu Gua (Chaenomeles Fruit), and Gou Teng (Uncaria Rhynchophylla Hook) together and drink.
Alternatively, use Wu Ling Zhi (Trogopterus Dung) and Hong Hua (Safflower), decocted in wine, which is also excellent.