痰裹，痰既不消，食亦不化，故有留中数载，仍为旧物，人所未知也。两胁之地，乃肝木之
位，痰食积于中，自生如疟之症，发寒发热，状似劳瘵，以劳瘵治之，则惊气不解，而痰食
如故，病何能愈哉。治法开其惊，降其痰食，数载之病一朝可去。
方用释惊汤治之。
白芍（一两） 当归（五钱） 青木香（三钱） 大黄（三钱） 枳实（一钱） 白芥子（三钱） 茯苓（三钱） 枳
壳（一钱） 甘草（五分） 麦芽（一钱） 山楂（十粒）
水煎服。一剂而痰食尽下，不必再剂。
此方消痰降食，专走于两胁之间，开其惊气，故奏功如神耳。
此症用易消散亦效。
山楂（三钱） 麦芽（三钱） 白术（一两） 鳖甲（一两） 茯苓（三钱） 半夏（三钱） 附子（一片）
水煎服。
人有足胫渐细，足膝渐大，骨中酸疼，身渐瘦弱，人以为鹤膝之风，谁知水湿之入骨乎。
夫骨最坚硬，湿邪似难深入，何竟入于膝乎？此因立而行房所成也。凡人行房，必劳其筋
骨，至于精泄之后，则髓必空虚，髓空则骨空，邪即乘其虚空而直入矣。若膝则筋骨联接之
处，骨静而膝动，动能变而静不能变也。不变者形消，能变者形大。但其病虽成于肾精之虚，
而治病断不可单治其肾，因所犯者湿耳。湿乃阴邪，阴邪必须以阳气祛之。肾之精，阴水
也。补精则精旺，阴与阴合，阴无争战之机，不战而邪何能去？故不当补精而当补气。方用
蒸膝汤∶
生黄 （八两） 金钗石斛（二两） 薏仁（二两） 肉桂（三钱）水煎二碗，先服
一碗，即拥被而卧，觉身中有汗意，再服第二碗，必两足如火之热，切戒不可坐起，任其
出汗，至汗出到涌泉之下，始可缓缓去被，否则万万不可去也。一剂病去大半，
再剂病全愈。
此方补气未免太峻，然气不旺不能周遍于一身，虽用利湿健膝之药，终不能透入于邪所犯
之处，而祛出之也。第大补其气，而不加肉桂之辛热，则寒湿裹住于膝中，亦不能斩关直入
于骨髓而大发其汗也。至于绝不治风者，以此病原无风也。若作风治，愈耗其气，安得取效哉。
此症用加味 桂汤亦妙。
黄 （三两） 肉桂（三钱） 破故纸（二钱） 牛膝（三钱）水煎服。服必有大汗
如雨，二服愈。
鹤膝之症有二，一本于水湿之入骨，一本于风湿之入骨也。则条乃言水湿入骨，未言风
湿入骨之症。大约水湿之病，骨重难移∶风湿之症，骨轻可走，至于酸痛则一也。虽然酸痛
亦有微别，水湿之痛在一处而不迁，风湿之痛移来移去而无定。治法不可徒治风湿也，用散
膝汤治之。
黄 （五两） 防风（三钱） 肉桂（五钱） 茯苓（一两）水煎服。服后亦拥被而卧，
听其出汗，不必惊惶，汗出愈多，去病愈速。
夫黄 原畏防风，得防风而功更大。吾多用黄 ，正恐人之难受，加入防风，
能于补中以行其气。得肉桂之辛散，引入阳气，直达于至阴之中。又得茯苓共入膀胱，利
水湿之邪，内外兼攻，内既利水而外又出汗，何风湿之不解哉。惟是大汗淋漓，人恐有亡
阳之惧，谁知用散药以出汗，若为可虑，今用黄 补气以出汗，乃发邪汗而非损正汗也。邪
汗能亡阳，正汗反能益阳耳，所以二剂而收全功也。
此症用薏术防桑汤亦效。
防风（三钱） 桑叶（二两） 陈皮（一钱） 破故纸（二钱） 薏仁（一两） 白术（
一两）水煎服。亦必出大汗而愈，只消一剂也。
痰浊包裹，导致痰浊无法消散，食物也无法消化，因此有的滞留体内数年，仍然保持原来的状态，这是人们所不知道的。两胁部位，是肝木所在的位置，痰和食物积聚在中间，自然产生像疟疾一样的症状，发作时怕冷发热，形状类似虚劳肺痨，如果按照虚劳肺痨来治疗，那么惊恐之气不能解除，而痰和食物依旧存在，疾病怎么能痊愈呢？治疗方法要开解惊恐之气，降下痰和食物，数年的病证一天之内就可以去除。
方剂用释惊汤来治疗。
白芍（一两） 当归（五钱） 青木香（三钱） 大黄（三钱） 枳实（一钱） 白芥子（三钱） 茯苓（三钱） 枳壳（一钱） 甘草（五分） 麦芽（一钱） 山楂（十粒）
用水煎服。服用一剂后痰和食物全部排出，不需要再服用第二剂。
这个方剂消除痰浊、降下食物，专门作用于两胁之间，开解惊恐之气，所以取得神效。
这种病症使用易消散方也有效。
山楂（三钱） 麦芽（三钱） 白术（一两） 鳖甲（一两） 茯苓（三钱） 半夏（三钱） 附子（一片）
用水煎服。
人的小腿逐渐变细，足膝逐渐肿大，骨头里面酸痛疼痛，身体逐渐消瘦虚弱，人们以为是鹤膝风病，谁知道是水湿侵入骨骼呢？
骨骼最坚硬，湿邪似乎难以深入，为什么竟然进入膝盖呢？这是因为站立行走后又行房事所造成的。大凡人进行房事，必定劳累筋骨，到了精液泄出之后，髓海必然空虚，髓空则骨空，邪气就趁着其虚空之处直接入侵了。至于膝盖，则是筋骨连接的地方，骨头静止而膝盖运动，运动能变化而静止不能变化。不能变化的形体消瘦，能变化的形体肿大。但是此病虽然成因于肾精的虚弱，但治病绝对不可以只治疗肾脏，因为所侵犯的是湿邪罢了。湿是阴邪，阴邪必须用阳气来祛除。肾的精气，属于阴水。补精则精旺盛，阴与阴相合，阴没有争战的机会，不经过争战邪气怎么能去除？所以不应当补精而应当补气。方剂用蒸膝汤：
生黄芪（八两） 金钗石斛（二两） 薏苡仁（二两） 肉桂（三钱）用水煎煮成两碗，先服用一碗，立即盖上被子躺卧，感觉身体中有出汗的意思，再服用第二碗，必定双脚像火一样热，切记不可坐起，任凭其出汗，直到汗出到涌泉穴以下，才可以缓缓去掉被子，否则万万不可以去被。服用一剂病去大半，再服用一剂病全愈。
这个方剂补气未免过于峻猛，然而气不旺盛不能周遍一身，虽然使用利湿健膝的药物，终究不能透入到邪气侵犯的地方，从而将其祛除出来。只是大补其气，而不加入肉桂的辛热之性，那么寒湿包裹在膝盖中，也不能斩关直入骨髓而大发其汗。至于完全不治风的原因，是因为此病原无风邪。如果按风邪治疗，更加耗损其气，怎么能取得疗效呢？
这种病症使用加味桂枝汤也奇妙。
黄芪（三两） 肉桂（三钱） 破故纸（二钱） 牛膝（三钱）用水煎服。服用后必定有大汗如雨，服用两剂痊愈。
鹤膝风病症有两种，一种本源于水湿侵入骨骼，一种本源于风湿侵入骨骼。陈士铎这里只说了水湿入骨，没有说风湿入骨的病症。大概水湿的病，骨头沉重难以移动；风湿的症，骨头轻快可以走动，至于酸痛疼痛则是一样的。虽然酸痛也有细微区别，水湿的痛处固定在一处而不迁移，风湿的痛处移来移去而没有定处。治疗方法不可以仅仅治疗风湿，用散膝汤来治疗。
黄芪（五两） 防风（三钱） 肉桂（五钱） 茯苓（一两）用水煎服。服用后也盖上被子躺卧，听任其出汗，不必惊慌，汗出越多，去除病邪越快。
黄芪原本畏惧防风，得到防风而功效更大。我多用黄芪，正担心人难以忍受，加入防风，能在补益中气的同时运行其气。得到肉桂的辛散之性，引入阳气，直达于至阴之中。又得到茯苓共同进入膀胱，利除水湿之邪，内外兼攻，内部既利水而外部又出汗，什么风湿不能解除呢？只是大汗淋漓，人们恐怕有亡阳的恐惧，谁知道使用发散药来出汗，如果是可忧虑的，现在用黄芪补气来出汗，乃是发邪汗而不是损伤正气之汗。邪汗能亡阳，正汗反而能益阳耳，所以两剂就能收全功。
这种病症使用薏术防桑汤也有效。
防风（三钱） 桑叶（二两） 陈皮（一钱） 破故纸（二钱） 薏苡仁（一两） 白术（一两）用水煎服。也必定出大汗而痊愈，只需消受一剂即可。
Phlegm encases the interior; since phlegm does not dissipate, food also fails to digest. Thus, some remain trapped in the middle for several years, retaining their original state, a fact unknown to people. The area of both hypochondria is the residence of Liver Wood (Liver system). When phlegm and food accumulate within, symptoms resembling malaria naturally arise, with alternating chills and fever, appearing similar to Consumption (Lao Zai, a chronic wasting disease often involving the lungs). If treated as Consumption, the shock qi (Jing Qi) will not be resolved, and the phlegm and food will remain unchanged; how can the disease be cured? The treatment method should open up the shock qi and descend the phlegm and food; a disease lasting several years can be eliminated in one day.
Prescribe Shijing Tang (Decoction for Resolving Shock) for treatment.
Bai Shao (Radix Paeoniae Alba, 1 liang), Dang Gui (Radix Angelicae Sinensis, 5 qian), Qing Mu Xiang (Radix Aucklandiae, 3 qian), Da Huang (Radix et Rhizoma Rhei, 3 qian), Zhi Shi (Fructus Aurantii Immaturus, 1 qian), Bai Jie Zi (Semen Mustardae, 3 qian), Fu Ling (Poria, 3 qian), Zhi Ke (Pericarpium Citri Reticulatae Viride, 1 qian), Gan Cao (Radix Glycyrrhizae, 5 fen), Mai Ya (Fructus Hordei Germinatus, 1 qian), Shan Zha (Fructus Crataegi, 10 pieces).
Decoct in water and take orally. After one dose, the phlegm and food are completely discharged; no further doses are needed.
This formula eliminates phlegm and descends food, acting specifically between the two hypochondria, opening the shock qi, thus achieving miraculous results.
For this condition, Yixiaosan (Formula for Easy Dissipation) is also effective.
Shan Zha (Fructus Crataegi, 3 qian), Mai Ya (Fructus Hordei Germinatus, 3 qian), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1 liang), Bie Jia (Carapax et Plastrum Testudinis, 1 liang), Fu Ling (Poria, 3 qian), Ban Xia (Rhizoma Pinelliae, 3 qian), Fu Zi (Radix Aconiti Lateralis Preparata, 1 slice).
Decoct in water and take orally.
Some people experience gradual thinning of the lower legs and swelling of the knees, with soreness and pain deep in the bones, and gradual emaciation of the body. People mistake this for Crane’s Knee Wind (He Xi Feng); who would know it is due to Water-Dampness invading the bones?
Bone is the hardest tissue, and Dampness seems unlikely to penetrate deeply, so why does it enter the knee? This results from standing/walking combined with sexual intercourse. Whenever one engages in intercourse, the sinews and bones are labored. After ejaculation, the Marrow (Sui) becomes empty; when Marrow is empty, Bone is empty, and pathogenic factors take advantage of this emptiness to invade directly. The knee is where sinews and bones connect; bone remains static while the knee moves. Movement allows change, whereas stillness does not. What cannot change wastes away, while what can change swells. Although the disease originates from Kidney Essence deficiency, treatment must absolutely not focus solely on the Kidneys, because the pathogen involved is Dampness. Dampness is a Yin pathogen; Yin pathogens must be dispelled by Yang Qi. Kidney Essence is Yin Water. Tonifying Essence makes Essence abundant; Yin combines with Yin, leaving no opportunity for struggle. Without struggle, how can the pathogen be expelled? Therefore, one should not tonify Essence but rather tonify Qi. Prescribe Zhengxi Tang (Decoction for Steaming the Knees):
Sheng Huang Qi (Radix Astragali, 8 liang), Jin Chai Shi Hu (Caulis Dendrobii Nobiles, 2 liang), Yi Yi Ren (Semen Coicis, 2 liang), Rou Gui (Cortex Cinnamomi, 3 qian). Decoct in water to yield two bowls. Drink one bowl first, then cover oneself with blankets and lie down. When one feels the urge to sweat, drink the second bowl. Both feet will become hot as fire. Strictly avoid sitting up; allow sweating to proceed until sweat flows out below the Yongquan point (KI-1). Only then may the blankets be slowly removed; otherwise, under no circumstances should they be removed. One dose eliminates most of the disease; a second dose cures it completely.
This formula tonifies Qi somewhat aggressively. However, if Qi is not vigorous, it cannot circulate throughout the body. Even with herbs that promote diuresis and strengthen the knees, they ultimately cannot penetrate the site invaded by the pathogen to expel it. Merely greatly tonifying Qi without adding the acrid-warm nature of Rou Gui means Cold-Dampness wrapped around the knee cannot break through to the marrow to induce profuse sweating. As for not treating Wind at all, it is because there is no Wind pathogen originally. If treated as Wind, Qi is further depleted, making efficacy impossible.
For this condition, Jiawei Guizhi Tang (Modified Cinnamon Twig Decoction) is also excellent.
Huang Qi (Radix Astragali, 3 liang), Rou Gui (Cortex Cinnamomi, 3 qian), Po Gu Zhi (Fructus Psoraleae, 2 qian), Niu Xi (Radix Achyranthis Bidentatae, 3 qian). Decoct in water and take orally. Profuse sweating like rain will occur after administration; two doses result in cure.
There are two types of Crane’s Knee Wind: one originates from Water-Dampness invading the bone, and the other from Wind-Dampness invading the bone. Chen Shiduo here only discusses Water-Dampness invading the bone, omitting Wind-Dampness invading the bone. Generally, in Water-Dampness diseases, the bones feel heavy and difficult to move; in Wind-Dampness conditions, the bones feel light and mobile. The soreness and pain are similar in both. However, there are subtle differences in pain: Water-Dampness pain is fixed in one location and does not migrate, whereas Wind-Dampness pain migrates without a fixed position. Treatment should not merely address Wind-Dampness; use Sanxi Tang (Decoction for Scattering the Knees).
Huang Qi (Radix Astragali, 5 liang), Fang Feng (Radix Saposhnikoviae, 3 qian), Rou Gui (Cortex Cinnamomi, 5 qian), Fu Ling (Poria, 1 liang). Decoct in water and take orally. After ingestion, cover oneself with blankets and lie down, allowing sweat to occur without panic. The more sweat produced, the faster the disease resolves.
Huang Qi traditionally has an antagonistic relationship with Fang Feng, yet combining them enhances efficacy. I frequently use Huang Qi, worrying that patients may find it hard to tolerate; adding Fang Feng allows it to move Qi within the context of tonifying the Middle Jiao. With the acrid-dispersing property of Rou Gui, Yang Qi is guided to reach the deepest Yin levels. Together with Fu Ling entering the Bladder, Water-Dampness pathogens are drained. Attacking internally and externally simultaneously—draining water internally and inducing sweating externally—how could Wind-Dampness fail to resolve? Although profuse sweating might cause fear of Yang Collapse (Wang Yang), using dispersing herbs to induce sweating might be concerning. Here, however, we use Huang Qi to tonify Qi to induce sweating; this releases Pathogenic Sweat (Xie Han) rather than damaging Healthy Sweat (Zheng Han). Pathogenic Sweat can lead to Yang collapse, but Healthy Sweat actually benefits Yang. Thus, full efficacy is achieved in two doses.
For this condition, Yishu Fangsang Tang (Coix Seed, Atractylodes, Saposhnikovia, and Mulberry Leaf Decoction) is also effective.
Fang Feng (Radix Saposhnikoviae, 3 qian), Sang Ye (Folium Mori, 2 liang), Chen Pi (Pericarpium Citri Reticulatae, 1 qian), Po Gu Zhi (Fructus Psoraleae, 2 qian), Yi Yi Ren (Semen Coicis, 1 liang), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1 liang). Decoct in water and take orally. Profuse sweating must occur for recovery; only one dose is needed.