治诸节疼痛，身体 羸，脚肿如脱，头眩短气，温温欲吐。
桂枝（四两） 芍药（三两） 甘草 麻黄（各二两） 附子（二枚炮） 防风 知母
（各四两） 白
桂枝芍药知母汤，甘术麻黄姜附防。（此桂枝汤合术附汤，去大枣，加麻黄、防风、知
母。）湿热外伤肢节痛，上冲心胃呕眩攘。香港脚冲心为恶候，汉时已有此方详。（旭高按∶此
与香港脚冲心之候颇同。诸家谓唐以前无香港脚，勿致思尔。《金匮要略·中风历节病篇》云∶“
诸肢节疼痛，身体 羸，脚肿如脱。”后人不知“脱”字之音义，遂置此条于不论，故此方
从未有诠释之者。抑知“脱”字北音读作“腿”字，试一提出，则形瘦、头眩、短气，岂非
多因脚肿之所致耶？脚肿至如腿，则病非一日矣。揆其致病之由，《金匮》于此方左右，论
列数条∶一则由汗出入水，热为寒郁；一则由风血相搏，血为风动；一则由饮酒汗出当风，
风湿相合；更推及筋骨并伤，营卫俱微，身体羸瘦，独足肿大一条；而殿之曰∶“假令发热，
便为历节。”则知风、寒、湿三气，无不因虚阻袭筋骨，而历节、香港脚，总由风、寒、湿三
气而成，为同源异流之证，但以独足肿为香港脚，诸节痛为历节焉耳。是方用麻、防、姜、桂，
宣发卫阳，通经络以驱外入之风寒；附子、白术，暖补下焦，壮筋骨而祛在里之寒湿。然三
气杂合于筋骨血脉之中，久必郁蒸而化热，而欲束筋利骨者，必须滋养阳明，故又用芍、甘、
知母，和阳明之血，以致太阴之液，斯宗筋润、机关利，而香港脚历节可平，平则眩呕悉已矣
此为湿热外伤肢节，而复上冲心胃之治法也。）
治疗各种关节疼痛，身体消瘦虚弱，脚部肿胀严重如同脱落感，头晕目眩，呼吸短促，心中烦闷想要呕吐。
桂枝（四两） 芍药（三两） 甘草 麻黄（各二两） 附子（二枚，炮制） 防风 知母（各四两） 白术（原文漏字，据方名补）
桂枝芍药知母汤，由甘草、白术、麻黄、干姜、附子、防风组成。（这是桂枝汤合用术附汤，去掉大枣，加入麻黄、防风、知母。）湿热之邪外伤导致肢节疼痛，病气上冲心胃引起呕吐和眩晕。香港脚（古病名，类似痛风或下肢水肿性疾病）冲心属于恶候，汉代已有此方的详细记载。（旭高按语：此证与香港脚冲心的症状颇为相似。各家说法认为唐代以前没有“香港脚”这一病名，不要对此产生疑惑。《金匮要略·中风历节病篇》说：“各种肢节疼痛，身体消瘦虚弱，脚肿得像要脱落一样。”后人不知道“脱”字的读音和意义，于是将这条经文搁置不论，因此这个方子从来没有被诠释过。殊不知“脱”字在北方音中读作“腿”字，试将其提出解释，那么形体消瘦、头晕、呼吸短促，难道不是多因脚肿所致吗？脚肿严重到像大腿一样粗，说明病情不是一天形成的。推究其致病原因，《金匮要略》在此方前后论述了数条：一条是由出汗后进入水中，热气被寒气郁闭；一条是由风邪与血相搏，血液受风邪扰动；一条是由饮酒出汗后当风受凉，风湿相结合；更进一步推导至筋骨并伤，营卫俱虚，身体消瘦，唯独脚部肿大的一条；最后总结说：“假令发热，便为历节。”由此可知，风、寒、湿三气，无不因为正气虚弱而侵袭筋骨，而历节病、香港脚，总归是由风、寒、湿三气造成的，是同源异流的病证，只是以独足肿胀称为香港脚，各个关节疼痛称为历节罢了。此方使用麻黄、防风、干姜、桂枝，宣发卫阳，疏通经络以驱除外来的风寒；附子、白术，温暖补益下焦，强壮筋骨以祛除体内的寒湿。然而风、寒、湿三气杂合在筋骨血脉之中，时间久了必然郁结蒸腾而化热，而想要约束筋脉、利通骨节的人，必须滋养阳明经，所以又使用芍药、甘草、知母，调和阳明经的血分，从而生成太阴经的津液，这样宗筋得到滋润，关节滑利，而香港脚和历节病就可以平息，平息之后眩晕和呕吐也就全部消除了。这是针对湿热外伤肢节，并且病气上冲心胃的治疗方法。）
Treats various joint pains, emaciation of the body, severe swelling of the feet as if detached, dizziness, shortness of breath, and a sensation of nausea with an urge to vomit.
Guizhi (Cinnamon Twig) (4 liang), Shaoyao (Peony Root) (3 liang), Gancao (Licorice Root), Mahuang (Ephedrae Herba) (2 liang each), Fuzi (Aconiti Lateralis Radix Praeparata) (2 pieces, prepared), Fangfeng (Saposhnikoviae Radix), Zhimu (Anemarrhenae Rhizoma) (4 liang each), Baizhu (Atractylodis Macrocephalae Rhizoma).
Guizhi Shaoyao Zhimu Tang (Cinnamon Twig, Peony Root, and Anemarrhena Decoction) consists of Gancao, Baizhu, Mahuang, Jiang (Ginger), Fuzi, and Fangfeng. (This formula combines Guizhi Tang (Cinnamon Twig Decoction) and Shufu Tang (Atractylodes and Aconite Decoction), removing Dazao (Jujube Fruit), and adding Mahuang, Fangfeng, and Zhimu.) Damp-heat pathogenic factors externally injuring the limbs and joints cause pain; upward rushing to the Heart and Stomach causes vomiting and dizziness. Xianggangjiao (Hong Kong Foot, an ancient term for conditions like gout or lower limb edema) rushing to the Heart is a malignant condition; detailed records of this formula existed since the Han Dynasty. (Xu Gao's note: This presentation is quite similar to the syndrome of Xianggangjiao rushing to the Heart. Various scholars state that there was no "Xianggangjiao" before the Tang Dynasty; do not doubt this. The *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) in the chapter on Wind-Stroke and Li-Jie Disease states: "Various limb and joint pains, emaciation of the body, and foot swelling as if detached." Later generations did not understand the pronunciation and meaning of the character "Tuo" (detached/leg), thus neglecting this clause, so this formula has never been interpreted. It is unknown that in Northern pronunciation, "Tuo" is read as "Tui" (leg). If proposed as such, then emaciation, dizziness, and shortness of breath are indeed caused by the foot swelling. When foot swelling is as severe as the thigh, the disease has not developed in one day. Inferring the cause of illness, the *Jin Gui* discusses several clauses around this formula: one is sweating and entering water, where heat is constrained by cold; one is wind and blood fighting, where blood is agitated by wind; one is drinking alcohol, sweating, and exposing to wind, where wind-dampness combines; further deducing to simultaneous injury of sinews and bones, with both Ying (Nutrient) and Wei (Defensive) Qi deficient, body emaciated, but only the foot swollen; and concludes with: "If fever occurs, it becomes Li-Jie." Thus, it is known that Wind, Cold, and Dampness all invade the sinews and bones due to deficiency, and Li-Jie and Xianggangjiao are totaly caused by these three pathogens, being diseases of the same origin but different manifestations, distinguished merely by single foot swelling as Xianggangjiao and multi-joint pain as Li-Jie. This formula uses Mahuang, Fangfeng, Jiang, and Guizhi to disseminate and release Wei Yang, unblock meridians and collaterals to drive out external Wind-Cold; Fuzi and Baizhu warm and tonify the Lower Jiao, strengthen sinews and bones to dispel internal Cold-Dampness. However, when Wind, Cold, and Dampness mix within the sinews, bones, and blood vessels, long-term stagnation inevitably steams and transforms into Heat. To bind sinews and benefit bones, one must nourish the Yangming channel; thus, Shaoyao, Gancao, and Zhimu are used to harmonize the blood of Yangming, thereby generating fluids of Taiyin. Consequently, the Zongjin (Major Sinew) is moistened, joints move freely, and Xianggangjiao and Li-Jie can be pacified. Once pacified, dizziness and vomiting cease. This is the treatment method for damp-heat externally injuring the limbs and joints, while simultaneously rushing upward to the Heart and Stomach.)