（古名痛痹）
论
《内经》曰∶诸风掉眩，强直支痛， 戾里急筋缩，皆足厥阴风木之位，肝胆之气也。又曰∶风寒湿三气杂至，合
而为痹。其风气胜者为行痹，寒气胜者为痛痹，湿气胜者为着痹。以冬遇此为骨痹，以春遇此为筋痹，以夏遇此为脉痹，
以至阴（六月也）遇此为肌痹，以秋遇此为皮痹。夫古之所谓痛痹者。即今之痛风也。诸方书又谓之白虎历节风，以其
走痛于四肢骨节，如虎咬之状，而以其名名之耳。丹溪曰∶大率因血虚受热，其血已自沸腾，或加之以涉水受湿，热血
得寒，污浊凝滞，不得营运，所以作痛。夜则痛甚，行于阴也。治以辛温，监以辛凉，流散寒湿，开通郁结，使血行气
和，更能慎口节欲，无有不安者也。
脉法
《脉经》曰∶脉涩而紧者痹。少阴脉浮而弱，弱则血不足，浮则为风，风血相搏，则疼痛如掣。盛人脉涩小，短气
自汗出，历节痛不可屈伸，此皆饮酒汗出当风所致也。
寸口脉沉而弦，沉则主骨，弦则主筋，沉则为肾，弦则为肝，汗出入水中，因水伤心，历节痛而黄汗出，故曰历节
风也。
味酸则伤筋，筋伤则缓，名曰泄，味咸则伤骨，骨伤则痿，名曰枯，枯泄相搏，名断泄，荣气不通，卫不独行，荣
卫俱微，三焦无御，四属断绝，身体羸瘦，独足肿大，黄汗出，胫冷，假令发热，变为历节风，疼痛不可屈伸。
方法
丹溪曰∶因湿痰浊血流注为病，以其在下焦道路远，非乌附气壮不能行，故用为引经，若以为主治之，非惟无益而
有杀人之毒。此病必行气流湿舒风，导滞血，补新血，降阳升阴，治有先后，须明分肿与不肿可也。不可食肉，肉属阳，
大能助火。素有火盛者，小水不能制，若食肉浓味，下有遗溺，上有痞闷，须将鱼腥、面酱、酒醋皆断去之。先以二陈
汤加酒浸白芍药，少佐以黄连降心火，看作何应又为区处也。
大法用苍术、南星、川芎、白芷、当归、酒芩，在上者加羌活、桂枝、桔梗、葳灵仙，在下者加牛膝、防己、木通、
黄柏。
加味四物汤 治白虎历节风证。
本方加∶桃仁（煮数次，去皮尖） 牛膝（酒浸） 陈皮 茯苓 甘草 白芷 草龙胆（各等分）
上细切，作一服，水二钟，煎至一钟，去渣温服。如痛在上者属风，加羌活、桂枝、葳灵仙。在下者属湿，加牛膝、
防己、木通、黄柏。气虚者，加人参、白术、龟板。有痰者，加南星、半夏、生姜。血虚者，倍川归、川芎，佐以桃仁、
红花，水煎服之。
因痰者，二陈汤加酒洗黄芩、羌活、苍术。
因湿者，用苍术、白术，佐以竹沥、姜汁及行气之药。
或曰∶有湿郁而周身走痛，或关节间痛，遇阴寒即发，当作湿郁治（或用白术一味，酒煎服之，其痛立愈）。
肥人多是湿与痰饮，流注经络（脉必滑）；瘦人多是血虚与热（脉必涩）。
下部有湿肿痛，用防己、龙胆草、黄柏、知母，固是捷药。若肥人病此，宜苍术、白术、南星、滑石、茯苓之类；
瘦人，宜用当归、红花、桃仁、牛膝、槟榔等药。
薄桂味淡者，能横行手臂，领南星、苍术等药至痛处。
葳灵仙治上体痛风，人虚弱勿用。
一方 治上中下痛风。
黄柏（酒炒） 苍术（米泔浸一、二宿） 南星（各二两） 神曲（炒） 台芎（各一两） 防风 白芷 桃仁（各
五钱） 葳灵仙（酒炒） 桂枝（横行手臂） 羌活（各二钱） 草龙胆（一钱五分） 酒红花（五分）
上为细末，神曲糊丸，如梧桐子大，每服一百丸，空腹服。
大羌活汤 治风湿相搏，肢节疼痛。
羌活 升麻（各一钱） 独活（七分） 苍术 防己 葳灵仙 川归 白术 茯苓 泽泻（各五分）
上细切，作一服，水二盏，煎至一盏，去渣空心温服。
四妙散 治走注疼痛。
葳灵仙（酒浸焙干，五钱） 羯羊角灰（三钱） 苍耳子（一钱五分） 白芥子（一钱半，炒）
上为细末，每服一钱匕，姜汤调下。
一方 治饮酒湿痰痛风。
黄柏（酒炒） 葳灵仙（酒炒，各五钱） 苍术（米泔浸一宿） 羌活（各三钱） 甘草（炙，三钱） 陈皮（去
白） 芍药（各一钱）
上为细末，每服一钱匕，生姜汤调下。
凡因久痢后，两脚酸软疼痛，或膝肿如鼓捶者，此亡阴也，宜以芎、归、熟地黄等补血药治之自愈。挟气虚者，加
参、 。挟风湿者，加羌活、防风、白术之类。切不可纯作风治，反燥其血，终不能愈。
气血两虚，有痰浊阴火痛风。
人参 山药 海石 南星（各一两） 白术 熟地黄 黄柏（酒炒褐色） 龟板（酥炙，各二两） 干姜（烧存性）
琐阳（各五钱）
上为末，酒糊为丸服。
肢节肿痛，痛属火，肿属湿，兼受风寒而发动于经络之中，湿热流注于肢节之间而无已也。
麻黄（去根节） 赤芍药（各一钱） 防风 荆芥 羌活 独活 白芷 苍术 葳灵仙 片芩（酒浸） 枳实 桔
梗葛根 川芎（各五分） 甘草 当归稍 升麻（各三分）
上细切，作一服，水二盏，煎至一盏，去渣服。下焦加酒黄柏，妇人加酒红花，肿多加槟榔、大腹皮、泽泻，更加
没药一钱定痛尤妙。一云∶脉涩数者有瘀血，宜用桃仁、红花、芎、归加大黄微利之。
二妙散 治脚膝下焦湿热成痛。
黄柏（酒浸焙干，二两） 苍术（米泔浸，春秋二宿，冬三宿，夏一宿，四两）
上为细末，沸汤入姜汁调服。或用蒸饼为丸，姜、盐汤送下。二味皆有雄壮之气，表实气实者加酒少许佐之，有气
加气药，血虚加补血药，痛甚者加生姜汁热服。
潜行散
用黄柏一味酒浸，曝干为细末，每服方寸匕，煎四物汤调下，治血虚阴火痛风药也，多服帖数取效。
手臂痛，是上焦湿痰，横行经络中作痛也。
半夏 酒芩 白术 南星 香附（各一钱） 陈皮 茯苓（各五分） 苍术（一钱半） 葳灵仙（三钱） 甘草（三
分）
上细切，作一服，加生姜五片，水二盏，煎至一盏，食后服。
加味二陈汤 治臂痛。
本方加酒芩、羌活、葳灵仙、入姜水煎，食后温服。
一方 治痛风神效。
赤芍药 青皮（各一钱半） 紫葳 台芎（各七分半） 葳灵仙 木鳖子（各一钱半） 防风（七分半） 甘草（五
分）
上细切，作一服，酒煎服之。
治妇人胸背胁走痛。
赤芍药（一钱） 桂枝 苍术（各五分） 香附 炒黄柏（各一钱） 甘草（五分） 葳灵仙（七钱半，酒拌湿炒）
上细切，作一服，水二盏，煎至一盏服。
治走注疼痛方。
葳灵仙 苍术（米泔浸） 桂枝 川归（酒洗） 桃仁（去皮尖，炒，各一钱） 生桃仁（七个） 甘草（二钱） 川
芎（一钱半）
上细切，作一服，加生姜五片，水二盏，煎至一盏，入童便、竹沥各半盏，再煎至一盏，热服。忌猪、羊、鸡肉，
鱼腥、湿面。
定痛丸 治风湿一切痛。
乳香 没药 金星草 地龙（去土炒） 五灵脂 木鳖子（去壳）
上各等分，为细末，炼蜜为丸，如弹子大，每服一丸，温酒磨化下。或只作小丸，温酒送下亦可。
世俗有用草药而获速效者，如用石丝以为之君，过山龙等以为之佐，皆性热而燥者，不能养筋滋阴，但能燥湿病之
浅者，湿痰得燥而开，瘀血得热而行，故有速效。若病之深而血少者，愈劫愈虚而病愈深矣，戒之戒之！
（以上丹溪方法凡二十六条）
黄 酒（局方） 治风寒湿痹，身体顽麻，皮肤燥庠，筋脉挛急，语言蹇涩，手足不遂等证。
黄 防风 桂枝 天麻 萆 石斛 虎胫骨（酥炙） 白芍药 当归 云母粉 白术 茵芋叶 木香 仙灵脾
甘草 川续断（各一两）
上细切，以生绢袋盛，用无灰好酒一斗，以瓷罐浸之，包封罐口，勿令泄气，春五、夏三、秋七、冬十日，每服一
盏，温饮之，不拘时候。
独活寄生汤（局方） 治肝肾虚弱，感冒风湿，致痿痹，两足缓纵，软弱不仁。（方见腰痛门。）
防风天麻散 治风湿麻痹，肢节走注疼痛，中风偏枯，或暴喑不语，内外风热壅滞昏眩。
防风 天麻 川芎 羌活 白芷 草乌头 白附子 荆芥穗 当归 甘草（炙，各五钱） 白滑石（二两）
上为细末，每服五分，加至一钱，热酒化蜜少许调下，觉药力营运微麻为度。或炼蜜为丸，如弹子大，每服半丸至
一丸，热酒化下，白汤亦可。此药散郁干结、宣风通气之妙剂也。
舒筋汤（局方） 治臂痛不能举，盖是气血凝滞经络不行所致。一名通气饮子，一名五痹汤，其效如神。
片子姜黄（二钱） 甘草（炙） 羌活（各五分） 海桐皮（去外皮） 当归（去头） 赤芍药 白术（各一钱）
上细切，作一服，加生姜三片，水一盏半，煎至一盏，去渣，磨沉香水少许入内温服，凡腰以上痛食后，腰以下痛
食前服。
（祖传方）
九藤酒 治远年痛风，及中风左瘫右痪，筋脉拘急，日夜作痛，叫呼不已等证，其功甚速。
青藤 钓钩藤 红藤（即理省藤也） 丁公藤（又名风藤） 桑络藤 菟丝藤（即无根藤） 天仙藤（即青木香也）
阴地蕨（名地茶，取根，各四两） 忍冬藤 五味子藤（俗名红内消，各二两）
上细切，以无灰老酒一大斗，用瓷罐一个盛酒，其药用真绵包裹，放酒中浸之，密封罐口，不可泄气，春秋七日，
冬十日，夏五日，每服一盏，日三服，病在上食后及卧后服，病在下空心食前服。
加味三妙丸 治两足湿痹疼痛，或如火燎，从足附热起，渐至腰胯，或麻痹痿软，皆是湿为病，此药主之。
苍术（四两，米泔浸） 黄柏（二两，酒浸日干） 川牛膝（一两，去芦） 当归尾（一两，酒洗） 川萆 （一
两） 防己（一两） 龟板（酥炙，一两）
上为细末，酒煮面糊为丸，如梧桐子大，每服一百丸，空心姜盐汤下。
川木通汤
一男子年四十岁，因感风湿，得白虎历节风证，遍身抽掣疼痛，足不能履地者三年，百方不效，身体羸瘦骨立，自
分于死。一日梦与木通汤服愈，遂以四物汤加木通服，不效，后以木通二两锉细，长流水煎汁顿服，服后一时许，遍身
痒甚，上体发红丹如小豆大粒，举家惊惶，随手没去，出汗至腰而止，上体不痛矣。次日又如前煎服，下体又发红丹，
方出汗至足底，汗干后通身舒畅而无痛矣。一月后，人壮气复，步履如初。后以此法治数人皆验。故录于此，以示后学。
熏洗痛风法 治手足冷痛如虎咬者。
用樟木屑一斗，以急流水一担熬沸，以樟木屑置于大桶内，桶边放一兀凳，用前沸汤泡之，桶内安一矮凳子，令人
坐桶边，放一脚在内，外以草荐一领围之，勿令汤气入眼，恐坏眼，其功甚捷。
（古称痛痹）
论说
《黄帝内经》说：各种风邪引起的肢体震颤、眩晕，以及身体强直、四肢疼痛、筋脉扭曲拘急、收缩短缩等症状，都属于足厥阴肝经风木之气所主的部位，是肝胆之气的病变。又说：风、寒、湿三种邪气混杂侵袭人体，结合而成痹证。其中风气偏胜的称为行痹，寒气偏胜的称为痛痹，湿气偏胜的称为着痹。如果在冬季感受这些邪气，则成为骨痹；在春季感受，则成为筋痹；在夏季感受，则成为脉痹；在长夏（农历六月）感受，则成为肌痹；在秋季感受，则成为皮痹。古代所说的痛痹，就是现在的痛风病。许多医方书籍又称之为白虎历节风，因为这种病疼痛游走于四肢骨节之间，如同老虎咬噬一般，因此以此命名。朱丹溪说：大体上是因为血虚受热，血液已经沸腾，如果再加之涉水受湿，热血遇到寒气，变得污浊凝滞，不能正常运行，所以产生疼痛。夜间疼痛加重，是因为病行于阴分。治疗应当使用辛温药物，佐以辛凉药物，以流散寒湿，开通郁结，使血液运行通畅、气机调和，再加上谨慎饮食、节制房事，没有不痊愈的。
脉法
《脉经》说：脉象涩而紧的，属于痹证。少阴脉浮而弱，弱表示血不足，浮表示有风邪，风邪与血相搏结，则疼痛如牵掣般剧烈。肥胖之人脉象涩小，伴有短气和自汗，出现历节风疼痛且关节不可屈伸，这都是饮酒后出汗当风所致。
寸口脉沉而弦，沉主骨病，弦主筋病，沉对应肾，弦对应肝，这是因出汗后进入水中，导致水邪伤心，出现历节风疼痛并伴有黄汗出，所以称为历节风。
味道过酸会损伤筋，筋受损则松弛无力，称为泄；味道过咸会损伤骨，骨受损则痿软无力，称为枯。枯和泄相互搏结，称为断泄。此时营气不通，卫气不能独行，营卫俱微，三焦失去防御功能，四肢肌肉断绝营养，身体消瘦，唯独脚部肿大，出黄汗，小腿发冷。假如发热，就会转变为历节风，疼痛剧烈无法屈伸。
方法
朱丹溪说：这是由于湿痰浊血流注经络而致病，因为病变在下焦，道路遥远，非乌头、附子这样气壮的药物不能引导药力到达，所以将它们作为引经药。如果把它们当作主治药物，不仅无益，反而会有杀人的毒性。此病必须行气、祛湿、舒风，疏导停滞的瘀血，补养新血，降阳升阴，治疗要有先后次序，必须分清肿胀与否来辨证施治。不能吃肉类，肉属阳，极易助火。素来火盛的人，小便不能制约火势，如果食用浓味肉食，会导致下部遗尿，上部痞闷，必须将鱼腥、面酱、酒醋全部戒除。先用二陈汤加酒浸白芍药，稍加黄连以降心火，根据病情反应再作相应处理。
基本大法使用苍术、天南星、川芎、白芷、当归、酒炒黄芩。病位在上者，加羌活、桂枝、桔梗、威灵仙；病位在下者，加牛膝、防己、木通、黄柏。
加味四物汤 治疗白虎历节风证。
本方加入：桃仁（煮多次，去皮尖）、牛膝（酒浸）、陈皮、茯苓、甘草、白芷、草龙胆（各等分）。
以上切碎，为一剂用量，加水两碗，煎至一碗，去渣温服。如果疼痛在上部属于风邪，加羌活、桂枝、威灵仙。在下部属于湿邪，加牛膝、防己、木通、黄柏。气虚者，加人参、白术、龟板。有痰者，加天南星、半夏、生姜。血虚者，加倍使用当归、川芎，佐以桃仁、红花，水煎服。
因痰湿引起的，用二陈汤加酒洗黄芩、羌活、苍术。
因湿邪引起的，用苍术、白术，佐以竹沥、姜汁及行气药物。
有人说：有湿邪郁滞导致周身游走疼痛，或关节间疼痛，遇阴寒即发作，应当按湿郁治疗（或者单用一味白术，酒煎服下，疼痛立即痊愈）。
肥胖的人多是湿与痰饮，流注经络（脉象必滑）；瘦人多是血虚与热（脉象必涩）。
下部有湿肿痛，使用防己、龙胆草、黄柏、知母，确实是见效快的药物。如果是肥胖之人患此病，宜用苍术、白术、天南星、滑石、茯苓之类；瘦人，宜用当归、红花、桃仁、牛膝、槟榔等药。
薄桂（肉桂的一种，味道淡），能横行手臂，带领天南星、苍术等药到达疼痛处。
威灵仙治疗上体痛风，人体虚弱者勿用。
一方 治疗上、中、下三焦痛风。
黄柏（酒炒）、苍术（米泔水浸泡一至两个晚上）、天南星（各二两）、神曲（炒）、台芎（各一两）、防风、白芷、桃仁（各五钱）、威灵仙（酒炒）、桂枝（横行手臂）、羌活（各二钱）、草龙胆（一钱五分）、酒红花（五分）。
以上研为细末，用神曲糊制成梧桐子大小的丸药，每次服用一百丸，空腹服用。
大羌活汤 治疗风湿相搏，肢节疼痛。
羌活、升麻（各一钱）、独活（七分）、苍术、防己、威灵仙、川归、白术、茯苓、泽泻（各五分）。
以上切碎，为一剂用量，加水两盏，煎至一盏，去渣空腹温服。
四妙散 治疗游走性疼痛。
威灵仙（酒浸焙干，五钱）、羯羊角灰（三钱）、苍耳子（一钱五分）、白芥子（一钱半，炒）。
以上研为细末，每次服用一钱匕，用姜汤调服。
一方 治疗饮酒导致的湿痰痛风。
黄柏（酒炒）、威灵仙（酒炒，各五钱）、苍术（米泔水浸泡一个晚上）、羌活（各三钱）、甘草（炙，三钱）、陈皮（去白）、芍药（各一钱）。
以上研为细末，每次服用一钱匕，用生姜汤调服。
凡是因久痢之后，双脚酸软疼痛，或膝盖肿胀如鼓槌者，这是亡阴的表现，宜用川芎、当归、熟地黄等补血药物治疗即可自愈。兼有气虚者，加人参、白术。兼有风湿者，加羌活、防风、白术之类。切不可单纯按风证治疗，否则反会燥伤其血，最终不能痊愈。
气血两虚，伴有痰浊阴火的痛风。
人参、山药、海浮石、天南星（各一两）、白术、熟地黄、黄柏（酒炒至褐色）、龟板（酥炙，各二两）、干姜（烧存性）、锁阳（各五钱）。
以上研为末，用酒糊制成丸药服用。
肢节肿痛，痛属于火，肿属于湿，兼受风寒而在经络中发动，湿热流注于肢节之间而无休止。
麻黄（去根节）、赤芍药（各一钱）、防风、荆芥、羌活、独活、白芷、苍术、威灵仙、片芩（酒浸）、枳实、桔梗、葛根、川芎（各五分）、甘草、当归梢、升麻（各三分）。
以上切碎，为一剂用量，加水两盏，煎至一盏，去渣服用。下焦痛加酒黄柏，妇人加酒红花，肿多加槟榔、大腹皮、泽泻，再加没药一钱定痛效果更佳。另一说法：脉象涩数者有瘀血，宜用桃仁、红花、川芎、当归加大黄轻微通便。
二妙散 治疗脚膝下焦湿热成痛。
黄柏（酒浸焙干，二两）、苍术（米泔水浸，春秋两晚，冬三晚，夏一晚，四两）。
以上研为细末，沸水冲入姜汁调服。或用蒸饼制成丸药，姜盐汤送下。这两味药都有雄壮之气，表实气实者加少许酒辅助，有气虚加气药，血虚加补血药，疼痛严重者加生姜汁热服。
潜行散
只用黄柏一味，酒浸，晒干研为细末，每次服用方寸匕，用四物汤调服，这是治疗血虚阴火痛风药，多服几次可取效。
手臂痛，是上焦湿痰，横行经络中作痛。
半夏、酒芩、白术、天南星、香附（各一钱）、陈皮、茯苓（各五分）、苍术（一钱半）、威灵仙（三钱）、甘草（三分）。
以上切碎，为一剂用量，加生姜五片，加水两盏，煎至一盏，饭后服用。
加味二陈汤 治疗臂痛。
本方加酒芩、羌活、威灵仙，入姜水煎，饭后温服。
一方 治疗痛风神效。
赤芍药、青皮（各一钱半）、紫葳、台芎（各七分半）、威灵仙、木鳖子（各一钱半）、防风（七分半）、甘草（五分）。
以上切碎，为一剂用量，酒煎服。
治疗妇人胸背胁肋游走疼痛。
赤芍药（一钱）、桂枝、苍术（各五分）、香附、炒黄柏（各一钱）、甘草（五分）、威灵仙（七钱半，酒拌湿炒）。
以上切碎，为一剂用量，加水两盏，煎至一盏服。
治疗游走性疼痛方。
威灵仙、苍术（米泔浸）、桂枝、川归（酒洗）、桃仁（去皮尖，炒，各一钱）、生桃仁（七个）、甘草（二钱）、川芎（一钱半）。
以上切碎，为一剂用量，加生姜五片，加水两盏，煎至一盏，加入童便、竹沥各半盏，再煎至一盏，热服。忌食猪、羊、鸡肉，鱼腥、湿面。
定痛丸 治疗风湿一切疼痛。
乳香、没药、金星草、地龙（去土炒）、五灵脂、木鳖子（去壳）。
以上各等分，研为细末，炼蜜为丸，如弹子大，每次服用一丸，温酒磨化送下。或者只做成小丸，温酒送下也可以。
世俗有用草药而获得速效的，如用石丝作为君药，过山龙等作为佐药，都是性热而燥的药物，不能养筋滋阴，只能燥湿治疗浅层的病，湿痰得燥而开，瘀血得热而行，所以有速效。如果病深而血少的人，越攻伐越虚，病越深，切记切记！
（以上是丹溪的方法共二十六条）
黄酒（局方） 治疗风寒湿痹，身体顽麻，皮肤干燥瘙痒，筋脉挛急，语言蹇涩，手足不遂等证。
黄芪、防风、桂枝、天麻、萆薢、石斛、虎胫骨（酥炙）、白芍药、当归、云母粉、白术、茵芋叶、木香、仙灵脾、甘草、川续断（各一两）。
以上切碎，用生绢袋装好，用无灰好酒一斗，用瓷罐浸泡，包封罐口，不让漏气，春五、夏三、秋七、冬十日，每次服用一盏，温饮，不限时候。
独活寄生汤（局方） 治疗肝肾虚弱，感冒风湿，导致痿痹，两足缓纵，软弱不仁。（方见腰痛门。）
防风天麻散 治疗风湿麻痹，肢节游走疼痛，中风偏枯，或暴喑不语，内外风热壅滞昏眩。
防风、天麻、川芎、羌活、白芷、草乌头、白附子、荆芥穗、当归、甘草（炙，各五钱）、白滑石（二两）。
以上研为细末，每次服用五分，加至一钱，用热酒化少许蜂蜜调服，感觉药力运行微麻为度。或者炼蜜为丸，如弹子大，每次服用半丸至一丸，热酒化下，白开水也可以。此药是疏散郁结、宣通风气的神妙药剂。
舒筋汤（局方） 治疗手臂痛不能举起，这是因为气血凝滞经络不行所致。又名通气饮子，又名五痹汤，效果神奇。
片子姜黄（二钱）、甘草（炙）、羌活（各五分）、海桐皮（去外皮）、当归（去头）、赤芍药、白术（各一钱）。
以上切碎，为一剂用量，加生姜三片，加水一盏半，煎至一盏，去渣，磨沉香香水少许加入内温服。凡腰以上痛饭后服，腰以下痛饭前服。
（祖传方）
九藤酒 治疗多年痛风，及中风左瘫右痪，筋脉拘急，日夜作痛，叫呼不已等证，功效甚速。
青藤、钓钩藤、红藤（即理省藤也）、丁公藤（又名风藤）、桑络藤、菟丝藤（即无根藤）、天仙藤（即青木香也）、阴地蕨（名地茶，取根，各四两）、忍冬藤、五味子藤（俗名红内消，各二两）。
以上切碎，用无灰老酒一大斗，用一个瓷罐盛酒，药材用真绵包裹，放入酒中浸泡，密封罐口，不可漏气，春秋七日，冬十日，夏五日，每次服用一盏，每日三次，病在上部饭后及卧后服，病在下部空腹饭前服。
加味三妙丸 治疗两足湿痹疼痛，或如火燎，从足踝热起，渐至腰胯，或麻痹痿软，皆是湿邪致病，此药主治。
苍术（四两，米泔浸）、黄柏（二两，酒浸日干）、川牛膝（一两，去芦）、当归尾（一两，酒洗）、川萆薢（一两）、防己（一两）、龟板（酥炙，一两）。
以上研为细末，酒煮面糊为丸，如梧桐子大，每次服用一百丸，空腹姜盐汤送下。
川木通汤
一名男子四十岁，因感受风湿，得了白虎历节风证，遍身抽掣疼痛，足不能踩地三年，百方无效，身体消瘦骨立，自认必死。一天梦见喝木通汤痊愈，于是用四物汤加木通服用，无效，后来用木通二两锉细，长流水煎汁顿服，服药后约一小时，遍身痒甚，上体发红丹如小豆大粒，全家惊慌，随手抹去，出汗至腰部而止，上体不痛了。第二天又如前煎服，下体又发红丹，才出汗至足底，汗干后通身舒畅而无痛了。一个月后，人壮气复，步履如初。后来用此法治愈数人皆有效验。故记录于此，以示后学。
熏洗痛风法 治疗手足冷痛如虎咬者。
用樟木屑一斗，用急流水一担熬沸，将樟木屑置于大桶内，桶边放一兀凳，用前沸汤泡之，桶内安一矮凳子，令人坐桶边，放一脚在内，外以草荐一领围之，勿令汤气入眼，恐坏眼，其功甚捷。
(Ancient name: Painful Bi Syndrome)
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "All wind-induced tremors, vertigo, stiffness, limb pain, twisting of tendons, and tendon contraction belong to the position of Jueyin Liver Wind-Wood, representing the Qi of the Liver and Gallbladder." It further states: "When Wind, Cold, and Dampness mix and invade together, they combine to form Bi Syndrome. When Wind is predominant, it is called Moving Bi; when Cold is predominant, it is called Painful Bi; when Dampness is predominant, it is called Fixed Bi." If contracted in Winter, it becomes Bone Bi; in Spring, Tendon Bi; in Summer, Vessel Bi; in Late Summer (the sixth lunar month), Muscle Bi; and in Autumn, Skin Bi. The ancient term "Painful Bi" refers to what is now known as Gout (Tongfeng). Many medical texts also call it White Tiger Migratory Joint Wind (Baihu Lijie Feng), because the pain migrates through the joints of the four limbs like a tiger bite, hence the name. Zhu Danxi said: "Generally, it is due to Blood deficiency with Heat, where the Blood is already boiling. If combined with wading in water or contracting Dampness, the hot Blood meets Cold, becoming turbid and stagnant, unable to circulate, thus causing pain. Pain worsens at night because the pathogen moves into the Yin aspect. Treatment should use Acrid-Warm herbs, supervised by Acrid-Cool herbs, to disperse Cold-Dampness, open stagnation, and promote smooth Blood flow and harmonious Qi. Additionally, one must be cautious with diet and sexual activity, and there will be no case that does not heal."
Pulse Diagnosis
The *Maijing* (Pulse Classic) states: "A choppy and tight pulse indicates Bi Syndrome. A floating and weak Shaoyin pulse indicates insufficient Blood (weakness) and Wind (floating). When Wind and Blood contend, pain feels like pulling or tearing." In obese individuals, a choppy and small pulse with shortness of breath and spontaneous sweating, accompanied by severe joint pain preventing flexion and extension, is caused by sweating after drinking alcohol and exposure to wind.
At the Cunkou (Radial Artery) pulse, sinking indicates Bone disease, and wiry indicates Tendon disease. Sinking corresponds to the Kidney, and wiry corresponds to the Liver. This results from entering water while sweating, injuring the Heart with Water pathogens, leading to Migratory Joint pain and yellow sweat, hence called Migratory Joint Wind.
Excessive Sour flavor damages Tendons; damaged Tendons become lax, termed "Xie" (Leakage). Excessive Salty flavor damages Bones; damaged Bones become flaccid, termed "Ku" (Withered). When Withered and Leakage combine, it is called "Duanxie" (Severance and Leakage). Ying Qi fails to circulate, Wei Qi cannot move independently, both Ying and Wei become deficient, the Sanjiao loses its defense, the four extremities lose nourishment, the body becomes emaciated, while only the feet swell, with yellow sweat and cold calves. If fever occurs, it transforms into Migratory Joint Wind, with severe pain preventing movement.
Methods
Zhu Danxi stated: "This disease is caused by the flow of Damp-Phlegm and turbid Blood into the channels. Because the lower Jiao is distant, only potent herbs like Aconite (Wutou) and Prepared Root of Brown-Flowered Aconite (Fuzi) can guide the medicine. Thus, they are used as guiding herbs. Using them as primary treatments is not only ineffective but toxic." This disease requires promoting Qi circulation, resolving Dampness, soothing Wind, directing stagnant Blood, tonifying new Blood, descending Yang and ascending Yin. Treatment must follow a sequence, distinguishing between swollen and non-swollen conditions. Meat should be avoided as it is Yang and greatly aids Fire. For those with inherent excess Fire, if rich meat is consumed, it may cause urinary incontinence below and chest stuffiness above. Fishy odors, fermented bean paste, wine, and vinegar must all be abstained from. Initially, use Erchen Tang (Two-Aged Decoction) with Wine-soaked Radix Paeoniae Alba (Baishao), slightly supplemented with Rhizoma Coptidis (Huanglian) to descend Heart Fire, adjusting based on response.
The general principle uses Rhizoma Atractylodis Macrocephalae (Cangzhu), Rhizoma Pinelliae Preparatum (Nanxing), Rhizoma Chuanxiong (Chuanxiong), Radix Angelicae Dahuricae (Baizhi), Radix Angelicae Sinensis (Danggui), and Wine-fried Radix Scutellariae (Huangqin). For upper body symptoms, add Radix Notopterygii (Qianghuo), Ramulus Cinnamomi (Guizhi), Fructus Platycodonis (Jiegeng), and Herba Siegesbeckiae (Weilingxian). For lower body symptoms, add Rhizoma Cyathulae (Niuxi), Radix Stephaniae Tetrandrae (Fangji), Caulis Akebiae (Mutong), and Cortex Phellodendri (Huangbai).
Modified Four Substances Decoction (Jiawei Siwu Tang) treats White Tiger Migratory Joint Wind syndrome.
Add to this formula: Peach Kernel (Taoren, boiled several times, skin and tip removed), Rhizoma Cyathulae (Niuxi, wine-soaked), Pericarpium Citri Reticulatae (Chenpi), Poria (Fuling), Radix Glycyrrhizae (Gancao), Radix Angelicae Dahuricae (Baizhi), and Radix Gentianae Macrophyllae (Caolongdan) in equal parts.
Cut finely, take one dose, add two cups of water, decoct to one cup, remove dregs, and take warm. If pain is in the upper body (Wind type), add Qianghuo, Guizhi, Weilingxian. If in the lower body (Damp type), add Niuxi, Fangji, Mutong, Huangbai. For Qi deficiency, add Ginseng (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu), Tortoise Shell (Guiban). For Phlegm, add Nanxing, Pinellia Rhizome (Banxia), and Fresh Ginger (Shengjiang). For Blood deficiency, double Danggui and Chuanxiong, assisted by Taoren and Safflower (Honghua), decocted in water.
For cases caused by Phlegm, use Erchen Tang with Wine-washed Huangqin, Qianghuo, and Cangzhu.
For cases caused by Dampness, use Cangzhu and Baizhu, assisted by Bamboo Sap (Zhuli), Ginger Juice (Jiangzhi), and Qi-moving herbs.
Some say: For generalized wandering pain or joint pain triggered by cold-damp oppression, treat as Damp oppression (using single Baizhu decocted in wine for immediate relief).
Obese people often have Dampness and Phlegm-fluids flowing into collaterals (pulse must be slippery); thin people often have Blood deficiency and Heat (pulse must be choppy).
For lower body Damp swelling and pain, Fangji, Longdan Cao, Huangbai, and Anemarrhena Rhizome (Zhimu) are effective. For obese patients, use Cangzhu, Baizhu, Nanxing, Talcum (Huashi), and Fuling. For thin patients, use Danggui, Honghua, Taoren, Niuxi, and Areca Seed (Binglang).
Thin Cinnamon Bark (Bo Gui) with mild flavor can travel horizontally to the arms, guiding Nanxing and Cangzhu to the painful area.
Weilingxian treats upper body Gout; avoid in weak patients.
One Prescription for Upper, Middle, and Lower Gout:
Phellodendron Bark (Huangbai, wine-fried), Atractylodes Rhizome (Cangzhu, soaked in rice wash water for 1-2 nights), Pinellia Rhizome (Nanxing) [each 2 liang], Medicated Leaven (Shenqu, fried), Ligusticum Wallichii Rhizome (Taixiong) [each 1 liang], Saposhnikovia Root (Fangfeng), Angelica Dahurica Root (Baizhi), Peach Kernel (Taoren) [each 5 qian], Siegesbeckia Herb (Weilingxian, wine-fried), Cinnamon Twig (Guizhi, for arm pain), Notopterygium Root (Qianghuo) [each 2 qian], Gentian Root (Caolongdan) [1.5 qian], Safflower (Honghua, wine-treated) [0.5 qian].
Grind to fine powder, make pills with Shenqu paste, size of Sophora seeds. Take 100 pills on an empty stomach.
Da Qianghuo Tang (Great Notopterygium Decoction) treats Wind-Damp contention causing limb and joint pain.
Qianghuo, Cimicifuga Rhizome (Shengma) [each 1 qian], Pubescent Angelica Root (Duhuo) [0.7 qian], Cangzhu, Fangji, Weilingxian, Danggui, Baizhu, Fuling, Alisma Rhizome (Zexie) [each 0.5 qian].
Cut finely, one dose, two cups water, decoct to one cup, strain, take warm on an empty stomach.
Simiao San (Four Marvels Powder) treats migrating pain.
Weilingxian (wine-soaked, dried, roasted, 5 qian), Horn of Sheep (Jieyangjiao) ash (3 qian), Xanthium Fruit (Cangerzi) [1.5 qian], White Mustard Seed (Baijiezi) [1.5 qian, fried].
Grind to powder, take 1 qian per dose, mixed with Ginger Tea.
One Prescription for Alcohol-induced Damp-Phlegm Gout:
Huangbai (wine-fried), Weilingxian (wine-fried) [each 5 qian], Cangzhu (soaked in rice wash overnight), Qianghuo [each 3 qian], Licorice Root (Gancao, honey-fried) [3 qian], Chenpi (peel removed), Peony Root (Shaoyao) [each 1 qian].
Grind to powder, take 1 qian per dose, mixed with Ginger Soup.
For foot soreness and pain or knee swelling like a drumstick after chronic dysentery, this indicates Yin exhaustion. Treat with Xiong, Danggui, and Shudihuang to tonify Blood. For Qi deficiency, add Renshen and Baizhu. For Wind-Damp, add Qianghuo, Fangfeng, Baizhu. Do not treat purely as Wind, as this dries the Blood and prevents healing.
Qi and Blood dual deficiency with Phlegm-Turbidity and Deficient Fire Gout:
Renshen, Chinese Yam (Shanyao), Floating Stone (Haishi), Nanxing [each 1 liang], Baizhu, Shudihuang, Huangbai (wine-fried brown), Guiban (roasted with butter) [each 2 liang], Dried Ginger (Ganjiang, charred but retaining nature), Cynomorium (Suoyang) [each 5 qian].
Grind to powder, make pills with wine paste.
Limb and joint swelling and pain: Pain belongs to Fire, Swelling belongs to Dampness. Combined with Wind-Cold activating in collaterals, Damp-Heat flows into joints endlessly.
Ephedra Stem (Mahuang, root tips removed), Red Peony Root (Chishaoyao) [each 1 qian], Fangfeng, Schizonepeta Spike (Jingjie), Qianghuo, Duhuo, Baizhu, Cangzhu, Weilingxian, Scutellaria Root (Pianqin, wine-soaked), Immature Bitter Orange (Zhishi), Jiegeng, Kudzu Root (Gegen), Chuanxiong [each 0.5 qian], Gancao, Danggui tip, Shengma [each 0.3 qian].
Cut finely, one dose, two cups water, decoct to one cup, strain, take. For lower Jiao, add wine-Huangbai. For women, add wine-Honghua. For severe swelling, add Binglang, Betel Nut Peel (Dafupi), Zexie. Adding Myrrh (Moyao) 1 qian is excellent for pain relief. Another view: Choppy-numerous pulse indicates Blood stasis; use Taoren, Honghua, Xiong, Danggui, plus Rhubarb (Dahuang) to mildly purge.
Er Miao San (Two Marvels Powder) treats Damp-Heat pain in lower Jiao (feet/knees).
Huangbai (wine-soaked, dried, roasted, 2 liang), Cangzhu (rice wash soaked, 2 nights spring/autumn, 3 nights winter, 1 night summer, 4 liang).
Grind to powder, mix with boiling water and Ginger Juice. Or make pills with steamed dough, take with Ginger-Salt water. These two herbs have strong energy. For exterior/excess Qi, add wine. For Qi deficiency, add Qi-tonics. For Blood deficiency, add Blood-tonics. For severe pain, add Ginger Juice and take hot.
Qianxing San
Use Huangbai alone, soak in wine, dry, grind to powder. Take one square-inch scoop, mixed with Siwu Tang decoction. This treats Blood-deficiency Deficient-Fire Gout; take multiple doses for effect.
Arm pain is caused by Upper Jiao Damp-Phlegm moving horizontally in collaterals.
Pinellia Tuber (Banxia), Wine-Huangqin, Baizhu, Nanxing, Cyperus Rhizome (Xiangfu) [each 1 qian], Chenpi, Fuling [each 0.5 qian], Cangzhu [1.5 qian], Weilingxian [3 qian], Gancao [0.3 qian].
Cut finely, one dose, add 5 slices of Ginger, two cups water, decoct to one cup, take after meals.
Modified Erchen Tang treats Arm Pain.
Add Wine-Huangqin, Qianghuo, Weilingxian to base formula, decoct with Ginger water, take warm after meals.
One Prescription for Effective Gout Treatment:
Chishaoyao, Qingpi [each 1.5 qian], Purple Wisteria Root (Ziwei), Taixiong [each 0.75 qian], Weilingxian, Momordica Seed (Mubiezi) [each 1.5 qian], Fangfeng [0.75 qian], Gancao [0.5 qian].
Cut finely, one dose, decoct in wine, take.
Treatment for Women's Chest, Back, and Flank Migrating Pain:
Chishaoyao [1 qian], Guizhu, Cangzhu [each 0.5 qian], Xiangfu, Fried Huangbai [each 1 qian], Gancao [0.5 qian], Weilingxian [7.5 qian, wet-fried with wine].
Cut finely, one dose, two cups water, decoct to one cup, take.
Prescription for Migrating Pain:
Weilingxian, Cangzhu (rice wash soaked), Guizhi, Chuan Gui (wine-washed), Taoren (skin/tip removed, fried) [each 1 qian], Raw Taoren (7 pieces), Gancao [2 qian], Chuanxiong [1.5 qian].
Cut finely, one dose, add 5 slices Ginger, two cups water, decoct to one cup. Add Child's Urine (Tongbian) and Zhuli (0.5 cup each), decoct again to one cup, take hot. Avoid Pork, Mutton, Chicken, Fishy foods, and Wet Dough.
Dingtong Wan (Definite Pain Pill) treats all Wind-Damp pains.
Frankincense (Ruxiang), Myrrh (Moyao), Venus Grass (Jinxingcao), Earthworm (Dilong, cleaned and fried), Trogopterus Dung (Wulingzhi), Mubiezi (shelled).
Equal parts, grind to powder, make pills with refined honey, size of bullet. Take one pill, dissolve in warm wine. Or make small pills, take with warm wine.
Secular use of herbal medicines for rapid effects, such as using Shisi as the sovereign herb and Guoshanlong as assistants, involves hot and drying herbs. They cannot nourish Tendons and Yin but can dry Dampness for superficial diseases. Damp-Phlegm opens with dryness, Blood stasis moves with heat, hence rapid effect. However, for deep diseases with low Blood, further depletion causes deeper illness. Beware!
(Above are 26 methods from Danxi)
Huangjiu (Bureau Formula) treats Wind-Cold-Damp Bi, body numbness, dry/itchy skin, tendon spasms, slurred speech, and hemiplegia.
Astragalus Root (Huangqi), Fangfeng, Guizhi, Gastrodia Rhizome (Tianma), Dioscorea Hypoglauca Rhizome (Bixie), Dendrobium Stem (Shihu), Tiger Tibia Bone (Hu Jinggu, butter-roasted), Baishao, Danggui, Cloud Mother Powder (Yunmu Fen), Baizhu, Ilex Leaf (Yinyu Ye), Costus Root (Muxiang), Epimedium Herb (Xianlingpi), Gancao, Teasel Root (Chuanduan) [each 1 liang].
Cut finely, place in raw silk bag, soak in 1 dou of good unadulterated wine in a porcelain jar. Seal tightly. Spring 5 days, Summer 3 days, Autumn 7 days, Winter 10 days. Take one cup, warm, anytime.
Duhuo Jisheng Tang (Bureau Formula) treats Liver-Kidney deficiency with Wind-Damp invasion causing flaccidity and numbness, weak legs. (See Low Back Pain section.)
Fangfeng Tianma San treats Wind-Damp numbness, migrating joint pain, stroke hemiplegia, sudden aphasia, and internal/external Wind-Heat obstruction causing vertigo.
Fangfeng, Tianma, Chuanxiong, Qianghuo, Baizhi, Grass Aconite Root (Caowutou), Typhonium Rhizome (Baifu Zi), Jingjie Hua, Danggui, Gancao (fried) [each 5 qian], White Talcum (Baishihua) [2 liang].
Grind to powder, take 0.5 qian up to 1 qian, mixed with hot wine and honey until slight numbness is felt. Or make honey pills, size of bullet, take half to one pill with hot wine or plain water. This is a superb formula for dispersing stagnation and venting Wind.
Shujin Tang (Bureau Formula) treats arm pain preventing lifting, caused by Qi-Blood stagnation in collaterals. Also called Tongqi Yinzi or Wubi Tang. Highly effective.
Turmeric Tuber (Pianzi Jianghuang) [2 qian], Gancao (fried), Qianghuo [each 0.5 qian], Celtis Bark (Haitongpi, outer bark removed), Danggui (head removed), Chishaoyao, Baizhu [each 1 qian].
Cut finely, one dose, add 3 slices Ginger, 1.5 cups water, decoct to 1 cup. Strain, add a little Agarwood (Chenxiang) water, take warm. Pain above waist: take after meal. Pain below waist: take before meal.
(Ancestral Formula)
Jiu Teng Jiu (Nine Vine Wines) treats chronic Gout, stroke hemiplegia, tendon spasms, day-and-night pain, and screaming. Rapid efficacy.
Qingteng, Uncaria Vine (Diaogouteng), Hongteng (Lishengteng), Dinggongteng (Fengteng), Mulberry Twig (Sangluoteng), Cuscuta Seed Vine (Tusiteng), Aristolochia Vine (Tianxianteng), Polypodium Root (Yindi Jue/Dicha, roots, each 4 liang), Honeysuckle Stem (Rendongteng), Schisandra Vine (Wuweizi Hongneixiao, each 2 liang).
Cut finely, soak in 1 dou old unadulterated wine in porcelain jar. Wrap herbs in real silk, immerse in wine. Seal tightly. Spring/Autumn 7 days, Winter 10 days, Summer 5 days. Take one cup, 3 times daily. Upper body: after meal/before bed. Lower body: empty stomach/before meal.
Jiawei Sanmiao Wan treats Damp-Bi pain in both feet, burning sensation rising from ankles to hips, or numbness/flaccidity. All caused by Dampness.
Cangzhu (4 liang, rice wash soaked), Huangbai (2 liang, wine-soaked sun-dried), Chuan Niuxi (1 liang, stem removed), Danggui Tail (1 liang, wine-washed), Chuan Bixie (1 liang), Fangji (1 liang), Guiban (butter-roasted, 1 liang).
Grind to powder, make pills with wine-boiled flour paste, size of Sophora seeds. Take 100 pills with warm Ginger-Salt water on empty stomach.
Chuan Mutong Tang
A 40-year-old man suffered from White Tiger Migratory Joint Wind due to Wind-Damp, with full-body twitching pain and inability to walk for three years. Hundreds of prescriptions failed. He was emaciated and expected to die. One night he dreamed of curing himself with Mutong Tang. He tried Siwu Tang plus Mutong without success. Later, he used 2 liang of Mutong, finely cut, decocted in running water, and drank it all at once. After one hour, his whole body itched severely, red rashes appeared on the upper body like mung beans. The family panicked, wiped them away. Sweating stopped at the waist, and upper body pain ceased. The next day, he took it again; red rashes appeared on the lower body, sweating continued to the soles of the feet. After sweating dried, he felt comfortable and pain-free throughout. One month later, his strength returned, and he walked normally. This method cured several others successfully. Recorded here for future students.
Fumigation and Washing Method for Gout treats cold pain in hands/feet like tiger bites.
Use 1 dou of Camphor Wood chips. Boil 1 dan of fast-flowing water. Place wood chips in a large barrel. Place a stool outside the barrel. Pour boiling water over chips. Place a low stool inside the barrel. Sit on the edge, put one foot in. Surround the barrel with straw mat to trap steam. Avoid steam entering eyes to prevent damage. Very effective.