〔罗〕 丸 治鹤膝风，腰膝风缩之疾。
（头尾全者，一条） 桃仁（生） 白附 阿魏 桂心 安息（桃仁同研） 白芷
（各一两） 乳香 没药（各三分，以上九味用童便酒二升炒熟另处） 北漏芦 当归 白芍 牛膝
羌活 地骨皮 威灵仙（各一两，为末）
上蜜为丸，弹子大。空心温酒化下一丸。胡楚望博士，病风 ，手足指节皆如桃李
，痛不可忍，服之悉愈。
〔丹〕一丈人，年七十岁，患脚膝疼稍肿。
生地 归头 白芍 苍术 炒柏（三钱） 川芎 桂（二钱） 木通（一钱半）
分四帖，煎取小盏，食前热服。
一男子年近三十，滋味素浓，性多焦怒，秋间髀枢左右一点发痛，延及膝，昼静夜剧，
痛剧恶寒，口或渴或不渴，或痞或不痞。医多用风药，兼用补血。至次年春，其膝渐肿，痛
愈甚，食渐减，形瘦赢。至春末，膝肿如桃，不可屈伸。诊其脉，左弦大颇实，寸涩甚，大
率皆数，知其小便必数而短。遂作饮食痰积在太阳、阳明治之。炒柏一两，生甘草梢、犀角
屑、苍术盐炒各三钱，川芎二钱，陈皮、牛膝、木通、芍药各五钱，遇暄热，加条芩三钱为
细末，每三钱重，与生姜自然汁同研细。多少以水荡起煎令沸，带热食前饮之，一昼夜四次
与。至半月后，数脉渐减，痛渐轻。去犀角，加牛膝、败龟板半两，当归半两，如前服。又
与半月，肿渐减，食渐进，不恶寒。唯脚膝酸软，未能久立久行，去苍术、黄芩，时当夏热
，加炒黄柏至一两半。予根据本方内加牛膝，春夏用茎叶，冬用根，杵取汁用之，效尤速。须
断酒、肉、湿曲、胡椒，当仲夏、加生地黄半两；冬加茱萸、桂枝。
〔世〕换骨丹 通治风，兼治鹤膝风。
防风 牛膝 当归 虎骨（酥炙，各一两） 枸杞（二两半） 羌活 独活 败龟板 秦艽 萆
松节 蚕砂（各一两） 茄根（二两，洗） 苍术（四两）
酒浸，或酒糊丸，皆可。
〔《食》〕脚筋急痛，煮木瓜令烂，研作粥浆样，用裹痛处，冷即易，一宿三五度热裹便
瘥。煮木瓜时，入一半酒煮之。
〔子和〕∶岭北李文卿，病两膝膑屈伸有声剥剥然。或以为骨鸣，戴人曰∶非也。骨不戛，
焉能鸣，此筋湿也。湿则筋急，缓者不鸣，急者鸣也。若用予之药，一涌一泄，上下去其水
，则自无声矣。李文卿从其言，既而果然。
〔《素》〕蹇膝伸不屈，治其楗（骨空论。下同。经云∶辅骨上横骨下为楗。王注云
∶髀辅骨上，横骨下，股外之中，侧立摇动取之，筋动应手。滑寿云∶楗，骨之下为髀枢，
盖楗即两骨相接处为楗也）。坐而膝痛，治其机（经云∶挟髋为机。王注云∶髋骨两傍相接处
。滑寿云∶髋骨挟腰两傍，髋骨为机，机后为臂）。立而暑解，治其骸关（经云∶膝解为骸关
。王注云∶暑，热也。若膝痛起立而膝骨解中热者，治其骸关。经云∶起而引膝骨，解之中
也。滑寿云∶挟膝解中为膑）膝痛，痛及拇指，治其 （经云∶辅上为 。王
注云∶ 为膝解之后，曲脚之中，委中穴）。坐而膝痛，如物隐者，治其关
（经云∶ 上为关。王注云∶关在 上。当楗之后，背立按之动摇筋应手）。膝痛不可
屈伸，治其背内（王注云∶大杼穴也）。连 若折，治阳明中俞 （王注云∶若膝痛不可屈
伸，连 痛如折者，则针阳明脉中俞 ，三里穴也）。膝痛若别，治巨阳少阴荥（王注云
∶若痛而膝如别离者，则治足太阳荥通谷穴，足少阴荥然谷穴也）。淫泺胫酸，不能立久，
治少阳之维，在外上五寸。（外上当作外踝上。王注∶淫泺谓似酸痛而无力也。外踝上五寸
，光明穴也）
右楗机骸关诸穴，更参订之。
〔《灵》〕膝中痛，取犊鼻以员利针之，发而间之，针大如 ，刺膝无疑。（杂病篇）
〔《玉》〕鹤膝风肿及腿痛∶髋骨（在膝盖骨上一寸，梁丘穴两傍各五分，针入五分，留
一吸，泻之） 膝关（在膝盖骨下，犊鼻内傍，横针透膝眼，在犊鼻外傍，禁灸，留八呼，泻之）
〔《集》〕又法∶膝关 委中（三寸半但紫脉上出血为妙） 三里 不已，取下穴∶阳陵泉
中脘 丰隆
〔通〕膝肿∶行间
〔《撮要》〕阳陵泉（横透阴陵泉，补生，泻成） 阴陵泉（横透阳陵泉。补生，泻成） 膝
关（法见前玉龙下）
〔世〕脚拗痛，委中出血。
〔桑〕脚膝痛筋急∶风池 三间 三阴交 三里
【罗天益】丸剂：治疗鹤膝风，以及腰膝拘挛收缩的疾病。
（取完整的一条）桃仁（生用）、白附子、阿魏、桂心、安息香（与桃仁一同研磨）、白芷（各一两）；乳香、没药（各三分，以上九味药材用童子小便和二升酒炒熟后另放一边）；北漏芦、当归、白芍、牛膝、羌活、地骨皮、威灵仙（各一两，研为细末）。
以上药物用蜂蜜制成丸药，大小如弹子。空腹时温酒化开服用一丸。胡楚望博士患有风痹，手足指节都肿大像桃李一样，疼痛难以忍受，服用此药后全部痊愈。
【朱丹溪】一位七十岁的老人，患脚膝疼痛且轻微肿胀。
生地黄、归头、白芍、苍术、炒黄柏（各三钱）；川芎、桂枝（各二钱）；木通（一钱半）。
分为四帖，煎取少量药汁，饭前热服。
一名近三十岁的男子，平时饮食滋味浓厚，性格急躁易怒。秋季髀枢左右某处开始发痛，蔓延至膝盖，白天安静夜间加剧，疼痛剧烈时伴有恶寒，有时口渴有时不渴，有时痞闷有时不痞闷。医生多用祛风药，兼用补血药。到了次年春季，他的膝盖逐渐肿胀，疼痛更加严重，食欲逐渐减退，身体消瘦羸弱。到春末，膝盖肿得像桃子一样，不能屈伸。诊察其脉象，左脉弦大且颇实，寸口脉涩得很厉害，总体脉率都偏快，推测他的小便一定频数而短少。于是将其诊断为饮食痰积在太阳经和阳明经所致。用炒黄柏一两，生甘草梢、犀角屑、盐炒苍术各三钱，川芎二钱，陈皮、牛膝、木通、芍药各五钱，遇到天气暄热时，加条芩三钱，研为细末。每次取三钱重，与生姜自然汁一同研磨细腻。根据病情多少，用水荡起煎至沸腾，趁热在饭前饮用，一昼夜四次给予。半个月后，数脉逐渐减少，疼痛逐渐减轻。去掉犀角，加牛膝、败龟板半两，当归半两，按之前的方法服用。又过了半个月，肿胀逐渐减轻，食欲逐渐恢复，不再恶寒。只是脚膝酸软，不能久站久行，去掉苍术、黄芩，当时正值夏热，加炒黄柏至一两半。我根据本方内加牛膝，春夏季节用牛膝的茎叶，冬季用根，捣碎取汁使用，效果尤其迅速。必须戒断酒、肉、湿曲、胡椒，应当在中暑时节加生地黄半两；冬季加茱萸、桂枝。
【世传】换骨丹：通用治疗风邪，兼治鹤膝风。
防风、牛膝、当归、虎骨（酥炙，各一两）；枸杞（二两半）；羌活、独活、败龟板、秦艽、萆薢、松节、蚕砂（各一两）；茄根（二两，洗净）；苍术（四两）。
用酒浸泡，或用酒糊制丸，都可以。
【《食疗本草》】脚筋拘急疼痛，煮木瓜直到烂熟，研磨成粥浆状，用来包裹疼痛部位，凉了即更换，一夜换三五次，热敷后即可好转。煮木瓜时，加入一半酒一起煮。
【张子和】岭北的李文卿，患两膝膑骨屈伸时有剥剥的声音。有人认为是骨头鸣响，戴人（张子和号）说：不是这样。骨头不会摩擦，怎么能发出声音？这是筋受湿邪所致。湿邪导致筋脉拘急，松弛的筋不鸣响，拘急的筋才会鸣响。如果采用我的药法，一次涌吐一次泻下，上下去除体内的水湿，那么自然就没有声音了。李文卿听从了他的话，后来果然如此。
【《素问》】膝盖僵硬伸展不利，治疗楗穴（《骨空论》。下同。经文说：辅骨之上、横骨之下为楗。王冰注解说：在大腿辅骨上，横骨下，股外侧中间，侧身站立摇动以取穴，筋脉跳动应手。滑寿说：楗，是骨之下为髀枢，大概楗就是两骨相接之处为楗也）。坐着时膝盖疼痛，治疗机穴（经文说：挟持髋骨处为机。王冰注解说：髋骨两旁相接处。滑寿说：髋骨挟腰两旁，髋骨为机，机后为臂）。站立时感觉膝部发热解弛，治疗骸关穴（经文说：膝解处为骸关。王冰注解说：暑，即热。如果膝痛起身时膝骨解中发热者，治疗骸关。经文说：起身牵引膝骨，解中也。滑寿说：挟膝解中为髌骨）。膝盖疼痛，疼痛放射到大拇指，治疗委中穴（经文说：辅骨之上为... 王冰注解说：...位于膝解之后，弯曲小腿之中，即委中穴）。坐着时膝盖疼痛，感觉像有物隐藏其中，治疗关元穴（经文说：...之上为关。王冰注解说：关在...之上。位于楗之后，背立按压时动摇筋脉应手）。膝盖疼痛不能屈伸，治疗背部内侧穴位（王冰注解说：是大杼穴）。疼痛连及...如同折断，治疗足阳明经的中俞穴（王冰注解说：如果膝痛不能屈伸，连...痛如折断者，则针刺阳明脉中的俞穴，即三里穴）。膝盖疼痛若感觉分离，治疗足太阳经和足少阴经的荥穴（王冰注解说：如果痛而膝如别离者，则治疗足太阳经荥穴通谷穴，足少阴经荥穴然谷穴）。肢体酸痛无力，小腿酸软，不能久立，治疗足少阳经的维脉，在外踝上五寸处（外上当作外踝上。王冰注：淫泺谓似酸痛而无力也。外踝上五寸，即光明穴）。
以上楗、机、骸关等穴位，需进一步参详考证。
【《灵枢》】膝盖中部疼痛，取犊鼻穴用员利针针刺，发作时施针，间歇期停针，针粗如...，刺入膝盖无疑。（《杂病篇》）
【《玉龙歌》】鹤膝风肿胀及腿痛：髋骨穴（在膝盖骨上一寸，梁丘穴两旁各五分，针入五分，留一吸的时间，用泻法）；膝关穴（在膝盖骨下，犊鼻穴内侧旁边，横针透刺膝眼，在犊鼻穴外旁，禁灸，留八呼的时间，用泻法）。
【《针灸集成》】又一种方法：膝关穴、委中穴（在三寸半处，只要见到紫色脉络上出血就很好）；足三里穴。如果无效，取下部穴位：阳陵泉穴、中脘穴、丰隆穴。
【《针灸撮要》】阳陵泉穴（横透阴陵泉穴，补法用于生证，泻法用于成证）；阴陵泉穴（横透阳陵泉穴。补法用于生证，泻法用于成证）；膝关穴（方法见前玉龙歌下方）。
[Luo] Pill: Treats *He Xi Feng* (Crane's Knee Wind, a type of Bi syndrome characterized by knee swelling and deformity) and diseases involving contraction and shrinkage of the waist and knees.
(One whole piece with head and tail intact): Tao Ren (Peach Seed, raw), Bai Fu Zi (Aconitum kusnezoffii Rhizome), A Wei (Ferula resin), Gui Xin (Cinnamon Twig Heart), An Xi Xiang (Benzoin Resin - ground together with Tao Ren), Bai Zhi (Angelicae Dahuricae Radix) (each 1 liang); Ru Xiang (Frankincense), Mo Yao (Myrrh) (each 3 fen, the above nine herbs are stir-fried with 2 sheng of urine from an uncircumcised boy and wine, then set aside separately); Bei Lou Lu (Euphorbiae Pekinensis Radix), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Niu Xi (Achyranthis Bidentatae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Di Gu Pi (Lycii Cortex), Wei Ling Xian (Clematidis Radix) (each 1 liang, processed into fine powder).
Mix with honey to form pills the size of a bullet pill. Take one pill dissolved in warm wine on an empty stomach. Dr. Hu Chuwang suffered from wind-bi, where the joints of his hands and feet swelled like peaches or plums, and the pain was unbearable. After taking this medicine, he recovered completely.
[Zhu Danxi] An old man aged seventy suffered from pain and slight swelling in his feet and knees.
Sheng Di Huang (Rehmanniae Radix), Gui Tou (Head of Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Cang Zhu (Atractylodis Rhizoma), Chao Bo (Stir-fried Phellodendri Cortex) (each 3 qian); Chuan Xiong (Ligusticum Chuanxiong Rhizoma), Gui (Cinnamomi Ramulus) (each 2 qian); Mu Tong (Akebiae Caulis) (1.5 qian).
Divide into four doses, decoct to obtain a small cupful, and take hot before meals.
A man near thirty years old, accustomed to rich flavors and prone to irritability and anger, developed a spot of pain around the hip pivot in autumn, which extended to the knee. The pain was quiet during the day but severe at night. When the pain was severe, he felt aversion to cold; sometimes he was thirsty, sometimes not; sometimes he felt stifling sensation, sometimes not. Physicians mostly used wind-dispelling medicines and blood-nourishing medicines. By the following spring, his knee gradually swelled, the pain became more severe, his appetite decreased, and he became emaciated and weak. By late spring, his knee swelled like a peach, and he could not flex or extend it. Palpation of his pulse revealed the left pulse was wiry, large, and quite full; the cun position was very choppy; generally, the pulse rate was rapid. I deduced that his urination must be frequent and scanty. Thus, I diagnosed it as food retention and phlegm accumulation in the Taiyang and Yangming meridians. Use Chao Bo (Stir-fried Phellodendri Cortex) 1 liang, Sheng Gan Cao Gao (Raw Licorice Root Tip), Xi Jiao Xie (Rhinocerotis Cornu Powder), Yan Chao Cang Zhu (Salt-stir-fried Atractylodis Rhizoma) (each 3 qian), Chuan Xiong 2 qian, Chen Pi (Tangerine Peel), Niu Xi (Achyranthis Bidentatae Radix), Mu Tong (Akebiae Caulis), Shao Yao (Paeoniae Radix) (each 5 qian). In warm and hot weather, add Tiao Qin (Scutellariae Radix) 3 qian, and process into fine powder. Each time, take 3 qian, grind finely with fresh ginger juice. Depending on the condition, add water, bring to a boil, and drink hot before meals, four times a day. After half a month, the rapid pulse gradually decreased, and the pain lightened. Remove Xi Jiao, add Niu Xi (Achyranthis Bidentatae Radix) and Bai Gui Ban (Testudinis Carapax et Plastrum) 0.5 liang, Dang Gui (Angelicae Sinensis Radix) 0.5 liang, and administer as before. After another half month, the swelling gradually subsided, appetite improved, and aversion to cold ceased. Only the feet and knees felt sore and weak, unable to stand or walk for long periods. Remove Cang Zhu (Atractylodis Rhizoma) and Huang Qin (Scutellariae Radix). Since it was summer heat, add Chao Huang Bo (Stir-fried Phellodendri Cortex) up to 1.5 liang. I added Niu Xi (Achyranthis Bidentatae Radix) to this base formula; use stems and leaves in spring and summer, roots in winter, crush to extract juice for use, which yields especially fast results. Must abstain from alcohol, meat, damp yeast, and pepper. Add Sheng Di Huang (Rehmanniae Radix) 0.5 liang during mid-summer; add Yu Zhu (Corni Fructus) and Gui Zhi (Cinnamomi Ramulus) in winter.
[World Transmission] Huan Gu Dan (Bone-Replacing Pill): Universally treats wind pathogens, and also treats He Xi Feng (Crane's Knee Wind).
Fang Feng (Saposhnikoviae Radix), Niu Xi (Achyranthis Bidentatae Radix), Dang Gui (Angelicae Sinensis Radix), Hu Gu (Pantheris Os, prepared with butter) (each 1 liang); Gou Qi (Lycii Fructus) (2.5 liang); Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Bai Gui Ban (Testudinis Carapax et Plastrum), Qin Jiao (Gentianae Macrophyllae Radix), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Song Jie (Pinus Massoniana Node), Can Sha (Bombyx Batryticatus) (each 1 liang); Qie Gen (Solanis Lycopersici Radix) (2 liang, washed); Cang Zhu (Atractylodis Rhizoma) (4 liang).
Soak in wine, or make pills with wine paste; both methods are acceptable.
[Food Therapy] For acute pain of foot tendons, boil Mu Gua (Chaenomeles Fruit) until soft, grind into a porridge-like paste, and wrap it around the painful area. Replace when cool. Apply hot wraps 3-5 times overnight for improvement. When boiling Mu Gua, add half wine to boil.
[Hezi/Zhang Zhongjing's School] Li Wenqing from Lingbei suffered from popping sounds in both knees when flexing and extending. Some thought it was bone grinding. Dairen (Zihehe/Zhang Zhongjing's school representative) said: No. Bones do not rub against each other to make sound; this is tendon dampness. Dampness causes tendon tension; relaxed tendons do not make sound, tense ones do. If you use my medicine, one emetic and one purgative treatment will remove water from above and below, and the sound will cease naturally. Li Wenqing followed his advice, and it indeed worked.
[Suwen/Basic Questions] Stiff knee unable to extend, treat Jian point (Gu Kong Lun. Same below. Classic says: Above the auxiliary bone and below the horizontal bone is Jian. Wang Bing notes: Above the thigh auxiliary bone, below the horizontal bone, in the middle of the lateral thigh, stand sideways and shake to locate; the tendon moves and responds to touch. Hua Shou says: Jian refers to the junction of two bones). Sitting with knee pain, treat Ji point (Classic says: Flanking the hip bone is Ji. Wang Bing notes: The junction of the two sides of the hip bone. Hua Shou says: On both sides of the waist flanking the hip bone, the hip bone is Ji, behind Ji is Bi). Standing with heat sensation in the knee joint, treat Hai Guan point (Classic says: The knee joint resolution is Hai Guan. Wang Bing notes: Shu means heat. If knee pain arises and there is heat in the knee joint resolution upon standing, treat Hai Guan. Classic says: Rising and pulling the knee bone, within the resolution. Hua Shou says: Flanking the knee joint resolution is the patella). Knee pain, pain radiating to the big toe, treat Weizhong point (Classic says: Above the auxiliary bone is... Wang Bing notes: ...located behind the knee resolution, in the middle of the bent leg, i.e., Weizhong point). Sitting with knee pain, feeling as if something is hidden, treat Guan Yuan point (Classic says: ...above is Guan. Wang Bing notes: Guan is above.... Located behind Jian, stand with back turned and press; shaking the tendon responds). Knee pain unable to flex or extend, treat the inner back points (Wang Bing notes: This is Dashu point). Pain connecting... as if broken, treat the Middle Shu point of the Yangming Meridian (Wang Bing notes: If knee pain cannot flex or extend, and pain connects... as if broken, then needle the Shu point in the Yangming meridian, i.e., Zusanli point). Knee pain feeling separated, treat the Ying-Spring points of Taiyang and Shaoyin (Wang Bing notes: If pain feels like the knee is separating, then treat the Ying-Spring point of Foot-Taiyang, Tonggu point, and the Ying-Spring point of Foot-Shaoyin, Ranggu point). Yinluo (aching weakness) with calf soreness, unable to stand for long, treat the Wei vessel of Shaoyang, located five cun above the outer ankle (Outer Shang should be read as Outer Malleolus Shang. Wang Bing note: Yinluo means aching weakness and lack of strength. Five cun above the outer malleolus is Guangming point).
The above points Jian, Ji, Hai Guan, etc., require further verification and discussion.
[Lingshu/Spiritual Pivot] Pain in the middle of the knee, select Dubi point and needle with Yuanli needle. Needle during attacks, leave intervals. Needle thickness like..., insert into the knee without doubt. (Za Bing Pian/Miscellaneous Diseases Chapter)
[Yulong Ge/Jade Dragon Song] He Xi Feng (Crane's Knee Wind) swelling and leg pain: Kun Gu point (1 cun above the kneecap, 0.5 cun on both sides of Liangqiu point, insert 0.5 cun, retain for one inhalation, reduce method); Xi Guan point (below the kneecap, medial side of Dubi, horizontally penetrate through Xiyan, lateral side of Dubi, moxibustion prohibited, retain for eight exhalations, reduce method).
[Ji Cheng/Collection] Another method: Xi Guan point, Weizhong point (at 3.5 cun, bleeding from purple veins is ideal); Zusanli point. If ineffective, select lower points: Yanglingquan point, Zhongwan point, Fenglong point.
[Tong Treatment] Knee swelling: Xingjian point.
[Cuo Yao/Summary of Acupuncture and Moxibustion] Yanglingquan point (horizontally penetrate Yinlingquan point, tonify for emerging conditions, reduce for established conditions); Yinlingquan point (horizontally penetrate Yanglingquan point. Tonify for emerging conditions, reduce for established conditions); Xi Guan point (method seen previously under Yulong).
[World Transmission] Ankle sprain pain, bleed Weizhong point.
[Sang] Foot and knee pain with tendon tension: Fengchi point, Sanjian point, Sanyinjiao point, Zusanli point.