治气血凝滞， 癖 瘕，心腹疼痛，腿疼臂疼，内外疮疡，一切脏腑积聚，经络湮淤。
当归（五钱） 丹参（五钱） 生明乳香（五钱） 生明没药（五钱）
上药四味作汤服。若为散，一剂分作四次服，温酒送下。
腿疼加牛膝。臂疼加连翘。妇女瘀血腹疼，加生桃仁（带皮尖作散服炒用）、生五灵脂。疮红肿属阳者，加金银花、
知母、连翘。白硬属阴者，加肉桂、鹿角胶（若恐其伪可代以鹿角霜）。疮破后生肌不速者，加生黄 、知母（但加黄
恐失于热）、甘草。脏腑内痈，加三七（研细冲服）、牛蒡子。
一人，年三十许。当脐忽结 瘕，自下渐长而上，其初长时稍软，数日后即硬如石，旬日长至心口。向愚
询方，自言凌晨冒寒，得于途间，时心中有惊恐忧虑，遂觉其气结而不散。按∶此病因甚奇，然不外气血凝滞。
为制此方，于流通气血之中，大具融化气血之力，连服十剂全消。以后用此方治内外疮疡，心腹四肢疼痛，凡
病之由于气血凝滞者，恒多奇效。
高××年近五旬。资禀素羸弱。一日访友邻村，饮酒谈宴，彻夜不眠，时当季冬，复清晨冒寒，步行旋里。
行至中途，觉两腿酸麻，且出汗，不能行步，因坐凉地歇息，至家，遂觉腿痛，
用热砖熨之疼益甚。其人素知医，遂自服发汗之药数剂，病又增剧，因服药过热，吐血数口，大便燥结，延愚
诊视。见其仰卧屈膝，令两人各以手托其两腿，忽歌忽哭，疼楚之态万状，脉弦细，至数微数。因思此证，热
砖熨而益疼者，逼寒内陷也；服发汗药而益疼者，因所服之药，散肌肉之寒，不能散筋骨之寒，且过汗必伤气
血，血气伤，愈不能胜病也。遂用活络效灵丹，加京鹿角胶四钱（另炖兑服）、明天麻二钱，煎汤饮下，左腿
遂愈。而右腿疼如故，遂复用原方，以虎骨胶易鹿角胶，右腿亦出凉气如左而愈。
一少妇，左胁起一疮，其形长约五寸，上半在乳，下半在肋，皮色不变，按之甚硬，而微热于他处。延医
询方，调治两月不效，且渐大于从前。后愚诊视，阅其所服诸方，有遵林屋山人治白疽方治者，有按乳痈治者。
愚晓病家曰∶此证硬而色白者，阴也。按之微热者，阴中有阳也。统观所服诸方，有治纯阴阳之方，无治半阴
半阳之方，勿怪其历试皆不效也。用活络效灵丹，俾作汤服之，数剂见轻，三十剂后，消无芥蒂。
一妇人年五十许。脑后发一对口疮。询方于愚，时初拟出活络效灵丹方，即书而予之，连服十剂全愈。
一妇人，年五十余。项后筋缩作疼，头向后仰，不能平视，腰背强直，下连膝后及足跟大筋皆疼，并牵周
身皆有疼意。广延医者延医，所用之药，不外散风、和血、润筋、通络之品。两载无效，病转增剧，卧不能起，
起不能坐，饮食懒进。后愚诊视，其脉数而有力，微有弦意，知其为宗筋受病。治以活络效灵丹，加生薏米八
钱，知母、玄参、白芍各三钱，连服三十剂而愈。
盖筋属于肝，独宗筋属胃，此证因胃腑素有燥热，致津液短少，不能荣养宗筋。夫宗筋为筋之主，故宗筋
拘挛，而周身牵引作疼也。薏米性味冲和，善能清补脾胃，即能荣养宗筋。又加知
母、玄参，以生津滋液，活络效灵丹，以活血舒筋，因其脉微弦，恐其木盛侮土，故又加芍药以和肝，即以扶脾胃也。
薏米主筋急拘挛《神农本草经》原有明文。活络效灵丹中加薏米，即能随手奏效。益叹《神农本草经》
之精当，为不可及。
活络效灵丹，治心腹疼痛，无论因凉、因热、气郁、血郁皆效。同里有一少年，脐下疼甚剧。医者投以
温药益甚，昼夜号呼不止。又延他医，以药下之稍轻，然仍昼夜呻吟，继又服药数剂，亦不见效。适愚自津门
旋里，诊其脉，两尺洪实。询其得病之由，言夜晚将寝觉饥，因食冷饼一块，眠起遂疼。晓之曰，此虽由于食
凉物，然其疼非凉疼，乃下焦先有蕴热，又为凉物所迫，其热愈结而不散也。投以活络效灵丹，加龙胆草、川
楝子各四钱，一剂而愈。
或问∶此证医者曾用药下之，何以其下焦之郁热，不随之俱下？答曰∶热在大肠者，其热可随降药俱下，
然又必所用之下药为咸寒之品，若承气汤是也。今其热，原郁于奇经冲任之中，与大肠无关，冲任主血，而活
络效灵丹诸药品，皆善入血分，通经络，故能引龙胆、楝子直入冲任，而消解其郁热。况其从前所服之下药，
原非咸寒之品，是以从前不效，而投以此药，则随手奏效也。
附录∶
直隶青县张××来函∶
族兄×，年三十余，素强壮无病。壬戌中秋，因在田间掘壑，劳苦过甚，自觉气力不支，即在壑中吃烟
休息，少缓须臾又复力作。至晚归家时，途中步行，觉两腿酸木不仁。及至夜间，两腿抽疼甚剧。适生在里，
其弟扣门求为往治。诊其脉，迟滞而细，号呼不已，气逆不顺，身冷，小溲不利。遂用活络效灵丹方，
加白芍三钱、桂枝尖二钱、生姜三片。一剂腿疼大减，小便即利，身冷亦退。再剂，霍然全愈。
又∶天津王媪，年五十七岁，右膝盖部发炎，红热肿疼，食减不眠。其嗣××延为诊视。至其家，闻病者呼
号不止，口称救命。其右脉洪数有力，心悸头眩，舌苔白而腻，大便三日未行，小便赤热。此足征湿热下注。
予以活络效灵丹，加生石膏六钱，知母、怀牛膝、生薏米冬四钱，甘草梢一钱，嘱服一剂。次日自能来寓，其
疼减肿消，夜已成寐，尚云右臂酸疼。又即原方加青连翘、金银花、油松节各二钱，服之全愈。
治疗气血凝滞，癖瘕（腹内结块），心腹疼痛，腿疼臂疼，内外疮疡，一切脏腑积聚，经络湮淤。
当归（五钱） 丹参（五钱） 生明乳香（五钱） 生明没药（五钱）
以上四味药煎汤服用。如果制成散剂，一剂药分四次服用，用温酒送服。
腿疼加牛膝。臂疼加连翘。妇女瘀血引起的腹疼，加生桃仁（带皮尖作散服炒用）、生五灵脂。疮红肿属阳证者，加金银花、知母、连翘。白硬属阴证者，加肉桂、鹿角胶（如果担心是假货可用鹿角霜代替）。疮破后生肌不快的，加生黄芪、知母（但加黄芪恐怕会助热）、甘草。脏腑内痈，加三七（研细冲服）、牛蒡子。
有一人，三十岁左右。肚脐处突然结成癖瘕，从下向上逐渐生长，刚开始时稍软，几天后就硬如石头，十天长到心口部位。向我询问方子，他自己说是凌晨冒寒出行，途中受了风寒，当时心中又有惊恐忧虑，于是觉得气机郁结不散。按：这个病因很奇特，但不外乎是气血凝滞。为此制定此方，在流通气血之中，具有强大的融化气血之力，连续服用十剂后完全消除。后来用此方治疗内外疮疡，心腹四肢疼痛，凡是病由于气血凝滞的，往往有奇效。
高某某年近五十岁。体质素来羸弱。一天去邻村访友，饮酒宴饮，通宵未眠，当时正值深冬，又清晨冒寒，步行回家。走到半路，觉得两腿酸麻，且出汗，不能行走，于是坐在凉地上休息，到家后，就觉得腿痛，用热砖熨烫反而更疼。这个人素来懂医，就自己服用发汗的药几剂，病情更加严重，因为服药过热，吐血几口，大便燥结，请我诊治。见他仰卧屈膝，让人各托住他的两条腿，忽而唱歌忽而哭泣，痛苦之态万状，脉弦细，至数微数。我想这个病症，用热砖熨烫而更疼，是因为逼迫寒气内陷；服用发汗药而更疼，是因为所服的药，只能散肌肉的寒，不能散筋骨的寒，而且过汗必然伤气血，气血受伤，更不能战胜病邪。于是用活络效灵丹，加京鹿角胶四钱（另炖兑服）、明天麻二钱，煎汤喝下，左腿就好了。而右腿疼如故，于是再用原方，用虎骨胶代替鹿角胶，右腿也排出凉气像左腿一样好了。
一个少妇，左胁起一个疮，形状长约五寸，上半在乳房，下半在肋骨，皮色不变，按之很硬，比其他地方微热。延请医生询问方子，调治两个月无效，且比从前渐大。后来我诊治，查阅他所服的各种方子，有的遵循林屋山人治白疽方治疗的，有的按乳痈治疗的。我告诉病人家属说：这个证硬而色白的，是阴证。按之微热的，是阴中有阳。统观所服各种方子，有治纯阴纯阳的方子，没有治半阴半阳的方子，不要奇怪历试皆无效。用活络效灵丹，让它作汤服用，几剂见轻，三十剂后，消除无痕迹。
一个妇人五十岁左右。脑后长一对口疮。向我询问方子，当时刚拟定活络效灵丹方，就写给她，连续服用十剂全愈。
一个妇人五十多岁。项后筋缩作疼，头向后仰，不能平视，腰背强直，向下连及膝后及足跟大筋都疼，并牵动周身都有疼意。广泛延请医生，所用的药，不外散风、和血、润筋、通络之品。两年无效，病情转增剧，卧不能起，起不能坐，饮食懒进。后来我诊治，其脉数而有力，微有弦意，知道是宗筋受病。治疗用活络效灵丹，加生薏米八钱，知母、玄参、白芍各三钱，连续服用三十剂而愈。
大概筋属于肝，唯独宗筋属于胃，这个证因胃腑素有燥热，导致津液短少，不能荣养宗筋。夫宗筋为筋之主，所以宗筋拘挛，而周身牵引作疼。薏米性味冲和，善于清补脾胃，即能荣养宗筋。又加知母、玄参，以生津滋液，活络效灵丹，以活血舒筋，因其脉微弦，恐其木盛侮土，所以又加芍药以和肝，即以扶脾胃也。薏米主筋急拘挛《神农本草经》原有明文。活络效灵丹中加薏米，即能随手奏效。更加感叹《神农本草经》的精当，为不可及。
活络效灵丹，治疗心腹疼痛，无论因凉、因热、气郁、血郁都有效。同乡有一个少年，脐下疼得很剧烈。医生投以温药更甚，昼夜号呼不止。又延请其他医生，以药下之稍轻，然而仍昼夜呻吟，继而又服药几剂，也不见效。恰好我从天津回乡，诊其脉，两尺洪实。询问他得病的缘由，说夜晚将要睡觉觉得饿，因吃冷饼一块，睡醒遂疼。告诉他：这虽然由于食凉物，然而其疼不是凉疼，乃下焦先有蕴热，又被凉物所迫，其热愈结而不散也。投以活络效灵丹，加龙胆草、川楝子各四钱，一剂而愈。
有人问：这个证医生曾用药下之，为什么其下焦的郁热，不随之俱下？回答说：热在大肠的，其热可随降药俱下，然而又必所用之下药为咸寒之品，如承气汤是。现在其热，原本郁于奇经冲任之中，与大肠无关，冲任主血，而活络效灵丹诸药品，皆善入血分，通经络，所以能引龙胆、楝子直入冲任，而消解其郁热。何况其从前所服之下药，原本非咸寒之品，是以从前不效，而投以此药，则随手奏效也。
附录：
直隶青县张某某来函：
族兄某某，三十多岁，素来强壮无病。壬戌中秋，因为在田间掘壑，劳苦过甚，自觉气力不支，就在壑中吃烟休息，稍缓片刻又复力作。到晚回家时，途中步行，觉得两腿酸木不仁。等到夜间，两腿抽疼很剧烈。适逢生在里，其弟敲门求为前往治疗。诊其脉，迟滞而细，号呼不已，气逆不顺，身冷，小溲不利。就用活络效灵丹方，加白芍三钱、桂枝尖二钱、生姜三片。一剂腿疼大减，小便即利，身冷亦退。再剂，霍然全愈。
又：天津王媪，五十七岁，右膝盖部发炎，红热肿疼，食减不眠。其嗣某某延为诊治。到她家，闻病者呼号不止，口称救命。其右脉洪数有力，心悸头眩，舌苔白而腻，大便三日未行，小便赤热。这是湿热下注的确征。给予活络效灵丹，加生石膏六钱，知母、怀牛膝、生薏米冬四钱，甘草梢一钱，嘱服一剂。次日自能来寓，其疼减肿消，夜已成寐，尚云右臂酸疼。又即原方加青连翘、金银花、油松节各二钱，服之全愈。
Treats Qi and Blood stagnation, Pi Jia (abdominal masses), pain in the heart and abdomen, leg and arm pain, internal and external sores, all accumulations and consolidations of the Zang-Fu organs, and blockage of the meridians.
Dang Gui (Radix Angelicae Sinensis) (5 qian)
Dan Shen (Radix Salviae Miltiorrhizae) (5 qian)
Sheng Ming Ru Xiang (Resina Olibani) (5 qian)
Sheng Ming Mo Yao (Resina Myrrhae) (5 qian)
The above four herbs are decocted as a soup for oral administration. If prepared as a powder, one dose is divided into four servings, taken with warm wine.
For leg pain, add Niu Xi (Radix Achyranthis Bidentatae). For arm pain, add Lian Qiao (Fructus Forsythiae). For abdominal pain due to blood stasis in women, add Sheng Tao Ren (Semen Persicae, with skin and tip, used as powder or stir-fried) and Sheng Wu Ling Zhi (Pollen Typhae). For red and swollen soles belonging to Yang syndromes, add Jin Yin Hua (Flos Lonicerae Japonicae), Zhi Mu (Rhizoma Anemarrhenae), and Lian Qiao. For white and hard soles belonging to Yin syndromes, add Rou Gui (Cortex Cinnamomi) and Lu Jiao Jiao (Colla Cornus Cervi) (if counterfeit is feared, Lu Jiao Shuang can be substituted). For slow healing after ulceration, add Sheng Huang Qi (Radix Astragali Membranacei) and Zhi Mu (but adding Huang Qi may risk exacerbating heat), plus Gan Cao (Radix Glycyrrhizae Uralensis). For internal abscesses of the Zang-Fu organs, add San Qi (Radix Notoginseng, finely ground and taken with decoction) and Niu Bang Zi (Fructus Arctii).
A man, about thirty years old, suddenly developed a Pi Jia at the navel, growing gradually from below upwards. Initially soft, it became hard as stone after several days, reaching the epigastrium within ten days. He consulted me for a prescription, stating that he had exposed himself to cold early in the morning while traveling, and simultaneously experienced fear and anxiety, leading to a sensation of Qi stagnation without dispersion. Analysis: Although the etiology is peculiar, it essentially stems from Qi and Blood stagnation. This formula was devised to possess strong power to dissolve Qi and Blood while promoting their circulation. After continuous intake for ten doses, the mass completely disappeared. Subsequently, this formula was used to treat internal and external sores, and pain in the heart, abdomen, and limbs; for conditions caused by Qi and Blood stagnation, it often yields miraculous effects.
Gao XX, nearly fifty years old, had always been constitutionally weak. One day, visiting friends in a neighboring village, he drank and feasted, staying awake all night. It was deep winter, and he walked home exposing himself to cold in the early morning. Halfway there, his legs felt sore and numb, accompanied by sweating, making walking impossible. He sat on the cold ground to rest. Upon arriving home, he felt leg pain. Applying hot bricks made the pain worse. Being knowledgeable in medicine, he self-administered diaphoretic herbs for several doses, worsening the condition. Due to the excessive heat of the medication, he vomited blood several times and suffered from dry constipation. I examined him. He lay supine with knees flexed, requiring two people to support his legs. He alternately sang and cried, displaying extreme agony. His pulse was wiry and thin, with a slightly rapid rate. I reasoned that the worsening pain from hot brick application indicated forced invasion of cold into the interior; the worsening pain from diaphoretics indicated that the herbs only dispersed cold from the muscles but not from the sinews and bones, and excessive sweating inevitably damaged Qi and Blood. Damaged Qi and Blood further weakened the body's ability to overcome the pathogen. Therefore, I prescribed Huo Luo Xiao Ling Dan, adding Jing Lu Jiao Jiao (Colla Cornus Cervi, separately stewed and mixed in) 4 qian and Tian Ma (Rhizoma Gastrodiae) 2 qian, decocted and drunk. The left leg healed. The right leg remained painful, so I repeated the original formula, substituting Hu Gu Jiao (Collus Os Tigris) for Lu Jiao Jiao. The right leg also expelled cold air like the left and healed.
A young woman developed a sore on her left hypochondrium, approximately five cun long, extending from the breast above to the ribs below. The skin color was unchanged, very hard upon palpation, and slightly warmer than surrounding areas. Doctors treated her for two months without effect, and the sore grew larger. Upon examination, I reviewed previous prescriptions: some followed Lin Wu Shan Ren’s Bai Ju (White Gangrene) formula, others treated it as Ru Yong (Breast Abscess). I told the family: "This condition is hard and white, indicating a Yin syndrome. Slight warmth upon palpation indicates Yin containing Yang. All previous formulas treated pure Yin or pure Yang, none addressed half-Yin half-Yang, hence their ineffectiveness." I prescribed Huo Luo Xiao Ling Dan as a decoction. Improvement was seen after a few doses, and after thirty doses, it resolved completely without trace.
A woman, about fifty years old, developed a Dui Kou Chuang (carbuncle) behind the head. She consulted me when I had just formulated Huo Luo Xiao Ling Dan. I wrote it down for her. Ten doses resulted in complete recovery.
A woman, over fifty years old, suffered from tendon contraction and pain in the posterior neck, causing her head to tilt backward, unable to look straight ahead. Her lower back and waist were stiff, extending down to the tendons behind the knees and heels, with pain radiating throughout the body. Various doctors prescribed wind-dispelling, blood-nourishing, tendon-moistening, and meridian-unblocking herbs for two years without success. The condition worsened; she could neither lie down nor sit up, and lost her appetite. Upon examination, her pulse was rapid, forceful, and slightly wiry. I diagnosed it as a disease of the Zong Jin (Major Tendons). Treatment involved Huo Luo Xiao Ling Dan, adding Sheng Yi Mi (Semen Coicis) 8 qian, Zhi Mu (Rhizoma Anemarrhenae), Xuan Shen (Radix Scrophulariae), and Bai Shao (Radix Paeoniae Alba) each 3 qian. Thirty doses led to recovery.
Generally, tendons belong to the Liver, but the Zong Jin belongs to the Stomach. This case arose because chronic dry-heat in the Stomach depleted fluids, failing to nourish the Zong Jin. As the master of tendons, Zong Jin spasms cause whole-body traction pain. Yi Mi has a mild nature and flavor, effectively clearing and tonifying the Spleen and Stomach, thereby nourishing the Zong Jin. Zhi Mu and Xuan Shen generate fluids and moisten dryness. Huo Luo Xiao Ling Dan invigorates blood and relaxes tendons. Given the slight wiriness of the pulse, suggesting Wood overacting on Earth, Bai Shao was added to harmonize the Liver and support the Spleen. Yi Mi treats tendon spasm and contracture, as stated in the *Shennong Bencao Jing*. Adding Yi Mi to Huo Luo Xiao Ling Dan ensures immediate efficacy. This further confirms the precision of the *Shennong Bencao Jing*, which is unsurpassable.
Huo Luo Xiao Ling Dan treats heart and abdominal pain, effective regardless of whether caused by Cold, Heat, Qi stagnation, or Blood stagnation. A youth in my neighborhood suffered severe pain below the umbilicus. Warm herbs administered by a doctor exacerbated the pain, causing day-and-night wailing. Another doctor used purgatives, providing slight relief, but groaning continued. Several more doses failed. Returning from Tianjin, I examined his pulse: both Chi positions were surging and full. Inquiry revealed he ate a cold pancake late at night due to hunger before sleep, and pain started upon waking. I explained: "Although caused by cold food, this is not cold-induced pain. There was pre-existing latent heat in the Lower Jiao, aggravated and consolidated by the cold food." I prescribed Huo Luo Xiao Ling Dan, adding Long Dan Cao (Radix Gentianae) and Chuan Lian Zi (Fructus Toosendan) each 4 qian. One dose cured him.
Question: Why did purgatives fail to clear the latent heat in the Lower Jiao? Answer: Heat in the Large Intestine can be cleared by purgatives, provided they are salty-cold agents like Cheng Qi Tang. Here, the heat was originally stagnant in the Chong and Ren Mai (Penetrating and Conception Vessels), unrelated to the Large Intestine. The Chong and Ren govern Blood. The herbs in Huo Luo Xiao Ling Dan enter the Blood level and unblock meridians, allowing Long Dan Cao and Chuan Lian Zi to directly enter the Chong and Ren to dissipate the stagnant heat. Moreover, the previous purgatives were not salty-cold, hence ineffective. This formula works immediately.
Appendix:
Letter from Zhang XX of Qing County, Zhili:
My clan brother XX, over thirty years old, was usually robust and healthy. During the Mid-Autumn Festival of the Renxu year, while digging trenches in the fields, he overexerted himself, feeling his strength failing. He rested smoking in the trench, then resumed work shortly after. Walking home in the evening, his legs felt sore, numb, and insensible. At night, his legs suffered severe cramping pain. My younger brother knocked on my door seeking treatment. His pulse was sluggish, fine, and slow. He wailed incessantly, with rebellious Qi, cold body, and difficult urination. I prescribed Huo Luo Xiao Ling Dan, adding Bai Shao (Radix Paeoniae Alba) 3 qian, Gui Zhi Jian (Ramulus Cinnamomi) 2 qian, and Sheng Jiang (Rhizoma Zingiberis Recens) 3 slices. One dose greatly reduced leg pain, urination normalized, and body warmth returned. Two doses resulted in complete recovery.
Also: Widow Wang of Tianjin, 57 years old, suffered inflammation of the right knee, with redness, heat, swelling, and pain, decreased appetite, and insomnia. Her son invited me to examine her. Hearing her wailing for help, I found her right pulse surging, rapid, and forceful. She had palpitations, dizziness, white greasy tongue coating, no bowel movement for three days, and dark hot urine. This confirmed damp-heat sinking downward. I prescribed Huo Luo Xiao Ling Dan, adding Sheng Shi Gao (Gypsum Fibrosum) 6 qian, Zhi Mu (Rhizoma Anemarrhenae), Huai Niu Xi (Radix Achyranthis Bidentatae), Sheng Yi Mi (Semen Coicis) 4 qian, and Gan Cao Shao (Radix Glycyrrhizae Uralensis, tip) 1 qian, advising one dose. The next day, she visited my residence voluntarily. Pain decreased, swelling subsided, and she slept at night, though reporting right arm soreness. I added Qing Lian Qiao (Fructus Forsythiae), Jin Yin Hua (Flos Lonicerae Japonicae), and You Song Jie (Nodus Cum Ramis Pinus Massoniana) each 2 qian to the original formula. She recovered completely.