【方歌】膝痈焮肿色红疼，疪疽如郁色不红，宜软为顺坚硬逆，
脾肾肝经邪所乘。
【注】膝痈生于膝盖，色红、焮肿、疼痛，属气血实；疪疽亦
生在膝盖，肿大如痈，其色不变，寒热往来，属气血虚
。宣软为顺，坚硬如石者为逆。经云：肉之小会为溪。
溪者，二肘、二膝、四腕也。凡脾病在溪；肾有邪，其
气留于两膝；凡筋病皆属于节，筋乃肝之余，故又属肝
，是以溪会有病，皆从脾、肾、肝三经，邪气乘之也。
始终内、外治法，俱按痈疽肿疡、溃疡门。惟两膝俱生
属败证，不可治也。
【方歌】膝眼风在鬼眼生，疼痛如锥脾肿形，下虚风湿寒侵袭，
屈伸不遂温散灵。
【注】此证生于膝眼穴，又名鬼眼穴，在膝盖之下，左右两骨
空陷中。由下焦素虚，外邪易于侵袭，先从膝眼隐隐作
疼，如风胜，其痛则走注不定；寒胜，则痛如锥刺；湿
胜，则外见胖肿。屈不能伸，其病在筋；伸不能屈，其
病在骨；动移不遂，沈寒痼冷之候也，惟在临证宜详辨
之。初服万灵丹温散之，其痛即止；次服独活寄生汤宣
补之。效迟者，兼用火针针膝眼穴，此转重就轻之法也
。单膝生者轻，双膝生者重。若左膝方愈，复病右膝，
右膝方愈，复病左膝者，名过膝风，属险，治法同前。
方剂：独活寄生汤
组成：独活 人参
桑寄生（如无真者，以川续断代之）
茯苓 川芎（酒洗）
防风 桂心
杜仲（姜汁炒，去丝） 牛膝
秦艽 细辛（各一钱五分）
当归 白芍（酒炒）
熟地 甘草（各一钱）
生姜五片，水二钟，煎七分，食前服。
【方歌】独活寄生肝肾虚，寒湿注膝肿痛居，参苓四物防风桂，
杜膝秦艽甘细宜。
又方：万灵丹（见肿疡门）
【方歌】膝痈（膝盖部位的痈肿）红肿灼热、颜色发红且疼痛，疪疽（一种发于筋骨间的阴证疮疡）肿胀但颜色不红。症状表现为柔软者为顺证，坚硬者为逆证，这是由于脾、肾、肝三经受邪气侵袭所致。
【注】膝痈生于膝盖部位，表现为颜色红、红肿灼热、疼痛，属于气血实证；疪疽也生在膝盖，肿胀大如痈，但颜色不变，伴有寒热往来症状，属于气血虚证。局部变软为顺证，坚硬如石头者为逆证。《内经》云：肌肉的小会合处称为“溪”。“溪”指的是两肘、两膝和四腕。凡是脾病多在溪部发生；肾有邪气，其气常停留于两膝；凡是筋的病证都归属于关节，因为筋是肝的余气所化，所以又归属于肝。因此，溪部有病，都是从脾、肾、肝三经，邪气乘虚侵袭所致。治疗上始终遵循内治和外治法，均按照痈疽肿疡期、溃疡期的门类进行辨证施治。只有双膝同时发病属于败证，无法治愈。
【方歌】膝眼风（发生于膝眼穴的风湿痹痛）生于鬼眼穴，疼痛如锥刺，伴有肿胀，因下焦虚弱，风湿寒邪侵袭所致，导致屈伸不利，采用温散疗法效果灵验。
【注】此证生于膝眼穴，又名鬼眼穴，位于膝盖下方，左右两骨之间的凹陷处。由于下焦素来虚弱，外邪容易侵袭，起初从膝眼隐隐作痛，若风邪偏胜，疼痛则游走不定；寒邪偏胜，则疼痛如锥刺；湿邪偏胜，则外部可见肿胀。屈而不能伸，病在筋；伸而不能屈，病在骨；活动受限，是沉寒痼冷的征候，临证时应当详细辨别。初起服用万灵丹以温散邪气，疼痛即可停止；随后服用独活寄生汤以宣通补益。疗效迟缓者，兼用火针针刺膝眼穴，这是转重就轻的治疗方法。单侧膝盖发病较轻，双侧膝盖发病较重。如果左膝刚愈，右膝又病，或右膝刚愈，左膝又病，称为过膝风，属于险证，治疗方法同前。
方剂：独活寄生汤
组成：独活、人参、桑寄生（如果没有真品，可用川续断代替）、茯苓、川芎（酒洗）、防风、桂心、杜仲（姜汁炒，去丝）、牛膝、秦艽、细辛（各一钱五分）、当归、白芍（酒炒）、熟地黄、甘草（各一钱）。生姜五片，水二钟，煎至七分，饭前服用。
【方歌】独活寄生汤主治肝肾虚损，寒湿注于膝部导致的肿痛，方中含有人参、茯苓及四物汤（当归、川芎、白芍、熟地），加上防风、桂心、杜仲、牛膝、秦艽、甘草、细辛适宜使用。
[Prescription Verse] Xiyong (abscess of the knee) presents with redness, swelling, heat, and pain; Diju (a type of yin-type carbuncle arising from muscles and bones) is swollen but not red. Softness indicates a favorable prognosis, while hardness indicates an unfavorable one. This is caused by pathogenic factors invading the Spleen, Kidney, and Liver meridians.
[Annotation] Xiyong arises at the knee, characterized by redness, swelling, heat, and pain, belonging to excess patterns of Qi and Blood. Diju also arises at the knee, appearing swollen like an abscess but without color change, accompanied by alternating chills and fever, belonging to deficiency patterns of Qi and Blood. Local softening indicates a favorable course, whereas hardness like stone indicates an unfavorable course. The Classics state: "The small gatherings of flesh are called Xi." Xi refers to the two elbows, two knees, and four wrists. Diseases of the Spleen often occur in the Xi areas; when the Kidney has pathogenic factors, their Qi tends to remain in both knees; diseases of the tendons all belong to the joints, as tendons are the surplus of the Liver, thus they also belong to the Liver. Therefore, diseases in the Xi areas result from pathogenic factors invading through the Spleen, Kidney, and Liver meridians. Treatment always follows internal and external methods, categorized according to the sections on abscesses and sores during the swelling stage and ulceration stage. Only when both knees are affected simultaneously does it constitute a fatal syndrome that cannot be treated.
[Prescription Verse] Xiyanfeng (wind-damp bi syndrome at the knee eye acupoint) arises at the Guiyan point, causing pain like needle insertion accompanied by swelling. It is caused by deficiency in the Lower Jiao allowing invasion of wind, cold, and dampness, leading to impaired flexion and extension, which responds well to warming and dispersing therapies.
[Annotation] This condition arises at the Xiyan acupoint, also known as the Guiyan acupoint, located in the depressions between the bones below the knee. Due to inherent deficiency in the Lower Jiao, external pathogens easily invade. Initially, there is hidden pain at the Xiyan; if Wind predominates, the pain migrates unpredictably; if Cold predominates, the pain feels like needle insertion; if Dampness predominates, visible swelling appears externally. Inability to flex but ability to extend indicates disease in the tendons; inability to extend but ability to flex indicates disease in the bones; restricted movement signifies deep-seated cold and chronic cold conditions, requiring careful differentiation during clinical practice. Initially, administer Wanling Dan to warm and disperse, stopping the pain; subsequently, administer Duhuo Jisheng Tang to promote circulation and tonify. For slow responses, combine with fire-needle therapy at the Xiyan acupoint, a method of transforming heavy treatment into light treatment. Unilateral knee involvement is mild; bilateral knee involvement is severe. If the left knee heals and then the right knee becomes diseased, or vice versa, it is named Guoxifeng (Knee-Crossing Wind), which is a dangerous syndrome, treated similarly to the above.
Formula: Duhuo Jisheng Tang
Composition: Du Huo (Radix Angelicae Pubescentis), Ren Shen (Radix Ginseng), Sang Ji Sheng (Herba Taxilli) [if authentic is unavailable, substitute with Chuan Xu Duan (Radix Dipsaci)], Fu Ling (Poria), Chuan Xiong (Rhizoma Chuanxiong) [washed with wine], Fang Feng (Radix Saposhnikoviae), Gui Xin (Cortex Cinnamomi), Du Zhong (Cortex Eucommiae) [stir-fried with ginger juice, remove silk fibers], Niu Xi (Radix Achyranthis Bidentatae), Qin Jiao (Radix Gentianae Macrophyllae), Xi Xin (Herba Asari) [each 1.5 qian], Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Paeoniae Alba) [stir-fried with wine], Shu Di Huang (Radix Rehmanniae Praeparata), Gan Cao (Radix Glycyrrhizae) [each 1 qian]. Add five slices of Sheng Jiang (Rhizoma Zingiberis Recens), two zhong of water, decoct until seven parts remain, take before meals.
[Prescription Verse] Duhuo Jisheng Tang treats deficiency of the Liver and Kidney, where cold and dampness lodge in the knee causing swelling and pain. It contains Ren Shen, Fu Ling, Si Wu Tang (Four Substances Decoction), plus Fang Feng, Gui Xin, Du Zhong, Niu Xi, Qin Jiao, Gan Cao, and Xi Xin, which are appropriate for use.
Another Formula: Wanling Dan (see section on Swelling Stage Sores)