【方歌】鹤膝风肿生于膝，上下枯细三阴虚，风寒湿邪乘虚入，
痛寒挛风筋缓湿。
【注】此证一名游膝风，一名鼓捶风，痢后得者为痢风。单生
者轻，双生者最重。因循日久，膝肿粗大，上下股胫枯
细。由足三阴经虚，风、寒、湿邪乘虚而入为是病也。
膝内隐痛寒胜也，筋急而挛风胜也，筋缓无力湿胜也。
初肿如绵，皮色不变，亦无焮热，疼痛日增，无论单双
，俱宜服五积散汗之。次服万灵丹温散之，外敷回阳玉
龙膏；常服换骨丹，或蛜〔虫祁〕丸，以驱其邪。若日
久不消，势欲溃者，宜服独活寄生汤，或大防风汤补而
温之，痛甚加乳香。溃后时出白浆，浮皮虽腐，肿痛仍
前，不可用蚀药，只宜芙蓉叶、菊花叶各五钱，研末，
大麦米饭拌均贴之，亦可止疼，或用豆腐渣蒸热捏作饼
，贴之亦可。此证系外证中之败证也，收功甚难。
方剂：换骨丹
组成：苍术（四两） 枸杞（二两五钱）
茄根（洗，二两） 当归
牛膝 败龟板
防风 秦艽
独活 萆薢
羌活 蚕沙
松节 虎骨（酥制，各一两）
共享酒浸晒干，研为细末，酒糊为丸，如梧桐子大
。每服三钱，食前白滚水送下。
【方歌】换骨丹归膝枸苍，龟板风艽独薢羌，蚕沙松节茄根虎，
鹤膝风生服最良。
又方：蛜〔虫祁〕丸
组成：蛜〔虫祁〕（即全蝎生者，一个）
白芷 桂心
安息香
阿魏（以上各用童便、酒炒熟）
威灵仙 白附子（童便、酒炒）
当归 羌活
桃仁（童便、酒炒） 牛膝
北漏芦 地骨皮
白芍（酒炒，各一两） 乳香
没药（二味用童便、酒炒）
共研末，炼蜜为丸，桐子大。每服三钱，空心温酒
送下。
【方歌】蛜〔虫祁〕丸治鹤膝风，芷桂安息魏威灵，白附归羌桃
乳没，膝漏骨皮芍蜜成。
又方：五积散（见内痈部肾痈）
大防风汤（见股部附骨疽）
万灵丹、回阳玉龙膏（见肿疡门）
独活寄生汤（见本部膝眼风）
【方歌】鹤膝风肿胀生于膝盖，上下肢体枯细是由于足三阴经虚弱，风寒湿邪趁虚侵入，
疼痛、畏寒、拘挛由风邪偏盛所致，筋脉松弛无力由湿邪偏盛所致。
【注】此病证又名游膝风，又名鼓捶风，痢疾后患上的称为痢风。单侧发病的较轻，双侧发病的最重。病情迁延日久，膝盖肿胀粗大，上下大腿和小腿肌肉萎缩枯细。这是由于足三阴经（肝、脾、肾）虚弱，风、寒、湿邪趁虚而入导致此病。
膝盖内部隐痛且畏寒，是寒邪偏盛的表现；筋脉紧急拘挛，是风邪偏盛的表现；筋脉松弛无力，是湿邪偏盛的表现。
初期肿胀如棉絮般柔软，皮肤颜色不变，也没有红肿发热，但疼痛日渐加重，无论单侧还是双侧，都适宜服用五积散通过发汗来治疗。随后服用万灵丹温通发散，外用敷贴回阳玉龙膏；平时常服换骨丹，或者蛜〔虫祁〕丸，以驱除病邪。如果日久不消退，病情有溃破趋势的，适宜服用独活寄生汤，或者大防风汤进行补益和温煦治疗，疼痛剧烈时加入乳香。溃破后时常流出白色浆液，虽然表皮腐烂，但肿痛依旧，不可使用腐蚀药物，只宜取芙蓉叶、菊花叶各五钱，研成粉末，与大麦米饭拌匀后贴敷患处，也可以止痛，或者用豆腐渣蒸热后捏成饼状，贴敷患处也可以。此病证属于外科中的败坏难治之证，收效很难。
方剂：换骨丹
组成：苍术（四两） 枸杞（二两五钱）
茄根（洗净，二两） 当归
牛膝 败龟板
防风 秦艽
独活 萆薢
羌活 蚕沙
松节 虎骨（酥炙，各一两）
以上药材共同用酒浸泡后晒干，研为细末，用酒调面糊制成丸药，大小如梧桐子。每次服用三钱，饭前用白开水送服。
【方歌】换骨丹包含当归、牛膝、枸杞、苍术，龟板、防风、秦艽、独活、萆薢、羌活，蚕沙、松节、茄根、虎骨，
治疗鹤膝风服用效果最好。
又一方：蛜〔虫祁〕丸
组成：蛜〔虫祁〕（即生全蝎，一个）
白芷 桂心
安息香
阿魏（以上各用童子尿、酒炒熟）
威灵仙 白附子（童子尿、酒炒）
当归 羌活
桃仁（童子尿、酒炒） 牛膝
北漏芦 地骨皮
白芍（酒炒，各一两） 乳香
没药（这两味用童子尿、酒炒）
共同研成粉末，用炼蜜制成丸药，大小如梧桐子。每次服用三钱，空腹时用温酒送服。
【方歌】蛜〔虫祁〕丸治疗鹤膝风，白芷、桂心、安息香、阿魏、威灵仙，白附子、当归、羌活、桃仁、乳香、没药，配合牛膝、漏芦、地骨皮、白芍，用蜂蜜制成丸剂。
又一方：五积散（参见内痈部肾痈章节）
大防风汤（参见股部附骨疽章节）
万灵丹、回阳玉龙膏（参见肿疡门章节）
独活寄生汤（参见本部膝眼风章节）
[Prescription Verse] Elephant-knee disease (He Xi Feng) presents with swelling at the knee, while the upper and lower limbs become emaciated due to deficiency of the Foot Three Yin meridians. Wind, cold, and dampness pathogens enter when the body's defensive qi is deficient. Pain and aversion to cold indicate an excess of wind; muscle spasms and contracture indicate an excess of wind; flaccidity and weakness indicate an excess of dampness.
[Annotation] This condition is also known as You Xi Feng (Wandering Knee Wind) or Gu Chui Feng (Drum-Beating Wind). When it occurs after dysentery, it is called Li Feng (Dysentery Wind). Unilateral occurrence is mild, while bilateral occurrence is the most severe. After prolonged neglect, the knee becomes swollen and enlarged, while the thighs and calves above and below become emaciated. This disease arises from deficiency in the Foot Three Yin meridians (Liver, Spleen, Kidney), allowing wind, cold, and dampness pathogens to invade due to this deficiency.
Deep, hidden pain in the knee accompanied by aversion to cold indicates an excess of cold. Urgency and contracture of the tendons indicate an excess of wind. Flaccidity and lack of strength indicate an excess of dampness.
In the initial stage, the swelling feels soft like cotton, the skin color remains unchanged, and there is no redness or heat. However, pain increases daily. Whether unilateral or bilateral, it is appropriate to administer Wu Ji San (Five Accumulations Powder) to induce sweating. Subsequently, Wan Ling Dan (Ten Thousand Spirits Pill) should be taken for warm dispersion, and Wai Fu Hui Yang Yu Long Gao (Restore Yang Jade Dragon Ointment) applied externally. Regularly take Huan Gu Dan (Bone-Replacing Pill) or Yi Qi Wan (Yi Qi Pill) to expel the pathogens. If the condition persists without subsiding and shows signs of impending ulceration, Du Huo Ji Sheng Tang (Angelica Pubescens Decoction for Sustaining the Parasites) or Da Fang Feng Tang (Great Saposhnikovia Decoction) should be taken to tonify and warm. Add Ru Xiang (Frankincense) if pain is severe.
After ulceration, if white serous fluid frequently oozes out, and although the superficial skin is necrotic, pain and swelling persist, corrosive medicines must not be used. Instead, take Fu Rong Ye (Hibiscus Leaf) and Ju Hua Ye (Chrysanthemum Leaf), five qian each, grind them into powder, mix evenly with barley rice paste, and apply as a poultice to relieve pain. Alternatively, steam tofu dregs until hot, shape into a cake, and apply to the affected area, which is also effective. This condition belongs to the refractory category among external diseases, making recovery difficult.
Formula: Huan Gu Dan (Bone-Replacing Pill)
Composition: Cang Zhu (Atractylodis Rhizoma, 4 liang), Gou Qi (Lycii Fructus, 2.5 liang), Qie Gen (Solanis Lycopersici Caulis, washed, 2 liang), Dang Gui (Angelicae Sinensis Radix), Niu Xi (Achyranthis Bidentatae Radix), Bai Gui Ban (Testudinis Carapax et Plastrum), Fang Feng (Saposhnikoviae Radix), Qin Jiao (Gentianae Macrophyllae Radix), Du Huo (Angelicae Pubescentis Radix), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Can Sha (Bombyx Batryticatus), Song Jie (Pinus Massoniana Node), Hu Gu (Pantheris Os, prepared with butter, each 1 liang).
Soak all ingredients in wine, dry them, grind into fine powder, and make pills using wine paste, sized like paulownia seeds. Take three qian per dose, administered with plain boiled water before meals.
[Prescription Verse] Huan Gu Dan contains Dang Gui, Niu Xi, Gou Qi, Cang Zhu; Gui Ban, Fang Feng, Qin Jiao, Du Huo, Bi Xie, Qiang Huo; Can Sha, Song Jie, Qie Gen, Hu Gu. It is most effective for treating He Xi Feng (Elephant-knee disease).
Another Formula: Yi Qi Wan (Yi Qi Pill)
Composition: Yi Qi (Scorpio [Quanchexie], i.e., fresh Scorpius, one piece), Bai Zhi (Angelicae Dahuricae Radix), Gui Xin (Cinnamomi Cortex), An Xi Xiang (Benzoinum), A Wei (Ferulae Resina) (the above four are stir-fried with child's urine and wine). Wei Ling Xian (Salviae Miltiorrhizae Radix et Rhizoma - *Note: WHO standard usually maps Wei Ling Xian to Salviae Miltiorrhizae or sometimes Cistanches, but traditionally Clematis; here adhering to common TCM context often implying Clematis root in older texts, but WHO term is Salviae Miltiorrhizae Radix et Rhizoma? No, Wei Ling Xian is Clematis Root. WHO Term: Clematis Root.* Correction: Wei Ling Xian (Clematis Root)), Bai Fu Zi (Typhonii Rhizoma), Dang Gui (Angelicae Sinensis Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Tao Ren (Persicae Semen), Niu Xi (Achyranthis Bidentatae Radix), Bei Lou Lu (Euphorbiae Pekinensis Radix), Di Gu Pi (Lycii Cortex), Bai Shao (Paeoniae Radix Alba, stir-fried with wine, each 1 liang), Ru Xiang (Olibanum), Mo Yao (Myrrha) (the latter two are stir-fried with child's urine and wine).
Grind all into powder, make pills using refined honey, sized like paulownia seeds. Take three qian per dose, administered with warm wine on an empty stomach.
[Prescription Verse] Yi Qi Wan treats He Xi Feng (Elephant-knee disease); Bai Zhi, Gui Xin, An Xi Xiang, A Wei, Wei Ling Xian; Bai Fu Zi, Dang Gui, Qiang Huo, Tao Ren, Ru Xiang, Mo Yao; combined with Niu Xi, Lou Lu, Di Gu Pi, Bai Shao, formed with honey.
Other Formulas:
Wu Ji San (Five Accumulations Powder) (See Internal Abscess section, Kidney Abscess)
Da Fang Feng Tang (Great Saposhnikovia Decoction) (See Thigh section, Bone-Attached Carbuncle)
Wan Ling Dan (Ten Thousand Spirits Pill), Hui Yang Yu Long Gao (Restore Yang Jade Dragon Ointment) (See Ulcerated Disease Section)
Du Huo Ji Sheng Tang (Angelica Pubescens Decoction for Sustaining the Parasites) (See this section, Knee Eye Wind)