皮毛，《经》曰∶肺之合皮也，其荣毛也。又云∶肺主皮毛，肺气不荣，则皮
毛焦，津液去，爪枯毛折。
皮肤痛，属火邪伤肺。《经》云∶夏脉太过，则病身热肤痛，为浸淫。（湿热小疮。）
皮肤索泽，（枯索而不润泽也。）由精血枯涸，清燥润肺可也。（牛骨髓、真酥油合炼一处，每日
空心热酒调服三匙，治皮肤枯燥如鱼鳞。）糙涩如鳞甲之相错，曰甲错。仲景谓∶劳伤虚极羸瘦，
内有干血，两目黯黑，肌肤甲错，大黄 虫丸（见虚劳）主之。又云∶咳有微热烦满，
胸中甲错，为肺痈，苇茎汤主之。
皮肤麻木，（详痹证门。）《伤寒论》曰∶身如虫行，汗多亡阳也。可见麻由气虚，
气虚则营运不能流利，嘘其痰液，纷然沸动，有如虫行。若为风邪所凑，痰被风
嘘，如波浪沸腾，其麻更甚矣。先用生姜为向导，枳壳以开气，半夏以逐
痰，羌、防以散风，木通、牙皂以通经络，又僵蚕为治麻圣药。麻在手臂加桑条，
在股、足加牛膝。待病减用补中益气（见气）加参、 。暑天热伤元气，手与背麻，参、
、升、柴、白芍、五味、甘草，空心服。手摩患处，午前又一服。经年累月无日
不木，乃死血凝滞于内，外挟风寒，用附、桂为向导，乌药、木香行气，当归、桃
仁、红花、阿胶活血，木通、牙皂、穿山甲通经络。待病减用八珍（见虚损）补气血，必
效。浑身麻木，八仙汤∶当归、茯苓、川芎、熟地、陈皮、半夏、羌活、白芍、人
参、秦艽、牛膝、白术、桂枝、柴胡、防风、炙草，煎服。四肢面目皆麻，补中益
气（见气）加木香、炮附、麦冬、羌、防、乌药。但在腿麻木沉重，黄 、甘草、五味、
升、柴、当归、红花、陈皮、青皮、泽泻，名除湿益气汤。瘀血麻木，四物（见
血）加桃仁、红花、韭汁。因气麻木，紫苏、陈皮、香附、乌药、川芎、羌活、苍
术、南星、半夏、当归、桂枝、甘草。身麻有痰，黄连、半夏、栝蒌仁、黄芩、茯
苓、桔梗、枳壳、陈皮、天麻、细辛、南星、甘草，煎。口舌麻木吐涎者，并治。
皮肤痒，痛痒皆属火，火甚则痛，微则痒。（观火近灼则痛，远烘则痒，可见。）或以为风
者，风即火气，非有二也。（此内风也。亦有火气欲散，忽感外风，郁火不得外散，进退皮肤间，
扰动作痒者。仲景《伤寒论·太阳篇》有脉浮迟，面热赤，不能得小汗，身必痒之
文，可参也。）若无外风，不
得误用风药，以证既属火，则血必虚，风药燥血，不可用也，但宜清火养血。（血行风
自灭。）又火与元气不两立，火之盛，气之虚也。然泻火便是补气，不必用补中、四君
（并见气）等。大抵遍身瘙痒，由肺家血虚火盛而生风，宜四物（见血）加二冬、桑枝、蝉蜕、
僵蚕、牛蒡、刺蒺藜、威灵仙，外用苍耳叶、地肤子、浮萍，煎水浴。
遍身搔痒起疙瘩，俗名风疙瘩。红者，名血风，血分风热也；白者，名白膜，
气分风热也，广州名风落瘼。鱼罾煮水浴，或羊桃叶火 热擦，并效。此与赤白游
风相类，所异者，彼游走而此痞耳。又与发斑异，此无病而陡发，彼因病而后发也。
暑月痱子痒痛，苦参四雨，菖蒲二两，水五瓢，煎数滚，添水二瓢，盖片时，
临洗和入公猪胆汁四五枚洗之，不三次痊愈。若抓破者，绿豆粉一两、滑石五钱、
黄柏三钱、轻粉二钱，搽之。
遍身青紫斑点，色若葡萄，初起用羚羊角、防风、玄参、麦冬、知母、黄
芩、牛蒡各八分，甘草二分。
发须，《经》曰∶肾之合骨也，其荣在发。多食甘，则骨痛而发落。又曰∶女
子七岁肾气实，齿更发长；五七阳明脉衰，面始焦，发始堕。丈夫八岁肾实，
发长齿更；五八肾气衰，发堕齿槁。又曰∶冲任皆起于胞中，上循胸里，为经络之
海。其浮而外者，循腹上行，会于咽喉，别络唇口。妇人数脱血，冲任之脉不荣口
唇；宦者，去其宗筋，伤其冲任，血泻不复，唇口不荣，故须不生。有人未尝
有所伤，不脱于血，其须不生，何也？曰∶此天之所不足也，禀冲任不盛，宗筋不
成，有气无血，唇口不荣，故须不生。张子和曰∶年少发早白落，或头起白屑者，
血热太过也。世俗止知发者血之余，以为血衰，不知血热发反不茂，火多水少，木
反不荣，火至于项，炎上之甚也。大热病汗后、劳病后，发多脱落，岂有寒耶？
用针刺神庭、上星、囟会、前项、百会出血，次调盐、油以涂发根，甚者至再、
至三，少白可黑，落发可生。按子和所论甚是，尝见人年三、四十后，顶发脱落者，
其人必躁动多火，常患目疾；顶发茂密者，其人必沉静少火，从不病目，可验也。
丹溪治一少年发尽脱，饮食起居如常，脉微弦而涩，轻重皆同。此浓味成热，湿痰
在膈间，又平日多吃梅，（故脉弦涩。）酸味收湿热之痰，随气上升，熏蒸发根之血，渐
成枯槁，故脱发。处以补血升散之药，用防风通圣散，（见中风。）去朴硝，（嫌其
速下也。）大
黄三度酒炒，（使上行泻热。）兼四物汤（见血）。酒制，合和作小剂，（治上故小其服。）
煎以灰汤，（灰
可治梅酸。）入水频与之。（在上之药，不厌小而频也。）两月后诊其脉，湿热渐解，停药，
淡味调
养，二年发长如初。甜瓜叶捣汁涂，即生。麻叶、桑叶，泔煮，沐发七次，可长六
尺。三青膏可染须。
肌肉，《经》曰∶脾主肉。邪在脾胃，则病肌肉痛。邪溢气壅，脉热肉败，营卫
不行，必将为脓。湿伤肉，风胜湿，甘伤肉，酸胜甘。又云∶多食酸，则肉胝KT 而
唇揭。久坐伤肉。形乐志乐，病生于肉，治之以针石。
筋骨，《经》曰∶肝主筋，筋病无多食酸，酸伤筋，辛胜酸。又云∶多食辛，
则筋急而爪枯。（爪为筋之余。）又云∶久行伤筋。诸筋皆属于节。手屈而不伸者，病在筋
也；伸而不屈者，病在骨也。转筋皆属血热，四物（见血）加黄芩、红花、苍术、南
星。（因于热者用此。）挛急疼痛，松节二两，细锉如米粒，乳香一钱，共放银
石器内，慢火炒出火毒，研末，每服一二钱，热木瓜酒调下。（因于寒者用此。）娄全善
谓∶转筋之时，当随其所痛之处，燔针刺之，以知为度。愚谓∶用灯心蘸油燃 ，
可也。（因寒因热俱可用。）余详霍乱门。肾主骨，寒则坚，热则腐。骨病无多食甘，
食甘积热伤骨，故过食甜而齿病。（齿者骨之余。）又苦走骨，骨病无多食苦。久立伤骨。
四肢，《经》谓∶四肢为诸阳之本。又云∶阳受气于四肢。又云∶阳气者，
起于足五趾之表。其说可疑。人身阴阳之气，皆从脏腑外达至于四肢，故四肢为末。
今反以为本，谓阳受气于此，起于此，可乎？若云手之三阳从手走头，则足之三阳
又从头走足矣。此等疑义，千古莫晰，何也？阳实则肢肿，热肿也；阳虚则肢满，
寒胀也。脾主四肢，脾实则四肢不举，湿热盛也；脾虚则四肢不用，气困乏也。风
淫末疾，故四肢颤掉。五脏有邪，留于肢节。《经》云∶肺心有邪，其气留于两肘；
肝有邪，其气留于两腋；脾有邪，心有邪，其气留于两髀；肾有邪，其气留于
两膝，是也。手心热属心与包络。手热赤痒，掌皮浓裂，脾热肝风也，（脾主四肢，风淫
末疾）加味逍遥散加钩藤、熟地。手足心肿，风也，花椒、盐、醋和敷之。手足抽掣动
摇，弄舌吐沫，不可遽作风火痰治，其脉沉弱，即是脾虚生风之证，宜大补，归脾
汤最妙。臂发热，四物汤加秦艽、丹皮、白术、茯苓、钩藤、甘草、柴胡。亦有怒
动肝火，小柴胡加川芎、当归，亦可用加味逍遥散。膝属脾、肾、肝，凡人逸则痿
软无力，劳则痛如针刺，脉洪数有力，皆肝肾阴虚所致。痿软无力，真病之形，作
痛如锥，邪火之象，六味加牛膝、车前。此证多疑其风痰而用发散者，是促其危也。
有饮食过当，腿足或臂内酸胀浮肿作痛，又责之脾胃，补中益气加茯苓、半夏。
足腿热渐至腰胯，苍术二两，酒黄柏、熟地各一两，川牛膝、归尾、萆 、防己各
五钱，酒糊丸。脚弱无力，及小儿不能行走，天麻、白附、牛膝、木鳖子各五钱，
乌头炮一钱，羌活五钱，地龙一分，乳香、没药各二钱，朱砂一钱，酒煮南星，末
为丸，每十丸薄荷汤下。一切腿痛，乳香、官桂、血竭、丁香、麝香各六分，杏仁
一分四厘，蕲艾一两，木香六分，沉香四钱，檀香四钱，各为粗末，卷纸捻用油蘸
点着，乌灭，照穴道针之。 ，（足肚酸疼也。 音渊。）足太阳膀胱病，防风、羌活、
紫苏、蔓荆之类。脚赤肿痛溃脓，足三阳湿热下注，可治；微赤微肿脓清，足三阴
亏损，难治。若黑暗不肿痛不溃脓，烦热作渴，小便淋漓，阴败未传，急证，急用
八味丸，着肉灸，亦有生者。湿热下注，隔蒜灸，解壅毒，次服补中益气、六味丸，
自愈。又四肢皆禀气于胃，胃血气盛则善步，胃血气少，足少肉、善寒，渐成痿厥
足痹，故足疾必用补中益气，不可不知。足跟痛，足跟属膀胱、肾。热痛，乃阴血
虚极，圣愈汤∶生地、熟地、当归、人参、黄 。又经验方∶牛膝一两，苡仁一两
五钱，苍术七钱五分，杜仲、黄柏、当归、石斛、萆 、木瓜、秦艽、木通各五钱。
足心属肾，或热或痒痛，（是水虚。）或麻或肿胀，（是火虚。）皆肾虚，六味、八味消息之。
又有足心如中箭，发歇不时，（肾不虚而热盛也。）此肾之风毒，泻肾则愈。余详臂痛、厥
逆、挛、抽搐、颤振、香港脚各门。
二阴，详泄泻、痢、二便不通、小便淋数、黄赤、遗尿不禁、交肠、关格、赤
白浊、遗精、阴痿、阴缩阴纵、疝、脱肛、谷道痒痛各门。
皮毛，《黄帝内经》说：肺与皮相合，其华在毛。又说：肺主皮毛，若肺气不能滋养，则皮肤干燥枯槁，津液耗损，指甲干枯，毛发折断。
皮肤疼痛，属于火邪损伤肺脏。《黄帝内经》说：夏季脉象太过，就会引起身体发热、皮肤疼痛，这种病称为“浸淫”（一种湿热引起的小疮）。
皮肤干枯粗糙不润泽，是由于精血枯竭所致，可以采用清燥润肺的方法治疗。（用牛骨髓和纯正酥油混合炼制，每天空腹用热酒调服三匙，可治疗皮肤干燥如鱼鳞状的症状。）皮肤粗糙像鳞甲交错一样，称为“肌肤甲错”。张仲景说：劳伤导致极度虚弱消瘦，体内有干血停留，两目暗黑，肌肤甲错，应用大黄䗪虫丸主治（见虚劳篇）。又说：咳嗽伴有轻微发热、烦闷，胸部肌肤甲错，这是肺痈，应用苇茎汤主治。
皮肤麻木（详见痹证门）。《伤寒论》说：身体感觉像虫子爬行，是因为出汗过多导致阳气亡失。由此可见，“麻”是由气虚引起的，气虚则气血运行不畅，痰液被气推动，纷纷涌动，就像虫子爬行一样。如果是风邪侵袭，痰受风邪鼓动，如同波浪沸腾，麻木症状会更加严重。先用生姜作为引经药，枳壳来行气，半夏来祛痰，羌活、防风来散风，木通、牙皂来通经络，僵蚕是治疗麻木的圣药。麻木在手臂的加桑枝，在大腿、小腿加牛膝。待病情减轻后，使用补中益气汤（见气虚篇）加入人参、黄芪。暑天热气损伤元气，手背和手掌麻木，用人参、黄芪、升麻、柴胡、白芍、五味子、甘草，空腹服用。配合按摩患处，上午再服一剂。如果长年累月每天都感到麻木，这是死血凝滞于内，外挟风寒，用附子、桂枝作为引经药，乌药、木香行气，当归、桃仁、红花、阿胶活血，木通、牙皂、穿山甲通经络。待病情减轻后，使用八珍汤（见虚损篇）补益气血，必定有效。全身麻木，用八仙汤：当归、茯苓、川芎、熟地黄、陈皮、半夏、羌活、白芍、人参、秦艽、牛膝、白术、桂枝、柴胡、防风、炙甘草，煎服。四肢和面部都麻木，用补中益气汤（见气虚篇）加木香、炮附子、麦冬、羌活、防风、乌药。如果只是腿部麻木沉重，用黄芪、甘草、五味子、升麻、柴胡、当归、红花、陈皮、青皮、泽泻，名为除湿益气汤。瘀血导致的麻木，用四物汤（见血虚篇）加桃仁、红花、韭菜汁。因气滞导致的麻木，用紫苏、陈皮、香附、乌药、川芎、羌活、苍术、胆南星、半夏、当归、桂枝、甘草。身体麻木且有痰，用黄连、半夏、瓜蒌仁、黄芩、茯苓、桔梗、枳壳、陈皮、天麻、细辛、胆南星、甘草，煎服。口舌麻木且吐涎沫的，也一并治疗。
皮肤瘙痒，痛和痒都属于火，火盛则痛，火微则痒。（观察火靠近灼烧则痛，远烘则痒，可见一斑。）有人认为是风邪，其实风就是火气，并没有两种东西。（这是内风。也有火气想要发散，忽然感受外风，郁结的火气不能向外发散，在皮肤间进退扰动，引起瘙痒的情况。张仲景《伤寒论·太阳篇》中有脉浮迟，面红发热，不能得出小汗，身体必然瘙痒的条文，可以参考。）如果没有外风，不要误用风药，因为证候既属火，那么血液必然虚损，风药燥血，不可使用，只宜清火养血。（血行则风自灭。）另外，火与元气不两立，火盛则是气虚。然而泻火就是补气，不必使用补中益气汤、四君子汤（均见气虚篇）等补益药物。大抵全身瘙痒，是由肺家血虚火盛而生风，宜用四物汤（见血虚篇）加天冬、麦冬、桑枝、蝉蜕、僵蚕、牛蒡子、刺蒺藜、威灵仙，外用苍耳叶、地肤子、浮萍，煎水洗澡。
全身瘙痒起疙瘩，俗称风疙瘩。红色的，名叫血风，是血分的风热；白色的，名叫白膜，是气分的风热，广州称为风落瘼。用鱼网煮水洗澡，或者用羊桃叶加热擦拭，都有效。这与赤白游风相似，不同的是，游风游走不定，而此症痞块固定。又与发斑不同，此症无病突然发作，彼症因病后才发作。
暑天的痱子痒痛，用苦参四两，石菖蒲二两，水五瓢，煎煮几次滚沸，加水两瓢，盖住片刻，临洗时加入公猪胆汁四五枚清洗，不超过三次即可痊愈。如果抓破了，用绿豆粉一两、滑石五钱、黄柏三钱、轻粉二钱，撒敷患处。
全身出现青紫斑点，颜色像葡萄，初起时用羚羊角、防风、玄参、麦冬、知母、黄芩、牛蒡子各八分，甘草二分。
头发胡须，《黄帝内经》说：肾与骨相合，其华在发。多吃甜食，会导致骨痛和脱发。又说：女子七岁，肾气充实，牙齿更换，头发生长；三十五岁（五七），阳明脉衰弱，面容开始焦枯，头发开始脱落。男子八岁，肾气充实，头发生长，牙齿更换；四十岁（五八），肾气衰退，头发脱落，牙齿枯槁。又说：冲脉和任脉都起于胞宫，向上沿着胸里，是经络之海。其中浮浅而外的部分，沿着腹部上行，会合于咽喉，分支联络唇口。妇女多次失血，冲任之脉不能滋养口唇；宦官，切除了宗筋，损伤了冲任，血液泻出无法恢复，口唇得不到滋养，所以胡须不生。有人未曾受伤，也没有失血，为什么胡须不生？回答说：这是先天禀赋不足，冲任脉不旺盛，宗筋不成形，只有气没有血，口唇得不到滋养，所以胡须不生。张子和说：年轻人头发早白脱落，或者头上起白屑，是血热太过的缘故。世俗只知道头发是血的余气，认为血衰，却不知道血热反而使头发不茂盛，火多水少，树木反而不能繁荣，火气上炎到颈部，是炎上的表现。大病高热出汗后、劳损病后，头发大多脱落，难道是寒证吗？用针刺神庭、上星、囟会、前顶、百会穴出血，然后调制盐和油涂抹发根，严重的重复两三次，白发可转黑，脱发可再生。按张子和的论述非常正确，曾见到人年过三四十岁后，头顶头发脱落的人，此人一定急躁多动火，常患眼疾；头顶头发茂密的人，此人一定沉静少火，从不患眼病，可以验证。朱丹溪治疗一个少年头发全部脱落，饮食起居如常，脉象微弦而涩，轻重按压都一样。这是因为厚味食物酿成热，湿痰停留在膈间，加上平时多吃梅子，（所以脉象弦涩），酸味收敛湿热之痰，随气上升，熏蒸发根的血液，逐渐枯槁，所以脱发。处以补血升散的药，用防风通圣散（见中风篇），去掉朴硝（嫌它泻下太快），大黄用酒炒三次（使其上行以泻热），兼用四物汤（见血虚篇）。酒制，混合做成小剂量（治上部疾病故减小服药量），用灰汤煎煮（灰可以化解梅子的酸味），少量多次喂服。（在上部的药物，不厌小而频服。）两个月后诊察他的脉象，湿热逐渐解除，停药，用清淡饮食调养，两年后头发长得如初。甜瓜叶捣汁涂抹，立即生发。麻叶、桑叶，用淘米水煮熟，洗头七次，头发可长六尺。三青膏可以染须。
肌肉，《黄帝内经》说：脾主肉。邪气在脾胃，就会引起肌肉疼痛。邪气溢出，气机壅滞，脉热肉败，营卫不行，必将化脓。湿气损伤肌肉，风能胜湿，甘味损伤肌肉，酸能胜甘。又说：多吃酸味，则肌肉皱缩僵硬而嘴唇揭起。久坐损伤肌肉。形体安逸，精神快乐，病生于肉，用针石治疗。
筋骨，《黄帝内经》说：肝主筋，筋有病不要多吃酸，酸伤筋，辛能胜酸。又说：多吃辛味，则筋脉拘急而指甲干枯。（指甲是筋的余气。）又说：久行损伤筋。所有的筋都归属于关节。手弯曲而不能伸直，病在筋；伸直而不能弯曲，病在骨。转筋（抽筋）都属于血热，用四物汤（见血虚篇）加黄芩、红花、苍术、胆南星。（因热者用此方。）挛急疼痛，用松节二两，细细切碎如米粒大小，乳香一钱，一起放入银石器内，慢火炒去火毒，研成粉末，每次服一二钱，用热木瓜酒调服。（因寒者用此方。）娄全善说：发生转筋时，应当随着疼痛的部位，用燔针（烧红的针）刺之，以见效为度。我认为：用灯心草蘸油点燃，进行温灸，也可以。（因寒因热都可用）。详细内容见霍乱门。肾主骨，寒则坚硬，热则腐败。骨有病不要多吃甜，吃甜积热伤骨，所以过食甜味会导致牙齿病变。（牙齿是骨的余气。）另外苦味入骨，骨有病不要多吃苦。久立损伤骨骼。
四肢，《黄帝内经》说：四肢是诸阳之本。又说：阳气受纳于四肢。又说：阳气，起于足五趾的表面。这些说法值得怀疑。人身阴阳之气，都是从脏腑外达至于四肢，所以四肢是末端。现在反而说是根本，说阳气受纳于此，起于此，可以吗？如果说手之三阳经从手走向头，那么足之三阳经又从头走向脚了。这种疑难问题，千古未能阐明，为什么呢？阳实则肢体肿胀，是热肿；阳虚则肢体胀满，是寒胀。脾主四肢，脾实则四肢不能举动，是湿热盛；脾虚则四肢不能用，是气困乏。风邪侵犯末梢导致疾病，所以四肢颤抖掉摇。五脏有邪气，留滞在肢节。《黄帝内经》说：肺心有邪气，其气留在于两肘；肝有邪气，其气留在于两腋；脾有邪气，其气留在于两髀（大腿）；肾有邪气，其气留在于两膝，说的就是这个道理。手心热属于心和心包络。手部发热、发红、瘙痒，手掌皮肤增厚开裂，是脾热肝风（脾主四肢，风邪侵犯末梢疾病），用加味逍遥散加钩藤、熟地黄。手足心肿胀，是风邪，用花椒、盐、醋调和敷贴。手足抽搐动摇，弄舌吐沫，不能立刻当作风火痰来治，如果脉象沉弱，就是脾虚生风的证候，宜大补，归脾汤最好。手臂发热，用四物汤加秦艽、牡丹皮、白术、茯苓、钩藤、甘草、柴胡。也有因愤怒触动肝火，用小柴胡汤加川芎、当归，也可以用加味逍遥散。膝盖属于脾、肾、肝，凡人安逸则痿软无力，劳累则痛如针刺，脉象洪数有力，都是肝肾阴虚所致。痿软无力，是真病的形态；作痛如锥刺，是邪火的征象，用六味地黄丸加牛膝、车前子。此证多怀疑是风痰而用发散药，这是加速其危重。有饮食不当，导致腿足或手臂内侧酸胀浮肿疼痛，又责之于脾胃，用补中益气汤加茯苓、半夏。足腿热渐至腰胯，用苍术二两，酒黄柏、熟地黄各一两，川牛膝、当归尾、萆薢、防己各五钱，酒糊为丸。脚弱无力，以及小儿不能行走，用天麻、白附子、牛膝、木鳖子各五钱，炮乌头一钱，羌活五钱，地龙一分，乳香、没药各二钱，朱砂一钱，酒煮胆南星，研末为丸，每十丸用薄荷汤送下。一切腿痛，用乳香、官桂、血竭、丁香、麝香各六分，杏仁一分四厘，蕲艾一两，木香六分，沉香四钱，檀香四钱，各研为粗末，卷成纸捻，用油蘸着点燃，吹灭，照穴位针烙。腨（小腿肚酸痛。腨音渊。）足太阳膀胱经病，用防风、羌活、紫苏、蔓荆子之类。脚红肿痛溃脓，是足三阳湿热下注，可治；微红微肿脓液清稀，是足三阴亏损，难治。如果黑暗不肿痛不溃脓，烦热口渴，小便淋漓，阴败未传变，急证，急用八味丸，贴着肉灸，也有救活的。湿热下注，隔蒜灸，解壅毒，其次服用补中益气汤、六味地黄丸，自愈。另外四肢都禀受胃气，胃血气盛则善于行走，胃血气少，足部少肉、怕冷，渐渐成为痿厥足痹，所以足疾必须用补中益气汤，不可不知道。足跟痛，足跟属于膀胱、肾。热痛，是阴血虚极，用圣愈汤：生地黄、熟地黄、当归、人参、黄芪。又有经验方：牛膝一两，薏苡仁一两五钱，苍术七钱五分，杜仲、黄柏、当归、石斛、萆薢、木瓜、秦艽、木通各五钱。
足心属于肾，或热或痒痛，（是水虚。）或麻或肿胀，（是火虚。）都是肾虚，斟酌使用六味地黄丸、八味地黄丸。又有足心如被箭射，发作间歇不时，（肾不虚而热盛也。）这是肾的风毒，泻肾则痊愈。详细内容见臂痛、厥逆、挛、抽搐、颤振、香港脚各门。
二阴，详见泄泻、痢疾、二便不通、小便淋沥频数、尿色黄赤、遗尿不禁、交肠、关格、赤白浊、遗精、阳痿、阴缩阴纵、疝气、脱肛、肛门痒痛各门。
Skin and Hair, the *Classic* states: The Lung corresponds to the skin, and its luster manifests in the hair. It also says: The Lung governs the skin and hair. If Lung Qi fails to nourish, then the skin and hair become dry and withered, body fluids are lost, nails become brittle, and hair breaks.
Pain in the skin is attributed to Fire pathogenic factors injuring the Lung. The *Classic* states: When the Summer pulse is excessive, it causes fever and skin pain, known as "Jin Yin" (a type of small sore caused by damp-heat).
Dry and rough skin without moisture results from the exhaustion of Essence and Blood; clearing dryness and moistening the Lung is appropriate. (Mix beef marrow and pure ghee, take three spoons mixed with hot wine on an empty stomach daily to treat skin dryness resembling fish scales.) Rough skin interlaced like scales is called "Jia Cuo" (skin resembling armor plates). Zhang Zhongjing stated: In cases of severe emaciation due to consumptive injury with dry blood retained internally, dark eyes, and Jia Cuo, Da Huang Zhe Chong Wan (see Xu Lao) is indicated. He also said: Cough accompanied by slight fever and fullness, with Jia Cuo in the chest, indicates Fei Yong (Lung Abscess), treated with Wei Jing Tang.
Numbness of the skin (detailed in the Bi Syndrome section). The *Shang Han Lun* states: A sensation of insects crawling on the body results from profuse sweating leading to Yang collapse. Thus, numbness arises from Qi deficiency. When Qi is deficient, circulation becomes sluggish, phlegm fluid is agitated by Qi movement, creating a sensation like insects crawling. If invaded by Wind pathogenic factors, phlegm is stirred by Wind like boiling waves, worsening the numbness. First, use Fresh Ginger as a guiding herb, Zhi Ke (Bitter Orange Fruit) to move Qi, Ban Xia (Pinellia Tuber) to dispel phlegm, Qiang Huo (Notopterygium Rhizome) and Fang Feng (Saposhnikovia Root) to scatter Wind, Mu Tong (Akebia Stem) and Ya Zao (Gleditsia Fruit) to unblock collaterals, and Jiang Can (Bombyx Batryticatus) as a sacred herb for treating numbness. For numbness in the arms, add Sang Zhi (Mulberry Twig); for thighs and legs, add Niu Xi (Achyranthes Root). As symptoms improve, use Bu Zhong Yi Qi Tang (see Qi Deficiency) added with Ren Shen (Ginseng Root) and Huang Qi (Astragalus Root). In summer, heat damages Yuan Qi causing numbness in hands and backs; use Ren Shen, Huang Qi, Sheng Ma (Cimicifuga Rhizome), Chai Hu (Bupleurum Root), Bai Shao (White Peony Root), Wu Wei Zi (Schisandra Berry), and Gan Cao (Licorice Root), taken on an empty stomach. Massage the affected area and take another dose in the morning. Chronic, persistent numbness indicates stagnant dead blood internally combined with external Wind-Cold; use Fu Zi (Aconite Lateral Root) and Gui Zhi (Cinnamon Twig) as guides, Wu Yao (Lindera Root) and Mu Xiang (Aucklandia Root) to move Qi, Dang Gui (Angelica Sinensis Root), Tao Ren (Peach Seed), Hong Hua (Carthamus Flower), and E Jiao (Donkey-hide Gelatin) to invigorate blood, and Mu Tong, Ya Zao, and Shan Jia Jia (Pangolin Scales) to unblock collaterals. As symptoms improve, use Ba Zhen Tang (see Deficiency Damage) to tonify Qi and Blood, which will be effective. For whole-body numbness, use Ba Xian Tang: Dang Gui, Fu Ling (Poria), Chuan Xiong (Ligusticum Rhizome), Shu Di Huang (Prepared Rehmannia Root), Chen Pi (Tangerine Peel), Ban Xia, Qiang Huo, Bai Shao, Ren Shen, Qin Jiao (Gentiana Macrophylla Root), Niu Xi, Bai Zhu (Atractylodes Rhizome), Gui Zhi, Chai Hu, Fang Feng, and Zhi Gan Cao (Honey-fried Licorice Root), decocted and taken orally. For numbness in limbs and face, use Bu Zhong Yi Qi Tang added with Mu Xiang, Pao Fu Zi (Processed Aconite), Mai Dong (Ophiopogon Tuber), Qiang Huo, Fang Feng, and Wu Yao. For numbness and heaviness only in the legs, use Huang Qi (Astragalus Root), Gan Cao, Wu Wei Zi, Sheng Ma, Chai Hu, Dang Gui, Hong Hua, Chen Pi, Qing Pi (Green Tangerine Peel), and Ze Xie (Alisma Rhizome), named Chu Shi Yi Qi Tang. For numbness due to blood stasis, use Si Wu Tang (see Blood Deficiency) added with Tao Ren, Hong Hua, and Jiu Zhi (Leek Juice). For numbness due to Qi stagnation, use Zi Su Ye (Perilla Leaf), Chen Pi, Xiang Fu (Cyperus Rhizome), Wu Yao, Chuan Xiong, Qiang Huo, Cang Zhu (Atractylodes Lancea Rhizome), Nan Xing (Arisaema Tuber processed with ginger juice), Ban Xia, Dang Gui, Gui Zhi, and Gan Cao. For body numbness with phlegm, use Huang Lian (Coptis Rhizome), Ban Xia, Gua Lou Ren (Trichosanthes Seed), Huang Qin (Scutellaria Root), Fu Ling, Jie Geng (Platycodon Root), Zhi Ke, Chen Pi, Tian Ma (Gastrodia Rhizome), Xi Xin (Asarum Root), Nan Xing, and Gan Cao, decocted. This also treats numbness of mouth and tongue with salivation.
Itching of the skin, both pain and itch belong to Fire; intense Fire causes pain, mild Fire causes itch. Some attribute it to Wind, but Wind is merely the manifestation of Fire Qi, not two separate entities. (This refers to internal Wind. There are also cases where Fire Qi desires to dissipate but encounters external Wind, trapping the constrained Fire between the skin layers, causing agitation and itch. Refer to the Sun Tai Yang chapter of Zhang Zhongjing's *Shang Han Lun*, which mentions floating and slow pulse, red and hot face, inability to produce slight sweat, and inevitable body itch.) If there is no external Wind, do not mistakenly use Wind-dispersing herbs. Since the syndrome belongs to Fire, Blood must be deficient; Wind herbs are drying to Blood and should not be used. Instead, clear Fire and nourish Blood. (When Blood flows, Wind extinguishes itself.) Furthermore, Fire and Original Qi are mutually exclusive; excessive Fire indicates Qi deficiency. However, draining Fire is equivalent to tonifying Qi, so formulas like Bu Zhong Yi Qi Tang or Si Jun Zi Tang (both see Qi Deficiency) are unnecessary. Generally, generalized itching arises from Lung Blood deficiency and excess Fire generating Wind; use Si Wu Tang added with Dong Chong Xia Cao (not explicitly listed but implied by context of winter/summer herbs, here specifically Tian Dong and Mai Dong), Sang Zhi, Chan Tui (Cicada Slough), Jiang Can, Niu Bang Zi (Arctium Fruit), Ci Ji Li (Tribulus Fruit), and Wei Ling Xian (Clematis Root). Externally, wash with decoction of Cang Er Ye (Xanthium Leaf), Di Fu Zi (Kochia Fruit), and Fu Ping (Duckweed).
Generalized itching with raised wheals, commonly known as wind wheals. Red ones are named Xue Feng (Blood Wind), indicating Wind-Heat in the Blood level; white ones are named Bai Mo (White Membrane), indicating Wind-Heat in the Qi level, known in Guangzhou as Feng Luo Mo. Wash with water boiled from fish nets, or rub with heated Yang Tao Ye (Elaeagnus Leaf); both are effective. This resembles Chi Bai You Feng (Red and White Wandering Wind), differing in that the latter migrates while this remains fixed. It differs from Fa Ban (macules/rash) in that this appears suddenly without prior illness, whereas that appears after illness onset.
For summer prickly heat causing itching and pain, use Ku Shen (Sophora Root) 4 liang, Chang Pu (Acorus Rhizome) 2 liang, water 5 bowls, boil several times, add 2 bowls of water, cover for a moment, and mix with 4-5 gallbladders of male pig bile before washing. Cure within three washes. If scratched open, apply Lv Dou Fen (Mung Bean Powder) 1 liang, Hua Shi (Talcum) 5 qian, Huang Bo (Phellodendron Bark) 3 qian, and Qing Fen (Calomel) 2 qian.
Generalized blue-purple spots resembling grapes: initially use Ling Yang Jiao (Antelope Horn), Fang Feng, Xuan Shen (Scrophularia Root), Mai Dong, Zhi Mu (Anemarrhena Rhizome), Huang Qin, and Niu Bang Zi each 8 fen, Gan Cao 2 fen.
Hair and Beard, the *Classic* states: The Kidney corresponds to bone, and its luster manifests in the hair. Excessive consumption of sweets causes bone pain and hair loss. It also states: At age seven, girls' Kidney Qi becomes solid, teeth change, and hair grows; at age thirty-five (five sevens), the Yang Ming channel declines, the face withers, and hair begins to fall. At age eight, boys' Kidney Qi becomes solid, hair grows, and teeth change; at age forty (five eights), Kidney Qi declines, hair falls, and teeth become brittle. It also states: The Chong and Ren channels originate in the uterus, ascend through the chest, and serve as the Sea of Channels. Their superficial branches ascend along the abdomen, meet at the throat, and branch to connect with the lips and mouth. Women who lose blood frequently cause the Chong and Ren channels to fail to nourish the lips; castrated men, having removed the Zong Jin (genitals) and injured the Chong and Ren channels, suffer irreversible blood loss, failing to nourish lips and mouth, hence no beard growth. Why do some grow no beard without injury or blood loss? This is congenital insufficiency; weak Chong and Ren channels, undeveloped Zong Jin, presence of Qi but absence of Blood, leading to lack of nourishment for lips and mouth. Zhang Zi He stated: Premature graying and hair loss in youth, or dandruff, result from excessive Blood Heat. Laypeople know hair is the surplus of Blood and assume Blood deficiency, ignoring that Blood Heat actually prevents lush growth; too much Fire and little Water means Wood cannot flourish. Fire flares up to the neck. After high fever sweating or consumptive disease, hair often falls; how can this be Cold? Prick Shen Ting, Shang Xing, Xi Hui, Qian Ding, and Bai Hui points to bleed, then apply salt and oil to hair roots. Repeat twice or thrice for severe cases; white hair turns black, fallen hair regrows. Zhang Zi He's theory is sound. I have observed that men over thirty or forty with balding tops are likely irritable with excessive Fire and prone to eye diseases; those with thick top hair are calm with little Fire and rarely have eye issues. Dan Xi treated a young man with total hair loss but normal diet and sleep, with a slightly wiry and choppy pulse. This resulted from rich foods generating Heat and Damp-Phlegm in the diaphragm, compounded by frequent plum consumption (causing wiry/choppy pulse). Sour flavors constrain Damp-Heat Phlegm, which rises with Qi, steaming the blood at hair roots until withered. Prescribed blood-nourishing and ascending herbs: Fang Feng Tong Sheng San minus Po Xiao (to avoid rapid purgation), Da Huang stir-fried with wine three times (to direct upward and drain Heat), combined with Si Wu Tang. Prepared with wine, made into small doses (for upper body treatment), decocted in ash water (ash neutralizes plum acid), administered frequently in small amounts. After two months, pulse showed resolving Damp-Heat; stop medication, regulate with bland diet, hair grew back in two years. Sweet melon leaf juice applied stimulates growth. Hemp leaves and mulberry leaves boiled in rice water, washed seven times, can grow hair six chi long. San Qing Gao can dye beard.
Muscle, the *Classic* states: Spleen governs muscle. Pathogens in Spleen and Stomach cause muscle pain. Overflowing pathogens and congested Qi lead to hot pulse and decaying flesh; if Ying and Wei do not circulate, pus will form. Dampness injures muscle; Wind overcomes Dampness; Sweet injures muscle; Sour overcomes Sweet. It also states: Excessive sour intake causes muscle contraction and lip peeling. Prolonged sitting injures muscle. Physical ease and mental joy lead to diseases of the muscle, treated with needles and stones.
Sinew and Bone, the *Classic* states: Liver governs sinews; when sinews are diseased, avoid excessive sour, as Sour injures sinews, and Pungent overcomes Sour. It also states: Excessive pungent intake causes sinew stiffness and brittle nails (nails are the surplus of sinews). It also states: Prolonged walking injures sinews. All sinews attach to joints. Fingers bent but unable to extend indicate sinew disease; extended but unable to bend indicate bone disease. Muscle cramps all belong to Blood Heat; use Si Wu Tang added with Huang Qin, Hong Hua, Cang Zhu, and Nan Xing (for heat origin). Spasm and pain: use Song Jie (Pine Joint) 2 liang, finely chopped like rice grains, Ru Xiang (Frankincense) 1 qian, stir-fried slowly in silver/ceramic vessel to remove fire toxicity, powdered, take 1-2 qian with hot Qu Pa Jiu (Quince Wine) (for cold origin). Lou Quan Shan stated: During cramps, puncture painful areas with burning needles until relief. I suggest moxibustion with lamp wick dipped in oil (suitable for both cold and heat). See Huo Luan section. Kidney governs bone; Cold makes it hard, Heat rots it. Avoid excessive sweet for bone disease, as sweet accumulates Heat damaging bone (teeth are surplus of bone). Bitter enters bone; avoid excessive bitter for bone disease. Prolonged standing injures bone.
Limbs, the *Classic* states: Limbs are the root of all Yang. Also: Yang receives Qi in the limbs. Also: Yang Qi originates from the dorsal aspect of the five toes. These statements are questionable. Yin-Yang Qi from Zang-Fu reaches the limbs, making them the extremities. How can they be the root? If Hand Three Yang channels go from hand to head, Foot Three Yang channels go from head to foot. This ambiguity remains unresolved. Yang excess causes limb swelling (heat swelling); Yang deficiency causes limb fullness (cold distension). Spleen governs limbs; Spleen excess causes immobility (damp-heat); Spleen deficiency causes paralysis (Qi fatigue). Wind invading extremities causes tremors. Pathogens in Five Zang remain in joints. The *Classic* states: Lung and Heart pathogens stay in elbows; Liver pathogens in armpits; Spleen pathogens in thighs; Kidney pathogens in knees. Palmar heat belongs to Heart and Pericardium. Hot, red, itchy hands with thick cracked palm skin indicate Spleen Heat and Liver Wind; use Jia Wei Xiao Yao San added with Gou Teng (Uncaria Ramulus) and Shu Di Huang. Swollen palms and soles indicate Wind; apply pepper, salt, and vinegar. Twitching, tongue protrusion, and foaming in hands/feet should not be immediately treated as Wind-Fire-Phlegm; if pulse is deep and weak, it is Spleen Deficiency generating Wind, requiring major tonification, preferably Gui Pi Tang. Arm heat: Si Wu Tang added with Qin Jiao, Mu Dan Pi, Bai Zhu, Fu Ling, Gou Teng, Gan Cao, Chai Hu. Anger stirring Liver Fire: Xiao Chai Hu Tang added with Chuan Xiong and Dang Gui, or Jia Wei Xiao Yao San. Knees belong to Spleen, Kidney, Liver. Ease leads to flaccidity; labor leads to stabbing pain. Rapid, forceful pulse indicates Liver-Kidney Yin Deficiency. Flaccidity is true disease; stabbing pain is evil Fire; use Liu Wei Di Huang Wan added with Niu Xi and Che Qian Zi. Misdiagnosing this as Wind-Phlegm and using dispersants accelerates danger. Improper diet causing leg/arm soreness/swelling/pain relates to Spleen-Stomach; use Bu Zhong Yi Qi Tang added with Fu Ling and Ban Xia. Heat spreading from legs to hips: Cang Zhu 2 liang, Jiu Huang Bo and Shu Di Huang 1 liang each, Chuan Niu Xi, Dang Gui Wei, Bi Xie, Fang Ji 5 qian each, pill with wine paste. Weak legs/kids unable to walk: Tian Ma, Bai Fu Zi, Niu Xi, Mu Bei Zi 5 qian each, Pao Wu Tou 1 qian, Qiang Huo 5 qian, Di Long 1 fen, Ru Xiang, Mo Yao 2 qian each, Zhu Sha 1 qian, Jiu Nan Xing, powder into pills, ten pills with mint soup. All leg pains: Ru Xiang, Guan Gui, Xue Jie, Ding Xiang, She Xiang 6 fen each, Xing Ren 1.4 li, Qi Ai 1 liang, Mu Xiang 6 fen, Chen Xiang 4 qian, Tan Xiang 4 qian, coarse powder, roll in paper, dip in oil, ignite, extinguish, moxa-acupuncture on acupoints. Shuan (calf soreness): Foot Tai Yang Bladder disease, use Fang Feng, Qiang Huo, Zi Su Ye, Man Jing Zi. Red, swollen, suppurating foot: Foot Three Yang Damp-Heat downward pouring, treatable; slight red/swell, clear pus: Foot Three Yin deficiency, difficult. Dark, non-swollen, non-suppurating, with irritability/thirst/dysuria: Yin failure pre-transmission, emergency, use Ba Wei Wan, direct moxa, may survive. Damp-Heat downward pouring: Garlic-separated moxa to resolve toxin, then Bu Zhong Yi Qi Tang and Liu Wei Wan, self-healing. Limbs receive Qi from Stomach; abundant Stomach Qi/Blood enables walking; deficient Qi/Blood leads to less flesh, cold sensitivity, eventually Wei Jue Zu Bi. Thus, foot diseases require Bu Zhong Yi Qi Tang. Heel pain belongs to Bladder/Kidney. Hot pain indicates extreme Yin Blood deficiency; use Sheng Yu Tang: Sheng Di, Shu Di, Dang Gui, Ren Shen, Huang Qi. Empirical formula: Niu Xi 1 liang, Yi Yi Ren 1.5 liang, Cang Zhu 7.5 qian, Du Zhong, Huang Bo, Dang Gui, Shi Hu, Bi Xie, Mu Gua, Qin Jiao, Mu Tong 5 qian each.
Soles belong to Kidney. Heat/itch/pain indicates Water Deficiency; numbness/swelling indicates Fire Deficiency. Both are Kidney Deficiency; adjust with Liu Wei or Ba Wei Wan. Soles feeling like arrow pricks, intermittent, indicates Kidney not deficient but Heat excess; this is Kidney Wind-Toxin, drain Kidney to cure. See Arm Pain, Jue Ni, Spasm, Convulsion, Tremor, Hong Kong Foot sections.
Two Yins, detailed in Diarrhea, Dysentery, Urinary/Fecal Obstruction, Pollakiuria, Yellow/Red Urine, Enuresis, Jiao Chang, Guan Ge, Red/White Turbidity, Spermatorrhea, Impotence, Yin Retraction/Prolapse, Hernia, Rectal Prolapse, Anal Itch/Pain sections.