中书粘合公。年四旬有余。躯干魁梧。丙辰春。从征至扬州北之东武隅。香港脚忽作。遍身肢体
微肿。其痛手不能近。足胫尤甚。履不任穿。跣以骑马。控两镫而以竹器盛之。以困急来告。予思
内经。有云。饮发于中。 肿于上。又云。诸痛为实。血实者宜决之。以三棱针数刺其肿上。血突
出高二尺余。渐渐如线流于地。约半升许。其色紫黑。顷时肿消痛减。以当归拈痛汤重一两半服之
。是夜得睡。明日再服而愈。本草十剂云。宣可去壅。通可去滞。内经云。湿淫于内。治以苦温。
羌活苦辛。透关节而胜湿。防风甘辛。温。散经络中留湿。故以为主。水性润下。升麻、葛根苦辛
平。味之薄者阴中之阳。引而上行以苦发之也。白术苦甘温。和中胜湿。苍术体轻浮。气力雄壮。
能去皮肤腠理间湿。故以为臣。夫血壅而不流则痛。当归身辛温以散之。使血气各有所归。人参甘草
甘温。补脾胃。养正气。使苦剂不能伤胃。仲景云。湿热相合。肢节烦疼。苦参、黄芩、知母。
茵陈苦寒。乃苦以泄之者也。凡酒制炒以为因用。治湿不利小便。非其治也。猪苓甘温平。泽泻咸
平。淡以
渗之。又能导其留饮。故以为佐。气味相合。上下分消其湿。使壅滞之气得宣通也。
【当归拈痛汤】治湿热为病。肢体烦疼。肩背沉重。胸膈不利。下疰于胫。肿痛不可忍。
甘草（炙） 茵陈蒿（酒炒） 酒黄芩 羌活（各半两）
防风 知母（酒洗） 猪苓（去皮） 泽泻
当归身（各三钱） 苦参（酒洗） 升麻 黄芩（炒）
人参 葛根 苍术（各二钱） 白术（一钱半）
上 咀。每服一两。水二盏半。先以水拌湿。候少时煎至一盏。去渣。温服。食前。待少时。
美膳压之。
中书省官员粘合公，年龄四十多岁。他身材魁梧高大。丙辰年春季，随军征讨至扬州以北的东武隅。香港脚（一种以足胫肿痛为主要表现的疾病）突然发作。全身肢体轻微肿胀，疼痛剧烈，手无法触碰，小腿部位尤为严重，鞋子穿不进去，只能赤脚骑马，双手控住马镫，用竹器盛放双脚，因病情危急前来求诊。我思考《内经》中的论述，其中有说：“饮邪发于体内，水肿多见于上部。”又说：“各种疼痛多属实证，血实者应当采用决泄的方法治疗。”于是我用三棱针多次针刺其肿胀部位，血液突出喷射，高达两尺有余，随后渐渐如线状流到地上，大约半升左右，血色紫黑。片刻之间，肿胀消退，疼痛减轻。随后服用当归拈痛汤（Danggui Niantong Tang），剂量为一两半。当晚便能入睡，第二天再次服药后痊愈。
《本草十剂》中说：“宣散之剂可以去除壅滞，通利之剂可以消除停滞。”《内经》说：“湿邪淫溢于体内，应用苦温之药治疗。”羌活气味苦辛，能透达关节而胜湿；防风气味甘辛、性温，能疏散经络中留存的湿邪，因此将它们作为主药。水性润下，升麻和葛根气味苦辛平，属于味薄阴中之阳，能引导药力上行，并用苦味发散。白术气味苦甘温，能调和脾胃、胜湿；苍术质地轻浮，气力雄壮，能去除皮肤腠理间的湿邪，因此将它们作为辅药。血气壅滞而不流通则会产生疼痛，当归身气味辛温，能散瘀行血，使气血各有所归。人参和甘草气味甘温，能补益脾胃、滋养正气，防止苦寒药物损伤胃气。张仲景曾说：“湿热相合，导致肢节烦疼。”苦参、黄芩、知母，以及茵陈蒿气味苦寒，是用苦味来泄热。凡是经过酒制炒制的药材，都是依据这一原则使用。治疗湿邪如果不通利小便，就不是正确的治疗方法。猪苓气味甘温平，泽泻气味咸平，用淡味来渗湿，又能引导滞留的水饮排出，因此将它们作为佐药。各种药物的气味相互配合，上下分消体内的湿邪，使壅滞的气机得以宣通。
【当归拈痛汤】主治湿热引起的疾病，表现为肢体烦疼、肩背沉重、胸膈部不适、湿邪下注于小腿，肿痛难以忍受。
处方组成：甘草（炙）、茵陈蒿（酒炒）、酒黄芩、羌活（各半两）、防风、知母（酒洗）、猪苓（去皮）、泽泻、当归身（各三钱）、苦参（酒洗）、升麻、黄芩（炒）、人参、葛根、苍术（各二钱）、白术（一钱半）。
制法与用法：将上述药材捣碎成粗末。每次服用一两，加水二盏半。先用水拌湿药材，等待片刻，煎煮至一盏，去渣，温服。饭前服用，稍后再进食美味食物以压住药气。
Mr. Zhania, an official of the Secretariat, was in his forties. He had a robust and sturdy physique. In the spring of the Bingchen year, while campaigning to Dongwuyu north of Yangzhou, he suddenly suffered from "Hongxiangjiao" (a condition characterized by swelling and pain in the lower legs). His entire body and limbs were slightly swollen. The pain was so severe that it could not be touched by hand, with the shins being particularly affected. He could not wear shoes and had to ride barefoot, holding the stirrups with both hands while resting his feet in a bamboo container. He came seeking help due to the urgency of his condition. I recalled the *Neijing* (Classic of Internal Medicine), which states: "Fluid retention originates internally but manifests as edema primarily in the upper parts." It also states: "All pain is due to excess; when blood is excessive, it should be drained." Therefore, I used a three-edged needle to puncture the swollen areas multiple times. Blood spurted out, reaching a height of over two chi, then flowed down like a thread onto the ground, amounting to approximately half a sheng. The blood was dark purple and black. Immediately after, the swelling subsided and the pain decreased. He then took Danggui Niantong Tang (Cinnamon Twig and Angelica Decoction for Damp-Heat Pain) at a dose of one liang and half. That night, he was able to sleep. After taking another dose the next day, he recovered.
The *Bencao Shiji* (Ten Categories of Materia Medica) states: "Dispersing agents can remove stagnation; unblocking agents can eliminate obstruction." The *Neijing* states: "When dampness dominates internally, treat it with bitter-warm herbs." Qianghuo (Notopterygii Rhizoma et Radix) is bitter and acrid, penetrating the joints to overcome dampness. Fangfeng (Saposhnikoviae Radix) is sweet and acrid, warm, dispersing retained dampness in the meridians; thus, they serve as the chief herbs. Water nature is moistening and tends downward. Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Radix) are bitter, acrid, and neutral. Their thin flavors represent yang within yin, guiding the medicinal action upward and dispersing via bitter flavor. Baizhu (Atractylodis Macrocephalae Rhizoma) is bitter, sweet, and warm, harmonizing the middle jiao and overcoming dampness. Cangzhu (Atractylodis Rhizoma) is light and floating, with vigorous qi, capable of removing dampness from the skin and interstices; thus, they serve as deputy herbs. When blood is stagnant and does not flow, pain occurs. Dangguishen (Radix Angelicae Sinensis - root body) is acrid and warm, dispersing stasis and ensuring that qi and blood return to their proper locations. Renshen (Ginseng Radix) and Gancao (Glycyrrhizae Radix) are sweet and warm, tonifying the spleen and stomach, nourishing healthy qi, and preventing bitter-cold herbs from damaging the stomach. Zhang Zhongjing stated: "When damp-heat combines, it causes vexing pain in the limbs and joints." Kushen (Sophorae Flavescentis Radix), Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), and Yinchenhao (Artemisiae Scopariae Herba) are bitter and cold, using bitterness to drain heat. All herbs processed with wine or stir-fried follow this principle. Treating dampness without promoting urination is incorrect therapy. Zhuling (Polyporus) is sweet, warm, and neutral; Zexie (Alismatis Rhizoma) is salty and neutral. Using bland flavors to leach out dampness, they also guide away retained fluid retention; thus, they serve as assistant herbs. The combination of flavors and properties allows for the simultaneous dispersion of dampness from above and below, enabling the stagnated qi to become unblocked.
[Danggui Niantong Tang] treats diseases caused by damp-heat, manifesting as vexing pain in the limbs, heaviness in the shoulders and back, discomfort in the chest and diaphragm, dampness sinking into the shins, and unbearable swelling and pain.
Ingredients: Gancao (Zhi/Cured) (Yinchenhao/Jiu Chao/Wine-fried) (Jiu Huangqin/Wine Scutellaria) Qianghuo (each 0.5 liang); Fangfeng; Zhimu (Jiu Xi/Wine-rinsed); Zhuling (Qu Pi/Peel removed); Zexie; Dangguishen (each 3 qian); Kushen (Jiu Xi/Wine-rinsed); Shengma; Huangqin (Chao/Stir-fried); Renshen; Gegen; Cangzhu (each 2 qian); Baizhu (1.5 qian).
Preparation and Administration: Coarsely crush the ingredients. Take 1 liang per dose, add 2.5 zhan of water. Moisten the herbs with water first, let stand for a moment, then decoct until 1 zhan remains. Strain and take warm before meals. Wait a short while, then eat a good meal to settle the stomach.