论曰伤寒后骨节烦疼者,由津液不足,血脉皆虚,余毒客于经络,营卫涩滞于骨节之间,
故令骨节烦疼也,诊三部脉细而迟涩者,乃其候也。
治伤寒后毒瓦斯未解,四肢少力,骨节烦疼,心腹胀满。葛根汤方
葛根(锉) 生干地黄(焙) 羌活(去芦头) 桂(去粗皮) 芍药 芎 麻黄(去
根节汤煮掠去沫) 陈橘皮汤浸(去白焙) 木香(各半两) 甘草(炙锉一分)
上一十味,粗捣筛,每服五钱匕,水一盏半,入生姜半分拍碎,枣三枚劈破,同煎至七
分,去滓空心温服,晚食前再服。
治伤寒后百节疼痛,壮热头疼。柴胡汤方
柴胡(去苗) 芍药 知母(焙) 桃仁(汤浸去皮尖双仁炒黄) 木香 山栀子仁 升
麻大青 白芷 黄芩(去黑心各半两) 细辛(去苗叶) 甘草(炙锉各一分) 石膏(一
两)
上一十三味,粗捣筛,每服五钱匕,水一盏半,入生姜半分拍碎,同煎至七分,去滓,
食后温服日三。
治伤寒后骨节疼痛,咳嗽不能食,口舌干燥,乍寒乍热,唇口生疮。柴胡饮方
柴胡(去苗) 升麻 茯神(去木) 芍药 犀角(镑) 百合 地骨皮 麦门冬(去
心焙) 黄芩(去黑心) 人参(各半两) 鳖甲(去裙 醋炙) 石膏(各一两) 甘草
(炙锉一分)
上一十三味,粗捣筛,每服五钱匕,水一盏半,入生姜半分拍碎,竹叶三七片,同煎至
七分去滓,食后温服日再。
治伤寒后壮热,骨肉疼痛,头重呕哕。芍药汤方
芍药 柴胡(去苗) 赤茯苓(去黑皮) 人参 麦门冬(去心焙) 藿香叶 白芷(各
半两) 生芦根(一两) 甘草(炙一分)
上九味,锉如麻豆大,每服五钱匕,水一盏半,入生姜半分拍碎,同煎至七分,去滓空
心温服,晚食前再服。
治伤寒后四肢烦热,骨节疼痛。百合汤方
百合 知母(焙) 鳖甲(去裙 醋炙) 柴胡(去苗) 葛根(锉) 桑根白皮(锉
各一两)
上六味粗捣筛,每服五钱匕,水一盏半,煎至八分,去滓入生地黄汁一合,搅匀食后温
服、日再。
治伤寒后骨节烦疼,乍起眼暗,气冲胸背,上气满急。茯苓汤方
白茯苓(去黑皮) 柴胡(去苗) 桔梗(炒) 细辛(去苗叶) 芍药 大腹皮(各
半两) 枳壳(去瓤麸炒) 陈橘皮(汤浸去白焙各一两) 杏仁(汤浸去皮尖双仁炒三分)
甘草(炙一分)
上一十味,粗捣筛,每服五钱匕,水一盏半,入生姜半分拍碎,同煎至八分去滓,食后
温服日再。
治伤寒后骨节烦疼,不欲食,食即气胀、汗出。补气黄 汤方
黄 (锉) 芍药 桂(去粗皮) 麦门冬(去心焙) 五味子 前胡(去芦头) 白
茯苓(去黑皮) 当归切(焙) 人参(各半两) 甘草(炙一分)
上一十味,粗捣筛,每服五钱匕,水一盏半,入生姜半分拍碎,枣三枚劈破,同煎至七
分,去滓温服、日三。
治伤寒后遍身骨节疼痛,脚膝无力。防风汤方
防风(去叉) 白术 附子(炮裂去皮脐) 白藓皮 黄 桂(去粗皮) 薏苡仁(各
一两)
上七味,锉如麻豆,每服三钱匕,水一盏,入生姜半分拍碎,同煎至半盏,去滓温服,
日三。
治伤寒后下焦风虚,骨髓酸痛,腰脚顽痹,不能久立,日渐消瘦。羌活汤方
羌活(去芦头) 防风(去叉) 五加皮(锉) 牛膝(去苗酒浸切焙) 酸枣仁(微
炒) 丹参 麻黄(去根节汤煮掠去沫焙) 芍药 当归(切焙) 独活(去芦头) 槟榔
(锉) 玄参(坚者) 木通(锉各半两) 桂(去粗皮) 黄 (锉各三分)
上一十五味,粗捣筛,每服五钱匕,水一盏半,煎至七分,去滓空心温服,日晚再服。
治伤寒热毒瓦斯攻肾,腰背疼痛,脊膂强急,头不痛,左手尺脉浮微数,续断汤方
续断 杜仲(去粗皮炙锉) 麻黄(去根节汤煮掠去沫焙) 羌活(去芦头) 芎 (各
一两) 牵牛(一分熟炒)
上六味,粗捣筛,每服三钱匕,水一盏,煎一二沸,去滓空心服。
论述说:伤寒病后出现骨节烦扰疼痛,是因为津液不足,血脉空虚,残余的病邪毒气客居于经络之中,营气和卫气在骨节之间运行涩滞不通,所以导致骨节烦痛。诊察寸、关、尺三部脉象,如果呈现细弱、迟缓且涩滞的特征,就是这种病症的征候。
治疗伤寒后毒气未解,四肢乏力,骨节烦痛,心腹胀满的葛根汤方:
葛根(锉碎)、生干地黄(焙干)、羌活(去芦头)、桂枝(去粗皮)、芍药、川芎、麻黄(去根节,用汤煮掠去浮沫)、陈橘皮(汤浸,去白焙干)、木香(以上各半两)、甘草(炙,锉碎一分)。
以上十味药,粗捣筛过,每次服用五钱匕,加水一盏半,放入生姜半分拍碎,大枣三枚劈破,一同煎煮至七分水量,滤去药渣,空腹时温服,晚饭前再服一次。
治疗伤寒后全身关节疼痛,高热头痛的柴胡汤方:
柴胡(去苗)、芍药、知母(焙干)、桃仁(汤浸去皮尖,双仁炒黄)、木香、山栀子仁、升麻、大青叶、白芷、黄芩(去黑心,以上各半两)、细辛(去苗叶)、甘草(炙,锉碎,以上各一分)、石膏(一两)。
以上十三味药,粗捣筛过,每次服用五钱匕,加水一盏半,放入生姜半分拍碎,一同煎煮至七分水量,滤去药渣,饭后温服,每日三次。
治疗伤寒后骨节疼痛,咳嗽不能进食,口舌干燥,忽冷忽热,唇口生疮的柴胡饮方:
柴胡(去苗)、升麻、茯神(去木心)、芍药、犀角(镑片)、百合、地骨皮、麦门冬(去心焙干)、黄芩(去黑心)、人参(以上各半两)、鳖甲(去裙边,醋炙)、石膏(以上各一两)、甘草(炙,锉碎一分)。
以上十三味药,粗捣筛过,每次服用五钱匕,加水一盏半,放入生姜半分拍碎,竹叶三十余片,一同煎煮至七分水量,滤去药渣,饭后温服,每日两次。
治疗伤寒后高热,骨肉疼痛,头重恶心呕吐的芍药汤方:
芍药、柴胡(去苗)、赤茯苓(去黑皮)、人参、麦门冬(去心焙干)、藿香叶、白芷(以上各半两)、生芦根(一两)、甘草(炙一分)。
以上九味药,锉碎如麻豆大小,每次服用五钱匕,加水一盏半,放入生姜半分拍碎,一同煎煮至七分水量,滤去药渣,空腹时温服,晚饭前再服一次。
治疗伤寒后四肢烦热,骨节疼痛的百合汤方:
百合、知母(焙干)、鳖甲(去裙边,醋炙)、柴胡(去苗)、葛根(锉碎)、桑根白皮(锉碎,以上各一两)。
以上六味药,粗捣筛过,每次服用五钱匕,加水一盏半,煎煮至八分水量,滤去药渣,加入生地黄汁一合,搅匀,饭后温服,每日两次。
治疗伤寒后骨节烦痛,突然起身眼前发黑,气冲胸背,上气急促胸闷的茯苓汤方:
白茯苓(去黑皮)、柴胡(去苗)、桔梗(炒)、细辛(去苗叶)、芍药、大腹皮(以上各半两)、枳壳(去瓤麸炒)、陈橘皮(汤浸去白焙,以上各一两)、杏仁(汤浸去皮尖,双仁炒三分)、甘草(炙一分)。
以上十味药,粗捣筛过,每次服用五钱匕,加水一盏半,放入生姜半分拍碎,一同煎煮至八分水量,滤去药渣,饭后温服,每日两次。
治疗伤寒后骨节烦痛,不想吃东西,吃后即气胀、出汗的补气黄芪汤方:
黄芪(锉碎)、芍药、桂枝(去粗皮)、麦门冬(去心焙干)、五味子、前胡(去芦头)、白茯苓(去黑皮)、当归(切,焙干)、人参(以上各半两)、甘草(炙一分)。
以上十味药,粗捣筛过,每次服用五钱匕,加水一盏半,放入生姜半分拍碎,大枣三枚劈破,一同煎煮至七分水量,滤去药渣温服,每日三次。
治疗伤寒后遍身骨节疼痛,脚膝无力的防风汤方:
防风(去叉)、白术、附子(炮裂去皮脐)、白鲜皮、黄芪、桂枝(去粗皮)、薏苡仁(以上各一两)。
以上七味药,锉碎如麻豆大小,每次服用三钱匕,加水一盏,放入生姜半分拍碎,一同煎煮至半盏水量,滤去药渣温服,每日三次。
治疗伤寒后下焦风虚,骨髓酸痛,腰脚麻木痹阻,不能久立,日渐消瘦的羌活汤方:
羌活(去芦头)、防风(去叉)、五加皮(锉碎)、牛膝(去苗酒浸切焙)、酸枣仁(微炒)、丹参、麻黄(去根节汤煮掠去沫焙干)、芍药、当归(切焙)、独活(去芦头)、槟榔(锉碎)、玄参(质地坚硬的)、木通(锉碎,以上各半两)、桂枝(去粗皮)、黄芪(锉碎,以上各三分)。
以上十五味药,粗捣筛过,每次服用五钱匕,加水一盏半,煎煮至七分水量,滤去药渣,空腹时温服,晚上再服一次。
治疗伤寒热毒攻肾,腰背疼痛,脊背强直拘急,头部不痛,左手尺部脉象浮而微数的续断汤方:
续断、杜仲(去粗皮炙锉)、麻黄(去根节汤煮掠去沫焙干)、羌活(去芦头)、川芎(以上各一两)、牵牛子(一分,熟炒)。
以上六味药,粗捣筛过,每次服用三钱匕,加水一盏,煎煮一二沸,滤去药渣,空腹服用。
Commentary states: Regarding bone and joint vexatious pain after Shanghan (Cold Damage disease), it arises from insufficient body fluids and deficiency of the blood vessels. Residual pathogenic toxins lodge in the meridians, causing the Ying (Nutrient) and Wei (Defensive) Qi to flow sluggishly between the bones and joints, thus leading to vexatious pain in the bones and joints. Upon examining the Cun, Guan, and Chi pulses at the three positions, if they appear thin, slow, and choppy, this is the characteristic sign of this condition.
Ge Gen Tang (Kudzu Root Decoction) for treating residual toxic qi after Shanghan, with weakness in the four limbs, vexatious pain in bones and joints, and abdominal distension/fullness:
Puerariae Radix (Ge Gen) (chopped), Rehmanniae Radix (Sheng Gan Di Huang) (baked), Notopterygii Rhizoma et Radix (Qiang Huo) (rhizome head removed), Cinnamomi Ramulum (Gui Zhi) (coarse bark removed), Paeoniae Radix Alba (Bai Shao), Ligustici Chuanxiong Rhizoma (Chuan Xiong), Ephedrae Herba (Ma Huang) (root nodes removed, boiled in water to remove foam), Citri Reticulatae Pericarpium (Chen Pi) (soaked in water, white pith removed, baked), Costi Radix (Mu Xiang) (each half liang), Glycyrrhizae Radix et Rhizoma (Gan Cao) (roasted, chopped, one fen).
The above ten herbs are coarsely crushed and sieved. Each dose consists of five qian bi, decocted with one and a half zhan of water, half a ban of smashed fresh ginger, and three fractured jujubes. Decoct until seven-tenths remain, strain, and take warm on an empty stomach; administer again before the evening meal.
Chai Hu Tang (Bupleurum Decoction) for treating pain in all joints, high fever, and headache after Shanghan:
Bupleuri Radix (Chai Hu) (sprouts removed), Paeoniae Radix Alba (Bai Shao), Anemarrhenae Rhizoma (Zhi Mu) (baked), Persicae Semen (Tao Ren) (soaked in water, peel and pointed ends removed, double-kernel fried yellow), Costi Radix (Mu Xiang), Gardeniae Fructus (Shan Zhi Zi) (kernel only), Cimicifugae Rhizoma (Sheng Ma), Isatidis Folium (Da Qing Ye), Angelicae Dahuricae Radix (Bai Zhi), Scutellariae Radix (Huang Qin) (black heart removed, each half liang), Asari Radix et Rhizoma (Xi Xin) (sprouts and leaves removed), Glycyrrhizae Radix et Rhizoma (Gan Cao) (roasted, chopped, each one fen), Gypsum Fibrosum (Shi Gao) (one liang).
The above thirteen herbs are coarsely crushed and sieved. Each dose consists of five qian bi, decocted with one and a half zhan of water and half a ban of smashed fresh ginger. Decoct until seven-tenths remain, strain, and take warm after meals, three times daily.
Chai Hu Yin (Bupleurum Drink) for treating bone and joint pain, coughing, inability to eat, dry mouth and tongue, alternating chills and fever, and sores on lips and tongue after Shanghan:
Bupleuri Radix (Chai Hu) (sprouts removed), Cimicifugae Rhizoma (Sheng Ma), Poria (Fu Shen) (wood core removed), Paeoniae Radix Alba (Bai Shao), Rhinocerotis Cornu (Xi Jiao) (sliced), Lili Bulbus (Bai He), Lycii Cortex (Di Gu Pi), Ophiopogonis Tuber (Mai Men Dong) (heart removed, baked), Scutellariae Radix (Huang Qin) (black heart removed), Ginseng Radix (Ren Shen) (each half liang), Testudinis Carapax et Plastrum (Bie Jia) (skirt removed, vinegar-roasted), Gypsum Fibrosum (Shi Gao) (each one liang), Glycyrrhizae Radix et Rhizoma (Gan Cao) (roasted, chopped, one fen).
The above thirteen herbs are coarsely crushed and sieved. Each dose consists of five qian bi, decocted with one and a half zhan of water, half a ban of smashed fresh ginger, and about thirty-seven slices of bamboo leaf. Decoct until seven-tenths remain, strain, and take warm after meals, twice daily.
Shao Yao Tang (Peony Decoction) for treating high fever, bone and muscle pain, heavy head, nausea, and vomiting after Shanghan:
Paeoniae Radix Alba (Bai Shao), Bupleuri Radix (Chai Hu) (sprouts removed), Poria Cum Radix Xyloni (Chi Fu Ling) (black skin removed), Ginseng Radix (Ren Shen), Ophiopogonis Tuber (Mai Men Dong) (heart removed, baked), Agastachis Folium (Huo Xiang Ye), Angelicae Dahuricae Radix (Bai Zhi) (each half liang), Phragmitis Rhizoma Recens (Sheng Lu Gen) (one liang), Glycyrrhizae Radix et Rhizoma (Gan Cao) (roasted, one fen).
The above nine herbs are chopped like hemp seeds. Each dose consists of five qian bi, decocted with one and a half zhan of water and half a ban of smashed fresh ginger. Decoct until seven-tenths remain, strain, and take warm on an empty stomach; administer again before the evening meal.
Bai He Tang (Lily Bulb Decoction) for treating vexatious heat in the four limbs and bone and joint pain after Shanghan:
Lilii Bulbus (Bai He), Anemarrhenae Rhizoma (Zhi Mu) (baked), Testudinis Carapax et Plastrum (Bie Jia) (skirt removed, vinegar-roasted), Bupleuri Radix (Chai Hu) (sprouts removed), Puerariae Radix (Ge Gen) (chopped), Morus Albae Radix Cortex (Sang Bai Pi) (chopped, each one liang).
The above six herbs are coarsely crushed and sieved. Each dose consists of five qian bi, decocted with one and a half zhan of water until eight-tenths remain. Strain, add one he of fresh Rehmanniae Radix juice, mix well, and take warm after meals, twice daily.
Fu Ling Tang (Poria Decoction) for treating vexatious pain in bones and joints, sudden dim vision upon rising, qi rushing to chest and back, and upper jiao fullness/urgency after Shanghan:
Poria (Fu Ling) (black skin removed), Bupleuri Radix (Chai Hu) (sprouts removed), Platycodonis Radix (Jie Geng) (fried), Asari Radix et Rhizoma (Xi Xin) (sprouts and leaves removed), Paeoniae Radix Alba (Bai Shao), Arecae Pericarpium (Da Fu Pi) (each half liang), Aurantii Fructus Immaturus (Zhi Ke) (pulp and bran removed, stir-fried), Citri Reticulatae Pericarpium (Chen Pi) (soaked in water, white pith removed, baked, each one liang), Armeniacae Semen Amarum (Xing Ren) (soaked in water, peel and pointed ends removed, double-kernel fried, three qian), Glycyrrhizae Radix et Rhizoma (Gan Cao) (roasted, one fen).
The above ten herbs are coarsely crushed and sieved. Each dose consists of five qian bi, decocted with one and a half zhan of water and half a ban of smashed fresh ginger. Decoct until eight-tenths remain, strain, and take warm after meals, twice daily.
Bu Qi Huang Qi Tang (Qi-Nourishing Astragalus Decoction) for treating vexatious pain in bones and joints, loss of appetite, postprandial bloating, and sweating after Shanghan:
Astragali Radix (Huang Qi) (chopped), Paeoniae Radix Alba (Bai Shao), Cinnamomi Ramulum (Gui Zhi) (coarse bark removed), Ophiopogonis Tuber (Mai Men Dong) (heart removed, baked), Schisandrae Fructus (Wu Wei Zi), Peucedani Radix (Qian Hu) (rhizome head removed), Poria (Fu Ling) (black skin removed), Angelicae Sinensis Radix (Dang Gui) (cut, baked), Ginseng Radix (Ren Shen) (each half liang), Glycyrrhizae Radix et Rhizoma (Gan Cao) (roasted, one fen).
The above ten herbs are coarsely crushed and sieved. Each dose consists of five qian bi, decocted with one and a half zhan of water, half a ban of smashed fresh ginger, and three fractured jujubes. Decoct until seven-tenths remain, strain, and take warm, three times daily.
Fang Feng Tang (Saposhnikovia Decoction) for treating generalized bone and joint pain and weakness in legs and knees after Shanghan:
Saposhnikoviae Radix (Fang Feng) (forked parts removed), Atractylodis Macrocephalae Rhizoma (Bai Zhu), Aconiti Lateralis Radix Praeparata (Fu Zi) (cracked, skin and navel removed), Dictamni Cortex (Bai Xian Pi), Astragali Radix (Huang Qi), Cinnamomi Ramulum (Gui Zhi) (coarse bark removed), Coicis Semen (Yi Yi Ren) (each one liang).
The above seven herbs are chopped like hemp seeds. Each dose consists of three qian bi, decocted with one zhan of water and half a ban of smashed fresh ginger. Decoct until half a zhan remains, strain, and take warm, three times daily.
Qiang Huo Tang (Notopterygium Decoction) for treating lower jiao wind-deficiency, soreness and pain in bone marrow, numbness and obstruction in waist and legs, inability to stand for long periods, and gradual emaciation after Shanghan:
Notopterygii Rhizoma et Radix (Qiang Huo) (rhizome head removed), Saposhnikoviae Radix (Fang Feng) (forked parts removed), Acanthopanacis Cortex (Wu Jia Pi) (chopped), Achyranthis Bidentatae Radix (Niu Xi) (sprouts removed, wine-soaked, cut, baked), Ziziphi Spinosae Semen (Suan Zao Ren) (lightly fried), Salviae Miltiorrhizae Radix (Dan Shen), Ephedrae Herba (Ma Huang) (root nodes removed, boiled to remove foam, baked), Paeoniae Radix Alba (Bai Shao), Angelicae Sinensis Radix (Dang Gui) (cut, baked), Angelicae Pubescentis Radix (Du Huo) (rhizome head removed), Areca Semen (Bing Lang) (chopped), Scrophulariae Radix (Xuan Shen) (firm ones), Akebiae Caulis (Mu Tong) (chopped, each half liang), Cinnamomi Ramulum (Gui Zhi) (coarse bark removed), Astragali Radix (Huang Qi) (chopped, each three qian).
The above fifteen herbs are coarsely crushed and sieved. Each dose consists of five qian bi, decocted with one and a half zhan of water until seven-tenths remain. Strain, take warm on an empty stomach, and administer again in the evening.
Xu Duan Tang (Dipsacus Decoction) for treating Shanghan heat-toxin attacking the Kidney, causing lower back and back pain, stiffness and tension of the spine, absence of headache, and a floating, slightly rapid pulse at the Chi position of the left hand:
Dipsaci Radix (Xu Duan), Eucommiae Cortex (Du Zhong) (coarse bark removed, roasted, chopped), Ephedrae Herba (Ma Huang) (root nodes removed, boiled to remove foam, baked), Notopterygii Rhizoma et Radix (Qiang Huo) (rhizome head removed), Ligustici Chuanxiong Rhizoma (Chuan Xiong) (each one liang), Phaseoli Semen (Qian Niu) (one fen, cooked/fried).
The above six herbs are coarsely crushed and sieved. Each dose consists of three qian bi, decocted with one zhan of water for one or two boils. Strain and take on an empty stomach.