论曰内经谓病蛊弗治，肾传之心病，筋脉相引而急，病名曰螈。夫精属肾，筋属肝，脉
属心，精盛则滋育诸筋，荣灌诸脉，故筋脉和柔。今风客于肾，病蛊出白，则精已亏矣，经
所谓风客淫气，精乃亡，邪伤肝者如此，其证筋脉燥急相引而螈是也。
治螈病筋脉相引而急。建中汤方
人参 甘草（炙锉） 桂（去粗皮） 白茯苓（去黑皮） 当归（切焙各二两） 黄
（锉） 龙骨 麦门冬（去心焙各三两） 芍药 生干地黄（焙各四两） 附子（炮裂去皮
脐） 浓朴（去粗皮生姜汁炙各一两）
上一十二味。粗捣筛，每服五钱匕。水一盏半，生姜三片，枣二枚劈破，煎至一盏，去
滓入饴糖少许，再煎数沸温服，日二夜一。
治螈病筋脉相引，强筋力，滋血脉。石菖蒲丸方
石菖蒲 牛膝（一味切同以酒浸一宿焙） 远志（去心） 人参 白茯苓（去黑皮） 地
骨皮（生干地黄焙） 菟丝子（酒浸别捣末） 白术（各一两）
上九味，为细末，炼蜜丸如梧桐子大。每服二十丸，空心日午夜卧，温酒下。
治螈病筋脉相引，及五劳七伤，小便数腰疼，久立不得，坐即脚痹，腹肚不安。肉苁蓉
丸方
肉苁蓉（酒浸切焙） 山芋 熟干地黄（焙各三两） 菟丝子（酒浸别捣） 五味子 杜
仲（去粗皮炙锉） 泽泻 覆盆子 山茱萸 远志（去心） 续断 桂（去粗皮） 附子（炮
裂去皮脐） 甘草（炙锉） 白茯苓（去黑皮） 石斛（去根） 鹿茸（去毛酥炙） 人参 蛇
床子 巴戟天（去心各一两半）
上二十味，为细末，炼蜜丸如梧桐子大。每服二十丸，空心日午夜卧，温酒下。
治螈病及虚羸等疾。牛羊髓丸方
牛髓（研） 羊髓（研） 白蜜 酥 枣肉（各半升） 白茯苓（去黑皮） 麦门冬
（去心焙） 芎 桂（去粗皮） 当归（切焙） 甘草（炙锉） 羌活（去芦头各一两） 干
姜（炮） 生干地黄（焙各三分） 人参 五味子 防风（去叉） 细辛（去苗叶各半两） 白
术（一两一分）
上一十九味。除前五味外，捣罗为末，先与枣肉相和，次入二髓酥蜜搅匀，纳银石器中
，重汤煮之，堪丸即丸如梧桐子大。每服三十丸加至四十丸，酒下、日再。
治螈病筋脉相引，通百节，利九窍，补下焦伤竭不足。茯苓钟乳丸方
白茯苓（去黑皮） 黄 （锉） 枳壳（去瓤麸炒） 蛇床子（各二两） 炼成钟乳粉
（六两） 牛膝（酒浸切焙） 肉苁蓉（酒浸切焙） 人参 石斛（去根） 五味子（各一
两半） 熟干地黄（焙） 菟丝子（酒浸别捣各三两）
上一十二味，为细末，炼蜜丸梧桐子大。每服三十丸，空心酒下。治螈病筋脉相引。
万金丸方
熟干地黄焙（十两） 天门冬（去心焙七两） 巨胜子炊（去皮曝干五两） 白茯苓（去
黑皮） 甘菊花（各三两） 肉苁蓉（酒浸切焙） 牛膝（酒浸切焙） 山芋（各二两） 桂
（去粗皮） 酸枣仁（炒） 甘草（炙锉） 巴戟天（去心各一两）
上一十二味。为细末，煮枣肉与熟蜜，和捣三千杵，丸如梧桐子大。每服三十丸至四十
丸，空心日午、温酒下。
治螈，筋脉相引。补虚损，去元脏久冷，上焦客热，健忘心忪。五味子丸方
五味子（一两半） 熟干地黄（焙） 肉苁蓉（酒浸切焙各四两） 牛膝（酒浸切焙） 菟
丝子（酒浸别捣） 泽泻 白茯苓（去黑皮） 巴戟天（去心） 赤石脂 山茱萸 杜仲（去
粗皮炙） 山芋 石膏（碎） 远志（去心） 柏子仁（各二两）
上一十五味。为细末，炼蜜和捣，入真酥五两再捣，丸如梧桐子大。每服二十丸，至三
十丸，空心日午温酒下。
论述说：《内经》中提到，蛊病如果不治疗，会由肾传至心，导致筋脉相互牵引而拘急，这种病症称为“螈”（抽搐痉挛）。精液归属于肾，筋归属于肝，脉归属于心。精气旺盛则能滋养所有的筋，荣润所有的脉，因此筋和脉能够柔和顺畅。如今风邪侵入肾脏，导致蛊病出现白浊症状，那么精气已经亏损了。正如经文所说：“风邪客居体内扰乱正气，精气就会消亡”，以及“邪气伤害肝脏”都是这种情况。其临床表现就是筋脉干燥紧急、相互牵引而发生抽搐痉挛。
治疗螈病，表现为筋脉相互牵引且拘急的方剂：建中汤方
人参、甘草（炙后锉碎）、桂枝（去除粗皮）、白茯苓（去除黑皮）、当归（切片焙干），以上各二两；黄芪（锉碎）、龙骨、麦门冬（去除心焙干），以上各三两；芍药、生干地黄（焙干），以上各四两；附子（炮裂后去皮脐）、厚朴（去除粗皮，用生姜汁炙），以上各一两。
以上十二味药。粗捣筛过，每次服用五钱匕。用水一盏半，生姜三片，大枣二枚劈破，煎煮至一盏量，去渣，加入少许饴糖，再煮沸几次，温服，每日两次，夜间一次。
治疗螈病，筋脉相互牵引，强健筋骨，滋养血脉的方剂：石菖蒲丸方
石菖蒲、牛膝（单独切碎，用酒浸泡一夜后焙干）、远志（去除心）、人参、白茯苓（去除黑皮）、地骨皮、生干地黄（焙干）、菟丝子（用酒浸泡后单独捣成末）、白术，以上各一两。
以上九味药，研为细末，用炼蜜制成梧桐子大小的丸药。每次服用二十丸，空腹时于半夜和睡前，用温酒送服。
治疗螈病，筋脉相互牵引，以及五劳七伤，小便频数腰痛，久站困难，坐下即脚部麻木，腹部不适的方剂：肉苁蓉丸方
肉苁蓉（用酒浸泡切片焙干）、山药、熟干地黄（焙干，以上各三两）；菟丝子（用酒浸泡后单独捣碎）、五味子、杜仲（去除粗皮炙后锉碎）、泽泻、覆盆子、山茱萸、远志（去除心）、续断、桂枝（去除粗皮）、附子（炮裂去皮脐）、甘草（炙后锉碎）、白茯苓（去除黑皮）、石斛（去除根）、鹿茸（去毛后用酥油炙）、人参、蛇床子、巴戟天（去除心，以上各一两半）。
以上二十味药，研为细末，用炼蜜制成梧桐子大小的丸药。每次服用二十丸，空腹时于半夜和睡前，用温酒送服。
治疗螈病及身体虚弱消瘦等疾病的方剂：牛羊髓丸方
牛髓（研磨）、羊髓（研磨）、白蜜、酥油、枣肉（以上各半升）；白茯苓（去除黑皮）、麦门冬（去除心焙干）、川芎、桂枝（去除粗皮）、当归（切片焙干）、甘草（炙后锉碎）、羌活（去除芦头，以上各一两）；干姜（炮制）、生干地黄（焙干，以上各三分）；人参、五味子、防风（去除叉枝）、细辛（去除苗叶，以上各半两）；白术（一两一分）。
以上十九味药。除前五味外，捣碎过罗成末，先与枣肉混合，然后加入两种骨髓、酥油和蜂蜜搅拌均匀，放入银器或石器中，隔水炖煮，可以制丸时做成梧桐子大小。每次服用三十丸，加至四十丸，用酒送服，每日两次。
治疗螈病，筋脉相互牵引，疏通全身关节，通利九窍，补益下焦损伤枯竭不足的方剂：茯苓钟乳丸方
白茯苓（去除黑皮）、黄芪（锉碎）、枳壳（去除瓤麸炒）、蛇床子（以上各二两）；炼成的钟乳粉（六两）；牛膝（用酒浸泡切片焙干）、肉苁蓉（用酒浸泡切片焙干）、人参、石斛（去除根）、五味子（以上各一两半）；熟干地黄（焙干）、菟丝子（用酒浸泡后单独捣碎，以上各三两）。
以上十二味药，研为细末，用炼蜜制成梧桐子大小的丸药。每次服用三十丸，空腹时用酒送服。用于治疗螈病，筋脉相互牵引。
万金丸方
熟干地黄（焙干，十两）、天门冬（去除心焙干，七两）、巨胜子（蒸熟后去皮晒干，五两）；白茯苓（去除黑皮）、甘菊花（以上各三两）；肉苁蓉（用酒浸泡切片焙干）、牛膝（用酒浸泡切片焙干）、山药（以上各二两）；桂枝（去除粗皮）、酸枣仁（炒制）、甘草（炙后锉碎）、巴戟天（去除心，以上各一两）。
以上十二味药。研为细末，煮枣肉与熟蜜，混合捣击三千杵，制成梧桐子大小的丸药。每次服用三十丸至四十丸，空腹时于中午和半夜，用温酒送服。
治疗螈病，筋脉相互牵引。补益虚损，祛除元脏久寒，清除上焦客热，改善健忘心悸的方剂：五味子丸方
五味子（一两半）；熟干地黄（焙干）、肉苁蓉（用酒浸泡切片焙干，以上各四两）；牛膝（用酒浸泡切片焙干）、菟丝子（用酒浸泡后单独捣碎）、泽泻、白茯苓（去除黑皮）、巴戟天（去除心）、赤石脂、山茱萸、杜仲（去除粗皮炙）、山药、石膏（打碎）、远志（去除心）、柏子仁（以上各二两）。
以上十五味药。研为细末，用炼蜜调和捣碎，加入真酥油五两再次捣匀，制成梧桐子大小的丸药。每次服用二十丸，至三十丸，空腹时于中午用温酒送服。
Commentary states: The *Neijing* (Classic of Internal Medicine) mentions that if Gu disease (a condition characterized by wasting and internal parasites or toxins) is not treated, it transmits from the Kidney to the Heart, causing the sinews and vessels to pull and contract tightly, a condition named "Yuan" (spasms and convulsions). Essence belongs to the Kidney, sinews belong to the Liver, and vessels belong to the Heart. When essence is abundant, it nourishes all sinews and enriches all vessels, thus keeping the sinews and vessels soft and flexible. Now, wind pathogen invades the Kidney, causing Gu disease with white discharge, meaning the essence has already been depleted. As the classics state, "When wind pathogen lodges and disrupts vital energy, essence perishes," and "when pathogenic factors injure the Liver," this is precisely such a case. Its clinical manifestations are dryness and tightness of the sinews and vessels, mutual pulling, and resulting spasms.
Formula for treating Yuan disease, characterized by mutual pulling and tightness of sinews and vessels: Jianzhong Tang (Reinstitute the Middle Decoction)
Ren Shen (Ginseng Radix), Gan Cao (Licorice Radix et Rhizoma, honey-fried and crushed), Gui Zhi (Cinnamon Twig, bark removed), Bai Fu Ling (Poria, black skin removed), Dang Gui (Angelicae Sinensis Radix, sliced and dried over fire), each 2 liang; Huang Qi (Astragali Radix, crushed), Long Gu (Fossilized Mammal Bones), Mai Dong (Ophiopogonis Radix, heart removed and dried over fire), each 3 liang; Shao Yao (Paeoniae Radix), Sheng Di Huang (Rehmanniae Radix, dried over fire), each 4 liang; Fu Zi (Aconiti Lateralis Radix Praeparata, cracked by frying, skin and umbilicus removed), Hou Po (Magnoliae Officinalis Cortex, bark removed, fried with ginger juice), each 1 liang.
The above twelve ingredients. Coarsely crush and sieve. Take 5 qian bi (approx. 15-20g) per dose. Add 1.5 zhan of water, 3 slices of Sheng Jiang (Fresh Ginger), and 2 fractured Da Zao (Jujube Fruit). Decoct until 1 zhan remains. Remove dregs, add a small amount of Yi Tang (Maltose), boil briefly, and take warm. Administer twice daily and once at night.
Formula for treating Yuan disease, mutual pulling of sinews and vessels, strengthening sinews and muscles, and nourishing blood and vessels: Shichangpu Wan (Acorus Pill)
Shi Chang Pu (Acori Tatarinowii Rhizoma), Niu Xi (Achyranthis Bidentatae Radix, cut separately, soaked in wine overnight, then dried over fire), Yuan Zhi (Polygalae Radix, heart removed), Ren Shen (Ginseng Radix), Bai Fu Ling (Poria, black skin removed), Di Gu Pi (Lycii Cortex), Sheng Di Huang (Rehmanniae Radix, dried over fire), Tu Si Zi (Cuscutae Semen, soaked in wine and pounded separately into powder), Bai Zhu (Atractylodis Macrocephalae Rhizoma), each 1 liang.
The above nine ingredients. Pound into fine powder. Mix with refined honey to form pills the size of Sophora seeds (Wutongzi). Take 20 pills per dose on an empty stomach, at midnight, and before sleep, with warm wine.
Formula for treating Yuan disease, mutual pulling of sinews and vessels, as well as Wu Lao Qi Shang (Five Excesses and Seven Injuries), frequent urination with lower back pain, difficulty standing for long periods, numbness in feet upon sitting, and abdominal discomfort: Roushou Rong Wan (Cynomorii Fructus Pill)
Rou Cong Rong (Cynomorii Folii Herba, soaked in wine, sliced, and dried over fire), Shan Yao (Dioscoreae Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata, dried over fire), each 3 liang; Tu Si Zi (Cuscutae Semen, soaked in wine and pounded separately), Wu Wei Zi (Schisandrae Chinensis Fructus), Du Zhong (Eucommiae Cortex, bark removed, fried, and crushed), Ze Xie (Alismatis Rhizoma), Fu Pen Zi (Rubi Chamaemori Fructus), Shan Zhu Yu (Corni Fructus), Yuan Zhi (Polygalae Radix, heart removed), Xu Duan (Dipsaci Radix), Gui Zhi (Cinnamon Twig, bark removed), Fu Zi (Aconiti Lateralis Radix Praeparata, cracked by frying, skin and umbilicus removed), Gan Cao (Licorice Radix et Rhizoma, honey-fried and crushed), Bai Fu Ling (Poria, black skin removed), Shi Hu (Dendrobii Caulis, roots removed), Lu Rong (Cervi Cornu Pantotrichum, hair removed, fried with butter), Ren Shen (Ginseng Radix), She Chuang Zi (Cnidii Fructus), Ba Ji Tian (Morindae Officinalis Radix, heart removed), each 1.5 liang.
The above twenty ingredients. Pound into fine powder. Mix with refined honey to form pills the size of Sophora seeds. Take 20 pills per dose on an empty stomach, at midnight, and before sleep, with warm wine.
Formula for treating Yuan disease and other conditions of deficiency emaciation: Niu Yang Sui Wan (Ox and Sheep Marrow Pill)
Niu Sui (Bovis Medulla), Yang Sui (Ovis Medulla), Bai Mi (White Honey), Su (Butter), Zao Rou (Jujube Flesh), each half sheng; Bai Fu Ling (Poria, black skin removed), Mai Dong (Ophiopogonis Radix, heart removed and dried over fire), Xiong Qiong (Ligustici Chuanxiong Rhizoma), Gui Zhi (Cinnamon Twig, bark removed), Dang Gui (Angelicae Sinensis Radix, sliced and dried over fire), Gan Cao (Licorice Radix et Rhizoma, honey-fried and crushed), Qiang Huo (Notopterygii Rhizoma et Radix, rhizome removed), each 1 liang; Gan Jiang (Zingiberis Rhizoma Praeparatum, fried), Sheng Di Huang (Rehmanniae Radix, dried over fire), each 3 fen; Ren Shen (Ginseng Radix), Wu Wei Zi (Schisandrae Chinensis Fructus), Fang Feng (Saposhnikoviae Radix, forked parts removed), Xi Xin (Asari Radix et Rhizoma, seedlings and leaves removed), each half liang; Bai Zhu (Atractylodis Macrocephalae Rhizoma), 1 liang 1 fen.
The above nineteen ingredients. Except for the first five, pound and sieve into powder. First mix with jujube flesh, then add the two marrow types, butter, and honey, stirring evenly. Place in a silver or ceramic vessel and steam-cook over boiling water. When ready, form into pills the size of Sophora seeds. Take 30 pills, increasing to 40, with wine, twice daily.
Formula for treating Yuan disease, mutual pulling of sinews and vessels, unblocking all joints, benefiting the nine orifices, and tonifying deficiency and exhaustion of the Lower Jiao: Fu Ling Zhong Ru Wan (Poria and Milky Quartz Pill)
Bai Fu Ling (Poria, black skin removed), Huang Qi (Astragali Radix, crushed), Zhi Ke (Aurantii Fructus, pulp and bran removed, stir-fried), She Chuang Zi (Cnidii Fructus), each 2 liang; Lian Cheng Zhong Ru Fen (Refined Milky Quartz Powder), 6 liang; Niu Xi (Achyranthis Bidentatae Radix, soaked in wine, sliced, and dried over fire), Rou Cong Rong (Cynomorii Folii Herba, soaked in wine, sliced, and dried over fire), Ren Shen (Ginseng Radix), Shi Hu (Dendrobii Caulis, roots removed), Wu Wei Zi (Schisandrae Chinensis Fructus), each 1.5 liang; Shu Di Huang (Rehmanniae Radix Praeparata, dried over fire), Tu Si Zi (Cuscutae Semen, soaked in wine and pounded separately), each 3 liang.
The above twelve ingredients. Pound into fine powder. Mix with refined honey to form pills the size of Sophora seeds. Take 30 pills per dose on an empty stomach with wine. For treating Yuan disease, mutual pulling of sinews and vessels.
Wan Jin Wan (Myriad Gold Pill)
Shu Di Huang (Rehmanniae Radix Praeparata, dried over fire), 10 liang; Tian Men Dong (Asparagi Radix, heart removed and dried over fire), 7 liang; Ju Sheng Zi (Sesami Fructus, steamed, skin removed, and sun-dried), 5 liang; Bai Fu Ling (Poria, black skin removed), Gan Ju Hua (Chrysanthemi Flos), each 3 liang; Rou Cong Rong (Cynomorii Folii Herba, soaked in wine, sliced, and dried over fire), Niu Xi (Achyranthis Bidentatae Radix, soaked in wine, sliced, and dried over fire), Shan Yao (Dioscoreae Rhizoma), each 2 liang; Gui Zhi (Cinnamon Twig, bark removed), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried), Gan Cao (Licorice Radix et Rhizoma, honey-fried and crushed), Ba Ji Tian (Morindae Officinalis Radix, heart removed), each 1 liang.
The above twelve ingredients. Pound into fine powder. Boil jujube flesh with mature honey, mix, and pound for three thousand strokes. Form into pills the size of Sophora seeds. Take 30 to 40 pills per dose on an empty stomach at noon and midnight, with warm wine.
Formula for treating Yuan, mutual pulling of sinews and vessels. Tonifying deficiencies, removing chronic cold from the Yuan Zang (Primary Organs), clearing exogenous heat from the Upper Jiao, and improving forgetfulness and palpitations: Wu Wei Zi Wan (Schisandra Pill)
Wu Wei Zi (Schisandrae Chinensis Fructus), 1.5 liang; Shu Di Huang (Rehmanniae Radix Praeparata, dried over fire), Rou Cong Rong (Cynomorii Folii Herba, soaked in wine, sliced, and dried over fire), each 4 liang; Niu Xi (Achyranthis Bidentatae Radix, soaked in wine, sliced, and dried over fire), Tu Si Zi (Cuscutae Semen, soaked in wine and pounded separately), Ze Xie (Alismatis Rhizoma), Bai Fu Ling (Poria, black skin removed), Ba Ji Tian (Morindae Officinalis Radix, heart removed), Chi Shi Zhi (Halloysit Rubrum), Shan Zhu Yu (Corni Fructus), Du Zhong (Eucommiae Cortex, bark removed and fried), Shan Yao (Dioscoreae Rhizoma), Shi Gao (Gypsum Fibrosum, crushed), Yuan Zhi (Polygalae Radix, heart removed), Bai Zi Ren (Platycladi Semen), each 2 liang.
The above fifteen ingredients. Pound into fine powder. Mix with refined honey and pound. Add 5 liang of true butter and pound again. Form into pills the size of Sophora seeds. Take 20 to 30 pills per dose on an empty stomach at noon, with warm wine.