论曰∶《内经》谓风寒湿三气杂至,合而为痹,其风气胜者为行痹。夫气之在人,本自
流通,所以痹者,风寒湿三气合而为病也。然三气之中,各有阴阳,风为阳气,善行数变,
故风气胜则为行痹。其证上下左右,无所留止,随其所至,气血不通是也。治法虽通行血气,
宜多以治风之剂。
治行痹行走无定。防风汤方。
防风(去叉) 甘草(炙,锉各一两) 黄芩(去黑心三分) 当归(切,焙) 赤茯
苓(去黑
皮各一两) 秦艽(去苗土) 葛根(锉各三分) 桂(去粗皮) 杏仁(汤去皮尖、双仁,
炒各
一两) 麻黄(去根节,煎,掠去沫,焙半两)
上一十味,粗捣筛。每服五钱匕,酒一盏,水一盏,枣三枚(劈破),生姜五片,同煎
至
一盏,去滓温服,日二夜一。
治行痹头面四肢袭着,筋脉挛急,手足不随,痰涎胶粘,语涩昏浊,口眼偏 。羚羊角
丸方。
羚羊角(镑一两) 木香 青橘皮(汤浸,去白,焙) 半夏(汤洗,同生姜捣曲,焙
干)
羌活(去芦头) 独活(去芦头) 芎 藿香叶 干蝎(去土,炒) 白花蛇(酒炙,去
皮、骨)
香(研) 牛黄
(研) 龙脑(研各一两)
上一十七味,除研药外,为细末,再和匀,用皂荚薄荷鹅梨汁各一碗,同熬成膏,和丸
如绿豆大。每服七丸,温酒或薄荷汤下,不计时候。
治风痹行走无定处,亦治血痹。萆 丸方。
萆 山芋 牛膝(去苗,酒浸,焙干) 泽泻(各一两) 生干地黄(焙二两半) 白
术
(半两) 茵芋 蛴螬(微炒) 干漆(炒烟出) 狗脊(去毛) 车前子 天雄(炮裂,
去皮脐)
(各一分)
上一十二味,为细末,炼蜜丸如梧桐子大。每服温酒下二十丸,加至三十丸,日三。
治风痹游走无常处,亦治血痹。山茱萸丸方。
山茱萸(炒一两一分) 生干地黄(焙二两半) 山芋 牛膝(去苗,酒浸,焙) 泽
泻萆
(各一两) 天雄(炮裂,去皮脐) 蛴螬(微炒) 车前子 干漆(炒烟出) 狗脊(去
毛) 白
术地肤子(各三分) 茵芋(去粗茎半两)
上一十四味,为细末,炼蜜丸如梧桐子大。每服温酒下二十丸,加至三十丸,日三。
治诸风痹,走移无定。干地黄丸方。
生干地黄(焙) 泽泻 山茱萸(炒各一两) 山芋 牛膝(去苗,酒浸,切,焙) 白
术(锉
各一两) 天雄(炮裂,去皮脐一分) 蛴螬(炒微) 干漆(炒烟出) 狗脊(去毛) 车
前子 茵
芋(各三钱) 萆 (炒半两)
上一十三味,为细末,炼蜜丸如梧桐子大。每空腹用温酒下二十丸,日二夜一。
治诸风痹。附子酒方。
附子三枚(重二两者,炮裂,去皮脐)
上一味,锉如麻豆大,以醇酒五升,浸三五日。每温服一合,去滓,以唇口麻痹为度,
日再。
论述说:《内经》指出,风、寒、湿三种邪气混杂侵袭人体,结合而发为痹证,其中风气偏盛的称为行痹。人体的气原本应当流通顺畅,之所以发生痹阻,是因为风、寒、湿三气合而为病。然而在这三气之中,各自又分阴阳属性,风属于阳气,其特性是善于游走且变化迅速,因此风气偏盛就形成行痹。其临床表现是疼痛或麻木在身体上下左右各处游走,没有固定停留之处,随着邪气所至之处,导致气血运行不通畅。治疗方法虽然需要通行气血,但宜多用祛风的方剂。
治疗行痹,症状表现为疼痛游走不定。防风汤方。
防风(去除叉枝) 甘草(炙烤,锉碎,各一两) 黄芩(去除黑心部分三分) 当归(切片,焙干) 赤茯苓(去除黑皮,各一两) 秦艽(去除苗和泥土) 葛根(锉碎,各三分) 桂枝(去除粗皮) 杏仁(用热水去皮尖及双仁的,炒制,各一两) 麻黄(去除根节,煎煮,撇去浮沫,焙干,半两)
以上十味药,捣碎并筛成粗末。每次服用五钱匕,加入酒一盏、水一盏、大枣三枚(掰破)、生姜五片,共同煎煮至一盏量,滤去药渣,温服,每日两次,夜间一次。
治疗行痹,头面四肢受邪侵袭,筋脉拘挛紧急,手足不能随意运动,痰涎粘稠,言语涩滞神志昏浊,口眼歪斜。羚羊角丸方。
羚羊角(镑成片,一两) 木香 青橘皮(热水浸泡,去除白色内皮,焙干) 半夏(热水清洗,同生姜捣制成曲,焙干) 羌活(去除芦头) 独活(去除芦头) 川芎 藿香叶 全蝎(去除泥土,炒制) 白花蛇(酒炙,去除皮、骨) 麝香(研磨) 牛黄(研磨) 冰片(研磨,各一两)
以上十七味药,除需研磨的药外,其余研为细末,再混合均匀,用皂荚、薄荷、鹅梨汁各一碗,共同熬制成膏,调和药末制成如绿豆大小的丸药。每次服用七丸,用温酒或薄荷汤送下,不限时间。
治疗风痹,疼痛游走无定处,也治疗血痹。萆薢丸方。
萆薢 薯蓣(山芋) 牛膝(去除苗,酒浸,焙干) 泽泻(各一两) 生干地黄(焙干,二两半) 白术(半两) 茵芋 蛴螬(微炒) 干漆(炒至烟出) 狗脊(去除毛) 车前子 天雄(炮裂,去除皮脐,各一分)
以上十二味药,研为细末,用炼蜜制成如梧桐子大小的丸药。每次用温酒送下二十丸,加量至三十丸,每日三次。
治疗风痹,游走无常处,也治疗血痹。山茱萸丸方。
山茱萸(炒,一两一分) 生干地黄(焙干,二两半) 薯蓣(山芋) 牛膝(去除苗,酒浸,焙干) 泽泻 萆薢(各一两) 天雄(炮裂,去除皮脐) 蛴螬(微炒) 车前子 干漆(炒至烟出) 狗脊(去除毛) 白术 地肤子(各三分) 茵芋(去除粗茎,半两)
以上十四味药,研为细末,用炼蜜制成如梧桐子大小的丸药。每次用温酒送下二十丸,加量至三十丸,每日三次。
治疗各种风痹,疼痛走移不定。干地黄丸方。
生干地黄(焙干) 泽泻 山茱萸(炒,各一两) 薯蓣(山芋) 牛膝(去除苗,酒浸,切片,焙干) 白术(锉碎,各一两) 天雄(炮裂,去除皮脐,一分) 蛴螬(微炒) 干漆(炒至烟出) 狗脊(去除毛) 车前子 茵芋(各三钱) 萆薢(炒,半两)
以上十三味药,研为细末,用炼蜜制成如梧桐子大小的丸药。每次空腹用温酒送下二十丸,每日两次,夜间一次。
治疗各种风痹。附子酒方。
附子三枚(重二两的,炮裂,去除皮脐)
以上一味药,锉碎如麻豆大小,用优质酒五升,浸泡三到五天。每次温服一合,滤去药渣,以唇口麻痹感消失为度,每日两次。
Commentary states: The *Neijing* (Classic of Internal Medicine) asserts that the mixed invasion of wind, cold, and dampness pathogens combines to form Bi syndrome (obstruction syndrome). When wind pathogen predominates, it is termed Xing Bi (Wandering Bi). Qi in the human body is originally free-flowing; the occurrence of Bi obstruction is due to the combination of wind, cold, and dampness pathogens. Among these three pathogens, each possesses Yin and Yang attributes. Wind belongs to Yang Qi and is characterized by its ability to move rapidly and change frequently; therefore, when wind predominates, Xing Bi occurs. Its clinical manifestations involve pain or numbness wandering up, down, left, and right without fixed retention, following the path of the pathogen, resulting in the obstruction of Qi and Blood circulation. Although the treatment method requires promoting the circulation of Qi and Blood, it is advisable to predominantly use formulas that dispel wind.
For treating Xing Bi with wandering pain, Fangfeng Tang (Saposhnikovia Decoction) is indicated.
Fangfeng (Radix Saposhnikoviae, forked parts removed), Gancao (Radix Glycyrrhizae, honey-fried, crushed, 1 liang each), Huangqin (Radix Scutellariae, black heart removed, 3 qian), Danggui (Radix Angelicae Sinensis, sliced, dried), Chifuling (Poria Cocos with red skin, black peel removed, 1 liang each), Qinjiao (Rhizoma Gentianae Macrophyllae, seedlings and soil removed), Gegen (Radix Puerariae, crushed, 3 qian each), Guizhi (Ramulus Cinnamomi, coarse bark removed), Xingren (Semen Pruni Armeniacae, blanched, skin and tip removed, twin kernels discarded, fried, 1 liang each), Mahuang (Herba Ephedrae, roots and joints removed, decocted, foam skimmed off, dried, 0.5 liang).
The above ten ingredients are coarsely pounded and sieved. For each dose, take 5 qianbi, add one zhan of wine, one zhan of water, three dates (split open), and five slices of fresh ginger. Simmer together until one zhan remains, strain, and take warm. Administer twice daily and once at night.
For treating Xing Bi where head, face, limbs, and extremities are invaded, causing tendon and vessel spasms, immobility of hands and feet, sticky phlegm-saliva, slurred speech, confusion, and deviation of the mouth and eyes, Lingyangjiao Wan (Antelope Horn Pill) is indicated.
Lingyangjiao (Cornu Saigae Tataricae, shaved, 1 liang), Muxiang (Radix Aucklandiae), Qingju pi (Pericarpium Citri Reticulatae Viride, soaked in hot water, white pith removed, dried), Banxia (Rhizoma Pinelliae, washed in hot water, pounded with fresh ginger into a paste, dried), Qianghuo (Rhizoma et Radix Notopterygii, rhizome head removed), Duhuo (Radix Angelicae Pubescentis, rhizome head removed), Xiong (Rhizoma Chuanxiong), Huoxiang Ye (Folus Pogostemonis), Quanxie (Scorpio, earth removed, fried), Baihuashe (Bungarus multicinctus, wine-roasted, skin and bones removed), Shexiang (Moschus, ground), Niuhuang (Calculus Bovis, ground), Longnao (Borneolum Syntheticum, ground, 1 liang each).
The above seventeen ingredients, excluding those requiring grinding, are powdered finely, then mixed uniformly. Use one bowl each of Gaojiao juice (from Fructus Gleditsiae Sinensis), Bohe juice (Menthae Haplocalycis Herba), and E Li juice (Pyrus Betulifolia fruit juice), simmer together into a paste, mix with the powder to form pills the size of mung beans. Take seven pills per dose, with warm wine or Bohe tea decoction, at any time.
For treating Feng Bi with wandering pain without fixed location, and also for Xue Bi (Blood Bi), Bixie Wan (Dioscoreae Hypoglaucae Caulis Pill) is indicated.
Bixie (Caulis Dioscoreae Hypoglaucae), Shanyu (Rhizoma Dioscoreae Oppositae), Niuxi (Radix Achyranthis Bidentatae, seedlings removed, wine-soaked, dried), Zexie (Rhizoma Alismatis Orientals, 1 liang each), Shenggan Dihuang (Radix Rehmanniae Preparata, dried, 2.5 liang), Baizhu (Radix Atractylodis Macrocephalae, 0.5 liang), Yinyu (Fructus Cnidii), Qicao (Larva Silphidae, lightly fried), Ganqi (Resina Drynariae, fried until smoke appears), Gouji (Rhizoma Cibotii, hairs removed), Cheqianzi (Semen Plantaginis), Tianxiong (Radix Aconiti Lateralis Preparata, cracked, skin and navel removed, 1 fen each).
The above twelve ingredients are powdered finely, mixed with refined honey to form pills the size of Sophora japonica seeds. Take twenty pills per dose with warm wine, increasing to thirty pills, three times daily.
For treating Feng Bi with wandering pain without regular location, and also for Xue Bi, Shanzhuyu Wan (Fructus Corni Officinalis Pill) is indicated.
Shanzhuyu (Fructus Corni Officinalis, fried, 1 liang 1 fen), Shenggan Dihuang (Radix Rehmanniae Preparata, dried, 2.5 liang), Shanyu (Rhizoma Dioscoreae Oppositae), Niuxi (Radix Achyranthis Bidentatae, seedlings removed, wine-soaked, dried), Zexie (Rhizoma Alismatis Orientals), Bixie (Caulis Dioscoreae Hypoglaucae, 1 liang each), Tianxiong (Radix Aconiti Lateralis Preparata, cracked, skin and navel removed), Qicao (Larva Silphidae, lightly fried), Cheqianzi (Semen Plantaginis), Ganqi (Resina Drynariae, fried until smoke appears), Gouji (Rhizoma Cibotii, hairs removed), Baizhu (Radix Atractylodis Macrocephalae), Difuzi (Herba Kochiae Scopariae, 3 qian each), Yinyu (Fructus Cnidii, coarse stems removed, 0.5 liang).
The above fourteen ingredients are powdered finely, mixed with refined honey to form pills the size of Sophora japonica seeds. Take twenty pills per dose with warm wine, increasing to thirty pills, three times daily.
For treating various Feng Bi with migrating pain without fixation, Di Huang Wan (Rehmannia Pill) is indicated.
Shenggan Dihuang (Radix Rehmanniae Preparata, dried), Zexie (Rhizoma Alismatis Orientals), Shanzhuyu (Fructus Corni Officinalis, fried, 1 liang each), Shanyu (Rhizoma Dioscoreae Oppositae), Niuxi (Radix Achyranthis Bidentatae, seedlings removed, wine-soaked, sliced, dried), Baizhu (Radix Atractylodis Macrocephalae, crushed, 1 liang each), Tianxiong (Radix Aconiti Lateralis Preparata, cracked, skin and navel removed, 1 fen), Qicao (Larva Silphidae, lightly fried), Ganqi (Resina Drynariae, fried until smoke appears), Gouji (Rhizoma Cibotii, hairs removed), Cheqianzi (Semen Plantaginis), Yinyu (Fructus Cnidii, 3 qian each), Bixie (Caulis Dioscoreae Hypoglaucae, fried, 0.5 liang).
The above thirteen ingredients are powdered finely, mixed with refined honey to form pills the size of Sophora japonica seeds. Take twenty pills per dose on an empty stomach with warm wine, twice daily and once at night.
For treating various Feng Bi, Fuzi Jiu (Aconite Wine) is indicated.
Fuzi (Radix Aconiti Lateralis Preparata, three pieces, weighing two liang each, cracked, skin and navel removed).
The above single ingredient is crushed to the size of hemp seeds, soaked in five sheng of pure wine for three to five days. Take one ge of warm liquid per dose, strain, and continue until numbness of the lips and mouth disappears. Administer twice daily.