（妇人症见《妇人良方》，小儿症见《保婴粹要》）
鹤膝风乃调摄失宜，亏损足三阴经，风邪乘虚而入，以致肌肉日瘦，内热减食，肢体挛
痛，久则膝大而腿细，如鹤之膝，故名之。若伤于脾胃者，补中益气汤为主。伤于肝肾者，六味
丸为主。若欲其作脓，或溃后，十全大补汤为主，皆佐以大防风汤。初起须以葱熨，可以内
消。若津涸口干，中气不足也，补中益气汤加五味子。头晕头痛，阳气不升也，补中益气汤
加蔓荆子。发热晡热，阴血虚弱也，用四物、参、 、白术。畏寒憎寒，阳气虚弱也，用十
全大补汤。饮食少思，胸膈膨胀，脾胃虚痞也，用四君子汤。面色痿黄，饮食少思，脾胃虚
弱也，用六君子汤。脓水清稀，肌肉不生，气血俱虚也，用八珍汤。热来复去，有时而动，
无根虚火也，用十全大补汤。形瘦嗜卧，寝息发热，痰盛作渴，小便频数，五脏虚损也，用
六味丸。脐腹疼痛，夜多漩溺，脚膝无力，头晕吐痰，肾气冷败也，用八味丸。发热大渴，
不欲近衣，面目赤色，脉大而虚，血虚发燥也，用当归补血汤。或有痢后而患者，亦治以前
法。余当临症制宜。
治验
州守张天泽，左膝肿痛，胸膈痞满，饮食少思，时欲作呕，头晕痰壅，日晡益倦。此脾
肺气
防风汤，十余剂；又用补中益气，三十余剂而消。
通府刘国威，先筋挛骨痛，右膝漫肿。用化痰消毒之剂，肿痛益甚，食少体倦；加祛风
消毒等药，寒热作呕，大便不实；用二陈除湿之类，肿起色赤，内痛如锥。余诊其脉，滑数而无
力，此脓已成，元气虚而不能溃也，用十全大补汤四剂，佐以大防风汤，一剂而溃；又百余
一儒者腿筋弛长，月余两膝肿痛，此阴虚湿热所乘也，用六味丸为主，佐以八珍汤，加
牛膝、杜仲，间以补中益气汤，三月余而消。
一男子腿痛膝肿，脉浮按之弦紧，此肝肾虚弱也，用大防风汤，二剂已退。彼惑于附子
有毒
小便不禁，膀胱虚而不能约制也；燥热虚痞，胃气弱而不能化也；恍惚健忘，精神失而愦乱
也。恶症蜂集，余辞之，后果殁。
（妇女的病症记载于《妇人良方》，小儿的病症记载于《保婴粹要》）
鹤膝风是由于调养摄生不当，导致足三阴经（肝、脾、肾经）亏损，风邪乘虚侵入，致使肌肉日渐消瘦，出现内热、食欲减退、肢体拘挛疼痛等症状。日久则膝盖肿大而小腿纤细，状如鹤之膝，因此得名。若病由脾胃损伤引起，以补中益气汤为主治方剂；若病由肝肾损伤引起，以六味丸为主治方剂。若希望脓液形成，或在溃破之后，以十全大补汤为主治方剂，均配合使用大防风汤。疾病初起时需用葱白熨烫患处，可以使病灶从内部消散。若津液枯竭、口干，属于中气不足，用补中益气汤加五味子。头晕头痛，属于阳气不能上升，用补中益气汤加蔓荆子。发热或傍晚发热，属于阴血虚弱，用四物汤加人参、[原文缺字，据理应为茯苓或类似健脾药]、白术。畏寒或憎恶寒冷，属于阳气虚弱，用十全大补汤。饮食减少且思食欲低，胸膈部胀满，属于脾胃虚痞，用四君子汤。面色萎黄，饮食减少且思食欲低，属于脾胃虚弱，用六君子汤。脓水清稀，肌肉不生，属于气血俱虚，用八珍汤。热感来去无常，定时发作，属于无根虚火，用十全大补汤。形体消瘦、嗜睡卧床，睡眠呼吸时发热，痰多口渴，小便频数，属于五脏虚损，用六味丸。脐腹部疼痛，夜间多尿，脚膝无力，头晕吐痰，属于肾气冷败，用八味丸。发热且大渴，不想靠近衣物，面目红色，脉象大而虚，属于血虚发燥，用当归补血汤。或者在痢疾后患病者，也以前述方法治疗。其余情况应当根据临证具体情况灵活制宜。
治疗案例：
州守张天泽，左膝肿痛，胸膈痞闷胀满，饮食减少且思食欲低，时常想呕吐，头晕痰壅，傍晚时分更加疲倦。此乃脾肺气虚所致，先用大防风汤十余剂；又用补中益气汤三十余剂，肿块消散。
通府刘国威，先出现筋脉拘挛骨痛，右膝弥漫性肿胀。使用化痰消毒的药物，肿痛反而加重，食少体倦；加入祛风消毒等药物，出现寒热往来、呕吐，大便不成形；使用二陈汤除湿之类药物，肿处颜色变红，内部疼痛如锥刺。我诊察其脉象，滑数但无力，这是脓已形成，元气虚弱而不能溃破，用十全大补汤四剂，配合大防风汤，一剂后溃破；又服用百余剂……
一位儒者腿部筋脉弛缓伸长，月余后两膝肿痛，这是阴虚湿热所侵袭，以六味丸为主治方剂，配合八珍汤，加牛膝、杜仲，间服补中益气汤，三月余后消散。
一名男子腿痛膝肿，脉浮取弦紧，这是肝肾虚弱，用大防风汤，两剂后退去。他因受附子有毒的说法迷惑……小便失禁，是膀胱虚弱不能约束；燥热虚痞，是胃气弱不能运化；恍惚健忘，是精神失守而昏乱。恶症蜂拥而至，我推辞不治，后来果然去世。
(The symptoms in women are described in *Furen Liangfang*, and those in children in *Baoying Cuiyao*.)
He Xi Feng (Crane's Knee Wind) results from improper regulation of life and diet, leading to deficiency of the Foot Three Yin Meridians (Liver, Spleen, Kidney). Pathogenic wind enters due to this deficiency, causing muscles to waste away daily, internal heat, reduced appetite, and limb spasms with pain. Over time, the knees become enlarged while the legs grow thin, resembling a crane's knee, hence the name. If the injury is to the Spleen and Stomach, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is the primary formula. If the injury is to the Liver and Kidneys, Liu Wei Wan (Six-Ingredient Pill with Rehmannia) is the primary formula. If suppuration is desired, or after ulceration, Shi Quan Da Bu Tang (Great Tonifying Decoction for Ten Powers) is the primary formula, always assisted by Da Fang Feng Tang (Major Saposhnikovia Decoction). In the initial stage, moxibustion or hot compresses with scallions should be applied to resolve the condition internally. If fluids are depleted and the mouth is dry, it indicates insufficiency of Middle Qi; use Bu Zhong Yi Qi Tang with added Wu Wei Zi (Schisandra Fruit). Dizziness and headache indicate failure of Yang Qi to ascend; use Bu Zhong Yi Qi Tang with added Man Jing Zi (Vittatis Seed). Fever or afternoon fever indicates deficiency of Yin Blood; use Si Wu Tang (Four Substances Decoction) with added Ren Shen (Ginseng), [character missing in original], and Bai Zhu (Atractylodes Rhizome). Aversion to cold indicates deficiency of Yang Qi; use Shi Quan Da Bu Tang. Reduced desire for food and distension in the chest and epigastrium indicate Spleen-Stomach deficiency with stagnant Qi; use Si Jun Zi Tang (Four Gentlemen Decoction). Withered yellow complexion and reduced desire for food indicate Spleen-Stomach weakness; use Liu Jun Zi Tang (Six Gentlemen Decoction). Thin and clear pus with non-healing flesh indicates dual deficiency of Qi and Blood; use Ba Zhen Tang (Eight Treasures Decoction). Intermittent fever occurring at specific times indicates rootless deficient fire; use Shi Quan Da Bu Tang. Emaciation, lethargy, fever during sleep/respiration, profuse phlegm, thirst, and frequent urination indicate deficiency and damage to the Five Zang Organs; use Liu Wei Wan. Pain in the umbilical and abdominal regions, nocturnal enuresis, weakness in the feet and knees, dizziness, and expectoration of phlegm indicate cold degeneration of Kidney Qi; use Ba Wei Wan (Eight-Ingredient Pill with Rehmannia). Fever with intense thirst, aversion to clothing, redness of the face and eyes, and a large but empty pulse indicate dryness arising from Blood deficiency; use Dang Gui Bu Xue Tang (Angelica Tonifying Blood Decoction). Cases occurring after dysentery are also treated by the aforementioned methods. Other cases require adaptation to clinical circumstances.
**Clinical Records:**
Zhang Tianze, Prefectural Administrator, presented with swelling and pain in the left knee, fullness and stagnation in the chest and epigastrium, reduced appetite, frequent urge to vomit, dizziness with phlegm obstruction, and increased fatigue in the late afternoon. This was due to deficiency of Spleen and Lung Qi. First, Da Fang Feng Tang was administered for over ten doses; subsequently, Bu Zhong Yi Qi Tang was used for over thirty doses, resulting in resolution.
Liu Guowei, Circuit Intendant, initially suffered from tendon spasms and bone pain, followed by diffuse swelling of the right knee. Treatment with phlegm-resolving and toxin-dispelling agents exacerbated the swelling and pain, accompanied by poor appetite and fatigue. Addition of wind-dispelling and toxin-dispelling herbs led to alternating chills and fever, vomiting, and loose stools. Use of Er Chen Tang (Two-Cured Decoction) for dampness resulted in reddish swelling and severe internal pain like needle pricks. Upon palpation, the pulse was slippery, rapid, yet forceless, indicating that pus had formed but Yuan Qi (Original Qi) was too weak to cause rupture. Shi Quan Da Bu Tang was administered for four doses, assisted by Da Fang Feng Tang; rupture occurred after one dose. After more than a hundred doses...
A scholar suffered from laxity and elongation of leg tendons, followed by bilateral knee swelling and pain after a month. This was caused by damp-heat invading due to Yin deficiency. Liu Wei Wan was used as the main formula, assisted by Ba Zhen Tang, with added Niu Xi (Achyranthes Root) and Du Zhong (Eucommia Bark), interspersed with Bu Zhong Yi Qi Tang. Resolution occurred after more than three months.
A man presented with leg pain and knee swelling. The pulse was floating and taut/tight upon pressure, indicating Liver and Kidney deficiency. Da Fang Feng Tang was administered, and symptoms receded after two doses. Confused by the belief that Fu Zi (Aconite Lateral Root) is toxic... Urinary incontinence indicates Bladder deficiency failing to constrain; dry heat and false stagnation indicate weak Stomach Qi failing to transform;恍惚 (trance-like state) and forgetfulness indicate loss of Spirit causing confusion. Malignant symptoms converged. I declined treatment; he subsequently died.