夫肉极者。主脾也。脾应肉。肉与脾合。若脾病则肉变色。至阴遇风。为肌痹。痹不已
复感
变。
汗。
动则
本
实则泻之。虚则补之。肉绝不治五日死。足太阴气绝。则脉不营其口唇。口唇者肌肉之本也
。脉不营。则肌肉不滑泽。肌肉不滑泽。则肉满。肉满则唇反。唇反则肉先死。甲日笃。乙
日死。木胜土。不可治也。
治肉极。肌肤如鼠走。津液开泄。或痹不仁。四肢急痛。薏苡仁散方。
薏苡仁（一两） 石膏（二两） 芎 （一两） 桂心（半两） 羚羊角（半两） 赤
芍药（半两） 防
两） 杏仁（半两汤浸去皮
上件药。捣粗罗为散。每服四钱。以水一中盏。入生姜半分。煎至六分。去滓。不计时
候温
治肉极。皮肤不通。表实里虚。外不得泄。腰脚疼痛。独活散方。
独活（二两） 当归（一两半） 白茯苓（一两半） 干姜（一两炮裂锉） 人参（一
两去芦头）
黄
两炙微
赤
上件药。捣粗罗为散。每服四钱。以水一大盏。入大豆半合。煎至五分。去滓。食前温
服。
治肉极。肌肉变。舌强阴缩。腰脚疼弱。防风散方。
防风（一两半去芦头） 独活（一两半） 白茯苓（一两半） 人参（一两去芦头） 干
姜（一
两炮
两）
桂心
上件药。捣粗罗为散。每服四钱。以水酒各半中盏。煎至六分。去滓。食前温服。
治肉极。虚寒则胁下阴阴。引背痛。不可以动。动则咳嗽胀满。留饮痰癖。大便不
利。小腹
半夏（一两汤洗七遍去滑） 白术（一两） 赤茯苓（一两） 人参（三分去芦头） 甘
草（半
两炙
香（三
分）
上件药。捣粗罗为散。每服三钱。以水一中盏。入生姜半分。枣三枚。煎至六分。去滓。
食
治肉极。坐卧不安。寒气所加。体重怠堕。四肢不举。关节疼痛。饮食无味。茯苓
散方。
白茯苓（二两） 黄 （二两锉） 牛膝（一两去苗） 附子（二两炮裂去皮脐） 人
参（一两
去芦
两） 桂心
（一两
上件药。捣筛为散。每服三钱。以水一中盏。入生姜半分。煎至六分。去滓。食前温服。
治肉极。身体津液大泄。为 风。若下焦虚极。则脚膝缓弱。并宜服石斛散方。
石斛（一两半去根锉） 牛膝（一两半去苗） 五加皮（一两） 白术（一两） 山茱
萸（一两）
天
仁（一两）
独活（一两） 防风（一两去芦头）
上件药。捣粗罗为散。每服三钱。以水一中盏。入生姜半分。枣三枚。煎至六分。去滓。
食
治肉极。则身上如鼠走。或风痹。唇口坼。皮肤色变。宜服石南散方。
石南（二两半） 薯蓣（三分） 黄 （三分锉） 山茱萸（三分） 天雄（半两炮裂
去皮脐）
桃花
两炙微赤
锉）
上件药。捣细罗为散。食前。以温酒调下二钱。
治肉极。四肢急强。连胁肋背。心下满痛。饮食不多。手足不举。忧恚思虑。宜服
人参丸方
人参（三两去芦头） 附子（三分炮裂去皮脐） 远志（半两去心） 白术（一两） 茯
神（一
两）
裂锉）
麦门冬
上件药。捣罗为末。炼蜜和捣二三百杵。丸如梧桐子大。食前。以温酒下三十丸。
治肉极。虚寒为脾风。体重怠堕。四肢不欲举。关节疼痛。不嗜饮食。黄 丸方。
黄 〔一（二）两锉〕 巴戟（二两） 桂心（一两） 石斛〔二（一）两去根锉〕 泽
泻（一
两）
芍药（一两）
山茱萸
术（一
两）
上件药。捣罗为末。炼蜜和捣三二百杵。丸如梧桐子大。每服空心。及晚食前。以温酒
下三
肉极，主要与脾脏有关。脾对应肌肉，肌肉与脾相合。如果脾有病，肌肉就会发生颜色变化。当至阴之气遇到风邪，就会形成肌痹（肌肉痹证）。如果肌痹不愈，再次感受邪气而发生变化，就会出现汗出异常、活动后症状加重等情况。治疗原则是：实证用泻法，虚证用补法。如果肌肉之气完全断绝，五天后会死亡。足太阴脾经之气断绝，则脉气不能濡养口唇。口唇是肌肉的根本所在。脉气不能濡养，肌肉就不滑润光泽；肌肉不滑润光泽，肌肉就会胀满；肌肉胀满则口唇外翻；口唇外翻说明肌肉之气先死。在甲日病情加重，乙日死亡。这是因为木克土，属于不可治愈的病症。
治疗肉极，表现为肌肤感觉像老鼠在皮下爬行，津液开泄外漏，或者出现麻木不仁、四肢拘急疼痛等症状。使用薏苡仁散方。
薏苡仁（一两） 石膏（二两） 川芎（一两） 桂心（半两） 羚羊角（半两） 赤芍药（半两） 防风（一两） 杏仁（半两，汤浸去皮尖及双仁）
以上药物，捣碎过粗罗成为散剂。每次服用四钱，用水一中盏，加入生姜半分，煎煮至六分，去渣滓。不分时候温服。
治疗肉极，表现为皮肤腠理不通，表实里虚，邪气外不得宣泄，腰脚疼痛。使用独活散方。
独活（二两） 当归（一两半） 白茯苓（一两半） 干姜（一两，炮裂锉碎） 人参（一两，去芦头） 黄芪（一两，炙微赤）
以上药物，捣碎过粗罗成为散剂。每次服用四钱，用水一大盏，加入大豆半合，煎煮至五分，去渣滓。饭前温服。
治疗肉极，表现为肌肉变形，舌体僵硬，阴器收缩，腰脚疼痛无力。使用防风散方。
防风（一两半，去芦头） 独活（一两半） 白茯苓（一两半） 人参（一两，去芦头） 干姜（一两，炮裂） 甘草（一两，炙微赤） 桂心（一两）
以上药物，捣碎过粗罗成为散剂。每次服用四钱，用水和酒各半中盏，煎煮至六分，去渣滓。饭前温服。
治疗肉极，虚寒导致胁下隐隐作痛，牵引背部疼痛，不能活动，活动后咳嗽胀满，体内留饮痰癖，大便不通利，小腹胀满。使用半夏散方。
半夏（一两，汤洗七遍去滑腻） 白术（一两） 赤茯苓（一两） 人参（三分，去芦头） 甘草（半两，炙微赤） 陈皮（三钱）
以上药物，捣碎过粗罗成为散剂。每次服用三钱，用水一中盏，加入生姜半分，大枣三枚，煎煮至六分，去渣滓。饭前温服。
治疗肉极，坐卧不安，寒气侵袭，身体沉重倦怠，四肢无法抬起，关节疼痛，饮食无味。使用茯苓散方。
白茯苓（二两） 黄芪（二两，锉碎） 牛膝（一两，去苗） 附子（二两，炮裂去皮脐） 人参（一两，去芦头） 甘草（一两，炙微赤） 桂心（一两）
以上药物，捣碎筛细成为散剂。每次服用三钱，用水一中盏，加入生姜半分，煎煮至六分，去渣滓。饭前温服。
治疗肉极，身体津液大量泄出，为风邪所伤。如果下焦极度虚弱，则脚膝软弱无力。都适宜服用石斛散方。
石斛（一两半，去根锉碎） 牛膝（一两半，去苗） 五加皮（一两） 白术（一两） 山茱萸（一两） 天雄（一两，炮裂去皮脐） 人参（一两） 独活（一两） 防风（一两，去芦头）
以上药物，捣碎过粗罗成为散剂。每次服用三钱，用水一中盏，加入生姜半分，大枣三枚，煎煮至六分，去渣滓。饭前温服。
治疗肉极，表现为身上感觉像老鼠爬行，或者风痹，口唇开裂，皮肤颜色改变。适宜服用石南散方。
石南（二两半） 薯蓣（三分） 黄芪（三分，锉碎） 山茱萸（三分） 天雄（半两，炮裂去皮脐） 桃花（三分） 甘草（半两，炙微赤） 桂心（三分，锉碎）
以上药物，捣碎细罗成为散剂。饭前，用温酒调服二钱。
治疗肉极，表现为四肢拘急强直，牵连胁肋背部，心下痞满疼痛，饮食减少，手足不能抬起，伴有忧恚思虑情绪。适宜服用人参丸方。
人参（三两，去芦头） 附子（三分，炮裂去皮脐） 远志（半两，去心） 白术（一两） 茯神（一两） 麦门冬（一两，去心）
以上药物，捣罗成为末，炼蜜调和捣杵二三百下，制成梧桐子大小的丸药。饭前，用温酒送服三十丸。
治疗肉极，因虚寒导致脾风，身体沉重倦怠，四肢不想抬起，关节疼痛，不喜欢饮食。使用黄芪丸方。
黄芪（二两，锉碎） 巴戟天（二两） 桂心（一两） 石斛（一两，去根锉碎） 泽泻（一两） 芍药（一两） 山茱萸（一两） 白术（一两）
以上药物，捣罗成为末，炼蜜调和捣杵三二百下，制成梧桐子大小的丸药。每次空腹及晚饭前，用温酒送服三丸。
Flesh Extreme primarily relates to the Spleen. The Spleen corresponds to flesh, and flesh is harmonized with the Spleen. If the Spleen is diseased, the flesh changes color. When Yin-Zhi (Extreme Yin) encounters Wind pathogen, it manifests as Muscle Bi (Muscle Obstruction Syndrome). If Muscle Bi persists and one is re-infected by pathogens causing transformation, symptoms such as abnormal sweating and aggravation upon movement may occur. The treatment principle is: for Excess patterns, use draining methods; for Deficiency patterns, use tonifying methods. If the Qi of the flesh is completely exhausted, death occurs within five days. When the Qi of the Foot-Taiyin (Spleen Meridian) is exhausted, the vessels fail to nourish the lips. The lips are the root of the flesh. If vessels fail to nourish, the flesh becomes rough and unsmooth; if the flesh is unsmooth, it becomes distended; if the flesh is distended, the lips evert; if the lips evert, the flesh dies first. The condition worsens on Jia days and leads to death on Yi days. This is because Wood overacts on Earth, making it incurable.
To treat Flesh Extreme, manifesting as a sensation of skin and muscles like mice running underneath, leakage of body fluids, or numbness and pain/stiffness in the four limbs, use Yiyiren San (Coix Seed Powder).
Yi Yi Ren (Coicis Semen, 1 liang), Shigao (Gypsum Fibrosum, 2 liang), Xiong (Ligustici Chuanxiong Rhizoma, 1 liang), Guixin (Cinnamomi Ramulus, 0.5 liang), Lingyangjiao (Saigae Tataricae Cornu, 0.5 liang), Chi Shaoyao (Paeoniae Radix Rubra, 0.5 liang), Fangfeng (Saposhnikoviae Radix, 1 liang), Xingren (Armeniacae Semen Amarum, 0.5 liang, soaked in decoction, skin and tips removed).
The above herbs are coarsely ground into powder. Take 4 qian per dose, with one zhongzhan of water and 0.5 fen of fresh ginger, decocted to 0.6 volume. Strain and take warm at any time.
To treat Flesh Extreme, manifesting as blocked skin pores, exterior excess with interior deficiency, inability to vent externally, and pain in the waist and legs, use Duhuo San (Angelicae Pubescentis Root Powder).
Duhuo (Angelicae Pubescentis Radix, 2 liang), Danggui (Angelicae Sinensis Radix, 1.5 liang), Baifuling (Poria, 1.5 liang), Ganjiang (Zingiberis Rhizoma, 1 liang, roasted and crushed), Renshen (Ginseng Radix, 1 liang, rhizome removed), Huangqi (Astragali Radix, 1 liang, honey-fried until slightly red).
The above herbs are coarsely ground into powder. Take 4 qian per dose, with one dazhan of water and half he of soybeans, decocted to 0.5 volume. Strain and take warm before meals.
To treat Flesh Extreme, manifesting as muscle deformation, stiff tongue, contraction of the yin organs, and weak pain in the waist and legs, use Fangfeng San (Saposhnikoviae Radix Powder).
Fangfeng (Saposhnikoviae Radix, 1.5 liang, rhizome removed), Duhuo (Angelicae Pubescentis Radix, 1.5 liang), Baifuling (Poria, 1.5 liang), Renshen (Ginseng Radix, 1 liang, rhizome removed), Ganjiang (Zingiberis Rhizoma, 1 liang, roasted), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried until slightly red), Guixin (Cinnamomi Ramulus, 1 liang).
The above herbs are coarsely ground into powder. Take 4 qian per dose, with half zhongzhan of water and half zhongzhan of wine, decocted to 0.6 volume. Strain and take warm before meals.
To treat Flesh Extreme, where deficiency-cold causes dull pain under the hypochondrium radiating to the back, immobility, cough and distension upon movement, retained fluid and phlegm masses, constipation, and lower abdominal fullness, use Banxia San (Pinelliae Rhizoma Powder).
Banxia (Pinelliae Rhizoma, 1 liang, washed seven times in hot water to remove slipperiness), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Chifuling (Poria with Red Hoof, 1 liang), Renshen (Ginseng Radix, 3 qian, rhizome removed), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, honey-fried until slightly red), Chenpi (Citri Reticulatae Pericarpium, 3 qian).
The above herbs are coarsely ground into powder. Take 3 qian per dose, with one zhongzhan of water, 0.5 fen of fresh ginger, and three jujubes, decocted to 0.6 volume. Strain and take warm before meals.
To treat Flesh Extreme, manifesting as restlessness in sitting and lying, invasion by cold pathogen, heavy body and lethargy, inability to lift the four limbs, joint pain, and loss of taste, use Fuling San (Poria Powder).
Baifuling (Poria, 2 liang), Huangqi (Astragali Radix, 2 liang, crushed), Niuxi (Achyranthis Bidentatae Radix, 1 liang, sprouts removed), Fuzi (Aconiti Lateralis Radix Praeparata, 2 liang, roasted, skin and umbilicus removed), Renshen (Ginseng Radix, 1 liang, rhizome removed), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried until slightly red), Guixin (Cinnamomi Ramulus, 1 liang).
The above herbs are finely ground into powder. Take 3 qian per dose, with one zhongzhan of water and 0.5 fen of fresh ginger, decocted to 0.6 volume. Strain and take warm before meals.
To treat Flesh Extreme, manifesting as massive leakage of body fluids and wind injury. If the Lower Jiao is extremely deficient, leading to flaccidity and weakness of the feet and knees, Shihu San (Dendrobii Caulis Powder) is suitable.
Shihu (Dendrobii Caulis, 1.5 liang, roots removed and crushed), Niuxi (Achyranthis Bidentatae Radix, 1.5 liang, sprouts removed), Wujia Pi (Acanthopanacis Cortex, 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Shanzhuyu (Corni Fructus, 1 liang), Tianxiong (Aconiti Kusnezoffii Radix, 1 liang, roasted, skin and umbilicus removed), Renshen (Ginseng Radix, 1 liang), Duhuo (Angelicae Pubescentis Radix, 1 liang), Fangfeng (Saposhnikoviae Radix, 1 liang, rhizome removed).
The above herbs are coarsely ground into powder. Take 3 qian per dose, with one zhongzhan of water, 0.5 fen of fresh ginger, and three jujubes, decocted to 0.6 volume. Strain and take warm before meals.
To treat Flesh Extreme, manifesting as a sensation of mice running on the body, wind-bi, cracked lips and mouth, and changed skin color, Shinan San (Rhododendri Daurici Folium Powder) is suitable.
Shinan (Rhododendri Daurici Folium, 2.5 liang), Shuyao (Dioscoreae Rhizoma, 3 qian), Huangqi (Astragali Radix, 3 qian, crushed), Shanzhuyu (Corni Fructus, 3 qian), Tianxiong (Aconiti Kusnezoffii Radix, 0.5 liang, roasted, skin and umbilicus removed), Taohua (Prunus Persicae Flos, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, honey-fried until slightly red), Guixin (Cinnamomi Ramulus, 3 qian, crushed).
The above herbs are finely ground into powder. Before meals, mix 2 qian with warm wine and take.
To treat Flesh Extreme, manifesting as stiffness and rigidity of the four limbs extending to the hypochondrium and back, epigastric fullness and pain, reduced food intake, inability to lift hands and feet, accompanied by worry and anxiety, Ren Shen Wan (Ginseng Pill) is suitable.
Renshen (Ginseng Radix, 3 liang, rhizome removed), Fuzi (Aconiti Lateralis Radix Praeparata, 3 qian, roasted, skin and umbilicus removed), Yuanzhi (Polygalae Radix, 0.5 liang, heart removed), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Fushen (Poria with Pine Root, 1 liang), Maimendong (Ophiopogonis Radix, 1 liang, heart removed).
The above herbs are ground into fine powder, mixed with refined honey, and pounded 200-300 times to form pills the size of paulownia seeds. Before meals, take 30 pills with warm wine.
To treat Flesh Extreme due to deficiency-cold causing Spleen Wind, manifesting as heavy body and lethargy, unwillingness to lift the four limbs, joint pain, and aversion to food, Huangqi Wan (Astragalus Pill) is used.
Huangqi (Astragali Radix, 2 liang, crushed), Bajiji (Morindae Officinalis Radix, 2 liang), Guixin (Cinnamomi Ramulus, 1 liang), Shihu (Dendrobii Caulis, 1 liang, roots removed and crushed), Zexie (Alismatis Rhizoma, 1 liang), Shaoyao (Paeoniae Radix, 1 liang), Shanzhuyu (Corni Fructus, 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang).
The above herbs are ground into fine powder, mixed with refined honey, and pounded 200-300 times to form pills the size of paulownia seeds. Take 3 pills on an empty stomach and before evening meal with warm wine.