膝头重大作痛，腿胫渐细故名。致筋挛不能屈伸，由风寒湿气流注也，更宜风湿痹门捡方急治
。有日久不痊，延及臀股，肿大出脓，至肉削而毙者。
主方 羌活 防风 白芷 当归 牛膝 苡仁 川芎 川乌 杜仲 白术 木瓜 水煎服。
瘀血加桃仁、漏芦；筋挛加木瓜、秦艽、威灵仙；痛甚加乳、没，研细调服。或小续命汤加川
萆、川楝子、羌、独活、木瓜，服时调麝香少许。后以五积散去麻黄，酒煎服。
膝肿大痛∶旱莲草（摘断黑者）一握，捣，入糯饭（一团）酒菜（一块）匀，烘放膝上，箬油
纸、布包火熨，闻酒香，数日愈；未安再包。或陈年糟炒热包暖。
又 无名异（五钱） 地骨皮（三钱） 乳香 没药（各研钱半） 麝（一分，研匀） 车前
草汁，入酒调敷。
经曰∶阳虚生外寒。盖阳气不能外卫，所以恶寒。必背恶寒甚，脉浮无力，阳虚，宜参 之类
。甚者加附子三分。病久而恶寒者，亦宜解郁。盖恶寒非寒，明是热证，火极似水，热甚而反觉自
冷，实非
寒也。有用热药少愈者，以辛能发散，郁遏暂开耳。又曰∶火热内炽，寒必荡外。故实非寒证以辩
理，并外证参酌，拟定寒热用药。
主方 （寒邪内伏） 人参 白术 干姜 炙草 白茯苓 半夏 肉桂 五味子 陈皮 姜、枣
煎。热月犹要浓绵衣加附子。
清凉饮 恶寒而脉洪数，兼目痛口渴，心烦便秘，属热。
黄连 黄芩 栀子 连翘 薄荷 甘草
上加灯心，水煎服。有夏月外棉衣，脉洪数，小便短赤，大便秘结，加大黄、芒硝，愈。饮酒
人恶寒，黄 （二两，） 葛根（一两）煎服。汗出，安。
膝盖肿大且剧烈疼痛，小腿逐渐变细，因此得名。导致筋脉拘挛、无法屈伸，是由于风寒湿邪气流注所致，更应当从风湿痹证门类中挑选方剂紧急治疗。若病程日久不愈，蔓延至臀部和大腿，出现肿胀化脓，直至肌肉消瘦而死亡的案例也有。
主方：羌活、防风、白芷、当归、牛膝、苡仁、川芎、川乌、杜仲、白术、木瓜，用水煎服。若有瘀血，加入桃仁、漏芦；若筋脉拘挛，加入木瓜、秦艽、威灵仙；若疼痛剧烈，加入乳香、没药，研成细末调服。或者使用小续命汤（Minor Xu Ming Decoction），加入川萆薢、川楝子、羌活、独活、木瓜，服用时调入少许麝香。之后用五积散（Wu Ji San）去掉麻黄，用酒煎服。
膝盖肿大疼痛：取一把折断后呈黑色的旱莲草（Ecliptae Herba），捣碎，加入一团糯米饭、一块酒糟，混合均匀，烘热后敷在膝盖上，用箬竹叶油纸和布包裹，用火熨烫，闻到酒香味，数日可愈；若未痊愈，再包裹熨烫。或者用陈年的酒糟炒热后包裹保暖。
又方：无名异（五钱）、地骨皮（三钱）、乳香、没药（各研细一钱半）、麝香（一分，研匀），用车前草汁，加入酒调和后外敷。
《内经》说：阳气虚弱产生外寒。大概是因为阳气不能在外护卫体表，所以感到恶寒。必定是背部特别怕冷，脉象浮而无力，属于阳虚，适宜用人参等药物。严重的加附子三分。患病日久且恶寒的，也适宜疏解郁结。因为恶寒并非真正的寒证，明明是热证，火极似水，热势极盛反而觉得自身发冷，实际上并不是寒证。有用热药稍微缓解的，是因为辛味能发散，使郁遏暂时开通罢了。又说：火热在内炽盛，寒气必然被荡涤于外。所以如果不是寒证，要通过辨析医理，并结合外在症状参考斟酌，拟定寒热用药。
主方（寒邪内伏）：人参、白术、干姜、炙甘草、白茯苓、半夏、肉桂、五味子、陈皮，加生姜、大枣煎服。即使在炎热的月份，也要穿厚棉衣，并加入附子。
清凉饮（Qing Liang Yin）：恶寒且脉象洪大数急，兼有眼痛口渴、心烦便秘，属于热证。黄连、黄芩、栀子、连翘、薄荷、甘草，上加灯心草，用水煎服。若是夏天穿着薄棉衣，脉象洪大数急，小便短赤，大便秘结，加入大黄、芒硝，即可痊愈。饮酒之人恶寒，用黄芪（二两）、葛根（一两）煎服。汗出后，病情安定。
The knee becomes swollen and large with severe pain, while the calf gradually thins, hence the name. This leads to tendon spasms preventing flexion and extension, caused by the flow and accumulation of Wind-Cold-Dampness pathogens. It is advisable to urgently select a prescription from the section on Wind-Damp Bi Syndrome for treatment. If the condition persists for a long time without recovery, it may spread to the buttocks and thighs, causing swelling and suppuration, leading to emaciation and death.
Main Prescription: Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Bai Zhi (Angelicae Dahuricae Radix), Dang Gui (Angelicae Sinensis Radix), Niu Xi (Achyranthis Bidentatae Radix), Yi Yi Ren (Coicis Semen), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Chuan Wu (Aconiti Kusnezoffii Radix), Du Zhong (Eucommiae Cortex), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Mu Gua (Chaenomelis Fructus). Decoct in water and take orally.
If there is blood stasis, add Tao Ren (Persicae Semen) and Lou Lu (Lehmannia Cernua Root); if there are tendon spasms, add Mu Gua, Qin Jiao (Gentianae Macrophyllae Radix), and Wei Ling Xian (Clematidis Radix); if pain is severe, add Ru Xiang (Olibanum) and Mo Yao (Myrrha), grind into fine powder, and mix for oral administration. Alternatively, use Xiao Xu Ming Tang (Minor Xu Ming Decoction), adding Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Chuan Lian Zi (Meliae Fructus), Qiang Huo, Du Huo (Angelicae Pubescentis Radix), and Mu Gua. When taking, mix in a small amount of She Xiang (Moschus). Subsequently, use Wu Ji San (Five Accumulations Powder) removing Ma Huang (Ephedrae Herba), decocted in wine.
For swollen and painful knees: Take a handful of Han Lian Cao (Ecliptae Herba) that turns black when broken, crush it, add a ball of glutinous rice and a piece of fermented rice cake (Jiu Zao), mix evenly, warm it, and apply to the knee. Wrap with oil-paper made from bamboo leaves and cloth, and apply heat熨 (ironing/warming). When the aroma of wine is detected, it will heal in a few days; if not fully healed, re-wrap and apply heat. Alternatively, stir-fry old fermented rice cake until hot and wrap for warmth.
Another Prescription: Wu Ming Yi (Hematitum, 5 qian), Di Gu Pi (Lycii Cortex, 3 qian), Ru Xiang, Mo Yao (each ground to 1.5 qian), She Xiang (She Xiang, 1 fen, ground evenly). Mix with Che Qian Cao (Plantaginis Herba) juice and wine for external application.
The *Classic* states: "Yang deficiency generates external cold." This is because Yang Qi cannot defend the exterior, thus causing aversion to cold. Specifically, there is severe aversion to cold in the back, and the pulse is floating and weak, indicating Yang deficiency. It is suitable to use drugs like Ren Shen (Ginseng Radix et Rhizoma). In severe cases, add Fu Zi (Aconiti Lateralis Radix Praeparata), 3 fen. For those who have been ill for a long time and suffer from aversion to cold, it is also appropriate to resolve stagnation. Aversion to cold is not true cold; it is clearly a heat syndrome. Extreme fire resembles water; when heat is extreme, one feels cold internally, but it is actually not cold. Some find slight relief with hot medicines because pungent flavors can disperse and temporarily open up stagnation. It is also said: "When fire-heat blazes within, cold must be swept away externally." Therefore, if it is not a cold syndrome, one must analyze the pathology and consult external symptoms to determine the use of cold or hot medications.
Main Prescription (for latent Cold Pathogens within): Ren Shen, Bai Zhu, Gan Jiang (Zingiberis Rhizoma), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Bai Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma), Rou Gui (Cinnamomi Cortex), Wu Wei Zi (Schisandrae Fructus), Chen Pi (Citri Reticulatae Pericarpium). Decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus). Even in hot months, wear thick cotton clothes and add Fu Zi.
Qing Liang Yin (Cooling Drink): Aversion to cold with a flooding and rapid pulse, accompanied by eye pain, thirst, restlessness, and constipation, belongs to Heat. Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), Lian Qiao (Forsythiae Fructus), Bo He (Menthae Haplocalycis Herba), Gan Cao (Glycyrrhizae Radix et Rhizoma). Add Deng Xin Cao (Junci Medullia), decoct in water and take orally. If in summer, wearing thin cotton clothes, with a flooding and rapid pulse, short and red urine, and severe constipation, add Da Huang (Rhei Radix et Rhizoma) and Mang Xiao (Natrii Sulfas), which will lead to recovery. For drinkers suffering from aversion to cold, use Huang Qi (Astragali Radix, 2 liang) and Ge Gen (Puerariae Lobatae Radix, 1 liang), decoct and take orally. Once sweating occurs, the condition stabilizes.