而精神饮食如常，与甘露饮加藕汁、童便，四剂而止，咳嗽亦安。于是专治其下部之肿以固本，加知、柏、
贝母、花粉、旋复花、橘络、丝瓜筋、羚羊角、楝实、葱须、大豆卷、黄芩、薏苡仁、竹沥，出入为剂，
二三帖肿处痒甚，搔之水出如汗，而作葱气。六七日后，两腿反干瘦燥痛，肾囊亦随之而消矣。盖寒湿则
伤阳，热湿则伤阴，血流皆阴也。大用甘润，尚且肿消，后干痛咽燥，设投燥脾利水，当何如哉？善后
之法，宜滋养血液，少佐竹沥，以搜络中未净之痰，庶免为异日之累。如法服之，竟无消渴之变而愈。
朱丹溪治一丈人，年七十岁，患脚膝病稍肿，此血虚而挟湿热也。用生地、归头、白芍、苍术、炒柏、
川芎、桂、木通，水煎，食前热服。
一男子年近三十，滋味素浓，性多焦怒。秋间髀枢左右一点发痛，延及膝 ，昼静夜剧，痛处恶寒，或渴
或不渴，或痞或不痞，医多用风药兼补血。次年春，其膝渐渐肿痛愈甚，食减形羸。至春末膝肿如桃，不
可屈伸。诊其脉，左弦大颇实，寸涩甚，右皆数大。知其小便必数而短，遂作饮食痰积在太阴经治之。炒
柏一两，生甘草梢、犀角屑、苍术、盐各三钱，川芎二钱，陈皮、牛膝、木通、白芷、白芍各五钱，遇暄热加
条芩三钱，为细末，每三钱重，与生姜自然汁同研细，以水荡起。煎令沸，带热食前饮之，一昼夜四次。与至
半月后，数脉渐减，痛渐轻。去犀角，加牛膝、败龟板半两，当归半两，如前服。又与半月，肿渐减，食渐
进，不恶寒。惟脚膝酸软，未能久立久行，去苍术、黄芩，时当夏热，加炒柏至一两半，根据本方内加牛膝，春
夏用茎叶，冬用根梗，取汁用之效尤速。须断酒肉、湿面、胡椒。当仲夏加生地半两，冬加茱萸、桂枝。
镇江外科史姓者，曾治一人鹤膝风，以虾蟆用碗锋略破腹有缝，不可穿缚，置患处跳动移时，受毒辄死。
如前再易一枚，不过三枚愈。（《戒庵漫笔》李诩。）
孙文垣治程绍溪，中年患鹤膝风，两腿及腿肚内外， 肉尽削，两膝肿大，乃酒后纵欲所致。且四肢脓疥
淫湿腌 ，自分必死。家人以病久医药破家，不复求治。孙以邻人之亲往诊，左寸关浮数，右寸短弱，两尺脉
沉微。曰∶此气虚血热之候，法当大补，壮其筋骨，犹可冀生，第非百日不见功。盖补血无速效，必渐而濡之，
关节通利，骨正筋柔，腿肉自生。初以龟板、苡仁各三钱，苍耳子、五加皮、头二蚕砂、节节香各一钱，当归、
人参、黄 、苍术、杜仲、黄柏各八分，红花八分，十剂而疮疥渐稀，精神稍长。再以苡仁、五加皮、龟板各
二钱，节节香、苍耳子、地黄、丹参、苍术、黄柏、首乌各一钱，人参、当归各八分，红花、木通各五分，三
十剂可倚杖而行，腿肉渐生，疮疥尽愈，膝肿消去其六。后以虎潜丸加鹿角胶、首乌、狗脊、节节香、牛膝，
用龟胶为丸，服三月，腿肉复完而愈。
薛立斋治韩廷仪，先患风症，用疏风化痰养血之药而痊。其腿膝骨肉内发热作痛，服十味固本丸、天麻丸
益甚，两尺脉数而无力。谓此肾水虚，不能生肝木，虚火内动而作，非风邪所致也。不信，又服羌活愈风丹之
类，四肢痿软，遍身麻木，痰涎上涌，神思不清。曰∶此皆脾气亏损，不能荣养周身，又不能摄涎归源。先用
六君子、芎、归、木香，数剂，以助五脏生化之气，以荣养周身，而诸症渐愈。乃朝以补中益气汤培养脾肺，
夕以六味丸滋补肝肾，如此三月而安。
一妇人久郁怒，膝肿胸胁不利，内热寒热，经候不调，遍身酸痛，此胃气亏损。先用补中益气汤加半夏、
茯苓，三十余剂胃气渐醒。又用大风汤与归脾汤，膝肿渐消。用加味逍遥散、大风汤全消。又用八珍汤加丹皮，
调理而安。
一妇人患前症，肿痛寒热，先用大风一剂，又用加味逍遥散四剂、月余肿痛渐退。惑于速效，另服劫风败
毒，虚症蜂起。仍由用大防风为主，佐以十全大补而消。又服大补汤，两月而全愈。
一妇人患前症，两拗中腿股筋牵作痛，内热寒热，此肝火气滞之症。先用加味小柴胡汤，四剂后，以加味
逍遥散为主，佐以大防风汤而消。又患痢后两膝肿痛，寒热往来，用十全大补汤为主，佐以防风汤而消。
一妇人患前症，虽溃而肿不消，朝寒暮热，饮食不思，经水三四月一至，此肝脾气血俱虚也。用补中益气、
加味归脾二汤各三十余剂，肿渐消而寒热止。又佐以大防风，月余而能步履，再月余经行如期。又服六味丸、
八珍汤，三月而愈。
一男子腿筋弛长月余，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。
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。诊其脉滑而无力，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，又百余剂而愈。
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，乃服治疡之
药，日渐消瘦，虚症渐至，复求治。曰∶倦怠消瘦，脾肾衰而不能营运也；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，精神衰而昏乱也。恶症蜂集，辞之，后果殁。
一男子患腿痛，膝微肿，轻诊则浮，按之弦紧，此鹤膝风也。与大防风汤二剂，已退二三。彼谓附子有毒，
乃服败毒药，日渐消瘦。复求治，薛谓今饮食不为肌肤，水谷不能运化精微，灌溉脏腑周身百脉，神将何根据？
夫气短而促，真气损也，怠惰嗜卧，脾气虚也；小便不禁，膀胱不藏也；时有躁热，心下虚痞，胃气不能上荣
也；恍惚健忘，神明乱也。不治，后果然。此症多患于不足之人，故以加减小续命、大防风二汤有效。若服攻
毒药必误。
一妇人膝肿痛，遇寒痛益甚，月余不愈，诸药不应，脉弦紧，此寒邪深伏于内也。用大防风汤及火龙膏治
之而消。大抵此症，虽云肿有浅深，感有轻重，其所受皆因真气虚弱，邪气得以深袭。若真气壮实，邪气焉能
为患也？故附骨痈疽及鹤膝风症，虚者多患之。前人用附子者，以补温肾气，而又能行药势散寒邪也。亦有体
虚之人，秋夏露卧，为冷气所袭，寒热伏结，多成此症。不能转动，乍寒乍热而无汗，按之痛应骨者是也。若
经久下消，极阴生阳，寒化为热而溃也。若被贼风所伤，患处不甚热，而洒淅恶寒，不时汗出，熨之痛止，须
大防风汤及火龙膏治之。若失治，为弯弓曲偏枯，硬如石，谓之石疽。若热暖积日不溃，肉色紫赤，皮肉俱烂，
名绶疽。其始末皆宜服前汤，欲其驱散寒邪以补虚托里也。
一人患鹤膝风五年，敷药三日即愈。王心涵传乳香、没药各一钱五分，地骨皮三钱，无名异五钱，麝香
一分，各为末，车前草捣汁入老酒少许，调敷患处。（《广笔记》。）
立斋治一男子左膝肿大，三月不溃。谓体虚之人，风邪袭于骨节，使气滞而不行，故膝愈大而腿愈细，名
曰鹤膝风，遂以大防风汤三十余剂而消。张上舍亦患此，伏枕半载，流脓三月。彼云∶初服大防风汤去附子一
钱，服三十余剂少愈，乃去附子五钱。服至三十余剂将愈，乃去附子。更以三十余剂而愈。盖桂、附当用而不
用，则无力也。
王汝道膝腿肿，筋骨痛，服十宣散不应。脉沉细，以五积散二剂而痛止。更以十宣散去桔梗，加牛膝、杜
仲，三十余剂脓溃而愈。此寒气之肿，八风之变也。
然而患者精神与饮食均正常，给予甘露饮加藕汁、童便（儿童尿液），服用四剂后症状停止，咳嗽也随之安宁。于是专门治疗下部的肿胀以固护根本，加入知母、黄柏、贝母、天花粉、旋覆花、橘络、丝瓜筋、羚羊角、川楝子、葱须、大豆卷、黄芩、薏苡仁、竹沥，根据病情变化调整药味组成，服用二三帖后，肿胀处瘙痒剧烈，搔抓后流出液体如汗，并散发葱的气味。六七日后，双腿反而变得干瘦燥痛，阴囊也随之消退。这是因为寒湿损伤阳气，热湿损伤阴液，血液运行皆属阴分。大量使用甘润药物，尚且能使肿胀消退，后来出现干燥疼痛、咽喉干燥，如果投用燥脾利水的药物，将会怎样呢？善后调理的方法，应当滋养血液，少量佐以竹沥，以搜剔经络中未清除干净的痰浊，以免成为日后的祸患。按照这种方法服药，最终没有发生消渴病的变化而痊愈。
朱丹溪治疗一位七十岁的老人，患有脚膝部位轻微肿胀，这是血虚兼夹湿热所致。使用生地、当归头、白芍、苍术、炒黄柏、川芎、桂枝、木通，水煎煮，饭前热服。
一名男子接近三十岁，平时口味浓厚，性情多焦躁易怒。秋季髀枢左右某一点开始发痛，蔓延至膝盖，白天安静夜间加剧，疼痛部位怕冷，有时口渴有时不渴，有时痞闷有时不痞闷，医生多用风药兼补血药治疗。次年春季，其膝盖逐渐肿痛更加严重，食欲减退，形体消瘦。到了春末，膝盖肿胀像桃子一样大，不能屈伸。诊察其脉象，左手脉弦大且颇实，寸口脉涩滞严重，右手脉皆数大。推断他小便必然频数且短少，于是将其作为饮食痰积在太阴经的病证来治疗。将炒黄柏一两，生甘草梢、犀角屑、苍术、盐各三钱，川芎二钱，陈皮、牛膝、木通、白芷、白芍各五钱，遇到天气暄热时加条芩三钱，研成细末，每次取三钱重，与生姜自然汁一同研磨细碎，用水荡起药渣。煎至沸腾，带热在饭前饮用，一昼夜四次。服用到半月后，数脉逐渐减少，疼痛逐渐减轻。去掉犀角，加入牛膝、败龟板半两，当归半两，像之前那样服用。又服用半个月，肿胀逐渐减退，食欲逐渐恢复，不再怕冷。只是脚膝酸软，不能久立久行，去掉苍术、黄芩，当时正值夏热，加入炒黄柏至一两半，依据原方内加牛膝，春夏季节用茎叶，冬季用根梗，取汁服用效果尤其迅速。必须戒断酒肉、湿面、胡椒。当仲夏时节加入生地半两，冬季加入茱萸、桂枝。
镇江外科史姓医生，曾治疗一名鹤膝风患者，用蛤蟆（虾蟆）用碗锋略微破开腹部有缝，无法穿绳捆绑，放置在患处跳动一段时间，蛤蟆受毒气后随即死亡。像这样再换一只，不过三只即可痊愈。（出自《戒庵漫笔》李诩。）
孙文垣治疗程绍溪，中年患鹤膝风，双腿及小腿肚内外肌肉完全削薄，双膝肿大，这是酒后纵欲所致。而且四肢脓疥湿气浸淫，自己认为必死无疑。家人因为治病久了医药费耗尽家产，不再求医治疗。孙文垣通过邻居的亲戚去诊治，左寸关脉浮数，右寸脉短弱，两尺脉沉微。说：这是气虚血热的征候，治法应当大补，强壮其筋骨，还可以希望生存，只不过不是百日见不到功效。因为补血没有速效，必须逐渐濡养，关节通利，骨骼端正筋脉柔和，腿部肌肉自然生长。起初用龟板、薏苡仁各三钱，苍耳子、五加皮、头二蚕砂、节节香各一钱，当归、人参、黄芪、苍术、杜仲、黄柏各八分，红花八分，十剂后疮疥逐渐稀疏，精神稍有好转。再用薏苡仁、五加皮、龟板各二钱，节节香、苍耳子、地黄、丹参、苍术、黄柏、首乌各一钱，人参、当归各八分，红花、木通各五分，三十剂后可以倚仗拐杖行走，腿部肌肉逐渐生长，疮疥全部痊愈，膝盖肿胀消退了十分之六。后来用虎潜丸加鹿角胶、首乌、狗脊、节节香、牛膝，用龟胶为丸，服用三个月，腿部肌肉恢复完整而痊愈。
薛立斋治疗韩廷仪，先前患风症，用疏风化痰养血的药物而痊愈。他的腿膝骨肉内部发热作痛，服用十味固本丸、天麻丸后病情加重，两尺脉数而无力。说这是肾水虚，不能生肝木，虚火内动而产生，并非风邪所致。患者不信，又服用羌活愈风丹之类药物，导致四肢痿软，遍身麻木，痰涎上涌，神志不清。说：这都是脾气亏损，不能荣养周身，又不能摄涎归源。先用六君子汤加川芎、当归、木香，数剂，以助五脏生化之气，以荣养周身，诸症逐渐痊愈。于是早晨服用补中益气汤培养脾肺，晚上服用六味丸滋补肝肾，如此三个月而安定。
一名妇人长期郁怒，膝盖肿胀胸胁不利，内热寒热交替，月经不调，遍身酸痛，这是胃气亏损。先用补中益气汤加半夏、茯苓，三十余剂后胃气逐渐苏醒。又用大风汤与归脾汤，膝盖肿胀逐渐消退。用加味逍遥散、大风汤完全消除。又用八珍汤加丹皮，调理而安定。
一名妇人患上述病症，肿痛寒热，先用大风汤一剂，又用加味逍遥散四剂，月余肿痛逐渐退去。被追求速效所迷惑，另外服用劫风败毒药，虚症蜂拥而起。仍然由使用大防风汤为主，佐以十全大补汤而消退。又服用大补汤，两个月而全愈。
一名妇人患上述病症，两拗中大腿股部筋脉牵拉作痛，内热寒热交替，这是肝火气滞的病症。先用加味小柴胡汤，四剂后，以加味逍遥散为主，佐以大防风汤而消退。又患痢疾后两膝肿痛，寒热往来，用十全大补汤为主，佐以防风汤而消退。
一名妇人患上述病症，虽然溃破但肿胀不消，早晨怕冷傍晚发热，饮食不思，月经三四月来一次，这是肝脾气血俱虚。用补中益气汤、加味归脾汤各三十余剂，肿胀逐渐消退而寒热停止。又佐以大防风汤，月余后能步履，再过月余月经如期而行。又服用六味丸、八珍汤，三个月而痊愈。
一名男子腿筋弛长月余，两膝肿痛，这是阴虚湿热所乘袭。用六味丸为主，佐以八珍汤加牛膝、杜仲，间以补中益气汤，三月余而消退。
通府刘国威，先筋挛骨痛，右膝漫肿，用化痰消毒的药剂，肿痛更加严重，食少体倦。加祛风消毒等药，寒热发作呕吐，大便不成形。用二陈除湿之类药物，肿胀起色赤，内部疼痛如锥刺。诊察其脉滑而无力，这是脓已成，元气虚而不能溃破。用十全大补汤四剂，佐以大防风汤一剂而溃破，又百余剂而痊愈。
一名男子腿痛膝肿，脉浮，按之弦紧，这是肝肾虚弱。用大防风汤二剂已退。他因迷信附子有毒，于是服用治疡的药物，日渐消瘦，虚症渐至，再次求治。说：倦怠消瘦，是脾肾衰败而不能营运；小便不禁，是膀胱虚而不能约制；燥热虚痞，是胃气弱而不能化；恍惚健忘，是精神衰而昏乱。恶症蜂集，推辞不治，后果然去世。
一名男子患腿痛，膝微肿，轻诊则浮，按之弦紧，这是鹤膝风。给大防风汤二剂，已退二三。他认为附子有毒，于是服用败毒药，日渐消瘦。再次求治，薛立斋说现在饮食不为肌肤所用，水谷不能运化精微，灌溉脏腑周身百脉，神将何依凭？夫气短而促，是真气受损，怠惰嗜卧，是脾气虚；小便不禁，是膀胱不藏；时有躁热，心下虚痞，是胃气不能上荣；恍惚健忘，是神明混乱。不治，后果然如此。此症多患于不足之人，所以用加减小续命汤、大防风汤有效。如果服用攻毒药必误。
一名妇人膝肿痛，遇寒痛益甚，月余不愈，诸药不应，脉弦紧，这是寒邪深伏于内。用大防风汤及火龙膏治疗而消退。大抵此症，虽云肿有浅深，感有轻重，其所受皆因真气虚弱，邪气得以深袭。若真气壮实，邪气焉能为患也？故附骨痈疽及鹤膝风症，虚者多患之。前人用附子者，以补温肾气，而又能行药势散寒邪也。亦有体虚之人，秋夏露卧，为冷气所袭，寒热伏结，多成此症。不能转动，乍寒乍热而无汗，按之痛应骨者是也。若经久下消，极阴生阳，寒化为热而溃也。若被贼风所伤，患处不甚热，而洒淅恶寒，不时汗出，熨之痛止，须大防风汤及火龙膏治之。若失治，为弯弓曲偏枯，硬如石，谓之石疽。若热暖积日不溃，肉色紫赤，皮肉俱烂，名绶疽。其始末皆宜服前汤，欲其驱散寒邪以补虚托里也。
一人患鹤膝风五年，敷药三日即愈。王心涵传授乳香、没药各一钱五分，地骨皮三钱，无名异五钱，麝香一分，各为末，车前草捣汁入老酒少许，调敷患处。（出自《广笔记》。）
立斋治疗一名男子左膝肿大，三月不溃。说体虚之人，风邪袭于骨节，使气滞而不行，故膝愈大而腿愈细，名叫鹤膝风，遂以大防风汤三十余剂而消退。张上舍也患此症，伏枕半年，流脓三月。他说：初服大防风汤去附子一钱，服三十余剂稍好，乃去附子五钱。服至三十余剂将愈，乃去附子。更以三十余剂而愈。盖桂、附当用而不用，则无力也。
王汝道膝腿肿，筋骨痛，服十宣散不应。脉沉细，以五积散二剂而痛止。更以十宣散去桔梗，加牛膝、杜仲，三十余剂脓溃而愈。此寒气之肿，八风之变也。
However, the patient's spirit and diet were normal. Ganlu Yin (Sweet Dew Decoction) was administered with lotus root juice (Ou Zhi) and child's urine (Tong Bian). After four doses, the symptoms ceased, and the cough also subsided. Subsequently, treatment focused exclusively on the swelling in the lower body to consolidate the root. Ingredients added included Zhimu (Anemarrhenae Rhizoma), Baipi (Phellodendri Cortex), Beimu (Fritillariae Bulbus), Huafen (Trichosanthis Radix), Xuanfuhua (Inulae Flos), Jieluo (Citri Reticulatae Pericarpium Viride), Sigujin (Luffae Fibra), Lingyangjiao (Saigae Tataricae Cornu), Lianshi (Meliae Fructus), Congxu (Allii Fistulosi Caulis), Dadoujuan (Sojae Semen Praeparatum), Huangqin (Scutellariae Radix), Yiyiren (Coicis Semen), and Zhuli (Bambusae Caulis in Taenia). The formula was modified according to the condition. After two or three doses, severe itching occurred at the swollen site; scratching caused fluid to exude like sweat, accompanied by the odor of green onions. After six or seven days, both legs became dry, thin, and painful, and the scrotum simultaneously receded. This is because cold-dampness injures Yang, while heat-dampness injures Yin; blood flow belongs to the Yin category. Even with heavy use of sweet and moistening agents, the swelling subsided. Later, dryness, pain, and throat dryness appeared. If one were to administer spleen-drying and diuretic drugs, what would be the outcome? For post-illness care, nourishing the blood is appropriate, with a small amount of Zhuli (Bambusae Caulis in Taenia) added to search out residual phlegm in the collaterals, thereby avoiding future complications. Following this method, the patient recovered without developing Xiao Ke (Wasting and Thirsting Syndrome).
Zhu Danxi treated an elderly man aged seventy who suffered from slight swelling in the feet and knees. This was due to Blood deficiency complicated by damp-heat. He used Shengdi (Rehmanniae Radix), Guitou (Angelicae Sinensis Radix Caput), Baishao (Paeoniae Radix Alba), Cangzhu (Atractylodis Rhizoma), Chao Bai (Stir-fried Phellodendri Cortex), Chuanxiong (Chuanxiong Rhizoma), Guizhi (Cinnamomi Ramulus), and Mutong (Akebiae Caulis). These were decocted in water and taken hot before meals.
A man nearing thirty years old, accustomed to rich flavors and prone to irritability and anger, developed pain at a specific point around the hip joint in autumn, extending to the knee. The pain was quiet during the day but severe at night; the painful area felt cold. He sometimes felt thirsty and sometimes not; sometimes he felt stifled and sometimes not. Physicians mostly used wind-dispelling herbs combined with blood-nourishing herbs. By the following spring, his knee swelling and pain worsened significantly, appetite decreased, and he emaciated. By late spring, the knee swelled as large as a peach, making flexion and extension impossible. His pulse was wiry, large, and quite full on the left, with significant choppy quality at the Cun position; on the right, it was rapid and large throughout. It was inferred that his urination must have been frequent and scanty. Thus, it was treated as food retention and phlegm accumulation in the Taiyin Meridian. Stir-fried Baipi (Phellodendri Cortex) 1 liang, raw Gancao Shao (Glycyrrhizae Radix et Rhizoma Tip), Xijiao Xie (Rhinocerotis Cornu Powder), Cangzhu (Atractylodis Rhizoma), and salt each 3 qian, Chuanxiong (Chuanxiong Rhizoma) 2 qian, Chenpi (Citri Reticulatae Pericarpium), Niuxi (Achyranthis Bidentatae Radix), Mutong (Akebiae Caulis), Baizhi (Angelicae Dahuricae Radix), and Baishao (Paeoniae Radix Alba) each 5 qian. On warm and hot days, add Tiaohuangqin (Scutellariae Radix) 3 qian. Grind into fine powder. Each dose of 3 qian is ground finely with fresh ginger juice, suspended in water, boiled until bubbling, and drunk hot before meals, four times a day. After half a month, the rapid pulse gradually decreased, and pain lightened. Remove Xijiao (Rhinocerotis Cornu), add Niuxi (Achyranthis Bidentatae Radix) and Baiguiban (Testudinis Carapax et Plastrum) 0.5 liang, Danggui (Angelicae Sinensis Radix) 0.5 liang, and take as before. After another half month, swelling gradually reduced, appetite improved, and aversion to cold ceased. Only soreness and weakness in the feet and knees remained, preventing prolonged standing or walking. Remove Cangzhu (Atractylodis Rhizoma) and Huangqin (Scutellariae Radix). Since it was midsummer heat, add stir-fried Baipi (Phellodendri Cortex) up to 1.5 liang. Based on the original formula, add Niuxi (Achyranthis Bidentatae Radix); use stems and leaves in spring and summer, roots and stalks in winter, extracting juice for faster effect. Must abstain from alcohol, meat, wet noodles, and pepper. In midsummer, add Shengdi (Rehmanniae Radix) 0.5 liang; in winter, add Zhuyu (Corni Fructus) and Guizhi (Cinnamomi Ramulus).
Doctor Shi, a surgeon from Zhenjiang, once treated a patient with He Xi Feng (Crane Knee Wind) using a toad (Xama). The abdomen was slightly broken with a bowl edge to create a seam, but it could not be tied. It was placed on the affected area where it jumped for a while; the toad died from absorbing the toxicity. Replacing it with another, no more than three toads cured the condition. (From *Jie'an Manbi* by Li Xu.)
Sun Wen Yuan treated Cheng Shaoxi, who in middle age suffered from He Xi Feng (Crane Knee Wind). The muscles of both legs and calves were completely wasted, and both knees were swollen, caused by indulgence in alcohol and sexual activity after drinking. Furthermore, pus and sores covered the limbs with dampness oozing out; he considered himself doomed. His family, having exhausted their wealth on medicine due to the long illness, gave up seeking treatment. Sun Wen Yuan examined him via a neighbor's relative. The Left Cun and Guan pulses were floating and rapid; the Right Cun was short and weak; both Chi pulses were deep and faint. He said: "This is a pattern of Qi deficiency and Blood heat. The treatment should be major tonification to strengthen bones and tendons; survival is still possible, but it will not show results within a hundred days. Nourishing Blood has no quick effect; it must be done gradually to moisten. Once joints are unobstructed, bones are straight, and tendons are supple, leg muscle will naturally grow." Initially, using Guiban (Testudinis Carapax et Plastrum) and Yiren (Coicis Semen) each 3 qian, Cang'erzi (Xanthii Fructus), Wujia Pi (Acanthopanacis Cortex), Tou Er Can Sha (Bombyx Batryticatus Head and Second Cast Skin), Jiejie Xiang (Spatholobi Caulis) each 1 qian, Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix), Huangqi (Astragali Radix), Cangzhu (Atractylodis Rhizoma), Duzhong (Eucommiae Cortex), Huangbai (Phellodendri Cortex) each 8 fen, Honghua (Carthami Flos) 8 fen. After ten doses, sores thinned, and spirit slightly improved. Then, using Yiren (Coicis Semen), Wujia Pi (Acanthopanacis Cortex), Guiban (Testudinis Carapax et Plastrum) each 2 qian, Jiejie Xiang (Spatholobi Caulis), Cang'erzi (Xanthii Fructus), Dihuang (Rehmanniae Radix), Danshen (Salviae Miltiorrhizae Radix), Cangzhu (Atractylodis Rhizoma), Huangbai (Phellodendri Cortex), Shouwu (Polygoni Multiflori Radix) each 1 qian, Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix) each 8 fen, Honghua (Carthami Flos), Mutong (Akebiae Caulis) each 5 fen. After thirty doses, he could walk leaning on a cane, leg muscle grew, sores healed, and knee swelling reduced by sixty percent. Later, using Hu Qian Wan (Tiger Crouch Pill) plus Lujiao Jiao (Cervi Cornus Colla), Shouwu (Polygoni Multiflori Radix), Gouji (Drynariae Rhizoma), Jiejie Xiang (Spatholobi Caulis), Niuxi (Achyranthis Bidentatae Radix), made into pills with Guijiao (Testudinis Carapax et Plastrum Colla). After three months of服用, leg muscle fully recovered, and he was cured.
Xue Lizhai treated Han Tingyi, who previously suffered from Wind syndrome and recovered using wind-dispelling, phlegm-resolving, and blood-nourishing herbs. However, his leg and knee flesh and bone felt hot and painful. Taking Shimwei Guben Wan (Ten-Ingredient Root-Fixing Pill) and Tianma Wan (Gastrodia Pill) worsened the condition. Both Chi pulses were rapid and powerless. He stated: "This is Kidney Water deficiency failing to generate Liver Wood, causing internal movement of deficient fire, not caused by external Wind pathogen." The patient did not believe this and took Qianghuo Yufeng Dan (Notopterygii Radix et Rhizoma Wind-Expelling Pellet) and similar formulas, resulting in flaccidity of four limbs, numbness all over the body, surging phlegm-saliva, and unclear consciousness. Xue said: "These are all signs of Spleen Qi damage, unable to nourish the whole body, and unable to guide saliva back to its source." First, using Liu Jun Zi Tang (Six-Gentlemen Decoction) plus Chuanxiong (Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Muxiang (Aucklandiae Radix) for several doses to assist the transformative and generative Qi of the five Zang organs, nourishing the whole body, and various symptoms gradually improved. Then, morning administration of Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction) to cultivate Spleen and Lung, evening administration of Liuwei Wan (Six-Ingredient Pill) to tonify Liver and Kidney. After three months, stability was achieved.
A woman suffering from long-term depression and anger had knee swelling, chest and hypochondriac stiffness, internal heat alternating with chills, irregular menstruation, and generalized body ache. This was Spleen Qi deficiency. First, Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction) plus Banxia (Pinelliae Rhizoma) and Fuling (Poria) for over thirty doses awakened the Spleen Qi. Then Dafeng Tang (Great Wind-Dispersing Decoction) and Guipi Tang (Restore the Spleen Decoction) were used, and knee swelling gradually subsided. Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Dafeng Tang (Great Wind-Dispersing Decoction) completely eliminated it. Then Bazhen Tang (Eight-Treasure Decoction) plus Danpi (Moutan Cortex) was used for regulation and stabilization.
Another woman with the aforementioned symptoms had swelling, pain, chills, and fever. First, one dose of Dafeng Tang (Great Wind-Dispersing Decoction), then four doses of Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). After more than a month, swelling and pain gradually receded. Bewitched by the desire for quick effects, she took other anti-wind and detoxifying herbs, causing deficiency syndromes to arise. Treatment reverted to Dafeng Tang (Great Wind-Dispersing Decoction) as the main formula, assisted by Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction), which resolved the swelling. She then took Dabu Tang (Great Tonifying Decoction) and recovered fully in two months.
A woman with the aforementioned symptoms had pulling pain in the thigh muscles between the knees, internal heat alternating with chills. This was Liver Fire and Qi stagnation. First, Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction) for four doses, then Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) as the main formula, assisted by Dafeng Tang (Great Wind-Dispersing Decoction), which resolved it. Later, after dysentery, she had bilateral knee swelling and pain with alternating chills and fever. Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) was used as the main formula, assisted by Fangfeng Tang (Saposhnikoviae Decoction), which resolved it.
A woman with the aforementioned symptoms had ulceration but persistent swelling, morning chills and evening fever, poor appetite, and menstruation occurring only every three to four months. This was simultaneous deficiency of Liver and Spleen Qi and Blood. Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction) and Jiawei Guipi Tang (Modified Restore the Spleen Decoction) were each taken for over thirty doses; swelling gradually subsided, and chills/fever stopped. Assisted by Dafeng Tang (Great Wind-Dispersing Decoction), she could walk after a month, and menstruation resumed on schedule after another month. Liuwei Wan (Six-Ingredient Pill) and Bazhen Tang (Eight-Treasure Decoction) were taken for three months until recovery.
A man had lax leg tendons for over a month and swollen, painful knees. This was Yin deficiency with damp-heat invasion. Liuwei Wan (Six-Ingredient Pill) was used as the main formula, assisted by Bazhen Tang (Eight-Treasure Decoction) plus Niuxi (Achyranthis Bidentatae Radix) and Duzhong (Eucommiae Cortex), interspersed with Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction). After over three months, it resolved.
Liu Guowei, Prefectural Administrator, first had tendon spasms and bone pain, with diffuse swelling of the right knee. Using phlegm-resolving and detoxifying agents worsened swelling and pain, leading to poor appetite and fatigue. Adding wind-dispelling and detoxifying herbs caused chills, fever, vomiting, and loose stools. Using Er Chen Tang (Two-Aged Decoction) for dampness removal resulted in reddish swelling and internal stabbing pain. His pulse was slippery and powerless, indicating pus formation but insufficient Yuan Qi to rupture it. Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) for four doses, assisted by Dafeng Tang (Great Wind-Dispersing Decoction) for one dose, led to rupture. Over a hundred doses later, he recovered.
A man had leg pain and knee swelling. The pulse was floating, becoming wiry and tight upon pressure. This was Liver and Kidney deficiency. Dafeng Tang (Great Wind-Dispersing Decoction) for two doses alleviated it. Confused by the belief that Fuzi (Aconiti Lateralis Radix Preparata) is toxic, he took ulcer-treating herbs, becoming increasingly emaciated with worsening deficiency symptoms, and sought treatment again. He was told: "Fatigue and emaciation indicate Spleen and Kidney decline failing to circulate; urinary incontinence indicates Bladder deficiency failing to constrain; dry heat and false fullness indicate weak Stomach Qi failing to transform; confusion and forgetfulness indicate spiritual decline and chaos." With malignant symptoms arising, he declined treatment and subsequently died.
Another man had leg pain and slight knee swelling. Light palpation revealed a floating pulse, becoming wiry and tight on pressure. This was He Xi Feng (Crane Knee Wind). Dafeng Tang (Great Wind-Dispersing Decoction) for two doses reduced it by two or three parts. Believing Fuzi (Aconiti Lateralis Radix Preparata) is toxic, he took detoxifying herbs and became progressively emaciated. Seeking treatment again, Xue said: "Now food cannot form flesh; water and grain cannot transform into essence to irrigate organs and meridians. Where does the Spirit reside? Shortness of breath indicates loss of True Qi; lethargy indicates Spleen Qi deficiency; urinary incontinence indicates Bladder failure to store; occasional restlessness and epigastric fullness indicate Stomach Qi failing to rise and nourish; confusion and forgetfulness indicate chaotic Shen Ming (Spiritual Clarity)." Untreated, this proved true. This syndrome often affects those with deficiency; thus, Jia Jian Xiao Suming Tang (Modified Minor Suming Decoction) and Dafeng Tang (Great Wind-Dispersing Decoction) are effective. Taking attacking/toxic herbs is a mistake.
A woman had swollen, painful knees, worse with cold, lasting over a month, unresponsive to various herbs. The pulse was wiry and tight, indicating deep-seated Cold pathogen. Dafeng Tang (Great Wind-Dispersing Decoction) and Huolong Gao (Fire Dragon Ointment) resolved it. Generally, although swelling depth and pathogen severity vary, the underlying cause is always deficiency of True Qi allowing pathogens to invade deeply. If True Qi is strong, how can pathogens cause harm? Therefore, Fusgu Yongju (Bone-Adherent Carbuncle) and He Xi Feng (Crane Knee Wind) are mostly suffered by the deficient. Ancients used Fuzi (Aconiti Lateralis Radix Preparata) to warm and tonify Kidney Qi and to drive the medicinal force to dispel Cold. Also, deficient individuals sleeping exposed in autumn/summer may suffer Cold Qi invasion, leading to latent Cold-Heat knots forming this syndrome. Inability to move, alternating chills/fever without sweat, and pain responding to bone pressure characterize it. If chronic, extreme Yin generates Yang, Cold transforms to Heat, and it ruptures. If injured by Thief Wind, the site is not very hot but feels chilly with aversion to cold, sweating intermittently, and pain stops with warming. Dafeng Tang (Great Wind-Dispersing Decoction) and Huolong Gao (Fire Dragon Ointment) are required. If neglected, it becomes bent, crooked, paralyzed, hard as stone, called Shiju (Stone Carbuncle). If warm and accumulating heat fails to rupture over days, with purple-red flesh and rotting skin/muscle, it is named Shouju (Slow Carbuncle). Throughout onset to resolution, the aforementioned decoction should be taken to dispel Cold and tonify deficiency/support the interior.
One person suffered from He Xi Feng (Crane Knee Wind) for five years and was cured in three days with topical application. Wang Xinhan transmitted a recipe: Rushiang (Olibanum) and Moyao (Myrrha) each 1.5 qian, Digupi (Lycii Cortex) 3 qian, Wumingyi (Haematitum) 5 qian, Shexiang (Moschus) 1 fen. All ground to powder. Mix with juice of Cheqian Cao (Plantaginis Herba) and a little old wine, apply to the affected area. (From *Guang Biji*.)
Lizhai treated a man with left knee swelling for three months without rupture. He stated: In deficient individuals, Wind pathogen attacks bone joints, causing Qi stagnation and blockage, hence the knee swells while the leg thins, named He Xi Feng (Crane Knee Wind). Dafeng Tang (Great Wind-Dispersing Decoction) for over thirty doses resolved it. Zhang Shangshe also suffered this, bedridden for half a year, draining pus for three months. He said: Initially taking Dafeng Tang (Great Wind-Dispersing Decoction) removing 1 qian of Fuzi (Aconiti Lateralis Radix Preparata), taking over thirty doses improved slightly, then removed 5 qian of Fuzi (Aconiti Lateralis Radix Preparata). Taking over thirty doses near cure, then removed Fuzi (Aconiti Lateralis Radix Preparata). Another thirty doses completed the cure. Essentially, if Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Preparata) are needed but not used, there is no power.
Wang Rudao had knee/leg swelling and bone/tendon pain. Shixuan San (Ten-Expelling Powder) was ineffective. Pulse was deep and fine. Wuji San (Five-Accumulations Powder) for two doses stopped pain. Then Shixuan San (Ten-Expelling Powder) minus Jiegeng (Platycodonis Radix), plus Niuxi (Achyranthis Bidentatae Radix) and Duzhong (Eucommiae Cortex) for over thirty doses led to pus rupture and cure. This is swelling from Cold Qi, a variation of Eight Winds.