则筋柔软，筋柔软则可以束骨而利机关，又何挛掉之有？以五加皮、薏仁、红花、人参、鹿角胶、龟板、虎骨、
当归、丹参、地黄、骨碎补、苍耳子之类，服两月，肌肉渐生，饮食大进，两手挛掉亦瘳。
黄履素曰∶余己酉夏，应试南都，与姊文吴公甫联社课艺，见公甫步履微有不便，云苦腿痛，精神固无恙
也。听庸医之言，以为风湿，专服祛风燥湿之剂，形容日槁。八月间，见咯血之症，肌肉尽削，至冬而殁。即
此验之，则腿足酸痛疼，不可概作风治也益明矣。腿足皆是三阴部位，多系肝肾阴虚，法宜滋补，顾反服风药
以耗之，岂不速其死哉！
张三锡治一苍瘦人，每坐辄不能起，左脉微弱，右关寸独弦急无力，因酒色太过所致。用丹溪加味四物汤，
不二十剂愈。后服鹿角胶调理。
一人体浓，二足行履不便，时作眩晕，以大剂二陈加南星、二术、黄柏、黄芩，入竹沥、姜汁，数剂顿愈。（作痰治。）
一人自觉两足热如火炙，自足踝上冲腿膝，且痿弱软痛，脉濡而数，乃湿热挟虚也。以苍术、黄柏为君，
四两，牛膝二两，龟板、虎胫骨、汉防己各一两，当归二两，人参二两，山药糊丸桐子大。每服一百丸，
空心盐汤送下。上方加附子。
一老人痿厥，用虎潜丸不应，后予虎潜丸加附子，遂愈。盖附子有反佐之功也。
一人两足沉重不能举，六脉沉数。询之，平居痛饮，遂作湿热治。乃以四苓、三妙，加牛膝、木通、防己，
数服渐减。用健步丸调理而安。
薛立斋治举人于尚之，素肾虚积劳，足痿不能步履，复舌喑不能言，面色黧黑，谓此肾气虚寒，不能运及
所发，用地黄饮子治之而愈。后不慎调摄而复作，或用牛黄清心丸之类，小便秘涩，口舌干燥，仍用前饮，及
加减八味丸渐愈。又用补中益气汤而痊。
冢宰刘紫岩因劳，下体软痛，发热痰盛，用清燥汤入竹沥、姜汁，服之热痛减半，再剂而全愈。
张路玉治劳俊卿，年高挛废。或用木瓜、独活、防己、威灵仙、 之类半年余，致跬步不能移动。或令
服八味丸亦不应。脉之，尺中微浮而细。时当九夏，自膝至足，皆寒冷如从水中出，知为肾虚，风雨所犯而成
是疾，遂与安肾丸方，终剂能步履，连服二料，绝无痿弱之患矣。
陆养愚治施凤冈母，年及五旬，患四肢削而微肿，腕膝指节间肿更甚，筋外露而青。向来月事后必烦躁一
二日，因而吐血或便血一二日，服凉血药丹皮、生地、芩、连之类，三剂方止。若不服药则去血必多。近来天
癸既绝，血症亦减，而肢节之症作矣，史国公药酒服之无效。数年间，苍术、乌、附、羌、防、 ，及活络
诸汤，驱寒胜湿之剂皆遍服。今且饮食，便溺，动辄须人，挛痛尤不可忍。脉之，六部微涩，两尺缓弱尤甚。
曰∶始因过用寒凉，损其肝气，继则多用风燥，耗其肝血。肝主筋，今气血俱虚，筋失其养，故肿露而持行俱
废。用人参、川芎、当归、首乌，少佐肉桂、秦艽为煎剂，以虎潜丸料，倍鹿角胶为丸，服月余而减，三月而
持行如故，半年全瘳。（雄按∶用药未善。）
朱丹溪治郑安人，年六十，虚而有痰，脉缓足弱，与半夏天麻白术汤，下酒芩丸愈。
一士夫因脚弱求诊，两手俱浮洪稍鼓，饮食如常，惟言问不答，肌上起白屑如麸片。时在冬月，作极虚处
治。询其弟，乃知半年前，曾于背臂腿三处，自夏至秋冬节次生疽，率用五香连翘汤、十宣散与之，今结痂久
矣。为作参 白术当归膏，以二陈汤化饮之，三日后尽药一斤，白屑没者大半，病者自喜呼吸有力。补药应取
效以渐，而病家反怨药不速应，自作风病论治。炼青礞石二钱半，以青州白丸作料，煎饮子顿服之。阻之不听，
因致不救，书以为警云。（痿症作风治多死。）
薛立斋治一妇人，患血痔，兼腿酸痛似痹，此阴血虚不能养于筋而然也。宜先养血为主，遂以加味四斤丸治之愈。
一老人筋挛骨痛，两腿无力，不能步履，以《局方》换腿丸，治之而愈。
一妇人筋牵痹纵，两腿无力，不能步履，以《三因》胜骏丸，治之而瘥。河间云∶香港脚由肾虚而生，然妇
人亦有香港脚者，乃因血海虚，而七情所感，遂成斯疾。今妇人病此亦众，则知妇人以血海虚而得之，与男子肾
虚类也。男女用药固无异，更当兼治七情，无不效也。（因虚而成，故以入痿。）
姚僧垣治金州刺史伊芳娄穆，自腰至脐似有三缚，两脚缓纵，不复自持。僧垣为诊脉，处汤三剂。穆初服一
剂上缚即解，次服一剂中缚后解，又服一剂三缚悉解。而两服疼痹犹自挛弱，更为合散一剂，稍得屈伸。僧垣
曰∶终待霜降，此患当愈。及至九月遂能起行。（《周书》。）
按∶此即春夏剧，秋冬瘥之痿症也。
张子和曰∶宛邱军校三人皆病痿，积年不瘥，腰以下肿痛不举，遍身疮疥，两目昏暗，唇干舌燥，求治于
张。张欲投泻剂，二人不从，为他医温补之药所惑，皆死。其同病有宋子玉者，俄省曰∶彼以热死，我其改之，
竟从治之而愈。张曰∶诸痿独取阳明，阳明者胃与大肠也。此言不止谓针也，针与药同也。
王执中曰∶《列子》载偃师造偈云，废其肾则足不能行。人之患此，盖肾有病也，当灸肾俞。再一再灸而
不效，宜灸环跳、风市、犊鼻、膝关、阳陵泉、阴陵泉、三里、绝骨等穴。但按略酸疼处即是受病处，灸之无
不效也。（《资生经》。）
施灵修有一里人，善酒，卧床褥者三年，灵修怜而索方于仲淳。仲淳亲诊之，知其酒病也。夫酒，湿热之
物，多饮者，湿热之邪贯于阳明。湿热胜则下客于肾而为骨痿，故昔人治痿独取阳明。以五味子为君，黄连为
臣，麦冬、干葛、扁豆为佐，服之愈。（《广笔记》。）
薛立斋治一人，年逾五十，筋骨软痿，卧床五年，遍身瘙痒，午后尤甚，以生血药治之，痒渐愈，痿少可。
更以加味四斤丸治之，调理谨守年余而痊。河间云∶热淫于内，而用温补药何也？盖阴血衰弱，不能养筋，筋
缓不能自持。阳燥热淫于内，宜养阳滋阴，阴实则水升火降矣。
钱国宾治龙泉沈士彦，平生无病，肝气不平，过五八腿无故而软，由软至瘫，由瘫至挛，卧不起矣。遍写
病状与知识求医。答之曰∶能直不能屈者，其病在骨，能屈不能直者，其病在筋，筋舒则无病矣。《内经》云∶
心生血，肝藏血。公平生肝薄多怨，血不能养筋，筋不能束骨耳，久则冷痹而挛。彼闻此论，遣使求方。用脐
带、紫河车为君，人乳、枸杞、何首乌为臣，芎、归、地黄、牛膝、红花为佐使。血旺则养筋，筋和则束骨，
此药作丸服矣。外取童便数升，盛大钵内，以腿于钵上，钵放腿下，另置炭火一炉，用新瓦三四片，每片打二
三块，烧红淬童便内，更易不论次数，口取热气，熏灼约一时，（ 按∶外治法精妙。）止之。次日再如此，
半月筋舒，一月能步，二月能走矣。童便味咸寒，咸能软坚，久能走血散瘀。经云∶血不足者，补之以气，谓阴
生于阳也。又经火气热散筋骨冷痹，藉瓦引导入筋骨之分。治法深奥，得窍者知之。
魏玉横曰∶张玉书子，年近三十忽寒热头痛。时师谓伤寒也，蛮治月余，后竟不知为何病，惟昼夜喊叫痛
极。延诊，问何迟？曰∶人皆谓先生专用补，渠系伤寒，故不敢请。领之入视，见病患尸卧在床，发长覆额，
面垢鼻煤，皮枯肉腊，状如奇鬼。脉之弦而坚，左关尺殊涩数。询其痛处，起自臂侧，下连趾踵肩背，头脑亦
时抽痛，僵直莫能动，动则欲死。乃谓其父曰∶此筋骨兼痿之候也。若早补，何至此极？此由少年不慎，接内
之后，即远行劳役，三阴受伤。今痛自环跳穴，下连大敦、隐白、涌泉，盖三穴为肝脾肾所主，至连肩背头脑
皆掣痛，督脉亦伤矣。其母私问之，果以接内后，因事疾走江干，归而疾发。其父曰∶洵如是，已误治许时，
今奈何？曰∶幸少年血气易复，第须服药百剂，否则虽愈必跛也。与肉苁蓉、生熟地、杞子、米仁、当归、牛
膝、红花、丹皮、蒌仁、麦冬之属，十剂能起坐，又十剂可杖而行。其父素悭吝，见病已起，遂勿药，从后果
一足筋短一二寸，至今行路倾欹。
吴太宜人，年六旬外，病筋络抽掣，上连巅顶肩项，下至腰腹胸胁，莫不牵痛，背胀头昏，口燥心忡，便
数食减，两手极热，常欲冷水浸之。诊得脉弦急而疾，曰∶症即多端，均由肝火盛而血液亏，筋燥失养，久之
则成痿矣。但濡以润之，可立愈也。与养荣汤加米仁、蒌仁、当归、女贞等十剂而痊。
那么筋就会柔软，筋柔软就可以约束骨骼并利于关节活动，又怎么会有痉挛颤抖的症状呢？使用五加皮、薏苡仁、红花、人参、鹿角胶、龟板、虎骨、当归、丹参、地黄、骨碎补、苍耳子等药物，服用两个月后，肌肉逐渐生长，饮食大量增加，双手的痉挛颤抖也痊愈了。
黄履素说：我在己酉年夏天，到南京参加科举考试，与姐姐吴文公甫结社学习文章，看到公甫走路稍微有些不便，他说腿部疼痛难受，但精神原本很好。听信庸医的话，认为是风湿病，专门服用祛风燥湿的药物，导致形体日渐枯槁。八月间，出现咯血症状，肌肉完全消瘦，到了冬天就去世了。由此验证，腿足酸痛疼痛，不能一概当作风病来治疗，这一点更加明确了。腿足都属于三阴经部位，多属于肝肾阴虚，治法应当滋补，反而服用风药来耗伤正气，岂不是加速了他的死亡吗！
张三锡治疗一个身体瘦弱的人，每次坐下后就不能起身，左脉微弱，右关脉和寸脉单独弦急而无力，这是由于酒色过度所致。使用丹溪加味四物汤，不到二十剂就好了。后来服用鹿角胶进行调理。
另一个人身体肥胖，两脚行走不便，时常发生眩晕，用大剂量二陈汤加入天南星、白术、苍术、黄柏、黄芩，加入竹沥、姜汁，几剂药后立刻痊愈。（按痰证治疗。）
另一个人自觉双脚发热像火烤一样，从脚踝向上冲到腿膝，并且痿软疼痛，脉象濡缓而数，这是湿热夹杂虚证。以苍术、黄柏为君药，各四两，牛膝二两，龟板、虎胫骨、汉防己各一两，当归二两，人参二两，山药糊丸如梧桐子大。每次服用一百丸，空腹用盐汤送下。上方中加入附子。
一位老人患痿厥症，使用虎潜丸没有效果，后来给予虎潜丸加入附子，于是痊愈。这是因为附子有反佐的作用。
另一个人两脚沉重不能抬起，六脉沉数。询问得知，平时喜欢豪饮，于是按湿热证治疗。使用四苓散、三妙散，加入牛膝、木通、防己，服几剂后逐渐减轻。再用健步丸调理而安定。
薛立斋治疗举人于尚之，素来肾虚且积劳成疾，足部痿弱不能行走，加上舌喑不能说话，面色黧黑，认为这是肾气虚寒，不能运达所发之处，用地黄饮子治疗而痊愈。后来不慎调养又复发，有人用牛黄清心丸之类，导致小便秘涩，口舌干燥，仍然使用前方的地黄饮子，以及加减八味丸，逐渐痊愈。后又用补中益气汤而康复。
冢宰刘紫岩因为劳累，下身软弱疼痛，发热痰多，使用清燥汤加入竹沥、姜汁，服用后热痛减半，再服一剂而全愈。
张路玉治疗劳俊卿，年纪大且挛缩废用。有人用木瓜、独活、防己、威灵仙等药物半年多，导致连一步都不能移动。有人让他服用八味丸也没有效果。诊其脉，尺中微浮而细。当时正值盛夏，从膝盖到脚，都寒冷得像从水中出来一样，知道这是肾虚，被风雨侵袭而形成的疾病，于是给予安肾丸方，服完一剂就能行走，连续服用两料，完全没有痿弱的隐患了。
陆养愚治疗施凤冈的母亲，年龄五十岁，患四肢消瘦而轻微肿胀，腕、膝、指节间肿胀更严重，筋外露且青色。向来月经结束后必烦躁一二日，因而吐血或便血一二日，服用凉血药牡丹皮、生地、黄芩、黄连等，三剂才停止。如果不吃药则失血必多。近来天癸已绝，血症也减少，而肢节的病症发作了，服用史国公药酒无效。几年间，苍术、乌头、附子、羌活、防风，以及活血通络诸汤，驱寒胜湿的药物都遍服过了。现在连饮食、大小便都需要人照顾，挛痛尤其难以忍受。诊其脉，六部微涩，两尺脉缓弱尤其严重。说：开始因为过用寒凉，损伤了肝气，接着多用风燥药，耗伤了肝血。肝主筋，现在气血俱虚，筋失去滋养，所以肿胀外露且持行功能全部废弃。用人参、川芎、当归、首乌，少佐肉桂、秦艽作为煎剂，以虎潜丸的药料，加倍鹿角胶制成丸药，服用一个多月后减轻，三个月后持行如常，半年完全痊愈。（徐灵胎按：用药不够妥善。）
朱丹溪治疗郑安人，六十岁，体虚而有痰，脉缓足弱，给予半夏天麻白术汤，配合酒炒黄芩丸治愈。
一位士大夫因脚弱求诊，两手脉浮洪稍鼓，饮食正常，只是问话不回答，皮肤上起白屑如麸片。当时在冬天，按极度虚损处理。询问他的弟弟，才知道半年前，曾在背部、手臂、腿部三处，从夏至秋冬季节依次生疽，都用五香连翘汤、十宣散给他，现在结痂很久了。为他制作参、白术、当归膏，用二陈汤化解痰饮，三天后吃完一斤药，白屑消退大半，病人自己高兴呼吸有力。补药应该慢慢见效，而病人家属反而抱怨药不速效，自作主张按风病论治。炼制青礞石二钱半，以青州白丸作配料，煎饮子顿服。劝阻不听，因此导致无法救治，写下此事作为警示。（痿症按风病治疗多致死。）
薛立斋治疗一位妇人，患血痔，兼腿酸痛似痹症，这是阴血虚不能滋养筋脉所致。应当先以养血为主，于是用加味四斤丸治疗而愈。
一位老人筋挛骨痛，两腿无力，不能行走，用《局方》换腿丸，治疗而愈。
一位妇人筋牵痹纵，两腿无力，不能行走，用《三因方》胜骏丸，治疗而好转。河间说：香港脚由肾虚而生，然而妇人也有香港脚的，是因为血海虚，受七情影响，遂成此疾。现在妇人患此病也很多，就知道妇人是因血海虚而得病，与男子肾虚类似。男女用药固然没有不同，更应当兼治七情，没有不有效的。（因为因虚而成，所以归入痿证。）
姚僧垣治疗金州刺史伊芳娄穆，从腰部到肚脐好像有三道束缚，两脚松弛放纵，不再能自主控制。僧垣为他诊脉，开三剂汤药。穆初服一剂，上缚即解；次服一剂，中缚后解；又服一剂，三缚悉解。而两次服药后疼痹仍然挛弱，再合散剂一剂，稍微能够屈伸。僧垣说：最终等到霜降，这个病应当痊愈。到了九月就能起来行走。（《周书》。）
按：这就是春夏加重，秋冬缓解的痿症。
张子和说：宛邱军校三人皆患痿症，多年不愈，腰以下肿痛不能抬起，遍身疮疥，两眼昏暗，唇干舌燥，向张子和求治。张子和想投泻剂，两人不服从，被其他医生温补药物迷惑，都死了。同病有个叫宋子玉的人，忽然醒悟说：他们因热而死，我应当改变治疗方法，竟然听从张子和的治疗而痊愈。张子和说：诸痿独取阳明，阳明是指胃与大肠。这话不只是指针灸，针与药是一样的。
王执中说：《列子》记载偃师造傀儡说，废除其肾脏则脚不能行走。人患此病，大概是肾有病，应当灸肾俞穴。一再灸而不效，宜灸环跳、风市、犊鼻、膝关、阳陵泉、阴陵泉、三里、绝骨等穴。只要按压感到酸疼的地方就是受病处，灸之没有不有效的。（《资生经》。）
施灵修有一个同乡，善于饮酒，卧床三年，灵修怜悯他向仲淳索要药方。仲淳亲自诊察，知道是酒病。酒是湿热之物，多饮者，湿热之邪贯穿阳明。湿热盛则下行客于肾而为骨痿，所以古人治痿独取阳明。以五味子为君药，黄连为臣药，麦冬、干葛、扁豆为佐药，服用而愈。（《广笔记》。）
薛立斋治疗一人，年过五十，筋骨软弱痿废，卧床五年，遍身瘙痒，午后尤其严重，用生血药治疗，痒渐愈，痿稍可。再用加味四斤丸治疗，谨慎调理一年多而痊愈。河间说：热淫于内，为什么用温补药呢？因为阴血衰弱，不能养筋，筋缓不能自持。阳燥热淫于内，宜养阳滋阴，阴实则水升火降矣。
钱国宾治疗龙泉沈士彦，平生无病，肝气不平，过了五八之年腿无故而软，由软至瘫，由瘫至挛，卧不起矣。遍写病情给亲友求医。回答说：能直不能屈者，病在骨，能屈不能直者，病在筋，筋舒则无病矣。《内经》说：心生血，肝藏血。你平生肝薄多怨，血不能养筋，筋不能束骨耳，久则冷痹而挛。他听到这番议论，派人求方。用脐带、紫河车为君药，人乳、枸杞、何首乌为臣药，川芎、当归、地黄、牛膝、红花为佐使药。血旺则养筋，筋和则束骨，此药做成丸服用。另外取童便数升，放在大钵内，将腿放在钵上，钵放腿下，另置炭火一炉，用新瓦三四片，每片打两三块，烧红淬入童便内，更换不限次数，口吸热气，熏灼约一时辰，（徐灵胎按：外治法精妙。）停止。第二天再如此，半月筋舒，一月能步，二月能走矣。童便味咸寒，咸能软坚，久能走血散瘀。经云：血不足者，补之以气，谓阴生于阳也。又经火气热散筋骨冷痹，藉瓦引导入筋骨之分。治法深奥，得窍者知之。
魏玉横说：张玉书的儿子，年近三十忽然寒热头痛。当时的医生说伤寒，胡乱治疗一个月后，竟然不知道是什么病，只是昼夜喊叫痛极。延请诊治，问为何迟？回答说：人都说先生专用补药，他是伤寒，所以不敢请。领进去看，见病患尸体般躺在床上，头发长覆盖额头，面垢鼻煤，皮枯肉腊，状如奇鬼。诊其脉弦而坚，左关尺特别涩数。询问疼痛处，起自臂侧，下连趾踵肩背，头脑也时抽痛，僵直不能动，动则欲死。于是对其父说：这是筋骨兼痿的候象。如果早补，何至于此极？这由少年不慎，房事之后，立即远行劳役，三阴受伤。现在痛自环跳穴，下连大敦、隐白、涌泉，这三穴为肝脾肾所主，直到连肩背头脑皆掣痛，督脉也伤了。其母私下问他，果真是房事后，因事疾走江边，回来就发病。其父说：确实是这样，已经误治许久，现在怎么办？说：幸好少年血气易复，只需服药百剂，否则虽然痊愈必定跛脚。给予肉苁蓉、生熟地、杞子、米仁、当归、牛膝、红花、丹皮、蒌仁、麦冬等药，十剂能起坐，又十剂可杖而行。其父素来吝啬，见病已起，遂停药，后来果然一只脚筋短一二寸，至今走路倾斜。
吴太宜人，年过六十，病筋络抽掣，上连巅顶肩项，下至腰腹胸胁，无不牵痛，背胀头昏，口燥心忡，便数食减，两手极热，常欲冷水浸之。诊得脉弦急而疾，说：症状虽多端，均由肝火盛而血液亏，筋燥失养，久之则成痿矣。但濡以润之，可立愈也。给予养荣汤加米仁、蒌仁、当归、女贞等十剂而痊。
Then the sinews will become soft; if the sinews are soft, they can bind the bones and facilitate joint movement, so how could there be spasms and tremors? Using herbs such as *Acanthopanacis Senticosi Cortex* (Wujiapi), *Coicis Semen* (Yiren), *Carthami Flos* (Honghua), *Ginseng Radix et Rhizoma* (Renshen), *Cornu Cervi Gelatinum* (Lujiaojiao), *Testudinis Carapax et Plastrum* (Guiban), *Ossis Tigris* (Hugu), *Angelicae Sinensis Radix* (Danggui), *Salviae Miltiorrhizae Radix* (Danshen), *Rehmanniae Radix* (Digu), *Drynariae Rhizoma* (Gusuibu), and *Xanthii Fructus* (Cangerzi), after two months of administration, muscles gradually grew, dietary intake significantly increased, and the spasms and tremors of both hands were cured.
Huang Lvsu said: In the summer of the Jiyi year, I went to Nanjing for the imperial examinations. I formed a study society with my sister's husband, Gongfu, and noticed that his gait was slightly inconvenient. He complained of severe leg pain, although his spirit was originally fine. Listening to quacks, he believed it was wind-dampness and exclusively took wind-dispelling and dampness-drying formulas. His appearance became increasingly emaciated. In August, hemoptysis occurred, muscles wasted away completely, and he died in winter. From this case, it is further confirmed that leg and foot soreness and pain cannot generally be treated as wind diseases. The legs and feet belong to the Three Yin meridians and mostly involve Liver-Kidney Yin deficiency; the appropriate method is tonification. Instead, taking wind drugs depletes the body, hastening death!
Zhang Sanxi treated a thin man who could not rise after sitting. His left pulse was weak, while the right Guan and Cun positions were distinctly wiry, rapid, and powerless, caused by excessive alcohol and sexual indulgence. He used Danxi's Modified Siwu Decoction and recovered in less than twenty doses. Later, he took Cornu Cervi Gelatin for conditioning.
Another person was obese, had difficulty walking, and suffered from frequent dizziness. A large dose of Erchen Decoction added with Arisaematis Rhizoma (Nanxing), Atractylodis Rhizoma (Baizhu), Atractylodis Macrocephalae Rhizoma (Cangzhu), Phellodendri Cortex (Huangbai), and Scutellariae Radix (Huangqin), along with Bamboo Juice (Zhuli) and Ginger Juice (Jiangzhi), cured him in a few doses. (Treated as phlegm.)
Another person felt intense heat in both feet as if burning, radiating from the ankles up to the knees and thighs, accompanied by flaccidity, weakness, and pain. The pulse was soggy and rapid, indicating damp-heat with deficiency. The prescription used Atractylodis Rhizoma and Phellodendri Cortex as sovereign herbs (4 liang each), Achyranthis Bidentatae Radix (2 liang), Testudinis Carapax et Plastrum, Ossis Tigris Tibiae, and Stephaniae Tetrandrae Radix (1 liang each), Angelicae Sinensis Radix and Ginseng Radix et Rhizoma (2 liang each). These were made into pills with yam paste, sized like wisteria seeds. Each dose was 100 pills, taken on an empty stomach with salted water. Aconiti Lateralis Radix Preparata (Fuzi) was added to the above formula.
An elderly patient with flaccidity and cold limbs did not respond to Huqian Wan. Later, adding Aconiti Lateralis Radix Preparata to Huqian Wan cured him. This is because Fuzi has a counter-assisting effect.
Another person had heavy legs unable to lift, with all six pulses deep and rapid. Inquiry revealed a habit of heavy drinking, so it was treated as damp-heat. Siling Powder and Sanmiao Powder, added with Achyranthis Bidentatae Radix, Akebiae Caulis (Mutong), and Stephaniae Tetrandrae Radix, reduced symptoms after several doses. Jianbu Wan was then used for conditioning.
Xue Lizhai treated Yu Shangzhi, a Jinshi degree holder, who had chronic Kidney deficiency and overwork, resulting in leg flaccidity preventing walking, aphasia, and dark complexion. Xue diagnosed this as Kidney Qi deficiency and cold, failing to transport energy to the extremities, and cured him with Dihuang Yinzi. After relapse due to poor care, others used Niuhuang Qingxin Wan, causing urinary retention and dry mouth/tongue. Xue reverted to Dihuang Yinzi and Jiaban Bawei Wan, leading to gradual recovery, followed by full cure with Buzhong Yiqi Tang.
Zhongzai Liu Ziyan suffered lower body weakness and pain, fever, and profuse phlegm due to overwork. Qingzao Tang with Bamboo Juice and Ginger Juice halved the fever and pain after one dose, and cured him after two doses.
Zhang Luyu treated Lao Junqing, an elderly man with contracture and disability. Half a year of treatment with Papaveris Pericarpium (Mugua), Angelicae Pubescentis Radix (Duohuo), Stephaniae Tetrandrae Radix, and Sparaxis Spica (Weilingxian) rendered him immobile. Bawei Wan was ineffective. His pulse was slightly floating and fine at the Chi position. During midsummer, his knees to feet felt cold as if emerging from water. Diagnosing Kidney deficiency exacerbated by wind and rain, Zhang prescribed Anshen Wan. One dose allowed walking; two courses eliminated flaccidity.
Lu Yangyu treated the mother of Shi Fenggang, aged fifty, with emaciated and slightly swollen limbs, worse at wrists, knees, and finger joints, with exposed blue veins. She historically experienced irritability, hematemesis, or hematochezia for one to two days post-menstruation, controlled only by cooling blood herbs like Moutan Cortex, Rehmanniae Radix, Scutellariae Radix, and Coptidis Rhizoma. Post-menopause, bleeding decreased, but limb symptoms worsened. Shiguo Gong Medicinal Wine was ineffective. Over years, she took Cangzhu, Wutou, Fuzi, Qianghuo, Fangfeng, and various blood-invigorating and wind-damp dispelling formulas. Now, she needed assistance for eating and toileting, suffering unbearable spasmodic pain. All six pulses were faint and choppy, especially slow and weak at the Chi positions. Lu stated: Initial overuse of cold herbs damaged Liver Qi; subsequent wind-dry herbs depleted Liver Blood. Since the Liver governs sinews, current Qi and Blood deficiency left sinews un nourished, causing swelling, exposure, and loss of mobility. He prescribed Ren Shen, Chuanxiong, Dang Gui, and Shou Wu with small amounts of Rou Gui and Qin Jiao as decoction, and Huqian Wan ingredients with doubled Lujiaojiao as pills. Symptoms improved in one month, normal mobility returned in three months, and full cure was achieved in six months. (Xu Lingtai notes: Medication was not optimal.)
Zhu Danxi treated Zheng Anren, aged sixty, with deficiency and phlegm, slow pulse, and weak legs. Banxia Tianma Baizhu Tang combined with Jiuqin Wan cured her.
A scholar sought treatment for weak legs. Both hands showed floating, full, and slightly distended pulses; diet was normal, but he did not respond to questions. White scales appeared on his skin like bran. It was winter, so extreme deficiency was assumed. His brother revealed he had developed carbuncles on his back, arms, and legs from summer to autumn, treated with Wuxiang Liaoqiao Tang and Shixuan San, now scabbed. Zhu prepared a paste of Ren Shen, Baizhu, and Dang Gui, using Erchen Tang to resolve phlegm-fluids. After consuming one jin of medicine in three days, half the scales disappeared, and breathing strengthened. Tonics work slowly, but the family complained and self-treated for wind disease. They ingested Qingmengshi processed with Qingzhou Baiwan. Despite opposition, he died. (Treating flaccidity as wind disease often leads to death.)
Xue Lizhai treated a woman with hemorrhoids and leg soreness resembling bi-syndrome, caused by Yin Blood deficiency failing to nourish sinews. She was cured with Jiabin Sijin Wan after focusing on nourishing blood.
An elderly man with tendon cramps, bone pain, and leg weakness was cured with Huantui Wan from *Jufang*.
A woman with tendon traction, bi-paralysis, and leg weakness was improved with Shengjun Wan from *Sanyinfang*. He Jian noted: Hongkong jiao arises from Kidney deficiency, but women also suffer it due to Blood Sea deficiency and emotional factors. Women's cases resemble men's Kidney deficiency. Treatment is similar, but emotional regulation is essential for efficacy. (Included in flaccidity due to deficiency origin.)
Yao Sengyuan treated Yi Fanglou Mu, Governor of Jinzhou, who felt bound from waist to navel, with loose legs unable to support himself. Yao prescribed three doses of decoction. After the first dose, the upper binding resolved; after the second, the middle; after the third, all bindings resolved. Pain and stiffness remained, so a powder was given, allowing slight flexion. Yao predicted recovery by frost descent. By September, he could walk. (*Book of Zhou*.)
Note: This describes flaccidity worsening in spring/summer and improving in autumn/winter.
Zihe said: Three military officers in Wanqiu suffered from flaccidity for years, with painful swelling below the waist, skin sores, dim vision, dry lips, and tongue. Zihe wanted to use purgatives. Two refused, trusting warm-tonifying doctors, and died. Song Ziyu, similarly ill, changed his mind, accepted Zihe's treatment, and recovered. Zihe stated: "For all flaccidity, treat only the Yangming." Yangming refers to Stomach and Large Intestine. This applies to both acupuncture and herbal medicine.
Wang Zhizhong cited *Liezi*: If kidneys fail, legs cannot walk. For this condition, moxa Shenshu. If ineffective, moxa Huantiao, Fengshi, Dubi, Xiguan, Yanglingquan, Yinlingquan, Zusanli, and Taichong. The tender spot upon pressure indicates the diseased area; moxibustion there is always effective. (*Zisheng Jing*.)
Shi Lingxiu's acquaintance, a heavy drinker, was bedridden for three years. Lingxiu asked Zhongchun for a prescription. Zhongchun diagnosed alcohol-induced disease. Alcohol generates damp-heat, which penetrates Yangming. Excess damp-heat descends to Kidneys, causing bone flaccidity. Hence, ancient texts say "treat Yangming alone for flaccidity." The formula used Schisandrae Fructus as sovereign, Coptidis Rhizoma as minister, Ophiopogonis Radix, Puerariae Radix, and Dolichoris Semen as assistants. Cure was achieved. (*Guang Biji*.)
Xue Lizhai treated a man over fifty with soft, flaccid tendons/bones, bedridden for five years, with severe itching worse in the afternoon. Blood-nourishing herbs reduced itching and improved flaccidity slightly. Jiabin Sijin Wan completed the cure after a year of careful conditioning. He Jian commented: Why use warm tonics for internal heat? Because Yin Blood deficiency fails to nourish sinews, causing laxity. Internal Yang dryness/heat requires nourishing Yang and Yin; when Yin is substantial, Water rises and Fire descends.
Qian Guobin treated Shen Shiyan from Longquan, previously healthy but with stagnant Liver Qi. After age forty, legs weakened spontaneously, progressing to paralysis and contracture. Friends suggested: Straightness without bending indicates bone disease; bending without straightness indicates sinew disease. Relaxed sinews mean no disease. *Neijing* states: Heart generates blood; Liver stores blood. Shen's resentment depleted blood, failing to nourish sinews and bind bones, leading to cold bi and contracture. The prescription used Umbilicus (Qidai) and Placenta Humana (Ziheche) as sovereign, Human Milk, Lycii Fructus, and Polygoni Multiflori Radix as ministers, Chuanxiong, Dang Gui, Dihuang, Achyranthis Bidentatae Radix, and Honghua as assistants. Rich blood nourishes sinews; harmonized sinews bind bones. Pills were taken. External therapy: Several liters of infant urine placed in a large bowl. Legs rested above the bowl. Red-hot tiles were quenched in the urine repeatedly. Steam was inhaled and applied to the legs for one hour. (External therapy is exquisite.) Infant urine is salty and cold; salt softens hardness and moves blood/stasis. *Classic* says: Supplement Qi to treat Blood deficiency, implying Yin born from Yang. Heat disperses cold bi in bones/sinews, guided by tiles. Profound method, known only to those who grasp the essence.
Wei Yuheng described Zhang Yushu's son, nearly thirty, with sudden chills, fever, and headache. Doctors treated it as Taiyang disease for a month, leading to confusion and excruciating pain. Upon examination, the patient lay corpse-like, hair covering forehead, face dirty, skin dry, flesh wasted, looking like a demon. Pulse was wiry, firm, choppy, and rapid at Left Guan/Chi. Pain started at the arm side, extending to toes, shoulders, back, and head, with spasms and rigidity. Wei told the father: This is combined sinew-bone flaccidity. Early tonification would have prevented this. Caused by youthful indiscretion, intercourse followed by long-distance travel and labor, damaging Three Yin. Pain starts at Huantiao, extending to Dadun, Yinbai, Yongquan (Liver/Spleen/Kidney points), and shoulder/head (Du Mai injury). Mother confirmed intercourse followed by rushing to the riverbank. Wei advised: Youthful Qi/Blood recovers easily. Needs 100 doses, or permanent limp. Prescribed Roushou Rong, Sheng/Di Huang, Gouqi, Yiren, Dang Gui, Niuxi, Honghua, Danpi, Louren, Maidong. Ten doses allowed sitting; ten more allowed walking with a cane. Father, stingy, stopped medication when improvement began. Result: One leg shortened by 1-2 inches, causing limping.
Wu Taiyi, over sixty, suffered tendon spasms connecting vertex, shoulders, neck, waist, abdomen, chest, and ribs, with back distension, dizziness, dry mouth, palpitations, frequent urination, reduced appetite, and hot hands craving cold water. Pulse was wiry, rapid, and urgent. Diagnosis: Many symptoms stem from excess Liver Fire and deficient Blood, causing dry sinews and eventual flaccidity. Moistening and nourishing would cure quickly. Yangrong Tang with Yiren, Louren, Dang Gui, and Nvzhen cured her in ten doses.