人有一身上下，由背而至腰膝两胫，无不作痛，饮食知味，然不能起床，即起
床席，而痛不可耐，仍复睡卧，必须捶敲按摩，否则其痛走来走去，在骨节空隙之
处作楚，而不可忍。人以为此症乃痛风也。然痛风之症，多感于风湿，而风湿之感，
多入于骨髓。风湿入于经络则易去，风湿入于骨髓则难祛，以骨髓属肾，肾可补而
不可泻，祛风湿则伤肾，肾伤则邪欺正弱，将深居久住，而不肯遽出矣。虽然肾不
可泻，而胃与大肠未尝不可泻也。泻胃与大肠之风湿，而肾之风湿自去。盖胃为肾
之关，而大肠为肾之户也。方用并祛丹∶
黄 （一两） 白术（五钱） 茯苓（五钱） 甘菊花（三钱） 炙甘草（一钱） 羌活（五分）
防风（五分） 水
煎服。一剂而痛减，二剂而痛除，三剂而痛全愈矣。愈后，用八味地黄丸调理，永无再犯之患。
论理，不治肾而治胃与大肠之风湿，去风宜用干葛也，去湿宜用猪苓也。有风
有湿，必化为火，去火亦宜用石膏、知母也。然邪在骨髓，必须用气分之剂提出，
在气分，使微寒之品，与轻散之味以和解之，则邪易于速化。然后用补肾之药补其
肾中之水火，真水足而邪水不敢再入，真火足而邪火不能再侵也。
此症亦可用 术两活汤∶
人参 肉桂（各三钱） 白术 黄 （各一两） 茯苓（五钱） 甘草（一钱） 羌活 独活（各五分）
水煎服。四剂愈。
人有遍身疼痛，至腰以下不痛者，人亦以为痛风也，谁知乃火郁于上中二焦，
不能散而成者也。若作风湿治之，全不能效，然而仅治其火，亦正徒然。盖火生于
郁。则肝胆之气不宣，木必下克脾胃之土，而土气不升，则火亦难发，以致气血耗
损，不能灌注于经络而作痛矣。方用逍遥散加味治之。
柴胡（二钱） 白芍（五钱） 当归（一两） 甘草（一钱） 炒栀子（三钱） 陈皮（一钱） 茯苓（三钱）
白术（二钱） 羌活（一钱） 水煎服。一剂而痛如失矣。
逍遥散专解肝胆之郁，栀子尤善于解郁中之火，肝胆之火既盛，则胆中之汁必
干，肝中之血必燥，多加当归、芍药，更于平肝平胆之内而济之滋胆滋肝之味也。
血足而气自流通，复加羌活以疏经络，自然火散而痛除耳。
此症用和肝消火散。
柴胡 栀子 丹皮 苍术 天花粉（各二钱） 白芍（五钱） 茯苓 生地（各三钱） 甘草（一钱）
陈皮（五分） 川芎（一钱） 水煎服。四剂全愈。
人有遍身生块而痛者，此虽是痛风，然因湿气不入脏腑而外走经络、皮肤以生
此块，乃湿痰结成者也。消痰于肠胃之内者易为力，而消痰于经络、皮肤者难为功。
虽然经络皮肤固难治，而肠胃可易治也，吾治其肠胃而经络皮肤之痛块自消。方用
消块止痛丹∶
人参（三钱） 黄 （五钱） 防风（一钱） 半夏（三钱） 羌活（一钱） 白术（三钱） 桂枝（五分）
茯苓（五钱） 薏仁（五钱）水煎服。二剂而痛轻，四剂而痛止，十剂而块消，二十剂而块尽消也。
夫块结不散，正气虚也。气虚则痰结，吾用人参、 、术以补其气，而痰之势
衰矣。况益之茯苓、薏仁以利湿，半夏以消痰，防风、羌活以去风，桂枝以逐邪，
则痰之党羽既孤，而不能留其块垒矣。倘徒治经络皮肤，反耗损肠胃之气，而气不
能行于经络皮肤，则块且益大，何以消之哉。
此症用防 分湿汤甚效。
黄 白术 茯苓（各五钱） 薏仁（五钱） 防风 柴胡 天花粉（各一钱） 桂枝（三分）
麻黄（五分） 水煎服。四剂愈。
人有遍身疼痛，殆不可忍，然有时止而不疼，人以为风湿相搏，谁知是气血亏
损，凝滞而不通乎。夫风寒束于肌骨，雨湿入于肢节，皆能作痛，然其痛必一定不
迁，非时而痛，时而不痛也。惟气血既虚，不能流行于肢节肌骨之中，每视盛衰以
分轻重，气到之时则痛轻，气散之后则痛重，血聚之时则痛轻，血滞之时则痛重也。
倘认作风寒雨湿之邪，而用祛除扫荡之药，则气血愈虚，而疼痛更甚。治法必大补
其气血，而佐以温热之味，则正旺而邪不敢侵，不必止痛而痛自止也。方用忘痛汤∶
当归（一两） 黄 （二两） 肉桂（二钱） 延胡索（一钱） 天花粉（三钱） 秦艽（一钱）
水煎服。一剂必出大汗，听其自干，一服即愈，二服不再发。
此方即补血汤之变方也。补血汤名为补血，实气血双补之神剂，今益以肉桂之
祛寒，延胡索之活血化气，天花粉之消痰去湿，秦艽之散风，即有外邪，无不兼治，
何痛之不愈乎。
此症用化凝汤亦妙。
当归（五钱） 黄 （一两） 肉桂（五分） 茯苓（五钱） 柴胡 甘草 羌活 半夏（各一钱）
水煎服。四剂愈。
一个人全身上下，从背部一直到腰部、膝盖和小腿胫骨，没有一处不疼痛的，饮食能知味道，但是无法起床；即使勉强起床坐在席子上，也痛得难以忍受，只好重新躺下睡觉。必须通过捶打敲击或按摩来缓解，否则疼痛会游走不定，在骨节空隙之处产生剧烈酸痛，让人无法忍受。人们认为这种病症是痛风。然而，痛风的成因，多是由于感受了风湿之邪，而风湿之邪侵袭人体，大多深入骨髓。如果风湿之邪只停留在经络层面，则容易祛除；但如果侵入骨髓，则很难清除。因为骨髓归属于肾，肾的功能只能补益而不能泻泄，若要强行祛除风湿则会损伤肾脏，肾气受损则正气虚弱，邪气就会趁机占据优势，深居固守而不肯轻易离去。虽然肾脏不可泻，但胃与大肠却并非不能泻。通过泻除胃与大肠中的风湿之邪，肾脏中的风湿自然也就去除了。这是因为胃是肾的关隘，而大肠是肾的门户。方剂使用并祛丹：
黄芪（一两） 白术（五钱） 茯苓（五钱） 甘菊花（三钱） 炙甘草（一钱） 羌活（五分）
防风（五分）
用水煎服。服用一剂后疼痛减轻，两剂后疼痛消除，三剂后疼痛完全痊愈。病愈后，用八味地黄丸进行调理，从此永不复发。
从医理上讲，不直接治疗肾脏，而是治疗胃与大肠的风湿之邪。去除风邪适宜用干葛（葛根），去除湿邪适宜用猪苓。既有风又有湿，必然化生为火，清除火热适宜用石膏、知母。然而，邪气位于骨髓深处，必须使用作用于气分的药物将其提引出来。在气分层面，使用性质微寒且气味轻扬发散的药物来和解表里，这样邪气就容易迅速化解。然后再用补肾的药物来补益肾中的真阴（水）和真阳（火），当真阴充足时，邪水就不敢再侵入；当真阳充足时，邪火就不能再侵犯。
这种病症也可以使用术两活汤：
人参 肉桂（各三钱） 白术 黄芪（各一两） 茯苓（五钱） 甘草（一钱） 羌活 独活（各五分）
用水煎服。服用四剂即可痊愈。
有的人全身疼痛，但腰部以下不痛，人们也以为是痛风，谁知道这其实是火邪郁结在上焦和中焦，无法散发而形成的。如果按照风湿来治疗，完全无效；然而仅仅清火也是徒劳无功的。因为火邪生于郁结，会导致肝胆之气不得宣畅，肝木必然向下克制脾胃之土，导致脾土之气不能上升，那么火邪也难以发越，从而导致气血耗损，不能灌注于经络而产生疼痛。方剂使用逍遥散加味进行治疗。
柴胡（二钱） 白芍（五钱） 当归（一两） 甘草（一钱） 炒栀子（三钱） 陈皮（一钱） 茯苓（三钱）
白术（二钱） 羌活（一钱）
用水煎服。服用一剂后疼痛消失如失。
逍遥散专门解除肝胆的郁结，栀子尤其善于解除郁结中的火邪。既然肝胆之火旺盛，那么胆中的胆汁必然干枯，肝中的血液必然燥热，因此多加当归、芍药，在平抑肝气和胆气的同时，补充滋养肝胆的物质。血液充足则气机自然流通，再加上羌活来疏通经络，自然火邪消散而疼痛消除。
这种病症使用和肝消火散也很有效。
柴胡 栀子 丹皮 苍术 天花粉（各二钱） 白芍（五钱） 茯苓 生地（各三钱） 甘草（一钱）
陈皮（五分） 川芎（一钱）
用水煎服。服用四剂完全痊愈。
有的人全身出现肿块并伴有疼痛，这虽然是痛风的表现，但因为湿气没有进入脏腑，而是向外流窜到经络、皮肤而生成了这些肿块，这是湿痰凝结而成的。在肠胃内部消除痰湿比较容易奏效，而在经络、皮肤表面消除痰湿则难以成功。虽然经络和皮肤确实难治，但肠胃却是容易治疗的，我通过治疗肠胃，经络和皮肤上的疼痛肿块自然就会消除。方剂使用消块止痛丹：
人参（三钱） 黄芪（五钱） 防风（一钱） 半夏（三钱） 羌活（一钱） 白术（三钱） 桂枝（五分）
茯苓（五钱） 薏苡仁（五钱）
用水煎服。服用两剂后疼痛减轻，四剂后疼痛停止，十剂后肿块消退，二十剂后肿块全部消除。
肿块结聚不散，是因为正气虚弱。气虚则导致痰湿凝结，我用人参、黄芪、白术来补气，痰湿的势头就会衰减。何况再加上茯苓、薏苡仁来利湿，半夏来消痰，防风、羌活来祛风，桂枝来驱逐邪气，那么痰湿的同党既已孤立，就无法再留存那些结块的垒石了。如果仅仅治疗经络和皮肤，反而会耗损肠胃之气，气不能在经络和皮肤运行，那么肿块只会更加增大，又怎么能消除呢？
这种病症使用防[风]分湿汤非常有效。
黄芪 白术 茯苓（各五钱） 薏苡仁（五钱） 防风 柴胡 天花粉（各一钱） 桂枝（三分）
麻黄（五分）
用水煎服。服用四剂痊愈。
有的人全身疼痛，几乎难以忍受，但有时疼痛会停止而不痛，人们以为是风寒湿邪相互搏结，谁知道这是气血亏损，凝滞不通所致。风寒束缚于肌肤骨骼，雨湿侵入肢体关节，都能引起疼痛，但这种疼痛一定是固定不移的，不会时而痛时而止。只有当气血已经虚弱，不能在肢体肌骨中正常运行时，疼痛才会根据气血的盛衰而分轻重：气到达的时候疼痛就轻，气散去之后疼痛就重；血聚集的时候疼痛就轻，血停滞的时候疼痛就重。如果误认为是风寒雨湿之邪，而使用祛除扫荡的药物，那么气血会更加虚弱，疼痛反而更严重。治疗方法必须大补气血，并辅以温热的药物，使正气旺盛而邪气不敢侵犯，不必专门止痛，疼痛自然会停止。方剂使用忘痛汤：
当归（一两） 黄芪（二两） 肉桂（二钱） 延胡索（一钱） 天花粉（三钱） 秦艽（一钱）
用水煎服。服用一剂必定出大汗，听任其自行干燥，服用一次即痊愈，服用两次不再复发。
这个方子就是补血汤的变方。补血汤名为补血，实际上是气血双补的神妙药剂，现在增加了肉桂来驱寒，延胡索来活血行气，天花粉来消痰祛湿，秦艽来散风，即使有外邪存在，也能一并治疗，还有什么疼痛不能治愈的呢？
这种病症使用化凝汤也很奇妙。
当归（五钱） 黄芪（一两） 肉桂（五分） 茯苓（五钱） 柴胡 甘草 羌活 半夏（各一钱）
用水煎服。服用四剂痊愈。
A person suffers from pain throughout the entire body, extending from the back down to the waist, knees, and calves, with no area spared. Although their sense of taste for food remains intact, they are unable to rise from bed; even if they force themselves to sit on a mat, the pain is unbearable, compelling them to lie down again. They require beating, knocking, or massage to alleviate the discomfort; otherwise, the pain wanders, causing severe soreness in the gaps between bone joints that is intolerable. People assume this condition is gout (Tongfeng). However, gout is mostly caused by contracting wind-dampness (Fengshi), which tends to penetrate into the bone marrow. If wind-dampness remains in the meridians and collaterals (Jingluo), it is easy to dispel; but if it enters the bone marrow, it is difficult to eradicate because the bone marrow belongs to the Kidney (Shen). The Kidney can be tonified but not purged. Purging wind-dampness damages the Kidney; once the Kidney is damaged, the pathogen overwhelms the weakened righteous qi, settling deeply and refusing to leave easily. Nevertheless, although the Kidney cannot be purged, the Stomach (Wei) and Large Intestine (Dachang) can be. By purging the wind-dampness from the Stomach and Large Intestine, the wind-dampness in the Kidney will naturally dissipate. This is because the Stomach serves as the gate for the Kidney, and the Large Intestine serves as its door. Use the Formula Binqu Dan (Simultaneous Dispelling Decoction):
Huangqi (Astragali Radix, 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 5 qian), Fuling (Poria, 5 qian), Ganjuhua (Chrysanthemi Flos, 3 qian), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 1 qian), Qianghuo (Notopterygii Rhizoma et Radix, 5 fen), Fangfeng (Saposhnikoviae Radix, 5 fen).
Decoct in water and take orally. After one dose, pain decreases; after two doses, pain disappears; after three doses, pain is completely cured. Post-recovery, regulate with Bajia Dihuang Wan (Eight-Ingredient Rehmannia Pill) to prevent recurrence permanently.
Theoretically, instead of treating the Kidney directly, we treat the wind-dampness in the Stomach and Large Intestine. To expel wind, Ge Gen (Puerariae Lobatae Radix) is suitable; to drain dampness, Zhuling (Polyporus) is suitable. When both wind and dampness are present, they must transform into fire; Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhenae Rhizoma) are suitable for clearing heat. However, since the pathogen resides deep in the bone marrow, agents acting on the Qi level (Qi Fen) must be used to draw it out. At the Qi level, using slightly cold and lightly dispersing herbs to harmonize allows the pathogen to resolve quickly. Subsequently, tonify the Kidney's true Yin (Water) and true Yang (Fire). When true Yin is sufficient, evil water dare not re-enter; when true Yang is sufficient, evil fire dare not invade again.
This condition can also be treated with Shu Lianghuo Tang (Two Huos with Atractylodes Decoction):
Renshen (Ginseng Radix), Rougui (Cinnamomi Cortex), each 3 qian; Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), each 1 liang; Fuling (Poria), 5 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 1 qian; Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), each 5 fen.
Decoct in water and take orally. Cured after four doses.
Some people experience pain throughout the body, but not below the waist. People also mistake this for gout, unaware that it is actually fire stagnating in the Upper and Middle Jiao (Sanjiao), unable to disperse. Treating it as wind-dampness yields no effect, yet merely clearing fire is also futile. Fire arises from stagnation, causing the Qi of the Liver and Gallbladder (Gan dan) to fail to circulate freely. Wood (Liver) overacts upon Earth (Spleen/Stomach), preventing Earth Qi from ascending, making it difficult for fire to vent. This leads to consumption of Qi and Blood, which fail to irrigate the meridians, causing pain. Treat with Xiaoyao San (Free and Easy Wanderer Powder) modified:
Chaihu (Bupleuri Radix), 2 qian; Shaoyao (Paeoniae Radix Alba), 5 qian; Danggui (Angelicae Sinensis Radix), 1 liang; Gancao (Glycyrrhizae Radix et Rhizoma), 1 qian; Chao Zhizi (Gardeniae Fructus, stir-fried), 3 qian; Chenpi (Citri Reticulatae Pericarpium), 1 qian; Fuling (Poria), 3 qian; Baizhu (Atractylodis Macrocephalae Rhizoma), 2 qian; Qianghuo (Notopterygii Rhizoma et Radix), 1 qian.
Decoct in water and take orally. Pain vanishes after one dose.
Xiaoyao San specifically resolves Liver-Gallbladder stagnation, while Zhizi excels at clearing fire within stagnation. Since Liver-Gallbladder fire is excessive, gallbladder juice dries up, and Liver blood becomes dry. Adding more Danggui and Shaoyao nourishes the Liver and Gallbladder while soothing them. When blood is sufficient, Qi flows freely. Adding Qianghuo unblocks the meridians, naturally dispersing fire and relieving pain.
He Gan Xiao Huo San (Harmonizing Liver and Eliminating Fire Powder) is also effective for this condition:
Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus), Danpi (Moutan Cortex), Cangzhu (Atractylodis Rhizoma), Tianhuafen (Trichosanthis Radix), each 2 qian; Shaoyao (Paeoniae Radix Alba), 5 qian; Fuling (Poria), Shengdi (Rehmanniae Radix), each 3 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 1 qian; Chenpi (Citri Reticulatae Pericarpium), 5 fen; Chuanxiong (Ligustici Chuanxiong Rhizoma), 1 qian.
Decoct in water and take orally. Cured after four doses.
Some people have lumps all over their bodies accompanied by pain. Although this resembles gout, it occurs because dampness does not enter the Zang-Fu organs but moves outward to the meridians and skin, forming lumps composed of condensed damp-phlegm. Resolving phlegm within the intestines and stomach is easy, but resolving it in the meridians and skin is difficult. Although meridians and skin are hard to treat, the intestines and stomach are accessible. By treating the intestines and stomach, the painful lumps in the meridians and skin will naturally disappear. Use Xiaokuai Zhitong Dan (Eliminating Lumps and Relieving Pain Elixir):
Renshen (Ginseng Radix), 3 qian; Huangqi (Astragali Radix), 5 qian; Fangfeng (Saposhnikoviae Radix), 1 qian; Banxia (Pinelliae Rhizoma), 3 qian; Qianghuo (Notopterygii Rhizoma et Radix), 1 qian; Baizhu (Atractylodis Macrocephalae Rhizoma), 3 qian; Guizhi (Cinnamomi Ramulus), 5 fen; Fuling (Poria), Yiren (Coicis Semen), each 5 qian.
Decoct in water and take orally. Pain lightens after two doses, stops after four doses, lumps vanish after ten doses, and are completely gone after twenty doses.
Lumps that do not disperse indicate deficiency of Righteous Qi (Zheng Qi). Qi deficiency leads to phlegm condensation. Using Renshen, Huangqi, and Baizhu tonifies Qi, weakening the momentum of phlegm. Furthermore, adding Fuling and Yiren promotes diuresis to drain dampness, Banxia resolves phlegm, Fangfeng and Qianghuo expel wind, and Guizhi drives out pathogens. With the phlegm's allies isolated, the lump formations cannot persist. If one only treats the meridians and skin, it depletes the Qi of the intestines and stomach; without Qi circulating in the meridians and skin, the lumps would grow larger, making elimination impossible.
Fang Feng Fen Shi Tang (Wind-Expelling and Damp-Draining Decoction) is very effective for this condition:
Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), each 5 qian; Yiren (Coicis Semen), 5 qian; Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Tianhuafen (Trichosanthis Radix), each 1 qian; Guizhi (Cinnamomi Ramulus), 3 fen; Mahuang (Ephedrae Herba), 5 fen.
Decoct in water and take orally. Cured after four doses.
Some people suffer from unbearable pain throughout the body, which sometimes ceases. People attribute this to the struggle between wind-cold and dampness, but it is actually due to Qi and Blood deficiency causing stagnation and blockage. Wind-cold binding the muscles and bones, and rain-dampness entering the joints, can cause pain, but such pain is fixed and does not migrate or come and go intermittently. Only when Qi and Blood are deficient and fail to circulate freely in the limbs and bones does the pain vary in severity based on their abundance: pain is mild when Qi arrives and heavy when it disperses; pain is mild when Blood gathers and heavy when it stagnates. Mistaking this for wind-cold-rain-dampness and using harsh expelling drugs will further deplete Qi and Blood, worsening the pain. The treatment must heavily tonify Qi and Blood, assisted by warm-natured herbs. When Righteous Qi is robust, pathogens dare not invade; pain will cease spontaneously without direct analgesics. Use Wangtong Tang (Forget-Pain Decoction):
Danggui (Angelicae Sinensis Radix), 1 liang; Huangqi (Astragali Radix), 2 liang; Rougui (Cinnamomi Cortex), 2 qian; Yanhusuo (Corydalis Rhizoma), 1 qian; Tianhuafen (Trichosanthis Radix), 3 qian; Qinjiao (Gentianae Macrophyllae Radix), 1 qian.
Decoct in water and take orally. Profuse sweating occurs after one dose; let it dry naturally. Cured after one dose, no recurrence after two doses.
This formula is a variation of Buxue Tang (Tonify Blood Decoction). Named "Tonify Blood," it is actually a divine agent for dual tonification of Qi and Blood. Adding Rougui to dispel cold, Yanhusuo to invigorate Blood and move Qi, Tianhuafen to resolve phlegm and drain dampness, and Qinjiao to scatter wind, it treats external pathogens simultaneously. How could any pain remain uncured?
Huaning Tang (Transforming Stagnation Decoction) is also excellent for this condition:
Danggui (Angelicae Sinensis Radix), 5 qian; Huangqi (Astragali Radix), 1 liang; Rougui (Cinnamomi Cortex), 5 fen; Fuling (Poria), 5 qian; Chaihu (Bupleuri Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Banxia (Pinelliae Rhizoma), each 1 qian.
Decoct in water and take orally. Cured after four doses.