热痹者，闭热于内也。《内经》论痹有云∶其热者，阳气多，阴气少，病气胜，阳遭阴
，故
为痹热，所谓阳遭阴者，腑脏经络，先有蓄热，而复遇风寒湿气客之，热为寒郁，气不得通
，久之寒亦化热，则 痹 然而闷也。
升麻汤
升麻 射干 甘草 芎 （各二两） 麦冬 葳蕤 生姜（各三两） 赤小豆（炒，三合）
每服四钱，入生地黄汁半合，青竹叶十五片，水煎，温服无时。
河间升麻汤 治热痹，肌肉热极，体上如鼠走，唇口反纵，皮色变。
升麻（三两） 茯苓 人参 防风 犀角 羚羊角 羌活（各一两） 官桂（三钱）
上为末，每服四钱，水二盏，姜二片，竹沥半酒杯，同煎至一盏，温服无时。
《千金》犀角汤 治热毒流入四肢，历节肿痛。（方见风症。）
肠痹者，《内经》所谓数饮而出不得，中气喘争，时发飧泄是也。夫大肠者，传导之腑
，小
肠者，受盛之官，皆水谷气味，出入之要路也。今风寒湿三气痹之，邪气独留，正气遂闭，
由是水道不通，糟粕不化，则虽多饮而不得溲便，中气喘满而时发飧泄也。
吴茱萸散 治肠痹，寒湿内搏，腹痛气急，大便飧泄。
吴茱萸（汤炮，焙干） 干姜（泡） 甘草（炙） 肉豆蔻（煨，各五钱） 砂仁 神曲 白
术（各一两） 浓朴（姜汁炒） 陈皮（去白，焙） 良姜（各二两）
上为末，每服一钱，食前米饮下。
热痹，是指热邪闭阻于体内的病证。《内经》论述痹症时说：那些出现热象的痹症，是因为患者阳气偏盛、阴气偏少，病邪之气强盛，阳热之气与阴寒之邪相搏结，所以表现为痹热。所谓“阳遭阴”，是指脏腑经络中原本就有蓄积的热邪，又外感风寒湿邪侵袭，热邪被寒邪郁遏，导致气机运行不畅，久而久之，寒邪也转化为热邪，于是出现痹痛且伴有烦闷的症状。
升麻汤
组成：升麻、射干、甘草、川芎（各二两），麦冬、玉竹、生姜（各三两），赤小豆（炒制，三合）。
用法：每次服用四钱，加入新鲜生地黄汁半合、青竹叶十五片，加水煎煮，不拘时候温服。
河间升麻汤 治疗热痹，肌肉热势极盛，身体感觉像有老鼠在皮肤下爬行，口唇松弛歪斜，皮肤颜色改变。
组成：升麻（三两），茯苓、人参、防风、犀角、羚羊角、羌活（各一两），官桂（三钱）。
用法：以上药物研为细末，每次服用四钱，用水两盏，生姜两片，竹沥半酒杯，共同煎煮至一盏，不拘时候温服。
《千金方》犀角汤 治疗热毒流入四肢，导致历节肿痛。（方剂见风症章节。）
肠痹，就是《内经》所说的频繁饮水却小便不通畅，腹部气机逆乱作响，时常发生完谷不化的泄泻。大肠是传导糟粕的腑，小肠是受纳和盛装水谷的器官，它们都是水谷精微与气味出入的重要通道。如今风寒湿三气痹阻这些部位，邪气独自停留，正气随之闭塞，因此水道不通，糟粕无法消化转化，所以虽然大量饮水却无法排尿排便，腹部气机壅滞胀满并时常发生完谷不化的泄泻。
吴茱萸散 治疗肠痹，寒湿内迫，腹痛气急，大便完谷不化。
组成：吴茱萸（汤洗炮制，焙干）、干姜（炮制）、甘草（炙）、肉豆蔻（煨制，各五钱），砂仁、神曲、白术（各一两），浓朴（姜汁炒制）、陈皮（去白瓤，焙干）、高良姜（各二两）。
用法：以上药物研为细末，每次服用一钱，饭前用米汤送服。
Re Bi (Heat Bi), refers to a syndrome where heat pathogen is closed within the interior. The *Neijing* discusses Bi syndromes, stating: For those presenting with heat, it is because Yang Qi is abundant and Yin Qi is scarce; the pathogenic factor prevails, and Yang encounters Yin. Thus, it manifests as Re Bi. What is meant by "Yang encountering Yin" is that there is initially accumulated heat in the Zang-Fu organs and meridians, which is then invaded by external Wind-Cold-Dampness pathogens. The heat is constrained by the Cold, causing Qi mechanism obstruction. Over time, the Cold also transforms into Heat, resulting in Bi pain accompanied by stifling sensation.
Shengma Tang (Cimicifugae Decoction)
Ingredients: Shengma (Rhizoma Cimicifugae), Shegan (Radix Belamcandae), Gancao (Radix Glycyrrhizae), Xiongqiong (Radix Chuanxiong) (each 2 liang); Maidong (Radix Ophiopogonis), Weirui (Rhizoma Polygonati Odorati), Shengjiang (Rhizoma Zingiberis Recens) (each 3 liang); Chi Xiaodou (Semen Phaseoli Rubri) (stir-fried, 3 he).
Usage: Take 4 qian per dose, add Ban He of fresh Shengdihuang juice (Radix Rehmanniae Preparata) and 15 leaves of Qing Zhuye (Folium Bambusae in Templa), decoct with water, and take warm at any time.
Hejian Shengma Tang (Liu Wansu's Cimicifuga Decoction) Treats Re Bi (Heat Bi), characterized by extreme heat in muscles, a sensation on the body like mice running under the skin, inversion or flaccidity of the lips and mouth, and changes in skin color.
Ingredients: Shengma (Rhizoma Cimicifugae) (3 liang); Fuling (Poria), Renshen (Radix Ginseng), Fangfeng (Radix Saposhnikoviae), Xijiao (Cornu Rhinocerotis), Lingyangjiao (Cornu Saigae Tataricae), Qianghuo (Rhizoma et Radix Notopterygii) (each 1 liang); Guanzi Gui (Cortex Cinnamomi) (3 qian).
Usage: Grind the above ingredients into powder. Take 4 qian per dose with 2 zhan of water, 2 slices of ginger, and half a wine cup of Zhuli (Bamboo Juice). Decoct together until one zhan remains, and take warm at any time.
Xijiao Tang (Rhinoceros Horn Decoction) from *Qianjin Fang* Treats Heat-Toxin flowing into the four limbs, causing Li Jie swelling and pain. (Formula see Feng Zheng chapter.)
Chang Bi (Intestinal Bi) is what the *Neijing* describes as frequent drinking yet inability to urinate, middle-jiao Qi turbulence and borborygmus, and occasional Sund Xie (undigested stool diarrhea). The Large Intestine is the Fu organ of transmission and conduction; the Small Intestine is the official responsible for receiving and containing. Both are crucial pathways for the entry and exit of water and grain essences. Now, if the three pathogens of Wind, Cold, and Dampness Bi-obstruct these areas, the pathogenic factor remains alone while the Healthy Qi becomes blocked. Consequently, the Water Dao (urinary pathway) is unblocked, and the waste products are not transformed. Thus, although one drinks much, one cannot urinate or defecate; the middle-jiao Qi becomes stagnant and full, and Sund Xie occurs frequently.
Wuzhuyu San (Evodia Powder) Treats Chang Bi (Intestinal Bi), where Cold-Dampness struggles internally, causing abdominal pain,急促 Qi (shortness of breath/urgency), and Sund Xie (undigested stool diarrhea).
Ingredients: Wuzhuyu (Fructus Evodiae) (washed with water, processed, dried by baking), Ganjiang (Radix Zingiberis Preparata), Gancao (Radix Glycyrrhizae Preparata), Roudoukou (Semen Myristicae) (baked, each 5 qian); Sharen (Fructus Amomi), Shenqu (Massa Medicata Fermentata), Baizhu (Rhizoma Atractylodis Macrocephalae) (each 1 liang); Houpo (Cortex Magnoliae Officinalis) (stir-fried with ginger juice), Chenpi (Pericarpium Citri Reticulatae) (white pith removed, baked), Liangjiang (Rhizoma Alpiniae Officinarum) (each 2 liang).
Usage: Grind the above ingredients into powder. Take 1 qian per dose before meals, washed down with Mi Yin (rice drink).