师曰。病趺蹶。其人但能前不能却。刺 入二寸。此太阳经伤也。
人身经络。阳明行身之前。太阳行身之后。太阳伤。故不能却也。太阳之脉。下贯 内。刺之所以
和利其经脉也。 、足肚也。
病患常以手指臂肿动。此人身体 者。藜芦甘草汤主之。
湿痰凝滞关节则肿。风邪袭伤经络则动。手指臂肿动。身体 者。风痰在膈。攻走肢体。陈无
择所谓痰涎留在胸膈上下。变生诸病。手足项背。牵引钓痛。走易不定者是也。藜芦吐上膈风痰。甘
草亦能取吐。方虽未见。然大略是涌剂耳。（李氏）
转筋之为病。其人臂脚直。脉上下行。微弦。转筋入腹者。鸡屎白散主之。
肝主筋。上应风气。肝病生风。则为转筋。其人臂脚直。脉上下行微弦。经云。诸暴强直。皆属
于风也。转筋入腹者。脾土虚而肝木乘之也。鸡为木畜。其屎反利脾气。故取治是病。且以类相求。
则尤易入也。
鸡屎白散方
鸡屎白为散。取方寸匕。以水六合。和温服。
阴狐疝气者。偏有小大。时时上下。蜘蛛散主之。
阴狐疝气者。寒湿袭阴。而睾丸受病。或左或右。大小不同。或上或下。出没无时。故名狐疝。
蜘蛛有毒。服之能令人利。合桂枝辛温入阴。而逐其寒湿之气也。
蜘蛛散方
蜘蛛（十四枚熬焦） 桂枝（半两）
上二味为散。取八分一匕。饮和服。日再。蜜丸亦可。
问曰。病腹痛有虫。其脉何以别之。师曰。腹中痛。其脉当沉若弦。反洪大。故有蛔虫。
腹痛脉多伏。阳气内闭也。或弦者。邪气入中也。若反洪大。则非正气与外邪为病。乃蛔动而气
厥也。然必兼有吐涎心痛等证。如下条所云。乃无疑耳。
蛔虫之为病。令人吐涎心痛。发作有时。毒药不止者。甘草粉蜜汤主之。
吐涎。吐出清水也。心痛。痛如咬啮。时时上下是也。发作有时者。蛔饱而静。则痛立止。蛔饥
求食。则痛复发也。毒药。即锡粉、雷丸等杀虫之药。毒药者。折之以其所恶也。甘草粉蜜汤者。诱
之以其所喜也。白粉即铅白粉。能杀三虫。而杂于甘草、白蜜之中。诱使虫食。甘味既尽。毒性旋发。
而虫患乃除。此医药之变诈也。
甘草粉蜜汤方
甘草（二两） 白粉（一两） 白蜜（四两）
上三味。以水三升。先煮甘草。取二升。去滓。内粉蜜。搅令和。煎如薄粥。温服一升。瘥即止。
蛔厥者。当吐蛔。令病者静而复时烦。此为脏寒。蛔上入其膈。故烦。须臾复止。得食而呕。又
烦者。蛔闻食臭出。其人当自吐蛔。蛔厥者。乌梅丸主之。
蛔厥。蛔动而厥。心痛吐涎。手足冷也。蛔动而上逆。则当吐蛔。蛔 安而复动。则病亦静而复
时烦也。然蛔之所以时安而时上者何也。虫性喜温。脏寒则虫不安而上膈。虫喜得食。脏虚则蛔复上
而求食。故以人参、姜、附之属。益虚温胃为主。而以乌梅、椒、连之属。苦酸辛气味。以折其上入
之势也。
乌梅丸方
乌梅（三百个） 细辛（六两） 干姜（十两） 黄连（一斤） 当归 川椒（各四两）
附子（炮） 桂枝 人参 黄柏（各六两）
上十味。异捣筛。合治之。以苦酒渍乌梅一宿。去核。蒸之五升米下。饭熟。捣成泥。和药令相
得。内曰中。与蜜杵二千下。丸如梧子大。先食饮服十丸。日三服。稍增至二十丸。禁生冷滑臭等物。
老师说：患趺蹶病的人，只能向前迈步，不能向后倒退。治疗时针刺腨肠（小腿肚）部位，进针深度为二寸。这是太阳经受伤所致。
人体的经络中，阳明经行走在身体前面，太阳经行走在身体后面。太阳经受伤，所以不能向后倒退。太阳经的经脉，向下贯穿腨肠。针刺的目的就是为了调和并疏通该处的经脉。腨，就是足部的小腿肚。
病人经常手指和手臂肿胀跳动，并且身体也随之震颤抽搐的，用藜芦甘草汤主治。
湿痰凝滞于关节导致肿胀，风邪侵袭损伤经络导致跳动。手指和手臂肿胀跳动，身体震颤抽搐，这是因为风痰停留在膈上，攻窜走注于肢体。正如陈无择所说：“痰涎留在胸膈上下，变生各种疾病，手足、项背牵引拘急疼痛，游走不定，就是这种情况。”藜芦能涌吐上膈的风痰，甘草也能起到催吐作用。虽然原方已佚，但大略属于涌吐剂一类。（李氏注）
转筋这种病，病人的手臂和脚僵硬挺直，脉象在上下行走且微带弦象。如果转筋严重到牵连腹部，用鸡屎白散主治。
肝主司筋脉，向上应合风气。肝病生风，就会导致转筋。病人手臂和脚僵硬挺直，脉象上下行走且微弦，《内经》说：“所有突然发生的强直症状，都归属于风。”转筋牵连腹部的情况，是因为脾土虚弱而肝木乘虚克制它。鸡是木畜，它的粪便反而能通利脾气，所以取用它来治疗这个病。而且利用“同类相求”的原理，药力更容易进入病所。
鸡屎白散的配方：
将鸡屎白研成散剂，取一方寸匕的量，用六合水调和，温服。
阴狐疝气病，表现为睾丸偏侧大小不一，时常上下移动。用蜘蛛散主治。
阴狐疝气病，是因为寒湿侵袭阴部，导致睾丸受病。有时在左，有时在右，大小不同；有时上升，有时下降，出没没有定时，所以叫作狐疝。蜘蛛有毒，服用后能使人腹泻。配合桂枝辛温入阴分，以驱逐寒湿之气。
以上两味药研成散剂，取八分之一匕的量，用水送服。每天服用两次。也可以做成蜜丸。
问：患有腹痛且有寄生虫的病，其脉象如何辨别？老师说：腹中疼痛，脉象应当沉或弦，如果反而洪大，说明有蛔虫。
腹痛的脉象多伏匿，是因为阳气内闭。或者呈弦象，是因为邪气入中。如果反而洪大，那就不是正气与外邪相争导致的病症，而是蛔虫扰动导致的气机厥逆。然而必须兼有吐涎、心痛等症状，像下面条文所说的那样，才毫无疑问。
蛔虫引起的病，让人吐涎水、心痛，发作有定时。如果用一般杀虫毒药无效的情况，用甘草粉蜜汤主治。
吐涎，是指吐出清水。心痛，是指疼痛如被咬啮，位置时时上下移动。发作有定时，是因为蛔虫吃饱后安静，疼痛立即停止；蛔虫饥饿求食，疼痛就复发。毒药，即锡粉、雷丸等杀虫药物。使用毒药，是用它们厌恶的东西去折服它。甘草粉蜜汤，则是用它们喜欢的东西去引诱它。白粉即铅白粉，能杀灭三虫，混杂在甘草和白蜜之中，引诱虫子吃下。甘味吃完后，毒性随即发作，虫害也就消除了。这是医药运用的一种权变策略。
以上三味药，用三升水，先煮甘草，取二升药液，去掉药渣。加入白粉和白蜜，搅拌调和，煎煮成稀粥状。温服一升，病愈即停服。
蛔厥病，应当吐出蛔虫。让病人保持安静，但又时不时感到心烦。这是因为内脏寒冷，蛔虫上行进入膈部，所以心烦。过了一会儿又停止。进食后呕吐，再次心烦，是因为蛔虫闻到食物的气味而出动，这个人自然会吐出蛔虫。蛔厥病，用乌梅丸主治。
蛔厥，是因蛔虫扰动导致四肢厥冷，伴有心痛、吐涎、手脚冰凉。蛔虫扰动而上逆，就会吐蛔虫。蛔虫暂时安宁然后又活动，病情也就表现为安静后又不时心烦。然而蛔虫之所以时而安宁时而上行是什么原因呢？虫性喜温，内脏寒冷则虫不安宁而上行至膈。虫喜欢得到食物，内脏虚弱则蛔虫再次上行求食。所以用人参、干姜、附子之类，以补益虚损、温胃为主；再用乌梅、花椒、黄连之类，利用苦、酸、辛的气味，以遏制蛔虫上行的势头。
乌梅丸的配方：
乌梅（三百个） 细辛（六两） 干姜（十两） 黄连（一斤） 当归 川椒（各四两）
附子（炮制） 桂枝 人参 黄柏（各六两）
以上十味药，分别捣碎筛匀，混合处理。用醋浸泡乌梅一夜，去核，放在五升米下蒸熟，捣成泥状，与药末混合均匀，放入臼中，加蜂蜜杵捣两千下，制成梧桐子大小的丸药。饭前饮服十丸，每天三次，逐渐增加至二十丸。禁止食用生冷、滑腻、腥臭等食物。
The Master said: In cases of Diejue (foot sprain/paralysis), the patient can only move forward but not backward. Acupuncture should be applied to the Shuchang (calf muscle) area, with a depth of two cun. This is an injury to the Taiyang Meridian.
In the human body's meridians, the Yangming Meridian runs along the anterior aspect of the body, while the Taiyang Meridian runs along the posterior aspect. Because the Taiyang Meridian is injured, the patient cannot move backward. The Taiyang Meridian passes downward through the calf. The purpose of acupuncture here is to harmonize and facilitate the flow of the meridian. "Shu" refers to the calf of the leg.
If a patient frequently experiences swelling and twitching of the fingers and arms, accompanied by tremors or convulsions of the body, Lili Gancao Tang (Celandine and Licorice Decoction) is the primary treatment.
When damp-phlegm stagnates in the joints, it causes swelling; when wind-pathogens invade and damage the meridians, they cause twitching. Swelling and twitching of the fingers and arms, along with body tremors, indicate that wind-phlegm is lodged in the diaphragm region, attacking and moving through the limbs. As Chen Wuze stated: "Phlegm-fluids remaining in the upper and lower chest/diaphragm generate various diseases, causing牵引 (pulling/tightening) and painful cramping in the hands, feet, neck, and back, wandering without fixed location." Lili (Celandine Herb) induces vomiting to expel wind-phlegm from the upper diaphragm, and Gancao (Licorice Root) also has emetic properties. Although the original formula is lost, it is broadly categorized as an emetic agent. (Note by Li)
In cases of Zhuanjin (muscle cramp/spasm), the patient’s arms and legs are stiff and straight, and the pulse travels up and down with a slight wiry quality. If the spasm extends into the abdomen, Jixishi Bai San (Chicken Dropping White Powder) is the primary treatment.
The Liver governs the sinews and corresponds to wind pathogenic factors. Liver disease generating wind leads to spasms. The stiffness of arms and legs and the wiry pulse traveling up and down align with the Classic saying: "All sudden instances of rigidity and stiffness belong to Wind." Spasms extending into the abdomen occur because Spleen Earth is deficient, allowing Liver Wood to overact upon it. The chicken is a wood animal; its droppings have the effect of benefiting Spleen Qi, thus it is used to treat this condition. Furthermore, utilizing the principle of "similar things seeking each other," the medicinal efficacy enters the pathological site more easily.
Formula for Jixishi Bai San:
Grind Chicken Dropping White (Gallus gallus domesticus excrement) into a powder. Take one fangcun bi (a square-inch measure) and mix with six he of water. Take warm.
Yin Huxian Qi (Yin Fox Hernia) is characterized by asymmetrical size of the testicles, which move up and down intermittently. Zhizhu San (Spider Powder) is the primary treatment.
Yin Huxian Qi results from cold-dampness invading the yin regions, affecting the testicles. They may differ in size on the left or right, and move up or down unpredictably, hence the name "Fox Hernia." Zhizhu (Spider) is toxic and induces purgation when taken. Combined with Guizhi (Cinnamon Twig), which is acrid-warm and enters the yin, it drives out cold-damp pathogens.
Formula for Zhizhu San:
Zhizhu (Spider, 14 pieces, roasted until charred) Guizhi (Cinnamon Twig, half liang)
Pulverize the above two ingredients into a powder. Take one-eighth of a bi measure, mixed with water for oral administration. Take twice daily. Honey pills are also acceptable.
Question: How can one distinguish the pulse in abdominal pain caused by parasites?
The Master said: In abdominal pain, the pulse should typically be deep or wiry. If it is instead flooding and large, it indicates the presence of roundworms (Ascaris).
Abdominal pain pulses are often hidden due to internal closure of Yang Qi. Or if wiry, it indicates pathogenic factors entering the interior. If the pulse is instead flooding and large, it is not a disease of righteous Qi battling external pathogens, but rather Qi reversal caused by the movement of roundworms. However, this must be accompanied by symptoms such as salivation and heart pain, as described in the following clause, to be certain.
Roundworm disease causes salivation, heart pain, and intermittent attacks. If standard antiparasitic drugs fail, Gancao Fenmi Tang (Licorice, Starch, and Honey Decoction) is the primary treatment.
"Salivation" refers to vomiting clear fluid. "Heart pain" refers to pain like biting or gnawing, moving up and down intermittently. Intermittent attacks occur because when roundworms are full, they become quiet, and pain stops immediately; when hungry, they seek food, and pain recurs. "Toxic drugs" refer to antiparasitic agents like Tin Powder or Polyporus Pill. Using toxic drugs is about subduing them with what they dislike. Gancao Fenmi Tang uses what they like to lure them. Baifen (Lead White Powder) kills three types of worms. Mixed with Gancao and white honey, it lures the worms to eat. Once the sweet taste is consumed, the toxicity activates, eliminating the worm infestation. This represents a tactical variation in medicine.
Formula for Gancao Fenmi Tang:
Gancao (Licorice Root, 2 liang) Baifen (Lead White Powder, 1 liang) Baimi (White Honey, 4 liang)
Take the above three ingredients with 3 sheng of water. First decoct Gancao to obtain 2 sheng of liquid, then strain. Add Baifen and Baimi, stir and mix well, and simmer until it resembles thin porridge. Take 1 sheng warm. Stop taking once the illness resolves.
Hui Jue (Roundworm Reversal Cold) involves vomiting roundworms. The patient remains quiet but occasionally becomes vexed. This is due to cold in the zang organs, causing roundworms to ascend into the diaphragm, leading to vexation. After a moment, it subsides. Vomiting after eating and subsequent vexation occur because roundworms emerge upon smelling food odor, leading the person to naturally vomit roundworms. Hui Jue is treated primarily with Wumei Wan (Mume Pill).
Hui Jue involves limb coldness due to roundworm agitation, accompanied by heart pain, salivation, and cold hands and feet. When roundworms agitate and reverse upward, roundworms are vomited. When they temporarily settle and then move again, the condition alternates between quietness and occasional vexation. Why do roundworms alternate between settling and ascending? Worms prefer warmth; internal cold makes them restless, causing them to ascend to the diaphragm. Worms crave food; internal deficiency causes them to ascend to seek food. Therefore, Ren Shen (Ginseng Root), Gan Jiang (Dried Ginger), and Fu Zi (Prepared Aconite Root) are used to tonify deficiency and warm the stomach. Wumei (Mume Fruit), Huajiao (Sichuan Pepper), and Huanglian (Coptis Rhizome) are used for their bitter, sour, and acrid flavors to counteract the upward movement of the worms.
Formula for Wumei Wan:
Wumei (Mume Fruit, 300 pieces) Xixin (Asarum Root, 6 liang) Ganjiang (Dried Ginger, 10 liang) Huanglian (Coptis Rhizome, 1 jin) Danggui (Angelica Sinensis Root) Chuanjiao (Sichuan Pepper, 4 liang each)
Fuzi (Prepared Aconite Root) Guizhi (Cinnamon Twig) Renshen (Ginseng Root) Huangbai (Phellodendron Bark, 6 liang each)
Pulverize and sieve the above ten ingredients separately, then mix. Soak Wumei in vinegar overnight, remove pits, and steam over five sheng of rice until cooked. Mash into a paste, mix with the herbal powders, place in a mortar, add honey, and pound for two thousand strokes to form pills the size of wutong seeds. Take ten pills before meals with drinkable liquid, three times daily. Gradually increase to twenty pills. Avoid raw, cold, slippery, and foul-smelling foods.