Rheumatic polymyalgia occurs mostly in the elderly and is characterized by pain and stiffness in the proximal muscles (scapular girdle, pelvic girdle) and cervical muscles, with a significant increase in blood sedimentation and non-specific systemic symptoms. The etiology of this disease is unknown, and Western medicine mostly treats this disease with small doses of hormones. This disease belongs to the category of “paralysis” and “muscle paralysis” in Chinese medicine. 1, etiology and pathogenesis of rheumatic polymyalgia is based on the aging of the body and the declining function of the internal organs; Yang Qi is insufficient, the couples are not dense, or exposed to wind and cold, or sitting and lying cold and wet, wind, cold and wet and other evil invade the body, the cold leads, wet and sticky, paralyzing the muscles, blocking the tendons and veins, the flow of Qi and blood is suppressed by it, and if it does not pass, it hurts, so the disease is developed. The lung, spleen, liver and kidney are all related organs of rheumatic polymyalgia. If the body is aging, the kidney is deficient in yang energy, the lung is deficient in couples, and it is easy to feel the evil, plus the liver and spleen are deficient, the tendons and muscles lose their moistening, so the external evil paralyzes the body and causes this disease. The disease is mostly seen in middle-aged and elderly women, mostly due to deficiency of liver and blood, kidney deficiency, wind, cold and dampness invade the body, blocking the meridians and blood, is a deficiency of the real evidence. If the course of the disease is short, the patient mainly suffers from pain in the joints and muscles of the limbs, and the wind, cold and dampness are prevalent. If the disease is recurrent, the evil is blocking the meridians and blood vessels for a long period of time, the Ying and Wei are unfavorable, the dampness gathers as phlegm, the meridians and blood vessels are stagnant, and the phlegm and phlegm are intertwined, it is mostly a deficiency of evil. In summary, Ma believes that the pathological nature of the disease is deficient and real, with the liver, spleen and kidneys declining in function as the basis and wind, cold and dampness paralyzing the symptoms. 2, identification and treatment Ma Lao believes that the disease is always caused by external evil paralysis and obstruction of the meridians, so the principle of treatment should be the first to remove the evil and open the meridians, and the long-standing deficiency of the body, and the liver and kidney should be the main supplement. If you see severe pain in the joints and muscles of the limbs, the pain is relieved by heat, the pain is fixed, the form is cold and the limbs are cold, the coating is white, and the pulse is tight, the treatment is to warm the meridians and disperse the cold, pass the channels and relieve the pain, and Wu Fu Ma Xin Gui Jiang Tang is added and subtracted, commonly used to make Cao Wu, Shu Fu Zi, Gan Jiang, Ephedra, Xiao Xin, Gui Zhi and Gan Cao. If we see cold pain in the joints and muscles of the limbs, wandering, increasing in cold, or evil wind and cold, with a light tongue and tight pulse, we should treat wind-cold paralysis, dispelling wind and cold, warming the meridians and opening the channels, and we should add and reduce the formula Wu Tou Tang, commonly used in the form of Chuan Cao Wu, Ephedra, Fang Feng, Huang Qi, Bai Shao, Gentiana, and Licorice. If you see cold pain in the joints of the limbs, unfavorable flexion and extension, fat and light tongue, white greasy coating, slow or sunken pulse, identify as cold and damp paralysis, the treatment is to warm the meridians to disperse cold, dispel dampness and open the ligaments, with the addition and subtraction of Radix et Rhizoma Polygonati, Atractylodes Macrocephalae, Semen Coix, Radix Paeoniae, Radix Dulcis, Radix Gentianae Macrophylla, Poria, Cinnamon and Radix et Rhizoma Sinensis. If you see muscle and joint pains, especially at night, tendons and veins are constricted, flexion and extension are unfavorable, waist and knees are sore and weak, or insomnia and dreaminess, five hearts are troubled and hot, tongue is red and less mossy, pulse is fine or string is fine, then it is a deficiency of liver and kidney, treatment is to nourish liver and kidney, strengthen tendons and bones, choose the formula Duluxiaosheng Tang with Zuo Gui Wan plus or minus. Ma Lao’s treatment of this disease prefers to use worm medicine, believing that most patients have a long history of illness, long-standing disease into the ligaments, severe pain, with varying degrees of stasis in the veins and ligaments, only worm medicine can pick the ligaments and search the wind, resolve stasis and relieve pain, so the whole scorpion, centipede, ground turtle worm, wuzhu snake and so on are mostly found in the prescription of this disease. At the same time, Ma also emphasizes flexible identification and use of medicine according to the evidence, for example, if the original wind-cold paralysis and see thin yellow moss, the evil has the sign of heat, this is a mixed type of cold and heat, it is appropriate to combine cold and heat, can choose Gui Zhi peony Zhi Mu Tang plus or minus. For cold and dampness obstruction, phlegm and stagnation, use Chuan Wu, Gui Zhi, Gentiana, Fang Ji, Niu Kne, Lactuca, Chuan Xiong, Di Long, Pieces of Pine, Bai Shao, White Mustard Seed, Saponaria, Papaya, and add insects such as Centipede and Scorpion. For kidney essence deficiency, liver loss of moistening type, can use dog’s spine, raw earth, Chuan break, bone crushed tonic, beehive, deer with grass, wuzhang snake, leech, soap horn thorn. 4.Example of case Patient Chen, female, 57 years old, was first diagnosed on 12/01/2004. Since April 2003, she has been suffering from stiffness and pain in the back of the shoulder without any cause and cannot turn to the side, and after one month, she developed pain in the hip muscles, which affects walking when serious. He was diagnosed with “rheumatic polymyalgia” without using western medicine, and the effect of physiotherapy was not satisfactory, so he sought Chinese medicine consultation in our hospital. He was diagnosed with “rheumatic polymyalgia”. He was given Ephedra, Radix et Rhizoma, and Ocimum sanctum, plus and minus. Prescription: 10g each of Ephedra, Fructus Eucommiae, Cinnamomum, Fructus Chuanwu, Fructus Herbaceus, Scorpion, Fangfeng, Hooked Vine, three Centipedes, 3g of Hesperidin, 12g each of Danggui, Angelica, Chuanxiong, Xianling Spleen, Wailingxian, 20g each of Pueraria Mirifica, Fried White Peony, Coix Seed, 6g of Glycyrrhiza glabra. 7 doses of the medicine were taken and the pain in the limbs was significantly reduced. After taking 14 doses, the patient’s neck, shoulder and hip symptoms basically disappeared, and the blood sedimentation dropped to 30 mm/h. The patient is nearing the age of the first birthday, the liver and kidney are insufficient, the yin energy is half, and the evil of cold and dampness is guest in the limbs and muscles, and the meridians are closed. In this formula, the warming and generalizing products such as Radix et Rhizoma Pseudostellariae, Ephedra, Cinnamomum, Ocimum sanctum, and Fructus Sinensis are the monarchs, which have the effect of warming and dispersing cold in the meridians.