治破伤风。
金头蜈蚣（一条，去头、足，炙） 天麻（五钱） 草乌头（去芦，五钱） 香白芷（少许）
全蝎（十个） 为末，每服一字，发热清茶下，发寒温酒，或半夏茯苓下。
治破伤风，血凝心，针入肉三证如神，方用乌鸦翎烧灰，存性，细研，酒服一
钱，或白滚汤下。
胃风者，因食后风冷而致其候，胀满食饮不下。形瘦腹大，恶风头汗，隔塞不通，其
脉右关弦而缓带浮，宜用胃风汤主之。又
曰∶胃风之症，治呕而愈呕者是也。此皆好食甘甜之物，膏粱之味，积久成热，因而生
风，非一朝一夕之故也。宜用川乌一两，洗净，去皮、脐，不去尖，以浆水一碗煮干，
每枚切作二片，复用浆水一碗煮尽，切作四片，每细嚼一片，以少温水下，少顷，呕遂
止。古书之治法如此，临症宜审用之。
风冷入于肠胃，泄下鲜血，肠胃湿毒，下如豆汁。
人参 茯苓 川芎 当归 桂 白术 白芍（各等分） 加粟米百粒，水煎服。如腹痛加木香。
《经》曰∶风寒湿三气杂至，合而为痹也。风气胜者为行痹，行痹者，行而不定
也，今称为走注疼痛，俗名流火及历节风。寒气胜者为痛痹，痛痹者，疼痛苦楚，关节
浮肿，世称为痛风及白虎飞尸。湿气胜者为着痹，着痹者留着其处而不移，世称为麻木
不仁，或痛着一处，始终不移者是也。凡风则阳受之，故为痹行，寒则阴受之，湿则皮
肉筋骨受之，故为痹着而不去，皮肤不仁，是以夫痹从风寒湿之所生也。
《经》又曰∶以冬遇此者为骨痹，以春遇此者为筋痹，以夏遇此者为脉痹，以至阴
遇此者为肌痹，以秋遇此者为皮痹，此以所遇之时。所客之处命名。以时令配五脏所合
而言也，至阴者六月也。又曰∶其入脏者死。其留连筋骨间者疼久，其留皮肤间者易
已。又曰∶痛者寒气多也，有寒故痛也。其不痛不仁者，痛久入深，营卫之行涩，经络
时疏，故不痛，皮肤不营故为不仁，盖痹在于骨则重，在于脉则血凝而不流，在于筋则
屈不伸，在于肉则不仁，在皮则寒，故此五者则不痛也。凡痹之类，逢寒则急，逢热则
纵，皆由内虚为本，可以风名，不可以作风治也。
统旨曰∶风痹者，游行上下，随其虚邪，与血气相搏，聚于关节，筋脉弛纵而不
收也。寒痹者四肢挛痛，关节浮肿。湿痹者留而不移汗多，四肢缓弱，皮肤不仁，精神
昏塞。热痹者脏腑移热，复遇外邪客搏经络，留而不行，阳遭其阴，故HT 痹 然而
闷，肌肉热极，体上如鼠走之状，唇口反裂，皮肤色受。（《经》言∶止有风寒湿三痹，此更有
热者，盖郁久成热，热在三气之内变生者耳。）三气合而为痹，则皮肤顽浓或肌肉酸痛，此为邪
中，周身搏于血脉，积年不已则成瘾疹风疮，搔之不痛，头发脱落，治宜疏风凉血。
总由营卫舍虚，外邪留居，血气凝结而成也，太抵湿多则肿，热多则痛，阴虚则脉弦
数，而重在夜，阳虚则脉虚大则重在日。
痹者，闭也。五脏六腑正气，为邪气所闭，则痹而不仁。痹虽有五，多由体虚之
人，腠理空疏，为风寒湿三气侵入于皮脉肌筋骨，不能随时驱散，留滞于内，久而为
痹。其为病也，寒多则掣痛，风多则引注，湿多则重着。然风寒湿三气客于经络，为病
不一，或为痛或为痒，或为麻痹不仁，或为手足缓弱，所以然者，有新久轻重之分，有
湿痰死血之异耳。治以攻补兼施，而标本兼顾也。薄桂味薄，能横行手臂∶领南星、苍
术等药至痛处成功；葳灵仙治上体痛风；汉防己治下体痛风。然虚弱人并当以气血药兼
之。方能有力营运药势。
痛风者，古名痛痹，俗谓之白虎历节风，即四肢骨节走症也。夫气行脉外，血行
脉内，昼行阳，夜行阴，各二十五度，得寒则行迟而不及，得热则行速而太过，内伤外
感则疾作矣。彼痛风者，因血受热已自沸腾，或再涉冷受湿取凉，热血得寒，污浊碍
涩，荣卫难行，坚牢闭碍，邪正交战，所以作痛，夜痛甚者，行于阴也。治当以辛烈暴
悍之剂，流散寒湿开郁行气，破瘀豁痰，舒风和血，开发腠理，则怫郁开，而血行气和
自愈，大约有余则发散攻邪，不足则补养气血，然亦有数种治法不能无异。或因风热，
或因痰，或在风湿，或因血虚，或湿痰浊血，流注为病，在下焦而道路远者，非乌附
气壮者不能行，故用为引经。若以为主治，非徒无益也，总肢节肿痛，因经络感受风
寒，郁久成为湿热流注，肢节之内痛者火也。肿者，湿也。其治宜疏风燥湿，佐以调
补气血以助药力营运，终以滋养肝肾，以壮筋骨坚强，此其治也。然痛要在势如刀割，
尚属邪正相争之象，若至全然不痛，则邪正混为一家，相安于无事矣。
《内经》论痹，四时之令，皆能为邪，五脏之气，各能受病，六气之中，风寒湿居
其半，所谓杂至与合，则知非偏受一气，可以致痹。又云∶风胜寒胜湿胜者，则知但分
邪有轻重耳。皮肉筋骨脉各有五脏之合，初病在外，久而不去，则各因其合，而内舍于
脏，在外者祛之犹易，入脏者攻之实难，治外者散邪为亟，治脏者养正为先。治行痹者
散风为主，御寒燥湿仍不可废，大抵必参以补血之剂，盖治风先治血，血行风自灭也。
治痛痹者散寒为主，疏风燥湿仍不可缺，大抵必参以补火之剂，非大辛大温，不能释其
凝寒之害也。治着痹者利湿为主，祛风解寒亦不可缺，大抵必参以补脾补气之剂，盖土
强可以胜湿，而气足自无顽麻也。病退之后，内节欲以保精髓，慎寒冷以祛外邪，戒
酒面以杜湿热，服补养以生气血，则病不复发矣。
痹之为证，有筋挛不伸，肌肉不仁，与风症相似，但风则阳受之，痹则阴受之，故
多重着沉痛。其三气之中，风气者为行痹，故走而不守，不拘上下，左右关节之间，流
走而痛，或三日五日，又移一处，俗名流火，又名白虎风，言其往来而痛，一如虎咬
之状，日轻夜重也。寒气胜者为痛痹，因血脉寒凝，痛在一处而不移，俗名白虎飞尸。
湿气胜者为着痹，上下脉理滞塞不通，致令肌肉先麻而后木，木而不知痛痒，即所谓不
仁，《经》又以所遇之时，所客筋骨皮肉脉之处而命名，非行痛着三者之外，另有骨筋
之诸痹也。崔紫虚曰∶风寒湿气合而为痹，浮紧兼涩，三脉乃药，则紧涩之脉，重痛沉
着之症，皆纯阴也。当助阳温散之剂，方为对病。
《灵枢》曰∶卫气不行，则为麻木。丹溪曰∶麻是气虚，木是湿痰死血。然则曰
麻，曰木者，以不仁中分而为二也。虽然亦有气血俱虚。但麻而不木者，亦有虚而感
湿，麻木并作者。又有因虚而感风寒湿三气乘之，故周身掣痛，麻木并作者。古方谓之
周痹；治法宜先汗而后补也。当以类而推治，然麻木者，不仁之渐也。麻为木之微，
木为麻之甚，古方名为麻痹。《原病式》曰∶麻者亦犹涩也。由水液衰少而燥涩，气血壅
滞而不得滑泽通行，气强攻冲而为麻也，俗方治麻多用乌附者，令气行之暴甚，冲开道
路，得以通利，则中气行而麻自愈也。然乌附止能温行，更必须兼以补益，盖麻木未有
不由于气血两虚也。或谓麻木为风，虽三尺之童，皆以为然，然如久坐而起，亦有麻
木，假如以绳缚系释之，亦觉麻木，久则自已者，此非因风邪，乃气不行也，故不须治
风，当补其肺中之气，则麻木自去。亦有因阴火乘其阳分，火动于中而麻木者，当兼治
阴火则愈，不必去火补阴，而火自息也。大抵诸脉有余，痹在表，诸脉不足痹在里。
风者四时八方之气，从鼻而入乃天之气也。痰者五谷百物之味，从口而入，脾胃之
湿所结乃地之气也。故风胜者先治其风，痰胜者先治其痰，风与疾相等，则治风兼治
痰，此定法也，《经》云∶风之伤人也，先从皮毛而入，次传肌肉，次传筋脉，次传骨
髓，故善治者，先治皮毛，次治肌肉，由此观之。乃从右而渐入于左也。皮毛者右肺主
之，肌肉者右胃主之，筋脉者左肝主之，骨髓者左肾主之，从外入者转入转深，故治皮
毛治肌肉不使其深入也。又曰∶湿之伤人也，先从足始，此则自下而之上，无分左右
者也。从外入者，以渐而驱之于外，从下上者，以渐而驱之于下，此其治也。
十指麻木，丹溪云∶是乃胃中有湿痰死血，宜二陈汤加苍术、白术、桃仁、红花、
附子。
有或腿足或肩背，一块肌肉木者，此阳气不足，不能周及，以致阴寒凝泣也。
身上虚痒者，是血不荣于腠理也。用四物汤加黄芩煎，调浮萍末服之。
治疗破伤风。
金头蜈蚣（一条，去掉头部和足部，炒炙） 天麻（五钱） 草乌头（去掉芦头，五钱） 香白芷（少许）
全蝎（十个）
以上药物研成细末，每次服用“一字”的量，发热时用清茶送服，发冷时用温酒送服，或者用半夏、茯苓煎汤送服。
治疗破伤风，以及血凝于心、针刺入肉这三种病症，效果如神。方剂使用乌鸦羽毛烧成灰，保留药性，研磨极细，用酒送服一钱，或者用白开水送服。
胃风证，是因为进食后感受风冷而导致的症状，表现为腹胀满、饮食难以下咽。身体消瘦但腹部胀大，怕风且头部出汗，胸膈堵塞不通畅，其脉象右关部弦而缓并带浮象，适宜使用胃风汤为主进行治疗。又说：胃风的病症，表现为呕吐反而加剧的就是这种病。这大多是因为喜好食用甘甜之物、肥美厚味的食物，日久积热而生风，不是一朝一夕形成的。适宜使用川乌一两，洗净，去皮和脐，不去尖，用浆水一碗煮至干透，每枚切成两片，再用浆水一碗煮尽，切成四片，每次细细咀嚼一片，用少量温水送下，片刻之后，呕吐就会停止。古书中的治疗方法如此，临症时应当审慎使用。
风冷侵入肠胃，导致排泄出鲜血；肠胃湿毒，排泄物像豆汁一样。
人参 茯苓 川芎 当归 桂枝 白术 白芍（各等分） 加入粟米一百粒，水煎服。如果腹痛，加木香。
《黄帝内经》说：风、寒、湿三种邪气混杂侵袭人体，合而为痹证。风气偏胜的叫行痹，行痹的特点是疼痛游走不定，现在称为走注疼痛，俗称流火及历节风。寒气偏胜的叫痛痹，痛痹的特点是疼痛剧烈痛苦，关节浮肿，世称痛风及白虎飞尸。湿气偏胜的叫着痹，着痹的特点是病位固定不移，世称为麻木不仁，或者疼痛固定在一处，始终不移动的就是这种。凡是风邪，多侵犯阳分，所以表现为痹证游走；寒邪多侵犯阴分；湿邪多侵犯皮肤、肌肉、筋骨，所以表现为痹证固定而不去除，皮肤感觉迟钝，因此痹证是由风、寒、湿邪气产生的。
《黄帝内经》又说：在冬季遇到这些邪气的叫骨痹，在春季遇到的叫筋痹，在夏季遇到的叫脉痹，在长夏（至阴之时）遇到的叫肌痹，在秋季遇到的叫皮痹，这是根据所遇的时令和邪气停留的部位来命名的。这是将时令与五脏相配合而言的，所谓“至阴”是指六月。又说：邪气侵入脏腑的预后不良（死）；邪气留连在筋骨间的，疼痛持久；邪气停留在皮肤间的，容易治愈。又说：疼痛的是因为寒气多，有寒所以疼痛。不痛且麻木的，是因为疼痛日久深入，营卫之气运行涩滞，经络时常空虚疏泄，所以不痛，皮肤得不到气血濡养所以为麻木。大概痹证在骨则沉重，在脉则血液凝滞不流动，在筋则屈伸不利，在肉则麻木不仁，在皮则寒冷，所以这五种情况都不痛。凡属痹证的类型，遇到寒邪则拘急，遇到热邪则弛纵，这都是以内虚为本质的，可以称之为风痹，但不能单纯按风邪来治疗。
统旨说：风痹，疼痛游走上下，随着虚邪，与血气相互搏结，聚于关节，导致筋脉弛纵而不能收敛。寒痹，四肢挛缩疼痛，关节浮肿。湿痹，病位固定不移，汗多，四肢缓弱，皮肤麻木不仁，精神昏沉闭塞。热痹，脏腑移热，又遇外邪客居搏结于经络，停留而不流通，阳遭受阴邪阻滞，所以感到烦闷，肌肉热极，身体上有像老鼠爬行一样的感觉，嘴唇口角反裂，皮肤颜色改变。（《内经》言：只有风寒湿三痹，这里还有热痹，这是因为郁久化热，热在三气之中变化生成的。）风、寒、湿三气合而为痹，则皮肤顽厚或肌肉酸痛，这是邪气中伤，周身搏结于血脉，长年不已则成为瘾疹风疮，搔抓不痛，头发脱落，治疗宜疏风凉血。
总归是由于营卫虚弱，外邪留居，血气凝结而成。大致湿气重则肿胀，热气重则疼痛，阴虚则脉弦数，且在夜间加重；阳虚则脉虚大，且在白天加重。
痹，就是闭阻的意思。五脏六腑的正气，被邪气闭阻，则痹阻而不仁。痹证虽然有五种，大多由体质虚弱的人，腠理空疏，被风、寒、湿三气侵入皮、脉、肌、筋、骨，不能随时驱散，留滞在体内，日久形成痹证。它发病时，寒气多则牵引疼痛，风气多则引注疼痛，湿气多则沉重附着。然而风、寒、湿三气客居于经络，致病不一，有的疼痛，有的瘙痒，有的麻痹不仁，有的手足缓弱。之所以这样，是因为有新久轻重之分，有湿痰死血的差异罢了。治疗以攻补兼施，标本兼顾为原则。薄桂（肉桂的一种），气味淡薄，能横行于手臂；岭南星、苍术等药能直达痛处发挥作用；威灵仙治疗上体痛风；汉防己治疗下体痛风。然而虚弱之人还应当配合气血药物一起使用，才能有力推动药势运行。
痛风，古名痛痹，俗称为白虎历节风，即四肢骨节游走性疼痛。气行于脉外，血行于脉内，白天行于阳分二十五周，夜晚行于阴分二十五周，遇到寒邪则运行迟缓而不及，遇到热邪则运行迅速而太过，内伤外感则疾病发作。那痛风患者，是因为血液受热已经沸腾，如果再涉水受冷、受湿、贪凉，热血得寒，变得污浊碍涩，营卫难以通行，坚牢闭阻，邪正交战，所以产生疼痛，夜间疼痛严重的，是因为行于阴分。治疗应当使用辛烈暴悍的药物，流散寒湿，开郁行气，破瘀豁痰，舒风和血，开发腠理，则郁结打开，血行气和自然痊愈。大致有余则发散攻邪，不足则补养气血，然而也有几种治法不能没有差异。或者因风热，或者因痰，或者在风湿，或者因血虚，或者湿痰浊血，流注为病，在下焦且道路遥远的，非乌头、附子气壮者不能通行，所以用作引经药。如果把它们作为主治药物，不仅无益反而有害。总之肢节肿痛，是因为经络感受风寒，郁久成为湿热流注，肢节内部的痛是火邪所致。肿，是湿邪所致。治疗宜疏风燥湿，佐以调补气血以助药力运行，最终以滋养肝肾，以强壮筋骨，这就是治疗方法。然而疼痛如果势如刀割，尚属于邪正相争的现象，如果到了完全不痛的地步，则是邪正混为一谈，相安无事（病情危重或转为慢性潜伏）。
《内经》论述痹证，四季的气候，都能成为邪气，五脏的气，各自能受病，六气之中，风、寒、湿占了一半，所谓混杂侵袭和合而为痹，就知道不是单独一种邪气就能导致痹证。又说：风胜、寒胜、湿胜，就知道只是区分邪气的轻重而已。皮、肉、筋、骨、脉各有五脏的配合，初病在外，日久不去，则各自因其配合关系，内舍于脏，在表的祛除还容易，入脏的攻治确实困难，治在表的以疏散邪气为紧急，治在脏的以扶正为先。治疗行痹，以疏散风邪为主，御寒燥湿仍不可废弃，大致必须参入补血药剂，因为治风先治血，血行风自灭。治疗痛痹，以散寒为主，疏风燥湿仍不可缺，大致必须参入补火药剂，非大辛大温之品，不能解除其凝寒的危害。治疗着痹，以利湿为主，祛风解寒也不可缺，大致必须参入补脾补气药剂，因为土强可以胜湿，气足自然没有顽固麻木。病退之后，内部节制欲望以保养精髓，谨慎避免寒冷以祛除外邪，戒除酒面以防湿热，服用补养药物以生气血，那么病就不会复发了。
痹证的表现，有筋脉挛缩不伸展，肌肉麻木不仁，与风症相似，但风邪多侵犯阳分，痹证多侵犯阴分，所以多重着沉痛。在这三气之中，风气偏胜的叫行痹，所以游走而不守定，不拘泥于上下左右关节之间，流走而痛，或者三日五日，又转移一处，俗称流火，又名白虎风，形容其往来疼痛，就像老虎咬一样，白天轻晚上重。寒气偏胜的叫痛痹，因为血脉寒凝，痛在一处而不移动，俗名白虎飞尸。湿气偏胜的叫着痹，上下脉络滞塞不通，致使肌肉先麻而后木，木到不知痛痒，即所谓不仁，《内经》又以所遇的时令、所客居的筋骨皮肉脉的部位来命名，并非在行、痛、着三者之外，另有骨、筋等诸痹。崔紫虚说：风、寒、湿三气合而为痹，脉象浮紧兼涩，这三脉才是药脉，那么紧涩之脉，重痛沉着之症，都是纯阴之象。应当使用助阳温散的药剂，才是对症的。
《灵枢》说：卫气不行，则为麻木。朱丹溪说：麻是气虚，木是湿痰死血。那么说麻、说木，是从不仁中分为两类的。虽然也有气血俱虚的。但只有麻而没有木的，也有因虚而感湿，麻木并作的。又有因虚而感受风、寒、湿三气乘虚而入，所以周身牵引疼痛，麻木并作的。古方称之为周痹；治疗方法宜先发汗然后补益。应当类推治疗，然而麻木是不仁的渐进表现。麻是木的轻微表现，木是麻的严重表现，古方名为麻痹。《原病式》说：麻也如同涩一样。由于水液衰少而干燥涩滞，气血壅滞而不能滑泽通行，气强盛攻冲而产生麻。世俗方剂治疗麻多用乌头、附子，是让气行变得暴烈迅猛，冲开道路，得以通利，则中气运行而麻自愈。然而乌头、附子只能温通，更必须兼以补益，因为麻木没有不是由于气血两虚引起的。有人说麻木是风邪所致，即使是三尺孩童也都这么认为，然而如久坐起身，也会有麻木，假如用绳子捆绑后解开，也会觉得麻木，久了自己会好，这不是因为风邪，而是气不行，所以不需要治风，应当补肺中之气，则麻木自去。也有因阴火乘袭阳分，火动于中而导致麻木的，应当兼治阴火则愈，不必专门去火补阴，而火自息。大致诸脉有余，痹在表；诸脉不足，痹在里。
风，是四时八方的气候，从鼻而入，是天之气。痰，是五谷百物的味道，从口而入，是脾胃之湿所结，是地之气。所以风胜者先治其风，痰胜者先治其痰，风与疾相等，则治风兼治痰，这是定法。《内经》说：风伤人，先从皮毛而入，次传肌肉，次传筋脉，次传骨髓，所以善于治疗的，先治皮毛，次治肌肉，由此看来，是从右而渐入于左。皮毛由右肺主之，肌肉由右胃主之，筋脉由左肝主之，骨髓由左肾主之，从外入者转入转深，所以治皮毛、治肌肉不让其深入。又说：湿伤人，先从足开始，这是自下而上，不分左右的。从外入的，逐渐驱之于外；从下上的，逐渐驱之于下，这就是治疗方法。
十指麻木，丹溪说：这是胃中有湿痰死血，适宜二陈汤加苍术、白术、桃仁、红花、附子。
有的腿部足部或肩背，一块肌肉麻木的，这是阳气不足，不能周遍全身，导致阴寒凝滞。
身上虚痒的，是血不能荣养腠理。用四物汤加黄芩煎煮，调浮萍末服用。
Treatment for tetanus (Po-shang feng).
Centipede with golden head (one piece, remove head and feet, stir-fry) Gastrodia elata (Tianma, 5 qian) Aconitum kusnezoffii root (Caowutou, remove rhizome, 5 qian) Angelica dahurica (Xiangbaizhi, a small amount)
Scorpion (Quanxie, ten pieces)
Grind the above herbs into fine powder. Take one "yi zi" (a traditional unit of weight, approx. 0.3-0.6g) per dose. If feverish, take with clear tea; if chills are present, take with warm wine; or take with decoction of Pinellia ternata (Banxia) and Poria cocos (Fuling).
For treating tetanus, blood stasis in the heart, and needle embedded in flesh, this prescription is miraculous. Use crow feathers burned to ash, preserving their medicinal nature, grind finely, and take 1 qian with wine, or with plain boiled water.
Wei Feng syndrome (Stomach Wind), caused by exposure to wind and cold after eating, presents with abdominal distension and inability to swallow food. The body is emaciated while the abdomen is enlarged, there is aversion to wind and sweating on the head, and obstruction in the chest and diaphragm. The pulse at the right Guan position is wiry, slow, and floating. It is appropriate to use Wei Feng Tang as the primary treatment. It is also said: The symptom of Wei Feng where vomiting worsens upon treatment is indicative of this condition. This usually results from a long-term preference for sweet foods and rich, greasy meats, which accumulate heat over time and generate wind; it does not happen overnight. It is appropriate to use 1 liang of Chuanwu (Aconitum carmichaelii lateral root), washed clean, skin and umbilicus removed but tip retained. Boil in one bowl of fermented grain water until dry. Cut each piece into two slices, then boil again in one bowl of fermented grain water until the liquid is consumed. Cut into four slices. Chew one slice thoroughly and swallow with a little warm water. After a short while, vomiting will cease. Ancient texts describe treatment methods thus; clinicians should apply them judiciously.
When wind-cold enters the intestines and stomach, it causes passage of bright red blood. Intestinal and stomach damp-toxin causes discharge resembling bean curd dregs.
Ginseng Radix et Rhizoma (Renshen) Poria cocos (Fuling) Ligusticum wallichii (Chuanxiong) Angelica sinensis (Danggui) Cinnamomi Ramulus (Gui) Atractylodis macrocephalae Rhizoma (Baizhu) Paeonia lactiflora (Baishao) (all in equal parts) Add 100 grains of millet, decoct in water and take. If abdominal pain occurs, add Costus root (Muxiang).
The *Classic* states: The three pathogens—wind, cold, and dampness—mix and combine to form Bi syndrome (Obstruction Syndrome). When wind is predominant, it is called Xing Bi (Wandering Bi), characterized by wandering and不定 (uncertain) pain, now called moving injection pain, commonly known as Liu Huo (Flowing Fire) and Li Jie Feng (Joint Wind). When cold is predominant, it is called Tong Bi (Painful Bi), characterized by severe pain and joint swelling, known in the world as Tong Feng (Wind-Pain/Gout) and Bai Hu Fei Shi (White Tiger Flying Corpse). When dampness is predominant, it is called Zhuo Bi (Fixed Bi), characterized by staying in one place without moving, known in the world as Ma Mu Bu Ren (Numbness and Insensitivity) or pain fixed in one location that never shifts. Generally, wind affects Yang, hence Bi moves; cold affects Yin; dampness affects skin, muscle, sinew, and bone, hence Bi is fixed and persistent, causing insensitivity of the skin. Thus, Bi arises from wind, cold, and dampness.
The *Classic* further states: Encountering these in winter results in Gu Bi (Bone Bi); in spring, Jin Bi (Sinew Bi); in summer, Mai Bi (Vessel Bi); during the late summer (Zhi Yin), Ji Bi (Muscle Bi); and in autumn, Pi Bi (Skin Bi). These are named according to the season encountered and the site of invasion. This correlates seasons with the organs they correspond to; "Zhi Yin" refers to the sixth month. It also states: Invasion of the Zang organs leads to death; lingering between sinews and bones causes prolonged pain; lingering in the skin is easily cured. It also states: Pain indicates excessive cold; because there is cold, there is pain. Lack of pain and numbness indicates that pain has been deep for a long time, Ying and Wei Qi flow is sluggish, and meridians are occasionally empty, hence no pain; skin lacks nourishment, hence numbness. Generally, Bi in bone causes heaviness; in vessels, blood coagulates and stagnates; in sinews, flexion and extension are impaired; in muscles, there is numbness; in skin, there is cold. Therefore, these five types do not necessarily cause pain. All Bi types contract when exposed to cold and relax when exposed to heat. This is fundamentally due to internal deficiency; it can be named Wind-Bi but cannot be treated solely as wind pathogen.
The General Principles state: Wind-Bi wanders up and down, following deficient evil, clashing with Blood and Qi, gathering at joints, causing sinews and vessels to relax and fail to contract. Cold-Bi causes limb spasms and pain, joint swelling. Damp-Bi stays fixed without moving, with profuse sweating, weak limbs, skin numbness, and mental dullness. Heat-Bi involves heat transferring from Zang organs, combined with external pathogens lodging in meridians, blocking flow. Yang encounters Yin, causing stifling sensation; muscles become extremely hot; the body feels like mice running under the skin; lips and mouth crack; skin color changes. (*The Classic* mentions only Wind-Cold-Damp Bi; the addition of Heat-Bi arises from long-term stagnation transforming into heat within the three pathogens.) When the three pathogens combine to form Bi, skin becomes thick and tough or muscles ache sore. This is evil striking, battling in blood vessels throughout the body. If unceasing for years, it becomes urticaria or wind sores, scratching yields no pain, hair falls out. Treatment should disperse wind and cool blood.
Ultimately, it is due to deficiency of Ying and Wei, allowing external pathogens to linger, condensing Blood and Qi. Generally, excess dampness causes swelling; excess heat causes pain. Yin deficiency leads to wiry-rapid pulse, worsening at night; Yang deficiency leads to void-large pulse, worsening during the day.
Bi means obstruction. The righteous Qi of the Five Zang and Six Fu organs is obstructed by evil pathogens, leading to Bi and insensitivity. Although there are five types of Bi, it mostly occurs in people with weak constitutions, where pores are loose, allowing wind, cold, and dampness to invade skin, vessels, muscles, sinews, and bones. Unable to disperse them promptly, they stay inside, forming Bi over time. In its pathology, excess cold causes pulling pain; excess wind causes radiating pain; excess dampness causes heaviness and fixation. However, wind, cold, and dampness invading meridians cause various diseases: some painful, some itchy, some numb and insensitive, some with weak limbs. This is due to differences in new/old severity and the presence of damp-phlegm or dead blood. Treatment requires combining attack and tonification, addressing both root and branch. Hou Gui (thin cinnamon bark) has mild flavor and travels horizontally in arms; Nanxing (Arisaema cum Bile) and Cangzhu (Atractylodes lancea) reach the pain site effectively; Weilingxian (Symplocos racemosa) treats upper body gout; Hanfangji (Stephania tetrandra) treats lower body gout. However, weak patients must also take Qi and Blood tonics to effectively transport the medicinal force.
Tong Feng (Wind-Pain), ancient name Tong Bi, commonly called Bai Hu Li Jie Feng (White Tiger Joint-Walking Wind), refers to wandering pain in the limbs and joints. Qi flows outside vessels, Blood flows inside. Daytime Qi travels Yang 25 cycles, nighttime travels Yin 25 cycles. Cold slows flow, causing delay; heat speeds flow, causing excess. Internal injury and external contraction trigger disease. In Tong Feng, Blood is heated and boiling. If one then wades in cold, gets wet, or seeks coolness, hot blood meets cold, becoming turbid and obstructed. Ying and Wei struggle to circulate, creating firm blockage, evil and righteous Qi clash, causing pain. Night pain is severe because Qi travels in Yin at night. Treatment should use pungent, fierce, and potent agents to scatter cold-damp, open depression, move Qi, break stasis, resolve phlegm, soothe wind, harmonize Blood, and open pores. Once depression opens, Blood flows and Qi harmonizes, healing naturally. Generally, excess requires dispersing and attacking evil; deficiency requires tonifying Qi and Blood. However, treatments vary. It may be due to wind-heat, phlegm, wind-damp, Blood deficiency, or damp-phlegm/turbid blood flowing downward. For lower Jiao diseases with distant pathways, only strong Qi herbs like Wutou (Aconitum) and Fuzi (Prepared Aconite Root) can guide the medicine. Using them as main treatments is futile. Overall, limb joint swelling and pain result from wind-cold invading meridians, stagnating into damp-heat flow. Pain inside joints is Fire; swelling is Damp. Treatment should disperse wind and dry damp, assist with regulating and tonifying Qi and Blood to aid drug transport, and finally nourish Liver and Kidney to strengthen sinews and bones. This is the treatment. However, if pain is knife-like, it indicates evil-righteous struggle. If completely painless, evil and righteous have merged, resting peacefully (critical or chronic latent stage).
*Neijing* discusses Bi: Four seasons' commands can all be evil; Five Zang Qi can all be diseased. Among Six Qi, wind, cold, and damp account for half. "Mixing and combining" implies no single pathogen causes Bi alone. It also says wind/cold/damp predominance distinguishes severity. Skin, muscle, sinew, bone, vessel each correspond to a Zang. Initial disease is exterior; if prolonged, it enters corresponding Zang. Exterior removal is easy; interior attack is difficult. Treating exterior prioritizes dispersing evil; treating interior prioritizes supporting righteousness. Treating Xing Bi focuses on dispersing wind; controlling cold and drying damp is still necessary. Generally, combine with Blood-tonifying formulas, for treating wind requires treating Blood first; when Blood flows, wind extinguishes itself. Treating Tong Bi focuses on dispersing cold; dispersing wind and drying damp is indispensable. Generally, combine with Fire-tonifying formulas; only large pungent-warm herbs can relieve congealed cold harm. Treating Zhuo Bi focuses on draining damp; dispelling wind and resolving cold is indispensable. Generally, combine with Spleen-Qi tonifying formulas, for strong Earth overcomes damp, and sufficient Qi eliminates stubborn numbness. After symptoms recede, practice moderation in desires to preserve essence, avoid cold to expel external evil, abstain from alcohol and wheat to prevent damp-heat, take tonics to generate Qi and Blood, and the disease will not recur.
Bi syndrome presents with sinew spasm and immobility, muscle numbness, similar to Wind syndrome. But Wind affects Yang, Bi affects Yin, hence Bi is often heavy and deeply painful. Among the three pathogens, wind predominance creates Xing Bi, wandering without staying, affecting any joint, moving pain every few days, commonly called Liu Huo or Bai Hu Feng, describing pain like tiger bites, lighter by day, heavier by night. Cold predominance creates Tong Bi, blood-vessel cold coagulation, pain fixed in one spot, commonly called Bai Hu Fei Shi. Damp predominance creates Zhuo Bi, meridian blockage, muscle numbness progressing to insensitivity (Bu Ren). *Classic* names Bi based on season and site, not implying separate Bone/Sinew Bi beyond Wandering/Pain/Fixed. Cui Zixu said: Wind-cold-damp combine to form Bi; floating-tight-and-choppy pulses indicate pure Yin symptoms like heavy, fixed pain. Treatment should use Yang-supporting and warming-dispersing agents.
*Ling Shu* states: Wei Qi not flowing causes numbness. Danxi stated: Numa (Ma) is Qi deficiency; Mumu (Mu) is damp-phlegm and dead blood. Thus, Ma and Mu are subdivisions of insensitivity. There are cases of both Qi and Blood deficiency. Only Ma without Mu can occur from deficiency contracting damp, or simultaneous Ma and Mu. Also, deficiency contracting wind-cold-damp causes whole-body pulling pain and simultaneous numbness. Ancient formula calls this Zhou Bi (Circulating Bi); treatment should sweat first, then tonify. Treat by analogy. Numa is the beginning of insensitivity. Ma is slight Mu; Mu is severe Ma. Ancient formula calls it Ma Bi. *Yuan Bing Shi* states: Ma is like涩 (astringency/choppy). Due to fluid depletion and dryness, Qi and Blood stagnate and cannot flow smoothly. Strong Qi attacks causing Ma. Folk remedies use Wutou/Fuzi to violently move Qi, opening pathways, allowing Middle Qi to flow, curing Ma. However, Wutou/Fuzi only warm and move; they must be combined with tonification, for Ma/Mu always stems from Qi and Blood deficiency. Some say Ma/Mu is Wind, even children agree. But sitting long and standing up causes numbness; releasing tight binding causes numbness, resolving spontaneously. This is not Wind evil, but Qi non-flow. Do not treat Wind; tonify Lung Qi instead, and numbness resolves. Some have Yin Fire attacking Yang, fire stirring internally causing numbness; treat Yin Fire, and it heals. No need to specifically clear fire or nourish Yin; fire subsides naturally. Generally, excess pulses, Bi is exterior; deficient pulses, Bi is interior.
Wind is the Qi of four seasons and eight directions, entering via nose, Heaven's Qi. Phlegm is taste of grains and foods, entering via mouth, Earth's Qi結 from Spleen-Stomach damp. Thus, wind-predominant treats wind first; phlegm-predominant treats phlegm first; if equal, treat wind and phlegm together. This is fixed rule. *Classic* says: Wind harms humans, first enters skin-hair, then muscle, then sinew-vessel, then bone-marrow. Good doctors treat skin-hair first, then muscle. Thus, entering from right gradually to left. Skin-hair governed by Right Lung; Muscle by Right Stomach; Sinew-Vessel by Left Liver; Bone-Marrow by Left Kidney. Entering from outside goes deeper. Treating skin/muscle prevents deep invasion. Also: Damp harms humans, starts from feet, ascending from below,不分左右 (no left/right distinction). Entering from outside, drive out gradually; ascending from below, drive down gradually. This is treatment.
Ten fingers numbness: Danxi said: Stomach has damp-phlegm and dead blood. Use Er Chen Tang plus Cangzhu, Baizhu, Taoren, Honghua, Fuzi.
If leg/foot or shoulder/back has a patch of muscle numbness: Yang Qi insufficient to circulate, causing Yin-cold stagnation.
General body itching due to deficiency: Blood fails to nourish Couli (pores/skin interspaces). Use Si Wu Tang plus Huangqin decocted, mixed with Fuping (Lemna minor) powder.