Commentary states: The three pathogenic factors of Wind, Cold, and Dampness mix and invade the body together, combining to form Bi syndrome (Obstruction Syndrome). It is also stated that encountering these factors during the time of Extreme Yin (late summer) results in Muscle Bi. If Muscle Bi persists and is not cured, repeated exposure to pathogens causes the disease to transmit internally and lodge in the Spleen, which is termed Spleen Bi. Its manifestations include flaccidity and lassitude of the four limbs, coughing with vomiting of saliva, and severe obstruction/stagnation in the upper jiao. As the classics state, various Bi syndromes, if left untreated, will gradually transmit inward; this is exactly such a case.

Treatment for Spleen Bi presenting with muscle emaciation, abdominal distension and fullness, inability to digest food and fluids, nausea immediately after eating, loss of taste, limb fatigue, or occasional diarrhea. Use Huang Wan Formula.
Ingredients: Huang (cut into pieces), Shihu (Dendrobii Caulis, remove roots), Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, remove skin and navel), Rongshu (Cistanche Deserticola, soaked in wine, sliced, dried), Yizhi (Alpiniae Oxyphyllae Fructus, remove skin), Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix et Rhizoma) [each 1 liang], Gui (Cinnamomi Ramulus, remove rough bark), Houpo (Magnoliae Officinalis Cortex, remove rough bark, stir-fried with ginger juice, each 1.5 liang), Helile (Terminalia Chebulae Fructus, roasted, remove pits, 2 liang), Wuweizi (Schisandrae Chinensis Fructus), Danggui (Angelicae Sinensis Radix, sliced, dried), Baidoukou (Amomi Fructus Rotundus, remove skin), Chenxiang (Aquilariae Lignum Resinatum, cut into pieces), Gaoliangjiang (Galangal Rhizome), Zhishi (Aurantii Fructus Immaturus, remove pulp, stir-fried with bran, each 0.3 fen).
The above eighteen ingredients are ground into fine powder, mixed with paste made from boiled dates, pounded five hundred times, and formed into pills the size of sophora seeds. Take thirty pills per dose, administered with warm wine before meals.

Treatment for Spleen Bi causing abdominal distension and fullness, anorexia, qi stagnation and heaviness after eating, and weakness in the four limbs. Use Baizhu Tang Formula.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Bidengqie (Piperis Kadsurae Fructus) [each 1 liang], Helile (Terminalia Chebulae Fructus, roasted, remove pits, 2 liang), Dingxiang (Syzygii Aromatisati Flos), Caodoukou (Cardamomi Fructus, remove skin), Huang (likely Huangqi/Astragali Radix based on context, though text says Huang), Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, remove skin and navel), Baifuling (Poria, remove black skin), Mai (Tritici aestivi Granum, lightly stir-fried), Chenxiang (Aquilariae Lignum Resinatum), Chenjupi (Citri Reticulatae Pericarpium, soaked in water, remove white pith, dried), Muxiang (Aucklandiae Radix) [each 0.3 fen].
The above fifteen ingredients are cut into pieces the size of hemp seeds. Take three qianbi per dose, decocted with one sheng of water, five slices of fresh ginger, and two broken jujubes, until reduced to seven-tenths. Strain and take warm, at any time.

Treatment for Spleen Bi resulting in extreme deficiency and cold of muscles, heavy body and lassitude, unwillingness to move the four limbs, joint pain, and aversion to food. Use Huang Jiu Formula.
Ingredients: Huang (likely Huangqi/Astragali Radix), Gui (Cinnamomi Ramulus, remove rough bark), Bajitian (Morindae Officinalis Radix, remove heart), Shihu (Dendrobii Caulis, remove roots), Zexie (Alismatis Rhizoma), Baifuling (Poria, remove black skin), Baiziren (Platycladi Semen), Ganjiang (Zingiberis Rhizoma, processed), Shujiao (Sichuan Pepper, remove eyes and closed mouths, stir-fried until oil appears, each 3 liang), Fangfeng (Saposhnikoviae Radix, remove forked branches), Duhuo (Angelicae Pubescentis Radix, remove rhizome head), Renshen (Ginseng Radix et Rhizoma) [each 2 liang], Tianxiong (Aconiti Kusnezoffii Radix, processed until cracked, remove skin and navel), Shaoyao (Paeoniae Radix), Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, remove skin and navel), Wutou (Aconiti Radix, processed until cracked, remove skin and navel), Yinyu (Ilicis Cornuti Caulis), Banxia (Pinelliae Rhizoma, washed seven times in hot water to remove slipperiness), Xixin (Asari Radix et Rhizoma, remove seedlings and leaves), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin (Scutellariae Radix, remove black heart), Gualougen (Trichosanthis Radix), Shanzhuyu (Corni Fructus) [each 1 liang].
The above twenty-three ingredients are chopped, placed in a silk bag, and soaked in three dou of clear wine. Soak for seven days in autumn/winter, three days in spring/summer. Start with a dose of three he, gradually increasing. Efficacy is indicated by slight numbness. Take twice daily.

Treatment for Spleen Bi presenting with limb lassitude and coughing. Use Da Banxia Tang Formula.
Ingredients: Banxia (Pinelliae Rhizoma, ground into powder, mixed with ginger juice to make cakes, dried, 5 liang), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria, remove black skin), Renshen (Ginseng Radix et Rhizoma), Gancao (Licorice Root, honey-fried), Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, remove skin and navel), Chenjupi (Citri Reticulatae Pericarpium, soaked in water, remove white pith, dried, each 2 liang), Gui (Cinnamomi Ramulus, remove rough bark, 3 liang).
The above eight ingredients are cut into pieces the size of hemp seeds. Take five qianbi per dose, decocted with one and a half sheng of water and five slices of fresh ginger, until reduced to one sheng. Strain and take warm, three times daily.

Treatment for Spleen Bi presenting with limb flaccidity and extreme heat in the muscles. use Mahuang Tang Formula.
Ingredients: Mahuang (Ephedrae Herba, remove root joints), Zhishi (Aurantii Fructus Immaturus, remove pulp, stir-fried with bran), Fangfeng (Saposhnikoviae Radix, remove forked branches), Baizhu (Atractylodis Macrocephalae Rhizoma), Xixin (Asari Radix et Rhizoma, remove seedlings and leaves, each 3 liang), Shigao (Gypsum Fibrosum, crushed, 8 liang), Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, remove skin and navel, 4 liang), Gancao (Licorice Root, honey-fried), Gui (Cinnamomi Ramulus, remove rough bark, each 2 liang).
The above nine ingredients are cut into pieces the size of hemp seeds. Take five qianbi per dose, decocted with one and a half sheng of water and five slices of fresh ginger, until reduced to one sheng. Strain and take warm, three times daily.

Treatment for Spleen Bi presenting with limb flaccidity, blocked skin pores, and inability to vent pathogens externally. Use Fengyin Tang Formula.
Ingredients: Duhuo (Angelicae Pubescentis Radix, remove rhizome head, 4 liang), Danggui (Angelicae Sinensis Radix, sliced, dried), Baifuling (Poria, remove black skin, each 3 liang), Ganjiang (Zingiberis Rhizoma, processed), Gancao (Licorice Root, honey-fried), Renshen (Ginseng Radix et Rhizoma), Huang (likely Huangqi/Astragali Radix), Fangfeng (Saposhnikoviae Radix, remove forked branches, each 2 liang), Gui (Cinnamomi Ramulus, remove rough bark), Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, remove skin and navel, each 1 liang), Dadou (Sojae Semen Preparatum, two sheng, roasted, peeled).
The above eleven ingredients are cut into pieces the size of hemp seeds. Take five qianbi per dose, decocted with one sheng of water and half a sheng of wine, until reduced to one sheng. Strain and take warm, three times daily and once at night.

Treatment for Spleen Bi presenting with coughing and vomiting of saliva. Use Wenzhong Faqu Wan Formula.
Ingredients: Faqu (Medicated Leaven, stir-fried), Wuzhuyu (Evodiae Fructus, soaked in water, dried, stir-fried), Xiaomai (Tritici Levigationis Fructus, lightly stir-fried, each 5 he), Zhishi (Aurantii Fructus Immaturus, remove pulp, stir-fried with bran), Gancao (Licorice Root, honey-fried), Gui (Cinnamomi Ramulus, remove rough bark), Houpo (Magnoliae Officinalis Cortex, remove rough bark, stir-fried with ginger juice), Danggui (Angelicae Sinensis Radix, sliced, dried), Baifuling (Poria, remove black skin, each 3 liang), Xixin (Asari Radix et Rhizoma, remove seedlings and leaves), Ganjiang (Zingiberis Rhizoma, processed), Maidong (Ophiopogonis Tuber, remove heart, dried), Renshen (Ginseng Radix et Rhizoma), Jiegeng (Platycodonis Radix, stir-fried), Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, remove skin and navel, each 1 liang).
The above fifteen ingredients are ground into fine powder, mixed with refined honey to form pills the size of sophora seeds. Take seven pills per dose, administered with warm water before meals, three times daily.