To treat Bi syndrome (obstructive syndrome) caused by Wind-Cold-Dampness, characterized by insensitivity of the skin and flesh, severe pain in the bone marrow that is unbearable.
Tianxiong (Radix Aconiti Kusnezoffii Preparata, processed, peel and umbilicus removed, 1 liang) Fuzi (Radix Aconiti Lateralis Preparata, processed, peel and umbilicus removed, 1 liang) Guigui (Cortex Cinnamomi Preparata, peel removed, 1.5 liang) Ganjiang (Rhizoma Zingiberis Preparata, processed, 2 liang) Fangfeng (Radix Saposhnikoviae, remove forked branches, 3 liang)
Grind the above into a fine powder, mix with refined honey to make pills, size of Sophora japonica seeds. Take 20 pills per dose, administered before meals with warm wine.

To treat Wind-Cold-Dampness lingering in the body without dispersal, causing itching and numbness in the four limbs, spasms, and edema.
Chifuling (Poria cocos with Red Peel, peel removed) Sangbaipi (Cortex Mori Radicis, each 2 liang) Fangji (Radix Stephaniae Tetrandrae) Guigui (Cortex Cinnamomi Preparata, peel removed) Chuanxiong (Rhizoma Chuanxiong) Shaoyao (Radix Paeoniae Alba seu Rubra) Mahuang (Herba Ephedrae, remove roots and joints, decoct first, skim off foam, dry by baking) Danggui (Radix Angelicae Sinensis, each of the above 1.5 liang) Gancao (Radix Glycyrrhizae Preparata, honey-fried, 3 liang)
Cut the above ingredients coarsely. For each dose, take 6 qian, add two zhan of water and three dates (pitted), decoct until one zhan remains, filter out the dregs, and take on an empty stomach and before sleep. If sweating is desired, after taking the medicine, drink hot porridge with ginger to induce sweat; be careful to avoid external wind after sweating. Another prescription removes Fangji and uses Fangfeng instead.

Regarding Hong Kong Jiao (Jiaogqi / Foot Qi disease), there is a distinction between the South and the North. Sun Simiao stated: In all four seasons, one must not sit or stand for long periods in damp and cold places, nor should one strip naked and barefoot to cool off in the wind while drunk. All these actions can lead to Hong Kong Jiao. If one sits or stands for long periods in damp and cold places during the summer months, the damp-cold qi steams through the meridians, causing the disease to manifest with fever, soreness and pain in the four limbs, and restlessness. If one sits or stands for long periods in damp and cold places during the winter months, the damp-cold qi enters the meridians from above, causing the disease to manifest with spasms (charley horse) in the four limbs. Scholars who study diligently often sit or stand for long periods on wet ground; when cold wind enters the meridians unnoticed, the disease forms. The *Neijing* states: Cooling off in the wind and engaging in sexual activity after drunkenness can cause this disease. Li Dongyuan stated: The records in *Qianjin Fang*, *Waitai Miyao*, and *Zonglu* refer to southern regions that are low-lying and damp, where fog and dew accumulate. The people there have loose interstices (couli), and their Yang qi cannot secure the exterior. Consequently, when they encounter dampness, clear-damp pathogens attack the deficiency, and the disease arises from below. This is due to weakened blood and qi, which are invaded by clear-damp pathogens. The pathogens run parallel with the blood in the skin and interstices. When pathogens are strong and healthy qi is weak, blood and qi become stagnant. Stagnation leads to Bi syndrome, and weakness leads to debility, hence it is called "Bi Ruo" (Bi and Weakness), later named Hong Kong Jiao. The *Zhenjing* (Needling Classic) states: What has come by a path can go by a path. Treatment mostly favors moxibustion to guide dampness outwards, and drinking Lao Li (fermented rice wine) to unblock meridians and scatter pathogens. The prescribed formulas contain few cold-natured herbs and many hot-natured ones, using herbs such as Mahuang, Chuanwu, Jiang, and Fu. The *Neijing* states: When dampness overflows internally, use bitter herbs to disperse them. Mahuang is bitter and warm, possessing dispersing properties; Chuanwu is acrid and hot, moving freely but not retaining, unblocking the meridians; Jiang and Fu are acrid, sweet, and greatly hot, assisting Yang and retreating Yin, also scattering heat-clearing pathogens. Furthermore, observe which of the Foot Three Yin and Three Yang meridians is affected, using this as the guiding herb for treatment. Examine the Six Qi to determine which pathogen is invading, and treat with assistant and envoy herbs. *Yixue Faming* states: The *Yifang Fangyi Lun* chapter of the *Neijing* mentions that in the North, the terrain is high and hilly, and the inhabitants live in cold, windy, and icy conditions, with customs involving drinking milk curds and eating meat. Those who drink milk curds do so quickly and in large amounts. The classics state: Drinking excessively causes Qi to rebel upwards. It also says: Food enters the Yin, transforms into Qi and moves as Yang, thereby reversing the course of Yin. Milk curds and strong wine are damp-heat substances; drinking them belongs to the category of "drinks." Coupled with excessive nourishment, this generates dampness. Water nature flows downward; if Yang Qi fails to warm, dampness sinks to the lower legs, accumulating over time to form swelling, fullness, and pain. This results from dietary fluids flowing downward. The *Tongping Xuushi Lun* states: When grain intake is high but Qi is low, dampness resides below. How much more so when the damp-heat of milk curds and strong wine accumulates within the grain? The *Zhiyun Yao Da Lun* states: When Taiyin wins, Fire Qi stagnates internally and flows outward, causing swelling of the lower legs, fluid retention internally, and edema below. This is what is meant. Thus, when drinks enter the Stomach, their essence floats and overflows, uploading to the Spleen. The Spleen scatters the essence, sending it up to the Lung. The Lung regulates the water passages, downloading to the Bladder. Water essence distributes in all directions, running through the Five Meridians, conforming to the Yin-Yang of the Four Seasons and Five Zang organs, serving as the norm. If food and drink double, the Spleen and Stomach are injured. Then Stomach Qi cannot perform its functions, and Spleen Qi cannot distribute in all directions, so it flows downward, attacking the Liver and Kidney. Dampness flows to the lower legs. Added to irregular sexual activity, leading to Yang deficiency and Yin excess, Hong Kong Jiao is formed. Sun Simiao said: Ancients rarely had this disease; since the southward migration during the Yongjia era, many among the gentry suffered from it. This is also the meaning. Li Dongyuan said: Hong Kong Jiao is truly caused by water and dampness. Generally, dampness harms the skin, flesh, tendons, and vessels, with the pathology located below. However, there are two types: one contracted externally, and one generated internally. Southern diseases are contracted externally. Northern diseases are generated internally. Their treatments should naturally differ, which is why various experts analyzed and discussed them in detail. Yan Shi said: There was no concept of Hong Kong Jiao in ancient times. The *Neijing* called it Jue, the Two Han dynasties called it Huan Feng (Sluggish Wind), and later it was called Hong Kong Jiao. Although the names differ, the essence is the same. Initially, there is no sensation; it manifests only due to other illnesses, or suddenly becomes extremely stifling, becoming apparent after two or three days. It starts from the feet. Symptoms may include slow weakness, pain, and numbness; sudden collapse while walking; swelling of both calves; withered and thin foot and knees; palpitations; insensitivity of the lower abdomen; whole-body spasms; vomiting upon seeing food or aversion to the smell of food; chest fullness and shortness of breath; or generalized soreness and pain. These are the different manifestations. Pulse floating and wiry indicates origin from Wind; pulse soggy and weak indicates origin from Damp; pulse surging and rapid indicates origin from Heat; pulse slow and choppy indicates origin from Cold. All these arise from Kidney deficiency. However, women also suffer from Hong Kong Jiao, necessarily due to emptiness of the Blood Sea (Chong and Ren meridians), compounded by emotional disturbances, leading to this disease. Moreover, many women suffer from this because of Blood Sea emptiness, similar to Kidney deficiency in men. The medication for men and women is fundamentally the same, but adding herbs to treat sorrow and resentment ensures efficacy. One must assess the person's strength and weakness, adding slight tonification; otherwise, Qi and blood will decline daily, inevitably causing recurrence every year during hot and humid weather, which is logical. Chen Wuyue said: Hong Kong Jiao does not focus solely on one Qi, nor is it confined to one meridian, thus differing from Zhong Feng (Wind Stroke), Cold, Summerheat, and Dampness. When complicated by various other diseases, it is difficult to distinguish; one must locate the disease in the Three Yin and Three Yang meridians, then examine the pulse for deficiency or excess to guide treatment. *Faming* states: The *Neijing* discusses the South as having low terrain, weak water and soil, and accumulation of fog and dew. Jiangdong and Lingnan areas are generally like this. During the transition of Spring and Summer, mountains and rivers steam with damp-heat, making Wind-Damp toxic vapors severe; contracting this leads to Miasma-Toxic Hong Kong Jiao. *Waitai Miyao* states: First, avoid anger. Anger causes heart vexation; vexation triggers Hong Kong Jiao attacks. Second, avoid loud talking. Loud talking injures the Lung; Lung injury also triggers the disease. Third, do not expose feet to wind or wash them with cold water. Even in summer, one must keep them protected. Be very cautious. *Faming* states: First, do not consume alcohol and milk curds excessively. Excess damages the Spleen and Stomach, causing dampness to sink to the lower legs and swell, forming Hong Kong Jiao. Second, do not indulge in desires. Indulgence triggers Hong Kong Jiao attacks. After eating, one should walk slowly. The classics say: Those who are idle should move. It also says: When the disease is in the Spleen, avoid warm foods, overeating, and wearing damp clothes. Yang Dashou said: Since ancient times, Jiaogqi (Foot Qi) has always been treated with purgative methods because of the obstruction. However, it must not be too aggressive, as this damages the Spleen and Stomach, preventing the transport and transformation Qi from ascending, causing it to sink downward and become Hong Kong Jiao. Nor should it be insufficient; insufficiency leaves Qi obstructed and unable to dissipate. The following formulas are provided, to be used according to deficiency or excess: Qianghuo Daozhi Tang, Daoshui Wan, Chushi Dan. These medicines are used for purgation when Hong Kong Jiao is at the surface or in the Qi and Blood levels, applied as appropriate. *Huren Shu* states: Using tonic medicines or herbal baths for Hong Kong Jiao are major prohibitions for physicians. Yang Dashou said: Hong Kong Jiao is an obstructive disease; it should be treated with dispersing and unblocking agents to prevent Qi obstruction. If obstruction is already established and severe, use Bian stone (lithotripsy/bleeding therapy) to drain evil blood and reduce the severe condition. The classics state: Accumulation leads to swelling and heat; use Bian stone to pierce and drain. The discussions by predecessors vary regarding the etiology of Hong Kong Jiao: some contract it at the surface, some in the Qi and Blood levels, some from Wind, Cold, Summerheat, and Dampness, and some from deficiency or excess. It depends on the physician's decisive diagnosis and treatment.