即《内经》风寒湿三气杂至，合而为痹也。虽言寒为痛痹，然三者皆能作痛，但寒胜者痛甚如掣，
湿者痛着如肿，风者其痛行动无常处，悉因凝滞之痹与流行荣卫真气相击搏，则作痛痹，若不干其流行
出入之道，则不痛但痿痹耳！随其痹所在，或阳多阴少则为痹热，或阴多阳少则为痹寒，或骨重，或筋挛不
伸，肌肉不仁，或血脉凝而不流，或在皮则寒，或逢热则纵。后人就中摘出为痛者分六条，具数百方。夫
药在乎明道，不在多言。苟明其道，虽一言一方亦可类推；道若不明，奚适于用而取择焉？今六条中，有
谓由
风寒湿气，则血凝涩不得流通，关节诸筋无以滋养，真邪相搏，历节痛者；有谓风百节痛者；
有谓风气走注，痛无常处者，有谓白虎风者，或在骨节，或走四肢，昼静夜发，发则痛彻入骨；有风腰
痛者∶岂非悉是风寒湿三气痹而痛乎？曰∶《痹论》止言寒为痛痹，未闻行痹亦痛。曰∶《灵枢·周痹篇》
有众痹，有周痹，即此云也。又《内经·四时刺逆从论篇》于六经皆云有余不足悉为痹。注曰∶痹，痛也。
此非人气之邪亦作痛耶？今以一条而举众病何也？盖因是集有所未备耳！且人身体痛，在外有皮肉脉筋骨
之异，由病有不同之邪，亦各欲正其名，名不正将何以施治？如邪是六淫者，便须治邪；是人气者，便须
补泻其气；病在六经四属者，各从其气。故制方须宜分别药之轻重缓急，适当其所，庶得经意。
这正是《黄帝内经》中所说的风寒湿三气混杂侵袭人体，合而成为痹证。虽然文中说寒邪导致的是痛痹，然而这三种邪气都能引起疼痛，只是寒邪偏胜时疼痛剧烈如牵引掣动，湿邪偏胜时疼痛沉重固定如同肿胀，风邪偏胜时疼痛游走不定、没有固定位置。这都是因为凝滞的痹阻之气与运行中的营卫真气相互搏击，从而产生痛痹；如果这些邪气不干扰气血运行的通道，那么就不会疼痛，只会表现为痿弱和麻木。根据痹证所在部位的不同，如果阳气多而阴气少，就会形成热痹；如果阴气多而阳气少，就会形成寒痹；或者出现骨骼沉重、筋脉拘挛不能伸展、肌肉麻木不仁、血脉凝涩不通等症状；邪气在皮肤则感觉寒冷，遇到热邪则肢体松弛无力。后世医家从中摘取以疼痛为主要表现的病症分为六条，列出了数百个方剂。用药的关键在于明白医理，而不在于言辞繁多。如果明白了医理，即使是一句话或一个方子也可以类推运用；如果不懂医理，又怎么能恰当使用并做出选择呢？现在这六条中，有的认为是由风寒湿气导致血液凝涩流通不畅，关节和各处筋脉得不到滋养，真邪相互搏击，导致历节疼痛；有的认为是风邪导致全身关节疼痛；有的认为是风气走窜，疼痛没有固定位置；有的称为白虎风，病位在骨节或游走于四肢，白天安静夜间发作，发作时疼痛深入骨髓；有的称为风腰痛。这些难道不都是风寒湿三气导致的痹证而疼痛吗？有人说：《痹论》只提到寒邪导致痛痹，没听说行痹（风邪为主）也会疼痛。回答说：《灵枢·周痹篇》中有众痹和周痹的说法，指的就是这种情况。另外，《内经·四时刺逆从论篇》中对六经都提到有余和不足都会导致痹证。注释说：痹，就是疼痛的意思。这难道不是人气之邪也能导致疼痛吗？为什么现在用一条来概括众多的病症呢？大概是因为这部集子有所不完善吧！况且人的身体疼痛，在外有皮、肉、脉、筋、骨的区别，由于致病邪气不同，也各自需要端正其名称，名称不正确将如何施治？如果邪气是六淫所致，就必须治疗邪气；如果是人气失调，就必须补泻其气；病在六经和四属的，要顺应其气的特性。因此制定方剂必须区分药物的轻重缓急，使其恰到好处，这样才能符合经旨原意。
This corresponds to the statement in the *Huangdi Neijing* (Yellow Emperor's Inner Canon) that the three pathogens of Wind, Cold, and Dampness mix together and invade the body, combining to form Bi Syndrome (Obstruction Syndrome). Although it is stated that Cold predominates in Painful Bi (Tongbi), all three pathogens can cause pain. However, when Cold is predominant, the pain is severe and feels like pulling or twitching; when Dampness is predominant, the pain is fixed and heavy, resembling swelling; when Wind is predominant, the pain migrates without a fixed location. All these occur because the stagnant pathogenic obstruction clashes with the circulating Ying (Nutrient) and Wei (Defensive) True Qi, resulting in Painful Bi. If the pathogens do not interfere with the pathways of circulation and entry/exit, there will be no pain, only Wei Syndrome (Flaccidity) and numbness. Depending on the location of the Bi syndrome: if Yang is excessive and Yin is deficient, it becomes Heat Bi; if Yin is excessive and Yang is deficient, it becomes Cold Bi; symptoms may include heavy bones, contracted sinews unable to extend, insensitivity of muscles, and coagulation/stagnation of blood vessels. If the pathogen is in the skin, there is cold sensation; if exposed to heat, the limbs become flaccid. Later generations extracted those cases characterized by pain into six categories, listing hundreds of prescriptions. The key to using herbs lies in understanding the principles (Dao), not in verbose explanations. If one understands the principles, even a single phrase or prescription can be applied by analogy; if the principles are not understood, how can one select and use them appropriately? Among these six categories, some attribute the condition to Wind-Cold-Dampness causing blood stagnation and poor circulation, leading to lack of nourishment for joints and sinews, with true and evil qi clashing to cause Li Jie Tong (Joint Pain); some attribute it to Wind causing pain in all joints; some describe Wind migrating with pain having no fixed location; some call it Bai Hu Feng (White Tiger Wind), located in bone joints or moving through the four limbs, quiet during the day but occurring at night with pain penetrating to the bone; some refer to Wind-induced lower back pain. Are these not all Bi syndromes caused by Wind, Cold, and Dampness resulting in pain? One might argue: The *Bi Lun* (Discourse on Bi Syndrome) only mentions Cold as causing Painful Bi, and it has not been heard that Xing Bi (Migratory Bi, primarily Wind) also causes pain. The response is: The *Lingshu · Zhou Bi Pian* (Zhou Bi Chapter of the Spiritual Pivot) discusses Zhong Bi (Multiple Bi) and Zhou Bi (General Bi), which refers to this. Furthermore, in the *Sishi Ci Ni Cong Lun Pian* (Discourse on Following or Opposing Needles According to the Four Seasons) of the *Neijing*, it is stated that both excess and deficiency in the Six Channels result in Bi. The commentary states: "Bi means pain." Does this not indicate that pathogenic factors from human activity can also cause pain? Why does this text use one category to summarize numerous diseases? It is likely because the collection is incomplete. Moreover, bodily pain differs according to whether it affects the skin, flesh, vessels, sinews, or bones. Since the pathogenic factors differ, their names must be correctly defined; if the names are incorrect, how can treatment be administered? If the pathogen is one of the Six Excesses (Liu Yin), one must treat the pathogen; if it is a disorder of human Qi, one must tonify or reduce the Qi; if the disease is in the Six Channels and Four Belongings, one must follow the nature of the Qi. Therefore, when formulating prescriptions, one must distinguish the weight, lightness, slowness, and urgency of the herbs, applying them appropriately, so as to align with the intent of the classics.