【湿痹之症】或一处麻痹不仁，或四肢手足不举，或半身不能转侧，或湿变为热，热变
为燥，收引拘挛作痛，蜷缩难伸，名曰着痹，此湿痹之症也。
【湿痹之因】或身居卑湿，湿气袭人，或冲风冒雨，湿留肌肉，内传经脉，或雨湿之年
，起居不慎，而湿痹之症作矣。
【湿痹之脉】脉见浮濡，乃是风湿；脉见浮紧，乃是寒湿。脉洪而数，湿热之诊。
【湿痹之治】发汗，羌活除湿汤。胸满闷，茯苓汤。风湿，苍防二妙汤。寒湿，术附汤
羌活除湿汤 通治风寒湿热，四气成痹。
羌活 防风 柴胡 独活 苍术 茯苓 泽泻 猪苓 甘草 陈皮 黄连 黄柏 川芎
茯苓汤 即枳桔二陈汤易赤茯苓。
苍防二妙汤 治风湿成痹。
苍术 防风
二味等分同煎。
术附汤 治寒湿成痹。
苍术 熟附子
苍柏二妙丸 见前湿热痿。
【热痹之症】肌肉热极，唇口干燥，筋骨痛不可按，体上如鼠走状，此《内经》所云阳
气多，阴气少，阳独盛，故为热痹之症。《内经》原有热痹，方书止列三条，误也。
【热痹之因】阴血不足，阳气偏旺，偶因热极见寒，风寒外束，《内经》云∶灵气相
薄，则脉满而痛。此热痹所由生也。
【热痹之脉】浮大而数，热在经络。沉大而数，热已深入。大数属气，细数者血。寸脉
数大，热在于上。尺热数大，热在于下。
【热痹之治】热在经络者，四味舒筋汤。热已深入，潜行散。气分有热者，苍柏二妙丸
四味舒筋汤 治腿足肿痛，脚筋挛缩。
独活 当归 黄柏 苍术
四味等分同煎。
潜行散 滋阴补肾，壮骨健行，此方独胜。
黄柏
一味炒研，水丸服。
苍柏二妙丸 治湿热伤气分者。
苍术 黄柏
二味同研水丸。
虎潜丸 治湿热入血分者。
龟板胶（四两） 黄柏（四两炒） 知母（四两） 川牛膝（二两） 熟地黄（四两） 白芍药（
（四两） 当归（四两） 虎骨骱（一两，炙）
上为细末，玄武胶溶化为丸。
【湿痹的症状】有的表现为身体某一部位麻木不仁，有的表现为四肢手足无法抬起，有的表现为半身不能翻身转动。或者湿气转化为热邪，热邪转化为燥邪，导致筋脉收缩牵引、拘急挛缩并产生疼痛，身体蜷曲收缩难以伸展，这叫做着痹，这就是湿痹的症状。
【湿痹的成因】有的因为居住在低洼潮湿的地方，湿气侵袭人体；有的因为顶风冒雨，湿气滞留于肌肉，进而内传至经脉；有的因为在多雨潮湿的年份，起居不慎，从而导致湿痹发作。
【湿痹的脉象】脉象浮而濡软，这是风湿之证；脉象浮而紧，这是寒湿之证。脉象洪大且数，是湿热之诊。
【湿痹的治疗】采用发汗法，使用羌活除湿汤。若伴有胸中胀满闷塞感，使用茯苓汤。若是风湿所致，使用苍防二妙汤。若是寒湿所致，使用术附汤。
羌活除湿汤：通治由风、寒、湿、热四气引起的痹症。
药材：羌活、防风、柴胡、独活、苍术、茯苓、泽泻、猪苓、甘草、陈皮、黄连、黄柏、川芎。
茯苓汤：即枳桔二陈汤（Zhi Ju Er Chen Tang），将原方中的茯苓改为赤茯苓（Chi Fuling）。
苍防二妙汤：治疗风湿形成的痹症。
药材：苍术、防风。
用法：两味药等量同煎服用。
术附汤：治疗寒湿形成的痹症。
药材：苍术、熟附子（Shu Fuzi）。
苍柏二妙丸：见前文“湿热痿”章节。
【热痹的症状】肌肉感觉极度发热，嘴唇和口腔干燥，筋骨疼痛且不可触碰，体表感觉像有老鼠在爬行游走，这是《黄帝内经》中所说的阳气多、阴气少，阳气单独亢盛，因此形成热痹的症状。《黄帝内经》中原本就有热痹的记载，后世医书只列出三条，这是错误的。
【热痹的成因】阴血不足，阳气偏旺，偶尔因极热而出现假寒现象，风寒束缚于体表，《黄帝内经》说：“灵气相互搏结，则脉道充盈而疼痛。”这就是热痹产生的原因。
【热痹的脉象】脉象浮大而数，说明热邪在经络。脉象沉大而数，说明热邪已经深入体内。脉大且数属于气分有热，脉细且数属于血分有热。寸口脉数大，说明热邪在上部；尺部脉数大，说明热邪在下部。
【热痹的治疗】热邪在经络者，使用四味舒筋汤。热邪已深入者，使用潜行散。气分有热者，使用苍柏二妙丸。
四味舒筋汤：治疗腿足肿痛，脚部筋脉挛缩。
药材：独活、当归、黄柏、苍术。
用法：四味药等量同煎服用。
潜行散：滋阴补肾，强壮骨骼，促进行走，此方效果独特。
药材：黄柏。
用法：一味药炒制后研成粉末，用水泛为丸服用。
苍柏二妙丸：治疗湿热损伤气分的病症。
药材：苍术、黄柏。
用法：两味药共同研末，用水泛为丸。
虎潜丸：治疗湿热侵入血分的病症。
药材：龟板胶（Gui Ban Jiao，4 liang）、黄柏（Huangbai，4 liang，炒）、知母（Zhimu，4 liang）、川牛膝（Chuan Niuxi，2 liang）、熟地黄（Shu Dihuang，4 liang）、白芍药（Baishao，4 liang）、当归（Danggui，4 liang）、虎骨骱（Hu Gu Jia，1 liang，炙烤）。
用法：以上药物研为细末，用玄武胶（Xuanwu Jiao，即龟板胶）溶化后制成丸剂。
[Symptoms of Damp-Bi Syndrome] Some present with numbness and insensitivity in a specific area, some with the inability to lift the limbs and hands/feet, and some with the inability to turn the body sideways. Alternatively, dampness may transform into heat, and heat may transform into dryness, leading to contraction, pulling, spasm, and pain, with the body curled up and difficult to extend. This is called Zhuo-Bi (Fixed Bi), which constitutes the symptoms of Damp-Bi syndrome.
[Etiology of Damp-Bi Syndrome] It arises from residing in low-lying and damp places where dampness invades the human body; or from exposing oneself to wind and rain, causing dampness to remain in the muscles and subsequently transmit internally to the meridians; or from careless daily living during years of excessive rain and humidity, thereby triggering Damp-Bi syndrome.
[Pulse Diagnosis of Damp-Bi Syndrome] A floating and soggy pulse indicates Wind-Dampness; a floating and tight pulse indicates Cold-Dampness. A surging and rapid pulse indicates Damp-Heat.
[Treatment of Damp-Bi Syndrome] Employ sweating methods using Qiang Huo Chu Shi Tang (Notopterygium Decoction for Expelling Dampness). If accompanied by chest fullness and oppression, use Fu Ling Tang (Poria Decoction). For Wind-Dampness, use Cang Fang Er Miao Tang (Atractylodes and Saposhnikovia Two Marvels Decoction). For Cold-Dampness, use Shu Fu Tang (Atractylodes and Prepared Aconite Decoction).
Qiang Huo Chu Shi Tang: Universally treats Bi syndrome caused by the four qi of Wind, Cold, Dampness, and Heat.
Herbs: Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Chai Hu (Bupleuri Radix), Du Huo (Angelicae Pubescentis Radix), Cang Zhu (Atractylodis Rhizoma), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Huang Lian (Coptidis Rhizoma), Huang Bai (Phellodendri Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma).
Fu Ling Tang: Is Zhi Ju Er Chen Tang (Immature Bitter Orange and Citron Two-Aged Decoction) with Chi Fu Ling (Red Poria) substituted for regular Poria.
Cang Fang Er Miao Tang: Treats Bi syndrome formed by Wind-Dampness.
Herbs: Cang Zhu (Atractylodis Rhizoma), Fang Feng (Saposhnikoviae Radix).
Usage: Decoct equal parts of these two herbs together.
Shu Fu Tang: Treats Bi syndrome formed by Cold-Dampness.
Herbs: Cang Zhu (Atractylodis Rhizoma), Shu Fu Zi (Prepared Aconiti Lateralis Radix).
Cang Bai Er Miao Wan: See the section on "Damp-Heat Wei Syndrome" above.
[Symptoms of Heat-Bi Syndrome] Muscles feel extremely hot, lips and mouth are dry, bones and sinews are painful and cannot be touched, and the skin feels as if mice are running across it. This corresponds to what the *Nei Jing* (Inner Canon) describes as excessive Yang qi and deficient Yin qi, where Yang alone is hyperactive, thus forming Heat-Bi syndrome. The *Nei Jing* originally recorded Heat-Bi; later medical texts listing only three types is an error.
[Etiology of Heat-Bi Syndrome] Deficiency of Yin blood with hyperactive Yang qi, occasionally presenting with cold sensations due to extreme heat, while Wind-Cold binds the exterior. The *Nei Jing* states: "When vital qi clashes, the vessels become full and painful." This is the origin of Heat-Bi.
[Pulse Diagnosis of Heat-Bi Syndrome] A floating, large, and rapid pulse indicates heat in the meridians. A deep, large, and rapid pulse indicates heat has penetrated deeply. A large and rapid pulse belongs to Qi-level heat; a fine and rapid pulse belongs to Blood-level heat. A rapid and large pulse at the Cun position indicates heat in the upper body; a rapid and large pulse at the Chi position indicates heat in the lower body.
[Treatment of Heat-Bi Syndrome] For heat in the meridians, use Si Wei Shu Jin Tang (Four-Ingredient Relaxing Sinew Decoction). For heat that has penetrated deeply, use Qian Xing San (Secret Walking Powder). For heat in the Qi level, use Cang Bai Er Miao Wan.
Si Wei Shu Jin Tang: Treats swelling and pain in the legs and feet, and contracture of foot sinews.
Herbs: Du Huo (Angelicae Pubescentis Radix), Dang Gui (Angelicae Sinensis Radix), Huang Bai (Phellodendri Cortex), Cang Zhu (Atractylodis Rhizoma).
Usage: Decoct equal parts of these four herbs together.
Qian Xing San: Nourishes Yin and tonifies the Kidney, strengthens bones, and promotes mobility; this formula excels uniquely.
Herbs: Huang Bai (Phellodendri Cortex).
Usage: Fry one herb, grind into powder, and take as water-pilled capsules.
Cang Bai Er Miao Wan: Treats conditions where Damp-Heat injures the Qi level.
Herbs: Cang Zhu (Atractylodis Rhizoma), Huang Bai (Phellodendri Cortex).
Usage: Grind both herbs together and form water pills.
Hu Qian Wan (Tiger Crouching Pill): Treats conditions where Damp-Heat enters the Blood level.
Herbs: Gui Ban Jiao (Testudinis Carapacis et Plastratis Colla, 4 liang), Huang Bai (Phellodendri Cortex, 4 liang, stir-fried), Zhi Mu (Anemarrhenae Rhizoma, 4 liang), Chuan Niu Xi (Cyathulae Radix, 2 liang), Shu Di Huang (Rehmanniae Radix Praeparata, 4 liang), Bai Shao Yao (Paeoniae Radix Alba, 4 liang), Dang Gui (Angelicae Sinensis Radix, 4 liang), Hu Gu Jia (Ossum Tigridis Articulation, 1 liang, roasted).
Usage: Grind all ingredients into fine powder, dissolve Xuan Wu Jiao (also known as Gui Ban Jiao) and form pills.