夫风湿寒三气杂至,合而为痹。虽曰合痹,其用自殊。风胜则为行痹,寒胜则为痛痹,
湿胜则为着痹。三气袭人经络,入于筋脉、皮肉、肌肤,久而不已,则入五脏。凡使人烦满
,喘而吐者,是痹客于肺;烦心上气,嗌干恐噫,厥胀满者,是痹客于心;多饮,数小便,
小腹痛如怀妊,夜卧则惊者,是痹客于肝;善胀,尻以代踵,脊以代头者,是痹客于肾;四
肢解惰,发咳呕沫,上为大塞者,是痹客于脾。又有肠痹者,数饮而小便不利,中气喘急,
时发飧泄。又胞痹者,小腹按之内痛,若沃以汤,涩于小便,上为清涕。又六腑各有俞,风
寒湿中其俞,而食饮应之,故循俞而入,各舍其腑。治之,随其腑俞,以施针灸之法,仍服
逐风湿寒发散等药,则病自愈。大抵痹之为病,寒多则痛,风多则行,湿多则着;在骨则重
而不举,在脉则血凝不流,在筋则屈而不伸,在肉则不仁,在皮则寒,逢寒则急,逢热则纵
。又有血痹,以类相从,附于此门。外有支饮作痹,见痰饮门。
治风湿寒痹,骨节疼痛,皮肤不仁,肌肉重着,四肢缓纵。
附子(生去皮脐) 白芍药 桂心 甘草 白茯苓 人参(各三分) 白术(一两)
上为锉散。每服四钱,水三盏,煎七分,去滓,食前服。
治尊荣人骨弱肌重,因疲劳汗出,卧不时动摇,加以微风,遂作血痹,脉
当阴阳俱微,尺中少紧,身体如风痹状。
黄 芍药 桂心(各等分)
上为锉散。每服四大钱,水二盏,姜五片,枣三枚,煎七分,去滓,食前服。
The three pathogenic factors of wind, dampness, and cold mix together to combine and form Bi syndrome (Obstruction Syndrome). Although collectively referred to as combined Bi, their clinical manifestations differ. When wind is predominant, it forms Xing Bi (Wandering Bi); when cold is predominant, it forms Tong Bi (Painful Bi); when dampness is predominant, it forms Zhuo Bi (Fixed Bi). These three pathogens invade the meridians, entering the sinews, vessels, flesh, and skin. If not cured for a long time, they enter the five Zang organs. Whenever one experiences irritability and fullness, wheezing and vomiting, this indicates Bi pathogen lodging in the Lung; irritability with rebellious Qi, dry throat, fear of belching, cold limbs, and fullness indicate Bi pathogen lodging in the Heart; excessive drinking, frequent urination, lower abdominal pain resembling pregnancy, and night terrors indicate Bi pathogen lodging in the Liver; propensity for bloating, inability to walk upright replacing heels with buttocks, and spine curvature replacing the head indicate Bi pathogen lodging in the Kidney; flaccidity of the four limbs, coughing with frothy sputum, and severe obstruction above indicate Bi pathogen lodging in the Spleen. There is also Chang Bi (Intestinal Bi), characterized by frequent drinking but difficult urination,急促 breathing in the middle jiao, and occasional undigested stool diarrhea. There is also Bao Bi (Bladder/Reproductive Organ Bi), characterized by internal pain upon pressing the lower abdomen, a sensation as if scalded by hot water, dribbling urine, and clear nasal discharge above. Furthermore, each of the six Fu organs has its Shu points. When wind, cold, and dampness strike these Shu points, and dietary intake responds accordingly, the pathogens enter via the Shu points and lodge in their respective Fu organs. Treatment involves applying acupuncture and moxibustion according to the Shu points of the affected Fu organs, while administering herbs that expel wind, dampness, and cold and induce diaphoresis, leading to spontaneous recovery. Generally speaking, in Bi disease, excess cold causes pain, excess wind causes wandering pain, and excess dampness causes fixed heaviness; when in the bone, the body feels heavy and difficult to move; when in the vessels, blood coagulates and fails to flow; when in the sinews, flexion occurs without extension; when in the flesh, there is numbness; when in the skin, there is coldness, with contraction upon exposure to cold and relaxation upon exposure to heat. There is also Blood Bi, which is classified here due to similarity. External cases where Zhi Yin (Branching Fluid Retention) causes Bi are detailed in the Phlegm-Fluids section.
To treat Bi caused by wind, dampness, and cold, involving joint pain, skin numbness, muscle heaviness, and flaccidity of the four limbs:
Fuzi (Aconiti Lateralis Radix Praeparata, raw, peeled and navel removed) Baishao Yao (Paeoniae Radix Alba) Guixin (Cinnamomi Cortex) Gancao (Glycyrrhizae Radix et Rhizoma) Baifuling (Poria) Renshen (Ginseng Radix) [each 3 fen] Baizhu (Atractylodis Macrocephalae Rhizoma) [1 liang]
Crush the above ingredients into coarse powder. Take 4 qian per dose, add 3 zhan of water, decoct until reduced to 7 fen volume, strain, and take before meals.
To treat "Zunrong Ren" (persons of noble constitution) with weak bones and loose muscles, who develop Blood Bi after fatigue-induced sweating, restless sleep, and exposure to slight wind. The pulse should be micro in both Yin and Yang positions, slightly tight at the Chi position, and the body presents symptoms similar to Feng Bi (Wind Bi):
Huangqi (Astragali Radix) Shaoyao (Paeoniae Radix) Guixin (Cinnamomi Cortex) [equal parts]
Crush the above ingredients into coarse powder. Take 4 da qian per dose, add 2 zhan of water, 5 slices of fresh ginger, and 3 dates, decoct until reduced to 7 fen volume, strain, and take before meals.