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Progressive muscular dystrophy is an extremely stubborn and difficult-to-cure disease. I once used Qimai Tang (Cinnamon Twig and Ophiopogon Decoction), Dihuang Yinzi (Rehmannia Decoction), and Baohe Wan (Preserve Harmony Pill) added with Qi-tonifying and Yin-nourishing agents, achieving temporary effects. However, long-term use often proved ineffective. Reluctantly, I had to return to syndrome differentiation and treatment. I once treated a patient, Zhang XX, male, 19 years old. Two months prior, he suddenly felt weakness in all four limbs. Three days later, movement of the limbs became very difficult. He rushed to a certain hospital for inpatient treatment and was diagnosed with polyneuritis. After two months of hospitalization, his condition did not improve; instead, significant muscle wasting of the trunk appeared. A consultation diagnosed progressive muscular dystrophy. Walking and turning over were very difficult. He invited me to treat him. I immediately prescribed Qimai Tang (Cinnamon Twig and Ophiopogon Decoction) for 10 doses. After taking the medicine, symptoms did not decrease; rather, appetite worsened. Upon detailed examination of the syndrome: besides significant muscle wasting of the trunk and upper/lower limbs, there were cold extremities, white tongue coating, and a deep, fine, and slow pulse. Synthesizing the pulse and syndrome, I concluded: this is a syndrome of untransformed cold-dampness. I formulated Xingren Yiyi Tang (Apricot Seed and Coix Seed Decoction): Xingren (Armeniacae Semen Amarum) 9g, Yimi (Coicis Semen) 9g, Guizhi (Cinnamomi Ramulus) 1.5g, Shengjiang (Zingiberis Rhizoma Recens) 3 slices, Houpo (Magnoliae Officinalis Cortex) 3g, Banxia (Pinelliae Rhizoma) 4.5g, Fangji (Stephaniae Tetrandrae Radix) 5g, Baijili (Tribuli Fructus) 6g. After taking approximately 10 doses, the patient could stand and walk independently, and muscles became slightly plumper. Continuing to take more than 200 doses, various symptoms basically disappeared.

Primary lateral sclerosis is roughly included within the category of Wei Syndrome (Flaccidity Syndrome) in Traditional Chinese Medicine. I once treated a patient, Zhang XX, male, 24 years old. For seven or eight years, he suffered from coldness, heaviness, and stiffness in the waist and legs, with difficulty walking. In recent years, it has gradually worsened. He had been diagnosed with primary lateral sclerosis in hospitals in Taiyuan, Baotou, Hohhot, etc. Repeated hospitalizations were ineffective, so he reluctantly sought treatment from TCM. Examining his sallow complexion, mental fatigue, poor appetite, cough, head distension, cold/stiff/heavy waist and legs, difficulty walking (requiring support from others), normal muscles, hyperactive tendon reflexes, positive Babinski sign, normal cerebrospinal fluid, thin white tongue coating, and deep, wiry, fine, and slow pulse. Synthesizing the pulse and syndrome, I diagnosed cold-dampness lodging in the meridians, with the chronic illness affecting the Kidney. I initially prescribed methods to diffuse the Lungs, eliminate dampness, and unblock Yang, using Xingren Yiyi Tang (see formula above). After 8 doses, various syndromes improved; I added Mugua (Chaenomelis Fructus) 9g and Yinyanghuo (Epimedii Folium) 3g to tonify the Liver and Kidneys. After 28 doses, walking improved significantly. He was instructed to walk with a goose-step posture and could move freely. After a total of 36 doses, his weight increased by more than 4 kg, sallow complexion disappeared, showing slight ruddiness, tongue coating white, pulse wiry and fine with the cun-guan positions slightly larger than chi, appetite and sleep normal. However, given the long duration of the disease, it was appropriate to tonify the Kidney and Mingmen (Gate of Vitality) for consolidation. Using modified Dihuang Yinzi (Rehmannia Decoction) for two months, all symptoms disappeared. Later, another case of primary lateral sclerosis was encountered, and the same formula was administered again. It was not only ineffective but aggravated the condition. Careful examination of the syndrome revealed, besides leg stiffness and walking difficulty for over 5 years, a pale face with tender red cheeks, excessive sweating, thin white tongue coating, tender red tongue body, and empty, large, wiry, and slippery pulse. Synthesizing the pulse and syndrome, I diagnosed Qi and Yin deficiency with damp-heat damaging the sinews. I prescribed Qimai Tang (Cinnamon Twig and Ophiopogon Decoction) for 30 doses, after which symptoms decreased significantly. After 60 doses, walking was basically normal.

Luoli (Scrofula)
Luoli (Scrofula) is called "Jiehe" (Tubercles) in the *Neijing* (Inner Canon), and later physicians called it Luoli. Physicians through the ages generally believed it was formed by emotional stagnation due to worry, thought, and anger. Shen Jin'ao said: "Its origin lies in fire anger, wind heat, blood dryness, or deficiency of essence and blood in the Liver and Kidney meridians, causing internal movement of deficient fire, or reversal of anger qi and excessive worry/thought, allowing wind-heat pathogens to internally attack the Liver. The Liver governs sinews; when the Liver is diseased, sinews contract, forming lumps like beads on a string." I followed this intent and found it effective for lymphatic tuberculosis. For example: Zhao XX, female, adult. For over 10 months, she had 8 swellings of varying sizes on both sides of the neck, large ones like peach pits, small ones like soybeans, non-red and non-painful, but some tightness/discomfort when twisting the head to either side. Previous doctors first used anti-tuberculosis drugs for over 2 months, then combined them with Chinese medicines Xiaoluo Wan (Eliminate Scrofula Pill), Maozhucao (Ranunculi Ternati Herba), and other softening-hardness-resolving formulas for over 4 months, still without effect. Examining her slightly greenish complexion indicating suppressed anger, occasional irritability, frequent sighing, insomnia, poor appetite, white tongue coating, and deep, wiry, slightly slippery pulse. Synthesizing the pulse and syndrome, I diagnosed Qi stagnation and Blood stasis with Phlegm-Heat coagulation. I formulated: Xiakucao (Prunellae Spica) 30g, Danggui (Angelicae Sinensis Radix) 9g, Chishao (Paeoniae Radix Rubra) 10g, Qingpi (Citri Reticulatae Pericarpium Viride) 10g, Jiuye (Citri Reticulatae Folium) 10g, Zhexiecao (Paris Polyphyllae Rhizoma) 10g, Lianqiao (Forsythiae Fructus) 9g, Muli (Ostreae Concha) 9g, Baijiezi (Sinapis Semen) 3g. After 3 doses, all symptoms decreased, and the mass shrank. After another 6 doses, the mass reduced by half. To consolidate the effect, she continued taking 40 doses and recovered.

Regarding Luoli (Scrofula), many experts consider it equivalent to cervical lymphatic tuberculosis in modern medicine. However, carefully examining ancient physicians' discussions, it seems not limited to cervical lymphatic tuberculosis. Shen Jin'ao said: "Luoli is the general name. Classifying by shape, each has specific names. Arranged in rows, surrounding the neck, or two or three, or six or seven, red or white, deep or floating, initially like beans, later like plums, even like chicken eggs, this is named Panshe Li (Coiling Snake Scrofula); if caused by worry/thought and labor, it becomes painful, red, and swollen, urgent to treat early. Only one occurring between the neck and jaw is named Danke Li (Single Nest Scrofula), most difficult to treat. An external sac containing dozens of nodules is named Lianzi Li (Lotus Seed Scrofula); movable by hand, still treatable with medicine. If hard as stone, accompanied by fever and dry thirst, death is inevitable. Initially single on left/right neck, later overlapping, named Chongtai Li (Double Terrace Scrofula), also fatal, harming quickly. Shape resembling swallow's nest is named Yanwo Li (Swallow's Nest Scrofula), also fatal. Initially appearing at the nape, breaking and flowing to limbs, forming toxins throughout the body with dripping pus, named Liuzhu Li (Flowing Injection Scrofula), also known as Qiansui Chuang (Thousand-Year Sore), common in women." I also follow this principle, achieving efficacy by soothing the Liver, regulating Qi, invigorating Blood, resolving masses, transforming Phlegm, and clearing Heat. For example: Zhang XX, female, adult. Swellings on both sides of the neck for over 2 months. A certain hospital diagnosed malignant lymphoma? Cervical lymphatic tuberculosis? The doctor first used anti-tuberculosis drugs for over 1 month, causing the swelling to increase significantly. The doctor wanted a pathological biopsy for confirmation, but the patient feared surgery, so it was abandoned. Inviting me to treat. Examining a duck-egg-sized swelling on the left side of the neck and an egg-sized swelling on the right, skin color unchanged, hard upon pressure, accompanied by irritability, chest fullness with radiating pain, dizziness, white tongue coating, ecchymosis on the edges, and wiry, slightly slippery pulse. Synthesizing the pulse and syndrome, I diagnosed Qi stagnation and Phlegm depression with Blood stasis obstruction. I formulated soothing the Liver, regulating Qi, invigorating Blood, and transforming Phlegm: Xiakucao (Prunellae Spica) 30g, Danggui (Angelicae Sinensis Radix) 9g, Chishao (Paeoniae Radix Rubra) 10g, Qingpi (Citri Reticulatae Pericarpium Viride) 10g, Jiuye (Citri Reticulatae Folium) 10g, Zhexiecao (Paris Polyphyllae Rhizoma) 12g, Lianqiao (Forsythiae Fructus) 9g, Muli (Ostreae Concha) 9g. After about 6 doses, the mass shrank significantly, and chest fullness, irritability, and dizziness decreased. After continuing 40 doses, the mass disappeared. To consolidate, she took another 40 doses and recovered.

Jie Xiong (Chest Binding)
The *Shanghan Lun* (Treatise on Cold Damage) states: "In cold damage, after six or seven days, Jie Xiong (Chest Binding) with Heat and Excess, pulse deep and tight, pain below the heart, hardness like stone upon pressure, Da Xianxiong Tang (Major Draining the Chest Decoction) governs." "In Taiyang disease, after heavy sweating and subsequent purging, constipation for five or six days, dry tongue with thirst, slight tidal fever in the late afternoon, hardness and fullness from below the heart to the lower abdomen with pain too severe to approach, Da Xianxiong Tang (Major Draining the Chest Decoction) governs." This indicates that major Jie Xiong cannot be resolved without the purging action of Da Xianxiong Tang. However, if Shaoyang (Lesser Yang) symptoms are present, using only purging will not remove the water-heat binding and may cause exterior pathogens to enter the interior, worsening the disease. Thus, the *Shanghan Lun* also says: "In cold damage for ten-plus days, heat bound in the interior, with alternating chills and fever, give Da Chaihu Tang (Major Bupleurum Decoction); if Jie Xiong exists without significant heat, this is water binding in the chest and hypochondrium, with only slight sweating on the head, Da Xianxiong Tang (Major Draining the Chest Decoction) governs." Following this intent, I attempted treatment on a patient with pelvic abscess, achieving rapid results. For example: Zheng XX, female, adult. Abdominal fullness, hardness, pain, and refusal to press, with chills and high fever for over 7 months. A certain hospital diagnosed tuberculous pelvic abscess complicated by staphylococcal infection, vesicovaginal/rectovaginal fistula, and peritonitis. Western antibiotic treatment for over 6 months was ineffective. Combined with TCM heat-clearing and detoxifying agents for over 1 month, still ineffective. Inviting me to treat. Examining alternating chills and fever (temperature 39.5°C); mental fatigue and emaciation, profuse sweating, nausea and vomiting, abdominal fullness and distending pain, hardness and fullness from below the heart to the lower abdomen with pain preventing touch, flexion, or extension, yellow and foul leukorrhea, dry stool with occasional discharge of foul water from the anus, turbid urine, yellow greasy tongue coating, and wiry, slippery, rapid pulse. Synthesizing the pulse and syndrome, I diagnosed water-heat mutual binding, Jie Xiong with Heat and Excess, complicated by Shaoyang syndrome. I formulated harmonizing and purging the interior, draining water and clearing heat. Modified Da Chaihu Tang (Major Bupleurum Decoction): Chaihu (Bupleuri Radix) 24g, Banxia (Pinelliae Rhizoma) 12g, Huangqin (Scutellariae Radix) 12g, Chishao (Paeoniae Radix Rubra) 12g, Zhishi (Aurantii Fructus Immaturus) 15g, Baijiangcao (Patriniae Herba) 30g, Baijiezi (Sinapis Semen) 9g, Dahuang (Rhei Radix et Rhizoma) 9g, Shengjiang (Zingiberis Rhizoma Recens) 3 slices. After 1 dose, pain decreased, fever dropped, vomiting stopped. After 2 more doses, pain decreased by more than half, abdomen softened upon pressure, appetite increased, temperature 37.5°C. After 10 more doses, abdominal pain subsided by 80-90%, appetite greatly increased, pus in stool and yellow leukorrhea disappeared. TCM was paused, and she recovered with antibiotics.

Bi Zheng (Obstruction Syndrome)
Bi Zheng (Obstruction Syndrome) is a disease that is both ancient and broadly defined, deeply understood historically, yet not fully recognized today. It is ancient because it was recorded in the *Shan Hai Jing* (Classic of Mountains and Seas) during the Western Zhou period. It is broad because it includes not only rheumatic fever, rheumatoid arthritis, and rheumatoid arthritis as defined in modern medicine, but also joint diseases such as hypertrophic spondylitis, cervical spondylosis, Kashin-Beck disease, osteoporosis, and non-joint diseases like brucellosis, thromboangiitis obliterans, scleroderma, erythema nodosum, nodular vasculitis, systemic lupus erythematosus, and polymyositis. It has been deeply understood because the earliest existing medical text, *Huangdi Neijing Suwen* (Yellow Emperor's Inner Canon: Basic Questions), contains a dedicated chapter. It states: "Wind, Cold, and Dampness mixing together cause Bi. Dominance of Wind causes Xing Bi (Wandering Bi); dominance of Cold causes Tong Bi (Painful Bi); dominance of Dampness causes Zhu Bi (Fixed Bi)." "Encountering this in winter causes Gu Bi (Bone Bi); in spring, Jin Bi (Sinew Bi); in summer, Mai Bi (Vessel Bi); in the season of extreme Yin, Ji Bi (Muscle Bi); in autumn, Pi Bi (Skin Bi)." "The Five Zang organs have their corresponding tissues. If the disease persists, it enters the interior and lodges in its correspondence. Thus, if Gu Bi does not resolve and evil is re-contracted, it lodges in the Kidney; if Jin Bi does not resolve... it lodges in the Liver; if Mai Bi... lodges in the Heart; if Ji Bi... lodges in the Spleen; if Pi Bi... lodges in the Lung... Lung Bi presents with vexation, fullness, wheezing, and vomiting; Heart Bi presents with vessel obstruction, palpitations when vexed, sudden upward Qi and wheezing, dry throat, frequent belching, and fear when rebellious Qi rises; Liver Bi presents with fright during sleep, excessive drinking, frequent urination, and pulling sensation upwards like pregnancy; Kidney Bi presents with bloating, sitting with buttocks replacing heels, and spine replacing head; Spleen Bi presents with flaccid limbs, coughing, vomiting fluids, and severe upper obstruction; Intestinal Bi presents with frequent drinking but inability to urinate, mid-abdominal Qi turbulence, and occasional diarrhea; Bladder Bi presents with internal pain upon pressing the lower abdomen/bladder, feeling like pouring hot water, difficult urination, and clear nasal discharge upwards." "Pain is due to excess Cold; thus, Cold causes pain. Non-painful numbness occurs when disease is deep and chronic, Ying and Wei flow becomes sluggish, meridians are occasionally sparse, hence obstruction, skin lacks nourishment, hence numbness. Cold syndromes have little Yang and much Yin, adding to the disease, hence coldness. Heat syndromes have much Yang and little Yin, disease Qi dominates, Yang encounters Yin, hence Bi Heat. Profuse sweating and wetness occur when encountering severe Dampness, little Yang and abundant Yin, two Qi interacting, hence sweating and wetness." "Bi in bone causes heaviness; in vessels, blood coagulates and stops flowing; in sinews, flexion without extension; in flesh, numbness; in skin, coldness." It is not fully recognized today because neither TCM nor Western medicine has completely mastered the etiology, pathogenesis, and transmission patterns of Bi Zheng.

To clarify issues, I believe much experience and lessons from predecessors are worth learning from.
I. Dispersing Cold and Resolving the Exterior
Since Bi Zheng is caused by Wind, Cold, and Dampness, dispelling Wind, dispersing Cold, and eliminating Dampness becomes the natural treatment method. Therefore,历代 physicians used Wind-dispelling, Cold-dispersing, and Damp-eliminating herbs, such as calling Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Guizhi (Cinnamomi Ramulus), Baizhi (Angelicae Dahuricae Radix), and Xixin (Asari Radix et Rhizoma) Wind-Dampness dispelling herbs. However, since some of these have strong acrid-dispersing action but weak Damp-eliminating action, and Wind moves/disperses while Dampness is sticky/hard to transform, treating this disease often results in Wind leaving but Dampness remaining. As Zhang Zhongjing stated in *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet): "When Wind-Dampness struggles, the whole body aches. The method is sweating to resolve. If rainy weather continues, doctors say sweating is possible. Why does sweating fail to cure? Sweating heavily removes only Wind, leaving Dampness, hence failure. To treat Wind-Damp, sweating should be slight, as if about to sweat, so both Wind and Damp leave."
II. Eliminating Dampness
Dampness is a Yin pathogen, sticky nature, prone to generating Heat and damaging Yang when stagnant, often combining with other pathogens. Treatment varies by location and combined pathogens. For example, Zhongjing's *Jingui Yaolue* states: "Dampness patients with body ache, fever, yellow face, wheezing, headache, nasal congestion, and vexation, large pulse, able to eat, normal abdomen, disease is Cold-Damp in the head, hence nasal congestion. Inserting medicine into the nose cures it." Dongyuan stated: "Shoulder/back pain preventing looking back is Hand Taiyang Qi stagnation, disperse with Wind herbs. Like back pain, stiff neck/waist like breaking, neck like pulling, upward rushing headache, is Foot Taiyin insufficiency, governed by Qianghuo Shengshi Tang (Notopterygium Overcoming Dampness Decoction)." If偏向 interior/lower, promote urination. Zhongjing's *Jingui Yaolue* says: "Taiyang disease, joint pain and vexation, deep/fine pulse, named Shi Bi (Damp Bi). Signs of Shi Bi: difficult urination, loose stools, only promote urination."
III. Heat Bi
Since Heat Bi is a disease of "much Yang, little Yin, disease Qi dominates, Yang encounters Yin," it naturally involves: ① Much Yang, ② Little Yin, ③ More Damp than Heat, ④ More Heat than Damp. Thus, treatment must distinguish between clearing Heat, nourishing Yin, eliminating Dampness and clearing Heat, and clearing Heat and eliminating Dampness. As Zhongjing's *Jingui Yaolue* states: "Patient with whole body ache, fever, worse in late afternoon, named Wind-Damp, caused by sweating into wind or long-term cold exposure, give Mahuang Xingren Yiyi Gancao Tang (Ephedra, Apricot Seed, Coix Seed, Licorice Decoction)." If exterior releasing and interior purging are contraindicated, treat with clearing Heat and promoting urination. Wu Jutong's *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases) states: "Slow pulse, body ache, pale yellow slippery tongue. Thirst but little drinking, or no thirst, slight sweating with temporary heat relief then recurrence, internal inability to transport Water-Grain Dampness, external seasonal Dampness, neither exterior releasing nor interior purging applicable. Mistaking for Cold Damage leads to deterioration. Merely clearing Heat leaves Dampness; merely removing Dampness intensifies Heat. Huangqin Huashi Tang (Scutellaria and Talc Decoction) governs." "Damp gathering and Heat steaming, accumulating in meridians, chills and high fever, bone/joint烦痛, gray stagnant tongue coating, sallow face, named Wet Bi, Xuanbi Tang (Dispersing Bi Decoction) governs." "Dampness郁 in meridians, body heat/pain, profuse sweating, spontaneous diarrhea, white rash on chest/abdomen, interior/exterior combined evil, pure Acrid moving exterior, pure Bitter clearing Heat, both taboo. Acrid-Cool and Light method, Yiyi Zhuye San (Coix Seed and Bamboo Leaf Powder) governs." "Summer-Damp Bi, Jiawei Mufangji Tang (Modified Stephania Decoction) governs."
IV. Tonification
The Five Zang organs store Essence and Qi, as *Suwen · Wuzangielun* states: "The Five Zang store Essence and Qi and do not drain." If Bi Zheng persists, it enters the interior and damages Zang Essence/Qi, as *Suwen · Bilun* states: "Five Zang have correspondences. Chronic disease lodges in its correspondence. Bone Bi... Kidney; Sinew Bi... Liver; Vessel Bi... Heart; Muscle Bi... Spleen; Skin Bi... Lung." Thus, chronic Bi Zheng is mostly treated with tonification, tonifying Heart/Lung/Liver/Spleen/Kidney, or Qi/Blood. As Zhongjing's *Jingui Yaolue*: "Wind-Damp body heaviness, sweating, aversion to wind, Fangji Huangqi Tang (Stephania and Astragalus Decoction) governs" uses Huangqi (Astragali Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). Lou Ying's *Yixue Gangmu*: "Numb hands, tired limbs, lethargy, is Damp-Heat damaging Yuan Qi" uses Renshen Qiyi Tang (Ginseng Qi-Yang Decoction).
V. Tonifying and Unblocking Yang
Since Tong Bi (Painful Bi) is caused by little Yang and much Yin, it naturally involves excess Cold and little Yang. Treatments include: ① Dispelling Wind and dispersing Cold, ② Dispersing Cold and searching Wind, ③ Warmly tonifying Yang. As Zhongjing's *Jingui Yaolue* states: "Joint disease unable to bend/extend with pain, Wutou Tang (Aconite Decoction) governs." "Cold damage 8-9 days, Wind-Damp struggling, body ache/vexation, unable to turn, no vomiting/thirst, floating/empty/astringent pulse, Guizhi Fuzi Tang (Cinnamon Twig and Prepared Aconite Decoction) governs. If hard stool, free urination, remove Cinnamon, add Atractylodes, governed by Qu Gui Jia Baizhu Tang." "Wind-Damp struggling, joint ache/vexation, pulling pain unable to bend/extend, touching worsens pain, sweating, shortness of breath, aversion to wind, unwilling to remove clothes, or slight swelling, Gancao Fuzi Tang (Licorice and Prepared Aconite Decoction) governs." Therefore, descendants desiring Wind-dispersing/Cold-dispersing commonly use Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Duhuo (Angelicae Pubescentis Radix), Baizhi (Angelicae Dahuricae Radix), Xixin (Asari Radix et Rhizoma); searching Wind/dispersing Cold/unblocking Yang commonly use Chuanwu (Aconiti Radix Preparata), Caowu (Aconiti Kusnezoffii Radix Preparata), Fuzi (Aconiti Lateralis Radix Preparata); Yang insufficiency commonly use Huangqi (Astragali Radix), Dangshen (Codonopsis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Lurong (Cervi Cornu Degelatinatum), Lujiao (Cervi Cornu), Roucongrong (Cynomorchii Herba), Bajitian (Morindae Officinalis Radix), Yinyanghuo (Epimedii Folium), Fuzi (Aconiti Lateralis Radix Preparata), Rougui (Cinnamomi Cortex).
VI. Nourishing Blood and Invigorating Blood