《袖珍方》曰∶凡痹疾，病目有五种，筋痹、脉痹、骨痹、皮痹、肌痹是也。多由体
虚之人，腠理空疏，为风寒湿三气所侵，不能随时驱散，流注经络，久而为痹病者也。风多
则引注；寒多掣痛；湿多则重着。治之当辨其所感风寒湿三气注于何部分，其表里须从偏胜
者主之药饵。如有此证，治之宜早为贵乎。
五痹汤（《和剂方》）治风寒湿之气各留肌体，手足缓弱，麻顽不仁。
羌活 白术 防己（各一两） 片子 姜黄（一两，洗去灰土） 甘草（微炙，半两）
上 咀。每服四钱，水一盏半，姜七片，煎八分，去渣。病在上食后服，病在下食前服。
防风汤（《宣明方》）风寒湿三气合为痹，风气胜者行痹，上下左右无留，随所至作，防
风汤主之。治行痹行走无定。
防风 甘草 当归 赤茯苓（去皮） 杏仁（去皮，炒熟） 桂（各一两） 黄芩 秦
艽葛根（各三钱） 麻黄（去节，半两）
上为末。每服五钱，酒水各二盏，枣三枚，姜五片，煎至一盏，温服。
茯苓汤（《宣明方》）寒气胜者为痛痹，大宜宣通。阴寒为痛，宜通气温经而愈，茯苓汤
加减主之。治痛痹四肢疼痛，拘倦浮肿。
赤茯苓（去皮） 桑白皮（各二两） 防风 官桂 川芎 芍药 麻黄（去节。各一两
半）
上为末。每服五钱，水一盏，枣一枚，煎至八分，温服。以姜粥投之，汗泄为度，效矣。
茯苓川芎汤（《宣明方》）湿气胜者为着痹，湿地水气甚重，着而不去，多汗而濡者，茯
苓川芎汤主之。治着痹留注不去，四肢麻木，拘挛浮肿。
赤茯苓 桑白皮 防风 官桂 川芎 麻黄 芍药 当归 甘草（炙。各五分）
上为末。每服四钱半，水二盏，枣三枚，同煎至一盏，去滓，空心温服。如欲出汗，以
粥投之。
蠲痹汤（《济生方》）治手足冷痹，腰腿沉重及身体烦疼，背项拘急。
当归（去芦，酒洗） 赤芍药 黄 （去芦） 防风（去芦） 片子 姜黄 羌活（各
一两半） 甘草（炙，半两）
上 咀。每服四钱，水一盏半，姜五片，枣一枚，煎八分，去渣温服。
防风汤（《济生方》）治血痹，皮肤不仁。
川当归（去芦，洗） 赤茯苓（去皮） 川独活（各一两） 甘草（炙，半两） 防风
（一两） 赤芍药 黄苓（各一两） 杏仁（去皮尖，半两） 秦艽（去芦，一两） 桂心
（不
见火，半两）
上 咀。每服四钱，水一盏，姜五片，煎七分，去渣温服，不拘时。
续断丸（《本事方》）治风湿流注，四肢浮肿，肌肉麻痹。
当归（炒） 川续断 萆 （各一两） 川芎（七钱半） 乳香（半两） 天麻、防风、
附子（各一两） 没药（半
两）
上为末，炼蜜丸如梧桐子大。每服四十丸，温酒或饮任下。
黄 酒（《济生方》）治风湿痒痛，筋脉挛急，或身体顽痹。
当归（去芦） 云母粉 茵芋叶 白术 虎骨 萆 木香（不见火） 仙灵脾 川续
断甘草（炙） 白芍药 黄 （去芦） 防风（去芦） 官桂（不见火） 天麻 石斛
（去根。各一两）
上 咀，用绢袋盛，以好酒一斗浸之，春五、夏三、秋七、冬十日。每服一盏，温暖服
之，常令酒气相续为佳。
茯苓汤（《济生方》）治停蓄支饮，手足麻痹，多睡眩冒。
半夏（汤洗七次） 赤茯苓（去皮） 陈皮（各一两） 枳实（去穣，麸炒） 桔梗（去
芦） 甘草（炙。各半两）
上 咀。每服四钱，水一盏半，姜七片，煎七分，温服。
增损续断丸（《本事方》）治寒湿之气痹滞关节，麻木疼痛。
人参 防风 鹿角胶 白术（炮。各七两） 麦门冬 干地黄 黄 续断 薏苡仁 山
芋牡丹皮 桂心 山茱萸 白茯苓 石斛（各二两）
上为末，炼蜜丸如梧桐子大。每服五十丸，温酒空心下。
羌活汤（《济生方》）治白虎历节，风毒攻注，骨节疼痛，发作不定。
羌活（去芦。二两） 附子（炮，去皮脐） 秦艽（去芦） 桂心 木香（不见火） 川
芎当归（去芦） 牛膝（川者，去芦，洗） 桃仁（去皮尖，麸炒） 骨碎补 防风（去
芦。各一两） 甘草（
上 咀。每服四钱，水一盏半，姜五片，煎七分，温服。
虎骨散（《济生方》）治白虎风，肢节疼痛，发则不可忍。（方见白虎历节风门。）
谨按∶痹病盖因风寒湿三气，客于经络，为病不一，或为痛，或为痒，或为麻痹不仁，
或为手足缓弱，所以然者，有新久轻重之分，有湿痰死血之异。《济生》防风汤、茯苓汤所
治已露端倪也，学人细心求之。仁斋先生不言痹病，盖已中风、白虎历节风条内矣。但所言
病之见证，古人所言病之原因，即中庸费隐之义也。
According to *Xiu Zhen Fang* (Pocket Manual), generally speaking, Bi syndrome (Obstruction Syndrome) has five types of disease names: Jin Bi (Sinew Bi), Mai Bi (Vessel Bi), Gu Bi (Bone Bi), Pi Bi (Skin Bi), and Ji Bi (Muscle Bi). These conditions mostly occur in individuals with weak constitutions whose Cou Li (skin texture and pores) are loose. They are invaded by the three pathogenic factors of Wind, Cold, and Dampness. If these pathogens cannot be dispersed in time, they flow into the meridians and collaterals, eventually forming Bi syndrome over a long period. When Wind is predominant, it causes pulling pain; when Cold is predominant, it causes spasmodic pain; when Dampness is predominant, it causes heaviness and fixed sensation. Treatment should distinguish which part of the body is affected by the predominant Wind, Cold, or Dampness. The treatment for exterior or interior conditions must be based on the medicine that addresses the predominant pathogen. If such symptoms exist, early treatment is preferred.
Wu Bi Tang (Five-Bi Decoction) [from *He Ji Ju Fang*] treats Wind, Cold, and Dampness lingering separately in the muscles and body, resulting in weakness of the hands and feet, numbness, stiffness, and insensitivity.
Qiang Huo (Notopterygii Rhizoma et Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fang Ji (Stephaniae Tetrandrae Radix) (each 1 liang); Pian Jiang Huang (Curcumae Longae Rhizoma), Jiang Huang (Curcumae Longae Rhizoma) (1 liang, washed to remove dust); Gan Cao (Glycyrrhizae Radix et Rhizoma) (lightly roasted, 0.5 liang).
Crush the herbs into coarse pieces. Take 4 qian per dose, add 1.5 zhan of water and 7 slices of fresh ginger, decoct until 0.8 zhan remains, strain, and drink. For diseases located in the upper body, take after meals; for diseases located in the lower body, take before meals.
Fang Feng Tang (Saposhnikoviae Decoction) [from *Xuan Ming Fang Lun*] treats Bi syndrome caused by the combination of Wind, Cold, and Dampness. When Wind is predominant, it is called Xing Bi (Wandering Bi), characterized by pain moving without fixation up, down, left, or right, occurring wherever the pathogen goes. Fang Feng Tang is the primary formula. It treats Wandering Bi with migrating pain.
Fang Feng (Saposhnikoviae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chi Fu Ling (Poria with Red Hosta Parasitica), Xing Ren (Armeniacae Semen Amarum, peeled and stir-fried), Gui Zhi (Cinnamomi Ramulus) (each 1 liang); Huang Qin (Scutellariae Radix), Qin Jiao (Gentianae Macrophyllae Radix), Ge Gen (Puerariae Lobatae Radix) (each 3 qian); Ma Huang (Ephedrae Herba, nodes removed, 0.5 liang).
Grind into fine powder. Take 5 qian per dose, add 2 zhan each of wine and water, 3 jujubes, and 5 slices of fresh ginger. Decoct until 1 zhan remains, and take warm.
Fu Ling Tang (Poria Decoction) [from *Xuan Ming Fang Lun*] treats Tong Bi (Painful Bi) where Cold is predominant, which greatly benefits from promoting circulation. Pain caused by Yin-Cold heals by promoting circulation and warming the meridians. Modified Fu Ling Tang is the primary formula. It treats Painful Bi with limb pain, spasm, fatigue, and edema.
Chi Fu Ling (Poria with Red Hosta Parasitica, peeled), Sang Bai Pi (Mori Cortex) (each 2 liang); Fang Feng (Saposhnikoviae Radix), Guan Gui (Cinnamomi Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Shao Yao (Paeoniae Radix Alba) (each 1.5 liang); Ma Huang (Ephedrae Herba, nodes removed, 1.5 liang).
Grind into fine powder. Take 5 qian per dose, add 1 zhan of water and 1 jujube. Decoct until 0.8 zhan remains, and take warm. Administer with ginger congee to induce sweating as the limit of efficacy.
Fu Ling Chuan Xiong Tang (Poria and Ligusticum Decoction) [from *Xuan Ming Fang Lun*] treats Zhuo Bi (Fixed Bi) where Dampness is predominant. In damp places, Water-Dampness is heavy, adhering and not departing, often accompanied by excessive sweating and moisture. This formula is used for Fixed Bi that lingers without departing, causing limb numbness, spasm, and edema.
Chi Fu Ling (Poria with Red Hosta Parasitica), Sang Bai Pi (Mori Cortex), Fang Feng (Saposhnikoviae Radix), Guan Gui (Cinnamomi Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Ma Huang (Ephedrae Herba), Shao Yao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted) (each 5 fen).
Grind into fine powder. Take 4.5 qian per dose, add 2 zhan of water and 3 jujubes. Decoct together until 1 zhan remains, strain, and take warm on an empty stomach. To induce sweating, administer with congee.
Juan Bi Tang (Expel Bi Decoction) [from *Ji Sheng Fang*] treats cold Bi of the hands and feet, heaviness of the waist and legs, general body pain, and stiffness of the back and neck.
Dang Gui (Angelicae Sinensis Radix, radix end removed, washed with wine), Chi Shao Yao (Red Paeoniae Radix), Huang Qi (Astragali Radix, radix end removed), Fang Feng (Saposhnikoviae Radix, radix end removed), Pian Jiang Huang (Curcumae Longae Rhizoma), Jiang Huang (Curcumae Longae Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix) (each 1.5 liang); Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 0.5 liang).
Crush into coarse pieces. Take 4 qian per dose, add 1.5 zhan of water, 5 slices of fresh ginger, and 1 jujube. Decoct until 0.8 zhan remains, strain, and take warm.
Fang Feng Tang (Saposhnikoviae Decoction) [from *Ji Sheng Fang*] treats Blood Bi with skin numbness and insensitivity.
Chuan Dang Gui (Angelicae Sinensis Radix, radix end removed, washed), Chi Fu Ling (Poria with Red Hosta Parasitica, peeled), Chuan Du Huo (Angelicae Pubescentis Radix) (each 1 liang); Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 0.5 liang), Fang Feng (Saposhnikoviae Radix, 1 liang), Chi Shao Yao (Red Paeoniae Radix), Huang Qin (Scutellariae Radix) (each 1 liang); Xing Ren (Armeniacae Semen Amarum, peeled and cored, 0.5 liang), Qin Jiao (Gentianae Macrophyllae Radix, radix end removed, 1 liang), Gui Xin (Cinnamomi Cortex core, not exposed to fire, 0.5 liang).
Crush into coarse pieces. Take 4 qian per dose, add 1 zhan of water and 5 slices of fresh ginger. Decoct until 0.7 zhan remains, strain, and take warm at any time.
Xu Duan Wan (Teasel Pill) [from *Ben Shi Fang*] treats wind-dampness flowing into the joints, limb edema, and muscle paralysis.
Dang Gui (Angelicae Sinensis Radix, stir-fried), Chuan Xu Duan (Dipsaci Radix), Bi Xie (Dioscoreae Hypoglaucae Rhizoma) (each 1 liang); Chuan Xiong (Ligustici Chuanxiong Rhizoma, 7.5 qian), Ru Xiang (Olibanum, 0.5 liang); Tian Ma (Gastrodiae Rhizoma), Fang Feng (Saposhnikoviae Radix), Fu Zi (Aconiti Lateralis Radix Praeparata) (each 1 liang); Mo Yao (Myrrha, 0.5 liang).
Grind into fine powder, mix with refined honey to make pills the size of paulownia seeds. Take 40 pills per dose, swallowed with warm wine or any beverage.
Huang Qi Jiu (Astragalus Wine) [from *Ji Sheng Fang*] treats wind-dampness itching and pain, tendon and vessel spasm, or stubborn Bi syndrome of the body.
Dang Gui (Angelicae Sinensis Radix, radix end removed), Yun Mu Fen (Muscovite Powder), Yin Yu Ye (Ilicis Cornei Folium), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Hu Gu (Pantheris Os), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Mu Xiang (Aucklandiae Radix, not exposed to fire), Xian Ling Pi (Epimedii Folium), Chuan Xu Duan (Dipsaci Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted), Bai Shao Yao (White Paeoniae Radix), Huang Qi (Astragali Radix, radix end removed), Fang Feng (Saposhnikoviae Radix, radix end removed), Guan Gui (Cinnamomi Cortex, not exposed to fire), Tian Ma (Gastrodiae Rhizoma), Shi Hu (Dendrobii Caulis, roots removed) (each 1 liang).
Crush the herbs, place in a silk bag, and soak in 1 dou of good wine. Soak for 5 days in spring, 3 days in summer, 7 days in autumn, and 10 days in winter. Take 1 zhan per dose, warm before drinking. It is best to maintain a continuous mild alcohol effect.
Fu Ling Tang (Poria Decoction) [from *Ji Sheng Fang*] treats retained fluid and branch-fluid retention, causing limb numbness, excessive sleepiness, and dizziness.
Ban Xia (Pinelliae Rhizoma Praeparatum, washed seven times in hot water), Chi Fu Ling (Poria with Red Hosta Parasitica, peeled), Chen Pi (Citri Reticulatae Pericarpium) (each 1 liang); Zhi Shi (Aurantii Fructus Immaturus, pulp removed, stir-fried with bran), Jie Geng (Platycodonis Radix, radix end removed), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted) (each 0.5 liang).
Crush into coarse pieces. Take 4 qian per dose, add 1.5 zhan of water and 7 slices of fresh ginger. Decoct until 0.7 zhan remains, and take warm.
Zeng Sun Xu Duan Wan (Modified Teasel Pill) [from *Ben Shi Fang*] treats obstruction of joints by Cold-Dampness, causing numbness and pain.
Ren Shen (Ginseng Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix), Lu Jiao Jiao (Colla Cornus Cervi), Bai Zhu (Atractylodis Macrocephalae Rhizoma, processed) (each 7 liang); Mai Men Dong (Ophiopogonis Tuber), Gan Di Huang (Rehmanniae Radix Preparata), Huang Qi (Astragali Radix), Xu Duan (Dipsaci Radix), Yi Yi Ren (Coicis Semen), Shan Yu (Corni Fructus), Mu Dan Pi (Moutan Cortex), Gui Xin (Cinnamomi Cortex core), Shan Zhu Yu (Corni Fructus), Bai Fu Ling (Poria), Shi Hu (Dendrobii Caulis) (each 2 liang).
Grind into fine powder, mix with refined honey to make pills the size of paulownia seeds. Take 50 pills per dose, swallow on an empty stomach with warm wine.
Qiang Huo Tang (Notopterygium Decoction) [from *Ji Sheng Fang*] treats Bai Hu Li Jie Feng (Tiger Stride Joint Wind), where wind-toxin attacks and flows, causing bone and joint pain with irregular onset.
Qiang Huo (Notopterygii Rhizoma et Radix, radix end removed, 2 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, peeled and navel removed), Qin Jiao (Gentianae Macrophyllae Radix, radix end removed), Gui Xin (Cinnamomi Cortex core), Mu Xiang (Aucklandiae Radix, not exposed to fire), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix, radix end removed), Niu Xi (Achyranthis Bidentatae Radix, Sichuan variety, radix end removed, washed), Tao Ren (Persicae Semen, peeled and cored, stir-fried with bran), Gu Sui Bu (Drynariae Rhizoma), Fang Feng (Saposhnikoviae Radix, radix end removed) (each 1 liang); Gan Cao (Glycyrrhizae Radix et Rhizoma) [dosage missing in original text].
Crush into coarse pieces. Take 4 qian per dose, add 1.5 zhan of water and 5 slices of fresh ginger. Decoct until 0.7 zhan remains, and take warm.
Hu Gu San (Tiger Bone Powder) [from *Ji Sheng Fang*] treats Bai Hu Feng (Tiger Wind), causing limb and joint pain that is unbearable during attacks. (Formula see section on Bai Hu Li Jie Feng.)
Note: Bi syndrome is generally caused by Wind, Cold, and Dampness invading the meridians and collaterals. The manifestations vary: some present with pain, some with itching, some with numbness and insensitivity, and some with weakness of the limbs. This variation arises from differences in newness versus chronicity, severity, and the presence of Damp-Phlegm or Stagnant Blood. The treatments in *Ji Sheng Fang*'s Fang Feng Tang and Fu Ling Tang already reveal the clues. Students should investigate carefully. Mrin Zhai did not discuss Bi syndrome separately because it was likely included under the entries for Stroke (Zhong Feng) and Tiger Stride Joint Wind (Bai Hu Li Jie Feng). However, his description of the clinical manifestations and the ancient understanding of etiology reflect the principle of "Fei Yin" (the explicit and the implicit) found in the Doctrine of the Mean.