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2. In Zhou Bi (General Bi Syndrome), the pain is fixed and unceasing, does not shift left or right, but moves up and down. It resembles hemiplegia caused by wind-stroke, affecting only the hands or feet, without deviation of the mouth and eyes, yet accompanied by body pain.
[Note] Zhou Bi (General Bi Syndrome) may present with pain or swelling in the hands or feet. The affected site is fixed, and the pain is unceasing. The pathology may move from upper to lower parts or from lower to upper parts, unlike Zhong Bi (Cluster Bi Syndrome), where pain has intervals and shifts left and right. Zhou Bi (General Bi Syndrome) may affect both hands, both feet, or only one hand and one foot, or cause hemiplegia with numbness and immobility, resembling stroke, but without deviation of the mouth and eyes, merely presenting with body pain.

3. When Bi (Obstruction Syndrome) resides in the sinews and bones, the pain is difficult to cease; when it resides in the skin and vessels, it is easy to treat. If Bi (Obstruction Syndrome) enters the Zang organs after a long duration and the Zang Qi (Visceral Qi) is deficient, death ensues; if the Zang Qi is solid and rejects the pathogen, returning to the exterior, life can be preserved.
[Note] When Bi (Obstruction Syndrome) is in the sinews and bones, the pathogenic invasion is deep, so the pain persists and is hard to cure. When Bi (Obstruction Syndrome) is in the skin and vessels, the pathogenic invasion is superficial, so it is easy to treat. Generally, if Bi (Obstruction Syndrome) lingers for a long time and transmits internally to its corresponding Zang organ, it becomes Zang Bi (Visceral Obstruction). If the person has deficient Zang Qi and accepts the pathogen, it is difficult to treat and often fatal; if the person has solid Zang Qi that rejects the pathogen, causing it to return outward, it is easy to treat and often curable. For example, if chronic Pi Bi (Skin Obstruction) is re-exposed to pathogens and should transmit internally to the Lung to form Fei Bi (Lung Obstruction), but there are no symptoms of chest fullness, irritability, wheezing, and coughing, this indicates solid Zang Qi rejecting the pathogen. The same applies to other Zang organs.

4. Fei Bi (Lung Obstruction) presents with irritability, chest fullness, wheezing, and coughing; Shen Bi (Kidney Obstruction) presents with abdominal distension, inability to extend the legs (sitting on the buttocks as if replacing the heels), and spinal curvature (stooping forward); Pi Bi (Spleen Obstruction) presents with vomiting, epigastric stuffiness and hardness, and flaccidity and drooping of the limbs; Xin Bi (Heart Obstruction) presents with mental restlessness, palpitations, belching, and occasional fear; Gan Bi (Liver Obstruction) presents with excessive thirst, frequent urination, night terrors during sleep, and sighing; Chang Bi (Intestinal Obstruction) presents with alternating constipation and diarrhea, and abdominal distension; Bao Bi (Bladder Obstruction) presents with urinary retention, pain in the lower abdomen feeling like hot water pouring, and clear nasal discharge; San Jiao (Triple Burner), Stomach, and Gallbladder do not suffer from Bi (Obstruction).
[Note] If chronic Pi Bi (Skin Obstruction) is re-exposed to pathogens, presenting with chest fullness, irritability, wheezing, and coughing, the pathogen has transmitted internally to the Lung, forming Fei Bi (Lung Obstruction). If chronic Gu Bi (Bone Obstruction) is re-exposed to pathogens, presenting with abdominal distension, inability to extend the legs, spinal curvature, and stooping, the pathogen has transmitted internally to the Kidney, forming Shen Bi (Kidney Obstruction). If chronic Ji Bi (Muscle Obstruction) is re-exposed to pathogens, presenting with vomiting of saliva, epigastric stuffiness and hardness, and flaccidity of the limbs, the pathogen has transmitted internally to the Spleen, forming Pi Bi (Spleen Obstruction). If chronic Mai Bi (Vessel Obstruction) is re-exposed to pathogens, presenting with mental restlessness, palpitations, dry throat, belching, and occasional fear, the pathogen has transmitted internally to the Heart, forming Xin Bi (Heart Obstruction). If chronic Jin Bi (Sinew Obstruction) is re-exposed to pathogens, presenting with excessive thirst, frequent urination, night terrors, and sighing, the pathogen has transmitted internally to the Liver, forming Gan Bi (Liver Obstruction). If chronic Bi (Obstruction) persists and is re-exposed to pathogens, and the Zang Qi is solid rejecting the pathogen which then transmits to the Fu organs, presenting with excessive thirst, urinary retention, and alternating bloating and diarrhea, the pathogen has transmitted internally to the Large and Small Intestines, forming Chang Bi (Intestinal Obstruction). If presenting with pain in the lower abdomen and bladder area, feeling like hot water pouring upon pressure, urinary retention and difficulty, and clear nasal discharge, the pathogen has transmitted internally to the Bladder, forming Bao Bi (Bladder Obstruction). San Jiao (Triple Burner) Bi (Obstruction) attaches to the Bladder, following the water passages. Stomach Bi (Obstruction) attaches to the Large and Small Intestines, following the transmission and transformation functions. The Gallbladder is a pure and clear Fu organ and does not accept Bi (Obstruction) pathogens, hence "no worry."
Xiaoxuming Decoction (Minor Continuation Life Decoction), Zengwei Wubi Tang (Modified Five-Obstruction Decoction)

5. For deficiency-type Bi (Obstruction), use Jiajian Xiaoxuming Tang (Modified Minor Continuation Life Decoction); for excess-type Bi (Obstruction), use Zengwei Wubi Tang (Modified Five-Obstruction Decoction). Ingredients include Ephedrae Herba (Mahuang), Cinnamomi Ramulus (Guizhi), Carthami Flos (Honghua), Angelicae Dahuricae Radix (Baizhi), Puerariae Lobatae Radix (Gegen), Aconiti Lateralis Radix Preparata (Fuzi), Ossis Tigridis (Hugu), Cornu Saigae Tataricae (Lingyangjiao), Astragali Membranacei Radix (Huangqi), Glycyrrhizae Radix et Rhizoma (Gancao), Saposhnikoviae Radix (Fangfeng), Stephaniae Tetrandrae Radix (Fangji), and Notopterygii Rhizoma et Radix (Qianghuo).
[Note] Deficiency-type Bi (Obstruction) refers to various Bi syndromes occurring in persons with Qi deficiency. One should use Jiajian Xiaoxuming Tang (Modified Minor Continuation Life Decoction): for Wind-Bi (Moving Obstruction) where wind is predominant, double the dose of Fangfeng; for Cold-Bi (Painful Obstruction) where cold is predominant, double the dose of Fuzi; for Damp-Bi (Fixed Obstruction) where dampness is predominant, double the dose of Fangji; for Pi Bi (Skin Obstruction), add Huangqi or Guizhi; for Mai Bi (Vessel Obstruction), add Jianghuang or Honghua; for Ji Bi (Muscle Obstruction), add Gegen or Baizhi; for Jin Bi (Sinew Obstruction), add Lingyangjiao or Xuduan; for Gu Bi (Bone Obstruction), add Hugu or Gouji. Reduce Mahuang if sweating is present; reduce Fangji if stools are loose; reduce Huangqin and add Ganjiang if cold is predominant; reduce Fuzi and add Shigao if heat is predominant, adjusting accordingly. Excess-type Bi (Obstruction) refers to various Bi syndromes occurring in persons with excess Qi and Blood. One should use Zengwei Wubi Tang (Modified Five-Obstruction Decoction), composed of Mahuang, Guizhi, Honghua, Baizhi, Gegen, Fuzi, Hugu, Lingyangjiao, Huangqi, Gancao, Fangfeng, Fangji, and Qianghuo. For Wind-Bi (Moving Obstruction), Qianghuo and Fangfeng are principal herbs; for Cold-Bi (Painful Obstruction), Mahuang and Fuzi are principal herbs; for Damp-Bi (Fixed Obstruction), Fangji and Qianghuo are principal herbs; for Pi Bi (Skin Obstruction), Huangqi and Guizhi Pi are principal herbs; for Mai Bi (Vessel Obstruction), Honghua and Guizhi are principal herbs; for Ji Bi (Muscle Obstruction), Gegen and Baizhi are principal herbs; for Jin Bi (Sinew Obstruction), Lingyangjiao is the principal herb; for Gu Bi (Bone Obstruction), Hugu is the principal herb. These are added to the standard treatments for the Five Obstructions.
Mutong Tang (Akebia Decoction), Fuzi Wuling San (Aconite Five-Ling Powder), Cangzhu Wuling San (Atractylodes Macrocephala Five-Ling Powder)

6. For Three Bi (Three Types of Obstruction), use Mutong Tang decocted with long-flowing water; add Fangji for dampness, Qianghuo and Fangfeng for wind; for Cold-Bi, use Fuzi or Mahuang to induce sweating; for Bao Bi and Chang Bi, use Wuling San with Fuzi or Cangzhu respectively.
[Note] Three Bi refers to Wind-Bi (Moving Obstruction), Cold-Bi (Painful Obstruction), and Damp-Bi (Fixed Obstruction). Use single-herb Mutong Tang: two liang of Mutong (without visible moisture), decocted in two bowls of long-flowing water until one bowl remains, taken hot to induce slight sweating. If ineffective, take again until cured. If pain migrates up/down/left/right, add Qianghuo and Fangfeng to dispel wind. If pain is severe, add Fuzi if sweating is present, or Mahuang if no sweating, to dispel cold. If pain is heavy and fixed, add Fangji to overcome dampness. Added herbs should not exceed three qian; reduce dosage by half for weak patients. For Bao Bi (Bladder Obstruction), use Wuling San with Fuzi; for Chang Bi (Intestinal Obstruction), use Wuling San with Cangzhu, to drain cold-fluid retention. See Shanghan Lun section for Wuling San formula.
Sanbi Tang (Three-Obstruction Decoction), Duhuo Jisheng Tang (Angelica Pubescens and Sangjisheng Decoction)

7. Sanbi Tang is derived from Shiquan Dabu Tang (Ten Complete Tonifying Decoction) minus Baizhu, plus Niuxi, Qinjiao, Xuduan, Duzhong, Xixin, Duhuo, and Fangfeng. Duhuo Jisheng Tang is based on Sanbi Tang, adding Sangjisheng, and removing Huangqi and Xuduan. These formulas treat persistent Five Obstructions that penetrate the Zang organs due to deficiency and linger for a long time, serving as formulas for regulating Bi syndrome.
[Note] "Sanbi" refers to Sanbi Tang, which is Shiquan Dabu Tang (Ten Complete Tonifying Decoction) minus Baizhu, plus Niuxi, Qinjiao, Xuduan, Duzhong, Xixin, Duhuo, and Fangfeng. "Duhuo" refers to Duhuo Jisheng Tang, which is based on Sanbi Tang, adding Sangjisheng, and removing Huangqi and Xuduan. These all treat Five Obstructions that persist, penetrate the Zang organs due to deficiency, and linger for a long time; they are formulas for managing Bi syndrome.
Huangqi Yiqi Tang (Astragalus Qi-Supplementing Decoction)

8. Huangqi Yiqi Tang treats Pi Bi (Skin Obstruction) caused by Qi deficiency, manifesting as numbness in the skin with insensitivity to itch and pain. It is Buzhong Yiqi Tang (Middle-Supplementing Qi-Tonifying Decoction) plus Honghua and Huangbai, with Wuweizi added in autumn, Huangqin in summer, and Guizhi Pi in winter.
[Note] Numbness due to Qi excess is treated with Xiaoxuming Tang (Minor Continuation Life Decoction) plus Mahuang. Numbness due to Qi deficiency is treated with Huangqi Yiqi Tang (Astragalus Qi-Supplementing Decoction), which is Buzhong Yiqi Tang (Middle-Supplementing Qi-Tonifying Decoction) plus Honghua and Huangbai. Add Wuweizi in autumn, Huangqin in summer, and Guizhi Pi in winter.
Juanbi Tang (Expelling Obstruction Decoction), Jiawei Shengyang Sanhuo Tang (Modified Raising Yang and Dispersing Fire Decoction)

9. Juanbi Tang treats Leng Bi (Cold Obstruction) with symptoms of body coldness and cold extremities; ingredients include Fuzi, Danggui, Huangqi, Zhi Cao, Guizhi, Qianghuo, and Fangfeng. Re Bi (Heat Obstruction) is characterized by muscle heat like fire and is treated with Jiawei Shengyang Sanhuo Tang (Modified Raising Yang and Dispersing Fire Decoction) containing Lingyangjiao and Xijiao.
[Note] Juanbi Tang consists of Fuzi, Danggui, Huangqi, Zhi Cao, Guizhi, Qianghuo, and Fangfeng. It treats Bi syndrome with body coldness, absence of fever, and cold extremities, named Leng Bi (Cold Obstruction). Jiawei Shengyang Sanhuo Tang (Modified Raising Yang and Dispersing Fire Decoction) is the Shengyang Sanhuo Tang from the Internal Injury section plus Lingyangjiao and Xijiao. It treats Bi syndrome with muscle heat like fire, named Re Bi (Heat Obstruction).