血痹者饮酒过多。怀热太盛。或寒折于经络。或湿犯于荣卫。因而血抟。遂成其咎。故使人血不能荣于外。
气不能养于内。内外已失。渐渐消削。左先枯则右不能举。右先枯则左不能伸。上先枯则上不能制于下。
下先枯则下不能克于上。中先枯则不能通疏。百证千状皆失血也。其脉。左手寸口脉结而不流利，或如
断绝者。是也。
肉痹者。饮食不节。膏粱肥美之所为也。脾者肉之本。脾气已失。则肉不荣。肉不荣则肌肤不滑泽。肌肉不
滑泽。则腠理疏。则风寒暑湿之邪易为入。故久不治则为肉痹也。肉痹之状。其先能食而不能充悦。四肢
缓而不收持者。是也。其右关脉举按皆无力。而往来涩者是也。宜节饮食以调其脏。常起居以安其脾。然
后根据经补泻以求其愈尔。
筋痹者。由怒叫无时。行步奔急。淫邪伤肝。肝失其气。因而寒热所客。久而不去。流入筋会。则使人筋急。而
不能行步舒缓也。故曰筋痹。宜活血以补肝。温气以养肾。然后服饵汤丸。治得其宜。即疾瘳已。不然则害
人矣。其脉。左关中弦急而数。浮沉有力者。是也。
骨痹者乃嗜欲不节。伤于肾也。肾气内消。则不能关禁。不能关禁。则中上俱乱。中上俱乱。则三焦之气痞
而不通。三焦痞而饮食不糟粕。饮食不糟粕。则精气日衰。精气日衰。则邪气妄入。邪气妄入。则上冲心舌。
上冲心舌。则为不语。中犯脾胃。则为不充。下流腰膝。则为不遂。傍攻四肢。则为不仁。寒在中则脉迟。热在
中则脉数。风在中则脉浮。湿在中则脉濡。虚在中则脉滑。其证不一。要在详明。治疗法列于后章。
Blood Bi (Blood Stasis Obstruction) arises from excessive alcohol consumption, leading to an excess of internal heat. It may also result from cold pathogenic factors damaging the meridians or dampness invading the Ying and Wei levels. Consequently, blood becomes stagnant, giving rise to this condition. Thus, blood fails to nourish the exterior, and Qi fails to nourish the interior. With both interior and exterior losing their nourishment, the body gradually emaciates. If the left side becomes withered first, the right side cannot be lifted; if the right side becomes withered first, the left side cannot extend; if the upper part becomes withered first, it cannot control the lower part; if the lower part becomes withered first, it cannot support the upper part; if the middle part becomes withered first, the Qi mechanism fails to circulate freely. Various symptoms manifesting in thousands of forms all stem from blood loss or blood dysfunction. The pulse is characterized by: at the Cun Kou position on the left hand, the pulse is knotted and unsmooth, or appears as if interrupted. This indicates Blood Bi.
Flesh Bi (Muscle Obstruction) is caused by irregular diet, specifically the overconsumption of rich and fatty foods. The Spleen is the root of the flesh. When Spleen Qi is impaired, the flesh loses its nourishment. When the flesh is not nourished, the skin and muscles become rough and lack luster. When the skin and muscles are not smooth and lustrous, the Cou Li (pores and interstices) become loose, making it easy for Wind, Cold, Summer-heat, and Dampness pathogens to invade. Therefore, if left untreated for a long time, it develops into Flesh Bi. The manifestation of Flesh Bi includes: initially being able to eat but lacking physical fullness and vitality, and having flaccid limbs that cannot maintain posture or control movement. This is Flesh Bi. The pulse is characterized by: at the Guan position on the right hand, the pulse is weak upon both lifting and pressing, and flows sluggishly. This indicates Flesh Bi. One should regulate the diet to harmonize the Zang-Fu organs and maintain regular daily routines to soothe the Spleen. Subsequently, treatment should follow the meridians using tonification and sedation methods to seek recovery.
Tendon Bi (Sinew Obstruction) results from uncontrolled anger and shouting, rapid walking or running, and pernicious influences injuring the Liver. When Liver Qi is lost or impaired, Cold and Heat pathogens may lodge within. If these persist for a long time without departing, they flow into the gathering points of the tendons, causing tendon tightness and preventing smooth, leisurely walking. Hence, it is called Tendon Bi. Treatment should involve activating blood circulation to tonify the Liver and warming Qi to nourish the Kidney. Thereafter, administering decoctions or pills appropriately will lead to recovery. Otherwise, it will harm the patient. The pulse is characterized by: at the Guan position on the left hand, the pulse is wiry, rapid, and forceful upon both superficial and deep palpation. This indicates Tendon Bi.
Bone Bi (Bone Obstruction) arises from immoderate desires, which injure the Kidneys. When Kidney Qi dissipates internally, it fails to secure the gates and controls. Failure to secure the gates leads to disorder in both the Middle and Upper Jiao. Disorder in the Middle and Upper Jiao causes Qi stagnation and blockage in the San Jiao (Triple Burner). When the San Jiao is blocked, food and drink fail to separate into clear and turbid parts. Failure to process food properly leads to a daily decline of Essence and Qi. As Essence and Qi decline daily, pathogenic factors intrude recklessly. When pathogenic factors intrude recklessly, they rush upward to attack the Heart and Tongue, resulting in aphasia (inability to speak); they invade the Middle Jiao affecting the Spleen and Stomach, resulting in lack of physical fullness; they flow downward to the waist and knees, resulting in paralysis or inability to move freely; and they attack the four limbs laterally, resulting in anesthesia or numbness. Cold in the Middle Jiao presents with a slow pulse; Heat in the Middle Jiao presents with a rapid pulse; Wind in the Middle Jiao presents with a floating pulse; Dampness in the Middle Jiao presents with a soggy pulse; Deficiency in the Middle Jiao presents with a slippery pulse. The syndromes vary, so careful differentiation is essential. The treatment methods are listed in the following chapter.