痹之为证，有筋挛不伸、肌肉不仁，与风证相似。故世俗多类于风痿痹之证混同通
治，此千古之弊也。大抵固当分其所因。风则阳受之。痹为风寒湿所感，则阴受之，为病
多重着沉痛。痿因血少气虚，火盛克金，肺叶燥枯，宗筋不润，肝木乘胜，脾土受伤，饮
食少，四肢倦，为精血虚耗，故筋骨痿而不用。治宜润燥、养血、滋阴，非若痹之气血凝
滞，留而不行，或痛而手足为之麻木不仁，治以行气胜湿为主。三证虽大略相似，而所
以施治迥然不同。执事者其辨诸。
痹因虚而感风寒湿之邪气，有在肌肤血脉浅深之异。入腑者，多死。昔人经论虽详，
而方未尽其变。今悉考证区别，具眼者识之。
《脉经》曰∶肺涩而紧者为痹痛。严氏曰∶其脉大而涩为痹，脉来急亦为痹。寸口关上
脉紧宜针，引阳气，令脉和，紧去则愈。
（《济生》）五痹汤 治风寒湿三气客留肌体，手足缓，麻痹不仁。
羌活 白术 防己 片姜黄（各一钱） 甘草（一钱）
水盏半，姜五片，煎八分，食前服。
（《济生》）蠲痹汤 治手足冷痹，腰痛沉重及身体烦痛，背项拘急。
当归（酒浸） 赤芍药 黄 片姜黄 羌活（各二钱） 甘草（五分）
上水盏半、姜五片、红枣一枚，煎八分，不拘时服。一方加防风。
三痹汤 治血气凝滞，手足拘挛，风痹等疾皆治。
人参 黄 当归 川芎 白芍药 生地黄 杜仲（姜汁炒） 川续断 防风
桂心 细辛 白茯苓 秦艽 川 牛膝 川独活 甘草（各等分）
上水三盏、生姜三片、枣一枚，煎五分，不拘时服。
活络丹 治风湿痹痛、诸药不效。
白术 当归 羌活 独活 川芎（各一钱） 甘草（五分）
水盏半，姜五片，煎七分服。
舒经汤 治气血凝滞，经络不行，臂痛不可忍。
羌活 白术 当归（各一钱） 片姜黄（二钱） 甘草 赤芍药（五分） 海桐皮（
一钱）
上水煎服。
乌药顺气散（方见风门） 治五痹。
乳香定痛丸 治诸痹，风湿流注，骨节疼痛麻痹。
苍术（五两，米坩浸） 五灵脂（二两） 草乌（五两，去皮） 自然铜（二两，火
醋淬） 乳香（两半） 没药 羌活 当归尾（各一两） 两头尖（去皮生用，五钱）
上为末，酒糊丸，小豆大。每服十五丸至二十丸，温酒下。
仙传史国公浸酒方 治诸风五痹，左瘫右痪，口眼 斜，四肢疼痛，七十二般风，二十
四般气，其效不可尽述。
当归 虎胫骨（酥油炙） 川羌活 川萆 防风（各二两） 秦艽（四两） 鳖甲（一
两，醋炙） 川牛膝（酒浸） 松节 晚蚕砂（炒。各二两） 枸杞子（五两） 干茄根（八
两，饭上蒸熟） 苍耳子（四两，炒捶碎） 一方加白花蛇一条，一方加寻风藤二两。
上十四味用无灰酒一大坛，将绢袋盛药悬于酒内，密封固，候十四日后，开坛取酒。
取酒时不可面对坛口，恐药气冲人面目。每饮一盏，毋令药力断绝，饮尽病痊。将药渣晒
为末，米糊丸，梧桐子大。每服八十丸，空心温酒下。忌食动风辛热之物。此药可以常服。
五加皮浸酒方 治一切风湿相搏，腰腿疼痛，并风痹，四肢挛急，皮肤搔痒，大补五劳
七伤，和气生血，久服神效。
五加皮（五两） 南木香（二两）
上为粗末，用生绢袋盛之，以好酒一坛浸，用 裹封口，入锅内煮一时，取出浸二七
日，开坛。空心临卧随意饮二杯。
黄 酒 治风湿痹。身体顽麻，皮肤搔痒，筋脉拘急，言语謇涩。
黄 防风 天麻 官桂 当归 白术 虎骨 云母粉 木香 仙灵皮 甘草（炙） 茵
子叶 白芍药 川续断 萆 石斛（去根各一两）
上用绢袋盛，以好酒一升浸之，春五、夏二、秋七、冬十日。每服一盏，温暖服之，
常令酒气相续为佳。
万病无忧酒除百病，理风湿，乌须发，健腰膝，快脾胃，进饮食，治伤损，补虚怯，
消积滞，滋血养气，明目清心。
防风 白芷 五灵脂 川牛膝 台芎 荆芥穗 甘草 天台乌药 八角茴香 木瓜 地
骨皮（各一两） 乳香 没药 南木香 羌活（各五钱） 赤芍药（二两） 五加皮（两半）
故纸（炒） 自然铜（制） 威灵仙（各二两） 当归（二两） 紫荆皮 杜
仲（制。各半两） 黑小豆（二两，炒，去皮）
上 咀，生绢袋盛之，以无灰酒一大坛，入药在内，密封坛口。春秋浸五日，夏
三日，冬十日后开坛取酒，温饮之。或晨昏午后随量常饮不绝。去风活血和气，大有神效。
秘传药酒方 治男子妇人风湿相搏，腰膝痛，或因坐卧湿地，雨露所袭，遍身骨节痛，
风湿香港脚，并皆治之。
麻黄 白芷 桔梗 芍药 当归 川芎 肉桂 半夏 防己 甘草（各一两） 陈皮
浓朴 枳壳 乌药（各二两） 苍术 槟榔（两半） 川牛膝（二两） 川木瓜 独活（
各两半） 杜仲（制，二两）
上锉粗末，以绢袋盛之，用无灰酒三斗浸于坛内，密封坛口，锅内重汤煮一时，然后取
出，过三日开，取酒饮之，量饮，一日三次。渣晒干为末，酒糊丸，梧桐子大。每服七十
丸，空心酒下。
Bi syndrome is a condition characterized by tendon spasms with inability to extend, and muscle insensibility, resembling wind disorders. Therefore, laypeople often confuse wind, flaccidity (Wei), and Bi syndromes, treating them indiscriminately; this has been a malpractice for millennia. Generally, one must distinguish the etiology. Wind pathogens affect the Yang aspects. Bi syndrome is caused by the invasion of cold, wind, and dampness, affecting the Yin aspects, presenting as heaviness and severe pain. Flaccidity syndrome arises from blood deficiency and Qi deficiency, with excessive fire controlling Metal (Lung), causing the Lung lobes to become dry and withered. The Zong Jin (tendons) lose moisture, Liver Wood overacts due to dominance, and Spleen Earth is injured, leading to poor appetite, limb fatigue, and depletion of essence and blood, resulting in flaccid sinews and bones that cannot function. Treatment should focus on moistening dryness, nourishing blood, and yin-nourishing, unlike Bi syndrome where Qi and blood are stagnant and lodged, or painful with numbness in limbs, which requires treatment primarily to move Qi and overcome dampness. Although these three conditions are roughly similar, their treatments are radically different. Practitioners must differentiate them carefully.
Bi syndrome occurs when deficiency allows the invasion of cold, wind, and dampness pathogens, varying in depth within the skin, muscles, vessels, and channels. If pathogens enter the Fu organs, death is likely. Although ancient classics detailed the meridians, formulas did not exhaust all variations. Now, having thoroughly investigated and distinguished them, let those with insight recognize this.
The *Mai Jing* (Pulse Classic) states: A pulse that is choppy and tight indicates Bi pain. Yan Shi said: A large and choppy pulse indicates Bi; a rapid pulse also indicates Bi. Tight pulses at the Cun (inch) and Guan (bar) positions are suitable for acupuncture to guide Yang Qi, harmonizing the pulse; when the tightness disappears, recovery ensues.
*(From "Ji Sheng Fang") Wu Bi Tang (Five Bi Decoction)* Treats cold, wind, and dampness lodging in the body, causing limpness of hands and feet, and numbness/insensibility.
Qiang Huo (Notopterygii Rhizoma et Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fang Ji (Stephaniae Tetrandrae Radix), Pian Jiang Huang (Curcumae Longae Rhizoma) (each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 qian).
Add 1.5 cups of water and 5 slices of ginger, decoct to 0.8 cup, take before meals.
*(From "Ji Sheng Fang") Juan Bi Tang (Expel Bi Decoction)* Treats cold Bi of hands and feet, heavy lower back pain, general body pain, and stiffness of the back and neck.
Dang Gui (Angelicae Sinensis Radix, soaked in wine), Chi Shao Yao (Paeoniae Radix Rubra), Huang Qi (Astragali Radix), Pian Jiang Huang (Curcumae Longae Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix) (each 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.5 qian).
Add 1.5 cups of water, 5 slices of ginger, and 1 red date, decoct to 0.8 cup, take at any time. Another formula adds Fang Feng (Saposhnikoviae Radix).
San Bi Tang (Three Bi Decoction)* Treats stagnation of Qi and blood, spasm of hands and feet, and various wind-Bi diseases.
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Bai Shao Yao (Paeoniae Radix Alba), Sheng Di Huang (Rehmanniae Radix), Du Zhong (Eucommiae Cortex, stir-fried with ginger juice), Chuan Xu Duan (Dipsaci Radix), Fang Feng (Saposhnikoviae Radix), Gui Xin (Cinnamomi Ramulus), Xi Xin (Asari Radix et Rhizoma), Bai Fu Ling (Poria), Qin Jiao (Gentianae Macrophyllae Radix), Chuan Niu Xi (Cyathulae Radix), Chuan Du Huo (Angelicae Pubescentis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Add 3 cups of water, 3 slices of fresh ginger, and 1 date, decoct to 0.5 cup, take at any time.
Huo Luo Dan (Activate Collaterals Pill)* Treats wind-damp Bi pain when other medicines fail.
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Chuan Xiong (Chuanxiong Rhizoma) (each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.5 qian).
Add 1.5 cups of water and 5 slices of ginger, decoct to 0.7 cup, take.
Shu Jing Tang (Relax Meridians Decoction)* Treats stagnation of Qi and blood, obstruction of collaterals, and unbearable arm pain.
Qiang Huo (Notopterygii Rhizoma et Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix) (each 1 qian), Pian Jiang Huang (Curcumae Longae Rhizoma) (2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chi Shao Yao (Paeoniae Radix Rubra) (each 0.5 qian), Hai Tong Pi (Cryptocarya Alatae Cortex) (1 qian).
Decoct with water and take.
Wu Yao Shun Qi San (May Apple Regulate Qi Powder) (See Wind Section for formula)* Treats Five Bi.
Ru Xiang Ding Tong Wan (Frankincense Pain-Relieving Pill)* Treats various Bi syndromes, flowing wind-damp, bone joint pain, and numbness.
Cang Zhu (Atractylodis Rhizoma, 5 liang, soaked in rice wash), Wu Ling Zhi (Trogopterori Faeces, 2 liang), Cao Wu (Aconiti Kusnezoffii Radix, 5 liang, peeled), Zi Ran Tong (Pyritum, 2 liang, quenched in vinegar with fire), Ru Xiang (Olibanum, 1.5 liang), Mo Yao (Myrrha), Qiang Huo (Notopterygii Rhizoma et Radix), Dang Gui Wei (Angelicae Sinensis Radix tail, each 1 liang), Liang Tou Jian (Lycopodii Herba, peeled and raw, 5 qian).
Grind into powder, make pills with wine paste, size of adzuki beans. Take 15–20 pills per dose with warm wine.
Xian Chuan Shi Guo Gong Jin Jiu Formula (Immortal Transmitted Duke Shi’s Infused Wine)* Treats various winds and Five Bi, left hemiplegia, right paralysis, deviation of mouth and eyes, limb pain, seventy-two types of wind, twenty-four types of qi; effects are too numerous to recount.
Dang Gui (Angelicae Sinensis Radix), Hu Jing Gu (Pantheris Os, roasted with lard oil), Chuan Qiang Huo (Notopterygii Rhizoma et Radix), Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Fang Feng (Saposhnikoviae Radix) (each 2 liang), Qin Jiao (Gentianae Macrophyllae Radix) (4 liang), Bie Jia (Testudinis Carapax et Plastrum, roasted with vinegar, 1 liang), Chuan Niu Xi (Cyathulae Radix, soaked in wine), Song Jie (Pinus Resina), Wan Can Sha (Bombyx Batryticatus, fried, each 2 liang), Gou Qi Zi (Lycii Fructus) (5 liang), Gan Qie Gen (Solanis Lycopersici Radix, steamed over rice, 8 liang), Cang Er Zi (Xanthii Fructus, fried and crushed, 4 liang). Another version adds 1 Bai Hua She (Bungarus multicinctus), another adds 2 liang Xun Feng Teng (Vitis Vinefera Caulis).
Place the above fourteen herbs in a large jar of pure wine, suspend the herb bag in the wine, seal tightly, wait 14 days, then open and take the wine. When taking, do not face the jar opening to avoid inhaling strong fumes. Drink one cup per dose, ensuring continuous medicinal effect until cured. Dry the dregs, grind to powder, make pills with rice paste, size of sophora seeds. Take 80 pills per dose with warm wine on an empty stomach. Avoid spicy, heating, and wind-aggravating foods. This medicine can be taken regularly.
Wu Jia Pi Jin Jiu Formula (Acanthopanacis Cortex Infused Wine)* Treats all wind-damp clashing, waist and leg pain, wind-Bi, limb spasms, skin itching, greatly tonifying five labors and seven injuries, harmonizing Qi and generating blood, with miraculous effects after long-term use.
Wu Jia Pi (Acanthopanacis Cortex, 5 liang), Nan Mu Xiang (Aucklandiae Radix, 2 liang).
Grind to coarse powder, place in a raw silk bag, soak in one jar of good wine, wrap and seal, boil in a pot for one shichen (2 hours), remove and steep for 14 days, then open. Drink two cups freely on an empty stomach and before bed.
Huang Qi Jiu (Astragalus Wine)* Treats wind-damp Bi, body numbness, skin itching, tendon spasms, and slurred speech.
Huang Qi (Astragali Radix), Fang Feng (Saposhnikoviae Radix), Tian Ma (Gastrodiae Rhizoma), Guan Gui (Cinnamomi Ramulus), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Hu Gu (Pantheris Os), Yun Mu Fen (Muscovite), Mu Xiang (Aucklandiae Radix), Xian Ling Pi (Epimedii Folium), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted), Yin Zi Ye (Ilicis Cornutae Folium), Bai Shao Yao (Paeoniae Radix Alba), Chuan Xu Duan (Dipsaci Radix), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Shi Hu (Dendrobii Caulis, roots removed, each 1 liang).
Place in a silk bag, soak in one sheng (approx. 200ml) of good wine. Spring: 5 days, Summer: 2 days, Autumn: 7 days, Winter: 10 days. Take one cup per dose, warm. It is best to maintain a continuous sensation of wine warmth.
Wan Bing Wu You Jiu (Ten Thousand Diseases Worries-Free Wine)* Eliminates hundred diseases, regulates wind-damp, blackens beard/hair, strengthens waist/knees, benefits spleen/stomach, promotes appetite, treats trauma, tonifies deficiency, resolves accumulation, nourishes blood/Qi, brightens eyes/clears heart.
Fang Feng (Saposhnikoviae Radix), Bai Zhi (Angelicae Dahuricae Radix), Wu Ling Zhi (Trogopterori Faeces), Chuan Niu Xi (Cyathulae Radix), Tai Xiong (Ligusticum Chuanxiong Rhizoma), Jing Jie Sui (Schizonepetae Spica), Gan Cao (Glycyrrhizae Radix et Rhizoma), Tian Tai Wu Yao (Illicii Mesnyi Fructus), Ba Jiao Hui Xiang (Illicii Veri Fructus), Mu Gua (Chaenomelis Fructus), Di Gu Pi (Lycii Cortex, each 1 liang), Ru Xiang (Olibanum), Mo Yao (Myrrha), Nan Mu Xiang (Aucklandiae Radix), Qiang Huo (Notopterygii Rhizoma et Radix) (each 5 qian), Chi Shao Yao (Paeoniae Radix Rubra) (2 liang), Wu Jia Pi (Acanthodis Cortex, 1.5 liang), Gu Zhi (Psoraleae Fructus, fried), Zi Ran Tong (Pyritum, processed), Wei Ling Xian (Clematidis Radix et Rhizoma) (each 2 liang), Dang Gui (Angelicae Sinensis Radix) (2 liang), Zi Jing Pi (Broussonetiae Cortex), Du Zhong (Eucommiae Cortex, processed, each 0.5 liang), Hei Xiao Dou (Sojae Semen Nigrum, fried, peeled, 2 liang).
Crush, place in a raw silk bag, put in a large jar of pure wine, seal tightly. Steep 5 days in spring/autumn, 3 days in summer, 10 days in winter, then open and take warm. Drink continuously morning/evening/afternoon as desired. Disperses wind, invigorates blood, harmonizes Qi, with great efficacy.
Secret Prescribed Medicinal Wine Formula* Treats men and women with wind-damp clashing, waist/knee pain, or pain from sitting/sleeping on damp ground, exposure to rain/dew, generalized joint pain, wind-damp jiaoqi (foot weakness), all treated hereby.
Ma Huang (Ephedrae Herba), Bai Zhi (Angelicae Dahuricae Radix), Jie Geng (Platycodonis Radix), Shao Yao (Paeoniae Radix), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Rou Gui (Cinnamomi Cortex), Ban Xia (Pinelliae Rhizoma), Fang Ji (Stephaniae Tetrandrae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 1 liang), Chen Pi (Citri Reticulatae Pericarpium), Hou Po (Magnoliae Officinalis Cortex), Zhi Ke (Aurantii Fructus Immaturus), Wu Yao (Linderae Radix) (each 2 liang), Cang Zhu (Atractylodis Rhizoma), Bing Lang (Arecae Semen, 1.5 liang), Chuan Niu Xi (Cyathulae Radix) (2 liang), Chuan Mu Gua (Chaenomelis Fructus), Du Huo (Angelicae Pubescentis Radix) (each 1.5 liang), Du Zhong (Eucommiae Cortex, processed, 2 liang).
Cut into coarse pieces, place in a silk bag, soak in 3 dou (approx. 6 liters) of pure wine in a jar, seal tightly, boil in a double boiler for one shichen (2 hours), remove, wait 3 days, then open and drink. Drink moderately, three times daily. Dry dregs, grind to powder, make pills with wine paste, size of sophora seeds. Take 70 pills per dose with wine on an empty stomach.