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(One treatise, one formula, two moxibustion methods)

The treatise states: Guji (Bone Extremity Syndrome) is primarily governed by the Kidney. The Kidney corresponds to the bones, and the bones harmonize with the Kidney. It is also said that contracting disease in winter is termed Gubi (Bone Bi Syndrome). If Gubi persists and is not cured, subsequent exposure to pathogenic factors allows the evil to enter internally and reside in the Kidney. Tinnitus and a blackish complexion are its signs. If Kidney disease leads to Guji, there is severe toothache, pain in the hands and feet, inability to stand for long periods, difficulty in flexion and extension, body numbness, and soreness of the brain marrow. If wind pathogens injure the Kidney on Ren or Gui days in winter, it is called Shenfeng (Kidney Wind). Since wind traverses the bones, it is termed Guji. If Yin qi is deficient, deficiency generates cold; cold causes facial edema and a dull, blackish complexion, lumbar and spinal pain preventing prolonged standing, and difficulty in flexion and extension. When Qi declines, hair falls out and teeth become dry; the waist and back pull each other in pain, and severe pain leads to severe coughing and expectoration. If Yang qi is excessive, excess generates heat; heat causes a reddish complexion hidden beneath the skin, bladder dysfunction leading to urinary retention, severe pain in the teeth and brain marrow, numbness or spasms in the hands and feet, tinnitus, and a blackish complexion. This represents the extreme stage of Guji. One must carefully distinguish Yin and Yang, examine the clarity and turbidity of Qi and Blood, know the distribution of the pathology, and observe breathing. A skilled healer begins treatment at the level of the skin and sinews, treating them promptly. If the pathogen enters the Zang-Fu organs, half of the patients will die.

Bian Que said: Gujue (Bone Exhaustion) is incurable. The patient experiences extreme pain, cannot extend or flex the body, and dies within ten days. Bones correspond to the Foot-Shaoyin (Kidney) channel. When the Qi of Shaoyin exhausts, the bones wither. Hair loses luster, indicating that the Qi of the bones has died first.

To treat Guji, specifically for Kidney Heat Disease presenting with bladder dysfunction, blockage of urination and defecation, a scorched and blackish face, tinnitus, and deficiency-heat, use the following formula:

Dahuang (Rhubarb Root), sliced and separately soaked in one sheng of water; Huangqin (Scutellaria Root), three liang; Zhizi (Gardenia Fruit), fourteen pieces; Gancao (Licorice Root), one liang; Mangxiao (Mirabilite), two liang.

Crush the above five herbs into coarse powder. Use four sheng of water. First decoct Huangqin, Zhizi, and Gancao until one sheng and five he remain. Strain out the dregs. Add Dahuang and boil for two more boils. Then add Mangxiao. Divide into three doses.

For symptoms of stiffness and inconvenience in the waist and back, sinew contraction and bi-numbness, and blockage due to deficiency-heat, apply moxibustion to the second-one vertebra (Th14 paravertebral area), 1.5 cun lateral to the midline on both sides. The number of moxa cones should correspond to the patient's age (Sui Nian Zhuang).

For difficulty in urination, abdominal distension and fullness accompanied by deficiency and fatigue, apply moxibustion to Xiaochangshu (BL27). The number of moxa cones should correspond to the patient's age (Sui Nian Zhuang).