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The *Ling Shu* (Spiritual Pivot) states: "Zei wind and evil qi harm the human body, causing disease." Now, there are those who do not leave their shelter or exit their rooms, yet suddenly fall ill. This is not because they are spared from zei wind and evil qi. What is the reason? The answer is: This is all due to previous injury by dampness, which has hidden within the blood vessels and between the muscle layers, lingering for a long time without dispersing; or perhaps due to previous falls or injuries, with bad blood retained inside and not expelled; compounded by sudden unregulated emotions of joy or anger, inappropriate diet, and irregular exposure to cold and warmth, leading to the closure and obstruction of the cou li (skin pores and interstitial spaces). When the cou li open and encounter wind-cold, the blood and qi coagulate, combining with the existing evil qi, resulting in Cold Bi syndrome. If there is heat, sweating occurs; after sweating, one becomes susceptible to wind. Even without encountering new zei wind and evil qi, an attack will inevitably be triggered by these factors. If neither external evil qi nor frightful emotional disturbances are encountered, yet illness strikes suddenly, what is the reason? Is it solely due to ghosts and spirits? The answer is: This also involves old evil qi remaining latent and unmanifested, combined with mental aversion or longing, causing internal disorder of blood and qi, where two types of qi clash. The origin of this condition is subtle, invisible to the eye, and inaudible to the ear, thus appearing as if caused by ghosts and spirits.

The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: "At the cunkou pulse position, if the pulse is deep and weak, 'deep' indicates bone pathology, and 'weak' indicates tendon pathology; 'deep' corresponds to the Kidney, and 'weak' corresponds to the Liver. Sweating while entering water damages the Heart, leading to Li Jie disease with yellow sweat discharge, hence named Li Jie. In obese individuals, the pulse may be choppy and small, accompanied by shortness of breath, spontaneous sweating, Li Jie pain, and inability to flex or extend joints. These are all caused by drinking alcohol, sweating, and then being exposed to wind."

For Li Jie characterized by pain and inability to flex or extend joints, Wu Tou Tang (Aconite Decoction) is the primary treatment. It also treats Hong Kong Foot (podagra/foot swelling) pain with inability to flex or extend joints.

Wu Tou Tang treats Li Jie pain with joint stiffness and also Hong Kong Foot pain with stiffness. Both conditions result from wind-cold damaging the tendons. Ma Huang (Ephedrae Herba) opens the sweat pores, unblocks the cou li, disperses cold evil, and resolves wind-Bi; Shao Yao (Paeoniae Radix) regulates blood bi; Gan Cao (Glycyrrhizae Radix) unblocks meridians to harmonize the herbs; Huang Qi (Astragali Radix) tonifies Wei Qi (Defensive Qi); when Wei Qi is strong, evil retreats; Wu Tou (Aconiti Radix) moves freely, enters the Liver channel, and expels wind-cold. Therefore, cases of tendon spasm must be treated with Wu Tou. However, it is decocted with honey to缓 its potency, allowing it to linger in the sinews and bones to facilitate flexion and extension. Moreover, the moistening nature of honey nourishes blood and tendons, while simultaneously counteracting the dry-heat toxicity of Wu Tou.

Zhu Danxi stated: "Gout (Tong Feng) generally arises because the blood is heated and boiling. Subsequently, if one contacts cold water, stands on wet ground, fans oneself for coolness, or sleeps facing the wind, external cold combats internal heat. The blood, affected by wind-cold, becomes turbid and coagulated, causing pain. Pain worsens at night because the pathogen travels through the Yin aspects. The treatment method involves using acrid-hot agents to disperse cold-dampness and open the cou li. Once the blood circulates and harmonizes with Qi, the disease resolves naturally. However, there are several variations requiring slightly different treatments. For gout with fixed pain sites, redness, swelling, burning heat, or systemic high fever, indicating impending Wind Toxicity, Bai Du San (Detoxification Powder) is indicated. For limb joint pain, Qiang Huo (Notopterygii Rhizoma et Radix) is essential for dispelling wind-dampness. In obese individuals with limb joint pain, it is often due to wind-damp-phlegm-fluid accumulation; Dao Tan Tang (Phlegm-Dissolving Decoction) is appropriate. In thin individuals with thigh/joint pain, it is due to Blood deficiency; Si Wu Tang (Four Substances Decoction) plus Qiang Huo and Fang Feng is suitable. For elderly individuals with irritability and overwork, suffering from leg pain worsening with movement, or due to dysentery treated with astringents leading to bad blood entering the meridians and transforming into gout, Si Wu Tang plus Tao Ren (Persicae Semen), Chen Pi (Citri Reticulatae Pericarpium), Niu Xi (Achyranthis Bidentatae Radix), and raw Gan Cao, decocted with fresh ginger and mixed with Qian Xing San, is indicated. For cases with blood stasis, take warm with wine and prick Wei Zhong (BL40) to bleed. However, efficacy usually requires 20-30 doses. For young adults with irritable temper and preference for rich foods, suffering from gout-induced spasms due to phlegm and Qi stagnation, Dao Tan Tang plus Niu Xi, Zhi Ke (Aurantii Fructus), Tong Cao (Tetrapanacis Medulla), and Tao Ren, decocted with fresh ginger and mixed with Qian Xing San taken warm, is used. Multiple doses are necessary for effect.

Note: When damp-heat, phlegm-fire, and dead blood stagnate in the meridians, causing limb numbness, pain, or itching, mild and recent cases can be treated gradually. Severe and chronic cases require Wu Tou (Aconiti Radix) and Fu Zi (Aconiti Lateralis Radix Praeparata) to drive out phlegm-dampness and strengthen Qi to move through the meridians. If stool is obstructed, Da Huang (Rhei Radix et Rhizoma) is mandatory. Ignorant physicians fear harsh purgatives, leading to hesitation. They fail to realize that evil toxins filling the meridians cannot be dispersed without Wu Tou and Fu Zi, nor can dry-heat stagnation in the intestines be moistened without Xiao Shi (Natrii Sulfas) and Da Huang. The key lies in appropriateness.

Li Jie: Zhang Jingyue in *Jing Yue Quan Shu* states: "Li Jie wind-pain, due to its wandering pain location, belongs to Xing Bi (Wandering Bi)." The *Bing Yuan* states: "Li Jie wind-pain results from inherent deficiency of Qi and Blood, or from drinking alcohol causing open cou li and sweating into the wind; or from fatigue and improper care, allowing three evils to traverse joints, clashing with Qi and Blood, causing severe pain, sometimes like a tiger bite, hence the name White Tiger Li Jie." The *Zhong Zang Jing* states: "Li Jie pain is caused by indulging in sex after drunkenness." This covers the general overview. Most Bi syndromes involving pain are lighter during the day and heavier at night, reflecting Yin evil in the Yin aspect. Cases worsening in wind/rain/cloudy weather reflect Yin evil overwhelming Yang. Cases worsening with warmth/heat reflect Fire syndrome injuring Yin due to damp-heat. Cases with Fire signs should be treated with cooling methods; cases with Cold signs with warming methods. If tendons and vessels are stiff with limited mobility, it is Blood deficiency and dryness, requiring Blood and Qi nourishment. Whole-body joint pain, limbs feeling like hammered, quiet by day but severe by night like a tiger bite, represents severe Gout. This invariably stems from drinking in the wind, sweating, and entering water. For Cold patterns, select Cang Gong Dang Gui Tang, Qian Jin Da Zao Tang, or Fang Ji Tang. For Heat patterns, select Qian Jin Xi Jiao Tang or Dang Gui Nian Tong Tang plus Jiang Zhi Chao Huang Bo (Ginger-fried Phellodendri Cortex). Tugging sensations indicate Cold; swelling indicates Dampness; abnormal sweating indicates Wind. The three evils mix and enter the blood vessels, causing stagnation of Ying and Wei Qi, resulting in pain. Herbs may include Hu Gu (Bonis Os), Xi Jiao (Rhinocerotis Cornu - note: use substitutes legally), Chen Xiang (Aquilariae Lignum), Qing Mu Xiang (Aucklandiae Radix), Dang Gui (Angelicae Sinensis Radix), Qiang Huo, Gui Zhi (Cinnamomi Ramulus), Qin Jiao (Gentianae Macrophyllae Radix), Niu Xi, Gu Sui Bu (Drynariae Rhizoma), Tao Ren, Gan Cao. Decoct in water with a small amount of She Xiang (Moschus). For Li Jie wind-toxin attacking joints with unpredictable pain, use Wu Yao Shun Qi San; if ineffective, use Wu Ji San. For four-limb Li Jie pain with shortness of breath and deep pulse, indicating retained fluid, modify Dao Tan Tang. For body swelling and pain, use Mu Tong (Akebiae Caulis) alone, 2 liang decocted; red rashes will appear, sweating to the feet, resolving quickly. External treatment: Use 1 jin of Qi Ai (Artemisia argyi). Roast half until dry, apply to the painful area, cover with a layer of Deng Xin Cao (Junci Medulla), and frequently prick around the pain with fingernails. Replace with roasted portions when cold. Rest briefly after three cycles, then repeat. Efficacy appears after 4-5 sessions. Do not massage, as this causes blockage of the seven orifices. Another method: Boil 5 large bowls of aged vinegar, add 1 jin of Cong Bai (Allii Fistulosi Bulbus), wrap the painful area with the scallions for hot compress. Immediate numbness occurs.

Shi Wan stated: "Regarding Gout, the *Ling Shu* calls it Zei Wind, the *Su Wen* calls it Bi, and the *Jin Gui* names it Li Jie. Later generations renamed it White Tiger Li Jie. It mostly arises from wind-cold-dampness invading the meridians due to deficiency, causing Qi and Blood stagnation. Recently, heretical theories have prevailed, naming it Arrow Wind. When wind-toxin causes swelling and ulceration, it is called Arrow Bag. All herbal decoctions are forbidden, and only moxibustion and needle pricking are allowed. Although this resembles the *Ling Shu*'s method for commoners, the formulas for medicinal hot compresses are unknown in the world. This subjects already diseased muscles to innocent suffering. How lamentable it is to be ignorant and willingly deceived!"