风痹一证，即今人所谓痛风也。盖痹者，闭也。以血气为邪所闭，不得通行而病也。如
《痹论》曰∶风气胜者为行痹。盖风者善行数变，故其为痹，则走注历节，无有定所，是为
行痹，此阳邪也。曰∶寒气胜者为痛痹。以血气受寒则凝而留聚，聚则为痛，是为痛痹，此
阴邪也。曰∶湿气胜者为着痹。以血气受湿则濡滞，濡滞则肢体沉重而疼痛顽木，留着不移
，是为着痹，亦阴邪也。凡此三者，即痹之大则也。此外如五脏六腑之痹，则虽以饮食居处
皆能致之，然必重感于邪而内连脏气，则合而为痹矣。若欲辨其轻重，则在皮肤者轻，在筋
骨者甚，在脏腑者更甚。若欲辨其寒热，则多热者方是阳证，无热者便是阴证。然痹本阴邪
，故惟寒者多而热者少，此则不可不察。
观《痹论》曰∶风寒湿三气杂至，合而为痹，而《寿夭刚柔篇》又曰∶在阳者命曰风，
在阴者命曰痹，何也？盖三气之合，乃专言痹证之所因也。曰∶在阳为风，在阴为痹。又分
言表里之有殊也。如风之与痹，本皆由感邪所致，但外有表证之见，而见发热头疼等证，或
得汗即解者，是皆有形之谓，此以阳邪在阳分，是即伤寒中风之属也，故病在阳者命曰风。
若既受寒邪，而初无发热头疼，又无变证，或有汗，或无汗，而筋骨之痛如故，及延绵久不
能愈，而外无表证之见者，是皆无形之谓，此以阴邪直走阴分，即诸痹之属也。故病在阴者
命曰痹。其或既有表证，而疼痛又不能愈，此即半表半里，阴阳俱病之证，故阴阳俱病者命
曰风痹。此所以风病在阳，而痹病在阴也。然则诸痹者，皆在阴分，亦总由真阴衰弱，精血
亏损，故三气得以乘之而为此诸证。经曰∶邪入于阴则痹，正谓此也。是以治痹之法，最宜
峻补真阴，使血气流行，则寒邪随去。若过用风湿痰滞等药而再伤阴气，必反增其病矣。
The syndrome of Fengbi (Wind Bi, Wind-Obstruction) is what people nowadays call gout. The term "Bi" implies obstruction. It refers to a disease caused by the blockage of Qi and Blood by pathogenic factors, preventing their smooth circulation.
As stated in the *Neijing Suwen: Pi Lun* (Treatise on Obstruction): When Wind pathogen predominates, it is called Xingbi (Moving Bi). Since Wind is characterized by its ability to move rapidly and change frequently, the pain caused by this type of Bi wanders through the joints without a fixed location; thus, it is termed Xingbi, which belongs to Yang pathogens.
It further states: When Cold pathogen predominates, it is called Tongbi (Painful Bi). When Qi and Blood are affected by Cold, they coagulate and stagnate; accumulation leads to pain; hence, it is termed Tongbi, which belongs to Yin pathogens.
It also states: When Dampness pathogen predominates, it is called Zhuobi (Fixed Bi). When Qi and Blood are affected by Dampness, they become heavy and stagnant; stagnation results in heaviness of the limbs, pain, and numbness, with the pathology remaining fixed in one place; thus, it is termed Zhuobi, which is also a Yin pathogen.
These three constitute the general principles of Bi syndromes. Furthermore, regarding Bi syndromes of the Zang and Fu organs, although improper diet and lifestyle can contribute, they must involve a secondary invasion of pathogens that internally connects with the organ Qi to form Bi.
To distinguish severity: if the pathology is in the skin, it is mild; if in the tendons and bones, it is severe; if in the Zang and Fu organs, it is even more severe. To distinguish between Cold and Heat: cases with significant heat signs are Yang syndromes, while those without heat signs are Yin syndromes. However, since Bi is fundamentally a Yin pathogen, Cold patterns are common while Heat patterns are rare; this point requires careful observation.
Observing the *Pi Lun*, it says: "The mixed invasion of Wind, Cold, and Dampness combines to form Bi." Yet, the *Shou Yao Gang Rou Pian* (Chapter on Longevity, Shortness of Life, Rigidity, and Flexibility) states: "What is in the Yang is called Feng (Wind); what is in the Yin is called Bi." Why is this?
The combination of the three pathogens specifically addresses the etiology of Bi syndromes. The distinction between "Feng in Yang" and "Bi in Yin" differentiates the locations of exterior and interior.
Although both Feng and Bi result from pathogenic invasion, if there are exterior manifestations such as fever and headache, or resolution after sweating, these represent tangible pathogens. This occurs because Yang pathogens reside in the Yang aspect, belonging to conditions like Shanghan (Cold Damage) or Zhongfeng (Wind Strike); thus, pathology in the Yang is called Feng.
If one has contracted Cold pathogen but initially lacks fever, headache, or other transformational signs, and whether sweating or not, the pain in the tendons and bones persists, dragging on for a long time without cure and lacking exterior signs, these represent intangible pathogens. This occurs because Yin pathogens directly enter the Yin aspect, belonging to various Bi syndromes; thus, pathology in the Yin is called Bi.
Cases presenting with both exterior signs and persistent pain represent a half-exterior, half-interior condition where both Yin and Yang are diseased; thus, it is called Fengbi. This explains why Feng diseases are in the Yang, while Bi diseases are in the Yin.
However, all Bi syndromes reside in the Yin aspect, generally resulting from the deficiency of True Yin and depletion of Essence and Blood, allowing the three pathogens to invade and cause these symptoms. The Classics state: "When pathogens enter the Yin, Bi results," which precisely refers to this mechanism.
Therefore, the treatment method for Bi should prioritize vigorously tonifying True Yin to promote the flow of Qi and Blood, thereby expelling Cold pathogens naturally. Overuse of herbs for dispelling Wind-Dampness or resolving Phlegm-Stasis will further damage Yin Qi, inevitably exacerbating the disease.