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When a person reaches forty years of age, the Yin Qi naturally becomes balanced; this has been the case from ancient times to the present. However, your constitution is unique: due to insufficient Zheng Qi (Upright Qi) and a pre-existing abundance of Dampness-Phlegm, you are experiencing premature impotence.

I occasionally consulted medical texts, which state that those who sleep with their arms exposed outside the blanket often suffer from cold-induced pain. Similarly, women who sleep with their arms exposed while using infants as pillows are also prone to cold-induced pain. Although your condition did not arise from exposing arms outside blankets or on infants, the root cause of your pain lies in sleeping on a bamboo couch. Bamboo couches possess a cold and cool nature; daily use allows cold and cool pathogens to inevitably invade the sinews and bones. This is more severe than the previous two scenarios where only the meridians were occasionally injured. Consequently, Yang Qi fails to circulate freely, leading to difficulty in flexion and extension, persistent daily pain, and a preference for warmth while disliking cold.

Zhang Zhongjing stated: "Inability to raise one arm indicates Bi Syndrome," recorded under "Zhong Men Feng" (a type of Wind Stroke). Although it is not true external wind-stroke, it shares similar pathogenesis with stroke; how can it be ignored? The current treatment principle prioritizes tonifying Yang while nourishing Yin Blood, incorporating methods to dispel cold, adding phlegm-resolving herbs, and combining them with techniques to unblock the meridians. Thus, the formulation will naturally adhere to the principles of Jun-Chen-Zuo-Shi (Monarch-Minister-Assistant-Courier).

Da Shu Di Huang (Rehmanniae Radix Preparata, 8 liang), Gui Shen (Angelicae Sinensis Radix, 4 liang), Chi Shao (Paeoniae Radix Rubra, 2 liang), Fu Zi (Aconiti Lateralis Radix Preparata, 2 liang), Dang Shen (Codonopsis Radix, 4 liang), Yu Zhu (Atractylodis Rhizoma, 4 liang), Fu Ling (Poria, 8 liang), Huang Qi (Astragali Radix, 2 liang), Ban Xia (Pinelliae Rhizoma, 4 liang), Hu Zhang (Arisaematis Cum Bile, 1 pair), E Jiao (Colla Corii Asini, 3 liang), Ju Hong (Citri Reticulatae Pericarpium, 2 liang), Jiang Huang (Curcumae Longae Rhizoma, 1 liang), Gui Zhi (Cinnamomi Ramulus, 1 liang), Chen Xiang (Aquilariae Lignum Resinatum, 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang), Zhi Qiao (Aurantii Fructus Immaturus, 2 liang), Hai Tong Pi (Saposhnikoviae Radix, 2 liang), Feng Hua Xiao (Natrii Sulfas Exsiccatus, 1 liang), Xi Qiang Huo (Saposhnikoviae Radix, 1 liang). Grind into powder. Take one tea bowl of Zhu Li (Bambusa Textilis Culmus Succus), two spoons of Jiang Zhi (Zingiberis Recens Juice), mix with light honey water, and form pills.

The head is the "Tian Gu" (Heavenly Valley, referring to the brain, where Shen [Spirit] resides). A face lacking luster and frequent tinnitus in the head indicate emptiness within the Tian Gu and a lack of vibrant spirit. However, since the tinnitus is more pronounced on the right side, there must be significant Phlegm-Fire, which requires concurrent attention.

Da Shu Di Huang (Rehmanniae Radix Preparata), Tian Dong (Asparagi Radix), Dang Shen (Codonopsis Radix) — these three decocted into paste; Zhi Yu Zhu (Prepared Atractylodis Rhizoma), Huang Qi (Astragali Radix), Long Yan Rou (Longan Arillus), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Fu Ling (Poria), Yuan Zhi Rou (Polygalae Radix), Shi Jue Ming (Haliotidis Concha), Zao Ren (Ziziphi Spinosae Semen), Mu Xiang (Aucklandiae Radix), Ban Xia (Pinelliae Rhizoma), Ju Hong (Citri Reticulatae Pericarpium), E Jiao (Colla Corii Asini), Zhu Ru (Bambusa Textilis Caulis Membrana), Gan Ju (Chrysanthemi Flos). Grind into powder, bind with paste to form pills. Each pill weighs 3 qian; take with salt water.