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[Main Symptoms] Mental restlessness (Xin Fan), palpitations (Xin Ji), heart pain (Xin Tong), sudden onset of rebellious Qi with asthma (Bao Shang Qi Er Chuan), sometimes accompanied by fear (Kong), dry throat (Yan Gan), and belching (Yi Qi).
[Diagnosis] Based primarily on the main symptoms of this disease, combined with medical history regarding previous occurrences of Mai Bi (Vessel Bi Syndrome) or discoloration of blood vessels, diagnosis is not difficult.
[Therapeutic Method] Nourish the Heart, dispel pathogenic factors, invigorate blood circulation, and unblock meridians.
[Formulas]
(1) Sanbi Tang (Three Obstructions Decoction): Indicated for Xin Bi (Heart Bi Syndrome) accompanied by deficiency of Qi and Blood.
(2) Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction): This formula is derived from Sanbi Tang by removing Huangqi (Astragali Radix) and Xuduan (Dipsaci Radix), and adding Sangjisheng (Taxilli Herba). It is a formula for treating Bi Syndromes that have persisted for a long time and invaded the zang organs, possessing effects of tonifying blood and dispelling pathogens. It can be used for Xin Bi characterized by deficiency of healthy Qi and excess of pathogenic factors.
(3) Jiawei Wubi Tang (Modified Five Obstructions Decoction): Derived from Wubi Tang by adding Yuanzhi (Polygalae Radix), Fushen (Poria with Hostwood), Maidong (Ophiopogonis Radix), and Xijiao (Rhinocerotis Cornu - note: modern substitutes are used due to conservation laws), with doubled Baishao (Paeoniae Radix Alba). Indicated for Xin Bi with deficiency of healthy Qi.
Old Li believes that the above three formulas are all agents that tonify healthy Qi and dispel pathogens, and can be used for Xin Bi. The difference among the three lies in their potency: Sanbi Tang has the strongest effect, Duhuo Jisheng Tang is second, and Wubi Tang is third. Selection should be made according to the syndrome; paying attention to dosage would be even more appropriate.

15. Liver Bi Syndrome (Gan Bi)
[Etiology/Name Explanation] Liver Bi arises when Jin Bi (Tendon Bi Syndrome) persists for a long time without healing, followed by re-infection with pathogens, which then invade the Liver internally.
[Main Symptoms] Thirst with preference for drinking, frequent and copious urination, fright during sleep, and frequent sighing (Tai Xi).
[Diagnosis] Diagnosis is not difficult. Based on the main symptoms, combined with a history of Jin Bi (symptoms such as tendon spasms and limited flexion and extension of joints), it can be confirmed.
[Therapeutic Method] Support healthy Qi and dispel pathogens.
[Formulas]
(1) Sanbi Tang (Three Obstructions Decoction): Tonifies healthy Qi and dispels pathogens; can be used for severe cases of Liver Bi.
(2) Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction): Tonifies healthy Qi and dispels pathogens; can be used for Liver Bi.
(3) Jiawei Wubi Tang (Modified Five Obstructions Decoction): Derived from Wubi Tang by adding Suanzaoren (Ziziphi Spinosae Semen) and Chaihu (Bupleuri Radix), with doubled Baishao (Paeoniae Radix Alba). Treats Liver Bi accompanied by Liver Qi stagnation and restless sleep at night.

16. Spleen Bi Syndrome (Pi Bi)
[Etiology/Name Explanation] Spleen Bi arises when Ji Bi (Muscle Bi Syndrome) persists for a long time without healing, followed by re-infection with pathogens.
[Main Symptoms] Vomiting of saliva/phlegm, epigastric fullness and hardness (Xin Xia Pi Ying), and flaccidity/laziness of the four limbs.
[Diagnosis] Diagnosis is not difficult. First, based on the main symptoms of this disease, combined with whether there was a previous history of Ji Bi causing symptoms such as muscle numbness and insensitivity to pain and itch, confirmation can be made.
[Therapeutic Method] Primarily tonify healthy Qi,酌情 (judiciously) adding herbs to dispel pathogens.
[Formulas]
(1) Sanbi Tang (Three Obstructions Decoction).
(2) Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction).
(3) Jiawei Wubi Tang (Modified Five Obstructions Decoction): Derived from Wubi Tang by adding Houpo (Magnoliae Officinalis Cortex), Zhishi (Aurantii Fructus Immaturus), Sharen (Amomi Fructus), Shenqu (Massa Medicata Fermentata), with doubled Baizhu (Atractylodis Macrocephalae Rhizoma).
The above three formulas primarily focus on tonifying healthy Qi and dispelling pathogens. Among them, Sanbi Tang has the strongest effect, Duhuo Jisheng Tang is second, and Wubi Tang is third. They should be selected or modified according to the severity of the syndrome.

17. Lung Bi Syndrome (Fei Bi)
[Etiology/Name Explanation] Lung Bi arises when Pi Bi (Skin Bi Syndrome) persists for a long time without healing, followed by re-infection with pathogens.
[Main Symptoms] Mental restlessness, chest fullness, asthma, cough, and vomiting.
[Diagnosis] Diagnosis is not difficult. Based on the main symptoms, combined with whether there was a previous history of Pi Bi symptoms such as skin numbness, confirmation can be made.
[Therapeutic Method] Since it is a chronic disease, the primary approach remains tonifying healthy Qi and dispelling pathogens.
[Formulas]
(1) Sanbi Tang (Three Obstructions Decoction).
(2) Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction).
(3) Jiawei Wubi Tang (Modified Five Obstructions Decoction): Derived from Wubi Tang by adding Banxia (Pinelliae Rhizoma), Ziwan (Asteris Radix), Xingren (Armeniacae Semium Amarum), and Mahuang (Ephedrae Herba).
The above three formulas primarily focus on tonifying healthy Qi and dispelling pathogens. Sanbi Tang has the strongest effect, Duhuo Jisheng Tang is second, and Wubi Tang is third. Selection should be made based on specific symptoms.

18. Kidney Bi Syndrome (Shen Bi)
[Etiology/Name Explanation] Kidney Bi refers to a visceral Bi Syndrome formed when Gu Bi (Bone Bi Syndrome) persists for a long time without healing, followed by re-infection with pathogens.
[Main Symptoms] Abdominal distension, sitting on the buttocks instead of walking on heels (indicating severe spinal deformity), and bending the spine so the head replaces the neck position.
[Diagnosis] Determined based on main symptoms; accuracy is improved by combining with a history of Gu Bi symptoms.
[Therapeutic Method] Tonify healthy Qi and dispel pathogens.
[Formulas]
(1) Sanbi Tang (Three Obstructions Decoction).
(2) Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction).
(3) Jiawei Wubi Tang (Modified Five Obstructions Decoction): Derived from Wubi Tang by adding Duhuo (Angelicae Pubescentis Radix), Guanzi Gui (Cinnamomi Cortex), Duzhong (Eucommiae Cortex), Niuxi (Achyranthis Bidentatae Radix), Huangqi (Astragali Radix), and Bibai (Dioscoreae Hypoglaucae Rhizoma), with doubled Baishao (Paeoniae Radix Alba).
The above three formulas are all agents that tonify healthy Qi and dispel pathogens. Sanbi Tang has the strongest effect, Duhuo Jisheng Tang is second, and Wubi Tang is third. Better results are achieved if they are appropriately tailored to the symptoms during use.

Coma and Shen Hun (Loss of Consciousness) Differentiation and Treatment
Shen Hun (Loss of Consciousness) is one of the common critical syndromes in clinical practice. Its manifestation is characterized by unclear consciousness and unconsciousness. However, its specific etiology, pathogenesis, and clinical manifestations are complex and require careful differentiation.
If Shen Hun belongs to the Yangming channel/syndrome, presenting with extreme thirst, yellow and dry tongue coating, high fever, and a surging pulse, it is an indication for Baihu Tang (White Tiger Decoction). If the tongue coating is yellow and dry, the abdomen is full and tender to pressure, and the pulse is deep, solid, and forceful, it is an indication for Chengqi Tang (Gut-Purging Decoction).
If Shen Hun occurs in Shaoyin disease, the characteristics are lethargy (Chen Chen Yu Mei), monotonous speech (Zheng Sheng), a moist tongue with no coating, and a deep, faint pulse, often accompanied by cold extremities. If accompanied by heat, it often indicates Yin excess repelling Yang outward (Yin Sheng Ge Yang), appearing in the late stage of the disease. If complicated by phlegm-dampness, with greasy tongue coating and difficult urination, it is an indication for Zhenwu Tang (True Warrior Decoction); otherwise, it is an indication for Sini Tang (Frigid Extremities Decoction). (Note: Early-stage heat syndromes should consider Mahuang Fuzi Xixin Tang (Ephedra, Aconite and Asarum Decoction)).
If pathogenic factors enter the Pericardium, it is often accompanied by delirium, crimson tongue, and high fever. Shen Hun in warm diseases is mostly of this type, belonging to cerebral disorders. There are also cases caused by blood stasis. For example, a patient suffered postpartum coma, lower abdominal tenderness, no fever, and stiffness; recovery occurred after applying blood-dispelling methods.
If Shen Hun occurs in Jueyin disease, it is often accompanied by convulsions, stiffness, and seizures. Clearing heat formulas must be added with Lingyangjiao (Saiga Tataricae Cornu), Gouteng (Uncariae Ramulus cum Uncis), Quanxie (Scorpio), and Wugong (Scolopendra). Some convulsions belong to Baihu Tang (White Tiger Decoction) indications, while others belong to pathogenic factors entering the Ying (Nutritive) level of the Heart. The latter can be treated with Angong Niuhuang Wan (Calculus Bovis Pill for Opening the Orifices), Zhibao Dan (Precious Treasure Pellet), or Zixue Dan (Purple Snow Pellet), assisted by decoctions to clear the Heart, open the orifices, calm fright, and extinguish wind.
Shen Hun caused by other pains is mostly acute; consciousness returns once the pain stops. Shen Hun caused by hysteria (Yi Bing) usually presents without fever, triggered by emotional stimulation, and is often accompanied by limb contracture. Shen Hun caused by turbid phlegm obscuring the clear orifices必然 (inevitably) presents with thick and greasy tongue coating, commonly seen in damp-warmth syndromes. It should be treated with Changpu Yujin Tang (Acorus and Curcuma Decoction) combined with Suhexiang Wan (Styrax Pill).
The above is a general overview of Shen Hun treatment. Generally, Shen Hun is a critical condition requiring high attention. Cases with clear and forceful pulses are mostly curable; those with weak, fine, rapid, or indistinct pulses have a poor prognosis.
There is also a phenomenon called Yu Mao (Depression and Vertigo), often seen before Zhan Han (Shivering Sweat). Patients suddenly become confused and drowsy. This is a phenomenon of Yang depression欲 (desiring) to produce shivering sweat, accompanied by cold limbs and hidden pulse. It should be assessed based on the disease progression. If there is no deterioration and it is unrelated to medication, this consideration is valid.

Carbon Monoxide Poisoning
Treatment of Carbon Monoxide Poisoning from the Perspective of Phlegm and Stasis
Old Li believes that mild to moderate carbon monoxide poisoning may resolve spontaneously or require emergency administration of vinegar or pickled cabbage soup for recovery. Severe cases, especially those presenting with dementia, stupor, paralysis, aphasia, prolonged coma, and convulsions, are particularly difficult to treat. Generally, dementia, aphasia, and coma are caused by turbid pathogens obscuring the Heart orifices. Paralysis and convulsions are often caused by blood failing to nourish the Liver or by blood stasis obstruction. The former is primarily treated by opening orifices and resolving phlegm; the latter by invigorating blood and relaxing sinews.
Case 1: Patient Li, male, 60 years old, exposed to coal gas for over 60 days. After treatment at another hospital, consciousness returned, but he was left with dementia, dysarthria, mobility issues, limb tremors, continuous swallowing when fed, and no request for food when not fed. He was administered Jufang Zhibao Dan (Official Bureau's Precious Treasure Pill), 2 pills daily, and recovered in 10 days.
Case 2: Patient Mao, male, 28 years old, comatose from coal gas poisoning for 48 days. Hospitalization at another institution was ineffective, so he was transferred to our hospital. Examination revealed coma, generalized spastic paralysis, fever, crimson tongue with no coating, and rapid pulse. Synthesizing pulse and symptoms, the diagnosis was turbid pathogens obscuring the Pericardium and blood stasis obstruction. The treatment principle was cooling blood, invigorating blood, opening orifices, and resolving turbidity. Formula used: Jufang Zhibao Dan (Official Bureau's Precious Treasure Pill) to open orifices and resolve turbidity; Huoluo Xiaoling Dan (Collateral-Activating and Pain-Alleviating Decoction) modified to invigorate blood and cool blood:
Danshen (Salviae Miltiorrhizae Radix et Rhizoma) 15g, Chishao (Paeoniae Radix Rubra) 9g, Ruxiang (Olibanum) 7.5g, Moyao (Myrrha) 7.5g, Sangzhi (Mori Ramulus) 30g.
After 20 days, the patient's consciousness basically returned, but dementia, aphasia, and spastic paralysis did not improve significantly. Recalling Zhang Xichun's "Records of Chinese Medicine Integrating Eastern and Western": "For those with body contractures unable to extend, the sinews of the body are mainly governed by the Zong Jin (General Sinews), which are nourished by the Yangming [Stomach/Spleen]. If the person has inherent weakness of the Spleen and Stomach, unable to transform grain into fluids to nourish the Zong Jin, compounded by internal latent heat consuming them, or attacked by wind-cold, causing the Zong Jin to lose free extension and only retract, resulting in contracture... For those whose sinews are not contracted, muscles are not numb, but feel weak legs unable to walk, this is due to exhaustion of bone marrow and Kidney deficiency failing to provide strength.' 'For Bone Wei (Atrophy), add Lujiaojiao (Cervi Cornus Colla), as deer horn uses bone to tonify bone.' 'If atrophy is specifically in the lower limbs, use Niuxi (Achyranthis Bidentatae Radix) to guide downward. If hands and feet are both atrophic, add Guizhi (Cinnamomi Ramulus) to guide upward.' 'For muscle numbness where scratching does not elicit pain or itch, the cause may be wind-cold invading collaterals, phlegm-saliva blocking collaterals, or wind-cold and phlegm-saliva condensing between collaterals, leading to blood vessel closure, the root cause being deficiency of Great Qi.'" Therefore, on the basis of Huoluo Xiaoling Dan (Collateral-Activating and Pain-Alleviating Decoction), Mugua (Chaenomelis Fructus), Lujiaojiao (Cervi Cornus Colla), Hugu Jiaojiao (Pantheris Os Cum Cartilagine - substitute used), and Huangqi (Astragali Radix) were added. Paralysis and aphasia gradually improved, and after half a year, all symptoms disappeared, resulting in recovery.

Deficiency Labor (Xu Lao)
Treatment of Blood Deficiency Syndrome
Blood Deficiency is a syndrome characterized by insufficient blood or reduced nourishing function of blood, also known as anemia or blood deficit. Severe cases are termed Blood Dryness (Xue Ku) or Blood Collapse (Xue Tuo). Its formation is attributed to excessive blood loss, dysfunction of hematopoiesis, or insufficient supply of hematopoietic materials. Blood Deficiency includes Heart Blood Deficiency, Liver Blood Deficiency, Qi and Blood Dual Deficiency, Blood Deficiency generating Heat, Blood Dryness, Blood Collapse, and modern medical conditions such as Aplastic Anemia.
Blood circulates throughout the body, nourishing and moistening the whole organism, reaching internally to the Zang-Fu organs and externally to the skin, flesh, sinews, and bones. Thus, Blood Deficiency is a syndrome of systemic or local loss of nourishment and reduced functional activity. Old Li describes Blood Deficiency by dividing it into main symptoms and symptoms in various parts of the body:
Main Symptoms: Pale complexion. Pale red eyelids, lips, and tongue. No pain upon abdominal pressure. Fine, choppy, or weak pulse.
Symptoms in Various Parts of the Body: Low-grade fever, becoming hotter as deficiency increases; emaciation; dry skin; yellow and brittle hair; sinew contracture with inability to extend/flex freely; irritable and angry temperament; dizziness and headache; tinnitus; lusterless, pale, or sallow complexion; dry eyes, vertigo, blurred vision; palpitations and fright; insomnia and forgetfulness; dry intestines with difficult defecation; pale lips; tender red and dry tongue or pale tongue with no coating; fine, choppy, weak, slow, or knotted pulse. In gynecology, it manifests as delayed menstruation, amenorrhea, scanty menses with pale red or watery yellow color, post-menstrual abdominal pain, fetal malnutrition, threatened miscarriage, and postpartum susceptibility to Blood Fainting, Convulsions, difficult defecation, and lochia retention.