白虎汤治热厥腹满身重难以转侧面垢谵语遗溺手足厥冷自汗脉沉滑 方见暑门
经曰风寒湿三气杂至合而为痹其风气胜者为行痹寒气胜者为痛痹湿气胜者为着痹以冬遇
此为骨痹以夏遇此为筋痹以夏遇此为脉痹以至阴遇此为肌痹以秋遇此为皮痹
按本论备五脏等痹甚详宜玩本文
脉经曰脉涩而紧痹病
陈无择曰虽三气合痹其用不同三气袭人经络入于筋脉皮肉肌骨久而不已则入五脏烦满喘
而呕
者是痹客于肺烦心上气嗌干恐噫厥胀满者是痹客于心多饮数小便小腹痛如怀妊夜卧则惊者是
痹客于肝善胀尻以代肿脊以代头者是痹客于肾四肢懈堕发咳呕沫上为大寒者是痹客于脾又有
肠痹胞痹及六腑各有俞风寒湿所中治之随其腑俞以施针灸之法仍服逐三气发散等药则病自愈
大抵痹之为病寒多则痛风多则行湿多则着在骨则重而不举在脉则血凝不流在筋则屈而不伸在
肉则不仁在脾则寒逢寒则急逢热则纵又有血痹以类相从外有支饮作痹
谨按痹之为证有筋挛不伸肌肉不仁者与风证绝相似故世俗多类于风痿痹证通治此千古之
弊也
徐先生已于卷首分出痿证一门大抵固当分其所因风则阳受之痹感风寒湿之气则阴受之为病多
重痛沉着患者难易得去如钱仲阳为宋之一代明医自患周痹止能移于手足为之偏废不能尽去可
见其为难治也况今世俗多类于风证通治宜乎不能得其病情也
Baihu Tang (White Tiger Decoction) is used to treat Heat Jue (Heat Reversal Syndrome), with symptoms including abdominal fullness, heaviness of the body making it difficult to turn over, a greasy appearance of the face, delirium, urinary incontinence, coldness of the hands and feet, spontaneous sweating, and a deep and slippery pulse. The formula can be found in the "Summerheat Section".
The Classic says: When Wind, Cold, and Dampness three Qi mix together and invade, they combine to form Bi Syndrome (Obstruction Syndrome). When Wind Qi prevails, it is called Xing Bi (Wandering Bi); when Cold Qi prevails, it is called Tong Bi (Painful Bi); when Dampness Qi prevails, it is called Zhuo Bi (Fixed Bi). If contracted in Winter, this is Gu Bi (Bone Bi); if contracted in Summer, this is Jin Bi (Tendon Bi); if contracted in Summer [Note: Textual variation], this is Mai Bi (Vessel Bi); if contracted at Zhi Yin (Late Summer), this is Ji Bi (Muscle Bi); if contracted in Autumn, this is Pi Bi (Skin Bi).
According to this treatise, the five Zang organ Bi syndromes are recorded in great detail; one should carefully study the original text.
The Pulse Classic says: A choppy and tight pulse indicates Bi Syndrome.
Chen Wuyue said: Although the three Qi jointly cause Bi, their manifestations differ. The three Qi attack the meridians, entering the tendons, vessels, skin, flesh, muscles, and bones. If prolonged without resolution, they enter the five Zang organs. Irritation, fullness, wheezing, and vomiting indicate Bi pathogen lodging in the Lung; vexation, upward rushing of Qi, dry throat, fear of belching, cold limbs, and abdominal distension indicate Bi pathogen lodging in the Heart; excessive thirst, frequent urination, lower abdominal pain resembling pregnancy, and waking with fright during sleep indicate Bi pathogen lodging in the Liver; propensity for distension, swelling of the buttocks replacing the waist, and spinal curvature where the spine replaces the head indicate Bi pathogen lodging in the Kidney; flaccidity of the four limbs, coughing, vomiting of froth, and internal severe Cold indicate Bi pathogen lodging in the Spleen. There are also Chang Bi (Intestine Bi) and Bao Bi (Bladder Bi), and each of the six Fu organs has its Shu points; when attacked by Wind, Cold, and Dampness, treatment involves applying acupuncture and moxibustion according to the respective Fu organ's Shu points, while administering herbs that expel the three Qi and disperse pathogens, leading to natural recovery.
Generally speaking, in Bi syndrome, an excess of Cold results in Tong Bi (Painful Bi), an excess of Wind results in Xing Bi (Wandering Bi), and an excess of Dampness results in Zhuo Bi (Fixed Bi). If in the bones, the body is heavy and immobile; if in the vessels, blood coagulates and does not flow; if in the tendons, flexion occurs but extension is impossible; if in the flesh, there is numbness and insensitivity; if in the Spleen, there is aversion to cold, becoming rigid in cold and relaxed in heat. There is also Blood Bi, which follows similar patterns; externally, Zhi Yin (Branching Fluid Retention) can also manifest as Bi.
Carefully observing: Bi syndrome presents with tendon spasms preventing extension and muscle numbness, which are extremely similar to Wind syndromes. Therefore, laypeople often classify it under Wind syndromes and treat Wei Bi (Flaccidity-Bi) collectively. This is a flaw lasting for millennia.
Mr. Xu already separated the Wei Syndrome (Flaccidity Syndrome) category at the beginning of the volume. Generally, one must distinguish the etiology. Wind pathogen affects the Yang meridians, whereas Bi syndrome caused by Wind-Cold-Dampness affects the Yin meridians. As a disease, Bi is characterized by severe pain and stagnation; patients find it difficult to eradicate. For example, Qian Zhongyang, a renowned physician of the Song Dynasty, suffered from Zhou Bi (General Bi). He could only shift the condition to his hands and feet, resulting in hemiplegia, unable to fully recover. This demonstrates its difficulty to treat. Moreover, since contemporary people often misclassify it as Wind syndrome and treat it uniformly, it is no wonder they fail to grasp the true nature of the illness.