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Yan stated: Bi syndrome (Bi Syndrome) arises from physical deficiency and loose interstices (loose skin texture and pores), allowing pathogenic factors to enter. Upon exposure to cold, the sinews become tense; upon exposure to heat, they become flaccid. The specific manifestations depend on the nature of the pathogenic factor received. Palpation reveals that a large and choppy pulse indicates Bi syndrome; a rapid pulse also indicates Bi syndrome; a choppy and tight pulse is likewise indicative of Bi syndrome, which may involve Wind-Bi or Blood-Bi, where Yin pathogens invade the blood vessels and meridians.

Note: Humans develop Bi syndrome by contracting the three pathogenic factors (Wind, Cold, Dampness) precisely because of physical and blood deficiency. The difference lies only in the depth of invasion into the muscle, skin, or blood vessels. Therefore, if the pathogen enters the Zang organs, the prognosis is poor (often fatal). Although Chen’s commentary on the classics is quite detailed, his formulas do not exhaust all variations. Practitioners should naturally expand upon these principles.

San Yin Fuzi Decoction (Aconite Decoction for Three Causes): Treats Bi syndrome caused by Wind-Cold-Dampness, characterized by joint pain, cutaneous anesthesia, heavy and adherent muscles, and flaccidity/weakness of the four limbs.
Ingredients: Raw Aconite Root (Fuzi), White Peony Root (Baishao), Cinnamon Heart (Guixin), Licorice Root (Gancao), Poria (Baifuling), Ginseng Radix et Rhizoma (Renshen) (each 3 fen); Atractylodes Macrocephala Rhizome (Baizhu) (1 liang).
Preparation and Administration: Coarsely crush the herbs. Take 4 qian per dose, decoct with water, and drink.
Commentary: This formula belongs to the Taiyang category and is a warming interior and releasing the exterior formula.

San Yin Huangqi Wuwu Decoction (Huangqi Five-Ingredient Decoction for Three Causes): Treats individuals with weak bones and heavy muscles who, after sweating due to fatigue and moving during sleep, are exposed to slight wind, resulting in Blood-Bi. The pulse should be faint in both yin and yang positions, slightly tight at the cun position of the chi pulse. The body feels as if affected by Wind-Bi.
Ingredients: Astragalus Root (Huangqi), Peony Root (Shaoyao), Cinnamon Heart (Guixin) (equal parts).
Preparation and Administration: Coarsely crush the herbs. Take 4–5 qian per dose, decoct with ginger and jujube, and drink.

Yan Shi Juanbi Decoction (Yan’s Bi-Dispelling Decoction): Treats vexing body pain, stiffness or pain/heaviness in the neck and back, difficulty in movement, cold numbness in hands and feet, heaviness in waist and legs, and weakness of sinews and vessels.
Ingredients: Angelica Sinensis Radix (Danggui), Peony Root (Shaoyao), Astragalus Root (Huangqi), Turmeric Tuber (Pianzi Jianghuang), Notopterygium Rhizome et Radix (Qianghuo) (each 1.5 liang); Roasted Licorice Root (Zhi Gancao) (0.5 liang).
Preparation and Administration: Coarsely crush the herbs. Take 4–5 qian per dose, decoct with ginger and jujube, and drink.

Huangqi Wine (Huangqi Infusion in Wine): Treats Wind-Damp Bi syndrome manifesting as stubborn numbness, pruritus, sinew contracture, dysarthria, hemiplegia or inability to move extremities, and frequent sensations of anesthesia.
Ingredients: Astragalus Root (Huangqi), Saposhnikovia Root (Fangfeng), Cinnamon Twig (Guizhi), Gastrodia Rhizome (Tianma), Dioscorea Hypoglauca Rhizome (Bixie), Dendrobium Stem (Shihu), Tiger Bone (processed) (Hugu), White Peony Root (Baishao), Angelica Sinensis Radix (Danggui), Cloud Mother Powder (Yunmu Fen), Atractylodes Macrocephala Rhizome (Baizhu), Ilex Leaf (Yinyu Ye), Costus Root (Muxiang), Epimedium Herba (Xianlingpi), Licorice Root (Gancao), Teasel Root (Chuanxuduan).
Preparation and Administration: Cut the herbs into pieces the size of hemp seeds. Place in a raw silk bag and steep in 1 dou of good wine. Steep for 5 days in spring, 3 days in summer, 7 days in autumn, and 10 days in winter. Take one zhan per dose, warm and drink, without restriction on time.

Fangfeng Decoction (Saposhnikovia Decoction): Treats Blood-Bi causing cutaneous anesthesia.
Ingredients: Saposhnikovia Root (Fangfeng) (2 liang), Pubescent Angelica Root (Chuan Du Huo), Angelica Sinensis Radix (Chuan Dang Gui), Red Poria (Chi Fu Ling), Gentiana Macrophylla Root (Qinjiao), Red Peony Root (Chi Shao), Scutellaria Root (Huangqin) (each 1 liang); Cinnamon Heart (Guixin), Apricot Seed (Xingren), Roasted Licorice Root (Zhi Gancao) (each 0.5 liang).
Preparation and Administration: Coarsely crush the herbs. Take 4–5 qian per dose, decoct with ginger, and drink.

Duhuo Jisheng Decoction (Notopterygium and Sangjisheng Decoction): Treats Bi syndrome caused by Liver and Kidney deficiency combined with Wind-Damp invasion, manifesting as flaccidity and weakness in the lower calves, and numbness/anesthesia.
Source: See the section on Hongxiangjiao (Charley Horse/Podagra).

Note: The above formulas mostly belong to the Taiyang category. Generally, Bi syndrome may involve concurrent Wind, concurrent Dampness, or an excess of Cold or Heat, affecting different Zang and Fu organs. Users should appropriately expand their application based on the condition. However, since this syndrome arises from deficiency leading to pathogenic attachment that does not easily disperse, it is necessary to prepare targeted medicines for daily consumption. Even if recovery is slow, adhering to dietary and lifestyle restrictions to prevent the pathogen from entering the Zang organs can help sustain life. For example, Qian Zhongyang had a patient consume a large Poria sclerotium (larger than a bushel) according to specific methods, finishing it over a month. Although the patient suffered from hemiplegia, their Qi and bone structure remained robust, akin to a healthy person, and they lived to the age of eighty-two. It is a pity that his formula was not transmitted.