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According to the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet): When Wind, Cold, and Dampness pathogenic factors mix and invade together, they combine to form Bi Syndrome (Obstruction Syndrome). When Wind is predominant, it is called Xing Bi (Wandering Bi); when Cold is predominant, it is called Tong Bi (Painful Bi); when Dampness is predominant, it is called Zhuo Bi (Fixed Bi). The classics state: "When Wind is predominant, there is movement/tremor; when Heat is predominant, there is swelling." It is presumed that this arises from Cold-Damp obstructing the collaterals, transforming into Fire and steaming with Heat, leading to disharmony between Ying (Nutritive) and Wei (Defensive) Qi, resulting in global joint soreness, pulling pain, and forming Li Jie Feng Bi (Lijie Wind-Bi, a type of arthritis characterized by severe joint pain). Onset is accompanied by aversion to cold and fever. It may start in the hands, or in the feet, or affect the whole body; sometimes only one joint becomes diffusely swollen, subsiding after seven days, then another joint attacks, or it remains fixed in one location. This generally depends on the severity of Damp-Heat. If the pathology is in the Qi level, the color is white; if in the Blood level, the color is red. Medication should focus on releasing the exterior, drying Dampness, and relaxing the muscles. Once heat subsides and swelling recedes, use herbs to harmonize Ying blood and unblock collaterals. For cases lasting several months without healing, since pathogens have been expelled but Ying blood is deficient, tonification should be used.

Lou Jian Feng (Leaking Shoulder Wind), characterized by soreness in the shoulder joint, or pain with diffuse swelling, is also caused by Wind-Cold-Damp obstructing the collaterals. The medication used is the same as for the aforementioned condition.

Yang Mei Chuang (Plum-knot Sore, syphilis), formally known as Yang Mei Chuang, also called Shi Chuang (Seasonal Sore) or Mian Zi Chuang (Cotton-seed Sore). It is entirely generated by Damp-Heat pathogenic fire. If transmitted via infectious sores through qi transformation, the condition is mild; this involves toxicity in the Lung and Spleen meridians. The sores first appear on the upper body, causing skin itching without bone/muscle pain. The lesions are small, dry, firm, and raised, resembling cotton seeds, hence the name "Mian Zi Chuang." Since the toxin is in the skin and has not entered the collaterals, treatment should employ dispersing and detoxifying methods, such as Fang Feng Tong Sheng San (Saposhnikovia Powder to Unblock the Intestines) or Ma Huang Yi Ji Yin (Ephedra One-Dose Decoction). If contracted through illicit sexual intercourse, where semen transforms into desire-induced infection, the condition is severe; this involves toxicity in the Liver and Kidney meridians. It may begin with Xia Gang (Chancre) or Yu Kou (Fish Mouth, inguinal lymphadenitis), followed by these sores appearing first on the lower body and gradually spreading to the whole body. The lesions are large, hard, become wet and ulcerate upon moisture, cause bone/muscle pain, and present with dysuria and strangury. This is the most severe presentation. Because the toxic vapors enter the marrow internally and reach the skin externally, unless sweating and purging methods are combined, how can the viscera be washed clean? At this time, Ji Zi Da Huang Wan (Chicken Egg Large Rhubarb Pill) or Jiu Long Dan (Nine Dragons Pill) should be used to purge, allowing toxic turbidity to exit via the bowels; this is the correct treatment. One must absolutely avoid using Qian Fen (Calomel) or Sheng Dan (Red Mercury Oxide) to suppress the toxin. If Yang Mei Chuang is treated with Qian Fen, the toxin enters the bones and muscles like oil penetrating flour, becoming inseparable. Accumulated over time, it attacks outward, inevitably leading to Jie Du (Knotting Toxors) and ulceration, manifesting as various malignant symptoms, often difficult to manage, and potentially harming the whole body and even affecting spouses and children. These disasters are all consequences of using suppressing agents like Qian Fen and Sheng Dan. Generally, there are four methods for treating Yang Mei Chuang in the world: 1) Suppressing the toxin to prevent its exit; 2) Heavily using purgatives to drive out the toxin; 3) Using ascending/dispersing agents to release the toxin; 4) Using resolving/supporting agents to defeat the toxin. Among these, ascending and resolving methods, though unable to expel the toxin immediately, will eventually take effect and carry no harm. Conversely, suppression and internal retention cause profound damage and must not be used. Even heavy purging often severely damages Yuan Qi (Primal Qi); how can physicians lightly use these without assessing deficiency and excess? If the patient has had sores for a long time, Qi and Blood are already deficient, yet the toxin remains, purging is contraindicated. Instead, detoxifying and supporting dispersion methods should be employed, requiring flexibility in clinical practice. Besides these, fumigation strips, topical rubs, and inhalation methods are not good approaches and should be discarded. Regarding powders to close wounds, they should only be used after bone/muscle pain ceases, the sore base turns pale white, and internal toxins have dispersed; otherwise, premature closure leaves residual toxins, leading to future complications.

As for Jie Du (Knotting Toxors, late-stage syphilis), initially, there is bone/muscle pain, followed by gradual swelling arising unpredictably anywhere. If it occurs at joints, it damages bones and tendons; even if healed, flexion and extension are impaired. If it occurs in the mouth or nose, it causes collapse of the nasal bridge and loss of lips; even if healed, disfigurement remains. If it occurs in the throat, it alters the voice. If it occurs in hands and feet, it impedes movement. If it invades the crown, it causes splitting headaches and distending eye pain. The initial site of the sore is purple-black; after ulceration, yellow pus floods, foul water drips continuously, and the odor is unbearable. The oral cavity becomes concave and convex, resembling karst rocks. All these result from toxic vapors being suppressed and stagnant, sinking into the marrow, and attacking outward. Examining surgical texts, there are hundreds of formulas for regulation and treatment, but generally, they do not exceed the two ends of "Purging" and "Suppressing." Among them, only Xian Yi Liang Tang (Immortal Wild Yam Decoction), Jin Chan Tuo Jia Jiu (Golden Cicada Shedding Shell Wine), Xiong Gui Er Zhu Tang (Angelica and Atractylodes Two-Atractylodes Decoction) for the weak, Wu Bao Dan (Five Treasures Pill) for chronic cases, and Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) for non-healing sores, along with Tu Fu Ling (Smilax Glabra Rhizome) decoction, are usable. Recently, the Shi Wei Dan Zhai Fang (Ten-Ingredient Dan Zhai Formula) has proven most effective. Its ingredients are pure; not only does it cure the disease, but it also completely resolves residual latent toxins, preventing recurrence forever.