【湿痹之症】或一处麻痹不仁，或四肢手足不举，或半身不能转侧，或湿变为热，热变
为燥，收引拘挛作痛，蜷缩难伸，名曰着痹，此湿痹之症也。
【湿痹之因】或身居卑湿，湿气袭人，或冲风冒雨，湿留肌肉，内传经脉，或雨湿之年
，起居不慎，而湿痹之症作矣。
【湿痹之脉】脉见浮濡，乃是风湿；脉见浮紧，乃是寒湿。脉洪而数，湿热之诊。
【湿痹之治】发汗，羌活除湿汤。胸满闷，茯苓汤。风湿，苍防二妙汤。寒湿，术附汤
羌活除湿汤 通治风寒湿热，四气成痹。
羌活 防风 柴胡 独活 苍术 茯苓 泽泻 猪苓 甘草 陈皮 黄连 黄柏 川芎
茯苓汤 即枳桔二陈汤易赤茯苓。
苍防二妙汤 治风湿成痹。
苍术 防风
二味等分同煎。
术附汤 治寒湿成痹。
苍术 熟附子
苍柏二妙丸 见前湿热痿。
【热痹之症】肌肉热极，唇口干燥，筋骨痛不可按，体上如鼠走状，此《内经》所云阳
气多，阴气少，阳独盛，故为热痹之症。《内经》原有热痹，方书止列三条，误也。
【热痹之因】阴血不足，阳气偏旺，偶因热极见寒，风寒外束，《内经》云∶灵气相
薄，则脉满而痛。此热痹所由生也。
【热痹之脉】浮大而数，热在经络。沉大而数，热已深入。大数属气，细数者血。寸脉
数大，热在于上。尺热数大，热在于下。
【热痹之治】热在经络者，四味舒筋汤。热已深入，潜行散。气分有热者，苍柏二妙丸
四味舒筋汤 治腿足肿痛，脚筋挛缩。
独活 当归 黄柏 苍术
四味等分同煎。
潜行散 滋阴补肾，壮骨健行，此方独胜。
黄柏
一味炒研，水丸服。
苍柏二妙丸 治湿热伤气分者。
苍术 黄柏
二味同研水丸。
虎潜丸 治湿热入血分者。
龟板胶（四两） 黄柏（四两炒） 知母（四两） 川牛膝（二两） 熟地黄（四两） 白芍药（
（四两） 当归（四两） 虎骨骱（一两，炙）
上为细末，玄武胶溶化为丸。
[Symptoms of Damp-Bi Syndrome] Some present with numbness and insensitivity in a specific area, some with the inability to lift the limbs and hands/feet, and some with the inability to turn the body sideways. Alternatively, dampness may transform into heat, and heat may transform into dryness, leading to contraction, pulling, spasm, and pain, with the body curled up and difficult to extend. This is called Zhuo-Bi (Fixed Bi), which constitutes the symptoms of Damp-Bi syndrome.
[Etiology of Damp-Bi Syndrome] It arises from residing in low-lying and damp places where dampness invades the human body; or from exposing oneself to wind and rain, causing dampness to remain in the muscles and subsequently transmit internally to the meridians; or from careless daily living during years of excessive rain and humidity, thereby triggering Damp-Bi syndrome.
[Pulse Diagnosis of Damp-Bi Syndrome] A floating and soggy pulse indicates Wind-Dampness; a floating and tight pulse indicates Cold-Dampness. A surging and rapid pulse indicates Damp-Heat.
[Treatment of Damp-Bi Syndrome] Employ sweating methods using Qiang Huo Chu Shi Tang (Notopterygium Decoction for Expelling Dampness). If accompanied by chest fullness and oppression, use Fu Ling Tang (Poria Decoction). For Wind-Dampness, use Cang Fang Er Miao Tang (Atractylodes and Saposhnikovia Two Marvels Decoction). For Cold-Dampness, use Shu Fu Tang (Atractylodes and Prepared Aconite Decoction).
Qiang Huo Chu Shi Tang: Universally treats Bi syndrome caused by the four qi of Wind, Cold, Dampness, and Heat.
Herbs: Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Chai Hu (Bupleuri Radix), Du Huo (Angelicae Pubescentis Radix), Cang Zhu (Atractylodis Rhizoma), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Huang Lian (Coptidis Rhizoma), Huang Bai (Phellodendri Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma).
Fu Ling Tang: Is Zhi Ju Er Chen Tang (Immature Bitter Orange and Citron Two-Aged Decoction) with Chi Fu Ling (Red Poria) substituted for regular Poria.
Cang Fang Er Miao Tang: Treats Bi syndrome formed by Wind-Dampness.
Herbs: Cang Zhu (Atractylodis Rhizoma), Fang Feng (Saposhnikoviae Radix).
Usage: Decoct equal parts of these two herbs together.
Shu Fu Tang: Treats Bi syndrome formed by Cold-Dampness.
Herbs: Cang Zhu (Atractylodis Rhizoma), Shu Fu Zi (Prepared Aconiti Lateralis Radix).
Cang Bai Er Miao Wan: See the section on "Damp-Heat Wei Syndrome" above.
[Symptoms of Heat-Bi Syndrome] Muscles feel extremely hot, lips and mouth are dry, bones and sinews are painful and cannot be touched, and the skin feels as if mice are running across it. This corresponds to what the *Nei Jing* (Inner Canon) describes as excessive Yang qi and deficient Yin qi, where Yang alone is hyperactive, thus forming Heat-Bi syndrome. The *Nei Jing* originally recorded Heat-Bi; later medical texts listing only three types is an error.
[Etiology of Heat-Bi Syndrome] Deficiency of Yin blood with hyperactive Yang qi, occasionally presenting with cold sensations due to extreme heat, while Wind-Cold binds the exterior. The *Nei Jing* states: "When vital qi clashes, the vessels become full and painful." This is the origin of Heat-Bi.
[Pulse Diagnosis of Heat-Bi Syndrome] A floating, large, and rapid pulse indicates heat in the meridians. A deep, large, and rapid pulse indicates heat has penetrated deeply. A large and rapid pulse belongs to Qi-level heat; a fine and rapid pulse belongs to Blood-level heat. A rapid and large pulse at the Cun position indicates heat in the upper body; a rapid and large pulse at the Chi position indicates heat in the lower body.
[Treatment of Heat-Bi Syndrome] For heat in the meridians, use Si Wei Shu Jin Tang (Four-Ingredient Relaxing Sinew Decoction). For heat that has penetrated deeply, use Qian Xing San (Secret Walking Powder). For heat in the Qi level, use Cang Bai Er Miao Wan.
Si Wei Shu Jin Tang: Treats swelling and pain in the legs and feet, and contracture of foot sinews.
Herbs: Du Huo (Angelicae Pubescentis Radix), Dang Gui (Angelicae Sinensis Radix), Huang Bai (Phellodendri Cortex), Cang Zhu (Atractylodis Rhizoma).
Usage: Decoct equal parts of these four herbs together.
Qian Xing San: Nourishes Yin and tonifies the Kidney, strengthens bones, and promotes mobility; this formula excels uniquely.
Herbs: Huang Bai (Phellodendri Cortex).
Usage: Fry one herb, grind into powder, and take as water-pilled capsules.
Cang Bai Er Miao Wan: Treats conditions where Damp-Heat injures the Qi level.
Herbs: Cang Zhu (Atractylodis Rhizoma), Huang Bai (Phellodendri Cortex).
Usage: Grind both herbs together and form water pills.
Hu Qian Wan (Tiger Crouching Pill): Treats conditions where Damp-Heat enters the Blood level.
Herbs: Gui Ban Jiao (Testudinis Carapacis et Plastratis Colla, 4 liang), Huang Bai (Phellodendri Cortex, 4 liang, stir-fried), Zhi Mu (Anemarrhenae Rhizoma, 4 liang), Chuan Niu Xi (Cyathulae Radix, 2 liang), Shu Di Huang (Rehmanniae Radix Praeparata, 4 liang), Bai Shao Yao (Paeoniae Radix Alba, 4 liang), Dang Gui (Angelicae Sinensis Radix, 4 liang), Hu Gu Jia (Ossum Tigridis Articulation, 1 liang, roasted).
Usage: Grind all ingredients into fine powder, dissolve Xuan Wu Jiao (also known as Gui Ban Jiao) and form pills.