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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When Wind, Cold, and Dampness pathogenic factors mix and invade the body together, they combine to form Bi syndrome (Obstruction Syndrome). When Wind is predominant, it is called Xing Bi (Wandering Bi). According to the described symptoms, pain started from the right knee, radiating to the calf muscles, and gradually shifted to the left, resembling Wandering Bi. Wandering Bi belongs to Wind pathogen; treatment should focus on expelling the pathogen, which is not incorrect in principle. However, where pathogenic factors gather, Qi must be deficient. Moreover, the patient is a child with weak constitutional endowment and unfulfilled Kidney Yuan Qi (Original Qi). If expulsion is too vigorous, Blood and Qi will be depleted. The Liver governs the sinews; without Blood nourishment, sinews become spasmodic and tight. The Spleen governs the muscles; without Yang Qi warming, muscles become emaciated. This leads to the calves becoming increasingly dry and the thighs increasingly swollen, rendering the feet unable to bear weight, eventually resulting in disability. The ancients said: "To treat Wind, first treat the Blood; when Blood flows, Wind extinguishes itself." I heard that the various prescriptions taken were not entirely devoid of blood-regulating herbs. Unfortunately, herbs such as Guizhi Tang (Cinnamon Twig Decoction), Mahuang Tang (Ephedra Decoction), Qianghuo (Notopterygii Rhizoma et Radix), and Duhuo (Angelicae Pubescentis Radix) have overly harsh properties, making them difficult to control, so only harm was seen, not benefit. In the early stage of the disease, when Blood and Qi were not yet depleted, supporting healthy Qi and expelling pathogens could be done simultaneously. Now that the patient is this exhausted, what Wind remains to be expelled, and what collaterals remain to be unblocked? If one continues to seek quick results and treats the disease merely by its symptoms, not only will the disease not be cured, but life may also be endangered. One must realize that once a disease has resulted in disability, restoring vitality is indeed not an easy task. There is only one method: tonifying the Liver and Kidneys. The knee is the residence of sinews, and the meridians of the Liver and Kidneys attach to the feet; the feet can walk only when nourished by Blood. Another method is to regulate the Spleen and Stomach. All four limbs derive Qi from the Stomach. If Spleen disease prevents the Stomach from distributing fluids, the meridians become obstructed, and sinews, bones, and muscles lack Qi generation, hence these conditions arise. If Spleen Qi is strong and Stomach Qi is healthy, the four limbs receive grain Qi, meridians flow smoothly, and naturally the skin becomes plump and muscles warm. These two methods, although not explicitly discussing disease treatment, contain the essence of treating diseases.

An Bo's commentary: Although this case was reportedly cured as stated, the child's prior weak constitution is evident, suggesting a sign of short lifespan.

Previously, it was advised to harmonize the middle and unblock the fu organs. After bowel movement, the feeling of fullness and oppression gradually relieved, and food intake slightly increased. Due to fluctuating seasonal temperatures and cold, the weak constitution was prone to external contraction, causing fever and chills to recur after remission. Recently, although the cold signs have disappeared, residual heat remains. The pulse is deficient and approaching rapidity. This is an additional complication, not a transformation of the primary syndrome. It is merely that Yuan Qi deficiency has not recovered, and the couli (pores) are loose; daily life requires utmost caution. To claim that this episode of fever and chills is unrelated to external contraction and entirely due to internal injury would imply Yin and Yang dual deficiency and disease of the extraordinary vessels, which should not appear so abruptly. Furthermore, fever and chills due to internal injury typically occur during the Shen hour (3-5 PM) or You hour (5-7 PM), persisting daily, not occasionally. The sensation of shivering is not as severe as this. Based on reasoning, it seems unlikely to be internal injury. Currently, bowel movements have not occurred for over ten days. Although there is no abdominal pain, there is a general discomfort. Pure tonification might not be tolerated. The reason is that the disease originated from dampness coagulation and Qi stagnation; miscellaneous medications confused the Stomach Fu, leading to dysfunction of transportation and transformation. Using bland methods to nourish Stomach Qi and sweet methods to benefit Spleen Yin, combined with moistening intestines, will prevent stagnation and new complications, allowing gradual improvement. On follow-up, although bowel movements occurred only once every half month, there was no abdominal distress. Slow defecation is acceptable; there is no need to rush. Previously, due to recurrent external contraction, mild tidal fever persisted until the Shen hour (3-5 PM) after fever and chills subsided. Thirst during fever, sweating at the Xu hour (7-9 PM) leading to resolution, indicates residual waves have not cleared. However, prolonged heat damages fluids. We discussed advancing yin-nourishing herbs; if Yin blood moistens downward, bowels will unblock, serving not just to reduce fever. With recurrent external contraction, excessive heat damaging Yin, intestinal dryness causing constipation, continuous use of yin-nourishing and fluid-moistening herbs led to heat reduction, increased appetite, normalized rapid pulse, and returning spirit. Described yesterday noon, dry stool passage remained difficult, straining hard, showing the pathogen has been long-standing, Yuan Qi is depleted, and fluids are unfulfilled. After bowel unblocking, prevention of re-obstruction is needed. According to theory, to rescue Yang Qi, Jianzhong Tang (Middle-Builder Decoction) should be used; to rescue Yin fluids, Maiguan Tongmai Tang (Pulse-Recovering Decoction) should be administered. Following the *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) method, supplemented with human milk, soft-shelled turtle, and swallow's nest—substances with emotional affinity (blood and flesh)—we wait for fluid recovery and virtual return, until Stomach strength and Spleen health are restored, then discuss follow-up plans.

An Bo's commentary: In cases of constipation, patients often believe that one successful evacuation constitutes a cure. Feces are indeed stagnant matter, requiring continuous pushing by Middle Qi; thus, effort during defecation facilitates passage. It is frequently observed that after illness, even after a month or two when the body has emaciated, smooth defecation finally occurs. This shows that treating constipation is not solely about tonifying Blood and moistening intestines; the assistance of boosting Qi and smoothing Qi cannot be ignored. Therefore, the classics state: "When Middle Qi is insufficient, urination and defecation change."