李 左臂自肩以下骨节大痛，经所谓寒胜则痛也。来势甚骤，若游走上下骨骱，即俗谓白虎历节风。
痛如虎咬，刻不可忍，此非厉剂不除，投以川乌头炮去脐皮、草乌头炮去皮，姜汁制、松节油，一剂，服后饮
酒以助药势达病所。夜半身麻汗出，平旦而病若失矣。此仿活络丹法。
张 五旬外，左臂素患肿痛，因涉江受风，一夜，全身麻痹，脉虚濡，此真气虚而风湿为病，乃痱中根萌
也。经曰∶营虚则不仁，卫虚则不用。营卫失调，邪气乘虚袭入经络，蠲痹汤主之，数服而效。《准绳》云，
凡风痹偏枯，未有不因真气不周而病者。治不用黄 为君，人参、归、芍为臣，桂枝、钩藤、荆沥、竹沥、姜汁
为佐。徒杂乌、附、羌活以涸营而耗卫，未之能愈也。严氏蠲痹汤用黄 、炙草以实卫，当归、白芍活血以
调营，羌、防除湿疏风，姜黄理血中滞气，入手足而驱寒湿，用酒和服，专借以行药力也。
王 伤酒涉水，湿袭阴络，右腿痹痛，由髀骨直至委中穴。参用三痹汤内服，桂心、茯苓、牛膝、杜仲、
白术、苍术、当归、独活、桑枝煎汤。外用防风、桂枝、木瓜、当归、 、葱白煎汤熏洗，汗出为度。夫
湿痹重着，今腿痛已定，通移膝胫，仍以逐湿通痹法治。川乌、桂心、独活、牛膝、虎胫骨、归尾、没药，以溺
少加茯苓、车前子。二服，兼用洗药，痛止能行。数十日内，戒酒肉风冷劳动。
王氏女 风寒湿合而成痹，蕴邪化热，蒸于经络，四肢痹痛，筋骨不舒。盖邪中于经为痹，中于络为痿。
《金匮》云∶经热则痹，络热则痿，倘经腑治失宣通，延为痿 。杏仁、滑石、石膏、赤苓、威灵仙、蚕砂、
薏仁，数服痛减，乃用白术、薏仁、茯苓、桂枝、片姜黄、钗斛、归身、玉竹、五加皮、桑枝煎汤，数十服肢体
活动。又服丸剂平补肝肾，步履如常。
族妇 右臂痛手不能举，此为肢痹。用舒筋汤。片姜黄、当归、羌活、炙草、姜渣、海桐皮，加桂枝，四
五服渐瘳。凡筋得
寒则急，得热则纵， 短为拘，弛长为痿。风寒湿三气杂至合而成痹。风胜为行痹，寒胜为痛痹，湿胜为着痹，
宜宣风逐寒燥湿，兼通络。如臂痛，服舒筋汤，必腋下 汗出，则邪不滞于筋节，而拘急舒矣。如气虚加参、
，血虚加地、芍，肩背加羌活、狗脊、鹿胶，腰脊加杜仲、独活、沙苑子，臂指加姜黄、桂枝，骨节加油松
节、虎膝，下部加牛膝、薏苡、五加皮、虎胫骨，经络加桑寄生、威灵仙、钩藤。久而不痊，必有湿痰败血瘀
滞经络，加桂心、胆星、川乌、地龙、红花、桃仁以搜逐之。
王有年，盛暑脉沉缓，身半以下酸
痛，胫膝无汗，手足不温，便艰梦泄，皆湿热壅阻致痹，先通其壅。
用蒸牛膝、当归、秦艽、川芎、玉竹、杏仁、陈皮、淡苁蓉。二服便润，去苁蓉、杏仁，专理经络湿邪，
加桂枝、桑寄生、独活、薏苡、杜仲、熟地（炒）。十数服全瘳。
Patient Li: Severe pain in the bone joints of the left arm from the shoulder downwards, as stated in the *Classic of Internal Medicine*: "Excess Cold leads to pain." The onset was sudden. If the pain wanders up and down through the joints, it is commonly known as "White Tiger Arthritis" (Baihu Lijie Feng). The pain is like being bitten by a tiger, unbearable for even a moment; such a condition cannot be cured without potent agents. A prescription was administered consisting of Chuanwu Tou (Sichuan Aconite Root, processed to remove umbilicus and skin), Caowu Tou (Wild Aconite Root, processed to remove skin, treated with ginger juice), and Songjie You (Pine Joint Oil). After one dose, wine was consumed to assist the medicinal force in reaching the disease site. At night, numbness and sweating occurred on half of the body; by dawn, the illness seemed to have vanished. This method imitates the formula of Huoluo Dan (Activate Collaterals Pill).
Patient Zhang: Over fifty years old, suffering from chronic swelling and pain in the left arm. After crossing a river and being exposed to wind, he experienced total body paralysis overnight. His pulse was deficient and soggy (Xu Ru). This indicates deficiency of True Qi with pathogenic Wind-Dampness, which is the root germination of Feizhong (Apoplexy/Flaccidity). The Classics state: "Deficiency of Ying [Nutritive] Qi leads to insensibility (Bu Ren); deficiency of Wei [Defensive] Qi leads to inability to move (Bu Yong)." Disharmony of Ying and Wei allows pathogens to invade the collaterals due to deficiency. The primary treatment was Juanbi Tang (Eliminate Bi Decoction), which proved effective after several doses. *Zhunsheng* states: "All cases of Wind-Bi or hemiplegia arise from the failure of True Qi to circulate freely." Treatment should use Huangqi (Astragalus Root) as the Sovereign herb, Renshen (Ginseng Root), Danggui (Angelica Sinensis Root), and Baishao (White Peony Root) as Ministers, Guizhi (Cinnamon Twig), Gouteng (Uncaria Rhynchophylla), Jingli (Liquidambar Resin solution), Zhuli (Bamboo Sap), and Jiangzhi (Ginger Juice) as Assistants. Merely mixing Wutou (Aconite Root), Fuzi (Prepared Aconite Root), and Qianghuo (Notopterygium Root) would deplete Ying and consume Wei, failing to cure the disease. Yan's Juanbi Tang uses Huangqi and Zhi Gancao (Honey-fried Licorice Root) to solidify Wei, Danggui and Baishao to invigorate blood and harmonize Ying, Qianghuo and Fangfeng (Saposhnikovia Root) to drain dampness and disperse wind, Jianghuang (Turmeric Rhizome) to regulate stagnant Qi in the blood, acting on the limbs to drive out Cold-Dampness. It is taken with wine to specifically borrow the wine's power to propel the medicinal efficacy.
Patient Wang: Excessive alcohol consumption combined with wading in water caused Dampness to invade the Yin collaterals. He suffered from Bi pain in the right leg, extending from the thigh bone directly to Weizhong BL-40. Internally, Sanbi Tang (Triple Deficiency Bi Decoction) was used, decocted with Guixin (Cinnamon Bark), Fuling (Poria), Niuxi (Achyranthes Root), Duzhong (Eucommia Bark), Baizhu (Atractylodes Macrocephala Rhizome), Cangzhu (Atractylodes Rhizome), Danggui (Angelica Sinensis Root), Duhuo (Angelica Pubescens Root), and Sangzhi (Mulberry Twig). Externally, a decoction of Fangfeng (Saposhnikovia Root), Guizhi (Cinnamon Twig), Mugua (Chaenomeles Fruit), Danggui (Angelica Sinensis Root), Xixin (Asarum Root), and Congbai (Scallion White) was used for fumigation and washing, stopping when sweating occurred. Damp-Bi is characterized by heaviness and fixed location. Now that the leg pain has stabilized and shifted to the knee and shins, the treatment remains focused on draining Dampness and unblocking Bi. The prescription included Chuanwu (Sichuan Aconite Root), Guixin (Cinnamon Bark), Duhuo (Angelica Pubescens Root), Niuxi (Achyranthes Root), Hu Jinggu (Tiger Tibia Bone - substitute required), Dangguiwei (Angelica Sinensis Tail), Moyao (Myrrh). Due to scanty urination, Fuling (Poria) and Cheqianzi (Plantago Seed) were added. After two doses, combined with external washes, the pain ceased and walking resumed. For dozens of days, alcohol, meat, wind, cold, and labor were avoided.
Ms. Wang: Wind, Cold, and Dampness combined to form Bi syndrome. The accumulated pathogens transformed into Heat, steaming the collaterals, causing Bi pain in the four limbs and stiffness in sinews and bones. Generally, pathogens entering the meridians constitute Bi, while those entering the collaterals constitute Wei (Flaccidity). *Jingui Yaolue* states: "Heat in the meridians leads to Bi; heat in the collaterals leads to Wei." If the treatment of meridians and fu-organs fails to promote free circulation, it may prolong into Wei syndrome. The initial prescription included Xingren (Apricot Seed), Huashi (Talcum), Shigao (Gypsum), Chiling (Red Poria), Weilingxian (Syringa Root), Can Sha (Silkworm Frass), and Yiren (Coix Seed). After several doses, pain decreased. Subsequently, Baizhu (Atractylodes Macrocephala Rhizome), Yiren (Coix Seed), Fuling (Poria), Guizhi (Cinnamon Twig), Pian Jianghuang (Turmeric Rhizome), Chaihu (Dendrobium Stem - note: text says 钗斛, likely Dendrobium), Dangguishen (Angelica Sinensis Head), Yuzhu (Polygonatum Rhizome), Wujiapi (Acanthopanax Bark), and Sangzhi (Mulberry Twig) were decocted. After dozens of doses, limb movement normalized. Finally, pills were taken to gently tonify Liver and Kidney, restoring normal gait.
Clan Woman: Pain in the right arm preventing elevation, classified as Zhibi (Limb Bi). Shujin Tang (Relax Sinews Decoction) was used. Ingredients included Pian Jianghuang (Turmeric Rhizome), Danggui (Angelica Sinensis Root), Qianghuo (Notopterygium Root), Zhi Gancao (Honey-fried Licorice Root), Jiangzha (Ginger Residue), Haitongpi (Piliostigma Bark), plus Guizhi (Cinnamon Twig). After four or five doses, gradual recovery occurred. Generally, sinews contract and become tight when cold, and relax and lengthen when hot. Shortening constitutes Ju (Cramp/Tetany), while relaxation and lengthening constitute Wei (Flaccidity). Wind, Cold, and Dampness mixed together form Bi. Excess Wind constitutes Xingbi (Wandering Bi), excess Cold constitutes Tongbi (Painful Bi), and excess Dampness constitutes Zhuobi (Fixed Bi). Treatment should disperse Wind, expel Cold, dry Dampness, and unblock collaterals. For arm pain, taking Shujin Tang must result in sweating under the axilla; thus, pathogens will not stagnate in the sinew joints, and cramping will relieve. If Qi deficiency, add Renshen (Ginseng Root) and Huangqi (Astragalus Root); if Blood deficiency, add Shudi (Rehmannia Root) and Baishao (White Peony Root); for shoulder/back pain, add Qianghuo (Notopterygium Root), Gouji (Dogspine Herb), and Lu Jiao Jiao (Deer Antler Glue); for waist/spine pain, add Duzhong (Eucommia Bark), Duhuo (Angelica Pubescens Root), and Shayuanzi (Astragalus Complanatus Seed); for arm/finger pain, add Jianghuang (Turmeric Rhizome) and Guizhi (Cinnamon Twig); for joint pain, add Songjie (Pine Joint) and Hu Xi (Tiger Knee - substitute); for lower body pain, add Niuxi (Achyranthes Root), Yiyi (Coix Seed), Wujiapi (Acanthopanax Bark), and Hu Jinggu (Tiger Tibia Bone); for meridian obstruction, add Sangjisheng (Taxillus Branch) and Weilingxian (Syringa Root). If chronic and unhealed, there must be Damp-Phlegm and ruined blood stasis obstructing collaterals; add Guixin (Cinnamon Bark), Dansheng (Arisaema with Bile), Chuanwu (Sichuan Aconite Root), Dilong (Earthworm), Honghua (Safflower), and Taoren (Peach Kernel) to search out and expel them.
Wang Nian: In midsummer, the pulse was deep and slow. Acidic pain below the waist, no sweat in calves and knees, cold hands and feet, difficult defecation, and nocturnal emission. All these indicate Bi caused by Damp-Heat obstruction. First, unblock the stagnation. Prescription: Zheng Niuxi (Steamed Achyranthes Root), Danggui (Angelica Sinensis Root), Qin Jiao (Gentiana Macrophylla Root), Chuanxiong (Ligusticum Rhizome), Yuzhu (Polygonatum Rhizome), Xingren (Apricot Seed), Chenpi (Citrus Peel), Dan Congrong (Cistanche Stem). After two doses, stool became moist. Cistanche and Apricot Seed were removed. Focus shifted to regulating meridian Dampness, adding Guizhi (Cinnamon Twig), Sangjisheng (Taxillus Branch), Duhuo (Angelica Pubescens Root), Yiyi (Coix Seed), Duzhong (Eucommia Bark), and Shudi (Prepared Rehmannia Root, stir-fried). After more than ten doses, full recovery was achieved.