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[Pulse] The pulse at the Cun Kou (Inch Port) is rapid and firm, indicating Bi syndrome (Obstruction Syndrome) in the Heart; rapid and floating, indicating Bi syndrome in the Lung; long and rebounding to the left and right, indicating Bi syndrome in the Liver; large and deficient, indicating Bi syndrome in the Spleen; firm and large, indicating Bi syndrome in the Kidney.

[Etiology] Wind pathogen causes Xing Bi (Wandering Bi), characterized by migrating pain. The nature of wind is agile and mobile. Cold pathogen causes Tong Bi (Painful Bi), characterized by severe, fixed pain. The nature of cold is contracting and pulling. Dampness pathogen causes Zhuo Bi (Fixed Bi), characterized by heaviness and fixed soreness. The nature of dampness is heavy and stagnant. The root causes of Bi syndrome induced by these three pathogens are either external contraction combined with other diseases, or solely due to these factors. There is no case where Bi syndrome occurs without these three pathogens.

[Manifestations] When the three pathogens combine to form Bi syndrome: contraction in Winter results in Gu Bi (Bone Bi); in Spring, Jin Bi (Sinew Bi); in Summer, Mai Bi (Vessel Bi); in Late Summer, Ji Bi (Muscle Bi); in Autumn, Pi Bi (Skin Bi). If the condition persists for a long time, it transmits inward and resides in the organs associated with these tissues. Once it resides within the Zang-Fu organs, it becomes difficult to treat. In the "Bi Lun" chapter of the *Huangdi Neijing*, it is discussed that Wind, Cold, and Dampness can all lodge in the Zang-Fu organs because these pathogens invade when the body's righteous Qi is deficient. If Jin Bi does not resolve, it transmits inward to the Liver; if Pi Bi does not resolve, it transmits inward to the Lung; if Ji Bi does not resolve, it transmits inward to the Spleen; if Mai Bi does not resolve, it transmits inward to the Heart; if Gu Bi does not resolve, it transmits inward to the Kidney. When lodging in the Heart, it causes mental restlessness, rebellious Qi rising, dry throat, fear, belching, and cold distension of the limbs. When lodging in the Lung, it causes vexation, fullness, wheezing, and vomiting. When lodging in the Liver, it causes excessive drinking, frequent urination, lower abdominal pain resembling pregnancy, and night terrors. When lodging in the Spleen, it causes flaccidity and weakness of the four limbs, thirst, vomiting of frothy saliva, and severe upper jiao obstruction. When lodging in the Kidney, it causes easy distension, inability to stand upright (relying on the sacrum as heels), and spinal curvature (spine replacing the head). When lodging in the Intestines, it causes frequent drinking but inability to urinate, abdominal rumbling and qi conflict, and occasional diarrhea with undigested food. The Large Intestine is the official of transmission and transformation, maintaining harmonious Qi. When Wind, Cold, and Dampness invade due to deficiency, this harmonious Qi becomes blocked. The water passages do not flow freely, causing improper transformation of waste, leading to rumbling and diarrhea. When lodging in the Bao (Bladder/Lower Jiao area), pressing the lower abdomen and bladder causes internal pain. It feels like being poured with hot water, urine is scanty and painful, and clear nasal discharge occurs above. Because Wind, Cold, and Dampness lodge in the Bao, Qi cannot transform and exit, causing Bao distension and blocked water passages, with pathogens following the meridians to emerge from the nasal orifices. When lodging in the blood vessels, circulating up and down along the meridians, ascending and descending throughout the body, it is called Zhou Bi (General Bi).

Hua Tuo on Bi Syndrome states that Bi syndrome is caused by evil pathogens combining with abnormal Qi of the four seasons, affecting the Zang-Fu organs. It is divided into Qi Bi, Blood Bi, Sinew Bi, Muscle Bi, and Bone Bi. Qi Bi arises from excessive worry, thought, anger, or joy, causing Qi to knot in the upper body. If unresolved, it damages the Lung, weakening righteous Qi and allowing evil Qi to prevail. Stagnating in the upper body causes chest and abdominal pain and anorexia; flowing to the lower body causes heavy waist and legs and inability to walk; penetrating the tongue causes aphasia; lingering in the abdomen causes urinary retention. Stagnation causes pain, while flow causes numbness. A deep, slow, and choppy pulse at the Right Cun indicates Qi Bi. Blood Bi arises from excessive alcohol consumption, excessive internal heat, cold damaging the collaterals, or dampness invading Ying and Wei levels, causing blood stasis and gradually leading to emaciation and blood loss. A knotted and non-smooth pulse at the Left Cun indicates Blood Bi. Muscle Bi arises from irregular diet and excessive rich foods. Muscles lack nourishment, skin lacks luster, pores become loose, and Wind, Cold, and Dampness invade, causing flaccid limbs that cannot be controlled. A weak and choppy pulse at the Right Guan indicates Muscle Bi. Sinew Bi arises from uncontrolled shouting and anger, hurried walking or running, and pathogenic invasion damaging the Liver. Loss of Liver Qi allows Cold and Heat to lodge, flowing into the sinew hubs, causing sinew tightness and stiffness. A wiry, rapid, and forceful pulse at the Left Guan indicates Sinew Bi. Bone Bi arises from excessive desires damaging Kidney Qi, leading to internal depletion and failure to secure essence, allowing evil Qi to enter. A slow pulse indicates Cold, rapid indicates Heat, floating indicates Wind, soggy indicates Dampness, and slippery indicates Deficiency. Treatment methods should be adapted accordingly.

Differentiation of Numbness: This is caused by Wind-Damp-Heat sinking into the Blood level and Yin aspect, preventing Yang Qi from circulating. The symptom is whole-body numbness when closing the eyes. There are also cases of itching due to Phlegm in the Blood level, where Blood fails to nourish the muscle and interstices.

[Treatment] Fuzi Tang (Aconite Decoction) treats Wind, Cold, and Damp Bi.
Prepared Fuzi (processed, peeled, navel removed) Cinnamon Twig White Peony Root Licorice Poria Ginseng (each 3 qian) Atractylodes Macrocephala Rhizome (1 liang).
For Xing Bi (Wandering Bi), add Mahuang Guizhi Tang (Ephedra and Cinnamon Twig Decoction); for Tong Bi (Painful Bi), add Fuzi, Shengjiang (Fresh Ginger), and Fuling (Poria) decoction; for Bao Bi, add Si Ling San (Four Poria Powder); for Chang Bi (Intestinal Bi), add Pingwei San (Calm the Stomach Powder), Evodia Fruit, Nutmeg, and Cardamom.

Dai Ren Method: Use bitter agents to induce vomiting of Cold Phlegm, followed by phlegm-resolving agents. Use Baizhu (to remove dampness), Fuling (to nourish Kidney Water), Guizhi (to subdue Wood/Liver), Shengjiang (Fresh Ginger), and Fuzi (add if Cold prevails).

Numbness Formula: Ginseng (to assist Yang Dao), Danggui (to move Yin/Blood), Raw Licorice (to clear heat), Baizhu, Fuling (to remove damp-heat), Shengma, Chaihu, Baishao, Cangzhu, Huangbai. If Phlegm is present, add Erchen Tang (Two-Chen Decoction).

Jinyingteng Gao (Lonicera Japonica Vine Paste) treats spasticity caused by the Five Bis (Skin, Vessel, Muscle, Sinew, Bone Bi).