Library

Abdominal pain in patients with a history of bleeding is mostly caused by blood stasis. This is detailed in the chapter on Blood Stasis. However, there are also cases of Qi-related pain. In individuals who have lost blood, Qi becomes disordered first, leading to unstable blood and resulting in hematemesis or epistaxis. Nevertheless, Qi pain in these patients differs from Qi pain in miscellaneous diseases. Qi pain in miscellaneous diseases is severe, whereas Qi pain in bleeding-prone patients is not severe; it merely feels like a lack of smoothness in the chest and abdomen, with a sensation of stagnation and accumulation. Xiaoyao San (Free Wanderer Powder) should be used, added with Jianghuang (Turmeric Rhizome), Xiangfuzi (Cyperi Rhizoma), Binglang (Areca Seed), and Tiantai Wuyao (Linderae Radix). For more details, refer to the section on Blood Stasis and Fullness.

Numbness of the body and pain in the four limbs are now called gout, while in ancient times they were referred to as Bi syndrome (Obstruction Syndrome). When deficient individuals contract external wind, and the pathogen lodges in the vessel layers, it results in Blood Bi (Blood Obstruction). Zhang Zhongjing used Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction), utilizing Guizhi (Cinnamon Twig) to enter the blood level, which is highly effective for expelling wind. Patients with a history of bleeding often have deficient blood vessels and are prone to contracting external wind, developing Bi pain. The pain may wander or remain fixed in one area. Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction) is appropriate, with increased doses of Danggui (Angelicae Sinensis Radix), Danpi (Moutan Cortex), and Honghua (Carthami Flos). If the patient has blood deficiency with hyperactive fire, where wind combines with fire, presenting externally as Bi syndrome and internally with symptoms such as short urine, rapid pulse, and thirst, the acrid-warm nature of Guizhi (Cinnamon Twig) is unsuitable. Instead, Siwu Tang (Four-Substance Decoction) should be used, added with Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Danpi (Moutan Cortex), Qinjiao (Gentianae Macrophyllae Radix), Xuduan (Dipsaci Radix), Lingyangjiao (Saigae Tataricae Cornu), Sangjisheng (Taxilli Herba), Yuzhu (Polygonati Odorati Rhizoma), and Maidong (Ophiopogonis Radix). Wind generated from blood deficiency often occurs in this manner. Use Danggui (Angelicae Sinensis Radix), Honghua (Carthami Flos), and Jingjie (Schizonepetae Spica), decocted in wine and water. Blood stasis wandering into the four limbs can also cause pain, resembling Blood Bi. However, pain from blood stasis is often sharp like a needle prick, and the pulse is neither floating nor tense, which differs slightly. See the chapter on Blood Stasis for details.

Zhou Bi (General Bi) and Hongjiaojiao (Hong Kong Foot/Gouty Arthritis) caused by phlegm-dampness flowing and pouring belong to miscellaneous diseases and are not discussed here.

Wei syndrome refers to the inability to walk due to leg paralysis. It is treated according to five types. Heat in Heart Qi causes Mai Wei (Vessel Atrophy), characterized by flaccid tendons unable to support the body; Tianwang Buxin Dan (Emperor of Heaven's Tonic for the Heart Pill) added with Danpi (Moutan Cortex) is used. Heat in Liver Qi causes Jin Wei (Tendon Atrophy), characterized by tight and contracted tendons; Siwu Tang (Four-Substance Decoction) added with Lingyangjiao (Saigae Tataricae Cornu), Xuduan (Dipsaci Radix), Shanzhuyu (Corni Fructus), Huangbai (Phellodendri Cortex), and Digupi (Lycii Cortex) is used. Heat in Spleen Qi causes Rou Wei (Muscle Atrophy), characterized by a dry stomach with thirst and insensate muscles; Siwu Tang (Four-Substance Decoction) added with Renshen (Ginseng Radix), Shanyao (Dioscoreae Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zexie (Alismatis Rhizoma), and Yunling (Poria) is used. Heat in Kidney Qi causes Gu Wei (Bone Atrophy), characterized by an immobile lower back and spine; Dihuang Tang (Rehmannia Decoction) and Dabu Yin Wan (Great Tonify Yin Pill) are used. Heat in Lung Qi causes Jin Wei (Fluid Atrophy), where fluids cannot irrigate the feet, causing fatigue and immobility; Qingzao Jiufei Tang (Clear Dryness Rescue Lung Decoction) is used. Although the above treatments differentiate by the five zang organs, they all stem from yin deficiency and heat scorching, leading to dysfunction of the sinews and bones. To clear heat, nothing is better than nourishing yin; to generate yin, nothing is better than focusing on the Yangming channel. Yangming is the sea of the five zang and six fu organs, primarily moistening the Zongjin (Major Sinew). Zongjin binds the bones and facilitates joint movement. Deficiency of Yangming leads to flaccidity of Zongjin and failure of the Dai Mai (Girdle Vessel) to pull, resulting in foot atrophy and immobility. Qiongyu Gao (Jade Elixir Paste) added with Yuzhu (Polygonati Odorati Rhizoma), Shigao (Gypsum Fibrosum), Shihu (Dendrobii Caulis), Huafen (Trichosanthis Radix), Zhenzhu (Margarita), and Zhuru (Bambusae Caulis in Taenia) is appropriate. Yuni Jian (Jade Woman Decoction) added with Xijiao (Rhinocerotis Cornu) is also effective. However, although the root of Wei syndrome lies in the Stomach, its manifestation lies in the sinews and bones. All of the following can be added as guiding herbs: Hugu (Pantheris Os), Guiban (Testudinis Carapax et Plastrum), Lujin (Cervi Tendo), Zhujingsui (Porci Medulla Spinalis), Niujingsui (Bovis Medulla Spinalis), Gouji (Cantori Os), Gusuibu (Drynariae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix), Yiren (Coicis Semen), Gouqizi (Lycii Fructus), Tusizi (Cuscutae Semen), and Xuduan (Dipsaci Radix).

Wei syndrome differs from Hongjiaojiao (Hong Kong Foot/Gouty Arthritis); wind-expelling drugs must never be mistakenly used.