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1. There was a person fond of drinking alcohol who had been bedridden for three years. Zhang Zhongchun diagnosed him and determined it was an illness caused by excessive alcohol consumption. Alcohol is inherently a substance of damp-heat; excessive drinking leads to severe damp-heat in the Yangming channel. This pathogen descends to affect the Kidney, resulting in Gu Wei (Bone Atrophy). In ancient times, treating Wei syndrome often involved selecting Yangming channel points or herbs, using Wuweizi (Schisandra Berry) as the Sovereign herb, Huanglian (Coptis Rhizome) as the Minister herb, Maidong (Ophiopogon Tuber), Gange (Kudzu Root), and Baibian Dou (White Hyacinth Bean) as Assistant herbs. Upon taking this prescription, the patient improved immediately.

2. A young man developed softness and weakness in his legs after his recent marriage, accompanied by severe pain. This was identified as Kidney Deficiency. The *Shennong Bencao Jing* states: Duzhong (Eucommia Bark) benefits Essence and Qi, and strengthens sinews and bones. Using one liang, decocted with half water and half wine, rapid efficacy can be achieved. Indeed, he could walk after three days and recovered fully after another three days.

Bi syndrome arises inevitably from the mixed invasion of Wind, Cold, and Dampness. Thus, the Classics state: "When Wind, Cold, and Dampness combine, they form Bi." When Wind predominates, it is called Xing Bi (Wandering Bi); when Cold predominates, it is called Tong Bi (Painful Bi); when Dampness predominates, it is called Zhuo Bi (Fixed Bi). "Bi" means obstruction. When the three pathogens mix and invade, meridians become blocked, and Qi and Blood fail to flow, causing Bi syndrome. Among the three pathogens, only the severity of the evil differs. The Classics' mention of Wind predominance, Cold predominance, and Dampness predominance refers to the etiology; Xing Bi, Tong Bi, and Zhuo Bi refer to the clinical manifestations. Discussions on Fei Bi (Lung Bi), Xin Bi (Heart Bi), Pi Bi (Spleen Bi), Gan Bi (Liver Bi), and Shen Bi (Kidney Bi) refer to the affected Zang organs; Pi Bi (Skin Bi), Mai Bi (Vessel Bi), Ji Bi (Muscle Bi), Jin Bi (Tendon Bi), and Gu Bi (Bone Bi) refer to the location of the disease. Therefore, ancients said: Xing Bi, Tong Bi, and Zhuo Bi caused by Wind, Cold, and Dampness are named based on the time of exposure and the location of the pathogen; there are no additional Pi, Mai, etc., Five Bies outside of Wandering, Painful, and Fixed Bi. Only Wang Sun'an's discussion on Bi in recent times shows profound insight. He first uses "Bi" as a general outline, then categorizes them, stating directly: Xing Bi presents as wandering and unstable pain, known in the world as moving injection pain, commonly called Liu Huo (Flowing Fire); Tong Bi presents as severe pain and suffering, known as Tong Feng (Gout) or Bai Hu Li Jie (White Tiger Joint); Zhuo Bi presents as heaviness and immobility, known as numbness and insensitivity. Regarding the key to treating Bi, as Li Shicai stated: To treat Xing Bi, dispelling Wind is primary, but dispersing Cold and draining Dampness cannot be abandoned; generally, blood-nourishing agents should be added. Because treating Wind requires treating Blood first; when Blood flows, Wind extinguishes itself. To treat Tong Bi, dispersing Cold is primary, but dispersing Wind and drying Dampness cannot be lacking; generally, Fire-tonifying (Yang-warming) agents should be added. Only large acrid and warm herbs can release the harm of coagulated Cold. To treat Zhuo Bi, draining Dampness is primary, but dispelling Wind and resolving Cold cannot be lacking; generally, Spleen-tonifying and Qi-nourishing agents should be added. Because strong Earth overcomes Dampness, and sufficient Qi eliminates stubborn numbness. This reasoning traces back to the *Neijing*, and the theory is excellent. However, if Bi is indeed caused by the three pathogens, treatment should proceed as described; but if pathogens stagnate for a long time, Wind transforms into Fire, Cold transforms into Heat, and Dampness transforms into Pain, the treatment approach must change. One should use formulas that unblock meridians and invigorate Blood, disperse pathogenic stagnation, and add herbs that clear Fire, drain Heat, and resolve Phlegm. Do not rigidly adhere to Li Shicai's methods; this principle was understood by Zhu Danxi. The *Neijing* originally describes Re Bi (Heat Bi), so this is not a forced interpretation. Generally, Bi syndromes where the patient feels pain and itching are easier to treat; those without pain or sensation are difficult to cure. Early intervention is advisable; delay may lead to the condition described in the Classics: If Pi Bi persists and re-exposure to pathogens occurs, the pathogen enters internally to lodge in the Lung, forming Fei Bi, with symptoms of irritability, fullness, wheezing, and vomiting. If Mai Bi persists and re-exposure occurs, the pathogen lodges in the Heart, forming Xin Bi, with symptoms of irritability, rising Qi, dry throat, and frequent belching. If Ji Bi persists and re-exposure occurs, the pathogen lodges in the Spleen, forming Pi Bi, with symptoms of four-limb flaccidity, vomiting, sweating, and abdominal fullness. If Jin Bi persists and re-exposure occurs, the pathogen lodges in the Liver, forming Gan Bi, with symptoms of fright during sleep, increased thirst, and frequent urination. If Gu Bi persists and re-exposure occurs, the pathogen lodges in the Kidney, forming Shen Bi, with symptoms of leg contracture unable to extend, sitting on the buttocks instead of standing on heels, body curvature unable to straighten, and leaning forward with the spine instead of the head. Once Zang Bi manifests, it becomes difficult to treat. Thus, the Classics state: Pathogens entering the Zang organs result in death; those lingering between sinews and bones cause prolonged pain; those remaining in the skin are easily cured. Practitioners treating Bi must examine carefully.

Main Prescription for Xing Bi: Treats Xing Bi caused by Wind predominance, regardless of limb location, upper or lower, left or right, with wandering bone-joint pain. Pain may last three to five days and then shift to another area. [Wind nature belongs to Yang, is good at movement and change.] Pain is lighter during the day and heavier at night. [During the day, Yang qi interacts with Yang aspects, Wei Qi circulates on the exterior, so pain alleviates; at night, Yang qi interacts with Yin aspects, Ying Qi circulates within vessels, Ying Qi stagnates, Wei Qi returns to Yin, meridians block, so pain intensifies.] Or redness or swelling, extreme heat upon pressing. [Wind transforms into Heat.] Severe cases may show aversion to cold and preference for warmth. [Warmth disperses Bi Qi and alleviates pain; Cold causes Bi Qi to coagulate and worsens pain; this is not true internal Cold.]
Qin Jiao (Gentiana Macrophylla Root) [Dispels Wind-Damp], Xu Duan (Dipsacus Root) [Unblocks and circulates Blood vessels], Dang Gui (Angelica Sinensis Root) [Invigorates Blood and stops pain], Moyao (Myrrh) [Breaks Blood stasis and stops pain], Weilingshen (Clematis Root) [Its nature is mobile, also moves horizontally, good for Gout above and below, each 2 qian], Songjie (Pine Node) [Searches out Wind in bones, removes Dampness in Blood], Wancansha (Silkworm Feces) [Dry nature overcomes Dampness and dispels Wind], Hugu (Tiger Bone) [Enters bones to dispel Wind and stop pain, each 4 qian], Qianghuo (Notopterygium Rhizome), Fangfeng (Saposhnikovia Root) [Treats whole-body joint pain, essential herbs for dispelling Wind and removing Dampness, each 1 qian], Sangzhi (Mulberry Twig) [Unblocks and benefits joints, 3-4 liang, stir-fried]. Decoct in soup to cook the medicine. For headache and eye pain, add Ganju (Chrysanthemum Flower), Chuanxiong (Ligusticum Rhizome); for shoulder and back pain, add Jiegeng (Platycodon Root), double Qianghuo; for arm and hand pain, add Pian Jianghuang (Turmeric Rhizome); for waist, knee, and foot pain, add Niuxi (Achyranthes Root), Duzhong (Eucommia Bark), Chuanbi Xie (Dioscorea Hypoglauca Rhizome); for tendon and vessel spasm, add Lingyangjiao (Antelope Horn, ground powder), Yangjinggu (Sheep Tibia Bone, powder); for redness, swelling, and pain, add Shengdihuang (Rehmannia Root), Huangqin (Scutellaria Root, wine-fried).

Main Prescription for Tong Bi: Treats Tong Bi caused by Cold predominance. Regardless of limb location, upper or lower, left or right, pain is fixed in one spot and extremely severe.
Add Guizhi (Cinnamon Twig) to the previous formula, double Dang Gui, suitable for decoction with wine. [Not suitable for long-term use.] External application: Cansha (Silkworm Feces, stir-fried hot, wrapped in silk and ironed) or Niu Pi Jiao (Ox Hide Glue melted with Ginger Juice applied topically).

Main Prescription for Zhuo Bi: Treats Zhuo Bi caused by Dampness predominance, characterized by heavy limbs unable to move, pain, and numbness.
Add Cangzhu (Atractylodes Rhizome) [Dries Dampness], Fuling (Poria), Zexie (Alisma Rhizome) [Leaches out Dampness], Tianma (Gastrodia Rhizome) [Mainly treats Damp-Bi numbness] to the previous formula. For severe cases, add Baixianpi (Dictamnus Bark) [Clears Damp-Heat, treats dead flesh]; for swollen and painful feet and knees [Dampness stagnates transforming into Heat], add Huangbai (Phellodendron Bark), Fangji (Stephania Root) [Specifically dispels Lower Jiao Damp-Heat].

This syndrome generally relies on herbs that unblock meridians, invigorate Blood, and disperse pathogenic stagnation as the mainstay. Based on the three invaded pathogens, the severity of the evil, and the cold/heat and deficiency/excess of symptoms, appropriate symptomatic herbs are added. For Tong Bi, if pain occurs immediately upon initial Cold contraction, Guizhi and wine decoctions/ironing can be used, but once Cold transforms into Heat due to duration, these must be avoided. Although it is said that pain has no tonification method, prolonged pain damages Yuan Qi, requiring Qi and Blood tonification. Renshen (Ginseng Root), [missing text], Baizhu (Atractylodes Macrocephala Rhizome), Dihuang (Rehmannia Root) and similar herbs should be used as appropriate. In treating diseases and prescribing herbs, once the syndrome is clearly identified, the corresponding medicine should be administered flexibly; one need not be confined to the fixed formulas of this specific category.

*Jinkui Yaolue* Gualou Xiebai Tang: Treats Xiong Bi (Chest Bi) where the patient cannot lie flat, and heart pain radiates to the back. [Qi closure in the chest causes pain in both front and back.]
Gualou Shi (Trichosanthes Fruit, half fruit), Xiebai (Allium Macrostemon Bulb, 1 liang, Acrid-Warm to promote Yang circulation), Banxia (Pinellia Tuber, [description: Chest is like the sky, Yang Qi functions; Bi implies Yang Qi deficiency and failure to transport, fluids condense into Phlegm, thus Banxia combined with Gualou descends Phlegm, a small amount]). Decoct with Baijiu (White Wine). [To promote circulation of Ying and Wei Qi.] This is Zhang Zhongjing's divine formula for treating Xiong Bi. According to Xu Jiayan: The chest is like the vast sky; where Yang Qi passes, it is like the sun shining in the sky, open and boundless. If Earth Qi rises even slightly, obstruction increases. Therefore, treating Xiong Bi addresses the condition where Yang Qi does not govern and Yin Qi is above. Treatment uses Xiebai and Baijiu to promote Yang and dissipate Yin, not relying on tonification.