风、痹、痿三症不同，近世不能为辨，而混同施治，误人不浅。兹特分别之。
风者，肢节走痛也。《内经》谓之贼风，后人谓之痛风，又谓之白虎历节风。其中表里寒热
虚实，宜因脉辨症而药之。至久痛必入络，如木通、刺蒺藜、红花、金银花、钩藤之类，最
能通络，可随宜加入。久痛必挟郁，郁而成热，热盛则生痰，如南星、半夏、栝蒌根、黄柏
、郁金、川贝、竹沥、姜汁之类，俱能解郁清热化痰，可随宜加入。多用桑枝、桑寄生者，
盖以桑为箕星之精也；多用虎骨者，以风从虎，亦以骨治骨之义也。用乌、附、辛、桂之药
而不效者，宜用葳蕤、麦冬、桑叶、脂麻、生 、菊花、蒺藜、阿胶、甘草之类为膏，滋养
阳明，亦是柔润熄肝风之法。
痹者，闭也。风寒湿杂至，合而为痹，与痛风相似。但风则阳受之，痹则阴受之。虽行
痹属风，痛痹属寒，着痹属湿，而三气之合，自当以寒湿为主。盖以风为阳邪，寒湿为阴邪
，阴主闭，闭则重着而沉痛。是痹症不外寒湿，而寒湿亦必挟风。寒曰风寒，湿曰风湿，此三
气杂合之说也。《内经》云∶在阳命曰风，在阴命曰痹。以此分别，则两症自不混治矣。
至于治法，不外三痹汤及景岳三气饮之类为主，如黄 五物汤、黄 防己汤、桂枝芍药知母
汤、乌头汤之类，皆古圣经方，当知择用。张景岳云∶只宜峻补真阴，宣通脉络，使气血得
以流行，不得过用驱风等药，再伤阴气，必反增其病矣。若胸痹、胞痹及脏腑之痹，当另立
一门，方能分晓，《医门法律》分别甚详，宜熟玩之。
痿者，两足痿弱而不痛也。《内经》分为五脏∶肺痿者，主皮毛痿也；心痿者，脉痿也
；肝痿者，筋痿也；脾痿者，肉痿也；肾痿者，骨痿也。而其要旨，在独取阳明。盖阳明为
五脏六腑之海，主润宗筋。宗筋主束骨而利机关，若阳明虚，不能藏受水谷之气而布化，则
五脏无所禀，宗筋无所养，而痿 作矣。医者不知，误投姜、独风药，则火得风而益炽；
误投乌、附劫药，则阴被劫而速亡。要知此症无寒，当遵张子和为定论。若用痛风三痹蒸汤
灸燔等法，立见其危。至于方治，以虎潜丸、加减四斤丸为主。痿久者，间服六君子汤加黄
柏、苍术、竹沥、姜汁。黑瘦人血虚多燥，宜间服二妙地黄丸。肥白人气虚多痰，宜间服当
归补血汤加竹沥、姜汁。定不可误服辛热之药，或问辛热既不可用，何张石顽云，老人痿厥
用虎潜丸而不愈，少加附子而即愈乎？不知此法是借附子辛热之力，以开通经隧，原非为肾
脏虚寒而设也。
风病、痹病、痿病这三种病症是不同的，近代医生不能加以辨别，而混淆在一起进行治疗，误人非常严重。现在特别将它们分别论述。
风病，表现为肢体关节游走性疼痛。《内经》称之为贼风，后人称之为痛风，又称之为白虎历节风。其病位在表在里、性质属寒属热、邪正属虚属实，应当根据脉象和症状来辨证用药。至于久痛必然深入络脉，如木通、刺蒺藜、红花、金银花、钩藤这类药物，最能疏通络脉，可以根据情况适当加入。久痛必然夹杂气机郁滞，郁滞化热，热盛则生痰，如天南星、半夏、栝蒌根、黄柏、郁金、川贝母、竹沥、姜汁这类药物，都能解郁清热化痰，可以根据情况适当加入。多用桑枝、桑寄生，是因为桑树是箕宿星的精华；多用虎骨，是因为“风从虎”，也是以骨治骨的义理。使用乌头、附子、细辛、桂枝等药物而不奏效的，适宜使用葳蕤（玉竹）、麦冬、桑叶、脂麻（黑芝麻）、生地黄、菊花、蒺藜、阿胶、甘草这类药物制成膏方，滋养阳明经，这也是柔润以平息肝风的治法。
痹病，就是闭塞不通的意思。风寒湿三气杂至，合而为痹，与痛风相似。但风病多侵犯阳分，痹病多侵犯阴分。虽然行痹属于风，痛痹属于寒，着痹属于湿，但这三种邪气相合，自然应当以寒湿为主。因为风为阳邪，寒湿为阴邪，阴主闭藏，闭塞则导致沉重、固定且剧烈的疼痛。所以痹病不外乎寒湿，而寒湿也必然夹杂风邪。寒称为风寒，湿称为风湿，这是三气杂合的说法。《内经》说：在阳分叫作风，在阴分叫做痹。以此区分，这两种病症自然不会混淆治疗了。
至于治疗方法，不外乎以三痹汤及张景岳的三气饮等为主，如黄芪五物汤、黄芪防己汤、桂枝芍药知母汤、乌头汤等，都是古代经典方剂，应当知晓选择使用。张景岳说：只宜峻补真阴，宣通脉络，使气血得以流行，不可过用驱风等药物，再损伤阴气，必定反而加重病情。如果是胸痹、胞痹以及脏腑之痹，应当另立一门类讨论，才能条理清晰，《医门法律》中区分得非常详细，应当仔细研读。
痿病，表现为两足痿弱无力但不疼痛。《内经》将其分为五脏：肺痿，主要指皮毛痿；心痿，主要指脉痿；肝痿，主要指筋痿；脾痿，主要指肉痿；肾痿，主要指骨痿。而其关键要点，在于独取阳明经。因为阳明经是五脏六腑的海，主管滋润宗筋。宗筋主管约束骨骼而利于关节运动，如果阳明经虚弱，不能受纳水谷之气而布散化生，那么五脏就无所禀受，宗筋就得不到滋养，痿病就发生了。医生不了解这一点，误投生姜、独活等风药，则火借风势更加炽盛；误投乌头、附子等劫夺阴液的药物，则阴液被劫夺而迅速消亡。要知道此症没有寒邪，应当遵循张子和的观点作为定论。如果使用治疗痛风的三痹蒸汤、灸燔等方法，立刻就会见到危险。至于方药治疗，以虎潜丸、加减四斤丸为主。痿病日久者，间服六君子汤加黄柏、苍术、竹沥、姜汁。形体黑瘦的人血虚多燥，适宜间服二妙地黄丸。形体肥白的人气虚多痰，适宜间服当归补血汤加竹沥、姜汁。绝对不可误服辛热药物。有人问：既然辛热药物不可用，为什么张石顽说，老人痿厥用虎潜丸不愈，稍加附子就痊愈了呢？不知道这个方法是借用附子辛热的力量，来开通经络隧道，原本不是为了肾脏虚寒而设立的。
Wind, Bi (Obstruction), and Wei (Flaccidity) are three distinct syndromes. In recent times, physicians have failed to distinguish them, treating them interchangeably, which has caused significant harm. Here, they are specifically differentiated.
Wind syndrome is characterized by wandering pain in the limbs and joints. It is called "Zei Feng" (Thief Wind) in the *Nei Jing* (Inner Canon), later referred to as "Tong Feng" (Gout), or "Bai Hu Li Jie Feng" (White Tiger Joint Pain). Its location (exterior or interior), nature (cold or heat), and condition (deficiency or excess) should be diagnosed based on pulse and symptoms for appropriate herbal prescription. For chronic pain that inevitably penetrates the collaterals, herbs such as *Akebiae Caulis* (Mutong), *Tribuli Fructus* (Ciji Li), *Carthami Flos* (Hong Hua), *Lonicerae Japonicae Flos* (Jinyinhua), and *Uncariae Ramulus cum Uncis* (Gouteng) are most effective at unblocking the collaterals and can be added as appropriate. Chronic pain often involves Qi stagnation; stagnation generates heat, and excessive heat produces phlegm. Herbs such as *Arisaematis Rhizoma Praeparatum* (Nanxing), *Pinelliae Rhizoma* (Banxia), *Trichosanthis Radix* (Gualou Gen), *Phellodendri Cortex* (Huangbai), *Curcumae Radix* (Yujin), *Fritillariae Thunbergii Bulbus* (Chuanbei), *Bambusae Succus* (Zhuli), and *Zingiberis Rhizoma Recens* (Jiangzhi) can all resolve stagnation, clear heat, and transform phlegm, and may be added as appropriate. The frequent use of *Mori Ramulus* (Sangzhi) and *Taxilli Herba* (Sangjisheng) is because mulberry is considered the essence of the Ji Star; the frequent use of *Ossis Tigris* (Hugu) is based on the saying "wind comes from the tiger," and also follows the principle of using bone to treat bone. If treatments using *Aconiti Lateralis Radix Praeparata* (Wutou), *Aconiti Radix* (Fuzi), *Asari Radix* (Xixin), and *Cinnamomi Ramulus* (Guizhi) are ineffective, it is suitable to prepare a paste using *Polygonati Odorati Rhizoma* (Weirui/Yuzhu), *Ophiopogonis Radix* (Maidong), *Mori Folium* (Sangye), *Sesami Fructus Nigrum* (Zhima), *Rehmanniae Radix* (Shengdi), *Chrysanthemi Flos* (Juhua), *Tribuli Fructus* (Jili), *Ecoris Asini Colla* (Ejiao), and *Glycyrrhizae Radix et Rhizoma* (Gancao) to nourish the Yangming channel. This is also a method of moistening and softening to extinguish Liver wind.
Bi syndrome means obstruction. When Wind, Cold, and Dampness combine, they form Bi syndrome, which resembles gout. However, Wind typically affects the Yang aspects, while Bi affects the Yin aspects. Although Xing Bi (Wandering Bi) is attributed to Wind, Tong Bi (Painful Bi) to Cold, and Zhuo Bi (Fixed Bi) to Dampness, when these three pathogens combine, Cold and Dampness are primarily dominant. This is because Wind is a Yang pathogen, whereas Cold and Dampness are Yin pathogens. Yin governs closure; closure leads to heaviness, fixed location, and deep pain. Thus, Bi syndrome essentially involves Cold and Dampness, and Cold-Dampness must necessarily involve Wind. Cold combined with Wind is called "Feng Han"; Dampness combined with Wind is called "Feng Shi." This refers to the mixing of the three pathogens. The *Nei Jing* states: "In the Yang, it is named Wind; in the Yin, it is named Bi." Using this distinction prevents the confusion of treatments for these two syndromes.
Regarding treatment methods, the main formulas include San Bi Tang and Zhang Jingyue's San Qi Yin. Other classical formulas such as Huangqi Wuwu Tang, Huangqi Fangji Tang, Guizhi Shaoyao Zhimu Tang, and Wutou Tang are ancient classic prescriptions and should be selected appropriately. Zhang Jingyue stated: "One should only vigorously tonify True Yin and unblock the collaterals to allow Qi and Blood to circulate freely. One must not overuse wind-dispelling drugs, which would further injure Yin and inevitably exacerbate the disease." If it involves Chest Bi, Bladder Bi, or Zang-Fu Bi, a separate category should be established for clarity. *Yi Men Fa Lü* distinguishes these in detail, and one should study it thoroughly.
Wei syndrome is characterized by flaccid weakness in both legs without pain. The *Nei Jing* divides it into five Zang organs: Lung Wei corresponds to skin/hair Wei; Heart Wei corresponds to vessel Wei; Liver Wei corresponds to tendon Wei; Spleen Wei corresponds to muscle Wei; Kidney Wei corresponds to bone Wei. The key principle lies in exclusively treating the Yangming channel. Yangming is the sea of the five Zang and six Fu organs and governs the nourishment of the Zong Jin (major tendons). The Zong Jin binds the bones and facilitates joint movement. If Yangming is deficient and cannot receive and distribute the Qi of water and grain, the five Zang organs will lack nourishment, the Zong Jin will not be sustained, and Wei syndrome will arise. Physicians who do not understand this may mistakenly prescribe Wind-dispelling herbs like *Zingiberis Rhizoma* (Jiang) and *Angelicae Dahuricae Radix* (Duhuo); Fire will intensify with the wind. They may mistakenly prescribe *Aconiti Radix* (Wutou/Fuzi) which depletes Yin; Yin will perish rapidly. It must be known that this syndrome does not involve Cold; one should follow Zhang Zihe’s conclusion as definitive. Using methods for gout such as San Bi steaming or moxibustion/fire therapy will immediately lead to danger. Regarding prescription treatment, Hujian Wan and Ji Jian Sijin Wan are the main formulas. For chronic Wei syndrome, Liu Junzi Tang with Huangbai, Cangzhu, Zhuli, and Jiangzhi can be taken intermittently. Individuals who are dark-skinned and thin often have Blood deficiency with dryness; Er Miao Dihuang Wan can be taken intermittently. Individuals who are fat and fair-complexioned often have Qi deficiency with Phlegm; Danggui Buxue Tang with Zhuli and Jiangzhi can be taken intermittently. One must absolutely avoid taking acrid-warm drugs. Some may ask: Since acrid-warm drugs are contraindicated, why did Zhang Shiwenn say that for elderly patients with Wei and Jue (flaccidity and cold extremities), Hujian Wan was ineffective, but adding a small amount of Fuzi resulted in immediate cure? It is unknown that this method borrows the acrid-warm power of Fuzi to open up the meridians and tunnels; it was originally not intended for Kidney deficiency-cold.