6.36 Di Syndrome
6.36.1 Try to describe the relationship between Bi syndrome and pathogens of wind cold and dampness
Wind, cold and dampness invading the body, which is caused by changeable climate and alternate cold and heat, or dwelling in damp places, or wading, or being caught in the rain, and linger in channels and joints, resulting in Bi syndrome as the result of stagnation of Qi and blood.

6. 36.2 How many types is Bi syndrome classified into? Describe their main points of differentiation, treatments and recipes.
Bi syndrome caused by wind-cold-dampness
(1 )Xing Bi
[Main points of differentiation] Wandering soreness of joints.
[Treatment] Dispelling wind, dredging channels and removing dampness.
[Recipe] Fang Feng Tang

(2) Tang Bi
[Main points of differerxriation] Severe pain of joints with fixed spot and aggravated with cold.
[Treatment] Expelling pathogenic cold from-channels and removing wind and dampness.
[Recipe] Wu Tou Tang

(3)Zhuo Bi
[Main points of differentiation] Soreness and heaviness of joints, numbness of muscIes whitish and greasy fur.
[Treatment] Removing dampness and obstruction in the collaterals, expelling wind and clearing away cold.
[Recipe] Yi YiRen Tang
Bi syndrome resulting from wind-heat-dampness
[Main points of differentiation] Swelling joints with burning
pain aggravated with heat, slippery and rapid pulse.
[Treatment] Clearing away heat expelling wind and dampness, and removing obstruction in the collaterals?
[Recipe] Bai Hu Jia Zhi Tang
6. 36.3 Acupuncture Treatment
[Treatment]
Select points along the meridians supplying the diseased area, according to the nature and location of the disease. Combine the Ioca points with distal points. In the case of Hi syndrome clue to invasion of wind, cold and darnp points are selected to dispel wind, remove cold and eliminate damp. If it is due to invasion of wind heat! points are for clearing away heat and eliminating dampness.
[PrescriPtion]
(1) Points chosen according to the location of disease
Pain in the shouder: Jianyu, Jianliao, and Naoshu
Pain in the elbow: Quchi, Tianjing, Chize, Hegu , Waiguan
Pain in the wrisl: Yangchi, Waiguan, Yangxi and Wangu
Vain in the hack: Shuisou, Shenzhu, Yaozngguan, Jiaji
Pain in the hip joints: Huantiao, Juliao, Xuanzhong
Pain in the thigh: Zhibian , Chengfu, Fengshi. Yanglingqnun
Pain in the knee joints: Dubi, Lianqiu , Yanglingquan Xiyang n
Pain in the ankle: Shenmai, Zhaohai, Kunlun , and Qiuxu
(2) Points chosen according to the rature of be syndrome
Wandering Bi Geshu, and Xuehai
Painful Bi: Shenshu and Gucsnvuan
Fixed Bi: Zusanli and Sanyinjiao
Heat Bi: Dazhui and Quchi

6.37 Flaccidity Syndrome
6. 37. 1 What is the definition of flaccidity syndrome?

Flaccidity syndrome i a morbid condtion manifested as flaccidity of tendons and muscles which will result in rnyoatrophy because it is impossible for tendons and muscles to move freely.

6. 37. 2 flow many types is flaccidity syndrome classified into? What are their respective main points of differentiation trea tmentts and recipes?
(1 )The impairment of body fluid by the lung-heat and malnutrition of muscles, tendons and vessels
[Main points of differentiation] Onset with fever, after abate- ment of fever appearing weakness of limbs, cough, dry throat, red tongue with little fur.
[Treatment] Clearing away heat, moisturzing dryness and nourishing the lung to produce body fluid.
[Recipe] Qing ZaoJiu Fei Tang
(2)Damp-heat invading the body nd failure of Qi and blood in circulation
[Main points of differentiarion] Flaccidity of limbs, stuffiness in epigastrium, dark urine, yellowish and greasy fur.
[Treatment] Eliminating dampness and heat and easing joint movement
[Recipe] Jia Wei Er Miao San
(3)Dcficicncy of the spleen and stoniach causing food essence of fail to be transported to the whole body
[ Main points of differentiation] Weakness of limbs to become more severe grdually, poor appette, loose stool and pale tongue.
[Treatment] Invigorating the spleen and replenishng Qi to promote their functons of transporting and transforming food essence.
[Recipe] Shen Ling Bai Zhu San
(4)Deficiency of the liver and kidney and myoartophy
[Main points of diffcrentiaion] Slow onset, flaccid lower
limbs,soreness of the loins, tinnitus, red tongue with little fur. [Treatment] Invigorating the liver and kidney and nourishing
Yin to clear away heat.
[Recipe] Hu qian Wan

6. 37 .3 Acupuncture Treatment
[Treatment]
Select points on the Foot- Yangming, Taiyin meridians as main points and points on the foot- Shaoyin and Jueyin meridians as secondary ones. The reinforcing method is used.
[Prescription]
Jianliao, Quch: Hegu Yangri, Higuan, Liangqiu, Zusanli, Jiexii
[Modification with various syndromes]
Lung heat: Chize and Feishu
Stomach heat: Melting and Zhongwan
Damp-heat Yinlingquan and Pishu
Deficiency of spleen and stomach: Pishu, Zhongwan and Zusanli
Deficiency of liver and kidney: Ganshu, Shenshu, Xuanzhong and Yanglingquan

6.38 Fever Resulting from Internal Injury
?
6. 38. 1 How do you distinguish fever resulting from internal injury from that caused by exopaihogenic fever?

6. 38. 2 What are the common types of fever caused by internal injury? And what are the main points of differentiation of each?
(1 )Fever due to stagnation of the hver-Qi
[Main points of differentiation] Fever, vexalion, the fever condition changing in dependence on the patient’s moods fullness in hypochondrium, bittertaste, wiry and rapid pulse.
[Treatment] Soothing the liver and relieving mental depression, removing heat.
[Recipe] Dan Zhi Xiayao San

(2) Fever due to blood stasis
[Main points of differentiation] Fever in the afternoon or at night, fixed pain-spot or mass in the body, dark purplish tongue.
[Treatment] Removing blood stasis by promoting blood circuat ion.
[Recipe] Xue Fu Zhu Yu Tang
(3)Fever due to deficiency of Yin
[Main points of differenriation] Fever in the afternoon or at night, feverish sensation in the palms and soles, night sweat, dreamful sleep, red and dry tongue with little or without fur.
[Treatment] Nourishing Yin and clearing away heat.
[Recipe] Qing Gu San
(4)Fevcr due to blood deficiency
[Main points of differentiation] Low fever, dizziness, blurred vision, pale complexion, paie lips ind nails
[Treatment] Replenishing Qi to nourish blood.
[Recipe] Qui Pi Tang or Dang Qui Bu Xue Tang
(5)Fevcr due to Qi deficiency
[Main points of differentiation] Fever often occurring or aggravated after tiredness, poor appetite, loose stool, short breath and being lazy to talk.
[Treatment] Supplementing Qi to strengthen the spleen, warm in property to remove heat.
[Recipe] Bu Zhong Y? Qi Tang
6.39 Consumptive Disease

6. 39. 1 What are the differences of between pulmonary tuherculosis arid Consumptive disease in etiology, diseased regioiis and clinical manifestation?
As to the differentiation 0f consumptive disease and pulmariary tuboculosis, the latter is an infectious disease caused by invasion of tuberculosis germs, and its diseased region is mainly in the lungs, pathologically marked by excessive heat due to deficiency of Yin and clinically manifested by cough, hemoptysis. hectic fever, night sweat emaciated constitution, While the fonrier is a non-infective disease caused by many factors and the lesion parts are chiefly in five zang-organs, pathogenically characterized by consumption of Qi blood, Yin and Yang , and manifested hy various clinical .symptoms showing deficiency of Qi , blood. Yin and Yang in five Zang-organs.