风寒湿三气杂至，合而为痹。（痹者，闭也，一阴一阳结谓之喉痹，食痹而吐，是皆闭塞之义也。故
风寒湿三气杂至，则壅闭经络，血气不行而病为痹，即痛风不仁之属。痹，音秘。）其风气胜者为行痹，
风者善行数变，故为行痹。凡走注历节疼痛之类皆是也。）寒气胜者为痛痹，（阴寒之气客于肌肉筋骨之间，
则凝结不散，阳气不行，故痛不可当，即痛风也。）湿气胜者为着痹也。（着痹者，肢体重着不移，或为疼
痛，或为顽木不仁。湿从土化，病多发于肌肉。）其有五者∶以冬遇此者为骨痹，以春遇此者为筋痹，以
夏遇此者为脉痹，以至阴遇此者为肌痹，以秋遇此者为皮痹。（遇此者，指上文之三气也。）内舍五脏六腑，
五脏皆有合，病久而不去者，内舍于其合也。（皮、肉、筋、骨、脉皆有五脏之合，病在外而久不去，则
各因其合而内连于脏矣。）故骨痹不已，复感于邪，内舍于肾；筋痹不
已，复感于邪，内舍于肝；脉痹不已，复感于邪，内舍于心；肌痹不已，复感于邪，内舍于脾；皮痹不已，复
感于邪，内舍于肺。所谓痹者，各以其时，重感于风、寒、湿之气也。（舍者，邪入而居之也。时，谓气王
之时，五脏各有所应也。病久不去，而复感于邪，气必更深，故内舍其合而入于脏。）凡痹之客五脏
者，肺痹者烦满喘而呕；（肺在上焦，其脉循胃口。故为烦满喘而呕也。）心痹者脉不通，烦则心下鼓暴，
上气而喘，嗌干善噫，厥气上则恐；（心合脉而痹气居之，故脉不通。心脉起于心中，其支者
上挟咽，其直者却上肺，故病此诸症。厥气，阴气也。心火衰则邪乘之，故神怯而恐。）肝痹者夜卧则惊，
多饮数小便，上为引如怀；（肝藏魂，肝气痹则魂不安，故主夜卧惊骇。肝脉下者过阴器，抵少腹，上
者循喉咙之后，上入颃颡，故为病如此。）肾痹者善胀，尻以代踵，脊以代头；（肾者，胃之关。肾气痹
则阴邪乘胃，故腹善胀。尻以代踵者，足挛不能伸也。脊以代头者，身偻不能直也。以肾脉入跟中，上
内，出 内廉，贯脊属肾，故为是病。）脾痹者四肢解堕，发咳呕汁，上为大塞；（脾主四肢，故令解堕，其
脉属脾络胃，上膈挟咽，今其气痹不行。故发咳呕汁，甚则上焦痞隔，为大塞不通也。）肠痹者，数
饮而出不得，中气喘争，时发飧泄；（肠痹者，兼大、小肠而言。肠间病痹，则下焦之气不化，故虽数饮
而水不得出，水不出则本末俱病，故与中气喘争，盖其清浊不分，故时发飧泄。）胞痹者少腹膀胱，按
之内痛，若沃以汤，涩于小便，上为清涕。（胞，膀胱之脬也。膀胱气闭，故按之则内痛；水闭不行，则蓄
而为热，故若沃以汤，且涩于小便也。膀胱之脉，从巅入络脑，故上为清涕。）阴气者，静则神藏，
躁则消亡。（阴气者，脏气也。五脏者，所以藏精，神、魂、魄、志、意者也。人能安静，则邪不能干，故
精神完固，而五内若躁扰妄动，则精气耗散，神志消亡，故外邪得以乘之，五脏之痹，因而生矣。）饮食自倍，
肠胃乃伤。（六腑者，所以受水谷而化物者也。若过用不节。致伤脾胃，则六腑之痹因而生矣。）淫气喘息，
痹聚在肺；淫气忧思，痹聚在心；淫气遗溺，痹聚在肾；淫气乏竭，痹聚在肝；淫气肌绝，痹聚在脾。（淫气，
邪乱之气也。五脏之痹，上文虽已详言，然犹有其辨者如此，又可因之以知其聚在何脏也。诸痹不已，亦
益内也。在表者不去，必日内而益深矣。）其风气胜者，其人易已也。（风为阳邪，可以散之，故易已；然
则寒、湿二痹，愈之较难，以阴邪留滞不易行也。）痹，其时有死者，或疼久者，或易已者。 其入脏者
死，其留连筋骨间者疼，久留皮肤间者易已。（入脏者死，伤真阴也，留连筋骨者疼久，邪之深也；留皮肤者
易已，邪之浅也。）其客于六腑者，亦其食饮居处为其病本也。（水谷之寒热，感则害及六腑；居处之邪气，
感则伤在六阳，故食饮居处，为六腑致病之本。）六腑亦各有俞，风、寒、湿气中其俞，而食饮应之，循
俞而入，各舍其腑也。（俞，言周身之穴。凡邪可入，皆谓之俞；非荣俞、背俞之谓，食伤于内。邪中于外，
表里相应，故得乘虚而入舍于腑。）荣卫之气，不令人痹。盖荣者，水谷之精气也。和调于五脏，洒陈
于六腑，乃能入于脉也。故循脉上下，贯五脏，络六腑也。卫者，水谷之悍气也，其气 疾滑利，不能入于
脉也。故循皮肤之中，分肉之间，熏于肓膜，散于胸腹。（肓者，凡控腹肉理之间，上下空隙之处也。膜，筋
膜也。）逆其气则病，从其气则愈。不与风、寒、湿气合，故不为痹。（营卫之气，但不可逆，故逆之
则病，从之则愈。然非若皮肉、筋骨、血脉，脏腑之有形者也，无迹可着，故不与三气为合，盖无形亦无痹
也。）痹或痛，或不痛，或不仁，或寒或热，或燥或湿。痛者寒气多也，有寒故痛也。（寒多则血脉凝滞，
故必为痛。）其不痛不仁者，病久入深，荣卫之行涩，经络时疏，故不痛。皮肤不营，故为不仁。其寒者阳气少，
阴气多，与病相益，故寒也。（凡病寒者，不必尽由于外寒，但阳气不足，阴气有余，则寒从中生，与病
相益，故为寒症。）其热者阳气多，阴气少，病气胜，阳遭阴，故为痹热。（遭，逢也。阳盛遭阴，则
阴气不能胜之，故为痹热。）其多汗而濡者，此其逢湿盛也。阳气少，阴气盛，两气相感，故汗出而濡也。
（上文兼燥而言，此则全提寒、湿两气也。其文法如此，阴气有余，为多汗身寒，亦此义也。）夫
痹而不痛者，痹在于骨则重，在于脉则血凝而不流，在于筋则屈不伸，在于肉则不仁，在于皮则寒。具此
五者，则不痛也。（具此五者，则筋、骨、皮、肉、血脉间，气无不痹，故不得为痛也。）
凡痹之类，逢寒则急，逢热则纵。
周痹之在身也，上下移徙随脉，其上下左右相应，间不容空，此痛在血脉之中，邪将在分肉之间乎？何
以其痛之移也？间不及下针，其 痛之时，不及定治，而痛已止。（ 痛，动而痛也。间不及下针，不及定
治，言移动之速也， ，音触。）此名众痹，非周痹也。各在其处，更发更止，更居更起，以右应
左，以左应右，非能周也，更发更休也。（各在其处，谓随聚而发也。不能周遍上下，但或左或右，更发更
休，患无定所，故曰众痹。）必刺其处，勿令复起。（治从其本，故可勿令复起。）周痹者，在于血脉
之中，随脉以上，随脉以下，不能左右，各当其所。（能上能下，但随血脉而周遍于身，故曰周痹，非若众
痹之左右移易也。）痛从上下者，先刺其下以过之，后刺其上以脱之。痛从下上者，先刺其上以过之，后
刺其下以脱之。（过者，去之之谓。脱者，拔绝之谓，先刺以过之，去其标也；后刺以脱之，拔其本也。）
此痛安生而有名？风寒湿气，客于外分肉之间，迫切而为沫，沫得寒则聚，聚则排分肉而分裂也，分裂则痛。（
邪气客于肌表，渐入分肉之间，则迫切津液而为汁沫；沫得寒则聚而不散，故排裂肉理为痛。）痛
则神归之，神归之则热，热则痛解，痛解则厥，厥则他痹发，发则如是。（痛则心注其处，故神归之。神归即
气归也，气归则热，热则寒散而痛暂解，然其逆气仍在，故痛虽解而厥未除，则别有所聚，故或自上而下，
或自下而上，他痹发矣，是名周痹，发仍如此。）此内不在脏，而外未发于皮，独居分肉之间，真气不能周，
故命曰周痹。（真气不能周，即气闭不行也，故曰痹者闭也。）
足太阳之筋病，小趾支跟踵痛 挛，（其筋起于足小趾，结于踵，上循跟，结于 也。）脊反折，项筋
急，肩不举，腋支缺盆中纽痛，不可左右摇。（其别者，结于臀，上挟脊，上项；其支者，结于
肩，入腋下，上出缺盆，故为此病。）治在燔针，名曰仲春痹也。（仲春痹者，足太阳之经应二月之气也，
此以手、足六经，分主十二月，盖以辨阴阳盛衰之义也。）足少阳之筋病，小趾次趾支转筋，引膝外
转筋，膝不可屈伸， 筋急。（足少阳之经，起于小趾次趾，上循胫外廉，结于膝外廉也。）前引髀，后引尻，
即上乘 ，季胁痛，（其筋之支者，上走髀，前者结于伏兔，后者结于尻，其直者上乘 及季胁
也。）上引缺盆，膺乳颈维筋急。（其直者，系于膺乳，结于缺盆，上循耳后也。维者，牵系之谓。）从左
之右，右目不开，上过右角，并跷脉而行，左络于右。（从左之右，则右目不开，是右病由左也。
然则左目不开者，病由于右可知矣。角，额角也，并跷脉而行者，阴跷阳跷，阴阳相交，阳入阴，阴出阳，
交于目锐 ，故左络于右。）故伤左角，右足不用，命曰维筋相交。（伤左角之筋，而右足不用，则其
从右之左者亦然。盖筋之维络相交如此也。）治在燔针，名曰孟春痹也。（足少阳以生阳之经，故应正月之
气也。）足阳明之筋病，足中趾支胫转筋，脚跳坚，（本经之筋，起于中趾，结于跗上，邪外上行，加
于辅骨上，结于膝外廉。其直者，上循 ，结于膝也。跳者，跳动。坚者，坚强也。）
伏兔转筋，髀前肿， 疝，腹筋急，（其直者，上循
伏兔，结于髀，聚于阴器，上腹而布也。）引缺盆乃颊，卒口僻急者，目不合；热则筋纵，目不开。颊筋有
寒则急，引颊移口；有热则筋弛纵，缓不胜收，故僻。（僻，歪斜也。其经自缺盆上颈颊，
挟口，上合于太阳，太阳为目上纲，阳明为目下纲。故凡目之不合不开，口之急纵歪僻者，皆足阳明之筋病，寒
则急而热则缓也。）治之以马膏膏其急者，以白酒和桂以涂其缓者。以桑钩钩之，即以生桑炭置之坎中，高
下以坐等，以膏熨急颊，且饮美酒，啖美炙肉。不饮酒者，自强也，为之三拊而已。（马膏，马脂也。其性味
甘平柔润，能养筋治痹，故可以膏其急者。白酒辣，桂性味辛温，能通经络，行血脉，故可以涂其缓者。桑
之性平，能和关节，除风寒湿痹诸痛，故以桑钩钩之者，钩正其口也。复以生桑火炭置之地坎之中，高下以坐等
者，欲其深浅适中，便于坐而得其暖也。然后以前膏熨其急颊，且饮之美酒，啖之美肉，皆助血舒筋之法也。
虽不善饮，亦自强之。三拊而已，言再三拊摩其患处，则病自已矣。啖，音淡。拊，音府。）治在燔针，名
曰季春痹也。（足阳明正盛之经，三月应之气也。）足太阴之筋病，足大趾支内踝痛，转筋痛，（足太阴之筋，
起大趾之端，上结于内踝也。）膝内辅骨痛，阴股引髀而痛，阴器纽痛，下引两脐胁痛，引
膺中脊内痛。（其直者，络于膝内辅骨，上阴股，结于髀，聚于阴器，上脐腹胸胁；其内者，着于脊也。）
治在燔针，命曰仲秋痹也。（盖足太阴之经，应八月之气也。）足少阴之筋病，足下转筋，及所过而
结者皆痛，及转筋。（足少阴之经，起于小趾之下，故病足下转筋，所过而结者，以其并足太阴之筋，斜走
内踝之下，结于踵，又与太阳之经，合而上结于内辅之下；又并太阴之筋，而上循阴股，结于阴器，皆能为痛
及转筋也。）病在此者，主痫螈及痉。（痫，癫痫也。螈，牵急也。痉，坚强反张，尤甚于螈者也。足少阴
为天一之经，真阴受伤，故为此病。螈，音炽。）在外者不能俯，在内者不能仰。故阳病者腰反
折，不能俯，阴病者不能仰。（在外者，与太阳之筋合，故不能俯；在内者，循脊内挟膂，上至项，故不能
仰。阳病者，即在外者也；阴病者，即在内者也。）治在燔针，在内者熨引饮药，此筋折纽，纽
发数甚者，死不治，（熨引所以舒筋，饮药所以养血。折纽者，即转筋之甚。发日数，病日甚者，阴亏之极
也，故当死不治。）名曰孟秋痹也。（盖足少阴为生阴之经，应七月之气也。）足厥阴之筋病，足大趾支内
踝之前痛，内辅痛，阴股痛，转筋，（足厥阴之筋，起于大趾之上，结于内踝之前，又结于内辅骨之下，上
循阴股也。）阴器不用∶伤于内则不起，伤于寒则阴缩入，伤于热则纵挺不收。（阴器者，前阴之具也，厥
阴之筋结于此，阴器病者，有此三者之异。）治在行水，清阴气。（清，理也。此言当以药治之，在通行
水脏而调阴气，盖水则肝之母也。）其病转筋者，治在燔针，（转筋者，治当在经也。）命曰季
秋痹也。（足厥阴者，阴尽之经也，故应九月之气也。）手太阳之筋病，小指支肘内锐骨后廉痛，循臂阴入腋
下，腋下痛，腋后廉痛，绕肩脾引颈而痛，应耳中鸣痛引颔，目瞑，良久乃得视。（手太阳之筋起于小指，上
结于腕，结于肘内锐骨之后，上结于腋下，上肩循颈，结于耳后，结于颔上，属目外 ，故其痛引耳颔则
瞑目，良久方可开视也。）颈筋急，则为筋 颈肿，寒热在颈者，治在燔针。（筋 颈肿，即鼠瘰之属。）
Wind, cold, and dampness pathogenic factors mix and invade together, combining to form Bi syndrome (Bi syndrome, obstruction). (Bi means obstruction. When Yin and Yang knots together, it is called Hou Bi (throat obstruction); when food stagnates and vomits, it is called Shi Bi (food obstruction); these all imply the meaning of obstruction. Therefore, when wind, cold, and dampness mix and invade, they obstruct and close the meridians, causing blood and Qi to fail to circulate, resulting in Bi syndrome, which belongs to conditions like gout and numbness. Bi is pronounced "mi".) When wind pathogen prevails, it is called Xing Bi (wandering Bi), (Wind is agile and changes rapidly, hence called Xing Bi. Conditions such as migrating pain and joint pain belong to this.) When cold pathogen prevails, it is called Tong Bi (painful Bi), (Yin-cold pathogen enters between muscles, sinews, bones, and tendons, condensing and not dispersing, preventing Yang Qi from circulating, thus causing unbearable pain, also known as gout.) When dampness pathogen prevails, it is called Zhuo Bi (fixed Bi). (Zhuo Bi presents with heavy limbs fixed in place, either painful or numb. Dampness transforms according to Earth, and diseases often occur in the muscle layer.) There are five types: contracting these three pathogens in winter results in Gu Bi (bone Bi); in spring, Jin Bi (sinew Bi); in summer, Mai Bi (vessel Bi); at Zhi Yin (the time of extreme Yin/late summer), Ji Bi (muscle Bi); and in autumn, Pi Bi (skin Bi). ("Contracting these" refers to the aforementioned three pathogens.) If internal organs are involved, each Zang organ has its corresponding tissue; if the disease persists for a long time without resolving, the pathogen moves inward to reside in its corresponding Zang organ. (Skin, flesh, sinews, bones, and vessels all have correspondences with the five Zang organs. If the pathogen remains on the exterior for a long time, it connects internally to the Zang organs according to their correspondences.) Thus, if Gu Bi does not resolve and the patient is re-exposed to pathogens, the pathogen resides in the Kidney; if Jin Bi does not resolve and the patient is re-exposed, the pathogen resides in the Liver; if Mai Bi does not resolve and the patient is re-exposed, the pathogen resides in the Heart; if Ji Bi does not resolve and the patient is re-exposed, the pathogen resides in the Spleen; if Pi Bi does not resolve and the patient is re-exposed, the pathogen resides in the Lung. The so-called Bi syndrome occurs when one contracts wind, cold, and dampness repeatedly during their respective seasonal peaks. ("Reside" means the pathogen enters and stays. "Season" refers to the time when the Five Elements Qi is prosperous, and each Zang organ corresponds to a specific season. If the disease persists and the patient is re-exposed, the Qi becomes deeper, thus residing internally in the corresponding Zang.) For Bi pathogens residing in the five Zang organs: Fei Bi (Lung Bi) presents with vexation, fullness, panting, and vomiting; (The Lung is in the Upper Jiao, and its meridian circles the stomach and passes through the cardia. Hence, vexation, fullness, panting, and vomiting occur.) Xin Bi (Heart Bi) presents with blocked vessels, vexation with palpitations like drumbeats in the epigastrium, upward rushing Qi with panting, dry throat, frequent belching, and fear when rebellious Qi rises; (The Heart governs vessels, and Bi Qi occupies them, so vessels are blocked. The Heart meridian originates in the heart, branches go up to clamp the throat, and the main branch goes up to the lung, hence these symptoms. Jun Qi refers to Yin Qi. When Heart Fire declines, pathogens take advantage, causing spirit deficiency and fear.) Gan Bi (Liver Bi) presents with fright during sleep, excessive drinking, frequent urination, and upward rushing Qi feeling like pregnancy; (The Liver stores Hun (Ethereal Soul). When Liver Qi is obstructed, Hun is unsettled, leading to night frights. The Liver meridian descends past the genitalia to the lower abdomen and ascends behind the throat to enter the pharynx, hence these symptoms.) Shen Bi (Kidney Bi) presents with frequent distension, sitting with the buttocks replacing the heels, and the spine replacing the head; (The Kidney is the gate of the Stomach. When Kidney Qi is obstructed, Yin pathogens attack the Stomach, causing abdominal distension. "Buttocks replacing heels" means leg contracture preventing extension. "Spine replacing head" means body curvature preventing upright posture. Since the Kidney meridian enters the heel, ascends the medial leg, emerges at the medial malleolus, penetrates the spine, and connects to the Kidney, these symptoms arise.) Pi Bi (Spleen Bi) presents with flaccid limbs, coughing, vomiting of saliva, and severe upper Jiao obstruction; (The Spleen governs the four limbs, causing flaccidity. Its meridian connects to the Spleen, links to the Stomach, crosses the diaphragm, and clamps the throat. Now Spleen Qi is obstructed, causing cough and vomiting of saliva. Severe cases lead to upper Jiao blockage and severe obstruction.) Chang Bi (Intestine Bi) presents with frequent drinking but inability to urinate, abdominal borborygmi and qi contention, and occasional undigested stool diarrhea; (Chang Bi refers to both Large and Small Intestines. Intestinal Bi causes Lower Jiao Qi transformation failure, so despite frequent drinking, water cannot exit. Water retention causes root and branch pathology, leading to abdominal qi contention due to unclear separation of clear and turbid, causing occasional undigested stool diarrhea.) Bao Bi (Bladder Bi) presents with pain in the lower abdomen/bladder upon pressure, a sensation of hot water pouring inside, difficult urination, and clear nasal discharge above; (Bao refers to the bladder sac. Bladder Qi closure causes internal pain upon pressure. Water stagnation generates heat, causing a sensation of hot water and difficult urination. The Bladder meridian enters the brain from the vertex, hence clear nasal discharge.) Yin Qi, when still, hides the spirit; when restless, it dissipates. (Yin Qi refers to Zang Qi. The five Zang organs store Jing, Shen, Hun, Po, Zhi, and Yi. If one remains calm, pathogens cannot interfere, keeping spirit solid; if the interior is restless, Jing Qi dissipates, spirit vanishes, allowing external pathogens to invade, generating Zang Bi.) Doubling food intake injures the intestines and stomach. (The six Fu organs receive water and grain and transform them. Overuse and lack of moderation injure the Spleen and Stomach, generating Fu Bi.) Dysregulated Qi causing panting indicates Bi gathering in the Lung; dysregulated Qi causing worry/thought indicates Bi gathering in the Heart; dysregulated Qi causing enuresis indicates Bi gathering in the Kidney; dysregulated Qi causing exhaustion indicates Bi gathering in the Liver; dysregulated Qi causing muscle wasting indicates Bi gathering in the Spleen. (Yin Qi here refers to chaotic pathogenic Qi. Although Zang Bi was detailed earlier, this distinction helps identify where Bi gathers. All Bi syndromes persisting will deepen internally. Exterior pathogens not resolved will move inward and deepen.) When wind prevails, recovery is easy. (Wind is a Yang pathogen, easily dispersed, hence easy to cure; however, Cold and Damp Bi are harder to cure because Yin pathogens linger and are difficult to move.) Bi may cause death, prolonged pain, or easy recovery. Pathogens entering Zang organs cause death; those lingering in sinews and bones cause prolonged pain (deep pathogen); those staying in skin recover easily (shallow pathogen). Pathogens residing in the six Fu organs have diet and lifestyle as the root cause. (Cold and hot food/drink harm the Fu organs; environmental pathogens injure the Yang meridians; thus, diet and lifestyle are the root of Fu organ disease.) Each Fu organ has Shu points. Wind, cold, and dampness attacking these Shu points, combined with dietary responses, allow pathogens to enter via the Shu points and reside in the respective Fu organs. (Shu refers to acupoints throughout the body. Any point where pathogens can enter is called Shu, not just Five-Shu or Back-Shu points. Internal dietary injury and external pathogen invasion correspond internally and externally, allowing pathogens to enter vacant Fu organs.) Ying and Wei Qi do not cause Bi. Ying Qi is the essence of water and grain, harmonized with the five Zang organs, distributed to the six Fu organs, and then enters the vessels, circulating上下, connecting five Zang and six Fu. Wei Qi is the fierce Qi of water and grain, swift and slippery, unable to enter vessels. It circulates in the skin and between muscles, steaming the Huang membrane, and dispersing in the chest and abdomen. (Huang refers to spaces between abdominal muscles; Mo refers to fascia.) Violating Qi causes disease; following Qi leads to recovery. Without combining with wind, cold, and dampness, Bi does not form. (Ying and Wei Qi should not be violated; violation causes disease, compliance brings recovery. Unlike有形 tissues, they leave no trace, so they do not combine with the three pathogens; being formless, there is no Bi.) Bi may be painful or painless, numb, cold or hot, dry or damp. Pain is due to excess cold; cold causes pain. (Excess cold coagulates blood vessels, causing pain.) Painless numbness occurs when disease is deep and chronic, Ying and Wei flow is sluggish, and meridians are occasionally empty, so there is no pain. Skin lacks nourishment, causing numbness. Cold sensations arise from deficient Yang and excess Yin, reinforcing the pathological cold. (Not all cold stems from external cold; insufficient Yang and excess Yin generate internal cold, reinforcing the condition.) Heat arises from excess Yang and deficient Yin; pathogenic Qi overcomes Yang encountering Yin, causing Bi-heat. (Zao means encounter. Yang abundance encountering Yin means Yin cannot overcome Yang, causing Bi-heat.) Profuse sweating and wetness result from abundant dampness. Deficient Yang and abundant Yin interact, causing sweating and wetness. (This section focuses on cold and damp. Excess Yin causing profuse sweat and cold body follows this logic.) Painless Bi: in bone, heaviness; in vessel, blood stasis; in sinew, flexion inability; in muscle, numbness; in skin, cold. Having all five results in no pain. (If Qi is obstructed in all tissues, pain does not occur.) Generally, Bi tightens with cold and relaxes with heat.
Zhou Bi (Circulating Bi) moves up and down along meridians, with left-right correspondence, leaving no gaps. This pain is in the vessels, and the pathogen is in the intermuscular spaces? Why does the pain move? It moves too fast for acupuncture. By the time treatment is decided, the pain stops. (Pain implies movement. Fast movement prevents acupuncture. This is Zhong Bi, not Zhou Bi.) Zhong Bi (Multiple Bi) occurs in fixed locations, alternating onset and cessation, right mirroring left, not circulating globally, but alternating rest. (Fixed location means onset with pathogen aggregation. Not global, but left/right alternating, hence Zhong Bi.) Must needle the site to prevent recurrence. (Treating the root prevents recurrence.) Zhou Bi resides in vessels, moving up and down with meridians, not left/right, stopping at specific sites. (Moves up/down globally along vessels, hence Zhou Bi, unlike Zhong Bi.) For pain moving downward, needle below first to intercept, then above to eradicate. For pain moving upward, needle above first to intercept, then below to eradicate. (Intercept removes the branch; eradicate removes the root.) How does this pain arise and get named? Wind, cold, dampness in intermuscular spaces compress fluids into foam. Cold condenses foam, which pushes apart muscle fibers, causing pain. (Pathogens enter intermuscular spaces, compressing fluids into foam. Cold condenses foam, splitting muscle tissue, causing pain.) Pain draws Shen (spirit/mind) to the site. Shen arrival generates heat. Heat resolves pain. Pain resolution leads to Qi reversal. Reversal causes other Bi sites to flare. (Pain focuses mind/Qi. Qi convergence generates heat, dispersing cold and temporarily relieving pain. However, rebellious Qi remains, aggregating elsewhere, causing upward/downward flare-ups, named Zhou Bi.) This pathogen is neither in Zang nor on skin, but isolated in intermuscular spaces, blocking True Qi circulation, hence named Zhou Bi. (Blocked True Qi circulation means obstruction, hence Bi means obstruction.)
Foot Taiyang Sinew disease: little toe supports heel and sole pain/spasm, (Originating at little toe, knotting at heel, ascending along Achilles tendon to popliteal fossa.) spinal hyperextension, neck stiffness, shoulder immobility, axillary and supraclavicular pulling pain, inability to shake head. (Branches knot at buttocks, ascend along spine to neck; another branch knots at shoulder, enters axilla, emerges at supraclavicular fossa, causing these symptoms.) Treat with burning needle, named Zhong Chun Bi. (Zhong Chun Bi corresponds to February's Qi, distinguishing Yin/Yang prosperity via twelve meridians governing twelve months.) Foot Shaoyang Sinew disease: little and second toe spasm, pulling lateral knee spasm, knee immobility, popliteal stiffness. (Meridian originates at little/second toes, ascends lateral tibia, knots at lateral knee.) Pulls anterior thigh, posterior sacrum, and superior costal margin pain. (Branches ascend thigh, anterior knots at Futu, posterior at sacrum; main line ascends to costal margin.) Pulls supraclavicular fossa, pectoral, breast, and neck Weijin stiffness. (Main line ties to pectorum/breast, knots at supraclavicular fossa, ascends behind ear. Weijjin refers to connecting sinews.) Left-to-right lesion causes right eye closure; ascending right corner, merging with Chongmai, left connects to right. (Left lesion affecting right eye implies right pathology from left. Right eye closure implies left pathology from right. Corner refers to frontal angle. Merging with Chongmai involves Yin/Yang Chong intersection at outer canthus, hence left-right connection.) Injury to left corner sinew paralyzes right foot, named Weijin Jiaoxiang. (Sinew connections cross over.) Treat with burning needle, named Meng Chun Bi. (Shaoyang is generating Yang meridian, corresponding to January.) Foot Yangming Sinew disease: middle toe calf spasm, foot jumping/stiffness. (Sinews originate at middle toe, knot at dorsum, ascend auxiliary bone, knot at lateral knee; main line ascends to knee.) Futu spasm, anterior thigh swelling, hernia, abdominal sinew tension. (Main line ascends Futu, knots at thigh, gathers at genitalia, spreads to abdomen.) Pulls supraclavicular fossa and cheek, sudden facial deviation/stiffness, eyes unable to close; heat causes sinew relaxation, eyes unable to open. Cheek sinew cold causes stiffness/pulling; heat causes relaxation/inability to control, causing deviation. (Deviation means crookedness. Meridian ascends neck/cheek, joins Taiyang. Taiyang is upper eyelid纲, Yangming is lower. Eye opening/closing and mouth deviation are Yangming sinew issues; cold causes stiffness, heat causes relaxation.) Treat stiff side with horse fat plaster, relaxed side with white wine and cinnamon paste. Use mulberry hook to straighten, place live mulberry charcoal in pit, adjust height to sitting position, apply plaster to stiff cheek, drink fine wine, eat roasted meat. Non-drinkers must force themselves, massage three times. (Horse fat is sweet/neutral/moisturizing, nourishes sinews. White wine/cinnamon are pungent/warm, unblock meridians. Mulberry harmonizes joints. Charcoal provides warmth. Wine/meat nourish blood/sinews. Massage aids recovery.) Treat with burning needle, named Ji Chun Bi. (Yangming corresponds to March.) Foot Taeyin Sinew disease: big toe medial malleolus pain/spasm. (Sinews originate at big toe end, knot at medial malleolus.) Medial knee pain, medial thigh pulling thigh pain, genital pulling pain, umbilical/hypochondriac pain, chest/spinal pain. (Main line knots at medial knee, ascends medial thigh, knots at thigh, gathers at genitalia, ascends to abdomen/chest; internal part attaches to spine.) Treat with burning needle, named Zhong Qiu Bi. (Taeyin corresponds to August.) Foot Shaoyin Sinew disease: sole spasm, pain at passage/knots, spasm. (Meridian originates below little toe. Passes with Taeyin sinew,斜走 medial malleolus, knots at heel, merges with Taiyang at medial knee, ascends medial thigh to genitalia, causing pain/spasm.) Disease here causes epilepsy, convulsions, and spasms. (Epilepsy, convulsion, spasm. Shaoyin is Tianyi meridian, true Yin injury causes this.) Exterior inability to bend forward, interior inability to bend backward. Yang disease causes spinal hyperextension (exterior); Yin disease causes inability to extend (interior). (Exterior combines with Taiyang, preventing bending forward; interior runs along spine to neck, preventing bending backward.) Treat with burning needle, interior treated with moxibustion/guidance/herbs. Severe twisting/spasms indicate terminal Yin deficiency, untreatable death. Named Meng Qiu Bi. (Shaoyin is generating Yin meridian, corresponding to July.) Foot Jueyin Sinew disease: big toe medial malleolus anterior pain, medial knee pain, medial thigh pain, spasm. (Sinews originate at big toe, knot at medial malleolus anterior, medial knee inferior, ascend medial thigh.) Genital dysfunction: internal injury causes impotence, cold causes retraction, heat causes flaccid protrusion. (Genitalia are Jueyin sinew attachment points. Three distinct presentations.) Treat by promoting water metabolism and clearing Yin Qi. (Clear means regulate. Promote water organ function to regulate Yin, as Water is Liver's mother.) Spasms treated with burning needle. Named Ji Qiu Bi. (Jueyin is Yin-extreme meridian, corresponding to September.) Hand Taiyang Sinew disease: little toe elbow inner sharp bone posterior pain, arm Yin entering axilla, axillary pain, axillary posterior pain, scapular wrapping neck pain, ear ringing/jaw pain, eye closing, delayed vision. (Sinews originate at little finger, knot at wrist, elbow posterior, axilla, shoulder, neck, ear posterior, mandible, outer canthus. Pain radiating to ear/jaw causes eye closing.) Neck sinew stiffness causes scrofula/swelling. Neck cold-heat treated with burning needle. (Neck sinew stiffness/swelling refers to scrofula.)