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[Diagram of the Nine Palaces and Solar Terms]

In *Suwen: Bi Lun* (Treatise on Obstruction Syndromes), the Yellow Emperor asked, "How are obstruction syndromes generated?" Qibo replied, "When Wind, Cold, and Dampness three pathogens mix and invade together, they combine to form an obstruction syndrome. When Wind Qi is predominant, it is called Xing Bi (Wandering Obstruction); when Cold Qi is predominant, it is called Tong Bi (Painful Obstruction); when Dampness Qi is predominant, it is called Zhuo Bi (Fixed Obstruction)."

Wind belongs to Yang, while Cold and Dampness belong to Yin. These three pathogens mix and combine to form an obstruction disease. Wind is Yang in nature and its character is moving and unstable; it injures Wei Qi (Defensive Qi) and thus, when Wind is excessive, pain wanders about, hence named Wandering Obstruction. Cold is Yin in nature and its character is congealing and contracting; it injures Ying Blood (Nutritive Blood) and thus, when Cold is excessive, the body suffers from pain, hence named Painful Obstruction. Dampness pathogen is turbid and stagnant, injuring both Ying and Wei Qi; thus, when Dampness is excessive, Qi and Blood stagnate and adhere, causing heaviness of the body, hence named Fixed Obstruction. This is one disease divided into three syndromes based on the predominance of the pathogens.

The Yellow Emperor asked, "Why are there five types?" Qibo replied, "Those who encounter this [pathogenic combination] in Winter are called Gu Bi (Bone Obstruction); those who encounter it in Spring are called Jin Bi (Sinew Obstruction); those who encounter it in Summer are called Mai Bi (Vessel Obstruction); those who encounter it during the Late Summer (Zhi Yin period) are called Ji Bi (Muscle Obstruction); and those who encounter it in Autumn are called Pi Bi (Skin Obstruction)."

The Kidney governs the Winter season, and bones belong to the Kidney; the Liver governs the Spring season, and sinews belong to the Liver; the Heart governs the Summer season, and blood vessels belong to the Heart; the Spleen governs the Late Summer, and muscles belong to the Spleen; the Lung governs the Autumn season, and skin and hair belong to the Lung. The *Feng Lun* (Treatise on Wind) in this classic states: "Those injured by Wind on Jia-Yi days [Wood days] in Spring will develop Liver Wind, and the same applies to other Zang organs." The pathology of Bi pathogens follows this same principle. Essentially, the Five Zang organs correspond to the climatic characteristics of the Five Seasons; therefore, external pathogens take advantage of the seasonal Qi to enter their respective regions, resulting in disease.

The Yellow Emperor asked, "What causes the internal lodging of pathogens in the Five Zang and Six Fu organs?" Qibo replied, "Each Zang organ has a corresponding exterior tissue. If the disease persists for a long time without resolving, the pathogen internally lodges in its corresponding organ. Thus, if Bone Obstruction does not resolve and the patient is re-exposed to pathogens, the pathogen internally lodges in the Kidney; if Sinew Obstruction does not resolve and the patient is re-exposed, it lodges in the Liver; if Vessel Obstruction does not resolve and the patient is re-exposed, it lodges in the Heart; if Muscle Obstruction does not resolve and the patient is re-exposed, it lodges in the Spleen; if Skin Obstruction does not resolve and the patient is re-exposed, it lodges in the Lung. What is referred to as Bi syndrome is caused by repeatedly encountering Wind, Cold, and Dampness pathogens during their respective seasons."

All twelve meridians of the hands and feet have acupoints, named Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points. The points where Qi emerges are called Jing-Well points; the points where Qi enters deeply are called He-Sea points. Qi and Blood exit and enter through these points, circulating throughout the body. Pathogens invade taking advantage of seasonal Qi; if they remain for a long time without departing, they internally lodge in the corresponding tissues. If they still do not depart and the patient is re-exposed to pathogens, they deeply lodge in the Zang organs. It is precisely because of repeated exposure to pathogens that the disease progresses from superficial to deep levels, becoming closed and obstructed, unable to exit. Hence, it is named Bi. The *Lingshu: Wu Bian Pian* (Chapter on Five Variations) states: "Those with coarse skin texture and unfirm muscles are prone to Bi diseases." This is because coarse texture and unfirm muscles lead to loose Cou Li (skin pores and interstices), allowing pathogens to easily enter and remain stagnant, thereby forming Bi syndrome.