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Chang Bi (Intestinal Bi Syndrome) is characterized by frequent drinking yet inability to urinate, abdominal Qi rebellion and conflict, and occasional occurrence of Sundun Xie (diarrhea with undigested food). Bao Bi (Bladder/Pelvic Bi Syndrome) is characterized by pain in the lower abdomen at the Bladder region upon palpation, a sensation as if scalded by hot water, difficult and painful urination, and clear nasal discharge from the upper body.

The food and fluids in the Stomach descend and are transformed by the Small Intestine, which separates the clear from the turbid; the clear seeps into the Bladder, while the turbid transmits to the Large Intestine. When pathogenic factors obstruct the intestines, the transmission and transformation functions fail, and body fluids are not distributed, leading to dryness of the mouth and tongue and frequent drinking. Since the water below cannot be metabolized, it accumulates in the middle jiao and conflicts with the Middle Qi, causing panting. After prolonged conflict, the water violently drains out, causing Sundun Xie. Sundun Xie refers to diarrhea with undigested food, all caused by Chang Bi. Bao refers to the Bao Mai (Pelvic Vessels), which connect to the Bladder. Bao Bi causes Qi stagnation, resulting in internal pain upon palpation of the lower abdomen. Because Yang Qi stagnates and transforms into heat, there is a sensation like being scalded by hot water, and urination becomes difficult. Since the fluid cannot drain downward, it is steamed upward by the heat, resulting in clear nasal discharge.

Yin Qi, when quiet, stores the Shen (Spirit); when restless, it dissipates and perishes. If diet doubles its usual amount, the intestines and stomach are injured. Abnormal Qi causing panting indicates Bi syndrome gathering in the Lung; abnormal Qi causing worry and rumination indicates Bi syndrome gathering in the Heart; abnormal Qi causing urinary incontinence indicates Bi syndrome gathering in the Kidney; abnormal Qi causing exhaustion and weakness indicates Bi syndrome gathering in the Liver; abnormal Qi causing muscle wasting and necrosis indicates Bi syndrome gathering in the Spleen. If various Bi syndromes do not heal, they will further damage the interior organs. Among them, those dominated by Wind Qi are easily cured.

Here, "Yin Qi" refers to Zang Qi, as the Zang organs belong to Yin. Emotional restlessness injures the Zang, while unregulated diet injures the Fu organs. Although the causes differ, both constitute internal injury to the Yuan Qi (Original Qi), allowing external pathogens to gather and form Bi syndrome. When Yin and Yang are peaceful and secure, the Spirit is regulated. Thus, when Yin Qi is quiet, the Spirit is stored; if restless, it is consumed and perished. Diet is meant to nourish; if unregulated and doubled, it damages the intestines and stomach. Any Qi that is biased, mixed, or impure is called Abnormal Qi (Yin Qi). Shanghan (Cold Damage) injures the Yuan Qi; once the Yuan Qi is damaged, Abnormal Qi gathers, and the Righteous Qi becomes obstructed. Therefore, if panting occurs due to Abnormal Qi, one knows the Bi syndrome gathers in the Lung; if worry and rumination occur due to Abnormal Qi, one knows the Bi syndrome gathers in the Heart; if urinary incontinence occurs due to Abnormal Qi, one knows the Bi syndrome gathers in the Kidney; if exhaustion and weakness occur due to Abnormal Qi, one knows the Bi syndrome gathers in the Liver; if muscle wasting occurs due to Abnormal Qi, one knows the Bi syndrome gathers in the Spleen. "Muscle wasting" refers to the lack of warming and harmonizing by Yang Qi, resulting in insensitivity to pain and itch. If various Bi syndromes do not heal, the internal injury to the Yuan Qi becomes more severe. If Wind Qi dominates, forming Xing Bi (Wandering Bi), the disease is easily cured; if Cold-Dampness or other Yin pathogens dominate, stagnation makes it difficult to cure.

The Emperor asked: Regarding Bi syndrome, why do some patients die immediately, some suffer long-term pain, and some recover easily? Qibo replied: Those where the pathogen enters the Zang organs die; those where it lingers in the sinews and bones suffer long-term pain; those where it remains between the skin and muscles recover easily.

This passage explains that because the depth of pathogenic obstruction differs, the ease or difficulty of recovery varies. If the pathogen enters the Zang organs, the Yuan Qi exhausts, leading to death.