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*Ling Shu: Zhou Bi Chapter* (Full Text)

The Yellow Emperor asked Qibo, "Zhou Bi (General Bi Syndrome) exists in the body; its pain migrates up and down following the meridians, with corresponding reactions on the upper/lower and left/right sides, leaving no gaps. I wish to know: is this pain located within the blood vessels (Xue Mai), or between the muscle layers (Fen Rou)? How does it arise? When the pain shifts, it moves too quickly to insert a needle; when it flares, it changes too rapidly to determine treatment, yet the pain ceases before treatment can be applied. What principle causes this? I wish to understand the reason." ('Xie' is synonymous with 'Ye'. Muscles have grain-like textures, hence called Fen Rou. 'Tong' refers to pain caused by movement/agitation. 'Jian bu ji xia zhen' means there is insufficient time to determine treatment, indicating the speed of migration. Pronunciation: chu.)

Qibo replied, "This is Zhong Bi (Multiple/Clustered Bi Syndrome), not Zhou Bi."

The Yellow Emperor said, "I wish to hear about Zhong Bi."

Qibo answered, "Zhong Bi resides in specific locations, alternating between flare-ups and cessation, staying and rising again. The right corresponds to the left, and the left to the right. It cannot circulate throughout the entire body but alternates in occurrence and rest." (Residing in specific locations means it flares where pathogens gather. It cannot circulate fully up and down, only appearing on the left or right, alternating in flare-up and rest, with unpredictable sites, thus called Zhong Bi.)

The Yellow Emperor said, "Excellent. How should it needled?"

Qibo replied, "When needling this condition, although the pain may cease, one must definitely needle the original site to prevent recurrence." (Needling the original site means targeting the initial location of pain. Treating from the root prevents recurrence.)

The Yellow Emperor said, "Excellent. I wish to know what Zhou Bi is like."

Qibo replied, "Zhou Bi lies within the blood vessels, moving upward along the meridians and downward along the meridians, without lateral movement, each occurring at its respective position." (Capable of moving up and down, circulating through the body via the blood vessels, hence called Zhou Bi, unlike Zhong Bi which shifts laterally.)

The Yellow Emperor said, "How should it be needled?"

Qibo replied, "If the pain moves from top to bottom, first needle the lower part to intercept the pathogenic factor, then needle the upper part to eliminate the root cause. If the pain moves from bottom to top, first needle the upper part to intercept the pathogenic factor, then needle the lower part to eliminate the root cause." ('Guo' means to remove/pass through. 'Tuo' means to extract/cut off completely. Needling first removes the branch/symptom; needling second extracts the root/cause.)

The Yellow Emperor said, "Excellent. How is this pain generated? Why is it named so?"

Qibo replied, "Wind-Cold-Dampness pathogens lodge externally, between the muscle layers, pressing the fluids into foam. When the foam encounters cold, it aggregates; aggregation pushes against the muscle layers causing separation, and separation results in pain." (Pathogens lodging in the muscle surface gradually enter the Fen Rou, pressing body fluids into juice-foam. This foam aggregates due to cold and does not dissipate, thus splitting the muscle texture and causing pain.) When pain occurs, the spirit (Shen) focuses on the affected area; focus generates heat; heat resolves the pain temporarily; after resolution, Qi rebellion (Jue) occurs; Qi rebellion triggers other Bi syndromes elsewhere, manifesting as described above. (When in pain, the mind concentrates on the site, so Shen returns there. Shen returning implies Qi returning; Qi returning generates heat, dispersing cold and temporarily relieving pain. However, rebellious Qi remains, so even if pain resolves, Qi obstruction persists, leading to accumulation elsewhere. Thus, Bi syndromes may occur from top-to-bottom or bottom-to-top, termed Zhou Bi, with such manifestations.) This pathology is internally not in the Zang-Fu organs, nor externally manifested in the skin, but resides solely between the muscle layers. Since the True Qi (Zhen Qi) cannot circulate freely, it is named Zhou Bi. (True Qi failing to circulate indicates Qi blockage; hence Bi means closure. The phrase 'The Emperor said: Excellent, I have grasped its meaning' previously found here is a duplication error from the following text and has been deleted.) Therefore, when needling Bi syndromes, one must first palpate the six meridians of the lower limbs, assess their deficiency or excess, examine large collaterals for blood stasis and obstruction, and identify areas of deficiency where pulses are sunken and empty, then regulate them. Use moxibustion/warming therapy to unblock them. For muscle twitching and tendon contraction/torsion, guide the Qi to promote circulation." (The six meridians below refer to the Foot meridians. Blood stasis in large collaterals requires draining; deficiency with sunken pulses requires tonifying; Cold stagnation with Qi obstruction requires warming/unblocking therapy. 'Chong' refers to acute tendon contraction/torsion, requiring needle guidance to move Qi. Pronunciation: chi.)

The Yellow Emperor said, "Excellent. I have grasped the intent and mastered the methods. The nine needles embody the principles of the meridians and are the basis for treating diseases of Yin and Yang in the twelve primary meridians." (Intent refers to the nature of the disease. Method refers to the therapeutic approach. 'Nine' refers to the nine needles. 'Xun' means complete/equipped. This means that both the understanding of the disease and the therapeutic methods reside in the nine needles, which encompass the principles of the meridians, covering all diseases of Yin and Yang in the twelve primary meridians.)