黄帝问曰∶痹之安生？岐伯对曰∶风寒湿三气杂至，合而为痹也。其风气胜者为行痹，寒气胜
者为痛痹，湿气胜者为着痹也。帝曰∶其有五者何也？岐伯曰∶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。帝曰∶内舍五脏六腑，何气使然？岐伯曰∶五脏皆
有合，病久而不去者，内舍于其合也。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。凡痹之客五脏者，肺痹者，烦满喘而呕。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。肝痹者，夜卧则惊，多饮数小便，上为引如
怀。肾痹者，善胀，尻以代踵，脊以代头。脾痹者，四肢解惰，发咳呕汁，上为大塞。肠痹者，数饮而出不得，
中气喘争，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。阴气者，静则神藏，躁
则消亡，饮食自倍，肠胃乃
伤。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。诸痹不已，亦益内也。其风气胜者，其人易已也。帝曰∶痹，其时有死者，或疼久者，或易已者，
其故何也？岐伯曰∶其入脏者死，其留连筋骨间者疼久，其留皮肤间者易已。帝曰∶其客于六腑者何也？岐伯
曰∶此亦其食饮居处，为其病本也。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。
帝曰∶以针治之奈何？岐伯曰∶五脏有俞，六腑有合，循脉之分，各有所发，各随其
过，则病瘳也。帝曰∶荣卫之气亦令人痹乎？岐伯曰∶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，逆其气则病，从其气则愈，不与风寒湿气合，故不为痹。
帝曰∶善。痹或痛，或不痛，或不仁，或寒，或热，或燥，或湿，其故何也？岐伯曰∶痛者，寒气多也，有寒
故痛也。其不痛不仁者，病久入深，荣卫之行涩，经络时疏，故不通，皮肤不营，故为不仁。其寒者，阳气少，
阴气多，与病相益，故寒也。其热者，阳气多，阴气少，病气胜阳遭阴，故为痹热。其多汗
而濡者，此其逢湿甚也，阳气少，阴气盛，两气相感，故汗出而濡也。帝曰∶夫痹之为病，不痛何也？岐伯
曰∶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，故具此五者，则
不痛也。凡痹之类，逢寒则虫，逢热则纵。帝曰∶善。
Huangdi asked: How is Bi syndrome (Obstruction Syndrome) generated? Qibo replied: When Wind, Cold, and Dampness pathogenic factors mix and invade the body together, they combine to form Bi syndrome. If Wind predominates, it is called Xing Bi (Moving Bi); if Cold predominates, it is called Tong Bi (Painful Bi); if Dampness predominates, it is called Zhuo Bi (Fixed/Heaviness Bi).
Huangdi asked: Why are there five types? Qibo said: Contracting these pathogens in Winter results in Gu Bi (Bone Bi); in Spring, Jin Bi (Tendon Bi); in Summer, Mai Bi (Vessel Bi); during the late summer period (Zhi Yin), Ji Bi (Muscle Bi); and in Autumn, Pi Bi (Skin Bi).
Huangdi asked: What causes the pathogens to enter internally and lodge in the Zang and Fu organs? Qibo said: Each of the Five Zang organs has an internal connection with specific tissues. If the disease persists without resolution, the pathogens will enter internally into their corresponding Zang organ. Thus, if Gu Bi does not resolve and the patient is re-exposed to pathogens, it enters internally into the Kidney. If Jin Bi does not resolve and the patient is re-exposed, it enters internally into the Liver. If Mai Bi does not resolve and the patient is re-exposed, it enters internally into the Heart. If Ji Bi does not resolve and the patient is re-exposed, it enters internally into the Spleen. If Pi Bi does not resolve and the patient is re-exposed, it enters internally into the Lung. This is what is meant by Bi syndrome: contracting Wind, Cold, and Dampness repeatedly during their respective seasons.
Regarding Bi pathogens lodging in the Five Zang organs: In Fei Bi (Lung Bi), symptoms include vexation, fullness, wheezing, and vomiting. In Xin Bi (Heart Bi), vessels are obstructed; when vexed, there is palpitation like a drumbeat under the heart; sudden upward Qi rebellion causes wheezing; the throat becomes dry; frequent belching occurs; and when rebellious Qi rises, fear arises. In Gan Bi (Liver Bi), the patient startles easily during sleep, drinks excessively, urinates frequently, and experiences upper body pulling sensations resembling pregnancy. In Shen Bi (Kidney Bi), abdominal distension is common; the patient walks on their buttocks instead of heels (Kao Yi Dai Zhong), and the spine is elevated while the head is lowered (Ji Yi Dai Tou). In Pi Bi (Spleen Bi), the limbs are flaccid and weak; coughing occurs with vomiting of saliva; and severe obstruction occurs in the upper jiao. In Chang Bi (Intestinal Bi), despite frequent drinking, urination is difficult; there is gurgling Qi movement in the middle jiao; and sporadic undigested stool diarrhea (Sun Xie) occurs. In Bao Bi (Bladder Bi), pressing the lower abdomen and bladder area causes internal pain, feeling as if scalded by hot water; urination is scanty and difficult; and clear mucus drips from the nose.
Yin Qi functions such that when quiet, the Spirit is stored; when agitated, the Spirit dissipates. Doubling food intake damages the intestines and stomach.
Excessive Qi causing wheezing indicates Bi gathering in the Lung; excessive Qi causing sorrow/thought indicates Bi gathering in the Heart; excessive Qi causing enuresis indicates Bi gathering in the Kidney; excessive Qi causing exhaustion indicates Bi gathering in the Liver; excessive Qi causing muscle atrophy indicates Bi gathering in the Spleen. All forms of Bi, if unresolved, will gradually move inward. Among them, Bi dominated by Wind is easier to cure.
Huangdi asked: Some patients with Bi die, some suffer long-term pain, and some recover easily. What is the reason? Qibo said: Those whose pathogens enter the Zang organs will die; those whose pathogens linger between sinews and bones will suffer prolonged pain; those whose pathogens remain in the skin will recover easily.
Huangdi asked: What about pathogens lodging in the Six Fu organs? Qibo said: This also stems from improper diet and lifestyle as the root cause. The Six Fu organs each have Shu points. When Wind, Cold, and Dampness attack these Shu points, and dietary irregularities respond internally, the pathogens follow the Shu points inward and lodge in their respective Fu organs.
Huangdi asked: How should acupuncture be used for treatment? Qibo said: The Five Zang organs have Shu points, and the Six Fu organs have He-Sea points. Following the distribution of meridians, each has specific reaction sites. Treating according to the location of the pathology leads to recovery.
Huangdi asked: Do Ying (Nutrient) Qi and Wei (Defensive) Qi also cause Bi syndrome? Qibo said: Ying Qi is the essence derived from food and water. It harmonizes with the Five Zang organs and distributes to the Six Fu organs, then enters the vessels. Thus, it circulates up and down along the vessels, penetrating the Five Zang and connecting the Six Fu. Wei Qi is the fierce Qi derived from food and water. Its nature is rapid and slippery, unable to enter the vessels. Therefore, it circulates among the skin and between muscles, steaming the Huang membrane (Sanjiao membrane), and dispersing in the chest and abdomen. If its flow is reversed, disease occurs; if it flows smoothly, health is maintained. Since it does not combine with Wind, Cold, or Dampness, it does not form Bi syndrome.
Huangdi said: Good. Some Bi syndromes are painful, some are not; some involve numbness, some cold, some heat, some dryness, some dampness. What is the reason? Qibo said: Pain is due to excess Cold; the presence of Cold causes pain. Non-painful numbness occurs because the disease is deep-seated, Ying and Wei Qi circulation is sluggish, meridians are occasionally empty, so sensation is blocked; skin lacks Ying Qi nourishment, resulting in numbness. Cold sensations arise from deficiency of Yang Qi and excess of Yin Qi, which mutually reinforce the pathological cold, causing chills. Heat sensations arise from excess Yang Qi and deficiency of Yin Qi; the pathological Yang overcomes the deficient Yin, resulting in Bi Heat. Profuse sweating and wetness occur when exposed to severe Dampness; with deficient Yang and abundant Yin, the two energies interact, causing sweating and wetness.
Huangdi asked: Why do some Bi syndromes not hurt? Qibo said: If Bi is in the bone, the body feels heavy; if in the vessels, blood coagulates and stagnates; if in the sinews, flexion and extension are impaired; if in the flesh, there is numbness; if in the skin, there is cold. Possessing any of these five conditions results in no pain. Generally, Bi syndromes contract when exposed to Cold and relax when exposed to Heat.
Huangdi said: Good.