《素问》云∶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。其名有五，皆由此三气客于五脏而成。遇春得者为筋
痹，中于肝则筋挛，夜卧惊恐，饮食多而小便数；遇夏得者为血痹，中于心则血脉不通，心
下鼓气，暴上逆喘，嗌干喜噫；遇仲夏得者为肌痹，中于脾则四肢怠惰，发咳呕汁；遇秋得
者为皮痹，中于肺则皮无所知，烦满时呕气奔痛；遇冬而得者为骨痹，中于肾则骨重不可举
，善胀，尻以代踵，脊以代头。大抵风胜则游走上下，无所留止，随其虚邪与血气相搏。聚
于关节，为驰纵筋脉不收也，此名风痹；寒胜，四肢挛痛，关节浮肿，为痛痹；湿气留而不
移，汗多，四脚缓弱，皮肤不仁，精神昏塞，为着痹；风寒湿合而为痹，则皮肤顽浓，或肌
肉酸痛，此为邪中周身。搏于血脉，积年不已，则成瘾疹风疮，搔之不痛，头发脱落，为本
痹；其中又有胞痹肠痹血痹热痹数者之异。名胞痹者，小肠膀胱按之内痛而满，水道不化，
上为清涕；肠痹者，三气乘虚，客于大肠，其病数饮，中气喘急，时作飧泄，小便不通；血
痹者，邪入于阴血之分，其状体常如被微风所吹，骨弱劳瘦，汗出，卧则不时摇动；热痹者
，盖脏腑移热，复遇风寒湿三气杂至，而客搏经络，留而不行，阳遭其阴，故 痹 然而闷
也。肌肉热极，体上如鼠走之状，唇舌反坏，皮肤色变。经曰∶痹之为病，或痛或不痛，或
不仁，或寒或热，或燥或湿。凡痛者，寒多也。不痛不仁者，病久邪深，荣卫行涩，经络不
通，皮肤不营，因而不痛不仁也。若阴气多阳气少，与病相益，故寒也；若阴气少阳气多，
病气胜阳遭阴，故热也。至于汗多而濡者，是湿甚也。痹而不痛者，在骨则重着，在脉则血
凝，在筋则屈不伸，在肉则痹不仁，在皮则寒。此五者皆不痛也。外有支饮，亦令人痹。支
饮之病，饮之为痰故也。治之之法，当辨其三气，留在何经部分，或表或里，虚实偏胜，推
其因，详其证，果因三气为病，随经治之，或不因三气，从他痹而为病者，当随他病而治之
。又有水痹与白虎历节风之证，岂可一概施之？在乎医者诚心究治，则庶几不瘥矣。
《素问》说：痹证是怎么产生的？岐伯回答说：风、寒、湿三种邪气混杂侵袭人体，结合在一起就形成了痹证。其中风气偏胜的称为行痹，寒气偏胜的称为痛痹，湿气偏胜的称为着痹（重着不移）。痹证名称有五种，都是由于这三种邪气侵入五脏而形成的。在春季感受邪气的称为筋痹，病位在于肝，会导致筋脉拘挛，夜间睡眠时惊恐不安，食欲旺盛但小便频数；在夏季感受邪气的称为血痹，病位在于心，导致血脉不通畅，心下部悸动如鼓，突然气逆上冲而喘息，咽喉干燥且喜欢打嗝；在仲夏（夏季中期）感受邪气的称为肌痹，病位在于脾，导致四肢倦怠无力，发作咳嗽并呕吐涎沫；在秋季感受邪气的称为皮痹，病位在于肺，导致皮肤感觉迟钝或丧失，胸中烦闷且时常呕吐气逆疼痛；在冬季感受邪气的称为骨痹，病位在于肾，导致骨骼沉重难以抬起，容易腹胀，严重时臀部代替脚后跟站立，脊柱弯曲头部前倾。大抵风气偏胜则疼痛游走上下，没有固定停留之处，随着虚邪与气血相互搏结，聚集于关节，导致筋脉弛缓松弛无法收摄，这叫做风痹；寒气偏胜，则四肢拘挛疼痛，关节浮肿，这叫做痛痹；湿气滞留而不移动，汗出多，四肢软弱无力，皮肤麻木不仁，精神昏沉闭塞，这叫做着痹；风、寒、湿三气结合形成痹证，则皮肤坚硬增厚，或者肌肉酸痛，这是邪气侵扰周身。邪气搏结于血脉，积年累月不愈，就会形成瘾疹风疮，搔抓时不觉疼痛，头发脱落，这叫做本痹；其中又有胞痹、肠痹、血痹、热痹等不同情况。所谓胞痹，是指按压小肠和膀胱部位内部疼痛且胀满，水道气化不利，上部流出清稀鼻涕；所谓肠痹，是指三气乘虚侵入大肠，病症表现为频繁饮水，中途气喘急促，时常发生完谷不化的泄泻，小便不通；所谓血痹，是指邪气侵入阴血之分，症状表现为身体常常像被微风吹拂一样，骨骼脆弱形体消瘦，出汗，睡觉时身体不时摇动；所谓热痹，是因为脏腑移热，又遇到风、寒、湿三气混杂侵袭，客居于经络，停留而不运行，阳气遭受阴邪阻滞，所以感到痹阻闷热。肌肉热极，体表感觉像老鼠爬行一样，嘴唇舌头溃烂，皮肤颜色改变。经书说：痹证这种疾病，有的疼痛有的不痛，有的麻木不仁，有的发冷有的发热，有的干燥有的潮湿。凡是疼痛的，多是寒气所致。不痛且麻木不仁的，是病程长久邪气深入，营卫运行涩滞，经络不通，皮肤得不到濡养，因此不痛且不仁。如果阴气多而阳气少，与病邪相合，所以表现为寒；如果阴气少而阳气多，病气胜过阳气而遭遇阴邪，所以表现为热。至于汗多而湿润的，是湿气极盛的表现。痹证但不疼痛的，在骨则沉重着着，在脉则血液凝滞，在筋则屈曲不能伸展，在肉则麻痹不仁，在皮则寒冷。这五种情况都不疼痛。此外还有支饮，也会使人产生痹证。支饮这种病，是因为水饮转化为痰的缘故。治疗的方法，应当辨别风、寒、湿三气停留在哪条经络的哪个部位，是在表还是在里，虚实偏胜如何，推究病因，详察证候，如果是因三气致病，就随其所在的经络进行治疗；如果不是因三气，而是由其他痹证引发的疾病，就应当随其他疾病进行治疗。另外还有水痹和白虎历节风的证候，怎么能一概而论地施用同样的治疗方法呢？关键在于医生诚心探究并治疗，这样病情才有望好转。
The *Suwen* (Basic Questions) states: How is Bi syndrome generated? Qibo replied: When Wind, Cold, and Dampness (Feng, Han, Shi) three pathogens mix and invade together, they combine to form Bi syndrome. Among them, the one where Wind pathogen predominates is called Xing Bi (Moving Bi); the one where Cold pathogen predominates is called Tong Bi (Painful Bi); the one where Dampness pathogen predominates is called Zhuo Bi (Fixed/Heavy Bi). There are five names for Bi syndrome, all arising from these three pathogens invading the Zang organs. Contracted in Spring, it is Jin Bi (Sinew Bi), affecting the Liver, leading to sinew spasms, fright during sleep, increased appetite but frequent urination; contracted in Summer, it is Xue Bi (Blood Bi), affecting the Heart, leading to unsmooth blood vessels, palpitations like drumbeats in the epigastrium, sudden upward rushing of Qi causing panting, dry throat, and a tendency to belch; contracted in Mid-Summer, it is Ji Bi (Muscle Bi), affecting the Spleen, leading to lethargy of the four limbs, coughing, and vomiting of saliva; contracted in Autumn, it is Pi Bi (Skin Bi), affecting the Lung, leading to loss of sensation in the skin, chest fullness with vexation, and occasional retching with pain; contracted in Winter, it is Gu Bi (Bone Bi), affecting the Kidney, leading to heavy bones difficult to lift, frequent abdominal distension, and in severe cases, sitting on the buttocks instead of standing on heels, and bending the spine so the head leans forward. Generally, when Wind predominates, pain wanders up and down without staying in one place, interacting with deficient evil and Qi-Blood, gathering at joints, causing sinews to relax and fail to contract, named Feng Bi (Wind Bi); when Cold predominates, there are spasmodic pains in the four limbs and swollen joints, named Tong Bi (Painful Bi); when Dampness lingers and does not move, with excessive sweating, weakness of the four limbs, numbness of the skin, and mental confusion, named Zhuo Bi (Fixed Bi); when Wind, Cold, and Dampness combine to form Bi, the skin becomes thick and hard, or muscles ache, indicating evil invading the whole body. If evil combats in the blood vessels and persists for years, it forms wheals and wind sores, itching causes no pain, hair falls out, named Ben Bi (Root Bi); among these, there are differences such as Bao Bi (Bladder/Uterus Bi), Chang Bi (Intestine Bi), Xue Bi (Blood Bi), and Re Bi (Heat Bi). Bao Bi refers to internal pain and fullness upon pressing the Small Intestine and Bladder, failure of water pathways to transform, and clear mucus flowing from above; Chang Bi refers to the three pathogens taking advantage of deficiency to invade the Large Intestine, characterized by frequent drinking, mid-meal panting, occasional undigested diarrhea, and urinary obstruction; Xue Bi refers to evil entering the Yin-Blood level, presenting as if the body is constantly blown by a slight breeze, weak bones and emaciation, sweating, and restless tossing during sleep; Re Bi (Heat Bi) occurs when heat shifts from the Zang-Fu organs and encounters the mixture of Wind, Cold, and Dampness, lodging in the meridians and stagnating, where Yang encounters Yin, resulting in a stifling sensation of Bi. Muscles become extremely hot, the body feels like mice running under the skin, lips and tongue ulcerate, and skin color changes. The classics state: In Bi disease, there may be pain or no pain, numbness or coldness or heat, dryness or dampness. Pain is mostly due to Cold. No pain and numbness indicate long-standing disease with deep-seated evil, sluggish Ying-Wei circulation, blocked meridians, and lack of nourishment to the skin, hence no pain and numbness. If Yin Qi is abundant and Yang Qi is scarce, combining with the disease, it manifests as Cold; if Yin Qi is scarce and Yang Qi is abundant, disease Qi overcomes Yang encountering Yin, manifesting as Heat. Excessive sweating and wetness indicate extreme Dampness. Bi without pain: in Bone, heaviness; in Vessels, blood coagulation; in Sinews, flexion without extension; in Flesh, numbness; in Skin, cold. These five do not hurt. Additionally, Zhi Yin (Branching Fluid Retention) can also cause Bi. Zhi Yin is caused by fluid transforming into Phlegm. The treatment method should distinguish which meridian and part the three pathogens have stayed in, whether in the Exterior or Interior, and the excess or deficiency bias. Investigate the cause, examine the symptoms carefully. If caused by the three pathogens, treat according to the affected meridian; if not caused by the three pathogens but arising from other Bi diseases, treat according to those other diseases. Furthermore, Shui Bi (Water Bi) and Bai Hu Li Jie Feng (White Tiger Migratory Joint Wind) syndromes cannot be treated uniformly. It depends on the physician's sincere investigation and treatment for the condition to improve.