痹者，顽木不仁，不知痛痒之病也。其病之因，多起于风寒湿，有浅深之殊，有难易之分。始知不知痛痒
之痹，乃痹之一端，而其义为未全也。然味经中所言，痹之在脏腑者，如心痹脉不通，肝痹引如怀，肾痹善
胀，脾痹大塞，肠痹饮出不得，胞痹内痛，涩于小便，以至痹聚在肺在心等，皆有壅塞不通之意，是痹又以闭
而得名也。（篇中更出“阴气者静则神藏”四句，文义甚精，但实与痹无涉，必错简也。）
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。（虽合而为痹，发起亦殊矣。风则
阳受之，故为痹行，寒则阴受之，故为痹痛，湿则皮肉筋脉受之，故为痹着而不去也。按∶着，直略切，不动
移也。）
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。（按∶此谓风寒湿也。冬感此邪，则痹在骨等，亦大略之言也。）
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。（按∶合，如肾合骨、
肝合筋之类。风寒湿之邪，由外入内，筋骨受痹，若更感外邪，则必内及于肝肾，是谓内舍于其合。下五段，
正是分疏内舍。）
凡痹之客五脏者，肺痹者，烦满喘而呕。（以脏气应息，又其脉还循胃口，故使烦满喘而呕。）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。（心合脉，受邪则脉不通利也。邪气内扰，故烦
也。手心主心包之脉，起于胸中，出属心包，下膈。手少阴心脉，起于心中，出属心系，下膈，络小肠。其支
别者，从心系上挟咽喉。其直者，复从心系却上肺。故烦则心下鼓满，暴上气而喘嗌干也。心主为噫，以下鼓
满，故噫之以出气也。若是逆气上乘于心，则恐畏也，神惧凌弱故尔。）肝痹者，夜卧则惊，多饮，数小便，
上为引如怀。（肝主惊骇，气相应，故中夜卧则惊也。肝之脉，循股阴，入髦中，环阴器，抵少腹，挟胃，属肝，
络胆，上膈，布胁肋，循喉咙之后，上入项颡。故多饮水，数小便，上引少腹如怀妊之状。）肾痹者，善胀，
尻以代踵，脊以代头。肾者胃之
关，关不利则胃气不转，故善胀也。尻以代踵，谓足挛急也。脊以代头，谓身 屈也。按∶尻以代踵二句，
语意奇妙，盖状善胀之形容也。凡人之气，上至头，下至足，营运不息，则折旋任意，俯仰自如。今邪着于肾，
气闭不行，一身尽胀，但可坐而不可行，但能俯而不能仰，如踵以尻，而头以脊也。善胀之状，乃至于此。岂
知肾为生气之源，肾气痹，遂令如是乎。注亦滥引经脉为解，未免肤浅。尻， 骨。踵，足跟也。脾痹者，四
肢解堕，发咳呕汁，上为大塞。（土王四季，外主四肢，故四肢解堕。又以其脉起于足，循 ，上膝股也。
然脾脉入腹，属肾，络胃，上膈，挟咽，故发咳呕汁。脾气养肺，胃复连咽，故上为大塞也。按∶堕作惰。）
肠痹者，数饮而出不得，中气喘争，时发飧泄。（按∶大肠小肠者，脾肺之下流也。人之饮食，上入必下出。
今邪入二肠，气痹不行，不能下达，中气壅闭，喘急争乱，食饮内停，不能变化，时或下出，则为飧泄，皆二
肠气痹，不能传送所致也。）胞痹者，少腹膀胱，按之内痛若沃以汤，涩于小便，上为清涕。（……按∶膀胱居
少腹之内，故云少腹膀胱。内痛若沃以汤者，火也，火盛故不可按也。膀胱为津液之器，热则癃，故小便涩。
小便涩则火不得下行，反上烁其脑而为清涕，出于鼻窍矣。元起本内痛作两髀，非也。盖胞痹之热者也。若阴
寒凝结，亦令胞痹，少腹绞痛，小便不通，脉沉而紧，予尝治数十人矣，用桂附而愈，惟无沃汤清涕诸证耳。）
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。（淫气谓气之妄行者，各随脏之所主而入为痹也。按，新校正云∶“详上凡痹之客五脏者至此，全
元起本在阴阳别论中，此王氏之所移也。”）
诸痹不已者，亦益内也。（从外不去，则益深至于身内。）其风气胜者，其人易已也。（按∶风虽胜，尚
是外袭易治，不
若深入脏腑之难也。）
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。（入脏者死，以神去也。筋骨疼久，以其定也。皮肤易已，以浮浅也。由斯深浅，故有是
不同。）
帝曰∶其客于六腑者，何也？岐伯曰∶此亦其饮食居处，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。（按∶腑阳而浅，故其为痹，皆从饮食居处得之。然俞为六腑之门户，
风寒湿气固易于中，而苟无饮食不节之患，则所入者亦仅至毫腠而止。惟起居不密，饥饱失时，六腑之气先已
不固，而后风寒湿气乃得从而入之也。）
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。（按∶
过犹过失。瘳，愈也。随谓随脉发之过失而施治，则病自愈也。过注作脉所经过，误矣。瘳音抽。）
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。（正理论曰∶“谷入于胃，脉道乃行。水入于经，其血乃成。”灵枢经
曰∶“荣气之道，内谷为宝。”荣行脉内，故无所不至。按∶和调者营运无间，洒陈者遍满不遗，然惟和调，
故能洒陈也。）卫者水谷之悍气也，其气栗疾滑利，不能入于脉也。故循皮肤之中，分肉之间，熏于盲膜，
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。（悍气谓浮盛之气也。以其浮盛之气，
故栗疾滑利。皮肤之中，分肉之间，谓脉外也。按∶水谷之精气为荣，荣行脉内，贯通脏腑，无处不到。水
谷之悍气为卫，卫行脉外，屏藩脏腑，捍御
诸邪。邪欲中人，必乘卫气之虚而入，入则由络抵经，由腑入脏。是风寒湿之为痹也，皆因卫虚，不能悍之于
外，以致内入，初非与风寒湿相合而然，是故痹止于荣而不及卫也。）
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。（按∶痛独指寒者，寒则气闭血凝，故痛。若热则痹而不痛也。其不痛不仁者，病久入深，荣卫之行
涩，经络时疏，故不痛；按∶此不痛，是顽木不知痛痒，即是不仁，故不痛与不仁兼言也。病久之人，气血
衰弱，营运涩滞，惟涩滞，故经络顽痹而不知痛也。王本故不通，甲乙作不痛，是也，从之。）皮肤不营，故
为不仁。（不仁者，皮顽不知有无也。按∶人之知有痛痒者，以其血足而能运动也，故以不仁为荣血不足。）
其寒者阳气少，阴气多，与病相益，故寒也。（病生于风寒湿，故阴气益之也。）其热者阳气多，阴气少，病
气胜，阳遭阴，故为痹热。（按∶遭甲乙作乘，言阳盛乘阴故热，即阴虚火多之类也。）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。（按∶阴与湿为同气，故云两气相感。）
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，逢寒则急，逢热则纵。帝曰∶善！（按∶痹之不痛，
有五者之殊，而前则言寒多则痛，寒痛又为痹中之一，但痛者少而不痛者多也。逢寒则急二句，是总结痹病之大
凡也。王本逢寒则虫，甲乙作则急，与纵相合，是也，从之。）
痹病，是指肢体顽钝麻木、失去知觉，不知痛痒的疾病。其发病原因，多由风、寒、湿三气杂合侵袭所致，有病情深浅的不同，也有难易的区别。起初只知道“不知痛痒”是痹病的一种表现，但这对其含义的理解并不全面。然而细味经文所言，痹病发生在脏腑的，如心痹导致脉道不通，肝痹牵引少腹如同怀孕，肾痹容易腹胀，脾痹腹部大塞不通，肠痹饮水后无法排出，胞痹内部疼痛且小便涩滞，以至于痹邪积聚在肺、在心等，都有壅塞不通的意思，因此痹病又以“闭”而得名。（篇中另外出现“阴气者静则神藏”四句，文义非常精妙，但实际上与痹病无关，必定是竹简错乱造成的。）
黄帝问道：痹病是如何产生的？岐伯回答说：风、寒、湿三种邪气混杂侵入人体，结合在一起就形成痹病。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。（虽然三者合而为痹，但发起的原因有所不同。风邪属阳，所以侵犯阳分，导致痹病游走不定；寒邪属阴，所以侵犯阴分，导致痹病疼痛剧烈；湿邪侵犯皮肉筋脉，所以痹病沉重固定而不去除。按：着，读音为zháo，意为不动移。）
黄帝说：为什么会有这五种痹病呢？岐伯说：在冬季感受这种邪气的称为骨痹，在春季感受这种邪气的称为筋痹，在夏季感受这种邪气的称为脉痹，在长夏（至阴）感受这种邪气的称为肌痹，在秋季感受这种邪气的称为皮痹。（按：这里指的风寒湿邪。冬季感受此邪，则痹病在骨等处，也是大概的说法。）
黄帝说：邪气内传五脏六腑，是什么气使然呢？岐伯说：五脏各有与其相合的组织，如果疾病日久不愈，就会内传于与其相合的脏器。所以骨痹不愈，再次感受邪气，就会内传于肾；筋痹不愈，再次感受邪气，就会内传于肝；脉痹不愈，再次感受邪气，就会内传于心；肌痹不愈，再次感受邪气，就会内传于脾；皮痹不愈，再次感受邪气，就会内传于肺。所谓的痹病，都是在相应季节再次感受风寒湿邪气所致。（按：合，如肾合骨、肝合筋之类。风寒湿之邪，由外入内，筋骨受痹，如果再感受外邪，则必然内及于肝肾，这叫内传于其相合的脏器。下面五段文字，正是分别阐述内传的情况。）
凡是痹邪客居五脏的：肺痹，表现为烦闷、气喘而呕吐。（因为脏气对应呼吸，且其经脉还循胃口，所以导致烦闷气喘而呕吐。）心痹，表现为脉道不通，心烦时感觉心下悸动，突然气逆上冲而气喘，咽喉干燥，经常嗳气，逆气上冲于心则恐惧。（心合脉，受邪则脉道不通利。邪气内扰，所以心烦。手厥阴心包经，起于胸中，出属心包，下行穿过膈肌。手少阴心经，起于心中，出属心系，下行穿过膈肌，联络小肠。其支脉，从心系上行挟咽喉。其直行者，又从心系回上于肺。所以心烦时心下鼓满，突然气逆上冲而气喘、咽喉干燥。心主嗳气，因心下鼓满，所以通过嗳气来排气。如果是逆气上乘于心，则会产生恐惧，因为心神受到凌辱而虚弱所致。）肝痹，夜间睡眠易惊骇，多饮，小便频数，向上牵引少腹如同怀孕。（肝主惊骇，气机相应，所以在半夜睡觉时惊骇。肝的经脉，沿大腿内侧，进入阴毛中，环绕生殖器，抵少腹，挟胃，属肝，络胆，上行穿过膈肌，散布于胁肋，沿喉咙之后，上行入项颡。所以多饮水，小便频数，向上牵引少腹如同怀孕的样子。）肾痹，容易腹胀，臀部代替脚后跟站立，脊柱代替头部直立。肾是胃的关口，关口不利则胃气不运转，所以容易腹胀。臀部代替脚后跟，是说足部挛急。脊柱代替头部，是说身体弯曲。按：这两句话语意奇妙，大概是形容严重腹胀的状态。凡人的气，上至头，下至足，运行不息，就能随意折旋，俯仰自如。现在邪气附着于肾，气机闭塞不行，全身都胀，只能坐不能走，只能俯不能仰，就像用臀部当脚后跟，用脊柱当头一样。腹胀的症状，竟然到了这种地步。哪里知道肾是生气的源头，肾气痹阻，竟然导致这样啊。注释也滥引经脉来解释，未免肤浅。尻，尾骨。踵，脚后跟。脾痹，四肢懈怠无力，咳嗽呕吐涎沫，上部严重痞塞。（土旺于四季，外部主管四肢，所以四肢懈怠无力。又因为其经脉起于足，沿小腿内侧，上膝股。然而脾脉入腹，属肾，络胃，上行穿过膈肌，挟咽喉，所以引发咳嗽呕吐涎沫。脾气滋养肺，胃又连咽，所以上部严重痞塞。按：堕通惰。）肠痹，多次饮水却排不出尿，腹部气机喘急争乱，时常发生完谷不化的泄泻。（按：大肠小肠，是脾肺的下流通道。人的饮食，上入必须下出。现在邪气侵入大小肠，气机痹阻不行，不能下达，中气壅闭，喘急争乱，食饮内停，不能变化，有时向下排出，就成为完谷不化的泄泻，这都是大小肠气机痹阻，不能传送所致。）胞痹，少腹膀胱部位，按压内部疼痛像浇了热水一样，小便涩滞，上部流出清涕。（……按：膀胱位于少腹之内，所以说少腹膀胱。内部疼痛像浇了热水，是因为有火，火盛所以不可按压。膀胱是津液之器，热则癃闭，所以小便涩滞。小便涩滞则火不得下行，反而上灼脑部成为清涕，从鼻窍流出。元起本将“内痛”作“两髀”，是不对的。这是胞痹的热证。如果是阴寒凝结，也会造成胞痹，表现为少腹绞痛，小便不通，脉沉而紧，我曾治疗过几十人，用桂枝、附子治愈，只是没有浇热水样痛和清涕等症状。）
淫乱之气导致喘息，痹邪聚积在肺；淫乱之气导致忧思，痹邪聚积在心；淫乱之气导致遗尿，痹邪聚积在肾；淫乱之气导致乏力衰竭，痹邪聚积在肝；淫乱之气导致肌肉萎缩，痹邪聚积在脾。（淫气指妄行的气，各自随着所主的脏器而入成为痹病。按：新校正说：“详细考察上文‘凡痹之客五脏者’至此，全元起本在《阴阳别论》中，这是王冰所移置的。”）
各种痹病日久不愈，也会逐渐向内深入。（从体表不去除，就会越来越深直到体内。）其中风气偏胜的，这种人容易痊愈。（按：风虽偏胜，但还是外袭之邪，容易治疗，不如深入脏腑那样难治。）
黄帝说：痹病，有的当时死亡，有的疼痛长久，有的容易痊愈，这是什么缘故？岐伯说：邪气传入脏的会死亡，邪气留连在筋骨间的疼痛长久，邪气停留在皮肤间的容易痊愈。（传入脏的死亡，是因为神气离散。筋骨疼痛长久，是因为病位固定。皮肤间容易痊愈，是因为病位浮浅。由于深浅不同，所以有这些区别。）
黄帝说：邪气客居六腑，是怎么回事？岐伯说：这也是以饮食起居作为致病根本。六腑也各有俞穴，风寒湿气中伤其俞穴，而饮食与之相应，顺着俞穴进入，各自停留于相应的腑。（按：腑属阳而位置浅，所以其患痹病，都是从饮食起居得来的。然而俞穴是六腑的门户，风寒湿气固然容易中伤，但如果如果没有饮食不节的祸患，那么侵入的也只到毫腠而止。只有起居不严密，饥饱失时，六腑之气先已不固，然后风寒湿气才得以随之进入。）
黄帝说：用针刺治疗怎么样？岐伯说：五脏有俞穴，六腑有合穴，沿着经脉的分界，各有所发生的部位，根据病变所在的部位进行针刺，病就能痊愈。（按：过犹过失。瘳，音chōu，痊愈。随谓顺着经脉发生的病变部位而施治，病就能自愈。把“过”注为脉所经过的地方，是错误的。瘳，音抽。）
黄帝说：营卫之气，也会导致痹病吗？岐伯说：营气是水谷的精微之气，调和于五脏，布散于六腑，才能进入脉中。所以沿脉上下，贯通五脏，联络六腑。（正理论说：“谷入于胃，脉道乃行。水入于经，其血乃成。”灵枢经说：“荣气之道，内谷为宝。”营行脉内，所以无所不到。按：和调者营运无间，洒陈者遍满不遗，然而正因为和调，所以能洒陈。）卫气是水谷的悍烈之气，其气慓疾滑利，不能进入脉中。所以沿皮肤之中，分肉之间，熏蒸于肓膜，散布于胸腹，逆其气则生病，顺其气则痊愈，不与风寒湿气相合，所以不形成痹病。（悍气指浮盛之气。因为它浮盛，所以慓疾滑利。皮肤之中，分肉之间，指脉外。按：水谷的精气为营，营行脉内，贯通脏腑，无处不到。水谷的悍气为卫，卫行脉外，屏藩脏腑，抵御诸邪。邪气想要中人，必乘卫气之虚而入，入则由络抵经，由腑入脏。所以风寒湿之所以成为痹病，都是因为卫气虚，不能悍拒于外，以致邪气内入，起初并非与风寒湿相合而然，因此痹病只涉及营而不涉及卫。）
黄帝说：好！痹病有的痛，有的不痛，有的麻木，有的寒，有的热，有的燥，有的湿，这是什么缘故？岐伯说：痛的，是因为寒气多，有寒所以痛。（按：痛独指寒者，寒则气闭血凝，所以痛。如果热则痹而不痛。那些不痛且麻木的，是病久入深，营卫之行涩滞，经络时而空虚，所以不痛；按：这个不痛，是顽木不知痛痒，即是不仁，所以不痛与不仁兼言。病久的人，气血衰弱，营运涩滞，唯其涩滞，所以经络顽痹而不知痛。王本作“故不通”，甲乙本作“不痛”，是正确的，遵从它。）皮肤得不到营血濡养，所以为不仁。（不仁者，皮肤顽钝不知有无。按：人之所以知痛痒，是因为血足而能运动，所以认为不仁是营血不足。）那些发冷的，是因为阳气少，阴气多，与病邪相益，所以寒冷。（病生于风寒湿，所以阴气助长它。）那些发热的，是因为阳气多，阴气少，病气胜，阳遭阴（遭遇阴邪），所以为痹热。（按：遭，甲乙本作乘，言阳盛乘阴故热，即阴虚火多之类。）那些多汗而湿润的，这是因为逢湿邪甚，阳气少，阴气盛，两气相感，所以汗出而湿润。（按：阴与湿为同气，所以说两气相感。）
黄帝说：痹病这种病，为什么不痛呢？岐伯说：痹在骨则沉重，在脉则血凝而不流，在筋则屈伸不利，在肉则麻木不仁，在皮则寒冷，所以具备这五种情况，就不痛了。大凡痹病之类，逢寒则拘急，逢热则弛纵。黄帝说：好！（按：痹之不痛，有这五种区别，而前面说寒多则痛，寒痛又是痹中的一种，但痛者少而不痛者多。逢寒则急二句，是总结痹病的大概规律。王本作“逢寒则虫”，甲乙本作“急”，与“纵”相对，是正确的，遵从它。）
Bi Syndrome (Obstruction Syndrome) refers to a condition characterized by numbness, stiffness, and loss of sensation, where the patient is unaware of pain or itching. The etiology of this disease mostly arises from the mixed invasion of Wind, Cold, and Dampness pathogens, varying in depth and severity. Initially, it was understood that "unawareness of pain and itching" was merely one aspect of Bi Syndrome, indicating an incomplete comprehension of its meaning. However, upon reviewing the text, Bi Syndromes affecting the Zang-Fu organs include Heart Bi causing obstruction of vessels, Liver Bi causing drawing sensations in the lower abdomen resembling pregnancy, Kidney Bi prone to abdominal distension, Spleen Bi causing severe abdominal blockage, Intestine Bi preventing urination after drinking, Bladder Bi causing internal pain and dysuria, up to Bi accumulation in the Lung or Heart, all implying a state of stagnation and obstruction. Thus, Bi Syndrome is also named for "closure" (obstruction). (The four sentences "Yin Qi, when still, stores the Spirit" appearing elsewhere in the chapter are highly refined in meaning but irrelevant to Bi Syndrome, likely due to bamboo slip dislocation.)
The Yellow Emperor asked: How does Bi Syndrome arise? Qibo replied: When Wind, Cold, and Dampness mix and invade together, they combine to form Bi Syndrome. If Wind predominates, it is called Xing Bi (Wandering Bi); if Cold predominates, it is called Tong Bi (Painful Bi); if Dampness predominates, it is called Zhuo Bi (Fixed Bi). (Although they combine to form Bi, their origins differ. Wind, being Yang, affects Yang aspects, leading to wandering Bi; Cold, being Yin, affects Yin aspects, leading to painful Bi; Dampness affects skin, flesh, tendons, and vessels, leading to fixed and lingering Bi. Note: Zhuo [fixed] implies immobility.)
The Yellow Emperor 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 (Zhi Yin), Ji Bi (Muscle Bi); and in Autumn, Pi Bi (Skin Bi). (Note: This refers to Wind, Cold, and Dampness. Contracting these pathogens in Winter leads to Bi in bones, etc., which is a general statement.)
The Yellow Emperor asked: What causes the pathogens to enter internally and lodge in the Zang-Fu organs? Qibo said: Each Zang organ has a corresponding exterior tissue. If the disease persists without resolution, it enters internally into its corresponding Zang. Thus, if Bone Bi persists and re-exposure occurs, it lodges in the Kidney; if Tendon Bi persists, it lodges in the Liver; if Vessel Bi persists, it lodges in the Heart; if Muscle Bi persists, it lodges in the Spleen; if Skin Bi persists, it lodges in the Lung. Such Bi Syndromes occur when one contracts Wind, Cold, and Dampness again during the respective seasonal associations. (Note: "Correspondence" refers to relationships like Kidney-Bone, Liver-Tendon. Pathogens enter from outside to inside; if tendons/bones are obstructed and external pathogens are contracted again, they inevitably affect the Liver/Kidney, termed lodging in their correspondence. The following five paragraphs detail this internal lodging.)
When Bi pathogens lodge in the Zang organs:
Lung Bi manifests as irritability, fullness, wheezing, and vomiting. (Due to organ qi relating to respiration and meridians circling the stomach region.)
Heart Bi manifests as vessel obstruction, palpitations when irritable, sudden upward rushing of Qi with wheezing, dry throat, frequent belching, and fear when rebellious Qi ascends to the Heart. (Heart corresponds to vessels; pathogen obstruction causes vessel dysfunction. Internal disturbance causes irritability. The Pericardium meridian originates in the chest, and the Heart meridian originates in the heart, both connecting via the diaphragm. Branches ascend to the throat and lungs. Irritation causes palpitations and upward Qi rush. Belching releases pressure. Rebellious Qi frightening the Heart spirit causes fear.)
Liver Bi manifests as fright during sleep, excessive thirst, frequent urination, and upward pulling sensations in the lower abdomen resembling pregnancy. (Liver governs fright. Its meridian circles the genitals and ascends to the lower abdomen, causing these symptoms.)
Kidney Bi manifests with frequent abdominal distension, inability to stand upright using heels (using buttocks instead of heels), and stooping posture (spine replacing the head). (Kidney is the gate of the Stomach; obstruction causes distension. "Buttocks replacing heels" indicates leg contracture; "Spine replacing head" indicates spinal curvature. These describe severe distension and immobility. Kidney is the source of vital Qi; its obstruction leads to this state.)
Spleen Bi manifests as flaccidity and weakness of the four limbs, coughing, vomiting of fluids, and severe upper jiao blockage. (Earth governs the four limbs; meridian pathways explain the other symptoms.)
Intestine Bi manifests as frequent drinking but inability to urinate, abdominal Qi turbulence, and occasional undigested stool diarrhea. (Pathogens in intestines obstruct Qi transmission, causing stagnation and diarrhea.)
Bladder Bi manifests as internal pain in the lower abdomen/bladder area upon pressure (feeling like hot water pouring), dysuria, and clear nasal discharge above. (Heat in the bladder causes pain and dysuria; rising heat causes clear nasal discharge. Cold condensation can also cause Bladder Bi with cold pain and retention, treatable with Cinnamon Twig and Aconite Decoction.)
Rebellious Qi causing wheezing indicates Bi accumulating in the Lung; rebellious Qi causing worry/thought indicates Bi accumulating in the Heart; rebellious Qi causing enuresis indicates Bi accumulating in the Kidney; rebellious Qi causing exhaustion indicates Bi accumulating in the Liver; rebellious Qi causing muscle atrophy indicates Bi accumulating in the Spleen. (Rebellious Qi refers to erratic Qi entering according to the affected organ. Note: Some editions place this section in the Treatise on Differentiating Yin and Yang.)
If various Bi Syndromes persist, they deepen internally. Those dominated by Wind are easier to cure (as they remain superficial compared to deep Zang-Fu involvement).
The Yellow Emperor asked: Why do some die, some suffer long-term pain, and some recover easily? Qibo said: Invasion of Zang organs leads to death (loss of Spirit); lingering in sinews/bones causes long-term pain (fixed location); remaining in skin allows easy recovery (superficial).
The Yellow Emperor asked: How does Bi affect the Fu organs? Qibo said: This stems from diet and lifestyle. Fu organs have Shu points; Wind/Cold/Dampness attack these points, and improper diet facilitates entry, lodging in the respective Fu. (Fu are Yang/superficial; lifestyle factors weaken defense, allowing pathogens to enter.)
The Yellow Emperor asked: How to treat with acupuncture? Qibo said: Zang organs have Shu points, Fu organs have He-Sea points. Following meridian distributions and treating specific lesions (Guo) leads to recovery (Chou). (Note: "Guo" means lesion/error, not just pathway. "Chou" means cure.)
The Yellow Emperor asked: Do Ying (Nutrient) and Wei (Defensive) Qi cause Bi? Qibo said: Ying Qi is essence of food/water, harmonizing Zang, distributing to Fu, entering vessels to circulate everywhere. Wei Qi is fierce/hasty Qi of food/water, too rapid to enter vessels. It circulates in skin/muscle spaces, warming Huang membrane and chest/abdomen. If Wei Qi flows smoothly, health prevails; if reversed, disease occurs. Since Wei Qi does not combine with Wind/Cold/Dampness internally, it does not form Bi itself. (However, Wei Qi deficiency allows pathogens to enter, leading to Bi involving Ying Qi but sparing Wei Qi initially.)
The Yellow Emperor asked: Why do some Bi cases hurt, others not, some numb, some cold, some hot, some dry, some damp? Qibo said: Pain is due to excess Cold (Cold causes Qi/Blood stasis). Lack of pain and numbness indicates deep disease, sluggish Ying/Wei flow, and empty meridians. Skin lack of Ying nourishment causes numbness. Cold sensation arises from deficient Yang and excess Yin. Heat sensation arises from excess Yang and deficient Yin (Yang overcoming Yin). Sweating and dampness result from severe Dampness combined with weak Yang and strong Yin (Yin and Dampness resonate).
The Yellow Emperor asked: Why is Bi sometimes painless? Qibo said: Bi in bone causes heaviness; in vessels, blood stagnation; in tendons, flexion inability; in flesh, numbness; in skin, coldness. Possessing these five signs results in no pain. Generally, Bi tightens with Cold and relaxes with Heat. (Note: Painless Bi varies by location. Cold causes pain; thus, many painless cases exist. Cold causes contraction; Heat causes relaxation.)