痔痛，攒竹主之。痔，会阴主之。凡痔与阴相通者死，阴中诸病，前后相引痛，不得
大小便，皆主之。痔骨蚀，商丘主之。痔，篡痛，飞扬、委中及承扶主之。痔篡痛，承筋
主之。脱肛下，刺气街主之。
黄帝问曰∶周痹之在身也，上下移徙，随其脉上下，左右相应，间不容空，愿闻此痛
在血脉之中耶，将在分肉之间乎，何以致是？其痛之移也，间不及下针，其蓄痛之时，不及
定治而痛已止矣，何道使然？岐伯对曰∶此众痹也，非周痹也。此各在其处，更发更止，更居
更起，以左应右，以右应左，非能周也，更发更休。刺此者，痛虽已止，必刺其处，勿令
复起。
曰∶周痹何如？曰∶周痹在于血脉之中，随脉以上，循脉以下，不能左右，各当其所
。其痛从上下者，先刺其下以通之（通一作遏），后刺其上以脱之；其痛从下上者，先剌其上
以通之，后刺其下以脱之。曰∶此病安生，因何有名？曰∶风寒湿气客于分肉之间，迫切
而为沫，沫得寒则聚，聚则排分肉而分裂，分裂则痛，痛则神归之，神归之则热，热则痛
解，痛解则厥，厥则他痹发，发则如是。此内不在脏，而外未发于皮，独居分肉之间，真气
不能周，故名曰周痹。故刺痹者，必先循切其上下之大经，视其虚实，及大络之血结而不通
者，及虚而脉陷空者而调之，熨而通之，其 紧者，转引而行之。
曰∶何以候人之善病痹者？少俞对曰∶粗理而肉不坚者，善病痹。欲知其高下，视其三
部。曰∶刺有三变何也？曰∶
有刺营者，有刺卫者，有刺寒痹之留经者。刺营者出血，刺卫者出气，刺寒痹者内热
。曰∶营卫寒痹之为病奈何？曰∶营之生病也，寒热少气，血上下行。卫之生病也，气
血时来去，怫忾贲向，风寒客于肠胃之中。寒痹之为病也，留而不去，时痛而皮不仁。曰∶
刺寒痹内热奈何？曰∶刺布衣者，用火淬之。刺大人者，药熨之。方用醇酒二十升，蜀椒一
升，干姜一升，桂一升，凡四物，各细 咀，着清酒中。绵絮一斤，细白布四丈二尺
，并纳酒中。置酒马矢 中，善封涂，勿使气泄。五日五夜，出布絮曝干，复渍之，以
尽其汁。每渍必 其日，乃出布絮干之，并用滓与絮布长六七尺为六巾，即用之生
桑炭炙巾，以熨寒痹所乘之处，令热入至于病所，寒复炙巾以熨之，三十遍而止；即汗出
，炙巾以拭身，亦三十遍而止。起步内中，无见风，每刺必熨，如此病已失，此所谓内热。
曰∶痹将安生？曰∶风寒湿三气合至，杂而为痹。其风气胜者为行痹。寒气胜者为痛痹，
湿气胜者为着痹。曰∶其有五者何也？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。曰∶内舍五脏六腑，何气使然？
曰∶五脏皆有合，病久而不去者，内舍于合。故骨痹不已，复感于邪邪，内舍于肾；筋痹不
已，邪复感于，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，感于风寒湿之气也。诸痹不
已，亦益内也。其风气胜者，其人易已。曰∶其时有死者，或疼久者，或易已者，何也？曰
∶其入脏者死，其留连筋骨间者疼久，其留连皮肤间者易已。曰∶其客六腑者何如？曰∶
此亦其饮食居处为其病本也。六腑各有俞，风寒湿气中其俞，而食饮应之，循俞而入，
各舍其腑也。曰∶以针治之奈何？曰∶五脏有俞，六腑有合，循脉之分，各有所发，各治其
过，则病瘳矣。曰∶营卫之气，亦令人痹乎？曰∶营者水谷之精气也，和调五脏，洒陈六腑
，乃能入于脉。故循脉上下，贯五脏，络六腑。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，聚（《素问》作散）于胸腹，逆其气则病，
顺其气则愈，不与风寒湿气合，故不为痹也。
痔疮疼痛，取攒竹穴主治。痔疮，取会阴穴主治。凡是痔疮与阴部相通连的属于死证；阴部的各种疾病，前后相互牵引作痛，大小便不通畅，都取这些穴位主治。痔疮导致骨骼腐蚀，取商丘穴主治。痔疮及肛门疼痛，取飞扬、委中及承扶穴主治。痔疮及肛门疼痛，取承筋穴主治。脱肛下坠，针刺气街穴主治。
黄帝问道：周痹这种病发生在身上，疼痛部位上下移动，随着经脉上下走窜，左右相应，间隙极小，我希望知道这种疼痛是在血脉之中呢，还是在分肉之间？它是如何造成这样的？疼痛转移时，来不及进针；疼痛积聚发作时，来不及确定治疗方案疼痛就已经停止了，这是什么道理？岐伯回答说：这是众痹，不是周痹。众痹各自在固定的部位，交替发作又停止，交替出现又消失，左边对应右边，右边对应左边，不能周身遍发，是交替发作又休息。治疗这种病，虽然疼痛已经停止，也必须针刺疼痛曾经所在的部位，不让它再次发作。
黄帝问：周痹是怎样的？岐伯说：周痹位于血脉之中，随着经脉向上或向下走窜，不能向左右扩散，各在其相应的部位。如果疼痛从上往下移，先针刺下部以疏通经络（“通”一作“遏”，意为遏制），后针刺上部以解除病邪；如果疼痛从下往上移，先针刺上部以疏通经络，后针刺下部以解除病邪。黄帝问：这种病是怎么产生的，为什么叫这个名字？岐伯说：风寒湿气客居于分肉之间，逼迫津液凝结成沫，沫遇到寒气则聚集，聚集后排斥分肉使其分裂，分裂则产生疼痛；疼痛时精神集中于患处，精神集中则产生热感，热感使疼痛缓解，疼痛缓解后出现气机逆乱，气机逆乱则其他部位的痹症发作，发作就是这样。这种病内不在脏腑，外未发于皮肤，独自居于分肉之间，真气不能周流全身，所以名叫周痹。因此治疗痹症，必须先循按切诊上下主要经脉，观察其虚实情况，以及大络中血结不通者，还有虚弱而脉陷空虚者，对其进行调理，用熨法疏通经络，对于肌肉拘紧者，通过导引行气来治疗。
黄帝问：怎样判断一个人容易患痹症？少俞回答说：纹理粗糙且肌肉不坚实的人，容易患痹症。想知道病变的高下部位，要观察上、中、下三部。黄帝问：针刺有三种变化，是什么道理？回答说：有刺营分的，有刺卫分的，有刺寒痹留滞于经脉的。刺营分要出血，刺卫分要出气，刺寒痹要使体内发热。黄帝问：营分、卫分和寒痹致病的情况是怎样的？回答说：营分生病，表现为寒热、气短，血液上下妄行。卫分生病，表现为气血时而往来，郁结胀满，风寒客居于肠胃之中。寒痹致病，表现为病邪留滞不去，时常疼痛且皮肤麻木不仁。黄帝问：针刺寒痹使体内发热的方法是怎样的？回答说：对平民百姓，用火淬法治疗；对贵族大人，用药熨法治疗。药方用醇酒二十升，蜀椒一升，干姜一升，桂枝一升，共四味药，分别切碎，放入清酒中。绵絮一斤，细白布四丈二尺，一起浸入酒中。将容器放置在马粪火中，仔细密封涂抹，不要让气体泄漏。五天五夜后，取出布和絮晒干，再重新浸泡，以吸尽药汁。每次浸泡必须等到干燥的日子，然后取出布和絮晾干，并将药渣与布絮混合，裁成长宽六七尺的六条巾，使用时用生桑炭加热毛巾，熨烫寒痹侵袭的部位，让热气深入病灶，变冷后再加热毛巾熨烫，重复三十次为止；此时病人出汗，用加热的毛巾擦拭身体，也重复三十次为止。擦完后在室内走动，不要吹风。每次针刺后都要熨烫，这样病就好了，这就是所谓的“内热”。
黄帝问：痹症是如何产生的？回答说：风、寒、湿三种邪气合而到来，混杂在一起形成痹症。风气偏胜的叫行痹。寒气偏胜的叫痛痹。湿气偏胜的叫着痹。黄帝问：这五种痹症是怎么回事？回答说：冬天感受这种邪气的叫骨痹，春天感受的叫筋痹，夏天感受的叫脉痹，长夏（至阴）感受的叫肌痹，秋天感受的叫皮痹。黄帝问：邪气内舍于五脏六腑，是什么气使之然？回答说：五脏各有与其相合的组织，病程长久不愈的，邪气内舍于相合的组织。所以骨痹不愈，再次感受邪气，内舍于肾；筋痹不愈，邪气再次感受，内舍于肝；脉痹不愈，再次感受邪气，内舍于心；肌痹不愈，再次感受邪气，内舍于脾；皮痹不愈，再次感受邪气，内舍于肺。所谓痹症，都是因为在相应的季节感受了风寒湿之气所致。各种痹症不愈，也会逐渐向内传入脏腑。风气偏胜的人，病情容易痊愈。黄帝问：有的患者死亡，有的疼痛持久，有的容易痊愈，是什么原因？回答说：邪气入脏的会死亡，邪气留连在筋骨间的疼痛持久，邪气留连在皮肤间的容易痊愈。黄帝问：邪气客居六腑是怎样的？回答说：这也是以饮食起居作为发病根本。六腑各有输穴，风寒湿气中伤其输穴，饮食与之相应，邪气顺着输穴进入，各自停留于相应的腑。黄帝问：用针刺治疗怎么样？回答说：五脏有输穴，六腑有合穴，沿着经脉的分界，各有所发生的部位，针对病变部位进行治疗，病就能好了。黄帝问：营气和卫气也会让人得痹症吗？回答说：营气是水谷的精微之气，能调和五脏，散布于六腑，然后才能进入脉中。所以沿经脉上下运行，贯穿五脏，联络六腑。卫气是水谷的悍烈之气，其气运行急速滑利，不能进入脉中。所以行于皮肤之中，分肉之间，熏蒸于肓膜，散布于胸腹，逆乱其气就会生病，顺从其气就会痊愈，因为它不与风寒湿气结合，所以不会形成痹症。
Hemorrhoidal pain is primarily treated by Zanzhu (BL2,攒竹). Hemorrhoids are primarily treated by Huiyin (CV1,会阴). Cases where hemorrhoids communicate with the yin region are fatal. For various diseases of the yin region, involving mutual pulling pain between the anterior and posterior orifices, and inability to urinate or defecate, these acupoints are primarily used. Bone erosion caused by hemorrhoids is primarily treated by Shangqiu (SP5,商丘). Hemorrhoids and perineal pain are primarily treated by Feiyang (BL58,飞扬), Weizhong (BL40,委中), and Chengfu (BL36,承扶). Hemorrhoids and anal pain are primarily treated by Chengjin (BL57,承筋). Rectal prolapse is primarily treated by needling Qichuan (ST30,气街).
The Yellow Emperor asked: When Zhou Bi (Zhou-type Bi syndrome) occurs in the body, it migrates up and down, following the meridians, corresponding left and right, with no space in between. I wish to know if this pain lies within the blood vessels or between the muscle layers? How does it arise? When the pain shifts, there is not enough time to insert the needle; when the pain accumulates, there is not enough time to determine treatment before the pain ceases. What is the reason for this? Qibo replied: This is Zhong Bi (Zhong-type Bi syndrome), not Zhou Bi. Zhong Bi occurs at specific locations, alternating between onset and cessation, appearing and disappearing, with left corresponding to right and right to left. It does not circulate throughout the body but alternates in发作 and rest. To treat this, even if the pain has ceased, one must needle the site where the pain occurred to prevent recurrence.
The Yellow Emperor asked: What about Zhou Bi? Qibo said: Zhou Bi resides within the blood vessels, moving up and down along the meridians, without spreading left or right, affecting specific areas. If the pain moves from above downwards, first needle the lower part to unblock the flow (or to restrain it), then needle the upper part to release the pathogen; if the pain moves from below upwards, first needle the upper part to unblock the flow, then needle the lower part to release the pathogen. The Yellow Emperor asked: How does this disease originate, and why is it named so? Qibo said: Wind, cold, and dampness pathogens lodge between the muscle layers, pressing on fluids to form foam. When the foam encounters cold, it aggregates; aggregation pushes apart the muscle layers causing separation, which results in pain. When pain occurs, the spirit concentrates on the area; concentration generates heat; heat resolves the pain; resolution leads to Qi reversal; reversal causes other Bi syndromes to erupt, thus continuing the cycle. This disease is neither internal to the Zang organs nor external on the skin, but resides solely between the muscle layers, preventing the True Qi from circulating fully, hence named Zhou Bi. Therefore, to treat Bi syndrome, one must first palpate and examine the major meridians above and below, assess deficiency and excess, and regulate cases of blood stasis in the large collaterals or deficient, sunken pulses. Use moxibustion or hot compresses to unblock the channels, and apply guiding exercises for muscle tension.
The Yellow Emperor asked: How can one identify those prone to Bi syndrome? Shaoyu replied: Those with coarse texture and weak muscles are prone to Bi syndrome. To determine the location, observe the upper, middle, and lower regions. The Yellow Emperor asked: Why are there three variations in needling? He replied: There is needling of Ying (Nutrient) level, Wei (Defensive) level, and Cold Bi lodged in the meridians. Needling Ying releases blood; needling Wei releases Qi; treating Cold Bi induces internal heat. The Yellow Emperor asked: What are the manifestations of Ying, Wei, and Cold Bi diseases? He replied: Ying disease manifests as chills, fever, shortness of breath, and abnormal movement of blood up and down. Wei disease manifests as fluctuating Qi and Blood, oppression and distension, with wind-cold lodging in the stomach and intestines. Cold Bi manifests as persistent pathogen retention, intermittent pain, and numbness of the skin. The Yellow Emperor asked: How to induce internal heat when needling Cold Bi? He replied: For commoners, use fire-quenching (fire needle); for nobles, use medicinal hot compresses. The prescription uses 20 sheng of strong wine, 1 sheng of Shuzao (Sichuan pepper), 1 sheng of Ganjiang (Dried ginger), and 1 sheng of Guirou (Cinnamon bark). These four herbs are finely chopped and soaked in clear wine. Add 1 jin of cotton wadding and 42 chi of fine white cloth into the wine. Place the container in horse manure fire, seal tightly to prevent gas leakage. After five days and nights, remove the cloth and wadding, dry them in the sun, and re-soak to extract all juice. Each soaking must be followed by drying on a suitable day. Finally, cut the cloth and wadding mixed with dregs into six towels of 6-7 chi length. Heat the towels over live charcoal of mulberry wood and apply hot compresses to the Cold Bi affected areas, allowing heat to penetrate the lesion. Repeat heating and application thirty times until sweating occurs. Wipe the body with the heated towel thirty times. Then walk indoors, avoiding wind. Apply hot compress after every needling session. This resolves the disease and constitutes "internal heat."
The Yellow Emperor asked: How does Bi syndrome arise? He replied: Wind, cold, and dampness combine to form Bi. Dominance of Wind creates Xing Bi (Wandering Bi). Dominance of Cold creates Tong Bi (Painful Bi). Dominance of Dampness creates Zhuo Bi (Fixed Bi). The Yellow Emperor asked: What are the five types? He replied: Contracted in winter, it becomes 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); in autumn, Pi Bi (Skin Bi). The Yellow Emperor asked: How do pathogens enter the Zang and Fu organs? He replied: Each Zang organ has its associated tissue. If the disease persists, the pathogen enters the associated tissue. Thus, if Gu Bi persists and re-exposure occurs, it enters the Kidney; if Jin Bi persists, it enters the Liver; if Mai Bi persists, it enters the Heart; if Ji Bi persists, it enters the Spleen; if Pi Bi persists, it enters the Lung. Bi syndromes arise from contracting wind-cold-dampness in their respective seasons. Untreated Bi may progress internally. Cases with dominant Wind are easier to cure. The Yellow Emperor asked: Why do some die, some suffer long-term pain, and some recover easily? He replied: Pathogens entering the Zang lead to death; those lingering in sinews and bones cause prolonged pain; those in the skin recover easily. The Yellow Emperor asked: What about pathogens lodging in the Fu organs? He replied: Diet and lifestyle are the root causes. Each Fu organ has Shu points; wind-cold-dampness attacks these points, and dietary responses allow pathogens to enter via the Shu points and lodge in the respective Fu organs. The Yellow Emperor asked: How to treat with needles? He replied: Zang organs have Shu points, Fu organs have He-Sea points. Following the meridian pathways and treating the affected sites will cure the disease. The Yellow Emperor asked: Can Ying and Wei Qi cause Bi syndrome? He replied: Ying Qi is the essence of water and grain, harmonizing the Zang organs and distributing to the Fu organs, entering the vessels to circulate through the Zang and connect the Fu. Wei Qi is the fierce Qi of water and grain, moving rapidly and smoothly, unable to enter the vessels. It circulates in the skin and muscle layers, steaming the Huang membrane and dispersing in the chest and abdomen. If its flow is reversed, disease occurs; if smooth, health is maintained. Since it does not combine with wind-cold-dampness, it does not form Bi syndrome.