风寒湿三气杂至合而为痹也(壅闭经络。血气不行而病为痹)共风气胜者为行痹(走注历
节疼
痛之类)寒气胜者为痛痹(阴寒之气乘于肌肉筋骨阳气不行故痛)湿气胜者为着痹也(着于一处
。或为疼痛或为顽木。湿从土化。病在肌肉)以冬过此者为骨痹(冬主骨。此指风寒湿也)以
春遇此者为筋痹(春主筋)以夏遇此者为脉痹(夏主脉)以至阴遇此者为肌痹(长夏主肌肉)以秋
遇此者为皮痹(秋主皮)五脏皆有合。病久而不去者。内舍于其合也 肺痹者。烦满喘而呕(
肺脉循胃口)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(肾水上逆故令
恐)肝痹者夜卧则惊多饮数小便上为引如怀(上下牵引。腹大如有所怀)肾痹者。善胀。尻以
代踵(足不能伸也)春以代头。(头不能举也)脾痹者。四肢解(懈同)惰。发咳呕汁。上为大塞
。(隔塞)肠痹者。数饮而出不得。中气喘争。时发飧泄(下焦气闭。水液混于大肠)胞痹者少
腹
膀胱。按之内痛。若沃以汤。涩于小便。上为清涕(胞。同脬。膀胱也○脬音抛)六腑亦各有
俞风寒湿气中其俞。而食饮应之。循俞而入。各舍其府也 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。故不痛(旧本不通)皮肤不营。故为不仁(无
营血充养)其寒者。阳气少。阴气多。与病相益故寒也(寒从中生)其热者。阳气多。阴气少
。病气胜。阳遇阴(甲乙经改阳乘阴)故为痹热(阳盛逢阴。则阴不能胜阳)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 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(具备有之也)凡痹
之类逢寒则急(急旧本虫误)逢热则纵。
风寒湿三种邪气混杂侵袭人体，合而发为痹证（即经络壅闭，气血运行不畅而导致的病证）。其中风气偏胜的称为行痹（表现为疼痛游走不定，历节关节疼痛等）；寒气偏胜的称为痛痹（阴寒之气乘袭肌肉筋骨，阳气不能宣通，故见疼痛）；湿气偏胜的称为着痹（病邪固定于一处，或表现为疼痛，或表现为肢体麻木不仁。湿邪从土化，病变部位在肌肉）。
如果在冬季感受此邪气，则发为骨痹（冬气主骨，此处指风寒湿邪）；如果在春季感受此邪气，则发为筋痹（春气主筋）；如果在夏季感受此邪气，则发为脉痹（夏气主脉）；如果在长夏季节感受此邪气，则发为肌痹（长夏气主肌肉）；如果在秋季感受此邪气，则发为皮痹（秋气主皮）。五脏各有其相合的组织，若病程长久而不愈，邪气就会内传并留舍于与其相合的脏腑。
肺痹的症状是：烦闷、喘息且呕吐（因肺脉循行经过胃脘部）。心痹的症状是：血脉不通，心烦时自觉心下悸动如鼓击，突然气逆上冲而喘息，咽喉干燥，容易嗳气，厥逆之气上冲则产生恐惧感（因肾水上逆所致，故令人恐惧）。肝痹的症状是：夜间睡眠易惊，多饮，小便频数，腹部上下牵引作痛，腹大如怀孕状（上下牵引，腹部胀大如同有所怀胎）。肾痹的症状是：容易腹胀，臀部着地代替脚跟行走（因足不能伸展），头部低垂代替头顶抬起（因头不能举）。脾痹的症状是：四肢懈怠无力，发作咳嗽，呕吐涎水，上部出现严重的痞塞不通（膈塞）。肠痹的症状是：频繁饮水但排尿困难，腹部肠鸣气争，时常发生完谷不化的泄泻（因下焦气机闭塞，水液混入大肠）。胞痹的症状是：小腹部膀胱区域，按压时内部疼痛，感觉像被热水浇灌一样灼热，小便涩滞不利，上部流出清稀鼻涕（“胞”同“脬”，即膀胱；“脬”音抛）。
六腑也各有其腧穴，风寒湿邪气中伤其腧穴，加之饮食不当相应诱发，邪气便顺着腧穴深入，各自留舍于相应的腑中。
疼痛的痹证，是因为寒气较多，有寒邪所以疼痛。那些不痛且麻木不仁的，是因为病程长久，病邪深入，营卫之气运行涩滞，经络时而空虚疏漏，所以不痛（旧本误作“不通”）；皮肤得不到营血的濡养，所以表现为麻木不仁（无营血充养）。属于寒性的痹证，是因为患者阳气少，阴气多，阴寒与病邪相互助益，所以感到寒冷（寒邪从中而生）。属于热性的痹证，是因为患者阳气多，阴气少，病气盛，阳热遇到阴分（《甲乙经》改为“阳乘阴”），所以表现为痹热（阳盛逢阴，阴不能制阳）。多汗且皮肤湿润的，这是因为感受湿邪严重，阳气少而阴气盛，两气相互感应，所以出汗且皮肤湿润。
痹邪在骨，则身体沉重；在脉，则血液凝滞而不流通；在筋，则屈曲不能伸展；在肉，则麻木不仁；在皮，则畏寒。如果具备这五种情况中的症状，则可能不痛（意为具备这些特征即属此类痹证，并非一定不痛，此处原文逻辑稍显跳跃，意指上述五者对应不同表现，若仅具其一或兼夹，需具体分析，但原文最后总结为“故具此五者，则不痛也”似有脱误或特指某种特定语境，依字面译为：如果具备这五种情况，则表现为不痛——注：此处依原文直译，虽医理上存疑，但翻译需忠实原文）。凡是痹类疾病，遇到寒邪则拘急收敛，遇到热邪则弛缓纵散。
Wind, cold, and dampness are three pathogenic factors that mix and invade the body together, resulting in Bi syndrome (a disease condition caused by the obstruction of meridians and channels, leading to impaired circulation of blood and qi). When wind is predominant, it is called Moving Bi (characterized by wandering pain and joint pain throughout the body); when cold is predominant, it is called Painful Bi (yin-cold qi attacks muscles and bones/tendons, yang qi fails to circulate freely, thus causing pain); when dampness is predominant, it is called Fixed Bi (the pathogen remains fixed in one location, manifesting as either pain or numbness/woodiness. Dampness transforms according to Earth, and the pathology resides in the muscles).
If this pathogenic combination is encountered in winter, it results in Bone Bi (Winter governs bones; here referring to wind, cold, and dampness); if encountered in spring, it results in Sinew Bi (Spring governs sinews); if encountered in summer, it results in Vessel Bi (Summer governs vessels); if encountered in late summer (Changxia), it results in Flesh/Muscle Bi (Late summer governs muscles); if encountered in autumn, it results in Skin Bi (Autumn governs skin). Each of the Zang organs has a corresponding exterior tissue association. If the disease persists for a long time without resolving, the pathogen will penetrate inward and lodge in the associated Zang organ.
Lung Bi manifests as vexation, fullness, wheezing, and vomiting (as the Lung meridian passes through the stomach region). Heart Bi manifests as blocked vessels, vexation with palpitations felt as drumming below the heart, sudden upward rushing of Qi with wheezing, dry throat, frequent belching, and fear induced by rebellious Qi ascending (fear arises because Kidney water rebels upward). Liver Bi manifests as fright during sleep, excessive thirst, frequent urination, and pulling pain extending from top to bottom with abdominal distension resembling pregnancy (pulling sensations, abdomen enlarged as if pregnant). Kidney Bi manifests as frequent bloating, walking on the buttocks instead of heels (because the feet cannot extend), and bowing the head so that the head replaces the crown (because the head cannot be lifted). Spleen Bi manifests as flaccidity and lethargy of the four limbs, coughing with vomiting of saliva, and severe upper obstruction/blockage (diaphragmatic blockage). Intestine Bi manifests as frequent drinking but inability to urinate, abdominal borborygmi and Qi contention, and occasional diarrhea with undigested food (due to closure of Qi in the lower Jiao, where fluids mix with the large intestine). Bladder/Pao Bi manifests as pain in the lower abdomen over the bladder upon pressure, a sensation as if scalded by hot water, difficult and scanty urination, and clear nasal discharge above (‘Pao’ is synonymous with ‘Pa’, meaning bladder; ‘Pa’ is pronounced pao).
Each of the Fu organs also has its Shu points. Wind, cold, and dampness pathogens strike these Shu points, and dietary irregularities correspondingly trigger them. The pathogens enter along the Shu points and lodge in their respective Fu organs.
Painful conditions are due to an excess of cold; the presence of cold causes pain. Conditions that are neither painful nor sensitive (numb) occur when the disease has persisted for a long time and penetrated deeply. The circulation of Ying (Nutrient) and Wei (Defensive) Qi becomes sluggish, and the meridians become occasionally sparse/deficient, hence there is no pain (old texts erroneously read ‘blocked’); the skin lacks nourishment from Ying blood, hence numbness occurs (lack of Ying blood nourishment). Cold-type Bi is characterized by deficient Yang Qi and abundant Yin Qi; Yin and the pathogenic factor mutually reinforce each other, generating internal cold (cold generates from within). Heat-type Bi is characterized by abundant Yang Qi and deficient Yin Qi; the pathogenic factor prevails, and Yang encounters Yin (changed to ‘Yang overwhelms Yin’ in *Jia Yi Jing*), resulting in Bi-Heat (Yang abundance meeting Yin, where Yin cannot overcome Yang). Profuse sweating and moist skin occur when dampness is severe; deficient Yang Qi and abundant Yin Qi interact, causing sweating and moisture.
When Bi affects the bones, the body feels heavy; when it affects the vessels, blood coagulates and fails to flow; when it affects the sinews, flexion occurs but extension is impossible; when it affects the flesh, there is numbness; when it affects the skin, there is coldness. Therefore, possessing these five characteristics defines the nature of the Bi syndrome (Note: The original text states “thus possessing these five means no pain,” which may imply specific diagnostic criteria or contains textual corruption, but literally translates to: if these five conditions are present, there is no pain). Generally, Bi syndromes contract and tighten when exposed to cold, and relax and slacken when exposed to heat.