1.三痹之因风寒湿, 五痹筋骨脉肌皮, 风胜行痹寒痹痛, 湿胜着痹
重难支. 皮麻肌木脉色变, 筋挛骨重遇邪时, 复感于邪入脏腑, 周同
脉痹不相移.
【注】三痹之因, 风寒湿三气杂合而为病也. 其风邪胜者, 其痛流走
,故曰行痹. 寒邪胜者, 其痛甚苦, 故曰痛痹. 湿邪胜者, 其痛重着
,故曰着痹. 此为病之因而得名, 曰三痹也. 又有曰五痹者, 谓皮,
脉,肌, 筋, 骨之痹也. 以秋时遇此邪为皮痹, 则皮虽麻尚微觉痛痒
也.以夏时遇此邪为脉痹, 则脉中血不流行, 而色变也. 以长夏时遇
此邪为肌痹, 则肌顽木不知痛痒也. 以春时遇此邪为筋痹, 则筋挛节
痛屈而不伸也. 以冬时遇此邪为骨痹, 则骨重酸疼不能举也. 曰入脏
腑者, 谓内舍五脏之痹也. 以皮痹不巳, 复感于邪, 内舍于肺, 成肺
痹也. 脉痹不巳, 复感于邪, 内舍于心, 成心痹也. 肌痹不巳, 复感
于邪, 内舍于脾, 成脾痹也. 筋痹不巳, 复感于邪, 内舍于肝, 成肝
痹也. 骨痹不巳, 复感于邪, 内舍于肾, 成肾痹也. 此皆以病遇邪之
时,及受病之处而得名, 曰五痹也. 所谓邪者, 重感于风寒湿之气也
.周痹亦在血脉之中, 随脉上下为病, 故同脉痹, 但患有定处, 不似
脉痹左右相移也. 近世曰痛风, 曰流火, 曰历节风, 皆行痹之俗名也
.
1. 痹病（Bi Syndrome，以疼痛、麻木、沉重为主要表现的疾病）的成因是风、寒、湿三种邪气。五痹（Five Bi Syndromes，指皮、脉、肌、筋、骨五种部位的痹证）分别对应皮、脉、肌、筋、骨。风气偏胜的为行痹（Moving Bi Syndrome，疼痛游走不定），寒气偏胜的为痛痹（Painful Bi Syndrome，疼痛剧烈），湿气偏胜的为着痹（Fixed Bi Syndrome，肢体沉重难举）。皮肤麻木、肌肉木硬、血脉颜色改变、筋脉拘挛、骨骼沉重，都是在感受邪气时出现的症状。如果再次感受邪气，病邪就会深入脏腑，周痹（Zhou Bi Syndrome，疼痛沿经脉上下移动的痹证）与脉痹（Mai Bi Syndrome，血脉阻滞引起的痹证）在病变部位上有所不同，不会像脉痹那样左右转移。
【注】三痹的成因，是风、寒、湿三种邪气混杂在一起致病。其中风邪偏胜的，疼痛游走不定，所以称为行痹。寒邪偏胜的，疼痛非常剧烈痛苦，所以称为痛痹。湿邪偏胜的，疼痛部位固定且沉重，所以称为着痹。这是根据致病原因和命名特点，称为三痹。另外还有五痹的说法，指的是皮痹、脉痹、肌痹、筋痹、骨痹。如果在秋季感受这些邪气导致皮痹，虽然皮肤麻木，但尚能轻微感觉到痛痒。如果在夏季感受这些邪气导致脉痹，则血脉中血液运行不畅，肤色发生改变。如果在长夏（夏末秋初）感受这些邪气导致肌痹，则肌肉僵硬麻木，不知痛痒。如果在春季感受这些邪气导致筋痹，则筋脉拘挛，关节疼痛，屈伸不利。如果在冬季感受这些邪气导致骨痹，则骨骼沉重酸痛，无法抬起。所谓“入脏腑”，是指内舍于五脏的痹证。如果皮痹不愈，再次感受邪气，病邪内传于肺，形成肺痹（Lung Bi Syndrome）。如果脉痹不愈，再次感受邪气，病邪内传于心，形成心痹（Heart Bi Syndrome）。如果肌痹不愈，再次感受邪气，病邪内传于脾，形成脾痹（Spleen Bi Syndrome）。如果筋痹不愈，再次感受邪气，病邪内传于肝，形成肝痹（Liver Bi Syndrome）。如果骨痹不愈，再次感受邪气，病邪内传于肾，形成肾痹（Kidney Bi Syndrome）。这些都是根据发病季节及受病部位来命名的，称为五痹。所谓的“邪”，是指再次感受风、寒、湿之气。周痹也在血脉之中，随经脉上下移动而发病，所以与脉痹相似，但周痹疼痛有固定位置，不像脉痹那样左右转移。近代所说的痛风（Gout）、流火（Erysipelas-like condition）、历节风（Rheumatoid Arthritis-like condition），都是行痹的俗称。
1. The etiology of Bi syndrome (a disease characterized by pain, numbness, and heaviness) lies in the combination of Wind, Cold, and Dampness pathogens. The Five Bi syndromes refer to Bi conditions affecting the skin, vessels, muscles, sinews, and bones respectively. When Wind pathogen predominates, it is called Moving Bi syndrome (characterized by wandering pain); when Cold pathogen predominates, it is called Painful Bi syndrome (characterized by severe pain); when Dampness pathogen predominates, it is called Fixed Bi syndrome (characterized by heavy limbs difficult to lift). Symptoms such as skin numbness, muscle stiffness, discoloration of vessels, sinew contracture, and bone heaviness occur upon exposure to pathogens. If exposed to pathogens again, the disease may penetrate into the Zang-Fu organs. Zhou Bi syndrome (Bi syndrome with pain moving up and down along the meridians) shares similarities with Mai Bi syndrome (Bi syndrome caused by vessel obstruction), but its location is fixed, unlike Mai Bi syndrome which shifts from left to right.
[Annotation] The cause of the Three Bi syndromes is the mixed invasion of Wind, Cold, and Dampness pathogens. When Wind pathogen predominates, the pain wanders, hence it is called Moving Bi syndrome. When Cold pathogen predominates, the pain is extremely severe and bitter, hence it is called Painful Bi syndrome. When Dampness pathogen predominates, the pain is fixed and heavy, hence it is called Fixed Bi syndrome. These are named according to their etiological factors, collectively known as the Three Bi syndromes. There is also the concept of Five Bi syndromes, referring to Pi Bi (Skin Bi), Mai Bi (Vessel Bi), Ji Bi (Muscle Bi), Jin Bi (Sinew Bi), and Gu Bi (Bone Bi). If these pathogens are encountered in Autumn leading to Pi Bi, the skin is numb but still slightly sensitive to pain and itching. If encountered in Summer leading to Mai Bi, blood circulation within the vessels is impaired, resulting in discoloration. If encountered in Late Summer leading to Ji Bi, the muscles become stiff and numb, losing sensitivity to pain and itching. If encountered in Spring leading to Jin Bi, the sinews contract, joints ache, and flexion/extension is restricted. If encountered in Winter leading to Gu Bi, the bones feel heavy and sore, making lifting impossible. "Entering the Zang-Fu organs" refers to internal transmission to the five Zang organs. If Pi Bi persists and re-exposure occurs, the pathogen enters the Lung, forming Fei Bi (Lung Bi syndrome). If Mai Bi persists and re-exposure occurs, the pathogen enters the Heart, forming Xin Bi (Heart Bi syndrome). If Ji Bi persists and re-exposure occurs, the pathogen enters the Spleen, forming Pi Bi (Spleen Bi syndrome). If Jin Bi persists and re-exposure occurs, the pathogen enters the Liver, forming Gan Bi (Liver Bi syndrome). If Gu Bi persists and re-exposure occurs, the pathogen enters the Kidney, forming Shen Bi (Kidney Bi syndrome). These are named based on the season of onset and the affected site, collectively known as the Five Bi syndromes. The "pathogens" referred to here are the repeated exposure to Wind, Cold, and Dampness. Zhou Bi syndrome also resides within the blood vessels, causing disease by moving up and down along the meridians; thus, it resembles Mai Bi syndrome, but the pain has a fixed location, unlike Mai Bi syndrome which shifts laterally. In modern times, Gout, Liu Huo (a condition resembling erysipelas or acute cellulitis), and Li Jie Feng (a condition resembling rheumatoid arthritis) are all common names for Moving Bi syndrome.