《灵枢·周痹篇》帝曰∶周痹之在身也，上下移徙随脉，其上下左右相应，间不容空，愿闻此痛，在血
脉之中耶？将分肉之间乎？何以致是？其痛之移也，间不及下针，其 痛之时，不及定治，而痛已止矣，何道
使然？愿闻其故。岐伯曰∶此众痹也，非周痹也。帝曰∶愿闻众痹。岐伯曰∶此各在其处，各发更止，更居
更起，以右应左，以左应右，非能周也，更发更休也。刺此者，痛虽已止，必刺其处，勿令复起。
按此言忽痛忽止，上下移徙者，以其邪各在一处，此痛彼止，彼痛此止，或各痛各止，互起互伏，痹处众
多，故名众痹。因邪根据脉路，而脉中气血流行不住，故邪动静不常，动则痛，静则止，而经脉左右相同，故痛
必左右相应，而止在近脉之处，更发更休，非能周于一身，故不名周痹也。刺之者，其痛虽止，必刺其原痛
之处以去邪，勿使复痛也。
帝曰∶周痹何如？岐伯曰∶周痹者，在于血脉之中，随脉以上，随脉以下，不能左右，各当其所。帝
曰∶刺之奈何？岐伯曰∶痛从上下者，先刺其下以过之，后刺其上以脱之；痛从下上者，先刺其上以过之，
后刺其下以脱之。
此言邪在血脉之中，十二经脉行于周身，故名周痹。其痛上下行走，不能左右者，邪随阴阳升降之气而行，
故与众痹不同。痛从上下者，其痹在上，故先刺下以泄其标，再刺其上以脱其本；痛从下上者，其痹在下，故
先刺上以泄其标，再刺其下以脱其本。若众痹，邪根据脉外，脉外气宽，其邪与脉或近或远，近脉则动而痛，远
脉则静而止，以其气宽，故动则必根据脉路，左右相应也。
帝曰∶此痛安生？岐伯曰∶风寒湿气，客于外分肉之间，迫切而为沫，沫得寒则聚，聚则排分肉而分裂
也，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。
上文言邪在血脉之中，血脉本居分肉之间，分肉即卫气所周行者。风寒湿邪，必先伤卫，久则侵营，而入
血脉。当其由浅入深，而与卫气迫切而为沫，沫得寒而凝聚，则排分肉而分裂作痛，痛则心神注之，心之所之，
气亦至焉，故阳气随心而至痛处则热，热则寒散痛解，解则气厥而不通和，不通和，故他处之痹又发，发则又
如是而痛也。经脉内通于脏，而邪则痹聚营卫，未入五内，其营卫在分肉间，故外不及于皮，因是真元之气不
得行于周身，内外皆为邪痹肌肉之故，而名周痹。若以邪在血脉，而经脉周于一身，其义亦当名周痹也。至于
一处痛解，而他处痹痛又发，其义理与众痹同。众痹邪痹卫分而近于脉，此则邪痹肌肉间而入血脉，故其痛发，
随脉上下，而与众痹之左右相应者不同也。
《灵枢·周痹篇》中，黄帝问道：周痹这种病发生在身上时，疼痛部位会沿着经脉上下移动，身体上下的左右两侧相互呼应，疼痛之间几乎没有空隙。我想知道这种疼痛是在血脉之中呢？还是在分肉（肌肉间隙）之间？是什么导致了这种情况？当疼痛转移时，时间短暂到来不及下针；当疼痛发作时，还来不及确定治疗方案，疼痛就已经停止了。这是什么道理导致的？我希望听听其中的原因。岐伯回答说：这是众痹，不是周痹。黄帝说：我想了解什么是众痹。岐伯说：众痹的疼痛各自位于不同的部位，交替发作又交替停止，交替出现又交替消失，右侧的疼痛与左侧相应，左侧的疼痛与右侧相应，但不能遍及全身，是交替发作、交替休息的。治疗这种病，即使疼痛已经停止，也必须针刺原来疼痛的部位，以防止它再次发作。
按照这段文字所说，忽痛忽止、上下移动的疼痛，是因为邪气各自停留在一个地方，这里痛那里就停，那里痛这里就停，或者各自痛各自停，互相起伏，痹阻的部位众多，所以称为众痹。因为邪气依附于脉路，而脉中的气血流动不停，所以邪气的动静不固定，动则引起疼痛，静则疼痛停止，而且经脉左右相同，所以疼痛必然左右相应，并且停止在靠近脉的地方，交替发作和休息，不能遍及全身，所以不叫周痹。针刺治疗时，虽然疼痛已经停止，但必须针刺原来疼痛的地方以祛除邪气，不要让它再次疼痛。
黄帝问：周痹是怎样的？岐伯说：周痹位于血脉之中，随着经脉向上行，随着经脉向下行，不能向左右扩散，各自对应其所在的部位。黄帝问：如何针刺治疗？岐伯说：如果疼痛从上部向下部发展，先针刺下部以阻断病势，后针刺上部以去除病根；如果疼痛从下部向上部发展，先针刺上部以阻断病势，后针刺下部以去除病根。
这段话是说邪气在血脉之中，十二经脉行于周身，所以称为周痹。其疼痛上下行走，不能向左右扩散，是因为邪气随着阴阳升降的气机运行，所以与众痹不同。疼痛从上部向下部发展的，痹证在上部，所以先针刺下部以泄除标症，再针刺上部以脱除本因；疼痛从下部向上部发展的，痹证在下部，所以先针刺上部以泄除标症，再针刺下部以脱除本因。至于众痹，邪气依附于脉外，脉外的气机宽缓，邪气与经脉或近或远，靠近经脉则动而疼痛，远离经脉则静而停止，因为气机宽缓，所以动时必然依据脉路，左右相应。
黄帝问：这种疼痛是如何产生的？岐伯说：风寒湿邪气，客居在分肉之间，逼迫津液凝结成沫，沫遇到寒冷则聚集，聚集则排挤分肉使其分裂，分裂则产生疼痛，疼痛则精神集中于患处，精神集中于患处则产生热感，热感则疼痛缓解，疼痛缓解后则出现气逆，气逆则其他部位的痹证发作，发作时就是这样。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，所以称为周痹。
上文所说的邪气在血脉之中，血脉本来居住在分肉之间，分肉就是卫气所周流运行的地方。风寒湿邪气，必定先伤害卫气，久了则侵入营气，进入血脉。当邪气由浅入深，与卫气相迫结而成沫，沫遇到寒冷而凝聚，就会排挤分肉使其分裂而作痛，疼痛则心神专注于此，心之所向，气也到达那里，所以阳气随心动而至疼痛处则发热，发热则寒散痛解，痛解后则气机厥逆而不通调和，不通调和，所以其他部位的痹证又发作，发作时又像这样而疼痛。经脉内通于脏腑，而邪气痹聚于营卫，未进入五脏六腑，其营卫在分肉间，所以外不及于皮肤，因此真元之气不得行于周身，内外都被邪气痹阻于肌肉的缘故，所以称为周痹。如果认为邪气在血脉中，而经脉周于一身，这个意义也应该称为周痹。至于一个地方的疼痛缓解了，而其他部位的痹痛又发作，这个道理与众痹相同。众痹的邪气痹阻卫分而靠近经脉，这则是邪气痹阻肌肉间而进入血脉，所以其疼痛发作时，随着经脉上下移动，与众痹左右相应的特点不同。
In the "Zhou Bi" (Generalized Bi) chapter of the *Ling Shu* (Spiritual Pivot), the Yellow Emperor asked: When Zhou Bi disease occurs in the body, the pain migrates up and down following the meridians, with corresponding reactions between the upper and lower left and right sides, leaving no empty space. I wish to know if this pain is within the blood vessels or between the fen rou (muscle intervals)? What causes this? When the pain shifts, there is not enough time to insert a needle; when the pain arises, there is not enough time to determine the treatment, yet the pain has already ceased. What principle makes this happen? I wish to hear the reason. Qibo replied: This is Zhong Bi (Multiple Bi), not Zhou Bi. The Yellow Emperor said: I wish to understand Zhong Bi. Qibo said: Each part of Zhong Bi is located in its own place, alternating in onset and cessation, appearing and disappearing alternately, with the right responding to the left and the left to the right, but it does not circulate around the whole body; it alternates in attack and rest. To treat this, even if the pain has ceased, one must still needle the original site of pain to prevent recurrence.
According to this statement, the pain that appears suddenly and stops, moving up and down, is because the pathogenic factors are located in separate places; where it hurts here, it stops there, and where it hurts there, it stops here, or each hurts and stops independently, rising and falling mutually. Since there are many sites of Bi obstruction, it is named Zhong Bi. Because the pathogens rely on the meridian pathways, and the qi and blood in the meridians flow continuously, the movement and stillness of the pathogens are irregular. Movement causes pain, stillness causes cessation. Since the meridians are symmetrical on the left and right, the pain necessarily corresponds on both sides, and cessation occurs near the meridians. It alternates in attack and rest and cannot circulate throughout the entire body, so it is not called Zhou Bi. In needling treatment, although the pain may have stopped, one must needle the original painful area to eliminate the pathogen and prevent the pain from returning.
The Yellow Emperor asked: How about Zhou Bi? Qibo said: Zhou Bi resides within the blood vessels, moving up along the meridians and down along the meridians, without spreading to the left or right, corresponding to its specific location. The Yellow Emperor asked: How should it be needled? Qibo said: If the pain moves from above downwards, first needle the lower part to intercept it, then needle the upper part to eradicate it; if the pain moves from below upwards, first needle the upper part to intercept it, then needle the lower part to eradicate it.
This passage states that the pathogen is within the blood vessels, and the twelve regular meridians traverse the entire body, hence it is called Zhou Bi. The pain travels up and down but does not spread left or right because the pathogen follows the ascending and descending qi of yin and yang, which differs from Zhong Bi. For pain originating from above and moving down, the Bi syndrome is primarily above, so one first needles the lower part to drain the branch (symptom), then needles the upper part to remove the root (cause). For pain originating from below and moving up, the Bi syndrome is primarily below, so one first needles the upper part to drain the branch, then needles the lower part to remove the root. As for Zhong Bi, the pathogen relies on the exterior of the meridians. The qi outside the meridians is expansive; the pathogen may be close to or far from the meridians. Close to the meridian, it moves and causes pain; far from the meridian, it is still and pain ceases. Because the qi is expansive, when it moves, it necessarily follows the meridian pathways, causing left-right correspondence.
The Yellow Emperor asked: How is this pain generated? Qibo said: Wind, cold, and dampness pathogens lodge between the fen rou (muscle intervals), pressing upon fluids to form phlegm-rheum (mo). When this phlegm-rheum encounters cold, it aggregates. Aggregation pushes apart the fen rou, causing separation. Separation results in pain. Pain draws the shen (spirit/mind) to the area. When the shen gathers there, heat is generated. Heat resolves the pain. Once the pain resolves, jue (qi reversal/stagnation) occurs, leading to the emergence of Bi symptoms in other areas. This process repeats. This condition is internally not in the zang-fu organs, nor externally manifested in the skin, but resides exclusively between the fen rou. Because the true qi cannot circulate fully, it is named Zhou Bi.
The previous text mentioned pathogens within the blood vessels. Blood vessels reside within the fen rou, which is where wei qi (defensive qi) circulates. Wind, cold, and dampness pathogens first injure the wei qi; over time, they invade ying qi (nutritive qi) and enter the blood vessels. As they move from superficial to deep levels, pressing against the wei qi to form phlegm-rheum, and aggregating due to cold, they push apart the fen rou, causing separation and pain. Pain focuses the heart-mind (shen); where the heart-mind goes, qi also arrives. Thus, yang qi reaches the painful area via the heart's direction, generating heat. Heat disperses cold and relieves pain. Upon relief, qi becomes jue (stagnant/reversed) and fails to harmonize. Lack of harmony causes Bi symptoms to flare up elsewhere, repeating the cycle. Meridians connect internally to the zang-fu, while pathogens obstruct ying and wei qi without entering the five viscera. Since ying and wei qi are in the fen rou, the pathology does not reach the skin. Therefore, yuan qi (original qi) cannot circulate throughout the body. Internally and externally, muscles are obstructed by pathogens, hence the name Zhou Bi. If one considers the pathogen in the blood vessels and the meridians circulating the whole body, the meaning also justifies the name Zhou Bi. Regarding the phenomenon where pain resolves in one area only to flare up in another, the principle is similar to Zhong Bi. In Zhong Bi, pathogens obstruct the wei level near the meridians; in Zhou Bi, pathogens obstruct the muscle tissue and enter the blood vessels. Thus, their pain follows the meridians up and down, differing from the left-right correspondence seen in Zhong Bi.