黄帝问曰∶痹或痛、或不痛、或不仁、或寒、或热、或燥、或湿者，其故何也？岐仁对
曰∶痛者，其寒气多，有寒故痛。其不痛不仁者，病久入深，营卫之行涩，经络时疏，故不
痛，皮肤不营；故不仁。其寒者，阳气少，阴气多，与病相益，故为寒。其热者，阳气多，
阴气少，病气胜，阳乘阴，故为热。其多寒汗出而濡者，此其逢湿胜也。其阳气少，阴气盛
，两气相感，故寒，汗出而濡也。夫痹在骨则重，在脉则凝而不流，在筋则屈而不伸，在肉
则不仁，在皮则寒，故具此五者则不痛。凡痹之类，逢寒则急，逢热则纵。曰∶或有一脉生
数十病者，或痛或痈，或热或痒，或痹或不仁，变化无有穷时，其故何也？曰∶此皆
邪气之所生也。曰∶人有真气，有正气，有邪气，何谓也？曰∶真气者，所受于天，与水谷
气并而充身者也。正气者，正风，从一方来，非虚风也。（《太素》云非灾风也。）邪气者
虚风也。虚风之贼伤人也，其中人也深，不得自去。正风之中人也浅而自去，其气柔弱，
不能伤真气，故自去。虚邪之中人也，凄索动形，起毫毛而发腠理，其入深，内薄于骨则为
骨痹；薄于筋则为筋挛；薄于脉中则为血闭而不通，则为痈；薄于肉中，与卫气相搏，阳胜
则为热，阴胜则为寒，寒则其气去，去则虚，虚则寒；薄于皮肤，其气外发，腠理开，毫毛摇
气（一本作淫气）往来微行则为痒；气留而不去故为痹；卫气不去则为不仁。
病在骨，骨重不可举，骨髓酸痛，寒气至，名曰骨痹。深者刺无伤脉肉为故，其
道大小分，骨热病已止。病在筋，筋挛节痛，不可以行，名曰筋痹。刺筋上为故，刺分肉间
，不可中骨，病起筋热，病已止。病在肌肤，肌肤尽痛，名曰肌痹，伤于寒湿。刺大分、小分
，多发针而深之，以热为故，无伤筋骨，筋骨伤，痈发若变。诸分尽热，病已止。
曰∶人身非衣寒也，中非有寒气也，寒从中生者何？曰∶是人多痹，阳气少而阴气多，
故身寒如从水中出。曰∶人有身寒，汤火不能热也，浓衣不能温也，然不为冻栗，是为何病
？曰∶是人者，素肾气胜，以水为事，太阳气衰，肾脂枯不长。一水不能胜两火。肾者水
也。而主骨，肾不生则髓不能满，故寒甚至骨。所以不能冻栗者，肝一阳也，心二阳也
，肾孤脏也，一水不能胜上二火，故不能冻栗，病名曰骨痹，是人当挛节。着痹不去，久
寒不已，为肝痹（一作 痹）。骨痹举节不用而痛，汗注烦心，取三阴之经补之。厥痹
者，厥气上及腹，取阴阳之络，视主病者，泻阳补阴经也。风痹注（《灵枢》作淫泺）病不
可已者，足如履冰，时如入汤中，肢胫淫泺，烦心头痛，时呕时闷，眩已汗出，久则目眩
，悲以喜怒，短气不乐，不出三年死。足髀不可举，侧而取之，在枢阖中，以员利针，大针
不可。膝中痛，取犊鼻，以员利针，针发而间之，针大如 ，刺膝无疑。
足不仁，刺风府。腰以下至足清不仁，不可以坐起，尻不举，腰俞主之。痹，会阴及
太渊、消泺、照海主之。嗜卧，身体不能动摇，大温（一本作湿），三阳络主之。骨痹烦
满，商丘主之。足下热
关主之。痹，胫重，足跗不收，跟痛，巨虚下廉主之。胫痛，足缓失履，湿痹，足下热不能
久立，条口主之。胫苕苕（一本作苦）痹，膝不能屈伸，不可以行，梁丘主之。膝寒痹不仁，
不可屈伸，髀关主之。肤痛痿痹，外丘主之。膝外廉痛，不可屈伸，胫痹不仁，阳关主之。
髀痹引膝股外廉痛，不仁，筋急，阳陵泉主之。寒气在分肉间痛，上下筋痹不仁，中渎主之
。髀枢中痛不可举，以毫针寒留之，以月生死为 数，立已，长针亦可。腰胁相引急痛
，髀筋 ，胫痛不可屈伸，痹不仁，环跳主之。风寒从足小指起，脉痹上下带，胸胁痛无
常处，至阴主之。足大指搏伤，下车 地通背指端伤为筋痹，解溪主之。
黄帝问道：痹证有的疼痛，有的不痛，有的麻木不仁，有的发冷，有的发热，有的干燥，有的潮湿，这是什么原因呢？岐伯回答说：疼痛的，是因为寒气多，有寒所以疼痛。不痛且麻木不仁的，是因为病久深入，营卫之气运行涩滞，经络时常空虚，所以不痛；皮肤得不到营气的滋养，所以麻木不仁。发冷的，是因为阳气少，阴气多，与病邪相叠加，所以表现为寒冷。发热的，是因为阳气多，阴气少，病邪盛，阳热乘袭阴分，所以表现为发热。那些多寒、出汗且湿润的，这是因为逢遇湿气偏胜的缘故。如果阳气少，阴气盛，两气相互感应，所以发冷，出汗且湿润。痹证在骨则身体沉重，在脉则血液凝滞而不流动，在筋则屈曲不能伸展，在肉则麻木不仁，在皮则感觉寒冷，具备这五种情况就不疼痛。大凡痹证之类，逢遇寒邪则拘急，逢遇热邪则弛纵。
（有人）问：为什么有的经脉生出几十种病，有的疼痛，有的生痈肿，有的发热，有的瘙痒，有的痹阻，有的麻木不仁，变化无穷无尽，这是什么原因呢？答：这都是邪气产生的结果。又问：人有真气，有正气，有邪气，各指什么？答：真气，是禀受于先天，与水谷之气结合而充养全身的气。正气，是指正风，从一方而来，不是虚风。（《太素》说不是灾风。）邪气，是指虚风。虚风这种贼邪伤害人，侵入人体深，不能自行去除。正风伤人浅，能自行去除，其气柔弱，不能伤害真气，所以自行消散。虚邪中人，使人凄惨颤动，毫毛竖起，腠理开泄，侵入较深，内迫于骨则为骨痹；迫于筋则为筋挛；迫于脉中则为血闭不通，形成痈肿；迫于肉中，与卫气相搏，阳胜则发热，阴胜则发冷，冷则气去，气去则虚，虚则寒；迫于皮肤，气向外发散，腠理开，毫毛摇动，气往来微行则产生瘙痒；气停留不去则为痹证；卫气不去则为麻木不仁。
病在骨，骨重不可抬举，骨髓酸痛，寒气至，名叫骨痹。针刺要深，但不要损伤脉和肉为度，其道路由大分肉到小分肉，骨热病好后即止针。病在筋，筋脉拘挛关节疼痛，不能行走，名叫筋痹。针刺要在筋上，刺入分肉之间，不可伤及骨头，病起筋热，病好后即止针。病在肌肤，肌肤全部疼痛，名叫肌痹，这是伤于寒湿所致。针刺大分、小分，多下针并深刺，以局部发热为度，不要损伤筋骨，如果损伤筋骨，会引发痈肿或其他变证。各个分肉都感到热，病好后即止针。
问：人身并非因为穿衣少而寒冷，体内也没有寒气入侵，为什么寒气会从内生出来？答：这种人大多患有痹证，阳气少而阴气多，所以身体寒冷，好像从水中出来一样。问：有的人身体寒冷，用汤火不能使其温暖，穿厚衣也不能使其温热，然而却不发生冻栗，这是什么病？答：这种人平素肾气偏胜，从事涉水劳作，导致太阳膀胱经之气衰弱，肾脂枯竭不长。一水不能胜过两火。肾属水，主骨，肾不生则髓不能充满，所以寒冷甚至达于骨髓。之所以不发生冻栗，是因为肝为一阳脏，心为二阳脏，肾为孤脏，一水不能胜过上面的两火，所以不会冻栗，这种病名叫骨痹，这种人应当出现关节拘挛。着痹不去，久寒不已，会发展为肝痹。骨痹患者关节不用且疼痛，汗出如注，心烦意乱，取足三阴经穴位进行补法治疗。厥痹者，厥气上逆至腹部，取阴阳之络穴，视主要病变所在，泻阳经补阴经。风痹注（《灵枢》作淫泺），病情无法痊愈的，脚像踩在冰上，有时像进入热水中，四肢酸软无力，心烦头痛，时而呕吐时而胸闷，眩晕后出汗，久了则目眩，情绪悲喜无常，短气不乐，不出三年就会死亡。大腿和大腿根部不能抬举，侧卧取穴，在枢阖中，用员利针，不能用大针。膝中疼痛，取犊鼻穴，用员利针，针刺后间歇留针，针粗如铤，刺膝部无疑。
足部麻木不仁，刺风府穴。腰部以下至足部清冷麻木不仁，不能坐起，臀部抬不起来，由腰俞穴主治。痹证，由会阴、太渊、消泺、照海穴主治。嗜睡，身体不能动摇，大温（一本作湿），由三阳络穴主治。骨痹烦闷胀满，由商丘穴主治。足底发热，由关元穴主治。痹证，小腿沉重，足背下垂不收，脚跟疼痛，由巨虚下廉穴主治。小腿疼痛，足缓失履，湿痹，足底发热不能久站，由条口穴主治。小腿苦痹，膝盖不能屈伸，不能行走，由梁丘穴主治。膝外侧寒冷痹证麻木不仁，不能屈伸，由髀关穴主治。皮肤疼痛痿痹，由外丘穴主治。膝外侧疼痛，不能屈伸，小腿痹证麻木不仁，由阳关穴主治。大腿痹证牵引膝股外侧疼痛，麻木不仁，筋脉拘急，由阳陵泉穴主治。寒气在分肉间疼痛，上下筋痹麻木不仁，由中渎穴主治。大腿枢纽中疼痛不能抬举，用毫针寒留法，以月亮的盈亏决定针刺次数，立竿见影，长针也可以。腰胁相互牵引急痛，大腿筋急，小腿疼痛不能屈伸，痹证麻木不仁，由环跳穴主治。风寒从足小趾开始，脉痹上下牵连，胸胁疼痛无固定位置，由至阴穴主治。足大指挫伤，下车踏地通背指端受伤为筋痹，由解溪穴主治。
Huangdi asked: In Bi syndrome (Bi Syndrome, a condition characterized by blockage and pain), some cases involve pain, others do not; some involve numbness (Anesthesia/Numbness, loss of sensation), others coldness, others heat, others dryness, or dampness. What is the reason for this? Qibo replied: Pain occurs when there is an abundance of Cold pathogen (Han Qi); because of Cold, there is pain. Cases that are neither painful nor numb occur when the disease has been present for a long time and penetrated deeply; the circulation of Ying (Nutrient) Qi and Wei (Defensive) Qi becomes sluggish, and the meridians are occasionally empty; thus, there is no pain. The skin does not receive nourishment from Ying Qi; therefore, there is numbness. Cold sensations arise when Yang Qi is deficient and Yin Qi is abundant; these combine with the pathogenic factor, resulting in coldness. Heat sensations arise when Yang Qi is abundant and Yin Qi is deficient; the pathogenic factor prevails, and Yang overcomes Yin, resulting in heat. Those who experience excessive cold, sweating, and wetness do so because they have encountered an excess of Dampness (Shi). When Yang Qi is weak and Yin Qi is strong, the two energies interact, causing coldness and sweating with wetness. When Bi affects the bones, the body feels heavy; when it affects the vessels, blood coagulates and fails to flow; when it affects the tendons, flexion occurs but extension is impossible; when it affects the muscles, there is numbness; when it affects the skin, there is coldness. If all five conditions are present, there is no pain. Generally, Bi syndromes become contracted upon exposure to Cold and relaxed upon exposure to Heat.
Someone asked: Why can one meridian give rise to dozens of diseases, varying between pain, abscesses, heat, itching, obstruction, or numbness, with changes without end? What is the reason? The answer is: These are all generated by Evil Qi (Xie Qi). Another question was raised: Humans possess True Qi (Zhen Qi), Righteous Qi (Zheng Qi), and Evil Qi. What do these terms mean? True Qi is received from Heaven (congenital essence) and combines with Qi from water and grain to fill the body. Righteous Qi refers to Correct Wind (Zheng Feng), which comes from one direction and is not Deficient Wind (Xu Feng). (*Tai Su* states it is not Disaster Wind.) Evil Qi refers to Deficient Wind. Deficient Wind, as a thief-like pathogen, injures humans deeply and cannot depart on its own. Correct Wind injures humans superficially and departs on its own; its energy is weak and cannot damage True Qi, so it dissipates naturally. When Deficient Evil enters the human body, it causes shivering and trembling, raises the hair, and opens the Couli (pores). If it penetrates deeply and presses inward on the bones, it results in Bone Bi; if it presses on the tendons, it results in tendon spasms; if it presses into the vessels, it causes blood closure and obstruction, leading to abscesses; if it presses into the muscles and contends with Wei Qi, Yang predominance leads to heat, while Yin predominance leads to cold. Cold causes Qi to depart; departure leads to deficiency; deficiency leads to cold. If it presses on the skin, the Qi moves outward, opening the Couli and shaking the hair; the slight movement of Qi back and forth causes itching. If Qi remains and does not depart, it forms Bi; if Wei Qi does not depart, it causes numbness.
Disease in the bones manifests as heaviness of the bones, inability to lift them, soreness and pain in the bone marrow, and arrival of Cold Qi; this is named Bone Bi. Acupuncture should be deep, but care must be taken not to damage the vessels or flesh. The depth should extend from large muscle divisions to small ones. Stop needling when the bone heat subsides. Disease in the tendons manifests as tendon spasms, joint pain, and inability to walk; this is named Tendon Bi. Needling should target the tendons, penetrating the space between muscles, but avoiding the bone. Stop needling when the tendons feel warm and the illness resolves. Disease in the skin and muscles manifests as widespread pain; this is named Muscle Bi, caused by injury from Cold and Dampness. Needling should target large and small muscle divisions, using multiple needles inserted deeply, aiming for local warmth. Do not damage the sinews or bones; if damaged, abscesses or other complications may arise. Stop needling when all divisions feel warm.
It was asked: The human body is not cold due to lack of clothing, nor is there external Cold invasion; why does Cold generate from within? The answer is: Such individuals often suffer from Bi syndrome, with deficient Yang Qi and abundant Yin Qi, making the body feel cold as if emerging from water. It was further asked: Some people feel cold internally, unable to be warmed by hot water or fire, or by thick clothing, yet they do not shiver from freezing. What disease is this? The answer is: Such individuals typically have strong Kidney Qi but engage in watery labor, leading to decline of Taiyang (Bladder) Qi and depletion of Kidney essence/marrow. One Water cannot overcome Two Fires. The Kidney belongs to Water and governs the bones. If the Kidney fails to generate, Marrow will not fill, causing coldness to reach the bones. The reason they do not shiver is that the Liver is a Yang organ (one Yang), and the Heart is a Yang organ (two Yangs), whereas the Kidney is a solitary Yin organ. One Water cannot overcome the two upper Fires; thus, they do not shiver. This disease is named Bone Bi, and such individuals are prone to joint contracture. If Zhe Bi (Fixed Bi) persists and chronic Cold remains, it may develop into Liver Bi. For Bone Bi with joint immobility and pain, profuse sweating, and vexation, tonify the Foot-Yin meridians. For Jue Bi (Reversal Bi), where Reversal Qi ascends to the abdomen, select the Luo-Connecting points of the Yin and Yang meridians, treating the primary pathology by reducing Yang meridians and tonifying Yin meridians. For Feng Bi (Wind Bi) with persistent symptoms resembling "Yinluo" (wandering pain/weakness), where the feet feel like walking on ice or entering boiling water, accompanied by limb weakness, vexation, headache, occasional vomiting, oppression, dizziness followed by sweating, prolonged visual disturbance, emotional instability, shortness of breath, and unhappiness, death may occur within three years. For inability to lift the thigh and leg, take the patient's side and needle at Shuguan (Hubiao), using a Yuanli needle; a large needle is unsuitable. For knee pain, needle Dubi, using a Yuanli needle, inserting and withdrawing intermittently; a needle as thick as a pin is suitable for the knee without doubt.
For foot numbness, needle Fengfu. For coldness and numbness from the waist down to the feet, inability to sit up, and inability to lift the sacrum, treat with Yaoshu. For Bi syndrome, treat with Huiyin, Taiyuan, Xiaoluo, and Zhaohai. For lethargy and inability to move the body, associated with great warmth (or dampness), treat with Sanyangluo. For Bone Bi with vexation and fullness, treat with Shangqiu. For heat under the feet, treat with Guanyuan. For Bi with heavy calves, flaccid dorsum pedis, and heel pain, treat with Jiuxia Lian. For calf pain, foot weakness causing dropping of the foot, Damp Bi, and inability to stand long due to heat under the feet, treat with Tiaokou. For bitter Bi in the calves, inability to flex or extend the knees, and inability to walk, treat with Liangqiu. For cold Bi and numbness outside the knees, with inability to flex or extend, treat with Biguan. For skin pain, wasting, and Bi, treat with Waixiu. For pain on the lateral aspect of the knee, inability to flex or extend, and calf Bi with numbness, treat with Yangguan. For thigh Bi radiating to pain on the lateral thigh and knee, numbness, and tendon tension, treat with Yanglingquan. For pain in the muscle divisions due to Cold Qi, and upper/lower tendon Bi with numbness, treat with Zhongdu. For pain in the hip pivot with inability to lift, use a filiform needle with retention method for cold, determining the number of insertions based on the waxing and waning of the moon; relief is immediate. A long needle is also acceptable. For urgent pain radiating between the waist and hypochondrium, tight thigh tendons, calf pain with inability to flex or extend, and Bi with numbness, treat with Huantiao. For wind-cold starting from the little toe, involving Meridian Bi affecting the chest and hypochondrium with shifting pain, treat with Zhiyin. For trauma to the big toe, such as injury from stepping down from a cart affecting the back of the foot and toes, constituting Tendon Bi, treat with JieXi.