Classica Sinica Medica

Circulating Bi

周痺

Zhōu bì

A short dialogue that turns on a single distinction. The Emperor describes a pain that migrates up and down the body, answering left to right, moving too fast to needle — and calls it circulating bi. Qibo corrects him: that is the multitude of bi, which stays in one place, arises and rests by turns, and answers the opposite side. Circulating bi is different: it is inside the blood vessels, it travels only up and down, and it cannot cross from left to right.The correction matters because it changes the treatment. For the multitude, you needle the place where the pain was, even after it has stopped, so that it does not return. For the circulating form, direction decides order: pain moving downward is blocked below and drawn off above; pain moving upward is blocked above and drawn off below. Two rules, and they are opposites.The pathology that follows is one of the most vivid in the book. Wind, cold and damp lodge in the interstices and are pressed into foam; the foam congeals in cold, splits the flesh, and pain follows. Pain draws the spirit, the spirit generates heat, the heat dissolves the pain, and the dissolution produces a reversal that starts another bi elsewhere. It is a cycle, described in six clauses, and it explains why the disease keeps moving.The chapter closes with a technique rather than a theory: press and trace the six channels below, find where blood is knotted or the vessel has sunk, regulate, warm and press, and draw out what is tight. 經巽 in the last line is left as the base text has it, with the received alternatives noted.

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黃帝問于歧伯曰：周痺之在身也，上下移徙隨脉，其上下左右相應，間不容空。願聞此痛，在血脉之中邪？將在分肉之間乎？何以致是？其痛之移也，間不及下鍼，其慉痛之時，不及定治，而痛已止矣。何道使然？願聞其故。 黄帝问于歧伯曰：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，在血脉之中邪？将在分肉之间乎？何以致是？其痛之移也，间不及下针，其慉痛之时，不及定治，而痛已止矣。何道使然？愿闻其故。
Huáng Dì wèn yú Qí Bó yuē: zhōu bì zhī zài shēn yě, shàng xià yí xǐ suí mài, qí shàng xià zuǒ yòu xiāng yīng, jiān bù róng kōng. yuàn wén cǐ tòng, zài xuè mài zhī zhōng xié? jiāng zài fēn ròu zhī jiān hū? hé yǐ zhì shì? qí tòng zhī yí yě, jiān bù jí xià zhēn, qí chù tòng zhī shí, bù jí dìng zhì, ér tòng yǐ zhǐ yǐ. hé dào shǐ rán? yuàn wén qí gù.
黄帝问岐伯说：周痹在身上的时候，上下游走，随着脉而移动，它的上下左右相互对应，中间没有空隙。我想知道这种疼痛，是在血脉之中呢，还是在分肉之间？为什么会这样？疼痛移动的时候，快得来不及下针；抽痛的时候，又来不及定穴治疗，痛就已经止住了。是什么道理使它这样？希望听听其中的缘故。
The Yellow Emperor asked Qibo: when circulating bi is in the body, it moves up and down with the vessels, and what is above and below, left and right, answers to itself with no gap between. I should like to know whether this pain is in the blood vessels or in the interstices. How does it come about? The pain moves so fast that there is no time to put down the needle, and when the pulling pain comes there is no time to settle the treatment before the pain has already stopped. What way makes it so? I should like to hear the reason.
歧伯答曰：此衆痺也，非周痺也。 歧伯答曰：此众痹也，非周痹也。
Qí Bó dá yuē: cǐ zhòng bì yě, fēi zhōu bì yě.
岐伯回答说：这是众痹，不是周痹。
Qibo answered: this is the multitude of bi, not circulating bi.
黃帝曰：願聞衆痺。 黄帝曰：愿闻众痹。
Huáng Dì yuē: yuàn wén zhòng bì.
黄帝说：我想听听什么是众痹。
The Emperor said: I should like to hear of the multitude of bi.
歧伯對曰：此各在其處，更發更止，更居更起，以右應左，以左應右，非能周也，更發更休也。 歧伯对曰：此各在其处，更发更止，更居更起，以右应左，以左应右，非能周也，更发更休也。
Qí Bó duì yuē: cǐ gè zài qí chù, gēng fā gēng zhǐ, gēng jū gēng qǐ, yǐ yòu yīng zuǒ, yǐ zuǒ yīng yòu, fēi néng zhōu yě, gēng fā gēng xiū yě.
岐伯回答说：众痹各在它所在之处，时发时止，时伏时起，右边响应左边，左边响应右边，不能周遍全身，只是时发时休而已。
Qibo replied: each stays in its own place, now arising and now stopping, now settling and now rising; the right answers the left and the left answers the right, but it cannot go all round; it arises and rests by turns.
黃帝曰：善。刺之奈何？ 黄帝曰：善。刺之奈何？
Huáng Dì yuē: shàn. cì zhī nài hé?
黄帝说：好。那么怎样刺呢？
The Emperor said: good. How is it needled?
歧伯對曰：刺此者，痛雖已止，必刺其處，勿令復起。 歧伯对曰：刺此者，痛虽已止，必刺其处，勿令复起。
Qí Bó duì yuē: cì cǐ zhě, tòng suī yǐ zhǐ, bì cì qí chù, wù lìng fù qǐ.
岐伯回答说：刺这种病，疼痛虽然已经止住，也一定要刺它原来的地方，不使它再发。
Qibo replied: in needling this, though the pain has already stopped, one must needle the place where it was, so that it does not rise again.
帝曰：善。願聞周痺何如？ 帝曰：善。愿闻周痹何如？
dì yuē: shàn. yuàn wén zhōu bì hé rú?
黄帝说：好。我想听听周痹是怎样的。
The Emperor said: good. I should like to hear what circulating bi is like.
歧伯對曰：周痺者，在于血脉之中，隨脉以上，隨脉以下，不能左右，各當其所。 歧伯对曰：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。
Qí Bó duì yuē: zhōu bì zhě, zài yú xuè mài zhī zhōng, suí mài yǐ shàng, suí mài yǐ xià, bù néng zuǒ yòu, gè dāng qí suǒ.
岐伯回答说：周痹，是在血脉之中，随着脉上行，随着脉下行，不能左右相互影响，各停留在它所到之处。
Qibo replied: circulating bi is in the blood vessels; it goes up with the vessels and down with the vessels, and cannot affect left and right; it stays wherever it arrives.
黃帝曰：刺之奈何？ 黄帝曰：刺之奈何？
Huáng Dì yuē: cì zhī nài hé?
黄帝说：那么怎样刺呢？
The Emperor said: how is it needled?
歧伯對曰：痛從上下者，先刺其下以過之，後刺其上以脱之。痛從下上者，先刺其上以過之，後刺其下以脱之。 歧伯对曰：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。
Qí Bó duì yuē: tòng cóng shàng xià zhě, xiān cì qí xià yǐ guò zhī, hòu cì qí shàng yǐ tuō zhī. tòng cóng xià shàng zhě, xiān cì qí shàng yǐ guò zhī, hòu cì qí xià yǐ tuō zhī.
岐伯回答说：疼痛从上往下的，先刺它的下部以拦住它，后刺它的上部以脱去它；疼痛从下往上的，先刺它的上部以拦住它，后刺它的下部以脱去它。
Qibo replied: when the pain goes from above downward, first needle below to block it, then needle above to draw it off. When the pain goes from below upward, first needle above to block it, then needle below to draw it off.
黃帝曰：善。此痛安生？何因而有名？ 黄帝曰：善。此痛安生？何因而有名？
Huáng Dì yuē: shàn. cǐ tòng ān shēng? hé yīn ér yǒu míng?
黄帝说：好。这种疼痛是怎样产生的？为什么有这样的名称？
The Emperor said: good. How is this pain born? How does it come to have this name?
歧伯對曰：風寒濕氣，客于外分肉之間，迫切而爲沫，沫得寒則聚，聚則排分肉而分裂也。分裂則痛，痛則神歸之，神歸之則𤍠，𤍠則痛解，痛解則厥，厥則他痺發，發則如是。 歧伯对曰：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，神归之则𤍠，𤍠则痛解，痛解则厥，厥则他痹发，发则如是。
Qí Bó duì yuē: fēng hán shī qì, kè yú wài fēn ròu zhī jiān, pò qiè ér wéi mò, mò dé hán zé jù, jù zé pái fēn ròu ér fēn liè yě. fēn liè zé tòng, tòng zé shén guī zhī, shén guī zhī zé rè, rè zé tòng jiě, tòng jiě zé jué, jué zé tā bì fā, fā zé rú shì.
岐伯回答说：风寒湿气，客居在外的分肉之间，聚迫而成为涎沫，涎沫遇到寒就凝聚，凝聚就排挤分肉，使分肉分裂。分裂就痛，痛就使神气聚到那里，神气聚到那里就发热，发热就痛解，痛解就气逆，气逆就使别的痹发作，发作起来就是这样。
Qibo replied: wind, cold and damp qi lodge in the interstices outside; pressed together they become foam, and the foam, meeting cold, congeals. Congealing, it pushes apart the flesh and splits it. The splitting is pain; pain draws the spirit to it; the spirit there generates heat; heat dissolves the pain; the pain dissolved, there is reversal; and reversal brings on another bi, which arises in just this way.
帝曰：善。余已得其意矣。此内不在藏，而外未發于皮，獨居分肉之間，真氣不能周，故命曰周痺。故刺痺者，必先切循其下之六經，視其虚實，及大絡之血結而不通，及虚而脉陷空者而調之，熨而通之，其瘛堅，轉引而行之。 帝曰：善。余已得其意矣。此内不在藏，而外未发于皮，独居分肉之间，真气不能周，故命曰周痹。故刺痹者，必先切循其下之六经，视其虚实，及大络之血结而不通，及虚而脉陷空者而调之，熨而通之，其瘛坚，转引而行之。
dì yuē: shàn. yú yǐ dé qí yì yǐ. cǐ nèi bù zài zàng, ér wài wèi fā yú pí, dú jū fēn ròu zhī jiān, zhēn qì bù néng zhōu, gù mìng yuē zhōu bì. gù cì bì zhě, bì xiān qiè xún qí xià zhī liù jīng, shì qí xū shí, jí dà luò zhī xuè jié ér bù tōng, jí xū ér mài xiàn kōng zhě ér tiáo zhī, yùn ér tōng zhī, qí chì jiān, zhuǎn yǐn ér xíng zhī.
黄帝说：好。我已经领会它的意思了。这病在内不在脏腑，在外没有发于皮肤，单独居在分肉之间，真气不能周流，所以叫做周痹。所以刺痹，一定要先切按循察它下面的六经，看它的虚实，以及大络血结不通的地方，和虚而脉陷下空虚的地方，加以调治；用温熨使它通畅；筋脉牵引坚紧的，就转引它使它行散。
The Emperor said: good. I have grasped its meaning. This is inwardly not in the viscera, and outwardly not issued in the skin; it dwells alone in the interstices, and true qi cannot go round it, and so it is named circulating bi. Therefore in needling bi one must first press and trace the six channels below, look at their deficiency and excess, at the great luo where blood is knotted and does not pass, and where emptiness lets the vessel sink; regulate these, warm and press them through, and where the sinew is drawn tight, turn and draw it along.
黃帝曰：善。余已得其意矣，亦得其事也。九者，經巽之理，十二經脉陰陽之病也。 黄帝曰：善。余已得其意矣，亦得其事也。九者，经巽之理，十二经脉阴阳之病也。
Huáng Dì yuē: shàn. yú yǐ dé qí yì yǐ, yì dé qí shì yě. jiǔ zhě, jīng xùn zhī lǐ, shí èr jīng mài yīn yáng zhī bìng yě.
黄帝说：好。我已经领会它的意思，也知道它的做法了。九针，是合于经脉顺逆之理、十二经脉阴阳之病的。
The Emperor said: good. I have grasped its meaning and I have its practice as well. The nine needles are the principle of the channel’s compliance, and the disease of the yin and yang of the twelve channels.

Textual notes

Readings follow the base edition; significant variants are recorded here.

  1. 上下移徙隨脉上下移徙隨脈

    移徙，游走也。周痺隨脈而行，故上下移徙；衆痺各在其處，故更發更止。二者之別，全在能周與不能周。

  2. 間不容空間不容空

    間不容空，謂邪氣密布，幾無空隙。此黃帝所問周痺遊走之速，下文岐伯答以爲衆痺，非周痺，一章之眼目在此。

  3. 其慉痛之時其慉痛之時

    慉讀 chù，痛而牽掣也。慉痛與上文「痛之移」對言：移者其行速，慉者其痛聚。諸本或作「蓄」，義並難通。

  4. 迫切而爲沫迫切而爲沫

    迫切，聚迫也；沫，津液凝聚而成。寒濕客於分肉，聚而爲沫，沫得寒則聚，聚則排分肉而分裂，故痛。

  5. 痛則神歸之痛則神歸之

    神歸之，謂神氣聚於痛處。神聚則熱，熱則痛解；痛解則厥，厥則他痺復發。此一節論痺之往復，最爲精微。

  6. 熨而通之熨而通之

    熨，以藥溫熨也。血結不通者，先調其脈；虛而脈陷空者，熨而通之。此鍼灸之外治法，補鍼之所不及。

  7. 九者，經巽之理九者，經巽之理

    九者，九鍼也。巽，順也；經巽之理，謂九鍼合於經脈順逆之理。或謂「巽」當作「別」，然底本如此，照錄存參。

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APA

Huangdi Neijing · Lingshu 黃帝內經靈樞 (Compiled over the same span as the Suwen; the present text was put in order in the Tang.). Zhōu bì 周痺 [Circulating Bi], Chapter 27. In Classica Sinica Medica. Base text: 《黃帝素問靈樞經》十二卷八十一篇，宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入，卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」，並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。 Retrieved 28 October 2026, from https://classicstcm.com/classics/huangdi-neijing-lingshu/circulating-bi/

MLA

"Zhōu bì 周痺 [Circulating Bi]." Huangdi Neijing · Lingshu 黃帝內經靈樞, chapter 27, Classica Sinica Medica, 2026, https://classicstcm.com/classics/huangdi-neijing-lingshu/circulating-bi/. Accessed 28 Oct. 2026. Base text: 《黃帝素問靈樞經》十二卷八十一篇，宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入，卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」，並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。

Chinese scholarly

《黃帝內經靈樞·周痺》（Huángdì Nèijīng Língshū）。《黃帝素問靈樞經》十二卷八十一篇，宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入，卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」，並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。Classica Sinica Medica，2026 年 10 月 28 日 存取，https://classicstcm.com/classics/huangdi-neijing-lingshu/circulating-bi/。

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