Causes and Symptoms of Bi Disease in Traditional Chinese Medicine

The Yellow Emperor asked: “How does Bi disease come about?”
Qi Bo replied: “Bi disease is caused by the combined invasion of wind, cold, and dampness. When wind predominates, it’s called Xing Bi (circulating Bi). When cold dominates, it’s known as Tong Bi (painful Bi). When dampness is the main factor, it’s called Zhuo Bi (obstructive Bi).”

The Yellow Emperor inquired further: “Why is Bi disease classified into five types?”
Qi Bo explained: “The type of Bi disease depends on the season in which it occurs: if it happens in winter, it’s called Gu Bi (bone Bi); in spring, it’s Jin Bi (muscle Bi); in summer, it’s Mai Bi (pulse Bi); in late summer, it’s Ji Bi (muscle Bi); and in autumn, it’s Pi Bi (skin Bi).”

The Yellow Emperor continued: “What causes Bi disease to infiltrate the five organs and six bowels?”
Qi Bo answered: “Each organ is connected to specific tissues and organs in the body. If the pathogenic factors remain untreated for too long, they can invade the corresponding internal organs. For instance, if bone Bi lingers, it may eventually affect the kidneys; if muscle Bi persists, it may affect the liver; pulse Bi can affect the heart, and so on. Essentially, Bi disease is the result of repeated exposure to wind, cold, and dampness during specific seasonal vulnerabilities of each organ.”

The Yellow Emperor asked: “What are the specific symptoms when Bi disease affects each organ?”
Qi Bo explained: “When the lungs are affected by Bi disease, symptoms include a feeling of fullness, shortness of breath, and vomiting. If the heart is affected, the symptoms include poor circulation, irritability, sudden shortness of breath, dry throat, belching, and fear caused by reverse Qi flow. For the liver, symptoms include frequent waking during sleep, excessive thirst, and lower abdominal pain. If the kidneys are affected, the abdomen becomes distended, and the person may have difficulty walking, with pain in the hips and a curved spine. If the spleen is affected, symptoms include fatigue, cough, vomiting, and abdominal bloating. When Bi disease affects the intestines, the person may experience frequent thirst and difficulty urinating, along with digestive issues and diarrhea.”

Qi Bo continued: “When Bi disease enters the five organs, it manifests differently. Lung Bi causes breathing difficulties; heart Bi results in chest tightness; liver Bi may cause abdominal pain; kidney Bi causes weakness in the legs; spleen Bi leads to fatigue and poor digestion. If the disease persists, the wind, cold, or dampness in the body may cause the illness to spread deeper, leading to more severe symptoms. Wind-dominant cases tend to recover more easily.”

The Yellow Emperor asked: “Why do some people recover quickly from Bi disease, while others experience prolonged pain or even death?”
Qi Bo explained: “When the pathogenic Qi invades the five organs, it can cause death. If it remains in the muscles and bones, it leads to chronic pain that is hard to treat. However, when the disease is confined to the skin, it is more likely to heal.”

The Yellow Emperor asked: “Why does Bi disease affect the six bowels?”
Qi Bo responded: “Bi disease in the bowels is primarily caused by irregularities in diet or lifestyle. The six bowels have corresponding acupoints that, when attacked by wind, cold, or dampness, can lead to internal stagnation. This stagnation, combined with dietary damage, causes the disease to enter the bowels through the respective acupoints.”

The Yellow Emperor asked: “How can acupuncture be used to treat Bi disease?”
Qi Bo explained: “Each of the five organs has specific acupoints for treatment. Similarly, the six bowels have corresponding acupoints. By identifying the affected area and targeting the appropriate acupoint, the disease can be treated effectively.”

The Yellow Emperor asked: “Can the Qi of the Ying and Wei also cause Bi disease?”
Qi Bo replied: “Ying Qi is the essence derived from food and water. It circulates smoothly throughout the five organs and six bowels, connecting the internal organs and regulating the body. Wei Qi, on the other hand, is the protective Qi, which circulates through the skin and muscles. If the Ying and Wei Qi become imbalanced or disrupted, they can contribute to the development of Bi disease. However, if these Qi systems are harmonized and flow smoothly, the disease will be resolved. In general, Bi disease only occurs when the Ying and Wei Qi are combined with wind, cold, and dampness.”

The Yellow Emperor said: “Well said!”

The Yellow Emperor then asked: “Why do the symptoms of Bi disease vary in terms of pain, numbness, cold, heat, and skin moisture?”
Qi Bo explained: “Pain usually results from an excess of cold, as cold causes stagnation and pain. Numbness and lack of pain occur when the disease has been long-standing, and the Qi and blood have become stagnant and weak. Cold symptoms arise when the body’s Yang Qi is deficient, while heat symptoms indicate an excess of Yang Qi. Excessive sweating with moist skin occurs when the body is overwhelmed by dampness and cold, causing the Yin to dominate, which leads to sweating.”

The Yellow Emperor asked: “Why does Bi disease not cause severe pain in some cases?”
Qi Bo explained: “Bi disease affecting the bones results in a feeling of heaviness; in the pulse, it leads to poor circulation; in the muscles, it causes stiffness and limited movement; in the skin, it results in coldness. If the disease is confined to these areas, pain may not be as intense. In general, when Bi disease encounters cold, the tendons and muscles tighten, while heat causes them to loosen.”

The Yellow Emperor nodded: “Excellent!”