Understanding and Treating Painful Wandering Bi Syndrome

The Yellow Emperor asked Qi Bo: “When a person suffers from Wandering Bi Syndrome, the pathogenic factors move up and down with the blood vessels, causing pain to erupt in various parts of the body, making the whole body ache. In such cases, is the pathogen in the blood vessels, or between the muscles and flesh? Where does this ailment come from? The pain moves so swiftly that there’s no time to apply needles to the pain points. Even when a particular area hurts more, by the time we’ve decided on the treatment, the pain has already shifted. What is the reason behind this phenomenon? I am eager to understand its cause.”

Qi Bo answered: “This is Generalized Bi Syndrome, not Wandering Bi Syndrome.” The Yellow Emperor replied: “Let’s discuss Generalized Bi Syndrome then.” Qi Bo explained: “In Generalized Bi Syndrome, the pathogenic factors are dispersed throughout the body. They may erupt intermittently, sometimes affecting the left side and then the right side, but not the entire body. This pain tends to flare up and subside easily.”

The Yellow Emperor asked: “How should we perform acupuncture treatment?” Qi Bo answered: “Even when the pain has subsided, one should still apply needles to the original pain points to prevent recurrence.” The Yellow Emperor acknowledged: “Well said. Now, I’d like to hear more about Wandering Bi Syndrome.”

Qi Bo replied: “Wandering Bi Syndrome involves pathogenic factors within the blood vessels, moving up or down but not laterally. Wherever the pathogenic factors move, that area experiences pain.” The Yellow Emperor inquired: “What is the method to treat this condition with acupuncture?” Qi Bo explained: “If the pain originates in the upper part and migrates downward, first needle the lower part to halt the progression of the pathogenic factors, then needle the upper part to eliminate the source of pain. Conversely, if the pain starts in the lower part and moves upward, first needle the upper part to stop the disease progression, then needle the lower part to remove the pain source.”

The Yellow Emperor questioned: “How does this pain arise, and why do we call it Wandering Bi Syndrome?” Qi Bo answered: “Wind, cold, and dampness infiltrate the space between the muscles and skin, compressing the bodily fluids into froth. Upon exposure to cold, these fluids condense and stagnate, further pushing against the flesh and causing it to split, resulting in pain. This pain draws the spirit’s focus to the afflicted area, generating heat which disperses the cold and alleviates the pain. However, the relief can cause rebellious Qi to rise, leading to a blockage and resultant pain. Hence, Wandering Bi Syndrome involves this cyclical movement and recurrent pain.”

The Yellow Emperor said: “I understand the rationale. This ailment neither penetrates deep into the organs nor spreads externally to the skin; it lodges between the flesh, obstructing the true Qi from circulating throughout the body, hence the name Wandering Bi Syndrome. Therefore, acupuncture for Bi Syndrome must begin by pressing along the meridian pathways of the six meridians of the foot, assessing their state and the blood flow in the large collaterals for any stagnation or interior sinking due to deficiency, before proceeding with treatment. Warming techniques like moxibustion can be used to facilitate the flow in the meridians. In cases of tense and rigid sinews, methods like massage and physical therapy can be employed to promote the circulation of Qi and blood.”

The Yellow Emperor added: “Yes, understanding the mechanism of this ailment allows us to comprehend the treatment method. The Nine Needles can facilitate the flow of meridian Qi, thereby treating various conditions of deficiency and excess in the twelve meridians, as well as their Yin-Yang imbalances.”