Widespread Numbness

The Yellow Emperor asked Qi Bo, saying: In the case of Circumferential Bi impediment, the pain moves up and down along the channels, corresponding to the left and right sides, leaving no gap even for a needle. I wish to know whether this pain resides within the blood vessels or within the interstitial flesh? What is the cause of this? When the pain moves, it is so swift that there is no time to insert the needle; when the pain accumulates, before one can decide on a treatment method, the pain has already ceased. What mechanism leads to this? I wish to understand the reason. Qi Bo replied: This is Multiple Bi impediment, not Circumferential Bi impediment. The Yellow Emperor said: I wish to hear about the condition of Multiple Bi impediment. Qi Bo answered: Multiple Bi impediment resides in its own respective locations; it arises and ceases alternately, it settles and stirs alternately. The right side corresponds to the left side, and the left side corresponds to the right side, but it does not spread throughout the entire body. It arises and ceases in alternation. The Yellow Emperor said: Good. Then how should acupuncture treat Multiple Bi impediment? Qi Bo replied: In needling this disease, even though the pain has already stopped, one must needle the site where the pain arose, so as to prevent it from recurring.

The Yellow Emperor said: Good. I wish to hear about Circumferential Bi impediment. Qi Bo replied: Circumferential Bi impediment resides within the blood vessels. It moves upward following the vessel qi, and moves downward following the vessel qi; it does not shift left or right, each remaining in its corresponding location. The Yellow Emperor said: How should acupuncture treat Circumferential Bi impediment? Qi Bo replied: For pain that moves from above downward, first needle the lower part to guide it away, then needle the upper part to relieve it. For pain that moves from below upward, first needle the upper part to guide it away, then needle the lower part to relieve it.

The Yellow Emperor said: Good. How does this pain arise? And for what reason does it have this name? Qi Bo replied: Wind, cold, and damp qi invade the outer interstitial flesh, press upon the interstices, and generate fluids. When these fluids encounter cold, they congeal; congealing then compresses the interstitial flesh, causing it to split; splitting then gives rise to pain. Pain then focuses the spirit there; when the spirit focuses there, heat is generated; heat then relieves the pain; when the pain is relieved, reversal (jue) occurs; when reversal occurs, other bi impediments arise. This is how it manifests. The Yellow Emperor said: Good. I now understand its meaning. This condition is internal but does not reach the viscera, and externally it does not manifest on the skin; it alone lodges in the interstitial flesh, so that the true qi cannot circulate throughout the entire body, hence it is called Circumferential Bi impediment. Therefore, when needling bi impediment, one must first press along the six channels of the lower limbs, observe their vacuity and repletion, as well as areas of blood stagnation and blockage in the great collaterals, and places where the channel pathways have sunken and become empty due to vacuity, then regulate and treat them, and use hot fomentation to promote flow. For sinews that are tense and hard, draw them out to make them move. The Yellow Emperor said: Good. I now understand its meaning and have grasped its treatment. This accords with the principles of the nine needles and the patterns of yin and yang disorders in the twelve channels.