Library

The "Treatise on Flaccidity" (Wei Lun), "Treatise on Bi Syndrome" (Bi Lun), and "Treatise on Wind" (Feng Lun) in the *Huangdi Neijing* (Yellow Emperor's Inner Canon) are divided into three separate chapters. Their etiologies differ, and thus their treatment methods also vary. Later medical texts often mixed these contents into discussions of wind and bi syndrome, causing confusion in the original scriptures and leaving later learners bewildered and unable to distinguish them clearly.

According to definitions, flaccid paralysis of the four limbs is termed "Wei" (Flaccidity Syndrome). The *Neijing* states: "When lung heat scorches the leaves [of the lungs], the skin and hair become deficient, exhausted, thin, and tight; if this condition attaches, it generates Wei." It also says: "When the Dai Mai (Girdle Vessel) fails to draw together, the feet lose function." The classics primarily discuss Wei affecting the feet, categorizing it into Jin Wei (Sinew Flaccidity), Rou Wei (Muscle Flaccidity), Gu Wei (Bone Flaccidity), and Mai Wei (Vessel Flaccidity). Cases cured by Daoist practitioners indicate that Wei is not limited to the feet but can manifest as Tou Wei (Head Flaccidity), Yao Wei (Waist Flaccidity), Shou Wei (Hand Flaccidity), or Shen Ju Wei (Whole Body Flaccidity). Descriptions of physical emaciation versus nourishment in these accounts slightly diverge from the classics, yet their therapeutic principles remain consistent with classical theory, merely adding Gui Zhi (Cinnamon Twig) as a guiding agent within formulas for moistening dryness and invigorating blood. The discussions in this chapter are based on observed phenomena. This condition appears similar to Wind pathogen invasion but is fundamentally distant from it. Numbness and loss of function do not constitute Tan Huan (Paralysis) (*Zhengzitong*: "Tan Huan refers to numbness of the four limbs and spasticity of sinews and vessels." According to various medical texts, onset on the left is called Tan, while onset on the right is called Huan; males are more prone to left-sided onset, females to right-sided onset). There is no pain or swelling, nor is it Chou Chu (Convulsion/Tetany) (Spasm and contraction of sinews is Chou, relaxation and laxity of sinews is Hu, continuous extension and flexion is Chou. Note: Hu implies laxity, externally resembling Wind symptoms). Some cases resolve immediately upon onset, others take one or two days to heal only to recur, and some persist for half a year to a year. Speech remains clear, spirit remains bright, diet and physique remain unchanged, leaving physicians at a loss regarding how to proceed.

Examining materia medica notes, Huang Bo (Phellodendron Bark) and Cang Zhu (Atractylodes Rhizome) are essential herbs for treating Wei. Physicians often fail to understand this and dare not use them lightly, instead believing that the Spleen governs the four limbs and therefore treating solely with Spleen-tonifying and warming agents. Consequently, Wei becomes a lifelong affliction in many cases. Occasionally, some achieve success by using these herbs, knowing only that the disease healed but not why. Why not study the *Neijing* to gain sudden enlightenment? The *Neijing* states: "In treating Wei, focus exclusively on the Yangming channels." The Yangming channel moistens the Zong Jin (Major Sinews). If injured by Damp-Heat, the Zong Jin lose moisture, become lax, fail to bind the bones, and result in Wei. Cang Zhu strongly fortifies the Yangming channel, while Huang Bo clears Heat and strengthens the bones. When the medicine arrives, the disease vanishes, leading one to sigh at the ancients' wisdom; named Er Miao San (Two Marvels Powder), its efficacy is truly indescribable. If the etiology is unclear, one may hesitate to use the herbs in a formula; once the etiology is clear, understanding one category allows comprehension of others. Mai Dong (Ophiopogon Tuber) can treat Wei (Empirical Formula: Mai Dong cooked with Jing Mi [Rice]); when Damp-Heat steams the Lungs, lung leaves scorch, making diffusion and descending difficult. Gan Di Huang (Rehmannia Root) can treat Wei (Empirical Formula: Gan Di Huang 4 liang, Huang Bo 1 liang, Zhi Mu 1 liang, Rou Gui 1 qian, refined honey for pills); Damp-Heat injures Blood, causing blood vessels to dry up and fail to nourish sinews. According to materia medica, any herb that clears Heat and cools Blood can treat Wei. The physician must recognize the disease personally and formulate accordingly (Transmitting ancient formulas serves as a standard for posterity. One must understand the roles of Sovereign, Minister, Assistant, and Courier herbs, and the principles of tonification and purgation. This does not mean applying the same formula blindly to all patients. Differences in geography and water/soil between North and South, changing times between past and present, age differences, seasonal variations in cold and heat, constitutional differences in robustness, temperamental differences in clarity and turbidity, and circumstantial differences in fortune and adversity—all require the physician's skillful application, stored in the heart. Where there is a specific pattern, there must be a specific formula). Thus, omitting Huang Bo and Cang Zhu is acceptable; doubling their dosage is also acceptable. If accompanied by Wind, Bi, or Deficiency, mixing treatments for Wind, Bi, and tonification for Deficiency is perfectly permissible. As for pulse diagnosis, it may be disregarded in this context.