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Treatment for deficiency of both Liver and Kidney, insufficiency of Essence and Blood, leading to soreness and pain in the feet and knees, inability to walk freely, and foot pain caused by Wind-Cold-Dampness pathogens.
Hu Jing Gu (Tiger Tibia Bone) [prepared with Su oil], Tian Ma (Gastrodia Rhizome), Xuan Mu Gua (Chaenomeles Fruit) [one piece, pith removed], Rou Cong Rong (Cistanche Stem) [each 1 liang, soaked in wine, baked], Mo Yao (Myrrh), Ru Xiang (Olibanum/Gum Resin) [each 5 qian], Chuan Wu (Aconitum Carmichaelii Dehxan Root) [1 liang, processed, skin removed], Chuan Niu Xi (Cyathulae Radix) [1 liang 5 qian, soaked in wine]. Grind into fine powder, add Mu Gua Gao (Papaya Paste), mix with wine, pound and knead into pills, size of Wutong seeds (Cercidiphylli Fructus). Take 70 pills per dose, swallow with warm wine or light salt water on an empty stomach.
Dang Gui Nian Tong Tang (Angelica Sinensis Decoction for Relieving Pain)
See previous section on Shoulder and Back.

Wei Syndrome (Flaccidity Syndrome) refers to flaccid weakness of the hands and feet, and laxity of all joints unable to hold themselves. The *Classic* states: "The Five Zang organs can cause Wei," implying that each Zang organ has its corresponding Wei syndrome. It also states: "When Lung Heat scorches the leaves, the skin and hair become weak, tight, and thin, leading to Wei Bi (flaccidity of the lower limbs)." This means the Lung governs the skin and hair, is the chief of the Zang organs, and covers the Heart. If Lung Heat causes leaf scorching, the skin and hair become weak, tight, and thin, leading to Wei Bi. Furthermore, Lung Heat transmits heat qi to the Kidney. Thus, the legs cramp and cannot extend to walk. The Heart governs the blood vessels of the body; when blood is hot, the lower vessels revolt and move upward. Upward movement makes the lower vessels deficient, generating Mai Wei (Vessel Flaccidity), where the pivot breaks and cannot lift, the shins are lax and cannot bear weight. The Liver governs the tendino-muscular system; Liver Heat causes gallbladder bile to leak resulting in a bitter taste, dry tendons lead to tendon tension and cramping, manifesting as Jin Wei (Tendon Flaccidity). The Spleen governs the muscles; Spleen Heat causes dryness and thirst in the Stomach, muscle insensibility, manifesting as Rou Wei (Muscle Flaccidity). The Kidney governs the bone marrow; Kidney Heat causes inability to raise the waist and spine, bone desiccation and marrow reduction, manifesting as Gu Wei (Bone Flaccidity). It also states: "When the large channels are empty, Ji Bi (Muscle Bi) develops, transmitting to Mai Wei." Excessive sexual activity exhausts Essence and Qi, causing Zong Jin (Major Tendons) to relax and loosen, manifesting as Jin Wei. Dwelling in damp places causes muscle insensibility, yellowish complexion, and muscle twitching, called Rou Wei; thus it is said: "Rou Wei arises from damp ground." Traveling far while fatigued, encountering intense heat and thirst, thirst leads to internal attack by Yang Qi and internal consumption of Yin Qi, so Heat resides in the Kidney. The Kidney is the Water Organ. When Water cannot overcome Fire, bones become dry and marrow deficient, so the feet cannot support the body, the waist and spine cannot rise, manifesting as Gu Wei; thus it is said: "Gu Wei is born of great heat." All these five Weis resemble Rou Feng (Soft Wind) and Xiang Gang Jiao (Hong Kong Foot - a disease characterized by swollen and weak calves), but Rou Feng and Xiang Gang Jiao are due to external factors, whereas Wei is due to internal deficiency of the Five Zang.

Why does treating Wei focus solely on the Yangming? Because Yangming is the sea of the Five Zang and Six Fu organs, governing the moistening of Zong Jin. Zong Jin binds the bones and facilitates joint movement. Zong Jin refers to the tough tendons above and below the horizontal bone in the pubic region and beside the navel, reaching everywhere in the body. When Yangming is deficient, Zong Jin becomes lax, the Dai Mai (Girdle Vessel) fails to draw, so the feet become flaccid and unusable. Moreover, the four limbs receive their nourishment from the Stomach, but must rely on the Spleen to distribute it. The Spleen is Taiyin, its meridian passes through the Stomach, distributing Qi to the three Yin meridians of the hand and foot. The Stomach is Yangming, distributing Qi to the three Yang meridians of the hand and foot. If the Spleen is diseased, it cannot transport fluids for the Stomach to reach the four limbs. The four limbs do not receive Qi from grain and water, and the sinews, bones, and muscles lack Qi to generate, resulting in Wei. However, if Spleen Qi is excessive, it also causes inability to raise the limbs. As the *Classic* says: "When Earth is excessive, it is high and thick." 'Fu' means high, 'Dun' means thick. Being both thick and high requires purging treatment to weaken Qi and decline Yang until Earth returns to balance, curing the disease caused by rich foods. If Spleen is deficient, it fails to function. As the *Classic* says: "When Earth is insufficient, it is low and supervising." Treatment should primarily focus on tonifying the root.

*T Nei Jing*'s principle of treating Wei by focusing solely on Yangming is the general approach. To make Zong Jin moist, able to bind bones and facilitate joints, one must clear the source so the flow becomes clear, as the origin lies in the Lung. Therefore, one should treat according to the specific Zang associated with each of the five Weis. This ensures comprehensive efficacy. The *Classic* says: "Tonify their Ying points and unblock their Shu points, regulate deficiency and excess, harmonize reversal and smoothness." This shows treatment is not exclusive to Yangming.

Hand Yangming Large Intestine Meridian is the Fu organ of the Lung. Foot Yangming Stomach Meridian is the Fu organ of the Spleen. Why does treating Wei take only the Yangming meridian? The *Classic* says: "All Weis arise from Lung Heat." Among the Five Elements, there are two Fires. Although the Kidney has two aspects, Water occupies one. Yang is often in excess, Yin is often insufficient. Thus, the *Classic* says: "One Water cannot overcome Two Fires," which is inevitable. Lung Metal is dry in nature and resides superiorly, governing Qi transformation, fearing Fire. Spleen Earth is damp in nature and resides centrally, governing the four limbs, fearing Wood. Fire nature is flaming upward. If desires are unregulated, Water loses nourishment, Fire lacks restraint, and overcomes what it normally controls. Lung receives Fire pathogen and becomes hot. Wood nature is rigid and urgent. Lung receiving heat causes Metal to lose nourishment, Wood lacks restraint, and overcomes what it normally controls. Spleen receives Wood pathogen and is injured. Lung Heat cannot control the whole body; Spleen injury causes the four limbs to be unusable, and various Wei diseases arise. Purging the South (Heart Fire) clears Lung Metal and prevents East (Liver Wood) from being solid, preventing harm. Tonifying the North (Kidney Water) descends Heart Fire and prevents West (Lung Metal) from being deficient, preventing Lung Heat. Thus, when Yangming is substantial, Zong Jin is nourished and moist, naturally binding bones and facilitating joints. Treating Wei methods do not exceed this. Thus it is said: "When Wind and Fire are blazing, one must nourish Kidney Water." Therefore, Mr. Dongyuan took Huang Bo (Phellodendri Cortex) as the sovereign herb, assisted by tonics like Huang Qi (Astragali Radix) as ministers. However, some have phlegm accumulation, some have much Dampness, some have much Heat, some have half Dampness and half Heat, some have Qi stagnation. Formulating prescriptions based on the disease is difficult to fix. Moreover, rich flavors causing heat is an ancient maxim. But patients with Wei must eat bland food to ensure safety.

Short and tense sinews and vessels indicate Liver Qi trapped internally. One must understand the way Metal conquers Wood and nurtures it. Only when Metal loses rigidity and turns soft, does Wood lose softness and turn rigid. Therefore, treating this condition prioritizes clearing Metal. However, clearing Metal must precede clearing the Stomach. Otherwise, alcohol transports heat to the Lung, and rich flavors transport turbidity to the Lung. How much medicinal power can胜任 the task of clearing Metal! If Metal is not cleared, the major enemy is before us, the commander is weak, how can success be expected!

The difference between Feng (Wind) and Wei (Flaccidity): Pain indicates Wind, no pain indicates Wei. The *Classic* says: "Pain is Excess, no pain is Deficiency." Saying Wind, saying Wei, it is merely Excess and Deficiency. Dongyuan said: "Qi abundance leads to Wei abundance, Qi decline leads to disease decline." Why? When human Qi and Blood are substantial, Wind-Cold lodges in the collaterals, Evil and Righteous still contend, causing pain. When human Qi and Blood are deficient, Phlegm-Fire stagnates within the joints, Righteous cannot overcome Evil, so Wei-Bi arises. Danxi said: "Wei syndrome must never be treated as Wind using Wind medicines," because Wind is Excess, while Wei is Deficiency. Dispersing Evil and Tonifying Deficiency must not be confused. Also, avoid reckless use of acrid-hot drugs to damage True Yin and True Qi. If drug potency is biased and assists, the cycle of overcoming and flowing changes, causing greater harm.

Wei syndrome is like plants failing to be cultivated, branches and leaves wither, but the root is not greatly damaged. It differs from Xu Lao (Consumption) because there is no cough, hemoptysis, or aversion to cold/fever. Thus, prolonged bedridden patients show no pathological signs in appearance, nor pain/numbness like Bi syndrome. Bi syndrome is due to external Three Evils, disease in collaterals and blood vessels, blocking Qi and Blood. It can be discussed as Excess. Wei syndrome is due to Qi and Blood insufficiency. Disease is in the Five Zang and Six Fu, unable to fill and secure. Treatment should purely address Deficiency.

Wei is a Heat syndrome. It originates from internal deficiency of the Five Zang, with the principle lying in the Lung. Treatment focuses on Yangming. True Qi is received from Heaven, combined with Grain Qi to fill the body. Grain enters the Stomach first to irrigate the True Qi of the Five Zang. Heaven's Way is Grain Qi, Earth's Way is True Qi. True Qi and Grain Qi combine, establishing the Way of Form and Qi. Yangming deficiency means the Five Zang have nothing to receive, cannot circulate Qi and Blood to nourish the body, becoming weak. Yangming governs moistening Zong Jin, which determines the strength of the feet. Thus, hemiplegia and Wei Yi (flaccidity/ease), inability to use the four limbs, are Spleen diseases. The *Classic* says: "The four limbs receive Qi from the Stomach, must rely on the Spleen to receive it." Now, Spleen disease cannot transport fluids for the Stomach. Grain and water become daily deficient, Qi daily declines, vessel pathways are unfavorable, sinews, bones, and muscles lack Qi to generate, and the four limbs cannot be raised. The *Classic* again says: "In years of excessive Earth, abdominal fullness, reduced appetite, inability to raise the four limbs occur." This shows the Wei of the Four Zang is particularly heavy on Yangming, which is clear. Later theories on Kidney dominance include those attributing Wei to deficiency damage and those to excess pathogens. These must be distinguished by pulse diagnosis. Some say Essence deficiency and Blood consumption, internal deficiency of Five Zang causing Wei. Some say Dry Metal Qi stagnation, Blood depletion, inability to nourish the hundred bones causing Wei. Some say Yangming Damp-Heat steaming the Lung, obstructing the upper source of Water causing Wei. Some say excessive intercourse, insufficient Water failing to overcome Heart Fire, Fire burning Lung Metal and six leaves scorching, causing Wei. Some say Kidney governs bones and stores Essence, Liver governs tendons and stores Blood, immoderate desires lead to Liver-Kidney deficiency causing Wei. All these discuss internal injury and deficiency causing disease, totaling to Heat. Thus it is said: "Wei disease has no Cold, do not treat as Cold." It also says: "Wei belongs to Damp-Heat, do not treat as Wind. Focus on clearing Heat, tonifying Essence, and nourishing Blood." From this, it is clear that Wei disease also involves external contraction. However, since it initially arises from Qi Heat, sudden use of acrid-hot strong tonics is contraindicated.

Those establishing theories based on Excess Pathogens: Some say excessive mental labor, Heart Qi Heat causes Fire to shine alone, Kidney channel follows Fire upward causing Wei. Some say Dry Metal receives pathogen, source of Cold Water generation is cut off, Damp-Heat flows downward to Kidney and Liver causing Wei. Some say pure wine and rich foods, Ming Men Minister Fire excessively strong, forcing Yin outward causing Wei. Some say taking hot medicines excessively in late summer, Yin brightens and Fire-Evil hides internally causing Wei. Some say Lung Qi not soothing, stagnation transforms into Fire causing Wei. It also says: Damp-Phlegm gathers in the Middle Jiao, hands and feet soft and Wei. Some say Kidney-Liver Qi deficiency, Wind pathogen attacks deficiency causing Wei. Even the Classic text says treating Phlegm focuses on Yangming, it does not mean Yangming original deficiency is immediately seen. Otherwise, why do Wei patients have increasing appetite, fattening bodies, yet feet remain flaccid and unusable? Does Grain entering the Sea, Yangming Qi flourishing, fail to transform essence and subtle substances to strengthen sinews and bones? This is Fire-Evil hiding in the Stomach, only capable of killing grain (digestion), but unable to grow Blood-Qi, generate fluids, and irrigate the hundred bones. Most notably, diet is double that of normal people, yet feet are unusable. This is what is called "Strong Fire consumes Qi," Stomach Heat consuming grain and causing hunger. Yangming Heat-Evil originally comes from transmission of Lung Heat. Therefore, "Treating Wei focuses on Yangming" does not mean tonifying Yangming. Treating Yangming Bright Fire-Evil, without interfering with Qi and Blood, clears Damp-Heat and strengthens sinews and bones, so foot Wei naturally rises. The Classic says "take" not "tonify" because it means extracting Yangming Heat-Evil. All these establish theories based on Excess Pathogens. However, although the disease name is one, pulse diagnoses differ. Between Excess and Deficiency, is there no distinction? Know that Deficiency is Righteous Qi deficiency, Excess is Evil Qi excess. Can there be sufficient Qi, Blood, and Essence, yet sinews and bones suffer disease?