治痿废。
生黄 （六钱） 知母（四钱） 野台参（三钱） 于术（三钱） 当归（三钱） 生明乳香（三钱） 生明
没药（三钱） 威灵仙（钱半） 干姜（二钱） 牛膝（四钱）
热者，加生石膏数钱，或至两许。寒者去知母，加乌附子数钱。筋骨受风者，加明天麻数钱。脉弦硬而大
者，加龙骨、牡蛎各数钱，或更加山萸肉亦佳。骨痿废者，加鹿角胶、虎骨胶各二钱（另炖同服）。然二胶伪
者甚多，若恐其伪，可用续断、菟丝子各三钱代之。手足皆痿者，加桂枝尖二钱。
痿证之大旨，当分为三端∶有肌肉痹木，抑搔不知疼痒者。其人或风寒袭入经络，或痰涎郁塞经络，或
风寒痰涎，互相凝结经络之间，以致血脉闭塞，而其原因，实由于胸中大气虚损。盖大气旺，则全体充盛，气
化流通，风寒痰涎，皆不能为恙。大气虚，则腠理不固，而风寒易受，脉管湮淤，而痰涎易郁矣；有周身之筋
拘挛，而不能伸者。盖人身之筋，以宗筋为主，而能荣养宗筋者，阳明也。其人脾胃素弱，不能化谷生液，以
荣养宗筋，更兼内有蕴热以铄耗之，或更为风寒所袭，致宗筋之伸缩自由者，竟有缩无伸，浸成拘挛矣；有筋
非拘挛，肌肉非痹木，惟觉骨软不能履地者，乃骨髓枯涸，肾虚不能作强也。
方中用黄 以补大气，白术以健脾胃，当归、乳香、没药以流通血脉，灵仙以祛风消痰，恐其性偏走泄，
而以人参之气血兼补者
佐之，干姜以开气血之痹，知母以解干姜、人参之热，则药性和平，可久服而无弊。其阳明有实热者，加石膏
以清阳明之热，仿《金匮》风引汤之义也。营卫经络有凝寒者，加附子以解营卫经络之寒，仿《金匮》近效术
附汤之义也。至其脉弦硬而大，乃内风煽动，真气不固之象，故加龙骨、牡蛎以熄内风敛真气。骨痿者加鹿胶、
虎胶取其以骨补骨也。筋骨受风者，加明天麻取其能搜筋骨之风，又能补益筋骨也。若其痿专在于腿，可但用
牛膝以引之下行。若其人手足并痿者，又宜加桂枝兼引之上行。
或问∶此方治痿之因热者，可加生石膏至两许，其证有实热可知，而方中仍用干姜何也？答曰∶《金匮》
风引汤治热瘫痫之的方，原石膏、寒水石与干姜并用。盖二石性虽寒而味则淡，其寒也能胜干姜之热，其淡也
不能胜干姜之辣。故痿证之因热者，仍可借其异常之辣味，以开气血之痹也。
Treatment for Wei Syndrome (Wasting and Thirsting Syndrome) and limb paralysis.
Sheng Huangqi (Raw Radix Astragali, 6 qian) Zhimu (Cortex Anemarrhenae, 4 qian) Yetaishen (Radix Ginseng Wild Taiping, 3 qian) Yuzhu (Rhizoma Atractylodis Macrocephalae, 3 qian) Danggui (Radix Angelicae Sinensis, 3 qian) Shengming Ruxiang (Raw Resina Frankincense, 3 qian) Shengming Moyao (Raw Resina Myrrhae, 3 qian) Weilingxian (Herba Saposhnikoviae, 1.5 qian) Ganjiang (Rhizoma Zingiberis Recens, 2 qian) Niuxi (Radix Achyranthis Bidentatae, 4 qian)
If heat signs are present, add Sheng Shigao (Raw Gypsum Fibrosum) several qian, or up to one liang. If cold signs are present, remove Zhimu and add Wu Fuzi (Prepared Radix Aconiti Lateralis Preparata) several qian. For wind invasion affecting sinews and bones, add Ming Tianma (Rhizoma Gastrodiae) several qian. If the pulse is wiry, hard, and large, add Longgu (Fossilized Bones) and Muli (Concha Ostreae) each several qian, or adding Shanzhuyu (Fructus Corni) is also good. For bone Wei syndrome, add Lujiaojiao (Colla Cornu Cervi) and Hugu Jiaojiao (Colla Ossis Tigris) each 2 qian (decocted separately and taken together). However, these two jiaos have many counterfeits; if concerned about authenticity, Xuduan (Radix Dipsaci) and Tusizi (Semen Cuscutae) each 3 qian can be used as substitutes. For paralysis of both hands and feet, add Guizhi Jian (Ramulus Cinnamomi) 2 qian.
The general principle of Wei syndrome should be divided into three categories: First, numbness of muscles where scratching does not elicit pain or itch sensation. This may be due to wind-cold invading the meridians, phlegm-fluid obstructing the meridians, or wind-cold and phlegm-fluid condensing between the meridians, causing blood vessel obstruction. The root cause is actually deficiency of the Great Qi in the chest. When Great Qi is vigorous, the whole body is充盈 (full), qi transformation flows smoothly, and wind-cold/phlegm-fluid cannot cause disease. When Great Qi is deficient, the couli (pores/skin texture) are not secure, making wind-cold easy to invade, and vessels become stagnant, making phlegm-fluid prone to stagnation. Second, global tendon spasms preventing extension. The body's tendons are dominated by Zongjin (Major Tendons), which are nourished by the Yangming channel. Such individuals have inherently weak spleen and stomach, failing to transform grain into fluids to nourish Zongjin. Additionally, internal latent heat consumes them, or they are attacked by wind-cold, causing Zongjin to lose free extension/retraction ability, shrinking instead of extending, gradually forming spasms. Third, no tendon spasm, no muscle numbness, but feeling bone softness unable to stand/walk. This is due to exhaustion of marrow and kidney deficiency failing to provide strength.
In this formula, Huangqi is used to tonify Great Qi, Baizhu to strengthen spleen and stomach, Danggui, Ruxiang, and Moyao to circulate blood vessels, Weilingxian to dispel wind and resolve phlegm. Fearing their nature tends to scatter/leak, Renshen (which tonifies both qi and blood) is used as an assistant. Ganjiang opens qi-blood bi-obstruction, Zhimu resolves the heat from Ganjiang and Renshen, making the medicine mild and suitable for long-term use without harm. For excess heat in Yangming, add Shigao to clear Yangming heat, imitating the intent of Fengyin Tang in *Jin Gui Yao Lue*. For coagulated cold in Ying-Wei and meridians, add Fuzi to resolve cold, imitating the intent of Jin Xiao Zhu Fu Tang in *Jin Gui Yao Lue*. A wiry, hard, and large pulse indicates stirring of internal wind and insecurity of true qi, so Longgu and Muli are added to extinguish internal wind and astringe true qi. Bone Wei adds Lu Jiao Jiao and Hu Gu Jiao to "tonify bone with bone." Wind in sinews/bones adds Ming Tianma to search out wind in sinews/bones and tonify them. If Wei is specific to legs, only Niuxi can be used to guide downward. If hands and feet are both paralyzed, Guizhi should be added to guide upward.
Question: This formula treats Wei caused by heat, allowing addition of Sheng Shigao up to one liang, indicating excess heat. Why is Ganjiang still used? Answer: *Fengyin Tang* in *Jin Gui Yao Lue*, the specific formula for treating heat-induced paralysis and epilepsy, uses Shigao, Hanshui Shi (Halitum), and Ganjiang together. Although these two stones are cold in nature, they are bland in taste. Their coldness overcomes Ganjiang's heat, but their blandness does not overcome Ganjiang's pungency/spiciness. Therefore, for Wei caused by heat, one can still utilize its abnormal pungency to open qi-blood bi-obstruction.