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If Wei syndrome (Flaccidity Syndrome) is caused by Lung deficiency, the pulse is mostly fine and moderate. It may also present as choppy, tight, thready, or soggy.

"Wei" (Flaccidity) means to yield or collapse. The flaccidity of the legs rendering them unusable implies a state of listlessness and lack of vigor; hence the character contains the component "Wei" (Yield). Although its manifestations can arise from disorders of all five Zang organs, this text specifically attributes it to the Lung, following the *Su Wen* (Basic Questions). In the *Su Wen*, Qibo stated: "When the Lung is hot and scorched, the skin and hair become weak, tight, and thin, leading to Wei syndrome." He further said: "The Lung is the chief of the Zang organs and acts as a cover for the Heart." If one experiences forgetfulness or unfulfilled desires, it causes Lung Qi to rebel and produce wheezing sounds. These sounds indicate Lung heat scorching the lung leaves. Because of this Lung heat and scorching, the other four Zang organs develop Wei syndromes. Observing Qibo's words, we know that Wei syndromes of the five Zang organs must originate from the Lung. Internally, the lung leaves are scorched first; externally, the skin and hair become weak, tight, and thin first. This is because the Lung resides above the Heart, at the highest position, and connects with the skin and hair on the exterior, being the most superficial layer. Thus, it is called the chief of the Zang organs and the cover of the Heart. It governs the Qi of the whole body and controls respiration, meeting with the hundred vessels to circulate Ying (Nutrient) and Wei (Defensive) Qi. Therefore, the *Ping Ren Qi Xiang Lun* (Treatise on Normal and Abnormal Physiological and Pathological Signs) states: "The true Qi of the Zang organs is higher in the Lung, to circulate Ying, Wei, Yin, and Yang." Its function is to gather and descend, and its transformation is clear and肃 (pure/quiet). If there is forgetfulness or unfulfilled schemes, Lung Qi becomes stagnant. Stagnation causes the gathering function to over-gather, blocking Qi which transforms into fire, generating heat. Heat prevents the clear and descending transformation, forcing inflammatory and steaming pathogens. At this time, if Qi is not tranquil, wheezing occurs; if Zang organs are not moistened, they become scorched and flaccid. This is not limited to the Lung alone. Steaming Ying and Wei, depleting Zang Yin, subsequently the tissues associated with the five Zang organs, such as sinews, vessels, flesh, and bones, all fail to receive nourishment and moisture, causing various Wei syndromes to manifest.

Therefore, Qibo also said: "Heart Qi heat causes lower vessels to revolt and move upward. Upward movement makes lower vessels empty; emptiness generates Mai Wei (Vessel Flaccidity), where the joint pivot breaks and cannot lift, the shins are loose, and unable to bear weight. (Suitable formulas include Danxi's Hujian Wan [Tiger-Hide Pill] and Buyin Wan [Nourish-Yin Pill].)" "Liver Qi heat causes gallbladder bile to leak, resulting in a bitter taste, and dries the fascia. Dry fascia leads to tight and contracted sinews, developing into Jin Wei (Sinew Flaccidity). (Suitable formulas include Siwu Tang [Four Substances Decoction] and Sanyin Jiajian Sijin Wan [Three Causes Modified Four-Jin Pill].)" "Spleen Qi heat causes dryness and thirst in the stomach, numbness of muscles, developing into Rou Wei (Flesh Flaccidity). (Suitable formulas include Dongyuan's Shenxiao Huangqi Tang [Miraculous Efficacy Astragalus Decoction] and Qian's Xiehuang San [Drain-Yellow Powder].)" "Kidney Qi heat causes inability to raise the waist and spine, withered bones, and reduced marrow, developing into Gu Wei (Bone Flaccidity). (Suitable formulas include Danxi's Hujian Wan and Sanyin Jiajian Sijin Wan.)" All these describe how Lung heat scorches the leaves, making skin and hair tight and thin, with heat lingering and spreading disaster to the four Zang organs, causing various Wei syndromes. If the four Zang organs are not deficient and have no gaps for pathogens to exploit, heat cannot attack suddenly. Thus, Qibo later said: "Excessive grief severs the Bao Luo (Pericardium Collaterals). Severed Bao Luo causes internal movement of Yang Qi; upon manifestation, there is blood bursting from below the heart and frequent hematuria. Hence, the treatise says: 'Major channels become empty, developing into Ji Bi (Muscle Bi), transmitting to Mai Wei.'" (Suitable formulas include Zhongjing's Zhigancao Tang [Honey-Panax Decoction] and Heidihuang Wan [Black Earth Yellow Pill].) This explains that excessive grief causes the Xin Mai (Heart Vessels) to tighten and Bao Luo to sever. The *Ping Re Lun* (Treatise on Evaluating Heat) states: "Bao Mai (Uterine Vessels) belong to the Heart and connect to the Bao (Uterus/Lower Jiao). When severed, they cannot communicate upward with the Heart, allowing hyperactive Yang to press inward. Inward pressing causes blood overflow and downward bursting, exiting with urine. Bursting empties major channels, failing to nourish collaterals, thus starting as Ji Bi and gradually transmitting to Mai Wei."

It also says: "Endless thinking and unfulfilled wishes lead to lustful thoughts projecting outward; excessive intercourse causes Zong Jin (General Sinews) to relax and sag, developing into Jin Wei and Baiyin (White Turbidity)." Hence, the *Xia Jing* (Lower Classic) states: "Jin Wei arises from the Liver due to sexual activity." (Suitable formulas include Zhibai Bawei Wan [Anemarrhena, Phellodendron, and Eight-Ingredient Pill], Siwu Tang, and Jiawei Xiaoyao San [Modified Free Wanderer Powder].) This refers to external lustful thoughts going unsatisfied and excessive intercourse. One involves Liver Fire depression; the other involves depletion of Yin Essence. Both relate to the anterior orifice. The anterior orifice is the Zong Jin. Without Yin to nourish Zong Jin, but instead pressured by fire, it becomes relaxed, flaccid, and weak, and when lustful thoughts stir, white turbidity follows. Thus, Jin Wei arises from the Liver and sexual activity.

It also says: "Gradual exposure to dampness, working with water, staying in damp dwellings, causes muscle immersion, numbness, and development of Rou Wei." Hence, the *Xia Jing* states: "Rou Wei is obtained from damp ground." (Suitable formulas include Weiling Tang [Stomach-Cinnamon Decoction], Zhongjing's Fangji Huangqi Tang [Stephania and Astragalus Decoction], and Dongyuan's Shenzhu Tang [Ginseng and Atractylodes Decoction].) This describes working in wet places, living in damp environments, gradually receiving pathogenic factors that linger and immerse the muscles. Over time, muscles become numb, developing into Rou Wei. Thus, Rou Wei comes from damp ground.

It also says: "Long journeys and fatigue, encountering intense heat and thirst. Thirst causes Yang Qi to invade internally; internal invasion places heat in the Kidney. The Kidney is a Water organ; now Water cannot overcome Fire, leading to withered bones and empty marrow, so the feet cannot support the body, developing into Gu Wei." Hence, the *Xia Jing* states: "Gu Wei arises from intense heat." (Suitable formulas include Zhibai Bawei Wan, Liuwei Wan [Six-Ingredient Pill], and Buyin Wan.) This describes long journeys and fatigue, encountering heat and thirst. Thirst indicates severe internal heat. Severe internal heat attacks weakness. Long journeys and fatigue mean Kidney Qi is temporarily deficient. (*Jing Mai Bie Lun* states: 'Heavy lifting and long walking cause sweat from the Kidney; Kidney deficiency is evident.') With Kidney deficiency, it cannot withstand heat, gradually leading to reduced marrow and withered bones, so feet cannot support the body, developing into Gu Wei. Thus, Gu Wei arises from intense heat.

It also says: "The Yangming Meridian is the Sea of the Five Zang and Six Fu organs, primarily moistening Zong Jin. Zong Jin binds bones and facilitates joint movement. The Chong Meridian is the Sea of the Vessels, primarily infiltrating and irrigating the Xi Gu (Valleys/Cavities), merging with Yangming at Zong Jin. Yin and Yang converge at Zong Jin, meeting at Qijie (Street of Qi), with Yangming as their leader, all belonging to the Dai Mai (Girdle Vessel) and connecting to the Du Mai (Governor Vessel). (Inability to raise the waist and spine seems to involve Du Mai symptoms.) Therefore, Yangming deficiency leads to Zong Jin relaxation and Dai Mai failure to draw in, causing foot flaccidity and inability to use them. (Previous Baiyin seems to be a symptom of Dai Mai failure to draw in.)" It also says: "Tonify their Ying-Spring points and unblock their Shu-Stream points, regulate excess and deficiency, harmonize reversal and smooth flow. For sinews, vessels, bones, and flesh, treating them during their respective seasonal months will cure the disease." Qibo's discussion on the transmission of Wei syndromes was thorough, yet he ultimately returned to Yangming. Why? Because Yangming is the Sea of Water and Grain, and Chong is the Sea of Blood. Here, referring to Yangming as the Sea of Five Zang and Six Fu organs, and Chong as the Sea of Vessels, shows that Zang-Fu and vessels both derive from these two sources. One moistens Zong Jin (Yang); one irrigates Xi Gu (Yin). Converging at Zong Jin and meeting at Qijie, Yangming is promoted as the leader. Qijie is the main pathway of Yangming, also implying respect for Water and Grain. Du Mai runs vertically; Dai Mai encircles horizontally. Yangming and Chong belong to Dai and connect to Du. Yangming deficiency fails to nourish Zong Jin, and Dai Mai lacks strength to contract, causing foot flaccidity. Thus, binding bones and facilitating joints relies on Zong Jin, which in turn relies on Yangming's nourishment. Therefore, treating Wei syndrome focuses solely on Yangming. However, one must simultaneously observe the Ying and Shu points of each Zang, applying tonification or unblocking as appropriate; considering the season of onset, whether declining or flourishing, to harmonize reversal and smooth flow, regulate excess and deficiency, ensuring the disease is cured. This is Qibo's answer to the Emperor regarding acupuncture for Wei syndrome. The pulse being mostly fine and moderate, or choppy, tight, thready, or soggy, corresponds to: fine reflecting skin/hair, moderate reflecting muscles, choppy reflecting vessels, tight reflecting fascia, and thready/soggy reflecting bone/marrow.