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The *Ling Shu · Re Bing Pian* states: Piān kū (Hemiplegia) is characterized by the inability to move one side of the body accompanied by pain, while speech remains unchanged and mental clarity is preserved. The pathogen resides between the muscle intervals and interstices (fēn còu). Treatment requires the use of large needles to tonify deficiency and drain excess, thereby restoring health.

This condition arises from the deviation of Yin and Yang and Qi and Blood, leading to a loss of regulation in the meridian circulation. Consequently, pathogenic factors invade one side of the body, resulting in hemiplegia. Since speech is normal and mind is clear, it indicates that the five Zang organs are not damaged. As the disease is located in the muscle intervals and interstices, the method should be to support the healthy Qi and dispel pathogens, unblocking the meridians and regulating Ying (Nutrient) and Wei (Defensive) Qi. By tonifying deficiency and draining excess, Yin and Yang, Qi and Blood can return to equilibrium, allowing for recovery.

In the *Su Wen · Ni Diao Lun*, the Yellow Emperor asked: Regarding "Ròu kē" (Muscular Heaviness/Numbness), why does a patient feel heavy and numb despite wearing cotton wadding? Qibo replied: This is due to deficiency of Ying Qi and excess/stagnation of Wei Qi. When Ying Qi is deficient, there is insensibility (bù rén); when Wei Qi is deficient, there is immobility (bù yòng). If both Ying and Wei Qi are deficient, there is both insensibility and immobility, yet the muscle appearance remains unchanged. If the physical form and the spirit (Zhi) lose their connection, death ensues.

According to the *Tai Yin Yang Ming Lun*: The pathway of Yang tends toward excess, while the pathway of Yin tends toward deficiency. This means Yin resides internally with its Qi being open and permeable, while Yang guards externally with its Qi being solid and firm. Tai Yin and Yang Ming correspond to the Spleen and Stomach, which are the root of Ying and Wei Qi. Thus, saying Ying Qi is deficient refers to the fundamental Qi being open/permeable; saying Wei Qi is excessive refers to the fundamental Qi being solid. Muscles are governed by the Spleen and Stomach, within which Ying and Wei Qi reside. Ying is Yin and circulates within the vessels; Wei is Yang and circulates outside the vessels, thereby nourishing the muscles. Yin moistens, and Yang warms; thus, muscles must be soft and capable of sensing pain and itch. Currently, however, there is insensibility, lack of sensation, heaviness, and inability to move, while the muscle shape remains unchanged. This is because the vital Qi of Yin and Yang has perished, leaving no living Qi to fill the interior. This condition is named Ròu kē. Therefore, it is reiterated that Ying Qi deficiency leads to insensibility, and Wei Qi deficiency leads to immobility. This implies that the Qi of Ying, Wei, Yin, and Yang are all empty, leaving only dead flesh devoid of Qi. This state is incompatible with the Heart-Mind (Shen/Zhi), resulting in insensibility and immobility, where the patient may even fail to perceive their own body. This indicates the extinction of Spleen Qi, hence the prognosis of death. Furthermore, this disease corresponds to the severe stage of Ròu Wěi (Muscle Flaccidity Syndrome). Wěi syndromes generally originate from damage to the Zang organs. Once the Zang organs fail, death occurs and the condition becomes incurable. Similarly, Jin Wěi (Tendon Flaccidity), Mai Wěi (Vessel Flaccidity), Gu Wěi (Bone Flaccidity), etc., follow this pattern. Observing the current symptoms allows one to deduce the nature of the disease based on this principle.