（《素问·痿论》全）
黄帝问曰∶五脏使人痿何也？（五脏各有所合，故皆能使之痿。痿者，痿弱无力，举动不能也。痿音威。）岐伯对曰∶
肺主身之皮毛，心主身之血脉，肝主身之筋膜，脾主身之肌肉，肾主身之骨髓。（五脏所主不同，故痿生亦异。筋膜者，
按全元起曰∶人皮下肉上筋膜也。盖膜犹幕也，凡肉理脏腑之间，其成片联系薄筋，皆谓之膜，所以屏障血气者也。凡
筋膜所在之处，脉络必分，血气必聚，故又谓之膜原，亦谓之脂膜。膜、幕俱音莫。）故肺热叶焦，则皮毛虚弱急薄，着
则生痿 也。（肺痿者，皮毛痿也。盖热乘肺金，在内则为叶焦，在外则皮毛虚弱而为急薄。若热气留着不去，而及于筋
脉骨肉，则病生痿 。 者，足弱不能行也。 音壁。）心气热则下脉厥而上，上则下脉虚，虚则生脉痿，枢折挈，胫纵
而不任地也。（心痿者，脉痿也。心气热则火独上炎，故三阴在下之脉，亦皆厥逆而上，上逆则下虚，乃生脉痿。脉痿者，
凡四肢关节之处，如枢纽之折而不能提挈，足胫纵缓而不能任地也。挈，丘结切。）肝气热则胆泄口苦，筋膜干，筋膜干
则筋急而挛，发为筋痿。（肝痿者，筋痿也。胆附于肝，肝气热则胆汁溢泄，故为口苦。筋膜受热则血液干燥，故拘急而
挛，为筋痿也。）脾气热则胃干而渴，肌肉不仁，发为肉痿。（脾痿者，肉痿也。脾与胃以膜相连而开窍于口，故脾气热
则胃干而渴。脾主肌肉，今热蓄于内，则精气耗伤，故肌肉不仁，发为肉痿。）肾气热则腰脊不举，骨枯而髓减，发为骨
痿。（肾痿者，骨痿也。腰者肾之府，其脉贯脊，其主骨髓，故肾气热则见证若此。）
帝曰∶何以得之？（此下言五痿之所由生也。）岐伯曰∶肺者脏之长也，为心之盖也，（肺位最高，故谓之长。复于
心上，故谓之盖。）有所失亡，所求不得，则发肺鸣，鸣则肺热叶焦，（肺志不伸，则气郁生火，故喘息有声，发为肺鸣。
金脏病则失其清肃之化，故热而叶焦。）故曰五脏因肺热叶焦，发为痿 ，此之谓也。（故曰，引古语也。肺主气以行营
卫，治阴阳，故五脏之痿，皆因于肺气热，则五脏之阴皆不足，此痿 之生于肺也。五痿之证虽异，总皆谓之痿 。）悲
哀大甚则胞络绝，胞络绝则阳气内动，发则心下崩，数溲血也，（胞络者，子宫之络脉也。《评热病论》曰∶胞脉者属心
而络于胞中。故悲哀太甚，则心系急而胞络绝，上下不交，亢阳内动，逼血下崩，令人数为溺血也。）故《本病》曰∶大
经空虚，发为肌痹，传为脉痿。（《本病》，古经篇名。血失则大经空虚，无以渗灌肌肉，荣养脉络，故先为肌肉顽痹而后
传为脉痿者，生于心也。）思想无穷，所愿不得，意淫于外，入房太甚，宗筋弛纵，发为筋痿，及为白淫，（思想无穷，
所愿不得，欲不遂也。意淫于外，入房太甚，阴气伤也。故宗筋弛纵，发为筋痿。宗筋者聚于前阴，精伤于内，气陷于
下，故为白淫，即今之所谓带浊也。）故《下经》曰∶筋痿者生于肝使内也。（《下经》，古经也。肝主筋，故使内而筋痿
者，生于肝也。）有渐于湿，以水为事，若有所留，居处相湿，肌肉濡渍，痹而不仁，发为肉痿，（渐，有由来也。以水
为事，从事于卑湿之所也。相，并也。脾主肌肉而恶湿，湿着于肉，则卫气不荣，故肌肉顽痹而为肉痿。渍，蚤四切。）
故《下经》曰∶肉痿者得之湿地也。（地之湿气，感则害皮肉筋脉，病生于脾也。）有所远行劳倦，逢大热则渴，渴则阳
气内伐，内伐则热舍于肾，肾者水脏也，今水不胜火，则骨枯而髓虚，故足不任身，发为骨痿，（远行劳倦，最能生热，
阳盛则内伐真阴，水不胜火，故主于肾。）故《下经》曰∶骨痿者生于大热也。（热甚则精髓干涸，故骨枯而为痿，病生
于肾也。）
帝曰∶何以别之？（此下辨五痿之色证也。）岐伯曰∶肺热者色白而毛败，心热者色赤而络脉溢，肝热者色苍而爪枯，
脾热者色黄而肉蠕动，肾热者色黑而齿槁，（蠕者软，微动貌，又曰虫行貌。）
帝曰∶如夫子言可矣，论言治痿者独取阳明何也？（此下言治痿之法也。论言者，即《根结篇》曰∶痿疾者取之阳
明。见经络类三十。）岐伯曰∶阳明者，五脏六腑之海，主闰宗筋，宗筋主束骨而利机关也。（阳明，胃脉也。主纳水谷，
化气血，以资养表里，故为五脏六腑之海而下润宗筋。宗筋者，前阴所聚之筋也。为诸筋之会，凡腰脊溪谷之筋，皆属
于此，故主束骨而利机关也。）冲脉者，经脉之海也，主渗灌溪谷，与阳明合于主筋。（经脉之海者，冲脉为十二经之血
海也，故主渗灌溪谷。冲脉起于气街，并少阴之经，夹脐上行，阳明脉亦夹脐旁，去中行二寸下行，故皆会于宗筋。）阴
阳总宗筋之会，会于气街而阳明为之长，皆属于带脉而络于督脉。（宗脉聚于前阴，前阴者，足之三阴阳明少阳及冲任督
跷九脉之所会也。九者之中，则阳明为五脏六腑之海，冲为经脉之海，此一阴一阳总乎其间，故曰阴阳总宗筋之会也。
会于气街者，气街为阳明之正脉，故阳明独为之长。带脉者，起于季胁，围身一周。督脉者，起于会阴，分三岐为任冲
而上行腹背。故诸经者，皆联属于带脉，支络于督脉也。）故阳明虚则宗筋纵，带脉不引，故足痿不用也。（阳明虚则血
气少，不能润养宗筋，故至驰纵。宗筋纵则带脉不能收引，故足痿不为用。此所以当治阳明也。）帝曰∶治之奈何？岐伯
曰∶各补其荥而通其俞，调其虚实，和其逆顺，筋脉骨肉各以其时受月，则病已矣。帝曰∶善。（诸经之所溜为荥，所注
为俞，补者所以致气，通者所以行气。上文云独取阳明，此复云各补其荥而通其俞，盖治痿者当取阳明，又必察其所受
之经而兼治之也。如筋痿者取阳明厥阴之荥俞，脉痿者取阳明少阴之荥俞，肉痿骨痿，其治皆然。然筋脉肉骨，则各有
所受之时月，如木病者在筋，火病者在脉，土病者在肉，金病者在皮毛，水病者在骨，知所受之浅深以调虚实，知时气
之盛衰以和逆顺，则病可已矣。）
(Full text of "Discourse on Wei Syndrome" from *Suwen*)
The Yellow Emperor asked: Why do pathological changes in the Five Zang organs cause people to develop Wei syndrome (Flaccidity syndrome)? (Each of the Five Zang organs has its corresponding tissue, so all can lead to flaccidity. Wei refers to limb weakness and inability to move voluntarily. Wei sounds like 'wei'.)
Qibo replied:
The Lung governs the skin and hair of the body; the Heart governs the blood vessels of the body; the Liver governs the sinews (fascia) of the body; the Spleen governs the muscles of the body; the Kidney governs the bones and marrow of the body. (Since the tissues governed by the Five Zang organs differ, the resulting flaccidity also varies. Fascia, according to Quan Yuanqi, is located under the skin and above the muscle. Essentially, 'membrane' is like a 'curtain'; any thin tendons connecting flesh textures and organs in sheets are called membranes, which serve to screen Qi and Blood. Wherever fascia exists, collaterals must branch out, and Qi and Blood must gather, hence it is also called Membrane Origin or Fat Membrane. Both 'membrane' and 'curtain' are pronounced 'mo'.) Therefore, if there is Heat in the Lung, the lung leaves become scorched and dry, causing the skin and hair to become weak, tight, and thin. If the heat lingers without departing, it leads to Bi flaccidity (Wei Bi). (Lung Wei refers to flaccidity of the skin and hair. When Heat invades Metal in the Lung, internally it scorches the lung leaves, externally it makes the skin and hair weak, tight, and thin. If the pathogenic heat remains and affects sinews, vessels, bones, and flesh, Bi flaccidity arises. Bi refers to weakness of the legs making walking difficult. Bi sounds like 'bi'.) If Heart Qi is hot, the lower vessels will rebel and ascend; ascending causes the lower vessels to become deficient. Deficiency leads to Mai Wei (Vessel Flaccidity), characterized by joints breaking like a pivot and failing to lift, with calves hanging loose and unable to support the body weight. (Heart Wei refers to Vessel Flaccidity. When Heart Qi is hot, Fire flares upward alone, causing the Yin vessels below to rebel and ascend. Ascension leads to deficiency below, generating Vessel Flaccidity. In Vessel Flaccidity, the joints of the four limbs act like a broken pivot that cannot be lifted, and the calves hang loose, unable to bear weight. Qie is pronounced 'qiu jie'.) If Liver Qi is hot, Gallbladder bile leaks causing bitter taste in the mouth, sinews become dry. Dry sinews lead to spasms and contractures, developing into Jin Wei (Sinew Flaccidity). (Liver Wei refers to Sinew Flaccidity. The Gallbladder attaches to the Liver; when Liver Qi is hot, bile overflows, causing bitterness. Heat in sinews dries the Blood, causing contraction and spasms, becoming Sinew Flaccidity.) If Spleen Qi is hot, the Stomach becomes dry and thirsty, muscles become numb, developing into Rou Wei (Muscle Flaccidity). (Spleen Wei refers to Muscle Flaccidity. The Spleen connects to the Stomach via membranes and opens into the mouth; thus, when Spleen Qi is hot, the Stomach becomes dry and thirsty. The Spleen governs muscles; now heat accumulates internally, consuming Essence and Qi, so muscles become numb, developing into Muscle Flaccidity.) If Kidney Qi is hot, the waist and spine cannot straighten, bones become withered, and marrow decreases, developing into Gu Wei (Bone Flaccidity). (Kidney Wei refers to Bone Flaccidity. The waist is the residence of the Kidney, its meridians penetrate the spine, and it governs bone marrow; thus, when Kidney Qi is hot, these symptoms appear.)
The Emperor asked: How are these conditions acquired? (The following explains the origins of the five types of flaccidity.)
Qibo said: The Lung is the chief of the Zang organs and acts as a cover for the Heart. (The Lung is positioned highest, hence called the chief. It covers the Heart, hence called the cover.) If one suffers loss or fails to obtain desires, Lung Qi stagnates and produces sound (coughing/wheezing); this sound indicates Lung Heat and scorched lung leaves. (When Lung will is not expressed, Qi stagnates and generates Fire, causing wheezing sounds, termed Lung Ming. As a Metal organ, disease causes loss of clear descending function, leading to Heat and scorched leaves.) Thus, it is said that the Five Zang organs develop Wei Bi due to Lung Heat and scorched leaves; this is what is meant. (Thus saying quotes ancient texts. The Lung governs Qi to circulate Ying and Wei, regulating Yin and Yang. Therefore, flaccidity of the Five Zang organs stems from Lung Qi Heat, causing insufficiency of Yin in all Five Zang. This is how Wei Bi originates from the Lung. Although the five types of flaccidity present differently, they are collectively termed Wei Bi.) Excessive grief severs the Bao Luo (Pericardium Collaterals); severance causes Yang Qi to move internally. Upon onset, blood erupts from below the heart, and frequent urination of blood occurs. (Bao Luo refers to the collaterals of the uterus. *Ping Re Bing Lun* states: Bao Mai belongs to the Heart and connects to the Bao. Thus, excessive grief makes the Xin Mai tense and Bao Luo severed, blocking upper-lower communication. Hyperactive Yang moves internally, forcing blood downward to erupt, causing frequent hematuria.) Therefore, *Ben Bing* states: Great vessels become empty, leading to Ji Bi (Muscle Bi), which transmits to Mai Wei. (*Ben Bing* is an ancient classic chapter name. Blood loss empties great vessels, preventing nourishment of muscles and collaterals, first causing muscle numbness/Bi, then transmitting to Vessel Flaccidity, originating from the Heart.) Endless thinking and unfulfilled wishes, with lustful thoughts directed outward and excessive sexual intercourse, cause Zong Jin (Major Sinews) to relax, developing into Jin Wei and Bai Yin. (Endless thinking and unfulfilled wishes mean desires are not satisfied. Lustful thoughts outwardly and excessive intercourse injure Yin Qi. Thus Zong Jin relaxes, causing Jin Wei. Zong Jin gathers at the anterior yin; injury to essence internally and sinking of Qi downward leads to Bai Yin, i.e., leukorrhea or turbid discharge.) Therefore, *Xia Jing* states: Jin Wei originates from the Liver due to sexual indulgence. (*Xia Jing* is an ancient classic. The Liver governs sinews; thus, sinew flaccidity from indulgence originates from the Liver.) Gradual exposure to dampness, working with water, lingering in damp environments, soaking muscles in dampness, causing numbness and insensibility, develops into Rou Wei. (Jian means gradual origin. Working in low, damp places. Xiang means together. The Spleen governs muscles and dislikes dampness; dampness adhering to flesh prevents Wei Qi from nourishing, causing stiff, numb muscles and Rou Wei. Zi is pronounced 'zao si'.) Therefore, *Xia Jing* states: Rou Wei is caused by living in damp land. (Dampness of the earth harms skin, flesh, sinews, and vessels when contracted; disease originates from the Spleen.) Long journeys and fatigue, encountering intense heat causing thirst, thirst leads to internal attack by Yang Qi. Internal attack allows Heat to lodge in the Kidney. The Kidney is a Water organ; now Water cannot overcome Fire, bones wither, and marrow becomes deficient, so feet cannot support the body, developing into Gu Wei. (Long journeys and fatigue generate heat; excess Yang attacks True Yin internally; Water cannot overcome Fire, so disease centers on the Kidney.) Therefore, *Xia Jing* states: Gu Wei originates from intense heat. (Excessive heat dries essence and marrow, causing bone withering and flaccidity; disease originates from the Kidney.)
The Emperor asked: How to distinguish them? (The following distinguishes the color and signs of the five flaccidities.)
Qibo said: Lung Heat presents with white complexion and ruined hair; Heart Heat with red complexion and overflowing collateral vessels; Liver Heat with dark/greenish complexion and withered nails; Spleen Heat with yellow complexion and twitching muscles; Kidney Heat with black complexion and dry teeth. (Ru implies softness and slight movement, also resembling insect crawling.)
The Emperor asked: What you said is sufficient. But the treatise says treating Wei syndrome requires focusing solely on the Yangming meridian. Why? (The following discusses treatment methods. "Treatise says" refers to *Gen Jie Pian*: For Wei diseases, select Yangming. See Meridians Category 30.)
Qibo said: Yangming is the Sea of the Five Zang and Six Fu organs, primarily moistening Zong Jin. Zong Jin binds bones and facilitates joint movement. (Yangming refers to the Stomach meridian. It receives food and drink, transforms Qi and Blood to nourish interior and exterior, thus being the Sea of Zang and Fu, moistening Zong Jin below. Zong Jin refers to the sinews gathered at the anterior yin. It is the meeting point of all sinews; sinews of the waist, spine, and valleys belong here, binding bones and facilitating joints.) Chong Mai is the Sea of the meridians, primarily infiltrating the valleys, combining with Yangming at the sinew-governing site. (Sea of meridians: Chong Mai is the Blood Sea of the twelve meridians, infiltrating valleys. Chong Mai originates at Qichuang, runs alongside Shaoyin, ascending beside the navel. Yangming meridian also runs beside the navel, two cun lateral to midline descending; thus both meet at Zong Jin.) Yin and Yang converge at Zong Jin, meeting at Qichuang, with Yangming as the leader. All connect to Dai Mai and network through Du Mai. (Zong Mai gathers at the anterior yin, where Foot Taiyin, Shaoyin, Taiyang, Yangming, Shaoyang, plus Chong, Ren, Du, and Qiao meridians meet. Among these nine, Yangming is the Sea of Zang/Fu, Chong is the Sea of Meridians; Yin and Yang govern between them, hence convergence at Zong Jin. Meeting at Qichuang: Qichuang is the main pathway of Yangming, so Yangming leads. Dai Mai originates at the costal margin, encircling the body. Du Mai originates at Huiyin, splitting into three branches to ascend the abdomen and back. Thus, all meridians attach to Dai Mai and network through Du Mai.) Therefore, Yangming deficiency leads to relaxation of Zong Jin, and Dai Mai fails to draw inward, resulting in foot flaccidity and non-use. (Yangming deficiency means less Qi and Blood, failing to nourish Zong Jin, leading to laxity. Lax Zong Jin prevents Dai Mai from contracting, causing foot flaccidity. This is why Yangming must be treated.) The Emperor asked: How to treat? Qibo said: Tonify the Ying-Spring points and unblock the Shu-Stream points of each respective meridian, regulate deficiency and excess, harmonize reversal and smooth flow. Treat sinews, vessels, bones, and muscles according to their respective months of reception, and the disease will resolve. The Emperor said: Excellent. (Where Qi flows is Ying-Spring; where Qi pours is Shu-Stream. Tonification brings Qi; unblocking moves Qi. The previous text mentioned focusing on Yangming; this adds tonifying Ying and unblocking Shu of affected meridians. Treating Wei requires selecting Yangming, but must also examine the affected meridian and treat concurrently. E.g., Jin Wei selects Yangming and Jueyin Ying-Shu; Mai Wei selects Yangming and Shaoyin Ying-Shu; Rou Wei and Gu Wei follow similar principles. However, sinews, vessels, flesh, and bones have specific times/months: Wood disease in sinews, Fire in vessels, Earth in flesh, Metal in skin/hair, Water in bones. Knowing depth regulates deficiency/excess; knowing seasonal Qi harmonizes reversal/flow, curing the disease.)