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Wei (Wasting and Thirst Syndrome), as annotated, refers to the condition of limb weakness and inability to move. However, the cause of this weakness, while involving factors from the five Zang organs, ultimately relates to the Stomach. This is because the Stomach stores water and grain to nourish the human body, and all five Zang and six Fu organs receive Qi from it. Therefore, if Stomach Qi is deficient, the Zang and Fu organs lose their nourishment, and the meridians of Chong (Penetrating Vessel), Du (Governing Vessel), and Dai (Belt Vessel) fail to maintain each other. The Zong Jin (General Tendon) becomes flaccid, the whole body lacks strength, and thus Wei syndrome occurs. This is why the Yellow Emperor and Qibo debated this issue repeatedly.

The Yellow Emperor asked: "How can the five Zang organs cause Wei syndrome?" Qibo replied: "The Lung governs the skin and hair of the body; the Heart governs the blood vessels; the Liver governs the tendons and fascia; the Spleen governs the muscles; and the Kidney governs the bone marrow." (Since the governed areas differ, Wei arises in each according to its specific governance.) Thus, when Lung heat scorches the leaves (Lung Yin deficiency with dryness), the skin and hair become deficient, weak, thin, and adherent, leading to Wei Bi (inability to walk). (This means spasms where the feet cannot extend. Lung heat affects the Kidney due to shared heat. Note: The Lung combines with the skin and hair; its nature is light and floating, governing Qi. Thus, deficiency leads to weak and急促 Qi, and the form becomes thin and adherent. Metal deficiency fails to generate Kidney Water, causing the Kidney to be exhausted and spasmodic. Spasms imply pain.) If Heart Qi is hot, the lower vessels reverse and ascend; ascending causes the lower vessels to become deficient, leading to Mai Wei (Vessel Wei), where the pivot breaks, the tibia is lifted, and the limbs are flaccid and unable to bear weight on the ground. (Note: The Heart is a Fire organ; excess fire causes heat, which rises. Qi also ascends, reversing the flow of all vessels in the body. Excess above leads to deficiency below, manifesting as vessel Wei. Symptoms include immobility and inability to stand, resembling a broken pivot with lifted shins. This occurs because Heart deficiency and blood lack fail to nourish the tendons, causing flaccidity. Tibia refers to the fibula.) If Liver Qi is hot, bile leaks causing bitter taste, and the fascia dries up. Dry fascia leads to tendon spasms and contractures, resulting in Jin Wei (Tendon Wei). (Note: The Liver is a Zang organ, and the Gallbladder is a Fu organ, corresponding in Yin and Yang. Liver belongs to Wood and generates Fire; rising fire causes bile reflux and bitter taste. The Liver governs tendons, so heat dries the fascia. Dryness causes contraction and Wei. Although Wei implies flaccidity, contracture is also Wei because inability to extend is similar to flaccidity. Note: The Gallbladder lies between the short lobes of the liver; the annotation claiming the Gallbladder is the liver lobe is incorrect.) If Spleen Qi is hot, the Stomach becomes dry and thirsty, muscles become insensate, resulting in Rou Wei (Muscle Wei). (The Spleen and Stomach are connected by membranes; Spleen heat causes stomach fluids to leak, leading to dryness and thirst. The Spleen governs muscles; internal heat invasion causes muscle insensibility and Wei.) If Kidney Qi is hot, the waist and spine cannot lift, bones become withered, and marrow decreases, resulting in Gu Wei (Bone Wei). (The waist is the mansion of the Kidney; the Kidney meridian runs up the inner thigh, through the spine, and connects to the Kidney. Thus, Kidney heat prevents waist/spine movement. The Kidney governs bone marrow; heat causes bone withering and marrow depletion, leading to Bone Wei.)

The Emperor asked: "How is it acquired?" Qibo said: "The Lung is the chief of the Zang organs and the canopy of the Heart." (Positioned high and spreading leaves in the chest, it is the chief of Zang and covers the Heart.) Loss or unfulfilled desires cause Lung Ming (lung sounds/wheezing), which leads to Lung heat scorching the leaves. (… Frustrated will and stagnant Qi cause this. The Lung stores Qi; stagnation leads to wheezing and Lung heat/leaf scorching.) Extreme sorrow severs the Bao Luo (Pericardium Collateral); severance causes internal movement of Yang Qi, leading to heart bleeding and frequent hematuria. (… Note: Bao Luo refers to the Pericardium Collateral, which protects the Heart. Extreme sorrow causes urgent Qi, injuring the collateral and affecting the Heart. As the Heart governs Blood and belongs to Fire, Heart fire agitation causes blood to flow downward into urine.) Endless thinking and unfulfilled wishes, with lustful thoughts directed outward, combined with excessive sexual activity, cause Zong Jin to relax, leading to Jin Wei and Bai Yin (white discharge; for men, spermatorrhea; for women, leukorrhea). … Note: 'Endless' implies excessive desire. 'Outward' implies non-marital contexts. Bai Yin affects both genders. Evil thoughts and mental lust disturb Jing (Essence) even without physical act, contributing to Jin Wei along with excessive sex. Since Jin Wei is a Liver disease, why does sexual excess cause it? Because Kidney essence damage and Water deficiency fail to nourish Wood (Liver). Gradual exposure to dampness, working with water, or living in humid environments causes muscle immersion, bi obstruction, and insensibility, leading to Rou Wei. (… Working near water or living in low, wet areas involves water. Even normal people suffer over time, but those exposed more severely suffer more. Muscles belong to the Spleen; the Spleen dislikes dampness. Internal dampness blocks Ying Qi, causing Muscle Wei. Note: Jian is pronounced jian; Zi is pronounced zi, meaning infiltration.) Long journeys and fatigue, encountering intense heat and thirst, cause internal attack by Yang Qi. Heat settles in the Kidney. As the Kidney is a Water organ, if Water cannot overcome Fire, bones wither and marrow empties, making the feet unable to support the body, leading to Gu Wei. (… Note: Water controls Fire, but excessive Fire boils Water, worsening deficiency. Fatigue and heat cause internal Yang fire; Water fails to control it, damaging the Kidney. The Kidney governs bones, strengthened by marrow. Kidney deficiency leads to empty marrow, withered bones, and weak feet, named Bone Wei.) The Emperor asked: "How to distinguish them?" Qibo said: "Lung heat presents with white complexion and damaged hair; Heart heat with red complexion and overflowing collaterals; Liver heat with bluish complexion and withered nails; Spleen heat with yellow complexion and twitching muscles; Kidney heat with black complexion and withered teeth." (Identify by organ color and governed area. Note: Ru is pronounced ruan, meaning slight movement.)

The Emperor said: "Your explanation is sufficient. The classics state that treating Wei requires focusing solely on the Yangming channel. Why?" Qibo said: "The Yangming channel is the sea of the five Zang and six Fu organs; it primarily moistens the Zong Jin. The Zong Jin binds the bones and facilitates joint movement." (Zong Jin refers to the vertical tendons around the pubic bone. It connects to the chest/abdomen above, passes through the hips/sacrum below, and traverses the back/abdomen to the head/neck, thus binding bones and aiding joints. The waist is the major joint controlling flexion/extension, hence 'joint'. Note: 'Run' should be read as 'moisten'; organs transform food/qi to nourish the body, and Zong Jin relies on this moisture. As the chief of all tendons, it supports the body; dryness causes contraction, moisture ensures mobility.) The Chong Vessel is the sea of the meridians, primarily infiltrating the溪谷 (valleys/muscle spaces), and merges with Yangming at the Zong Jin. (Chong meridian runs 0.5 cun lateral to the umbilicus; Yangming runs 1.5 cun lateral; Zong Jin is in between, hence they merge. As the sea of twelve meridians, it infiltrates muscle spaces. Large muscle gatherings are 'Gu', small are 'Xi'. Note: Infiltration means penetrating everywhere. Chong governs Blood and Qi; though located laterally, Qi flows throughout the body, justifying the term 'infiltration'.) The Yin and Yang converge at the Zong Jin, meeting at the Qi Street (Qichong), with Yangming as the leader. All belong to the Dai Vessel and connect to the Du Vessel. Therefore, Yangming deficiency causes Zong Jin relaxation and Dai Vessel failure to draw, resulting in foot Wei and immobility. (Zong Jin joins the transverse bone below the umbilicus; Yangming supports externally, Chong resides internally, meeting at Qi Street with Yangming leading. Qi Street is the pulsating point beside the pubis. Dai Vessel originates from the hypochondrium, encircles the body, and connects to Du Vessel. Du Vessel originates at Guanyuan, running up/down the abdomen. They belong to Dai and connect to Du. Chong, Ren, and Du originate together but diverge, explaining the text's structure. 'Yin' means traction. Note: Abundant food/grain fills Yangming, strengthening Qi/Blood, making Zong Jin firm and strong. Deficiency causes flaccidity and inability to walk. This is because feet rely on tendons. Annotations citing irrelevant sources are inaccurate.) The Emperor asked: "How to treat?" Qibo said: "Tonify the Ying (Stream) points and unblock the Shu (Transport) points for each organ, regulate deficiency and excess, harmonize reversal and smoothness. For tendons, vessels, bones, and flesh, treat according to their respective months of dominance, and the illness will resolve." The Emperor said: "Excellent!" (Note: Ying refers to Blood. Ni Diao Lun states: 'Deficient Ying Qi causes insensibility.' Thus, treating Wei prioritizes tonifying Blood. Shu points are back-Shu points, one for each Zang. 'Months of dominance' refer to the seasons when each Zang is strongest; e.g., treat tendon/Liver issues in Spring when Wood is dominant, allowing pathogen expulsion and healthy Qi recovery. Tendons=Liver; Vessels=Heart; Bones=Kidney; Flesh=Spleen. Lung is omitted here because Lung governs skin/hair, which attach to flesh, possibly an ellipsis. Annotations are plausible but unclear.)