脉 脉浮洪。缓滑。右寸浮大而涩。浮缓为虚。洪大为热。滑则多痰涩而少血。
症 丹溪云∶内经言诸痿生于肺热。又谓治痿独取阳明胃。盖肺金体燥。居上。而主气。畏
火者也。脾土性湿居中。而主四肢。畏木者也。火性炎上。若嗜欲无节。则水失所养。火寡
于畏。而侮所胜。金肺得火邪而热矣。火性刚急。肺受热。则金失所养。木寡于畏而侮所胜
。土脾得木邪而伤矣。肺热则不能管摄一身。脾伤则四肢不能为用。而诸痿作矣。经虽有筋
脉骨肉之分。一皆主于肺热。临症宜详审之。
治 东垣取横柏苍术为君。黄 当归为佐。以治诸痿。无一定之方。有温多者。有热多者。
有温热相伴。有挟风者。临病制方。其善于治痿者欤。又云∶泻南方。则肺金清。而东方不
实。何脾伤之有。补北方。则心火降。而西方不虚。何肺热之有。故阳明实。则宗筋润。能
束骨而利机关矣。治痿之法。无出于此。虽然。天产作阳。浓味发热。凡病痿者。若不淡薄
食味。必不能保其全安也。
方 加减清燥汤治诸痿通用。
人参（七分） 黄 （一钱五分） 归身（一钱五分） 麦门冬（一钱） 黄柏（一钱） 苍术（一钱）
黄芩（八分） 五味（九粒） 生地黄（七分） 升麻（二分） 柴胡（三分） 甘草（三分） 白
术陈皮 白茯苓（各八分） 泽泻（五分）
上作一服。姜一片。枣一枚。煎。食远服。
兼风者。加姜活、独活、桑寄生。
兼湿者。加木瓜、防己、薏苡仁。
Pulse: The pulse is floating and surging, or slow and slippery. The right Cun position is floating, large, and choppy. Floating and slow indicates deficiency; surging and large indicates heat; slippery indicates excessive phlegm; choppy indicates blood deficiency.
Symptoms: Zhu Danxi stated: The *Neijing* states that all types of Wei syndrome (flaccidity syndrome) arise from lung heat. It also states that in treating Wei syndrome, one should exclusively focus on the Yangming Stomach meridian. This is because Lung Metal has a dry nature, resides in the upper jiao, governs Qi, and fears Fire. Spleen Earth has a damp nature, resides in the middle jiao, governs the four limbs, and fears Wood. Fire nature flares upward. If desires are unrestrained, Kidney Water loses its nourishment, causing Fire to lack restraint and overact upon its controlled element (Metal). Lung Metal suffers from Fire pathogen and becomes hot. Fire nature is rigid and urgent. When the Lung suffers heat, Metal loses nourishment; simultaneously, Wood lacks restraint and overacts upon its controlled element (Earth), injuring Spleen Earth. Lung heat fails to control the whole body; Spleen injury causes the four limbs to be unusable, thus various Wei syndromes arise. Although there are distinctions among tendons, vessels, bones, and flesh in the meridians, they are all primarily governed by lung heat. In clinical practice, careful examination is required.
Treatment: Li Dongyuan selected Huangbai (Phellodendri Cortex) and Cangzhu (Atractylodis Rhizoma) as sovereign drugs, and Huangqi (Astragali Radix) and Danggui (Angelicae Sinensis Radix) as minister drugs, to treat various Wei syndromes. There is no fixed formula. Some cases have more dampness, some more heat, some have both dampness and heat, and some are complicated by wind. Formulas should be adapted according to the disease; this is the skillful approach to treating Wei syndrome. He further stated: Clearing the Southern Heart Fire clears Lung Metal, preventing Eastern Liver Wood from becoming excessive, so how could Spleen Earth be injured? Tonifying Northern Kidney Water descends Heart Fire, preventing Western Lung Metal from becoming deficient, so how could Lung Heat exist? Therefore, when the Yangming meridian is sufficient, the Zongjin (major sinews) are moistened, able to bind the bones and facilitate joint movement. The method for treating Wei syndrome does not go beyond this. Nevertheless, animal products are yang in nature, and rich flavors generate heat. Patients with Wei syndrome must maintain a bland diet to preserve their health.
Formula: Jiajian Qingzao Tang (Modified Clear-Dryness Decoction) is a general formula for treating various Wei syndromes.
Renshen (Ren Shen, Ginseng Radix et Rhizoma) (7 fen), Huangqi (Huang Qi, Astragali Radix) (1.5 qian), Danggui (Dang Gui, Angelicae Sinensis Radix) (1.5 qian), Maimendong (Mai Men Dong, Ophiopogonis Tuber) (1 qian), Huangbai (Huang Bai, Phellodendri Cortex) (1 qian), Cangzhu (Cang Zhu, Atractylodis Rhizoma) (1 qian), Huangqin (Huang Qin, Scutellariae Radix) (8 fen), Wuweizi (Wu Wei Zi, Schisandrae Chinensis Fructus) (9 grains), Shengdihuang (Sheng Di Huang, Rehmanniae Radix) (7 fen), Shengma (Sheng Ma, Cimicifugae Rhizoma) (2 fen), Chaihu (Chai Hu, Bupleuri Radix) (3 fen), Gancao (Gan Cao, Glycyrrhizae Radix et Rhizoma) (3 fen), Baizhu (Bai Zhu, Atractylodis Macrocephalae Rhizoma), Chenpi (Chen Pi, Citri Reticulatae Pericarpium), Baifuling (Bai Fu Ling, Poria) (each 8 fen), Zexie (Ze Xie, Alismatis Rhizoma) (5 fen).
Take all ingredients as one dose. Add one slice of fresh ginger and one date. Decoct and take after meals.
For cases complicated by wind, add Qianghuo (Qiang Huo, Notopterygii Rhizoma et Radix), Duhuo (Du Huo, Angelicae Pubescentis Radix), and Sangjisheng (Sang Ji Sheng, Taxilli Herba).
For cases complicated by dampness, add Mugua (Mu Gua, Chaenomelis Fructus), Fangji (Fang Ji, Stephaniae Tetrandrae Radix), and Yiyiren (Yi Yi Ren, Coicis Semen).