肺热叶焦。则皮毛虚弱急薄。着则生痿 也。(热乘肺金。在内为叶焦。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。则病痿 ○ 。音璧。足弱不能行也)心气热则
下脉。(足三阴)厥而上。上则下脉虚虚则生脉痿枢折挈。胫纵而不任地也(枢纽关节之处。
如折而不能提挈。又足胫纵弛而不能任地)肝气热。则胆泄口苦。筋膜干筋膜干则筋急而挛
。发为筋痿(血液干燥)脾气热则胃干而渴。肌肉不仁。发为肉痿(肉不知痛痒)肾气热。则腰
脊不举。骨枯而髓减。发为骨痿 肺者。藏之长也。为心之盖也。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。故发喘鸣而叶焦)故曰五脏因肺热叶焦。发
为痿 (气无所主)悲哀太甚。则胞络绝(胞之络脉属心)胞络绝则阳气内动。发为心下崩。数
泄血也(心血下崩)故本病曰(古经篇名)大经空虚。发为肌痹。传为脉痿(血失则大绝空虚。
无以灌渗肌肉。发为肌肉顽痹。传变而为脉痿也)思想无穷所愿不得。意淫于外。(伤脾)入
房太甚。宗筋弛纵发为筋痿。及为白淫(白淫。浊带也)生于肝使内也(房劳○肝吴注改疾)有
渐于湿(渐近也)以水为事(有事于卑湿之所)若有所留(水湿留着)居处相湿。肌肉濡渍痹而不
仁。发为肉痿得之湿地也(病生于脾)有所远行劳倦。逢大热而渴。渴则阳气内伐(内戕真阴)
内伐则热舍于肾。肾者。水藏也今水不胜火。则骨枯而髓虚故足不任身。发为骨痿。生于大
热也 治痿者。独取阳明何也阳明者。五脏六腑之海。主闰(润同)宗筋(阴毛横骨上下之竖
筋)宗筋主束骨而利机关也冲脉者经脉之海也(受十二经之血)主渗灌 谷。与阳明合于宗筋
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。故阳明虚。则宗筋纵带
脉不引(不能收引)故足痿不用也。
When the Lungs are affected by Heat, the Lung leaves become scorched and dry. Consequently, the skin and hair (Pifu) become weak, tight, and thin. If the pathogenic Heat lingers and does not dissipate, spreading to the sinews, vessels, bones, and flesh, it gives rise to Wei syndrome (Flaccidity Syndrome). (Note: Wei, pronounced 'bi', refers to weakness of the lower limbs making walking impossible.)
When the Heart Qi is affected by Heat, the meridians of the lower extremities (the three Yin meridians of the foot) may reverse and ascend. Upon ascending, the meridians below become deficient. Deficiency in the lower meridians leads to Mai Wei (Vessel Flaccidity), characterized by the collapse of joint pivots such that they cannot be lifted or supported, and the shins become flaccid and unable to bear weight. (Note: The pivot points of joints appear as if broken and unable to support; also refers to the flaccidity of the lower legs preventing them from bearing weight.)
When the Liver Qi is affected by Heat, bile leaks out causing a bitter taste in the mouth. The sinews and fascia become dry. Dryness of the sinews and fascia leads to contraction and spasms of the tendons, developing into Jin Wei (Sinew Flaccidity). (Note: Caused by dryness of blood.)
When the Spleen Qi is affected by Heat, the Stomach becomes dry with thirst, and the muscles become insensate. This develops into Rou Wei (Flesh Flaccidity). (Note: The muscles lose sensitivity to pain and itch.)
When the Kidney Qi is affected by Heat, the waist and spine become stiff and difficult to move, the bones become withered, and the marrow diminishes. This develops into Gu Wei (Bone Flaccidity).
The Lung is the chief organ of the five Zang organs and serves as the canopy over the Heart. If one experiences loss or unfulfilled desires, it causes the Lung Qi to rebel and produce wheezing sounds. These sounds indicate Lung Heat and scorched Lung leaves. (Note: When the emotional aspect of the Lung is stifled, Qi stagnation generates Fire, leading to wheezing and scorched Lung leaves.) Therefore, it is said that when the Five Zang organs suffer from Lung Heat and scorched Lung leaves, Wei syndrome arises. (Note: Qi loses its mastery.)
Excessive grief severs the Bao Luo (Pericardium Collaterals). (Note: The collaterals of the Bao belong to the Heart.) When the Bao Luo is severed, Yang Qi moves internally, causing bleeding from the heart region and frequent hemorrhage. (Note: Collapse of Heart Blood downward.) Thus, the ancient classic *Ben Bing* states: When the large meridians become empty, Ji Bi (Muscle Bi) arises, which transmits to become Mai Wei. (Note: Loss of blood empties the large meridians, preventing them from nourishing and moistening the muscles, leading to insensate muscle Bi, which then transmits to Vessel Flaccidity.)
Endless thinking and unfulfilled wishes cause the mind to wander externally. (Injuring the Spleen.) Excessive sexual intercourse causes the Zong Jin (Major Sinews) to become flaccid and relaxed, resulting in Jin Wei (Sinew Flaccidity) and Bai Yin (White Turbidity/Leukorrhea). (Note: Bai Yin refers to turbid discharge.) This originates from internal injury to the Liver. (Note: Sexual exhaustion. Note Wu modifies this to "disease".)
Gradual exposure to dampness, engaging in activities involving water. (Working in low, damp places.) If water-dampness lingers, living in humid environments causes the muscles to be soaked and macerated, leading to Bi syndrome with insensibility, resulting in Rou Wei (Flesh Flaccidity). This arises from dwelling in damp ground. (Disease originates in the Spleen.)
Long journeys and fatigue, encountering intense heat and thirst. Thirst causes Yang Qi to attack internally (damaging True Yin internally). Internal attack allows Heat to lodge in the Kidneys. The Kidney is the Water Organ; now Water fails to overcome Fire, so the bones become withered and the marrow empty. Thus, the feet cannot support the body, resulting in Gu Wei (Bone Flaccidity). This arises from intense heat.
Why is Wei syndrome treated by exclusively selecting the Stomach Meridian of Foot-Yangming? The Yangming Meridian is the Sea of the Five Zang and Six Fu organs, primarily moistening the Zong Jin (Major Sinews). (Note: The vertical sinews above and below the pubic bone and inguinal region.) The Zong Jin binds the bones and facilitates joint movement. The Chong Mai (Penetrating Vessel) is the Sea of the Twelve Meridians, primarily infiltrating and irrigating the Gu (Valleys/Cavities), merging with the Yangming at the Zong Jin. Yin and Yang converge at the Zong Jin, meeting at the Qichuan (Groin) acupoint, with the Yangming acting as their leader. All are connected to the Dai Mai (Girdle Vessel) and linked to the Du Mai (Governor Vessel). Therefore, when the Yangming is deficient, the Zong Jin becomes flaccid, and the Dai Mai fails to draw inward (cannot contract and pull), resulting in flaccidity and non-use of the legs.