黄帝问曰。五脏使人痿何也。（痿者。四肢无力委弱。举动不能。若委弃不用之状。夫五脏各有所合。痹从外而合
病于内。外所因也。痿从内而合病于外。内所因也。故帝承上章而复问曰。五脏使人痿何也。）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。（夫形身之所以能举止动静者。由脏气之 养于筋脉骨肉
也。是以脏病于内。则形痿于外矣。）故肺热叶焦则皮毛虚弱急薄。着则生痿 也。（肺属金。肺热则金燥而叶焦矣。肺
主皮毛。肺热叶焦则皮毛虚薄矣。夫食饮于胃。其精液乃传之肺。肺朝百脉。输精于皮毛。毛脉合精。行气于脏腑。是
五脏所生之精神气血。所主之皮肉筋骨。皆由肺脏输布之精液以资养。皮肤薄着则精液不能转输。是以五脏皆热而生痿
矣。灵枢经云。皮肤薄着。毛腠夭焦。着者。皮毛燥着。而无生转之气。故曰着则生痿 矣。）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。（心为火脏。心气热则气惟上炎。心主脉。故脉气亦厥而上矣。上
则身半以下之脉虚而成脉痿也。夫经脉者。所以行气血而营阴阳。濡筋骨以利关节。故经脉虚则枢折于下矣。枢折。即
骨徭而不安于地。骨徭者。筋缓而不收。故筋骨徭挈不收。足胫缓纵而不能任地也。）肝气热则胆泄口苦。筋膜干。筋膜
干则筋急而挛。发为筋痿。（胆者中精之府。其应在筋。是周身之筋膜由胆藏之精汁以营养。胆附于肝。肝气热则胆汁泄
而口苦矣。胆汁泄则筋膜无以营养而干燥矣。筋膜干则挛急而发为筋痿也。）脾气热则胃干而渴。肌肉不仁。发为肉痿。
（阳明燥金主气。从中见太阴之湿化。是以脾气热则胃干而渴矣。脾胃之气。并主肌肉。阳明津液不生。太阴之气不至。
故肌肉不仁而发为肉痿也。）肾气热则腰脊不举。骨枯而髓减。发为骨痿。（肾主藏精。肾气热则津液燥竭矣。腰者肾之
府。是以腰脊不能伸举。肾生骨髓。在体为骨。肾气热而精液竭。则髓减骨枯而发为骨痿也。）帝曰。何以得之。岐伯
曰。肺者脏之长也。为心之盖也。有所失亡。所求不得。则发肺鸣。鸣则肺热叶焦。故曰。五脏因肺热叶焦。发为痿 。
此之谓也。（此申明五脏之热而成痿者。由肺热叶焦之所致也。脏真高于肺。朝百脉而行气于脏腑。故为脏之长。肺属干
金而主天。居心主之上。而为心之华盖。有所失亡。所求不得。则心志靡宁。而火气炎上。肺乃心之盖。金受火刑。即
发喘鸣而肺热叶焦矣。肺热叶焦。则津液无从输布。而五脏皆热矣。故曰五脏因肺热叶焦而成痿 者。此之谓也。 者。
足痿而不能任地。故曰。谓下经本病篇有此语也。）悲哀太甚则胞络绝。胞络绝则阳气内动。发则心下崩。数溲血也。
（此以下复论心肝脾肾。各有所因。而自成痿 也。胞络者。胞之大络。即冲脉也。冲脉起于胞中。为十二经脉之海。
心主血脉。是以胞络绝则心气虚而内动矣。阳气、心气也。心为阳中之太阳。故曰阳气。未水之精为志。火之精为神。
悲哀太甚。则神志俱悲而上下之气不交矣。是以胞络绝而阳气内动。心气动则心下崩而数溲血矣。）故本病曰。大经空虚。
发为肌痹。传为脉痿。（本病、即本经第七十三篇之本病论。大经、胞之大络也。胞乃血室。中焦之汁。奉心化赤。流溢
于中。从冲脉而上循背里者。贯于脉中。循腹右上行者。至胸中而散于脉外。充肤热肉。生毫毛。是胞络之血。半行于
脉中。半行于皮腠。脉外之血少。则为肌痹。脉内之血少。则为脉痿。是溲崩之血。从大经而下。先伤皮肤气分之血。
而复及于经脉之中。故曰。大经空虚。发为肌痹。传为脉痿。按皮肤之血。卧则归肝。五脏生成篇曰。人卧血归于肝。
正此血也。故卧出而风吹之。血凝于肤者为痹。再按男子络唇口而生髭须。女子月事以时下者。肝经冲脉之血也。是以
崩溲或大吐衄而不致于死。若心主脉中之血。一息不运则机缄穷。一毫不续则穹坏判矣。）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。（此论肝气自伤而发为筋痿也。肝者将军之官。谋虑出焉。思想无穷。
所愿不得。则肝气伤矣。前阴者。宗筋之所聚。足厥阴之脉。循阴股。入毛中。过阴器。意淫于外则欲火内动。入房太
甚则宗筋纵弛。是以发为阴痿。及为白淫。白淫者。欲火盛而淫精自出也。）故下经曰。筋痿者。生于肝。使内也。（下
经、即以下七十三篇之本病论。今遗亡矣。言本篇所论筋痿者。又生于所愿不遂而伤肝。兼之使内入房之太甚也。）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。故下经曰。肉痿者。得之湿地也。（有渐于湿
者。清湿地气之中于下也。以水为事者。好饮水浆。湿浊之留于中也。若有湿浊之所留。而居处又兼卑下。外内相湿。
以致肌肉濡渍。痹而不仁。发为肉痿也。）有所远行劳倦。逢大热而渴。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。故下经曰。骨痿者。生于大热也。（此论劳倦热渴而成骨痿也。远
行劳倦则伤肾。逢大热则暑 伤阴。渴则阴液内竭。是以阳热之气。内伐其阴。而热合于肾矣。肾者水脏。水盛则能制
火。今阳盛阴消。水不胜火。以致骨枯髓虚。足不任用于身。而发为骨痿也。）帝曰。何以别之。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。（痿病之因。皆
缘五脏热而精液竭。不能营养于筋脉骨肉。是以有因肺热叶焦。致五脏热而成痿者。有因悲思内伤。劳倦外热。致精血
竭而脏气热者。皆当诊之于形色也。爪者筋之应。齿者骨之余。）帝曰。如夫子言可矣。论言治痿者。独取阳明。何也。
（论言、即本病论中之言也。帝以伯言痿病之因于脏热。当从五脏所合之皮肉筋骨以治之。如夫子言可矣。然论言治痿。
何独取于阳明。）岐伯曰。阳明者。五脏六腑之海。主润宗筋。宗筋主束骨而利机关也。（阳明者。水谷血气之海。五脏
六腑。皆受气于阳明。故为脏腑之海。宗筋者。前阴也。前阴者。宗筋之所聚。太阴阳明之所合也。诸筋皆属于节。主
束骨而利机关。宗筋为诸筋之会。阳明所生之血气。为之润养。故诸痿独取于阳明。）冲脉者。经脉之海也。主渗灌溪谷。
与阳明合于宗筋。（溪谷者。大小分肉腠理也。冲脉起于胞中。上循背里。为经络之海。其浮而外者。渗灌于溪谷之间。
与阳明合于宗筋。是以宦者去其宗筋。则伤冲任。血泻不复。而须不生。）阴阳总宗筋之会。会于气街。而阳明为之长。
（少阴太阴阳明。冲任督脉。总会于宗筋。循腹上行。而复会于气街。气街者。腹气之街。在冲脉于脐左右之动脉间。
乃阳明之所主。故阳明为之主。长、主也。）皆属于带脉。而络于督脉。（带脉起于季胁。围身一周。如束带热。三阴三
阳。十二经脉。与奇经之任督冲维。经循于上下。皆属带脉之所约束。督脉起于会阴。分三歧为任冲。而上行腹背。是
以冲任少阴阳明。与督脉皆为联系。）故阳明虚则宗筋纵。（阳明为水谷之海。主润宗筋。阳明虚则宗筋纵。宗筋纵弛。
不能束骨而利机关。则成痿 矣。故诸痿独取于阳明。）带脉不引。故足痿不用也。（阴阳经脉。皆属带脉之所约束。如
带脉不能延引。则在下之筋脉纵弛。而足痿不用矣。）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。（伯言治痿之法。虽取阳明。而当兼取其五脏之荥俞也。各补其
营者。补五脏之真气也。通其俞者。通利五脏之热也。调其虚实者。气虚则补之。热盛则泻之也。和其顺逆者。和其气
之往来也。筋脉骨肉。内合五脏。五脏之气。外应四时。各以其四时受气之月。随其浅深而取之。其病已矣。按诊要经
终篇曰。正月二月。人气在肝。三月四月。人气在脾。五月六月。人气在头。七月八月。人气在肺。九月十月。人气在
心。十一月十二月。人气在肾。故春刺散俞。夏刺络俞。秋刺皮肤。冬刺俞窍。春夏秋冬。各有所刺。谓各随其五脏受
气之时月。合其浅深而取之。不必皮痿治皮。而骨痿刺骨也。）
Huangdi asked: Why do diseases of the five zang organs cause flaccidity syndromes (Wei syndrome, characterized by weakness and atrophy of the limbs)?
Qibo replied: The Lung governs the skin and hair of the body; the Heart governs the blood vessels; the Liver governs the tendons and sinews; the Spleen governs the muscles; and the Kidney governs the bones and marrow. Thus, when internal organs are diseased, external form becomes flaccid. Therefore, if the Lung is hot, its leaves become scorched, leading to weak, tight, and thin skin and hair; if this condition persists, flaccidity develops. If the Heart is hot, qi rebels upward from the lower vessels, causing deficiency in the lower vessels and resulting in vessel flaccidity (Mai Wei), where the joints cannot support weight and the shins are loose and unable to bear the body's weight. If the Liver is hot, bile leaks causing a bitter taste, and the tendons dry out, becoming tight and contracted, developing into tendon flaccidity (Jin Wei). If the Spleen is hot, the stomach becomes dry with thirst, and the muscles become numb, developing into muscle flaccidity (Rou Wei). If the Kidney is hot, the waist and spine cannot move, bones become withered, and marrow decreases, developing into bone flaccidity (Gu Wei).
Huangdi asked: How are these conditions acquired? Qibo said: The Lung is the chief of the zang organs and acts as a canopy for the Heart. Loss or unfulfilled desires can cause lung resonance, leading to lung heat and scorched leaves. This results in flaccidity due to lung heat affecting all five zang organs. Excessive grief can sever the pericardium collaterals, causing internal movement of yang qi, leading to bleeding from below and frequent hematuria. Thus, large vessels become empty, leading to muscle bi syndrome, which transmits to vessel flaccidity. Endless thinking and unfulfilled wishes, combined with excessive sexual activity, relax the ancestral sinews (Zong Jin), leading to tendon flaccidity and white discharge. Exposure to dampness and living in wet environments causes muscle flaccidity. Fatigue from long travel combined with intense heat and thirst leads to kidney heat, bone withering, and bone flaccidity.
To differentiate: Lung heat presents with pale complexion and damaged hair; Heart heat with red complexion and overflowing collateral vessels; Liver heat with bluish complexion and withered nails; Spleen heat with yellow complexion and twitching muscles; Kidney heat with dark complexion and withered teeth.
Regarding treatment, it is said to "solely select the Yangming." Qibo explained: The Yangming meridian is the sea of the five zang and six fu organs, moistening the Zong Jin, which binds bones and facilitates joint movement. The Chong Mai (Penetrating Vessel) is also a sea of vessels, irrigating the muscle spaces, and meets the Yangming at the Zong Jin. All yin and yang meridians converge at the Zong Jin and meet at the Qichuan point, with Yangming acting as the leader. They are all connected to the Dai Mai (Girdle Vessel) and linked to the Du Mai (Governor Vessel). If Yangming is deficient, Zong Jin becomes lax. If the Dai Mai fails to draw them in, the legs become flaccid and unusable.
Treatment involves tonifying the Ying-Spring points and unblocking the Shu-Stream points of the respective meridians, adjusting excess and deficiency, and harmonizing the flow of qi. Treatment should be timed according to the months when the tendons, vessels, bones, and muscles receive qi. Huangdi praised this method.