（唾水沉者，心腹绞痛下血如烂肉者，俱为蛊。）
〔《千》〕治中蛊下血如鸡肝出，其余四脏俱坏，惟心未毁，或鼻破待死。取马蔺根末，水
服方寸匕，随吐则出，极神。此苗似葛蔓绿紫，生子似橘子。
〔梅〕治卒中蛊毒，下血如鸡肝，昼夜不绝，脏腑败坏待死。用白 荷叶，密安病患席下，
勿令病患知觉，自呼蛊主姓名。
〔《百一》〕治中蛊毒，或吐下血者若烂肝。取蚯蚓十四枚，以苦酒三升渍之，蚓死但服其汁，
已死者皆可治。
〔《千金翼》〕治蛊毒下血。 毛烧末，水服方寸匕，当吐蛊毒。
〔《肘》〕疗中蛊毒，吐血下血，皆如烂肝者。苦瓠一枚，水二升煮取一升，服之吐即愈。
又方，用苦酒一升，煮瓠令消，服之神效。
痿者，手足痿软而无力，百节缓纵而不收也。
〔丹〕痿属湿热，有湿痰者，有气虚者，有血虚者，有食积妨碍不降者，有死血者。
〔《素》〕黄帝问曰∶五脏使人痿，何也？岐伯曰∶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。故肺热叶焦，则皮毛虚弱急薄，着则生痿 也。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。肝气热，则胆泄口苦，
筋膜干，筋膜干则筋急而挛，发为筋痿。脾气热，则胃干而渴，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。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。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。故《本病》曰∶大
经空虚，发为肌痹，传为脉痿，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。故《下经》曰∶筋痿者，生于肝，使内也。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。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。帝曰∶论言治痿者独取阳明何也？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。冲脉者，经脉之海也，主渗灌溪谷，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，
故足痿不用也。帝曰∶治之奈何？岐伯曰∶各补其荣而通其俞，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。（痿病论）
或问曰∶治痿之法，取阳明之一经．此引而未发之言，愿明以告我。予曰∶诸痿生于肺热。
只此一句，便
见治法大意。经曰；东方实则西方虚，泻南方，补北方。此固就生克言补泻，而大经大法，不
外于此。东方木肝也，西方金肺也，南方火心也，北方水肾也。五方之中，惟火有二。肾虽有两，
水居其一，阳常有余，阴常不足，故经曰一水不胜二火，理之必然。金体燥而居上，主气，畏火者
也。土性温而居中，主四肢，畏火者也。火性炎上，若嗜欲无节，则水失所养，火寡于畏而侮所
胜，肺得火邪则热矣。木性刚急，肺受热则失所养，木寡于畏而侮所胜，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，而诸痿之病作。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。骆龙吉亦曰∶风火既炽，当滋肾水。东垣先生取柏皮为君，黄 等补药辅佐，
以治诸痿，而无一定之方。有兼痰积者，有湿多者，有热多者，有湿热相半者，有挟气者，临病制
方，其善于治痿者乎。虽然，药中肯綮矣，若将理失宜，医不治也。天产作阳，气浓发热，先哲
格言。但是患痿之人，若不淡薄食味，吾知其必不能安也。
〔垣〕清暑益气汤 黄 人参汤 清燥汤（三方并见注夏）
〔丹〕补益丸 治痿。
龟板（酒炙，一两） 锁阳（酒浸，一两） 生地（酒浸，两半） 归身（酒浸，一两） 陈皮（一两）
杜牛膝（酒浸，一两） 白术（二两） 干姜（七钱半） 黄柏（炒，半两） 虎胫骨（酒炙，半两）
五味子（二钱） 茯苓（半两） 白芍药（酒浸，一两） 甘草（炙，一钱） 菟丝子（酒蒸熟，研如糊，入
余药末，晒干）
诸药为末，紫河车为丸。如无紫河车，猪脑骨髓亦得。
龙虎丹治痿。
败龟板（酒炙） 虎骨（酒炙） 黄柏（酒炙） 干姜（二钱半） 锁阳（七钱半） 金箔（十片）
神曲 如懒言语，加山药末七钱。
上为末，糯粉糊为丸，空心白汤服。
虎潜丸
龟板（四两） 知母（二两） 黄柏（四两） 熟地（二两） 牛膝（三两半） 锁阳（一两） 虎骨（炙，
一两） 当归（一两） 芍药（两半） 陈皮（七钱半）
干姜（半两）
上为末，酒糊丸。加附子，治痿厥如神。
湿热痿，东垣健步丸加芩、柏、苍术。东垣补益肾肝丸，治脚膝无力。（二方并见痿厥。）
萧炳神龟滋阴丸。（方见涎下。）丹溪气虚病痿，四君子加苍术、芩、柏。血虚病痿，四物汤
加苍术、黄柏，下补阴丸。《保命集》治脾虚四肢不用，以十全散者，盖治气血俱虚者也。
〔无〕加减四斤丸治肾肝虚，热淫于内，致筋骨痿弱，不自胜持，起居须人，足不任地，
惊恐战掉，潮热时作，饮食无味，不生气力，诸虚不足。
肉苁蓉（酒浸） 牛膝（酒浸） 木瓜 菟丝子（酒浸，另研） 鹿茸（燎去毛，切，酥炙）
熟地 天麻 五味子（酒浸，等分）
上为末，蜜丸如桐子大。每服五十丸，温酒米汤食前下。
王启玄传《玄珠》耘苗丹三方。序曰∶张长沙戒人妄服燥烈之药，谓药势偏有所助，胜克流
变，则真病生焉，犹悯苗不长而揠之者也。若禀气血不强，合服此而不服，是不耘苗者也，故
名耘苗丹。此丹养五脏，补不足，秘固真元，均调二气，和畅荣卫，保神守中。
五味子（半斤） 巴戟（去心） 远志（去心） 枸杞子 山药 白茯苓 肉苁蓉（酒浸）
百部（酒浸一宿，焙） 杜仲（炒，断丝） 蛇床子 防风（去芦） 柏子仁（另研） 菟丝子
（酒浸，另研。各二两）
上为末，蜜丸桐子大。食前温酒盐汤任下三十丸。春干枣汤下，夏加五味子四两，四季月加苁
蓉六两，秋加枸杞子六两。
卫生汤补虚劳，强五脏，除烦热，养真元，退邪热，顺血脉。
当归 白芍药（各四两） 甘草（炙，一两） 黄 （八两）
年老加酒半盏，同水煎。
〔萧炳〕治脚软丹参酒。（方见痿厥。）
〔《经》〕治骨软风腰膝疼，行履不得，遍身搔痒。何首乌大而有花纹者，同牛膝锉各一斤，
以好酒一升浸七宿焙干，于木臼捣末蜜丸，每日空心食前酒下三五十丸。
〔《保》〕四肢不举，俗曰瘫缓，故经所谓脾太过，则令人四肢不举。又曰土太过则敦阜。阜，
高也，敦，浓也。既浓而又高，则令除去，此真所谓膏粱之疾，其治则泻，令气弱阳衰，土平而愈，
或三化汤、调胃承气汤，选而用之。若脾虚则不用也，经所谓土不及则卑陷。卑，下也，陷，
坑也。故脾病四肢不举。四肢皆禀气于胃，而不能至经，必因于脾，方得禀受。今脾病不能与胃
行其津液，四肢不得禀水谷气，气日以衰，脉道不利，筋骨肌肉皆无气以生，故不用焉。其治可
十全散加减四物，去邪留正。
脾实病痿者。经云∶脾病者肉痿，足不收。又云∶脾脉太过，则令人四肢不举。又云∶其犯
雨湿之地，则为痿者是也。
〔丹〕湿痰病痿。二陈汤加苍术、白术、黄芩、黄柏之类，入竹沥。
〔《斗》〕商陆饭 治脚软。（方见痿厥。）
〔子和〕陈下一武卒宋子玉，因驻军息城，六月间暴得痿病，腰膝两足皆不任用， 而不行，
求治于予。予察其两手脉俱滑大而有力。予思《内经》火淫于内，治以咸寒。以盐水越其膈间寒
热宿痰，（新者为热，旧者为寒。）或宿食宿饮。在上脘者，可以涌之。宿痰既尽，因而下之。
节次间行，觉神志日清，饮食日美，两足渐举，脚膝渐伸，心降肾升。又继以黄连解毒汤加当归
等药，及泻心汤、凉膈散、柴胡饮子，大作剂煎，时时呷之。
〔《保》〕心热盛则火独亢，火炎上，肾之脉常下行。今火盛而上炎用事，故肾脉亦随火炎烁而
逆上行，阴气厥逆，火复内焰，阴上隔阳，下不守位，心气通脉，故生脉痿，膝腕枢如折去而不
相提挈，经筋纵缓而不任地故也，可下数百行而愈。
〔丹〕痿病食积妨碍不得降者，亦有死血者，俱宜下之。
〔《素》〕帝曰∶脾病而四肢不用，何也？岐伯曰∶四肢皆禀气于胃，而不得至经，必因于脾乃
得禀也。今
脾病不能为胃行其津液，四肢不得禀水谷气，气日以衰，脉道不利，筋骨肌肉皆无气以生，故不用
焉。帝曰∶脾与胃以膜相连耳，而能为之行其津液，何也？岐伯曰∶足太阴者，三阴也，其脉贯
胃属脾络嗌，故太阴为之行气于三阴，（手足三阴之经也。）阳明者，表也，五脏六腑之海也，
亦为之行气于三阳。（手足三阳之经也）脏腑各因其经而受气于阳明，故为胃行其津液。四肢不
得禀水谷气，日以益衰，阴道不利，筋骨肌肉无气以生，故不用焉。（太阴阳明篇调经篇云∶
脾藏肉不足则四肢不用。示从容论云∶四肢懈惰，此脾精之不行也。）
脾虚四肢不用，治法并见前肺热条。
诸痿喘呕，皆属于上。（全文见诊。）
此即诸痿皆生于肺热之义。王注云∶上谓上焦，心肺气也。
运气 痿有三∶一曰热痿。经云∶少阴之复，少气骨痿。又云∶少阳之复，少气脉痿是也。
二曰湿痿。经云∶岁土太过，甚则病肌肉痿，足痿不收。又云∶土太过曰敦阜，敦阜之纪，
其病四肢不举。又云∶太阳司天之政，寒湿之气持于气交，民病寒湿发肌肉痿，足痿不收。四
之气，风湿交争，风化为雨，民病大热，少气，肌肉痿，足痿。又曰∶阳明司天之政，四之气，
寒雨降，民病骨痿是也。
三曰风制脾痿。经云∶厥阴司天，风气下临，脾气上从而土且隆，体重，肌肉痿是也。
〔《灵》〕阳明根于厉兑，结于颡大。颡大者，钳耳是也。（颡大谓额角入发际，头维二穴也，
以其钳束于耳上，故名钳耳也。）阳明为阖，阖折则气无所止息，而痿疾起矣。故痿疾者，取之
阳明，视有余不足，无所止息者，真气稽留，邪气居之也。足阳明根于厉兑，溜于冲阳，注于下
陵，入于人迎、丰隆也。（下陵，三里穴也。）手阳明根于商阳，溜于合谷，注于阳溪，入于扶
突、偏历也。盛络皆当取之。（根结篇）
刺痿经文，见前热条，今概举其略。
肺热叶焦，则肺喘鸣，生痿 ，色白而毛败者，补其荥鱼际，通其俞太渊，至秋病已。
心热生脉痿，数溲血，枢折不相提挈，胫纵不能任用于地，色赤而络脉溢者，补其荥劳宫，
通其俞大陵，至夏病已。
肝热生筋痿，下白淫，口苦筋急挛，色苍而爪枯者，补其荥行间，通其俞太冲，至春病已。
脾热生肉痿，干渴，肌肉不仁，色黄而蠕动者，补其荥大都，通其俞太白，至长夏病已。
肾热生骨痿，足不任身，腰脊不举，骨枯髓减，色黑而齿槁者，补其荥然谷，通其俞太溪，
至冬病已。
又痿 足不收，取之少阳阳明之别。经云∶足少阳之别，名曰光明，去踝五寸，别走厥阴，
虚则痿 ，坐不能起，取之所别也。又云∶淫泺脞痿，不能久立，治少阳之维，在外踝上五寸。
又云∶足阳明之别，名曰丰隆，去踝八寸，别走太阴。其病虚，则足不收胫枯，取之所别者是也。
骨酸懈惰，取足少阴髓海。经云∶少气身漯漯也，言吸吸也，骨酸懈惰不能动，补足少阴。
又云∶脑为髓之海，其俞上在于其盖，下在风府。髓海不足，则脑转耳鸣，胫酸，懈怠安卧，
审守其俞，而调其虚实者是也。百节弛纵，取脾手太阳之络。经云∶脾之大络，名曰大包，
出渊腋下腋三寸，布胸胁，虚则百节尽皆纵，此脉若罗络之血者，取之脾之大络也。又云∶手太
阳之别，名曰支正，上脘五寸，实则节弛肘废，取之所别者是也。
〔《甲》〕痿不相知，太白主之。（一云身重骨痿不相知。）足下缓失履，冲阳主之。足缓不
收，痿不能行，不能言语，手足痿 不能行，地仓主之。
肾脉微滑为骨痿，坐不能起，起则目无所见。（全文见治虚实法。）
〔丹〕断不可作风治，而用风药。
（唾液吐入水中下沉的，心腹绞痛并排出如烂肉状的血块的，都诊断为蛊毒。）
〔《千金方》〕治疗中蛊毒后下血如鸡肝样排出，其余四脏都已败坏，只有心脏尚未毁坏，或者鼻子破损等待死亡。取马蔺根研成粉末，用水送服一方寸匕的量，如果随呕吐物吐出则蛊毒可出，效果极灵验。这种植物苗叶类似葛藤，茎叶绿紫色，结出的果实像橘子。
〔梅〕治疗突然中蛊毒，下血如鸡肝样，昼夜不停，脏腑败坏濒临死亡。用白荷叶，秘密地安放在患者坐卧的席子下面，不要让患者察觉，患者自然会呼叫蛊主的姓名。
〔《百一选方》〕治疗中蛊毒，或吐血、下血如烂肝状的。取蚯蚓十四条，用醋三升浸泡，蚯蚓死后只服用其汁液，即使是已经死亡的也可以治愈。
〔《千金翼方》〕治疗蛊毒下血。将毛茛烧成灰末，用水送服一方寸匕的量，应当能吐出蛊毒。
〔《肘后备急方》〕治疗中蛊毒，吐血下血，都像烂肝一样的。取苦瓠一个，加水二升煮取一升，服用后呕吐即可痊愈。另一个方子，用醋一升，煮瓠使其溶解，服用效果神妙。
〔朱丹溪〕痿证属于湿热，有的伴有湿痰，有的是气虚，有的是血虚，有的是食积阻碍气机下降，有的是瘀血阻滞。
〔《黄帝内经·素问》〕黄帝问道：五脏都能使人发生痿证，为什么呢？岐伯回答说：肺主管身体的皮毛，心主管身体的血脉，肝主管身体的筋膜，脾主管身体的肌肉，肾主管身体的骨髓。所以肺热导致叶焦枯，则皮毛虚弱紧缩变薄，久留不去就生痿躄。心气热，则下部脉气厥逆而上行，上行则下部脉空虚，空虚就生脉痿，关节枢纽折断提挈不起，小腿纵缓不能站立于地。肝气热，则胆汁外泄口苦，筋膜干燥，筋膜干燥则筋脉拘急挛缩，发为筋痿。脾气热，则胃干而口渴，肌肉麻木不仁，发为肉痿。肾气热，则腰脊不能挺举，骨骼枯槁而髓液减少，发为骨痿。黄帝说：为什么会得这些病呢？岐伯说：肺是五脏的首长，是心的覆盖物，如果有失亡之事，所求不得，就会使肺气鸣响，鸣响则肺热叶焦。所以说：五脏因肺热叶焦，发为痿躄，说的就是这个道理。悲哀太甚，则胞络闭塞不通，胞络闭塞则阳气内动，发作时心下出血，频繁小便出血。所以《本病》篇说：大经空虚，发为肌痹，传变为脉痿；思虑无穷，所愿不得，意念淫乱于外，房事过度，宗筋弛纵，发为筋痿，以及产生白淫。所以《下经》说：筋痿生于肝，因房事过度所致。逐渐感受湿气，以水为业，如有邪气停留，居处潮湿，肌肉浸渍，麻痹而不仁，发为肉痿。所以《下经》说：肉痿得之于湿地。有远行劳倦，逢大热而渴，渴则阳气内伐，内伐则热舍于肾，肾是水脏，现在水不胜火，则骨枯而髓虚，所以足不能支撑身体，发为骨痿。所以《下经》说：骨痿生于大热。黄帝说：如何区别它们呢？岐伯说：肺热者面色白而毛发败落。心热者面色赤而络脉充盈溢露。肝热者面色青苍而指甲枯槁。脾热者面色黄而肌肉蠕动。肾热者面色黑而牙齿枯槁。黄帝说：论述中说治疗痿证独取阳明，为什么呢？岐伯说：阳明经是五脏六腑的海，主要滋润宗筋，宗筋主束骨而利关节。冲脉是经脉的海，主要渗灌溪谷，与阳明经会合于宗筋，阴阳总汇于宗筋之会，会合于气街穴，而阳明经为之统领，都隶属于带脉，而联络于督脉，所以阳明虚，则宗筋弛纵，带脉不能牵引，所以足痿不能使用。黄帝说：怎么治疗呢？岐伯说：分别补益各经的荣穴而通调其俞穴，调节虚实，调和逆顺，筋脉骨肉，各自在其当令的月份接受治疗，那么病就好了。黄帝说：好。（《痿论》）
有人问道：治疗痿证的方法，只取阳明一经，这是引用经文而未阐发的话，希望明示告诉我。我说：诸痿生于肺热。只这一句，就见治法大意。经文说：东方实则西方虚，泻南方，补北方。这固然是在五行生克上讲补泻，但大经大法，不外乎于此。东方木对应肝，西方金对应肺，南方火对应心，北方水对应肾。五方之中，只有火有二象。肾虽有两个，但水居其一，阳常有余，阴常不足，所以经文说一水不胜二火，是理所当然的。金体燥而居上，主气，畏火。土性温而居中，主四肢，也畏火。火性炎上，如果嗜欲无节制，则水失所养，火寡于畏而侮所胜，肺得火邪则热了。木性刚急，肺受热则失所养，木寡于畏而侮所胜，脾得木邪而受伤了。肺热则不能管摄一身，脾伤则四肢不能为用，而诸痿之病发作。泻南方（心火），则肺金清而东方（肝）不实，何来脾伤。补北方（肾水），则心火降而西方（肺）不虚，何来肺热。所以阳明实则宗筋润，能束骨而利关节了。治疗痿证的方法，没有超出这个范围的。骆龙吉也说：风火既炽，当滋肾水。东垣先生取黄柏为君药，黄芪等补药辅佐，以治诸痿，而没有一定的固定方剂。有的兼有痰积，有的湿多，有的热多，有的湿热相半，有的挟气滞，临病制方，善于治疗痿证的医生大概就是这样吧。虽然如此，药物切中病机了，如果调养失宜，医生也无法治愈。天产之物作阳，气味浓厚易发热，是先哲格言。但是患痿的人，如果不淡薄饮食滋味，我知道他一定不能安宁。
〔李东垣〕清暑益气汤、黄芪人参汤、清燥汤（三方并见注夏条）。
〔朱丹溪〕补益丸，治疗痿证。
龟板（酒炙，一两）、锁阳（酒浸，一两）、生地（酒浸，一两半）、归身（酒浸，一两）、陈皮（一两）、杜牛膝（酒浸，一两）、白术（二两）、干姜（七钱半）、黄柏（炒，半两）、虎胫骨（酒炙，半两）、五味子（二钱）、茯苓（半两）、白芍药（酒浸，一两）、甘草（炙，一钱）、菟丝子（酒蒸熟，研如糊，入余药末，晒干）。
以上药物研为细末，紫河车为丸。如果没有紫河车，猪脑骨髓也可以。
龙虎丹，治疗痿证。
败龟板（酒炙）、虎骨（酒炙）、黄柏（酒炙）、干姜（二钱半）、锁阳（七钱半）、金箔（十片）、神曲。如果懒言语，加山药末七钱。
以上研为细末，糯米粉糊为丸，空腹时用白开水送服。
虎潜丸
龟板（四两）、知母（二两）、黄柏（四两）、熟地（二两）、牛膝（三两半）、锁阳（一两）、虎骨（炙，一两）、当归（一两）、芍药（一两半）、陈皮（七钱半）、干姜（半两）。
以上研为细末，酒糊为丸。加附子，治疗痿厥如神效。
湿热痿，东垣健步丸加黄芩、黄柏、苍术。东垣补益肾肝丸，治疗脚膝无力。（二方并见痿厥条）。
丹溪认为气虚病痿，用四君子汤加苍术、黄芩、黄柏。血虚病痿，用四物汤加苍术、黄柏，送服补阴丸。《保命集》治疗脾虚四肢不用，用十全散，大概是治疗气血俱虚的。
〔王隐〕加减四斤丸，治疗肾肝虚，热淫于内，致筋骨痿弱，不能自持，起居需人帮助，足不能任地，惊恐战栗，潮热时作，饮食无味，不生力气，诸虚不足。
肉苁蓉（酒浸）、牛膝（酒浸）、木瓜、菟丝子（酒浸，另研）、鹿茸（燎去毛，切，酥炙）、熟地、天麻、五味子（酒浸，等分）。
以上研为细末，蜜丸如梧桐子大。每服五十丸，温酒或米汤在饭前送下。
王启玄传授《玄珠》中的耘苗丹三方。序言说：张仲景告诫人们不要妄服燥烈之药，谓药势偏有所助，胜克流变，则真病生焉，就像怜悯禾苗不长而拔高它一样。如果禀赋气血不强，适合服用此药而不服，是不除草的禾苗，故名为耘苗丹。此丹养五脏，补不足，秘固真元，均调二气，和畅营卫，保神守中。
五味子（半斤）、巴戟天（去心）、远志（去心）、枸杞子、山药、白茯苓、肉苁蓉（酒浸）、百部（酒浸一夜，焙干）、杜仲（炒，断丝）、蛇床子、防风（去芦）、柏子仁（另研）、菟丝子（酒浸，另研。各二两）。
以上研为细末，蜜丸如梧桐子大。饭前用温酒盐汤任下三十丸。春季用干枣汤送下，夏季加五味子四两，四季月加肉苁蓉六两，秋季加枸杞子六两。
卫生汤，补虚劳，强五脏，除烦热，养真元，退邪热，顺血脉。
当归、白芍药（各四两）、甘草（炙，一两）、黄芪（八两）。
年老者加酒半盏，同水煎服。
〔《经验方》〕治疗骨软风腰膝疼，行走不便，遍身搔痒。选用大而花纹好的何首乌，同牛膝锉碎各一斤，用好酒一升浸泡七宿后焙干，在木臼中捣成末，蜜丸，每日空腹饭前用酒送下三五十丸。
〔《保命集》〕四肢不举，俗曰瘫缓，所以经文说脾太过，则令人四肢不举。又说土太过则敦阜。阜，是高；敦，是厚。既厚又高，则令除去，这真是所谓的膏粱之疾，其治则是泻法，令气弱阳衰，土平而愈，或用三化汤、调胃承气汤，选择使用。如果是脾虚则不用，经文说土不及则卑陷。卑，是下；陷，是坑。所以脾病四肢不举。四肢皆禀气于胃，而不能至经，必因于脾，方能禀受。现在脾病不能与胃行其津液，四肢不得禀水谷气，气日日渐衰，脉道不利，筋骨肌肉皆无气以生，所以不用。其治疗可用十全散加减四物汤，去邪留正。
脾实病痿者。经文说：脾病者肉痿，足不收。又说：脾脉太过，则令人四肢不举。又说：其犯雨湿之地，则为痿者是也。
〔朱丹溪〕湿痰病痿。用二陈汤加苍术、白术、黄芩、黄柏之类，加入竹沥。
〔张子和〕陈下一武卒宋子玉，因驻军息城，六月间暴得痿病，腰膝两足皆不能用，沉重而不行，求治于我。我察其两手脉俱滑大而有力。我想《内经》说火淫于内，治以咸寒。用盐水越其膈间寒热宿痰，（新者为热，旧者为寒。）或是宿食宿饮。在上脘者，可以涌吐之。宿痰既尽，因而下之。节次间行，觉神志日清，饮食日美，两足渐举，脚膝渐伸，心降肾升。又继以黄连解毒汤加当归等药，及泻心汤、凉膈散、柴胡饮子，大作剂煎，时时呷之。
〔《保命集》〕心热盛则火独亢，火炎上，肾之脉常下行。现在火盛而上炎用事，故肾脉亦随火炎烁而逆上行，阴气厥逆，火复内焰，阴上隔阳，下不守位，心气通脉，故生脉痿，膝腕枢如折去而不相提挈，经筋纵缓而不任地故也，可下数百行而愈。
〔《黄帝内经·素问》〕黄帝说：脾病而四肢不用，为什么呢？岐伯说：四肢皆禀气于胃，而不得至经，必因于脾乃得禀也。现在脾病不能为胃行其津液，四肢不得禀水谷气，气日日渐衰，脉道不利，筋骨肌肉皆无气以生，所以不用。黄帝说：脾与胃以膜相连耳，而能为之行其津液，为什么呢？岐伯说：足太阴者，三阴也，其脉贯胃属脾络嗌，故太阴为之行气于三阴，（手足三阴之经也。）阳明者，表也，五脏六腑之海也，亦为之行气于三阳。（手足三阳之经也）脏腑各因其经而受气于阳明，故为胃行其津液。四肢不得禀水谷气，日以益衰，阴道不利，筋骨肌肉无气以生，所以不用。（《太阴阳明篇》《调经篇》云：脾藏肉不足则四肢不用。《示从容论》云：四肢懈惰，此脾精之不行也。）
诸痿喘呕，皆属于上。（全文见诊法部分）。
这就是诸痿皆生于肺热的意思。王冰注说：上谓上焦，心肺气也。
运气学说中，痿有三类：一曰热痿。经文说：少阴之复，少气骨痿。又说：少阳之复，少气脉痿是也。二曰湿痿。经文说：岁土太过，甚则病肌肉痿，足痿不收。又说：土太过曰敦阜，敦阜之纪，其病四肢不举。又说：太阳司天之政，寒湿之气持于气交，民病寒湿发肌肉痿，足痿不收。四之气，风湿交争，风化为雨，民病大热，少气，肌肉痿，足痿。又说：阳明司天之政，四之气，寒雨降，民病骨痿是也。三曰风制脾痿。经文说：厥阴司天，风气下临，脾气上从而土且隆，体重，肌肉痿是也。
〔《灵枢》〕阳明经根于厉兑穴，结于颡大穴。颡大者，即钳耳穴。（颡大指额角入发际的头维二穴，以其钳束于耳上，故名钳耳也。）阳明为阖，阖折则气无所止息，而痿疾起矣。所以痿疾者，取之阳明，视有余不足，无所止息者，真气稽留，邪气居之也。足阳明根于厉兑，溜于冲阳，注于下陵，入于人迎、丰隆也。（下陵，即三里穴也。）手阳明根于商阳，溜于合谷，注于阳溪，入于扶突、偏历也。盛络皆当取之。（见《根结篇》）
刺痿经文，见前热条，今概举其略。
肺热叶焦，则肺喘鸣，生痿躄，色白而毛败者，补其荥穴鱼际，通其俞穴太渊，至秋病已。
心热生脉痿，数溲血，枢折不相提挈，胫纵不能任用于地，色赤而络脉溢者，补其荥穴劳宫，通其俞穴大陵，至夏病已。
肝热生筋痿，下白淫，口苦筋急挛，色苍而爪枯者，补其荥穴行间，通其俞穴太冲，至春病已。
脾热生肉痿，干渴，肌肉不仁，色黄而蠕动者，补其荥穴大都，通其俞穴太白，至长夏病已。
肾热生骨痿，足不任身，腰脊不举，骨枯髓减，色黑而齿槁者，补其荥穴然谷，通其俞穴太溪，至冬病已。
又痿躄足不收，取之少阳阳明之别络。经文说：足少阳之别，名曰光明，去踝五寸，别走厥阴，虚则痿躄，坐不能起，取之所别也。又说：淫泺脞痿，不能久立，治少阳之维，在外踝上五寸。又说：足阳明之别，名曰丰隆，去踝八寸，别走太阴。其病虚，则足不收胫枯，取之所别者是也。
骨酸懈惰，取足少阴髓海。经文说：少气身漯漯也，言吸吸也，骨酸懈惰不能动，补足少阴。又说：脑为髓之海，其俞上在于其盖，下在风府。髓海不足，则脑转耳鸣，胫酸，懈怠安卧，审守其俞，而调其虚实者是也。
百节弛纵，取脾手太阳之络。经文说：脾之大络，名曰大包，出渊腋下腋三寸，布胸胁，虚则百节尽皆纵，此脉若罗络之血者，取之脾之大络也。又说：手太阳之别，名曰支正，上腕五寸，实则节弛肘废，取之所别者是也。
〔《甲乙经》〕痿不相知，太白主之。（一说身重骨痿不相知。）足下缓失履，冲阳主之。足缓不收，痿不能行，不能言语，手足痿躄不能行，地仓主之。
肾脉微滑为骨痿，坐不能起，起则目无所见。（全文见治虚实法条）。
〔朱丹溪〕断不可作风治，而用风药。
(Those whose saliva sinks when spat into water, and those experiencing severe heart and abdominal colic with bleeding resembling rotten meat, are all diagnosed as Gu poison.)
[Qianjin Fang] Treats Gu poisoning where blood is discharged like chicken liver, with the other four viscera ruined but the heart not yet destroyed, or with a broken nose awaiting death. Take powdered roots of Iris domestica (Malin), administer one cubic inch with water; if vomiting occurs, the Gu poison will be expelled. This is extremely effective. The plant resembles a vine like Pueraria lobata (Kudzu), with green-purple stems and leaves, bearing fruit resembling an orange.
[Mei] Treats sudden onset of Gu poisoning, with continuous day-and-night discharge of blood like chicken liver, and ruined viscera nearing death. Place a white lotus leaf secretly under the patient's mat without their knowledge; they will naturally call out the name of the master of the Gu poison.
[Bai Yi Xuan Fang] Treats Gu poisoning, whether vomiting or defecating blood resembling rotten liver. Take fourteen earthworms, soak them in three sheng of vinegar. After the worms die, consume only their juice. Even cases already considered fatal can be treated.
[Qianjin Yifang] Treats Gu poisoning with bleeding. Burn the herb Aconitum coreanum (Maoluo) to ash, take one cubic inch with water; this should induce vomiting of the Gu poison.
[Zhou Hou Bei Ji Fang] Treats Gu poisoning with hematemesis and hematochezia resembling rotten liver. Take one bitter bottle gourd (Ku Hu), boil in two sheng of water until one sheng remains, and drink it; vomiting will lead to recovery. Another prescription: boil the gourd in one sheng of vinegar until dissolved; this is highly effective.
Wei syndrome refers to flaccidity and weakness of the limbs, and laxity of joints unable to support movement.
[Zhu Danxi] Wei syndrome belongs to damp-heat. Some cases involve damp-phlegm, some qi deficiency, some blood deficiency, some food stagnation obstructing descending, and some fixed blood stasis.
[Huangdi Neijing Suwen] The Yellow Emperor asked: How do 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 sinews; the Spleen governs the muscles; the Kidney governs the bones and marrow. Therefore, if Lung heat causes the leaves to scorch, the skin and hair become weak, tight, and thin; if persistent, fei bi (wei syndrome) arises. If Heart qi is hot, lower vessel qi rebels upward; upward rebellion leads to emptiness in the lower vessels, resulting in mai wei (vessel wei); the joint pivot breaks and cannot lift, the tibia hangs loose and cannot bear weight. If Liver qi is hot, gallbladder bile leaks causing bitter taste, sinews dry up; dried sinews become tight and contracted, leading to jin wei (sinew wei). If Spleen qi is hot, the stomach dries causing thirst, muscles become insensate, leading to rou wei (muscle wei). If Kidney qi is hot, the waist and spine cannot erect, bones wither and marrow decreases, leading to gu wei (bone wei). The Emperor asked: How are these diseases acquired? Qibo said: The Lung is the chief of the zang organs and the cover of the Heart. Loss or unfulfilled desires cause Lung resonance; resonance leads to Lung heat and scorched leaves. Thus, it is said that the five zang organs develop fei bi due to Lung heat and scorched leaves. Profound sorrow severs the Bao Luo (pericardium collaterals); severance causes internal movement of Yang qi, leading to collapse from below and frequent bloody urination. Thus, Ben Bing states: Great vessels become empty, leading to ji bi (muscle bi), which transmits to mai wei. Endless thinking and unfulfilled desires, with mind wandering externally and excessive intercourse, cause relaxation of Zong Jin (general sinew), leading to jin wei and bai yin (white turbid discharge). Thus, Xia Jing states: Jin wei originates from the Liver due to sexual excess. Gradual exposure to dampness, working with water, with pathogenic factors lingering in damp dwellings, causes muscle maceration, numbness, and bi, leading to rou wei. Thus, Xia Jing states: Rou wei results from damp places. Long journeys and fatigue, encountering intense heat and thirst, cause internal attack by Yang qi; heat lodges in the Kidney. As the Kidney is the Water organ, now Water cannot overcome Fire, bones wither and marrow empties, so feet cannot support the body, leading to gu wei. Thus, Xia Jing states: Gu wei originates from great heat. The Emperor asked: How to distinguish them? Qibo said: Lung heat presents with white complexion and failed hair. Heart heat presents with red complexion and overflowing collateral vessels. Liver heat presents with dark-green complexion and withered nails. Spleen heat presents with yellow complexion and twitching muscles. Kidney heat presents with black complexion and withered teeth. The Emperor asked: Why does treatment of wei syndrome focus solely on the Yangming channel? Qibo said: The Yangming is the sea of the five zang and six fu organs, primarily moistening the Zong Jin. The Zong Jin binds bones and facilitates joint movement. The Chong Mai is the sea of the meridians, primarily infiltrating the xi gu (valleys), merging with Yangming at the Zong Jin. Yin and Yang converge at the Zong Jin, meeting at the Qichui point, with Yangming as the leader, all belonging to the Dai Mai and connecting to the Du Mai. Therefore, Yangming deficiency leads to Zong Jin laxity and Dai Mai failure to draw, causing foot wei and inability to use. The Emperor asked: How to treat? Qibo said: Tonify the Ying-spring points and unblock the Shu-stream points of each meridian, regulate deficiency and excess, harmonize reversal and smooth flow. Treating the sinews, vessels, bones, and muscles according to their respective months of influence will cure the disease. The Emperor said: Excellent. (Wei Lun Chapter)
Someone asked: The method for treating wei syndrome takes only the Yangming meridian. This cites the classic without elaboration; please explain clearly. I say: All wei syndromes originate from Lung heat. This single phrase reveals the general principle of treatment. The Classic says: When the East is excess, the West is deficient; drain the South, tonify the North. This discusses tonification and drainage based on generation and restriction, encompassing the fundamental principles. The East corresponds to Wood and the Liver; the West to Metal and the Lung; the South to Fire and the Heart; the North to Water and the Kidney. Among the five directions, only Fire has two aspects. Although there are two Kidneys, Water resides within, and Yang is often in excess while Yin is often deficient; thus, the Classic states one Water cannot overcome two Fires, which is logical. Metal is dry and located superiorly, governing Qi, and fears Fire. Earth is warm and central, governing the four limbs, and also fears Fire. Fire flares upward; if desires are unregulated, Water loses nourishment, Fire lacks restraint and overacts upon what it controls, causing Lung heat. Wood is rigid and urgent; when the Lung is heated and loses nourishment, Wood lacks restraint and overacts upon what it controls, injuring the Spleen. Lung heat fails to govern the whole body; Spleen injury prevents the four limbs from functioning, giving rise to various wei syndromes. Draining the South clears Lung Metal and prevents East excess, avoiding Spleen injury. Tonifying the North descends Heart Fire and prevents West deficiency, avoiding Lung heat. Thus, Yangming excess moistens Zong Jin, binding bones and facilitating joints. Treatment of wei syndrome does not exceed this principle. Luo Longji also said: When wind and fire are blazing, one must nourish Kidney Water. Dongyuan used Huang Bo (Phellodendron Bark) as the sovereign herb, assisted by tonics like Huang Qi (Astragalus Root), to treat various wei syndromes, without a fixed formula. Cases may involve phlegm accumulation, dampness predominance, heat predominance, equal damp-heat, or qi constraint. Physicians skilled in treating wei adjust formulas case by case. Although the medication hits the target, improper management renders medical treatment ineffective. Animal products generate Yang and have strong flavors promoting heat, as stated by ancient sages. However, patients with wei syndrome who do not eat bland diets will surely not recover.
[Dongyuan] Qing Shu Yi Qi Tang (Clear Summerheat and Boost Qi Decoction), Huang Qi Ren Shen Tang (Astragalus and Ginseng Decoction), Qing Zao Tang (Clear Dryness Decoction) (See Zhu Xia chapter for details).
[Danxi] Bu Yi Wan (Tonify and Benefit Pill) treats wei syndrome.
Gui Ban (Tortoise Shell, prepared with wine, 1 liang), Suo Yang (Cynomorium Herb, soaked in wine, 1 liang), Sheng Di Huang (Rehmannia Root, soaked in wine, 1.5 liang), Gui Shen (Angelica Sinensis Root Tip, soaked in wine, 1 liang), Chen Pi (Citrus Peel, 1 liang), Du Niu Xi (Cyathula Root, soaked in wine, 1 liang), Bai Zhu (Atractylodes Macrocephala Rhizome, 2 liang), Gan Jiang (Dried Ginger, 7.5 qian), Huang Bo (Phellodendron Bark, stir-fried, 0.5 liang), Hu Jing Gu (Tiger Bone, prepared with wine, 0.5 liang), Wu Wei Zi (Schisandra Fruit, 2 qian), Fu Ling (Poria, 0.5 liang), Bai Shao Yao (White Peony Root, soaked in wine, 1 liang), Gan Cao (Licorice Root, roasted, 1 qian), Tu Si Zi (Dodder Seed, steamed in wine until cooked, ground into paste, mixed with other powders, dried).
Grind all herbs into powder, form pills using Zi He Che (Human Placenta). If Human Placenta is unavailable, pig brain and bone marrow may be used.
Long Hu Dan (Dragon and Tiger Pill) treats wei syndrome.
Bai Gui Ban (Old Tortoise Shell, prepared with wine), Hu Gu (Tiger Bone, prepared with wine), Huang Bo (Phellodendron Bark, prepared with wine), Gan Jiang (Dried Ginger, 2.5 qian), Suo Yang (Cynomorium Herb, 7.5 qian), Jin Po (Gold Leaf, 10 pieces), Shen Qu (Medicated Leaven). If speech is lazy, add Shan Yao (Dioscorea Rhizome) powder, 7 qian.
Grind into powder, form pills with glutinous rice paste. Take with plain warm water on an empty stomach.
Hu Qian Wan (Tiger Crouching Pill)
Gui Ban (Tortoise Shell, 4 liang), Zhi Mu (Anemarrhena Rhizome, 2 liang), Huang Bo (Phellodendron Bark, 4 liang), Shu Di Huang (Prepared Rehmannia Root, 2 liang), Niu Xi (Achyranthes Root, 3.5 liang), Suo Yang (Cynomorium Herb, 1 liang), Hu Gu (Tiger Bone, roasted, 1 liang), Dang Gui (Angelica Sinensis Root, 1 liang), Shao Yao (Peony Root, 1.5 liang), Chen Pi (Citrus Peel, 7.5 qian), Gan Jiang (Dried Ginger, 0.5 liang).
Grind into powder, form pills with wine paste. Add Fu Zi (Aconite Lateral Root) for wei jue (wei with cold extremities) with miraculous effect.
For damp-heat wei, Dongyuan's Jian Bu Wan (Brisk Walking Pill) added with Huang Qin (Scutellaria Root), Huang Bo (Phellodendron Bark), and Cang Zhu (Atractylodes Lancea Rhizome). Dongyuan's Bu Yi Shen Gan Wan (Tonify Kidney and Liver Pill) treats weak knees and ankles. (See Wei Jue chapter for both formulas).
Xiao Bing's Shen Gui Zi Yin Wan (Divine Tortoise Nourishing Yin Pill) (See Yan Xia chapter).
Danxi states: For qi deficiency wei, use Si Jun Zi Tang (Four Gentlemen Decoction) plus Cang Zhu (Atractylodes Lancea Rhizome), Huang Qin (Scutellaria Root), and Huang Bo (Phellodendron Bark). For blood deficiency wei, use Si Wu Tang (Four Substances Decoction) plus Cang Zhu (Atractylodes Lancea Rhizome) and Huang Bo (Phellodendron Bark), followed by Bu Yin Wan (Nourish Yin Pill). Baoming Ji states: For Spleen deficiency causing limb paralysis, use Shi Quan San (Ten Complete Powder), treating combined qi and blood deficiency.
[Wu Yin] Jia Jian Si Jin Wan (Modified Four-Jin Pill) treats Kidney and Liver deficiency with internal heat invasion, causing weak sinews and bones, inability to hold oneself, needing assistance for daily activities, inability to bear weight, fear, trembling, tidal fever, loss of appetite, lack of energy, and general deficiency.
Rou Cong Rong (Cistanche Stem, soaked in wine), Niu Xi (Achyranthes Root, soaked in wine), Mu Gua (Chaenomeles Fruit), Tu Si Zi (Dodder Seed, soaked in wine, ground separately), Lu Rong (Deer Antler, singed, trimmed, prepared with butter), Shu Di Huang (Prepared Rehmannia Root), Tian Ma (Gastrodia Rhizome), Wu Wei Zi (Schisandra Fruit, soaked in wine, equal parts).
Grind into powder, form honey pills the size of sesame seeds. Take 50 pills with warm wine or rice soup before meals.
Wang Xuanyuan transmitted three formulas of Yun Miao Dan (Weeding Pill) from Xuan Zhu. The preface states: Zhang Zhongjing warned against reckless use of drying and acrid drugs, as drug bias aids imbalance, altering normal transformation and generating true disease, like pulling seedlings to help them grow. Those with weak qi and blood who should take this but do not are like uncultivated fields, hence named Yun Miao Dan. This pill nourishes the five zang, tonifies deficiency, secures true yuan, balances yin and yang, harmonizes ying and wei, protects spirit, and maintains centrality.
Wu Wei Zi (Schisandra Fruit, 8 liang), Ba Ji Tian (Morinda Root, decentered), Yuan Zhi (Polygala Root, decentered), Gou Qi Zi (Goji Berry), Shan Yao (Dioscorea Rhizome), Bai Fu Ling (Poria, dehusked), Rou Cong Rong (Cistanche Stem, soaked in wine), Bai Bu (Stemona Root, soaked overnight, dried), Du Zhong (Eucommia Bark, stir-fried until fibers break), She Chuang Zi (Cnidium Fruit), Fang Feng (Saposhnikovia Root, de-rustled), Bai Zi Ren (Biota Seed, ground separately), Tu Si Zi (Dodder Seed, soaked in wine, ground separately. Each 2 liang).
Grind into powder, form honey pills the size of sesame seeds. Take 30 pills with warm wine and salt water before meals. In spring, take with dried jujube soup; in summer, add 4 liang of Wu Wei Zi; in seasonal months, add 6 liang of Rou Cong Rong; in autumn, add 6 liang of Gou Qi Zi.
Wei Sheng Tang (Health Preservation Decoction) tonifies deficiency and勞 (fatigue), strengthens five zang, removes irritability and heat, nourishes true yuan, dispels pathogenic heat, and smooths blood vessels.
Dang Gui (Angelica Sinensis Root), Bai Shao Yao (White Peony Root, each 4 liang), Gan Cao (Licorice Root, roasted, 1 liang), Huang Qi (Astragalus Root, 8 liang).
For the elderly, add half cup of wine, decoct with water.
[Xiao Bing] Dan Shen Jiu (Salvia Wine) for soft legs. (See Wei Jue chapter).
[Jing Fang] Treats bone-soft wind, waist and knee pain, difficulty walking, and generalized itching. Select large He Shou Wu (Polygonum Multiflorum Root) with distinct patterns, chop equally with Niu Xi (Achyranthes Root), each 1 jin. Soak in 1 sheng of good wine for seven nights, dry, grind in a wooden mortar into powder, form honey pills. Take 30-50 pills with wine on an empty stomach before meals daily.
[Baoming Ji] Limbs unable to move, commonly called tan huan (paralysis/flaccidity). Thus, the Classic states: Spleen excess causes limb paralysis. Also: Earth excess leads to Dun Fu (high mounds). Fu means high; Dun means thick. High and thick implies removal; this is truly a disease of rich food, treated by purging to weaken qi and yang, flattening earth for recovery. Use San Hua Tang (Three Transformations Decoction) or Tiao Wei Cheng Qi Tang (Regulate Stomach and Direct Downward Decoction) as appropriate. If Spleen deficiency, do not purge. The Classic states: Earth deficiency leads to Bei Xian (low depressions). Bei means low; Xian means pit. Thus, Spleen disease causes limb paralysis. The four limbs receive qi from the Stomach but cannot reach the meridians directly; they rely on the Spleen to transmit. Now, Spleen disease fails to transport fluids for the Stomach; limbs do not receive grain qi; qi declines daily, vessel pathways become obstructed, sinews, bones, and muscles lack qi to generate, hence unusable. Treatment can use Shi Quan San (Ten Complete Powder) modified with Si Wu Tang (Four Substances Decoction) to eliminate pathogen and preserve righteousness.
Spleen excess causing wei. The Classic says: Spleen disease causes rou wei (muscle wei) and foot inability to grasp. Also: Spleen pulse excess causes limb paralysis. Also: Exposure to rain and dampness causes wei.
[Danxi] Damp-phlegm wei. Use Er Chen Tang (Two Aged Herbs Decoction) plus Cang Zhu (Atractylodes Lancea Rhizome), Bai Zhu (Atractylodes Macrocephala Rhizome), Huang Qin (Scutellaria Root), Huang Bo (Phellodendron Bark), etc., adding Zhu Li (Bamboo Juice).
[Dou Men Fang] Shang Lu Fan (Phytolacca Rice) treats soft legs. (See Wei Jue chapter).
[Hezi] Song Ziyu, a soldier stationed at Xicheng in June, suddenly developed wei syndrome; waist, knees, and legs were useless, heavy and immobile. Seeking my treatment, I found his pulses slippery, large, and forceful in both hands. Recalling Neijing: "Fire invading internally is treated with salty-cold." I used saline water to induce vomiting of cold-heat and old phlegm between the diaphragm (new is heat, old is cold), or retained food/drink. For retention in the upper jiao, emesis is indicated. After old phlegm was cleared, I proceeded with purgation. Gradually, consciousness cleared, appetite improved, legs lifted, knees extended, heart descended, kidney ascended. Then, I administered Huang Lian Jie Du Tang (Coptis Decoction for Detoxification) plus Dang Gui (Angelica Sinensis Root), etc., along with Xie Xin Tang (Drain Epigastrium Decoction), Liang Ge San (Cool Chest Powder), and Chai Hu Yin Zi (Bupleurum Drink), brewed strongly, taken frequently in small sips.
[Baoming Ji] Excessive Heart heat causes solitary fire hyperactivity; fire flares upward. Kidney vessels normally descend. Now, fire is excessive and flares, causing Kidney vessels to rebel upward with fire. Yin qi rebels, fire flames internally, yin separates above yang, lower fails to maintain position. Heart qi connects to vessels, causing mai wei (vessel wei). Knee and ankle pivots seem broken and disconnected; tendons relax and cannot bear weight. Purging several hundred lines restores health.
[Danxi] Wei syndrome caused by food stagnation obstructing descent, or fixed blood stasis, both require purgation.
[Suwen] The Emperor asked: Why does Spleen disease cause limb paralysis? Qibo said: The four limbs receive qi from the Stomach but cannot reach the meridians directly; they rely on the Spleen to transmit. Now, Spleen disease fails to transport fluids for the Stomach; limbs do not receive grain qi; qi declines daily, vessel pathways become obstructed, sinews, bones, and muscles lack qi to generate, hence unusable. The Emperor asked: The Spleen and Stomach are connected by membrane, how does it transport fluids? Qibo said: Foot Taiyin is one of the three yin meridians; its vessel penetrates the Stomach, belongs to the Spleen, and connects to the throat. Thus, Taiyin transports qi to the three yin (hand and foot yin meridians). Yangming is exterior, the sea of five zang and six fu, also transporting qi to the three yang (hand and foot yang meridians). Zang and fu receive qi from Yangming via their respective channels, thus transporting fluids for the Stomach. Limbs not receiving grain qi decline daily, yin pathways obstructed, sinews, bones, and muscles lack qi, hence unusable. (Taiyin Yangming Pian, Tiao Jing Pian: Spleen flesh deficiency causes limb paralysis. Shi Cong Rong Lun: Limb lethargy is due to Spleen essence failing to circulate.)
Spleen deficiency causing limb paralysis; treatment methods are seen in the Lung Heat section above.
All wei, wheezing, and vomiting belong to the Upper Jiao. (Full text in Diagnosis section).
This means all wei syndromes originate from Lung heat. Wang Bing's commentary states: Upper refers to Upper Jiao, Heart and Lung qi.
In Yunqi (Five Movements and Six Qi) theory, there are three types of wei: First, Re Wei (Heat Wei). The Classic states: Shaoyin counteraction causes shortness of breath and gu wei (bone wei). Also: Shaoyang counteraction causes shortness of breath and mai wei (vessel wei). Second, Shi Wei (Damp Wei). The Classic states: Year of Earth excess causes severe muscle wei and foot inability to grasp. Also: Earth excess is called Dun Fu; in the era of Dun Fu, disease is limb paralysis. Also: Taiyang ruling heaven, cold-damp air holds at qi intersection, people suffer cold-damp muscle wei and foot inability to grasp. Fourth qi, wind-damp contend, wind turns to rain, people suffer great heat, shortness of breath, muscle wei, foot wei. Also: Yangming ruling heaven, fourth qi, cold rain descends, people suffer gu wei (bone wei). Third, Feng Zhi Pi Wei (Wind Restricting Spleen Wei). The Classic states: Jueyin ruling heaven, wind qi descends, Spleen qi ascends following it, earth rises, body feels heavy, muscle wei occurs.
[Lingshu] Yangming roots at Lidui (ST45), knots at Sangda. Sangda refers to Qian'er (Ear-Pincer). (Sangda refers to Touwei (ST8) at the forehead corner entering the hairline, named Qian'er because it pincers the ear). Yangming is the Closing mechanism; if Closing breaks, qi has no resting place, and wei disease arises. Therefore, for wei disease, select Yangming, observe excess or deficiency. Where qi does not rest, true qi stagnates, and pathogenic qi resides. Foot Yangming roots at Lidui (ST45), flows through Chongyang (ST42), notes at Xialing (ST36), enters Renying (ST9) and Fenglong (ST40). (Xialing is Zusanli ST36). Hand Yangming roots at Shangyang (LI1), flows through Hegu (LI4), notes at Yangxi (LI5), enters Futu (LI18) and Pianli (LI6). Full vessels should be selected. (See Genjie Chapter).
Acupuncture for wei text is seen in the Heat section above; here is a brief summary.
Lung heat scorches leaves, causing lung wheezing and sound, generating fei bi (wei with foot paralysis), white complexion, and failed hair. Tonify Ying-spring Yuji (LU10), unblock Shu-stream Taiyuan (LU9). Disease resolves in autumn.
Heart heat generates mai wei (vessel wei), frequent bloody urination, broken pivot unable to lift, tibia loose unable to bear weight, red complexion, and overflowing collaterals. Tonify Ying-spring Laogong (PC8), unblock Shu-stream Daling (PC7). Disease resolves in summer.
Liver heat generates jin wei (sinew wei), white turbid discharge, bitter taste, sinew tightness and contraction, dark-green complexion, and withered nails. Tonify Ying-spring Xingjian (LR2), unblock Shu-stream Taichong (LR3). Disease resolves in spring.
Spleen heat generates rou wei (muscle wei), dry mouth/thirst, muscle insensibility, yellow complexion, and twitching. Tonify Ying-spring Dadu (SP3), unblock Shu-stream Taibai (SP3). Disease resolves in late summer.
Kidney heat generates gu wei (bone wei), feet unable to support body, waist/spine unable to erect, withered bones, decreased marrow, black complexion, and withered teeth. Tonify Ying-spring RanGu (KI2), unblock Shu-stream Taixi (KI3). Disease resolves in winter.
For fei bi (wei with foot paralysis) and foot inability to grasp, select the divergent vessels of Shaoyang and Yangming. The Classic states: Foot Shaoyang divergent is named Guangming (GB37), 5 cun above the ankle, diverging to Jueyin. Deficiency causes fei bi, sitting unable to rise; select the divergent point. Also: Yinlu suo wei (dizziness and flaccidity), unable to stand long; treat Shaoyang Weimai (Linking Vessel) 5 cun above lateral malleolus. Also: Foot Yangming divergent is named Fenglong (ST40), 8 cun above ankle, diverging to Taiyin. Deficiency causes foot inability to grasp and dry tibia; select the divergent point.
Bone soreness and lethargy, select Foot Shaoyuan Sea of Marrow. The Classic states: Shortness of breath, body limp, gasping, bone soreness, lethargy, inability to move; tonify Foot Shaoyin. Also: Brain is the Sea of Marrow; its Shu points are above at the crown and below at Fengfu (DU16). Marrow sea deficiency causes dizziness, tinnitus, leg soreness, lethargy, and desire to lie down; carefully secure its Shu points and regulate deficiency/excess.
Joint laxity, select the Luo-connecting vessel of Spleen and Hand Taiyang. The Classic states: Spleen's great Luo is named Dabao (SP21), emerging 3 cun below Yuze, spreading over chest and hypochondrium. Deficiency causes all joints to relax; this vessel resembles net-like blood; select Spleen's great Luo. Also: Hand Taiyang divergent is named Zhizheng (SI7), 5 cun above wrist. Excess causes joint laxity and elbow waste; select the divergent point.
[Jiayi Jing] Wei with loss of sensation, Taibai (SP3) governs. (Another version: Body heaviness, bone wei, loss of sensation). Feet slow, losing shoes, Chongyang (ST42) governs. Feet slow unable to grasp, wei unable to walk, unable to speak, hand/foot wei unable to walk, Dicang (ST4) governs.
Kidney pulse slightly slippery indicates gu wei (bone wei), sitting unable to rise, rising then eyes see nothing. (Full text in Treating Deficiency and Excess chapter).
[Danxi] Absolutely do not treat as wind syndrome using wind-dispelling drugs.