五脏各有所合，皆能使人痿。（痿者，痿弱无力，举动不能也。）故肺热叶焦，则毛皮虚弱急薄，
着则生痿 也。（肺痿者，皮毛痿也，盖热乘肺金，在内则为叶焦，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，则病生痿 。 者，足弱不能行也。）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
不在地也。（心痿者，脉痿也。心气热则火独上炎，故三阴在下之脉，亦皆厥逆上，上逆则下虚，乃生脉痿，
脉痿者，凡四肢关节之处。如枢纽之折而不能提掣，足胫纵缓而不能任地也。）肝气热，则胆泄口苦，筋
膜干，筋膜干则筋急而挛，发为筋痿。（肝痿者，筋痿也。胆附于肝，肝气热则胆汁溢泄，故为口苦；筋
膜受热则血液干燥，故拘急而挛，为筋痿也。）脾气热，则胃干而渴，肌肉不仁，发为肉痿。（脾痿
者，肉痿也。脾与胃以膜相连而开窍于口；故脾气热则胃干而渴。脾主肌肉，今热蓄于内则精气耗伤，故肌
肉不仁，发为肉痿。）肾气热，则腰脊不举，骨枯而髓减，发为骨痿。（肾痿者，骨痿也。腰者肾之府，
其脉贯脊，其主骨髓，故肾气热则见症若此。）何以得之？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，发为痿 。（肺位最高，故谓之长；覆于心上，故谓之盖。肺志不伸，则
气郁生火，故喘息有声，发为肺鸣。金脏病则失其清肃之化，故热而叶焦，五脏之阴皆为之不足，此痿 之生
于肺也。）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。（胞络者，子宫之络脉也。
胞脉属心而络于胞中，故悲哀太甚则心系急而胞络绝，上下不交，亢阳内动，逼血下崩，令人数为溺血也。）
故大经空虚，发为肌痹，传为脉痿。（血失则大经空虚，无以渗灌肌肉，荣养脉络，故先为肌肉顽痹，而后传
为脉痿者，生于心也。）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。（思想无穷，所愿不得，欲不遂也。意淫于外，入房太甚，阴气伤也，故宗筋弛纵，发为筋痿。宗
筋者，聚于前阴。精伤于内，气陷于下，故为白淫，即今之所谓带浊也。）故曰筋痿者，生于肝使内也。
（肝主筋，故使内，而筋痿者，生于肝也。）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。（渐，有由来也。以水为事，从事于卑湿之所也。相，并也。脾主肌肉而恶湿，
湿着于肉则卫气不荣，故肌肉顽痹而为肉痿。渍，早四切。）故曰肉痿者，得之湿地也。（地之湿气，感则
害皮肉筋脉，病生于脾也。）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。（远行劳倦，最能生热。阳盛则内伐真
阴，水不胜火，故主于肾。）故曰骨痿者，生于大热也。（热甚则精髓干涸，故骨枯而为痿病，生于肾也。）
何以别之？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。（蠕，音软，微动貌。）言治痿者，独取阳明，（此下言治痿之法也。）
以阳明为五脏六腑之海，主润宗筋，宗筋主束骨而利机关也。（阳明，胃脉也，主纳水谷，化气
血，以资养表里，故为五脏六腑之海而下润宗筋。宗筋者，前阴所聚之筋也，为诸筋之会，凡腰脊溪谷之筋皆
属于此，故主束骨而利机关也。）冲脉者，经脉之海也，主渗灌溪谷，与阳明合于宗筋。（经脉之
海者，冲脉为十二经之血海也，故主渗灌溪谷。冲脉起于气街，并少阴之经挟脐上行，阳明脉亦挟脐旁去中行
二寸下行，故皆会于宗筋。）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。（宗筋聚于前阴。前阴者，足之三阴、阳明、少阳及冲、任、督、跷九脉之所会也，九者之中，则阳
明为五脏六腑之海，冲为经脉之海，此一阴一阳，总乎其间，故曰“阴阳总宗筋之会”也。会于气街者，气
街为阳明之正脉，故阳明独为之长。带脉者，起于季胁，围身一周；督脉者，起于会阴，分三歧为任、冲，
而上行腹背，故诸经者，皆联属于带脉，支络于督脉也。）故阳明虚则宗筋纵，带脉不引，故足痿不用也。
（阳明虚则血气少，不能润养宗筋，故至弛纵。宗筋纵则带脉不能收引，故足痿不为用，此所以当治阳明也。
）治之各补其荣而通其俞，调其虚实，和其逆顺。筋脉骨肉，各以其时受月，则病已矣。（诸经
之所溜为荣，所注为俞。补者所以致气，通者所以行气，上文云“独取阳明”，此复云“各补其荣而通其俞”，
盖治痿者当取阳明，又必察其所受之经而兼治之可也。）
五脏各有其相合的组织，都能导致人发生痿证。（痿证，是指肢体痿弱无力，动作无法完成。）所以肺受热邪熏灼而叶焦，则皮毛虚弱、紧缩变薄，若热邪留滞不去，就会发展为痿躄。（肺痿，是指皮毛的痿弱，大概是因为热邪侵犯肺金，在内表现为肺叶焦枯，在外表现为皮毛虚弱而紧缩变薄；如果热邪留滞不去并波及筋脉骨肉，就会产生痿躄病。痿躄，是指足部软弱不能行走。）心气有热，则下部血脉厥逆而上行，上行后下部血脉空虚，空虚则产生脉痿，表现为关节枢纽折断般提举无力，小腿纵缓而不能着地站立。（心痿，就是脉痿。心气热则火气独自上炎，所以下部三阴经的血脉也都厥逆向上，上逆则下部空虚，于是产生脉痿。脉痿，是指在四肢关节处，像枢纽折断一样不能提掣，小腿纵缓不能支撑身体站立。）肝气有热，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。（肝痿，就是筋痿。胆附于肝，肝气热则胆汁溢泄，所以口苦；筋膜受热则血液干燥，所以拘急挛缩，成为筋痿。）脾气有热，则胃干口渴，肌肉麻木不仁，发为肉痿。（脾痿，就是肉痿。脾与胃以膜相连且开窍于口；所以脾气热则胃干口渴。脾主肌肉，现在热邪蓄积在体内则精气耗伤，所以肌肉麻木不仁，发为肉痿。）肾气有热，则腰脊不能挺举，骨骼枯槁而骨髓减少，发为骨痿。（肾痿，就是骨痿。腰部是肾的外府，其经脉贯穿脊柱，主管骨髓，所以肾气热则出现上述症状。）为什么会得这些病呢？肺是五脏之长，覆盖在心之上。如果有丧失亡失之事，或所求不得，就会导致肺气鸣响，鸣响则肺热叶焦，发为痿躄。（肺的位置最高，所以称为长；覆盖在心之上，所以称为盖。肺志意不舒伸，则气郁生火，所以喘息有声，发为肺鸣。肺属金脏，患病则失去清肃的功能，所以发热而肺叶焦枯，五脏之阴都因此不足，这就是痿躄生于肺的原因。）悲哀太过，则胞络断绝，胞络断绝则阳气在内扰动，发作时心下血崩，频繁尿血。（胞络，是子宫的络脉。胞脉属于心而联络于胞中，所以悲哀太过则心系紧急而胞络断绝，上下不通，亢盛的阳气在内扰动，逼迫血液下崩，使人频繁溺血。）所以大经空虚，发为肌痹，进而传变为脉痿。（失血则大经空虚，无法渗灌肌肉、荣养脉络，所以先为肌肉顽痹，而后传变为脉痿，这是生于心的原因。）思虑无穷，愿望不得实现，意念淫逸于外，房事过度，宗筋弛缓纵缓，发为筋痿，以及白淫。（思虑无穷，愿望不得实现，欲望不能遂意。意念淫逸于外，房事过度，损伤阴气，所以宗筋弛缓纵缓，发为筋痿。宗筋，聚集在前阴。精气内伤，气陷于下，所以出现白淫，即现在的所谓带下浊物。）所以说筋痿，是由于肝经受邪且房劳过度所致。（肝主筋，所以房劳过度，筋痿就生于肝。）有人逐渐感受湿邪，从事与水有关的工作，或者居住在潮湿的地方，肌肉被湿气浸渍，麻痹而不仁，发为肉痿。（渐，是有由来。以水为事，是从事于低洼潮湿的地方。相，是并的意思。脾主肌肉而厌恶湿气，湿气附着于肌肉则卫气不能荣养，所以肌肉顽痹而成为肉痿。渍，音zì。）所以说肉痿，是由于居住在湿地所致。（地的湿气，感之则伤害皮肉筋脉，病生于脾。）有人远行劳倦，遇到大热而口渴，口渴则阳气在内攻伐，内攻伐则热邪停留于肾；肾是水脏，现在水不胜火，则骨骼枯槁而骨髓空虚，所以脚不能支撑身体，发为骨痿。（远行劳倦，最能生热。阳盛则内伐真阴，水不胜火，所以病主于肾。）所以说骨痿，是由于大热所致。（热甚则精髓干涸，所以骨骼枯槁而成为痿病，病生于肾。）如何辨别它们呢？肺热的人，面色白而毛发败坏；心热的人，面色赤而络脉充盈溢出；肝热的人，面色青苍而指甲枯槁；脾热的人，面色黄而肌肉微微蠕动；肾热的人，面色黑而牙齿枯槁。（蠕，音ruǎn，微动的样子。）说治疗痿证，要独取阳明经，（这里下文讲治疗痿证的方法。）因为阳明经是五脏六腑的海，主要滋润宗筋，宗筋主要约束骨骼而利于关节运动。（阳明，指胃脉，主要受纳水谷，化生气血，以滋养表里，所以是五脏六腑的海而下润宗筋。宗筋，是前阴聚集的筋，是诸筋的会合之处，凡是腰脊溪谷的筋都属于此，所以主要约束骨骼而利于关节运动。）冲脉，是十二经脉的海，主要渗灌溪谷，与阳明经会合于宗筋。（经脉的海，冲脉是十二经的血海，所以主要渗灌溪谷。冲脉起于气街，并少阴经挟脐上行，阳明脉也挟脐旁距中行二寸下行，所以都会在宗筋处会合。）阴阳总汇于宗筋，会合于气街，而阳明经为之主导，都归属于带脉，而联络于督脉。（宗筋聚集于前阴。前阴，是足三阴、阳明、少阳及冲、任、督、跷九条经脉会合的地方，九条之中，阳明是五脏六腑的海，冲脉是十二经脉的海，这一阴一阳，总括于其间，所以说“阴阳总汇于宗筋”。会合于气街，气街是阳明经的正脉，所以阳明经单独为之主导。带脉，起于季胁，环绕身体一周；督脉，起于会阴，分三歧为任、冲，而上行腹背，所以各条经脉，都联属于带脉，支络于督脉。）所以阳明经虚则宗筋弛缓，带脉不能收引，所以足部痿废不能使用。（阳明虚则气血少，不能润养宗筋，所以至弛缓。宗筋弛缓则带脉不能收引，所以足部痿废不能用，这就是所以要治疗阳明经的原因。）治疗时分别补益各经的荣穴而疏通其俞穴，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，病就好了。（各经气血所流注的为荣，所灌注的为俞。补法是用来致气，通法是用来行气，上文说“独取阳明”，这里又说“各补其荣而通其俞”，大概意思是治疗痿证应当取阳明经，又必须观察其所受的经脉而兼治它才行。）
Each of the five zang organs has its corresponding tissue, and all can cause Wei syndrome (Wei syndrome: a syndrome characterized by flaccidity and weakness of the limbs). Therefore, if lung heat scorches the lung leaves, the skin and hair become weak, tight, and thin; if the heat lingers and does not depart, it develops into Wei bi (Wei bi: flaccidity of the lower limbs, inability to walk). Lung Wei refers to the flaccidity of the skin and hair; this is because heat invades the Lung Metal, causing scorching of the lung leaves internally, and weakness and tightness of the skin and hair externally. If the pathogenic heat lingers and affects the sinews, vessels, bones, and flesh, Wei bi disease arises. Wei bi refers to the weakness of the legs and inability to walk. Heart Qi heat causes the vessels in the lower body to reverse and flow upward; when they flow upward, the lower vessels become deficient, leading to Mai Wei (Mai Wei: flaccidity of the vessels), where the joint pivot breaks and cannot be lifted, the shins are relaxed and cannot support the body on the ground. Heart Wei is Mai Wei. Heat in Heart Qi causes fire to flare up alone, so the vessels of the three Yin meridians below also reverse and flow upward; upward reversal leads to deficiency below, generating Mai Wei. In Mai Wei, at the joints of the four limbs, it is like a broken pivot that cannot be lifted; the shins are relaxed and cannot bear weight. Liver Qi heat causes bile to leak and bitter taste in the mouth, and the sinew membranes dry out. When sinew membranes dry, the sinews become tight and contract, developing into Jin Wei (Jin Wei: flaccidity of the sinews). Liver Wei is Jin Wei. The Gallbladder attaches to the Liver; Liver Qi heat causes bile to overflow and leak, resulting in a bitter taste. Sinew membranes heated by fire cause blood to dry, leading to contraction and cramping, becoming Jin Wei. Spleen Qi heat causes the stomach to dry and thirst, and muscles to lose sensation, developing into Rou Wei (Rou Wei: flaccidity of the muscles). Spleen Wei is Rou Wei. The Spleen and Stomach are connected by membranes and open into the mouth; thus, Spleen Qi heat causes stomach dryness and thirst. The Spleen governs the muscles; now heat accumulates internally, consuming essence and qi, so muscles lose sensation, developing into Rou Wei. Kidney Qi heat causes the waist and spine to be unable to rise, bones to wither, and marrow to decrease, developing into Gu Wei (Gu Wei: flaccidity of the bones). Kidney Wei is Gu Wei. The waist is the mansion of the Kidney, its meridian penetrates the spine, and it governs bone marrow; thus, Kidney Qi heat presents with these symptoms. How are these conditions acquired? The Lung is the chief of the zang organs and covers the Heart. If there is loss or unfulfilled desires, Lung Ming (Lung Ming: sound of lung qi due to depression) occurs; Ming leads to lung heat and scorched lung leaves, developing into Wei bi. The Lung is located highest, hence called "chief"; it covers the Heart, hence called "cover". If lung will is not expressed, qi stagnates and generates fire, causing wheezing sounds, developing into Lung Ming. As a Metal organ, disease causes loss of clear descending function, leading to heat and scorched leaves; yin of all five zang organs becomes insufficient, which is why Wei bi originates from the Lung. Excessive grief severs the Bao Luo (Bao Luo: collateral network of the uterus); severance causes yang qi to move internally, manifesting as heart blood collapse and frequent hematuria. Bao Luo is the collateral of the uterus. Bao vessels belong to the Heart and connect to the Bao; excessive grief makes the Heart tie urgent and Bao Luo severed, preventing communication between upper and lower, allowing hyperactive yang to move internally and force blood downward, causing frequent hematuria. Thus, large vessels become empty, developing into Ji Bi (Ji Bi: muscle bi syndrome), which transmits to Mai Wei. Blood loss empties large vessels, failing to moisten muscles and nourish collaterals, first causing numb and bi muscles, then transmitting to Mai Wei, originating from the Heart. Endless thinking and unfulfilled wishes, with mind wandering outward and excessive sexual intercourse, cause Zong Jin (Zong Jin: collective sinews of the genital region) to relax and sag, developing into Jin Wei and Bai Yin (Bai Yin: white discharge, leukorrhea). Endless thinking and unfulfilled wishes mean desires are not satisfied. Mind wandering outward and excessive intercourse injure yin qi, causing Zong Jin to relax, developing into Jin Wei. Zong Jin gathers at the anterior yin. Injury to essence internally and sinking of qi downward results in Bai Yin, known today as leukorrhea. Thus, it is said that Jin Wei originates from the Liver due to sexual activity. The Liver governs sinews; thus, sexual activity leads to Jin Wei originating from the Liver. Gradual exposure to dampness, working with water, or living in damp places causes muscles to be soaked by dampness, becoming numb and insensible, developing into Rou Wei. "Gradual" means having a source. Working with water means engaging in low, damp places. "Xiang" means together. The Spleen governs muscles and dislikes dampness; dampness adhering to muscles prevents Wei qi from nourishing, causing numb and bi muscles, becoming Rou Wei. "Zi" is pronounced zi. Thus, it is said that Rou Wei comes from damp land. Dampness of the earth, when contracted, harms skin, muscles, sinews, and vessels, with disease originating in the Spleen. Long journeys and fatigue, encountering intense heat and thirst, cause thirst which allows yang qi to attack internally; internal attack stores heat in the Kidney. The Kidney is a water organ; now water cannot overcome fire, bones wither and marrow empties, so feet cannot support the body, developing into Gu Wei. Long journeys and fatigue generate heat most easily. Excess yang attacks true yin internally; water cannot overcome fire, so disease resides in the Kidney. Thus, it is said that Gu Wei originates from intense heat. Intense heat dries essence and marrow, causing bone withering and Wei disease, originating in the Kidney. How to distinguish them? Lung heat presents with white complexion and ruined hair; Heart heat with red complexion and overflowing collaterals; Liver heat with dark green complexion and withered nails; Spleen heat with yellow complexion and twitching muscles; Kidney heat with black complexion and withered teeth. "Ru" is pronounced ruan, meaning slight movement. It is said that treating Wei syndrome requires focusing solely on the Yangming meridian. Here follows the methods for treating Wei syndrome. Yangming is the sea of the five zang and six fu organs, primarily moistening Zong Jin, which binds bones and facilitates joint movement. Yangming refers to the Stomach meridian, which accepts food and drink, transforms qi and blood, and nourishes interior and exterior, thus being the sea of the five zang and six fu organs, moistening Zong Jin below. Zong Jin are the sinews gathered at the anterior yin, the meeting point of all sinews; sinews of the waist, spine, and xigu all belong here, binding bones and facilitating joints. Chong Mai (Chong Mai: Penetrating Vessel) is the sea of the twelve regular meridians, primarily infiltrating xigu, and combines with Yangming at Zong Jin. The sea of meridians, Chong Mai is the blood sea of the twelve meridians, infiltrating xigu. Chong Mai originates at Qichuang, runs alongside the Shaoyin meridian up the navel; Yangming meridian also runs beside the navel, two cun from the midline, downwards; thus both meet at Zong Jin. Yin and Yang gather at Zong Jin, meeting at Qichuang, with Yangming as the leader; all belong to Dai Mai (Dai Mai: Girdle Vessel) and connect to Du Mai (Du Mai: Governing Vessel). Zong Jin gathers at the anterior yin. The anterior yin is the meeting point of the three Yin meridians of the foot, Yangming, Shaoyang, and Chong, Ren, Du, and Chong meridians. Among these nine, Yangming is the sea of the five zang and six fu, and Chong is the sea of the meridians; this yin and yang encompass the middle, hence "Yin and Yang gather at Zong Jin." Meeting at Qichuang, Qichuang is the main pathway of Yangming, so Yangming alone leads. Dai Mai originates at the costal margin, encircling the body once; Du Mai originates at Huiyin, branching into Ren and Chong, ascending the abdomen and back; thus all meridians attach to Dai Mai and branch to Du Mai. Therefore, Yangming deficiency causes Zong Jin to relax, and Dai Mai fails to draw inward, resulting in foot Wei and inability to use. Yangming deficiency means little qi and blood, failing to moisten and nourish Zong Jin, leading to relaxation. Relaxed Zong Jin prevents Dai Mai from drawing inward, causing foot Wei and non-use; this is why Yangming must be treated. Treatment involves tonifying the Ying (Ying: Flowing points) and unblocking the Shu (Shu: Stream points) of each respective meridian, regulating excess and deficiency, and harmonizing reversal and smooth flow. For sinews, vessels, bones, and flesh, treatment during their respective favorable months leads to recovery. Where qi flows is Ying; where qi pours is Shu. Tonification brings qi; unblocking moves qi. The text previously stated "focus solely on Yangming," but now says "tonify Ying and unblock Shu," implying that while treating Wei focuses on Yangming, one must also observe the affected meridian and treat it concurrently.