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。
此明痿病之因也。肺为心之盖，有所失亡，所求不得，则懊 而心火炽动，久则灼肺，肺鸣而热，以至
叶焦，发为痿 也；悲哀太甚，则伤心胞络，胞络之脉气阻绝不通，则阳气内动冲逆，心下如崩，以动血而数
溲血，血去则经脉空虚，无以滋养肌肉而发肌痹，痹者，麻木也，久则传为脉痿矣；思想意淫，入房太甚，皆
欲火耗精，阳气变成邪热，以致宗筋弛纵而成筋痿，白淫者，淋浊带下之类，以邪热炽盛，精不藏肾也，肝主
筋，故筋痿生于肝，使内损其精也；脾为湿土而主肌肉，故伤湿则肌肉不仁而成肉痿，上文言脾气热，则胃干
而渴，肌肉不仁，发为肉痿，大抵脾主肌肉，不拘热湿所伤，皆使肌肉不仁，乃名肉痿也；远行劳倦，逢大热
而渴者，此因过劳动火，以伤阴液，其阳和之气内伐，而化为邪热，热舍于肾，更耗其精，以至骨枯髓虚，两
足软弱，不任其身，而成骨痿也。
黄帝问道：痿证是如何产生的？岐伯回答说：肺是五脏的长官，位于心的上面。如果人遭遇丧失、愿望无法实现，就会导致肺气上逆发出声音（如咳嗽或喘息），肺气上逆则产生肺热，使肺叶焦枯。所以说，五脏因为肺热叶焦，从而引发各种痿证，说的就是这种情况；如果悲哀过度，就会使心包络的气血阻滞不通，心包络阻滞则阳气在内躁动，发作时会出现心下部出血，频繁小便带血的情况。所以《本病》篇说：大经脉空虚，引发肌痹，进而传变为脉痿；如果思虑无穷，愿望不得满足，意念外驰，加上房事过度，就会导致宗筋弛缓松弛，引发筋痿，以及出现白淫（指男子滑精、女子带下等症）。所以《下经》说：筋痿是由于肝的功能失调，因房事过度所致；如果长期处于潮湿环境，以水为业，或者居住地方湿气重，肌肉长期受湿邪浸渍，导致麻木不仁，就会引发肉痿。所以《下经》说：肉痿是由于感受湿地湿气所致；如果有长途跋涉、劳累疲倦，又逢大热天气而口渴，口渴则阳气在体内耗伤，阳气内耗则热邪留舍于肾。肾是水脏，现在水不能制约火，就会导致骨骼枯槁、骨髓空虚，所以双脚无力支撑身体，引发骨痿。所以《下经》说：骨痿是由于感受大热所致。
这段文字阐明了痿病的成因。肺位于心的上面，如果人遭遇丧失、愿望无法实现，就会心中烦闷懊恼，导致心火炽盛躁动，久而久之灼伤肺脏，导致肺气上逆发热，直至肺叶焦枯，引发痿证；悲哀过度会伤心包络，心包络的脉气阻滞不通，阳气在内冲动逆乱，心下部如崩塌般出血，因动血而导致频繁小便带血，血液流失则经脉空虚，无法滋养肌肉而引发肌痹，痹的意思是麻木，时间久了就会传变为脉痿；思虑过多、意念外驰、房事过度，都会因欲火消耗精气，阳气转化为邪热，导致宗筋弛缓松弛而形成筋痿。白淫是指淋证、浊证、带下之类疾病，是因为邪热炽盛，肾不能固藏精气。肝主筋，所以筋痿生于肝，是因房事过度损伤精气所致；脾属湿土，主司肌肉，所以受伤于湿邪则肌肉麻木不仁而形成肉痿。上文提到脾气热，会导致胃干燥而口渴，肌肉麻木不仁，引发肉痿，大体而言脾主肌肉，无论是热邪还是湿邪所伤，只要导致肌肉麻木不仁，都称为肉痿；长途跋涉、劳累疲倦，又逢大热天气而口渴，这是因为过度劳动引动相火，损伤阴液，体内的阳和之气向内耗伐，转化为邪热，热邪留舍于肾，进一步耗损精气，导致骨骼枯槁、骨髓空虚，双足软弱无力，无法支撑身体，从而形成骨痿。
The Yellow Emperor asked: How is it acquired? Qibo replied: The Lung is the chief of the Zang organs and serves as the canopy for the Heart. If one experiences loss or fails to achieve desired goals, it will cause Lung Qi to rebel and produce sounds (such as coughing or wheezing). This rebellion generates Lung Heat, leading to the scorching and withering of the Lung leaves. Therefore, it is said that when the Five Zang organs suffer from Lung Heat and withered Lung leaves, various types of Wei syndrome (flaccidity syndrome) arise; this is what is meant. If grief is excessive, it obstructs the Pericardium Collateral (Pericardium Meridian), causing the Qi and Blood within to stagnate. When the Pericardium Collateral is blocked, Yang Qi moves internally restlessly. Upon manifestation, there may be bleeding from the epigastrium and frequent hematuria (blood in urine). Thus, the *Ben Bing* chapter states: When the large meridians are empty, Ji Bi (muscle bi-syndrome) arises, which transmits into Mai Wei (vessel flaccidity); if thoughts are endless and wishes remain unfulfilled, with mental desires wandering outward and sexual intercourse being excessive, the Zong Jin (tendons/genitals) become flaccid and relaxed, leading to Jin Wei (tendon flaccidity) and Bai Yin (leukorrhea or spermatorrhea). Thus, the *Xia Jing* states: Jin Wei originates from the Liver due to excessive sexual activity; if one gradually becomes accustomed to dampness, engages in water-related work, or resides in damp environments, muscle tissue remains soaked by dampness, becoming numb and insensible, leading to Rou Wei (muscle flaccidity). Thus, the *Xia Jing* states: Rou Wei results from exposure to damp places; if one travels far, becomes fatigued, encounters intense heat, and feels thirsty, thirst causes internal consumption of Yang Qi. This internal consumption allows Heat to lodge in the Kidney. The Kidney is the Water organ; now Water cannot overcome Fire, leading to dry bones and empty marrow. Consequently, the feet cannot support the body, resulting in Gu Wei (bone flaccidity). Thus, the *Xia Jing* states: Gu Wei arises from intense heat.
This passage clarifies the etiology of Wei disease. The Lung sits above the Heart. Loss and unfulfilled desires cause inner vexation and agitation, leading to blazing Heart Fire. Over time, this scorches the Lung, causing Lung Qi rebellion, heat, and eventually withered Lung leaves, triggering Wei syndrome; excessive grief injures the Pericardium Collateral, blocking its meridian Qi. Internal Yang Qi then rushes upward and inward, causing epigastric collapse-like bleeding and frequent hematuria due to blood disturbance. Blood loss empties the meridians, depriving muscles of nourishment and causing Ji Bi. "Bi" refers to numbness; prolonged cases transmit into Mai Wei; excessive thinking, mental wandering, and sexual excess all consume Essence via desire-fire, transforming Yang Qi into pathogenic Heat. This leads to flaccidity of the Zong Jin, forming Jin Wei. Bai Yin refers to conditions like strangury, turbid urine, and leukorrhea, caused by blazing pathogenic Heat preventing the Kidney from storing Essence. The Liver governs tendons; thus, Jin Wei originates from the Liver due to Essence damage from sexual excess; the Spleen belongs to Damp Earth and governs muscles. Injury by Dampness causes muscle insensibility, forming Rou Wei. As mentioned earlier, Spleen Heat dries the Stomach, causing thirst and muscle insensibility, leading to Rou Wei. Generally, since the Spleen governs muscles, whether injured by Heat or Dampness, if it results in muscle insensibility, it is named Rou Wei; long journeys and fatigue combined with intense heat and thirst indicate that overwork stirs Minister Fire, damaging Yin fluids. The harmonious Yang Qi is consumed internally, transforming into pathogenic Heat, which lodges in the Kidney, further depleting Essence. This leads to dry bones and empty marrow, weak legs unable to support the body, forming Gu Wei.