痿证断不可作风治，而用风药。有湿热、湿痰、气虚、血虚、瘀血。湿热，东垣健
步丸，加
沥、姜汁；气虚，四君子汤加黄芩、黄柏、苍术之类；血虚，四物汤加黄柏、苍术，煎送补
阴丸；亦有食积死血妨碍不得下降者，大率属热，用参术四物汤、黄柏之类。
〔附录〕谨按五痿等证，特立篇目，所论至详。后代诸方，独于此证盖多缺略，考其由，
皆因混入中风条内故也。丹溪先生痛千古之弊，悯世之罹此疾者，多误于庸医之手。有志之
士，必当究其心焉。夫陈无择谓痿因五内不足所致，诚得之矣。然痿之所不足，乃阴血也。
方悉是补阳补气之剂，宁免实实虚虚之患乎？且无择以三因立方，可谓诸方之冠。其余此证
附方
健步丸（东垣方）
防己（酒洗，一两） 羌活 柴胡 滑石（炒） 甘草（炙） 栝蒌（酒洗，以上各半两） 泽泻
防风（各三钱） 苦参（酒洗） 川乌（各一钱） 肉桂（五分）
上为末，酒糊为丸，梧桐子大。每服七十丸，葱白煎愈风汤下（见中风类）。
补阴丸 见诸虚类。
清燥汤 治湿热成痿，以燥金受湿热之邪，是绝寒水生化之源，源绝则肾亏，痿厥之病
大作，腰以下痿软瘫痪不能动。
黄 （一钱五分） 苍术（一钱） 白术 橘皮 泽泻（各半钱） 人参 白茯苓 升麻（各三分） 麦
门冬 归身 生地黄 曲末 猪苓（各二分） 酒柏 柴胡 黄连（各一分） 五味子（九个） 甘草
（炙，二分）
上每服半两，水煎，空心服。
痿证绝对不可以当作风病来治疗，而使用祛风药物。痿证的病因主要有湿热、湿痰、气虚、血虚、瘀血这几种情况。若是湿热所致，可用东垣的健步丸，加入竹沥和姜汁；若是气虚所致，可用四君子汤，加入黄芩、黄柏、苍术等药；若是血虚所致，可用四物汤，加入黄柏、苍术，煎煮后送服补阴丸；也有因食积和死血（瘀血）阻碍，导致气机不得下降的情况，大率属于热证，可用参术四物汤、黄柏等药。
〔附录〕谨按：五痿等证，专门设立篇目论述，内容非常详尽。后代的医方中，唯独对此证大多缺略，考察其原因，都是因为将痿证混入中风条目的缘故。丹溪先生痛惜千古以来的弊端，怜悯世间遭受此疾的人，多被庸医误治。有志于医学的人士，必定应当探究其中的道理。陈无择认为痿证是由于五脏内部不足所致，确实抓住了要害。然而痿证所不足的，乃是阴血。后世方剂大多是补阳补气的药剂，怎能避免“实实虚虚”（使实证更实、虚证更虚）的祸患呢？况且陈无择依据三因学说立方，可以说是诸方中的典范。其余此证附方如下：
健步丸（李东垣方）
防己（酒洗，一两） 羌活 柴胡 滑石（炒） 甘草（炙） 栝蒌（酒洗，以上各半两） 泽泻 防风（各三钱） 苦参（酒洗） 川乌（各一钱） 肉桂（五分）
以上药材研为细末，用酒糊制作成梧桐子大小的丸剂。每次服用七十丸，用葱白煎煮愈风汤送下（见中风类）。
补阴丸 参见诸虚类。
清燥汤 治疗湿热导致的痿证。因为燥金受湿热之邪侵袭，断绝了寒水生化之源，水源枯竭则肾亏，导致痿厥之病大作，腰部以下痿软瘫痪不能活动。
黄芪（一钱五分） 苍术（一钱） 白术 橘皮 泽泻（各半钱） 人参 白茯苓 升麻（各三分） 麦门冬 当归身 生地黄 神曲末 猪苓（各二分） 酒制黄柏 柴胡 黄连（各一分） 五味子（九个） 甘草（炙，二分）
以上每剂取半两，加水煎煮，空腹服用。
Wei syndrome (flaccidity syndrome) must absolutely not be treated as wind disease, nor should wind-dispelling herbs be used. The etiologies include damp-heat, damp-phlegm, qi deficiency, blood deficiency, and blood stasis. If due to damp-heat, Jianbu Wan (Strengthening Steps Pill) from Dongyuan, added with Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice), is indicated. If due to qi deficiency, Sijunzi Tang (Four Gentlemen Decoction) added with Huangqin (Scutellaria Root), Huangbai (Phellodendron Bark), Cangzhu (Atractylodes Rhizome), etc., is indicated. If due to blood deficiency, Siwu Tang (Four Substance Decoction) added with Huangbai and Cangzhu, decocted and taken with Buyin Wan (Nourish Yin Pill), is indicated. There are also cases where food stagnation and dead blood (blood stasis) obstruct the downward flow of qi; these generally belong to heat syndromes, and Shenzhu Siwu Tang (Ren Shen, Bai Zhu, Siwu Tang) or Huangbai may be used.
[Appendix] A careful examination reveals that the five types of Wei syndromes have their own dedicated chapters, with discussions being extremely detailed. In subsequent medical formulas, there is a notable omission regarding this syndrome. Investigating the cause, it is because Wei syndrome was mixed into the Stroke (Zhongfeng) category. Mr. Danxi lamented this ancient malpractice and pitied those suffering from this disease who were often misdiagnosed by incompetent physicians. Those aspiring to medicine must certainly investigate its principles. Chen Wuyue stated that Wei syndrome is caused by insufficiency in the five internal organs, which is indeed correct. However, what is insufficient in Wei syndrome is yin-blood. Subsequent formulas mostly consist of agents that tonify yang and qi; how can one avoid the harm of "reinforcing the excess and depleting the deficient"? Furthermore, Chen Wuyue formulated prescriptions based on the Three Causes theory, making them the pinnacle of formulae. The following are attached formulas for this condition:
Jianbu Wan (Formula from Li Dongyuan)
Fangji (Stephania Root, washed with wine, 1 liang) Qianghuo (Notopterygium Rhizome) Chaihu (Bupleurum Root) Huashi (Talcum, stir-fried) Gancao (Licorice Root, honey-fried) Gualou (Trichosanthes Fruit, washed with wine, half a liang each above) Zexie (Alisma Rhizome) Fangfeng (Saposhnikovia Root) Kushen (Sophora Root, washed with wine) Chuanwu (Aconitum Carmandii Root, processed, 1 qian each) Rougui (Cinnamon Bark) (5 fen)
Grind the above into powder, make pills with wine paste, sized like paulownia seeds. Take 70 pills per dose, administered with Yufeng Tang (Wind-Dispelling Decoction) decocted with scallion white (see Stroke category).
Buyin Wan (Nourish Yin Pill) See the section on Various Deficiencies.
Qingzao Tang (Clear Dryness Decoction) Treats Wei syndrome caused by damp-heat. When dry metal (Lung/Metal element) is affected by damp-heat pathogens, it severs the source of cold water's generation. When the source is severed, Kidney deficiency occurs, causing severe Wei-Jue syndrome (flaccidity and cold extremities), resulting in flaccid paralysis and immobility below the waist.
Huangqi (Astragalus Root) (1.5 qian) Cangzhu (Atractylodes Rhizome) (1 qian) Baizhu (Atractylodes Macrocephala Rhizome) Jupi (Citrus Peel) Zexie (Alisma Rhizome) (half a qian each) Renshen (Ginseng Root) Baifuling (Poria Cocos) Shengma (Cimicifuga Rhizome) (3 fen each) Maimendong (Ophiopogon Tuber) Guishen (Angelica Sinensis Root Heart) Shengdihuang (Rehmannia Root, raw) Qumo (Medicated Leaven Powder) Zhuling (Polyporus) (2 fen each) Jiubai (Phellodendron Bark, wine-processed) Chaihu (Bupleurum Root) Huanglian (Coptis Rhizome) (1 fen each) Wuweizi (Schisandra Berry) (9 berries) Gancao (Licorice Root, honey-fried) (2 fen)
Take half a liang per dose, decoct in water, and take on an empty stomach.