痿证者，两足痿弱而不痛也。内经分为五脏∶肺痿者，皮毛痿也。心痿者，脉痿也。肝痿者，
筋痿也。脾痿者，肉痿也。肾痿者，足痿也。而其要宜独取阳明，阳明为五脏六腑之海，主润宗筋
，宗筋主束骨而利机关，若阳明虚不能藏受水谷之气而布化，
则五脏无所禀，宗筋无所养，则痿 之证作矣。如足痿不能行者，以虎潜丸主之。如痿证专属肾虚者，
以加减四斤丸主之。如气虚多痰者，以六君子汤加味主之。如血虚多火者，以六味丸加味主之。如
气血俱虚者，以当归补血汤加味主之。
虎潜丸
黄柏 知母 熟地（各三两） 龟板（四两） 白芍 当归 牛膝（各一两） 虎胫骨（酥炙）
琐阳 陈皮（各一两半） 干姜（五钱） 研末，酒煮羯羊肉一斤，切片，微火焙研末，和上诸药，
炼蜜为丸梧子大，每服五十丸，姜汤、盐汤、酒随意送下。或以淫羊藿剪去刺一两，天冬五钱，紫菀
三钱，苍术二钱，黄柏一钱，水煎服。
加减四斤丸
肉苁蓉 牛膝 木瓜 鹿茸 熟地 五味子 菟丝子各等分为末，炼蜜丸，如桐子
大，每服五十丸，温酒、米饮送下。
六君子汤
（方见疟疾）
加黄柏、苍术、紫菀。
六味丸
熟地（八两） 山萸肉（四两） 丹皮（三两） 山药（四两） 茯苓（三两） 泽泻（三两） 加
黄柏
、苍术炼蜜为丸，如桐子大，
每服三钱，淡盐汤送下。
当归补血汤
（方见头痛）
加竹沥、姜汁。
痿证，是指双下肢软弱无力且无疼痛感的病证。《黄帝内经》将其分为五脏：肺痿表现为皮毛痿；心痿表现为脉痿；肝痿表现为筋痿；脾痿表现为肉痿；肾痿表现为足痿。其治疗的关键在于独取阳明经，因为阳明经是五脏六腑气血汇聚的大海，主要功能是滋润宗筋（全身筋膜），而宗筋负责约束骨骼并利于关节运动。如果阳明经虚弱，不能受纳水谷精微之气并进行布散化生，那么五脏就缺乏禀受之源，宗筋得不到滋养，于是痿证的病症就会发生。如果是足部痿弱不能行走的，以虎潜丸为主治方剂。如果是痿证专门属于肾虚类型的，以加减四斤丸为主治方剂。如果是气虚且多痰湿的，以加味的六君子汤为主治方剂。如果是血虚且多内火的，以加味的六味丸为主治方剂。如果是气血都虚弱的，以加味的当归补血汤为主治方剂。
虎潜丸
黄柏、知母、熟地黄（各三两）、龟板（四两）、白芍、当归、牛膝（各一两）、虎胫骨（用酥油炙烤）、琐阳、陈皮（各一两半）、干姜（五钱）。将上述药材研成细末，用酒煮羯羊肉一斤，切成片，用微火焙干后研成细末，与前面的药末混合，用炼蜜制成梧桐子大小的药丸。每次服用五十丸，根据情况用姜汤、盐汤或酒送服。或者使用淫羊藿（剪去刺）一两、天冬五钱、紫菀三钱、苍术二钱、黄柏一钱，用水煎服。
加减四斤丸
肉苁蓉、牛膝、木瓜、鹿茸、熟地黄、五味子、菟丝子，各等分研成细末，用炼蜜制成药丸，大小如梧桐子。每次服用五十丸，用温酒或米饮送服。
六味丸
熟地黄（八两）、山茱萸肉（四两）、牡丹皮（三两）、山药（四两）、茯苓（三两）、泽泻（三两）。加入黄柏、苍术，用炼蜜制成药丸，大小如梧桐子。每次服用三钱，用淡盐汤送服。
Wei Syndrome (Flaccidity Syndrome) refers to a condition characterized by weakness and atrophy of both lower limbs without pain. The *Neijing* (Inner Canon) divides it into five categories corresponding to the Zang organs: Lung Wei manifests as skin and hair flaccidity; Heart Wei manifests as vessel flaccidity; Liver Wei manifests as tendon flaccidity; Spleen Wei manifests as muscle flaccidity; Kidney Wei manifests as foot flaccidity. The key to treatment lies in exclusively targeting the Yangming channels, as the Yangming is the sea of the five Zang and six Fu organs, primarily responsible for moistening the Zongjin (general tendons/membranes). The Zongjin binds the bones and facilitates joint movement. If the Yangming is deficient and unable to receive the Qi of water and grain and distribute it, the five Zang organs will lack their source of nourishment, and the Zongjin will not be sustained, leading to the manifestation of Wei syndrome. For cases of foot flaccidity with inability to walk, *Hujian Wan* (Tiger Knee Pill) is the primary formula. For cases where Wei syndrome is specifically attributed to Kidney deficiency, *Jiajian Sijin Wan* (Modified Four-Jin Pill) is used. For cases involving Qi deficiency with excessive phlegm, modified *Liujunzi Tang* (Six Gentlemen Decoction) is employed. For cases involving Blood deficiency with excessive internal heat, modified *Liuwei Wan* (Six-Ingredient Pill) is used. For cases involving simultaneous deficiency of both Qi and Blood, modified *Danggui Buxue Tang* (Angelica Tonifying the Blood Decoction) is used.
**Hujian Wan (Tiger Knee Pill)**
*Phellodendri Cortex* (Huangbai), *Anemarrhenae Rhizoma* (Zhimu), *Rehmanniae Radix Praeparata* (Shudi) [each 3 liang], *Testudinis Carapax et Plastrum* (Guiban) [4 liang], *Paeoniae Radix Alba* (Baishao), *Angelicae Sinensis Radix* (Danggui), *Achyranthis Bidentatae Radix* (Niuxi) [each 1 liang], *Ossis Tigris Tibia* (Hu Jinggu) [prepared with suet], *Cynomorii Herba* (Suoyang), *Citri Reticulatae Pericarpium* (Chenpi) [each 1.5 liang], *Zingiberis Rhizoma* (Ganjiang) [5 qian]. Grind all ingredients into powder. Boil one jin of castrated male sheep meat in wine, slice it, dry it over low heat, and grind it into powder. Mix this meat powder with the herbal powder. Form pills using refined honey, sized like wu-tzu (mulberry seeds). Take 50 pills per dose, administered with ginger decoction, salted water, or wine as appropriate. Alternatively, use *Epimedii Herba* (Yinyanghuo) [1 liang, thorns removed], *Asparagi Radix* (Tiantong) [5 qian], *Asterae Radix* (Ziwan) [3 qian], *Atractylodis Macrocephalae Rhizoma* (Cangzhu) [2 qian], *Phellodendri Cortex* (Huangbai) [1 qian]. Decoct in water and take orally.
**Jiajian Sijin Wan (Modified Four-Jin Pill)**
*Cynomorii Herba* (Roucongrou), *Achyranthis Bidentatae Radix* (Niuxi), *Chaenomelis Fructus* (Mugua), *Cornus Officinalis Fructus* (Shanzhuyu - note: text says Shanyurou but context implies Cornus/Goji usually in such formulas, however text explicitly lists "Shanyurou" which is often Shan Zhu Yu, here translated based on common ingredient list for this pill name, though strictly text says "Shanyurou" likely typo for Shan Zhuyu or just Cornus fruit), *Rehmanniae Radix Praeparata* (Shudi), *Schisandrae Fructus* (Wuweizi), *Cuscutae Semen* (Tusizi). Use equal parts, grind into powder, form pills with refined honey, sized like mulberry seeds. Take 50 pills per dose, administered with warm wine or rice drink.
**Liujunzi Tang (Six Gentlemen Decoction)**
(See formula under Malaria)
Add *Phellodendri Cortex* (Huangbai), *Atractylodis Macrocephalae Rhizoma* (Cangzhu), *Asterae Radix* (Ziwan).
**Liuwei Wan (Six-Ingredient Pill)**
*Rehmanniae Radix Praeparata* (Shudi) [8 liang], *Cornus Officinalis Fructus* (Shanyurou/Shanzhuyu) [4 liang], *Moutan Cortex* (Danpi) [3 liang], *Dioscoreae Rhizoma* (Shanyao) [4 liang], *Poria* (Fuling) [3 liang], *Alismatis Rhizoma* (Zexie) [3 liang]. Add *Phellodendri Cortex* (Huangbai) and *Atractylodis Macrocephalae Rhizoma* (Cangzhu). Form pills with refined honey, sized like mulberry seeds. Take 3 qian per dose, administered with light salted water.
**Danggui Buxue Tang (Angelica Tonifying the Blood Decoction)**
(See formula under Headache)
Add *Bambusae Succus* (Zhuli) and *Zingiberis Succus* (Jiangzhi).