痿者。手足不能举动是也。又名软风。下体痿弱。不能趋步。及手战摇。不能握物。此
症属
血虚。血虚属阴虚。阴虚生内热。热则筋弛。步履艰难。而手足软弱。此乃血气两虚。风湿
之症。古方通用风药治之。非也。独东垣丹溪二先生治法。始合经意。而以清燥汤主之。
丹溪又分血热湿痰。气虚血虚瘀血等法。湿热。用东垣健步丸。燥湿降阴火。加苍术、黄柏
、黄芩、牛膝之类。湿痰。二陈汤加苍术、白术、黄芩、黄柏、竹沥、姜汁。气虚。四君子
汤加苍术、黄芩之类。血虚。四物汤加黄柏、苍术。兼送补阴丸。亦有食积死。血妨碍不得
下降者。宜从食积死血治之。他如潜行散、二妙散、虎潜丸。皆治痿妙药也。
一论六七月间。湿令大行。子能令母实而热旺。湿热相合。而刑庚金大肠。故寒凉以救
之。
燥金受湿热之邪。绝寒水生化之源。源绝则肾亏。痿 之病大作。腰下痿软。瘫痪不能动履
清燥汤
黄 （蜜水炒一钱五分） 苍术（米泔浸一钱） 白术（去芦炒） 陈皮 泽泻（各五分）
人参
白茯苓 升麻（各三分） 麦门冬（去心） 当归身（酒洗） 生地黄 神曲（炒） 猪苓（
各四分） 黄柏（酒炒） 柴胡 黄连（各二分） 五味子（九个） 甘草（炙二分）
上锉一剂。水煎。空心。温服。
一论此药能去风顺气。活血壮筋。又治痢后脚弱缓痛。不能行履。名曰痢风。或两膝肿
痛。足胫枯细。名曰鹤膝风。兼治一切痹麻风湿。痿软挟虚之症。
大防风汤
当归（酒洗一钱） 川芎（七分） 白芍（酒洗一钱） 熟地黄（一钱） 黄 （蜜炙一钱）
人参
（五分） 大附子（炮去皮脐七分） 防风（一钱） 牛膝（酒洗五分） 杜仲（姜炒一钱）
甘草（炙五分） 羌活（五分） 白术（去芦一钱五分）
上锉一剂。生姜五片、枣一枚。水煎。温服。
按上四物汤以补血。参、 、术、草以补气。羌、防以散风湿。以利关节。牛膝、杜仲
以补
腰肾。以附子行参、 之气。而走周身脉络。盖治血气两虚。挟风湿而成痹痿不能行者之圣
药也。观其治痢后风可见矣。然可以治不足之痿弱。而不可治有余之风痹也。
一论五子益肾养心丸。治精血亏损。下部痿软无力。不能步履。（方见补益）
养血壮筋健步丸 治症同前。
黄 （盐水炒一钱） 山药（一两） 五味子（一两） 破故纸（盐水炒一两） 人参（一两）
白芍
（酒炒两半） 熟地黄（四两） 枸杞子（一两） 牛膝（去芦酒炒一两） 菟丝子（酒炒二两）
当
归（酒洗二两） 白术（炒一两） 杜仲（姜汁炒二两） 虎胫骨（酥炙两半） 龟板（酥炙一
两）
苍术（米泔浸二两） 黄柏（盐水炒二两） 防风（六钱） 羌活（酒洗三钱） 汉防己（五
钱）
上为细末。用猪脊髓七条。炼蜜为丸。如梧桐子大。每服百丸。空心盐汤下。
一治一切麻痹痿软风湿血虚之候。又治痢后脚软缓痛。不能行履。名曰痢风。或两膝肿
痛
足胫枯细。名曰鹤膝风。以十全大补汤去肉桂。加防风、羌活、牛膝、杜仲、大附子煨。
一人两足痿弱。不能动止。予用人参、鹿茸各五钱。上锉一剂。水煎。空心。温服。连
进数服而愈。
一治两脚痿弱。不能行者。用新砖火烧红。以好醋浇之。候温布包。烙脚下遍处。立能
行动。
一治肾气虚惫。腰膝酸痛。行步无力。
起痿丹
菟丝子（酒洗煨烂捣饼晒干二两五钱） 肉苁蓉（酒浸二两） 川萆 破故纸（酒炒） 胡
芦巴
（酒炒） 沙苑蒺藜（微炒） 川牛膝（去皮酒洗） 川杜仲（酒炒） 防风（酒洗） 甘枸杞子（各二
两）
上为末。酒煮猪腰子。捣烂和丸。如梧子大。每服七八十丸。空心。酒下。河间方。去
枸杞子。加桂枝减半。
痿证，是指手足不能随意运动的症状。又被称为软风。表现为下肢痿弱无力，无法行走迈步，以及手部颤抖摇晃，不能握持物品。此症属于血虚，血虚归属于阴虚，阴虚则产生内热，热邪导致筋脉弛缓，行走困难，手足软弱无力。这乃是气血两虚兼夹风湿的病证。古方通用祛风药物治疗，这是错误的。只有李东垣和朱丹溪两位先生的治法，才符合经典医理，并以清燥汤为主方。丹溪先生又分为血热、湿痰、气虚、血虚、瘀血等治法。若是湿热证，使用东垣的健步丸，以燥湿降阴火，加用苍术、黄柏、黄芩、牛膝等药。若是湿痰证，用二陈汤加苍术、白术、黄芩、黄柏、竹沥、姜汁。若是气虚证，用四君子汤加苍术、黄芩等药。若是血虚证，用四物汤加黄柏、苍术，并兼服补阴丸。也有因食积死血阻碍，导致气不得下降的情况，应当从食积死血来治疗。其他如潜行散、二妙散、虎潜丸，都是治疗痿证的妙药。
一段论述：在六七月间，湿气盛行，子能令母实而导致热势旺盛，湿热相合，进而克制庚金大肠。因此需用寒凉药物来救治。燥金受到湿热邪气的侵害，断绝了寒水（肾）生化之源，源头断绝则肾亏，痿证大病发作，腰部以下痿软瘫痪，不能行动。
清燥汤
黄芪（蜜水炒一钱五分） 苍术（米泔水浸泡一钱） 白术（去芦头炒制） 陈皮 泽泻（各五分）
人参
白茯苓 升麻（各三分） 麦门冬（去心） 当归身（酒洗） 生地黄 神曲（炒制） 猪苓（各四分）
黄柏（酒炒） 柴胡 黄连（各二分） 五味子（九个） 甘草（炙制二分）
以上药材锉碎为一剂，用水煎煮，空腹时温服。
一段论述：此药能祛除风邪、顺调气机、活血壮筋。又治疗痢疾后脚部虚弱迟缓疼痛，不能行走，名为痢风。或者两膝肿痛，小腿枯细，名为鹤膝风。兼治一切痹痛麻木风湿，以及痿软兼有虚损的病证。
大防风汤
当归（酒洗一钱） 川芎（七分） 白芍（酒洗一钱） 熟地黄（一钱） 黄芪（蜜炙一钱）
人参
（五分） 大附子（炮制去皮脐七分） 防风（一钱） 牛膝（酒洗五分） 杜仲（姜炒一钱）
甘草（炙五分） 羌活（五分） 白术（去芦一钱五分）
以上药材锉碎为一剂，生姜五片、大枣一枚，用水煎煮，温服。
按语：上述方剂中，四物汤用来补血，人参、黄芪、白术、甘草用来补气，羌活、防风用来疏散风湿，以利于关节。牛膝、杜仲用来补益腰肾，用附子推动参、芪之气，运行于周身脉络。这大概是治疗气血两虚，兼夹风湿而成痹证痿证不能行走的圣药。观察其治疗痢后风邪可见一斑。然而，它可以治疗不足之痿弱，而不能治疗有余之风痹。
一段论述：五子益肾养心丸，治疗精血亏损，下部痿软无力，不能行走。（方剂见补益篇）
养血壮筋健步丸，治疗的病症与前述相同。
黄芪（盐水炒一钱） 山药（一两） 五味子（一两） 破故纸（盐水炒一两） 人参（一两）
白芍
（酒炒半两） 熟地黄（四两） 枸杞子（一两） 牛膝（去芦头酒炒一两） 菟丝子（酒炒二两）
当归（酒洗二两） 白术（炒制一两） 杜仲（姜汁炒二两） 虎胫骨（酥炙半两） 龟板（酥炙一两）
苍术（米泔水浸泡二两） 黄柏（盐水炒二两） 防风（六钱） 羌活（酒洗三钱） 汉防己（五钱）
以上研为细末，用猪脊髓七条，炼蜜为丸，如梧桐子大小。每次服用一百丸，空腹时用盐汤送下。
一方治疗一切麻痹痿软风湿血虚之候。又治疗痢疾后脚软迟缓疼痛，不能行走，名为痢风。或者两膝肿痛，小腿枯细，名为鹤膝风。用十全大补汤去掉肉桂，加防风、羌活、牛膝、杜仲、煨制的大附子。
一人双足痿弱，不能动止。我用人参、鹿茸各五钱，锉碎为一剂，用水煎煮，空腹温服。连续服用几剂而痊愈。
一方治疗双脚痿弱，不能行走者。用新砖烧红，用好醋浇在上面，待温热后用布包裹，熨烙脚下各处，立刻就能行动。
一方治疗肾气虚惫，腰膝酸痛，行走无力。
起痿丹
菟丝子（酒洗煨烂捣饼晒干二两五钱） 肉苁蓉（酒浸二两） 川萆薢 破故纸（酒炒） 葫芦巴
（酒炒） 沙苑蒺藜（微炒） 川牛膝（去皮酒洗） 川杜仲（酒炒） 防风（酒洗） 甘枸杞子（各二两）
以上研为末，用酒煮猪腰子，捣烂和药末制成丸，如梧桐子大小。每次服用七八十丸，空腹时用酒送下。此为河间方，去掉枸杞子，加桂枝减半。
Wei syndrome refers to the symptom where the hands and feet cannot move voluntarily. It is also known as "Soft Wind" (Ruan Feng). It manifests as weakness in the lower limbs, inability to walk or step, and trembling or shaking of the hands, making it impossible to grasp objects. This condition belongs to Blood Deficiency (Xue Xu), which falls under Yin Deficiency (Yin Xu). Yin Deficiency generates internal heat; heat causes the sinews to relax, leading to difficulty in walking and weakness in the hands and feet. This is a condition of both Qi and Blood deficiency complicated by Wind-Dampness. Ancient formulas commonly used Wind-dispelling drugs for treatment, which is incorrect. Only the treatment methods of Mr. Li Dongyuan and Mr. Zhu Danxi align with the classic medical principles, using Qingzao Tang (Clearing Dryness Decoction) as the main formula. Danxi further classified treatments based on Blood Heat, Damp-Phlegm, Qi Deficiency, Blood Deficiency, and Blood Stasis. For Damp-Heat, Dongyuan's Jianbu Wan (Strengthen Legs Pill) is used to dry dampness and descend ministerial fire, adding herbs such as Cangzhu (Atractylodis Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), and Niuxi (Achyranthis Bidentatae Radix). For Damp-Phlegm, Erchen Tang (Two-Aged Decoction) is added with Cangzhu, Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin, Huangbai, Zhuli (Bambusae Caulis in Taenia), and Jiangzhi (Zingiberis Rhizoma Recens Juice). For Qi Deficiency, Sijunzi Tang (Four Gentlemen Decoction) is added with Cangzhu and Huangqin. For Blood Deficiency, Siwu Tang (Four Substances Decoction) is added with Huangbai and Cangzhu, accompanied by Buyin Wan (Nourish Yin Pill). There are also cases where food stagnation and dead blood obstruct the downward flow of Qi; these should be treated as food stagnation and blood stasis. Others such as Qianxing San (Qianxing Powder), Ermiao San (Two Marvels Powder), and Huqian Wan (Tiger-Kneeling Pill) are all excellent remedies for Wei syndrome.
One discussion states: In the months of June and July, the influence of Dampness prevails greatly. Following the principle that the child can make the mother full, Heat becomes vigorous. Dampness and Heat combine and attack Geng Metal (Large Intestine). Therefore, cold and cool properties are used to rescue it. When Zao Metal (Lung) is invaded by Damp-Heat, it cuts off the source of Shenghua (generation and transformation) of Han Water (Kidney). When the source is cut off, Kidney Deficiency occurs, and Wei disease erupts severely. The area below the waist becomes weak and flaccid, paralyzed and unable to move or walk.
Qingzao Tang (Clearing Dryness Decoction)
Huangqi (Astragali Radix, stir-fried with honey, 1.5 qian) Cangzhu (Atractylodis Rhizoma, soaked in rice water, 1 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizome and stir-fried) Chenpi (Citri Reticulatae Pericarpium) Zexie (Alismatis Rhizoma, each 0.5 qian)
Renshen (Panacis Ginseng Radix)
Baifuling (Poria, 0.3 qian) Shengma (Cimicifugae Rhizoma, each 0.3 qian) Maimendong (Ophiopogonis Radix, de-heart) Dangguishen (Angelicae Sinensis Radix, washed with wine) Shengdihuang (Rehmanniae Radix) Shenqu (Massa Medicata Fermentata, stir-fried) Zhuling (Polyporus, each 0.4 qian)
Huangbai (Phellodendri Cortex, stir-fried with wine) Chaihu (Bupleuri Radix) Huanglian (Coptidis Rhizoma, each 0.2 qian) Wuweizi (Schisandrae Fructus, 9 pieces) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.2 qian)
Chop the above into one dose. Decoct in water. Take warm on an empty stomach.
One discussion states: This medicine can dispel wind and regulate Qi, invigorate blood and strengthen sinews. It also treats leg weakness, slowness, and pain after dysentery, making walking difficult, named Lidai Feng (Dysentery Wind). Or swelling and pain in both knees, with withered and thin calves, named Hexi Feng (Crane Knee Wind). It also treats all types of Bi obstruction, numbness, wind-dampness, and Wei softness complicated by deficiency.
Da Fangfeng Tang (Great Saposhnikovia Decoction)
Danggui (Angelicae Sinensis Radix, washed with wine, 1 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 0.7 qian) Baishao (Paeoniae Radix Alba, washed with wine, 1 qian) Shudihuang (Rehmanniae Radix Praeparata, 1 qian) Huangqi (Astragali Radix, honey-fried, 1 qian)
Renshen (Panacis Ginseng Radix, 0.5 qian) Dafuzi (Aconiti Lateralis Radix Praeparata, processed, skin and umbilicus removed, 0.7 qian) Fangfeng (Saposhnikoviae Radix, 1 qian) Niuxi (Achyranthis Bidentatae Radix, washed with wine, 0.5 qian) Duzhong (Eucommiae Cortex, stir-fried with ginger, 1 qian)
Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 qian) Qianghuo (Notopterygii Rhizoma et Radix, 0.5 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizome, 1.5 qian)
Chop the above into one dose. Add five slices of fresh ginger and one jujube. Decoct in water. Take warm.
Note: In the above formula, Siwu Tang (Four Substances Decoction) nourishes Blood; Renshen, Huangqi, Baizhu, and Gancao tonify Qi; Qianghuo and Fangfeng disperse wind-dampness and benefit the joints; Niuxi and Duzhong tonify the waist and kidneys; Fuzi promotes the Qi of Renshen and Huangqi to circulate through the meridians of the whole body. This is arguably a sacred medicine for treating Wei syndrome and Bi obstruction caused by Qi and Blood deficiency complicated by wind-dampness, resulting in inability to walk. Observing its treatment of post-dysentery wind reveals this. However, it can treat Wei weakness due to insufficiency, but cannot treat Bi obstruction due to excess.
One discussion states: Wuzi Yishen Yangxin Wan (Five Seeds Kidney-Nourishing Heart-Nourishing Pill) treats depletion of essence and blood, weakness and lack of strength in the lower body, and inability to walk. (Formula see Tonification Section)
Yangxue Zhuangjin Jianbu Wan (Blood-Nourishing Sinew-Strengthening Leg-Strengthening Pill) treats the same symptoms as mentioned above.
Huangqi (Astragali Radix, salt-water fried, 1 qian) Shanyao (Dioscoreae Rhizoma, 1 liang) Wuweizi (Schisandrae Fructus, 1 liang) Poguzhi (Psoraleae Fructus, salt-water fried, 1 liang) Renshen (Panacis Ginseng Radix, 1 liang)
Baishao (Paeoniae Radix Alba, wine-fried, half liang) Shudihuang (Rehmanniae Radix Praeparata, 4 liang) Gouqizi (Lycii Fructus, 1 liang) Niuxi (Achyranthis Bidentatae Radix, de-rhizome and wine-fried, 1 liang) Tusizi (Cuscutae Semen, wine-fried, 2 liang)
Danggui (Angelicae Sinensis Radix, washed with wine, 2 liang) Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 1 liang) Duzhong (Eucommiae Cortex, ginger juice-fried, 2 liang) Hu Jinggu (Os Tigris, roasted with lard, half liang) Guiban (Carapax et Plastrum Testudinis, roasted with lard, 1 liang)
Cangzhu (Atractylodis Rhizoma, soaked in rice water, 2 liang) Huangbai (Phellodendri Cortex, salt-water fried, 2 liang) Fangfeng (Saposhnikoviae Radix, 6 qian) Qianghuo (Notopterygii Rhizoma et Radix, washed with wine, 3 qian) Hanfangji (Stephaniae Tetrandrae Radix, 5 qian)
Grind the above into fine powder. Use seven pig spinal cords. Make pills with refined honey, size of wutong seeds. Take 100 pills per dose, down with salt water on an empty stomach.
One prescription treats all conditions of numbness, paralysis, Wei softness, wind-dampness, and blood deficiency. It also treats leg weakness, slowness, and pain after dysentery, named Lidai Feng (Dysentery Wind). Or swelling and pain in both knees, with withered and thin calves, named Hexi Feng (Crane Knee Wind). Use Shiquan Dabu Tang (Ten Thousand Benefits Great Tonifying Decoction) removing Rougui (Cinnamomi Cortex), adding Fangfeng, Qianghuo, Niuxi, Duzhong, and Da Fuzi (processed Aconiti Lateralis Radix Praeparata).
One person had both legs weak and unable to move. I used Renshen (Panacis Ginseng Radix) and Lurong (Cervi Cornu Pantotrichum), each 5 qian. Chop into one dose. Decoct in water. Take warm on an empty stomach. Continued administration for several doses resulted in recovery.
One prescription for bilateral leg weakness and inability to walk: Use a new brick, burn it red, pour good vinegar on it. Wait until warm, wrap in cloth, and apply heat compress to all areas of the soles of the feet. Movement can be restored immediately.
One prescription for Kidney Qi exhaustion, soreness and pain in the waist and knees, and weakness in walking.
Qiwei Dan (Revitalize Wei Pill)
Tusizi (Cuscutae Semen, washed with wine, roasted until soft, mashed into cake, dried, 2.5 liang) Rongcongrou (Cynomorii Herba, soaked in wine, 2 liang) Chuanbi Xie (Dioscoreae Hypoglaucae Rhizoma) Poguzhi (Psoraleae Fructus, wine-fried) Hubalu (Trichosanthis Fructus, wine-fried) Shayuan Jili (Asteris Semen, slightly stir-fried) Chuan Niuxi (Achyranthis Bidentatae Radix, peeled and washed with wine) Chuan Duzhong (Eucommiae Cortex, wine-fried) Fangfeng (Saposhnikoviae Radix, washed with wine) Gan Gouqizi (Lycii Fructus, each 2 liang)
Grind into powder. Boil pig kidneys in wine, mash thoroughly, mix with powder to form pills, size of wutong seeds. Take 70-80 pills per dose, down with wine on an empty stomach. This is Hejian's formula, remove Gouqizi, add Guizhi (Cinnamomi Ramulus) halved.