痿，注谓痿弱无力以运动是也。然所以无力之故，既有五脏致此之因，而其原总关于胃。盖胃藏水谷以养
人，五脏六腑皆受气焉。故胃虚则脏腑均失所养，而冲、督、带之脉络皆不相维系，宗筋弛缓，一身无力，故
病为痿。此帝与伯所以更为辩难也。
黄帝问曰∶五脏使人痿，何也？岐伯对曰∶肺主身之皮毛，心主身之血脉，肝主身之筋膜，脾主身之肌肉，
肾主身之骨髓。（所主不同，痿生亦各归其所主。）故肺热叶焦则皮毛虚，弱急薄着，则生痿 也。（
谓挛 ，足不得伸也，肺热则肾受热气故尔。按∶肺合皮毛，其质轻浮而主气，故虚则气弱促急，其形薄而着。
金亏不能生肾水，肾亦虚惫而 也。 ，必亦切。）心气热，则下脉厥而上，上则下脉虚，虚则生脉痿，枢折
挈胫，纵而不任地也。（按∶心本火脏，火盛则热，热性炎上，气亦上行，周身之血脉皆逆而上矣。然上盛则
下必虚，而痿弱之象当见于脉。脉痿之证维何？身不能运动，足不能践地，如枢折而胫挈也。然其所以折而且
挈者，心虚少血，不能养筋，纵缓无力之故也。胫， 骨。）肝气热，则胆泄口苦，筋膜干，筋膜干则筋急而
挛，发为筋痿。（按∶肝为脏，胆为腑，阴阳本相应也。肝属木而生火，火上炎则胆汁上溢而口苦。肝又主筋，
故热则筋膜干，惟干故又挛急而为筋痿也。痿之为义似属弛缓，挛急亦痿者，急则拘缩而不能伸，与弛无异，
故亦能痿也。按胆居肝短叶间，注谓胆为肝叶，误矣。）脾气热，则胃干而渴，肌肉不仁，发为肉痿。（脾与胃
以膜相连，脾气热则胃液渗泄，故干而且渴也。脾主肌肉，今热薄于内，故肌肉不仁而发为肉痿。）肾气热，
则腰脊不举，骨枯而髓减，发为骨痿。（腰为肾府，又肾脉上股内，贯脊，属肾，故肾气热则腰脊不举也。肾
主骨髓，故热则骨枯而髓减，为骨痿。）
帝曰∶何以得之？岐伯曰∶肺者，脏之长也，为心之盖也。（位高而布叶于胸中，是故为脏之长，心之盖。）
有所失亡，所求不得，则发肺鸣，鸣则肺热叶焦。（……志苦不畅，气郁故也。肺藏气，气郁不利，故喘息
有声而肺热叶焦也。）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。（……按∶胞络，即
心包络也。包络所以卫心，悲哀太甚，则气急迫而胞络伤，络伤则心病。盖心属火而主血，心病火发，血不能
静，遂下流于溲溺也。）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。（……
按∶无穷谓多欲。外谓非己室也。白淫，男女皆有之，男为游精，女为阴液。邪思妄想，意淫而已，虽无实事，
而精气已为之动摇，故遂与入房太甚者，并足以致筋痿也。然筋痿，肝之病也，何以并得之色欲？盖肾败精伤，
水亏不能养木故也。）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。（……
业惟近湿，居处泽下，皆水为事也。平者久而犹怠，感之者尤甚矣。肉属于脾，脾气恶湿，湿着于内，则卫气
不营，故肉为痿也。按∶渐音尖。渍音滋，渗染也。）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。（……按∶水以制火，然火盛则
烁水，而水愈虚火愈炽。是故劳倦热渴，阳火内炽，水不能胜而肾亏矣。肾主骨，骨借髓以强，身凭足以任。
肾亏则髓虚，髓虚则骨枯而足无力以任身，是名骨痿也。）帝曰∶何以别之？岐伯曰∶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。（各求脏色及所主养而命之，
则其应也。按∶蠕音软，微动也。）
帝曰∶如夫子言可矣，论言治痿者独取阳明，何
也？岐伯曰∶阳明者，五脏六腑之海、主闰宗筋，宗筋主束骨而利机关也。（宗筋谓阴髦中横骨上下之竖筋也。
上络胸腹，下贯髋尻，又经于背腹，上头项，故云宗筋主束骨而利机关也。然腰者身之大关节，所以司屈伸，
故曰机关。按∶闰当作润，言脏腑资水谷以化气血而养人，宗筋借以滋润焉。宗筋为诸筋之宗，网维一身，干
槁则拘缩，滋润则便利也。）冲脉者，经脉之海也，主渗灌溪谷，与阳明合于宗筋。（冲脉循腹挟脐旁各同
身寸之五分而上，阳明脉亦挟脐旁各同身寸之一寸五分而上，宗筋脉于中，故云与阳明合于宗筋也。以为十二
经海，故主渗灌溪谷也。肉之大会为谷，小会为溪。按∶渗灌者，无微不入。冲脉主血兼气，其位虽止于挟
腹中行，而气则流行一身，无处不到，故取义于渗灌也。）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，故阳明虚则宗筋纵，带脉不引，故足痿不用也。（宗筋挟脐下，合于横骨，阳明辅其外，
冲脉居其中，故云会于气街而阳明为之长也。气街则阴髦两旁脉动处也。带脉者，起于季胁，回身一周而络于
督脉也。督脉者，起于关元，上下循腹。故云皆属于带脉而络于督脉也。冲、任、督三脉，同起而异行，故经
文参差而引之。引谓牵引。按∶水谷充盈则阳明实而气血盛，气血盛则宗筋劲调而有力，虚则缓弱无力而足不
能行矣。所以然者，足以筋为用也。注滥引，未确。）帝曰∶治之奈何？岐伯曰∶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。帝曰∶善！（按∶荣者，血也。逆调论言∶“荣气虚则不
仁。”故治痿之法，以补血为最也。俞，背穴，五脏各有俞。时受月者，五脏各有应王之月，如肝伤则筋病，
欲治筋病，必于春月木王之时，因时以受王月之气，则邪易去而正易复也。筋者，肝也；脉者，心也；骨者，
肾也；肉者，脾也。五脏独缺肺者，肺合皮毛，皮毛附于肉，或省文也。注似是而未明快。）
痿，注释说是指肢体软弱无力，无法运动。然而导致无力的原因，虽然涉及五脏致病的因素，但其根源总与胃有关。因为胃容纳水谷以滋养人体，五脏六腑都从中获取精气。所以胃气虚弱，则脏腑都失去滋养，冲脉、督脉、带脉的脉络都不能相互维系，宗筋松弛，全身无力，因此病发为痿证。这就是黄帝与岐伯反复辩论的原因。
黄帝问道：五脏都能使人发生痿证，为什么呢？岐伯回答说：肺主管身体的皮毛，心主管身体的血脉，肝主管身体的筋膜，脾主管身体的肌肉，肾主管身体的骨髓。（所主管的部位不同，痿证的发生也各自归属于其所主管的部位。）所以肺热叶焦（肺部受热熏灼，津液枯槁），则皮毛虚损，拘急变薄附着于骨，就会生痿躄（指足不能行）。（意思是挛缩，脚不能伸展。肺热则肾受热气影响所致。按：肺合皮毛，其质轻浮而主气，所以气弱急促，形体变薄而附着。金亏不能生肾水，肾也虚惫而挛缩。挛缩，必定是切痛的意思。）心气热，则下部血脉逆乱而上行，上行则下部血脉空虚，空虚则生脉痿，关节枢纽折断，小腿提起，弛缓无力，不能站立于地。（按：心本为火脏，火盛则热，热性炎上，气也上行，周身血脉皆逆乱而上。然上盛则下必虚，而痿弱的现象当见于血脉。脉痿的症状是什么？身体不能运动，脚不能踩地，如同枢纽折断而小腿提起。然而之所以折断且提起，是因为心虚血少，不能养筋，导致弛缓无力的缘故。胫，即腓骨。）肝气热，则胆汁外泄口苦，筋膜干燥，筋膜干燥则筋脉拘急而挛缩，发为筋痿。（按：肝为脏，胆为腑，阴阳本相应。肝属木而生火，火上炎则胆汁上溢而口苦。肝又主筋，所以热则筋膜干燥，正因为干燥所以又拘急而为筋痿。痿的含义似乎属于弛缓，但挛急也是痿者，因为拘缩而不能伸展，与弛缓无异，所以也能导致痿。按：胆位于肝短叶之间，注释说胆为肝叶，是错误的。）脾气热，则胃干而口渴，肌肉麻木不仁，发为肉痿。（脾与胃以膜相连，脾气热则胃液渗泄，所以干燥而且口渴。脾主肌肉，现在热邪侵迫于内，所以肌肉麻木不仁而发为肉痿。）肾气热，则腰脊不能抬起，骨骼枯槁而髓液减少，发为骨痿。（腰为肾之府，又肾脉上行股内侧，贯穿脊柱，属肾，所以肾气热则腰脊不能抬起。肾主骨髓，所以热则骨枯而髓减，成为骨痿。）
黄帝问：怎么得的呢？岐伯说：肺是五脏之长，为心的华盖。（位置高且在胸中布散叶片，所以是五脏之长，心的覆盖物。）如果有丧失亡失，所求不得，就会引发肺鸣（喘息有声），肺鸣则肺热叶焦。（……志意苦闷不畅，气机郁结的缘故。肺藏气，气郁不利，所以喘息有声而肺热叶焦。）悲哀太甚则胞络断绝，胞络断绝则阳气内动，发作时心下出血，频繁小便出血。（……按：胞络，即心包络。包络用来护卫心脏，悲哀太甚，则气急迫而胞络受伤，络伤则心病。盖心属火而主血，心病火发，血不能静，遂向下流入尿液中。）思虑无穷，愿望不得实现，意念淫逸于外，房事过度，宗筋弛纵，发为筋痿，以及白淫（男女皆有，男为遗精，女为带下）。……按：无穷谓多欲。外谓非己室也。白淫，男女皆有之，男为游精，女为阴液。邪思妄想，意淫而已，虽无实事，而精气已为之动摇，故遂与入房太甚者，并足以致筋痿也。然筋痿，肝之病也，何以并得之色欲？盖肾败精伤，水亏不能养木故也。）有逐渐感受湿邪，以涉水为职业，若湿气停留，居处潮湿，肌肉浸渍，痹阻而不仁，发为肉痿。（……业惟近湿，居处泽下，皆水为事也。平者久而犹怠，感之者尤甚矣。肉属于脾，脾气恶湿，湿着于内，则卫气不营，故肉为痿也。按：渐音尖。渍音滋，渗染也。）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。（……按：水以制火，然火盛则烁水，而水愈虚火愈炽。是故劳倦热渴，阳火内炽，水不能胜而肾亏矣。肾主骨，骨借髓以强，身凭足以任。肾亏则髓虚，髓虚则骨枯而足无力以任身，是名骨痿也。）黄帝问：怎么区别它们呢？岐伯说：肺热者面色白而毛发败坏，心热者面色赤而络脉充盈，肝热者面色青而爪甲枯槁，脾热者面色黄而肌肉蠕动，肾热者面色黑而牙齿枯槁。（各求脏色及所主养而命之，则其应也。按：蠕音软，微动也。）
黄帝说：像先生说的可以了，经论说治疗痿证独取阳明，为什么呢？岐伯说：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活动。（宗筋指阴毛中横骨上下之竖筋。上络胸腹，下贯髋尻，又经于背腹，上头项，所以说宗筋主束骨而利机关。然而腰是身体的大关节，所以司屈伸，故曰机关。按：闰当作润，言脏腑资水谷以化气血而养人，宗筋借以滋润焉。宗筋为诸筋之宗，网维一身，干槁则拘缩，滋润则便利也。）冲脉是经脉的海，主要渗透灌溉溪谷，与阳明经会合于宗筋。（冲脉循腹挟脐旁各同身寸之五分而上，阳明脉亦挟脐旁各同身寸之一寸五分而上，宗筋脉于中，所以说与阳明合于宗筋。以为十二经海，故主渗灌溪谷也。肉之大会为谷，小会为溪。按：渗灌者，无微不入。冲脉主血兼气，其位虽止于挟腹中行，而气则流行一身，无处不到，故取义于渗灌也。）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，所以阳明虚则宗筋纵，带脉不引，故足痿不用也。（宗筋挟脐下，合于横骨，阳明辅其外，冲脉居其中，所以说会于气街而阳明为之长。气街则是阴毛两旁脉动处。带脉者，起于季胁，回身一周而络于督脉。督脉者，起于关元，上下循腹。所以说皆属于带脉而络于督脉。冲、任、督三脉，同起而异行，所以经文参差而引之。引谓牵引。按：水谷充盈则阳明实而气血盛，气血盛则宗筋劲调而有力，虚则缓弱无力而足不能行矣。所以然者，足以筋为用也。注滥引，未确。）黄帝问：怎么治疗呢？岐伯说：各补其荣穴而通其俞穴，调其虚实，和其逆顺，筋脉骨肉，各以其时受月（根据五脏所主之时令月份进行治疗），则病已矣。黄帝说：好！（按：荣者，血也。逆调论言：“荣气虚则不仁。”故治痿之法，以补血为最也。俞，背穴，五脏各有俞。时受月者，五脏各有应王之月，如肝伤则筋病，欲治筋病，必于春月木王之时，因时以受王月之气，则邪易去而正易复也。筋者，肝也；脉者，心也；骨者，肾也；肉者，脾也。五脏独缺肺者，肺合皮毛，皮毛附于肉，或省文也。注似是而未明快。）
Wei (Wasting and Thirst Syndrome), as annotated, refers to the condition of limb weakness and inability to move. However, the cause of this weakness, while involving factors from the five Zang organs, ultimately relates to the Stomach. This is because the Stomach stores water and grain to nourish the human body, and all five Zang and six Fu organs receive Qi from it. Therefore, if Stomach Qi is deficient, the Zang and Fu organs lose their nourishment, and the meridians of Chong (Penetrating Vessel), Du (Governing Vessel), and Dai (Belt Vessel) fail to maintain each other. The Zong Jin (General Tendon) becomes flaccid, the whole body lacks strength, and thus Wei syndrome occurs. This is why the Yellow Emperor and Qibo debated this issue repeatedly.
The Yellow Emperor asked: "How can the five Zang organs cause Wei syndrome?" Qibo replied: "The Lung governs the skin and hair of the body; the Heart governs the blood vessels; the Liver governs the tendons and fascia; the Spleen governs the muscles; and the Kidney governs the bone marrow." (Since the governed areas differ, Wei arises in each according to its specific governance.) Thus, when Lung heat scorches the leaves (Lung Yin deficiency with dryness), the skin and hair become deficient, weak, thin, and adherent, leading to Wei Bi (inability to walk). (This means spasms where the feet cannot extend. Lung heat affects the Kidney due to shared heat. Note: The Lung combines with the skin and hair; its nature is light and floating, governing Qi. Thus, deficiency leads to weak and急促 Qi, and the form becomes thin and adherent. Metal deficiency fails to generate Kidney Water, causing the Kidney to be exhausted and spasmodic. Spasms imply pain.) If Heart Qi is hot, the lower vessels reverse and ascend; ascending causes the lower vessels to become deficient, leading to Mai Wei (Vessel Wei), where the pivot breaks, the tibia is lifted, and the limbs are flaccid and unable to bear weight on the ground. (Note: The Heart is a Fire organ; excess fire causes heat, which rises. Qi also ascends, reversing the flow of all vessels in the body. Excess above leads to deficiency below, manifesting as vessel Wei. Symptoms include immobility and inability to stand, resembling a broken pivot with lifted shins. This occurs because Heart deficiency and blood lack fail to nourish the tendons, causing flaccidity. Tibia refers to the fibula.) If Liver Qi is hot, bile leaks causing bitter taste, and the fascia dries up. Dry fascia leads to tendon spasms and contractures, resulting in Jin Wei (Tendon Wei). (Note: The Liver is a Zang organ, and the Gallbladder is a Fu organ, corresponding in Yin and Yang. Liver belongs to Wood and generates Fire; rising fire causes bile reflux and bitter taste. The Liver governs tendons, so heat dries the fascia. Dryness causes contraction and Wei. Although Wei implies flaccidity, contracture is also Wei because inability to extend is similar to flaccidity. Note: The Gallbladder lies between the short lobes of the liver; the annotation claiming the Gallbladder is the liver lobe is incorrect.) If Spleen Qi is hot, the Stomach becomes dry and thirsty, muscles become insensate, resulting in Rou Wei (Muscle Wei). (The Spleen and Stomach are connected by membranes; Spleen heat causes stomach fluids to leak, leading to dryness and thirst. The Spleen governs muscles; internal heat invasion causes muscle insensibility and Wei.) If Kidney Qi is hot, the waist and spine cannot lift, bones become withered, and marrow decreases, resulting in Gu Wei (Bone Wei). (The waist is the mansion of the Kidney; the Kidney meridian runs up the inner thigh, through the spine, and connects to the Kidney. Thus, Kidney heat prevents waist/spine movement. The Kidney governs bone marrow; heat causes bone withering and marrow depletion, leading to Bone Wei.)
The Emperor asked: "How is it acquired?" Qibo said: "The Lung is the chief of the Zang organs and the canopy of the Heart." (Positioned high and spreading leaves in the chest, it is the chief of Zang and covers the Heart.) Loss or unfulfilled desires cause Lung Ming (lung sounds/wheezing), which leads to Lung heat scorching the leaves. (… Frustrated will and stagnant Qi cause this. The Lung stores Qi; stagnation leads to wheezing and Lung heat/leaf scorching.) Extreme sorrow severs the Bao Luo (Pericardium Collateral); severance causes internal movement of Yang Qi, leading to heart bleeding and frequent hematuria. (… Note: Bao Luo refers to the Pericardium Collateral, which protects the Heart. Extreme sorrow causes urgent Qi, injuring the collateral and affecting the Heart. As the Heart governs Blood and belongs to Fire, Heart fire agitation causes blood to flow downward into urine.) Endless thinking and unfulfilled wishes, with lustful thoughts directed outward, combined with excessive sexual activity, cause Zong Jin to relax, leading to Jin Wei and Bai Yin (white discharge; for men, spermatorrhea; for women, leukorrhea). … Note: 'Endless' implies excessive desire. 'Outward' implies non-marital contexts. Bai Yin affects both genders. Evil thoughts and mental lust disturb Jing (Essence) even without physical act, contributing to Jin Wei along with excessive sex. Since Jin Wei is a Liver disease, why does sexual excess cause it? Because Kidney essence damage and Water deficiency fail to nourish Wood (Liver). Gradual exposure to dampness, working with water, or living in humid environments causes muscle immersion, bi obstruction, and insensibility, leading to Rou Wei. (… Working near water or living in low, wet areas involves water. Even normal people suffer over time, but those exposed more severely suffer more. Muscles belong to the Spleen; the Spleen dislikes dampness. Internal dampness blocks Ying Qi, causing Muscle Wei. Note: Jian is pronounced jian; Zi is pronounced zi, meaning infiltration.) Long journeys and fatigue, encountering intense heat and thirst, cause internal attack by Yang Qi. Heat settles in the Kidney. As the Kidney is a Water organ, if Water cannot overcome Fire, bones wither and marrow empties, making the feet unable to support the body, leading to Gu Wei. (… Note: Water controls Fire, but excessive Fire boils Water, worsening deficiency. Fatigue and heat cause internal Yang fire; Water fails to control it, damaging the Kidney. The Kidney governs bones, strengthened by marrow. Kidney deficiency leads to empty marrow, withered bones, and weak feet, named Bone Wei.) The Emperor asked: "How to distinguish them?" Qibo said: "Lung heat presents with white complexion and damaged hair; Heart heat with red complexion and overflowing collaterals; Liver heat with bluish complexion and withered nails; Spleen heat with yellow complexion and twitching muscles; Kidney heat with black complexion and withered teeth." (Identify by organ color and governed area. Note: Ru is pronounced ruan, meaning slight movement.)
The Emperor said: "Your explanation is sufficient. The classics state that treating Wei requires focusing solely on the Yangming channel. Why?" Qibo said: "The Yangming channel is the sea of the five Zang and six Fu organs; it primarily moistens the Zong Jin. The Zong Jin binds the bones and facilitates joint movement." (Zong Jin refers to the vertical tendons around the pubic bone. It connects to the chest/abdomen above, passes through the hips/sacrum below, and traverses the back/abdomen to the head/neck, thus binding bones and aiding joints. The waist is the major joint controlling flexion/extension, hence 'joint'. Note: 'Run' should be read as 'moisten'; organs transform food/qi to nourish the body, and Zong Jin relies on this moisture. As the chief of all tendons, it supports the body; dryness causes contraction, moisture ensures mobility.) The Chong Vessel is the sea of the meridians, primarily infiltrating the溪谷 (valleys/muscle spaces), and merges with Yangming at the Zong Jin. (Chong meridian runs 0.5 cun lateral to the umbilicus; Yangming runs 1.5 cun lateral; Zong Jin is in between, hence they merge. As the sea of twelve meridians, it infiltrates muscle spaces. Large muscle gatherings are 'Gu', small are 'Xi'. Note: Infiltration means penetrating everywhere. Chong governs Blood and Qi; though located laterally, Qi flows throughout the body, justifying the term 'infiltration'.) The Yin and Yang converge at the Zong Jin, meeting at the Qi Street (Qichong), with Yangming as the leader. All belong to the Dai Vessel and connect to the Du Vessel. Therefore, Yangming deficiency causes Zong Jin relaxation and Dai Vessel failure to draw, resulting in foot Wei and immobility. (Zong Jin joins the transverse bone below the umbilicus; Yangming supports externally, Chong resides internally, meeting at Qi Street with Yangming leading. Qi Street is the pulsating point beside the pubis. Dai Vessel originates from the hypochondrium, encircles the body, and connects to Du Vessel. Du Vessel originates at Guanyuan, running up/down the abdomen. They belong to Dai and connect to Du. Chong, Ren, and Du originate together but diverge, explaining the text's structure. 'Yin' means traction. Note: Abundant food/grain fills Yangming, strengthening Qi/Blood, making Zong Jin firm and strong. Deficiency causes flaccidity and inability to walk. This is because feet rely on tendons. Annotations citing irrelevant sources are inaccurate.) The Emperor asked: "How to treat?" Qibo said: "Tonify the Ying (Stream) points and unblock the Shu (Transport) points for each organ, regulate deficiency and excess, harmonize reversal and smoothness. For tendons, vessels, bones, and flesh, treat according to their respective months of dominance, and the illness will resolve." The Emperor said: "Excellent!" (Note: Ying refers to Blood. Ni Diao Lun states: 'Deficient Ying Qi causes insensibility.' Thus, treating Wei prioritizes tonifying Blood. Shu points are back-Shu points, one for each Zang. 'Months of dominance' refer to the seasons when each Zang is strongest; e.g., treat tendon/Liver issues in Spring when Wood is dominant, allowing pathogen expulsion and healthy Qi recovery. Tendons=Liver; Vessels=Heart; Bones=Kidney; Flesh=Spleen. Lung is omitted here because Lung governs skin/hair, which attach to flesh, possibly an ellipsis. Annotations are plausible but unclear.)