黄帝问曰∶人有八虚，各以何候？岐伯对曰∶肺心有邪，其气留于两腋；肝有邪，其气
留于两肘；脾有邪，其气留于两髀；肾有邪，其气留于两 。凡此八虚者，此机关之室
，真气之所过，血络之所由，是八邪气恶血因而得留，留则伤筋骨，机关不得屈伸，故拘挛
。
暴拘挛，痫眩，足不任身，取天柱主之。腋拘挛，暴脉急，引胁而痛，内引心肺，噫嘻
主之。从项至脊，自脊以下至十二椎，应手刺之，立已。转筋者，立而取之，可令
遂已；痿厥者，张而引之，可令立快矣。
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。故肺气热则叶焦，焦则皮毛虚弱急薄着，着则生痿
矣。故心气热则下脉厥而上，上则下脉虚，虚则生脉痿，枢折 ，胫肿而不任地（《素问
》作挈，肿作 ）。肝气热则胆热泄，口苦筋膜干，筋膜干则筋急而挛，发为筋痿。脾气
热则胃干而渴，肌肉不仁，发为肉痿。肾气热则腰脊不举，骨枯而髓减，发为骨痿。
曰∶何以得之？曰∶肺者脏之长也，为心之盖，有所亡失，所求不得，则发为肺鸣，
鸣则肺热叶焦，发为痿 。悲哀太甚则胞络绝，胞络绝则阳气内动，发则心下崩，数
溲血。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∶筋痿生于肝，使内也。有渐于湿
，以水为事，若有所留，居处伤湿，肌肉濡渍，痹而不仁，发为肉痿。故《下经》曰∶肉痿
者得之湿地。有所远行劳倦，逢大热而渴，渴则阳气内伐，内伐则热合（《素问》作舍）于
肾，肾者水脏，今水不胜火，则骨枯而髓空，故足不任身热，发为骨痿。故《下经》曰∶骨
痿生于大热。曰∶何以别之？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。曰∶治痿者独取阳明。何谓
也？曰∶阳明者，五脏六腑之海，主润宗筋。宗筋者，主束骨而利机关。冲脉者，经脉之海
，主渗灌溪谷，与阳明合于宗筋。阴阳总宗筋之会，会于气冲，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。治之各补其营而通其俞，
调其虚实，和其逆顺，则筋脉骨肉，各以其时受月，则病矣。痿厥为四末束闷，乃疾解之，
日二，不仁者十日而知，无休病已止。
足缓不收，痿不能行，不能言语，手足痿 不
能行，地仓主之。痿不相知（一云身重骨痿不相知），太白主之。痿厥，身体不仁，手足偏小
，先取京骨，后取中封、绝骨皆泻之。痿厥寒，足腕不收， ，坐不能起，髀枢脚痛，
丘墟主之。虚则痿 ，坐不能起，实则厥，胫热肘痛，身体不仁，手足偏小，善啮颊，
光明主之。
黄帝问道：人体有八个虚处，分别通过它们来诊察什么？岐伯回答说：肺和心如果有邪气，其病气会停留在两腋；肝如果有邪气，其病气会停留在两肘；脾如果有邪气，其病气会停留在两髀（大腿根部）；肾如果有邪气，其病气会停留在两腘（膝盖后方）。这八个虚处，是关节活动的枢纽所在，是真气经过的地方，也是血络通行的通道。因此，八种邪气和恶血容易在这里停留，一旦停留就会损伤筋骨，导致关节不能屈伸，所以会出现拘挛的症状。
突然发生拘挛、癫痫眩晕、双脚无法支撑身体，取天柱穴主治。腋下拘挛，脉象突然紧急，牵引胁部疼痛，向内牵连心肺，取噫嘻穴主治。从颈部到脊柱，以及从脊柱以下到第十二椎骨的位置，用手按压寻找反应点针刺，病立即可愈。发生转筋（肌肉痉挛），站立着取穴针刺，可以使病立即痊愈；发生痿厥（肢体萎软无力兼见四肢逆冷），张开肢体并引导经气，可以立刻感到舒适。
黄帝问道：五脏为什么会使人发生痿证？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。所以肺气热则肺叶焦枯，肺叶焦枯则皮毛虚弱、紧缩变薄且附着于内，附着于内就会发生痿证。所以心气热则下部血脉逆乱而上行，上行则下部血脉空虚，空虚就会发生脉痿，表现为关节如折毁般无力，小腿肿胀而不能踏地（《素问》中“挈”作“提”，“肿”作“浮”）。肝气热则胆热而胆汁外泄，口苦且筋膜干燥，筋膜干燥则筋脉拘急而挛缩，发为筋痿。脾气热则胃干而口渴，肌肉麻木不仁，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。
又问：这些痿证是如何产生的呢？答：肺是五脏之长，位于心的上面，如果人有所丧失或愿望得不到满足，就会引发肺鸣响，鸣响则肺热叶焦，发为痿躄（下肢痿废不用）。悲哀过度则胞络闭塞，胞络闭塞则阳气在内扰动，发作时心下出血，频繁小便带血。所以本病篇说：大经脉空虚，发为肌痹，传变为脉痿。思虑无穷，愿望不得实现，意念外驰，房事过度，导致宗筋弛缓松弛，发为筋痿，以及白淫（男子滑精、女子带下等症）。所以《下经》说：筋痿生于肝，因纵欲所致。长期处于潮湿环境，以水为业，湿气留滞，居住之处受湿邪侵袭，肌肉被湿气浸渍，麻木不仁，发为肉痿。所以《下经》说：肉痿是由于居住在湿地造成的。如果长途跋涉劳累疲倦，遇到大热天气而口渴，口渴则阳气在体内攻伐，攻伐则热邪结合于肾（《素问》中“合”作“舍”），肾是水脏，如今水不胜火，则骨骼枯槁而髓空，所以双脚无法支撑身体发热，发为骨痿。所以《下经》说：骨痿生于大热。
又问：如何辨别不同类型的痿证？答：肺热的表现是面色白而毛发败落；心热的表现是面色赤而络脉充盈溢出；肝热的表现是面色青苍而指甲枯槁；脾热的表现是面色黄而肌肉跳动；肾热的表现是面色黑而牙齿干枯。
又问：治疗痿证为什么要独取阳明经？答：阳明经是五脏六腑气血的海源，主要滋润宗筋。宗筋的主要功能是约束骨骼而利于关节活动。冲脉是十二经脉的海源，主要渗透灌溉溪谷，与阳明经会合于宗筋。阴阳诸经总汇于宗筋，会合于气冲穴，而阳明经在其中起主导作用，都归属于带脉，并联络于督脉。所以阳明经虚弱则宗筋弛纵，带脉不能牵引，因此足部痿废不能使用。治疗时应分别补益其营气并疏通其俞穴，调节虚实，调和逆顺，那么在筋脉骨肉各自当令的月份接受治疗，疾病就能痊愈。
对于痿厥导致的四肢束闷感，应立即解开束缚，每天两次，如果不仁者十天左右会有知觉，不要停止直到病愈。
足部迟缓不能收持，痿废不能行走，不能言语，手足痿废不能行走，取地仓穴主治。痿证感觉丧失（一说身体沉重骨痿感觉丧失），取太白穴主治。痿厥，身体麻木不仁，手足偏小，先取京骨穴，后取中封穴、绝骨穴，均用泻法。痿厥寒，足腕不能收持，髀枢部位疼痛，坐起困难，取丘墟穴主治。虚证则痿废，坐起困难；实证则厥逆，小腿热、肘痛，身体麻木不仁，手足偏小，喜欢咬脸颊，取光明穴主治。
Huangdi asked: The human body has eight empty places (Ba Xu). How can they be used for diagnosis? Qibo replied: If there is pathogenic qi in the Lung and Heart, its qi remains in the two axillae; if there is pathogenic qi in the Liver, its qi remains in the two elbows; if there is pathogenic qi in the Spleen, its qi remains in the two thighs (Bai); if there is pathogenic qi in the Kidney, its qi remains in the two popliteal fossae. These eight empty places are the chambers of joint mechanisms, where Zhen Qi (True Qi) passes through, and where blood collaterals traverse. Therefore, evil qi and foul blood tend to remain here. Once retained, they damage the sinews and bones, preventing joints from flexing and extending, thus causing spasm (Ju Luan).
For sudden spasm, epilepsy with dizziness, and inability of the feet to support the body, treat with Tian Zhu (BL10). For axillary spasm, sudden urgency of the pulse, pain radiating to the hypochondrium and internally affecting the Heart and Lung, treat with Yi Xi (BL54). From the neck to the spine, and from the spine down to the twelfth thoracic vertebra, palpate for tender points and needle them immediately for cure. For muscle cramps (Zhuan Jin), stand and needle; the disease will cease immediately. For Wei Jue (Flaccidity with cold limbs), extend the limbs and guide the Qi; comfort will be restored immediately.
Huangdi asked: Why do the Five Zang Organs cause Wei Syndrome (Flaccidity)? Qibo replied: The Lung governs the skin and hair of the body; the Heart governs the blood vessels; the Liver governs the sinews and fascia; the Spleen governs the muscles; the Kidney governs the bone marrow. Thus, if Lung Heat causes the lung leaves to become scorched and dry, the skin and hair become weak, tight, thin, and adherent, leading to Wei Syndrome. If Heart Heat causes the lower vessels to reverse and ascend, the lower vessels become deficient, leading to Mai Wei (Vessel Flaccidity), characterized by a broken pivot (joint instability), swollen shins, and inability to bear weight on the ground (In *Su Wen*, "Qie" is interpreted as lifting, and "Zhong" as swelling). If Liver Heat causes Gallbladder Heat and bile leakage, bitterness in the mouth, and dryness of the sinews, the sinews become tight and contracted, leading to Jin Wei (Sinew Flaccidity). If Spleen Heat causes stomach dryness and thirst, and numbness of the muscles, it leads to Rou Wei (Flesh Flaccidity). If Kidney Heat causes inability to raise the waist and spine, withered bones, and reduced marrow, it leads to Gu Wei (Bone Flaccidity).
Another question arose: How are these conditions acquired? The answer is: The Lung is the chief of the Zang Organs and acts as a canopy for the Heart. Loss or unfulfilled desires cause Lung resonance, which generates Lung Heat and scorches the lung leaves, leading to Wei Bi (Flaccidity of the lower limbs). Excessive grief severs the Bao Luo (Pericardium Collaterals); when severed, Yang Qi moves internally, causing heart bleeding and frequent bloody urination. Thus, the Ben Bing chapter states: When the large channels are empty, Ji Bi (Muscle Bi) occurs, transmitting into Mai Wei. Endless thinking and unfulfilled wishes, with mind wandering outward and excessive sexual activity, cause relaxation of the Zong Jin (General Sinews), leading to Jin Wei and Bai Yin (White Turbidity/Leukorrhea or Spermatorrhea). Thus, *Xia Jing* states: Jin Wei arises from the Liver due to sexual indulgence. Gradual exposure to dampness, working with water, or living in damp places causes muscle soaking and numbness, leading to Rou Wei. Thus, *Xia Jing* states: Rou Wei is caused by dwelling in damp places. Long journeys and fatigue combined with extreme heat and thirst cause internal attack by Yang Qi; this heat combines with the Kidney (In *Su Wen*, "He" is interpreted as "She"). As the Kidney is the Water Organ, if Water fails to overcome Fire, bones become withered and marrow empty, causing inability to bear weight and heat, leading to Gu Wei. Thus, *Xia Jing* states: Gu Wei arises from extreme heat.
How to differentiate them? Lung Heat presents with white complexion and ruined hair; Heart Heat with red complexion and overflowing collateral vessels; Liver Heat with dark-green complexion and withered nails; Spleen Heat with yellow complexion and twitching muscles; Kidney Heat with black complexion and dry teeth.
Why does treating Wei Syndrome focus solely on the Stomach Meridian of Foot-Yangming? The Yangming Meridian is the sea of the Five Zang and Six Fu Organs, primarily moistening the Zong Jin. The Zong Jin binds the bones and facilitates joint movement. The Chong Mai (Penetrating Vessel) is the sea of the twelve channels, permeating the muscle valleys, and converges with Yangming at the Zong Jin. All Yin and Yang channels converge at the Zong Jin, meeting at Qi Chong (ST30), with Yangming acting as the leader. They all belong to the Dai Mai (Girdle Vessel) and connect to the Du Mai (Governing Vessel). Thus, Yangming deficiency leads to Zong Jin laxity and Dai Mai failure to draw, resulting in foot flaccidity and non-use. Treatment involves tonifying Ying Qi and unshu points, regulating excess and deficiency, and harmonizing reversal and smooth flow. Treating during the appropriate months for each tissue ensures recovery.
For Wei Jue causing constriction in the four extremities, release bindings quickly, twice daily. Numbness improves within ten days; continue until cured.
For slow, unretractable feet, flaccidity preventing walking, and aphasia, with flaccid hands and feet unable to walk, treat with Di Cang (ST4). For loss of sensation in Wei syndrome (or heavy body with bone flaccidity and loss of sensation), treat with Tai Bai (SP3). For Wei Jue, body numbness, and small hands and feet, first needle Jing Gu (BL64), then Zhong Feng (LR4) and Jue Gu (GB39), using reducing methods. For cold Wei Jue, unretractable ankles, hip joint pain, and inability to rise from sitting, treat with Qiu Xu (GB40). For deficiency causing flaccidity and inability to sit up, or excess causing Jue, shin heat, elbow pain, body numbness, small hands and feet, and cheek-biting, treat with Guang Ming (GB37).