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，故肺热叶焦，则皮毛虚弱急薄着，则生痿 也。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。肝气热，则胆泄口苦筋膜干，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。帝曰∶
何以得之？岐伯曰∶肺者，脏之长也，为心之盖也，有所失亡，所求不得，则发肺鸣，鸣则肺热叶焦。故曰∶
五脏因肺热叶焦，发为痿 。此之谓也。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。
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∶筋痿者，生于肝使内也。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。故《下经》曰∶肉痿者，得之湿地也。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。
故《下经》曰∶骨痿者，生于大热也。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。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，主润宗筋，宗筋
主束骨而利机关也。冲脉者，经脉之海也，主渗灌溪谷，与阳明合于宗筋，阴阳 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。帝曰∶治之奈何？
岐伯曰∶各补其荥而通其俞，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。
黄帝问道：五脏的病变为什么会使人发生痿证呢？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。所以，如果肺有热邪导致叶焦枯槁，那么皮毛就会虚弱、拘急、变薄并附着于骨，从而产生痿躄（肢体萎弱不用）的病证。如果心气有热，则下部的血脉会逆乱而上行，上行后下部血脉就会空虚，血脉空虚就会产生脉痿，表现为关节枢纽折断般不能提举，小腿纵缓而不能站立着地。如果肝气有热，则胆汁外泄而口苦，筋膜干燥，筋膜干燥则筋脉拘急挛缩，发为筋痿。如果脾气有热，则胃中干燥而口渴，肌肉麻木不仁，发为肉痿。如果肾气有热，则腰脊不能举动，骨骼枯槁而髓液减少，发为骨痿。黄帝说：这些病是怎么得来的呢？岐伯说：肺是五脏之长，位于心的上面（如盖），如果有丧失亡失之事，或者所求不得，就会导致肺气鸣响，肺气鸣响则肺热叶焦。所以说：五脏因为肺热叶焦，从而发为痿躄，说的就是这个道理。悲哀太过，会导致胞络隔绝，胞络隔绝则阳气在内扰动，发作时会出现心下出血、频繁小便带血的症状。所以《本病》篇说：大经脉空虚，发为肌痹，传变为脉痿。思虑无穷，愿望得不到满足，意念淫逸于外，加上房事过度，导致宗筋弛缓纵放，发为筋痿，以及白淫（男子滑精、女子带下等症）。所以《下经》说：筋痿是由于肝的功能受损且房劳过度引起的。如果逐渐感受湿邪，以涉水为业，或者居住之处潮湿，肌肉被湿气浸渍，出现麻痹而不感觉疼痛，发为肉痿。所以《下经》说：肉痿是由于居住在潮湿地方引起的。如果有远行劳累，又逢大热天气而口渴，口渴则阳气在体内攻伐，阳气攻伐则热邪留舍于肾，肾是水脏，现在水不能胜火，则骨骼枯槁而髓液虚少，所以双脚不能支撑身体，发为骨痿。所以《下经》说：骨痿是由于大热引起的。黄帝说：如何辨别它们呢？岐伯说：肺热的面色白而毛发败落，心热的面色红而络脉充盈溢出，肝热的面色青而指甲枯槁，脾热的面色黄而肌肉蠕动，肾热的面色黑而牙齿干枯。黄帝说：像先生所说的那样就可以了，但医论中说治疗痿证要独取阳明经，这是什么原因呢？岐伯说：阳明经是五脏六腑气血的海源，主要滋润宗筋，宗筋主要约束骨骼而利于关节运动。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，阴阳诸经会聚于宗筋，会合于气街穴，而阳明经处于主导地位，所有经脉都归属于带脉，并联络于督脉。所以阳明经虚弱则宗筋弛缓，带脉不能牵引，因此双脚痿废不能使用。黄帝说：怎么治疗呢？岐伯说：分别补益各经的荥穴，疏通各经的输穴，调节虚实，调和逆顺，针对筋、脉、骨、肉的不同情况，在其所主之时令月份进行治疗，病就能痊愈了。黄帝说：好。
Huangdi asked, "How do the pathologies of the Five Zang Organs cause Wei syndrome (Flaccidity Syndrome)?" Qibo replied, "The Lung governs the skin and hair of the body; the Heart governs the blood vessels; the Liver governs the sinews (tendons and ligaments); the Spleen governs the muscles; and the Kidney governs the bone marrow. Therefore, if Heat in the Lung causes the lung leaves to wither and dry up, the skin and hair become weak, tight, thin, and adherent, leading to Wei Bi (limb flaccidity). If there is Heat in the Heart Qi, the blood vessels in the lower part reverse and ascend; upon ascending, the lower vessels become deficient. Deficiency leads to Mai Wei (Vessel Flaccidity), characterized by a collapse of the pivot mechanism where lifting is impossible, and the shins are relaxed and unable to bear weight. If there is Heat in the Liver Qi, the Gallbladder fluid leaks causing bitter taste, and the sinews become dry. Dry sinews lead to spasms and contractures, resulting in Jin Wei (Sinew Flaccidity). If there is Heat in the Spleen Qi, the Stomach becomes dry causing thirst, and the muscles become insensible, resulting in Rou Wei (Muscle Flaccidity). If there is Heat in the Kidney Qi, the waist and spine cannot move, the bones become withered, and the marrow decreases, resulting in Gu Wei (Bone Flaccidity)."
Huangdi said, "How are these conditions acquired?" Qibo said, "The Lung is the chief of the Zang organs and serves as the canopy for the Heart. Loss or unfulfilled desires cause Lung resonance (coughing/breathlessness), which leads to Lung Heat and withering of the lung leaves. Thus, it is said that the Five Zang organs develop Wei syndrome due to Lung Heat and withering of the lung leaves. Excessive sorrow cuts off the Bao Luo (Pericardium Collateral); when the Bao Luo is cut off, Yang Qi moves internally, causing bleeding from below and frequent hematuria. Therefore, the *Ben Bing* chapter states: 'When the large channels are empty, Ji Bi (Muscle Bi) develops, transmitting into Mai Wei.' Endless thinking and unfulfilled wishes, with mental wandering and excessive sexual intercourse, cause the Zong Jin (General Sinews) to relax and sag, resulting in Jin Wei and Bai Yin (seminal emission or leukorrhea). Therefore, the *Xia Jing* states: 'Jin Wei arises from Liver dysfunction and internal strain.' Gradual exposure to dampness, working with water, or dwelling in damp places causes muscle maceration and numbness, resulting in Rou Wei. Therefore, the *Xia Jing* states: 'Rou Wei arises from damp ground.' Long journeys and fatigue combined with extreme heat and thirst cause Yang Qi to attack internally; this internal attack allows Heat to reside in the Kidney. The Kidney is the Water organ; now Water fails to overcome Fire, leading to withered bones and deficient marrow, so the feet cannot support the body, resulting in Gu Wei. Therefore, the *Xia Jing* states: 'Gu Wei arises from extreme heat.'"
Huangdi said, "How can they be distinguished?" Qibo said, "Lung Heat presents with white complexion and damaged hair; Heart Heat with red complexion and overflowing collaterals; Liver Heat with greenish complexion and withered nails; Spleen Heat with yellow complexion and twitching muscles; Kidney Heat with dark complexion and dry teeth."
Huangdi said, "Your explanation is sufficient. However, medical texts state that treating Wei syndrome requires focusing solely on the Yangming channel. Why is this?" Qibo said, "The Yangming channel is the sea of the Five Zang and Six Fu organs, primarily nourishing 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, primarily infiltrating the Xi Gu (valleys between muscles). It combines with Yangming at the Zong Jin. The Yin and Yang converge at the Zong Jin, meeting at the Qichuan acupoint, with Yangming acting as the leader. All are connected to the Dai Mai (Girdle Vessel) and linked to the Du Mai (Governing Vessel). Therefore, deficiency in Yangming leads to relaxation of the Zong Jin and lack of traction from the Dai Mai, causing foot flaccidity and inability to use them."
Huangdi said, "How should they be treated?" Qibo said, "Tonify the Ying-Spring points and unblock the Shu-Stream points of each meridian, regulate excess and deficiency, harmonize reversal and smooth flow, addressing the sinews, vessels, bones, and flesh. Treat them according to their respective seasonal months, and the disease will resolve." Huangdi said, "Excellent."