素问·痿论 Discourse on Wei (Wilting) Syndrome
黄帝问曰：五藏使人痿，何也。歧伯对曰：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，急薄著则生痿躄也；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，则胆泄口苦筋膜乾，筋膜乾则筋急而挛，发为筋痿；脾气热，则胃乾而渴，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。歧伯曰：肺者藏之长也，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：五藏因肺热叶焦，发为痿躄，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，水藏也，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。歧伯曰：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。歧伯曰：阳明者，五藏六府之海，主闰宗筋，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，阴阳揔宗筋之会，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：治之柰何。歧伯曰：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。
Huangdi asked: How is it that the five viscera cause a person to develop wei, wilting or atrophy syndrome? Qibo replied: The lung governs the skin and body hair; the heart governs the blood vessels; the liver governs the sinews and membranes; the spleen governs the flesh and muscles; the kidney governs the bones and marrow. Thus, when the lung is heated and its lobes are scorched, the skin and body hair become weak and feeble; when this becomes acute and thin, it gives rise to wei with limpness of the limbs. When the heart qi is heated, the lower vessels reverse and rise upward; once they rise, the lower vessels become deficient, and this deficiency gives rise to vessel wei, in which the joints become as though snapped and unable to lift, and the shins become limp and cannot bear the body's weight on the ground. When the liver qi is heated, the gallbladder leaks its qi and the mouth becomes bitter, the sinews and membranes dry out; when the sinews and membranes dry out, the sinews become tense and contracted, giving rise to sinew wei. When the spleen qi is heated, the stomach dries out and there is thirst, the flesh becomes numb, giving rise to flesh wei. When the kidney qi is heated, the lower back and spine cannot be raised, the bones wither and the marrow diminishes, giving rise to bone wei.
Huangdi said: How is this contracted? Qibo said: The lung is the chief of the viscera and the canopy of the heart; when one experiences loss or bereavement, or when one's desires are not fulfilled, the lung is stirred to wheeze; wheezing then leads to heat in the lung and scorching of its lobes. Hence it is said: the five viscera, because of heat in the lung and scorching of its lobes, give rise to wei with limpness of the limbs — this is what is meant. When grief and sorrow are excessive, the connecting vessel of the uterus becomes severed; once severed, yang qi stirs internally, and when this erupts there is collapse below the heart and frequent bloody urination. Hence the lost text Ben Bing says: when the great channels are empty and hollow, this gives rise to muscle bi, which is transmitted and becomes vessel wei. When thoughts and longings are endless, and one's wishes are not fulfilled, so that the mind wanders licentiously outward, and one enters the bedchamber to excess, the ancestral sinew becomes slack and lax, giving rise to sinew wei, as well as to white seminal discharge. Hence the lost text Xia Jing says: sinew wei arises from the liver, brought on by indulgence within the bedchamber. When one is gradually steeped in dampness, engaged in work involving water, or dwells for a long time in a damp place, the flesh becomes soaked and macerated, becoming blocked and numb, giving rise to flesh wei. Hence the Xia Jing says: flesh wei is contracted from damp places. When one travels far and becomes fatigued, and encounters great heat and thirst, the thirst causes the yang qi to attack internally; this internal attack causes heat to lodge in the kidney. The kidney is the viscus of water; now when water cannot overcome fire, the bones wither and the marrow becomes deficient, so that the feet cannot bear the weight of the body, giving rise to bone wei. Hence the Xia Jing says: bone wei arises from great heat. Huangdi said: How does one distinguish among these? Qibo said: In lung heat, the complexion is white and the body hair is ruined; in heart heat, the complexion is red and the network vessels overflow; in liver heat, the complexion is greenish and the nails are withered; in spleen heat, the complexion is yellow and the flesh twitches; in kidney heat, the complexion is black and the teeth become dry and lusterless.
Huangdi said: What Master you have said is acceptable; but the treatises state that in treating wei, one should select the yangming channel alone — why is this? Qibo said: Yangming is the sea of the five viscera and six bowels; it governs the moistening of the ancestral sinew, and the ancestral sinew governs the binding of the bones and the smooth functioning of the joints. The chong channel is the sea of the channels and vessels; it governs the irrigation of the muscle interstices, and joins with the yangming at the ancestral sinew. The meeting of all the yin and yang channels at the ancestral sinew occurs at the qi thoroughfare, and yangming is the chief among them; all these channels belong to the girdling vessel and connect with the governing vessel. Therefore, when yangming is deficient, the ancestral sinew becomes slack, the girdling vessel fails to draw it taut, and thus the feet become wei and unusable. Huangdi said: How is this treated? Qibo said: In each case, supplement the ying, spring, point and free the shu, stream, point, regulate deficiency and excess, and harmonize counterflow and compliance; treating the sinews, vessels, bones, and flesh each according to the month in which they receive qi, the disease will be cured. Huangdi said: Good.