Discussion on Wei Atrophy

The Yellow Emperor asked: "The five viscera can all cause atrophy diseases in a person—what is the principle behind this?" Qi Bo replied: "The lungs govern the skin and body hair of the entire body, the heart governs the blood vessels of the entire body, the liver governs the sinews and membranes of the entire body, the spleen governs the muscles of the entire body, and the kidneys govern the bones and marrow of the entire body. Therefore, when the lungs have heat, the lung lobes become scorched and withered, then the skin and body hair become weak. If the heat pathogen presses urgently and lodges internally, it leads to wei bi (atrophy and paralysis of the four limbs, inability to walk). When the heart has heat, the blood vessels descending downward will surge upward; surging upward causes emptiness in the lower blood vessels; emptiness leads to mai wei (vessel atrophy), as if the pivot of a joint is broken and cannot be lifted, with the calves slack and unable to touch the ground. When the liver has heat, then bile leaks outward, the mouth tastes bitter, and the sinews and membranes become dry; dryness of the sinews and membranes causes them to become tense and spastic, resulting in jin wei (sinew atrophy). When the spleen has heat, then the stomach becomes dry and thirsty, the muscles become numb and insensible, resulting in rou wei (muscle atrophy). When the kidneys have heat, then the lower back and spine cannot be lifted, the bones become withered and the marrow decreases, resulting in gu wei (bone atrophy)."

The Yellow Emperor asked: "How do atrophy diseases arise?" Qi Bo said: "The lungs are the chief of the five viscera and also serve as the canopy over the heart. If one encounters disappointment or desires that cannot be fulfilled, then lung qi becomes obstructed with wheezing sounds; wheezing sounds cause lung heat and scorched lung lobes. Hence it is said: The five viscera, because of lung heat and scorched lobes, develop wei bi—this is the principle. Excessive grief severs the network vessels of the pericardium; when the network vessels of the pericardium are severed, then yang qi moves recklessly internally; when it erupts, it causes bleeding from the lower part of the heart, often manifesting as blood in the urine. Therefore, the Ben Bing says: When the large channels are empty, it leads to ji bi (muscle numbness), which then transforms into mai wei (vessel atrophy). If thoughts are endless and desires unfulfilled, with intentions indulgent externally and excessive sexual activity, then the ancestral sinew becomes slack and relaxed, resulting in jin wei (sinew atrophy) and bai yin (spermatorrhea in men, vaginal discharge in women). Therefore, the Xia Jing says: The disease of sinew atrophy arises from the liver, due to internal injury from excessive sexual activity. If one is gradually soaked by dampness, habitually exposed to water-dampness, or dwells in damp places, the muscles become soaked, numb, and insensible, resulting in rou wei (muscle atrophy). Therefore, the Xia Jing says: The disease of muscle atrophy comes from prolonged dwelling in damp places. If one becomes fatigued from long journeys and then encounters great heat and thirst, thirst causes yang qi to attack internally; internal attack causes heat pathogen to lodge in the kidneys. The kidneys are the water viscus; now if the water viscus cannot overcome the fire pathogen, it withered the bones and empties the marrow, so both feet cannot support the body, resulting in gu wei (bone atrophy). Therefore, the Xia Jing says: The disease of bone atrophy is due to great heat."

The Yellow Emperor asked: "How can these atrophy diseases be distinguished?" Qi Bo said: "In atrophy from lung heat, the complexion is white and the body hair is withered. In atrophy from heart heat, the complexion is red and the collateral vessels are engorged. In atrophy from liver heat, the complexion is green and the nails are withered. In atrophy from spleen heat, the complexion is yellow and the muscles twitch. In atrophy from kidney heat, the complexion is black and the teeth are withered."

The Yellow Emperor said: "The principles you, Master, have spoken are indeed correct. But the medical treatises say that for treating atrophy diseases, one should solely take the yangming channel—what is the reasoning behind this?" Qi Bo said: "The yangming channel is the source of the five viscera and six bowels, governing the nourishment of the ancestral sinew. The ancestral sinew governs the binding of bones and the lubrication of joints. The chong mai (thoroughfare vessel) is the source of the twelve channels, governing the irrigation and moistening of the xi gu (intermuscular spaces), and it meets the yangming channel at the ancestral sinew. The yin and yang channels all converge at the meeting point of the ancestral sinew, and they also meet at the qijie point. The yangming channel is their leader; they all connect to the dai mai (belt vessel) and are collateral to the du mai (governing vessel). Therefore, when the yangming channel is deficient, the ancestral sinew becomes slack and relaxed, and the dai mai cannot draw in, so both feet become atrophied and unable to function."

The Yellow Emperor asked: "How is it treated?" Qi Bo said: "For each channel, supplement its ying-spring point and unblock its shu-stream point, regulate its vacuity and repletion, and harmonize its rebellious and smooth flow. The sinews, vessels, bones, and muscles—each according to its corresponding seasonal month receive treatment, and then the disease will be cured." The Yellow Emperor said: "Well spoken."