Wei Zheng (flaccidity syndrome)

Western medicine – any disorder of the PNS that may cause weakness &/or numbness, MS, spinal & muscular disorders.

The wei syndrome is characterized by flaccidity or atrophy of the limbs with motor impairment. It is also called flaccid lame, for the leg is usually involved. The wei syndrome was first described in Chapter 44 of Plain Questions as a syndrome mainly caused by heat in the lung with the lobes scorched. The physicians of later generations further developed this theory. Zhang Jingyue (1156 - 1228 A. D.) pointed out, "It is not a few cases of wei syndromes that are due to the injury of primary qi leading to deficiency of essence which fails to irrigate, or deficiency of blood which fails to nourish."

On the treatment of wei syndromes, Chapter 44 of Plain Questions puts forward the theory: Only points along the Yangming Meridians are selected in treating wei syndromes. The stomach is believed to be the sea of water and food, and the source of acquired essence. The Foot - Yangming Meridian is enriched with qi and blood. The twelve meridians, tendons, bones, and muscles need the acquired qi and blood for nourishment, while the production of blood in the liver and essence in the kidney depends upon the transformation of water and food. Therefore, regulating the function of the Stomach Meridian of Yangming is the main principle in treating the wei syndromes. In clinical practice, treatment is determined according to differentiation of the syndrome as well as locality, etiology and pathogenesis of the disease. In a chronic bi syndrome there may be prolonged motor impairment of the joint because of pain. In this case there develops muscular atrophy or flaccidity of the limb on account of disuse. It should be differentiated from the wei syndrome which is characterized by absence of pain.

The muscular flaccidity or atrophy of the limb results from nourishment of the tendons due to exhaustion of body fluid. This condition may be caused by invasion of the lung by exogenous pathogenic heat, or excessive heat remaining in the lung after an illness. Epidemic febrile disease leads to weak limbs (meningitis, Guillian-Barre syndrome)

Main manifestations: Muscular flaccidity of the lower limbs with motor impairment, accompanied by fever, cough, irritability, thirst, scanty and brownish urine, reddened tongue with yellow coating, thready and rapid or rolling and rapid pulse.

Analysis: Fever and cough are the results of the invasion of the lung by the pathogenic heat. Irritability, thirst and scanty, brownish urine indicate that the body fluid has been damaged by the internal heat. Muscular flaccidity and motor impairment result from malnutrition of the tendons and muscles and damage of essence and body fluid. The thready, rapid pulse and reddened tongue with yellow coating indicate that the body fluid has been injured by heat. The rolling, rapid pulse is associated with excessive heat.

Feishu (BL13) and Chize (LU5) are used to dissipate heat from the lung. Pishu (BL20) and Yinlingquan (SP9) eliminate damp heat. Ganshu (BL18) and Shenshu (BL23) are chosen to tonify the yin in the liver and kidney.

Exogenous pathogenic damp invades in the body, and the accumulation of damp is eventually transformed into heat which damages the muscles and tendons. Hence, the muscles and tendons become flaccid. The wei syndromes may also be caused by excessive intake of greasy food which produces internal accumulation of damp - heat, resulting in stagnation of qi and blood in the meridians and collaterals.

Main manifestations: Flaccid or slight swollen legs, a little hot sensation on touch, general heaviness, sensation of fullness in the chest and epigastric region, painful urination, hot and brownish urine, yellow sticky tongue coating, soft and rapid pulse.

Analysis: Flaccidity of the legs is due to the stagnation of qi and blood in the tendons and muscles caused by prolonged accumulation of internal damp - heat. General heaviness is also due to accumulation of damp - heat. When damp - heat is accumulated in the chest, fullness sensation in the chest and epigastrium results. Hot, brownish urine, and painful urination suggest the downward flow of damp heat. Yellow sticky tongue coating, and soft rapid pulse are signs of damp - heat.

Since the liver stores blood and controls the tendons, and the kidney stores essence and dominates the bones' prolonged illness or indulgent sexual activity causes loss of essence and blood, resulting in malnutrition of the tendons. Conditions affecting the proper function of the liver and kidney may therefore also give rise to the wei syndrome.

Main manifestations: Muscular flaccidity of the lower limbs with motor impairment, combined with soreness and weakness of the lumbar region, seminal emission, prospermia, leukorrhoea, dizziness, blurring of vision, reddened tongue, thready and rapid pulse.

Analysis: In deficiency of yin of the liver and kidney the muscles, tendons and bones are poorly nourished essence and blood, and hence occurs muscular flaccidity with motor impairment. Soreness and weakness of the lumbar region, seminal emission and leucorrhoea are the result of deficiency of essence in the kidney. Since the kidney is located in the lumbar region, it stores essence, and its meridians connect with the Chong Meridian and the Ren Meridian. Dizziness and blurring of vision are caused by preponderance of yang in the liver arising from deficiency of yin in the kidney. Reddened tongue, thready and rapid pulse are signs of deficiency of yin of the liver and kidney.

Acupuncture

Deficiency of yin in the liver and kidney: Ganshu (BL18), Shenshu (BL23).
Incontinence of urine: Zhongji (RN3), Sanyinjiao (SP6).
Incontinence of feces: Dachangshu (BL25), Ciliao (BL32).

Contusion causes injury of the meridians and leads to retarded flow ofqi and blood in the meridians. As a result, the muscles and tendons are poorly nourished, and become flaccid. Thus occurs the wei syndrome.

Differentiation

Main manifestations: History of trauma, flaccid paralytic limbs, may be accompanied with incontinence of urine and feces, relaxed or hesitant pulse, pink or dark purplish tongue with thin white coating.

Analysis: Flaccid paralytic limbs arise from obstruction of the circulation of qi and blood at the injured site of trauma. Incontinence of urine and feces is mainly due to dysfunction of the kidney which fails to control urine and feces. In case of trauma, the Du Meridian which dominates the yang qi of the whole body is affected, and the qi activity of all zang - fu organs may be impaired, including the function of the kidney in controlling urine and feces. Damage of qi of the kidney causes incontinence of urine and feces. Hesitant pulse and dark purplish tongue indicate blood stasis.

Acupuncture

Method: Main points are selected from the Yangming Meridians to promote circulation of qi in the meridians, and to nourish the tendons and bones. If heat or damp heat in the lung is the main etiological factor, the reducing method should be used to dissipate heat. In case of deficiency of yin in the liver and kidney, the reinforcing method should be employed. For trauma, puncture the points on the affected side with even movement. Prescription:

Upper limb: Jianyu (LI15), Quchi (LI11), Hegu (LI4), Waiguan (SJ 5).
Lower limb: Biguan (ST31), Huantiao (GB30), Xuehai (SP10), Liangqiu (ST34), Zusanli (ST36), Yanglingquan (GB34), Jiexi (ST41), Xuanzhong (GB39).
Trauma: Huatuojiaji points at the corresponding level of spinal injury.

Explanation: In the above prescription points the Yangming Meridians are predominating. This is based upon the statement in Internal Classic: Only points along the Yangming Meridians are selected to treat paralysis of the limbs. Yanglingquan (GB34) and Xuanzhong (GB39), the Influential Points of tendon and marrow respectively, are added to enhance the effect of nourishing the tendons and bones.

Huatuojiaji points are selected to regulate qi in the Du Meridian. Zhongji (RN3) and Sanyinjiao (SP6) are taken to adjust the qi in the kidney and bladder. Dachangshu (BL25) and Ciliao (BL32) improve the function of the large intestine.

Spleen Stomach deficiency

muscle atrophy
Acupuncture – foot Yangming, Pai Ci, Hua Tou Jia Ji, Ren 6, SP 6, 9

Liver Kidney deficiency

Multiple Sclerosis (MS)
Acupuncture – foot Shaoyin, Yangming, Hua Tou Jia Ji, Pai Ci (upper and lower limbs), Wei Ci (around troubled area), RN4, SP6, KI3, BL23

Blood Stasis

neuropathy (Heart attack recovery)
Acupuncture – Hua Tou Jia Ji, local points, RN6, SP6, SP10, BL40

electrical- intermittent or alternating frequency, must see muscle twitch
7 star- BL meridian
injections- BL1, BL12