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Wilting
痿 〔痿〕wěi
Also atony (Obs.). Weakness and limpness of the sinews that in severe cases prevents the lifting of the arms and legs accompanied by the sensation that the elbow, wrist, knee, and ankle are dislocated. In advanced cases, atrophy sets in. In clinical practice, the condition is mainly found to affect the legs, preventing the patient from walking, hence it is also called crippling wilt. Wilting patterns include withering and paralysis of the limbs in neonates and infants after high fever, which Western medicine attributes to poliomyelitis.
Biomedical correspondence: polyneuritis (multiple neuritis); acute myelitis; poliomyelitis; progressive myatrophy; myesthenia gravis; periodic paralysis; myodystrophy; hysterical paralysis.
The pathomechanism of wilting has been explained in different ways over the centuries.
yáng brightness (yáng míng) is the sea of the five viscera and six bowels, and governs the moistening of the ancestral sinews (see ancestral sinew), which leash the bones and allow the hinges (i.e., the major joints) to move uninhibitedly. The thoroughfare (chōng) vessel is the sea of the channel vessels; it governs irrigation of the ravines and valleys, and unites with the yáng brightness (yáng míng) at the ancestral sinews The yīn and yáng (the thoroughfare (chōng) vessel and yáng brightness (yáng míng)) converge at the ancestral sinews... They home to the girdling dài vessel and net the governing dū vessel. Thus, when yáng brightness (yáng míng) is vacuous, the ancestral sinews are slack and the girdling fails to conduct; hence the legs become wilted and useless.
Over the centuries, wilting has generally been considered more commonly to be due to internal damage than to external evils, more commonly due to cold than heat, and more commonly to vacuity rather than to repletion.
Nowadays, the view prevails that it is due to lung heat scorching the lobes, which spreads to the other viscera. When the heat affects the yáng brightness (yáng míng) (stomach) channel’s ability to moisten the ancestral sinew,
the sinews are scorched by the heat and become wilted. Liver-kidney depletion also plays a role. When the kidney is depleted, the bones become desiccated and the marrow is reduced. When the kidney fails to nourish the liver, the sinews are deprived of nourishment. Liver-kidney depletion is considered to be sufficient in itself, without lung-stomach heat, to cause wilting. Wilting patterns, according to modern texts, primarily include lung heat with damage to liquid, soddening by damp-heat, spleen-stomach vacuity, and liver-kidney depletion. See also the entries listed below.
Patterns
Lung heat with damage to liquid (肺热伤津 fèi rè shāng jīn) during or after illness gives rise to sudden limpness of the limbs. It manifests as heat effusion, heart vexation, thirst, cough and dry pharynx, yellow or reddish urine, dry bound stool, a red tongue with yellow fur, and a fine rapid pulse. This is explained by warm heat invading the lung, which damages liquid. When liquid is insufficient, it cannot be distributed to all parts of the body so that the sinews are deprived of nourishment.
Medicinal therapy: Clear heat and moisten dryness; nourish the lung and engender liquid. Use
Soddening by damp-heat (湿热浸淫 shī rè jìn yín) (i.e., saturation of the flesh by damp-heat) causes wilting characterized by heavy cumbersome limbs that are limp and lack strength, and that may be slightly swollen or numb. The lower limbs are most commonly affected. This is associated with a liking for coolness and fear of heat, in some cases with heat effusion. Other signs include glomus and oppression in the chest, inhibited voidings of reddish urine with stinging pain, a slimy yellow tongue fur, and a soggy rapid pulse. The heavy cumbersome and possibly slightly swollen limbs are explained by damp-heat soddening the flesh. The limp wilting limbs and numbness are explained by damp-heat soddening the vessels obstructing qì and blood.
Medicinal therapy: Clear heat and disinhibit dampness. Use variations of
Spleen-stomach vacuity (脾胃虚弱 pí wèi xū ruò) gives rise to gradually worsening limpness and wilting of the limbs with reduced eating, sloppy stool, puffy face, lassitude of spirit and lack of strength, lusterless complexion, a thin white tongue fur, and a fine pulse.
Medicinal therapy: Fortify the spleen and boost qì. Use
Liver-kidney depletion (肝肾亏虚 gān shèn kuī xū) causes limp wilting lower limbs with limp aching lumbus. This condition develops slowly and is accompanied by dizziness, tinnitus, seminal emission, and in some cases enuresis and menstrual irregularities. The tongue is red with little fur, and the pulse is fine and rapid. Liver-kidney depletion causes insufficiency of essence-blood which deprives the sinews of nourishment.
Medicinal therapy: Supplement the liver and kidney; enrich yīn and clear heat. Use
Acumoxatherapy: Acupuncture and manipulation tuī ná provide effective complements to treatment. Acupuncture treatment is based mainly on hand and foot yáng brightness (yáng míng)
Etymology
Chin 痿 wěi is composed of the illness signifier 疒 with 委 wěi, probably used here as a simplification of 萎 wěi, wilt, wither. See the etymology of lung wilting.
Wilting (痿 wěi)
- Bone wilting
- Flesh wilting
- Skin and body hair wilting
- Sinew wilting
- Vessel wilting
- Damp-heat wilting
- Damp phlegm wilting
- Dryness-heat wilting
- Blood stasis wilting
- Blood vacuity wilting
- Yīn vacuity wilting
Qì vacuity wilting - Child wilting pattern