(附手足十指麻木)
厥,逆也,手足因气血逆而冷也。因气虚为主,有因血虚。气虚脉细,血虚脉大,
热厥脉数
,外感脉沉实,有痰脉弦。因痰者,用白术、竹沥;气虚,四君子;血虚,四物;热厥
,用承气;外感,用双解散加姜汁、酒。有阴厥阳厥,阴衰于下则热,阳衰于下则寒。
手足麻者,属气虚;手足木者,有湿痰死血;十指麻木,是胃中有湿痰死血。
〔附录〕厥者,甚也,短也,逆也,手足逆冷也,其证不一,散之方书者甚多。今姑撮大
概,且如寒热厥逆者,则为阴阳二厥也。阳厥者,是热深则厥,盖阳极则发厥也,不可作阴证
,而用热药治之,精魂绝而死矣。急宜大小承气汤,随其轻重治之。所谓阴厥者,始得之
身冷脉沉,四肢逆,足蜷卧,唇口青,或自利不渴,小便色白,此其候也。治之以四逆、理中
之辈,仍速灸关元百壮。又尸厥、飞尸、卒厥,此即中恶之候,因冒犯不正之气,忽然手
足
,此是卒厥客忤,飞尸鬼击、吊死问丧、入庙登冢,多有此病。以苏合丸灌之。候稍苏
,以
附汤,
中汤加
之?风中身温,气中身冷,以八味顺气散或调气散。如有痰,以四七汤、导痰汤服之。
附方
八味顺气散 见中风类。
调气散
白豆蔻 丁香 檀香 木香(各二钱) 藿香 甘草(炙,各八钱) 砂仁(四钱)
上为末。每服二钱,入盐少许,沸汤点服。
平胃散
苍术(泔浸,五斤) 浓朴(姜制炒) 陈皮(各三斤) 甘草(炒,三十两)
上为末。每服五钱,姜三片,枣一个,煎服,入盐一捻沸汤点服亦得。
四七汤
浓朴(二两) 茯苓(四两) 半夏(五两) 紫苏(二两)
上每服四钱,水一钟,姜七片,枣一个,煎服。
承气汤 见痢类。
四逆汤 理中汤 姜附汤 并见中寒类。
乌梅丸 见心痛类。
导痰汤 见痰类。
(With numbness of the ten fingers of hands and feet)
Jue (Cold Extremities), meaning reversal, refers to coldness in the hands and feet caused by the reversal of Qi and Blood flow. The pathogenesis is primarily due to Qi deficiency, but it can also be caused by Blood deficiency. In Qi deficiency, the pulse is fine; in Blood deficiency, the pulse is large. In Re Jue (Heat-induced Cold Extremities), the pulse is rapid; in exogenous pathogens, the pulse is deep and solid; with phlegm, the pulse is wiry. For cases due to phlegm, use Baizhu (Atractylodis Rhizoma) and Zhuli (Bambusae Caulis in Taenia); for Qi deficiency, use Sijunzi Tang (Four Gentlemen Decoction); for Blood deficiency, use Siwu Tang (Four Substance Decoction); for Re Jue, use Chengqi Tang (Chengqi Decoction); for exogenous pathogens, use Shuangjie San (Double Release Powder) added with Ginger Juice and Wine. There are Yin Jue and Yang Jue. If Yin declines at the lower part, heat arises; if Yang declines at the lower part, cold arises.
Numbness in the hands and feet belongs to Qi deficiency; a sense of woodenness (loss of sensation) in the hands and feet indicates damp-phlegm or dead blood (stasis); numbness in the ten fingers indicates damp-phlegm and stasis in the Stomach.
[Appendix] Jue means severe, short, or reversed, manifesting as cold extremities. The syndromes are diverse, and records scattered in various medical books are numerous. Here, we briefly summarize the general principles. For example, cold-heat Jue reversal is divided into Yin and Yang Jue. Yang Jue occurs when heat is deep, causing Jue, because extreme Yang generates Jue. It must not be treated as a Yin syndrome using hot medicines, otherwise, the spirit and soul will perish, leading to death. Urgently use Da Chengqi Tang (Major Order the Qi Decoction) or Xiao Chengqi Tang (Minor Order the Qi Decoction), treating according to the severity. What is called Yin Jue is characterized initially by cold body, deep pulse, cold extremities, curled legs lying down, blue lips and mouth, or spontaneous diarrhea without thirst, and white urine. This is its presentation. Treat with Sini Tang (Sichuan Aconite Root Decoction) or Lizhong Tang (Regulate the Middle Decoction), and rapidly moxa Guanyuan (CV4) for one hundred Zhu (moxa cones). There are also Shi Jue (Corpse Jue), Fei Shi (Flying Corpse), and Cu Jue (Sudden Jue), which are manifestations of Zhong E (sudden poisoning by evil qi). Due to offending improper qi, suddenly the hands and feet become [cold/stiff]. This is Cu Jue Ke Wu (Sudden Jue from Guest Hostility), Fei Shi Gui Ji (Flying Corpse Ghost Strike), visiting mourning, entering temples, climbing tombs, where this disease often occurs. Administer Suhexiang Wan (Styrax Pill). Wait until slightly revived, then use Fuzi Tang? Or add something to Fuzi Tang? Wind striking causes warm body, Qi striking causes cold body; use Bawei Shunqi San (Eight-Ingredient Qi-Regulating Powder) or Tiaoqi San (Qi-Regulating Powder). If there is phlegm, use Siqi Tang (Seven-Word Decoction) or Daotan Tang (Phlegm-Expelling Decoction).
Attached Formulas
Bawei Shunqi San See Stroke Category.
Tiaoqi San
Baidoukou (Cardamomi Fructus Rotundus), Dingxiang (Caryophylli Flos), Tanxiang (Santal Albi Lignum), Muxiang (Aucklandiae Radix) (each 2 qian), Huoxiang (Agastaches Herba), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 8 qian), Sharen (Amomi Fructus) (4 qian).
Grind into powder. Take 2 qian per dose, add a little salt, and take with boiling water.
Pingwei San
Cangzhu (Atractylodis Rhizoma, soaked in rice water, 5 jin), Nongpo (Magnoliae Officinalis Cortex, ginger-processed and fried), Chenpi (Citri Reticulatae Pericarpium) (each 3 jin), Gancao (Glycyrrhizae Radix et Rhizoma, fried) (30 liang).
Grind into powder. Take 5 qian per dose, add 3 slices of ginger and 1 jujube, decoct and take. Adding a pinch of salt and taking with boiling water is also acceptable.
Siqi Tang
Nongpo (Magnoliae Officinalis Cortex) (2 liang), Fuling (Poria) (4 liang), Banxia (Pinelliae Rhizoma) (5 liang), Zisu (Perillae Folium) (2 liang).
Take 4 qian per dose, add 1 zhong of water, 7 slices of ginger, and 1 jujube, decoct and take.
Chengqi Tang See Dysentery Category.
Sini Tang, Lizhong Tang, Jiangfu Tang See Cold Damage Category.
Wumei Wan See Heartache Category.
Daotan Tang See Phlegm Category.