Library

Cold Damage Numbness. How shall we elucidate it? "Ren" implies softness and flexibility. "Bu Ren" denotes a lack of such softness and flexibility. It signifies an insensitivity to itching, an insensitivity to pain, an insensitivity to cold, and an insensitivity to heat. One permits the body to flex or extend, or undergoes moxibustion and acupuncture, yet remains unaware of the reasons behind these sensations or actions; this is termed "Bu Ren" (numbness/loss of sensation). This condition arises from the abundance and obstruction of Pathogenic Qi (Xie Qi), which closes off and suppresses Healthy Qi (Zheng Qi), causing stagnation and failure to manifest. The Ying (Nutritive) and Wei (Defensive) blood and qi become deficient and scant, failing to circulate freely, thereby resulting in this state. The *Neijing* states: "When Ying Qi is deficient, there is numbness." The *Zhenjing* states: "When Wei Qi does not flow, there is numbness." Another classic states: "When Ying and Wei Qi cannot support each other, and the San Jiao (Triple Burner) has no reliance, the body suffers from Bi syndrome and numbness." From these statements, it is evident that when Ying and Wei blood and qi are deficient and fail to circulate, numbness occurs. Another classic states: "Those affected by cold develop Jue (cold extremities/stagnation), accompanied by depression, dizziness, and numbness." Regarding this specific type of Jue, it is caused by Healthy Qi being overwhelmed by Cold Qi, transforming into Jue Qi. It is not the Jue characterized by cold extremities. Why? Because "depression and dizziness" imply confusion, numbness, and insensitivity to pain and itch. Could this not be the Jue associated with Shi Jue (Corpse Jue)? The classic states: "When the Shao Yin pulse is absent, Kidney Qi is weak and scant. Essence and Blood surge, Qi becomes urgent and pressing, ascending into the chest and diaphragm. Zong Qi (Gathering Qi) gathers in reverse, Blood congeals below the heart. Yang Qi retreats downward, Heat returns to the inner thighs, interacting with Yin, causing the body to become numb. This is called Shi Jue." Thus, the Jue caused by cold, with depression, dizziness, and numbness, can be understood through the concept of Shi Jue. In antiquity, Yue Ren (Bian Que) entered the State of Guo to diagnose the Crown Prince with Shi Jue. He considered the depression, dizziness, and numbness as treatable, and after acupuncture, the patient recovered. This was indeed the diagnosis of a divine physician. Alas! If the pulse is floating and surging, sweat flows like oil, panting does not cease, fluids and food cannot be ingested, and the body is numb, this is another sign of life ending. Even if Yue Ren were present, could he revive him?

Cold Damage Fixed Gaze. How shall we elucidate it? Fixed gaze (Zhi Shi) refers to looking at objects without the movement of the eyeballs. If the eyeballs move, it is not fixed gaze. The essence of Water is Zhi (Will). The essence of Fire is Shen (Spirit). The eyes are the envoys of the Heart. Shen resides therein. They are the external manifestation of the Liver. Spirit and essence flourish there. The *Zhenjing* states: "The Qi of the Five Zang and Six Fu organs all ascends to the eyes, forming their essence. The nest of essence forms the pupil of the eye. The essence forms the pupil. The essence of Sinews forms the black part of the eye. The essence of Blood forms the collaterals. The essence of Qi forms the white part of the eye. The essence of Muscles forms the eyelid restraints. Wrapping and grasping sinews and bones, the essence of Blood and Qi, along with the vessels, form the meridians. These ascend and connect to the Brain. When the blood and qi of the Five Zang organs are abundant and flourishing, the eyes are harmonious and bright. In cold damage, fixed gaze of the eyes occurs because Pathogenic Qi is abundant and obstructing, covering the Healthy Qi, causing spirit and intellect to become dull. The essence Qi of the Zang organs fails to ascend to nourish the eyes, resulting in fixed gaze. When cold damage progresses to fixed gaze, it indicates that Pathogenic Qi is at its extreme, and the syndrome pattern is reversed; it is often difficult to treat. The classic states: "For those prone to epistaxis, sweating therapy should not be used. If sweat occurs, the temples sink, the pulse is urgent and tight, there is fixed gaze, inability to blink, and insomnia." Since the Liver receives blood to enable vision, for those who have lost blood, Liver Qi is already deficient, and Eye Qi is already weak. Furthermore, inducing sweating depletes Yang, leading to deficiency of both Yin and Yang. Although this is disordered and reversed, it is not yet severe. However, when delirious speech occurs, eyes roll back and gaze is fixed, this indicates Kidney Exhaustion. Fixed gaze with head shaking indicates Heart Exhaustion. All are signs of Organ Qi depletion and exhaustion. Fixed gaze with delirium, panting, and fullness leads to death. Diarrhea also leads to death. More severely, upon onset, one does not recognize people, picks at clothes, touches the bed, is startled and uneasy, has slight panting and fixed gaze. If the pulse is Wiry (Xian), there is survival; if Choppy (Se), there is death. All are due to abundant Pathogenic Qi and depleted Healthy Qi. If there is unclear vision ("Mu Zhong Liao Liao Bu"), unharmonious pupils, no Exterior or Interior syndromes, difficulty defecating, and slight fever, this is not fixed gaze. This is Internal Excess. Da Cheng Qi Tang (Major Order the Qi Decoction) or Da Chai Hu Tang (Major Bupleurum Decoction) can be used to purge it. Fixed gaze is an untreatable disease. Unclear vision is a treatable sign. The manifestations and symptoms of these two are similar. Practitioners should examine them carefully.