李正臣夫人病诊得六脉中俱得弦洪缓相合按之无力弦在上是风热下陷入阴中阳道不行其
证闭
目则浑身麻木昼减而夜甚觉而开目则麻木渐退久则绝止常开其目此证不作惧其麻木不敢合眼
致不得眠身体皆重时有痰嗽觉胸中常似有痰而不利时烦躁气短促而喘肌肤充盛饮食不减大小
便
如常惟畏其麻木不敢合眼为最苦观其色脉形病相应而不逆内经曰阳盛瞑目而动轻阴病闭目而
静重又云诸脉皆属于目灵枢经云闭目则阳道行阳气遍布周身闭目则阳道闭而不行如昼夜之分
知其阳衰而阴旺也且麻木为风三尺之童皆以为然细校之则有区别耳久坐而起亦有麻木为如绳
缚之久释之觉麻作而不敢动良久则自已以此验之非有风邪乃气不行主治之当补其肺中之气则
麻木自去矣如经脉中阴火乘其阳分火动于中为麻木也当兼去其阴火则愈矣时痰嗽者秋凉在外
在
上而作也当以温剂实其皮毛身重脉缓者湿气伏匿而作也时见躁作当升阳助气益血微泻阴火与
湿通行经脉调其阴阳则已矣非五脏六腑之本有邪也此药主之
生甘草(去肾热) 酒黄柏(泻火除湿) 白茯苓(除湿导火) 泽泻(除湿导火) 升麻(行
阳助
经) 柴胡(各一钱) 苍术(除湿补中) 草豆蔻仁(益阳退外寒各一钱五分) 橘皮 当归身
白术(各二钱) 白芍药 人参(各三钱) 佛耳草 炙甘草(各四钱) 黄 (五钱)
上 咀每服五钱水二盏煎至一盏去渣食远服之
Mrs., wife of Li Zhengchen, was ill. Pulse diagnosis revealed that all six pulses (Cun, Guan, Chi on both hands) presented a combination of Xian (Wiry), Hong (Surging), and Huan (Slow/Relaxed) qualities, with weakness upon deep pressure. The upper pulse position showed a Xian quality, indicating that Wind-Heat pathogen had sunk into the Yin aspect, causing the Yang pathways to fail in their circulation.
The symptoms manifested as follows: when closing her eyes, she experienced numbness throughout the body, which decreased during the day and worsened at night; upon awakening and opening her eyes, the numbness gradually subsided and eventually ceased entirely. She kept her eyes open constantly. During episodes, she feared the numbness so much that she dared not close her eyes, resulting in insomnia. Her body felt heavy, and she occasionally suffered from coughing with phlegm, feeling as though phlegm obstructed her chest without being easily expelled. She experienced occasional irritability, shortness of breath, rapid breathing, and panting. Her skin and flesh were plump, her diet remained normal, and urination and defecation were regular. The most distressing aspect was the fear of numbness preventing her from closing her eyes.
Observation of her complexion, pulse, and condition showed correspondence without contradiction. The *Neijing* states: "Yang excess leads to opening eyes and movement (indicating mild condition); Yin disease leads to closed eyes and stillness (indicating severe condition)." It also says: "All pulses are connected to the eyes." The *Lingshu Jing* (Spiritual Pivot) states: "Closing the eyes allows the Yang pathways to circulate, distributing Yang Qi throughout the body; improper closure blocks the Yang pathways." This distinction is akin to day and night, indicating that Yang Qi is deficient while Yin Qi is flourishing.
Furthermore, although it is commonly believed by children that numbness is caused by Wind pathogen, careful differentiation reveals distinctions. Numbness experienced after rising from prolonged sitting is like the sensation after releasing a tight rope binding; one feels tingling and dares not move immediately, but it resolves naturally after a while. Based on this verification, there is no external Wind pathogen; rather, it is due to the failure of Qi circulation. Treatment should tonify the Qi of the Lung, whereupon the numbness will resolve. If Yin Fire within the meridians attacks the Yang aspect, causing internal fire agitation leading to numbness, one must simultaneously clear the Yin Fire for recovery.
The occasional cough with phlegm is caused by Autumn Coolness affecting the exterior and upper jiao; treatment requires warm formulas to strengthen the defensive Wei Qi and skin/hair. Body heaviness with a Huan pulse indicates latent Dampness; occasional restlessness requires raising Yang, assisting Qi, nourishing Blood, slightly draining Yin Fire, and promoting the circulation of Dampness through the meridians to harmonize Yin and Yang. This is not due to pathogens in the root organs of the Five Zang and Six Fu. This prescription governs the condition.
Raw Licorice Root (*Gancao*, Sheng Gancao) [to clear Kidney Heat]
Wine-processed Phellodendron Bark (*Huangbai*, Jiu Huangbai) [to drain Fire and remove Dampness]
White Poria (*Fuling*) [to remove Dampness and guide out Fire]
Alisma Rhizome (*Zexie*) [to remove Dampness and guide out Fire]
Cimicifuga Rhizome (*Shengma*) [to promote Yang and assist meridians]
Bupleurum Root (*Chaihu*) [1 qian each]
Atractylodes Macrocephala Rhizome (*Cangzhu*) [to remove Dampness and tonify Middle]
Cardamom Seed (*Caodoukou*) [to benefit Yang and expel exterior Cold, 1.5 qian each]
Tangerine Peel (*Chenpi*)
Angelica Sinensis Root (*Danggui Shen*)
Atractylodes Rhizome (*Baizhu*) [2 qian each]
White Peony Root (*Baishao*)
Ginseng Root (*Renshen*) [3 qian each]
Petasites Flower (*Erercao*)
Roasted Licorice Root (*Zhigancao*) [4 qian each]
Astragalus Root (*Huangqi*) [5 qian]
Crush the above herbs. Take 5 qian per dose, decoct in two cups of water until one cup remains, strain, and take after meals.