论
《内经》曰∶风寒湿三气，合而为痹。故风气胜者为行痹，寒气胜者为痛痹，湿气胜者为着痹。河间曰∶留着不去，
四肢麻木拘挛也。经又曰∶痛者，寒气多也，有寒故痛也。其不痛不仁者，病久入深，荣卫之行涩，经络时疏，故不痛；
皮肤不营，故为不仁。夫所谓不仁者，或周身或四肢唧唧然麻木不知痛痒，如绳扎缚初解之状，古方名为麻痹者是也。
丹溪曰∶麻是气虚，木是湿痰死血。然则曰麻曰木者，以不仁中而分为二也。虽然，亦有气血俱虚，但麻而不木者。亦
有虚而感湿，麻木兼作者。又有因虚而风寒湿三气乘之，故周身掣痛兼麻木并作者，古方谓之周痹，治法宜光汗而后补
也。医者宜各以类推而治之，不可执一见也。
脉法
脉浮而濡属气虚。关前得之，麻在上体；关后得之，麻在下体也。
脉浮而缓，属湿，为麻痹。脉紧而浮，属寒，为痛痹。脉涩而芤，属死血，为木，不知痛痒。
方法
丹溪曰∶十指麻木，是胃中有湿痰死血，宜二陈汤加苍术、白术、桃仁、红花，少加附子行经。
（以上丹溪方法凡一条）
人参益气汤（东垣） 治两手麻木，四肢困倦，怠惰嗜卧，热伤元气也。
黄 （二钱） 炙甘草 升麻（各五分） 五味子（三十粒） 柴胡（六分） 生甘草 人参（各一钱二分半） 白
芍药（七分）
上细切，作一服，水二盏，煎至一盏，去渣稍热服。
导气汤（东垣） 治两腿麻木沉重。
黄 （二钱） 甘草（一钱五分） 青皮（一钱） 升麻 柴胡 当归梢 泽泻（各五分） 陈皮（二分半） 红
花（少许） 五味子（三十粒）
上细切，作一服，水二盏，煎至一盏，去渣温服。
天麻黄 汤（东垣） 治素有风证，因连日醉饮，其证复来，右口角并眼牵引侧视，及左手脚腿麻木疼痛。
天麻 芍药 神曲（炒） 羌活（如肢节不痛不用） 茯苓（各三分） 人参 黄连（各四分） 川归（五分） 黄
甘草 升麻 葛根 黄柏 苍术（各六分） 泽泻（七分） 柴胡（九分） 或加猪苓（六分）
上细切，作一服，水二盏，煎至一盏，去渣温服。
补气升阳和中汤（东垣）一妇人病，诊得六脉俱中得弦洪缓相合，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，觉而升目则麻木渐退，久则绝止，常开目则此证不作，是以不敢合眼，致不
得卧，身体皆重，时有痰嗽，觉胸中不利，烦躁气短喘促，肌肤充盛，饮食不减，大小便如常。此非风邪，乃气不行也，
治宜补益肺气自愈。如经脉中阴火乘其阳分，火动为麻木者，当兼去其阴火则安矣。
生甘草（去肾热） 黄柏（酒炒，除湿热） 白茯苓（除湿导水） 泽泻（除湿导水） 升麻（行阳助经） 柴胡
（以上各二分） 苍术（除湿补中，三分） 陈皮 当归身 白术（各四分） 人参 白芍药（各六分） 佛耳草 炙
甘草（各八分） 黄 （一钱） 草豆蔻（益阳辟外寒，三分）
上细切，作一服，水二盏，煎至一盏，去渣食远服。
麻黄桂枝升麻汤（东垣） 治妇人先患浑身麻木，睡觉则少减，开目则已。其证愈后，又因心中烦恼，遍身骨
节痛，身体沉重，饮食减少，腹中气不转运。
木香 生姜（各二分） 桂枝 半夏 陈皮 草豆蔻 浓朴（姜汁制） 黑附子（炮去皮脐） 黄柏（各三分） 炙
甘草 升麻 白术 茯苓 泽泻（各四分） 黄 麻黄（不去节） 人参（各五分）
上细切，作一服，水二盏，煎至一盏，去渣食远服。
神效黄 汤（东垣） 治浑身麻木不仁，或头面手足 背腿脚麻木，并皆治之，及两目羞明畏日，隐涩难开，
视物昏花，睛痛，亦皆治之。
蔓荆子（二分） 陈皮（五分） 人参（八分） 炙甘草（一钱） 白芍药（一钱） 黄 （二钱）
上细切，作一服，水二盏，煎至一盏，去渣临卧稍热服。如麻木不仁，虽有热，不加黄柏，只加黄 一钱，通三钱。
如麻木甚者，加芍药一钱，通二钱。如小便淋涩，加泽泻五分，一服去则止。如有大热证，加酒洗黄柏三分。
补气汤 治皮肤麻木，神效。
黄 陈皮 甘草（各一钱二分） 泽泻（六分） 芍药（八分）
上细切，作一服，水一盏半，煎至一盏，温服。
冲和补气汤 治合眼则麻木，开则不麻，四肢无力，痿厥醋心，目昏头眩，神效。
羌活（七分） 独活 川归 黄柏（各三分） 柴胡 神曲 木香 草豆蔻（各二分） 人参 白术 泽泻 猎苓
（各一钱） 甘草 升麻（各五分） 芍药（一钱） 黄 （二钱） 苍术 陈皮（各一钱） 黄连（二分） 麻黄（不
去节，二分）
上细切，分作二服，每服用水一盏半，煎至一盏，温服。
（祖传方）
三妙丸 治湿热下流，两脚麻木，或如火烙之热。
黄柏（四两，切片，酒拌略炒） 苍术（六两，米泔浸一、二宿，细切焙干） 川牛膝（去芦，二两）
上为细末，面糊为丸，如梧桐子大，每服五、七十丸，空心姜、盐汤下，忌鱼腥、荞麦、热面、煎炒等物。
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The combination of Wind, Cold, and Dampness pathogens leads to Bi Syndrome (Obstruction Syndrome). When Wind is predominant, it is called Moving Bi; when Cold is predominant, it is called Painful Bi; when Dampness is predominant, it is called Fixed Bi. Liu Hejian stated: Pathogens lingering without departure cause numbness and spasms in the four limbs. The classics further state: Pain arises from excessive Cold; the presence of Cold causes pain. Cases that are neither painful nor insensate ("Bu Ren") occur because the disease has progressed deeply over a long duration, causing the circulation of Ying (Nutritive) and Wei (Defensive) Qi to become sluggish, and the meridians to be occasionally empty and sparse; thus, there is no pain. Since the skin lacks nourishment, it manifests as insensibility. What is referred to as "insensibility" involves either the whole body or the four limbs experiencing a buzzing numbness where pain and itch sensation are lost, resembling the feeling immediately after tight bindings are untied. Ancient formulas termed this condition "Ma Bi" (Numbness and Paralysis). Zhu Danxi stated: "Ma" (numbness/tingling) is due to Qi deficiency, while "Mu" (woodiness/heaviness) is due to Damp-Phlegm and dead blood (stasis). Thus, "Ma" and "Mu" are differentiated from within the broader category of insensibility. Nevertheless, there are cases of combined Qi and Blood deficiency presenting only with "Ma" but not "Mu". There are also cases where deficiency allows for Dampness invasion, resulting in concurrent numbness and woodiness. Furthermore, due to deficiency, Wind, Cold, and Dampness may invade, causing generalized pulling pain accompanied by numbness; ancient formulas call this Generalized Bi. The treatment method should involve inducing sweating first, followed by tonification. Physicians should apply these principles analogously and treat accordingly, avoiding rigid adherence to a single viewpoint.
Pulse Diagnosis
A floating and soggy pulse indicates Qi deficiency. If found at the Cun position (proximal to the cun), numbness appears in the upper body; if found at the Chi position (distal to the cun), numbness appears in the lower body.
A floating and moderate pulse indicates Dampness, manifesting as numbness and paralysis. A tight and floating pulse indicates Cold, manifesting as Painful Bi. A choppy and hollow pulse indicates blood stasis, manifesting as "Mu" (woodiness/loss of sensation), with loss of pain and itch sensation.
Methods
Zhu Danxi stated: Numbness in all ten fingers indicates Damp-Phlegm and blood stasis in the Stomach. It is appropriate to use Er Chen Tang (Two-Cured Decoction) added with Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Tao Ren (Persicae Semen), and Hong Hua (Carthami Flos), with a small amount of Fu Zi (Aconiti Lateralis Radix Preparata) to promote meridian circulation.
(Above, one method from Danxi)
Renshen Yiqi Tang (Ginseng and Qi-Boosting Decoction, by Li Dongyuan) Treats numbness in both hands, fatigue and heaviness in the four limbs, lethargy, and drowsiness, caused by Heat damaging Yuan Qi (Original Qi).
Huang Qi (Astragali Radix) (2 qian) Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) Sheng Ma (Cimicifugae Rhizoma) (each 5 fen) Wu Wei Zi (Schisandrae Fructus) (30 grains) Chai Hu (Bupleuri Radix) (6 fen) Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) Renshen (Panacis Ginseng Radix) (each 1.25 qian) Bai Shao Yao (Paeoniae Radix Alba) (7 fen)
Finely cut the above ingredients into one dose. Add two zhan of water, decoct until one zhan remains, remove the dregs, and take warm.
Dao Qi Tang (Guiding Qi Decoction, by Li Dongyuan) Treats numbness and heaviness in both legs.
Huang Qi (Astragali Radix) (2 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (1.5 qian) Qing Pi (Citri Reticulatae Pericarpium Viride) (1 qian) Sheng Ma (Cimicifugae Rhizoma) Chai Hu (Bupleuri Radix) Dang Gui Shao (Tip of Angelicae Sinensis Radix) Ze Xie (Alismatis Rhizoma) (each 5 fen) Chen Pi (Citri Reticulatae Pericarpium) (2.5 fen) Hong Hua (Carthami Flos) (a little) Wu Wei Zi (Schisandrae Fructus) (30 grains)
Finely cut the above ingredients into one dose. Add two zhan of water, decoct until one zhan remains, remove the dregs, and take warm.
Tianma Huang Tang (Gastrodia and Ephedra Decoction, by Li Dongyuan) Treats patients with a history of Wind syndromes who relapse due to consecutive days of heavy drinking. Symptoms include deviation of the right corner of the mouth and eye towards one side, and numbness and pain in the left hand, foot, and leg.
Tian Ma (Gastrodiae Rhizoma) Shao Yao (Paeoniae Radix) Shen Qu (Massae Fermentatae Medicinalis) (stir-fried) Qiang Huo (Notopterygii Rhizoma et Radix) (omit if limb joints are not painful) Fu Ling (Poria) (each 3 fen) Renshen (Panacis Ginseng Radix) Huang Lian (Coptidis Rhizoma) (each 4 fen) Chuan Gui (Angelicae Sinensis Radix) (5 fen) Huang Qi (Astragali Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma) Sheng Ma (Cimicifugae Rhizoma) Ge Gen (Puerariae Lobatae Radix) Huang Bo (Phellodendri Cortex) Cang Zhu (Atractylodis Rhizoma) (each 6 fen) Ze Xie (Alismatis Rhizoma) (7 fen) Chai Hu (Bupleuri Radix) (9 fen) Or add Zhu Ling (Poria) (6 fen)
Finely cut the above ingredients into one dose. Add two zhan of water, decoct until one zhan remains, remove the dregs, and take warm.
Buqi Shengyang Hezhong Tang (Qi-Tonifying, Yang-Raising, and Middle-Jiao-Harmonizing Decoction, by Li Dongyuan) A female patient presented with six pulses that were string-taut, surging, and moderate upon middle pressure, but weak upon deep pressure. The string-taut pulse at the upper level indicates Wind-Heat sinking into the Yin, obstructing the pathway of Yang. Symptoms included generalized numbness when closing the eyes, which decreased during the day and worsened at night. Upon waking and opening the eyes, the numbness gradually receded; after a long time, it ceased completely. Keeping the eyes open prevented the symptom, so she dared not close her eyes, leading to insomnia. Her body felt heavy, with occasional phlegmy cough, chest discomfort, irritability, shortness of breath, and panting. Her skin appeared full, appetite was unchanged, and urination and defecation were normal. This was not a Wind pathogen but rather stagnation of Qi movement. Treatment should tonify Lung Qi for self-recovery. If Yin Fire within the meridians attacks the Yang aspect, causing fire agitation and numbness, one must simultaneously clear the Yin Fire for peace.
Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) (clears Kidney heat) Huang Bo (Phellodendri Cortex) (wine-fried, clears Damp-Heat) Bai Fu Ling (White Poria) (drains Dampness and guides out water) Ze Xie (Alismatis Rhizoma) (drains Dampness and guides out water) Sheng Ma (Cimicifugae Rhizoma) (moves Yang and assists meridians) Chai Hu (Bupleuri Radix) (each 2 fen) Cang Zhu (Atractylodis Rhizoma) (drains Dampness and tonifies Spleen, 3 fen) Chen Pi (Citri Reticulatae Pericarpium) Dang Gui Shen (Body of Angelicae Sinensis Radix) Bai Zhu (Atractylodis Macrocephalae Rhizoma) (each 4 fen) Renshen (Panacis Ginseng Radix) Bai Shao Yao (Paeoniae Radix Alba) (each 6 fen) Fo Er Cao (Pedicularis Resupinatae Herba) Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (each 8 fen) Huang Qi (Astragali Radix) (1 qian) Cao Dou Kou (Cardamomi Fructus Rotundus) (benefits Yang and expels external Cold, 3 fen)
Finely cut the above ingredients into one dose. Add two zhan of water, decoct until one zhan remains, remove the dregs, and take after meals.
Mahuang Guizhi Shengma Tang (Ephedra, Cinnamon Twig, and Cimicifuga Decoction, by Li Dongyuan) Treats women who initially suffered from generalized numbness, which lessened slightly during sleep and resolved upon opening the eyes. After recovery, due to mental distress, they experienced generalized joint pain, body heaviness, reduced appetite, and stagnant Qi in the abdomen.
Mu Xiang (Aucklandiae Radix) Sheng Jiang (Zingiberis Rhizoma Recens) (each 2 fen) Guizhi (Cinnamomi Ramulus) Ban Xia (Pinelliae Tuber) Chen Pi (Citri Reticulatae Pericarpium) Cao Dou Kou (Cardamomi Fructus Rotundus) Hou Po (Magnoliae Officinalis Cortex) (processed with ginger juice) Hei Fu Zi (Black Prepared Aconiti Lateralis Radix) (roasted, peeled, navel removed) Huang Bo (Phellodendri Cortex) (each 3 fen) Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) Sheng Ma (Cimicifugae Rhizoma) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Fu Ling (Poria) Ze Xie (Alismatis Rhizoma) (each 4 fen) Huang Qi (Astragali Radix) Mahuang (Ephedrae Herba) (without removing nodes) Renshen (Panacis Ginseng Radix) (each 5 fen)
Finely cut the above ingredients into one dose. Add two zhan of water, decoct until one zhan remains, remove the dregs, and take after meals.
Shenxiao Huangqi Tang (Miraculous Astragalus Decoction, by Li Dongyuan) Treats generalized numbness and insensibility, or numbness in the head, face, hands, feet, back, legs, and feet, addressing all such cases. It also treats photophobia, lacrimation, difficulty opening eyes, blurred vision, and eye pain.
Man Jing Zi (Vittariae Fructus) (2 fen) Chen Pi (Citri Reticulatae Pericarpium) (5 fen) Renshen (Panacis Ginseng Radix) (8 fen) Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (1 qian) Bai Shao Yao (Paeoniae Radix Alba) (1 qian) Huang Qi (Astragali Radix) (2 qian)
Finely cut the above ingredients into one dose. Add two zhan of water, decoct until one zhan remains, remove the dregs, and take slightly warm before bed. For numbness and insensibility, even if Heat is present, do not add Huang Bo; instead, increase Huang Qi by 1 qian, totaling 3 qian. For severe numbness, increase Shao Yao by 1 qian, totaling 2 qian. For dysuria with astringency, add Ze Xie 5 fen, stopping after one dose. If there is a severe Heat syndrome, add Jiu Xi Huang Bo (Wine-washed Phellodendri Cortex) 3 fen.
Buqi Tang (Qi-Tonifying Decoction) Treats skin numbness with miraculous effect.
Huang Qi (Astragali Radix) Chen Pi (Citri Reticulatae Pericarpium) Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 1.2 qian) Ze Xie (Alismatis Rhizoma) (6 fen) Shao Yao (Paeoniae Radix) (8 fen)
Finely cut the above ingredients into one dose. Add 1.5 zhan of water, decoct until one zhan remains, and take warm.
Chonghe Buqi Tang (Harmonious Qi-Tonifying Decoction) Treats numbness when closing eyes, resolving upon opening them; weakness of the four limbs; flaccidity, cold extremities, and acid regurgitation; blurred vision and dizziness. Miraculous effect.
Qiang Huo (Notopterygii Rhizoma et Radix) (7 fen) Du Huo (Angelicae Pubescentis Radix) Chuan Gui (Angelicae Sinensis Radix) Huang Bo (Phellodendri Cortex) (each 3 fen) Chai Hu (Bupleuri Radix) Shen Qu (Massae Fermentatae Medicinalis) Mu Xiang (Aucklandiae Radix) Cao Dou Kou (Cardamomi Fructus Rotundus) (each 2 fen) Renshen (Panacis Ginseng Radix) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Ze Xie (Alismatis Rhizoma) Zhu Ling (Poria) (each 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) Sheng Ma (Cimicifugae Rhizoma) (each 5 fen) Shao Yao (Paeoniae Radix) (1 qian) Huang Qi (Astragali Radix) (2 qian) Cang Zhu (Atractylodis Rhizoma) Chen Pi (Citri Reticulatae Pericarpium) (each 1 qian) Huang Lian (Coptidis Rhizoma) (2 fen) Mahuang (Ephedrae Herba) (without removing nodes, 2 fen)
Finely cut the above ingredients, divide into two doses. For each dose, use 1.5 zhan of water, decoct until one zhan remains, and take warm.
(Ancestral Formula)
Sanmiao Wan (Three-Awesome Pill) Treats Damp-Heat flowing downward, causing numbness in both feet, or a burning heat sensation like being branded by fire.
Huang Bo (Phellodendri Cortex) (4 liang, sliced, mixed with wine and lightly stir-fried) Cang Zhu (Atractylodis Rhizoma) (6 liang, soaked in rice wash water for one to two nights, finely cut and baked dry) Chuan Niu Xi (Cyathulae Radix) (devoid of radicle, 2 liang)
Grind the above ingredients into fine powder. Form pills using wheat paste, sized like paulownia seeds. Take 50-70 pills per dose on an empty stomach with ginger-salt water. Avoid fish, shellfish, buckwheat, hot noodles, fried, and roasted foods.