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Li Dongyuan treated a woman suffering from numbness. In all six pulse positions, the pulses were combined with Xian (wiry), Hong (surging), and Huan (moderate) qualities, feeling powerless upon deep pressure, with the Xian quality located superficially. This indicates that Wind-Heat pathogen has sunk into the Yin aspect, causing the Yang pathway to fail to circulate. The symptoms manifested as whole-body numbness when closing the eyes, decreasing during the day and worsening at night; upon waking and opening the eyes, the numbness gradually receded and eventually stopped. Fearing this, she dared not sleep. Her body felt heavy, she occasionally had phlegm-cough, feeling phlegm constantly obstructing in the chest without relief, occasional irritability, shortness of breath with panting, skin and flesh appeared full, diet and urination/defecation were normal. Only the fear of numbness preventing her from closing her eyes was the most distressing. Li said: Numbness is attributed to Wind, which everyone agrees with. However, just as one feels numb after sitting for a long time and then standing up, similar to a person bound by ropes where numbness arises upon release and subsides after a while, this is not due to Wind pathogen, but rather Qi failing to circulate. The Classics state: Yang diseases manifest with movement when eyes are open and feel light; Yin diseases manifest with stillness when eyes are closed and feel heavy. The *Ling Shu* states: Opening the eyes allows the Yang pathway to circulate, distributing Yang Qi throughout the body; closing the eyes blocks the Yang pathway, akin to the division between day and night. From this, it can be known that Yang is deficient and Yin is prosperous. Occasional phlegm-cough is due to autumn coolness on the exterior and dampness above. Heavy body and moderate pulse indicate dampness hiding in the Spleen. Occasional irritability indicates Yin Fire attacking the Yang aspect within the meridians. The treatment method should be to raise Yang, assist Qi, nourish Blood, slightly drain Yin Fire, remove dampness, unblock meridians, and harmonize Yin and Yang. This is not due to pathogens originally residing in the Zang-Fu organs. Huangqi (Astragali Radix) 5 fen, Renshen (Ginseng Radix) 3 fen, Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 4 fen, Shenggancao (Raw Glycyrrhizae Radix et Rhizoma) 1 fen, Chenpi (Citri Reticulatae Pericarpium) and Dangguishen (Angelicae Sinensis Radix) each 2 fen, Erercao (Tussilaginis Flos) 4 fen, Baishao (Paeoniae Radix Alba) 3 fen, Caodoukou (Amomi Fructus Rotundus) and Cangzhu (Atractylodis Rhizoma) each 1.5 fen, Baizhu (Atractylodis Macrocephalae Rhizoma) 2 fen, Huangbai (Phellodendri Cortex) washed with wine, Fuling (Poria), Zexie (Alismatis Rhizoma), and Shengma (Cimicifugae Rhizoma) each 1 fen. Decoct in water and take orally. Cured after eight doses. Named Buqi Shengyang Hezhong Tang (Qi-Supplementing and Yang-Raising Middle-Harmonizing Decoction).

Another patient, seventy years old, suffered from body heat and numbness, weakness in thighs and knees, sweating during meals, irrational laughter, easy hunger, difficult expectoration of saliva/phlegm, stiff tongue making speech difficult, hoarse voice unable to speak. Li diagnosed the pulse: the left hand pulse was Hong (surging) and large yet forceful, indicating Evil Heat lodging within the meridians. There were several scars on the outer sides of both arms. Upon inquiry, he replied they were caused by burning incense. Li said: Your illness stems from this. The human meridians: the three Yang meridians of the hands ascend from the hands to the head. Added with Fire pathogen, Yang merges with Yang, creating an intense momentum. Thus, Evil Heat wanders, scattering throughout the body causing heat-numbness. Heat damages Yuan Qi, leading to heaviness and weakness; Heat leaks Wei Qi, causing excessive sweating; Heart Fire flourishing causes irrational laughter; Stomach/Spleen Heat causes digestion of food and easy hunger; Lung Metal deficiency causes voice loss. As Zhang Zhongjing stated: When Fire becomes pathogenic, it scorches bones and injures sinews, making blood difficult to restore. The *Nei Jing* states: When Heat is excessively prevalent, treat with Bitter-Cold herbs, assist with Bitter-Sweet herbs, use Sweet herbs to drain, and Sour herbs to astringe. Use Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma) as the Sovereign herb for their Bitter-Cold nature to drain Fire pathogen and strengthen sinews/bones. Furthermore, the Kidney desires firmness; urgently eat Bitter substances to firm it. Use Huangqi (Astragali Radix) and Shenggancao (Raw Glycyrrhizae Radix et Rhizoma) for their Sweet-Cold nature to drain heat and tonify the exterior; Wuweizi (Schisandrae Fructus) for its Sour nature to stop sweating and tonify Lung Qi deficiency, serving as the Minister herb. Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) and Danggui (Angelicae Sinensis Radix) for their Sweet-Acrid nature to harmonize blood and moisten dryness; Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) for their Bitter-Ping (neutral) nature to move the Shaoyang and Yangming meridians from earth to heaven, using Bitter to disperse, serving as the Assistant herb. Named Qingyang Buqi Tang (Clear-Yang and Tonify-Qi Decoction). Additionally, employed Miao Ci (counter-pricking) acupuncture on the four limbs to drain the root of all Yang meridians, allowing the twelve meridians to connect and drain Fire pathogen. Cured in less than ten days.

Yu Zhen commented: Li Dongyuan’s discussion of diseases is entirely based on the *Nei Jing*, concise and accurate, able to elucidate the underlying causes. His medication also follows the *Nei Jing*, matching drug properties and flavors to Zang-Fu organs and meridians, devoid of embellishments, making the essential principles of Xuanyuan and Qibo clearly evident. Indeed, this is beyond the reach of recent physicians. However, the dosages were only one or two fen to four or five fen; why so small? Is it because the combination of flavors and properties is appropriate, resulting in agile and rapid efficacy? Later scholars often say: I wish to learn from Zhang Zhongjing, not Li Dongyuan. Yet, Li Dongyuan used extremely light dosages to cure difficult chronic illnesses, which is precisely what is easy to learn.

Wu Jiaoshan treated a woman who, in summer, sought coolness and often slept uncovered at night, allowing cold wind to penetrate the bones. She suffered from numbness and unceasing pain in both feet. Taking Wind-dispelling and pain-stopping medicines was ineffective. Prescribed Dafangfeng Tang (Great Wind-Dispersing Decoction) for several doses, the condition gradually lightened. Subsequently, she took Wutou Porridge (Aconite Porridge) for three mornings and was cured.

Yu Zhen commented: The medications used in the previous two cases were delicate and fitting; the two formulas used in this case were direct and straightforward. All matched the disease condition, each revealing its own brilliance.

Li Shicai treated Scholar Lu Wenhu, who suffered from numbness in both feet. Self-medicating with Blood-invigorating agents was ineffective; switching to Phlegm-attacking agents was also ineffective. After half a year, his hands also became numb, and there was a patch about one chi long under the left hypochondrium insensitive to pain and itch. Li said: This is what the Classics call Zhuo Bi (Fixed Bi Syndrome). The six pulses were large yet powerless, indicating damage to both Qi and Blood. Used Shenxiao Huangqi Tang (Miraculous Efficacy Astragalus Decoction), adding Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), and Dihuang (Rehmanniae Radix). After ten doses, slight improvement was seen. Then switched to Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) for over fifty doses before stabilizing.

Shouzai Jiang Tian’an suffered from numbness and paralysis of hands and feet, diplopia (seeing double). Taking Blood-tonifying medicines did not work; switching to Spleen-targeted medicines resulted in mental fatigue. Li diagnosed the Cun Kou pulse as large, while the two Chi pulses alone were Se (choppy). This indicated non-interaction between Heart and Kidney, with Water overflowing to form Phlegm. Thus, he took the ingredients of Dihuang Wan (Rehmannia Pill) as a decoction, doubling the dosage of Zexie (Alismatis Rhizoma) and Fuling (Poria), adding a little Qingyan (Green Salt). After six doses, diplopia resolved. Then, concurrently administered Ren Shen (Ginseng Radix) and Yuan Zhi (Polygalae Radix) etc., Spirit-calming agents. Within one month, he recovered fully.

Yu Zhen commented: The previous case supplemented both Qi and Blood, which is an established ancient method. This case used Dihuang Tang because the Chi pulses were choppy, thus first tonifying the Kidney, followed by Ren Shen and Yuan Zhi, which remains a standard method for treating numbness. In the later case, Master Zhang used Renshen Tang to administer Zixue (Purple Snow), opening a new realm. This is because the root of the disease lay in Phlegm-Fire. "Numbness upon opening eyes" is indeed the counterpart article to Dongyuan’s theory, explained best here.

Zhang Luyu treated the wife of foreign merchant Ba Cimings. Postpartum, she suffered from vertigo and palpitations, soul and spirit scattered, appearing as if losing her Zang-Fu organs. Upon opening her eyes, her whole body felt numb as if in clouds/fog; she had to keep her eyes tightly closed to feel slightly better. She was irritable during the day and quiet at night. A gynecologist used Siwu Tang (Four Substance Decoction) and other Blood medicines, causing vomiting and refusal to eat. Another doctor used Ginger and Aconite (Jiang, Fu) and other hot medicines, causing restlessness and agitation. Her pulse was Xu (empty) and large, rapid, scattering upon deep pressure, but responding to touch upon light pressure. This is a sign of floating and scattering Heart Fire. Due to difficult childbirth and fright, Phlegm-Fluids invaded the Pericardium collateral vacuously, lingering above the diaphragm, entering but not exiting, hence persisting endlessly. Generally, opening eyes opens all orifices; Phlegm-Fire blocks the Heart orifice, causing lack of mental mastery. Closing eyes closes all orifices; Phlegm-Fire lies dormant, hence slight relief. This is distinctly different from Dongyuan’s description of numbness due to Yang Qi failing to circulate when eyes are closed. Moreover, worsening during the day and improving at night clearly indicates a disease in the Upper Jiao Yang position. Prescribed Phlegm-regulating and Fire-clearing agents, symptoms gradually calmed. However, triggered intermittently by fright or diet, this is because the Phlegm lurking above the diaphragm could not be thoroughly scavenged. During attacks, used Dushen Tang (Single Ginseng Decoction) to administer Zixue (Purple Snow) to open the diaphragm membrane, then continued with the previous tonifying medicines. Recovered after half a year.

Yu Zhen commented: Numbness mostly occurs in hands and feet because the extremities are distant; when Qi is deficient, Wei Qi moves slowly and fails to reach them. Therefore, numbness without woodiness (stiffness/heaviness) must belong to Qi deficiency; otherwise, it is Wind-Phlegm. Whenever the pulse is Fu (floating) and soft, or large and weak, it is Qi deficiency. If the pulse is Fu (floating) and Hua (slippery), remaining unchanged upon deep pressure, it is Wind-Phlegm. If numbness and woodiness occur together, there are distinctions among Cold-Dampness, accumulated Phlegm, and dead Blood; their pulses differ between Chen-Chi-Hua-Shi (deep-slow-slippery-solid) and Chen-Se-Kou (deep-choppy-hollow). One should distinguish carefully.