营卫滞而不行则麻木。如坐久倚着。压住一处。麻不能举。理可见矣。麻则属痰属虚。木则
全属湿痰死血。一块不知
痛痒。若木然是也。脉沉滑。体浓人属痰与湿。二术、二陈。先少佐羌、独、桂枝等风药一二味。
次兼参、 补气。脉微弱。或弦大无力。病久体羸者。属气虚。补中益气加熟附子一片。夏月对
生脉散。或清燥汤。一块不知痛痒。阴寒益甚。或日轻夜重。脉涩而芤或弦。属痰挟死血。宜活
血行气。二陈加芎、归、桃仁泥、红花、牛膝、韭汁之类。大便见黑而不作泻者。小剂桃核承气
汤微利之。十指麻木。属胃中湿痰死血。二陈加二术、桃仁、红花。少加附子行经。湿热下流。
两脚麻木。或如火燎者。二妙加牛膝作丸。不应。少加肉桂。东垣治闭眼则浑身麻木。开眼则渐
退。久而方止。昼减夜甚。为阳气衰而湿伏阴分也。三痹汤去乌头。加苍术、黄柏。又合眼则麻。
开眼即不麻。近火则头旋眩晕者。风气下陷于血分。不得升越而作也。三痹汤去乌头。加羌活、
麻黄。凡妇人素有郁悒者。当舒郁。逍遥散加补气行湿药。
薛立斋治刘孟春有痰。两臂作麻。两目流泪。服祛风化痰药。痰愈甚。臂反痛不能伸。手指
俱挛。薛曰。麻属气虚。因前药而复伤肝。火盛而筋挛耳。况风自火出。当补脾肺滋水则风自退。
痰自清。遂用六味丸、补中益气汤。三月而愈。
石顽治洋客巴慈明妇。产后眩晕心悸。神魂离散。若失脏腑之状。开眼则遍体麻木。如在云
雾之中。必紧闭其目。似觉稍可。昼日烦躁。夜则安静。专事女科者。用四物等血药。则呕逆不
食。更一医用姜、附等热药。则躁扰不宁。其脉虚大而数。按之则散。举之应指。此心火浮散之
象。因艰产受惊。痰饮乘虚袭入心包络中。留伏膈上。有入无出。所以绵延不已。盖目开则诸窍
皆开。痰火堵塞心窍。所以神识无主。目闭则诸窍俱闭。痰火潜伏不行。故得稍安。与东垣所言。
合眼则阳气不行之麻木迥殊。况昼甚夜轻。明是上焦阳位之病。与理痰清火之剂。诸证渐宁。然或
因惊恚。或因饮食。不时举发。此伏匿膈上之痰。无从搜涤也。乘发时。用独参汤下紫雪开通膈
膜。仍与前药。调补半载而康。
When Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) stagnate and fail to circulate, numbness and anesthesia occur. For instance, when sitting for a long time and leaning against something, compressing a specific area, one feels numbness in that spot and cannot lift it; the rationale is evident here. Numbness (Ma) generally belongs to Phlegm or Deficiency, whereas woodiness/anesthesia (Mu) entirely belongs to Damp-Phlegm and Dead Blood (stasis). It manifests as a localized area unaware of pain or itchiness, resembling a piece of wood. If the pulse is deep and slippery, and the patient has a robust physique, it indicates Phlegm and Dampness. Use Er Zhu Tang (Cangzhu and Baizhu Decoction) combined with Er Chen Tang, initially adding one or two wind-dispelling herbs such as Qiang Huo (Notopterygii Rhizoma), Du Huo (Angelicae Pubescentis Radix), or Gui Zhi (Cinnamomi Ramulus) in small doses, followed by supplementation with Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix) to tonify Qi. If the pulse is weak or string-taut and large but powerless upon pressure, and the disease has been prolonged with a emaciated body, it belongs to Qi Deficiency. Use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with one slice of Shu Fu Zi (Prepared Aconiti Lateralis Radix); in summer, combine with Sheng Mai San (Generate the Pulse Powder) or Qing Zao Tang (Clear Dryness Decoction). If a specific block is unaware of pain and itchiness, with Yin-Cold being severe, or symptoms lighter during the day and heavier at night, and the pulse is choppy and Kou (cork-like/hollow) or string-taut, it indicates Phlegm complicated by Dead Blood. One should promote blood circulation and move Qi using Er Chen Tang added with Xiong Chuann (Chuanxiong Rhizome), Dang Gui (Angelicae Sinensis Radix), Tao Ren (Persicae Semen), Hong Hua (Carthami Flos), Niu Xi (Achyranthis Bidentatae Radix), and Jiu Zhi (Allii Tuberosi Juice). If black stools appear without diarrhea, use a small dose of Tao He Cheng Qi Tang (Peach Pit Decoctioin to Order the Qi) to mildly induce purgation. Numbness in all ten fingers belongs to Damp-Phlegm and Dead Blood in the Stomach. Use Er Chen Tang added with Er Zhu (Cangzhu and Baizhu), Tao Ren, and Hong Hua, with a small amount of Fu Zi (Aconiti Radix) to unblock the collaterals. Numbness in both legs due to Damp-Heat flowing downward, or feeling like burning, can be treated with Er Miao San (Two Marvels Powder) added with Niu Xi, made into pills. If ineffective, add a small amount of Rou Gui (Cinnamomi Cortex). Li Dongyuan treated a patient whose whole body became numb when closing eyes and gradually subsided upon opening them, stopping only after a while. Symptoms were lighter during the day and heavier at night, indicating Yang Qi deficiency with Dampness lurking in the Yin aspect. The prescription was San Bi Tang (Three Obstructions Decoction) with Wu Tou (Aconiti Radix) removed, added with Cang Zhu (Atractylodis Rhizoma) and Huang Bai (Phellodendri Cortex). In another case where numbness occurred upon closing eyes and ceased upon opening, accompanied by dizziness and vertigo near fire, this was caused by Wind Qi sinking into the Blood aspect, failing to ascend and emerge. The treatment was also San Bi Tang with Wu Tou removed, added with Qiang Huo (Notopterygii Rhizoma) and Ma Huang (Ephedrae Herba). Women who have a history of depression should soothe the Liver Qi; use Xiao Yao San (Free and Easy Wanderer Powder) added with Qi-tonifying and Damp-draining herbs.
Xue Lizhai treated Liu Mengchun, who had Phlegm, causing numbness in both arms and tearing from both eyes. After taking wind-dispelling and Phlegm-resolving medicines, the Phlegm worsened, the arms became painful and unable to extend, and the fingers contracted. Xue said: "Numbness belongs to Qi Deficiency. Due to previous medications, the Liver was further injured, leading to excessive Fire and tendon contraction. Moreover, Wind arises from Fire. One should tonify the Spleen and Lung and nourish Water (Kidney Yin), so that Wind will naturally recede and Phlegm clear." Thus, Liu Wei Wan (Six-Ingredient Pill with Rehmannia) and Bu Zhong Yi Qi Tang were used, resulting in recovery after three months.
Shi Wan treated the wife of a foreign merchant, Ba Ciming. Postpartum, she suffered from vertigo and palpitations, with her Spirit and Soul scattered, appearing as if her Zang-Fu organs had lost their support. Upon opening her eyes, her whole body felt numb, as if floating in clouds and mist; she had to keep her eyes tightly closed to feel slightly better. She was irritable during the day and quiet at night. A gynecologist prescribed Si Wu Tang (Four Substance Decoction) and other blood-nourishing medicines, causing vomiting, regurgitation, and loss of appetite. Another doctor prescribed hot medicines like Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Radix), causing restlessness and agitation. Her pulse was deficient, large, and rapid; upon deep pressure, it was scattered and rootless, while upon light pressure, it responded to the finger. This indicated floating and dispersing Heart Fire. Due to difficult labor and fright, Phlegm-Fluid invaded the Pericardium Collateral vacuously and lingered above the Diaphragm, entering but not exiting, thus prolonging the illness. Generally, when eyes open, all orifices open; Phlegm-Fire blocks the Heart orifices, causing the Spirit to lose mastery. When eyes close, all orifices close; Phlegm-Fire lies dormant and does not move, allowing for slight relief. This is distinctly different from the numbness described by Li Dongyuan where Yang Qi fails to circulate upon closing eyes. Moreover, since symptoms are worse during the day and lighter at night, it is clearly a disease in the Upper Jiao (Yang position). Treatment involved Phlegm-regulating and Fire-clearing agents, which gradually calmed the symptoms. However, due to fright or anger, or improper diet, attacks occurred frequently because the Phlegm lurking above the Diaphragm could not be thoroughly searched out and eliminated. During an attack, Du Shen Tang (Single Ginseng Decoction) was used to administer Zi Xue Dan (Purple Snow Pellet) to open the Diaphragm membrane, followed by the previous medicines. After half a year of regulation and tonification, she recovered.