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Since the body's righteous qi cannot accommodate the pathogenic factors, leading to chaotic qi mechanism. After the "Dao Cang" method (a therapy that clears gastrointestinal stagnation through induced vomiting), the Spleen Qi becomes even more deficient; the treatment principle should be to tonify Middle Qi and raise Yang, so that when the Middle Jiao Qi is clear and harmonious, phlegm will transform naturally. If it is due to deficiency-cold of Spleen Earth or decline of Mingmen Fire (Kidney Yang deficiency), Bawei Wan (Jinkui Shenqi Wan) must be used. If it is due to Kidney Qi deficiency, with water overflowing to transform into phlegm, or accompanied by dizziness and dry mouth, Liuwei Wan (Liuwei Dihuang Wan) should be used.

A woman, whose Yuan Qi had always been deficient, experienced body numbness and fever upon exertion, with Phlegm-Qi attacking upwards. Someone used Wuyao Shunqi San (Aucklandia Decoction for Regulating Qi) and Qufeng Huatan Wan (Wind-Expelling and Phlegm-Resolving Pill), resulting in flaccidity of limbs, spontaneous drooling, sallow complexion, physical fatigue, and extremely deficient Mai (pulse) of the Lung and Spleen meridians. This is a deficiency syndrome resembling wind-stroke. In the morning, Buchong Yiqi Tang (Tonify the Middle and Boost Qi Decoction) was administered; in the evening, Shiquan Dabu Tang (Ten Significant Tonifying Decoction) was given. She gradually recovered, and later used Jiawei Guipi Tang (Modified Guipi Decoction) for regulation until fully healed.

Another woman, with an irritable temperament, suffered from Liver Wind syndrome and frequently took Soufeng Shunqi Wan (Search-for-Wind and Smooth-Qi Pill) and Qinjiao Tang (Gentian Decoction). Later, she vomited blood after extreme anger, with her lips and corners of the mouth pulled tight, frequent urination, and occasional fatigue. I considered this to be excessive Liver Fire causing reckless bleeding, so I used Xiaochaihu Tang (Minor Bupleurum Decoction) with Zhizi (Gardeniae Fructus) and Mudanpi (Moutan Cortex), and she gradually improved. Later, she vomited blood again due to extreme anger, mistakenly taking fire-clearing, wind-expelling, and phlegm-resolving agents. This led to frequent bowel movements, chest fullness, poor appetite, and subsequent use of Qingqi Huatan agents resulted in vomiting without food intake, dizziness, dry mouth, and intermittent expectoration. Further use of Daotan (Phlegm-Resolving) and fire-clearing agents caused phlegm to gush out like a spring, with cold limbs. I said: Vomiting without eating, dizziness, and dry mouth indicate that Stomach Qi cannot ascend; phlegm gushing out indicates that Spleen Qi cannot control saliva; cold limbs indicate that Spleen Qi cannot circulate and transport. Therefore, Buchong Yiqi Tang with Fuling (Poria) and Banxia (Pinelliae Rhizoma) was used to treat her, and all symptoms gradually improved. She then took Jiawei Guipi Tang concurrently and stabilized.

The wife of Wang Jizhi, a Honglu Temple Minister, had a history of epilepsy, which was triggered by labor or anger, requiring a long time to regain consciousness. One day, after improper rest following meals and labor, she had an attack and did not regain consciousness for half a day, unable to speak. Some believed it was wind-pathogen invading the Zang organs and used wind-expelling, phlegm-resolving, and qi-smoothing agents along with Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill). The condition worsened significantly. The six pulses were floating and large; the two Cun positions were deficient and failed to reach their proper depth, yet she could still eat. I said: This is injury to Spleen and Stomach Qi. If wind-pathogen had invaded the Zang organs, disaster would have occurred instantly. They did not believe me and continued using wind-dispelling drugs; consequently, she died.

One should avoid cool winds, cold winds, dew, fog, and dampness. When the body is hot and limbs are sweating, or when removing clothes, boots, and socks, one must never expose oneself to wind to cool down, as this easily invites pathogens. Anger is particularly contraindicated. After drinking alcohol, one must avoid exposure to wind and cold. After removing head coverings and socks, one should rub the skin frequently with hands to close the hair follicles (pores). For such diseases, cold months pose a risk from cold winds, while summer months, with external heat and open pores, make one even more susceptible to pathogens.

If moxibustion is performed later, only points on the hands and feet should be treated. For treating wind syndromes, hand points such as Jianyu (LI15), Quchi (LI11), and Hegu (LI4) are suitable. For facial deviation, Jiache (ST6) and Chengjiang (CV24) can be moxa-ed. Moxa cones on the face must be small, whereas those on the hands and feet can be larger. Moxibustion must proceed from top to bottom, never from bottom to top.

I treated a woman with facial deviation, spasticity of the four limbs, difficulty with phlegm-secretions, aversion to wind and cold, and a floating-tight pulse. This was Wind-Cold lodging in the Hand and Foot Yangming meridians. I first prescribed Shengfeng Tang (Wind-Averting Decoction) for two doses, followed by Qinjiao Shengma Tang (Gentian and Cimicifugae Decoction), leading to recovery.

A woman, obese, suffered from dizziness and vertigo, limb numbness, flaccidity of legs and feet, spontaneous sweating, and heavy voice. Her pulse was slippery and rapid, but deep and slow upon pressure. This was Damp-Heat taking advantage of deficiency, causing Spleen Qi to sink into the Kidney and Liver regions. Qingzao Tang (Dryness-Clearing Decoction) and Qianghuo Tang (Notopterygii Decoction) were used to gradually improve the condition, supplemented with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) for complete recovery.

For areas of numbness on the face, Gui Zhi (Cinnamomi Ramulus) powder can be mixed with Niu Pi Jiao (Colla Corii Asini) dissolved in a little water and applied as a paste, 1-2 fen thick.

My commentary: For the aforementioned symptoms, if they belong to Lung Qi deficiency, tonify Spleen Earth; if ineffective, then tonify its mother organ (Spleen generates Lung).

For hard, numb areas on the soles of the feet, melt Niu Pi Jiao (Colla Corii Asini), mix with fresh Ginger juice, add Nanxing (Arisaematis Rhizoma) powder (5 qian), mix evenly, spread on thick paper to a thickness of 2-3 fen, apply warm to the soles, and keep warm with gentle heat. This is an external treatment method. The combination of glue and ginger juice originates from Nei Jing (Inner Canon), used to treat Bi syndrome, stating that Wind, Cold, and Dampness combine to cause disease, lodging between skin and muscles, resulting in loss of sensation, feeling numb like wood ear fungus! Later practitioners treating stiff painful waist and Bi numbness with pain in limbs added Rush Xiang (Olibanum) and Moyao (Myrrha), or added Qianghuo (Notopterygii Rhizoma) and Nanxing powder, which proved effective. If prepared correctly, it resembles a plaster. For limbs and waist, apply with a hot shoe sole.

My commentary: The Classics state: Wind, Cold, and Dampness mixing together result in Bi syndrome. Predominance of Wind leads to Xing Bi (Wandering Bi); predominance of Cold leads to Tong Bi (Painful Bi); predominance of Dampness leads to Zhuo Bi (Fixed Bi). Mr. Danxi stated: Generally, it is due to Blood deficiency with heat, where the Blood is already boiling. If combined with wading in cold water/dampness, the hot blood meets cold, becoming turbid and stagnant, unable to circulate, thus causing pain. Treatment uses acrid-warm herbs, assisted by acrid-cool herbs to disperse Cold-Damp, resolve stagnation, promote Blood flow and Qi smoothness, ensuring peace. If due to deficiency of the three Yin meridians of the foot, tonifying Yuan Qi should be the primary approach.

External applications treat skin and muscles; acupuncture treats vessels and collaterals; nourishing Blood treats sinews and bones. Sinews and bones without Blood nourishment cannot bear weight.

Paralysis and flaccidity are due to lack of Blood and concurrent Phlegm-Fire, Damp-Heat. The ancients said these should not be treated as Wind syndromes using Wind-dispelling drugs, referring to Xiao Xuming Tang (Minor Xuming Decoction), Xizhou Xuming Tang (Xizhou Xuming Decoction), Paifeng Tang (Wind-Expelling Decoction), etc., containing herbs like Qianghuo (Notopterygii Rhizoma), Fangfeng (Saposhnikoviae Radix), Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Wutou (Aconiti Radix), and Xixin (Asari Radix). These are all drugs that disperse Wind-pathogens and open interstices. Misuse will further dry up Yin Blood.

My commentary: Cases in Jiangnan are mostly due to Yin deficiency, Qi deficiency, and Damp-Heat with Ministerial Fire. Paralysis and flaccidity often involve Yin deficiency and Damp-Heat in the Hand and Foot Yangming meridians. Practitioners must examine carefully.