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Huangdi asked: "What qi causes tremors in humans?" Qibo replied: "When Stomach Qi is not substantial, the various meridians become deficient. When the various meridians are deficient, the sinews and vessels become lax and sagging. When the sinews and vessels are lax and sagging, walking becomes difficult, and strength cannot be recovered after exertion; thus, tremors occur. Treatment should involve tonification between the muscle layers (Fenrou Jian) according to the location of the lesion." The *Medical Outline* states: "Tremor and convulsion are similar; convulsions involve traction of the hands and feet with extension or flexion, whereas tremors merely involve trembling without extension or flexion." If there is Stomach deficiency with phlegm, use Ginseng Radix et Rhizoma (Renshen, 人参) and Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) to tonify Qi, and Poria (Fuling, 茯苓) and Pinelliae Tuber (Banxia, 半夏) to resolve phlegm; if there is excess heat with accumulation, apply Zhang Hezi's three methods (sweating, vomiting, purgation).

Xue Ji stated: "Tremor is shaking and vertigo." The *I Ching* says: "Nothing moves the myriad things faster than Wind." "Gudong" (drumming/moving) implies motion. Generally, shaking and vertigo result from the oscillation of Wood-Wind Qi. All wind diseases causing shaking and vertigo belong to the Liver. Treatment methods: If Liver Wood has excess heat, use Xieqing Wan (Liver Clearing Pill) [from *Pediatrics*, treating Liver disease]. If Liver Wood has deficiency heat, use Liuwei Wan (Six-Ingredient Pill) [from *Internal Medicine*, treating deficiency consumptive disease]. If Lung Metal overacts on Liver Wood, use Xiebai San (Lung Clearing Powder) [from *Internal Medicine*, treating fever]. If Liver Wood is weak, use Xiaoyao San (Free and Easy Wanderer Powder) [for regulating menstruation], add Ginseng Radix et Rhizoma (Renshen, 人参), Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), and Uncariae Ramulus cum Uncis (Gouteng, 钩藤). If Spleen Blood is deficient, use Liujunzi Tang (Six-Gentlemen Decoction) [from *Internal Medicine*, treating deficiency consumptive disease], add Ligusticum Chuanxiong Rhizoma (Chuanxiong, 川芎), Angelicae Sinensis Radix (Danggui, 当归), and Uncariae Ramulus cum Uncis (Gouteng, 钩藤). If Stomach Qi is weak, use Buzhong Yiqi Tang (Middle-Boosting and Qi-Invigorating Decoction) [for difficult diseases due to fatigue/overwork], add Uncariae Ramulus cum Uncis (Gouteng, 钩藤). If tremors occur postpartum, this is due to Qi and Blood depletion, with deficient fire flourishing generating Wind. One must not treat it solely as a Wind syndrome; one must strongly tonify, so as not to err.

One woman had a irritable disposition, fever, irregular menstruation (either delayed or early), limb fatigue, poor appetite, and tremors. I diagnosed Spleen Qi deficiency, Liver channel blood deficiency, and flourishing fire. In the morning, she took Tiaozhong Yiqi Tang (Regulating Middle and Boosting Qi Decoction) with added Poria (Fuling, 茯苓) and Fritillariae Thunbergii Bulbus (Beimu, 贝母), taken with Liuwei Wan (Six-Ingredient Pill); in the afternoon, she took Xiaoyao San (Free and Easy Wanderer Powder) taken with Liuwei Wan (Six-Ingredient Pill). She recovered after more than two months. Another woman had body tremors and delirious speech, unresponsive to various medicines. I attributed it to depression and anger. Upon inquiry, it was found she had harbored resentment toward her husband for a long time. She was given Xiao Chaihu Tang (Minor Bupleurum Decoction) [from *Shanghan Lun*, treating Shaoyang disease], which provided slight relief, followed by Jia Wei Guipi Tang (Modified Heart-Spleen Tonifying Decoction) [Guipi Tang plus Bupleuri Radix (Chaihu, 柴胡) and Gardeniae Fructus (Zhizi, 山栀)], leading to recovery.

Jiaojiao San (Cross-Adding Powder): Treats convulsions or tremors, or postpartum unconsciousness with salivation.
Ingredients: Angelicae Sinensis Radix (Danggui, 当归) and Schizonepetae Spica (Jingjie Sui, 荆芥穗) in equal parts.
Preparation: Grind into fine powder. Take 3 qian per dose, decoct with one cup of water and a little wine until reduced to 0.7 cups, and administer orally. Life can be restored.

Zengsun Chaihu Tang (Modified Bupleurum Decoction): Treats postpartum or sudden cessation of menstruation leading to hand and foot traction/twitching, teeth grinding, and fainting.
Ingredients: Bupleuri Radix (Chaihu, 柴胡) 8 qian, Astragali Membranacei Radix (Huangqi, 黄芪) stir-fried 5 qian, Scutellariae Radix (Huangqin, 黄芩) stir-fried, Gypsum Fibrosum (Shigao, 石膏) 4 qian, Pinelliae Tuber (Banxia, 半夏) 3 qian, Anemarrhenae Rhizoma (Zhimu, 知母), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) roasted 2 qian.
Preparation: Grind into coarse powder. Take 0.5 liang per dose, with 5 slices of ginger and 4 dates, decoct in water and take warm.

Benshi Qingyan Wan (Benshi Green Salt Pill): Treats Liver and Kidney deficiency with weakness in waist and knees, tremors, and dragging limbs.
Ingredients: Fragrant powder (Xiangmo, 香末) 3 liang, Cuscutae Semen (Tusizi, 菟丝子) 4 liang, Dioscoreae Rhizoma (Shanyao, 山药) dried 2 liang (powdered), Green Salt (Qingyan, 青盐) 1 liang (crushed).
Preparation: Wash Cuscutae Semen (Tusizi, 菟丝子), soak in clear wine for seven days, sun-dry, then roast near fire in winter until dry. Grind separately into fine powder and mix evenly. Form pills with wine paste, size of wu zi (large sesame seeds). Take 50-70 pills per dose with warm wine or salt water. Regular use strengthens sinews and bones and improves appetite. One woman who suffered from dragging limbs took this medicine and walked normally again.

Benshi Xingfu San (Benshi Star and Aconite Powder): Treats stroke where the patient can speak but has dragging limbs, with a deficient, floating, and rapid pulse.
Ingredients: Arisaematis Rhizoma (Nanxing, 南星) processed like Banxia, Pinelliae Tuber (Banxia, 半夏) sliced thin and soaked in ginger juice, Aconiti Lateralis Radix Preparata (Heifuzi, 黑附子) prepared, Aconiti Kusnezoffii Radix (Baifuzi, 白附子) prepared, Aconiti Radix (Chuanwu, 川乌头) prepared, Bombyx Batryticatus (Baijiangcan, 白僵蚕) stir-fried, Myrrha (Moyao, 没药), Ginseng Radix (Renshen, 人参), Polyporus (Baifuling, 白茯苓) in equal parts.
Preparation: Grind into coarse powder. Take 2 qian per dose, decoct with one cup of water and one cup of wine until reduced to 0.8 cups. Strain and take hot, 2-3 doses. Recovery occurs with sweating. In Tonglu, a patient treated with these three doses sweated and regained movement in hands and feet.

Sanyin Duhuo San (Three Causes Notopterygium Powder): Treats Qi deficiency with Wind invasion, or shock/fear exacerbating pathogenic factors in Liver and Gallbladder, causing Upper Qi to lose its proper position, resulting in head nodding/shaking, hand and foot trembling, gradually leading to blurred vision.
Ingredients: Notopterygii Rhizoma et Radix (Duhuo, 独活), Lycii Cortex (Digupi, 地骨皮), Asari Radix et Rhizoma (Xixin, 细辛), Ligusticum Chuanxiong Rhizoma (Chuanxiong, 川芎), Chrysanthemi Flos (Juhua, 菊花) sweet variety, Saposhnikoviae Radix (Fangfeng, 防风) de-bristled, Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) roasted in equal parts.
Preparation: Grind into coarse powder. Take 3 qian per dose, decoct with 1.5 cups of water until reduced to 1 cup. Strain, take 0.6 cup of clear liquid, add a little Bamboo Juice (Zhuli, 竹沥), boil briefly. Take warm after meals, twice daily.

Shichuan Fuling Wan (World-Transmitted Poria Pill): Treats arm traction/pulling or trembling inability to lift objects; immediate cure upon taking. Also treats Spleen Qi deficiency with Phlegm-Evil binding, stagnating in Zhongwan, causing cramping pain in arm sinews.
Ingredients: Polyporus (Fuling, 茯苓), Pinelliae Tuber (Banxia, 半夏) ginger-processed, each 2 liang; Aurantii Fructus (Zhike, 枳壳) bran-stir-fried 0.5 liang; Efflorescent Mirabilite (Fenghua Puxiao, 风化朴硝) 1 liang.
Preparation: Grind into powder, form pills with ginger juice paste, size of wu zi. Take 20 pills per dose after meals with ginger water.