一 一妇患痹症，右手连臂肩肿痛，不能移动。余用行
痹主方，加减治之不愈。改用草乌搜风胜湿祛寒，苍术、白术燥湿，当归养荣，乳香、没药活血散
血，止痛消肿，各一两为末，每服五分，陈酒调下，一日二服，〔如觉麻，饮米汤即止，不麻渐加
至一钱止。〕尽剂而愈。
二 一人胸中不舒者经年，不能自名其状。嘉言投以栝蒌薤白汤，一剂而愈。
麻木之症，有但麻而不木者，有麻木兼作者，麻为轻而木为重；木则不知痛痒寒热，即经所谓不
仁也。有因风伤卫气，气凝不行而致者，有因寒伤荣血，皮肤不荣〔无血以和之。〕而致者，有因湿伤
肌肉，脉理不通而致者，宜参治痹方治之。亦有因气虚，因血少，因气滞，因死血，因湿痰之不一，各
有的症可凭，详审投剂，庶不致误。
养阴清热润燥汤〔见燥。〕治血液苦涩，虚火作麻，甚则不仁。
原方宜加甘菊 首乌 秦艽之属，手臂麻木，宜桑枝煎汤代水，两足麻木加牛膝。
补中益气汤〔见泄泻。〕果属气虚麻木者，主此加减。
顺气开痰饮〔见中风。〕治肺气郁滞不行麻木者，加减用之。
犀角地黄汤〔见伤寒。〕果属瘀血停留中宫，气滞不行于四肢作麻木者用之。
原方宜加桃仁 红花 降香之属。
二陈汤〔见中风。〕果属湿痰停留，气滞不行麻木者用之。
原方宜加苍术 天麻 胆星之属。
此五方审其所因而用之。按东垣言麻木是气不行所致，
宜疏利肺气，开散郁滞。又丹溪曰∶麻是气虚，木属湿痰死血。愚谓瘦弱人麻木，多因血液枯涩，虚
火所致。
经曰∶荣气虚则不仁，〔不知痛痒。〕卫气虚则不用，〔不能举动。〕俱虚则不仁且不用，肉
如故也。人身与志不相有，〔身不与五志相有。〕曰死。
1. A female patient suffered from Bi syndrome (Obstruction Syndrome), with swelling and pain in her right hand, arm, and shoulder, rendering it immobile. I initially used the principal formula for Xing Bi (Wandering Bi Syndrome) with modifications, but it was ineffective. Subsequently, I switched to using Caowu (Aconitum kusnezoffii Rhizome) to search out wind, overcome dampness, and dispel cold; Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) to dry dampness; Danggui (Angelicae Sinensis Radix) to nourish the blood and promote nutrition; and Ruxiang (Olibanum) and Moyao (Myrrha) to invigorate blood, dissipate stasis, relieve pain, and reduce swelling. Each herb was processed into powder at a dosage of one liang. The patient took five fen per dose, mixed with aged yellow wine, twice daily. [If numbness is felt, drinking rice soup will stop it; if no numbness occurs, gradually increase the dose up to one qian.] After completing the course, she recovered.
2. A male patient had experienced chest discomfort for over a year and could not describe his condition accurately. Zhu Danxi (Zhu Zhenheng) prescribed Gualou Xiebai Tang (Trichosanthes and Macrostemon Decoction), and he recovered after one dose.
The symptom of numbness includes cases of only tingling without anesthesia, and cases where both occur together. Tingling is mild, whereas anesthesia is severe; anesthesia implies insensitivity to pain, itching, cold, and heat, which corresponds to the concept of "Bu Ren" (Insensibility) mentioned in the classics. Some cases are caused by wind damaging the Wei Qi (Defensive Qi), leading to stagnation and failure of circulation; some are caused by cold damaging the Ying Blood (Nutritive Blood), resulting in skin malnutrition [due to lack of blood to harmonize]; some are caused by dampness damaging the muscles, leading to blocked meridians and tissues. These should be treated with reference to formulas for Bi syndrome. Other causes include Qi deficiency, Blood deficiency, Qi stagnation, fixed blood stasis, and damp-phlegm. Each has specific symptoms for reference. Careful examination before prescribing ensures no errors.
Yangyin Qingre Runzao Tang (Nourishing Yin, Clearing Heat, and Moistening Dryness Decoction) [see section on Dryness] treats numbness caused by bitter-dry blood and deficient fire, progressing to insensibility.
It is advisable to add Ganju (Chrysanthemi Flos), Shouwu (Polygoni Multiflori Radix), and Qinjiao (Gentianae Macrophyllae Radix) to the original formula. For arm numbness, use Sangzhi (Toosendan Fructus or Mulberry Twig) decoction as water for brewing herbs. For leg numbness, add Niuxi (Achyranthis Bidentatae Radix).
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) [see section on Diarrhea] is the principal formula with modifications for numbness caused by Qi deficiency.
Shunqi Kaitan Yin (Regulating Qi and Opening Phlegm Infusion) [see section on Stroke] is used with modifications for numbness caused by stagnation and failure of Lung Qi circulation.
Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) [see section on Cold Damage] is used for numbness in the limbs caused by blood stasis lingering in the Middle Jiao (Spleen and Stomach) and Qi stagnation failing to circulate to the extremities.
It is advisable to add Taoren (Persicae Semen), Honghua (Carthami Flos), and Jiangxiang (Dalbergiae Odoriferae Lignum) to the original formula.
Erchen Tang (Two-Aged Decoction) [see section on Stroke] is used for numbness caused by damp-phlegm lingering and Qi stagnation failing to circulate.
It is advisable to add Cangzhu (Atractylodis Rhizoma), Tianma (Gastrodiae Rhizoma), and Danning (Arisaematis Cum Bile) to the original formula.
These five formulas should be selected based on the etiology. According to Li Dongyuan, numbness is caused by the failure of Qi circulation; thus, it is appropriate to regulate Lung Qi and disperse stagnation. Furthermore, Zhu Danxi stated: Tingling is due to Qi deficiency, while anesthesia belongs to damp-phlegm and fixed blood stasis. I believe that in emaciated individuals, numbness is mostly caused by dry-bitter blood and deficient fire.
The Classics state: Ying Qi deficiency leads to Bu Ren (insensibility) [inability to feel pain or itch]. Wei Qi deficiency leads to Bu Yong (inability to move) [inability to actuate]. When both are deficient, there is insensibility and inability to move, yet the flesh remains normal in appearance. When the body and the mind/will are disconnected [the body does not respond to the Five Emotions], it is termed death.