大率与痫相似,比痫为虚,治宜带补。气虚有火兼有痰,人参、竹沥之类,切不可作风治而兼用风药。治酒多风
搐∶白术(五钱) 人参(二钱半) 甘草(三钱) 陈皮 苍术(以上各一钱)
天麻(细切,酒浸一钱) 白芍药(酒浸一钱) 防风(五分) 川芎(五分) 上为末,作丸。如小便多加五味子。
属热郁,用火郁汤。葛根 柴胡 白芍药(以上各一两) 甘草(炙一两) 防风(五钱) 升麻(一两)
每服三钱,入葱白三寸,煎,稍热服。又方∶栀子、香附、白芷、苍术、半夏、川芎,上
末之,面糊丸。火郁,手足心发骨蒸,草还丹。
麻是气虚,木是湿痰死血。东垣云∶麻木,气不行也,当补肺中之气。一妇人,体肥气郁,舌麻眩晕,手足
麻,气塞有痰,便结,凉膈散加南星、香附、台芎开之。
有阳厥,有阴厥。阳衰于下即寒,阴衰于下即热。《原病式》中详之。以气血虚为主,有痰、有热。治痰,白
术竹沥;治热,承气汤,因外感解散加姜汁酒。气虚,脉细;血虚,脉如葱管;热厥,脉数;外感,脉浮;实痰脉
弦。一妇人年三十余,面白形长,心中常有不平事。忽半夜诞子,才分娩便晕厥,不知人,遂急于气海灼火十五壮,
而苏后以参、术等药两月而安。一妇人年十九,气怒事不发,一日忽大发,叫而欲厥,盖痰闭于上,火起于下而上
冲,始用∶香附(五钱) 生甘草(三钱) 川芎(七钱) 童便 姜汁煎服 后又用青黛、人参、白附子为丸,少
愈不除,后用大吐乃安。吐后用导痰汤加姜炒黄连、香附、生姜下龙荟丸。
大体上与痫病(癫痫)相似,但比痫病更为虚损,治疗应当兼顾补益。若是气虚兼有火热并伴有痰湿,可用人参、竹沥等药物,切不可当作风证治疗而兼用祛风药。治疗因饮酒过多导致的风抽搐:白术(五钱)、人参(二钱半)、甘草(三钱)、陈皮、苍术(以上各一钱)、天麻(细切,酒浸一钱)、白芍药(酒浸一钱)、防风(五分)、川芎(五分)。将上述药物研为细末,制成丸剂。如果小便增多,可加入五味子。
属于热郁证,使用火郁汤。葛根、柴胡、白芍药(以上各一两)、甘草(炙制一两)、防风(五钱)、升麻(一两)。每次服用三钱,加入葱白三寸,煎煮后稍热时服用。另一方:栀子、香附、白芷、苍术、半夏、川芎,研为细末,用面糊制成丸剂。火郁证表现为手足心发热如骨蒸感,可用草还丹治疗。
麻木是由于气虚所致,木僵(肢体活动不利或感觉丧失)是由于湿痰和瘀血阻滞。李东垣说:麻木是因为气机运行不畅,应当补益肺中的气。有一位妇女,体型肥胖且气机郁滞,出现舌体麻木、眩晕、手足麻木,气息壅塞并有痰,大便干结,使用凉膈散加天南星、香附、台芎(即川芎的一种)来开郁化痰。
厥证有阳厥和阴厥两种。阳气衰于下部则表现为寒证,阴气衰于下部则表现为热证。《原病式》中有详细论述。厥证以气血虚弱为主,可能兼有痰或热。治疗痰湿用白术和竹沥;治疗热证用承气汤,若因外感引起,则在解散表邪的基础上加入姜汁和酒。气虚者脉象细弱;血虚者脉象如葱管般中空;热厥者脉象数疾;外感者脉象浮;实痰证者脉象弦。一位三十多岁的妇女,面色苍白,身形修长,心中常有不平之事。半夜突然分娩,刚生完孩子就晕厥,不省人事,于是急忙在气海穴艾灸十五壮,苏醒后用人参、白术等药物治疗两个月才安稳。另一位十九岁的妇女,因愤怒之事未发泄,一天突然大发脾气,呼叫并想要晕厥,这是因为痰浊闭塞于上焦,火气起于下焦而上冲。起初使用香附(五钱)、生甘草(三钱)、川芎(七钱),配合童便(儿童尿液)和姜汁煎服。之后又用青黛、人参、白附子制成丸剂,症状稍减但未除尽,后来采用催吐法才安定下来。催吐后使用导痰汤加姜炒黄连、香附、生姜,送服龙荟丸。
Generally similar to epilepsy (Xian Bing), but more deficient than epilepsy; treatment should incorporate tonification. If there is Qi deficiency with fire and phlegm, use substances such as Renshen (Ginseng) and Zhuli (Bamboo Sap); strictly avoid treating it as a wind syndrome and using wind-dispelling herbs. For treating wind convulsions caused by excessive alcohol consumption: Baizhu (Atractylodis Rhizoma, 5 qian), Renshen (Ginseng Radix et Rhizoma, 2.5 qian), Gancao (Licorice Root, 3 qian), Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma, 1 qian each above), Tianma (Gastrodiae Rhizoma, finely cut, soaked in wine, 1 qian), Baishao Yao (Paeoniae Radix Alba, soaked in wine, 1 qian), Fangfeng (Saposhnikoviae Radix, 0.5 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 0.5 qian). Grind the above into powder and make pills. If urine output increases, add Wuweizi (Schisandrae Fructus).
For cases belonging to heat stagnation, use Huoyu Tang (Fire Stagnation Decoction). Gegen (Puerariae Lobatae Radix), Chaihu (Bupleuri Radix), Baishao Yao (Paeoniae Radix Alba, 1 liang each above), Gancao (Licorice Root, roasted, 1 liang), Fangfeng (Saposhnikoviae Radix, 5 qian), Shengma (Cimicifugae Rhizoma, 1 liang). Take 3 qian per dose, add 3 cun of Congbai (Scallion White), decoct, and take slightly warm. Another prescription: Zhizi (Gardeniae Fructus), Xiangfu (Cyperi Rhizoma), Baizhi (Angelicae Dahuricae Radix), Cangzhu (Atractylodis Rhizoma), Banxia (Pinelliae Tuber), Chuanxiong (Ligustici Chuanxiong Rhizoma). Grind into powder and make pills with wheat paste. For Fire Stagnation presenting with bone-steaming heat in the palms and soles, use Caohuan Dan.
Numbness (Ma) is due to Qi deficiency; stiffness/loss of sensation (Mu) is due to damp-phlegm and dead blood (stasis). Dongyuan (Li Dongyuan) said: Numbness and stiffness are caused by the failure of Qi to circulate; one should tonify the Qi in the Lung. A woman, obese with Qi stagnation, presented with tongue numbness, vertigo, limb numbness, Qi obstruction with phlegm, and constipation. She was treated with Liangge San (Cooling the Chest Powder) added with Nanting (Arisaematis Tuber) and Xiangfu (Cyperi Rhizoma) and Taixiong (Chuanxiong) to open the orifices and resolve phlegm.
There are Yang Jue (Yang Reversal) and Yin Jue (Yin Reversal). Yang deficiency at the lower part manifests as cold; Yin deficiency at the lower part manifests as heat. This is detailed in Yuanbing Shi (Original Patterns of Disease). The root is primarily Qi and Blood deficiency, possibly complicated by phlegm or heat. To treat phlegm, use Baizhu and Zhuli; to treat heat, use Chengqi Tang (Chengqi Decoction); if due to external contraction, add Jiangzhi (Ginger Juice) and Jiu (Wine) to the exterior-resolving formula. Qi deficiency presents with a fine pulse; Blood deficiency presents with a pulse like a scallion stalk (hollow); Heat Jue presents with a rapid pulse; External contraction presents with a floating pulse; Excess Phlegm presents with a wiry pulse. A woman over thirty years old, with a pale face and long slender body, often harbored unresolved grievances. Suddenly giving birth in the middle of the night, she fainted immediately after delivery, losing consciousness. Urgently, fifteen moxa cones were applied to Qihai (CV6), after which she revived. Subsequently, she was stabilized over two months with medicines such as Renshen and Baizhu. Another woman, nineteen years old, suppressed her anger for a day until it suddenly erupted; she shouted and was about to faint. This was because phlegm closed the upper jiao while fire rose from the lower jiao and rushed upward. Initially, she was given Xiangfu (5 qian), Sheng Gancao (Raw Licorice Root, 3 qian), Chuanxiong (7 qian), Tongbian (Child's Urine), and Jiangzhi (Ginger Juice) decocted together. Later, pills made of Qingdai (Indigo Naturalis), Renshen, and Baifu Zi (Radix Bungeae) were used. Symptoms slightly improved but did not disappear. Finally, emesis was induced, leading to stability. After emesis, Daotan Tang (Great Phlegm-Resolving Decoction) added with Jiangchao Huanglian (Ginger-fried Coptidis Rhizoma), Xiangfu, and Shengjiang (Fresh Ginger) was used to administer Longhui Wan (Longhui Pills).