〔《灵》〕卫气不行,则为麻木。(刺真节邪篇)
〔垣〕∶神效黄 汤 治浑身麻木不仁,或左或右,半身麻木,或面,或头,或手臂,或
脚腿,麻木不仁,并皆治之。(方见目门倒睫拳毛)
芍药补气汤 治皮肤间有麻木,此肺气不行也。(洁古老人立效神方)
黄 (一两) 白芍药(两半) 橘皮(一两) 泽泻(半两) 甘草(一两,炙)
上 咀。每服一两,水二大盏,煎至一盏,去渣温服。如肌肉麻,必待泻营气而愈
。如湿热相合,四肢沉痛。当泻湿热。
〔垣〕∶杜彦达患左手右腿麻木,右手大指次指亦常麻木至腕,已三四年矣。诸医不效,求
治明之,明之曰∶麻者,气之虚也,真气弱,不能流通,填塞经络,四肢俱虚,故生麻木不
仁。与一药,决三日夜。遂制人参益气汤。服二日,便觉手心热,手指中间如气满胀。至三
日后,又觉两手指中间皮肉如不敢触者,似痒痛满胀之意,指上瑟瑟,不敢用手擦傍触之。
明之云∶真气遍至矣。遂于两手指甲傍各以三棱针一刺之,微见血如黍粘许,则痹自息矣。
又为处第二、第三服之。
人参益气汤 治五六月间,两手麻木,四肢困倦,怠堕嗜卧。乃湿热伤元气也,以此药治之。
黄 (八钱) 人参 甘草(各五钱,生) 甘草(炙,二钱) 五味子(一百二十粒) 升麻(二钱) 柴
胡(二钱半) 芍药(三钱)
上 咀。每服称半两,水五盏,煎一盏,去渣,空心温服,服后令少卧。于麻痹处
,按摩屈伸少时,午饭前,又一服,日二服。第二次药,煎服如前。
黄 (八钱) 红花(五分) 陈皮(一钱) 泽泻
第三次服药
黄 (六钱) 黄柏(一钱二分) 橘皮(三钱) 泽泻 升麻(各二钱) 白芍(五钱) 生甘草(四钱) 五
味(一百粒) 生芩(八钱) 炙甘草(一分)
上 咀。分作四服,煎服如前法,稍热服。秋凉去五味,冬月去黄芩,服之大效。
除湿补气汤 治左腿麻木沉重。
黄 (八钱) 甘草梢(六钱) 五味(一百二十粒) 升麻梢 当归 柴胡梢 泽泻(各二钱) 红花(二
钱半) 陈皮(一钱) 青皮(四钱)
上 咀。分作四服,水三大盏,煎至一盏,去渣,稍热,食前服。
〔仲〕血痹病,从何得之?师曰∶夫尊荣人骨弱肌肤盛,重困疲劳,汗出卧,不时动摇,
加被微风遂得之。形如风状,但以脉自微涩,在寸口关上小紧,宜针引阳气,令脉和,紧去
则愈。血痹,阴阳俱微,寸口关上微,尺中小紧,外证身体不仁,如风痹状,黄 桂枝五物汤主之。
黄 芍药 桂枝(各三两) 生姜(六两) 大枣(十二枚)
上五味,以水六升,煮取二升,温服七合,日三服。一方有人参。
〔罗〕中书左丞张仲谦,至元戊辰春正月,在大都患风证,半身麻木。一医欲下之,未决
可否,命予决之。予曰∶治风当通因通用,汗之可也。然此地此时,虽交春令,寒气犹存,
汗之则虚,其表必有恶风、恶寒之证。仲谦欲速瘥,遂汗之,身体轻快。后数日,再来邀予
视之。曰∶果如君言,官事繁剧,不敢出行,当如之何?予曰∶仲景云,大法夏宜汗,阳气
在外故也。今时阳气尚弱,初出于地,汗之则使卫气亟夺,卫气失守,不能肥实腠理,表上
无阳,见风必大恶矣。《内经》曰∶阳气者,卫外而为固也。又云∶阳气者,若天与日,失
其所,则折寿而不彰。当此之时,犹有过汗之戒。况不当汗而汗之者乎。遂与黄 建中汤加
白术服之,滋养脾胃,生发荣卫之气,又以温粉扑其皮肤,待春气盛,表气渐实,即愈矣。
《内经》曰∶化不可伐,时不可违,此之谓也。
黄 建中汤(方见治虚实条。)
〔垣〕∶戊申春,节使赵君,年七旬,病体热麻,股膝无力,饮食有汗,妄喜笑,善饥,痰
涎不利,舌强难言,声嗄不鸣,身重如山。求治于先师,诊得左手脉洪大而有力,是邪热客
于经络中也。两臂外有数瘢,遂问其故。对以燃香所致。先师曰∶君之病,皆此也,夫人之
十二经,灌溉周身终而复始。盖手之三阳,从手表上行于头,加之以火邪,阳并于阳,势甚
炽焉。故邪热毒行流散于周身而热麻。《针经》云∶胃中有热则虫动,虫动则胃缓,胃缓则
廉泉开,故涎下。热伤元气,而沉重无力。饮食入胃, 悍之气,不循常度,故多汗
。心火盛,则妄喜笑。脾胃热,则消谷善饥。肺金衰,则声嗄不鸣。仲景云∶微数之脉,慎
不可灸,焦枯伤筋,血难复也。君奉养以膏粱之味,无故加以火毒热伤于经络,而为此病明
矣。《内经》曰∶热淫所胜,治以苦寒,佐以苦甘,以甘泻之,以酸收之。当以黄柏、知母
之苦寒为君,以泻火邪,壮筋骨。又肾欲坚,急食苦以坚之。黄 、生甘草之甘寒,泻热补
表。五味子酸止汗,补肺气之不足,以为臣。灸甘草、当归之甘辛,和血润燥,柴胡、升麻
之苦平,行少阳阳明二经,自地升天,以苦发之者也,以为佐。 咀。同煎取清汁服之
。更缪刺四肢,以泻诸阳之本,使十二经络相接,而泄火邪。不旬日而良愈,遂名其方曰清阳补气汤。
苍术(四钱) 本(二钱) 升麻(六钱) 柴胡(三钱) 五味(一钱半) 黄柏(酒制,三钱) 知母(酒
,二钱) 陈皮(二钱半) 甘草(生,二钱) 当归(二钱) 黄 (三钱)
上 咀。每服五钱,水一盏半,煎至一盏,去渣,空心服之。待少时,复以美膳压之。
补气升阳和中汤 李正臣夫人病,诊得六脉中俱弦洪缓相合,按之无力,弦在其上,是
风热下陷入阴中,阳道不行。其症闭目则浑身麻木,昼减而夜甚。觉而目开,则麻木渐退,
久则绝止。常开其目,此症不作。惧其麻木,不敢合眼,故不得眠。身体皆重,时有痰嗽,
觉胸中常是有痰而不利,时烦燥,气短促而喘,肌肤充盛,饮食大小便如常,惟畏麻木,不
敢合眼,为最苦。观其色脉形病相应而不逆,《内经》曰∶阳盛瞑目而动轻,阴病闭目而静
重。又云∶诸脉皆属于目。《灵枢》曰∶开目则阳道行,阳气遍布周身,闭目则阳道闭而不
行,如昼夜之分,知其阳衰而阴旺也。且麻木为风,虽三尺之童,皆以为然。细校之则非,
如久坐而起,亦有麻木,假为绳系缚之人释之,觉麻木作而不敢动,久则自已。以此验之,
非有风邪,乃气不行也。不须治风,当补其肺中之气,则麻木自去矣。知其经脉,阴火乘其
阳分,火动于中,为麻木也,当兼去阴火则愈矣。时痰嗽者,秋凉在外,湿在上作也,当实
其皮毛,以湿剂。身重脉缓者,湿气伏匿而作也。时见燥作,当升阳助气益血,微泻阴火去
湿,通行经脉,调其阴阳则已。非五脏六腑之本有邪也,补气升阳和中汤主之。
黄 (五钱) 人参(三钱) 甘草(炙,四钱) 陈皮(二钱) 当归(身二钱) 生草根(一钱,去肾热)
佛耳草(四钱) 白芍(三钱) 草豆蔻(钱半,益阳退寒) 黄柏(一钱,酒洗,除湿泻火) 白术(二钱)
苍术(钱半,除热调中) 白茯苓(一钱,除湿导火) 泽泻(一钱,用同上) 升麻(一钱,行阳明经)
柴胡(一钱)
上 咀。每服三钱,水二大盏,煎至一盏,去渣,稍热服,早饭后午饭前服之,至
八服而愈。
温经除湿汤 李夫人,十月二十日,得立冬严霜作时病,四肢无力,乃痿厥,湿热在下
焦也。醋心者,是浊气不降欲满也。合眼麻木者,阳道不行也。开目不麻木者,目开助阳道
,故阴寒之气少退也。头旋眩运者,风气下陷于血分,不伸越而作也。
羌活(七分) 独活(三分) 柴胡(二分) 黄 (二分) 人参(一钱) 甘草(炙,一钱) 白芍(三钱) 陈
皮(二钱) 白术(一钱) 苍术(二钱) 泽泻(一钱) 猪苓(一钱) 黄柏(三分) 黄连 木香(各二分) 草豆
蔻(二分) 神曲(二分) 麻黄(去节,三分) 升麻(五分) 当归(三分)
上锉如麻豆大。作二服,水二大盏,煎一盏,去渣,稍热服,食远。治肢节沉重疼痛无
力之圣药也。
湿气风症不退,眩运麻木不已,除风湿,羌活汤主之。
羌活(一两) 防风(一两) 柴胡(五分) 本(三分) 独活(五分) 苍术(米泔制,一钱) 茯苓(二钱)
泽泻(二分) 猪苓(去皮,二分) 甘草(炙,五分) 黄 (一钱) 陈皮(三分) 黄柏(三分) 黄连(去
须,一分) 升麻(七分) 川芎(三分,去头痛)
上 咀。每服三钱或五钱,水二盏,煎至一盏,去渣,稍热服,量虚实施用。如不
尽证候,根据加减法用之。
〔丹〕手足木者,是湿痰死血。十指麻,是胃中有湿痰死血。
〔子和〕郾城梁贾人,年六十余,忽晓梳发,觉左手指麻,斯须半臂麻,又一臂麻,斯须
头一半麻,比及梳毕,从胁至足皆麻,大便二三日不通。往问他医,皆云风,或药,或针,
皆不解,求治于戴人。戴人曰∶左手三部脉皆伏,比右手小三倍,此枯涩痹也,不可纯归之
风,亦有火燥相兼。乃命一涌一泄一汗,其麻立已。后以辛凉之剂调之,润燥之剂濡之,惟
小指次指尚麻。戴人云∶病根已去,此余烈也,可针溪谷。溪谷者,骨空也,一日晴和往针
之,用《灵枢》中鸡足法,向上卧针,三进三引讫。复卓针起向下卧针,送入十指间皆然,
手热如火,其麻全愈。
〔《济》〕茯苓汤 治停蓄支饮,手足麻痹,多睡眩冒。
半夏(汤泡) 赤茯苓(去皮) 陈皮(各一两) 枳实(去穣,麸炒) 桔梗(去芦) 甘草(炙,半两)
上 咀。每服四钱,水一盏,姜七片,煎服,不拘时。
形数惊恐,经络不通,病生于不仁,治之以按摩、醪药。(全文见治法)
〔《衍》〕一法。五灵脂二两,没药一两,乳香半两,川乌头一两半,炮去皮,同为末,
滴水丸如弹大。每服一丸,生姜温酒下,治风冷,气血闭,手足身体疼痛冷麻。
风论云∶风气行诸脉俞,散于分肉之间,与卫气相干,其道不利,故使肌肉愤
而有疡,卫气有所凝而不行,故其肉有不仁也。(全文见诸风)
又气穴论云∶肉分之间,溪谷之会,积寒留舍,荣卫不居,内为骨痹,外为不仁,命曰
大寒留于溪谷。此亦风寒相干卫气,故卫气不行而不仁也。(全文见气穴论)
〔仲〕黄 五物汤。(方见本守卫气条)
世传恶风而麻木者,乌、附最验。
〔《本》〕治风寒湿痹,麻木不仁,粥法。
川乌生,为末
上用白米作粥半碗。药末四钱,同米用慢火熬熟,稀薄不要稠,下姜汁一茶匙许,蜜三
大匙,搅匀空心啜之,温为佳。如是湿。更入薏苡仁二钱,增米作一钟服。此粥治四肢不随
,痛重不能举者,有此证,预宜防之。左氏曰∶风淫末疾,谓四肢为四末也。脾主四肢,风
邪客于肝则淫脾,脾为肝克,故疾在末。谷气引风湿之药,径入脾经,故四肢得安。此汤剂
极有力,予常用此方以授人,服者良验。
治风湿,四肢浮肿,肌肉麻痹,甚则手足无力,筋脉缓急,宜续断丸。
川续断 萆 当归(微炒) 附子 防风 天麻(各一两) 乳香 没药(各半两) 川芎(三分)
上为细末,炼蜜丸如桐子大。每服三、四十丸,酒或饮下,空心食前服。
〔丹溪〕刘河间作《原病式》,尝以麻为涩,同归于燥门中,真能识病机者也。
〔河〕前胡散 治荣虚卫实,肌肉不仁,致令 重,名曰肉苛。
前胡 白芷 细辛 官桂 白术 川芎(各三两) 附子(炮) 吴茱萸(汤炮,炒) 当归(各
二两) 川椒(去目并闭目者,生用,二两)
上锉。以茶酒三升,拌匀,同窨一宿,以炼成猪脂膏五斤,入药煎。候白芷黄紫色,漉
去渣成膏。病在处摩之。凡大 瘕疮痍皆治,并去诸风疮痒,痛伤折坠损。
《内经》针灸着痹分新久,新者,汤熨灸之。经云∶风寒客入皮肤,或痹不仁肿痛,可
汤熨,及火灸刺而去之是也(全文治法见师传条)。久者,淬针刺之。经云∶着痹不
去,久寒不已,淬取三里是也。(四时气篇)
〔垣〕∶陕帅郭巨济,偏枯,二指着痹,足不能伸。迎先师治之。以长针刺委中,至深骨而
不知痛,出血一二升,其色如墨,又且缪刺之。如是者六七次,服药三月,病良愈。
〔《甲》〕膝寒痹不仁,不屈伸,髀关主之。
着痹不移, 肉破,身热,脉偏绝,是逆也(全文见诊生死)。着痹久而入脏腑
者为逆。(刺法见诸痹)
〔《素》〕荣气虚则不仁,卫气虚则不用,荣卫俱虚则不仁且不用,肉如故也。人身与志
不相有,曰死。(逆调论)
〔《脉》〕诊人被风不仁痿蹙,其脉虚者生,紧急疾者死。
【《灵枢》】卫气运行不畅,就会导致肢体麻木。(出自《刺真邪篇》)
【李杲(号东垣)】神效黄芪汤:治疗全身麻木不仁,或者左侧或右侧半身麻木,或者是面部、头部、手臂、脚腿出现麻木不仁,这些情况都适用此方。(该方见“目门倒睫拳毛”章节)
芍药补气汤:治疗皮肤间出现的麻木感,这是由于肺气运行不畅所致。(由洁古老人创立的《立效神方》中记载)
药材组成:黄芪(一两)、白芍药(一两半)、橘皮(一两)、泽泻(半两)、甘草(一两,蜜炙)。
制法与服法:将药物捣碎成粗末。每次服用一两,加水两大盏,煎煮至一盏,去渣后温服。如果是肌肉麻木,必须通过泻除营气才能痊愈。如果湿热相结合,导致四肢沉重疼痛,应当采用泻除湿热的方法治疗。
【李杲】杜彦达患有左手和右腿麻木,右手的大拇指和食指也常常麻木延伸至手腕,这种情况已经持续了三四年。多位医生治疗无效,于是求治于我(李杲,字明之)。我说:麻的感觉,是气虚的表现,真气虚弱,不能流通,填塞在经络中,四肢都虚弱,所以产生麻木不仁的症状。给他开了一剂药,决定在三昼夜内见效。于是配制了人参益气汤。服用两天后,便觉得手心发热,手指中间感觉像有气充满胀满。到了第三天,又觉得两个手指中间的皮肉好像不敢触碰,有一种似痒又痛且胀满的意思,手指微微颤抖,不敢用手去擦拭或触碰旁边。我说:真气已经遍布全身了。于是在他两个手指甲旁各用三棱针刺一下,微微见到出血如黍米大小,那么痹症自然就会停止。又为他安排了第二、第三剂的处方。
人参益气汤:治疗在五六月间,双手麻木,四肢困倦乏力,懒动嗜卧。这是湿热损伤元气所致,用此药治疗。
药材组成:黄芪(八钱)、人参、生甘草(各五钱)、炙甘草(二钱)、五味子(一百二十粒)、升麻(二钱)、柴胡(二钱半)、芍药(三钱)。
制法与服法:将药物捣碎成粗末。每次称取半两,加水五盏,煎煮至一盏,去渣,空腹温服,服药后令患者稍作休息。在麻痹部位,进行按摩并屈伸肢体片刻,午饭前再服一剂,每日服两次。第二次服药,煎服方法同上。
第二次服药药材组成:黄芪(八钱)、红花(五分)、陈皮(一钱)、泽泻。
第三次服药药材组成:黄芪(六钱)、黄柏(一钱二分)、橘皮(三钱)、泽泻、升麻(各二钱)、白芍(五钱)、生甘草(四钱)、五味子(一百粒)、生黄芩(八钱)、炙甘草(一分)。
制法与服法:将药物捣碎成粗末,分成四份服用,煎服方法同上,稍微温热服用。秋季天气转凉去掉五味子,冬季去掉黄芩,服用效果极佳。
除湿补气汤:治疗左腿麻木沉重。
药材组成:黄芪(八钱)、甘草梢(六钱)、五味子(一百二十粒)、升麻梢、当归、柴胡梢、泽泻(各二钱)、红花(二钱半)、陈皮(一钱)、青皮(四钱)。
制法与服法:将药物捣碎成粗末,分成四份服用,加水三大盏,煎煮至一盏,去渣,稍微温热,饭前服用。
【张仲景】血痹病,是从哪里得来的呢?老师说:那些生活优裕的人,骨骼脆弱而肌肤丰盛,再加上过度疲劳,出汗时睡觉,身体不时动摇,加上受到微风的侵袭,于是就得了这种病。症状表现像风痹一样,但是脉象自己呈现微涩,在寸口和关上部位脉象轻微紧束,适宜用针刺引导阳气,使脉象调和,紧象消失则病愈。血痹证,阴阳脉象都微弱,寸口和关上脉微,尺中脉小紧,外部症状是身体麻木不仁,像风痹的样子,用黄芪桂枝五物汤主治。
药材组成:黄芪、芍药、桂枝(各三两)、生姜(六两)、大枣(十二枚)。
制法与服法:以上五味药,用水六升,煮取二升,温服七合,每日三次服用。另一版本有人参。
【罗天益】中书左丞张仲谦,在至元戊辰年春正月,在大都患中风证,半身麻木。一位医生想要用攻下法治疗,但未决定可否,让我来决断。我说:治疗风证应当通因通用,发汗是可以的。然而此地此时,虽然进入了春季,寒气仍然存在,发汗会导致正气虚弱,体表一定会有恶风、恶寒的症状。张仲谦希望快速痊愈,于是采用了发汗法,身体感到轻快。过了几天,他又来邀请我去诊治。他说:果然像您说的那样,公务繁忙,不敢出行,该怎么办呢?我说:张仲景说,大原则是夏季适宜发汗,因为阳气在外。现在时令阳气还弱,刚从地里发出,发汗会使卫气迅速耗夺,卫气失守,不能充实腠理,体表没有阳气,见到风一定会非常厌恶。《内经》说:阳气,护卫体表而固密。又说:阳气,就像天和太阳,失去其正常位置,就会折损寿命而不显赫。在这个时候,还有过汗的戒律,何况是不当汗而误汗的情况呢。于是给予黄芪建中汤加白术服用,滋养脾胃,生发荣卫之气,又用温粉扑洒在皮肤上,等到春气旺盛,表气逐渐结实,病就好了。《内经》说:生化之机不可伐灭,时令不可违背,说的就是这个道理。
黄芪建中汤(该方见“治虚实”条目)。
【李杲】戊申年春季,节度使赵君,七十岁,患病身体发热麻木,大腿膝盖无力,饮食时出汗,无故喜欢笑,容易饥饿,痰涎不利,舌强难言,声音嘶哑不能发声,身体沉重如山。求治于我的老师,诊得左手脉洪大而有力,这是邪热客居于经络中。见他两臂外侧有几处疤痕,于是询问原因。回答说是在燃香时造成的。老师说:您的病,都是因为这个引起的。人的十二经脉,灌溉周身循环往复。手之三阳经,从手部上行至头部,加上火邪的影响,阳并入阳,势头非常炽盛。所以邪热毒行流散于周身而发热麻木。《针经》说:胃中有热则虫动,虫动则胃缓,胃缓则廉泉穴开放,所以唾液流出。热伤元气,导致沉重无力。饮食进入胃中,悍气不循常度,所以多汗。心火盛,则无故喜欢笑。脾胃热,则消谷善饥。肺金衰,则声音嘶哑不能发声。张仲景说:脉象微数,千万不可灸,否则会焦枯伤筋,血液难以恢复。您以膏粱厚味奉养身体,无故加上火毒热邪伤害经络,从而得了这个病,是很明显的。《内经》说:热邪淫胜,用苦寒药治疗,佐以苦甘药,用甘药泻之,用酸药收之。应当以黄柏、知母的苦寒为君药,以泻火邪,壮筋骨。又肾欲坚,急食苦以坚之。黄芪、生甘草的甘寒,可以泻热补表。五味子的酸味可以止汗,补肺气之不足,作为臣药。炙甘草、当归的甘辛,可以和血润燥,柴胡、升麻的苦平,可以行少阳阳明二经,自地升天,以苦发散,作为佐药。将药物捣碎,同煎取清汁服用。再用缪刺法刺激四肢,以泻诸阳之本,使十二经络相接,而泄火邪。不到十天就完全好了,于是将此方命名为清阳补气汤。
药材组成:苍术(四钱)、藁本(二钱)、升麻(六钱)、柴胡(三钱)、五味子(一钱半)、黄柏(酒制,三钱)、知母(酒浸,二钱)、陈皮(二钱半)、甘草(生,二钱)、当归(二钱)、黄芪(三钱)。
制法与服法:将药物捣碎成粗末。每次服用五钱,加水一盏半,煎煮至一盏,去渣,空腹服用。过一会儿,再用美味食物压住药力。
补气升阳和中汤:李正臣夫人患病,诊得六脉中弦、洪、缓相合,按之无力,弦脉在上,这是风热下陷入阴分,阳道不行。其症状是闭眼则全身麻木,白天减轻夜间加重。醒来睁开眼睛,则麻木逐渐消退,久了就完全停止。经常睁着眼睛,这个症状就不会发作。因为害怕麻木,不敢闭眼,所以无法入睡。身体沉重,时有痰嗽,觉得胸中常有痰而不通畅,时常烦躁,气短促而喘,肌肤充盛,饮食大小便如常,只是畏惧麻木,不敢闭眼,最为痛苦。观察其色脉形病相应且不逆,《内经》说:阳盛则睁眼而动且身轻,阴病则闭目而静且身重。又说:诸脉皆属于目。《灵枢》说:睁眼则阳道行,阳气遍布周身,闭眼则阳道闭而不行,如同昼夜之分,可知其阳衰而阴旺。而且麻木被认为是风邪所致,虽然是三尺孩童也都这么认为。仔细推敲则不然,比如久坐后起身,也会有麻木,假如是被绳子捆绑的人解开后,感觉麻木发作而不敢动,久了自然会好。以此验证,并非有风邪,而是气不行。不需要治风,应当补肺中之气,则麻木自然去除。知道其经脉,阴火乘袭阳分,火动于中,导致麻木,应当兼去阴火则痊愈。时常痰嗽,是因为秋凉在外,湿气在上焦所致,应当实其皮毛,用湿剂。身体沉重脉缓,是湿气伏匿而发作。时常出现燥象,应当升阳助气益血,微泻阴火去湿,通行经脉,调其阴阳即可。这不是五脏六腑根本有邪气,用补气升阳和中汤主治。
药材组成:黄芪(五钱)、人参(三钱)、炙甘草(四钱)、陈皮(二钱)、当归身(二钱)、生甘草(一钱,去肾热)、佛耳草(四钱)、白芍(三钱)、草豆蔻(一钱半,益阳退寒)、黄柏(一钱,酒洗,除湿泻火)、白术(二钱)、苍术(一钱半,除热调中)、白茯苓(一钱,除湿导火)、泽泻(一钱,用法同上)、升麻(一钱,行阳明经)、柴胡(一钱)。
制法与服法:将药物捣碎成粗末。每次服用三钱,加水两大盏,煎煮至一盏,去渣,稍微温热服用,早饭后午饭前服用,服完八剂而痊愈。
温经除湿汤:李夫人,十月二十日,因立冬严霜发作时病,四肢无力,这是痿厥,湿热在下焦。反酸者,是浊气不降欲满也。闭眼麻木者,阳道不行也。睁眼不麻木者,睁眼助阳道,故阴寒之气稍退也。头晕眩晕者,风气下陷于血分,不能伸展越出而发作。
药材组成:羌活(七分)、独活(三分)、柴胡(二分)、黄芪(二分)、人参(一钱)、炙甘草(一钱)、白芍(三钱)、陈皮(二钱)、白术(一钱)、苍术(二钱)、泽泻(一钱)、猪苓(一钱)、黄柏(三分)、黄连、木香(各二分)、草豆蔻(二分)、神曲(二分)、麻黄(去节,三分)、升麻(五分)、当归(三分)。
制法与服法:将药物锉如麻豆大小。分为两份,加水两大盏,煎煮至一盏,去渣,稍微温热服用,离进食时间较远时服用。这是治疗肢节沉重疼痛无力的圣药。
湿气风症不退,眩晕麻木不已,除风湿,用羌活汤主治。
药材组成:羌活(一两)、防风(一两)、柴胡(五分)、藁本(三分)、独活(五分)、苍术(米泔水制,一钱)、茯苓(二钱)、泽泻(二分)、猪苓(去皮,二分)、炙甘草(五分)、黄芪(一钱)、陈皮(三分)、黄柏(三分)、黄连(去须,一分)、升麻(七分)、川芎(三分,去头痛)。
制法与服法:将药物捣碎成粗末。每次服用三钱或五钱,加水两盏,煎煮至一盏,去渣,稍微温热服用,根据虚实施用。如果不完全符合证候,根据加减法使用。
【朱震亨】手足麻木,是湿痰死血所致。十指麻木,是胃中有湿痰死血。
【张子和】郾城梁姓商人,六十多岁,忽然早晨梳头时,觉得左手指麻,一会儿半臂麻,又一臂麻,一会儿头一半麻,等到梳完头,从胁部到足部都麻,大便二三天不通。去问其他医生,都说是有风,用药或针灸,都不能解决,求治于戴人(张子和)。戴人说:左手三部脉都伏,比右手小三倍,这是枯涩痹症,不能单纯归咎于风,也有火燥相兼。于是命令用涌吐、泻下、发汗三种方法,其麻木立刻停止。后来用辛凉之剂调理,用润燥之剂濡养,只有小指和无名指还麻。戴人说:病根已去,这是余威,可以用针刺溪谷。溪谷就是骨空,一天晴朗温和时去针刺,用《灵枢》中的鸡足法,向上卧针,三进三引结束后。再将针竖起向下卧针,送入十指间都这样操作,手热如火,其麻木全愈。
【《济生方》】茯苓汤:治疗停蓄支饮,手足麻痹,多睡眩冒。
药材组成:半夏(汤泡)、赤茯苓(去皮)、陈皮(各一两)、枳实(去瓤,麸炒)、桔梗(去芦)、炙甘草(半两)。
制法与服法:将药物捣碎成粗末。每次服用四钱,加水一盏,姜七片,煎服,不拘时间。
形体多次惊恐,经络不通,病生于不仁,治疗用按摩、醪药。(全文见“治法”章节)
【《衍义》】一种方法。五灵脂二两,没药一两,乳香半两,川乌头一两半,炮制去皮,同为细末,滴水丸如弹子大。每次服用一丸,生姜温酒送下,治疗风冷,气血闭阻,手足身体疼痛冷麻。
《风论》说:风气行于诸脉俞,散于分肉之间,与卫气相干,其道不利,所以使肌肉愤懑而有疡,卫气有所凝而不行,所以其肉有不仁的症状。(全文见“诸风”章节)
又《气穴论》说:肉分之间,溪谷之会,积寒留舍,荣卫不居,内为骨痹,外为不仁,命曰大寒留于溪谷。这也是风寒相干卫气,所以卫气不行而不仁。(全文见“气穴论”章节)
【张仲景】黄芪五物汤。(该方见“本守卫气”条目)
世间流传恶风而麻木者,乌头、附子最验。
【《本草》】治疗风寒湿痹,麻木不仁,粥法。
川乌生,为末。
上用白米作粥半碗。药末四钱,同米用慢火熬熟,稀薄不要稠,下姜汁一茶匙许,蜜三大匙,搅匀空心啜之,温为佳。如果是湿证,更入薏苡仁二钱,增米作一钟服。此粥治四肢不随,痛重不能举者,有此证,预宜防之。左氏说:风淫末疾,谓四肢为四末也。脾主四肢,风邪客于肝则淫脾,脾为肝克,故疾在末。谷气引风湿之药,径入脾经,故四肢得安。此汤剂极有力,予常用此方以授人,服者良验。
治疗风湿,四肢浮肿,肌肉麻痹,甚则手足无力,筋脉缓急,宜续断丸。
药材组成:川续断、萆薢、当归(微炒)、附子、防风、天麻(各一两)、乳香、没药(各半两)、川芎(三分)。
制法与服法:上为细末,炼蜜丸如桐子大。每服三、四十丸,酒或饮下,空心食前服。
【朱丹溪】刘河间作《原病式》,曾经以麻为涩,同归于燥门中,真能识病机者也。
【刘完素】前胡散:治疗荣虚卫实,肌肉不仁,致令身体沉重,名曰肉苛。
药材组成:前胡、白芷、细辛、官桂、白术、川芎(各三两)、附子(炮)、吴茱萸(汤泡,炒)、当归(各二两)、川椒(去目并闭目者,生用,二两)。
制法与服法:上锉。以茶酒三升,拌匀,同窨一宿,以炼成猪脂膏五斤,入药煎。候白芷黄紫色,漉去渣成膏。病在处摩之。凡大癥瘕疮痍皆治,并去诸风疮痒,痛伤折坠损。
《内经》针灸着痹分新久,新者,汤熨灸之。经云:风寒客入皮肤,或痹不仁肿痛,可汤熨,及火灸刺而去之是也(全文治法见“师传”条)。久者,淬针刺之。经云:着痹不去,久寒不已,淬取三里是也。(《四时气篇》)
【李杲】陕帅郭巨济,偏枯,二指着痹,足不能伸。迎先师治之。以长针刺委中,至深骨而不知痛,出血一二升,其色如墨,又且缪刺之。如是者六七次,服药三月,病良愈。
【《甲乙经》】膝寒痹不仁,不屈伸,髀关主之。
着痹不移,肌肉破,身热,脉偏绝,是逆也(全文见“诊生死”)。着痹久而入脏腑者为逆。(刺法见“诸痹”)
【《素问》】荣气虚则不仁,卫气虚则不用,荣卫俱虚则不仁且不用,肉如故也。人身与志不相有,曰死。(《逆调论》)
【《脉经》】诊人被风不仁痿蹙,其脉虚者生,紧急疾者死。
[Ling Shu] When Wei Qi (Defensive Qi) fails to circulate, it leads to numbness. (From "Ci Zhen Xie Pian")
[Li Gao (Dong Yuan)] Shen Xiao Huang Qi Tang (Divine Efficacy Astragalus Decoction): Treats generalized numbness and insensibility, or hemibody numbness on either the left or right side, or numbness of the face, head, arms, or legs. It is applicable to all these conditions. (See formula in "Mu Men Dao Die Quan Mao" chapter).
Shao Yao Bu Qi Tang (Peony Qi-Nourishing Decoction): Treats numbness in the skin caused by the failure of Lung Qi to circulate. (Recorded in Li Gao's "Li Xiao Shen Fang").
Ingredients: Huang Qi (Astragali Radix, 1 liang), Bai Shao Yao (Paeoniae Radix Alba, 1.5 liang), Ju Pi (Citri Reticulatae Pericarpium, 1 liang), Ze Xie (Alismatis Rhizoma, 0.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried).
Preparation and Administration: Crush the herbs into coarse powder. Take 1 liang per dose, add 2 large bowls of water, decoct until 1 bowl remains, strain, and take warm. If the numbness is in the muscles, one must drain Ying Qi (Nutritive Qi) for recovery. If damp-heat combines causing heaviness and pain in the four limbs, one should drain the damp-heat.
[Li Gao] Du Yanda suffered from numbness in his left hand and right leg, and his right thumb and index finger were often numb extending to the wrist, a condition persisting for three to four years. Various physicians failed to treat him, so he sought my treatment. I said: Numbness indicates Qi deficiency; when True Qi is weak and cannot circulate, it obstructs the meridians, leading to weakness in the four limbs and resulting in numbness and insensibility. I prescribed a single dose, promising efficacy within three days and nights. Thus, I formulated Ren Shen Yi Qi Tang (Ginseng Qi-Supplementing Decoction). After two doses, he felt heat in his palms and a sensation of fullness in his fingers. By the third day, he felt that the skin between his fingers was sensitive to touch, experiencing sensations akin to itching, pain, and distension, with trembling in the fingers, making him afraid to rub or touch them. I said: True Qi has now circulated throughout the body. I then pricked beside the fingernails of both hands with a three-edged needle, drawing blood the size of a millet seed, after which the bi-syndrome ceased. I then prepared the second and third doses.
Ren Shen Yi Qi Tang (Ginseng Qi-Supplementing Decoction): Treats numbness in both hands and fatigue/heaviness in the four limbs during the fifth and sixth lunar months, accompanied by lethargy and desire to sleep. This is caused by damp-heat damaging Yuan Qi (Source Qi). Use this formula.
Ingredients: Huang Qi (Astragali Radix, 8 qian), Ren Shen (Panacis Ginseng Radix, 5 qian raw), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma, 5 qian), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 2 qian), Wu Wei Zi (Schisandrae Fructus, 120 grains), Sheng Ma (Cimicifugae Rhizoma, 2 qian), Chai Hu (Bupleuri Radix, 2.5 qian), Shao Yao (Paeoniae Radix, 3 qian).
Preparation and Administration: Crush into coarse powder. Weigh 0.5 liang per dose, add 5 bowls of water, decoct to 1 bowl, strain, and take warm on an empty stomach. Rest slightly after taking. Massage and flex/extend the numb areas briefly. Take another dose before lunch. Twice daily. The second dose is prepared similarly.
Second Dose Ingredients: Huang Qi (8 qian), Hong Hua (Carthami Flos, 0.5 fen), Chen Pi (Citri Reticulatae Pericarpium, 1 qian), Ze Xie (Alismatis Rhizoma).
Third Dose Ingredients: Huang Qi (6 qian), Huang Bo (Phellodendri Cortex, 1.2 fen), Ju Pi (Citri Reticulatae Pericarpium, 3 qian), Ze Xie (Alismatis Rhizoma), Sheng Ma (Cimicifugae Rhizoma, 2 qian each), Bai Shao (Paeoniae Radix Alba, 5 qian), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma, 4 qian), Wu Wei Zi (Schisandrae Fructus, 100 grains), Sheng Qin (Scutellariae Radix, 8 qian), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 1 fen).
Preparation and Administration: Crush into coarse powder, divide into four doses, decoct as above, take slightly warm. In autumn, remove Wu Wei Zi; in winter, remove Huang Qin (Scutellariae Radix). Highly effective.
Chu Shi Bu Qi Tang (Damp-Draining Qi-Supplementing Decoction): Treats numbness and heaviness in the left leg.
Ingredients: Huang Qi (Astragali Radix, 8 qian), Gan Cao Shao (Tip of Glycyrrhizae Radix et Rhizoma, 6 qian), Wu Wei Zi (Schisandrae Fructus, 120 grains), Sheng Ma Shao (Tip of Cimicifugae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chai Hu Shao (Tip of Bupleuri Radix), Ze Xie (Alismatis Rhizoma, 2 qian each), Hong Hua (Carthami Flos, 2.5 qian), Chen Pi (Citri Reticulatae Pericarpium, 1 qian), Qing Pi (Citri Reticulatae Pericarpium Viride, 4 qian).
Preparation and Administration: Crush into coarse powder, divide into four doses, add 3 large bowls of water, decoct to 1 bowl, strain, take slightly warm before meals.
[Zhang Zhongjing] How is Xue Bi (Blood Bi) obtained? The Master said: Those of noble status have weak bones but abundant flesh. When they are overworked and fatigued, sweat out while sleeping, and move restlessly, slight wind invasion causes this. The appearance resembles Feng Bi (Wind Bi), but the pulse is naturally micro-wiry and choppy, with a slight tightness at the Cun and Guan positions. One should use acupuncture to guide Yang Qi, harmonizing the pulse; when the tightness disappears, the disease cures. In Xue Bi, both Yin and Yang pulses are micro, Cun and Guan are micro, and Chi is slightly tight. External symptoms include body insensibility resembling Wind Bi. Huang Qi Gui Zhi Wu Wu Tang (Astragalus, Cinnamon Twig, and Five-Ingredient Decoction) is the primary treatment.
Ingredients: Huang Qi (Astragali Radix), Shao Yao (Paeoniae Radix), Gui Zhi (Cinnamomi Ramulus, 3 liang each), Sheng Jiang (Zingiberis Rhizoma Recens, 6 liang), Da Zao (Jujubae Fructus, 12 pieces).
Preparation and Administration: These five ingredients, decoct in 6 sheng of water to obtain 2 sheng. Take 7 ge warm, three times daily. Another version includes Ren Shen (Panacis Ginseng Radix).
[Luo Tianyi] Zhang Zhongqian, Left Chancellor of the Secretariat, in the first month of spring in the Wuchen year of the Zhiyuan era, suffered from Wind Syndrome in Dadu with hemibody numbness. A physician wished to use purgation but hesitated, asking me to decide. I said: To treat Wind, one should use the method of treating obstruction by promoting flow; sweating is appropriate. However, in this place and time, although spring has begun, cold qi still exists. Sweating will weaken the exterior, leading to aversion to wind and cold. Zhang Zhongqian desired a quick cure and sweated, feeling light and refreshed. Days later, he invited me again, saying: As you predicted, due to heavy official duties, I dare not go out. What should I do? I said: Zhang Zhongjing stated that summer is suitable for sweating because Yang Qi is on the exterior. Now, Yang Qi is still weak, just emerging from the earth. Sweating would rapidly deplete Wei Qi (Defensive Qi). With Wei Qi lost and unable to fill the Cou Li (interstices), the exterior lacks Yang, leading to severe aversion to wind. The Neijing says: Yang Qi guards the exterior and secures it. It also says: Yang Qi is like heaven and the sun; if it loses its proper position, lifespan is shortened. At this time, even caution against excessive sweating applies, let alone improper sweating. Thus, I prescribed Huang Qi Jian Zhong Tang (Astragalus and Middle-Warming Decoction) plus Bai Zhu (Atractylodis Macrocephalae Rhizoma) to nourish the Spleen and Stomach, generate Ying and Wei Qi, and applied warm powder to the skin. Waiting for strong spring Qi and solidified exterior Qi, he recovered. The Neijing says: Do not interfere with transformation processes, do not violate seasonal timing.
Huang Qi Jian Zhong Tang (Astragalus and Middle-Warming Decoction) (See "Treating Deficiency and Excess" entry).
[Li Gao] In spring of the Wushen year, Zhao Jun, the Jie Shi (Commissioner), aged seventy, suffered from body heat and numbness, weakness in thighs and knees, sweating during eating, irrational laughter, excessive hunger, difficulty with phlegm and saliva, stiff tongue, hoarse voice, and body heaviness like a mountain. He sought treatment from my teacher. The pulse at the left hand was洪大 (surging and large) and forceful, indicating pathogenic heat lodging in the meridians. Noticing scars on his outer arms, he explained they were from burning incense. My teacher said: Your illness stems from this. The twelve meridians irrigate the body continuously. The Three Yang Meridians of the Hand ascend from the hand to the head. Combined with Fire Pathogen, Yang merges with Yang, becoming extremely intense. Thus, pathogenic heat and toxin spread throughout the body, causing heat and numbness. The Zhen Jing says: Heat in the Stomach causes worms to move; moving worms cause the Stomach to relax; relaxation opens Lian Quan, causing salivation. Heat damages Yuan Qi, causing heaviness and weakness. Food enters the Stomach, but Hao Qi (Pugnacious Qi) does not follow normal pathways, causing excessive sweating. Excessive Heart Fire causes irrational laughter. Stomach and Spleen heat causes rapid digestion and hunger. Declining Lung Metal causes hoarseness. Zhang Zhongjing said: With a micro-rapid pulse, moxibustion is strictly forbidden, as it scorches and injures sinews, making blood difficult to restore. You nourished yourself with rich foods and added fire-toxin heat to the meridians, clearly causing this illness. The Neijing says: For excess heat, treat with bitter-cold, assist with bitter-sweet, purge with sweet, and astringe with sour. Use Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma) as sovereign drugs to purge fire and strengthen sinews/knees. Kidney desires firmness; eat bitter to firm it. Huang Qi (Astragali Radix) and Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) are sweet-cold to purge heat and tonify the exterior. Wu Wei Zi (Schisandrae Fructus) is sour to stop sweating and tonify Lung Qi deficiency, serving as minister. Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) and Dang Gui (Angelicae Sinensis Radix) are sweet-acrid to harmonize blood and moisten dryness. Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma) are bitter-ping to circulate Shaoyang and Yangming meridians, ascending from earth to heaven, using bitter to disperse, serving as assistants. Decoct together, take clear juice. Apply Miao Ci (lateral needling) to the four limbs to drain the root of Yang meridians, connecting the twelve meridians to vent fire. Within ten days, he fully recovered. The formula was named Qing Yang Bu Qi Tang (Clear-Yang Qi-Supplementing Decoction).
Ingredients: Cang Zhu (Atractylodis Rhizoma, 4 qian), Ben Cao (Ligustici Chuanxiong Rhizoma, 2 qian), Sheng Ma (Cimicifugae Rhizoma, 6 qian), Chai Hu (Bupleuri Radix, 3 qian), Wu Wei Zi (Schisandrae Fructus, 1.5 qian), Huang Bo (Phellodendri Cortex, wine-processed, 3 qian), Zhi Mu (Anemarrhenae Rhizoma, wine-soaked, 2 qian), Chen Pi (Citri Reticulatae Pericarpium, 2.5 qian), Gan Cao (Raw Glycyrrhizae Radix et Rhizoma, 2 qian), Dang Gui (Angelicae Sinensis Radix, 2 qian), Huang Qi (Astragali Radix, 3 qian).
Preparation and Administration: Crush into coarse powder. Take 5 qian per dose, add 1.5 bowls of water, decoct to 1 bowl, strain, take on an empty stomach. Wait a moment, then eat a good meal to settle the medicine.
Bu Qi Sheng Yang He Zhong Tang (Qi-Supplementing, Yang-Raising, and Middle-Harmonizing Decoction): Mrs. Li Zhengchen presented with six pulses combining Xian (wiry), Hong (surging), and Huan (relaxed), powerless upon pressure, with wiry quality superior. This indicates Wind-Heat sinking into Yin, blocking Yang pathways. Symptoms: Generalized numbness when eyes are closed, worse at night, improving during day. Upon waking and opening eyes, numbness recedes and eventually stops. Keeping eyes open prevents symptoms. Fear of numbness prevents closing eyes, causing insomnia. Body heaviness, occasional phlegm-cough, sensation of phlegm in chest, irritability, shortness of breath with panting, robust flesh, normal diet/excretion, but suffering most from fear of numbness. Pulse and form correspond without contradiction. Neijing says: Yang excess leads to open eyes, movement, and lightness; Yin disease leads to closed eyes, stillness, and heaviness. Also: All pulses relate to the eyes. Ling Shu says: Opening eyes allows Yang pathways to circulate, spreading Yang Qi; closing eyes blocks Yang pathways, like day and night separation, indicating Yang deficiency and Yin abundance. Although common people attribute numbness to Wind, careful analysis shows otherwise. Rising after long sitting causes numbness; releasing bound limbs causes temporary numbness that resolves. Thus, it is not Wind Pathogen, but Qi stagnation. Do not treat Wind; tonify Lung Qi, and numbness will resolve. The pathology involves Yin Fire attacking Yang branches, fire stirring internally causing numbness; thus, clear Yin Fire. Occasional phlegm-cough is due to autumn coolness and upper Jiao dampness; tonify exterior with damp-resolving agents. Body heaviness and relaxed pulse indicate latent dampness; address dryness by raising Yang, assisting Qi, benefiting Blood, mildly draining Yin Fire, removing dampness, unblocking meridians, and harmonizing Yin/Yang. This is not a root disorder of Zang-Fu; use Bu Qi Sheng Yang He Zhong Tang.
Ingredients: Huang Qi (Astragali Radix, 5 qian), Ren Shen (Panacis Ginseng Radix, 3 qian), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 4 qian), Chen Pi (Citri Reticulatae Pericarpium, 2 qian), Dang Gui Shen (Body of Angelicae Sinensis Radix, 2 qian), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma, 1 qian, clears Kidney heat), Fo Er Cao (Pedicularis Resupinatae Herba, 4 qian), Bai Shao (Paeoniae Radix Alba, 3 qian), Cao Dou Kou (Amomi Fructus Rotundus, 1.5 qian, benefits Yang dispels cold), Huang Bo (Phellodendri Cortex, 1 qian, wine-washed, drains damp-fire), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 2 qian), Cang Zhu (Atractylodis Rhizoma, 1.5 qian, clears heat harmonizes middle), Bai Fu Ling (Poria, 1 qian, drains damp guides fire), Ze Xie (Alismatis Rhizoma, 1 qian), Sheng Ma (Cimicifugae Rhizoma, 1 qian, circulates Yangming), Chai Hu (Bupleuri Radix, 1 qian).
Preparation and Administration: Crush into coarse powder. Take 3 qian per dose, add 2 large bowls of water, decoct to 1 bowl, strain, take slightly warm after breakfast and before lunch. Recovered after eight doses.
Wen Jing Chu Shi Tang (Warm-Meridians and Damp-Draining Decoction): Mrs. Li, on October 20th, contracted a seasonal illness due to severe frost at Start of Winter. Four limbs were weak, constituting Wei Jue (Atrophy and Cold Extremities), with damp-heat in Lower Jiao. Acid regurgitation indicates turbid Qi failing to descend and accumulating. Numbness with eyes closed indicates blocked Yang pathways. No numbness with eyes open indicates eye-opening aids Yang, retreating Yin-Cold. Dizziness indicates Wind Qi sinking into Blood level, failing to rise.
Ingredients: Qiang Huo (Notopterygii Rhizoma et Radix, 0.7 fen), Du Huo (Angelicae Pubescentis Radix, 0.3 fen), Chai Hu (Bupleuri Radix, 0.2 fen), Huang Qi (Astragali Radix, 0.2 fen), Ren Shen (Panacis Ginseng Radix, 1 qian), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 1 qian), Bai Shao (Paeoniae Radix Alba, 3 qian), Chen Pi (Citri Reticulatae Pericarpium, 2 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian), Cang Zhu (Atractylodis Rhizoma, 2 qian), Ze Xie (Alismatis Rhizoma, 1 qian), Zhu Ling (Polyporus, 1 qian), Huang Bo (Phellodendri Cortex, 0.3 fen), Huang Lian (Coptidis Rhizoma), Mu Xiang (Aucklandiae Radix, 0.2 fen each), Cao Dou Kou (Amomi Fructus Rotundus, 0.2 fen), Shen Qu (Massa Medicata Fermentata, 0.2 fen), Ma Huang (Ephedrae Herba, de-stemmed, 0.3 fen), Sheng Ma (Cimicifugae Rhizoma, 0.5 fen), Dang Gui (Angelicae Sinensis Radix, 0.3 fen).
Preparation and Administration: Cut into hemp-seed size. Divide into two doses, add 2 large bowls of water, decoct to 1 bowl, strain, take slightly warm far from meals. It is a sacred medicine for heaviness, pain, and weakness in joints.
If Damp-Wind syndrome persists with dizziness and numbness, use Qiang Huo Tang (Notopterygium Decoction) to expel Wind-Damp.
Ingredients: Qiang Huo (Notopterygii Rhizoma et Radix, 1 liang), Fang Feng (Saposhnikoviae Radix, 1 liang), Chai Hu (Bupleuri Radix, 0.5 fen), Ben Cao (Ligustici Chuanxiong Rhizoma, 0.3 fen), Du Huo (Angelicae Pubescentis Radix, 0.5 fen), Cang Zhu (Atractylodis Rhizoma, rice-water processed, 1 qian), Fu Ling (Poria, 2 qian), Ze Xie (Alismatis Rhizoma, 0.2 fen), Zhu Ling (Polyporus, peeled, 0.2 fen), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 0.5 fen), Huang Qi (Astragali Radix, 1 qian), Chen Pi (Citri Reticulatae Pericarpium, 0.3 fen), Huang Bo (Phellodendri Cortex, 0.3 fen), Huang Lian (Coptidis Rhizoma, de-filament, 0.1 fen), Sheng Ma (Cimicifugae Rhizoma, 0.7 fen), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 0.3 fen, relieves headache).
Preparation and Administration: Crush into coarse powder. Take 3 or 5 qian per dose, add 2 bowls of water, decoct to 1 bowl, strain, take slightly warm, dosage adjusted for deficiency/excess. Modify according to symptom variations.
[Zhu Zhenheng] Numbness in hands and feet is caused by Damp-Phlegm and Dead Blood. Numbness in ten fingers indicates Damp-Phlegm and Dead Blood in the Stomach.
[Zhang Yuhe] Liang, a merchant from Yancheng, over sixty, suddenly felt numbness in left fingers while combing hair in the morning, spreading to half-arm, then whole arm, then half-head. By finishing combing, numbness extended from hypochondrium to feet. Bowel movement was blocked for 2-3 days. Other doctors diagnosed Wind; medicines and acupuncture failed. He sought Zhang Yuhe (Dai Ren). Dai Ren said: Pulses at three positions of left hand were hidden (Fu), three times smaller than right hand. This is Dryness-Bi, not purely Wind, but combined with Fire-Dryness. He ordered Vomiting, Purging, and Sweating methods; numbness stopped immediately. Later, he regulated with Acrid-Cool agents and moistened with Dryness-Relieving agents. Only little and ring fingers remained numb. Dai Ren said: Root disease removed; this is residual effect. Prick Xi Gu (Valleys). Xi Gu refers to bone cavities. On a sunny day, he used Ji Zu Fa (Chicken-Foot Method) from Ling Shu, inserting needle horizontally upward, advancing and withdrawing three times. Then lifting needle vertically downward, inserting into spaces between fingers. Hands became hot as fire; numbness completely cured.
[Ji Sheng Fang] Fu Ling Tang (Poria Decoction): Treats retained fluid and branch-fluid retention, causing limb numbness, excessive sleep, and dizziness.
Ingredients: Ban Xia (Pinelliae Rhizoma, boiled), Chi Fu Ling (Red Poria, peeled), Chen Pi (Citri Reticulatae Pericarpium, 1 liang each), Zhi Shi (Aurantii Fructus Immaturus, de-pithed, bran-fried), Jie Geng (Platycodonis Radix, de-root), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 0.5 liang).
Preparation and Administration: Crush into coarse powder. Take 4 qian per dose, add 1 bowl of water, 7 slices of ginger, decoct, take anytime.
Frequent fright and panic block meridians, causing insensibility. Treat with massage and medicinal wine. (Full text in "Treatment Methods" chapter).
[Yan Yi] One method: Wu Ling Zhi (Trogopterori Faeces, 2 liang), Mo Yao (Myrrha, 1 liang), Ru Xiang (Olibanum, 0.5 liang), Chuan Wu Tou (Aconiti Radix Preparata, 1.5 liang, processed peeled). Grind to powder, mix with water to make pills like bullet sizes. Take one pill per dose with warm ginger wine. Treats Wind-Cold, Qi-Blood obstruction, painful/cold/numb hands, feet, and body.
"Lun Feng" states: Wind Qi travels through Shu points, disperses between muscle layers, interferes with Wei Qi, obstructing pathways. This causes muscle swelling and ulcers; stagnant Wei Qi fails to circulate, causing insensibility. (Full text in "Various Winds" chapter).
"A Qi Lun" states: Between muscle layers, at valley confluences, accumulated cold lodges, Ying and Wei fail to reside. Internally it is Bone Bi, externally insensibility, called Great Cold lodging in valleys. This is also Wind-Cold interfering with Wei Qi, causing Wei Qi stagnation and insensibility. (Full text in "Qi Acupoints" chapter).
[Zhang Zhongjing] Huang Qi Wu Wu Tang (Astragalus Five-Ingredient Decoction). (See "Protecting Wei Qi" entry).
Worldly tradition holds that for aversion to wind and numbness, Wu Tou (Aconiti Radix) and Fu Zi (Aconiti Lateralis Radix Preparata) are most effective.
"Ben Cao" treats Wind-Cold-Damp Bi and numbness with Porridge Method.
Chuan Wu Sheng (Raw Chuan Wu Tou), ground to powder.
Make half a bowl of white rice porridge. Mix 4 qian of herb powder with rice, simmer slowly until cooked, keep thin not thick. Add one teaspoon of ginger juice and three large spoons of honey, stir well, drink warm on empty stomach. For dampness, add 2 qian Yi Yi Ren (Coicis Semen) and increase rice to one cup. This porridge treats limbs unable to move, heavy pain unable to lift. Prevent if symptoms appear. Zuo Zhuan says: Wind invades extremities causing disease; limbs are the four extremities. Spleen governs limbs; Wind invading Liver overacts on Spleen; Spleen is controlled by Liver, so disease is in extremities. Grain Qi guides Wind-Damp herbs directly into Spleen meridian, calming limbs. This decoction is potent; I often give it to others with good results.
For Wind-Damp, limb edema, muscle numbness, severe limb weakness, tendon spasm, use Xu Duan Wan (Dipsacus Pill).
Ingredients: Xu Duan (Dipsaci Radix), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Dang Gui (Angelicae Sinensis Radix, lightly fried), Fu Zi (Aconiti Lateralis Radix Preparata), Fang Feng (Saposhnikoviae Radix), Tian Ma (Gastrodiae Rhizoma, 1 liang each), Ru Xiang (Olibanum), Mo Yao (Myrrha, 0.5 liang each), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 0.3 fen).
Preparation and Administration: Grind to fine powder, mix with refined honey to make pills like wattle seeds. Take 30-40 pills per dose with wine or water, on empty stomach before meals.
[Zhu Danxi] Liu Hejian wrote "Yuan Bing Shi", classifying numbness as roughness/dryness, grouping it under Dryness. He truly understood disease mechanisms.
[Liu Wansu] Qian Hu San (Peucedani Radix Powder): Treats Ying deficiency and Wei excess, muscle insensibility, causing heaviness, named Rou Ke (Muscle Severe Heaviness).
Ingredients: Qian Hu (Peucedani Radix), Bai Zhi (Angelicae Dahuricae Radix), Xi Xin (Asari Radix et Rhizoma), Guan Gui (Cinnamomi Cortex), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 3 liang each), Fu Zi (Aconiti Radix Preparata), Wu Zhu Yu (Evodiae Fructus, boiled fried), Dang Gui (Angelicae Sinensis Radix, 2 liang each), Chuan Jiao (Zanthoxyli Pericarpium, de-eye and closed ones, raw, 2 liang).
Preparation and Administration: Cut. Mix with 3 sheng tea and wine, marinate overnight. Add 5 jin refined lard, decoct herbs. When Bai Zhi turns yellow-purple, strain to make ointment. Rub on affected area. Treats large masses, ulcers, wind-itch, trauma, fractures.
Neijing distinguishes new vs old Zhuo Bi (Fixed Bi) in acupuncture. New cases: Treat with hot compresses and moxibustion. Classic says: Wind-Cold entering skin causing Bi, insensibility, pain/swelling can be treated with hot compresses, fire moxa, and needles. (Full text in "Master Transmission" entry). Old cases: Treat with quenched needles. Classic says: Fixed Bi not resolved, chronic cold persists, quench and prick Zu San Li. (Si Shi Qi Pian).
[Li Gao] Guo Juji, military commander of Shaanxi, suffered hemiplegia, fixed Bi in two fingers, inability to extend foot. I treated him. Used long needle to prick Wei Zhong (BL40) deeply to bone without pain, bleeding 1-2 sheng, color like ink. Applied Miao Ci. Repeated 6-7 times. Took medicine for 3 months; fully recovered.
"Jia Yi Jing": Bi coldness and insensibility in knee, inability to flex/extend, Bi Guan (ST31) treats it.
Fixed Bi not migrating, muscle wasting, body heat, pulse absent on one side, is adverse prognosis. (Full text in "Diagnosing Death/Life"). Fixed Bi entering Zang-Fu after long duration is adverse. (Acupuncture methods in "Various Bi" chapter).
"Suwen": Ying deficiency causes insensibility; Wei deficiency causes immobility; both Ying and Wei deficient cause insensibility and immobility, flesh remains unchanged. Body disconnected from mind indicates death. (Ni Tiao Lun).
"Mai Jing": Diagnosing patients with Wind-induced insensibility and atrophy/collapse: Void pulse indicates survival; urgent/rapid pulse indicates death.