或曰∶小儿亦有半身不遂者？余曰∶小儿自周岁至童年皆有，突然患此症者少，多半由
伤寒
如泥塑，皆是气不达于四肢。古人以风治，是于此症阅历无多。
或曰∶元气归并左右，病半身不遂，有归并上下之症乎？余曰∶元气亏五成，下剩五成
，周
之源，因足阳明胃经湿热，上蒸于肺，肺热叶焦，皮毛憔悴，发为痿症，概用清凉攻下之方
。余论以清凉攻下之药，治湿热腿疼痹症则可，治痿症则不相宜。岂知痹症疼痛日久，能令
腿瘫，瘫后仍然腿疼。痿症是忽然两腿不动，始终无疼痛之苦。倘标本不清，虚实混淆，
岂不遗祸后人。
此方治半身不遂，口服歪斜，语言蹇涩，口角流涎，大便干燥，小便频数，遗尿不禁。
黄 （四两，生） 归尾（二钱） 赤芍（一钱半） 地龙（一钱，去土） 川芎（一钱） 桃仁
（一钱） 红花（一钱）
水煎服。
初得半身不遂，根据本方加防风一钱，服四五剂后去之。如患者先有入耳之言，畏惧黄
，只
日，每日仍服一剂。如已病三两个月，前医遵古方用寒凉药过多，加附子四五钱。如用散风
药过多，加党参四五钱。若未服，则不必加。此法虽良善之方，然病久气太亏，肩膀脱落二
三指缝，胳膊曲而搬不直，脚孤拐骨向外倒，哑不能言一字，皆不能愈之症，虽不能愈，常
服可保病不加重。若服此方愈后，药不可断，或隔三五日吃一副，或七八日吃一副，不吃恐
将来得气厥之症。方内黄 ，不论何处所产，药力总是一样，皆可用。
方歌
补阳还五赤芍芎，归尾通经佐地龙，
四两黄 为主药，血中瘀滞用桃红。
有人问：小孩子也会有半身不遂（身体一侧肢体瘫痪）吗？我回答说：小孩子从一周岁到童年时期都有这种情况，突然患这种病的很少，多半是由于伤寒（外感寒邪引起的疾病）导致元气亏损。患者身体僵硬如泥塑一般，都是由于气不能通达四肢所致。古人用治风的方法来治疗此症，是因为对这类病症的阅历经验不多。
有人问：元气亏虚汇聚于身体左右两侧，导致半身不遂，有没有元气汇聚于上下部位导致的病症呢？我回答说：元气亏损五成，剩下五成，无法周流全身。关于痿症（肢体筋脉弛缓、软弱无力，甚至肌肉萎缩的一种病证），其根源在于足阳明胃经有湿热，湿热上蒸于肺，导致肺热叶焦（肺部受热熏灼，津液干枯），皮毛憔悴，从而发为痿症。前人一概使用清凉攻下（清热泻下）的方剂治疗。我认为用清凉攻下的药物来治疗湿热引起的腿疼痹症（以疼痛为主要表现的关节肌肉病变）是可以的，但用来治疗痿症就不适宜了。哪里知道痹症疼痛日久，会导致腿部瘫痪，瘫痪后仍然会腿疼；而痿症是忽然两腿不能活动，始终没有疼痛的痛苦。如果标本不清，虚实混淆，岂不是给后人留下祸患。
这个方子（补阳还五汤）用于治疗半身不遂，口眼歪斜，语言蹇涩（说话不清楚），口角流涎，大便干燥，小便频数，遗尿不禁。
黄芪（四两，生用） 当归尾（二钱） 赤芍（一钱半） 地龙（一钱，去土） 川芎（一钱） 桃仁（一钱） 红花（一钱）
用水煎服。
刚得半身不遂时，根据本方加防风一钱，服用四五剂后去掉防风。如果患者之前听信他人言论，畏惧黄芪，可以减半用量，每日仍服一剂。如果已经患病三两个月，前医遵循古方使用寒凉药过多，则加附子四五钱。如果之前使用散风药过多，则加党参四五钱。如果没有上述情况，则不必添加。这个方法虽然是良善的方子，但是如果病久气太亏，肩膀脱落二三指缝，胳膊弯曲扳不直，脚外踝骨向外倒，哑巴不能说出一个字，这些都是不能治愈的病症。虽然不能治愈，常服此方可以保证病情不加重。如果服用此方痊愈后，药不可断，或者隔三五天吃一副，或者七八天吃一副，不吃恐怕将来会得气厥（气机逆乱导致的昏厥）之症。方内的黄芪，不论产自何处，药力总是一样的，都可以使用。
方歌：
补阳还五赤芍芎，归尾通经佐地龙，
四两黄芪为主药，血中瘀滞用桃红。
A questioner asked: Do children also suffer from hemiplegia (paralysis of one side of the body)? I replied: Children from one year old to childhood age all have this condition. Those who suddenly develop this symptom are few; most cases arise from Shanghan (diseases caused by external cold pathogens) leading to a deficiency of Yuan Qi (Original Qi). The patients' bodies become stiff as if carved from clay, which is due to Qi failing to reach the four limbs. Ancient practitioners treated this with wind-dispelling methods because they had limited experience with such conditions.
Another questioner asked: When Yuan Qi is deficient and aggregates on the left or right sides, causing hemiplegia, are there conditions where it aggregates on the upper or lower parts? I replied: When Yuan Qi is deficient by half, leaving only half, it cannot circulate throughout the body. Regarding Wei Syndrome (a syndrome characterized by flaccidity and weakness of the limbs, sometimes with muscle atrophy), its root lies in damp-heat in the Foot-Yangming Stomach Meridian steaming upward to the Lungs. This causes Lung Heat and scorched lung leaves (dryness of lung fluids), resulting in emaciated skin and hair, manifesting as Wei Syndrome. Predecessors generally used cooling and purgative formulas to treat it. I argue that using cooling and purgative herbs to treat Bi Syndrome (painful obstruction syndrome) caused by damp-heat leg pain is acceptable, but it is inappropriate for treating Wei Syndrome. How could they know that prolonged pain from Bi Syndrome can lead to leg paralysis, yet pain persists after paralysis? In contrast, Wei Syndrome involves sudden immobility of both legs without any pain. If the root and branch are not distinguished clearly, and deficiency and excess are confused, would this not bring disaster to future generations?
This formula is used to treat hemiplegia, deviation of the mouth and eyes, dysarthria (slurred speech), drooling, dry stool, frequent urination, and urinary incontinence.
Huangqi (Radix Astragali Membranacei, 4 liang, raw)
Dangguiwe (Cauda Radix Angelicae Sinensis, 2 qian)
Chishao (Radix Paeoniae Rubra, 1.5 qian)
Dilong (Pheretima, 1 qian, cleaned of soil)
Chuanxiong (Rhizoma Chuanxiong, 1 qian)
Taoren (Semen Persicae, 1 qian)
Honghua (Flos Carthami Tinctorii, 1 qian)
Decoct in water and take orally.
For recent onset of hemiplegia, add Fangfeng (Radix Saposhnikoviae, 1 qian) to this base formula. After taking 4-5 doses, remove Fangfeng. If the patient has previously heard rumors and fears Huangqi, reduce the dosage by half, but still take one dose daily. If the illness has persisted for three to two months, and previous doctors excessively used cold-natured medicines according to ancient prescriptions, add Fuzi (Radix Aconiti Lateralis Preparata, 4-5 qian). If excessive wind-dispelling medicines were used previously, add Dangshen (Radix Codonopsis Pilosae, 4-5 qian). If these specific conditions do not apply, no addition is necessary. Although this is a benevolent formula, if the disease has been long-standing and Qi is severely deficient, resulting in shoulder joint laxity (gap of 2-3 finger widths), inability to straighten bent arms, eversion of the lateral malleolus (foot "gu guai" bone), and muteness (inability to speak a single word), these are incurable conditions. Although they cannot be cured, regular use can prevent the worsening of the condition. If the patient recovers after taking this formula, the medication should not be stopped abruptly. One may take a dose every 3-5 days or every 7-8 days. Failure to continue maintenance therapy may lead to Qi Jue (Qi syncope/collapse) in the future. The Huangqi in this formula, regardless of its place of origin, has consistent medicinal potency and can be used interchangeably.
Formula Song:
Bu Yang Huan Wu contains Chishao and Chuanxiong,
Dangguiwei unblocks meridians assisted by Dilong,
Four liang of Huangqi serves as the main herb,
To resolve blood stasis, Taoren and Honghua are employed.