谢(左) 风痰未清,络隧未和。手指常觉麻木。前法扩充。
于术(一钱五分枳实同打) 制苍术(一钱五分) 煨天麻(一钱五分) 制半夏(一钱五分) 左秦艽(一钱五
分) 茯苓(三钱) 白僵蚕(二钱) 酒炒桑枝(五钱) 防风(八分)
二诊 起居如常,手指尚觉麻木,膝膑微痛。再化痰宣络。
制半夏(一钱五分) 煨天麻(一钱五分) 酒炒桑寄生(三钱) 白蒺藜(三钱) 上广皮(一钱五分)
左秦艽(一钱五分) 海风藤(三钱) 白僵蚕(二钱) 指迷茯苓丸(三钱先服)
三诊 手指麻木渐退。化痰宣络祛风,参以补气,气旺则痰行水消也。
潞党参(三钱) 云茯苓(三钱) 制半夏(一钱五分) 煨天麻(一钱五分) 野于术(二钱) 白僵蚕(一钱
五分) 广橘红(一钱) 白蒺藜(三钱) 清气化痰丸(三钱先服)
左 肩项四肢麻木,麻少木多。脉形濡滑,舌心灰润。胃中湿痰闭郁。拟二术二陈进退。
制茅术(一钱五分) 制半夏(一钱) 煨天麻(一钱五分) 云茯苓(三钱) 炒于潜术(一钱五分) 上
广皮(一钱) 薤白头(三钱) 炒枳壳(一钱) 白僵蚕(二钱炒打)
张(右) 高年营血既亏,中气复弱。血虚则木失涵养,而虚风内动。气弱则阳明络空,风阳遂得袭入筋
络。筋络既阻,则营卫之气,滞而不行,四肢麻木不遂,腹中板滞不和。盖脾主运旋,木旺则脾土不能旋
运,所以气机从而凝滞也。脉象濡而带弦,舌胖心剥。湿痰素盛。宜通补阳明,舒筋养血,而不涉呆滞。古
稀之年,聊冀得尺得寸而已。
白归身(二钱) 奎党参(三钱) 甘杞子(三钱) 桑寄生(三钱) 大麦冬(三钱) 桑椹子(三钱)
阿胶珠(二钱) 粉丹皮(三钱) 杭白芍(一钱五分) 女贞子(三钱) 制半夏(一钱五分)
费(左) 人之一身,营卫气血而已。血所以丽气,气所以统血。非血之足以丽气也,营血所到之处,则气
无不丽焉。非气之足以统血也,卫气所到之处,则血无不统焉,气为血帅故也。经云卫气昼日行于阳,
夜行于阴,行于阳二十五度,行于阴亦二十五度,其所以能二十五度者,为其营能行,卫亦能行也。今
年逾大衍,气血暗衰,风寒湿久伏,乘瑕蹈隙,袭入经络,遂令营卫之气滞而不行,四肢酸麻,厥逆恶寒。
营不行则营不足用,有营若无营矣。卫不行则卫不足用,有卫若无卫矣。譬之久坐倚着,则麻木不得
行动,此理甚明。脉细沉濡,舌胖质腻,尤为风寒湿之明证。为今之计,欲治酸麻,必先行其营卫之滞而
后可。欲行营卫之滞,必先祛其所以阻我营卫者而后可。谁阻之。风寒与湿是也。拟理湿祛风法。风湿
既去,营卫自行,则厥热恶寒,不治自愈。但邪湿既久,其来也渐,其退也必迟。知者以为然否。
制半夏 左秦艽 炒于术 川羌活 甜广皮 川桂枝 焦苍术 酒炒桑枝(煎汤代水)
某 偏左麻木不用,咳嗽气逆痰多。脉形软滑。痰湿阻肺,兼袭经络,图治不易也。
苏子 白芥子 茯苓 杏仁 制半夏 枳壳 旋复花 郁金 橘红 桂枝
杨(左) 偏左麻木,不能运动,胸腹常有热气注射。脉形弦滑。此气虚而痰热内阻,类中之根也。
制半夏(一钱五分) 天竺黄(三钱) 粉丹皮(二钱) 橘红(一钱) 炒竹茹(一钱) 陈胆星(五分)
栝蒌仁(五钱) 海浮石(三钱) 山栀(二钱) 枇杷叶(四片) 陈关蛰(漂淡一两) 大荸荠(
拍碎四枚二味煎汤代水)
谭(左) 向有气撑,兹则胸次作闷,中脘不舒。右关脉滑。此胃中之痰气交阻,阳明为经脉之长,阳明病,
则四肢作麻矣。
薤白头(三钱) 炒枳实(一钱) 制半夏(二钱) 炒竹茹(一钱) 上广皮(一钱) 广郁金(一钱五
分) 左秦艽(一钱五分) 白蒺藜(去刺炒三钱) 云茯苓(四钱) 煨天麻(一钱五分) 越鞠丸(二钱)
二诊 咯出紫瘀四肢麻木转减。的是痰瘀阻胃。前法再进一步。
延胡索(酒炒一钱五分) 当归须(二钱) 紫丹参(三钱) 台乌药(一钱五分) 炒赤芍(一钱五分) 白
蒺藜(去刺炒三钱) 酒炒黑锦纹大黄(三钱) 瓦楞子(五钱) 生牛膝(三钱) 炙土鳖虫(五枚) 韭菜
汁(半酒杯冲)
吴(左) 遍身麻木,小溲结而不爽,中州不舒,目盲失明。脉象糊滑。此湿痰内滞,络隧不宣,脏腑之
精气,不能上注也。
苍术(一钱五分) 陈皮(一钱五分) 晚蚕砂(三钱) 赤白苓(各二钱) 制半夏(二钱) 白蒺藜
(三钱) 川羌活(一钱) 川桂枝(四钱) 川黄柏(二钱) 木猪苓(二钱) 泽泻(二钱) 防风(一钱)
吴(左) 麻木大退,渐能步履,两目略能隐约见物,不可不为转机。但脉仍弦滑,湿痰尚盛。再祛湿疏风。
川桂枝(五分) 防风(一钱) 制半夏(二钱) 晚蚕砂(三钱) 车前子(二钱) 川羌活(一钱)
独活(一钱) 云茯苓(五钱) 白蒺藜(三钱) 橘红(一钱) 二妙丸(三钱另服)
右 肢节作麻。气虚而湿痰内阻,为风痱之根。
半夏 茯苓 煨天麻 白蒺藜 上广皮 钩钩 炒枳实 白僵蚕 炒竹茹 清气化痰丸
左 右足搐动,肌肤麻木。痰湿化风,风主动摇故也。
川桂枝 青防风 羌独活 白蒺藜 煨天麻 制半夏
左秦艽 磨沉香 广橘皮 白茯苓 钩钩 二妙丸
二诊 右足搐动略定。再化痰熄风。
川桂枝 川黄柏 羌独活 左秦艽 白僵蚕 焦苍术
明天麻 木防己 制半夏 桑枝 全蝎(炙去毒三分)
三诊 右足搐动,既退之后,遇凉又剧。盖血气喜温而恶寒。再温经和络祛风。
煨明天麻(一钱五分) 羌独活(各一钱) 当归身(二钱) 青防风(一钱) 西潞党(三钱) 川桂枝(五
分) 桑寄生(二钱) 北细辛(三分) 川芎(一钱) 白术(二钱)
某 痛势稍定,热亦减轻。而右脐傍有气攻冲,冲则牵引经络作痛,大便不行。此风湿热郁结,脾土气
滞不能运旋。再参通府。
桂枝(四分) 焦苍术(二钱) 酒炒威灵仙(二钱) 制香附(二钱) 防己(二钱)
川黄柏(一钱五分) 龙胆草(三分) 金铃子(一钱五分) 磨沉香(四分冲) 当归龙荟丸(三钱开水下)
周(左) 外感湿热后,湿困不化,神疲体软,绵延二月,方得渐复。而每晨痰出不爽,四肢有时作麻。营卫
不宣,亦由湿阻。拟补气化痰。
奎党参(三钱) 制半夏(一钱五分) 茯苓神(各三钱) 生熟谷芽(各二钱) 炒于术(二钱) 木猪苓
(二钱) 炒枳壳(一钱) 广皮(一钱) 缩砂仁(五分) 姜汁炒竹二青(一钱五分)
二诊 脉濡而滑,痰不爽利,每至睡卧,四肢作麻。气虚夹湿夹痰,营卫流行为之所阻。再补气化痰,所
谓气旺则痰行水消也。
炒透霞天曲(三钱) 炙绵 (二钱) 炒于术(二钱) 茯苓(三钱) 生熟谷芽(各二钱)
奎党参(三钱) 广橘红(一钱) 猪苓(二钱) 蜜炙老生姜(一钱) 制半夏(二钱) 炒枳壳(一钱)
许(右) 痛虽减而肢麻色黄。气血窒痹不行。姑再宣通。
制香附 旋复花 陈皮 砂仁末 广郁金 当归尾 猩绛 沉香片 炒桃仁 炒枳壳 清半夏 葱管
钱 体麻作痛,时发时止者久。日来发热自汗,胸膺作痛。此风湿交蒸。恐成湿温时症。
桂枝 羌活 橘皮络 酒炒桑枝 秦艽 防风 旋复花 地骨皮
左 两足有麻木之意。风与湿内阻也。
独活 桑寄生 秦艽 茯苓 当归 防风 僵蚕 萆 生姜 二妙丸(生薏仁煎汤下)
叶(右) 四肢作麻大退。其为风湿相合,确然可见。当助鼓再进。
川桂枝 青防风 羌活 建泽泻 生甘草 明天麻 川芎 二妙丸 白芍 川萆 白僵蚕
俞(右) 四肢作麻,脉形细弱。营卫不足,风与湿袭留不解。势难急切图功。
川桂枝 焦苍术 明天麻 川芎 赤白苓 青防风
左秦艽 制半夏 白芍 羌活 姜汁炒黄柏
柴(左) 肢冷发麻,麻后身热纳减。还是湿阻情形。
川朴 赤白苓 白蔻仁 制半夏 郁金 广皮 建泽泻 大腹皮 沉香曲 猪苓
谢(左) 起居如常,惟手小指常觉麻木,右膝 微痛。素体丰盛,湿痰有余。考小指之端,为手太阳之脉
起处,而足太阳之脉从外廉下合 中,循京骨至小指外侧,则是所病之地,皆太阳部位。良以太阳为
寒水之藏,痰湿有余,则太阳之经气不宣。东垣有丸药养之之法,即宗其意,而参太阳引经之药。
奎党参(三两) 制半夏(一两五钱) 白蒺藜(二两) 潜于术(二两土炒) 白茯苓(三两) 青防风
(一两五钱) 白僵蚕(一两) 怀牛膝(二两酒炒) 川桂枝(四钱) 煨天麻(一两五钱) 甘杞子(三两
)杭白芍(一两酒炒) 上广皮(一两) 川羌活(一两五钱) 炙绵 (三两) 桑寄生(二两酒炒) 制首乌
(四两) 炙黑甘草(三钱) 炒当归(一两) 别直参(二两) 生山药(二两) 浓杜仲(二两)
上各研末,用桑枝膏糊丸,晨服三钱,下午服二钱。
费(左) 每至睡卧初醒,辄四肢懈怠作酸,两足欠温。气虚湿盛,卫气不宣。宜通补阳明,以宣卫气。
炙绵 (三钱) 酒炒白芍(一钱五分) 制半夏(一钱五分) 桑螵蛸(二钱) 川桂枝(六分) 炙甘草(五
分) 上广皮(一钱) 生姜(二片) 大枣(二枚)
二诊 补气以宣卫阳,四肢作酸较退,小便渐能收束,肢节有时作麻。皆营术气滞。再为宣通。
酒炒白芍(一钱五分) 煨天麻(一钱五分) 煨益智(七分) 川桂枝(四分) 炒香玉竹(三钱) 桑螵蛸(三
钱) 炙黑甘草(四分) 炙绵 (三钱) 生姜(三片) 大枣(三枚)
谢(左) 风痰尚未清除,经络通道尚未调和。手指经常感觉麻木。沿用前法继续治疗。
白术(一钱五分,与枳实同捣) 制苍术(一钱五分) 煨天麻(一钱五分) 制半夏(一钱五分) 左秦艽(一钱五分) 茯苓(三钱) 白僵蚕(二钱) 酒炒桑枝(五钱) 防风(八分)
二诊 起居如常,手指仍觉麻木,膝盖微痛。再次化痰宣通络脉。
制半夏(一钱五分) 煨天麻(一钱五分) 酒炒桑寄生(三钱) 白蒺藜(三钱) 上广皮(一钱五分)
左秦艽(一钱五分) 海风藤(三钱) 白僵蚕(二钱) 指迷茯苓丸(三钱先服)
三诊 手指麻木逐渐消退。化痰宣络祛风,参入补气之法,气旺则痰行水消。
潞党参(三钱) 云茯苓(三钱) 制半夏(一钱五分) 煨天麻(一钱五分) 野于术(二钱) 白僵蚕(一钱五分) 广橘红(一钱) 白蒺藜(三钱) 清气化痰丸(三钱先服)
左 肩项及四肢麻木,麻感少而木感多。脉象濡滑,舌心灰润。胃中湿痰闭郁。拟用二术二陈汤加减。
制茅术(一钱五分) 制半夏(一钱) 煨天麻(一钱五分) 云茯苓(三钱) 炒于潜术(一钱五分) 上广皮(一钱) 薤白头(三钱) 炒枳壳(一钱) 白僵蚕(二钱炒打)
张(右) 年高营血已亏,中气又弱。血虚则肝木失于涵养,导致虚风内动。气弱则阳明络脉空虚,风阳遂得侵袭筋络。筋络既已阻滞,则营卫之气滞涩不行,四肢麻木不遂,腹中板滞不和。脾主运化旋转,肝木过旺则脾土不能旋转运化,所以气机随之凝滞。脉象濡而带弦,舌体胖大中心剥落。素来湿痰盛。宜通补阳明,舒筋养血,而不致呆滞。古稀之年,仅期望病情有所好转而已。
当归身(二钱) 奎党参(三钱) 甘杞子(三钱) 桑寄生(三钱) 大麦冬(三钱) 桑椹子(三钱)
阿胶珠(二钱) 粉丹皮(三钱) 杭白芍(一钱五分) 女贞子(三钱) 制半夏(一钱五分)
费(左) 人之一身,不过是营卫气血罢了。血用来依附气,气用来统摄血。并非仅仅是血足以依附气,而是营血所到之处,气无不依附。并非仅仅是气足以统摄血,而是卫气所到之处,血无不被统摄,这是因为气为血之帅的缘故。经书说卫气白天行于阳分,夜晚行于阴分,行于阳分二十五周,行于阴分也是二十五周,之所以能行二十五周,是因为营能行,卫也能行的缘故。如今年龄超过六十岁,气血暗中衰退,风寒湿邪久伏体内,乘虚侵袭经络,致使营卫之气滞涩不行,四肢酸麻,手足厥冷恶寒。营气不行则营气不足用,好像有营气又像没有营气一样。卫气不行则卫气不足用,好像有卫气又像没有卫气一样。譬如久坐倚靠,则麻木不能行动,此理甚明。脉细沉濡,舌胖质腻,尤为风寒湿邪的明确证据。为今之计,想要治疗酸麻,必须先通行营卫的滞涩然后才可以。想要通行营卫的滞涩,必须先祛除阻碍营卫的因素然后才可以。什么阻碍了它?是风寒与湿邪。拟用理湿祛风法。风湿既去,营卫自行,则手足厥冷发热恶寒,不治自愈。但邪湿既然已久,其来也渐,其退也必迟。高明的人认为如何?
制半夏 左秦艽 炒于术 川羌活 甜广皮 川桂枝 焦苍术 酒炒桑枝(煎汤代水)
某 偏左侧麻木不用,咳嗽气逆痰多。脉象软滑。痰湿阻肺,兼袭经络,治疗不易。
苏子 白芥子 茯苓 杏仁 制半夏 枳壳 旋复花 郁金 橘红 桂枝
杨(左) 偏左侧麻木,不能运动,胸腹常有热气注射。脉象弦滑。这是气虚而痰热内阻,属于类中风之根。
制半夏(一钱五分) 天竺黄(三钱) 粉丹皮(二钱) 橘红(一钱) 炒竹茹(一钱) 陈胆星(五分)
栝蒌仁(五钱) 海浮石(三钱) 山栀(二钱) 枇杷叶(四片) 陈关蛰(漂淡一两) 大荸荠(拍碎四枚,二味煎汤代水)
谭(左) 向来有气撑之感,现在胸中作闷,中脘部不舒。右关脉滑。这是胃中痰气交阻,阳明经为经脉之长,阳明病,则四肢作麻。
薤白头(三钱) 炒枳实(一钱) 制半夏(二钱) 炒竹茹(一钱) 上广皮(一钱) 广郁金(一钱五分) 左秦艽(一钱五分) 白蒺藜(去刺炒三钱) 云茯苓(四钱) 煨天麻(一钱五分) 越鞠丸(二钱)
二诊 咯出紫瘀血,四肢麻木减轻。确是痰瘀阻胃。前法再进一步。
延胡索(酒炒一钱五分) 当归须(二钱) 紫丹参(三钱) 台乌药(一钱五分) 炒赤芍(一钱五分) 白蒺藜(去刺炒三钱) 酒炒黑锦纹大黄(三钱) 瓦楞子(五钱) 生牛膝(三钱) 炙土鳖虫(五枚) 韭菜汁(半酒杯冲服)
吴(左) 遍身麻木,小便结涩不爽,中焦不舒,目盲失明。脉象糊滑。这是湿痰内滞,经络通道不宣,脏腑的精气不能上注所致。
苍术(一钱五分) 陈皮(一钱五分) 晚蚕砂(三钱) 赤白苓(各二钱) 制半夏(二钱) 白蒺藜(三钱) 川羌活(一钱) 川桂枝(四钱) 川黄柏(二钱) 木猪苓(二钱) 泽泻(二钱) 防风(一钱)
吴(左) 麻木大退,渐能步履,两目略能隐约见物,不可不为转机。但脉仍弦滑,湿痰尚盛。再祛湿疏风。
川桂枝(五分) 防风(一钱) 制半夏(二钱) 晚蚕砂(三钱) 车前子(二钱) 川羌活(一钱)
独活(一钱) 云茯苓(五钱) 白蒺藜(三钱) 橘红(一钱) 二妙丸(三钱另服)
右 肢节作麻。气虚而湿痰内阻,为风痱之根。
半夏 茯苓 煨天麻 白蒺藜 上广皮 钩钩 炒枳实 白僵蚕 炒竹茹 清气化痰丸
左 右足搐动,肌肤麻木。痰湿化风,风主动摇的缘故。
川桂枝 青防风 羌独活 白蒺藜 煨天麻 制半夏
左秦艽 磨沉香 广橘皮 白茯苓 钩钩 二妙丸
二诊 右足搐动略定。再化痰熄风。
川桂枝 川黄柏 羌独活 左秦艽 白僵蚕 焦苍术
明天麻 木防己 制半夏 桑枝 全蝎(炙去毒三分)
三诊 右足搐动,在减退之后,遇凉又加剧。盖血气喜温而恶寒。再温经和络祛风。
煨明天麻(一钱五分) 羌独活(各一钱) 当归身(二钱) 青防风(一钱) 西潞党(三钱) 川桂枝(五分) 桑寄生(二钱) 北细辛(三分) 川芎(一钱) 白术(二钱)
某 痛势稍定,热亦减轻。而右脐旁有气攻冲,冲则牵引经络作痛,大便不行。这是风湿热郁结,脾土气滞不能运化旋转。再参入通腑之法。
桂枝(四分) 焦苍术(二钱) 酒炒威灵仙(二钱) 制香附(二钱) 防己(二钱)
川黄柏(一钱五分) 龙胆草(三分) 金铃子(一钱五分) 磨沉香(四分冲服) 当归龙荟丸(三钱开水下)
周(左) 外感湿热后,湿困不化,神疲体软,绵延二月,方得渐复。而每晨痰出不爽,四肢有时作麻。营卫不宣,亦由湿阻。拟补气化痰。
奎党参(三钱) 制半夏(一钱五分) 茯苓神(各三钱) 生熟谷芽(各二钱) 炒于术(二钱) 木猪苓(二钱) 炒枳壳(一钱) 广皮(一钱) 缩砂仁(五分) 姜汁炒竹二青(一钱五分)
二诊 脉濡而滑,痰不爽利,每至睡卧,四肢作麻。气虚夹湿夹痰,营卫流行为之所阻。再补气化痰,所谓气旺则痰行水消也。
炒透霞天曲(三钱) 炙绵芪(二钱) 炒于术(二钱) 茯苓(三钱) 生熟谷芽(各二钱)
奎党参(三钱) 广橘红(一钱) 猪苓(二钱) 蜜炙老生姜(一钱) 制半夏(二钱) 炒枳壳(一钱)
许(右) 痛虽减而肢麻色黄。气血窒痹不行。姑再宣通。
制香附 旋复花 陈皮 砂仁末 广郁金 当归尾 猩绛 沉香片 炒桃仁 炒枳壳 清半夏 葱管
钱 身体麻木作痛,时发时止者久。日来发热自汗,胸膺作痛。这是风湿交蒸。恐成湿温时症。
桂枝 羌活 橘皮络 酒炒桑枝 秦艽 防风 旋复花 地骨皮
左 两足有麻木之意。风与湿内阻也。
独活 桑寄生 秦艽 茯苓 当归 防风 僵蚕 萆薢 生姜 二妙丸(生薏仁煎汤下)
叶(右) 四肢作麻大退。其为风湿相合,确然可见。当助鼓再进。
川桂枝 青防风 羌活 建泽泻 生甘草 明天麻 川芎 二妙丸 白芍 川萆薢 白僵蚕
俞(右) 四肢作麻,脉形细弱。营卫不足,风与湿袭留不解。势难急切图功。
川桂枝 焦苍术 明天麻 川芎 赤白苓 青防风
左秦艽 制半夏 白芍 羌活 姜汁炒黄柏
柴(左) 肢冷发麻,麻后身热纳减。还是湿阻情形。
川朴 赤白苓 白蔻仁 制半夏 郁金 广皮 建泽泻 大腹皮 沉香曲 猪苓
谢(左) 起居如常,惟手小指常觉麻木,右膝微痛。素体丰盛,湿痰有余。考小指之端,为手太阳之脉起处,而足太阳之脉从外廉下合腘中,循京骨至小指外侧,则是所病之地,皆太阳部位。良以太阳为寒水之藏,痰湿有余,则太阳之经气不宣。东垣有丸药养之之法,即宗其意,而参太阳引经之药。
奎党参(三两) 制半夏(一两五钱) 白蒺藜(二两) 潜于术(二两土炒) 白茯苓(三两) 青防风(一两五钱) 白僵蚕(一两) 怀牛膝(二两酒炒) 川桂枝(四钱) 煨天麻(一两五钱) 甘杞子(三两) 杭白芍(一两酒炒) 上广皮(一两) 川羌活(一两五钱) 炙绵芪(三两) 桑寄生(二两酒炒) 制首乌(四两) 炙黑甘草(三钱) 炒当归(一两) 别直参(二两) 生山药(二两) 浓杜仲(二两)
上各研末,用桑枝膏糊丸,晨服三钱,下午服二钱。
费(左) 每至睡卧初醒,辄四肢懈怠作酸,两足欠温。气虚湿盛,卫气不宣。宜通补阳明,以宣卫气。
炙绵芪(三钱) 酒炒白芍(一钱五分) 制半夏(一钱五分) 桑螵蛸(二钱) 川桂枝(六分) 炙甘草(五分) 上广皮(一钱) 生姜(二片) 大枣(二枚)
二诊 补气以宣卫阳,四肢作酸较退,小便渐能收束,肢节有时作麻。皆营卫气滞。再为宣通。
酒炒白芍(一钱五分) 煨天麻(一钱五分) 煨益智(七分) 川桂枝(四分) 炒香玉竹(三钱) 桑螵蛸(三钱) 炙黑甘草(四分) 炙绵芪(三钱) 生姜(三片) 大枣(三枚)
Xie (Left) Wind-phlegm has not yet cleared, and the collaterals are not harmonized. The fingers often feel numb. Extend the previous method.
Atractylodis Rhizoma Albae (1.5 qian, pounded together with Aurantii Fructus Immaturus) Prepared Atractylodis Rhizoma (1.5 qian) Prepared Gastrodiae Rhizoma (1.5 qian) Prepared Pinelliae Tuber (1.5 qian) Left Gentianae Macrophyllae Radix (1.5 qian) Poria (3 qian) White Silkworm (2 qian) Mulberry Twig fried in wine (5 qian) Saposhnikoviae Radix (0.8 fen)
Second visit: Daily life is normal, but the fingers still feel numb, and the knees ache slightly. Again, resolve phlegm and unblock the collaterals.
Prepared Pinelliae Tuber (1.5 qian) Prepared Gastrodiae Rhizoma (1.5 qian) Taxilli Ramulus fried in wine (3 qian) Tribuli Fructus (3 qian) Upper-grade Tangerine Peel (1.5 qian)
Left Gentianae Macrophyllae Radix (1.5 qian) Sargentodoxae Caulis (3 qian) White Silkworm (2 qian) Zhimi Fuling Wan (3 qian, taken first)
Third visit: Finger numbness gradually recedes. Resolve phlegm, unblock collaterals, dispel wind, and incorporate Qi-tonifying methods. When Qi is vigorous, phlegm moves and water dissipates.
Luzhu Codonopsis Radix (3 qian) Yun Poria (3 qian) Prepared Pinelliae Tuber (1.5 qian) Prepared Gastrodiae Rhizoma (1.5 qian) Wild Atractylodis Rhizoma Albae (2 qian) White Silkworm (1.5 fen) Broad-spectrum Tangerine Peel (1 qian) Tribuli Fructus (3 qian) Qingqi Huatan Wan (3 qian, taken first)
Left: Numbness in shoulders, neck, and limbs; less numbness, more woodiness (stiffness/heaviness). Pulse is soggy and slippery; tongue center is gray and moist. Damp-phlegm is closed and stagnant in the stomach. Propose modifications of Ershu and Erchen formulas.
Prepared Atractylodis Rhizoma (1.5 qian) Prepared Pinelliae Tuber (1 qian) Prepared Gastrodiae Rhizoma (1.5 qian) Yun Poria (3 qian) Fried Yuqian Atractylodis Rhizoma Albae (1.5 qian) Upper-grade Tangerine Peel (1 qian) Allii Macrostemonis Bulbus (3 qian) Fried Aurantii Fructus (1 qian) White Silkworm (2 qian, fried and pounded)
Zhang (Right): In advanced age, Ying-Blood is deficient, and Middle Qi is weak. Blood deficiency causes Liver Wood to lose nourishment, leading to internal stirring of empty wind. Qi weakness leaves the Yangming collaterals empty, allowing wind-yang to invade the sinews and collaterals. Once the sinew-collaterals are obstructed, Ying-Wei Qi stagnates and fails to circulate, causing numbness and paralysis of the four limbs, and a board-like stiffness and discomfort in the abdomen. The Spleen governs rotation and transport; if Liver Wood is excessive, Spleen Earth cannot rotate and transport, so Qi mechanism becomes stagnant. Pulse is soggy and wiry; tongue is fat with central peeling. Damp-phlegm has been abundant since long ago. It is suitable to tonify and unblock Yangming, relax sinews, and nourish blood, without being stagnant. At an age of seventy, one can only hope for some improvement.
Angelica Sinensis Radix (2 qian) Kui Codonopsis Radix (3 qian) Goji Berry (3 qian) Taxillus Ramulus (3 qian) Ophiopogonis Tuber (3 qian) Mulberry Fruit (3 qian)
Donkey-hide Gelatin Pearl (2 qian) Moutan Cortex (3 qian) Hang White Peony Root (1.5 qian) Ligustrum Lucidum Fruit (3 qian) Prepared Pinelliae Tuber (1.5 qian)
Fei (Left): The human body consists merely of Ying-Wei, Qi, and Blood. Blood attaches to Qi, and Qi commands Blood. It is not that Blood alone attaches to Qi, but wherever Ying-Blood reaches, Qi attaches. It is not that Qi alone commands Blood, but wherever Wei-Qi reaches, Blood is commanded, because Qi is the commander of Blood. The Classics state that Wei-Qi travels in the Yang during the day and in the Yin at night, twenty-five circuits in Yang and twenty-five in Yin. The reason it can complete twenty-five circuits is that both Ying and Wei can travel. Now, past the age of sixty-four, Qi and Blood secretly decline. Wind-Cold-Damp have lain dormant for a long time, taking advantage of gaps to invade the collaterals, causing Ying-Wei Qi to stagnate. This results in soreness and numbness of the four limbs, cold extremities, and aversion to cold. If Ying does not travel, Ying is insufficient, appearing as if there were no Ying. If Wei does not travel, Wei is insufficient, appearing as if there were no Wei. For example, sitting for a long time leaning against something causes numbness and inability to move; this principle is clear. Pulse is fine, deep, and soggy; tongue is fat with greasy coating, which is strong evidence of Wind-Cold-Damp. As for the current plan, to treat soreness and numbness, one must first unblock the stagnation of Ying-Wei. To unblock the stagnation of Ying-Wei, one must first remove what obstructs Ying-Wei. What obstructs it? Wind, Cold, and Damp. Propose a method to regulate Damp and dispel Wind. Once Wind-Damp is removed, Ying-Wei will circulate on its own, and cold/heat and aversion to cold will heal without specific treatment. However, since pathogenic Damp has been present for a long time, its arrival was gradual, and its departure will be slow. Do experts agree?
Prepared Pinelliae Tuber Left Gentianae Macrophyllae Radix Fried Atractylodis Rhizoma Albae Chuan Notopterygii Rhizoma et Radix Sweet Tangerine Peel Chuan Cinnamon Twig Jiao Atractylodis Rhizoma Mulberry Twig fried in wine (decocted as water substitute)
Certain patient: Numbness and immobility on the left side, cough with rebellious Qi and profuse phlegm. Pulse is soft and slippery. Phlegm-damp obstructs the Lung and invades the collaterals; treatment is difficult.
Perilla Seed White Mustard Seed Poria Almond Kernel Prepared Pinelliae Tuber Aurantii Fructus Immaturus Inula Flower Curcuma Longa Tangerine Peel Cinnamon Twig
Yang (Left): Numbness and immobility on the left side, with a sensation of hot qi injecting into the chest and abdomen. Pulse is wiry and slippery. This is Qi deficiency with internal obstruction by Phlegm-Heat, the root of stroke-like conditions.
Prepared Pinelliae Tuber (1.5 qian) Hyacinth Bean Meal (3 qian) Moutan Cortex (2 qian) Tangerine Peel (1 qian) Bamboo Shavings fried (1 qian) Old Arisaema Cum Bile (0.5 fen)
Trichosanthis Semen (5 qian) Pumex (3 qian) Gardenia Fruit (2 qian) Loquat Leaf (4 pieces) Chen Guan Zhe (washed and desalted, 1 liang) Large Water Chestnut (crushed, 4 pieces, decocted with the above as water substitute)
Tan (Left): Previously had a sensation of Qi distension; now chest feels stuffy and epigastrium is uncomfortable. Right Guan pulse is slippery. This is interlocking obstruction of Phlegm and Qi in the Stomach. The Yangming Meridian is the leader of all meridians; when Yangming is diseased, the four limbs become numb.
Allii Macrostemonis Bulbus (3 qian) Fried Aurantii Fructus Immaturus (1 qian) Prepared Pinelliae Tuber (2 qian) Bamboo Shavings fried (1 qian) Upper-grade Tangerine Peel (1 qian) Curcuma Aromatica Rhizome (1.5 qian) Left Gentianae Macrophyllae Radix (1.5 qian) Tribuli Fructus (deprived of spines, fried, 3 qian) Yun Poria (4 qian) Prepared Gastrodiae Rhizoma (1.5 qian) Yueju Wan (2 qian)
Second visit: Coughing up purple stasis, limb numbness reduces. Indeed, Phlegm-Stasis obstructs the Stomach. Advance the previous method further.
Corydalis Rhizome (wine-fried, 1.5 qian) Angelica Sinensis Radix Stamen (2 qian) Salvia Miltiorrhiza Radix (3 qian) Lindera Root (1.5 qian) Red Peony Root fried (1.5 qian) Tribuli Fructus (deprived of spines, fried, 3 qian) Rhubarb fried in wine and charred (3 qian) Arca Shell (5 qian) Raw Achyranthes Bidentatae Radix (3 qian) Ground Beetle worm roasted (5 pieces) Leek Juice (half wine cup, mixed in)
Wu (Left): Whole-body numbness, urination is knotty and unsatisfactory, middle jiao is uncomfortable, blindness. Pulse is muddy and slippery. This is internal stagnation of Damp-Phlegm, failure of collaterals to unblock, preventing essence and Qi of zang-fu from ascending.
Atractylodis Rhizoma (1.5 qian) Chenpi (1.5 qian) Late Silkworm Sand (3 qian) Chi Bai Ling (each 2 qian) Prepared Pinelliae Tuber (2 qian) Tribuli Fructus (3 qian) Chuan Notopterygii Rhizoma et Radix (1 qian) Chuan Cinnamon Twig (4 qian) Chuan Phellodendri Cortex (2 qian) Mu Polyporus (2 qian) Alisma Rhizoma (2 qian) Saposhnikoviae Radix (1 qian)
Wu (Left): Numbness largely receded, gradually able to walk, eyes can vaguely see objects; this is a turning point. But pulse remains wiry and slippery, Damp-Phlegm is still abundant. Again, dispel Damp and disperse Wind.
Chuan Cinnamon Twig (0.5 fen) Saposhnikoviae Radix (1 qian) Prepared Pinelliae Tuber (2 qian) Late Silkworm Sand (3 qian) Plantago Seed (2 qian) Chuan Notopterygii Rhizoma et Radix (1 qian)
Angelicae Pubescentis Radix (1 qian) Yun Poria (5 qian) Tribuli Fructus (3 qian) Tangerine Peel (1 qian) Ermiao Wan (3 qian, taken separately)
Right: Joint numbness. Qi deficiency with internal obstruction by Damp-Phlegm, the root of Fengfei (wind apoplexy).
Pinelliae Tuber Poria Prepared Gastrodiae Rhizoma Tribuli Fructus Upper-grade Tangerine Peel Uncaria Rhynchophylla Fried Aurantii Fructus Immaturus White Silkworm Bamboo Shavings fried Qingqi Huatan Wan
Left: Right foot spasms, skin numbness. Phlegm-Damp transforms into Wind; Wind causes movement.
Chuan Cinnamon Twig Green Saposhnikoviae Radix Qiangduo (Qianghuo and Duhuo) Tribuli Fructus Prepared Gastrodiae Rhizoma Prepared Pinelliae Tuber
Left Gentianae Macrophyllae Radix Ground Agarwood Broad Tangerine Peel White Poria Uncaria Rhynchophylla Ermiao Wan
Second visit: Right foot spasms slightly stabilized. Again, resolve phlegm and extinguish wind.
Chuan Cinnamon Twig Chuan Phellodendri Cortex Qiangduo Left Gentianae Macrophyllae Radix White Silkworm Jiao Atractylodis Rhizoma
Ming Gastrodiae Rhizoma Stephaniae Tetrandrae Radix Prepared Pinelliae Tuber Mulberry Twig Scorpion (roasted, venom removed, 0.3 fen)
Third visit: Right foot spasms, after receding, worsen upon exposure to cold. Blood and Qi prefer warmth and dislike cold. Again, warm meridians, harmonize collaterals, and dispel wind.
Roasted Ming Gastrodiae Rhizoma (1.5 qian) Qiangduo (each 1 qian) Angelica Sinensis Radix (2 qian) Green Saposhnikoviae Radix (1 qian) Xi Luzhu Codonopsis Radix (3 qian) Chuan Cinnamon Twig (0.5 fen) Taxillus Ramulus (2 qian) Northern Asarum Root (0.3 fen) Chuan Ligusticum Wallichii Rhizome (1 qian) Atractylodis Macrocephalae Rhizoma (2 qian)
Certain patient: Pain intensity slightly settled, heat also reduced. But Qi attacks from the right umbilical region, pulling and causing meridian pain, with constipation. This is郁结 (constraint) of Wind-Damp-Heat, with Qi stagnation in Spleen Earth failing to transport. Again, incorporate purging the fu organs.
Cinnamon Twig (0.4 fen) Jiao Atractylodis Rhizoma (2 qian) Silver Vine Stem fried in wine (2 qian) Prepared Cyperi Rhizoma (2 qian) Stephaniae Tetrandrae Radix (2 qian)
Chuan Phellodendri Cortex (1.5 fen) Gentiana Scabra Root (0.3 fen) Belamcanda Chinensis Rhizome (1.5 fen) Ground Agarwood (0.4 fen, mixed in) Danggui Longhui Wan (3 qian, taken with boiling water)
Zhou (Left): After external contraction of Damp-Heat, Damp trapped and not transformed, mental fatigue and body softness lasted two months before gradually recovering. Every morning, phlegm is not expectorated smoothly, and limbs sometimes feel numb. Ying-Wei not unblocked, also due to Damp obstruction. Propose Qi-tonification and phlegm-resolution.
Kui Codonopsis Radix (3 qian) Prepared Pinelliae Tuber (1.5 qian) Poria and Poria with Hostwood (each 3 qian) Raw and Fried Barley Sprout (each 2 qian) Fried Atractylodis Rhizoma Albae (2 qian) Mu Polyporus (2 qian) Fried Aurantii Fructus (1 qian) Tangerine Peel (1 qian) Amomum Fruit (0.5 fen) Ginger juice fried Zhu'erqing (1.5 qian)
Second visit: Pulse soggy and slippery, phlegm not smooth, limbs feel numb every time lying down to sleep. Qi deficiency with Damp and Phlegm, Ying-Wei flow obstructed. Again, tonify Qi and resolve phlegm, as stated: "When Qi is vigorous, phlegm moves and water dissipates."
Thoroughly fried Xiaticurve (3 qian) Roasted Astragali Radix (2 qian) Fried Atractylodis Rhizoma Albae (2 qian) Poria (3 qian) Raw and Fried Barley Sprout (each 2 qian)
Kui Codonopsis Radix (3 qian) Broad-spectrum Tangerine Peel (1 qian) Polyporus (2 qian) Honey-roasted old ginger (1 qian) Prepared Pinelliae Tuber (2 qian) Fried Aurantii Fructus (1 qian)
Xu (Right): Pain reduced but limb numbness and yellow complexion persist. Qi and Blood are blocked and fail to circulate. Tentatively again unblock and promote circulation.
Prepared Cyperi Rhizoma Inula Flower Chenpi Sandamomum Powder Broad-spectrum Curcuma Longa Angelica Sinensis Radix Tail Scarlet Cloth Agarwood Slice Peach Kernel fried Aurantii Fructus Immaturus Clear Banxia Scallion Tube
Qian: Body numbness and pain, intermittent for a long time. Recently fever and spontaneous sweating, chest pain. This is steaming interaction of Wind and Damp. Fear of becoming Damp-Warm disease.
Cinnamon Twig Notopterygii Rhizoma et Radix Tangerine Peel Network Mulberry Twig fried in wine Gentianae Macrophyllae Radix Saposhnikoviae Radix Inula Flower Lycii Cortex
Left: Sensation of numbness in both feet. Internal obstruction by Wind and Damp.
Angelicae Pubescentis Radix Taxillus Ramulus Gentianae Macrophyllae Radix Poria Angelica Sinensis Radix Saposhnikoviae Radix Silkworm Betel Nut Rhizome Ginger Ermiao Wan (taken with decoction of raw Coix Seed)
Ye (Right): Limb numbness largely receded. The combination of Wind and Damp is clearly visible. Should assist momentum and advance further.
Chuan Cinnamon Twig Green Saposhnikoviae Radix Notopterygii Rhizoma et Radix Jian Ze Xie Raw Licorice Root Ming Gastrodiae Rhizoma Chuan Ligusticum Wallichii Rhizome Ermiao Wan White Peony Root Chuan Betel Nut Rhizome White Silkworm
Yu (Right): Limb numbness, pulse fine and weak. Ying-Wei insufficient, Wind and Damp invade and remain unresolved. Difficult to achieve quick results.
Chuan Cinnamon Twig Jiao Atractylodis Rhizoma Ming Gastrodiae Rhizoma Chuan Ligusticum Wallichii Rhizome Chi Bai Ling Green Saposhnikoviae Radix
Left Gentianae Macrophyllae Radix Prepared Pinelliae Tuber White Peony Root Notopterygii Rhizoma et Radix Ginger juice fried Phellodendri Cortex
Chai (Left): Cold limbs and numbness, followed by body heat and reduced appetite. Still Damp obstruction.
Magnolia Bark Chi Bai Ling White Cardamom Seed Prepared Pinelliae Tuber Curcuma Longa Broad Tangerine Peel Jian Ze Xie Areca Petiole Agarwood Qu Polyporus
Xie (Left): Daily life normal, except small finger often feels numb, right knee slightly painful. Constitution is robust, with excess Damp-Phlegm. Examining the tip of the small finger, it is the starting point of the Hand-Taiyang Meridian, and the Foot-Taiyang Meridian goes from the outer lateral aspect down to the popliteal fossa, follows Jinggu to the lateral side of the small finger. Thus, the diseased area belongs to the Taiyang region. Indeed, Taiyang is the storage of Cold Water; with excess phlegm-damp, the Taiyang meridian Qi is not unblocked. Dongyuan had a method of pill medicine to nourish it; following his intent, we add Taiyang guiding herbs.
Kui Codonopsis Radix (3 liang) Prepared Pinelliae Tuber (1.5 liang) Tribuli Fructus (2 liang) Qian Atractylodis Rhizoma Albae (2 liang, earth-fried) White Poria (3 liang) Green Saposhnikoviae Radix (1.5 liang) White Silkworm (1 liang) Huai Achyranthes Bidentatae Radix (2 liang, wine-fried) Chuan Cinnamon Twig (4 qian) Prepared Gastrodiae Rhizoma (1.5 liang) Goji Berry (3 liang) Hang White Peony Root (1 liang, wine-fried) Upper-grade Tangerine Peel (1 liang) Chuan Notopterygii Rhizoma et Radix (1.5 liang) Roasted Astragali Radix (3 liang) Taxillus Ramulus (2 liang, wine-fried) Prepared Polygoni Multiflori Caulis (4 liang) Roasted Black Licorice Root (3 qian) Fried Angelica Sinensis Radix (1 liang) Biezhi Ginseng Radix (2 liang) Raw Dioscoreae Rhizoma (2 liang) Concentrated Eucommiae Cortex (2 liang)
All powdered, made into pills with Mulberry Twig paste. Take 3 qian in the morning, 2 qian in the afternoon.
Fei (Left): Upon waking from sleep, limbs feel slack and sour, feet lack warmth. Qi deficiency with Damp abundance, Wei-Qi not unblocked. Suitable to unblock and tonify Yangming to unblock Wei-Qi.
Roasted Astragali Radix (3 qian) Wine-fried White Peony Root (1.5 qian) Prepared Pinelliae Tuber (1.5 qian) Sangpiaoxiao (2 qian) Chuan Cinnamon Twig (0.6 fen) Roasted Licorice Root (0.5 fen) Upper-grade Tangerine Peel (1 qian) Ginger (2 slices) Jujube (2 pieces)
Second visit: Tonifying Qi to unblock Wei-Yang, limb sourness receded, urination gradually controlled, joints sometimes feel numb. All due to Ying-Wei Qi stagnation. Again, unblock and promote circulation.
Wine-fried White Peony Root (1.5 qian) Prepared Gastrodiae Rhizoma (1.5 qian) Roasted Alpinia Oxyphylla Fruit (0.7 fen) Chuan Cinnamon Twig (0.4 fen) Fragrant Smilax Glabra Rhizome (3 qian) Sangpiaoxiao (3 qian) Roasted Black Licorice Root (0.4 fen) Roasted Astragali Radix (3 qian) Ginger (3 slices) Jujube (3 pieces)