【半身不遂之症】身发寒热,暴仆卒倒,醒后或左或右,偏废不用;或痛或木,或热
或冷,二便赤涩。此外感半身不遂之症也。
【半身不遂之因】起居不慎,卫气不固,风邪入于经络,邪踞不散,气血阻绝,则半
身为之废矣。
【半身不遂之脉】或病左,左手无脉。病右,右手无脉。或病左,左脉反大。病右,
右脉反大。
【半身不遂之治】脉洪大者,宜祛邪涤热,大秦艽汤。外邪抑遏,脉伏不出者,加减
续命
汤,散其表邪;痰火壅闭经络,脉伏不出者,三化汤、导痰汤,清其壅滞,则脉出而手足自
如。
大秦艽汤
加减续命汤
三化汤 以上三方。见前中风。
导痰汤
南星 半夏 枳实 甘草 橘红
【半身不遂之症】或一手一指,先见麻木,一年半载,渐渐不能举动,此病起
火内作,忽尔僵仆,少顷即苏,半身不能举动,此病因于火而急者。二者皆无表邪形象,故
曰内伤半身不遂也。
【半身不遂之因】或气凝血滞,脉痹不行;或胃热生痰,流入经隧,踞绝道路,
气血不得往还;或浩饮所伤,酒湿成瘫,则半身不遂之症作矣。
【半身不遂之脉】沉涩血痹,沉滑结痰,沉数酒湿,脉虚气亏,脉细血少。
【半身不遂之治】血痹者,活血汤;结痰者,二陈汤加竹沥、生姜;酒湿成瘫者,戒
酒,服散湿热之药,葛花平胃散,或加栀、连,或栀连二陈汤;若气虚补气,血少补血。
活血汤
当归 赤芍药 红花 丹皮 川芎 泽泻 郁金 木通 秦艽
二陈汤 见痰饮。
葛花平胃散
葛花 苍术 浓朴 广皮 甘草
有热,加山栀、黄连。栀连二陈汤,即二陈汤加栀、连。
【半身不遂的症状】身体出现寒热交替,突然昏倒仆地,苏醒后左侧或右侧肢体偏废、无法使用;或者感到疼痛或麻木,或者感觉发热或发冷,大小便颜色红赤且排尿涩痛。这是外感引起的半身不遂的症状。
【半身不遂的病因】起居不慎,卫气(保卫体表的气)不固密,风邪侵入经络,邪气盘踞不散,导致气血阻滞隔绝,从而造成半身瘫痪。
【半身不遂的脉象】如果病在左侧,左手无脉;病在右侧,右手无脉。或者病在左侧,左脉反而洪大;病在右侧,右脉反而洪大。
【半身不遂的治疗】脉象洪大的,适宜祛除湿热邪气,使用大秦艽汤(Da Qin Jiao Tang)。如果是外邪抑制遏阻,脉象伏隐不出,使用加减续命汤(Jia Jian Xu Ming Tang),以疏散表邪;如果是痰火壅塞闭阻经络,脉象伏隐不出,使用三化汤(San Hua Tang)和导痰汤(Dao Tan Tang),清除壅滞,则脉象复出而手足自然活动自如。
大秦艽汤
加减续命汤
三化汤 以上三方剂,参见前文中风章节。
导痰汤
天南星 半夏 枳实 甘草 橘红
【半身不遂的症状】或者一只手或一个手指,先出现麻木,经过一年半载,逐渐不能活动,这是病由火邪在内发作所致;忽然僵硬仆倒,片刻后即苏醒,但半身不能活动,这是因火邪引起的急症。这两种情况都没有表邪(外感病初期症状)的表现,所以称为内伤引起的半身不遂。
【半身不遂的病因】或者是气滞血瘀,脉道痹阻不通;或者是胃热生痰,痰液流入经脉隧道,占据阻塞道路,气血不得往来流通;或者是过度饮酒所伤,酒湿转化为瘫证,于是半身不遂的症状就产生了。
【半身不遂的脉象】血痹表现为脉沉涩,结痰表现为脉沉滑,酒湿表现为脉沉数,气虚表现为脉虚,血少表现为脉细。
【半身不遂的治疗】血痹者,使用活血汤(Huo Xue Tang);结痰者,使用二陈汤(Er Chen Tang)加竹沥、生姜;酒湿成瘫者,戒酒,服用发散湿热的药物,如葛花平胃散(Ge Hua Ping Wei San),或者加入栀子、黄连,或者使用栀连二陈汤(Zhi Lian Er Chen Tang);如果是气虚则补气,血少则补血。
活血汤
当归 赤芍药 红花 牡丹皮 川芎 泽泻 郁金 木通 秦艽
二陈汤 参见痰饮章节。
葛花平胃散
葛花 苍术 厚朴 广陈皮 甘草
如果有热,加入山栀、黄连。栀连二陈汤,即二陈汤加入栀子、黄连。
[Symptoms of Hemiplegia] The body experiences alternating chills and fever, sudden collapse and fainting. Upon waking, one side (left or right) is paralyzed and unusable; there may be pain or numbness, heat or cold sensations, and dark, scanty, or painful urination and defecation. These are the symptoms of hemiplegia caused by external pathogens.
[Etiology of Hemiplegia] Carelessness in daily life leads to insecure Wei Qi (Defensive Qi), allowing Wind Pathogens to enter the meridians. When pathogens lodge and do not disperse, Qi and Blood become obstructed and cut off, resulting in paralysis of half the body.
[Pulse Signs of Hemiplegia] If the disease is on the left, the left wrist pulse is absent. If on the right, the right wrist pulse is absent. Alternatively, if the disease is on the left, the left pulse is surprisingly large (Hong Da); if on the right, the right pulse is surprisingly large.
[Treatment of Hemiplegia] For a large pulse, it is appropriate to dispel pathogens and clear heat using Da Qin Jiao Tang (Great Notopterygium Decoction). If external pathogens are suppressed and the pulse is hidden/faint, use Jia Jian Xu Ming Tang (Modified Life-Prolonging Decoction) to scatter exterior pathogens. If Phlegm-Fire obstructs and closes the meridians and the pulse is hidden/faint, use San Hua Tang (Three Transformations Decoction) and Dao Tan Tang (Phlegm-Resolving Decoction) to clear stagnation; then the pulse will reappear and hand and foot movements will naturally recover.
Da Qin Jiao Tang
Jia Jian Xu Ming Tang
San Hua Tang: The above three formulas are referenced in the preceding section on Stroke.
Dao Tan Tang
Arisaema Cum Bile (Nanxing) Pinellia Rhizome Preparatum (Banxia) Immature Bitter Orange (Zhishi) Licorice Root (Gancao) Tangerine Peel (Juhong)
[Symptoms of Hemiplegia] Or, numbness appears first in one hand or finger. Over a year or half a year, movement gradually becomes impossible. This arises from Fire Pathogens acting internally, causing sudden stiffness and collapse, followed by quick recovery but inability to move half the body. This is an acute condition due to Fire. Neither case presents signs of Exterior Pathogens, hence they are termed Hemiplegia caused by Internal Injury.
[Etiology of Hemiplegia] It may be due to Qi Stagnation and Blood Stasis, with meridian obstruction preventing flow; or Stomach Heat generating Phlegm, which flows into the vessel tunnels, blocking the pathways so that Qi and Blood cannot circulate; or injury from excessive drinking, where Dampness from alcohol transforms into Paralysis, thus producing the symptoms of hemiplegia.
[Pulse Signs of Hemiplegia] Blood Bi (Obstruction) presents with a deep and choppy pulse; Phlegm accumulation presents with a deep and slippery pulse; Alcohol-Dampness presents with a deep and rapid pulse; Qi Deficiency presents with a deficient pulse; Blood Deficiency presents with a thin pulse.
[Treatment of Hemiplegia] For Blood Bi, use Huo Xue Tang (Blood-Invigorating Decoction); for Phlegm accumulation, use Er Chen Tang (Two-Aged Decoction) added with Bamboo Sap (Zhuli) and Fresh Ginger (Shengjiang); for Paralysis due to Alcohol-Dampness, abstain from alcohol and take herbs that dissipate Damp-Heat, such as Ge Hua Ping Wei San (Kudzu Flower Stabilizing the Spleen Powder), or add Gardenia (Zhizi) and Coptis Rhizome (Lianhua), or use Zhi Lian Er Chen Tang (Gardenia-Coptis Two-Aged Decoction). If Qi is deficient, tonify Qi; if Blood is deficient, nourish Blood.
Huo Xue Tang
Angelica Sinensis Radix (Danggui) Red Peony Root (Chishaoyao) Carthamus Flower (Honghua) Moutan Bark (Danpi) Ligusticum Chuanxiong Rhizome (Chuanxiong) Alisma Rhizome (Zexie) Curcuma Aromatica Rhizome (Yujin) Akebia Caulis (Mutong) Notopterygium Rhizome et Radix (Qinjiao)
Er Chen Tang: Refer to the Phlegm-Fluids section.
Ge Hua Ping Wei San
Puerariae Flos (Ge Hua) Atractylodes Macrocephala Rhizome (Cangzhu) Magnolia Officinalis Bark (Houpo) Citrus Reticulata Pericarpium (Guangpi) Licorice Root (Gancao)
If there is Heat, add Gardenia (Zhizi) and Coptis Rhizome (Lianhua). Zhi Lian Er Chen Tang is Er Chen Tang added with Zhizi and Lianhua.