陆(钮店桥) 血不荣筋,加以风湿阻络,阳明虚不能束筋骨以利机关,手指麻木不仁,
风淫末疾是也,脉小弦数,治宜和营,以祛风湿。
米仁 西秦艽 带皮苓 嫩桂枝 川萆 全当归 晚蚕沙 片姜黄 宣木瓜 粒
红花或易鸡血藤 野桑枝
邱 风寒湿三气杂至合而为痹,风胜为行痹,寒胜为痛痹,湿胜为着痹,足筋痹由血
不荣筋,寒湿下注阳明经络而成,脉弦数,苔薄白,治宜疏解。
米仁 西蓁艽 带皮苓 怀牛膝 川萆 全当归 晚蚕沙 虎胫骨 宣木瓜 粒
红花 垂下野桑枝 小活络丹(一颗剖开用开水化服)
康左(七月) 寒湿下注,足三里筋络肿痛,不能任地。《内经》云∶伸而不能屈,病在骨
是也,脉弦缓,治宜和营,以逐风湿。
照邱方加熟附片、威灵仙。
李左(二十六岁,馆前,初十) 半身不遂良由筋骨失于荣养,寒湿乘隙入于筋络所致。
前拟进温通筋络法已得小动,脉弦缓,仍步前法出入。
全当归 败龟版 米仁 晚蚕沙 东白芍 琐阳 川萆 制香附 虎胫骨 怀牛膝 宣木瓜 小活络丹一颗。
又半身不遂拟进河间虎潜法已得活动,而胫骨无力,大筋软短,犹是血不荣筋使然,脉弦,仍踵前法。
全当归 虎胫骨 怀牛膝 制香附 东白芍 败龟版 米仁 小活络丹 生地根 琐阳 晚蚕沙。
陆某(钮店桥):血液不能濡养筋脉,加之风湿阻滞经络,阳明经虚弱无法约束筋骨以利于关节运动,出现手指麻木、感觉迟钝的症状,这就是“风淫末疾”。脉象小弦而数,治疗应当调和营血,以祛除风湿。
薏苡仁 西秦艽 带皮茯苓 嫩桂枝 川萆薢 全当归 晚蚕沙 片姜黄 宣木瓜 红花粒
若用红花不便,可改用鸡血藤 野桑枝
另一位患者:风湿导致痹证,疼痛游走不定,在前方基础上加入乳香七分和陈酒半杯一同煎煮。
邱某:风寒湿三气混杂侵袭人体合而为痹,风气偏胜的为行痹,寒气偏胜的为痛痹,湿气偏胜的为着痹。足部筋脉痹阻是由于血液不能濡养筋脉,寒湿下注于阳明经络所致。脉象弦数,舌苔薄白,治疗应当疏风散寒解表。
薏苡仁 西秦艽 带皮茯苓 怀牛膝 川萆薢 全当归 晚蚕沙 虎胫骨 宣木瓜 红花粒
垂下的野桑枝 小活络丹(一颗剖开,用开水化开后服用)
康先生左氏(七月):寒湿下注,足三里部位的筋络肿痛,无法承受身体重量站立。《内经》说:“伸展而不能弯曲,病位在骨”,指的就是这种情况。脉象弦缓,治疗应当调和营血,以驱逐风湿。
参照邱某的方子,加入熟附片和威灵仙。
李先生左氏(二十六岁,馆前,初十):半身不遂很大程度上是因为筋骨失去荣养,寒湿乘虚侵入筋络所致。之前拟定的温通筋络的方法已经取得了一点效果,脉象弦缓,继续按照之前的方法加减使用。
全当归 败龟版 薏苡仁 晚蚕沙 东白芍 琐阳 川萆薢 制香附 虎胫骨 怀牛膝 宣木瓜 小活络丹一颗。
另外针对半身不遂,拟定采用河间虎潜法,已经获得了一些活动能力,但是小腿骨头无力,大筋软弱短缩,这仍然是血液不能濡养筋脉造成的。脉象弦,继续遵循前法。
全当归 虎胫骨 怀牛膝 制香附 东白芍 败龟版 薏苡仁 小活络丹 生地根 琐阳 晚蚕沙。
Lu (Niudian Bridge): Blood fails to nourish the sinews, compounded by wind-dampness obstructing the collaterals. The deficiency of the Yangming channel cannot bind the bones and sinews to facilitate joint movement, resulting in numbness and insensitivity of the fingers. This is what is known as "wind invading the extremities" (Feng Yin Mo Ji). The pulse is small, wiry, and rapid. Treatment should harmonize the Ying (Nutritive) level to dispel wind-dampness.
Coix Seed (Yiyi Ren), Western Gentian Root (Xiqinjiao), Poria with Skin (Daipiling), Tender Cinnamon Twig (Nengguizhi), Dioscorea Hypoglauca Rhizome (Chuanbi), Whole Angelica Sinensis (Quandanggui), Silkworm Frass (Wancansha), Turmeric Tuber Slice (Pianjiang Huang), Chaenomelas Fruit (Xuanmugua), Safflower Seeds (Honghuali).
If Safflower is unavailable, it may be replaced with Spatholobus Stem (Jixueteng) and Wild Mulberry Branch (Yesangzhi).
Another patient: Wind-dampness has caused Bi syndrome, characterized by wandering pain without a fixed location. Add Frankincense (Ruxiang) 7 fen and half a cup of aged rice wine to the previous prescription for decoction.
Qiu: The mixed invasion of wind, cold, and dampness constitutes Bi syndrome. When wind predominates, it is called Wandering Bi (Xing Bi); when cold predominates, it is called Painful Bi (Tong Bi); when dampness predominates, it is called Fixed Bi (Zhuo Bi). The bi obstruction of the foot sinews arises from blood failing to nourish the sinews, with cold-dampness sinking into the Yangming channels and collaterals. The pulse is wiry and rapid, and the tongue coating is thin and white. Treatment should involve dispersing and resolving.
Coix Seed (Yiyi Ren), Western Gentian Root (Xiqinjiao), Poria with Skin (Daipiling), Achyranthes Bidentata Root (Huainiuxi), Dioscorea Hypoglauca Rhizome (Chuanbi), Whole Angelica Sinensis (Quandanggui), Silkworm Frass (Wancansha), Tiger Tibia Bone (Hu Jing Gu), Chaenomelas Fruit (Xuanmugua), Safflower (Honghua).
Wild Mulberry Branch hanging down (Chuixia Yesangzhi), Xiao Huoluo Dan (Little Live-Lotus Pill) (one pill, split open and dissolved in boiling water for administration).
Mr. Kang Zuo (July): Cold-dampness sinks downward, causing swelling and pain in the sinews and collaterals at Zusanli (ST36), making it impossible to bear weight on the feet. The *Neijing* states: "Extension but not flexion indicates disease in the bone." The pulse is wiry and slow. Treatment should harmonize the Ying (Nutritive) level to drive out wind-dampness.
Referencing Qiu's formula, add Prepared Aconite Root (Shu Fupian) and Clematis Root (Weilingxian).
Mr. Li Zuo (26 years old, Guanqian, 10th day): Hemiplegia is largely due to the loss of nourishment to the bones and sinews, allowing cold-dampness to invade the sinews and collaterals through gaps. The previously proposed method of warming and unblocking the sinews and collaterals has yielded slight improvement. The pulse is wiry and slow; continue with the previous method with modifications.
Whole Angelica Sinensis (Quandanggui), Tortoise Plastron (Baiguiban), Coix Seed (Yiyi Ren), Silkworm Frass (Wancansha), Eastern White Peony Root (Dongbaishao), Cynomorium (Suoyang), Dioscorea Hypoglauca Rhizome (Chuanbi), Processed Cyperus Rhizome (Zhixiangfu), Tiger Tibia Bone (Hu Jing Gu), Achyranthes Bidentata Root (Huainiuxi), Chaenomelas Fruit (Xuanmugua), one pill of Xiao Huoluo Dan (Little Live-Lotus Pill).
Furthermore, regarding hemiplegia, the Hejian Tiger-Hiding Method (Hejian Hujian Fa) was proposed. Movement has been achieved, but there is weakness in the tibia, and the large sinews are soft and short. This is still due to blood failing to nourish the sinews. The pulse is wiry; continue following the previous method.
Whole Angelica Sinensis (Quandanggui), Tiger Tibia Bone (Hu Jing Gu), Achyranthes Bidentata Root (Huainiuxi), Processed Cyperus Rhizome (Zhixiangfu), Eastern White Peony Root (Dongbaishao), Tortoise Plastron (Baiguiban), Coix Seed (Yiyi Ren), Xiao Huoluo Dan (Little Live-Lotus Pill), Rehmannia Root (Shengdigen), Cynomorium (Suoyang), Silkworm Frass (Wancansha).