脉
脉浮而濡，属气虚。关前得之，麻在上；关后得之，麻在下也。
脉浮而缓，属湿，为麻痹；脉紧而浮，属寒，为痛痹；脉涩而芤，属死血，为木，不知痛痒。
证
丹溪曰∶麻是气虚，木是湿痰死血。
治
十指麻，是胃中有湿痰死血，宜二陈汤加苍术、白术、陈皮、茯苓、桃仁、红花，少加附子行经。又
宜四物汤加上药及羌活、苏木。如手指麻痹，因湿所致者，香苏散、苍术、麻黄、桂枝、白
芷、羌活、木瓜水煎；脉体虚者，用五积散亦好。
一、如感，手膊或痛，或木，或遍身麻木，用五积散主之。
一、凡人手足麻木，并指尖麻者，皆痰滞经络也。宜二陈汤加竹沥、姜汁、白芥子，以祛痰火，散
风气，更灸百会、肩 ，曲池、风市、足三里、绝骨，此六处共十一穴，以防中风瘫痪，但年少者不可多灸。
一、麻，用补中益气汤加当归、木香、香附、青皮、川芎，少加桂枝引经。木，用四物汤并二陈汤，
加桃仁、红花。二方俱用竹沥、姜汁、白芥子，以行经至胁肋，达痰之所在也。竹沥枳术丸、搜风顺气丸皆可选用。
麻木者，因风湿热下陷入血分，阴中阳道不行。亦有痰在血分者，其症合眼则浑身麻木痒者，血不
荣于肌腠。治以参 能助阳道，以当归能行阴道，二术、苓、甘、柏以除湿热，柴、升、芍药
以升提之。痰加二陈，治当活法。
方
加减补中益气汤 治气虚手足麻木。
根据本方加木香、大附子、麦门冬、防风、羌活、乌药。
人参益气汤〔批〕（按此方治气虚麻木之剂） 治手指麻木，四肢困倦，怠惰嗜卧。
黄 （二钱） 人参（二钱二分） 甘草（二钱二分） 白芍药（七分） 柴胡（六分）
甘草（炙，六分） 升麻（六分） 五味子（三十粒）
上锉一剂，水煎，稍热服。
开结舒经汤〔批〕（按此方治气郁麻木之剂） 治七情六郁，气滞经络，手足麻痹。
紫苏（八分） 陈皮（八分） 香附（醋炒，八分） 台乌（八分） 川芎（八分） 苍术
（米泔浸三日，锉碎，炒，八分） 羌活（八分） 南星（八分，制） 半夏（八分，制） 当归
（八分） 桂枝（四分） 甘草（四分）
上锉，生姜三片，水煎，入竹沥、姜汁各半盏服。
清风散〔批〕（按此方治风气麻木之剂） 治身体麻木，遍身结核。北
人谓之生饭，南人谓之鼓槌，俗谓风疙瘩，俱属热气滞。
防风（五分） 荆芥（三分） 羌活（五分） 独活（五分） 连翘（五分） 当归（五分）
赤芍药（一钱） 生地黄（五分） 苍术（一钱） 陈皮（一钱） 半夏（制，一钱） 白茯苓
（一钱） 乌药（七分） 槟榔（五分） 木瓜（六分） 牛膝（七分） 木香（三分） 黄连（五分）
玄参（七分） 鼠粘子（炒，五分） 萆 （二钱） 金银花（六分） 升麻（一钱） 白蒺
藜（炒，八分） 防己（五分）
上锉一剂，姜三片，葱白五寸，水二盏，煎八分服。
脉象
脉象浮而软，属于气虚。在关前（寸部）出现这种脉象，麻木出现在身体上部；在关后（尺部）出现这种脉象，麻木出现在身体下部。
脉象浮而缓，属于湿邪，表现为麻痹；脉象紧而浮，属于寒邪，表现为痛痹；脉象涩而芤，属于瘀血，表现为木（感觉丧失），不知痛痒。
治法
十个手指麻木，是胃中有湿痰和瘀血，适宜用二陈汤加苍术、白术、陈皮、茯苓、桃仁、红花，并少量加入附子以通行经络。又适宜用四物汤加上上述药物及羌活、苏木。如果是因湿邪导致的手指麻痹，可用香苏散、苍术、麻黄、桂枝、白芷、羌活、木瓜煎水服用；如果脉象显示体质虚弱，使用五积散也很好。
其一，如果感受外邪，手臂或疼痛，或麻木，或全身麻木，主要使用五积散治疗。
其一，凡是人的手足麻木，以及指尖麻木的，都是痰浊阻滞经络所致。适宜用二陈汤加竹沥、姜汁、白芥子，以祛除痰火，疏散风气，另外艾灸百会穴、肩髃穴、曲池穴、风市穴、足三里穴、绝骨穴，这六个部位共十一个穴位，以预防中风瘫痪，但年轻人不宜多灸。
其一，对于“麻”，用补中益气汤加当归、木香、香附、青皮、川芎，少量加入桂枝作为引经药。“木”，用四物汤和二陈汤，加桃仁、红花。这两个方剂都使用竹沥、姜汁、白芥子，以使药力通行经络到达胁肋，直达痰浊所在之处。竹沥枳术丸、搜风顺气丸都可以选用。
麻木者，是因为风湿热邪下陷进入血分，阴中的阳气通道不通畅。也有痰浊存在于血分的情况，其症状是闭眼时浑身麻木发痒，这是因为血液不能滋养肌肉腠理。治疗用人参能助长阳气通道，用当归能运行阴血通道，白术、苍术、茯苓、甘草、黄柏以清除湿热，柴胡、升麻、芍药以提升举陷。有痰则加二陈汤，治疗应当灵活变通。
方剂
加减补中益气汤 治疗气虚引起的手足麻木。
根据本方加入木香、大附子、麦门冬、防风、羌活、乌药。
人参益气汤〔批注〕（按：此方是治疗气虚麻木的药剂） 治疗手指麻木，四肢困倦，懒怠嗜睡。
黄芪（二钱） 人参（二钱二分） 甘草（二钱二分） 白芍药（七分） 柴胡（六分）
甘草（炙，六分） 升麻（六分） 五味子（三十粒）
以上锉成粗末为一剂，用水煎煮，稍热时服用。
开结舒经汤〔批注〕（按：此方是治疗气郁麻木的药剂） 治疗七情六郁，气滞经络，手足麻痹。
紫苏（八分） 陈皮（八分） 香附（醋炒，八分） 台乌（八分） 川芎（八分） 苍术
（米泔水浸泡三天，锉碎，炒制，八分） 羌活（八分） 南星（八分，制过） 半夏（八分，制过） 当归
（八分） 桂枝（四分） 甘草（四分）
以上锉成粗末，生姜三片，用水煎煮，加入竹沥、姜汁各半盏服用。
清风散〔批注〕（按：此方是治疗风气麻木的药剂） 治疗身体麻木，全身结核（皮下结节）。北方人称之为生饭疙瘩，南方人称之为鼓槌疙瘩，俗称风疙瘩，都属于热气滞留所致。
防风（五分） 荆芥（三分） 羌活（五分） 独活（五分） 连翘（五分） 当归（五分）
赤芍药（一钱） 生地黄（五分） 苍术（一钱） 陈皮（一钱） 半夏（制过，一钱） 白茯苓
（一钱） 乌药（七分） 槟榔（五分） 木瓜（六分） 牛膝（七分） 木香（三分） 黄连（五分）
玄参（七分） 鼠粘子（炒，五分） 萆薢（二钱） 金银花（六分） 升麻（一钱） 白蒺藜（炒，八分） 防己（五分）
以上锉成粗末为一剂，生姜三片，葱白五寸，水两盏，煎至八分满时服用。
Pulse Diagnosis
A pulse that is floating and soft indicates Qi deficiency. If this pulse is felt at the cun position (proximal to the wrist crease), numbness occurs in the upper body; if felt at the chi position (distal to the wrist crease), numbness occurs in the lower body.
A pulse that is floating and slow indicates Dampness, manifesting as paralysis/numbness (Ma Bi); a pulse that is tight and floating indicates Cold, manifesting as painful obstruction (Tong Bi); a pulse that is choppy and hollow indicates fixed blood stasis, manifesting as wood-like numbness (Mu), characterized by a loss of sensation to pain and itch.
Syndrome Differentiation
Zhu Danxi stated: Numbness (Ma) is caused by Qi deficiency, while wood-like numbness (Mu) is caused by Damp-Phlegm and Blood Stasis.
Treatment Methods
Numbness in all ten fingers indicates Damp-Phlegm and Blood Stasis in the Stomach. Er Chen Tang (Two-Cured Decoction) should be used with added Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria), Tao Ren (Persicae Semen), Hong Hua (Carthami Flos), and a small amount of Fu Zi (Aconiti Lateralis Radix Praeparata) to promote circulation through the collaterals. Alternatively, Si Wu Tang (Four Substances Decoction) combined with the aforementioned herbs plus Qiang Huo (Notopterygii Rhizoma et Radix) and Su Mu (Sappan Lignum) may be used. For finger paralysis caused by Dampness, Xiang Su San (Perilla Powder) along with Cang Zhu, Ma Huang (Ephedrae Herba), Gui Zhi (Cinnamomi Ramulus), Bai Zhi (Angelicae Dahuricae Radix), Qiang Huo, and Mu Gua (Chaenomelis Fructus) decocted in water is suitable. If the pulse indicates constitutional weakness, Wu Ji San (Five Accumulations Powder) is also effective.
First, if external pathogens are contracted causing arm pain or numbness, or generalized body numbness, Wu Ji San (Five Accumulations Powder) is the primary treatment.
Second, numbness in the hands and feet, including the fingertips, is due to Phlegm obstructing the meridians. Er Chen Tang (Two-Cured Decoction) with Zhu Li (Bambusae Succus), Jiang Zhi (Zingiberis Recens Juice), and Bai Jie Zi (Sinapis Semen) should be used to dispel Phlegm-Fire and scatter Wind-Qi. Additionally, moxibustion should be applied to Bai Hui (GV20), Jian Yu (LI15), Qu Chi (LI11), Feng Shi (GB31), Zu San Li (ST36), and Jue Gu (GB39). These six locations comprise eleven acupoints in total, serving to prevent stroke and paralysis, though young individuals should not undergo excessive moxibustion.
Third, for "Ma" (numbness), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is used with added Dang Gui (Angelicae Sinensis Radix), Mu Xiang (Aucklandiae Radix), Xiang Fu (Cyperi Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), and Chuan Xiong (Ligustici Chuanxiong Rhizoma), with a small amount of Gui Zhi (Cinnamomi Ramulus) as a guiding herb. For "Mu" (wood-like numbness), Si Wu Tang (Four Substances Decoction) and Er Chen Tang (Two-Cured Decoction) are used with added Tao Ren (Persicae Semen) and Hong Hua (Carthami Flos). Both formulas utilize Zhu Li (Bambusae Succus), Jiang Zhi (Zingiberis Recens Juice), and Bai Jie Zi (Sinapis Semen) to guide the medicine through the collaterals to the hypochondrium, reaching the site of Phlegm accumulation. Zhu Li Zhi Shu Wan (Bamboo Sap and Atractylodes Pill) and Sou Feng Shun Qi Wan (Search Wind and Smooth Qi Pill) are also selectable options.
Numbness arises when Wind-Damp-Heat sinks into the Blood level, obstructing the Yang pathways within Yin. There are also cases where Phlegm exists within the Blood level, presenting with symptoms of whole-body numbness and itching upon closing the eyes, indicating that Blood fails to nourish the muscle and interstices. Treatment involves using Ren Shen (Ginseng Radix et Rhizoma) to assist Yang pathways, and Dang Gui (Angelicae Sinensis Radix) to circulate Yin pathways. Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cang Zhu (Atractylodis Rhizoma), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Huang Bo (Phellodendri Cortex) are used to eliminate Damp-Heat. Chai Hu (Bupleuri Radix), Sheng Ma (Cimicifugae Rhizoma), and Shao Yao (Paeoniae Radix) are used to lift and raise. If Phlegm is present, Er Chen Tang (Two-Cured Decoction) is added; treatment requires flexibility.
Formulas
Modified Bu Zhong Yi Qi Tang (Modified Tonify the Middle and Augment the Qi Decoction): Treats numbness in hands and feet due to Qi deficiency.
Based on this formula, add Mu Xiang (Aucklandiae Radix), Da Fu Zi (Aconiti Lateralis Radix Praeparata), Mai Men Dong (Ophiopogonis Tuber), Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Wu Yao (Linderae Radix).
Ren Shen Yi Qi Tang (Ginseng and Qi-Supporting Decoction) [Commentary: According to this prescription, it is an agent for treating Qi-deficiency numbness]
Indications: Numbness in fingers, fatigue in the four limbs, lethargy, and desire to sleep.
Huang Qi (Astragali Radix) (2 qian)
Ren Shen (Ginseng Radix et Rhizoma) (2.2 qian)
Gan Cao (Glycyrrhizae Radix et Rhizoma) (2.2 qian)
Bai Shao Yao (Paeoniae Radix Alba) (0.7 qian)
Chai Hu (Bupleuri Radix) (0.6 qian)
Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) (0.6 qian)
Sheng Ma (Cimicifugae Rhizoma) (0.6 qian)
Wu Wei Zi (Schisandrae Chinensis Fructus) (30 grains)
Decoct these ingredients into one dose, drink warm.
Kai Jie Shu Jing Tang (Open Knots and Unblock Collaterals Decoction) [Commentary: According to this prescription, it is an agent for treating Qi-stagnation numbness]
Indications: Seven Emotions and Six Types of Stagnation, Qi stagnation in collaterals, paralysis and numbness of hands and feet.
Zi Su (Perillae Folium) (0.8 fen)
Chen Pi (Citri Reticulatae Pericarpium) (0.8 fen)
Xiang Fu (Cyperi Rhizoma, vinegar-fried) (0.8 fen)
Tai Wu (Linderae Radix) (0.8 fen)
Chuan Xiong (Ligustici Chuanxiong Rhizoma) (0.8 fen)
Cang Zhu (Atractylodis Rhizoma, soaked in rice water for three days, sliced, fried) (0.8 fen)
Qiang Huo (Notopterygii Rhizoma et Radix) (0.8 fen)
Nan Xing (Arisaematis Cum Bile Rhizoma, processed) (0.8 fen)
Ban Xia (Pinelliae Tuber, processed) (0.8 fen)
Dang Gui (Angelicae Sinensis Radix) (0.8 fen)
Gui Zhi (Cinnamomi Ramulus) (0.4 fen)
Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.4 fen)
Decoct these ingredients with three slices of fresh ginger in water. Add half a cup of Zhu Li (Bambusae Succus) and half a cup of Jiang Zhi (Zingiberis Recens Juice) before consumption.
Qing Feng San (Clear Wind Powder) [Commentary: According to this prescription, it is an agent for treating Wind-related numbness]
Indications: Body numbness, subcutaneous nodules throughout the body. Known as "raw rice lumps" in the North, "drumstick lumps" in the South, commonly called wind hives; all belong to Heat-Qi stagnation.
Fang Feng (Saposhnikoviae Radix) (0.5 fen)
Jing Jie (Schizonepetae Spica) (0.3 fen)
Qiang Huo (Notopterygii Rhizoma et Radix) (0.5 fen)
Du Huo (Angelicae Pubescentis Radix) (0.5 fen)
Lian Qiao (Forsythiae Fructus) (0.5 fen)
Dang Gui (Angelicae Sinensis Radix) (0.5 fen)
Chi Shao Yao (Paeoniae Radix Rubra) (1 qian)
Sheng Di Huang (Rehmanniae Radix) (0.5 fen)
Cang Zhu (Atractylodis Rhizoma) (1 qian)
Chen Pi (Citri Reticulatae Pericarpium) (1 qian)
Ban Xia (Pinelliae Tuber, processed) (1 qian)
Bai Fu Ling (Poria) (1 qian)
Wu Yao (Linderae Radix) (0.7 fen)
Bing Lang (Arecae Semen) (0.5 fen)
Mu Gua (Chaenomelis Fructus) (0.6 fen)
Niu Xi (Achyranthis Bidentatae Radix) (0.7 fen)
Mu Xiang (Aucklandiae Radix) (0.3 fen)
Huang Lian (Coptidis Rhizoma) (0.5 fen)
Xuan Shen (Scrophulariae Radix) (0.7 fen)
Niu Bang Zi (Arctii Fructus, fried) (0.5 fen)
Bi Xie (Dioscoreae Hypoglaucae Rhizoma) (2 qian)
Jin Yin Hua (Lonicerae Japonicae Flos) (0.6 fen)
Sheng Ma (Cimicifugae Rhizoma) (1 qian)
Bai Ji Li (Tribuli Fructus, fried) (0.8 fen)
Fang Ji (Stephaniae Tetrandrae Radix) (0.5 fen)
Decoct one dose with three slices of ginger and five cun of scallion white in two cups of water, reduce to eight-tenths, and consume.