【口眼 斜之症】头痛目疼，身发寒热，目筋缩短，软戾拘急。此外感口眼 斜
【口眼 斜之因】当风露卧，胃冷冲寒；肝主筋脉，风中肝木，则眼目拘缩；阳明主
肌肉，风中肌表，则口欠唇歪。
【口眼 斜之脉】左关弦紧，风中肝胆。右关弦长，风中阳明。浮数滑大，邪伤于
气。沉弦细数，邪伤于血。
【口眼 斜之治】风中肝胆，羌防四物汤。风中阳明，防风干葛汤。左 ，用羌防四
物汤
羌防四物汤 治风中于左，邪入厥阴，口眼 斜之症。
羌活 防风 当归 生地 川芎 白芍药
身痛加秦艽、钩藤、柴胡。
防风干葛汤 治风中于右，邪入阳明，口眼 斜之症。
防风 荆芥 干葛 升麻 广皮 甘草 白芷
身痛加秦艽、钩藤。
【口眼 斜之症】外无六经形症，忽尔眼欠口 ，此内伤口眼 斜之症也。
【口眼 斜之因】金燥木枯，则肝血不足，筋急牵引，燥金太过，则子合母虚，阳明
，亦必短缩，膏粱酒湿，湿热不攘，则脾火不运，筋脉软短，肌肉不仁，口眼 斜之症作矣。
【口眼 斜之脉】左关弦数，肝胆有邪；右关洪长，肠胃有热。左脉微涩，肝血不足
【口眼 斜之治】左关弦数者，当归钩藤汤。右关脉弦数者，栀连平胃散。加干葛、
木瓜、秦艽。膏粱积热者，干葛清胃汤。肝血不足，补肝散。脾气虚者，四君子汤。
当归钩藤汤
当归 钩藤 秦艽 丹皮 防风 青皮 黄芩 柴胡 甘草
栀连平胃散
山栀 川黄连 熟苍术 浓朴 广皮 甘草 葛根 木瓜 秦艽
干葛清胃汤
升麻 川黄连 山栀 丹皮 生地 甘草 干葛
四君子汤 见前内伤中风。
补肝散
归身 白芍药 川芎 生地 羌活 防风
阳明之脉，夹口环唇，入目络鼻。故口眼 斜，阳明主多，此系实邪之症，即同半身不
遂，但当去其病邪，用不得温补堵塞。前条虽有血虚、气虚，而立补方，亦不过预防其本
元耳，以内有痰涎积热，每多口眼 斜，故凡流涎口角，而 斜口眼者，悉以胃热主治，而
用清胃汤、防风干葛汤；舌音不清 斜者，皆主心胃有热，而用转舌膏；大便硬为大肠燥火
，而用四顺饮；即或泻或结，亦是大肠湿热，用川连枳壳汤；小便赤涩不利，为小肠燥火，
即或数数欲小便者，亦为小肠湿火，用导赤各半汤；二便皆涩，八正散。大凡治病，当察何
经主病，何经兼见；上观唇口眼鼻，则知上焦虚实寒热；下观二便通涩，即知下焦之虚实寒
【口眼歪斜的症状】头痛，眼睛疼痛，身体出现怕冷和发热，眼部筋脉缩短，眼睑及面部肌肉松弛、歪曲、拘挛紧急。这是外感引起的口眼歪斜。
【口眼歪斜的病因】在风露中睡觉，胃受寒冷冲击；肝主管筋脉，风邪侵袭肝木，导致眼睛拘挛收缩；阳明经主管肌肉，风邪侵袭肌表，导致嘴巴欠伸、嘴唇歪斜。
【口眼歪斜的脉象】左手关部脉弦紧，是风邪侵袭肝胆。右手关部脉弦长，是风邪侵袭阳明经。脉浮数滑大，是邪气伤及气分。脉沉弦细数，是邪气伤及血分。
【口眼歪斜的治疗】风邪侵袭肝胆，用羌防四物汤。风邪侵袭阳明，用防风干葛汤。左侧病变，使用羌防四物汤。
羌防四物汤：治疗风邪侵袭左侧，邪气进入厥阴经，引起口眼歪斜的症状。
组成：羌活、防风、当归、生地、川芎、白芍药。
若伴有身体疼痛，加秦艽、钩藤、柴胡。
防风干葛汤：治疗风邪侵袭右侧，邪气进入阳明经，引起口眼歪斜的症状。
组成：防风、荆芥、干葛（葛根）、升麻、广皮（陈皮）、甘草、白芷。
若伴有身体疼痛，加秦艽、钩藤。
【口眼歪斜的症状】外部没有六经病的症状表现，突然发生眼睛闭合不全、嘴巴歪斜，这是内伤引起的口眼歪斜的症状。
【口眼歪斜的病因】肺金燥热而肝木枯槁，导致肝血不足，筋脉急迫牵引；燥金之气太过，子病及母导致虚损，阳明经也会短缩；食用膏粱厚味及饮酒生湿，湿热不除，导致脾火不能运化，筋脉软弱短缩，肌肉麻木不仁，口眼歪斜的症状就产生了。
【口眼歪斜的脉象】左手关部脉弦数，说明肝胆有邪气；右手关部脉洪长，说明肠胃有热。左手脉微涩，说明肝血不足。
【口眼歪斜的治疗】左手关部脉弦数的，用当归钩藤汤。右手关部脉弦数的，用栀连平胃散。可加干葛、木瓜、秦艽。因膏粱积热者，用干葛清胃汤。肝血不足者，用补肝散。脾气虚者，用四君子汤。
当归钩藤汤
组成：当归、钩藤、秦艽、丹皮、防风、青皮、黄芩、柴胡、甘草。
栀连平胃散
组成：山栀、川黄连、熟苍术、浓朴、广皮、甘草、葛根、木瓜、秦艽。
干葛清胃汤
组成：升麻、川黄连、山栀、丹皮、生地、甘草、干葛。
阳明经的脉道，夹持口唇环绕嘴唇，进入目络鼻窍。所以口眼歪斜，多由阳明经主导，这属于实邪病症，就像半身不遂一样，只应当祛除病邪，不得使用温补堵塞之法。前条虽然提到血虚、气虚，并设立补方，也不过是为了预防其本元亏损罢了，因为体内有痰涎积热，常常导致口眼歪斜，所以凡是流口水、嘴角歪斜的，都从胃热主治，使用清胃汤、防风干葛汤；舌头发音不清且歪斜的，都主心胃有热，使用转舌膏；大便干燥为大肠燥火，使用四顺饮；即使腹泻或便秘，也是大肠湿热，使用川连枳壳汤；小便赤涩不利，为小肠燥火，即使频繁想小便，也是小肠湿火，使用导赤各半汤；大小便皆涩滞，用八正散。大凡治病，应当观察哪条经络主病，哪条经络兼见症状；上观唇口眼鼻，可知上焦的虚实寒热；下观二便通涩，即可知下焦的虚实寒热。
[Symptoms of Facial Paralysis] Headache, eye pain, aversion to cold and fever in the body, shortening of the tendons around the eyes, laxity, deviation, and spasm of the eyelid and facial muscles. This is facial paralysis caused by external contraction.
[Etiology of Facial Paralysis] Sleeping exposed to wind and dew, with cold striking the stomach; the Liver governs the tendons and vessels; when Wind pathogen invades Liver Wood, it causes constriction and shrinking of the eyes; the Yangming channel governs the muscles; when Wind pathogen invades the muscle surface, it causes gaping of the mouth and deviation of the lips.
[Pulse Diagnosis of Facial Paralysis] The pulse at the left Guan position is wiry and tight, indicating Wind pathogen invading the Liver and Gallbladder. The pulse at the right Guan position is wiry and long, indicating Wind pathogen invading the Yangming channel. A floating, rapid, slippery, and large pulse indicates pathogen injuring the Qi level. A deep, wiry, fine, and rapid pulse indicates pathogen injuring the Blood level.
[Treatment of Facial Paralysis] For Wind pathogen invading the Liver and Gallbladder, use Qiangfang Siwu Decoction (Notopterygium and Saposhnikovia Four Substances Decoction). For Wind pathogen invading Yangming, use Fangfeng Gange Decoction (Saposhnikovia and Pueraria Decoction). For lesions on the left side, use Qiangfang Siwu Decoction.
Qiangfang Siwu Decoction: Treats Wind pathogen invading the left side, where pathogen enters the Jueyin channel, causing facial paralysis.
Ingredients: Radix Notopterygii (Qianghuo), Radix Saposhnikoviae (Fangfeng), Radix Angelicae Sinensis (Danggui), Rhizoma Polygonati Multi-flori (Shengdi - *Note: Text says Shengdi, usually Rehmannia but context implies cooling blood*), Radix Chuanxiong (Chuanxiong), Radix Paeoniae Alba (Baishao).
If accompanied by body pain, add Radix Gentianae Macrophyllae (Qinjiao), Uncaria rhynchophylla (Gouteng), and Radix Bupleuri (Chaihu).
Fangfeng Gange Decoction: Treats Wind pathogen invading the right side, where pathogen enters the Yangming channel, causing facial paralysis.
Ingredients: Radix Saposhnikoviae (Fangfeng), Herba Schizonepetae (Jingjie), Radix Puerariae Lobatae (Gange/Shengma), Radix Cimicifugae (Shengma), Pericarpium Citri Reticulatae (Guangpi), Radix Glycyrrhizae (Gancao), Radix Angelicae Dahuricae (Baizhi).
If accompanied by body pain, add Radix Gentianae Macrophyllae (Qinjiao) and Uncaria rhynchophylla (Gouteng).
[Symptoms of Internal Injury Facial Paralysis] There are no exterior Six Channels symptoms; suddenly occurring incomplete eye closure and mouth deviation constitute the symptoms of facial paralysis due to internal injury.
[Etiology of Internal Injury Facial Paralysis] Lung Metal dryness and Liver Wood withering lead to insufficient Liver Blood and tendon tension; excessive Dry Metal leads to child affecting mother deficiency, causing the Yangming channel to also shorten; accumulation of rich food and alcohol dampness, if not dispelled, leads to Spleen Fire failing to transport, resulting in soft and short tendons and insensible muscles, thus producing facial paralysis.
[Pulse Diagnosis of Internal Injury Facial Paralysis] A wiry and rapid pulse at the left Guan position indicates pathogen in the Liver and Gallbladder; a surging and long pulse at the right Guan position indicates heat in the intestines and stomach. A faint and choppy pulse at the left hand indicates insufficient Liver Blood.
[Treatment of Internal Injury Facial Paralysis] For a wiry and rapid pulse at the left Guan position, use Danggui Gouteng Decoction. For a wiry and rapid pulse at the right Guan position, use Zhilian Pingwei San (Gardenia and Coptis Pingwei Powder). Add Radix Puerariae Lobatae (Gange), Fructus Papaveris (Mugua - *Note: Text says Mugua, likely Chaenomeles*), and Radix Gentianae Macrophyllae (Qinjiao). For heat accumulation from rich food, use Gange Qingwei Decoction. For insufficient Liver Blood, use Bugan San (Tonify Liver Powder). For Spleen Qi deficiency, use Sijunzi Decoction (Four Gentlemen Decoction).
Danggui Gouteng Decoction
Ingredients: Radix Angelicae Sinensis (Danggui), Uncaria rhynchophylla (Gouteng), Radix Gentianae Macrophyllae (Qinjiao), Cortex Moutan (Danpi), Radix Saposhnikoviae (Fangfeng), Pericarpium Aurantii Immaturum (Qingpi), Radix Scutellariae (Huangqin), Radix Bupleuri (Chaihu), Radix Glycyrrhizae (Gancao).
Zhilian Pingwei San
Ingredients: Fructus Gardeniae (Shanzhi), Rhizoma Coptidis (Chuanhuanglian), Prepared Rhizoma Atractylodis Macrocephalae (Shucangzhu), Cortex Magnoliae Officinalis (Nongpu), Pericarpium Citri Reticulatae (Guangpi), Radix Glycyrrhizae (Gancao), Radix Puerariae Lobatae (Gegen), Fructus Chaenomelis (Mugua), Radix Gentianae Macrophyllae (Qinjiao).
Gange Qingwei Decoction
Ingredients: Radix Cimicifugae (Shengma), Rhizoma Coptidis (Chuanhuanglian), Fructus Gardeniae (Shanzhi), Cortex Moutan (Danpi), Radix Rehmanniae Preparata (Shengdi - *Note: Text says Shengdi, Fresh Rehmannia*), Radix Glycyrrhizae (Gancao), Radix Puerariae Lobatae (Gange).
Sijunzi Decoction: See previous section on Internal Injury Stroke.
Bugan San (Tonify Liver Powder)
Ingredients: Radix Angelicae Sinensis (Guishen), Radix Paeoniae Alba (Baishao), Rhizoma Chuanxiong (Chuanxiong), Radix Rehmanniae Preparata (Shengdi - *Note: Text says Shengdi*), Radix Notopterygii (Qianghuo), Radix Saposhnikoviae (Fangfeng).
The Yangming channel passes alongside the mouth and encircles the lips, entering the eyes and connecting to the nose. Therefore, facial paralysis is predominantly governed by the Yangming channel; this is a syndrome of excess pathogen, similar to hemiplegia, but one should only eliminate the pathogen and must not use warming tonification or clogging methods. Although the previous sections mentioned Blood deficiency and Qi deficiency and established tonifying formulas, these were merely to prevent depletion of the original essence, as phlegm-fluids and accumulated heat inside often cause facial paralysis. Thus, for cases with drooling and mouth deviation, treatment focuses on Stomach Heat using Qingwei Decoction or Fangfeng Gange Decoction; for unclear speech and deviation, it is attributed to Heart and Stomach Heat, treated with Zhuanshe Gao (Tongue-Turning Paste); for hard stools due to Large Intestine dry fire, use Sishun Yin (Four Smooth Drink); whether diarrhea or constipation, if it is Large Intestine damp-heat, use Chuanlian Zhike Tang (Coptis and Immature Orange Decoction); for red, scanty, and difficult urination due to Small Intestine dry fire, or frequent urge to urinate due to Small Intestine damp-fire, use Daochi Geban Tang (Guide Out Red Half-Decoction); for both urinary and fecal obstruction, use Bazheng San (Eight Correctives Powder). Generally, in treating disease, one must observe which channel is primarily affected and which shows accompanying signs; observing the lips, mouth, eyes, and nose above reveals the deficiency/excess and cold/heat of the Upper Jiao; observing the patency or obstruction of urination and defecation below reveals the deficiency/excess and cold/heat of the Lower Jiao.