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Millwoods Acupuncture Center
102, 2603 Hewes Way
Edmonton AB,   Canada

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中风历节病脉证并治第五

Chapter 5, Zhongfeng, Lijie, their sysmptoms, pulse and treatment.

夫风之为病,当半身不遂,或但臂不遂者,此为痹,脉微而数,中风使然。

If the body is attacked by a Wind Xieqi, the person should have half body paralysis. If it is only an arm failing to move or loses feeling, it is called Bi syndrome[1].
      

寸口脉浮而缓,浮则为寒,缓为为虚;荣缓则为亡血,卫缓则为中风;邪气中经, 浮者血风,络脉空虚,贼邪不泻,或左或右,邪气反缓,正气即急,正气引邪,喎僻不遂。邪在于络,肌肤不仁;邪在于经,即重不胜;邪入于府,即不识人;邪入于藏,舌则难言,口吐涎。

If the pulse is floating and not so frequent on the Chun position, the floating pluse indicates the Cold invasion, the less frequent pulse is Weakness. Rongqi not frequent suggests depletion of blood; Weiqi not frequent suggests Wind invasion. If the Xieqi invades the meridian, the floating pulse also indicates Wind in the blood. The blood vescle branches is empty, the out-coming Xieqi remains, either in the left side or in the right side. The Xieqi is not so aggrisave, but the defense system is urgent to remove the Xieqi out. The defense Qi directs the Xieqi to cause the block of the meridian. If the Xieqi is in the branches, the skin loses its feeling ability to feel numb; if it is in the meridian stems, the body feels heaviness; if the Xieqi comes into the hollow organs, the person loses ability to recognize person; if it moves into the fullness organ, the person will have difficulty in speaking, and have running of saliva out of the mouth. 

寸口脉浮而紧,紧则为寒,浮则为虚,寒风相抟,邪在皮肤,则身痒而瘾疹;心气不足,邪气入中,则胸满而气短。

The pulse is floating and tight on the Chun position. The tight pulse suggests Cold; floating suggests weakness condition. The combination of the Cold and the Weakness makes the Xieqi ramins in the skin. The body will have itch and skin rash. If the person has weakness in the Heart, now the Xieqi will cause fullness in the chest and short of breath.


寸口脉沉而弱,沉即主骨,弱即主筋,沉即为肾,弱即为肝,汗出入水中,如水伤心,历节黄汗出,故曰历节。

The pulse on the Chun position is deep and weak. The deep means bone, and the weak means tendons. In another way, it can also be understand that the deep means the Kidney and the weak means the Liver. When a person has sweat but he jumps or contacts with water, the water damages the Heart[2], causing joint has yellow sweat. This condition is called Lijie disease. [3]


味酸则伤筋,筋伤则缓,名曰泄,咸则伤骨,骨伤则痿,名曰枯;枯泄相搏,名曰断绝。荣气不通,卫不独行,荣卫俱微,三焦无所御,四属断绝,身体羸瘦,独足肿大,黄汗出,胫冷,假令发热,便为历节也。病历节,不可屈伸,疼痛,乌头汤主之。(注:本段提示湿气为痹症原因之一)

Sour taste damages the tendon, the tendon becomes weak so as hard to contract, after damage. This condition is called depletion/relief. Salty taste damages the bone. The bone becomes atrophy after damage. This condition is called withered condition. When both the relief and the withered conditions are in the body, it is called Duanjue. If the Rongqi is blocked, the Weiqi can not move by itself. If both the Weiqi and Rongqi are weak, there is no defense system to defense the three Jao Cavity, and no more nutrition to nourish the arms and legs, the body becomes skinny and weakness with only the feet swelling and big. The body has yellow sweat[4], cold legs[5]. If the person feels hot[6], it belongs to Lijie disease. In this case, the joints feel pain, and hard to bend or to stretch. Use Wutou Tang for the treatment.[7]

乌头汤方

Wutou Tang

麻黄,芍药,黄耆各三两,甘草川乌(咀,以蜜二升,煎取一升,即出乌头)五枚

Mahuang 45 gram, Shaoyao 45 gram, Huangqi 45 gram, Gancao 15 gram, Chuangwu (cut into small pieces, cook in honey 500 ml, until there is about 250 ml honey left. Collect the Wutou) five badges.


右五味,咀四味,以水三升,煮取一升,去滓,内蜜煎中,更煎之,服七合;不知,尽服之。

Add the herbs into 750 ml water. Bring to boil and keep in mild boiling until there is about 250 ml liquid left. Remove the residue, collect the herbal tea, mix it with honey continue to cook for a while. Drink 70% of the collected tea. If the person feels nothing special[8], drink all the remaining tea.

诸肢节疼痛,身体尪羸,脚肿如脱,头眩短气,温温欲吐,桂枝芍药知母汤主之。(注:本段提示寒为痹症原因之一)

If the person feels pain in various small joints, and his body is very thin/slim[9], his feet is very swelling, he feels dizzy and short of breath[10], has willing to vomit[11], use Guizhi Shaoyao Zhimu Tang for the treatment. [12]

桂枝芍药知母汤方


桂枝
 四两,芍药 三两,甘草 二两,麻黄 二两,生姜 五两,白术 五两,知母 四两,防风 二两,附子(炮)二枚

Guizhi 60 gram, Shaoyao 45 gram, Gancao 30 gram, Mahuang 30 gram, Fresh ginger 78 gram, Baishu 78 gram, Zhimu 60 gram, Fangfeng 30 gram, Fuzi (processed) 2 badges.


右九味,以水七升,煮取二升,温服七合,日三服。

Add the herbs and 1750 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 500 ml liquid left. Collect the herbal tea. Drink one third of the tea each time, three times a day.


趺阳脉浮而滑,滑则谷气实,浮则汗自出。

Fuyang pulse[13] is floating and smooth. The smooth pulse suggests the stomach Qi is strong, and the floating pulse suggests the body has self sweat. [14]

少阴脉浮而弱,弱则血不足,浮则为风,风血相抟,即疼痛如掣。(注:本段提示血虚为痹症原因之一)

Shaoyin pulse[15] is floating and weak. The weak pulse suggests deficiency in blood; floating suggests the Wind. The Wind moves freely in the blood vesicle that contains less blood, to cause severe pain in the joints. [16]

盛人脉涩小,短气,自汗出,历节疼,不可屈伸,此皆饮酒汗出当风所致。

For a person with big body size, if his pulse is harsh and small, he has short of breath, sweat, pain the small joints so hart to bend or to stretch, his condition is due to drinking wine, had sweat and then exposed to wind. [17]



[1] For Bi disease, the pulse is usually deep and harsh.

[2] The Heart belongs to Fire. So the Water damages the Fire.

[3] The Heart also is associated with sweat. The Heart is weak, so the sweat is accumulated into Shi Xieqi in the body, a condition called Shi condition. The Liver is associated with Wind. The Liver is weak, so the Wind is relatively strong, causing spasm in the tendons around the joints, to cause the Lijie disease. The Lijjie disease is similar to various arthritis in the small joints.

[4] The Shi Xieqi evaporates from the body inside.

[5] Cold accumulated in the lower part of the body.

[6] If the body feels hot, it suggests he has Wind in the body.

[7] Improper diet can damage the Spleen, Stomach, Heart, Lung, Liver and Kidney to cause the Lijie disease. Overall, it can be due to the drinking of wine/liqor. After evaporation of the alcohol from the wine, the Shi Qi in the wine remains in the body. After long time accumulation, the Shi Qi creates Fire in the body. The body with the combined Shi Qi and Fire weaken the body Weiqi and Rongqi, so that the body is easy to be attacked by Xieqi. In clinic, it can be a combination of outside coming Wind with inside Shiqi; outside Cold with inside Shiqi; inside Cold attracts outside Shiqi; inside Fire attracts outside Shiqi, etc. For the treatment, it is needed to verify if the diseased joint is with more Fire, more Whiqi, or more Cold, or more Wind, to decide the treatment principle to evaporate body surface layer; to warm inside of the body; to improve the Yangqi movement; to support the weakness condition; to expel the Xieqi.

[8] Whenever there is the herb Wutou in the formula, the mark for the healing effect is to let the person feels kinds of slight dizzy, slight nausea or slight hot feeling on the face.  Wutou is a special toxix herb that needs extreme care in the preparation to remove the toxic effect but keep the healing effect. Wutou and Fuzi come from the same plant root. The Wutou is the main stem of the root, and the Fuzi is the small branches of it.

[9] Body is too slim/thin: the body Zhenqi is weak but Xieqi is too much.

[10] Dizzy and short of breath: weakness of Yangqi.

[11] Willing to vomit: overwhelming of Cold Xieqi in the body.

[12] Wutou Tang is used for overwhelming of Shiqi in the body, the body has yellow sweat. Here, the Guizhi Shaoyao Zhimu Tang is used for overwhelming of Cold. In another words, support Yangqi is the main function of the herb formula, depletion of cold-shi is second. Fresh ginger is more in the formula, since there is tendency to vomit.

[13] Fuyang pulse: the pulse is felt on the front of feet. Usually the pulse is felt on the wrist. Sometime doctor should also check the pulse in front of the feet of patient. The Fuyang pulse mostly indicates the condition of stomach system in the body.

[14] The sweat means yellow sweat in the Lijie disease. This paragraph tells that the yellow sweat condition can also be caused by Wind and Fire. The Fire is in the stomach (the pulse is smooth), and the Wind Xieqi is suggested by floating pulse.

[15] Shaoyin pulse is the Heart pulse. It is felt on the Chun position of the left wrist. The Heart is associated with blood. Weak pulse in this position suggests the deficiency of blood in the Heart.

[16] This paragraph tells that blood deficiency is one of the reasons causing the Lijie disease. In this condition, supply more blood before depleting the Wind.

[17] Over-weight person should have stronger pulse, the pulse should not be small. His breath should be long, not short. Now, small pulse and short of breath do not match the body ship. This paragraph tells another reason for the Lijie disease: drink wine, has sweat and exposes to wind.