《孫真人備急千金要方》Vol. 27

Prescriptions for Treating Various Wind Disorders

Hemiplegic Wind, Chapter Four (Prescriptions and Acupuncture Methods)

Fangfeng Decoction: Used to treat hemiplegic wind. Zhen Quan once used this prescription to treat the Duke of Anping.

One liang each of fangfeng, chuanxiong, baizhi, niuxi, gouji, bixi, and baizhu; two liang each of qianghuo, gegen, fuzi (the Waitai Miyao gives “renshen”), and xingren; three liang each of yiyi ren, shigao, and guixin; four liang of mahuang; and five liang of fresh ginger.

Cut the sixteen ingredients into pieces and decoct them in one dou and two sheng of water until three sheng of liquid remain. Divide this into three doses. If you feel better after one course, you may take another. With each course, receive acupuncture nine times. After nine courses and nine acupuncture treatments, the illness will be cured. Moxibustion may also be used.

Needle Fengchi, Jianyu, Quchi, Zhigou, Wushu, Yanglingquan, and Julixialian, one point at each location, for a total of seven points; this will cure the illness.

A guard at Renshou Palace fell ill and was ordered to receive acupuncture. Needling Huantiao, Yanglingquan, Julixialian, and Yangfu, one point at each location, for a total of four points, enabled him to stand and walk.

Zhao Qing of Dali suffered from wind illness. His waist and legs could not move, and he was unable to kneel or rise. Needling Shangliao, Huantiao, Yanglingquan, and Julixialian, one point at each location, for a total of four points, enabled him to kneel and rise.

Kudi Qin suffered from hemiplegic wind and could not draw a bow. Zhen Quan needled one point at Jianyu, and he was then able to draw a bow.

Prescription for Treating “Weitui Wind,” Hemiplegia, and Loss of Voice

Take three dou of apricot kernels, remove those with double kernels and the skins and tips, wash them, and pound them in a mortar. Then grind them into an apricot-kernel slurry, using the same method as for cold-food porridge. Take eight sheng of the juice and simmer it down to four sheng. It is cooked when it tastes fragrant and smooth; if it has not reached this state, it is undercooked, so be sure to cook it thoroughly. Once the liquid has cooled completely, add one dou and six sheng of high-quality yeast starter, then simmer it down to eight sheng. This is the first addition and fermentation.

Next, steam and boil it once more. Separately, take three sheng of apricot kernels and grind them; extract one dou and two sheng of juice and simmer it down to … The original text breaks off here, and the remainder of the method is not recorded.

The terms “needle” and “moxibustion” refer respectively to acupuncture and moxibustion, traditional therapeutic methods. All the named points in the text are acupuncture points.

For the second addition, take six sheng of rice and steam it as before. The amount of almond juice for the third addition depends on circumstances. If there is concern that the rice will be insufficient, grind another two sheng of almonds, extract eight sheng of juice, and reduce it by boiling to four sheng. Steam more rice as needed and add it in stages. If that is still insufficient, grind another two sheng of almonds, extract eight sheng of juice, reduce it to four sheng, and continue adding ingredients until the wine has fermented fully. In total, use one shi of rice and three dou of almonds. The almonds are ground in stages because boiling all the almond juice at once may make it sour. In winter, the almond juice may be boiled all at once: extract one shi and six dou of juice from three dou of almonds, reduce it to eight dou and four sheng, then use it to soak the yeast cake and add the ingredients in stages. Once the wine has fermented fully, seal it for twenty-eight days. Open it and let it settle, draw off the clear wine from the top, then press the lees. The lees can be dried in the sun, ground into powder, and taken mixed with wine; this is said to work very well. This is a secret formula.

Another formula: Take one sheng of castor oil and one dou of wine. Put them in a copper bowl, place the bowl in a vessel of wine, and boil for a day. When the medicine is thoroughly cooked, take it.

Another formula: Apply moxibustion, in sequence, to Baihui, Benshen, Chengjiang, Fengfu, Jianyu, Xinshu, Shouwuli, Shousuikong, Shoushaoyang, Zuwuli, Zusuikong, and Zuyangming, with five hundred cones at each point. Here, “moxibustion” means treatment with burning mugwort, and a “cone” is the unit used to measure moxibustion.

Formulas for treating severe wind disease and hemiplegia

Take two shi of silkworm droppings, steam them until hot, and divide them among three long bags, putting seven dou in each. While hot, place one bag on the affected area. When it cools, replace it with another, repeating this as often as needed until the illness is cured. Also take a sheep’s stomach and fill it with polished rice, scallions, ginger, pepper, and fermented black beans. Cook until tender and eat while hot, one stomach each day for ten consecutive days. The source calls this a formula “worth a thousand gold pieces, never to be passed on.”

Another formula: Steam the soil from a rat hole until hot, put it in a bag, and apply it as a hot compress. Stop once the illness is cured.

Ge Gen Decoction: Used to treat limpness and weakness in the limbs, bodily pain, difficulty moving, wind illness after childbirth, and fullness from Qi, among other conditions.

Take three liang each of kudzu root, peony, cinnamon bark, dried Rehmannia root, and Notopterygium root; two liang each of ephedra and licorice; and six liang of fresh ginger. Use three sheng of clear wine and five sheng of water to decoct the eight ingredients until three sheng remain. Take five he warm, three times a day.

Hemp Seed Decoction: Used to treat severe wind disease, as well as spasms throughout the body and limbs and wind invasion of the skin. The source does not yet give the formula’s ingredient details.

After physical exertion, forcibly taking this medicine will not make a person weak. It may also be used to treat mental dullness and confusion. The prescription is as follows:

Autumn-hemp seeds (harvested in autumn, three sheng; sort and clean them, then soak in water overnight), fangfeng, cinnamon bark (the bark of the cassia tree), fresh ginger, and gypsum (crush it and wrap it in a cotton cloth) (two liang of each of these four ingredients); mahuang (three liang); bamboo leaves and scallion whites (one handful of each); and fermented black beans (one he).

Chop all ten ingredients. First, boil the hemp seeds in two and a half dou of water until thoroughly cooked. Strain out the dregs and collect nine sheng of liquid. Boil the mahuang separately, bring it to a boil twice, and skim off the foam. Then add the remaining ingredients to the hemp-seed liquid and simmer until three sheng remain. Strain out the dregs. Divide into three doses and take on an empty stomach. After taking it, one should sweat lightly; once sweating begins, dust the body with powder. For very severe illness, take no more than three courses; for milder illness, one course should suffice for recovery.

For someone suffering from “great wind,” “thief wind,” or “stabbing wind”—ancient names for certain conditions attributed to pathogenic wind—add three liang of duhuo. According to old books, this prescription is roughly as potent as six or seven doses of Minor Continuation of Life Decoction.

Zhongjing’s Three-Yellow Decoction is used to treat contraction of the hands and feet after windstroke, pain throughout the joints, vexing heat, agitation of the spirit, and aversion to cold, when the illness has lasted many days and the person still has no desire to eat. The prescription is as follows:

Mahuang (thirty zhu), huangqin (eighteen zhu), huangqi and xixin (twelve zhu each), and duhuo (one liang).

Chop the five ingredients, simmer them in five sheng of water, and reduce the liquid to two sheng. Divide into two doses. One dose should induce light sweating; two doses will induce heavy sweating. If there is heat in the chest, add half a liang of da-huang. For abdominal distension and fullness, add six zhu of zhishi. For rebellious Qi, add eighteen zhu of ginseng. For palpitations, add eighteen zhu of oyster shell. For thirst, add eighteen zhu of trichosanthes fruit. If the person was already averse to cold, add one large aconite tuber. The text says this prescription was once kept secret and not shared.

White-bletilla and Coix Decoction is used to treat contraction of the limbs caused by pathogenic wind, making them unable to bend or straighten. The prescription is as follows:

White-bletilla, coix seed, peony, cinnamon bark, sour jujube seed, achyranthes, dried ginger, and licorice (one sheng of each), and three aconite tubers.

Chop the nine ingredients and soak them overnight in two dou of unfortified wine. Then simmer over low heat and bring to a boil three times. Take one sheng per dose, three times daily. After taking the medicine, the person may rise with the support of a staff and walk. If unable to drink wine, take five he per dose. The Qianjin Yifang records that this prescription also includes plantain seed.

Duhuo and Loranthus Decoction: Pain in the lower back and back is often caused by weakness of Kidney Qi, sleeping in a cold, damp place, or exposure to pathogenic wind. If not treated promptly, the pathogenic influence can readily move downward and flow into the feet and knees, becoming…

The title states that the following formula is suitable for early use in cases of partial paralysis, cold impediment, limbs that are slow and weak, pain and heaviness, or symptoms such as lower back pain, cramping in the legs and feet, and numbness and heaviness.

Take three liang of duhuo, two liang each of jisheng (replaced with xuduan in the Jingu Yan), duzhong, niuxi, xixin, qinjiao, fuling, guixin, fangfeng, chuanxiong, dried rehmannia, ginseng, licorice, danggui, and shaoyao—a total of fifteen ingredients—and cut them into pieces. Boil them in one dou of water until three sheng of liquid remain. Divide it into three warm doses, keep the body warm, and avoid getting chilled. People who are often weak and prone to diarrhea should omit the dried rehmannia.

Another treatment is to heat fresh leaves of shuodiao, a medicinal herb, over a fire and spread them thickly over a mat. Lie on them while they are hot; when they cool, heat them again. In winter, use the roots; in spring, use the stems. Boil them and lie on them for a better effect. Other parts of the plant may also be applied in a thin layer or used for hot compresses, but steaming the body with shuodiao is more effective. This method can also be used for rheumatic conditions elsewhere in the body.

Soon after childbirth, if a woman develops abdominal pain and cannot turn over, or has cramping pain in the lower back and legs, cannot bend or stretch, or suffers numbness and weakness, this decoction is also suitable. It is used to dispel Wind and regulate Qi and Blood. The formula recorded in the Zhouhou Fang adds one large aconite tuber and omits jisheng, ginseng, licorice, and danggui.

Chrysanthemum wine is used for men and women with lower back and back pain, poor appetite, weight loss, a poor complexion, and shortness of breath due to Wind-weakness and cold. Its purpose is to dispel Wind and cold and replenish deficiency.

Take one jin each of chrysanthemum and duzhong; four liang each of fangfeng, aconite, astragalus, dried ginger, guixin, danggui, and dendrobium; five liang each of purple fluorite and cistanche; eight liang each of bixiè, duhuo, and stalactite; and three liang of fuling—a total of fifteen ingredients. Cut them into pieces and steep them in seven dou of wine for five days. Take two he each time, three times a day, gradually increasing the dose to five he. The formula recorded in the Qianjin Yifang does not include dried ginger.

Duzhong wine is used for pain in the lower back and legs, difficulty moving about, and illnesses caused by Wind-weakness.

Take eight liang of duzhong, two liang of shinan, four liang of qianghuo, and five large aconite tubers. Cut them into pieces and steep them in one dou of wine for three nights. Take two he each time, twice a day. This formula is especially suitable for women with cold conditions.

The fifth section, “Wind-Fei,” discusses related illnesses, formulas, and moxibustion methods. It says that when Wind-Fei strikes, a person may suddenly become unable to speak, have the jaws clamped shut, and be unable to move the hands and feet…

“Stiffness” refers to rigid, constrained limbs. The treatment is to grind five sheng of Fulonggan (the earth from the heart of a stove) into a fine powder, mix it with eight sheng of cold water, and stir. Take the liquid from the top and drink it; it is best to finish the whole amount. The Zhouhou Fang records that this remedy is also used for agitation and disorientation, pain and distension in the abdomen, and even cases in which someone faints and then regains consciousness.

The nine prescriptions that follow are all for treating this kind of wind disorder. Consider them carefully and use them in sequence.

A medical treatise says: In treating this illness, one must understand the proper order of treatment and must not use decoctions indiscriminately. Inappropriate medication can mean missing the right moment for treatment. This may not only harm the patient but also cause the illness to become a chronic condition that is difficult to cure. After the illness begins, first take the three-ingredient Bamboo Sap Drink; it seems to be more helpful than ordinary medicines. Then take a decoction. For those with heat wind, it is especially important to begin with the Bamboo Sap Drink to clear heat toxins.

Bamboo Sap Decoction: Treats the inability to move the limbs, agitation and disorientation, confusion, and inability to speak.

Take two sheng of bamboo sap, one sheng of fresh kudzu juice, and three he of fresh ginger juice. Mix the three ingredients, warm the mixture, and divide it into three doses, taken in the morning, afternoon, and at night. After finishing the doses, if the limbs seem to have changed and the symptoms appear to be improving, continue with the next prescription.

For the next prescription, use one sheng of bamboo sap; five he of fresh kudzu juice; one liang each of Chuanxiong, Fangji, aconite, ginseng, peony, Scutellaria, licorice, and cassia bark; four liang of fresh ginger; three liang of antelope horn; six liang of gypsum; forty apricot kernels; and one and a half liang each of ephedra and Saposhnikovia. Cut the sixteen ingredients into pieces and decoct them in seven sheng of water. When the liquid has reduced by half, add the bamboo sap and continue decocting until two sheng and five he remain. Divide into three doses and take until perspiration occurs. After five days, take another dose, and continue until you have taken three doses. If the illness gradually lessens, continue with the next prescription.

For the following prescription, use three sheng of bamboo sap; two liang each of Saposhnikovia, Cimicifuga, antelope horn, Fangji, cassia bark, and Chuanxiong; and three liang of ephedra. Cut the eight ingredients into pieces, combine them with four sheng of water and the bamboo sap, and decoct until two sheng and five he remain. Divide into three doses. Take one dose every two days. In the usual preparation, it is best to add three liang of Angelica pubescens. This prescription is very effective and may be taken for three consecutive doses. If the hands and feet are cold, add five liang of fresh ginger and two liang of Atractylodes. If the illness has still not cleared, continue with the next prescription.

One sheng of bamboo sap (the liquid obtained by burning bamboo); licorice root (another text reads “gan gen”), two liang; ginseng, chuanxiong, duhuo, and cimicifuga, one liang each; fangfeng, ephedra, and peony root, one and a half liang each; fresh ginger, gypsum, antelope horn, fangji, cinnamon bark, scutellaria root, aconite (another text reads “forty apricot kernels”), and atractylodes, one liang each.

Chop the seventeen ingredients. Boil them in eight sheng of water until half remains, then add the bamboo sap and continue boiling. Strain off two and a half sheng and divide into three doses. Leave about as long as it takes a person to walk ten li between doses. If there are symptoms such as Qi deficiency, add one liang each of tangerine peel, achyranthes root, and five-flavor berry bark.

Anyone suffering from wind-related paralysis, in which wind pathogens cause limb numbness and difficulty moving, may take the decoction above. Once the condition improves, the following boiled powder can be taken regularly to dispel any remaining wind pathogens.

Fangfeng, fangji, duhuo, gentian root, astragalus, peony root, ginseng, atractylodes, poria with spirit, chuanxiong, polygala root, cimicifuga, dendrobium, achyranthes root, antelope horn, red sage root, licorice root, magnolia bark, asparagus root, five-flavor berry bark, and lycium root bark, one liang each; scutellaria root (the Qianjin Yifang reads “Chinese yam”) and cinnamon bark, one liang each (another account gives four liang each); dried rehmannia root, tangerine peel, fresh ginger, and ephedra, three liang each; betel nut (the Qianjin Yifang reads “licorice root”), ligusticum root (the Qianjin Yifang reads “aconite”), eucommia bark (the Qianjin Yifang reads “ophiopogon root”), and rhinoceros horn, two liang each (the Qianjin Yifang reads “cornelian cherry”); coix seed, one sheng; gypsum, six liang (another account gives three liang).

Pound the thirty-three ingredients and sift them into a coarse powder; mix thoroughly. For each dose, take three liang and boil in three sheng of water until one sheng remains. Strain through cotton to remove the dregs and drink the whole dose at once. After taking it, induce sweating. Take once a day. If you feel heat and unease in the chest, use bamboo sap instead of water to prepare the decoction.

Jing Sap Decoction: People with wind disorders often have considerable internal heat, so this formula is suitable for regular use.

Five ge each of jing-tree sap (the liquid obtained by burning the jing tree), bamboo sap, and fresh ginger juice. Mix the three ingredients, warm them, and drink the whole dose at once. Take the boiled powder in the morning and this decoction in the afternoon. Stop once the condition has settled and the patient has recovered.

Duhuo Boiled Powder: A formula for treating various forms of wind-related paralysis.

Eight liang of duhuo; chuanxiong, peony root, poria, fangfeng, fangji…

The ingredients in the preceding prescription are kudzu root, antelope horn, Chinese angelica, ginseng, cassia twig, dwarf lilyturf root, gypsum, magnetite, licorice, white atractylodes, and six others, making sixteen ingredients in all. Use six liang each of kudzu root, four liang each of gypsum and the other ingredients of that measure, ten liang of magnetite, three liang of licorice, and five liang of white atractylodes. Cut the sixteen ingredients into small pieces and divide them into twenty-four portions. For each portion, add fresh ginger, one sheng of sliced fresh rehmannia root, and fourteen apricot kernels. Boil in two sheng of water until seven he are left. It may be taken in the evening or at night, either once a day or every other day. There are no particular dietary restrictions.

Next is a prescription called “Five Tonifying Pills.” People with wind disorders who take decoctions often develop deficiency heat, with a faint warmth over the body, as light as a covering of feathers (“xi xiran”). A prescription to clear heat is suitable. Its ingredients are notopterygium root, ginseng, desert cistanche, dried rehmannia root, antelope horn, dwarf lilyturf root, and asparagus root, one and a half liang each; peony root, pubescent angelica root, dried ginger, white atractylodes, red sage root, Sichuan pepper, licorice, poria with hostwood, cimicifuga, astragalus root, sweet chrysanthemum flower, Chinese wolfberry root bark, dendrobium, achyranthes root, Siberian ginseng bark, and Chinese yam, thirty zhu each; large-leaved gentian, Sichuan lovage rhizome, cassia twig, fangji, powdered ginger, and scutellaria root, one liang each; aconite, eighteen zhu; gypsum, three liang; and glauberite, two liang. There are thirty-two ingredients in all. Grind them into a fine powder, mix with white honey, and form pills the size of Chinese parasol tree seeds. Take with a honey infusion of fresh ginger, twenty pills each time, three times a day, gradually increasing to thirty pills. Avoid greasy foods, wheat flour foods, garlic, raw or cold foods, vinegar, slippery foods, and pork, mutton, chicken, fish, and other meat.

Sun Simiao then comments: The ancients composed prescriptions by determining whether the root of an illness was cold or hot, and choosing the ingredients accordingly. People today, when faced with an acute illness, hastily leaf through a book, pick a prescription at random, and use it; as a result, it often has no effect. Anyone wishing to use a prescription should first determine whether the illness is cold or hot, then consult the appropriate formula. This approach never fails to be effective. The same applies to decoctions, pills, and powders. An attack of wind illness always results from an excess of heat; that is why cooling medicines such as bamboo sap and kudzu juice are used. Later scholars have not carefully understood the reasoning behind the prescriptions, so I have written this discussion in particular. He also says: Do not treat a patient unless there is a tightly enclosed, draft-free room for them. Even a healthy person can be struck by wind in a room that is not properly sealed, let alone a patient who is taking medicine.

Finally, another prescription is introduced to treat fengfei, a condition in which the body cannot move after a stroke, as well as inability to speak and loss of control over the hands and feet. First, measure the patient’s hand: take the distance from the web on the inner side of the little finger to its tip. Use this length as the standard for the measurements or treatment that follow.

Place the moxa cone on the navel, then measure upward to just below the chest and mark the upper point with cinnabar. Measure twice more. Align the three upper marks, leaving the lower end open and bringing the upper end together, so the shape resembles an upside-down “ム.” Use the left hand for a man’s measurements and the right hand for a woman’s. If the marks may be unclear, mark all three upper points with cinnabar. Apply moxibustion at all three points at the same time, using one hundred cones at each point, and the illness will be cured.

Here, “cone” is the unit used to count moxibustion, usually referring to one moxa cone burned to completion. The original describes a method for locating moxibustion points by measuring parts of the body.