《孫真人備急千金要方》Vol. 28

Sun Simiao’s Essential Formulas Worth a Thousand Gold Pieces (Beiji Qianjin Yaofang), Volume 28, discusses treatments for various wind disorders.

Wind-Related Loss of Speech, Section Six: Discussion, Formulas, and Acupuncture Methods

Duhuo Decoction: Treats wind-related disorders that affect the mind and speech. Symptoms include inability to speak, weakness in the limbs, and hands and feet that feel limp and drag along.

Formula: four liang of duhuo; two liang each of cinnamon bark, peony, trichosanthes root, and fresh kudzu root; six liang of fresh ginger; and three liang of licorice.

Chop the seven ingredients. Boil them in five sheng of water until three sheng of liquid remain. Divide into three doses and take them over the course of the day.

The original text explains that the Spleen channel connects with the stomach, runs alongside the throat to the base of the tongue, and also spreads beneath the tongue. A branch of the Heart channel likewise reaches the tongue’s base. When wind invades the Heart and Spleen, the tongue becomes stiff, making speech impossible.

Formula for locked jaws and inability to speak after windstroke:

Formula: two liang each of fangji, cinnamon bark, and ephedra; three liang of kudzu root; one liang each of licorice, saposhnikovia root, and peony; and four liang of fresh ginger.

Chop the eight ingredients. Boil them in six sheng of water until two and a half sheng remain, then divide into three doses. This formula may also be used for hoarseness and inability to speak.

Shinan Decoction: Treats various wind disorders. The symptoms described in the original include wind moving through the skin, causing a sensation like insects crawling; stiffness in the lower back and spine; limbs that are either limp and weak or tense and cramped; subtle skin eruptions that become sores when scratched; and sudden itching, swelling of the face and eyes, inability to raise the arms, locked jaws, and inability to speak.

Formula: one liang each of shinan, dried ginger, scutellaria, asarum, and ginseng; one and a half liang each of cinnamon bark, ephedra, Chinese angelica, and chuanxiong; two liang of licorice; eighteen zhu of dried rehmannia; and thirty zhu of Sichuan pepper.

Chop the twelve ingredients. Boil them in six sheng of water and three sheng of wine until three sheng of liquid remain, then divide into three doses. The original says that profuse sweating may follow; there is no need to be alarmed.

Formula for locked jaws and loss of consciousness after windstroke:

Formula: one sheng of mustard seed and three sheng of vinegar.

Cook the two ingredients together until one sheng remains. Wrap the mixture in cloth and apply it to the head once daily. The Zhouhou Beiji Fang records that this method is also used for sudden inability to speak.

Fermented soybeans (five sheng) and Sichuan pepper (one sheng).

Add seven sheng of water to these two ingredients and boil until three sheng remain. Take the decoction slowly in divided doses. The Handy Recipes for Emergencies (Zhouhou Fang) uses this prescription to treat loss of speech.

Another prescription: Boil four liang of atractylodes rhizome in three sheng of wine until one sheng remains, then take it all at once.

Another prescription: Take one sheng of juice from the chaste tree.

Another prescription: Take one sheng of juice from pale bamboo.

Acupuncture and Moxibustion

For a sudden stroke with the jaws clenched and the mouth unable to open, apply moxibustion to the two “Guanshu” points (called Jiache in the Supplement to the Thousand Gold Pieces Prescriptions, Qianjin Yifang). The points lie eight fen below the ears, slightly toward the front. Apply five cones of moxa to each point (each cone refers to one burning of a moxa cone), and speech will return. Afterward, one may apply one cone for each year of the person’s age. If the mouth and eyes are crooked, apply moxibustion on the affected side.

For loss of voice and inability to speak after a stroke, or slow speech accompanied by limp limbs that will not obey, first apply fifty cones of moxa to the Tianchuang point. Once the moxa has gone out, apply fifty cones to Baihui. After finishing, return to Tianchuang and apply another fifty cones.

If Baihui is treated first when the illness has just begun, the pathogenic wind may fail to disperse and instead penetrate inward into the five viscera, making the person prone to fainting and collapse, with continued loss of voice. It is therefore better to treat Tianchuang first, then Baihui. Apply fifty cones at each point for a thorough treatment, then add more according to the severity of the condition. In severe cases, as many as three hundred cones may be applied to one point, with marked effect.

If a person’s condition worsens after taking medicine for stroke, moxibustion may be applied to all points associated with wind disorders, using three cones at each point. The text says that all will recover, and that the effect is wondrous and certain, beyond doubt. But unless one can act with focused care, one should not apply large amounts of moxa casually.

Discussion

When pathogenic wind and cold enter the body and remain lodged without dispersing, they can cause loss of voice and inability to speak. A swollen or obstructed throat and a hoarse voice are also caused by pathogenic wind. Since wind entering the viscera can threaten life, these treatments are included after the prescriptions for treating wind disorders.

If a person lies unconscious as though dead, but the pulse remains as usual, this is caused by the Yang pulse sinking, the Yin pulse rising, and the flow of Qi becoming obstructed. One may needle Baihui to a depth of three fen and use the reinforcing method, then warm the areas beneath both flanks with a heated iron. One may also scrape black soot from above the stove opening, shape it into a pellet the size of a marble, and take it with rice-washing water.

Another option is to needle the tip of the middle toe, beside the edge of the nail, at a point about as wide as a leek leaf. One may also needle beneath the nail of the big toe, on the inner side, three fen from the nail.

Cinnamon Decoction for Sudden Loss of Voice

Boil cinnamon twigs down to a concentrated juice. Take one sheng, then cover the body with bedding to induce sweating. Alternatively, place ground cinnamon beneath the tongue and slowly swallow the medicinal liquid.

Another prescription: Boil soybeans down to a concentrated juice and hold it in the mouth; this is also effective. If soybeans are unavailable, fermented soybeans may be used instead.

Prescription for Sudden Inability to Speak

Mix five ge of wine with half a fen of human breast milk and take in two divided doses.

Discussion: Twitching eyelids and a crooked mouth are signs that pathogenic Wind has invaded the channels and caused them to contract. The patient may be given Xuming Decoction or Aconite Powder, and the affected area may be rubbed with Shenming Ointment or Salvia Ointment. Moxibustion may also be applied to the corresponding acupuncture points, warming them with burning mugwort.

A blocked throat and a sluggish tongue are also conditions of this kind. When pathogenic Wind invades the internal organs, it may cause loss of voice or even sudden unconsciousness. Other possible symptoms include the mouth and eyes being pulled to one side, locked jaws, inability to move the tongue, and a crooked face. Mix Fulonggan Powder with cockscomb blood and turtle blood, then apply it to the affected area. Reapply when it dries. At the same time, apply moxibustion to the horizontal crease at the corner of the mouth, where the red and white parts meet. On each side, use a number of moxa cones corresponding to the patient’s age; one cone counts as one unit once it has burned down. Repeat this treatment three times. If the patient has not recovered after three days, apply moxibustion once more.

Aconite Powder: Used for numbness and loss of sensation in the arms, and a crooked mouth and face, after Windstroke.

Five liang each of aconite and cinnamon bark; six liang each of asarum, fangfeng, ginseng, and dried ginger.

Grind the six ingredients into a fine powder. Take one square-inch spoonful, an ancient measure for medicinal powders, with wine three times a day, gradually increasing the dose.

Licorice Decoction: Used for long-standing hemiplegic Wind that has not healed, with wasting of the hands and feet, a crooked face and mouth, mental unrest, and confused speech.

Two liang each of licorice, cinnamon bark, chuanxiong, ephedra, angelica, peony, and ginseng; two aconite tubers and two lateral aconite tubers; three liang each of duhuo and fangji; four liang each of fresh ginger, gypsum, and fushen; one liang each of atractylodes, scutellaria, and asarum; qinjiao; one and a half liang of fangfeng; one sheng of chrysanthemum; and four sheng of diluted bamboo sap.

Coarsely chop the twenty-one ingredients. First boil the ephedra in one dou of water, skim off the foam, and reduce the liquid to seven sheng. Add the bamboo sap and the remaining ingredients, then boil down to three sheng. Divide into four doses. After taking three doses, wait as long as it takes to eat a bowl of congee, then take the last dose. Wait for the medicine to take effect; the body will sweat naturally. While taking it, avoid cold and raw foods, as well as vinegar, garlic, wheat-based foods, dairy products, and fish.

Another prescription: Used for the face and eyes being pulled to one side after Windstroke, with the mouth crooked toward one side and drawn close to the ear, locked jaws, and inability to move the tongue.

Three liang of duhuo; one sheng each of fresh rehmannia juice and bamboo sap.

Boil the three ingredients together until reduced to one sheng, and take as a single dose.

Another prescription

Grind equal amounts of oyster shell, alum, aconite, and yellow earth from beneath a stove into powder. Mix the powder with blood from the comb of a three-year-old domestic rooster and apply it to the affected area. Watch the patient’s face in a mirror. As soon as it begins to return to its normal appearance, wash the medicine off immediately.

If it is not treated promptly, the pathogenic influence will worsen, and later the condition will be beyond remedy. (The Qianjin Yifang says: for a tilt to the right, apply the medicine on the left; for a tilt to the left, apply it on the right.)

Another prescription

Three sheng of bamboo sap; two liang each of fangfeng, fangji, shengma, guixin, and chuanxiong; four liang of mahuang; and three liang of lingyang horn.

Cut the eight ingredients into pieces. Boil them in four sheng of water together with the bamboo sap until one and a half sheng remains. Divide into three doses and take one dose each time. Take one batch per day; this is often effective.

Another prescription

Take one jin of green pine needles and pound them until they release their juice. Soak them in one dou of clear wine for two nights, then leave the mixture near a fire overnight. Take half a sheng the first time, then gradually increase the dose to one sheng. Stop taking it once the head and face begin to sweat.

Another prescription

Boil cinnamon bark in wine and use the liquid to soak an old piece of cloth, then apply it to the affected area. If the patient’s face tilts to the left, apply it on the right; if it tilts to the right, apply it on the left. This is a secret prescription, not to be passed on. I use it often, and it works very well.

Prescription for deviation of the mouth and ear

Two liang each of fangfeng, fuzi, and gegen; three liang each of baishi and mahuang; four liang each of duhuo and ginger; and thirty almonds.

Cut the eight ingredients into pieces. Boil them in one dou of water and two sheng of wine until three sheng remain. Divide into four doses.

Prescription for sudden windstroke with deviation of the mouth

Take a piece of kongqing powder about the size of a bean and hold it in the mouth. The condition will then be cured.

Another prescription

Roast three sheng of soybeans until scorched. Pour three sheng of wine over them to extract the medicinal liquid, and take the whole amount at once. (The Zhouhou Fang uses this to treat locked jaws and inability to open the mouth.)

Another prescription

Take one liang of large zhaojia, remove the skin and seeds, and grind it into a fine powder. Mix it with three-year-old vinegar. If the face tilts to the left, apply it on the right; if it tilts to the right, apply it on the left. Reapply when it dries.

Another prescription

Take a reed tube five cun long. Insert one end into the ear canal and seal around it with dough so no air can escape. Place a soybean in the other end, add burning mugwort, and apply seven moxa cones; this will cure the condition. For an ailment on the right side, apply moxibustion to the left ear; for one on the left, apply it to the right ear. This is a secret method from the Qianjin Fang, not to be passed on. This method can also be used to treat ear ailments.

Another prescription

Apply three moxa cones at the crossing of the wrist vessels. For an ailment on the left side, apply moxibustion to the right hand; for one on the right, apply it to the left hand. Make each moxa cone the size of mouse droppings and lay it crosswise over the point, then light both ends.

Zhiru wine: for various conditions that other medicines cannot cure

Scrape the green outer layer from the surface of a zhishi fruit, scraping down almost to the woody core, and take five sheng of the scraped material. Fry it over a low flame to remove the moisture, then soak it in one dou of wine and warm it over a low flame…

Once the medicines have been prepared, take them according to the individual’s condition. They are highly effective for symptoms such as a crooked mouth and eyes or tight, contracted eyelids, and are also very good for treating mild or severe wind disorders. The Zhouhou Fang says this prescription can be used for stiffness of the body, inability to bend or stretch, and recurrent attacks. The bark of the Zhi tree may also be used.

Seventh: Prescription for opisthotonos

A prescription for sudden hemiplegia, tightness in the hands and feet that prevents bending or stretching, and a feeling of cold in the body. The patient may be conscious or confused; the body may be rigid and speech impossible, or the patient may seem at one moment alive and at another as if dead. There may also be delirious speech and symptoms that are difficult to describe. This prescription can also treat opisthotonos, in which the body bends backward like a bow, whether or not the patient wants to eat, and inability to pass urine or stool. It appears in the Gu Jin Lu Yan under the name “Eight Winds Life-Restoring Decoction.”

Ginseng, cinnamon heartwood, Chinese angelica, Asian tearthumb, Scutellaria root, dried ginger, and licorice, eighteen zhu each; gypsum, one and a half liang; apricot kernels, forty.

Cut the nine ingredients into pieces. Boil them in nine sheng of well water drawn at dawn, reducing the liquid to three sheng. Divide into three doses and take two doses a day. After taking a dose, cover the patient with bedding to induce sweating. If there is no sweating, prepare the medicine again, add five liang of ephedra, and take it.

Cang Gong’s Chinese Angelica Decoction

For locked jaws, opisthotonos, and convulsions caused by “thief wind,” an ancient term for illnesses brought on by sudden invasion of wind.

Chinese angelica and wind-protecting root, eighteen zhu each; Asian tearthumb, one and a half liang; aconite, one; asarum, half a liang; ephedra, thirty zhu.

Cut the six ingredients into pieces. Boil them in five dou of wine and three sheng of water, reducing the liquid to three sheng. Take one sheng at a time. If the mouth cannot be opened, pry it open and pour in the medicine. After one dose, the patient should regain consciousness; after two, sweat should appear lightly; after three, the patient should sweat heavily.

Another prescription: Boil one dou of wine with two jin of donkey-hide gelatin. Once the gelatin has melted, continue boiling until six sheng remain. Take one sheng at a time, gradually, until the illness is cured.

Another prescription: Taking only Jing tree sap is also effective.

Gentiana Macrophylla Powder

For hemiplegia, disordered speech, moods that shift between joy and sorrow, opisthotonos, and wind-related itching of the skin.

Gentiana macrophylla, Asian tearthumb, milkvetch root, ginseng, and wild chrysanthemum flowers, two liang each; Inula japonica, eighteen zhu; wind-protecting root, dendrobium, Cornus fruit, and cinnamon heartwood, one and a half liang each; aconite, Szechuan lovage, asarum, Chinese angelica, schisandra fruit, licorice, white atractylodes, dried ginger, and ephedra.

The notes in parentheses record differences in the ingredients among other versions: in the Hu Qia Fang, Asian tearthumb is replaced by monkshood, wild chrysanthemum flowers by Sichuan pepper, Inula japonica by Inula herb, dendrobium by Dioscorea hypoglauca, and Szechuan lovage by balloon flower root. The original text ends here and does not record the remaining dosages or instructions for preparing and taking Gentiana Macrophylla Powder.

White root bark, Tianxiong, and Yuanzhi, one liang each (the formula used by Hu Qia replaces Yuanzhi with Fangji); also Baixian, thirty zhu (the formula used by Hu Qia replaces White root bark with Baixian), thirty zhu each. Grind the twenty-two ingredients into a coarse powder and sift. Take with wine, one square-inch spoonful at a time (the capacity of a small ancient medicinal spoon), twice daily, gradually increasing to two spoonfuls each time. It is also said that this formula treats wind disorders regardless of how long they have been present, and has a tonic effect as well.

Wu Qinjiao Powder: Treats disorders caused by wind entering the limbs and spreading through all the hundred vessels. Symptoms may include swelling of the body; limbs drawn tight like a horn bow in opisthotonus, with the hands and feet extended; soreness and discomfort; an itching, numb sensation as though insects were crawling over the skin; pain throughout the body; loss of the eyebrows; deafness; palpitations, chest oppression, shortness of breath, and mental unease; dampness and itching in the genital area; blood in the stool; dark yellow urine; and the various disorders known as the Five Taxations and Seven Injuries.

Qinjiao, Sichuan pepper, ginseng, Poria, oyster shell, Asarum, Trichosanthes root, and ephedra, eighteen zhu each; dried ginger, aconite, Atractylodes, Platycodon, cinnamon bark, pubescent angelica, and Chinese angelica, one liang each; Scutellaria, bupleurum, achyranthes, Tianxiong, Shinan, Eucommia bark, Manshu, and aconite, half a liang each; licorice, Chuanxiong, and Saposhnikovia, one and a half liang each.

Grind the twenty-six ingredients into a coarse powder, sift, and place it in a medicine pouch woven from reed. Before meals, take one square-inch spoonful with one sheng of warm wine, three times daily. After taking the medicine, walk briskly for seven hundred steps, then drink another sheng of wine. Follow the usual dietary and medicinal prohibitions.

Chapter Eight: Wind Bi

Discussion: How does blood Bi arise? The master replied: People of high status who live in comfort often have weak bones and well-developed muscles. After exertion, they sweat; when they lie down, they fail to move their bodies in good time and are then exposed to a slight wind pathogen. This produces illness. Its outward signs resemble those of a wind disorder (the Origins and Symptoms of Diseases says the symptoms are like being brushed by a gentle breeze), but the pulse itself is faint and choppy: the choppy quality appears at the cun position, while the pulse at the guan position is tight. Needling is appropriate to guide Yang Qi and bring the pulse into harmony. Once the tightness subsides, the illness improves.

Formula for treating wind-dampness with a floating pulse, heaviness of the body, sweating, and aversion to wind:

Licorice, two liang; Astragalus, five liang; Han Fangji, four liang; ginger and Atractylodes, three liang each; twelve jujubes.

Cut the six ingredients into pieces, add six sheng of water, and boil down to three sheng. Divide into three doses. After taking the medicine, sit wrapped in a blanket. If you feel as though insects are crawling beneath the skin, lie down and induce sweating.

Iron Essence Decoction: Used to treat counterflow in the three Yin and three Yang channels, an excess of internal cold, and conditions such as distension and fullness in the chest and flanks.

Speech is impossible. The breath feels congested in the chest; the shoulders rise and fall rapidly, and the limbs alternate between cold and hot. The illness repeatedly changes and returns.

Formula for deficiency and debility with wheezing, palpitations, agitation, shortness of breath and shallow breathing, and a weak, wavering voice when speaking:

Thirty jin of yellow iron. Wash it with eight dou of flowing water, lifting and agitating it three thousand times. Three liang of ginseng. Separately, take fifty jin of charcoal. Heat the iron until red-hot and plunge it into cold water; heat it again and plunge it into cold water once more. Repeat this seven times. When the water has settled and cleared, take two dou of the liquid and use it to decoct the medicines.

One sheng each of pinellia and dwarf lilyturf tuber; four liang each of baiwei, baical skullcap root, licorice, and peony; five liang of gypsum; two liang of fresh ginger; and twenty jujubes.

Cut the ten ingredients above into pieces, put them into the iron liquid prepared earlier, and decoct until six sheng remain. Take one sheng per dose, three times a day, finishing the preparation in two days.

Astragalus Decoction: Treats blood impediment (obstructed movement of Qi and blood, causing numbness and loss of sensation). The pulse shows weakness in both Yin and Yang: the cun and guan pulses are faint and weak, while the chi pulse is slightly tight. The outward symptom is numbness and loss of sensation throughout the body, as if affected by wind.

Two liang each of Sichuan astragalus, ginseng (this ingredient is absent from the Jingui Yaolue), peony, and cassia bark; six liang of fresh ginger; and twelve jujubes.

Cut the six ingredients above into pieces. Add six sheng of water and decoct until two sheng remain. Take seven ge per dose, three times a day, until finished.

For wandering wind: Swellings caused by wind pathogens that move unpredictably. The swelling may at times be as large as a plate or a basin, and may appear on the abdomen, back, arms, or legs. This formula can be used for all such cases.

Three liang each of seaweed, poria, saposhnikovia root, pubescent angelica root, aconite, and atractylodes rhizome; five liang of rhubarb; two liang each of Chinese angelica (another version reads “danglu”) and winged euonymus twig.

Cut the nine ingredients above into pieces and soak them in two dou of wine for five days. Take two he at first, then gradually increase the dose until it feels suitable.

White-Rooted Rhizome Powder: Treats wind impediment (numbness and pain in the limbs and related symptoms caused by wind pathogens), with swelling and tightness of the sinews and vessels; the symptoms shift from one part of the body to another.

Half a liang of white-rooted rhizome and six zhu of aconite.

Grind the two ingredients into a fine powder. Take half a daogui measure with wine, three times a day. If it has no effect, increase the dose to one daogui measure. A feeling of internal warmth and the medicine’s effects beginning to circulate are signs that it is working. After ten days, its effects should become noticeable.

The “Great Change Formula” for wandering wind impediment: This type of illness is called blood impediment.

Two liang each of tokoro rhizome, Chinese yam, achyranthes root, and water plantain rhizome; half a liang each of kochia seed and atractylodes rhizome; dry lacquer, grub, and pubescent angelica root.

The source ends here; it gives neither the doses for these medicines nor instructions for subsequent decoction and administration.

Plantain seed and Tianxiong (a poisonous medicinal herb related to aconite), ten zhu each; Yinyu (a poisonous medicinal herb), six zhu; Asiatic cornelian cherry, thirty zhu; and dried Rehmannia root, two and a half liang.

Grind all fourteen ingredients into a fine powder, mix with honey, and form pills the size of parasol tree seeds. Take ten pills with wine three times a day, gradually increasing the dose.

A formula for treating various wind-related impediment disorders

Fangfeng, licorice, skullcap root, cinnamon heart (the inner bark of cinnamon), Chinese angelica, and poria, one liang each; large-leaved gentian and kudzu root, two liang each; fresh ginger, five liang; thirty jujubes; and fifty apricot kernels.

Cut up all eleven ingredients. Boil them in four sheng each of wine and water until the liquid is reduced to three sheng. Divide it into three doses and drink until sweating occurs.

Aconite wine: A formula for treating severe wind disorders, cold phlegm, abdominal masses and distention, and various impediment disorders

One large aconite tuber weighing two liang (some accounts say two tubers), and five sheng of wine. Soak for five days. Take one he each time, twice a day, until the illness is cured.

Hemp-seed wine: A formula for treating chronic debility and various illnesses, cold damage, wind-dampness, and, in women, vaginal discharge, irregular menstruation, and pain or numbness in the hands and feet, even to the point of being bedridden

One dan of hemp seeds and one dou of wine starter.

First pound the hemp seeds into powder. Add two shi of water to a pot and steam the hemp seeds until thoroughly cooked. Then steam and cook one shi of rice and remove it. Following the usual method of home brewing, ferment the rice with the hemp-seed residue and its liquid. Once the wine has fermented, strain off the clear wine and drink according to individual needs.