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Jingui Yaolue · Essentials from the Golden Cabinet
2. Spasm, Dampness and Summerheat Injury · Pulses, Signs and Treatment
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Greater Yang illness with fever, no sweat and aversion to cold is named rigid spasm disorder.
Greater Yang illness with fever and sweating but no aversion to cold is named yielding spasm disorder.
Greater Yang illness with fever and a deep, fine pulse is named spasm disorder and is difficult to treat.
Excessive sweating induced in Greater Yang illness consequently produces spasm disorder.
In wind illness, purging causes spasm. Further induced sweating must cause cramping.
A person with sores must not have sweating induced even with bodily pain. Sweating causes spasm.
Body heat with cold feet, tense, stiff neck, aversion to cold, occasional head heat, red face and eyes, head alone shaking, sudden locked mouth and backward-arched back constitute spasm disorder. If sweating is induced, cold and dampness join; the exterior grows more deficient and aversion to cold worsens. After sweating the pulse is like a snake. A variant instead gives the unclear han word for the pulse.
Sudden, great abdominal distention means impending resolution. A pulse unchanged, or instead hidden and wiry, indicates spasm.
The spasm pulse feels tight as a string under pressure and travels straight up and down. A variant says pounding and wiry. The Pulse Classic says a person with spasm has a hidden, firm pulse traveling straight up and down.
Spasm disorder with moxibustion sores is difficult to treat.
Greater Yang illness with its signs complete, body stiff and stretched in a ji-ji manner, but pulse deep and slow, is spasm. Gualou Guizhi Tang governs it.
Gualou Guizhi Tang Formula
Gualou root 2 liang; Guizhi 3 liang; Shaoyao 3 liang; Gancao 2 liang; Shengjiang 3 liang; Dazao 12 fruits.
For these six ingredients, use 9 sheng water and boil to obtain 3 sheng. Divide into three warm doses to obtain slight sweating. If sweat does not emerge, after the time taken for a meal sip hot gruel to induce it.
Greater Yang illness without sweat, with urine instead scanty, qi rushing upward into the chest and mouth locked so speech is impossible, is about to become rigid spasm. Gegen Tang governs it.
Gegen Tang Formula
Gegen 4 liang; Mahuang 3 liang, joints removed; Guizhi 2 liang, bark removed; Shaoyao 2 liang; Gancao 2 liang, roasted; Shengjiang 3 liang, sliced; Dazao 12 fruits, split.
Coarsely pound and cut the seven ingredients. With 1 dou water first boil Mahuang and Gegen, reducing by 2 sheng. Remove foam, add the other medicinals and boil to obtain 3 sheng. Strain. Take 1 sheng warm and cover to obtain the slightest sweat. No gruel is needed. Other aftercare and prohibitions follow the Guizhi Tang method.
In spasm disorder—a version places rigid before spasm—chest fullness, locked mouth, inability to lie upon the mat, contracted feet and grinding teeth permit Dachengqi Tang.
Dachengqi Tang Formula
Dahuang 4 liang, washed with wine; Houpo half a jin, roasted and bark removed; Zhishi 5 fruits; Mangxiao 3 he.
For these four ingredients, use 1 dou water. First boil Zhishi and Houpo to obtain 5 sheng and strain. Add Dahuang, boil to obtain 2 sheng and strain. Add Mangxiao and return to low heat for one or two boils. Divide into two warm doses. Once bowel movement is obtained, stop taking it.
Greater Yang illness with painful joints and vexation, deep and fine pulse—a variant says relaxed—is named damp impediment. The Jade Case calls it being struck by dampness. Its signs are difficult urination but stool instead passing freely. Only urination should be promoted.
In the illness of a person affected by dampness, the whole body aches—a variant says aches and is vexed. There is fever, the body colored as if smoke-yellowed.
A person affected by dampness sweats only at the head, has a stiff back and wants blankets and to face the fire. Early purging causes hiccups, or chest fullness and difficult urination; a variant says free urination. A coating-like tongue comes from heat in the elixir field and cold above the chest. Thirst with desire to drink but inability to do so gives dry mouth and vexation.
After a dampness patient is purged, sweating on the forehead, slight panting and free urination mean death; a variant reads difficult urination. Unceasing diarrhea also means death.
Wind and dampness contend, the whole body aches, and by the method sweating should resolve it. In unending overcast rain, a physician induces sweat, yet the illness does not recover. Why? Profuse sweating removes only wind qi while dampness remains. For wind-dampness, induce only the faintest suggestion of sweat; then both leave.
A dampness patient has body pain and fever, yellow face, panting, headache, blocked nose and vexation, with a large pulse. They can eat and drink, the abdomen harmonious and without illness. The illness is cold-dampness in the head, hence nasal blockage. Putting medicine into the nose brings recovery. The Pulse Classic instead has the patient panting and lacks the eleven characters from the opening dampness-patient phrase through panting.
For bodily vexation and pain in dampness illness, Mahuang Jia Zhu Tang may suitably induce sweating. Take care not to attack with fire.
Mahuang Jia Zhu Tang Formula
Mahuang 3 liang, joints removed; Guizhi 2 liang, bark removed; Gancao 2 liang, roasted; Xingren 70 kernels, skins and tips removed; Baizhu 4 liang.
For the five ingredients, use 9 sheng water. First boil Mahuang, reducing by 2 sheng, and remove surface foam. Add the other medicinals; boil to obtain 2.5 sheng and strain. Take 8 he warm and cover to obtain the faintest sweat.
Whole-body pain and fever worsening around late afternoon are named wind-dampness. This arises from meeting wind while sweating or prolonged harm from seeking cold. Mahuang Xingren Yiyi Gancao Tang may be given.
Mahuang Xingren Yiyi Gancao Tang Formula
Mahuang half a liang, joints removed and scalded; Gancao 1 liang, roasted; Yiyiren half a liang; Xingren 10 kernels, skins and tips removed, fried.
Chop to the size of hemp seeds or beans. For each dose use 4 qianbi, with 1.5 zhan water; boil to eight tenths of a zhan, strain and take warm. There should be slight sweat; avoid wind.
Wind-dampness with floating pulse, heavy body, sweating and aversion to wind is governed by Fangji Huangqi Tang.
Fangji Huangqi Tang Formula
Fangji 1 liang; Gancao half a liang, fried; Baizhu 7.5 qian; Huangqi 1 liang and 1 fen, reed-like base removed.
Chop to hemp-seed or bean size. Scoop 5 qianbi per dose, add Shengjiang 4 slices, Dazao 1 fruit and water 1.5 zhan. Boil to eight tenths of a zhan, strain and take warm; after a considerable interval take another dose. For panting add Mahuang half a liang; Stomach disharmony Shaoyao 3 fen; qi rushing upward Guizhi 3 fen; longstanding cold below Xixin 3 fen. After taking it, the skin should feel as if insects move within, and below the waist like ice. Then sit upon a quilt and wrap another below the waist, warming to slight sweat. The text says recovery follows.
Cold damage for eight or nine days, wind and dampness contending, body aching and vexed so the patient cannot turn unaided, no vomiting or thirst, pulse floating, deficient and rough: Guizhi Fuzi Tang governs. If stool is hard but urine passes freely, remove Guizhi and add Baizhu; that decoction governs.
Guizhi Fuzi Tang Formula
Guizhi 4 liang, bark removed; Shengjiang 3 liang, sliced; Fuzi 3 pieces, heat-processed, peeled and broken into eight pieces; Gancao 2 liang, roasted; Dazao 12 fruits, split.
Boil the five ingredients in 6 sheng water to obtain 2 sheng, strain and divide into three warm doses.
Baizhu Fuzi Tang Formula
Baizhu 2 liang; Fuzi 1.5 pieces, heat-processed and peeled; Gancao 1 liang, roasted; Shengjiang 1.5 liang, sliced; Dazao 6 fruits, split.
Boil the five ingredients in 3 sheng water to obtain 1 sheng. Strain and divide into three warm doses. After the first dose the body feels impeded; around half a day later take another, until all three are finished. If the person seems clouded, do not be surprised, the source says: Zhu and Fuzi both move in the skin to expel Water qi not yet removed.
Wind and dampness contending, joints painfully vexed and pulling, unable to bend or extend, pain worse upon approach, sweating, short qi, difficult urination, aversion to wind with reluctance to remove clothes, or slight swelling: Gancao Fuzi Tang governs.
Gancao Fuzi Tang Formula
Gancao 2 liang, roasted; Baizhu 2 liang; Fuzi 2 pieces, heat-processed and peeled; Guizhi 4 liang, bark removed.
Boil the four ingredients in 6 sheng water to obtain 3 sheng and strain. Take 1 sheng warm, three times daily. Slight sweat after the first dose resolves the disorder. If able to eat but sweat is followed by vexation, take 5 he. If 1 sheng seems too much, 6 or 7 he is best.
Greater Yang summerheat injury gives fever, aversion to cold, body heaviness and pain, pulse wiry, fine, hollow and slow. After urinating, shivering raises the hairs; hands and feet are reversely cold. Slight exertion heats the body; mouth opens and front incisors are dry. Induced sweating worsens aversion to cold; warm needling worsens fever; repeated purging worsens strangury.
Greater Yang struck by heat is summerheat injury. Sweating, aversion to cold, body heat and thirst are governed by Baihu Jia Renshen Tang.
Baihu Jia Renshen Tang Formula
Zhimu 6 liang; Shigao 1 jin, crushed; Gancao 2 liang; Jingmi 6 he; Renshen 3 liang.
Boil the five ingredients in 1 dou water until the rice is cooked and the decoction formed. Strain; take 1 sheng warm three times daily.
Greater Yang summerheat injury with body heat, pain and heaviness but a faint, weak pulse is caused by cold water injury in summer, Water moving within the skin. Yiwu Guadi Tang governs.
Yiwu Guadi Tang Formula
Guadi 20 pieces.
Chop, boil with 1 sheng water to obtain 5 he, strain and take as one dose.
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