bubble_chart Concept

Paralysis, also known as "tan yu," refers to the weakness and flaccidity of the limbs, with muscles that are loose and unable to contract, making movement difficult or completely impossible. The "Shengji Xilu" states: "Tan refers to a state of lethargy and inability to gather strength, while huan refers to a state of looseness and inability to control objects. Therefore, the condition where the limbs cannot be lifted, the tendons and joints are weak, and there is no ability to support oneself is called tan. If the limbs can still move, but the joints are weak and rely on external force to function, it is called huan. Some also refer to the left side as tan and the right side as huan."

The terms "inability to use the limbs," "inability to lift the limbs," "feet unable to gather," "drooping and dragging," and "atrophy-flaccidity" found in ancient medical texts all fall within the scope of this condition.

Additionally, "hemiplegia" and "half-body paralysis" refer to paralysis on one side of the body and are discussed in separate sections.

bubble_chart Pattern Analysis

1. Injury of Lung and Stomach Fluid︰During the external-contraction fever phase or after fever, there may be weakness and flaccidity in the upper or lower limbs, inability to grasp objects with the hands, inability to bear weight on the feet, or even paralysis, gradually leading to muscle wasting, dry skin, heart vexation and thirst, coughing with scant phlegm, feverish feeling in palms and soles, reddened cheeks, dry throat and lips, short and reddish urine with heat and pain, a red tongue with scant fluids, yellow coating, and a fine rapid pulse. This is mostly caused by warm febrile disease pathogens. When warm febrile disease pathogens invade the lungs, or residual heat remains unresolved after illness, lung heat scorches and burns. Suwen.Wei Lun states: "When lung heat scorches the lobes, the skin and hair become weak, tense, and thin; if this persists, atrophy-flaccidity arises." Zhang Zi-he also said: "Generally, flaccidity disorders are all caused by invading heat." Warm febrile disease pathogens most easily deplete and damage fluids. The lungs connect with all vessels and are delicate organs, while the stomach is the sea of water and grain and the source of body fluids. When pathogenic heat lodges in the lungs and stomach, the middle energizer's source of transformation becomes insufficient, the upper energizer cannot diffuse and disperse, the hundred vessels become empty, and the muscles and sinews lose nourishment, leading to paralysis of the hands and feet.
2. Liver-kidney Yin Deficiency︰The disease tends to progress slowly, gradually affecting the lower or upper limbs, leading to wilting impediment, weakness, and inability to use the limbs, along with soreness and weakness in the lower back and spine that makes it difficult to lift. Over time, the muscles and bones may become emaciated, occasionally accompanied by numbness, spasms, muscular twitching, dizziness, tinnitus, blurred vision, seminal emission, premature ejaculation, tidal fever, night sweats, flushed cheeks, low-grade fever, dry throat, scanty urine, dry stools, a deep red tongue with scant moisture, and a wiry, thin, and rapid pulse. The main manifestations include soreness in the lower back and weakness in the legs, dizziness, blurred vision, tinnitus, seminal emission, numbness, and muscular twitching, combined with symptoms of yin deficiency with internal heat, such as flushed cheeks, dry lips, low-grade fever, night sweats, vexing heat in the chest, palms, and soles, a red tongue with scant moisture and little coating, and a wiry, thin, rapid, and weak pulse. Although both conditions exhibit signs of insufficient yin and fluids, their pathogenic factors differ. This condition arises from internal damage, with clinical manifestations primarily characterized by deficient heat. The treatment should focus on nourishing water to moisten wood and fostering yin to clear heat, using the Modified Anemarrhena, Phelloendron and Rehmannia Pill. For prolonged cases with dual deficiency of yin and yang, the Hidden Tiger Pill should be used as the primary formula with modifications.
3. Dampness-heat︰Weakness or wilting of the limbs or lower extremities, even paralysis, burning sensation in the limbs relieved slightly by cooling, hidden fever, epigastric fullness and anorexia, sallow complexion with bodily fatigue, head feeling wrapped, puffy and dull facial appearance, dry and bitter sticky mouth, reddish and painful urination with heat sensation, red tongue with yellow greasy coating, soggy and rapid or slippery and rapid pulse. Manifestations of dampness-heat symptoms (hidden fever, puffy and dull facial appearance, sticky yet dry mouth, limb fatigue, epigastric fullness, anorexia, enlarged tongue with yellow greasy coating, mostly soggy and rapid or slippery and rapid pulse); treatment should focus on Two Wonderful Herbs Powder with additions to clear heat and dry dampness, harmonize the nutrient aspect, and unblock the collaterals.
4. Cold-dampness Infiltration︰Facial edema or puffiness with a dull and lusterless complexion, heaviness and fatigue in the limbs, clumsy movements, or even paralysis, soreness and stiffness in the lower back and spine, epigastric fullness with anorexia, nausea and vomiting, leukorrhea in women, or cutaneous pruritus, slight swelling of the feet, a swollen tongue with teeth marks, a white and greasy tongue coating, and a slippery and slow pulse. This is mostly caused by external contraction of cold-dampness pathogens, or prolonged residence in damp environments, leading to the infiltration of cold-dampness into the sinews and vessels, accumulating gradually. Alternatively, it may result from consuming raw or cold foods, irregular eating habits, or dysfunction of the spleen in transportation, causing internal stagnation of cold-dampness, with damp pathogens soaking the muscles and leading to limb paralysis. Suwen．Wei Lun states: "Gradual exposure to dampness, engaging in water-related activities, or residing in damp environments may lead to stagnation, soaking the muscles, resulting in numbness and flaccidity, manifesting as fleshy flaccidity." The onset of this syndrome often begins with limb fatigue and lack of strength, gradually progressing to paralysis. However, in rare cases, it may occur suddenly due to exhaustion and sweating, allowing cold-dampness to invade the weakened body, leading to sudden limb paralysis. The primary symptoms are those of cold-dampness (a puffy and dull complexion, anorexia with epigastric fullness, cold intolerance and cold limbs, a swollen tongue with teeth marks, a thick, white, and greasy tongue coating, and a slow pulse). Treatment should focus on invigorating the spleen and drying dampness, warming and dispersing cold pathogens. The recommended formula is Stomach Poria Decoction combined with herbs that harmonize the nutrient aspect and unblock the collaterals.
5. Spleen-Stomach Qi Deficiency︰Gradually, there is wilting impediment with weakness, leading to paralysis, shortage of qi, reluctance to speak, faint low voice, mental fatigue, lassitude, complexion pale and lusterless, dizziness, limb fatigue, loose stool, poor appetite (anorexia), pale tongue with thin coating, and fine soft pulse. It is often caused by inherent spleen-stomach deficiency, resulting in impaired reception and transportation, poor appetite (anorexia), and failure to transform water and grains into essence. The source of generation and transformation dries up, leading to malnutrition of the muscles, tendons, and vessels of the limbs, which over time results in paralysis. The key points of pattern identification are: limb paralysis, spleen-stomach deficiency manifesting as poor appetite (anorexia), loose stool, mental fatigue, lack of strength, pale complexion, emaciated limbs, pale tongue, and weak pulse. The treatment focuses on tonifying the spleen and stomach. Suwen．Wei Lun states: "For treating wilting, focus solely on the Yangming," "The Yangming is the sea of the five zang and six fu-organs, responsible for moistening all tendons, and all tendons govern binding the bones and facilitating joint movement." Therefore, regulating and nourishing the postnatal spleen and stomach is extremely important. Clinically, Middle-Tonifying Qi-Replenishing Decoction or Stomach-Tonifying Decoction with modifications is commonly used.
6. Kidney Yang Deficiency︰Four wilting impediment (paralysis), pale complexion, vertigo tinnitus, fatigue and lack of strength, sore waist and weak legs, slight swelling of the feet, cold limbs, impotence and seminal emission, skin and hair loss, abnormal sweating, pale tongue, and weak chi pulse. This is mostly caused by innate deficiency or prolonged illness depleting yang qi, leading to a lack of warmth in the muscles and tendons. The key points for differentiation are: limb paralysis, kidney deficiency (tinnitus, seminal emission, hair loss, aching pain in the waist and spine, etc.) and obvious cold signs (cold body and limbs, pale face and clear eyes, clear urine and loose stools, deep and slow pulse), which can help distinguish it. The treatment should focus on warming and tonifying kidney yang, using the modified Kidney Qi Pill from the Golden Cabinet.
7. Static Blood︰Paralysis of the lower limbs often occurs immediately after trauma, accompanied by incontinence or constipation, loss of sensation, foot edema, pallor, and dry, thin skin. Subsequently, muscle atrophy, scaly skin, cold limbs, stabbing pain in the chest, waist, or skin, a red tongue texture, or static blood spots may appear, with a deep, thin, and choppy pulse. This is mostly caused by trauma, but may also result from prolonged illness with static blood retention, or qi stagnation and blood stasis, blockage of the meridians, leading to malnutrition of the muscles and tendons. Cases caused by trauma tend to be more severe, while those due to prolonged static blood retention are milder, often accompanied by localized stabbing pain. The paralysis may manifest as flaccidity or spasticity at different stages, and if it persists for two years, recovery becomes difficult. Signs of traumatic static blood syndrome include obvious trauma sites, scaly skin, a purplish tongue coating, and a thin, choppy pulse. Treatment involves invigorating blood and resolving stasis, dredging meridians and activating collaterals, using formulas such as Peach Kernel, Carthamus and Four-Ingredient Decoction supplemented with Achyranthes Root, suberect spatholobus stem, Cibot Rhizome, and Earthworm.
8. Liver Depressionblood Deficiency︰The patient is sentimental, prone to sadness and weeping, and may suddenly develop limb {|###|}paralysis{|###|} when provoked by anger. However, even after prolonged illness, the limb muscles often remain unemaciated, with moist and lustrous skin. Symptoms are accompanied by {|###|}distending pain{|###|} in both flanks, {|###|}belching anorexia{|###|}, a {|###|}bitter taste in the mouth{|###|}, a pale-red tongue, and a wiry-thin pulse. This condition is mostly caused by emotional distress, with the patient experiencing obvious emotional stagnation before the onset. {|###|}Liver depression{|###|} leads to dysfunction in dispersion and discharge, and {|###|}liver blood{|###|} fails to nourish the sinews and vessels, resulting in malnutrition of the sinews and vessels and subsequent limb {|###|}paralysis{|###|}. Emotional regulation can lead to rapid recovery without residual symptoms, but the condition often recurs. Signs of {|###|}liver depression qi stagnation{|###|} syndrome may be observed, such as distension and fullness in the chest and flanks, {|###|}anorexia belching{|###|}, a {|###|}bitter taste in the mouth{|###|}, and a wiry-thin pulse. Treatment should involve {|###|}soothing the liver and nourishing blood{|###|}, using Licorice, Wheat and Jujube Decoction combined with Peripatetic Powder with modifications.

The condition of limb paralysis is often severe and difficult to treat, requiring careful clinical differentiation. Accurate diagnosis and early treatment are essential to achieve therapeutic effects. If misdiagnosed or mistreated in the initial stage, the condition may become difficult to recover from. For prolonged paralysis, chronic illness inevitably leads to blood stasis. Incorporating therapies that invigorate blood, resolve stasis, and harmonize nutrient flow to unblock collaterals can enhance treatment efficacy.

bubble_chart Documentation

1. Shuai Wen-Wei Lun: "When heart qi is hot, then there is a downward blood syncope and an upward movement, above then the lower pulse is deficient, deficiency then gives rise to vessel flaccidity, the pivot breaks and is lifted, the shin relaxes and cannot bear the ground; when liver qi is hot, then the gallbladder discharges a bitter taste in the mouth, the sinew membrane dries, the sinew membrane drying then causes the sinews to tense and contract, resulting in sinew flaccidity; when spleen qi is hot then the stomach dries and thirst arises, the muscles become insensitive, resulting in fleshy flaccidity; when kidney qi is hot then the waist and spine cannot lift, the bones wither and the marrow decreases, resulting in bone wilting."
2. Lingshu-Rebing: "The disease of paralysis is such that the body has no pain, the four limbs do not gather, the mind is not severely disordered, its speech is faint, short and understandable; severe then cannot speak, cannot be treated."
3. Zhu Bing Yuan Hou Lun-Feng Duo Ye Hou: "Wind duo ye is the slackening and inability to gather the limbs. People use stomach qi to nourish the muscles and meridians. If the stomach is weakened and damaged, its qi is not substantial, Jingmai is deficient, then the sinews and muscles become lazy, thus wind evil strikes the sinews, causing duo ye."
4. Chinese Medicine Lin Zheng Bei Yao-Lower Limb Paralysis: "The two lower limbs are heavy and weak, difficult to move, or accompanied by numbness, scurrying pain, but the upper limbs are generally normal, called 'paraplegia', belonging to wind paralysis, a category. Wind paralysis is a symptom and sign within 'apoplexy', originally the limbs cannot autonomously adjust at will, but mainly the lower limbs cannot move, thus Zhang Jing-yue said: 'Wind paralysis the four limbs do not gather, atrophy and numbness, walking and grasping cannot be achieved, even cannot step.' Use Rehmannia Decoction to warmly nourish the lower energizer water and fire."