Translated from Huáng Huáng’s Jīngfāng Formula Presentations 经方方证

Xù Mìng Tāng (Life-Restoring Decoction) from Gujin Luyan (Ancient and Modern Records of Proven Prescriptions)
Xù Mìng Tāng is an ancient formula for fēngfèi (wind paralysis).1 Traditionally it is classified as a wind-dispelling, cold-scattering prescription. It has the functions of restoring motor function, improving speech, relaxing the muscles, treating numbness, and relieving cough and wheezing. The presentation of Xù Mìng Tāng is characterized by paralysis or weakness of the limbs, numbness, and aphasia, and is most often seen in sudden-onset disorders.
I. Classical Formula
Má Huáng, Guì Zhī, Dāng Guī, Rén Shēn, Shí Gāo, Gān Jiāng, and Gān Cǎo, 3 liǎng each;
Chuān Xiōng, 1 liǎng;
Xìng Rén, 40 pieces.
Combine the nine ingredients. Decoct in one dǒu of water and reduce to four shēng. Take one shēng warm. A slight sweat should result. Lightly cover the back and sit leaning against a support. Recovery follows once sweating occurs. If sweating does not occur, administer another dose. There are no dietary restrictions, but exposure to wind should be avoided.
II. Classical Formula Presentation
Treats wind fēi strike [where] the body is unable to control itself, an inability to speak, clouded confusion and a lack of pain sensations, or hypertonicity preventing one from turning over to the side. Also treats those who can only lie prone and cannot lie flat, with cough, panting, and swelling of the face and eyes.
(Jīnguì Yàolüè, Chapter 5, addendum formula)
1. “The body is unable to control itself” (身体不能自收)
This generally refers to quadriplegia or hemiplegia. Commonly seen in:
- Post-stroke sequelae
- Cerebral infarction
- Guillain-Barré syndrome
- Acute myelitis
- Hypokalemic paralysis
- Radiculitis
2. “Inability to speak” (口不能言)
This refers to aphasia, where the patient cannot answer questions. It likely describes central aphasia caused by damage to language centers in the brain. Common causes include:
- Stroke
- Brain tumors
3. “Clouded confusion and a lack of pain sensations” (冒昧不知痛处)
Màomèi (冒昧) describes mental confusion.
- Mào (冒) depicts a hat covering the eyes.
- Mèi (昧) means obscured or unclear.
In the Waitai Miyao, the phrase is followed by “does not recognize people,” suggesting impairment of consciousness.
This represents mild cerebral dysfunction.
“Lack of pain sensations” refers to sensory impairment: when stimulated with a sharp object, the patient cannot localize the stimulus or withdraw appropriately. This corresponds to numbness and sensory loss, often seen in:
- Radiculitis
- Guillain-Barré syndrome
4. “Hypertonicity preventing one from turning over to the side.” (拘急不得转侧)
This describes increased muscle tone and associated neuropathic pain. Commonly seen in:
- Parkinsonian syndromes
- Post-stroke sequelae
The hypertonicity reflects upper motor neuron damage (“spastic paralysis”). Flaccid paralysis generally indicates lesions of the spinal cord or other lower motor neuron disorders.
5. “Can only lie prone and cannot lie flat, with cough, panting, and swelling of the face and eyes” (但伏不得卧,咳逆上气,面目浮肿)
This refers to:
- Cough and wheezing
- Orthopnea (inability to lie flat)
- Sitting upright to breathe
- Facial edema
Seen in:
- Chronic obstructive pulmonary disease (COPD)
- Cor pulmonale with heart failure
- Bronchial asthma
The formula contains elements of both Má Xìng Shí Gān Tāng and Má Huáng Tāng, well-known formulas for relieving wheezing. Like Mù Fáng Jǐ Tāng, it employs Guì Zhī, Rén Shēn, and Shí Gāo, herbs commonly used in pulmonary-heart disease.
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The key terms in the classical text encompass many of the major clinical manifestations of neurological disease. The formula may be viewed as a combination of Má Huáng Tāng, Má Xìng Shí Gān Tāng, and Dà Qīng Lóng Tāng. However, the addition of Dāng Guī, Chuān Xiōng, and Rén Shēn gives it a distinctive affinity for neurological disorders.
Traditional commentators explained:
“It is not merely disturbance by pathogenic qi, but also decline of the true qi.”
— You Yi
“A specialized formula for treating stroke.”
— Mo Meishi
“Wind enters and blocks the pores, obstructing the movement of ying and wei. Wind is often accompanied by cold. Initially it enters through the skin and gradually penetrates inward. Prolonged stagnation transforms into heat; heat damages yin. When yin is damaged, the zang-fu are no longer nourished internally, nor can nourishment reach the body externally. Thus arise loss of motor control, inability to speak, confusion, and loss of sensation.”
— Chen Xiuyuan
The pathological basis of the formula is closely related to disorders of the central nervous and motor systems.
The text’s emphasis on respiratory distress also deserves attention, suggesting usefulness in severe pulmonary disease.
III. Suitable Patient Characteristics
This is primarily an emergency formula and does not require a specific constitutional type. However, when used for chronic conditions over longer periods, characteristic patient features can be considered.
1. Robust Build with Yellow-Dusky Complexion (黄黯壮实)
Suitable for patients who are:
- Solidly built and sturdy
- Yellow-dusky rather than flushed
- Rough, dry skin
- Puffy or fatigued appearance
- Not prone to sweating
Symptoms are often triggered by fatigue, exposure to cold, or sudden invasion of wind-cold.
2. Slippery-Wet Tongue Coating (水滑苔)
Suitable when:
- Tongue coating is white, greasy, or moist/slippery
- Excess saliva or phlegm is present
- Urination is clear and copious
3. Prominent Neurological Symptoms
Suitable for patients with:
- Headache
- Neck and upper back soreness
- Muscular tension
- Joint pain
- Slowed reactions
- Aphasia
- Slurred or difficult speech
- Difficulty walking
- Difficulty swallowing
- Wheezing with phlegm sounds
Use cautiously or avoid in patients with:
- Marked heat intolerance
- Profuse sweating
- Significant arrhythmias
- Markedly elevated blood pressure
- Prostatic enlargement with urinary difficulty
IV. Applicable Disorders
This formula is most commonly used for neurological diseases affecting either the central or peripheral nervous systems.
Consider it when the presentation includes:
- Acute flaccid weakness or paralysis
- Increased muscle tone with neuropathic pain
- Sudden impairment of speech or swallowing
- Cough, wheezing, facial edema, or excessive salivation
1. Wind Paralysis (风痱)
An ancient disease category characterized by:
- Limb paralysis
- Numbness
- Aphasia
It resembles modern conditions such as:
- Myelitis
- Acute inflammatory polyneuropathy (Guillain-Barré syndrome)
- Certain forms of brainstem encephalitis
“Wind fēi is when one suddenly cannot speak, the mouth is clenched, and the limbs become impaired and rigid.”
(Beiji Qianjin Yaofang, Vol. 8)
The original instructions state:
“If sweating occurs, recovery follows; if not, administer another dose.”
Thus, mild sweating is considered a sign that the formula is taking effect.
If sweating does not occur, the dosage of Má Huáng may be increased.
According to Huang Shipei, tolerance to Má Huáng varies greatly among individuals; dosing should begin conservatively and increase gradually.
2. Stroke (脑卒中)
The formula presentation corresponds well to acute stroke symptoms such as:
- Facial deviation
- Hemiplegia
- Altered consciousness
- Difficulty speaking or understanding speech
- Visual disturbances
- Difficulty walking
- Dizziness
- Loss of balance and coordination
Use cautiously in:
- Severe hypertension
- Cerebral hemorrhage
Hu Xishu cautioned:
“One should be cautious when using this formula clinically for stroke.”
3. Parkinson’s Disease
The phrases:
“The body is unable to control itself” and “Hypertonicity preventing one from turning over to the side” closely resemble Parkinsonian features such as:
- Increased muscle tone
- Shuffling gait
Most appropriate in patients who are:
- Robustly built
- Have a moist, slippery tongue coating
- Maintain a normal appetite
For excessive salivation, combine with Wú Zhū Yú Tāng.
V. Formula Differentiation
1. Xù Mìng Tāng vs. Má Huáng Tāng
Both may be used for:
- Stroke
- Hemiplegia
- Aphasia
However, the neurological manifestations of Xù Mìng Tāng are considerably more severe.
2. Xù Mìng Tāng vs. Chái Hú Jiā Lóng Gǔ Mǔ Lì Tāng
Both can treat movement disorders.
- Xù Mìng Tāng treats:
- “The body is unable to control itself” and “Hypertonicity preventing one from turning over to the side”
- Chái Hú Jiā Lóng Gǔ Mǔ Lì Tāng treats:
- “The whole body feels heavy and cannot turn over”
However:
- Chái Hú Jiā Lóng Gǔ Mǔ Lì Tāng is more commonly used in patients with depression and insomnia.
- Fullness in the chest, vexation, and fright are characteristic signs.
These symptoms are generally absent in Xù Mìng Tāng, whose defining feature is sudden disease onset.
VI. Reference Dosage
- Má Huáng 15 g
- Guì Zhī 15 g
- Dāng Guī 15 g
- Rén Shēn 15 g
- Shí Gāo 20 g
- Gān Jiāng 15 g
- Gān Cǎo 15 g
- Chuān Xiōng 10 g
- Xìng Rén 15 g
Decoct in 1000 mL water and reduce to 400 mL.
Take in 2–3 divided doses throughout the day.
A mild sweat is considered the ideal therapeutic response.
If treatment is required for longer than seven days, the dosage may be reduced by half.
- Nigel Wiseman translates the character fèi 痱 as ‘wind disablement’, where he goes on to say, “Wilting, and loss of the use of the limbs without pain and with loss of mental faculties. The língshū states, ‘when disablement is the disease, and there is no generalized pain, the limbs cannot contract, cognitive faculties are not seriously confused, and speech is faint, the condition can be treated.’ This passage would indicate that disablement is a sequela of wind stroke.” (Wiseman, Practical Dictionary of Chinese Medicine, Pleco edition.) ↩︎









