Constraint – Ascending Liver wind (YTS)

Original Case by: Ye Tian-Shi (叶天士)

At the onset of the illness there was left-sided numbness and tingling, the tongue was stiff, the sinews were hoisted (tight?) and back of the head was painful. There was also phlegm obstruction in the throat. This is Liver wind ascending and guiding. This certainly is caused from constraint and clumping of the  emotions.

Saigae tataricae Cornu (líng yáng jiâo)
Forsythiae Semen (lián qiáo xïn)
Fresh Rehmanniae Radix (xiān shëng dì huáng)
Scrophulariae Radix (xuán shën)
Acori tatarinowii Rhizoma (shí chäng pû))
Curcumae Radix juice ( (yù jïn zhī)

Original Chinese: 某 初起左边麻木。舌强。筋吊脑后痛。痰阻咽喉。此系肝风上引。必由情怀郁勃所致。羚羊角 连翘心 鲜生地 元参 石菖蒲 郁金汁

Source: From the Constraint Chapter of Case Records as a Guide to Clinical Practice (Lín zhèng zhî nán yï àn) 《临证指南医案》.

Translated by:Jason Blalack

Translation Discussion:

1) 郁勃 (yu bo) – 勃 (bo) – by itself means vigorous, flourishing, thriving, or abrupt or sudden. I originally thought this sudden/abrupt meaning was important due to the nature of the case. However, I am not sure it is likely that there was a sudden constraint of emotions that caused this problem. It should be noted that historically (non-medical) it (勃) has been used as a compound (郁勃) with various meanings, one of them being, “constraint, clumping, and congestion (郁结壅塞).” Interestingly, in this usage (this constraint and clumping of the emotions) is compared to a wild animal trapped in a house grabbing, scratching, colliding into the walls, unable to find its way out. Other thoughts?

2) I think that this “guiding (引)”, has the meaning of taking phlegm, fire etc. upward with the ascending Liver wind. Do others have a different opinion?

3) 筋吊 – This 吊 (diao) means to hang, hoisten, lift up, or even to drop, fall, fall down or descend. Therefore here, the sinews may be considered slackened, however due to the pain, the stiff tongue, and nature of many strokes I went with a idea of tenseness. What do others think?