Chen's Sangjian Decoction for Fingertip Numbness
In Zabing Yuanliu Xizhu (Lamp-Holding at the Source of Miscellaneous Diseases) there is a formula called "Chen's Sangjian Decoction" (Chen's Mulberry-Tip Decoction); in Leizheng Zhicai (Treatment Patterns Organized by Categories) it bears the alternative name "Sangjian Decoction." Its composition is: Nen Sangzhi Jian (tender mulberry twig tips), 5 qian (15 g); Han Fangji (Han Stephaniae Tetrandrae Radix), 3 qian (9 g); Danggui Shen (Angelicae Sinensis Radibody), 2 qian (6 g); Huangqi (Astragali Radix) and Fuling (Poria), each 1 qian 5 fen (4.5 g); Weilingxian (Clematidis Radix et Rhizoma) and Qinjiao (Gentianae Macrophyllae Radix), each 1 qian (3 g); Chuanxiong (Chuanxiong Rhizoma) and Shengma (Cimicifugae Rhizoma), each 5 fen (1.5 g). Decoct in water; take warm, twice daily.
Modern practice: prepare the dried herbs according to the above dosages, soak in 600 ml of purified water for 15–30 minutes, then simmer over low heat until 300 ml remains; divide into two equal portions, one in the morning and one in the evening, taken after meals.
This formula boosts qi and nourishes blood, dispels wind and unblocks the collaterals. It treats numbness and loss of sensation in all ten fingertips.
Numbness of the fingertips may relate to many diseases, such as cervical spondylosis, post-stroke sequelae, cerebral infarction, hyperlipidemia, hypertension, hyperglycemia, and Raynaud's disease. It may also relate to certain treatments: nerve damage from chemotherapy drugs can cause fingertip numbness, and the use of vasoconstrictors in other diseases can likewise cause it. Some patients have numbness not only at the fingertips but also at the toe tips. Fingertip numbness is a distressing symptom that easily causes panic and anxiety, yet few effective treatments exist; Chinese medicine treats such conditions mainly symptomatically.
Chen's Sangjian Decoction uses mulberry tips as the chief herb; a mulberry tip is the tender twig—the very terminal, most tender part of the mulberry branch. Mulberry twig dispels wind-damp and benefits the joints, and treats wind-damp bi (obstruction) disease with aching, pain, and numbness in the shoulders, arms, and joints. The main active constituents of mulberry twig are the mulberry twig total alkaloids, which are most abundant in the tender twigs; hence twigs harvested in March, or the tips from other months, are preferred.
Han Fangji, Weilingxian, and Qinjiao in this formula have effects similar to mulberry twig—all are wind-damp-dispelling, joint-benefiting herbs that help improve fingertip numbness. Fuling fortifies the spleen and drains dampness, and also has some effect on wind-damp bi pain. Huangqi, Danggui, Chuanxiong, and Shengma are similar to the composition of Buzhong Yiqi Decoction; combined, they supplement qi and blood, improve stamina, and treat the deficiency pattern interwoven with wind-damp bi pain. Thus this formula addresses both root and manifestation, improving fingertip numbness caused by the various diseases above.