Face Blown Crooked by the Wind? Doctor Luo Tianyi’s Qinjiao Shengma Tang (Gentian Macrophylla and Bugbane Decoction) for Facial Paralysis

Opening scene: facial paralysis — a very common complaint

💬 Note from Doctor Luo: Today’s topic is facial paralysis — a great many people have it, and I am constantly meeting people who say, “The wind blew my face crooked.” There are two things to learn from this case: first, how Doctor Luo Tianyi treated the illness; and second, how he and his master handled herbs — they were especially brilliant with wind herbs.

The patient was Grand Commandant Shi (the taiwei was one of the Three Dukes, roughly the equivalent of a minister of defense), 68 years old — and in ancient times “from seventy onward, life has always been rare,” so he was no longer young.

It happened in the early tenth lunar month of the wuchen year of the Zhiyuan reign — roughly November by the Western calendar, when the weather had already turned cold. Grand Commandant Shi was serving a national master (an eminent monk deeply respected by the emperor) at Sheng’an Temple, living in the abbot’s quarters to care for him.

How the illness began: as the cold deepened, a coal fire was lit in the room for warmth — and the stove stood on the left side. Gradually the left side of his face grew hot, and his left cheek began to sweat slightly (the pores opened wide). Then the two of them went out together on business, and the cold November wind hit him — wind-cold attacked the left side of his face, and he developed facial paralysis.

💬 Note from Doctor Luo: Roasting only one side was a mistake — when one side is heated like that, the qi in the channels cannot run smoothly. The left side, baked by the fire, had relaxed muscles and open pores — no longer the same as the right side. Then when he stepped out into the cold wind, the wind-cold invaded the left side of his face.

The pattern of facial paralysis: the mouth always twists away from the injured side

💬 Note from Doctor Luo: In Chinese medicine this condition is called zhong jingluo — “wind striking the channels” — a local problem, which is what we now call facial nerve palsy, a crooked mouth and slanting eyes. The severe form is called zhong zangfu — “wind striking the organs,” like a cerebrovascular accident, where the distortion is much worse.

Everyone must master the twisting pattern of facial paralysis:

• When the left side is injured by wind pathogen (left face limp and weak) → the right-side muscles pull upward → the mouth twists to the right. You can poke the left cheek and the patient feels nothing — the nerve is damaged.
• When the right side is blown by wind → the right side droops → the mouth twists to the left.

Grand Commandant Shi was hit by wind-cold on the left side, so his mouth twisted to the right.

Diagnosis and acupuncture: Professor Hu moxas Dicang and Jiache first

Doctor Luo Tianyi was summoned (he was an imperial physician). Taking the pulse: floating and tight, and on deep pressure large and relaxed — wind-cold lodged at the exterior (external cold arriving makes the pulse floating and tight), and the weak response on deep pressure shows insufficient upright qi.

Doctor Luo Tianyi then invited his good friend Professor Hu — a colleague who specialized in acupuncture; the two often joined forces on cases. First, acupuncture and moxibustion:

💬 Note from Doctor Luo: Dicang (ST4) — draw a horizontal line from the corner of the mouth and a vertical line through the center of the eye; the point is where the two lines meet. It is a point of the foot yangming stomach channel, and it was moxaed with 7 cones. Why is it called “Dicang” — the “earth granary”? Because it is a transport hub: like a granary, it sends the nutrients absorbed by the spleen and stomach up to the face and head. It is a point that must be used to treat facial paralysis, and it is also a key beauty point (after a month of needling, patients have found their complexion and skin greatly improved — needling the stomach channel point correctly does that).

Jiache (ST6) — run diagonally upward from the angle of the jaw to one finger-width below the earlobe; when you clench your teeth, the muscle bulges and the point sits in the depression at its center. It is also a foot yangming stomach channel point — like a cart hauling the nourishment of the spleen and stomach upward, which is why it is called “Jiache,” the “cheek cart.” It is indispensable for treating facial paralysis, and it was moxaed with 14 cones — twice as many.

As for the right cheek (not injured by the pathogen, but tightened up): it was treated by warming it with hot hands — heating the hands and rubbing again and again. When treating facial paralysis, don’t focus only on the affected side; regulating both sides together gives better results.

The prescription: Qinjiao Shengma Tang — Gui Zhi Tang as the base, plus a stack of yangming wind herbs

After the acupuncture was done, Doctor Luo Tianyi wrote the prescription: Shengma Tang plus fang feng, qin jiao, bai zhi, and gui zhi — the formula is called Qinjiao Shengma Tang.

The result: cured after a few doses — after drinking it several times, the facial paralysis was gone!

💬 Note from Doctor Luo: That is remarkable — because Western medicine treats facial paralysis very poorly (the nerve-nourishing drugs mostly do nothing), which is why so many people abroad walk around with crooked mouths. Western medicine calls this a “self-limiting disease” (it heals on its own up to a point) — and that claim is not very scientific: some people do recover by themselves, but more than half do not (the external pathogen stays lodged), which is why we constantly see people with a twisted face and slanting eyes.

Acupuncture and Chinese medicine can cure this illness well: back when I studied with the old master Zhang Daokuan at the Liaoning Research Institute of Chinese Medicine, he treated this condition with a 100 percent cure rate — a penetrating needling technique; every practitioner has his own method. Some use a small blade to let out stagnant blood; some apply herbal plasters over Dicang (ST4) and Jiache (ST6)… Chinese medicine has an enormous number of methods, most of them external. Drinking a decoction can also work, though the effect is not always certain (some people improve, some don’t) — we must carefully study how the great doctors of antiquity treated it.

The rationale of the formula (explained by Doctor Luo Tianyi himself) — why is this illness so closely tied to the yangming channels?

💬 Note from Doctor Luo: The foot yangming channel arises at the nose, meets at the bridge of the nose, and follows the outside of the nose into the upper teeth; the hand yangming channel passes through the lower teeth; and both cheeks belong to yangming — the face is governed by the yangming channels! So the herbs must be precisely targeted — this is the medication heart-method handed down from Zhang Yuansu to Li Dongyuan to Luo Tianyi: each herb is classified with great clarity, which channel it enters, and no herb is ever wasted.

The composition of the formula:

• Sheng ma (bugbane rhizome): enters the lung, spleen, and stomach channels; raises yang and releases the exterior (it appears in Bu Zhong Yi Qi Tang; Doctor Zhang Xichun’s Sheng Xian Tang also uses sheng ma and chai hu) — it lifts the yang qi and releases the exterior, letting the yangming qi rise to fill the face and drive out the pathogen
• Ge gen (kudzu root): sweet-pungent and neutral, enters the spleen and stomach channels (Zhang Yuansu specifically discussed ge gen coursing the foot yangming channel) — it raises yang and relaxes the sinews (easing muscles tightened by cold), brings out rashes, and stops diarrhea (when wind has knocked you down with diarrhea and gurgling bowels, ge gen works beautifully)
• Bai zhi (Dahurian angelica root): pungent and warm, enters the lung, spleen, and stomach channels (summarized in Zhang Yuansu’s Zhen Zhu Nang, the Pearl Bag) — dispels wind, dries dampness, reduces swelling, and relieves pain; it is especially good at scattering wind pathogens of the head and face, and can be used externally. It is extremely fragrant — put two or three slices in your chicken and it comes out wonderfully aromatic (a famous brand of smoked chicken has bai zhi as its main seasoning; I recognized it the moment I smelled it)
• Qin jiao (gentian macrophylla root): bitter-pungent and neutral, enters the liver, stomach, and gallbladder channels (Tang Ye Ben Cao says it also enters the hand yangming large intestine channel) — dispels wind and scatters dampness, activates the blood, relaxes the sinews and frees the collaterals, clears heat and resolves toxin, and promotes urination (a different route from ge gen’s path through the urine)
• Fang feng (siler root): sweet-pungent and warm, enters the bladder, spleen, stomach, and lung channels — the taiyang channel’s own herb — releases the exterior, scatters cold, removes dampness, and relieves pain (in Jing Fang Bai Du San, jing jie and fang feng are routinely used together)
• Ren shen (ginseng): supports the upright qi — because the upright qi inside was insufficient (the yangming channels’ qi and blood were depleted), the cold outside could wound him at all. Raise the yang, scatter the wind pathogen, and support the upright qi all at once
• Gui zhi (cinnamon twig), bai shao (white peony root), zhi gan cao (honey-fried licorice): together these three form Gui Zhi Tang (Cinnamon Twig Decoction) — harmonizing the ying and wei, increasing the power of the spleen and stomach, the movement of qi and blood, and the body’s defense capability — when the spleen and stomach are sufficient, the channels and qi and blood are strong, and the exterior of the body is well supplied. Gui Zhi Tang as the base!

Sheng ma, ge gen, qin jiao, bai zhi, and fang feng — all wind herbs (wind-dispelling herbs), and every one of them enters the yangming channels — a precise strike!

Doctor Luo Tianyi’s summary: “Illnesses differ in root and branch, in channel and collateral; herbs differ in qi and flavor, in thickness and thinness.” When you have investigated the root of the illness and arranged the herbs with clarity, the effect comes “ru xiang ru gu” — as surely as a drum answers the drumstick. But if you do not understand the channels, do not understand the strength and weight of herbs, and simply take one formula to treat every case, you may not only fail to cure — you may harm — and so he wrote, “xue zhe yi jing si zhi” — those who study medicine must ponder this deeply.

Bonus: facial paralysis by deficiency and excess — Xi Jiao Shengma Tang

💬 Note from Doctor Luo: Qinjiao Shengma Tang treats the deficiency pattern of facial paralysis (insufficient upright qi plus invasion by an external pathogen). But facial paralysis also has an excess pattern: when internal fire blazes (from heat rising, from worry and haste) — pain inside the ear, a quick temper — Doctor Luo Tianyi wrote Xi Jiao Shengma Tang (Rhinoceros Horn and Bugbane Decoction) for it (the rhinoceros horn resolves toxin — of course rhinoceros horn can no longer be used today, but the idea of resolving the toxin remains: once the heat toxin is cleared, the illness can heal).

Distinguish deficiency from excess, distinguish the channels, distinguish root from branch — this is how Doctor Luo Tianyi practiced medicine.

And trace the School of Tonifying Earth down to Doctor Zhang Xichun — his Sheng Xian Tang (chai hu + sheng ma + jie geng + sheng huang qi) lifts the qi upward — it is all one continuous lineage. The currents of Chinese medical scholarship are endlessly fascinating.

What to take away: two lessons from this lecture

💬 Note from Doctor Luo:

1. Wind herbs: sheng ma, ge gen, bai zhi, du huo, qiang huo, qin jiao, fang feng, jing jie… these are called wind herbs (wind-dispelling herbs). The physicians of the Jin-Yuan period were especially skilled with wind herbs, and many later doctors were too — they are one of the most important tools in Chinese medicine
2. Distinguish deficiency and excess: every illness has its deficiency or excess pattern — sort them out clearly, and the treatment works far better

The original case record comes from Wei Sheng Bao Jian (Precious Mirror of Health) by Doctor Luo Tianyi; the commentary is adapted from the public lectures of Doctor Luo Dalun (Ph.D. in TCM Diagnostics, Beijing University of Chinese Medicine).