又 下虚上实。君相火亢。水涸液亏。多有暴怒跌仆之虞。此方滋液救焚。使补力直行下焦。不
助上热。议铁瓮申先生琼玉膏方。
鲜生地水洗净捣自然汁二斤。绵纸滤清。随和入生白沙蜜一斤。另置一铅罐。或圆铅球。
盛前药封坚固。用铁锅满盛清水。中做井字木架。放罐在上。桑柴火煮三昼夜。频添水不
可住火。至三日后。连器浸冷水中。一日顷取出。入后项药。
人参（蒸烘研细末六两） 白茯苓（蒸研粉十六两） 真秋石（银罐内 候冷研一两）
三味拌入前膏。如干豆沙样。收贮小口瓷瓶内。扎好勿令泄气。每早百滚水调服五六钱。
又立冬后三日。诊得左脉小弦动数。右手和平略虚。问得春夏平安。交秋后有头晕。左目流
泪。足痿无力。不能行走。舌生红刺。微咳有痰。此皆今年天气大热已久。热则真气泄越。虚则
内风再旋。经言痿生大热。热耗津液。而舌刺咳嗽流泪者。风阳升于上也。上则下焦无气矣。
故补肝肾以摄纳肾气为要。而清上安下。其在甘凉不伤脾胃者宜之。
制首乌（四两） 杞子（炒一两半） 天冬（去心二两） 茺蔚子（蒸二两） 黄甘菊（一两半） 黑 豆皮（二
两） 茯苓（蒸二两） 川石斛（熬膏八两） 虎骨胶（二两水溶）
上末以川斛膏同溶化。虎骨胶捣丸。早上滚水服三四钱。
又 久热风动。津液日损。舌刺咳嗽。议以甘药养其胃阴。老年纳谷为宝。
生扁豆（四两） 麦冬（四两） 北沙参（三两） 天花粉（二两） 甘蔗浆（十二两） 柿霜（二两）
白花百合（四两）
熬膏。加饴糖两许。每服时滚水调服三四钱。晚上服。
又 液燥下亏。阳挟内风上引。阴不上承。舌络强则言謇。气不注脉则肢痿乏力步趋。凡此皆
肝肾脏阴本虚。镇补之中。微逗通阳为法。以脏液虚。不受纯温药耳。
水制熟地（四两） 阿胶（二两） 女贞实（二两） 豆皮（二两） 淡肉苁蓉（一两） 茯神（二两）
旱莲草（二两） 川石斛（三两）
用精羯羊肉胶为丸。早上滚水服四五钱。
又 暂服煎方。
生地 沙参 茺蔚子 黑 豆皮 川斛 牛膝
又 晚服丸方。
九蒸桑叶（八两） 三角胡麻（四两） 九制首乌（三两） 白茯神（三两） 人参（二两）
炙甘草（一两） 酸枣仁（二两炒） 苡仁（二两）
上为末。桂圆肉三两煎汤法丸。每服三钱。百滚水下。
又 今年天符岁会。上半年阳气大泄。见病都属肝胃。以厥阴为风脏。而阳明为盛阳耳。阴
阳不肯相根据。势必暴来厥中。过大暑可免。以暑湿大热。更多开泄。致元气不为相接耳。然此
本虚标实。气火升腾所致。经旨以苦寒咸润酸泄。少佐微辛为治。议进补阳明泄厥阴法。
人参（一钱） 生牡蛎（五钱） 生白芍（二钱） 乌梅肉（四分） 川黄连（盐水炒六分） 熟半夏（醋炒清水
漂洗一钱）
上午服。
（丸方） 人参（二两） 茯苓（三两生） 盐水炒黄连（五钱） 半夏（醋炒水洗净一两半）
盐水炒广皮（二两） 枳实（麸炒一两半） 白蒺藜（鸡子黄制一两半） 生白芍（一两半） 乌梅肉（蒸一两）
为末。竹沥法丸。早上服三钱。百滚汤下。
又 夏月进酸苦泄热。和胃通隧。为阳明厥阴治甚安。入秋凉爽。天人渐有收肃下降之理。缘
有年下亏。木少水涵。相火内风旋转。熏灼胃脘。逆冲为呕。舌络被熏。则绛赤如火。消渴便阻。
犹剩事耳。凡此仍属中厥根萌。当加慎静养为宜。
生鸡子黄（一枚） 阿胶（一钱半） 生白芍（三钱） 生地（三钱） 天冬（去心一钱） 川连（一分生）
上午服。
又 心火亢上。皆为营液内耗。先以补心汤。理心之用。
人参（同煎一钱） 川连（水炒六分） 犀角（二钱镑） 元参（二钱） 鲜生地（五钱） 丹参（一钱）
卷心竹叶（二钱）
又 苦味和阳。脉左颇和。但心悸少寐。已见营气衰微。仿金匮酸枣仁汤方。仍兼和阳。益心气以通肝络。
酸枣仁（炒黑勿研五钱） 茯神（三钱） 知母（一钱） 川芎（一分） 人参（六分同煎） 天冬（去心一钱）
陈 脉左数。右弦缓。有年。形盛气衰。冬春之交。真 不相维续。内风日炽。左肢麻木不仁。舌歪
言謇。此属中络。调理百日。戒酒肉。可望向愈。（痰火阻络）
羚羊角 陈胆星 丹皮 橘红 连翘心 石菖蒲 钩藤 川斛
又 羚羊角 元参 连翘 花粉 川贝母 橘红 竹沥
又 丹溪云。麻为气虚。木是湿痰败血。诊左脉濡涩。有年偏枯。是气血皆虚。方书每称左属血
虚。右属气虚。未必尽然。
人参 半夏 广皮 茯苓 归身 白芍 炙草 桑枝
又 经络为痰阻。大便不爽。昨日跌仆气乱。痰出甚艰。转方以宣经隧。
炒半夏 石菖蒲 广橘红 茯苓 胆星 枳实 竹沥 姜汁
叶 初春肝风内动。眩晕跌仆。左肢偏痿。舌络不和。呼吸不爽。痰火上蒙。根本下衰。先宜清上痰火。
羚羊角 茯苓 橘红 桂枝 半夏 郁金 竹沥 姜汁
又 风热烁筋骨为痛。痰火气阻。呼吸不利。照前方去郁金竹沥姜汁。加白蒺藜钩藤。
又 炒半夏 茯苓 钩藤 橘红 金石斛 石菖蒲 竹沥 姜汁
又 人参 半夏 枳实 茯苓 橘红 蒺藜 竹沥 姜汁
风为百病之长。故医书咸以中风列于首门。其论症。则有真中类中。中经络血脉脏腑之
分。其论治。则有攻风劫痰。养血润燥。补气培元之治。盖真中虽风从外来。亦由内虚。而邪
得以乘虚而入。北方风气刚劲。南方风气柔和。故真中之病。南少北多。其真中之方。前人
已大备。不必赘论。其类中之症。则河间立论云。因烦劳则五志过极。动火而卒中。皆因热
甚生火。东垣立论。因元气不足。则邪凑之。令人僵仆卒倒如风状。是因乎气虚。而丹溪则
又云。东南气温多湿。由湿生痰。痰生热。热生风。故主乎湿。三者皆辨明类中之由也。类者
伪也。近代以来。医者不分真伪。每用羌防星半乌附细辛。以祛风豁痰。虚症实治。不啻如
枘凿之殊矣。今叶氏发明内风。乃身中阳气之变动。肝为风脏。因精血衰耗。水不涵木。木
少滋荣。故肝阳偏亢。内风时起。治以滋液熄风。濡养营络。补阴潜阳。如虎潜固本复脉之
类是也。 若阴阳并损。无阴则阳无以化。故以温柔濡润之通补。如地黄饮子还少丹之
类是也。更有风木过动。中土受戕。不能御其所胜。如不寐不食。卫疏汗泄。饮食变痰。治
以六君玉屏风茯苓饮酸枣仁汤之属。或风阳上僭。痰火阻窍。神识不清。则有至宝丹芳
香宣窍。或辛凉清上痰火。法虽未备。实足以补前人之未及。至于审症之法。有身体缓纵
不收。耳聋目瞀。口开眼合。撒手遗尿。失音鼾睡。此本实先拨。阴阳枢纽不交。与暴脱无异。
并非外中之风。乃纯虚症也。故先生急用大剂参附以回阳。恐纯刚难受。必佐阴药。以
挽回万一。若肢体拘挛。半身不遂。口眼 邪。舌强言謇。二便不爽。此本体先虚。风阳夹痰
火壅塞。以致营卫脉络失和。治法急则先用开关。继则益气养血。佐以消痰清火。宣通经
隧之药。气充血盈。脉络通利。则病可痊愈。至于风痱。风懿。风痹。瘫痪。乃风门之兼症。理
亦相同。案中种种治法。余未能尽宣其理。不过略举大纲。分类叙述。以便后人观览。余门仿此。（华岫云）
徐评 凡风淫所胜之病。自内经以及唐宋名家。皆以辛凉甘寒为本。而佐以驱风益血之药。
至河间有地黄饮子之法。此乃治肾虚痱症。有类中风。并非以此方治中风之急症。乃近日诸
医遇中风之症。总以人参附桂为开手第一方。轻者不起。重者立毙。问所从来。曰本之叶先生。
余始亦信其说果从叶氏出。及阅此书。乃知此翁学有渊源。心思灵变。与前人所论。分毫不背。
其人参亦于病势已退后。用以培元养气。当病甚时。必于驱风之药同用。其分两亦不过几分
至钱。无不中度。乃今之窃附其门墙。盗取其余论者。事事相反。此翁有知。能无痛恨。而以此等
邪说诬此翁以害人者。对此书能无愧死。
Furthermore: Deficiency in the lower jiao and excess in the upper jiao. Hyperactivity of Ministerial Fire (Ministerial Fire) and Heart Fire. Depletion of Kidney Water and Yin fluids. There is a risk of sudden collapse and falling due to violent anger. This prescription aims to nourish fluids to rescue from "burning," allowing the tonifying power to go directly to the lower jiao without aggravating upper heat. It is proposed to adopt Mr. Tie Wengshen's Qiongyu Gao (Jade Jade Paste) formula.
Fresh Sheng Di Huang (Rehmanniae Radix) two jin, washed with water, crushed to extract natural juice. Filtered clear through cotton paper. Then mixed with one jin of raw white rock honey. Placed separately in a lead pot (or round lead ball). The previous medicine is sealed tightly inside. Put into an iron pot filled with clear water. A cross-shaped wooden rack is placed in the middle, and the pot is set on top. Boiled over mulberry wood fire for three days and nights. Water is frequently added; the fire must not be stopped. After three days, immersed in cold water along with the vessel until cool, taking about a day to remove. Add the following medicines.
Ren Shen (Ginseng Radix et Rhizoma), steamed, dried, and ground into fine powder, six liang. Bai Fu Ling (Poria), steamed and ground into powder, sixteen liang. Zhen Qiu Shi (Lithii Carbonas), cooled in a silver jar and ground, one liang.
These three ingredients are mixed into the previous paste, resembling dry red bean paste. Stored in small-mouthed porcelain bottles, tightly sealed to prevent air leakage. Taken orally every morning, mixed with boiling water, five or six qian.
Furthermore: On the third day after Start of Winter, the left pulse was small, wiry, rapid, and moving. The right pulse was harmonious but slightly deficient. Inquiry revealed peace during spring and summer, but since autumn, symptoms included dizziness, tearing from the left eye, flaccidity and weakness of the feet, inability to walk. Red prickles appeared on the tongue, with slight cough and phlegm. These are all due to the prolonged extreme heat this year. Heat causes the true Qi to leak and scatter; deficiency causes internal wind to swirl again. The Classics state that Wei syndrome (flaccidity syndrome) arises from great heat, which consumes body fluids. The tongue prickles, cough, and tearing indicate Wind-Yang rising to the upper jiao. When the upper is excessive, the lower jiao lacks Qi. Therefore, tonifying the Liver and Kidneys to grasp and receive Kidney Qi is essential. To clear the upper and calm the lower, sweet-cool herbs that do not damage the Spleen and Stomach are suitable.
Zhi Shou Wu (Prepared Polygoni Multiflori Radix), four liang. Qi Zi (Lycii Fructus), stir-fried, one and a half liang. Tian Dong (Asparagi Radix), heart removed, two liang. Chong Wei Zi (Leonuri Fructus), steamed, two liang. Huang Gan Ju (Chrysanthemi Flos), one and a half liang. Hei Dou Pi (Phaseoli Vulgaris Pericarpium), two liang. Fu Ling (Poria), steamed, two liang. Chuan Shi Hu (Dendrobii Caulis), boiled into paste, eight liang. Hu Gu Jiao (Cornu Tigris Colla), two liang, dissolved in water.
The above powders are melted together with the Chuan Shi Hu paste. Hu Gu Jiao is pounded into pills. Taken orally in the morning with boiling water, three or four qian per dose.
Furthermore: Long-standing wind-heat stirs movement, daily loss of fluids. Tongue prickles and cough. It is proposed to use sweet medicines to nourish Stomach Yin. For the elderly, ability to eat is precious.
Sheng Bian Dou (Dolichoris Semen), four liang. Mai Dong (Ophiopogonis Radix), four liang. Bei Sha Shen (Glehniae Radix), three liang. Tian Hua Fen (Trichosanthis Radix), two liang. Gan Zhe Jiang (Saccharum Indicae Juice), twelve liang. Shi Shuang (Diospyros Fructus Frost), two liang. Bai Hua Bai He (Lilii Bulbus), four liang.
Boiled into paste. Added with a small amount of Yi Tang (Malt Sugar). Mixed with boiling water when taken, three or four qian per dose. Taken in the evening.
Furthermore: Dryness of fluids and deficiency in the lower jiao. Yang carries internal wind upward. Yin fails to ascend. Stiffness of tongue collaterals leads to slurred speech. Qi failing to enter the vessels leads to limb flaccidity, weakness, and difficulty walking. All these stem from the original deficiency of Liver and Kidney Yin. In the method of sedation and tonification, slightly promoting Yang circulation is adopted. Because organ fluids are deficient, they cannot tolerate purely warm medicines.
Shui Zhi Shu Di Huang (Rehmanniae Radix Praeparata), water-processed, four liang. E Jiao (Colla Corii Asini), two liang. Nv Zhen Zi (Ligustri Lucidi Fructus), two liang. Dou Pi (Phaseoli Vulgaris Pericarpium), two liang. Dan Rou Cong Rong (Cynomorii Herba), one liang. Fu Shen (Poria cum Radice Xylodi), two liang. Han Lian Cao (Ecliptae Herba), two liang. Chuan Shi Hu (Dendrobii Caulis), three liang.
Made into pills using gelatin from lean male lamb meat. Taken orally in the morning with boiling water, four or five qian per dose.
Furthermore: Temporarily take a decoction formula.
Sheng Di Huang (Rehmanniae Radix) | Sha Shen (Glehniae Radix) | Chong Wei Zi (Leonuri Fructus) | Hei Dou Pi (Phaseoli Vulgaris Pericarpium) | Chuan Shi Hu (Dendrobii Caulis) | Niu Xi (Achyranthis Bidentatae Radix)
Furthermore: Evening pill formula.
Jiu Zheng Sang Ye (Mori Folium, nine-steamed), eight liang. San Jiao Hu Ma (Sesami Semen Niger), four liang. Jiu Zhi Shou Wu (Polygoni Multiflori Radix Praeparata, nine-processed), three liang. Bai Fu Shen (Poria cum Radice Xylodi), three liang. Ren Shen (Ginseng Radix et Rhizoma), two liang. Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle), one liang. Suan Zao Ren (Ziziphi Spinosae Semen), stir-fried, two liang. Yi Yi Ren (Coicis Semen), two liang.
Ground into powder. Pills made using decoction of Gui Yuan Rou (Longan Arillus), three liang. Three qian per dose, taken with boiling water.
Furthermore: This year's climate features Tian Fu and Sui Hui. In the first half of the year, Yang Qi leaked excessively. Diseases observed belong to the Liver and Stomach. Jue Yin (Liver) is the organ of Wind, while Yang Ming (Stomach) is the organ of abundant Yang. Yin and Yang fail to support each other, inevitably leading to sudden Jue (reversal) obstruction. This can be avoided after Great Heat, as summer dampness and intense heat cause more opening and venting, preventing Yuan Qi (Original Qi) from connecting. However, this is root deficiency with branch excess, caused by ascending Qi and Fire. The Classic principles advocate bitter-cold, salty-moistening, sour-purging methods, with a slight addition of acrid-warm herbs. It is proposed to adopt the method of tonifying Yang Ming and draining Jue Yin.
Ren Shen (Ginseng Radix et Rhizoma), one qian. Sheng Mu Li (Concha Ostreae), five qian. Sheng Bai Shao (Paeoniae Radix Alba), two qian. Wu Mei Rou (Mume Fructus Carnositas), four fen. Chuan Huang Lian (Coptidis Rhizoma), stir-fried with salt water, six fen. Shu Ban Xia (Pinelliae Rhizoma Praeparatum), stir-fried with vinegar, rinsed with clear water, one qian.
Taken in the morning.
(Pill Formula) Ren Shen (Ginseng Radix et Rhizoma), two liang. Fu Ling (Poria), three liang, raw. Yan Shui Chao Huang Lian (Coptidis Rhizoma), stir-fried with salt water, five qian. Ban Xia (Pinelliae Rhizoma), stir-fried with vinegar, washed with water, one and a half liang. Yan Shui Chao Guang Pi (Citri Reticulatae Pericarpium), stir-fried with salt water, two liang. Zhi Shi (Aurantii Fructus Immaturus), bran-fried, one and a half liang. Bai Ji Li (Tribuli Fructus), processed with egg yolk, one and a half liang. Sheng Bai Shao (Paeoniae Radix Alba), one and a half liang. Wu Mei Rou (Mume Fructus Carnositas), steamed, one liang.
Ground into powder. Pills made with Zhu Li (Bambusae Succus). Taken in the morning, three qian per dose, with boiling water.
Furthermore: In summer, sour and bitter medicines are used to drain heat and harmonize the Stomach, unblocking the meridians. This treatment for Yang Ming and Jue Yin is very safe. With the cooling weather in autumn, Heaven and Earth gradually follow the principle of gathering and descending. Due to old age and lower deficiency, Wood lacks Water nourishment. Ministerial Fire and internal wind swirl, scorching the stomach region, reversing and causing vomiting. The tongue collaterals are scorched, appearing crimson like fire. Polydipsia and constipation are trivial matters. All this still belongs to the root sprout of Zhong Jue (Stroke/Reversal). Caution and quiet rest are advisable.
Sheng Ji Zi Huang (Ovi Ovum Vitellus), one piece. E Jiao (Colla Corii Asini), one and a half qian. Sheng Bai Shao (Paeoniae Radix Alba), three qian. Sheng Di Huang (Rehmanniae Radix), three qian. Tian Dong (Asparagi Radix), heart removed, one qian. Chuan Lian (Coptidis Rhizoma), raw, one fen.
Taken in the morning.
Furthermore: Heart Fire hyperactive at the upper level, all due to internal consumption of Ying (Nutritive) fluids. First, use Bu Xin Tang (Heart Tonifying Decoction) to regulate the function of the Heart.
Ren Shen (Ginseng Radix et Rhizoma), one qian, decocted together. Chuan Lian (Coptidis Rhizoma), water-fried, six fen. Xi Jiao (Rhinocerotis Cornu), two qian, shaved. Yuan Shen (Scrophulariae Radix), two qian. Xian Sheng Di Huang (Rehmanniae Radix), five qian. Dan Shen (Salviae Miltiorrhizae Radix), one qian. Juan Xin Zhu Ye (Bambusae Folium), two qian.
Furthermore: Bitter taste harmonizes Yang. The left pulse is quite harmonious, but there is palpitations and little sleep. This indicates decline of Ying Qi. Following the Suan Zao Ren Tang (Sour Jujube Seed Decoction) formula from *Jin Gui Yao Lue*, still harmonizing Yang, benefiting Heart Qi to unblock Liver collaterals.
Suan Zao Ren (Ziziphi Spinosae Semen), stir-fried black, not ground, five qian. Fu Shen (Poria cum Radice Xylodi), three qian. Zhi Mu (Anemarrhenae Rhizoma), one qian. Chuan Xiong (Ligustici Chuanxiong Rhizoma), one fen. Ren Shen (Ginseng Radix et Rhizoma), six fen, decocted together. Tian Dong (Asparagi Radix), heart removed, one qian.
Patient Chen: Left pulse rapid, right pulse wiry and slow. Elderly, robust appearance but weak Qi. At the transition of winter and spring, True Qi fails to sustain itself. Internal wind intensifies daily. Left limbs numb and insensible. Tongue deviated, speech slurred. This belongs to Zhong Luo (Stroke affecting collaterals). Regulate for one hundred days, abstain from alcohol and meat, hope for recovery. (Phlegm-fire obstructing collaterals)
Ling Yang Jiao (Capricornis Cornu) | Chen Dan Xing (Arannis Phlegma) | Dan Pi (Moutan Cortex) | Ju Hong (Citri Reticulatae Pericarpium Rubrum) | Lian Qiao Xin (Forsythiae Fructus Cor) | Shi Chang Pu (Acori Tatarinowii Rhizoma) | Gou Teng (Uncariae Ramulus cum Uncis) | Chuan Shi Hu (Dendrobii Caulis)
Furthermore: Ling Yang Jiao (Capricornis Cornu) | Yuan Shen (Scrophulariae Radix) | Lian Qiao (Forsythiae Fructus) | Hua Fen (Trichosanthis Radix) | Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) | Ju Hong (Citri Reticulatae Pericarpium Rubrum) | Zhu Li (Bambusae Succus)
Furthermore: Zhu Danxi said, numbness is Qi deficiency, stiffness is damp-phlegm and ruined blood. Diagnosis shows left pulse soft and choppy. Elderly patient with hemiplegia, indicating both Qi and Blood deficiency. Medical books often claim left side belongs to Blood deficiency and right side to Qi deficiency, which is not entirely accurate.
Ren Shen (Ginseng Radix et Rhizoma) | Ban Xia (Pinelliae Rhizoma) | Guang Pi (Citri Reticulatae Pericarpium) | Fu Ling (Poria) | Gui Shen (Angelicae Sinensis Radix) | Bai Shao (Paeoniae Radix Alba) | Zhi Cao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) | Sang Zhi (Mori Ramulus)
Furthermore: Meridians obstructed by phlegm, bowel movements unsatisfactory. Yesterday fell, causing Qi chaos, phlegm difficult to expectorate. Changed prescription to unblock meridians.
Chao Ban Xia (Pinelliae Rhizoma Praeparatum) | Shi Chang Pu (Acori Tatarinowii Rhizoma) | Guang Ju Hong (Citri Reticulatae Pericarpium Rubrum) | Fu Ling (Poria) | Dan Xing (Arannis Phlegma) | Zhi Shi (Aurantii Fructus Immaturus) | Zhu Li (Bambusae Succus) | Jiang Zhi (Zingiberis Rhizoma Recens Sucus)
Patient Ye: Early spring, internal stirring of Liver Wind. Dizziness and falling. Left limb hemiplegia and flaccidity. Tongue collaterals disharmonious. Breathing unsatisfactory. Phlegm-fire clouding upwards. Root deficiency in the lower jiao. First, clear upper phlegm-fire.
Ling Yang Jiao (Capricornis Cornu) | Fu Ling (Poria) | Ju Hong (Citri Reticulatae Pericarpium Rubrum) | Gui Zhi (Cinnamomi Ramulus) | Ban Xia (Pinelliae Rhizoma) | Yu Jin (Curcumae Radix) | Zhu Li (Bambusae Succus) | Jiang Zhi (Zingiberis Rhizoma Recens Sucus)
Furthermore: Wind-heat scorches bones and tendons causing pain. Phlegm-fire and Qi obstruction, breathing difficult. Follow previous formula, remove Yu Jin, Zhu Li, Jiang Zhi. Add Bai Ji Li (Tribuli Fructus) and Gou Teng (Uncariae Ramulus cum Uncis).
Furthermore: Chao Ban Xia (Pinelliae Rhizoma Praeparatum) | Fu Ling (Poria) | Gou Teng (Uncariae Ramulus cum Uncis) | Ju Hong (Citri Reticulatae Pericarpium Rubrum) | Jin Shi Hu (Dendrobii Caulis) | Shi Chang Pu (Acori Tatarinowii Rhizoma) | Zhu Li (Bambusae Succus) | Jiang Zhi (Zingiberis Rhizoma Recens Sucus)
Furthermore: Ren Shen (Ginseng Radix et Rhizoma) | Ban Xia (Pinelliae Rhizoma) | Zhi Shi (Aurantii Fructus Immaturus) | Fu Ling (Poria) | Ju Hong (Citri Reticulatae Pericarpium Rubrum) | Ji Li (Tribuli Fructus) | Zhu Li (Bambusae Succus) | Jiang Zhi (Zingiberis Rhizoma Recens Sucus)
Wind is the chief of all diseases, so medical texts list Stroke (Zhong Feng) as the first category. Symptom discussion distinguishes between True Stroke (Zhen Zhong) and Pseudo-Stroke (Lei Zhong), and involvement of collaterals, vessels, organs, and fu-organs. Treatment discussion includes expelling wind and attacking phlegm, nourishing blood and moistening dryness, tonifying Qi and cultivating origin. Generally, although True Stroke involves external wind, it also stems from internal deficiency, allowing pathogens to enter via deficiency. Northern wind is harsh and strong; Southern wind is gentle. Thus, True Stroke is less common in the South and more common in the North. Previous generations have fully prepared formulas for True Stroke, no need to elaborate. Regarding Pseudo-Stroke (Lei Zhong), Liu Hejian argued that fatigue causes the Five Emotions to exceed limits, stirring fire leading to stroke, all due to extreme heat generating fire. Li Dongyuan argued that insufficient Original Qi allows pathogens to gather, causing rigidity, collapse, and sudden falling resembling wind, due to Qi deficiency. Zhu Danxi argued that the Southeast has warm temperature and much dampness; dampness generates phlegm, phlegm generates heat, heat generates wind, thus emphasizing dampness. These three clarify the causes of Pseudo-Stroke. "Lei" means false/pseudo. Since modern times, physicians fail to distinguish true from false, often using Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Nan Xing (Arannis Phlegma), Ban Xia (Pinelliae Rhizoma), Wu Tou (Aconiti Radix), Fu Zi (Aconiti Lateralis Radix Praeparata), Xi Xin (Asari Radix et Rhizoma) to expel wind and resolve phlegm. Treating deficiency as excess is like trying to fit a square peg in a round hole. Now, Mr. Ye elucidates that Internal Wind is the movement of Yang Qi within the body. Liver is the organ of Wind. Due to depletion of essence and blood, Water fails to nourish Wood, Wood lacks nourishment, so Liver Yang becomes hyperactive, and Internal Wind arises. Treatment uses nourishing fluids to extinguish wind, moistening nutritive collaterals, tonifying Yin and subduing Yang, such as Hu Qian Wan (Tiger Crouching Pill), Gu Ben Wan (Root Consolidating Pill), and Fu Mai Tang (Restore Pulse Decoction). If both Yin and Yang are damaged, without Yin, Yang cannot transform, so gentle, moistening, and unblocking tonification is used, such as Di Huang Yin Zi (Rehmannia Drink) and Hai Shao Dan (Young Return Pill). Furthermore, if Wind-Wood moves excessively, damaging Middle Earth (Spleen/Stomach), which cannot control its conqueror (Wood controls Earth), symptoms include insomnia, anorexia, sparse defensive Qi with sweating, and food transforming into phlegm. Treatment uses Liu Jun Zi Tang (Six Gentlemen Decoction), Yu Ping Feng San (Jade Windscreen Powder), Fu Ling Yin (Poria Drink), Suan Zao Ren Tang (Sour Jujube Seed Decoction). Or if Wind-Yang rebels upward, phlegm-fire obstructs orifices, consciousness is unclear, then Zhi Bao Dan (Precious Treasure Pill) is used for aromatic opening of orifices, or acrid-cool herbs clear upper phlegm-fire. Although methods are not exhaustive, they sufficiently supplement predecessors' omissions. Regarding symptom differentiation: body flaccid and unable to hold, deafness, blurred vision, open mouth, closed eyes, letting go of hands, urinary incontinence, aphonia, snoring sleep—these indicate root foundation is uprooted, pivot of Yin and Yang does not connect, similar to sudden collapse. This is not external wind, but pure deficiency. Therefore, the master urgently uses large doses of Ren Shen (Ginseng Radix et Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata) to restore Yang. Fearing pure Yang-tonics are too harsh, Yin herbs are added to salvage the situation. If limbs are spasmodic, hemiplegia, facial deviation, stiff tongue, slurred speech, bowel/bladder dysfunction—this indicates prior constitutional deficiency, Wind-Yang carrying phlegm-fire obstructing, causing disharmony of Ying and Wei and collaterals. Urgent treatment first opens orifices, then benefits Qi and nourishes Blood, assisting with resolving phlegm, clearing fire, and unblocking meridians. When Qi is full and Blood abundant, collaterals are smooth, and disease can heal. Feng Fei (Wind Flaccidity), Feng Yi (Speech Impairment), Feng Bi (Wind Obstruction), and Paralysis are concurrent symptoms of the Wind category, with similar principles. Various treatments in cases, I cannot fully explain their rationale, only briefly outlining the main points, classified for later readers. My disciples imitate this. (Hua Xiuyun)
Commentary by Xu Lingtai: For diseases caused by excessive Wind, from the *Nei Jing* to famous doctors of Tang and Song, the basis is acrid-cool and sweet-cool, assisted by wind-expelling and blood-nourishing herbs. Liu Hejian introduced Di Huang Yin Zi (Rehmannia Drink), which treats Kidney deficiency Fei syndrome, resembling stroke, but is not used for acute stroke. Recently, many physicians encountering stroke always start with Ren Shen (Ginseng Radix et Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), and Gui Zhi (Cinnamomi Ramulus) as the first prescription. Mild cases do not recover, severe cases die immediately. Asked for the source, they say it comes from Mr. Ye. I initially believed this truly came from Ye. Upon reading this book, I realized this master had profound learning and flexible thinking, consistent with predecessors' theories. He uses Ren Shen (Ginseng Radix et Rhizoma) only after the disease trend recedes, to cultivate origin and nourish Qi. When the disease is severe, he definitely uses it with wind-expelling herbs. Dosages are only a few fen to qian, always appropriate. Today, those who falsely claim his discipleship and steal his residual theories act oppositely. If this master were alive, would he not hate them? And those using such heretical sayings to slander him and harm people, should they not die of shame facing this book?