中风大率主血虚有痰，治痰为先，次养血行血。或属虚，挟火（一作痰）与温，又须分气
虚血虚。半身不遂，大率多痰，在左属死血瘀（一作少）血，在右属痰有热，并气虚。左以四
物汤加桃仁、红花、竹沥、姜汁，上以二陈汤四君子等汤加竹沥、姜汁。痰壅盛者、口眼 斜
者、不能言者，皆当用吐法，一吐不已，再吐。轻者用瓜蒂一钱，或稀涎散，或虾汁，以虾
半斤，入酱、葱、姜等料物，水煮。先吃虾，次饮汁，后以鹅翎探引。吐痰用虾者，盖引其
风出耳，重者用藜芦半钱，或三分，加麝香少许，齑汁调，吐。若口噤昏迷者，灌入鼻内吐
之。虚者不可吐。气虚卒倒者，用参 补之，有痰，浓煎参汤加竹沥、姜汁；血虚用四物汤
，俱用姜汁炒，恐泥痰故也，有痰再加竹沥、姜汁入内服，能食者，去竹沥加荆沥。肥白人
多温，少用乌头、附子行经，凡用乌、附，必用童便煮过，以杀其毒。初昏倒，急掐人中，
至醒，然后用痰药，以二陈汤、四君子汤、四物汤加减用之；瘦人阴虚火热，用四物汤加牛
膝、竹沥、黄芩、黄柏，有痰者加痰药，治痰气实而能食，用荆沥，气虚少食，用竹沥。此
二味开经络行血气故也。入四物汤，必用姜汁助之。遗尿属气，以参 补之。筋枯者，举
动则痛，是无血不能滋养其筋，不治也。《脉诀》内言诸不治证∶口开手撒，眼合遗尿，吐
沫直视，喉如鼾睡，肉脱筋痛，发直摇头上窜，面赤如妆，或头面青黑，汗缀如珠，皆不可
治。
案《内经》以下，皆谓外中风邪。然地有南北之殊，不可一途而论。惟刘守真作将息失
宜，水不能制火，极是。由今言之，西北二方，亦有真为风所中者，但极少尔。东南之人，
多是湿土生痰，痰生热，热生风也。邪之所凑，其气必虚。风之伤人，在肺脏为多。许学士
谓气中者亦有，此七情所伤。脉微而数，或浮而紧，缓而迟。必也脉迟浮可治，大数而极者
死。若果外中者，则东垣所谓中血脉、中府、中脏之理，其于四肢不举，亦有与痿相类者，
当细分之。《局方》风痿同治，大谬。发挥甚详。子和用三法，如的系邪气卒中，痰盛实热
者可用，否则不可。
入方∶
肥人中风，口 ，手足麻木，左右俱作痰治。
贝母 栝蒌 南星 荆芥 防风 羌活 黄柏 黄芩 黄连 白术 陈皮 半夏 薄桂
甘草 威灵仙 天花粉
多食湿面，加附子、竹沥、姜汁、酒一匙行经。
一妇手足左瘫，口不能语，健啖。
防风 荆芥 羌活 南星 没药 乳香 木通 茯苓 浓朴 桔梗 麻黄 甘草 全蝎
上为末。汤酒调下。不效，时春脉伏，渐以淡盐汤齑汁每早一碗，吐五日。仍以白术、
陈皮、茯苓、甘草、浓朴、菖蒲，日二帖。后以川芎、山栀、豆豉、瓜蒂、绿豆粉、齑汁、
盐汤吐之，吐甚快。不食，后以四君子汤服之，以当归、酒芩、红花、木通、粘子、苍术、
姜南星、牛膝、茯苓为末，酒糊丸。服十日后，夜间微汗，手足动而能言。
一人瘫左。
酒连 酒芩 酒柏 防风 羌活 川芎 当归（半两） 南星 苍术 人参（一两） 麻黄 甘
草（三钱） 附子（三片）
上丸如弹子大。酒化服。
一人体肥中风，先吐，后以药∶
苍术 南星 酒芩 酒柏 木通 茯苓 牛膝 红花 升麻 浓朴 甘草
〔附录〕风者，百病之始，善行而数变。行者动也，风本为热，热胜则风动。宜以静胜其
燥，养血是也。治须少汗，亦宜少下，多汗则虚其卫，多下则损其荣。治其在经，虽有汗下
之戒，而有中脏、中府之分，中府者宜汗之，中脏者宜下之。此虽合汗下，亦不可太过，汗
多则亡阳，下多则亡阴，亡阳则损其气，亡阴则损其形。初谓表里不和，须汗下之，表里已
和，是宜治之在经。其中府者，面显五色，有表证而脉浮，恶风恶寒，拘急不仁，或中身之
后，身之前，身之侧，皆曰中府也。其治多易。中脏者，唇吻不收，舌不转而失音，鼻不闻
香臭，耳聋而眼瞀，大小便秘结，或眼合直视，摇头，口开，手撒，遗溺，痰如拽锯，鼻鼾
，皆曰中脏也。中脏者多不治也。六腑不和，留结为痈；五脏不和，九窍不通。无此乃在经
也，初证既定，宜以大药养之，当顺时令而调阴阳，安脏腑而和营卫，少有不愈者也。风中
府者，先以加减续命汤，随证发其表。如兼中脏，则大便多秘涩，宜以三化汤通其滞。初证
已定，别无他变，以大药和治之。大抵中府者多着四肢，中脏者多滞九窍。中府者多兼中脏
之证，至于舌强失音，久服大药，能自愈也。又因气中，其证与中风相似，但风中多痰涎，
气中口中无涎，治之之法，调气为先，经言治风者以理气，气顺则痰消，徐理其风，庶可收
效。又有中已，言不变，志不乱，病在分腠之间者，只宜温肝取解汗，为可复也。凡中风，
脉多沉伏，大法浮迟者吉，沉实者凶。先用麻油调苏合香丸，或用姜汁，或用白汤调，如口
噤，抉开灌之，稍醒则服八味顺气散。若痰盛者，只以省风导痰汤服之。若中则昏沉不省人
事，口噤，急以生半夏末吹入鼻中，或用细辛、皂角为末吹之，喷嚏则苏，无嚏者不治。肥
人中者，以其气盛于外而歉于内也，肺为气出入之道，肥者气必急，气急必肺邪盛，肺金克
木，胆为肝之府，故痰涎壅盛。所以治之必先理气为急，中后气未顺，痰未除，调理之剂，
惟当以藿香正气散和星香散煎服。此药非特可治中风之证，治中气中恶，尤宜，寻常止呕多
痰者，亦可用之。若前证多怒，宜小续命汤加羚羊角；热而渴者，汤中去附子，加秦艽半钱
；恍惚错语，加茯神、远志各半钱；不得睡，加酸枣仁半钱；不能言，加竹沥一蚬壳许；人
虚无力者，去麻黄，加人参如其数。若人自苏，能言能食，惟身体不遂，急则挛蜷，缓则
曳，经年不愈，以加减地仙丹常服。若饮食坐卧如常，但失音不语，只以小续命去附子，加
菖蒲一钱。治风之法，初得之，即当顺气，及日久，即当活血，此万古不易之至理，惟可以
四物汤吞活络丹愈者，正是此义。若先不顺气化痰，遽用乌、附，又不活血，徒用防风、天
麻、羌活辈，吾未见能治也。又见风中于肤腠，辄用脑麝治之者，是引风入骨髓也，尤为难
治，深可戒哉！如口 斜未正者，以蓖麻去壳烂捣，右 涂左，左 涂右，或鲜鱼血入麝香
少许，涂之即正。嚏嚏，初卒倒，僵仆不知人事，急以皂角末，或不卧散于鼻内吹之，就提
头顶发，立苏。若有嚏者可治，无嚏者不治。经曰∶风从汗泄，似可微汗。正如解表，表实
无汗者，散之劫之。表虚自汗者，温之解之。若气滞者难治，宜吐之（余症见前）。可下者，
此因内有便溺之阻隔，故里实。若三五日不大便者，可与《机要》三化汤，或子和搜风丸，
老人只以润肠丸。理气者，气滞气郁，肩膊麻痛之类，此七情也，宜乌药顺气、八味顺气之
类；理血者，无表里之急，血弱举发不时者，用大秦艽汤，或羌活愈风汤，兼用化痰丸子。
灸，可灸风池、百会、曲池、合谷、风市、绝骨、环跳、肩 、三里等穴。皆灸之以凿窍疏
附方∶
二陈汤
半夏（泡） 陈皮（二两半） 白茯苓（两半） 甘草（炙，七钱半）
上 咀。每服四钱，水一盏，生姜七片，乌梅一个，煎。
四君子汤 见脾胃类。
四物汤 见妇人类。
稀涎散 治中风忽然若醉，形体昏闷，四肢不收，涎潮搐搦。
猪牙皂角（四条，去黑皮） 白矾（一两）
上为末。每服三字，温水灌下。但吐出涎便醒，虚人不可大吐。
通顶散 治中风中气，昏愦不知人事，急用吹鼻即苏。
藜芦 生甘草 川芎 细辛 人参（各一钱）
上为末。吹入鼻中一字，就提头顶中发，立苏。有嚏者可治。
八味顺气散
白术 白茯苓 青皮 白芷 陈皮（去白） 台乌药 人参（各一两） 甘草（五钱）
每服五钱，水一钟半，煎七分，温服。仍以酒化苏合香丸间服。
乌药顺气散
麻黄 陈皮 台乌（各二两） 白僵蚕（炒） 川芎 枳壳（炒） 甘草（炙） 白芷 桔梗（各一
两） 干姜（炮，半两）
上为末。每服三钱，水二盏，生姜三片，枣一枚，煎服。
星香汤
南星（八钱） 木香（一钱）
分二服，水一钟，姜十片，煎服。
省风汤
南星（生，八两） 防风（四两） 独活 附子（生，去皮脐） 全蝎（炒） 甘草（生，各二
每服四钱，水一钟半，生姜十片，煎服。
小省风汤 与导痰汤相合，煎服。导痰汤见痰类。
防风 南星（生，各四两） 半夏（米泔浸） 黄芩 甘草（生，各二两）
每服四钱，姜十片。
小续命汤
麻黄（去节） 人参 黄芩 芍药 川芎 甘草（炙） 杏仁（炒，去皮尖） 防己 桂（各一
两） 防风（一两半）附子（炮，去皮脐，半两）
每服五钱，水一盏半，姜五片，枣一枚，煎。温服，取微汗。随人虚实与所中轻
重，加减于后∶若热者，去附子，入白附子亦可；筋急拘挛，语迟，脉弦，加苡薏仁；若筋
急，加人参，去黄芩、芍药，以避中寒，服后稍轻，再加当归；烦燥不大便，去附、桂，倍
加芍药、竹沥；如大便三五日不去，胸中不快，加枳壳、大黄；如言语謇涩，手足颤掉，加
菖蒲、竹沥；若发渴，加麦冬、葛根、栝蒌根；身体痛，加羌活；搐者亦加之；烦燥多惊者
，加犀角、羚羊角；汗多者，去麻黄。
家宝丹 治一切风疾瘫痪，痿痹不仁，口眼 僻者，邪入骨髓，可服。
川乌 轻粉（各一两） 五灵脂（姜汁制，另研） 草乌（各六两） 南星 全蝎 没药 辰砂（各二
两） 白附子 乳香 僵蚕（炒，三两） 片脑（五钱） 羌活 麝香 地龙（四两） 雄黄 天麻（三两）
上为末，作散。调三分，不觉，半钱。或蜜丸如弹子大，含化茶调皆可。
如神救苦散 治瘫痪，风湿痹走注，疼痛不止。此劫剂也，非痛不可服
米壳（一两，去顶膜，蜜炒） 陈皮（五钱） 虎骨（酥炙） 乳香（研） 没药（研） 甘草（各二钱
上为末。每服三钱，水一盏煎。连渣服，病在上食后，在下食前，煎时须顺搅之。
大秦艽汤 治中风，外无六经之形证，内无便溺之阻隔，
知血弱不能养筋，故手足不能运动，舌强不能言语，宜养血而筋自荣。
秦艽 石膏（各二两） 甘草 川芎 当归 白芍 羌活 防风 黄芩 白芷 白术 生
熟地黄 茯苓 独活（各一两） 细辛 春夏加知母（一两）
上 咀。每服一两，水煎服，无时。如遇天阴，加生姜七片；心下痞，加枳实一钱。
三化汤 外有六经之形证，先以加减续命汤治之。若内有便溺之阻隔，以此汤主之。
浓朴 大黄 枳实 羌活（等分）
每服三两，水煎服，以利为度。
〔附录〕法曰∶四肢不收举，俗曰瘫痪，故经所谓太过则令人四肢不举。又曰∶上太过则
敦阜。阜，高也；敦，浓也。既浓而又高，则令除去，此真所谓膏粱之疾，非肾肝经虚。何
以明之？经所谓三阳三阴发病，偏枯痿易，四肢不举。三阴不足，则发偏枯；三阳有余，则
为痿易，易为变易，常用而痿弱无力也。其治则泻令气弱，阳衰土平而愈，故以三化汤下之
。若脾虚则不用也，经所谓土不及则卑陷。卑，下也；陷，坑也。故脾病四肢不用，四肢皆
禀气于胃，而不能至经，必因脾方可得禀受也。令脾不能与胃行其津液，四肢不得禀水谷，
气日以衰，脉道不利，筋骨肌肉皆无气以生，故不用焉。其治可大补十全散、加减四物汤，
去邪留正。
愈风汤 中风症，内邪已除，外邪已尽，当服此药以行导诸经。久服大风悉去，纵有微
邪，只从此药加减治之。然治病之法，不可失于通塞，或一气之微汗，或一旬之通利，如此
乃常治之法也。久则清浊自分，营卫自和。如初觉风动，服此不至倒仆。
羌活 甘草（炙） 防风 防己 黄 蔓荆子 川芎 独活 细辛 枳壳 麻黄（去根）
地骨皮 人参 知母 甘菊 薄荷（去梗） 白芷 枸杞子 当归 杜仲（炒） 秦艽 柴胡
半夏 浓朴（姜制） 前胡 熟地黄（各二两） 白茯苓 黄芩（三两） 生地黄 苍术 石膏
芍药（各四两） 桂（一两）
上锉。每服一两，水二钟，生姜三片煎，空心一服，临卧煎渣。空心一服，吞下二
丹丸，为之重剂。临卧一服，吞下四白丹，为之轻剂。立其法，是动以安神，静以清肺。假
令一气之微汗，用愈风汤三两，加麻黄一两，匀作四服，加生姜空心服，以粥投之，得微汗
则佳。如一旬之通利，用愈风汤三两，加大黄一两，亦匀作四服，如前服，临卧服，得利为
度。此药常服之，不可失四时之辅。如望春大寒之后，本方中加半夏、人参、柴胡各二两，
通前四两，谓迎而夺少阳之气也；如望夏谷雨之后，本方中加石膏、黄芩、知母各二两，谓
Stroke is generally caused by blood deficiency with phlegm; treatment should prioritize resolving phlegm, followed by nourishing blood and promoting blood circulation. Some cases are due to deficiency, complicated by fire (or alternatively phlegm) and warmth, requiring differentiation between Qi deficiency and Blood deficiency. Hemiplegia is mostly due to phlegm obstruction; lesions on the left are attributed to dead blood stasis (or alternatively blood insufficiency), while those on the right are attributed to phlegm-heat accompanied by Qi deficiency. For left-sided lesions, Siwu Tang (Four Substances Decoction) is used with added Tao Ren (Peach Kernel), Hong Hua (Safflower), Zhu Li (Bamboo Sap), and Jiang Zhi (Ginger Juice). For right-sided lesions, Erchen Tang (Two Aged Ingredients Decoction), Sijunzi Tang (Four Gentlemen Decoction), or similar formulas are used with added Zhu Li and Jiang Zhi. In cases of severe phlegm congestion, facial deviation, or inability to speak, emesis therapy should be employed; if one dose is insufficient, repeat it. For mild cases, Gua Di (Melon Stalk) 1 qian is used, or Xixian San (Thin Saliva Powder), or shrimp juice (made by boiling half a jin of shrimp with sauce, scallion, ginger, etc.). The patient eats the shrimp first, then drinks the juice, and finally induces vomiting using a goose feather probe. Shrimp is used for emesis to guide wind out. For severe cases, Li Lu (Veratrum Root) 0.5 qian or 3 fen is used with a small amount of She Xiang (Musk), mixed with vinegar juice for emesis. If the patient has locked jaw and coma, the medicine is instilled into the nose to induce vomiting. Deficient patients must not undergo emesis. For sudden collapse due to Qi deficiency, Ren Shen (Ginseng) is used to tonify; if phlegm is present, concentrated Ren Shen decoction is used with Zhu Li and Jiang Zhi. For Blood deficiency, Siwu Tang is used, all ingredients stir-fried with Jiang Zhi to prevent cloying phlegm; if phlegm is present, Zhu Li and Jiang Zhi are added. If the patient can eat, Zhu Li is removed and Jing Li (Schizonepeta Sap) is added. Obese people often have dampness-warmth; Wu Tou (Aconite Lateral Root) and Fu Zi (Prepared Aconite Root) should be used sparingly for channel unblocking. Whenever Wu Tou or Fu Zi is used, they must be boiled in Tong Bian (Child's Urine) to reduce toxicity. Upon initial collapse, urgently pinch Ren Zhong (GV26) until consciousness returns, then use phlegm-resolving medicines, adjusting Erchen Tang, Sijunzi Tang, and Siwu Tang as needed. Thin people with Yin deficiency and fire-heat use Siwu Tang with Niu Xi (Achyranthes Root), Zhu Li, Huang Qin (Scutellaria Root), and Huang Bai (Phellodendron Bark); if phlegm is present, add phlegm-resolving herbs. For excess Qi and ability to eat, use Jing Li; for deficient Qi and poor appetite, use Zhu Li. These two substances open channels and promote Qi and Blood movement. When adding them to Siwu Tang, Jiang Zhi is essential. Enuresis is attributed to Qi deficiency and treated with Ren Shen. Withered sinews causing pain upon movement indicate lack of blood nourishment and are incurable. The *Mai Jue* lists several incurable signs: open mouth and scattered hands, closed eyes with enuresis, foaming at the mouth with fixed gaze, snoring sound in the throat, muscle wasting with sinew pain, straight hair with head shaking and upward eye deviation, face red like makeup, or blue-black head/face, sweat beads like pearls—all are incurable.
Commentary: Texts following the *Nei Jing* attribute stroke to external wind-pathogens. However, geographical differences between north and south mean one cannot apply a single approach universally. Liu Shouzhen’s view that improper lifestyle leads to water failing to control fire is highly accurate. From a modern perspective, true wind-stroke in the northwest exists but is rare. People in the southeast mostly suffer from damp-earth generating phlegm, which generates heat, which generates wind. Where pathogens gather, Qi is necessarily deficient. Wind pathogens injure the body most frequently in the Lung organ. Xu Xueshi mentions "Qi Zhong" (Qi Stroke) also exists, caused by emotional injuries. Pulse may be subtle and rapid, or floating and tight, slow and delayed. A slow and floating pulse indicates treatability; a large, rapid, and extreme pulse indicates death. If indeed an external wind strike, Dong Yuan’s theory of invasion of collaterals, fu-organs, and zang-organs applies. Limb paralysis may resemble Wei syndrome (flaccidity syndrome) and requires careful differentiation. The *Ju Fang* treating wind and wei together is a major error, which is elaborated here. He Zihe’s three methods are applicable only if there is definite pathogenic strike with excessive phlegm and excess heat; otherwise, they are contraindicated.
Prescriptions:
For obese patients with stroke, facial deviation, and numbness in limbs, treat both sides as phlegm disorders.
Bei Mu (Fritillaria Bulb), Gua Lou (Trichosanthes Fruit), Nan Xing (Arisaema Rhizome), Jing Jie (Schizonepeta Spike), Fang Feng (Saposhnikovia Root), Qiang Huo (Notopterygium Rhizome), Huang Bo (Phellodendron Bark), Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Bai Zhu (Atractylodes Rhizome), Chen Pi (Citrus Peel), Ban Xia (Pinellia Tuber), Bo Gui (Cinnamon Twig), Gan Cao (Licorice Root), Wei Ling Xian (Clematis Root), Tian Hua Fen (Trichosanthes Root).
If consuming much wet noodles, add Fu Zi, Zhu Li, Jiang Zhi, and one spoonful of wine to promote circulation.
Case: A woman with left-sided hemiplegia, aphasia, but good appetite.
Fang Feng, Jing Jie, Qiang Huo, Nan Xing, Mo Yao (Myrrh), Ru Xiang (Olibanum), Mu Tong (Akebia Stem), Fu Ling (Poria), Hou Po (Magnolia Bark), Jie Geng (Platycodon Root), Ma Huang (Ephedra Stem), Gan Cao, Quan Xie (Scorpion).
Grind into powder. Take with decoction or wine. If ineffective, during spring when pulse is hidden, gradually take one bowl of light salt-vinegar juice every morning, inducing vomiting for five days. Then use Bai Zhu, Chen Pi, Fu Ling, Gan Cao, Hou Po, Shi Chang Pu (Acorus Rhizome), two doses daily. Later, induce vomiting with Chuan Xiong (Ligusticum Rhizome), Shan Zhi (Gardenia Fruit), Dou Chi (Fermented Soybean), Gua Di, Lv Dou Fen (Mung Bean Powder), vinegar juice, and salt water, resulting in very effective vomiting. After fasting, administer Sijunzi Tang. Then make pills from Dang Gui (Angelica Sinensis), Jiu Qin (Wine-fried Scutellaria), Hong Hua, Mu Tong, Nian Zi (Plantago Seed), Cang Zhu (Atractylodes Rhizome), Jiang Nan Xing (Ginger-processed Arisaema), Niu Xi, Fu Ling, ground into powder, bound with wine paste. After ten days, slight night sweating occurred, limbs moved, and speech returned.
Case: One person with left-sided hemiplegia.
Jiu Lian (Wine-fried Coptis), Jiu Qin, Jiu Bai (Wine-fried Phellodendron), Fang Feng, Qiang Huo, Chuan Xiong, Dang Gui (half liang), Nan Xing, Cang Zhu, Ren Shen (one liang), Ma Huang, Gan Cao (three qian), Fu Zi (three slices).
Make pills the size of bullet seeds. Dissolve in wine and take.
Case: An obese person with stroke, first induced vomiting, then medicated:
Cang Zhu, Nan Xing, Jiu Qin, Jiu Bai, Mu Tong, Fu Ling, Niu Xi, Hong Hua, Sheng Ma (Cimicifuga Rhizome), Hou Po, Gan Cao.
[Appendix] Wind is the beginning of all diseases; it moves swiftly and changes frequently. Movement implies activity; wind is fundamentally heat, and excessive heat causes wind movement. Tranquility should overcome dryness; nourishing blood achieves tranquility. Treatment should involve minimal sweating and minimal purging. Excessive sweating damages Wei Qi (Defensive Qi); excessive purging damages Ying Blood (Nutritive Blood). Treating disease in the channels, although sweating and purging are cautioned against, there is a distinction between invasion of zang and fu organs. Invasion of fu organs requires sweating; invasion of zang organs requires purging. While this aligns with sweating and purging, it must not be excessive. Excessive sweating leads to loss of Yang; excessive purging leads to loss of Yin. Loss of Yang damages Qi; loss of Yin damages Form. Initially, if exterior and interior are disharmonious, sweating and purging are needed. Once harmonized, treat the channels. Fu organ invasion presents with five colors on the face, exterior symptoms, floating pulse, aversion to wind/cold, stiffness, insensitivity, affecting back, front, or sides of the body—this is Fu organ invasion, which is easier to treat. Zang organ invasion presents with loose lips, immobile tongue with aphasia, anosmia, deafness, blurred vision, constipation of urine and feces, closed eyes with fixed gaze, head shaking, open mouth, scattered hands, enuresis, sawing-sound phlegm, snoring—this is Zang organ invasion, mostly incurable. Disharmony of six fu organs leads to abscesses; disharmony of five zang organs leads to nine orifice blockage. Absence of these indicates channel involvement. Once initial diagnosis is confirmed, use major tonics to nourish, adjust Yin-Yang according to seasons, settle zang-fu, and harmonize Ying-Wei; recovery is likely. For wind invading fu organs, first use Modified Xuming Tang to release the exterior. If combined with zang invasion, constipation is common; use Sanhua Tang to clear stagnation. Once initial condition stabilizes without other changes, use major medicines to harmonize. Generally, fu invasion affects limbs; zang invasion affects nine orifices. Fu invasion often accompanies zang symptoms. Tongue stiffness and aphasia may resolve with long-term tonic use. "Qi Zhong" resembles stroke but lacks salivary secretion; treatment prioritizes regulating Qi. As stated, treating wind involves regulating Qi; smooth Qi resolves phlegm, then address wind slowly for effect. "Zhong E" (Heat Stroke) where speech and consciousness remain intact, with pathology in interstices, should be treated by warming Liver and inducing sweat for recovery. Stroke pulses are mostly deep and hidden; floating and slow pulses are auspicious, deep and solid are ominous. First use Su He Xiang Wan (Styrax Pill) mixed with sesame oil, or ginger juice, or warm water. If jaw is locked, pry open and instill. Once slightly awake, take Bawei Shunqi San (Eight-Ingredient Qi-Regulating Powder). For excessive phlegm, use Shengfeng Daotan Tang. If heat stroke causes coma and locked jaw, blow raw Ban Xia powder into nose, or fine Xin Xi (Asarum Root) and Zao Jiao (Soap Pod) powder; sneezing indicates revival, no sneezing is incurable. Obese stroke patients have excess Qi externally but deficiency internally. Lung governs Qi passage; obesity causes rapid Qi, leading to Lung excess. Lung Metal overacts on Wood; Gallbladder is the house of Liver, causing phlegm congestion. Thus, regulating Qi is urgent. Post-stroke, if Qi is unsmooth and phlegm remains, use Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) and Xingxiang Tang (Arisaema and Costus Decoction). This formula treats stroke, Qi stroke, and evil qi, and is suitable for vomiting with phlegm. If anger predominates, use Minor Xuming Tang with Ling Yang Jiao (Antelope Horn); if heat/thirst, remove Fu Zi, add Qin Jiao (Gentiana Root) 0.5 qian; if confusion/muttering, add Fu Shen (Poria with Hostwood) and Yuan Zhi (Polygala Root) 0.5 qian each; if insomnia, add Suan Zao Ren (Zizyphus Seed) 0.5 qian; if aphasia, add Zhu Li; if weak/depleted, remove Ma Huang, add Ren Shen equivalent. If self-recovering, able to speak/eat, but limb paralysis persists, spasming acutely or dragging chronically, unyielding for years, use Jiandi Xian Dan (Modified Immortal Pill) regularly. If diet/sleep normal but aphonic, use Minor Xuming Tang minus Fu Zi, add Shi Chang Pu 1 qian. Treating wind: initially regulate Qi, later invigorate Blood—this eternal principle is best realized by taking Silu Dan (Collateral-Unblocking Pill) swallowed with Siwu Tang. Failing to regulate Qi/resolve phlegm first, and hastily using Wu Tou/Fu Zi without invigorating Blood, merely using Fang Feng, Tian Ma (Gastrodia Rhizome), Qiang Huo, etc., will fail. Using Nao (Camphor) and She Xiang for wind in skin/subcutaneous tissue draws wind into marrow, making it difficult to treat—caution! For persistent facial deviation, mash castor beans (remove shell), apply right deviation to left side, left to right, or fresh fish blood with少许 Musk; application corrects deviation. For sudden collapse/coma, blow Zao Jiao powder or Buwo San (Non-Sleeping Powder) into nose, pull scalp hair; immediate revival occurs. Sneezing indicates treatability; absence indicates incurability. Scripture says: wind exits via sweat; slight sweating is appropriate. Like releasing exterior: exterior excess with no sweat requires dispersing/forcing; exterior deficiency with spontaneous sweating requires warming/releasing. Qi stagnation is hard to treat; emesis is indicated (see previous symptoms). Purging is indicated if internal stool/urine obstruction causes interior excess. For constipation of 3-5 days, use Sanhua Tang from *Jiyao* or He Zihe’s Sofeng Wan; elderly use Runchang Wan (Intestine-Moistening Pill). Regulating Qi addresses Qi stagnation/depression, shoulder/arm numbness/pain (Seven Emotions); use Wuyao Shunqi or Bawei Shunqi. Regulating Blood addresses non-urgent exterior/interior, frequent flare-ups due to weak Blood; use Daqin Jiao Tang or Qianghuo Yufeng Tang, combined with Huatan Wan (Phlegm-Resolving Pill). Acupuncture: Moxibustion on Fengchi (GB20), Baihui (GV20), Quchi (LI11), Hegu (LI4), Fengshi (GB31), Juegu (GB39), Huantiao (GB30), Jianyu (LI15), Zusanli (ST36). Moxa to open orifices and疏附...
Formulas:
Erchen Tang (Two Aged Ingredients Decoction)
Ban Xia (Processed Pinellia Tuber), Chen Pi (Citrus Peel, 2.5 liang), Bai Fu Ling (Poria, 1.5 liang), Zhi Gan Cao (Honey-fried Licorice Root, 0.75 qian).
Coarsely crush. Take 4 qian per dose, with one cup water, 7 slices ginger, one dark plum, decoct.
Sijunzi Tang (Four Gentlemen Decoction) See Spleen/Stomach category.
Siwu Tang (Four Substances Decoction) See Women’s category.
Xixian San (Thin Saliva Powder) Treats sudden stroke resembling drunkenness, mental clouding, limb flaccidity, saliva flooding, and convulsions.
Zhu Ya Zao Jiao (Tusk-like Soap Pod, 4 strips, remove black skin), Bai Fan (Alum, 1 liang).
Grind to powder. Take 3 zi per dose,灌 with warm water. Awakening occurs upon expulsion of saliva; do not induce strong emesis in deficient persons.
Tongding San (Reaching Top Powder) Treats stroke/Qi stroke with coma and unconsciousness. Blow into nose for immediate revival.
Li Lu (Veratrum Root), Sheng Gan Cao (Raw Licorice Root), Chuan Xiong (Ligusticum Rhizome), Xi Xin (Asarum Root), Ren Shen (Ginseng) (each 1 qian).
Grind to powder. Blow 1 zi into nose, simultaneously pull mid-scalp hair for immediate revival. Treatable if sneezing occurs.
Bawei Shunqi San (Eight-Ingredient Qi-Regulating Powder)
Bai Zhu (Atractylodes Rhizome), Bai Fu Ling (Poria), Qing Pi (Green Citrus Peel), Bai Zhi (Angelica Dahurica Root), Qu Bai Chen Pi (Citrus Peel minus white pith), Tai Wu Yao (Linderia Fruit), Ren Shen (Ginseng) (each 1 liang), Gan Cao (Licorice Root, 5 qian).
Take 5 qian per dose, with 1.5 cups water, decoct to 0.7 cup, take warm. Alternate with Su He Xiang Wan dissolved in wine.
Wuyao Shunqi San (Linderia Qi-Regulating Powder)
Ma Huang (Ephedra Stem), Chen Pi, Tai Wu Yao (each 2 liang), Chao Bai Jiang Can (Fried White Silkworm), Chuan Xiong, Chao Zhi Ke (Fried Aurantium Fruit), Zhi Gan Cao, Bai Zhi, Jie Geng (each 1 liang), Pao Gan Jiang (Roasted Dried Ginger, 0.5 liang).
Grind to powder. Take 3 qian per dose, with 2 cups water, 3 slices ginger, one jujube, decoct.
Xingxiang Tang (Arisaema and Costus Decoction)
Nan Xing (Arisaema Rhizome, 8 qian), Mu Xiang (Costus Root, 1 qian).
Divide into two doses. Decoct with one cup water, 10 slices ginger.
Shengfeng Tang (Wind-Prostrating Decoction)
Sheng Nan Xing (Raw Arisaema, 8 liang), Fang Feng (Saposhnikovia Root, 4 liang), Du Huo (Angelica Pubescens Root), Sheng Fu Zi (Raw Prepared Aconite Root, peeled), Chuan Quan Xie (Fried Scorpion), Sheng Gan Cao (Raw Licorice Root) (each 2 liang).
Take 4 qian per dose, with 1.5 cups water, 10 slices ginger, decoct.
Xiao Shengfeng Tang (Minor Wind-Prostrating Decoction) Combine with Daotan Tang (Phlegm-Expelling Decoction), see Phlegm category.
Fang Feng, Sheng Nan Xing (each 4 liang), Ban Xia (Rice-water soaked), Huang Qin, Sheng Gan Cao (each 2 liang).
Take 4 qian per dose, with 10 slices ginger.
Xiao Xuming Tang (Minor Xuming Decoction)
Qu Jie Ma Huang (De-jointed Ephedra), Ren Shen, Huang Qin, Shao Yao (Peony Root), Chuan Xiong, Zhi Gan Cao, Chao Xing Ren (Fried Apricot Seed, peeled/cored), Fang Ji (Stephania Root), Gui (Cinnamon Twig) (each 1 liang), Fang Feng (1.5 liang), Pao Fu Zi (Roasted Prepared Aconite Root, peeled, 0.5 liang).
Take 5 qian per dose, with 1.5 cups water, 5 slices ginger, one jujube, decoct. Take warm to induce slight sweating. Adjust based on deficiency/excess and severity: For heat, remove Fu Zi, add Bai Fu Zi (Typhonium Rhizome) is also acceptable; for stiff/tight sinews, delayed speech, string-taut pulse, add Yi Yi Ren (Coix Seed); for stiff sinews, add Ren Shen, remove Huang Qin/Shao Yao to avoid cold injury; after slight improvement, add Dang Gui; for irritability/constipation, remove Fu/Gui, double Shao Yao and Zhu Li; for 3-5 day constipation with chest discomfort, add Zhi Ke (Aurantium Fruit) and Da Huang (Rhubarb Root); for slurred speech/trembling limbs, add Shi Chang Pu and Zhu Li; for thirst, add Mai Dong (Ophiopogon Tuber), Ge Gen (Kudzu Root), Gua Lou Gen (Trichosanthes Root); for body pain/add cramps, add Qiang Huo; for irritability/fright, add Xi Jiao (Rhinoceros Horn - substitute with Buffalo Horn) and Ling Yang Jiao; for excessive sweating, remove Ma Huang.
Jiabao Dan (Family Treasure Pill) Treats all wind diseases, paralysis, flaccidity, insensitivity, facial deviation, pathogen entering marrow.
Chuan Wu (Sichuan Aconite), Qing Fen (Calomel) (each 1 liang), Wu Ling Zhi (Trogopterus Dung, ginger-processed, separately ground), Cao Wu (Heracleum Aconite) (each 6 liang), Nan Xing, Quan Xie, Mo Yao, Chen Sha (Cinnabar) (each 2 liang), Bai Fu Zi, Ru Xiang, Chao Jiang Can (Fried Silkworm, 3 liang), Pian Nao (Camphor, 5 qian), Qiang Huo, She Xiang (Musk), Di Long (Earthworm, 4 liang), Xiong Huang (Realgar), Tian Ma (Gastrodia Rhizome, 3 liang).
Grind to powder. Mix 3 qian, increase to 0.5 qian if no effect. Or honey-pilulate size of bullet seeds, dissolve in tea.
Rushen Jiuku San (Miraculous Salvation Powder) Treats paralysis, rheumatic bi migration, unremitting pain. This is a drastic agent, only for severe pain.
Mi Ke (Poppy Shell, 1 liang, remove top membrane, honey-fried), Chen Pi (5 qian), Hu Gu (Tiger Bone,酥-roasted), Ru Xiang (Olibanum, ground), Mo Yao (Myrrh, ground), Gan Cao (Licorice Root) (each 2 qian).
Grind to powder. Take 3 qian per dose, decoct with one cup water. Take with dregs. Upper body: post-prandial; Lower body: pre-prandial. Stir consistently during decoction.
Daqin Jiao Tang (Major Gentiana Decoction) Treats stroke without exterior Six Channel symptoms or interior stool/urine obstruction.
Recognizing blood weakness fails to nourish sinews, causing limb immobility and tongue stiffness/aphasia. Nourish blood so sinews thrive.
Qin Jiao (Gentiana Macrophylla Root), Shi Gao (Gypsum) (each 2 liang), Gan Cao, Chuan Xiong, Dang Gui, Bai Shao (White Peony Root), Qiang Huo, Fang Feng, Huang Qin, Bai Zhi, Bai Zhu, Sheng/Di Huang (Fresh/Raw Rehmannia Root), Fu Ling, Du Huo (each 1 liang), Xi Xin, Zhi Mu (Anemarrhena Rhizome, add 1 liang in Spring/Summer).
Coarsely crush. Take 1 liang per dose, decoct in water, anytime. Add 7 slices ginger on cloudy days; add 1 qian Zhi Shi (Immature Aurantium) for epigastric fullness.
Sanhua Tang (Three Transformations Decoction) For exterior Six Channel symptoms, first treat with Modified Xuming Tang. For interior stool/urine obstruction, this formula is primary.
Hou Po (Magnolia Bark), Da Huang (Rhubarb Root), Zhi Shi (Immature Aurantium), Qiang Huo (equal parts).
Take 3 liang per dose, decoct in water, stop when bowel movement occurs.
[Appendix] Method states: Limbs unable to move/grasp, commonly called paralysis. Scripture says excess leads to limb immobility. Also: Upper excess leads to Dunfu (High/Mound). Dunfu implies height and density. Removing this density/height treats "rich food disease," not Kidney/Liver deficiency. Why? Scripture: Three Yang/Three Yin onset causes hemiplegia, wei change, limb immobility. Three Yin insufficiency causes hemiplegia; Three Yang excess causes wei change (alteration/flaccidity/weakness). Treatment: Drain to weaken Qi, balance Earth as Yang declines, hence purge with Sanhua Tang. If Spleen deficiency causes immobility: Scripture says Earth insufficiency leads to Beixian (Low/Pit). Beixian implies low pit. Spleen disease causes limb immobility; limbs receive Qi from Stomach but cannot reach channels without Spleen. Now Spleen fails to transport fluids with Stomach; limbs lack grain/water essence; Qi declines daily, channels obstruct, sinews/muscles lack Qi generation, hence immobility. Treatment: Tonify greatly with Shiquan San (Ten Complete Powder) or Modified Siwu Tang, eliminate pathogen, preserve righteousness.
Yufeng Tang (Wind-Healing Decoction) For stroke where internal pathogens are cleared and external pathogens exhausted, take this to guide Qi through channels. Long-term use eliminates major wind; minor pathogens adjusted from this base. Treatment must not lose balance of unblocking/blocking. Slight sweating over one period, or free flow over ten days, is standard. Long-term use separates clear/turbid, harmonizes Ying-Wei. Early wind detection prevents collapse.
Qiang Huo, Zhi Gan Cao, Fang Feng, Fang Ji, Huang Qi (Astragalus Root), Man Jing Zi (Vernonia Fruit), Chuan Xiong, Du Huo, Xi Xin, Zhi Ke, Qu Gen Ma Huang (De-rooted Ephedra).
Di Gu Pi (Lycium Bark), Ren Shen, Zhi Mu, Gan Ju (Chrysanthemum Flower), Qu Geng Bo He (De-stemmed Mint), Bai Zhi, Gou Qi Zi (Goji Berry), Dang Gui, Chao Du Zhong (Fried Eucommia Bark), Qin Jiao, Chai Hu (Bupleurum Root).
Ban Xia, Jiang Zhi Hou Po (Ginger-processed Magnolia Bark), Qian Hu (Peucedanum Root), Shu Di Huang (Prepared Rehmannia Root) (each 2 liang), Bai Fu Ling, Huang Qin (3 liang), Sheng Di Huang (Fresh Rehmannia Root), Cang Zhu, Shi Gao, Shao Yao (each 4 liang), Gui (Cinnamon Twig, 1 liang).
Coarsely chop. Take 1 liang per dose, with 2 cups water, 3 slices ginger. Empty stomach dose;睡前 decoct dregs. Empty stomach dose: swallow Er Dan Wan (Heavy Agent). Bedtime dose: swallow Si Bai Dan (Light Agent). Principle: Movement calms Spirit, Stillness clears Lung. For slight sweating: Use 3 liang Yufeng Tang + 1 liang Ma Huang, divide into 4 doses, take empty stomach with ginger, follow with congee for slight sweat. For free flow over ten days: Use 3 liang Yufeng Tang + 1 liang Da Huang, divide into 4 doses, take as above, bedtime, stop when flow occurs. Regular use must respect four seasons aids. After Great Cold in Spring, add Ban Xia, Ren Shen, Chai Hu (2 liang each, total 4 liang) to welcome/rob Shaoyang Qi. After Grain Rain in Summer, add Shi Gao, Huang Qin, Zhi Mu (2 liang each)...