回阳急救用六君，（肉）桂附（子）干姜五味群，加麝三厘或胆汁，三阴寒厥见奇勋。
瘟疫病感冒四气务要先明
丹溪曰：春应温而反寒，夏应热而反凉，秋应凉而反热，冬应寒而反温，此非其时而有其气。是以一岁之中，长幼之病皆相似者，名曰瘟疫病也。其病初憎寒壮热、头疼身痛、口渴、不恶风寒，治以人参败毒散表之、小柴胡汤和解之；里症见者，以大柴胡汤下之。
败毒散（人）参（茯）苓，前（胡）羌（活）柴（胡）独（活）增，桔（梗）（川）芎甘（草）枳壳，薄荷生姜应。
九味羌活汤，（川）芎（细）辛（白）芷（甘）草防（风），苍（术）（黄）芩生地入，温热病相当。
芩连消毒散，甘（草）桔（梗）射（干）（川）芎防（风），（连）翘柴（胡）荆（芥）（白）芷（枳）壳。咽痛大头方。
冰解散最良。汗下兼行方，桂心甘（草）白芍，（黄）芩麻（黄）共大黄。
按：春温、夏热、秋凉、冬寒，这是四时的正常气候，当气候反常，夏应热而反凉，冬应寒而反温，这叫四时不正之气。当天气反常之时，凡衣著起居，不能与气候相适应者，患病多相似。但无"沿门閤户"传染情况者，不能叫疫。疾者"皆相染易"，指传染流行的情况。此篇命题为瘟疫病，所举九味羌活等方，多辛温表散药，对天气暴寒之外感为宜，以之统治瘟疫则多有不当，读者当参考《瘟疫明辨》、《寒温条辨》、《温病条辨》等书，作进一步的探讨，庶不致误。
东垣①曰："饮食不节则胃病，胃病则气短精神少。胃虚则火邪乘之而生大热，有时而显火上行，独燎其面。黄帝针经云'面热者，足阳明病。"胃既病则脾无所禀受……故亦从而病焉。形体劳役则脾病，病脾则怠惰嗜卧、四肢不收、大便泄泻。脾既病则胃不能独行津液，故亦从而病焉。大抵脾胃虚弱，阳气不能生长，是春夏之令不行，五藏之气不生。脾病则下流乘肾，土克水则骨乏无力，是为骨痿，令人骨髓空虚，足不能履地。是阴气重迭，此阴盛阳虚之症。"治宜升浮而助阳也，补中益气汤。内伤脾胃：有饥饿损伤，有饮食过伤，有服峻剂之药以致内伤，种种不同，治法亦异。
补中益气汤，（人）参（黄）芪甘（草）（白）术当（归），升（麻）柴（胡）陈（皮）八味，不足症堪尝。
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①李杲，字明之，号东垣老人。金、元间真定人（即河北省正定县）。是张元素弟子。治病以脾胃为重。著有《兰室秘藏》、《脾胃论》.....等。
平胃散（神）曲（麦）芽，苍（术）（厚）朴陈（皮）（甘）草（木）香，山查并草果，一服即宽肠。
葛花解酲①汤
解酲汤茯苓，青（皮）（干）姜白术陈（皮），（木）香砂（仁）（人）参（神）曲（豆）蔻，泽泻葛（花）猪苓。
发热之病，今人谓之四时伤寒，绝不知其出入之理。夫冬时伤寒，乃寒邪自外而入，故用麻黄、桂枝发汗之重剂。春夏发热之症，其由冬时感寒，偶不及发，寒毒藏于肌肤之间，至春变为湿病，至夏变为热病，其邪自内而出，故用羌活、前胡解表之轻剂。若夫春夏秋三时之间，感冒非时暴寒，又宜疏表利气之剂，如香苏饮、参苏饮、十神汤之类。
十神汤葛根，（川）芎（白）芷（赤）芍（紫）苏陈（皮），麻（黄）升（麻）香附（炙）（甘）草，感冒与时行。
参苏饮二陈②，枳（壳）桔（梗）葛（根）前（胡）（木）香，四时痰嗽药，无汗用之良。
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①酲：cheng1（音成）。酒醒以后，头昏脑胀。
②二陈：即二陈汤。
香苏饮见15页
按：伤寒与温热病的基本区别，在于有无内热潜伏。伤寒系单为寒邪所伤，邪自外而渐次及内。故初起恶寒重而发热轻，口皆不渴，绝无内热之象。治宜辛温解表，使邪从汗解而愈。温病系热邪潜伏；蕴蓄已久，每兼外感之诱因而发。初起即发热或微有恶寒，多数口渴，湿热并重者，口虽不渴，但思食凉物，甚则脉数舌绛，必有一派内热之象。治宜辛凉解表或辛凉透邪，大忌辛温之品。本篇方剂未出辛温范畴，羌活前胡等品并不适用于温热病。读者应参考《时病论》①、《温病条辨》、《温热经纬》②等书，作进一步的探讨。
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①《时病论》：清、雷丰（少逸）著。是一部专门阐述时令病的书籍。
②《温热经纬》：是清、王士雄（盂英）辑叶香□（上山下严）、薛生白、余师愚等各家有关温病论述的一部温热病专著，选材颇精，注释按语亦多卓见。
卒中风因有四端治分三中
《千金方》载中风大法有四：一日偏枯，谓半身不遂也；一日风痱，谓身无痛，四肢不收也；一曰风懿，谓奄忽不知人也；一曰风痹，类风状也。刘河间曰：中风瘫痪者……非外中于风，良由将息失宜①，心火暴盛，肾水虚衰不能制之，则阴虚阳实，而热气拂郁②，心神昏冒③，筋骨不用而卒倒无所知也。东垣曰：中风非外来风邪，乃本气自病。凡人年逾四旬气衰之际，或因忧、喜、忿、怒伤其气者，多有此疾。壮岁之时无有也。若肥盛者则间而有之，亦是形盛气衰而如此耳。丹溪曰……东南气温，而地多湿，有风病者，非风也，皆湿生痰，痰生热，热生风也。《发明论》曰：中风之症，有中腑、中藏、中血脉之分。中腑者多着四肢，面如土色，脉浮而恶风寒，四肢拘急不仁，或中身之前，或中身之后，或中身之侧，皆曰中腑，其治多易。中藏者多滞九窍，或唇缓、失音、耳聋、鼻塞、目瞀④、大小便秘结，皆曰中藏，其治多难。中血脉者口眼歪斜。三者治各不同。若中血脉，而外有六经之形症，则从小续命汤以发其表，调以通圣散辛凉之剂、若中腑而内有便溺之阻隔，则从三化汤以攻其里。然汗下又不可太过，汗多则亡阳，下多则亡阴，亡阳则损其卫；亡阴则损其营，此又不可不慎也。
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①将息失宜：《河间六书》指"……平日衣服、饮食、安处、动止、精魂神志、性情好恶、不循其宜而失其常"而言。
④目瞀：目不明。
如外无六经之形症，内无便溺之阻隔，但手足不遂、语言蹇涩①，此邪中于经络也，宜大秦艽汤、羌活愈风汤，补血以养筋。……中风痰厥，昏迷卒倒不省人事者，先用皂荚末拈纸条烧烟冲入鼻中，有嚏可治，无嚏难治。随用吐痰方，将皂荚末五分、白矾五分为细木，姜汁水调。探吐后，服导痰汤。半身不遂名曰瘫痪，大抵多是痰涎流注，初起急治则可，久则痰火郁结，用药少效。口眼歪斜无他症者，用白附子、僵蚕、全蝎（俱生用）等分为末，每次酒服二钱（名牵正散）。又方：用蓖麻子肉一两、冰片三分，共捣为膏（名改容膏）寒月加姜、附子各一钱。如左歪则敷其右，右歪则敷其左。或以鳝鱼血、冰片敷之皆效。中风舌强不语，用青黛、硼砂、薄荷各二钱，冰片、牛黄各三分，为细末，先以蜜水洗舌，后以姜汁擦之，将药蜜水调擦舌本。中风口噤不开，宜用马梅肉擦其牙关，牙关酸软，则易开矣。或用藜芦末稍加麝香，每用五分，水调，灌入鼻内，吐之。
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①蹇：jian3（音检）。蹇涩：舌强言语不清。
续命桂（枝）麻（黄）（人）参，（川）芎防（风）附子（黄）芩，杏仁甘（草）（白）芍（防）己，风中血脉寻。
附：古今录验续命汤
通圣散荆（芥）防（风），（连）翘麻（黄）（甘）草薄（荷）当（归），栀（子）（黄）芩（川）芎桔（梗）（白）术，（石）膏（白）芍滑（石）（芒）硝（大）黄。
大秦艽八珍（汤），去（人）参加（细）辛（黄）芩，（羌独）二活（石）膏（白）芷防（风），祛风兼养阴。
导痰汤见7页
羌活独活防风防己柴胡前胡麻黄细辛白芷菊花薄荷叶秦艽蔓荆子当归川穹熟地炙草黄芪枳壳地骨皮人参知母枸杞子杜仲炭姜半夏（各二两）官桂（一两）茯苓黄芩（各三两）生地苍术石膏芍药（各四两）以上诸药，共为粗末，每服一两，水煎服。
按：中风卒然昏倒不省人事，往往系脑溢血引起。实践证明，取嚏、催吐，都易使病情恶化。故古书虽有用取嚏通关，探吐导痰治疗本病的记载，但令人已少用之。
破伤风原有三种治别三经
破伤风症，或跌打损伤，风乘隙而客之；或疮疡久不合口，风邪乘间而袭之；或用热汤淋洗、或用艾火灸之，其汤火之气，亦与风邪无异。其症寒热兼作，甚则口噤目斜，身体强直，死在旦夕甚可畏也。脉浮无力太阳也，汗之而愈。脉长有力阳明也，下之而愈。脉浮而弦小少阳也，和解之而愈。若传变入里，无法治矣。
羌活防风汤，（川）穹（甘）草藁本当（归），细辛（地）榆白芍，在表服之康。
用防风、南星，等分为末。先以药敷于患处，然后用温酒调服二钱。又治疯狗咬伤。
按：近年来，各地用五虎追风汤随证加减治疗破伤风，疗效颇佳，可参考试用。
蝉衣（一两）天麻（三钱）南星（三钱）全蝎（三钱）僵蚕（三钱）朱砂（五分）（研细冲服）加水适量，煎好后，兑入黄酒一至二两，温服。服后五心出汗为良好现象。
中暑有动静之异
夏至日后，病热为暑。张洁古①曰；动而得之为中暍②，静而得之为中暑。东垣曰：日中劳役而得者谓之中暍，避暑于深堂而得者，谓之中暑。中暍之病，其因劳役于外，日光曝其皮肤，热气入于鼻窍，肺经受伤，其症身热头疼、洒然毛耸③、微寒、口开齿燥、舌苔、烦渴，治宜人参石膏知母汤。其由安处家庭，行走闾巷，蓦④然郁热熏蒸，口吸暑气，心包络受伤，其症烦渴自汗、面垢脉虚，或腹疼吐泻，或呕哕燥闷，重则昏不知人，治宜香薷饮。
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①张洁古：名元素，金、易州人（即河北省易县）。著有《珍珠囊引经佐使》、《病机气宜保命集》、《脏腑标本药式》、《医余启源》及《洁古家珍》等书。
③耸：song3。高突的意思。如耸直。
④蓦：mo4（音末）。突然。
十味香薷饮，（人）参（黄）芪（白）术茯（苓）陈（皮），（厚）朴甘（草）（木）瓜扁豆，清暑健脾经。
六和汤（茯）苓（白）术（人）参，（香）薷藿（香）扁（豆）砂仁，半（夏）甘（草）（木）瓜杏（仁）（厚）朴，霍乱暑伤神。
益气（汤）（当）归黄（芪）橘（皮），（白苍）二术甘（草）青（皮）（黄）柏，人参麦（冬）（五）味升（麻），葛根神曲泽（泻）。
按：中暑、中暍、中热，名虽不同，实系一症。由于机体的差异，工作于烈日之下，活动过度，湿随汗去，无湿而多热；恣意纳凉，又不活动，湿邪为重，故治法不同。这就是张洁古所说的动而得之、静而得之的区别。香薷饮之用，应以暑症无汗或兼有外感者为宜，自汗者当考虑不用。读者应参考《湿病条辨》暑温伏暑等治法。
受湿有内外之分
Qingdai (Indigo Naturalis), Zhizi (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), Xijiao (Rhinocerotis Cornu), Zhimu (Anemarrhenae Rhizoma), Yuan Shen (Scrophulariae Radix), Sheng Di Huang (Rehmanniae Radix), Shi Gao (Gypsum Fibrosum), Chai Hu (Bupleuri Radix), Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus).
Hui Yang Jiu Ji Tang (Decoction for Restoring Yang and Saving from Crisis)
Hui Yang Jiu Ji Tang is based on Liu Jun Zi Tang (Six Gentlemen Decoction), adding Rou Gui (Cinnamomi Cortex), Fu Zi (Aconiti Lateralis Radix Preparata), Gan Jiang (Zingiberis Rhizoma), and Wu Wei Zi (Schisandrae Chinensis Fructus). Adding 3 li of She Xiang (Moschus) or Niu Dan (Bovis Calculus) yields remarkable results for cold jue syndrome (cold reversal) of the three yin meridians.
Qiang Huo Chong He Tang (Decoction for Harmonizing with Qiang Huo) [i.e., Jiu Wei Qiang Huo Tang, see page 17]
Gui Zhi Jia Shao Yao Tang (Guizhi Decoction with Increased Shaoyao) [i.e., Guizhi Tang with increased dosage of Baishao (Paeoniae Radix Alba)]
Clarifying the Four Qi in Plague and Cold-Related Disorders
Danxi stated: Spring should be warm but turns cold; summer should be hot but turns cool; autumn should be cool but turns hot; winter should be cold but turns warm. This is having such qi (energy/climate) when it is not the proper time. Therefore, throughout the year, illnesses affecting people of all ages are similar, named plague disease (wen yi bing). Initially, there is aversion to cold, high fever, headache, body pain, thirst, and no aversion to wind or cold. Treatment involves using Ren Shen Bai Du San (Ginseng and Detoxification Powder) to release the exterior, and Xiao Chai Hu Tang (Minor Bupleurum Decoction) to harmonize. If interior syndromes appear, use Da Chai Hu Tang (Major Bupleurum Decoction) to purge.
Ren Shen Bai Du San
Bai Du San contains Ren Shen (Ginseng Radix et Rhizoma), Fu Ling (Poria), Qian Hu (Peucedani Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Chai Hu (Bupleuri Radix), Du Huo (Angelicae Pubescentis Radix); adds Jie Geng (Platycodonis Radix), Chuan Xiong (Chuanxiong Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zhi Ke (Aurantii Fructus Immaturus); uses Bo He (Menthae Haplocalycis Herba) and Sheng Jiang (Zingiberis Rhizoma Recens).
Jiu Wei Qiang Huo Tang
Jiu Wei Qiang Huo Tang contains Chuan Xiong (Chuanxiong Rhizoma), Xi Xin (Asari Radix et Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix), Cang Zhu (Atractylodis Rhizoma), Huang Qin (Scutellariae Radix), Sheng Di Huang (Rehmanniae Radix); suitable for heat-warmth diseases.
Qin Lian Xiao Du San
Qin Lian Xiao Du San contains Gan Cao (Glycyrrhizae Radix et Rhizoma), Jie Geng (Platycodonis Radix), She Gan (Belamcandae Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), Fang Feng (Saposhnikoviae Radix), Lian Qiao (Forsythiae Fructus), Chai Hu (Bupleuri Radix), Jing Jie (Schizonepetae Spica), Bai Zhi (Angelicae Dahuricae Radix), Zhi Ke (Aurantii Fructus Immaturus). It is a formula for sore throat and big head plague.
Bing Jie San
Bing Jie San is excellent. It is a formula that induces sweating and purging simultaneously, containing Gui Zhi (Cinnamomi Ramulus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Shao (Paeoniae Radix Alba), Huang Qin (Scutellariae Radix), Ma Huang (Ephedrae Herba), and Da Huang (Rhei Radix et Rhizoma).
Note: Spring warmth, summer heat, autumn coolness, and winter cold are the normal climates of the four seasons. When climate is abnormal, e.g., summer should be hot but is cool, winter should be cold but is warm, this is called abnormal qi of the four seasons. During abnormal weather, those whose clothing and living habits do not adapt to the climate often fall ill similarly. However, without "house-to-house" contagion, it cannot be called epidemic. Diseases where "all are infected" refer to contagious outbreaks. This section titles "Plague Disease," citing formulas like Jiu Wei Qiang Huo Tang, which contain many acrid-warm exterior-releasing drugs suitable for external contraction due to sudden cold weather. Using them to treat plagues generally is inappropriate. Readers should consult *Ping Yi Ming Bian*, *Han Wen Tiao Bian*, and *Wen Bing Tiao Bian* for further exploration to avoid errors.
Differentiating Excess and Deficiency in Internal Injury to Spleen and Stomach
Dongyuan said: "Irregular diet damages the stomach; stomach damage leads to shortness of breath and reduced spirit. Stomach deficiency allows fire pathogen to invade, generating intense heat, sometimes rising upward, burning only the face. The Yellow Emperor's Classic of Acupuncture states 'Facial heat indicates Foot Yangming disease.' Once the stomach is diseased, the spleen has nothing to receive... thus the spleen also becomes diseased. Physical overexertion damages the spleen; spleen disease causes lethargy, desire to lie down, flaccidity of limbs, and diarrhea. Once the spleen is diseased, the stomach cannot transport fluids alone, thus the stomach also becomes diseased. Generally, spleen and stomach weakness prevents yang qi from growing; the spring-summer command fails, and qi of the five zang organs does not generate. Spleen disease flows downward to attack the kidney; earth overcoming water leads to bone fatigue and weakness, termed bone痿 (bone atrophy), causing empty marrow and inability to stand. This is overlapping yin qi, a syndrome of yin excess and yang deficiency." Treatment should be ascending and floating to assist yang, using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Internal injury to spleen and stomach includes injury from hunger, overeating, or harsh medicines; various types require different treatments.
Bu Zhong Yi Qi Tang
Bu Zhong Yi Qi Tang contains Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Chen Pi (Citri Reticulatae Pericarpium); eight ingredients, suitable for deficiency syndromes.
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① Li Gao, courtesy name Mingzhi, pseudonym Dongyuan Laoren. A native of Zhengding during the Jin-Yuan period (now Zhengding County, Hebei Province). A disciple of Zhang Yuansu. Emphasized spleen and stomach in treatment. Authored *Lan Shi Mi Cang*, *Pi Wei Lun*, etc.
Jia Wei Ping Wei San
Ping Wei San contains Shen Qu (Massa Medicata Fermentata), Mai Ya (Hordei Fructus Germinatus), Cang Zhu (Atractylodis Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Mu Xiang (Aucklandiae Radix), Shan Zha (Crataegi Fructus), and Cao Guo (Tsaoko Fructus); one dose relaxes the intestines.
Ge Hua Jie Cheng Tang
Jie Cheng Tang contains Fu Ling (Poria), Qing Pi (Citri Reticulatae Pericarpium Viride), Gan Jiang (Zingiberis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Mu Xiang (Aucklandiae Radix), Sha Ren (Amomi Fructus), Ren Shen (Ginseng Radix et Rhizoma), Shen Qu (Massa Medicata Fermentata), Dou Kou (Cardamomi Fructus), Ze Xie (Alismatis Rhizoma), Ge Hua (Bambusae Flos), and Zhu Ling (Polyporus).
Understanding Summer Heat and Spring Warmth in External Contraction Heat Diseases
Heat-fever diseases are now called "four-seasons shang han" by modern people, who completely ignore their principles of entry and exit. Winter shang han is cold pathogen entering from outside, so heavy sweating agents like Ma Huang (Ephedrae Herba) and Gui Zhi (Cinnamomi Ramulus) are used. Summer and spring heat symptoms often result from winter cold contraction that was not released in time; cold toxin hides between skin and muscles, transforming into dampness in spring and heat disease in summer. The pathogen exits from inside, so light exterior-releasing agents like Qiang Huo (Notopterygii Rhizoma et Radix) and Qian Hu (Peucedani Radix) are used. In spring, summer, and autumn, if contracting sudden non-seasonal cold, formulas for releasing exterior and promoting qi flow, such as Xiang Su Yin, Shen Su Yin, and Shi Shen Tang, are appropriate.
Shi Shen Tang
Shi Shen Tang contains Ge Gen (Puerariae Lobatae Radix), Chuan Xiong (Chuanxiong Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Chi Shao (Paeoniae Radix Rubra), Zi Su Ye (Perillae Folium), Chen Pi (Citri Reticulatae Pericarpium), Ma Huang (Ephedrae Herba), Sheng Ma (Cimicifugae Rhizoma), Xiang Fu (Cyperi Rhizoma, roasted), and Gan Cao (Glycyrrhizae Radix et Rhizoma); for common cold and seasonal epidemics.
Shen Su Yin
Shen Su Yin is based on Er Chen Tang (Two-Aged Decoction), adding Zhi Ke (Aurantii Fructus Immaturus), Jie Geng (Platycodonis Radix), Ge Gen (Puerariae Lobatae Radix), Qian Hu (Peucedani Radix), and Mu Xiang (Aucklandiae Radix); a medicine for phlegm-cough in all seasons, effective for cases without sweat.
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① Cheng: Sound of "cheng". Dizziness and fullness after waking from drunkenness.
② Er Chen: Refers to Er Chen Tang.
Xiang Su Yin see page 15
Note: The basic difference between shang han and wen re bing lies in the presence or absence of latent internal heat. Shang han is solely caused by cold pathogen, entering gradually from outside. Thus, initially, aversion to cold is heavy while fever is light, mouth is not thirsty, and there is absolutely no sign of internal heat. Treatment should be acrid-warm to release the exterior, allowing pathogen to exit via sweat. Wen bing involves latent heat pathogen; accumulating for a long time, often triggered by external contraction. Initially, there is fever or slight aversion to cold, mostly thirst. In damp-heat cases, even if not thirsty, there is craving for cold food; pulse may be rapid, tongue crimson, showing signs of internal heat. Treatment should be acrid-cool to release the exterior or penetrate pathogen; acrid-warm substances are strictly contraindicated. The formulas in this section do not go beyond acrid-warm categories; Qiang Huo and Qian Hu are not suitable for wen re bing. Readers should consult *Shi Bing Lun*, *Wen Bing Tiao Bian*, and *Wen Re Jing Wei* for further exploration.
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① *Shi Bing Lun*: Written by Lei Feng (Shaoyi) in the Qing Dynasty. A book specifically expounding seasonal diseases.
② *Wen Re Jing Wei*: Compiled by Wang Shiheng (Mengying) in the Qing Dynasty, collecting discussions on warm diseases from Ye Tianshi, Xue Shengbai, Yu Shiyu, etc. Excellent selection and insightful annotations.
Acute Stroke Has Four Causes and Three Treatment Categories
The *Qian Jin Fang* records four major methods for stroke: first, pian gu (hemiplegia), meaning half-body paralysis; second, feng fe, meaning body painless but limbs flaccid; third, feng yi, meaning sudden loss of consciousness; fourth, feng bi, resembling wind patterns. Liu Hejian said: Stroke paralysis... is not struck by external wind, but truly due to improper lifestyle, sudden flourishing of heart fire, and deficiency of kidney water failing to control it, leading to yin deficiency and yang excess, stifled heat, confused mind, and sudden collapse without awareness. Dongyuan said: Stroke is not external wind, but self-disease of original qi. People past forty when qi declines, or injured by worry, joy, anger, often have this disease. Young adults rarely do. Obese people occasionally have it, also due to robust form but weak qi. Danxi said... Southeast is warm and humid; wind diseases are not wind, but damp generating phlegm, phlegm generating heat, heat generating wind. *Fa Ming Lun* says: Stroke has divisions of middle fu, middle zang, and middle blood vessels. Middle fu affects limbs, face pale, pulse floating, aversion to wind/cold, limb stiffness and numbness, occurring front, back, or side of body; treatment is easy. Middle zang blocks nine orifices, lip flaccidity, aphasia, deafness, nasal congestion, blurred vision, constipation; treatment is difficult. Middle blood vessel causes facial deviation. Treatments differ. If middle blood vessel with six meridians exterior symptoms, use Xiao Xu Ming Tang to release exterior, regulate with Fang Feng Tong Sheng San (acrid-cool). If middle fu with internal blockage of stool/urine, use San Hua Tang to purge interior. Sweating and purging must not be excessive; too much sweating loses yang, damaging wei qi; too much purging loses yin, damaging ying qi. Caution is essential.
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① Jiang Xi Shi Yi: From *He Jian Liu Shu*, referring to "daily clothes, diet, rest, movement, spirit, emotions, not following appropriateness and losing regularity."
② Re Qi Fu Yu: Heat qi unable to dissipate.
③ Hun Mao: Consciousness coma, unresponsive.
④ Mu Mao: Blurred vision.
If no exterior symptoms of six meridians and no internal blockage, only limb paralysis and slurred speech, this is pathogen in collaterals. Use Da Qin Jiao Tang or Qiang Huo Yu Feng Tang to nourish blood and tendons. ... For stroke phlegm jue, coma and sudden collapse, first use smoke from burning Sichuan soap pod powder inserted into nose; sneezing indicates treatability, no sneezing indicates difficulty. Then use expectorant formula: 5 fen Sichuan soap pod powder and 5 fen Bai Fan (Alumen), ground fine, mixed with ginger juice and water. After inducing vomiting, administer Dao Tan Tang. Hemiplegia is termed tan huan, mostly due to phlegm-saliva flowing and depositing; urgent treatment at onset works, but later phlegm-fire stagnation makes medication less effective. For facial deviation without other symptoms, use Bai Fu Zi (Typhonii Rhizoma), Jiang Can (Bombyx Batryticatus), Quan Xie (Scorpio) raw, equal parts, ground; take 2 qian with wine (named Qian Zheng San). Another formula: 1 liang Bi Ma Zi Rou (Ricini Semen) and 3 fen Bing Pian (Borneolum Syntheticum), pounded into paste (named Gai Rong Gao); add 1 qian each of Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Preparata) in cold months. Apply right side for left deviation, left side for right deviation. Eel blood with borneol applied is also effective. For stiff tongue and aphasia, use Qing Dai (Indigo Naturalis), Peng Sha (Borax), Bo He (Menthae Haplocalycis Herba) 2 qian each, Bing Pian (Borneolum Syntheticum), Niu Huang (Calculus Bovis) 3 fen each, ground fine. First wash tongue with honey water, rub with ginger juice, then apply medicine mixed with honey water to tongue root. For locked jaw, rub teeth with horse plum meat; jaw softens and opens easily. Or use Li Lu (Veratri Radix) powder with a little She Xiang (Moschus), 5 fen, mixed with water, instilled into nose to induce vomiting.
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① Jian: Sound of "jian". Jian Se: Stiff tongue and unclear speech.
Xiao Xu Ming Tang
Xu Ming Tang contains Gui Zhi (Cinnamomi Ramulus), Ma Huang (Ephedrae Herba), Ren Shen (Ginseng Radix et Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), Fang Feng (Saposhnikoviae Radix), Fu Zi (Aconiti Lateralis Radix Preparata), Huang Qin (Scutellariae Radix), Xing Ren (Armeniacae Semen Amarum), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Shao (Paeoniae Radix Alba), Fang Ji (Stephaniae Tetrandrae Radix); seek for wind striking blood vessels.
Appendix: Ancient and Modern Verified Xu Ming Tang
Ma Huang (Ephedrae Herba), Gui Zhi (Cinnamomi Ramulus), Dang Gui (Angelicae Sinensis Radix), Ren Shen (Ginseng Radix et Rhizoma), Shi Gao (Gypsum Fibrosum), Gan Jiang (Zingiberis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), Xing Ren (Armeniacae Semen Amarum), Fang Feng (Saposhnikoviae Radix)
Fang Feng Tong Sheng San
Tong Sheng San contains Jing Jie (Schizonepetae Spica), Fang Feng (Saposhnikoviae Radix), Lian Qiao (Forsythiae Fructus), Ma Huang (Ephedrae Herba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bo He (Menthae Haplocalycis Herba), Dang Gui (Angelicae Sinensis Radix), Zhi Zi (Gardeniae Fructus), Huang Qin (Scutellariae Radix), Chuan Xiong (Chuanxiong Rhizoma), Jie Geng (Platycodonis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Shi Gao (Gypsum Fibrosum), Bai Shao (Paeoniae Radix Alba), Hua Shi (Talcum), Mang Xiao (Natrii Sulfas), Da Huang (Rhei Radix et Rhizoma).
San Hua Tang
Same as Xiao Cheng Qi Tang plus Qiang Huo (Notopterygii Rhizoma et Radix).
Da Qin Jiao Tang
Da Qin Jiao Tang is based on Ba Zhen Tang (Eight Treasures Decoction), removing Ren Shen (Ginseng Radix et Rhizoma), adding Xi Xin (Asari Radix et Rhizoma), Huang Qin (Scutellariae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Shi Gao (Gypsum Fibrosum), Bai Zhi (Angelicae Dahuricae Radix), Fang Feng (Saposhnikoviae Radix); dispels wind and nourishes yin.
Dao Tan Tang see page 7
Qiang Huo Yu Feng Tang
Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Fang Feng (Saposhnikoviae Radix), Fang Ji (Stephaniae Tetrandrae Radix), Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Ma Huang (Ephedrae Herba), Xi Xin (Asari Radix et Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Ju Hua (Chrysanthemi Flos), Bo He Ye (Menthae Haplocalycis Herba), Qin Jiao (Gentianae Macrophyllae Radix), Man Jing Zi (Vittariae Fructus), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Shu Di Huang (Rehmanniae Radix Preparata), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma), Huang Qi (Astragali Radix), Zhi Ke (Aurantii Fructus Immaturus), Di Gu Pi (Lycii Cortex), Ren Shen (Ginseng Radix et Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Gou Qi Zi (Lycii Fructus), Du Zhong (Eucommiae Cortex), Du Zhong Tan (Carbonized Eucommiae Cortex), Jiang Ban Xia (Pinelliae Rhizoma Preparatum) (each 2 liang), Guan Gui (Cinnamomi Cortex) (1 liang), Fu Ling (Poria), Huang Qin (Scutellariae Radix) (each 3 liang), Sheng Di Huang (Rehmanniae Radix), Cang Zhu (Atractylodis Rhizoma), Shi Gao (Gypsum Fibrosum), Shao Yao (Paeoniae Radix) (each 4 liang). All herbs coarsely powdered, take 1 liang per dose, decoct in water.
Note: Sudden stroke with loss of consciousness is often caused by cerebral hemorrhage. Practical experience shows that inducing sneezing and vomiting can worsen the condition. Although ancient texts record using sneezing to open orifices and vomiting to guide out phlegm for treating this disease, these methods are rarely used today.
Wind-Tetanus Has Three Types and Three Meridian Treatments
Wind-tetanus syndrome arises from falls or injuries where wind enters gaps; or from chronic ulcers where wind attacks; or from hot water washing/moxibustion, where heat/fire qi acts like wind pathogen. Symptoms include alternating chills and fever, severe lockjaw and oblique eyes, body rigidity, death imminent, very frightening. Floating pulse without strength indicates Taiyang; sweating cures. Long and strong pulse indicates Yangming; purging cures. Floating, wiry, small pulse indicates Shaoyang; harmonizing cures. If transmitting inward, incurable.
Qiang Huo Fang Feng Tang.
Qiang Huo Fang Feng Tang contains Chuan Xiong (Chuanxiong Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Gao Ben (Ligustici Rhizoma et Radix), Dang Gui (Angelicae Sinensis Radix), Xi Xin (Asari Radix et Rhizoma), Di Yu (Sanguisorbae Radix), Bai Shao (Paeoniae Radix Alba); taking it when pathogen is in exterior brings health.
Yu Zhen San
Use Fang Feng (Saposhnikoviae Radix) and Nan Xing (Arisaematis Rhizoma), equal parts, ground to powder. Apply to affected area first, then take 2 qian mixed with warm wine. Also treats mad dog bites.
Note: In recent years, Wuhu Zhuifeng Tang modified according to syndrome has shown good efficacy in treating wind-tetanus locally; readers may refer to trial use.
Wuhu Zhuifeng Tang
Chan Yi (Cicadae Periostracum) (1 liang), Tian Ma (Gastrodiae Rhizoma) (3 qian), Nan Xing (Arisaematis Rhizoma) (3 qian), Quan Xie (Scorpio) (3 qian), Jiang Can (Bombyx Batrycticatus) (3 qian), Zhu Sha (Cinnabaris) (5 fen, finely ground and taken with decoction). Add appropriate water, decoct, mix with 1-2 liang yellow wine, take warm. Sweating from five hearts after taking is a good sign.
Summerstroke Has Differences Between Movement and Stillness
After Summer Solstice, heat illness is summerheat. Zhang Jiegu said: Obtained through movement is zhong ye (heatstroke); obtained through stillness is zhong shu (summerstroke). Dongyuan said: Obtained through labor at noon is zhong ye; obtained by avoiding heat in deep halls is zhong shu. Zhong ye disease results from external labor, sunlight exposing skin, heat qi entering nasal orifices, damaging Lung meridian. Symptoms: body heat, headache, goosebumps, slight chills, open mouth, dry teeth, tongue coating, vexation and thirst. Treatment: Ren Shen Shi Gao Zhi Mu Tang (Ginseng, Gypsum, and Anemarrhena Decoction). Zhong shu results from staying indoors, walking alleys, sudden oppressive heat steaming, inhaling summerheat qi, damaging Pericardium meridian. Symptoms: vexation, thirst, spontaneous sweating, dirty face, deficient pulse, or abdominal pain, vomiting/diarrhea, or retching/stuffiness, severe unconsciousness. Treatment: Xiang Ru Yin (Elsholtzia Decoction).
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① Zhang Jiegu: Name Yuansu, from Yizhou during Jin (now Yixian County, Hebei Province). Authored *Zhen Zhu Nang*, *Bing Ji Qi Yi Bao Ming Ji*, *Zang Fu Biao Ben Yao Shi*, *Yi Yu Qi Yuan*, and *Jie Gu Jia Zhen*.
② Ye: Sound of "he". Zhong Ye: Heatstroke. Also known as summerstroke.
③ Song: Sound of "song". Meaning protruding/high. Like standing straight.
④ Mo: Sound of "mo". Meaning sudden.
Ren Shen Shi Gao Zhi Mu Tang
Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Jing Mi (Oryza Sativa).
Xiang Ru Yin
Xiang Ru Yin contains Hou Po (Magnoliae Officinalis Cortex), Bian Dou (Lablab Album), Huang Lian (Coptidis Rhizoma); for summerstroke with abdominal pain, vomiting/diarrhea due to yin-yang conflict.
Shi Wei Xiang Ru Yin
Shi Wei Xiang Ru Yin contains Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Chen Pi (Citri Reticulatae Pericarpium), Hou Po (Magnoliae Officinalis Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma), Mu Gua (Chaenomelis Fructus), Bian Dou (Lablab Album); clears summerheat and strengthens spleen.
Liu He Tang
Liu He Tang contains Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Xiang Ru (Elsholtiae Herba), Huo Xiang (Pogostemonis Herba), Bian Dou (Lablab Album), Sha Ren (Amomi Fructus), Ban Xia (Pinelliae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Mu Gua (Chaenomelis Fructus), Xing Ren (Armeniacae Semen Amarum), Hou Po (Magnoliae Officinalis Cortex); for cholera and summerheat damaging spirit.
Sheng Mai San
Sheng Mai San contains Ren Shen (Ginseng Radix et Rhizoma), Wu Wei Zi (Schisandrae Chinensis Fructus), Mai Dong (Ophiopogonis Radix); clears heart and lung heat, tonifies qi and generates fluids.
Qing Shu Yi Qi Tang
Yi Qi Tang contains Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Ju Pi (Citri Reticulatae Pericarpium), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cang Zhu (Atractylodis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), Huang Bo (Phellodendri Cortex), Ren Shen (Ginseng Radix et Rhizoma), Mai Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Chinensis Fructus), Sheng Ma (Cimicifugae Rhizoma), Ge Gen (Puerariae Lobatae Radix), Shen Qu (Massa Medicata Fermentata), Ze Xie (Alismatis Rhizoma).
Note: Summerstroke, zhong ye, and zhong re have different names but are essentially the same syndrome. Due to individual differences, working under scorching sun with excessive activity removes dampness with sweat, leaving little dampness and much heat; seeking coolness excessively without activity makes dampness predominant. Thus treatments differ. This is Zhang Jiegu's distinction between obtaining through movement and stillness. Xiang Ru Yin is suitable for summerheat cases without sweat or with external contraction; those with spontaneous sweating should consider not using it. Readers should consult *Shi Bing Tiao Bian* regarding summer-warmth and latent summerheat treatments.
Dampness Invasion Has Internal and External Distinctions