麻黄（去节） 人参（去芦） 黄芩（酒炒） 芍药（酒炒） 川芎 炙甘草 杏仁（去
皮，炒）
分）
古人以此方混治中风，未详其证。昆谓麻黄、杏仁，麻黄汤也，仲景以之治太阳证之伤
寒。桂枝、芍药，桂枝汤也，仲景以之治太阳证之中风。如此言之，则中风而有头疼、身热、
脊强者，皆在所必用也。人参、甘草，四君子之二也，《局方》用之以补气；芍药、川芎，
四物汤之二也，《局方》用之以养血。如此言之，则中风而有气虚、血虚者，皆在所必用也。
风淫末疾，故佐以防风；湿淫腹疾，故佐以防己；阴淫寒疾，故佐以附子；阳淫热疾，故佐
以黄芩。盖病不单来，杂揉而至，故其用药，亦兼该也。
热者，去附子，用白附子；筋急语迟、脉弦者，倍人参，加薏苡、当归，去黄芩、芍药
以避中寒；烦躁、不大便，去附、桂，倍加芍药、竹沥；日久大便不行、胸中不快，加枳壳、
大黄；语言謇涩，手足颤掉，加石菖蒲、竹沥；口渴，加麦门冬、栝蒌、天花粉；身疼、发
搐，加羌活；烦渴、多惊，加犀角、羚羊角；汗多，去麻黄；舌燥，加石膏，去附、桂。
秦艽（去芦） 石膏（生用） 当归（酒洗） 芍药（酒炒） 羌活（去芦） 防风（去
芦） 黄芩
（酒炒） 生 （洗去土，音胡，即生地） 熟 甘草（炙） 川芎（洗） 白术（酒炒）
白芷 茯
苓（去皮） 独活（各一钱） 北细辛（去土，五分）
中风，手足不能运动，舌强不能言语，风邪散见不拘一经者，此方主之。
中风，虚邪也。许学士云∶留而不去，其病则实，故用驱风养血之剂兼而治之。用秦艽
为君者，以其主宰一身之风，石膏所以去胃中总司之火，羌活去太阳百节之风疼，防风为诸
风药中之军卒。三阳数变之风邪，责之细辛；三阴内淫之风湿，责之苓、术。去厥阴经之风，
则有川芎；去阳明经之风，则有白芷。风热干乎气，清以黄芩；风热干乎血，凉以生 。独
活疗风湿在足少阴，甘草缓风邪上逆于肺。乃当归、芍药、熟 者，所以养血于疏风之后，
一以济风药之燥，一使手得血而能握，足得血而能步也。
Ephedrae Herba (Mahuang, 麻黄) [devoid of nodes], Ginseng Radix et Rhizoma (Renshen, 人参) [devoid of rhizome], Scutellariae Radix (Huangqin, 黄芩) [stir-fried with wine], Paeoniae Radix (Shaoyao, 芍药) [stir-fried with wine], Chuanxiong Rhizoma (Chuanxiong), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao, 炙甘草), Armeniacae Semen Amarum (Xingren, 杏仁) [devoid of skin, stir-fried].
In ancient times, this formula was used indiscriminately to treat Stroke (Zhongfeng, 中风), without detailed differentiation of syndromes. I argue: Ephedrae Herba and Armeniacae Semen Amarum constitute Ma Huang Tang (Cinnamon Twig and Ephedra Decoction); Zhang Zhongjing used it to treat Cold Damage (Shanghan, 伤寒) in Taiyang Disease (Taiyang Bing, 太阳病). Cinnamon Twig (Guizhi, 桂枝) and Paeoniae Radix constitute Gui Zhi Tang (Cinnamon Twig Decoction); Zhang Zhongjing used it to treat Wind Strike (Zhongfeng, 中风) in Taiyang Disease. Thus, for Stroke presenting with headache, fever, and spinal rigidity, these herbs are essential. Ginseng Radix et Rhizoma and Glycyrrhizae Radix et Rhizoma Preparata are two ingredients of Si Jun Zi Tang (Four Gentlemen Decoction); the *Jufang* uses them to tonify Qi; Paeoniae Radix and Chuanxiong Rhizoma are two ingredients of Si Wu Tang (Four Substances Decoction); the *Jufang* uses them to nourish Blood. Thus, for Stroke accompanied by Qi deficiency or Blood deficiency, these herbs are essential. When Wind pathogen invades the extremities causing disease, Fang Feng (Saposhnikoviae Radix) is added as an assistant; when Dampness pathogen invades the abdomen causing disease, Fang Ji (Akebiae Caulis) is added as an assistant; when Yin-Cold pathogen causes cold diseases, Fu Zi (Aconiti Lateralis Radix Preparata) is added as an assistant; when Yang-Heat pathogen causes heat diseases, Huangqin is added as an assistant. Generally, pathogens do not arrive alone but mix together; therefore, the medication in this formula is comprehensive.
If Heat signs are present, remove Fu Zi and use Bai Fu Zi (Typhonii Radix). If tendons are tight, speech is slow, and the pulse is Wiry (Xian, 弦), double the dosage of Renshen, add Coicis Semen (Yiyi, 薏苡) and Danggui (Angelicae Sinensis Radix), and remove Huangqin and Shaoyao to avoid damaging Middle Jiao Cold. If there is irritability and constipation, remove Fu Zi and Guizhi, and significantly increase Shaoyao and Zhuli (Bamboo Juice). If the disease has persisted for a long time with no bowel movement and chest discomfort, add Zhike (Aurantii Fructus) and Dahuang (Rhei Radix et Rhizoma). If speech is slurred and hands/feet tremble, add Shichangpu (Acori Tatarinowii Rhizoma) and Zhuli. If thirsty, add Maimendong (Ophiopogonis Radix), Gualou (Trichosanthis Fructus), and Tianhuafen (Trichosanthis Radix). If body aches and convulsions occur, add Qianghuo (Notopterygii Rhizoma et Radix). If there is vexatious thirst and frequent fright, add Xijiao (Rhino Ceratostigma) and Lingyangjiao (Saiga Antelope Horn). If sweating is excessive, remove Mahuang. If the tongue is dry, add Shigao (Gypsum Fibrosum) and remove Fu Zi and Guizhi.
Qinjiao (Gentianae Macrophyllae Radix), Shigao (Gypsum Fibrosum) [raw], Danggui (Angelicae Sinensis Radix) [washed with wine], Shaoyao (Paeoniae Radix) [stir-fried with wine], Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix) [stir-fried with wine], Shengdihuang (Rehmanniae Radix) [washed to remove soil, pronounced 'Hu', i.e., raw Rehmannia], Shudihuang (Prepared Rehmannia Root), Gancao (Glycyrrhizae Radix et Rhizoma Preparata], Chuanxiong (Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) [stir-fried with wine], Baizhi (Angelicae Dahuricae Radix], Fuling (Poria), Duhuo (Angelicae Pubescentis Radix] [each 1 qian], Beixixin (Asari Radix et Rhizoma) [cleaned of dirt, 5 fen].
For Stroke manifesting as inability to move limbs, stiff tongue unable to speak, and wind pathogens appearing scattered without being confined to a single meridian, this formula is indicated.
Stroke is caused by deficient evil pathogens. Scholar Xu stated: "If the pathogen remains and does not depart, the condition becomes excess; therefore, formulas that expel wind and nourish blood are used to treat both aspects." Qinjiao is used as the Sovereign herb because it governs wind throughout the body; Shigao clears the fire governed by the Stomach; Qianghuo expels wind-pain in the joints of the Taiyang meridian; Fangfeng acts as the common soldier among wind-expelling herbs. For wind pathogens frequently changing in the Three Yang meridians, the responsibility lies with Xixin (Asari Radix et Rhizoma); for wind-dampness invading internally from the Three Yin meridians, the responsibility lies with Fulings (Poria) and Baizhu (Atractylodis Macrocephalae Rhizoma). To expel wind from the Jueyin meridian, Chuanxiong is used; to expel wind from the Yangming meridian, Baizhi is used. If wind-heat harasses Qi, it is cleared with Huangqin; if wind-heat harasses Blood, it is cooled with Shengdihuang. Duhuo treats wind-dampness in the Foot-Shaoyin meridian; Gancao moderates the counterflow of wind pathogens to the Lung. As for Danggui, Shaoyao, and Shudihuang, they nourish blood after expelling wind, one purpose being to mitigate the dryness of wind-expelling herbs, and the other ensuring that hands can grasp when nourished by blood and feet can walk when nourished by blood.