蒋宝素曰：真中风者，真为风邪所中。卒然击仆偏枯，神昏不语等证，与阴亏火盛，阳虚暴脱之击仆偏枯，神昏不语等证相类，而真伪难分，却真有风形可据之证也。《灵枢·刺节真邪论》曰：虚邪偏客于身半，其入深，内居营卫，营卫稍衰，则真气去，邪气独留，发为偏枯。又九宫八风篇曰：八风皆从其虚之乡来，乃能病人。三虚相搏，则为暴病卒死。其有三虚，而偏中于邪风，则为击仆偏枯矣。又岁露篇曰：三虚者，其死暴疾也。乘年之衰，逢月之空，失时之和，因为贼风所伤，是谓三虚。《素问·风论篇》曰：风之伤人也，或为寒热，或为热中，或为寒中，或为偏枯。又曰：风者善行而数变。又曰：心风之状，多汗恶风，善怒，赤色，甚则言不可快。又六元正纪大论曰：木郁之发，太虚埃昏，云物以扰，大风乃至。甚则耳鸣眩转，目不识人，善暴僵仆。又至真要大论曰：诸风掉眩，皆属于肝。诸暴强直，皆属于风。此《内经》诸篇，言暴病卒死，击仆偏枯，言不可快，眩转，目不识人，善暴僵仆，掉眩强直，乃风乘虚入，如此其明且著也。而河间、东垣、丹溪反谓中风非外来之风，何耶？吾友孙兰亭曰，风之中人，犹矢之中鹄。人之中风卒倒，何异中矢而倒，故经曰：避风如避矢石然。若以中风非外来之风，是犹无矢而云中鹄，有是理乎。此河间以来诸贤有不得辞其责也。至于中寒、中暑、中气、中痰等证，犹类中之中，皆仿中风中字之义。《难经》列中风与伤寒、湿温、热病、温病同归一体，《左传》言风淫末疾，即今之苛痹偏枯诸证。太仓公言病沓风，（沓风，乃前后重沓受风。风伏于内，复感风而发之证。）四肢不用，使人喑，喑即死，即今之中风不语。《金匮要略》言风之为病，当半身不遂，及㖞僻不识人，舌难言，口吐涎。《伤寒论》云：言迟者风也。华元化言中风之病，口禁筋急，舌强，手足不遂，偏枯失音等证甚详。《后魏书》言临淮王孙孚好酒遇风，手足俱痹，口不能言。巢元方言风证奄忽不知人，舌强不能言，口禁不开，口㖞，目不能平视，四肢不收，暴绝如死，孙思邈言偏枯、风痱、风懿、风痹，及卒暴诸病，皆从风得。诸家之论如是，上与经旨相符，下与今之中风诸证相合，岂可谓非外中于风欤。《唐书》许裔宗治柳太后感风不能言而口禁，用黄芪、防风数十斛置床下薰蒸，此从风治而愈。成讷张咏进豨莶丸表，言豨莶治中风良愈，亦从风治。由是观之，自春秋以来，至于李唐北宋，论中风皆宗《灵》《素》，作外入风淫论治。自宋金刘河间，始谓中风非外中于风，由乎将息失宜，心火暴甚，肾水虚衰，不能制之，则阴虚阳实。又云：阳实阴虚，而风热太甚以胜水湿，因而成燥。肝主于筋，而风气自甚。此河间主火立说，盖错认《内经》阴亏火盛之击仆偏枯无风似风诸证，以证有风之击仆偏枯诸证为非是。又云：风热太甚，风气自甚，（兰亭注曰：风热风气谓肝木化风，则背经义，谓外来之风，则自相悖戾。）遂自相矛盾，而起后世之疑。李东垣曰：中风者，非外来风邪，乃本气自病。凡人年逾四旬，气衰之际，或忧喜忿怒伤其气者，多有此疾。壮岁之时无有也。若肥盛者，则间有之，亦是形盛气衰而如此耳。此东垣主气立说，盖错认《内经》阳虚暴脱之击仆偏枯无风似风诸证，以证有风之击仆偏枯诸证为非是，同于河间之误。张子和言掉摇眩运，纡曲劲直，手足制颤，目斜口㖞，顿僵暴仆，昏不知人，为风木之象，厥阴肝木之用，肝木所以自甚者，盖肺金为心火所制，不能胜木故也。此子和明知经义中风，乃风淫外入，又惑于河间主火之说，遂以肺金为心火所制，不能平木，木火召风，两存其说，依违无决。朱丹溪曰：中风大率主血虚有痰。按《内经》以下，皆谓外中风邪，然地有南北之殊，不可一途而论。由今言之，西北二方，亦有真为风所中者，但极少耳。东南之人，多是湿土生痰，痰生热，热生风也。此丹溪主痰立说。盖不舍经义，又惑于河间、东垣之论，强分南北，曲为之解，遂以东南无中风，以附会河间、东垣之意，岂其然乎。王安道谓刘、李、朱三子，以类中风之病视为中风而立论，故使后人狐疑而不能决。殊不知因于风者，真中风也。因于火，因于气，因于湿者，类中风而非中风也。三子所论者，自是因火、因气、因湿而为暴病暴死之证，与风何相干哉。如《内经》所谓三阴三阳发病，为偏枯痿易，四肢不举，亦未尝必因于风而后能也。此安道之论，诚绝类离伦之见。然因于风，不因于风，何所凭哉，并无确证可据，为未尽善也。刘宗厚在凉州，亲见大风起自西北路，死者数人，可为中风暴死之据。王肯堂分六经形证，以小续命汤加减主之，是从风治。又云：血弱不能养筋，故手足不能运动，舌强不能语，治宜大秦艽汤。此以风药治无风之证，又云每用诸汁，以收奇功。此又以不治风之药以治风证，何其错乱。张景岳立非风门，（余友左子木曰：张景岳立非风门，而诸风门又有类中之名，夫非风与类中何以分也。若以《内经》并诸贤所论类中之名，当非风门之实，则诸风门所云类中，将何所指耶。若以《内经》并诸贤所论类中之实，当诸风门类中之名，则非风门何所指耶。既以暴脱诸证为非风，则诸风门不必复立类中之名。既有类中之名，又何以有非风名也。名色既多，混人耳目，贻误后人，岂容不辨。）论中风曰：单用河间、东垣之意，竟以非风名之。又立诸风门曰：风有真风、类风，不可不辨。引九宫八风、岁露、金匮真言诸篇为真风之据，盖不敢背经义，而惑于河间、东垣之论，遂自相悖戾如此。喻嘉言谓阳虚，邪害空窍为本，而风从外入者，必挟身中素有之邪，或火或气或痰而为标耶。此亦不舍经义，又从三子，语涉两歧，混而莫辨。夫自河间一误，遂致后世依违莫定。然则，何以辨之。曰：同一击仆偏枯，神昏不语等证，有邪证邪脉可据者。真中风也。无邪证邪脉可据者，阴亏火盛，阳虚暴脱等证，即类中风也。河间以前所论者真中风也。河间以后所论者，类中风作为真中风，反以真中风为无风之证也。所谓邪证者，前列经义，言之已悉，更以苔厚溲浑为主，其苔或白或黄，或灰或黑，或滑或涩，甚则苔黑起刺，或干赤起刺，其溲或白或黄，或赤或紫，皆浑浊不清，其他如头疼身痛，憎寒发热，神烦不寐等证，与伤寒伏邪门同证者皆是也。所谓邪脉者，其脉不必深求，但见软数虚弦不静者是也。夫风之中脉也，如水之得风也。软数虚弦不静者，乃风驰水逝之象也。所谓无邪证邪脉，见类中风门，持是以往，足以破近古之疑，而得病之情实，故特立真中风门，以告夫同志者。伤风证必咳嗽，即中风之轻者。见咳嗽门，兹不赘。
略曰：金匮侯氏黑散，风引续命诸汤，治中风善矣。然世异时移，近代嗜欲无穷，忧患不止，人稠禀薄，二气常亏，多有不堪峻剂者，故业师医案，每用玉屏风散，家君医话新制黄风汤，俱宗许裔宗治柳太后之意，可以类推矣。
真中风论列方
十全大补汤（一） 侯氏黑散（二） 风引汤（三） 续命汤（四） 玉屏风散（五）
类中风第二
《椿田医话》曰：第一类黄风汤，主治类中风，击仆偏枯，神昏不语等证，与真中风相类，但小便不浑，舌苔不厚，别无邪证邪脉可据者，唯见五绝不治。（五绝见真中风门。） 大熟地（八钱） 人参（三钱） 云茯苓（三钱） 淮山药（四钱） 当归身（三钱） 枸杞子（三钱） 山萸肉（四钱） 大麦冬（三钱） 五味子（一钱） 甘澜水（取甘澜水法，以千里长流水数斗，倾于盆内，用木杓扬之数千遍至万遍更妙。）煎服。若阳虚欲脱者，加制附子钱半，鹿茸二钱。若阴亏已极，加黄柏一钱，龟板三钱。若牙关不开，药不能入者，用苏合香丸擦牙即开，或乌梅肉亦可。本方服二三剂，或五七剂至十剂后，不见病情增剧，便是药证相当，接服第二方。
第二类黄风汤，主治类中风。服第一类黄风汤后，无问诸证进退效否，但病势不见转增，宜服此方。补阳不燥，补阴不寒，且兼清气化痰之意，最切于时用。 大熟地（六钱） 人参（钱半） 怀牛膝（二钱） 淮山药（三钱） 麦门冬（二钱） 福橘皮（一钱） 山萸肉（三钱） 五味子（八分） 炙甘草（五分） 甘澜水煎服。若阳虚欲脱，加制附子钱半，鹿茸二钱。若阴亏已极，加黄柏一钱，龟板三钱。本方服二三剂，或五七剂至十剂后，诸恙向安者，接服第三方。
第三类黄风汤，主治类中风。服第二类黄风汤后，诸证垂愈，宜静补真阴。第阴无骤补之法，此方补阴最得从容之理。 大熟地（四钱） 云茯苓（二钱） 怀山药（三钱） 大沙参（三钱） 大麦冬（二钱） 炙龟板（三钱） 野黄精（三钱） 五味子（五分） 甘澜水煎服。二三剂，或五七剂至十剂后，更以十剂为末，水叠丸。每早晚开水服三钱。
《庄子·内篇》曰：民湿寝，则腰脊偏死。
《史记·魏其武安列传》曰：魏其失势，默默不得志，独厚灌将军，及论灌夫及家属，魏其良久乃闻，闻即恚，病痱不食欲死。 《晋书·皇甫谧表》曰：久婴笃疾，半身不仁，右脚偏小。
《九峰医案》曰：舌强语言蹇涩，右臂麻木不舒，言乃心之声，赖肺金以宣扬，脾主四肢，其用在右，心火盛，肾水虚，将息失宜，五志过极，湿土生痰，机窍不利，脉来三五不调，类中复萌已著。理阳明，和太阴，佐化湿痰，不致阴阳离决，方克有济。 人参（三钱） 白蒺藜（三钱） 白茯神（三钱） 白僵蚕（二钱） 福橘皮（一钱） 制半夏（钱半） 炙甘草（五分） 鲜竹茹（钱半）
类中复萌，舌强言蹇，右臂屈伸不利，心火暴甚，肾水虚衰，智意不和，湿痰阻窍，本拟泻心法，缘脉来甚慢如结代之状，尺部尤甚，仍从中治。理阳明，和太阴，亦可保其心肾。 鲜首乌（三钱） 白蒺藜（三钱） 白茯神（三钱） 人参（三钱） 福橘皮（一钱） 制半夏（二钱） 白僵蚕（二钱） 冬白术（钱半） 炙甘草（五分）
两进理阳明，和太阴，佐化湿痰，舌强渐和，语言渐展，右肢麻痹亦舒，胸次反觉不畅，清涎上溢，湿痰未化，心火未平，脉仍三五不调，未宜骤补，原方加减。 鲜首乌（五钱） 白蒺藜（三钱） 白茯神（三钱） 福橘皮（一钱） 制半夏（二钱） 炙甘草（五分） 白僵蚕（二钱） 霜桑叶（一钱） 黑脂麻（五钱）
病原已载前方，服药以来，舌强渐和，语言渐爽，肢痹已苏，胸次亦畅，经以心脉系舌本，脾脉连舌本，肾脉循喉咙，挟舌本，太阴不营，湿痰自生，肾水不生，心火自盛，必得三经平复，水升火降，中土畅和，机窍自展，现在湿土用事，午火司权，暂以桑麻六君加味，崇土养荣，和肝息风，引益肾水。 人参（二两） 云茯苓（二两） 冬白术（二两） 炙甘草（五钱） 制半夏（两半） 福橘皮（一两） 霜桑叶（两半） 黑脂麻（三两） 黄菊花（五钱） 为末水叠丸，每早晚服三钱。
偏枯于左，口㖞于右，舌强言蹇，涎下不禁，脉来甚慢，大筋软短，小筋弛长，湿热不攘，中虚痰郁为患。 人参（二钱） 云茯苓（三钱） 冬白术（二钱） 炙甘草（五分） 羚羊片（一钱） 制半夏（钱半） 福橘皮（一钱） 淡竹沥（二钱） 生姜汁（一钱）
目盲不可视，足废不能行，小便或秘癃，或不禁，饮食如故，脏病腑不病，心肾乖违，情志郁勃，机窍阻塞。昔魏其侯伤意病此，名曰风痱。议刘守真地黄饮子。 大熟地（四钱） 制附子（一钱） 云茯苓（钱半） 巴戟天（钱半） 石菖蒲（五分） 远志肉（一钱） 山萸肉（二钱） 淡苁蓉（二钱） 五味子（五分） 油肉桂（八分） 麦门冬（二钱） 钗石斛（二钱）
经言阳之气，以天地之疾风名之。卒然昏愦无知，柔汗，溲便遗失，四肢不收，口噤不语，脉来迟慢，因烦劳太过，扰乱二十五阳，阳气动变，气不归精，精无所倚，精不化气，神无所依，乃阴阳离决之危候也。勉拟景岳回阳饮，迫敛散亡之气，未识阳能回否。 大熟地（八钱） 人参（三钱） 炙甘草（一钱） 制附子（三钱） 当归身（三钱） 炮姜灰（一钱）
午正进药，申末汗收，神志渐清，语言渐展，肢体自能徐转，脉象小駃于迟，惟心烦虑乱，莫能自主，乃阳回阴液未复，进锐退速，危证得安，乃天幸，非人力也。 大熟地（八钱） 人参（二钱） 炙甘草（五分） 制附子（钱半） 当归身（三钱） 炮姜灰（五分） 云茯神（三钱）
阳回阴液未复，中心愦愦不安，肢体虽和，语言尚蹇，脉象小駃于迟曰缓，经以无阳则阴无以生，连进回阳生阴之品，颇合机宜，安不忘危，善后更宜加意。 大熟地（八钱） 人参（二钱） 炙甘草（五分） 当归身（三钱） 云茯神（三钱） 炮姜灰（五分） 酸枣仁（三钱）
Jiang Baosu said: The so-called "True Wind Stroke" (Zhen Zhong Feng, true stroke caused by external wind pathogen) refers to being truly struck by the wind pathogen. Symptoms such as sudden collapse, hemiplegia (Biangu, paralysis of one side of the body), coma, and aphasia are similar to those caused by Yin deficiency with flourishing fire, or Yang deficiency with sudden collapse. These conditions are difficult to distinguish in terms of authenticity and falsity, yet True Wind Stroke indeed has evidence of wind pathogenic factors. The *Ling Shu · Ci Jie Zhen Xie Lun* states: When empty pathogens (Xu Xie, external pathogens taking advantage of deficiency) reside on one half of the body, penetrating deeply and lodging within Ying and Wei (Nutritive and Defensive Qi), if Ying and Wei gradually decline, the True Qi departs, leaving only the pathogen behind, resulting in hemiplegia. Furthermore, the *Jiu Gong Ba Feng Pian* states: The winds from the eight directions strike where the body is deficient, thereby causing disease. When three types of deficiency combine, it leads to sudden illness and death. If one has these three deficiencies and is partially struck by evil wind, it results in sudden collapse and hemiplegia. The *Sui Lu Pian* states: Regarding the "three deficiencies," death occurs due to sudden disease. Taking advantage of the year's decline, encountering the moon's emptiness (a period of lunar weakness), and losing harmony with the seasons, one is injured by thief wind (Zeifeng, irregular wind), which is called the "three deficiencies." The *Su Wen · Feng Lun Pian* states: Wind injuring humans may manifest as cold-heat alternation, heat in the middle, cold in the middle, or hemiplegia. It also states: Wind moves swiftly and changes frequently. It further states: The manifestation of Heart Wind includes excessive sweating, aversion to wind, irritability, red complexion, and severe cases may involve difficulty speaking. The *Liu Yuan Zheng Ji Da Lun* states: When Wood Qi stagnates and erupts, the sky becomes dark and dusty, clouds and objects are disturbed, and great winds arrive. Severe cases may present with tinnitus, vertigo, inability to recognize people, and frequent sudden stiff falls. The *Zhi Zhen Yao Da Lun* states: All wind diseases involving tremors and vertigo belong to the Liver. All sudden stiffness belongs to Wind. These chapters in the *Nei Jing* clearly demonstrate that sudden illness, death, collapse, hemiplegia, speech difficulties, vertigo, blindness, stiff falls, tremors, and stiffness are caused by wind entering through deficiency. Why did Liu Hejian, Li Dongyuan, and Zhu Danxi argue that stroke is not caused by external wind? My friend Sun Lanting said that wind striking a person is like an arrow hitting a target. A person collapsing suddenly from stroke is no different from falling after being hit by an arrow. Thus, the classics say: Avoid wind as you would avoid arrows and stones. To claim that stroke is not caused by external wind is like claiming to have hit a target without an arrow; does this make sense? This is a responsibility that scholars since Hejian cannot shirk. As for Cold Strike, Summerheat Strike, Qi Strike, and Phlegm Strike, they are analogous to stroke ("Lei Zhong Feng", stroke-like conditions), derived from the meaning of the character "Zhong" (strike/inflict). The *Nan Jing* categorizes Stroke together with Cold Damage, Damp-Warmth, Heat Disease, and Warm Disease. The *Zuo Zhuan* mentions that wind excess causes diseases of the extremities, referring to current conditions like Ke Bi and hemiplegia. Cangtai Gong (Chunyu Yi) stated that suffering from Ta Feng (repeated exposure to wind, where wind lies latent internally and re-emerges upon re-exposure) leads to immobility of the four limbs and muteness, which is fatal, corresponding to modern aphasia in stroke. The *Jin Gui Yao Lue* states that wind disease manifests as hemiplegia, facial deviation, inability to recognize people, tongue stiffness, difficulty speaking, and drooling. The *Shang Han Lun* states: Slurred speech indicates wind. Hua Yuanhua (Hua Tuo) detailed stroke symptoms including locked jaw, tendon tension, tongue stiffness, limb paralysis, hemiplegia, and loss of voice. The *Book of Later Wei* records that Prince Fu of Linhuai, after drinking and being exposed to wind, suffered numbness in his limbs and inability to speak. Chao Yuanfang described wind syndromes involving sudden unconsciousness, tongue stiffness, locked jaw, facial deviation, inability to look straight, flaccid limbs, and sudden cessation of breath resembling death. Sun Simiao stated that hemiplegia, Feng Fei (wind flaccidity), Feng Yi (wind stupor), Feng Bi (wind obstruction), and other sudden illnesses all originate from wind. Such discussions by various schools align with classical principles and match modern stroke symptoms; how can it be denied that it is externally contracted wind? The *Book of Tang* records Xu Yizong treating Empress Liu for wind-induced muteness and locked jaw using decoctions of Huangqi (Astragalus Root) and Fangfeng (Saposhnikovia Root) fumigated under her bed, curing her by treating the wind. Cheng Ne and Zhang Yong presented Xi Xian Wan (Siegesbeckia Pill), stating Xi Xian (Siegesbeckiae Herba) effectively treats stroke, again treating the wind. Thus, from the Spring and Autumn period through the Tang and Northern Song dynasties, stroke theories followed the *Ling Shu* and *Su Wen*, advocating treatment for externally invading wind. Since Liu Hejian of the Song-Jin period, it was argued that stroke is not caused by external wind but by improper lifestyle leading to sudden Heart Fire flourishing and Kidney Water deficiency, resulting in Yin deficiency and Yang excess. It was further claimed that Yang excess and Yin deficiency, combined with excessive wind-heat overcoming water-dampness, lead to dryness. Since the Liver governs tendons, wind Qi naturally becomes excessive. This is Hejian's theory based on Fire, mistakenly identifying the non-wind-like hemiplegia caused by Yin deficiency and fire flourishing in the *Nei Jing* as the rule, while rejecting actual wind-induced hemiplegia. He also claimed excessive wind-heat leads to excessive wind Qi (Lanting notes: attributing wind-heat to Liver Wood transforming into wind contradicts classics; attributing it to external wind is self-contradictory), creating internal contradictions and confusing later generations. Li Dongyuan stated: Stroke is not external wind but a disease of the original Qi. People over forty with declining Qi, or those injured by emotions, often suffer this; young adults do not. Obese individuals may occasionally suffer it due to form excess and Qi deficiency. This is Dongyuan's theory based on Qi, mistakenly identifying non-wind-like hemiplegia from Yang deficiency collapse as the rule, sharing Hejian's error. Zhang Zihe stated: Tremors, vertigo, twisting stiffness, trembling limbs, slanted eyes, crooked mouth, sudden stiff falls, and unconsciousness are images of Wind Wood and functions of Jueyin Liver Wood. Liver Wood becomes excessive because Lung Metal is controlled by Heart Fire and cannot subdue Wood. Zihe knew stroke involves external wind but was confused by Hejian's Fire theory, proposing that Lung Metal cannot control Wood due to Heart Fire, and Wood-Fire summons wind, holding both views indecisively. Zhu Danxi stated: Stroke is mostly due to Blood deficiency and Phlegm. Following the *Nei Jing*, all attribute it to external wind, but geography varies. In the northwest, true wind stroke exists but is rare. In the southeast, damp earth generates phlegm, phlegm generates heat, and heat generates wind. This is Danxi's theory based on Phlegm. While not abandoning classics, he was influenced by Hejian and Dongyuan, forcing a north-south distinction to accommodate their views, claiming no stroke in the southeast, which is incorrect. Wang Andao stated: Liu, Li, and Zhu treated Lei Zhong Feng (stroke-like conditions) as Zhong Feng (true stroke), causing confusion. One must know that conditions caused by wind are True Stroke. Conditions caused by Fire, Qi, or Dampness are Lei Zhong Feng, not True Stroke. Their discussions concerned sudden illnesses from Fire, Qi, or Dampness, unrelated to wind. Even the *Nei Jing* mentions San Yin San Yang diseases causing hemiplegia and limb paralysis without necessarily requiring wind. Andao's view is brilliant, yet lacks definitive proof for distinguishing wind vs. non-wind causes. Liu Zonghou witnessed deadly northwest winds in Liangzhou, providing evidence for sudden wind death. Wang Kentang differentiated Six Channels' manifestations, treating with modified Xu Ming Tang (Continuing Life Decoction), treating the wind. He also stated blood deficiency failing to nourish tendons causes limb immobility and tongue stiffness, treating with Da Qin Jiao Tang (Great Gentiana Root Decoction), using wind herbs for non-wind conditions. He also praised juices for miraculous cures, using non-wind herbs for wind conditions, showing confusion. Zhang Jingyue established the "Non-Wind Gate" (my friend Zuo Zimu questioned: If Non-Wind Gate covers Lei Zhong Feng, what do the Wind Gates refer to? If Non-Wind Gate covers the reality of Lei Zhong Feng, what does the name refer to? If sudden collapse is non-wind, why name Lei Zhong Feng in Wind Gates? Having both names confuses people and misleads future generations). He discussed stroke using Hejian and Dongyuan's ideas, naming it Non-Wind. He also established a Wind Gate distinguishing True Wind and Similar Wind, citing classics for True Wind but contradicting himself due to influence from Hejian and Dongyuan. Yu Jiayan stated: Yang deficiency and empty orifice invasion are the root; external wind carries internal pathogens like Fire, Qi, or Phlegm as the branch. This retains classic elements but follows the three masters, creating ambiguity. Since Hejian's error, later generations have been undecided. How to distinguish? Same symptoms of collapse, hemiplegia, coma, and aphasia: if supported by evil signs and pulses, it is True Stroke. If unsupported, it is Lei Zhong Feng (Yin deficiency/fire, Yang deficiency/collapse). Pre-Hejian theories discussed True Stroke. Post-Hejian theories mistook Lei Zhong Feng for True Stroke and dismissed True Stroke as non-wind. Evil signs include thick tongue coating (white, yellow, gray, black, slippery, rough, or black/thorny/dry-red) and turbid urine (white, yellow, red, purple, cloudy), along with headache, body pain, chills, fever, restlessness, and insomnia, matching Cold Damage latent pathogen patterns. Evil pulses are soft, rapid, deficient, wiry, and unstable, resembling wind driving water. Absence of evil signs/pulses points to Lei Zhong Feng. Establishing the True Stroke Gate clarifies ancient doubts and reveals disease reality. Wind injury causing cough is mild stroke; see Cough Gate.
Briefly: Hou Shi Hei San (Marigold Black Powder), Feng Yin Tang (Wind Pulling Decoction), and Xu Ming Tang (Continuing Life Decoction) in the *Jin Gui Yao Lue* treat stroke well. However, times change. Modern desires are endless, worries ceaseless, population dense, and constitution weak, with Yin-Yang often deficient. Many cannot tolerate harsh medicines. Thus, my master's medical cases often use Yu Ping Feng San (Jade Windscreen Powder), and my father's new prescription Huang Feng Tang (Yellow Wind Decoction), following Xu Yizong's method for Empress Liu, allowing for analogy.
Formulas Listed for True Stroke Theory
1. Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction)
2. Hou Shi Hei San (Marigold Black Powder)
3. Feng Yin Tang (Wind Pulling Decoction)
4. Xu Ming Tang (Continuing Life Decoction)
5. Yu Ping Feng San (Jade Windscreen Powder)
Lei Zhong Feng (Stroke-Like Conditions) Part Two
*Chuntian Yihua* states: Category 1 Huang Feng Tang (Yellow Wind Decoction) treats Lei Zhong Feng, presenting with collapse, hemiplegia, coma, and aphasia, similar to True Stroke, but with clear urine, thin tongue coating, and no evil signs/pulses. Only Five Extinctions (Wu Jue) are untreatable (see True Stroke Gate).
Recipe: Shu Di Huang (Rehmanniae Radix Preparata) 8 qian, Ren Shen (Ginseng Radix) 3 qian, Yun Fu Ling (Poria) 3 qian, Huai Shan Yao (Dioscoreae Rhizoma) 4 qian, Dang Gui Shen (Angelicae Sinensis Radix Corpus) 3 qian, Gou Qi Zi (Lycii Fructus) 3 qian, Shan Yu Rou (Corni Fructus) 4 qian, Da Mai Dong (Ophiopogonis Radix) 3 qian, Wu Wei Zi (Schisandrae Fructus) 1 qian. Decoct with Gan Lan Shui (Ganlan Water, made by stirring running water thousands of times). Take orally. For Yang deficiency with impending collapse, add Zhi Fu Zi (Aconiti Lateralis Radix Preparata) 1.5 qian, Lu Rong (Cervi Cornu Pantotrichum) 2 qian. For extreme Yin deficiency, add Huang Bai (Phellodendri Cortex) 1 qian, Gui Ban (Testudinis Carapax et Plastrum Preparatum) 3 qian. For locked jaw preventing medication intake, apply Su He Xiang Wan (Styrax Pill) to teeth to open, or use Wumei (Mume Fructus). After 2-3 doses, or 5-7 to 10 doses, if condition does not worsen, the medicine matches the syndrome; proceed to Formula 2.
Category 2 Huang Feng Tang treats Lei Zhong Feng. After taking Category 1, regardless of symptom progression or efficacy, if the disease trend does not increase, take this formula. It tonifies Yang without drying, tonifies Yin without chilling, and clears Qi resolving Phlegm, fitting current needs best.
Recipe: Shu Di Huang 6 qian, Ren Shen 1.5 qian, Huai Niu Xi (Achyranthis Bidentatae Radix) 2 qian, Huai Shan Yao 3 qian, Mai Men Dong (Ophiopogonis Radix) 2 qian, Fu Ju Pi (Citri Reticulatae Pericarpium) 1 qian, Shan Yu Rou 3 qian, Wu Wei Zi 0.8 fen, Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparatum) 0.5 fen. Decoct with Gan Lan Shui. For Yang deficiency with impending collapse, add Zhi Fu Zi 1.5 qian, Lu Rong 2 qian. For extreme Yin deficiency, add Huang Bai 1 qian, Gui Ban 3 qian. After 2-3 doses, or 5-7 to 10 doses, if symptoms stabilize, proceed to Formula 3.
Category 3 Huang Feng Tang treats Lei Zhong Feng. After taking Category 2, when symptoms nearly resolve, gently tonify True Yin. Yin cannot be tonified rapidly; this formula tonifies Yin with appropriate gentleness.
Recipe: Shu Di Huang 4 qian, Yun Fu Ling 2 qian, Huai Shan Yao 3 qian, Da Sha Shen (Glehniae Radix) 3 qian, Da Mai Dong 2 qian, Zhi Gui Ban 3 qian, Ye Huang Jing (Polygonati Rhizoma) 3 qian, Wu Wei Zi 0.5 fen. Decoct with Gan Lan Shui. After 2-3 doses, or 5-7 to 10 doses, grind remaining 10 doses into powder and make water pills. Take 3 qian with warm water morning and evening.
*Zhuangzi · Nei Pian* states: Sleeping in dampness causes paralysis of the waist and spine.
*Shiji · Weiqi Wu'an Liezhuan* states: When Weiqi Marquis lost power, he was silent and frustrated, favoring General Guan. When discussing Guan Fu and his family, Weiqi heard late, became angry, suffered Feng Fei (wind flaccidity), anorexia, and wished to die. *Jinshu · Huangfu Mi Biaoz* states: Suffering long-term severe illness, half-body insensitivity, right foot smaller than left.
*Jiufeng Yi'an* states: Tongue stiffness and slurred speech, right arm numbness. Speech is the voice of the Heart, relying on Lung Metal to disseminate. Spleen governs four limbs, function on the right. Heart Fire flourishes, Kidney Water deficient, improper care, extreme emotions generate damp-phlegm, blocking orifices. Pulse is irregular (3-5 variations). Lei Zhong Feng recurrence is evident. Regulate Yangming, harmonize Taiyin, assist in resolving damp-phlegm to prevent Yin-Yang separation.
Recipe: Ren Shen 3 qian, Bai Ji Li (Tribuli Fructus) 3 qian, Bai Fu Shen (Poria cum Radice Pinelli) 3 qian, Bai Jiang Can (Bombyx Batryticatus) 2 qian, Fu Ju Pi 1 qian, Zhi Ban Xia (Pinelliae Rhizoma Preparatum) 1.5 qian, Zhi Gan Cao 0.5 fen, Xian Zhu Ru (Bambusae Caulis in Taenia) 1.5 qian.
Lei Zhong Feng recurrence, tongue stiffness, slurred speech, right limb immobility, Heart Fire flourishing, Kidney Water deficient, mental disarray, damp-phlegm blocking orifices. Originally planned Xie Xin Fa (Drain Heart Method), but pulse is very slow, resembling Jie Dai (intermittent) pulse, especially at Chi position. Still treat from the Middle Jiao. Regulate Yangming, harmonize Taiyin, preserving Heart and Kidney.
Recipe: Xian Shou Wu (Polygoni Multiflori Caulis) 3 qian, Bai Ji Li 3 qian, Bai Fu Shen 3 qian, Ren Shen 3 qian, Fu Ju Pi 1 qian, Zhi Ban Xia 2 qian, Bai Jiang Can 2 qian, Dong Bai Zhu (Atractylodis Macrocephalae Rhizoma) 1.5 qian, Zhi Gan Cao 0.5 fen.
After two courses of regulating Yangming and harmonizing Taiyin, assisting in resolving damp-phlegm, tongue stiffness eased, speech improved, right limb numbness relieved. However, chest feels obstructed, clear saliva overflows, damp-phlegm unresolved, Heart Fire uncalmed, pulse still irregular. Do not tonify abruptly; modify original formula.
Recipe: Xian Shou Wu 5 qian, Bai Ji Li 3 qian, Bai Fu Shen 3 qian, Fu Ju Pi 1 qian, Zhi Ban Xia 2 qian, Zhi Gan Cao 0.5 fen, Bai Jiang Can 2 qian, Shuang Sang Ye (Mori Folium) 1 qian, Hei Zhi Ma (Sesami Fructus Niger) 5 qian.
Pathogenesis recorded in previous formulas. Since taking medicine, tongue stiffness eased, speech clearer, limb numbness resolved, chest畅通. Classics state Heart meridian connects to tongue base, Spleen meridian connects to tongue base, Kidney meridian follows throat and clutches tongue base. Taiyin fails to nourish, generating damp-phlegm. Kidney Water fails to generate, causing Heart Fire to flourish. Must restore three meridians, raise Water, descend Fire, harmonize Central Earth, and open orifices. Currently Damp Earth is active, Noon Fire holds power. Temporarily use Sang Ma Liu Jun Tang (Mulberry Seed and Sesame Six Gentlemen Decoction) with modifications to strengthen Earth, nourish Ying, harmonize Liver, extinguish wind, and benefit Kidney Water.
Recipe: Ren Shen 2 liang, Yun Fu Ling 2 liang, Dong Bai Zhu 2 liang, Zhi Gan Cao 5 qian, Zhi Ban Xia 1.5 liang, Fu Ju Pi 1 liang, Shuang Sang Ye 1.5 liang, Hei Zhi Ma 3 liang, Huang Ju Hua (Chrysanthemi Flos) 5 qian. Grind into powder, make water pills. Take 3 qian morning and evening.
Hemiplegia on the left, facial deviation on the right, tongue stiffness, slurred speech, uncontrollable drooling, very slow pulse. Large tendons soft and short, small tendons lax and long. Damp-heat not expelled, central deficiency with phlegm stagnation.
Recipe: Ren Shen 2 qian, Yun Fu Ling 3 qian, Dong Bai Zhu 2 qian, Zhi Gan Cao 0.5 fen, Ling Yang Pian (Capricornus Bubali Cornu) 1 qian, Zhi Ban Xia 1.5 qian, Fu Ju Pi 1 qian, Dan Zhu Li (Bambusae Succus) 2 qian, Sheng Jiang Zhi (Zingiberis Rhizoma Recens Sucus) 1 qian.
Blindness, leg failure unable to walk, urinary retention or incontinence, diet normal. Zang diseased, Fu healthy. Heart-Kidney discord, emotional depression, orifice blockage. Formerly Weiqi Marquis suffered this from grief, named Feng Fei. Propose Liu Shouzhen's Dihuang Yin Zi (Rehmannia Decoction).
Recipe: Shu Di Huang 4 qian, Zhi Fu Zi 1 qian, Yun Fu Ling 1.5 qian, Ba Ji Tian (Morindae Officinalis Radix) 1.5 qian, Shi Chang Pu (Acori Tatarinowii Rhizoma) 0.5 fen, Yuan Zhi Rou (Polygalae Radix) 1 qian, Shan Yu Rou 2 qian, Dan Cong Rong (Cistanches Herba) 2 qian, Wu Wei Zi 0.5 fen, You Rou Gui (Cinnamomi Cortex) 0.8 fen, Mai Men Dong 2 qian, Cha Shi Hu (Dendrobii Caulis) 2 qian.
Classics state Yang Qi is named after heaven and earth's swift wind. Sudden coma, soft sweat, incontinence, limb flaccidity, locked jaw, slow pulse. Due to excessive fatigue disturbing the Twenty-Five Yang, Yang Qi moves chaotically, Qi does not return to Essence, Essence has no support, Essence fails to transform Qi, Spirit has no reliance. This is a critical sign of Yin-Yang separation. Tentatively prescribe Jingyue's Hui Yang Yin (Return Yang Decoction) to gather scattered Qi, unsure if Yang can return.
Recipe: Shu Di Huang 8 qian, Ren Shen 3 qian, Zhi Gan Cao 1 qian, Zhi Fu Zi 3 qian, Dang Gui Shen 3 qian, Pao Jiang Hui (Zingiberis Rhizoma Preparatum Ash) 1 qian.
Medicine taken at noon, sweat stopped by late afternoon, spirit gradually clears, speech improves, limbs move slowly. Pulse slightly faster than before, but still slow. Restless mind, unable to control self. Yang returns, Yin fluids not restored. Rapid advance, rapid retreat. Critical condition stabilized by heaven's fortune, not human effort.
Recipe: Shu Di Huang 8 qian, Ren Shen 2 qian, Zhi Gan Cao 0.5 fen, Zhi Fu Zi 1.5 qian, Dang Gui Shen 3 qian, Pao Jiang Hui 0.5 fen, Yun Fu Shen 3 qian.
Yang returned, Yin fluids not restored. Inner restlessness, limbs harmonious but speech still slurred. Pulse slightly faster than slow, termed "Huan" (moderate). Classics state: Without Yang, Yin cannot generate. Continuously administer Yang-returning and Yin-generating substances, fitting the mechanism. Remember danger in safety, pay attention to follow-up.
Recipe: Shu Di Huang 8 qian, Ren Shen 2 qian, Zhi Gan Cao 0.5 fen, Dang Gui Shen 3 qian, Yun Fu Shen 3 qian, Pao Jiang Hui 0.5 fen, Suan Zao Ren (Ziziphi Spinosae Semen) 3 qian.