人有卒暴僵仆。或偏枯。或四肢不举。或不知人。或死。或不死者。世以中风呼之。而方书
亦以中风治之。余尝考诸内经。则曰风者。百病之始也。又曰风者。百病之长也。至其变
化。乃为他病。无常方。又曰风者。善行而数变。又曰风之伤人也。或为寒热。或为热中。
或为寒中。或为疠风。或为偏枯。或为风也。其卒暴僵仆。不知人。四肢不举者。并无所论
。止有偏枯一语而已。及观千金方。则引岐伯曰。中风大法有四。一曰偏枯。二曰风痱。三
曰风懿。四曰风痹。解之者。曰。偏枯者。半身不随。风痱者。身无痛。四肢不收。风懿者
。奄忽不知人。风痹者。诸痹类风状。金匮要略中风篇曰。寸口脉浮而紧。紧则为寒。浮则
为
虚。寒虚相搏。邪在皮肤。浮者血虚。络脉空虚。贼邪不泻。或左或右。邪气反缓。正气即
急。正气引邪。 僻不遂。邪在于络。肌肤不仁。邪在于经。即重不胜。邪入于腑。即不识
人。邪入于脏。舌即难言。口吐涎沫。由是观之。知卒暴僵仆。不知人。偏枯。四肢不举等
证。固为因风而致者矣。故用大小续命。西州续命。排风。八风等诸汤散治之。及近代刘河
间李东垣朱彦修三子者出。所论始与昔人异矣。河间曰。中风瘫痪者。非谓肝木之风实甚
。而卒中之。亦非外中于风。由乎将息失宜。心火暴甚。肾水虚衰不能制之。则阴虚阳实。
而热气怫郁。心神昏冒。筋骨不用。而卒倒无所知也。多因喜怒思悲恐五志有所过极而卒
中者。由五志过极。皆为热甚故也。俗云。风者。言末而忘其本也。东垣曰。中风者。非外
来风邪。乃本气病也。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。若肥盛则间有之。亦是形盛气衰而如此。彦修曰。西北气寒为风所中。诚有之矣。
东南气温而地多湿。有风病者非风也。皆湿土生痰。痰生热。热生风也。三子之论。河间主乎
火
。东垣主乎气。彦修主于湿。反以风为虚象。而大异于昔人矣。吁。昔人也。三子也。果孰
是欤。果孰非欤。以三子为是。昔人为非。则三子未出之前。固有从昔人而治愈者矣。以
昔人为是。三子为非。则三子已出之后。亦有从三子而治愈者矣。故不善读其书者。往往致
乱。以予观之。昔人三子之论。皆不可偏废。但三子以相类中风之病。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。夫风火气湿
之殊。望闻问切之异。岂无所辨乎。辨之为风。则从昔人以治。辨之为火气湿。则从三子以
治。
如此。庶乎析理明。而用法当矣。惟其以因火。因气。因湿之证。强因风而合论之。
所以真伪不分。而名实相紊。若以因火。因气。因湿证分出之则真中风病彰矣。所谓西北有
中风东南无中风者。其然欤。否欤。
There are cases where people suddenly stiffen and fall, or suffer from hemiplegia (hemiplegia), or cannot lift their limbs, or lose consciousness, or die, or survive. The world calls this "Zhong Feng" (Wind Stroke), and medical texts also treat it as such. I once examined the *Huangdi Neijing* (Yellow Emperor's Inner Canon), which states: "Wind is the beginning of all diseases." It also says: "Wind is the chief of all diseases." Regarding its changes, it transforms into other diseases without a fixed pattern. It further states: "Wind moves swiftly and changes frequently." And again: "When wind pathogen attacks humans, it may manifest as cold-heat alternation, heat in the middle jiao (internal heat accumulation), cold in the middle jiao (internal cold accumulation), leprosy (Lifeng), hemiplegia, or wind disease. However, regarding sudden stiffness and falling, loss of consciousness, and inability to move limbs, there is no specific discussion, except for the mention of hemiplegia."
Upon reviewing the *Qianjin Fang* (Prescriptions Worth a Thousand Gold), it quotes Qibo stating that there are four major categories of Zhong Feng: one is hemiplegia; two is Feng Fei (wind ataxia/paralysis); three is Feng Yi (wind stupor/coma); four is Feng Bi (wind bi-syndrome). Explanations clarify: Hemiplegia involves half-body immobility; Feng Fei involves body painlessness with flaccid limbs; Feng Yi involves sudden unconsciousness; Feng Bi refers to various Bi syndromes resembling wind patterns.
The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) chapter on Zhong Feng states: "If the pulse at the cunkou position is floating and tight, tight indicates cold, and floating indicates deficiency. Cold and deficiency interact, placing the pathogen in the skin. Floating indicates blood deficiency, leaving collateral vessels empty. The thief pathogen cannot be expelled. Whether on the left or right, the pathogen side becomes relaxed, while the healthy qi side becomes tense. Healthy qi pulls toward the pathogen, causing deviation and inability to control movement. If the pathogen is in the collaterals, there is numbness of skin and muscles. If in the meridians, there is heaviness and weakness. If entering the fu organs, there is loss of recognition. If entering the zang organs, speech becomes difficult, and saliva foams from the mouth."
From this, we know that symptoms like sudden stiffness and falling, loss of consciousness, hemiplegia, and limb paralysis are indeed considered caused by wind. Therefore, formulas such as Da Xueming Tang (Large Continuation Life Decoction), Xiao Xueming Tang (Small Continuation Life Decoction), Xizhou Xueming Tang (Xizhou Continuation Life Decoction), Paifeng Tang (Expel Wind Decoction), and Bafeng San (Eight Winds Powder) were used for treatment.
Later, during the modern era, Liu Hejian, Li Dongyuan, and Zhu Yanxiu emerged, and their theories began to differ from those of the ancients.
Hejian stated: Paralysis due to Zhong Feng is not caused by excessive liver wood wind striking suddenly, nor is it an external wind attack. Instead, it arises from improper lifestyle management leading to a violent surge of heart fire. When kidney water is deficient and fails to control it, yin deficiency and yang excess occur, causing heat qi to stagnate. This leads to mental confusion and stupor, rendering tendons and bones useless, resulting in sudden collapse and unconsciousness. This often happens when the five emotions (joy, anger, worry, thought, fear) reach extremes, as extreme emotional states generate intense heat. The common term "wind" addresses the symptom but forgets the root cause.
Dongyuan stated: Zhong Feng is not an external wind pathogen but a disorder of the fundamental qi. People over forty, during periods of qi decline, especially if injured by sorrow, joy, anger, or indignation, often suffer from this disease. Young adults rarely experience it. Even among the obese, it occurs occasionally, but this is still due to robust form with deficient qi.
Yanxiu stated: In the northwest, where the climate is cold, being struck by wind is indeed possible. However, in the southeast, where the climate is warm and dampness is prevalent, so-called wind diseases are not caused by wind. Rather, damp earth generates phlegm, phlegm generates heat, and heat generates wind.
Among these three scholars, Hejian emphasized fire, Dongyuan emphasized qi, and Yanxiu emphasized dampness. They regarded wind as a false image, differing significantly from ancient views. Alas! Between the ancients and these three, who is correct and who is wrong? If we consider the three correct and the ancients wrong, then before the three appeared, there were certainly cases cured by following the ancients. If we consider the ancients correct and the three wrong, then after the three appeared, there were also cases cured by following them. Thus, those who do not read their books well often become confused.
In my opinion, neither the ancient nor the three scholars' theories should be discarded entirely. However, the three scholars treated similar conditions as Zhong Feng to formulate their theories, causing later generations to hesitate. They failed to realize that cases caused by wind are true Zhong Feng, whereas those caused by fire, qi, or dampness are "pseudo-Zhong Feng" (Lei Zhong Feng) and not true Zhong Feng. The conditions discussed by the three scholars naturally refer to acute illnesses and sudden deaths caused by fire, qi, and dampness, having nothing to do with wind. As the *Neijing* states, diseases of the three yin and three yang meridians can lead to hemiplegia, flaccidity, and limb paralysis without necessarily involving wind.
The distinctions between wind, fire, qi, and dampness, reflected in the four diagnostic methods (inspection, auscultation/olfaction, inquiry, palpation), are certainly discernible. If identified as wind, follow the ancients' treatment; if identified as fire, qi, or dampness, follow the three scholars' treatment. This way, principles are clarified, and applications are appropriate. The reason for the confusion between true and false, and the mixing of names and realities, lies in forcing the differentiation of fire, qi, and dampness syndromes into a single discussion under the label of wind. If these syndromes are separated, true Zhong Feng will be clearly distinguished. Is it true that "the northwest has Zhong Feng, while the southeast does not"? Or is it otherwise?