《发明》云∶治风当通因通用,惟宜宣发以散之,不可便以苦寒之药妄下,龙、
麝、朱砂、牛黄诸镇坠之药泻之。若风本外邪,惟宜宣散,此风在表之时也。如伤寒中
风,传入于胃,亦未尝不可下。论中便字、妄字,可见其意。便者,有早与急之义;妄
者,谓有不当下之义。
如小便少,不可以药利之。既以自汗,则津液外亡,小便自少。若利之,使荣卫枯
竭,无以制火,烦热愈甚。当俟热退汗止,小便自行也。兼此证乃阳明经。大忌利小便。
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)与湿,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,在右属痰与热,并气虚。左以
四物汤加桃仁、红花、竹沥、姜汁,右以二陈汤、四君子汤等加竹沥、姜汁。气虚卒
倒者,用参者补之。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。肥白人多湿,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,急捏人中至醒,然后用痰药,以二陈汤、四君子汤、四物汤加减用。瘦人阴虚
火热,用四物汤加竹沥、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
虚,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、面亦
如妆、或头面青黑,汗缀如珠,皆不治。
The *Fa Ming* (Invention) states: In treating wind disorders, one should follow the principle of "treating obstruction with unblocking agents" (Tong Yin Tong Yong), and it is appropriate to use methods that disperse and ventilate to scatter the pathogen. One must not recklessly administer bitter-cold herbs for purgation, nor use heavy-settling and descending herbs such as Long Gu (Fossilized Bones), She Xiang (Musk), Zhu Sha (Cinnabar), and Niu Huang (Calculus Bovis) to drain excess. If the wind pathogen is originally an external invasion, dispersing and venting is the proper approach; this applies when the wind is at the exterior level. For instance, in Taiyang Wind Strike (Taiyang Zhong Feng) within Shanghan (Cold Damage) diseases, if the pathogen transmits to the Stomach, purgation is not absolutely contraindicated. The use of the characters "bian" (convenient/precipitate) and "wang" (reckless/false) in the text reveals its intent. "Bian" implies acting too early or hastily; "wang" implies using a method that is inappropriate, such as purgation when it is not indicated.
If urine output is scant, diuretic drugs should not be used. Since spontaneous sweating has occurred, body fluids are lost from the exterior, leading to naturally reduced urine volume. If diuretics are forced, Ying (Nutritive Qi) and Wei (Defensive Qi) will become depleted, failing to control Fire, thereby exacerbating irritability and heat. One should wait until the fever subsides and sweating stops, after which urination will normalize. This syndrome belongs to the Yangming Channel; the use of diuretics is strictly prohibited.
Wind strike (Zhong Feng) is generally caused by Blood deficiency accompanied by Phlegm; treatment should prioritize resolving Phlegm, followed by nourishing and invigorating Blood. It may also present as a deficiency pattern complicated by Fire (or Phlegm) and Dampness, requiring differentiation between Qi deficiency and Blood deficiency. Hemiplegia is mostly due to Phlegm. Lesions on the left side are attributed to stagnant Blood (or insufficient Blood), while lesions on the right side are attributed to Phlegm-Heat combined with Qi deficiency. For left-sided conditions, Si Wu Tang (Four Substances Decoction) is added with Tao Ren (Peach Kernel), Hong Hua (Safflower), Zhu Li (Bamboo Sap), and Jiang Zhi (Ginger Juice). For right-sided conditions, Er Chen Tang (Two Aged Herbs Decoction) and Si Jun Zi Tang (Four Gentlemen Decoction) are used, added with Zhu Li and Jiang Zhi. For sudden collapse due to Qi deficiency, Shen (Ginseng) is used to tonify. If Phlegm is present, Shen is decocted strongly, added with Zhu Li and Jiang Zhi. For Blood deficiency, Si Wu Tang is used. All herbs are stir-fried with Ginger Juice to prevent cloying and generating Phlegm. If Phlegm is present, Zhu Li and Jiang Zhi are additionally added for oral administration. If the patient can eat, Zhu Li is removed and Jing Li (Vitex Sap) is added. Obese individuals with white complexions tend to have Dampness; Wutou (Aconite Root) and Fuzi (Prepared Aconite Root) should be used sparingly to unblock meridians. Whenever Wutou or Fuzi are used, they must be boiled in Tong Bian (Child's Urine) to reduce their toxicity. In cases of initial unconsciousness, urgently pinch the Renzhong acupoint until consciousness returns, then administer Phlegm-resolving medicines, modifying Er Chen Tang, Si Jun Zi Tang, and Si Wu Tang as needed. Thin individuals with Yin deficiency and hyperactive Fire should be treated with Si Wu Tang added with Zhu Li, Huang Qin (Scutellaria Root), and Huang Bai (Phellodendron Bark). If Phlegm is present, add Phlegm-resolving herbs. For Phlegm-Qi excess patterns where the patient can eat, use Jing Li. For Qi deficiency with poor appetite, use Zhu Li. These two substances open the meridians and promote the circulation of Qi and Blood. When added to Si Wu Tang, Ginger Juice must be used to assist. Enuresis is due to Qi deficiency and should be treated with Shen (Ginseng) and Huang Qi (Astragalus Root) to tonify. Withered sinews cause pain upon movement; this indicates Blood failure to nourish the sinews and is incurable. The *Mai Jue* (Pulse Mantra) lists various incurable syndromes: mouth open and hands relaxed, eyes closed with enuresis, foaming at the mouth with fixed gaze, snoring-like sounds in the throat, muscle wasting and sinus pain, erect hair, head shaking with upward deviation, facial appearance like makeup, or cyanotic-black head and face, and sweat beads like pearls; all are considered incurable.