灵枢云。身半以上者。邪中之也。身半以下者。湿中之也。邪之中于人也无有常。中于阴则
溜于府。中于阳则溜于经。中于面则下阳明。中于项则下太阳。中于颊则下少阳。其中于膺背两
胁。亦中其经。中于阴者。常从臂 始。其阴皮薄。其肉淖泽。故俱受于风。独伤其阴。足阳明
之筋病。卒口僻。急者目不合。热则筋纵目不开。颊筋有寒则急。引颊移口。有热则筋弛纵。缓
不胜收。故僻。治之以马膏摩其急者。以白酒和桂以涂其缓者。以桑钩钩之。即以生桑灰置之坎
中。高下以坐等。以膏熨急颊。且饮美酒。啖炙肉。不饮酒者自强也。为之三拊而已。口颊 僻。
乃风中血脉也。手足阳明之经络于口。会太阳之经络于目。寒则筋急而僻。热则筋弛而纵。故左
中寒。则逼热于右。右中寒。则逼热于左。寒者急而热者缓也。急者皮肤顽痹。营卫凝滞。故用
马膏之甘平柔缓。以摩其急。以润其痹。以通其血脉。用桂酒之辛热急束。以涂其缓。以和其营
卫。以通其经络。桑能治风痹。通节窍也。病在上者。酒以行之。甘以助之。故饮美酒。啖炙肉。
若不饮者。自免强饮之。为之三拊者。再三拊其急处。使气血流动。其病自已也。
素问云。风中五脏六腑之俞。亦为脏腑之风。各入其门户所中。则为偏风。故风者百病之长也。
至其变化。乃为他病也。三阳三阴发病。为偏枯痿易。四肢不举。汗出偏沮。使人偏枯。偏枯痿厥。
肥贵人膏粱之疾也。胫有大小。髀 大疲。易偏枯。内夺而厥。则为喑痱。虚邪客于身半。其入
深。营卫衰则真气去。邪气内留。发为偏枯。胃脉沉鼓涩。胃外鼓大。心脉小坚急。皆鬲。偏枯。
男子发左。女子发右。不喑舌转可治。三十日起。其从者喑。三岁起。年不满二十者。三岁死。
赵以德曰。胃与脾为表里。胃之阳虚。则内从于脾。从于脾则脾之阴盛。故胃脉沉鼓涩。涩
者。少血多气之诊也。胃之阳盛。则脾之阴虚。虚则不得与阳主内。反从其胃越出部分。而鼓大
于臂之外。大者。多气少血之候也。心者。元阳君主之宅。生血生脉。今因元阳不足。阴寒乘之。
故心脉小坚急。小者阳不足。坚急者阴寒之象也。夫心胃之三等脉。见一即为偏枯。心乃天真神
机开发之本。胃乃谷气充天真之原。一有相失。则不能制其气而宗气散。故分布不周。不周于经
脉则偏枯。不周于五脏则喑。喑者肾与包络内绝也。张景岳曰。胃脉沉鼓涩。阳不足也。胃外鼓
大。阴受伤也。心脉小坚急。阴邪胜也。胃气既伤。血脉又病。故心下痞鬲。半身偏枯也。
金匮云。夫风之为病。当半身不遂。或但臂不遂者。此为痹。脉微而数。中风使然。
半身不遂者。偏风所中也。但臂不遂者。风遂上受也。风之所客。凝涩营卫。经脉不行。分
肉筋骨俱不利。故曰此为痹。今因风着为痹。营遂改微。卫遂改数。故脉见微数。盖微者阳之微。
数者风之炽也。此即内经风论所谓各入其门户所中者之一证也。千金补金匮之不逮。立附子散。
治中风手臂不仁。口面 僻。专以开痹舒筋为务也。
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。
寒邪之脉紧束。故浮紧并见于寸口。络脉从经脉左右双行。当邪入之时。不治。至邪随络脉
流行。缓急牵引。故口眼 斜不遂。邪在于络。则不营于肌肤。故不仁。邪在于经。则外不滋于肉。
故身重而不胜。所谓入腑入脏者。以胃为六腑之总司。心为五脏之君主。诸腑经络受邪。变极则
归于胃。胃得之则热甚。津液壅溢为痰涎。闭塞其神气出入之窍。故不识人也。诸脏受邪。极而
变者。亦必归于心。心得邪。则神散而枢机息。舌者心之窍。机息则舌纵廉泉开。舌纵则难以言。
廉泉开则口流涎也。主以侯氏黑散。祛之从外而散。取菊花之甘寒杜风。兼牡蛎、矾石之涩。使
药积腹中。以助祛风之力也。
寸口脉迟而缓。迟则为寒。缓则为虚。营缓则为亡血。卫缓则为中风。邪气中经。则身痒而
瘾疹。心气不足。邪气入中。则胸满而短气。
寸口脉迟。知营气不及而为亡血。寸口脉缓。知卫虚邪入而为中风。卫不外布于经。则为瘾
疹身痒。营不内荣于心。则客邪混郁于胸中。害其宗气之布息。故胸满而短气。治以风引汤。引
之从内而泄。故用大黄引领甘寒诸药镇摄虚风。即以石脂、牡蛎填塞复入之路。灵枢所谓久塞其
空。谓之良工是也。
中风痱。身体不能自收持。口不能言。冒昧不知痛处。或拘急不得转侧。古今录验续命汤。
痱病者。营卫气血不养于内外。故身体不用。机关不利。精神不治。然是证有虚有实。虚者自饮
食房劳七情得之。内经所谓内夺而厥。则为喑痱是也。实者是风寒暑湿感之。虚者不可以实治。
治则愈散其气血。此方明言治中风痱。乃营卫之实邪。故用续命。即麻黄汤之变方。加干姜开血
受寒痹。石膏解肌受风痹。当归和血。人参益气。芎 行血散风。其并治咳逆上气面浮者。亦为
风寒而致也。
中风手足拘急。百节疼痛。烦热心乱。恶寒。经日不欲饮食。千金三黄汤。
此六气敛束筋经。阳气不布。内搏于心。则神乱而烦热。以热郁于内。不得达表。所以恶寒。
经日而不发热。以邪气内贼。故不欲饮食耳。方以千金取名。宝之至也。观千金方引用。明注仲
景三黄汤。其为金匮原名可知。用麻黄为君者。以其能通阳气而开痹也。痹非得汗不开。然内虚
当虑。故以大剂黄 佐之。而虚复有寒热不同。虚热则用黄芩。虚寒则加附子。不易之定法也。
风虚头重眩。苦极。不知食味。暖肌补中益精气。近效白术附子汤。
肾气虚乏之人。外风直入无禁。而挟肾中浊阴之气。厥逆上攻。其头间重眩之苦。至极难耐。
兼以胃气亦虚。不知食味。故处方全不用风药。但用附子暖其水脏。白术、甘草暖其土脏。水土
一暖。则浊阴之气尽趋于下。而头苦重眩食不知味之证除矣。
千金云。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。夫诸急卒病
多是风。初得轻微。人所不悟。宜速与续命汤。根据输穴灸之。夫风者百病之长。岐伯所言四者。
说其最重也。
偏枯者。身半不随。肌肉偏不用而痛。言不变。志不乱。病在分腠之间。温卧取汗。益其不足。
损其有余。乃可复也。（甲乙经云。温卧取汗。则巨针取之。）
风痱者。身无痛。四肢不收。志乱不甚。言微知。则可治。甚则不能言。不可治。
风懿者。奄忽不知人。咽中塞窒窒然。（巢氏。作噫噫然有声。）舌强不能言。病在脏腑。先
入阴。后入阳。治之先补于阴。后泻于阳。发其汗。身转软者生。汗不出身直者。七日死。（巢
氏。作眼下及鼻人中左右白者可治。一黑一赤吐沫者不可治。）
风痹者。风寒湿诸痹类风状。风胜则周身走注疼痛。寒胜则骨节掣痛。湿胜则麻木不仁。（此
言贼风诸痹痛风之大纲也。）
石顽曰。千金述岐伯中风大法有四。方治颇繁。今每例采一专方。为逐证之纲旨。如偏枯用
八风续命汤。风痱用竹沥饮子。风懿用独活汤。风痹用附子散。此大略宗兆。余方不能具载。千
金所谓变动枝叶。各根据端绪以取之。端绪愈纷。则探求愈惑。圆机之士。谅不能固守成则也。
赵养葵云。河间所谓中风瘫痪者。非谓肝木之风实甚而卒中之。亦非外中于风。良由平日饮
食起居动静失宜。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
用而卒倒无知也。亦有因五志有所过极而卒中者。夫五志过极。皆为热甚。俗云风者。言末而忘
其本也。观河间之论。则以风为末。而以火为本。世之尊刘氏者。专守主火之说。殊不知火之有
余。水之不足也。刘氏原以补肾为本。观其地黄饮子之方可见矣。故中风又当以真阴虚为本。但阴
虚有二。有阴中之水虚。有阴中之火虚。火虚者。专以地黄饮子为主。水虚者。又当以六味丸为主。
果是水虚。辛热之药。与夫参、 之品。俱不可加。
东垣云。有中风者。卒然昏愦。不省人事。痰涎壅盛。语言謇涩。六脉沉伏。此非外来风邪。乃
本气自病也。凡人年逾四旬。气衰之际。或忧喜忿怒伤其气者。多有此证。壮岁之时无有也。若
肥盛者。亦间有之。形盛气衰故也。观东垣之论。当以气虚为主。纵有风邪。亦是乘虚而袭。当
此之时。岂寻常药饵。能通达于上下哉。急以三生饮一两。加人参两许煎服。夫三生饮乃行经治
痰之剂。斩关夺旗之将。必多用人参驾驭其邪。而补助真气。否则不惟无益。适足取败。观先哲
用参、附。其义可见矣。若遗尿手撒口开眼合鼻鼾。为不治证。然用前药。多有得生者。
丹溪云。人有气虚。有血虚。有湿痰。左手脉不足。及左半身不遂者。四物加姜汁、竹沥。
右手脉不足。及右半身不遂者。四君子佐姜汁、竹沥。如气血两虚而挟痰盛者。二陈加星、半、
竹沥、姜汁之类。观丹溪之论。平正通达。人盛宗之。但持此以治。多不效。或少延而久必毙者。
何也。盖半身风废。须察脉辨证。兼痰兼热为是。乃指左为血病。右为气病。教人如此认证。内经
则无此说也。左半虽血为主。非气以统之则不流。右半虽气为主。非血以丽之则易散。故肝胆居
左。其气常行于右。脾脏居右。其气常行于左。往来灌注。周流不息。岂可执着哉。凡治一偏之
病。法宜从阴引阳。从阳引阴。从左引右。从右引左。盍观树木之偏枯者。将溉枯者乎。抑灌其
未枯者使之荣茂。而因以条畅其枯者乎。至若一味攻击其风痰死血。是相引丧亡而已。
喻嘉言曰。河间指火为训。是火召风入。火为本。风为标矣。东垣指气为训。是气召风入。
气为本。风为标矣。丹溪指痰为训。是痰召风入。痰为本。风为标矣。然一人之身。每多兼三者
而有之。曷不曰阳虚邪害空窍为本。而风从外入者。必挟身中素有之邪。或火或气或痰而为标耶。
治法。风邪从外入者。必驱之使外出。然挟虚者。非补虚则风不出。挟
火者。非清热则风不出。挟气者。非开郁则风不出。挟湿者。非导湿则风不出。挟痰者。非豁痰
则风不出。王安道谓审其为风。则从内经。审其为火为气为痰。则从三子。徒较量于彼此之间。
得非拘泥而执一耶。
王节斋曰。古人论中风偏枯麻木酸痛不举诸证。以血虚亡血痰饮为言。是论其致病之根源。
至于得病。则必有所感触。或因六淫七情。遂成此病。此血与痰为本。而外邪为标。其病中于皮
肤血脉经络肌肉筋骨之间。而未入脏腑。故邪在皮肤肌肉。则不知痛痒。麻木不仁。如有物一重
贴于其上。或如虫蚁游行。或洒洒振寒。或肿胀。或自汗。遇热则或痒。遇阴寒则沉重酸痛。邪
入血脉筋络。则手足指掌肩背腰膝重硬不遂。难于屈伸举动。或走注疼痛。皆外自皮毛以至筋骨
之病。凡脉所经所络。筋所会所结。血气津液所行之处。皆凝滞郁遏。不得流通而致然也。亦何
必一一强度某病属某经。某病属某脏而杂治之哉。
薛立斋云。邪在气。气为是动。邪在血。血为所生病。经云。阳之气。以天地之疾风名之。
此非外来风邪。乃本气自病也。故诸方多言皆由气虚体弱。营卫失调。腠理不密。邪气乘虚而入。
然左半体者。肝肾所居之地。肝主筋。肾主骨。肝藏血。肾藏精。精血枯槁。不能滋养。故筋骨
偏废而不用也。风病多因热甚。惟其血热。故风寒之气一袭之。则外寒束内热而为痛。故有治风
先治血。血行风自灭之语。其真中风者。当辨其中脏中腑而治之。眼瞀者中于肝经。舌不能言者
中于心经。唇缓便秘者中于脾经。鼻塞者中于肺经。耳聋者中于肾经。此五者病深。多为难治。
然五脏虽中风邪。皆其经络受病。若伤其真脏。百无一生矣。中血脉者。外无六经之形证。内无
便溺之阻隔。肢不能举。口不能言。中腑者。多兼中脏。如左关脉浮弦。面目青。左胁偏痛。筋
脉拘急。目 头眩。手足不收。坐踞不得。此中胆兼中肝也。如左寸
脉浮洪。面赤汗多恶风。心神颠倒。语言謇涩。舌强口干。忪悸恍惚。此中小肠兼中心也。如右
关脉浮缓或浮大。面唇黄。汗多恶风。口 语涩。身重怠惰嗜卧。肌肤不仁。皮肉 动。腹胀不
食。此中胃兼中脾也。如右寸脉浮涩而短。鼻流清涕。多喘。胸中冒闷短气。自汗声嘶。四肢痿
弱。此中大肠兼中肺也。如左尺脉浮滑。面目黧黑。腰脊痛引小腹。不能俯仰。两耳虚鸣。骨节
疼痛。足痿善恐。此中膀胱兼中肾也。议其脏腑经脉之病。可因人随证而施。不必拘其方药也。
缪仲淳曰。凡言中风。有真假内外之别。西北土地高寒。风气刚猛。真气空虚之人。卒为所中。
The *Ling Shu* (Spiritual Pivot) states: Diseases of the upper half of the body are caused by pathogenic factors invading; diseases of the lower half of the body are caused by dampness invading. Pathogenic factors invading humans have no fixed pattern. If they invade Yin meridians, they flow into the Fu organs; if they invade Yang meridians, they flow into the Jing meridians. If they strike the face, they descend to the Stomach Meridian of Foot-Yangming; if they strike the nape, they descend to the Bladder Meridian of Foot-Taiyang; if they strike the cheek, they descend to the Gallbladder Meridian of Foot-Shaoyang. If they strike the chest, back, and lateral costal regions, they also invade their respective meridians. When pathogenic factors invade Yin meridians, they usually start from the arms. Because the skin in Yin meridian areas is thin and the flesh is soft and lustrous, they are all susceptible to wind pathogens, uniquely injuring the Yin. When the sinews of the Foot-Yangming Stomach Meridian are diseased, sudden deviation of the mouth occurs. If the sinews are tense, the eyes cannot close; if there is heat, the sinews relax and the eyes cannot open. Cold in the cheek sinews causes tension, pulling the mouth corner; heat causes relaxation, resulting in flaccidity and inability to control, leading to deviation. Treatment involves massaging the tense side with horse fat (Ma Gao), applying a mixture of white wine and Cinnamon Twig (Gui Zhi) to the flaccid side, using a mulberry hook for traction, placing live ash from burning mulberry branches in a pit at a height equal to the sitting position, warming the tense cheek with the fat, drinking fine wine, and eating roasted meat. Those who do not drink alcohol should force themselves to do so. Repeated massage three times is sufficient. Deviation of the mouth and cheek is due to wind pathogens striking the blood vessels. The Hand-Yangming Large Intestine and Foot-Yangming Stomach meridians connect to the mouth, and meet the Taiyang meridians at the eyes. Cold causes sinew tension and deviation; heat causes sinew relaxation. Thus, cold on the left forces heat to the right; cold on the right forces heat to the left. Cold causes tension, heat causes flaccidity. The tense side has numb and waxy skin, with stagnant Ying and Wei Qi. Therefore, the sweet, neutral, soft, and slow nature of horse fat is used to massage the tense area, moisten the numbness, and unblock the blood vessels. The pungent, hot, and binding nature of cinnamon wine is used to apply to the flaccid area, harmonize Ying and Wei Qi, and unblock the meridians. Mulberry can treat wind-bi syndrome and unblock joint orifices. For diseases in the upper part, wine guides the action upwards, and sweet flavors assist the righteous Qi. Hence, drinking fine wine and eating roasted meat. If one does not drink, one must force oneself. "Three massages" refers to repeatedly massaging the tense area to make Qi and Blood flow, causing the disease to resolve spontaneously.
The *Su Wen* (Basic Questions) states: Wind pathogens entering the Shu points of the Zang and Fu organs also become wind of the Zang and Fu organs. Entering through their respective gates, they form Pi Feng (Hemiplegia/Wind). Therefore, wind is the chief of all diseases. Its transformations lead to other illnesses. Onset in the Three Yang and Three Yin meridians leads to Pian Ku (Hemiplegia), Wei Yi (Flaccidity/Change), inability to move the four limbs, unilateral sweating, causing hemiplegia. Pian Ku and Wei Jue are diseases of wealthy individuals due to rich and greasy diets. Disparity in calf size and atrophy of the thigh muscles predispose to Pian Ku. Internal depletion leading to Jue (Reversal) results in Yin Fei (Aphasia and Flaccidity). Deficient pathogens lodging in half the body, penetrating deeply, cause Ying and Wei to decline, True Qi to depart, and pathogenic factors to remain internally, developing into Pian Ku. Stomach pulse deep and thready when pressed, but large when superficially pressed; Heart pulse small, firm, and rapid—all indicate Ge (Diaphragm obstruction) and Pian Ku. In men, onset is often on the left; in women, on the right. If there is no aphasia and the tongue moves freely, it is treatable, recovering in thirty days. If accompanied by aphasia, recovery takes three years. Those under twenty years old will die within three years.
Zhao Yi-de stated: The Stomach and Spleen are exterior-interior pairs. If Stomach Yang is deficient, it follows the Spleen. Following the Spleen, Splein Yin becomes excessive. Hence, the Stomach pulse is deep and thready. Thready indicates less blood and more Qi. If Stomach Yang is excessive, Spleen Yin is deficient. Deficiency prevents it from governing the interior with Yang, instead following the Stomach Qi to emerge externally, appearing large outside the arm. Large indicates much Qi and little blood. The Heart is the residence of Prime Yang and the Monarch. It generates blood and pulses. Now, due to insufficient Prime Yang, Yin-Cold invades. Hence, the Heart pulse is small, firm, and rapid. Small indicates Yang deficiency; firm and rapid indicates Yin-Cold. Among these three heart/stomach pulses, the appearance of one signifies Pian Ku. The Heart is the root of Tian Zhen (Innate Truth) and Shen Ji (Spirit Mechanism); the Stomach is the source of Gu Qi (Grain Qi) nourishing Tian Zhen. If they lose harmony, they cannot control Qi, causing Zong Qi (Gathering Qi) to scatter. Uneven distribution leads to Pian Ku in meridians and Yin Fei in Zang organs. Yin Fei implies internal severance between the Kidney and Pericardium. Zhang Jingyue stated: Deep and thready Stomach pulse indicates Yang deficiency; large superficial Stomach pulse indicates Yin injury; small, firm, rapid Heart pulse indicates Yin-Evil excess. With injured Stomach Qi and diseased blood vessels, Ge obstruction and hemiplegia occur.
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: Wind disease should present as hemiplegia. If only the arm is affected, this is Bi Syndrome. The pulse is micro and rapid, caused by Zhong Feng (Wind Strike). Hemiplegia is caused by Pian Feng (Half-body Wind). Only arm involvement is due to wind attacking upwards. Where wind lodges, it coagulates and stagnates Ying and Wei, hindering meridians, making muscles, flesh, bones, and joints dysfunctional, hence called Bi. Since wind remains causing Bi, Ying becomes micro and Wei becomes rapid, showing a micro-rapid pulse. Micro indicates Yang deficiency; rapid indicates rampant wind. This is one manifestation of "entering through respective gates" mentioned in the *Nei Jing*'s *Feng Lun*. *Qian Jin Fang* supplements *Jin Gui* by establishing Fuzi San to treat wind-strike arm numbness and facial deviation, focusing on opening Bi and relaxing sinews.
Cunkou pulse floating and tight: Tight indicates cold; floating indicates deficiency. Cold and deficiency interact, placing evil in the skin. Floating indicates blood deficiency and empty collaterals. Unexpelled evil attacks either left or right. The side with evil becomes flaccid; the side with righteous Qi becomes tense. Righteous Qi pulls the evil, causing deviation and paralysis. Evil in collaterals causes skin/muscle numbness; evil in meridians causes heaviness and weakness; evil in Fu organs causes unconsciousness; evil in Zang organs causes speech difficulty and drooling.
Cold pulse is tight, so floating-tight appears at Cunkou. Collaterals run bilaterally from meridians. If untreated upon invasion, as evil flows along collaterals, tension and traction cause facial deviation and paralysis. Evil in collaterals fails to nourish skin/muscles, causing numbness. Evil in meridians fails to nourish flesh externally, causing heaviness. Regarding entry into Fu/Zang: The Stomach governs all Fu organs; the Heart governs all Zang organs. Pathogens in Fu/Jing meridians eventually reach the Stomach. Stomach heat causes fluid congestion transforming into phlegm-drool, blocking spirit orifices, causing unconsciousness. Pathogens in Zang organs eventually reach the Heart. Heart pathology scatters spirit and stops pivot mechanism. The tongue is the Heart's orifice; pivot stoppage causes tongue flaccidity and Lian Quan opening, leading to speech difficulty and drooling. Treatment uses Hou Shi Hei San to disperse evil outward. Chrysanthemum's sweet-cool nature blocks wind; Oyster Shell and Alum's astringency keeps medicine in the abdomen to aid wind-dispersion.
Cunkou pulse slow and moderate: Slow indicates cold; moderate indicates deficiency. Moderate Ying indicates blood loss; moderate Wei indicates wind strike. Evil in meridians causes itching and urticaria. Insufficient Heart Qi allows evil to enter middle, causing chest fullness and shortness of breath.
Slow Cunkou pulse indicates insufficient Ying Qi and blood loss. Moderate Cunkou pulse indicates deficient Wei Qi allowing evil entry and wind strike. Wei failing to distribute externally causes urticaria/itching. Ying failing to nourish internally allows evil to stagnate in the chest, harming Zong Qi respiration, causing chest fullness and shortness of breath. Treatment uses Feng Yin Tang to guide evil out internally. Rhubarb leads cool-sweet herbs to subdue deficient wind; Kaolin and Oyster Shell block re-entry paths, aligning with *Ling Shu*: "Long-term sealing of emptiness makes a good physician."
Zhong Feng Fei presents as inability to control the body, inability to speak, dizziness without pain localization, or spasms preventing turning. Gu Jin Lu Yan Xu Ming Tang treats this. Fei patients lack Ying/Wei/Qi/Blood nourishment internally/externally, causing limb dysfunction, joint stiffness, and mental disorder. This condition has deficiency and excess types. Deficiency arises from diet, sexual excess, or emotions ("internal depletion leading to Jue causes Yin Fei"). Excess arises from external wind-cold-summerheat-dampness. Deficiency must not be treated as excess, or Qi/Blood will scatter. This formula treats Ying/Wei excess evil in Zhong Feng Fei, thus using Xu Ming (Continuing Life), a variation of Mahuang Tang. Dried Ginger opens cold-Bi in blood; Gypsum releases muscle wind-Bi; Dang Gui harmonizes blood; Ren Shen tonifies Qi; Xiong Diao moves blood and disperses wind. It also treats cough/wheezing and facial edema caused by wind-cold.
Zhong Feng with limb spasms, joint pain, vexation, heart chaos, aversion to cold, and anorexia is treated with Qian Jin San Huang Tang. Six qi constraining sinew meridians prevents Yang distribution, pressing inward on the Heart, causing mental chaos and vexation. Heat trapped internally cannot reach the surface, causing aversion to cold. Lack of fever for days indicates internal evil, causing anorexia. Named after *Qian Jin*, referencing Zhang Zhongjing's San Huang Tang. Ephedra is sovereign to unblock Yang and open Bi. Bi requires sweating to open, but internal deficiency must be considered. Thus, large doses of Astragalus support it. For deficient heat, use Scutellaria; for deficient cold, add Aconite. This is a fixed method.
Wind-deficiency causing heavy/dizzy head, severe suffering, and tastelessness is treated with Jin Xiao Bai Zhu Fu Zi Tang. In those with deficient Kidney Qi, external wind enters unchecked, carrying turbid Yin Qi from the Kidneys to attack upward, causing unbearable head heaviness/dizziness. Combined with weak Stomach Qi causing tastelessness, the prescription avoids wind-dispersing herbs. Instead, Aconite warms the Water organ; Atractylodes and Licorice warm the Earth organ. Warming Water and Earth directs turbid Yin downward, resolving head heaviness/dizziness and tastelessness.
*Qian Jin Fang* cites Qibo: Four major wind-strike patterns exist: 1. Pian Ku, 2. Feng Fei, 3. Feng Yi, 4. Feng Bi. Acute diseases are mostly wind. Early mild stages are unnoticed; treat quickly with Xu Ming Tang and moxa on acupoints. Wind is chief of diseases; Qibo's four describe the heaviest forms.
Pian Ku: Half-body paralysis, unilateral muscle non-use with pain, normal speech/consciousness, disease in fen-cou (interstices). Warm bed to induce sweat, tonify deficiency, reduce excess, then recovery is possible (*Jia Yi Jing* adds: use large needle).
Feng Fei: No pain, limb non-reception, mild mental confusion, faint but understandable speech (treatable); severe speech loss (incurable).
Feng Yi: Sudden unconsciousness, throat obstruction/choking. Tongue stiffness/speech loss. Disease in Zang/Fu. Enter Yin first, then Yang. Tonify Yin, drain Yang, induce sweat. Body softening indicates survival; rigid body/no sweat indicates death within seven days.
Feng Bi: Wind-cold-damp Bi mimicking wind. Wind excess causes wandering pain; Cold excess causes bone/joint pulling pain; Damp excess causes numbness/anesthesia. This outlines general wind-Bi patterns.
Shi Wan noted: *Qian Jin* lists Qibo's four patterns with many formulas. I select one specific formula per category as a guideline: Pian Ku uses Ba Feng Xu Ming Tang; Feng Fei uses Zhu Li Yin Zi; Feng Yi uses Du Huo Tang; Feng Bi uses Fuzi San. These are broad principles; other formulas are omitted. *Qian Jin* advises adapting to changing branches based on origins. Confusing origins lead to confusion. Wise physicians do not rigidly adhere to fixed rules.
Zhao Yangkui stated: Hejian's hemiplegia is not due to excessive Liver-Wind or external wind. It stems from improper diet/lifestyle causing violent Heart Fire and deficient Kidney Water, unable to control it. Yin deficiency and Yang excess lead to heat stagnation, spirit confusion, and sudden collapse. Also caused by extreme Five Emotions generating intense heat. "Wind" refers to symptoms, forgetting the root. Hejian views wind as branch, fire as root. Followers of Liu Wansu focus on fire, ignoring that fire excess stems from water deficiency. Liu originally focused on tonifying Kidney, seen in Dihuang Yin Zi. Thus, Zhong Feng root is True Yin deficiency. Two types: Yin-Water deficiency and Yin-Fire deficiency. Fire deficiency uses Dihuang Yin Zi; Water deficiency uses Liu Wei Di Huang Wan. For water deficiency, pungent-hot herbs and Ginseng/Astragalus are contraindicated.
Dong Yuan stated: Some Zhong Feng cases present with sudden coma, unconsciousness, copious phlegm, slurred speech, and deep-hidden pulses. This is not external wind, but Ben Qi (Root Qi) self-disease. People over forty with declining Qi, or emotional injuries, often suffer this. Young people rarely do. Obese individuals may also suffer due to robust form but weak Qi. Dong Yuan emphasizes Qi deficiency. Even if wind exists, it exploits deficiency. Ordinary herbs cannot penetrate then. Urgently use San Sheng Yin (one liang) plus Ren Shen (one liang). San Sheng Yin moves channels and resolves phlegm, a general breaking barriers. Must use ample Ren Shen to control evil and boost True Qi; otherwise, it causes defeat. Ancestral use of Ren Shen/Aconite illustrates this principle. Urination leakage, hand spreading, mouth opening, eye closing, snoring are incurable, yet previous medicines sometimes save lives.
Dan Xi stated: Cases involve Qi deficiency, Blood deficiency, or Damp-Phlegm. Left pulse deficiency/left hemiplegia: Si Wu Tang + Ginger Juice/Palm Juice. Right pulse deficiency/right hemiplegia: Si Jun Zi Tang + Ginger Juice/Palm Juice. Qi/Blood dual deficiency with heavy phlegm: Er Chen Tang + Nan Xing/Ban Xia/Palm/Ginger Juice. Dan Xi's theory is balanced and widely respected. However, treating solely by this method often fails or delays death. Why? Hemiplegia requires pulse/syndrome differentiation, considering phlegm/heat. Assigning left to Blood and right to Qi lacks *Nei Jing* basis. Left is Blood-dominated but needs Qi to flow; Right is Qi-dominated but needs Blood to anchor. Liver/Gallbladder reside left but Qi flows right; Spleen resides right but Qi flows left. Circulation is continuous; one cannot cling to sides. Treating unilateral disease requires drawing from Yin to Yang, Left to Right, etc. Like watering a withered tree, one waters healthy parts to promote growth, which aids the withered part. Attacking only wind/phlegm/blood stasis invites mutual destruction.
Yu Jiayan stated: Hejian identifies Fire as root, Wind as branch (Fire attracts Wind). Dong Yuan identifies Qi as root, Wind as branch (Qi attracts Wind). Dan Xi identifies Phlegm as root, Wind as branch (Phlegm attracts Wind). One body often combines all three. Why not state Yang deficiency/Evil damaging orifices as root, while external Wind carries internal pathogens (Fire/Qi/Phlegm) as branch? Treatment: External Wind must be expelled. But with deficiency, tonify deficiency to expel wind; with fire, clear heat to expel wind; with Qi stagnation, resolve depression to expel wind; with dampness, guide dampness to expel wind; with phlegm, resolve phlegm to expel wind. Wang Andao said: Judge as Wind, follow *Nei Jing*; judge as Fire/Qi/Phlegm, follow the Three Masters. Arguing between them is rigid and dogmatic.
Wang Jiezhai stated: Ancients attributed hemiplegia/numbness/pain to Blood deficiency, blood loss, and phlegm-fluids, discussing etiological roots. Disease acquisition requires contact, often via Six Evils or Seven Emotions. Here, Blood/Phlegm are root, External Evil is branch. Disease affects skin, vessels, meridians, muscles, tendons, bones, not yet Zang/Fu. Skin/muscle evil causes numbness/anesthesia, feeling like a layer on skin, insect crawling, chills, swelling, sweating, itching in heat, heaviness/pain in cold. Vessel/tendon evil causes limb heaviness/stiffness/paralysis, difficulty moving, wandering pain. All are external from skin to bone. Wherever meridians, tendons, Qi/Blood/Fluids flow, stagnation causes these symptoms. Why strictly assign diseases to specific meridians/Zang organs for mixed treatment?
Xue Lizhai stated: Evil in Qi causes Shi Dong disorders; Evil in Blood causes Suo Sheng disorders. Classics say Yang Qi is named Heaven/Earth's swift wind. This is not external wind, but Ben Qi self-disease. Formulas cite Qi deficiency, weak constitution, disharmonious Ying/Wei, loose couli, allowing evil entry. Left body is Liver/Kidney territory. Liver governs sinews, Kidney governs bones, Liver stores Blood, Kidney stores Essence. Essence/Blood exhaustion fails to nourish, causing limb abandonment. Wind diseases often stem from intense heat. Due to Blood heat, external cold binds internal heat causing pain. Hence, "Treat Wind by treating Blood; when Blood moves, Wind extinguishes." True Zhong Feng requires distinguishing Zang vs. Fu involvement. Eye issues: Liver Meridian. Speech loss: Heart Meridian. Lip laxity/constipation: Spleen Meridian. Nasal congestion: Lung Meridian. Deafness: Kidney Meridian. These five indicate deep disease, often difficult. Though Zang are affected, meridians bear the illness first. Injury to True Zang is fatal. Blood/Vessel involvement: No Six-Jiang signs, no bowel/bladder obstruction, limb immobility, speech loss. Fu involvement often accompanies Zang. Left Guan floating-stringy, green face, left hypochondriac pain, tendon spasm, dizziness, limb drop: Gallbladder/Liver. Left Cun floating-vigorous, red face, sweating, aversion to wind, mental chaos, slurred speech, dry mouth, palpitations: Small Intestine/Heart. Right Guan floating-moderate/large, yellow face/lips, sweating, aversion to wind, slurred speech, heaviness, lethargy, skin numbness, twitching, abdominal distension/anorexia: Stomach/Spleen. Right Cun floating-thready-short, clear nasal discharge, wheezing, chest oppression, shortness of breath, sweating, hoarseness, limb weakness: Large Intestine/Lung. Left Chi floating-slippery, dark face, back/waist pain radiating to lower abdomen, inability to bend/extend, tinnitus, bone/joint pain, leg weakness, fear: Bladder/Kidney. Treat according to Zang/Meridian pathology, adapting to individuals, not rigidly adhering to formulas.
Miu Zhongchun stated: Zhong Feng has true/false and internal/external distinctions. Northwest lands are high/cold with fierce wind. Those with empty True Qi are suddenly struck.