类中类乎中风证，尸厥中虚气食寒，火湿暑恶皆昏厥，辨在 斜偏废间。
【注】类中风证，皆名尸厥，谓形厥而气不厥也，故口鼻无气，状类死尸而脉自动也。
中虚、中气、中食、中寒、中火、中湿、中暑、中恶等证，虽忽然昏倒，人事不省，类
乎真中风病，但不见口眼 斜，偏废不仁不用等证，自可辨也。
独参汤 参附汤 星香汤 三物备急丹 夺命散
尸厥无气而脉动，或脉微细有无间。缘于病后气血竭，人参参附星香痰，气闭腹满
二便闭，或腹急痛备急丹，服后转鸣吐下验，喉间痰结夺命先。
【注】尸厥之证，有虚、有实，虚者，以独参汤。虚兼寒者，以参附汤。虚兼痰者，以
星香饮加人参汤。实者气闭似死，脉动有力，腹满胀，二便闭或腹急痛，气闭，前后不通
者，以备急丹。实兼痰者，以夺命散。
补中益气汤 生脉补精汤
补中益气疗虚中，烦劳过度气不升，虚冒有痰加苓半，欲冒生麦地归茸。
【注】补中益气汤治虚中之证，即李杲所云∶内伤气虚之人，烦劳过度，清气不升，忽
然昏冒也。欲冒，谓因房劳过度昏冒也。生脉饮即人参、麦冬、五味子合熟地、当归、鹿
茸，名曰生脉补精也。
木香调气饮
木香调气实气中，暴怒气逆噤昏痰，风浮肢温气沉冷，木藿砂蔻草丁檀。
【注】实气中，谓形气俱实之人中气也。因暴怒气逆，忽然昏倒噤急也。风浮肢温气
沉冷，谓中风之人，脉浮手足温，中气之人，脉沉手足冷，可别也。是方木香，藿香、砂
仁、白蔻、甘草、丁香、檀香也。
八味顺气散
八味顺气虚气中，标本兼施邪正安，参苓术草扶元气，乌芷青陈利气痰。
【注】虚气中，谓形气俱虚之人中气也。宜用此标本兼施，邪正相安之剂也。
瓜蒂散 姜盐汤
食中过饱感寒风，或因怒恼塞胸中，忽然昏厥肢不举，瓜蒂姜盐探吐平。
【注】瓜蒂散，挟痰者用之。姜汤，挟寒者用之。盐汤，过食者用之。探吐，谓作此
汤数盅，令病者饮一盅，随用指探吐，不吐再饮再探，以吐通快为度，可立愈也。
附子理中汤
附子理中疗寒中，腹痛拘急噤牙关，有汗身寒或吐泻，附子参术草姜干，无汗身寒
加麻细，阴毒川乌用生煎，呕吐丁香吴萸入，脉微欲绝倍参添。
【注】寒中之证，即腹痛诸证者是也，宜用附子理中汤。若无汗加麻黄。细辛，阴毒
加生川乌，呕吐加丁香、吴茱萸，脉微欲绝倍加人参，阴毒寒极也，详在《伤寒心法》。
凉膈散
凉膈火中神昏冒，栀翘芩薄草硝黄，兼治一切胸膈热，便燥谵妄与斑狂。
【注】火中之证，即刘完素所云∶七情过极，五志之火内发，则令人昏倒无知，筋骨
不用也。
香薷饮 藿香正气散 辰砂益元散 熨脐法 苍术白虎汤 人参白虎汤
暑中须分阴与阳，阴邪无汗似寒伤，壮热心烦或呕泻，香薷扁朴二香汤
，更兼昏愦蒸蒸汗，面垢喘渴证为阳，不省熨脐灌蒜水，益元苍参白虎汤。
【注】阴邪无汗似寒伤，谓暑中阴邪，似伤寒头痛身痛，恶寒无汗，而更壮热心烦，或
呕或泻也，得之于受暑纳凉，寒外暑内，宜香薷饮。二香汤，谓香薷饮合藿香正气饮，详
在霍乱门，若有如上之证，更兼精神昏愦，蒸蒸自汗，面垢喘渴，则为暑中阳邪，得之于
赤日长途，中外皆热，国中昏愦不省者，急以热物熨脐，蒜汁合水灌之即省，继以辰砂
益元散。气实者，苍术白虎汤，气虚者，人参白虎汤，选而用之可也。
渗湿汤
渗湿湿中内昏冒，震亨湿热热生痰，浓味醇酒生冷水，胃苓香附抚砂连。
【注】湿中内，谓湿从内生之病，即朱震亨所云∶湿热生痰，昏冒之证，得之于伤浓
味醇酒生冷水物过节也。渗湿汤，即胃苓汤加香附、抚芎、砂仁、黄连。
除湿汤
除湿阴雨湿蒸雾，卧湿涉水瘴山岚，头身重痛便溏肿，羌 升柴防水煎。
【注】除湿汤，即羌活、 本、升麻、柴胡、防风、苍术，治湿因外中。得之于天阴
淫雨，晴后湿蒸，早晨雾露，及久卧湿地，远行涉水，瘴气山岚。其证头身重痛，甚而
昏冒大便溏泻，皮肤浮肿也。
调气平胃散
调气平胃疗恶中。庙冢忤恶卒然昏。面黑错忘苏合主，次以木香平胃匀。
【注】苏合主，谓中恶之病，以苏合香丸为主也。次以木香平胃匀，谓以中气木香调
气散之方，合平胃散之药调理也。
The syndrome of "Lei Zhong Feng" (Stroke-like Syndrome) resembles true stroke, including Shi Jue (Corpse-like Coma), Zhong Xu (Middle Deficiency), Zhong Qi (Middle Qi Stagnation), Zhong Shi (Middle Food Retention), Zhong Han (Middle Cold), Zhong Huo (Middle Fire), Zhong Shi (Middle Dampness), Zhong Shu (Middle Heat/Summerheat), and Zhong E (Middle Evil). These syndromes all present with coma or fainting; the key to differentiation lies in the presence or absence of facial deviation (hemifacial paralysis) and hemiplegia.
[Note] The syndrome of Lei Zhong Feng is all named Shi Jue (Corpse-like Coma), meaning that while the limbs are cold (Jue), the vital Qi has not ceased. Therefore, although there is breath at the mouth and nose, resembling a dead corpse, the pulse continues to beat.
Syndromes such as Zhong Xu (Middle Deficiency), Zhong Qi (Middle Qi Stagnation), Zhong Shi (Middle Food Retention), Zhong Han (Middle Cold), Zhong Huo (Middle Fire), Zhong Shi (Middle Dampness), Zhong Shu (Middle Heat/Summerheat), and Zhong E (Middle Evil), although presenting with sudden collapse and loss of consciousness, resembling true stroke, can be distinguished by the absence of symptoms such as facial deviation, hemiplegia, numbness, and loss of function.
Du Shen Tang (Single Ginseng Decoction), Shen Fu Tang (Ginseng and Aconite Decoction), Xing Xiang Tang (Arisaema and Costus Root Decoction), San Wu Bei Ji Dan (Three-Ingredient Emergency Pill), Duo Ming San (Life-Saving Powder).
Shi Jue (Corpse-like Coma) presents with no breath but a beating pulse, or a faint, thin pulse that is intermittent. This is due to exhaustion of Qi and Blood after illness. For deficiency, use Ren Shen Tang (Ginseng Decoction), Shen Fu Tang (Ginseng and Aconite Decoction), or Xing Xiang Yin (Arisaema and Costus Root Drink) for phlegm. If caused by Qi closure leading to abdominal fullness and constipation of both bowels, or acute abdominal pain, use San Wu Bei Ji Dan (Three-Ingredient Emergency Pill). After administration, if borborygmus occurs and vomiting or purging ensues, it indicates efficacy. If there is phlegm obstruction in the throat, use Duo Ming San (Life-Saving Powder) first.
[Note] The syndrome of Shi Jue (Corpse-like Coma) has deficiency and excess types. For deficiency, use Du Shen Tang (Single Ginseng Decoction). For deficiency combined with cold, use Shen Fu Tang (Ginseng and Aconite Decoction). For deficiency combined with phlegm, use Xing Xiang Yin (Arisaema and Costus Root Drink) plus Ren Shen Tang (Ginseng Decoction). For excess type, characterized by Qi closure resembling death, strong pulse, abdominal distension, constipation of both bowels, or acute abdominal pain with blocked Qi mechanism, use San Wu Bei Ji Dan (Three-Ingredient Emergency Pill). For excess combined with phlegm, use Duo Ming San (Life-Saving Powder).
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Sheng Mai Bu Jing Tang (Generate Pulse and Nourish Essence Decoction).
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) treats Xu Zhong (Internal Injury Qi Deficiency), where excessive fatigue leads to failure of clear Yang to ascend, resulting in deficient fainting. If phlegm is present, add Fu Ling (Poria) and Ban Xia (Pinellia). If fainting is desired due to sexual exhaustion, use Sheng Mai Di Gui Rong Tang (which is Sheng Mai Bu Jing Tang).
[Note] Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) treats the syndrome of Xu Zhong (Internal Injury), as described by Li Gao: In individuals with internal injury and Qi deficiency, excessive fatigue causes clear Yang not to ascend, leading to sudden fainting. "Yu Mao" refers to fainting due to excessive sexual activity. Sheng Mai Yin (Generate Pulse Drink) consists of Ren Shen (Ginseng), Mai Dong (Ophiopogon), Wu Wei Zi (Schisandra), combined with Shu Di Huang (Rehmannia), Dang Gui (Angelica Sinensis), and Lu Rong (Deer Antler Velvet), named Sheng Mai Bu Jing Tang (Generate Pulse and Nourish Essence Decoction).
Mu Xiang Tiao Qi Yin (Costus Root Regulating Qi Drink).
Mu Xiang Tiao Qi Yin (Costus Root Regulating Qi Drink) treats Shi Qi Zhong (Excess Qi Middle/Stagnation) in individuals with robust form and Qi, caused by sudden anger leading to rebellious Qi, sudden collapse, lockjaw, coma, and phlegm. In Wind Stroke, the pulse is floating and extremities are warm; in Qi Middle/Stagnation, the pulse is deep and extremities are cold, allowing for differentiation. This formula contains Mu Xiang (Costus Root), Huo Xiang (Patchouli), Sha Ren (Cardamom), Bai Kou Ren (White Cardamom Seed), Gan Cao (Licorice), Ding Xiang (Clove), and Tan Xiang (Sandalwood).
[Note] Shi Qi Zhong (Excess Qi Middle/Stagnation) refers to Qi stagnation in individuals with robust form and Qi. It is caused by sudden anger leading to rebellious Qi and sudden collapse with lockjaw. Wind Stroke patients have a floating pulse and warm extremities; Qi Middle/Stagnation patients have a deep pulse and cold extremities, which allows for differentiation. This formula includes Mu Xiang (Costus Root), Huo Xiang (Patchouli), Sha Ren (Cardamom), Bai Kou Ren (White Cardamom Seed), Gan Cao (Licorice), Ding Xiang (Clove), and Tan Xiang (Sandalwood).
Ba Wei Shun Qi San (Eight-Ingredient Regulating Qi Powder).
Ba Wei Shun Qi San (Eight-Ingredient Regulating Qi Powder) treats Xu Qi Zhong (Deficient Qi Middle/Stagnation) in individuals with deficient form and Qi, treating both root and branch to harmonize pathogenic factors and healthy Qi. It uses Ren Shen (Ginseng), Fu Ling (Poria), Bai Zhu (Atractylodes), and Gan Cao (Licorice) to support Yuan Qi (Primal Qi), and Wu Yao (Lindera), Bai Zhi (Angelica Dahurica), Qing Pi (Green Tangerine Peel), and Chen Pi (Aged Tangerine Peel) to regulate Qi and resolve phlegm.
[Note] Xu Qi Zhong (Deficient Qi Middle/Stagnation) refers to Qi stagnation in individuals with deficient form and Qi. This formula, which treats both root and branch to harmonize pathogenic factors and healthy Qi, is appropriate.
Gua Di San (Melon Seed Powder), Jiang Yan Tang (Ginger Salt Decoction).
Overeating followed by exposure to cold wind, or chest congestion due to anger and resentment, causing sudden coma and inability to move limbs, can be treated with Gua Di San (Melon Seed Powder) or Jiang Yan Tang (Ginger Salt Decoction) to induce vomiting and restore balance.
[Note] Gua Di San (Melon Seed Powder) is used for cases complicated by phlegm. Ginger Decoction is used for cases complicated by cold. Salt Decoction is used for cases of overeating. "Inducing vomiting" means brewing several pots of this decoction, having the patient drink one pot, then using a finger to stimulate the throat to vomit. If vomiting does not occur, drink again and stimulate again, until vomiting is thorough and comfortable, which can lead to immediate recovery.
Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction).
Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) treats Han Zhong (Cold Strike), presenting with abdominal pain, spasm, and lockjaw. If there is sweating, cold body, or vomiting/diarrhea, use Fu Zi Li Zhong Tang (Fu Zi, Ren Shen, Bai Zhu, Gan Cao, Gan Jiang). If there is no sweating and cold body, add Ma Huang (Ephedra) and Xi Xin (Asarum). For Yin Du (Yin Toxin), use raw Chuan Wu (Aconitum carmichaelii). For vomiting, add Ding Xiang (Clove) and Wu Yu Zhu (Evodia). If the pulse is faint and near extinction, double the dose of Ren Shen (Ginseng).
[Note] The syndrome of Han Zhong (Cold Strike) refers to various abdominal pain conditions, for which Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) is suitable. Add Ma Huang (Ephedra) and Xi Xin (Asarum) if there is no sweating. Add raw Chuan Wu (Aconitum carmichaelii) for Yin Du (Yin Toxin). Add Ding Xiang (Clove) and Wu Yu Zhu (Evodia) for vomiting. Double Ren Shen (Ginseng) for a faint, near-extinct pulse. Yin Du (Yin Toxin) is an extreme cold condition, detailed in *Shang Han Xin Fa* (Essentials of Cold Damage).
Liang Ge San (Cool the Diaphragm Powder).
Liang Ge San (Cool the Diaphragm Powder) treats Huo Zhong (Fire Strike), presenting with mental confusion and fainting. It contains Zhi Zi (Gardenia), Qiao (Forsythia), Qin (Scutellaria), Bo He (Mint), Gan Cao (Licorice), Xiao (Niter), and Huang (Rhubarb). It also treats all heat in the chest and diaphragm, presenting with dry stool, delirium, and macules/rash with mania.
[Note] The syndrome of Huo Zhong (Fire Strike) is what Liu Wansu described: Extreme emotional agitation causes fire from the five zang emotions to arise internally, leading to collapse, unconsciousness, and immobility of tendons and bones.
Xiang Ru Yin (Mosla Drink), Huo Xiang Zheng Qi San (Patchouli Regulating Qi Powder), Chen Sha Yi Yuan San (Cinnabar Benefit Origin Powder), Yi Qi Fa (Umbilical Fomentation Method), Cang Zhu Bai Hu Tang (Atractylodes White Tiger Decoction), Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction).
Zhong Shu (Summerheat Strike) must be differentiated into Yin Summerheat and Yang Summerheat. Yin Summerheat has no sweating and resembles cold damage, presenting with high fever, irritability, or vomiting/diarrhea; treat with Xiang Ru Yin (Mosla Drink: Xiang Ru, Bian Dou, Hou Po) or Er Xiang Tang (Two-Mosla Decoction: Xiang Ru Yin combined with Huo Xiang Zheng Qi San). If accompanied by mental confusion, steaming spontaneous sweating, dirty complexion, panting, and thirst, it is Yang Summerheat. For unconsciousness, urgently apply hot fomentation to the umbilicus and administer garlic juice mixed with water to restore consciousness, followed by Chen Sha Yi Yuan San (Cinnabar Benefit Origin Powder). For excess Qi constitution, use Cang Zhu Bai Hu Tang (Atractylodes White Tiger Decoction); for deficient Qi constitution, use Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction), choosing appropriately.
[Note] Yin Summerheat with no sweating resembles cold damage, referring to Yin Summerheat pathogens resembling cold damage headache and body ache, aversion to cold, and no sweating, but accompanied by high fever, irritability, vomiting, or diarrhea. This results from contracting summerheat and then cooling off, with cold outside and summerheat inside; treat with Xiang Ru Yin (Mosla Drink). Er Xiang Tang (Two-Mosla Decoction) refers to Xiang Ru Yin (Mosla Drink) combined with Huo Xiang Zheng Qi San (Patchouli Regulating Qi Powder), detailed in the Huo Luan (Cholera) section. If the above symptoms are present, along with mental confusion, steaming spontaneous sweating, dirty complexion, panting, and thirst, it is Yang Summerheat, resulting from walking under the scorching sun, with heat inside and out. For unconsciousness, urgently apply hot fomentation to the umbilicus and administer garlic juice mixed with water to restore consciousness, followed by Chen Sha Yi Yuan San (Cinnabar Benefit Origin Powder). For excess Qi constitution, use Cang Zhu Bai Hu Tang (Atractylodes White Tiger Decoction); for deficient Qi constitution, use Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction), choosing appropriately.
Shen Shi Tang (Dampness Percolating Decoction).
Shen Shi Tang (Dampness Percolating Decoction) treats Shi Zhong (Dampness Strike) with internal mental confusion, as described by Zhu Zhenheng: Damp-heat generating phlegm leading to confusion, resulting from overindulgence in rich flavors, strong wine, and raw/cold foods. Shen Shi Tang (Dampness Percolating Decoction) is Wei Ling Tang (Stomach and Poria Decoction) plus Xiang Fu (Cyperus), Fu Xiong (Ligusticum chuanxiong var. jeholense), Sha Ren (Cardamom), and Huang Lian (Coptis).
[Note] Shi Zhong Nei (Internal Dampness Strike) refers to disease arising from internal dampness, as described by Zhu Zhenheng: Damp-heat generating phlegm leading to confusion, resulting from overindulgence in rich flavors, strong wine, and raw/cold foods. Shen Shi Tang (Dampness Percolating Decoction) is Wei Ling Tang (Stomach and Poria Decoction) plus Xiang Fu (Cyperus), Fu Xiong (Ligusticum chuanxiong var. jeholense), Sha Ren (Cardamom), and Huang Lian (Coptis).
Chu Shi Tang (Dampness Removing Decoction).
Chu Shi Tang (Dampness Removing Decoction) treats external dampness (rainy season, humid evaporation, fog, lying on damp ground, wading through water, miasma mountain vapors), presenting with heavy and painful head and body, loose stools, and edema. The formula contains Qiang Huo (Notopterygium), Ben (Ligusticum sinense), Sheng Ma (Cimicifuga), Chai Hu (Bupleurum), Fang Feng (Saposhnikovia), and Cang Zhu (Atractylodes).
[Note] Chu Shi Tang (Dampness Removing Decoction) consists of Qiang Huo (Notopterygium), Ben (Ligusticum sinense), Sheng Ma (Cimicifuga), Chai Hu (Bupleurum), Fang Feng (Saposhnikovia), and Cang Zhu (Atractylodes), treating dampness striking from outside. It results from rainy weather, humid evaporation after rain, morning fog and dew, long-term lying on damp ground, long-distance wading through water, and miasma mountain vapors. Symptoms include heavy and painful head and body, severe mental confusion, loose stools, and skin edema.
Tiao Qi Ping Wei San (Regulate Qi and Calm the Stomach Powder).
Tiao Qi Ping Wei San (Regulate Qi and Calm the Stomach Powder) treats E Zhong (Evil Strike/Sudden Collapse). For blackened face, confusion, and forgetfulness, Su He Wan (Styrax Pill) is primary. Secondarily, use Mu Xiang Ping Wei Yun (Costus Root Calm the Stomach Blend), which combines the Mu Xiang Tiao Qi San (Costus Root Regulating Qi Powder) for Qi Middle/Stagnation with Ping Wei San (Calm the Stomach Powder) for regulation.
[Note] "Su He Zhu" refers to E Zhong (Evil Strike), for which Su He Wan (Styrax Pill) is the primary formula. "Mu Xiang Ping Wei Yun" refers to combining the Mu Xiang Tiao Qi San (Costus Root Regulating Qi Powder) for Qi Middle/Stagnation with Ping Wei San (Calm the Stomach Powder) for regulation.