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The art of medicine is entirely based on a heart of benevolence and benefit; saving lives depends on dwelling in benevolence. Without moral integrity and sincerity, there will surely be spirits secretly observing [one's conduct]. To aid all things and jointly enter the realm of shared longevity, cultivating one's nature half serves to nourish one's own body. The "Apricot Grove" (a metaphor for the medical profession) and the "Orange Well" (a metaphor for virtuous physicians) are but past traces; we still rely on lingering fragrance to plant new virtue.

The vast universe is but one Qiankun (Heaven and Earth); the skill of harmonizing the tripod (metaphor for governing or regulating bodily balance) is passed down generation after generation. The scheming of "pointing at a deer and calling it a horse" is merely futile fabrication; the demeanor of "asking about the ox" (investigating the essence to regulate Yuan Qi) is truly the method of regulating Yuan Qi. Greedy people corrupt customs, changing the pure wind; virtuous ministers rectify the times, completing the sun of peace. Within the four seas, there is harmony and prosperity, with people and goods abundant; like spring wind, flowers, and willows, they preserve their vitality year after year.

The above two poems: one reveals the intention of practicing medicine through the Way, cautioning thus; the other reveals the root of the Great Dao, illustrating the meaning of regulating Yuan Qi as such. It is said that "when successful, one becomes a good minister; when unsuccessful, one becomes a good physician." This is not comparable to vulgar crafts and skills; indeed, it cannot be fathomed by those of small talent and wisdom.

Recorded respectfully by Liu Zongnong Fu from Zhongshan, on the second day after the Full Moon of the tenth month, in the year Wuzi (1408), during the Yongle era.

Apoplexy (Zhong Feng) generally stems from Blood deficiency. For Qi deficiency accompanied by Phlegm, treatment prioritizes resolving Phlegm. Cases complicated by Fire and Dampness leading to hemiplegia are mostly due to Phlegm. Lesions on the left belong to Dead Blood and lack of Blood; lesions on the right belong to Phlegm, Heat, and Qi deficiency.

Restoring Qi: Initially failing to distinguish between internal and external causes, many cases arise from agitation by the Seven Emotions, causing Qi Jue (Qi collapse/reversal) with sudden rebellion, leading to coma and locked jaw. If mistakenly treated as Apoplexy, medication often leads to death. One should only administer Suhe Xiang Wan (Styrax Pill) to induce awakening, as the disease resolves when Qi is restored. Apoplexy is like being struck by an arrowhead; it is not comparable to a common cold or wind-catch.

Quick Sneezing (Nasal Insufflation): For initial sudden fainting or apoplexy, use powder of Gleditsiae Fructus Spina (Zaojiao Mo) or Buwo San insufflated into the nose.

Sweating Method (Releasing the Exterior): For Exterior Excess with no sweating, use dispersing and seizing methods; for both Interior and Exterior Excess, use dispersing and seizing; for Exterior Deficiency with spontaneous sweating, use methods to consolidate the Exterior; for both Interior and Exterior Deficiency, use warming and resolving methods. The *Mai Jing* states: "Pulse floating and large indicates Wind." "Pulse sinking, slow, and weak" calls for selecting Xin-Wen (Acrid-Warm) formulas such as Pai Feng Tang (Dispel Wind Decoction) or Xiao Xu Ming Tang (Minor Continuation of Life Decoction), or Xin-Ping (Acrid-Neutral) formulas such as Xiao Feng Bai Jie San (Eliminate Wind Hundred-Resolve Powder) or Xiao Feng San (Eliminate Wind Powder). For pulse flooding and solid, use Xin-Liang (Acrid-Cool) methods, such as Qian Shi Da Qing Gao (Master Qian’s Large Green Paste).

Expeoration (Inducing Vomiting): Qi stagnation is difficult to treat; expeoration is suitable. For excess Phlegm-Qi, ability to eat, and severe Phlegm obstruction, as well as facial paralysis and inability to speak, expeoration is used. However, deficiency patterns where expeoration is contraindicated also exist.

Purgation (Attacking the Interior): This is because internal blockage of stool and urine necessitates attacking the Interior. Only after careful and accurate diagnosis should this method be applied. Key formulas include San Hua Tang (Three Transformations Decoction), Hezi Sou Feng Wan (Hezi’s Wind-Search Pill), and Lao Ren Run Chang Wan (Elder’s Intestine-Moistening Pill).

Double Resolution: The *Yao Lue* states: "Pulse subtle and rapid is caused by Apoplexy." For Wind-Heat in both Exterior and Interior, use Fang Feng Tong Sheng San (Saposhnikovia Universal Relief Powder) or Chuanxiong Shigao Tang (Ligusticum and Gypsum Decoction). For Wind-Cold, use Xiao Xu Ming Tang.

Seizing (Strong Wind-Expelling): Such as Reng Sheng San (Like-Sage Powder) and Tianma Fangfeng (Gastrodia and Saposhnikovia) types. (See below.)

Regulating Qi: Qi stagnation and depression, chest and hypochondriac fullness, shoulder and arm numbness and pain, etc., stem from the Seven Emotions. Regulate Qi using Wu Yao Shun Qi San (Litsea Smooth Qi Powder) or Ba Wei Shun Qi San (Eight-Ingredient Smooth Qi Powder).

Regulating Blood: In the absence of Exterior-Interior urgency, with rebellious Blood and irregular attacks, use Da Qin Jiao Tang (Major Gentian Decoction) or Qiang Huo Yu Feng Tang (Notopterygium Wind-Dispelling Decoction), combined with Dao Tan Wan (Phlegm-Guiding Pill). For diseases in the Channels, use Liu He Tang (Six-Harmony Decoction) or Yu Feng Tang (Wind-Dispelling Decoction). When there are no Exterior-Interior manifest signs but Blood and Qi are deficient, tonification is required. (See below.)

Tonifying Qi: For sudden collapse due to Qi deficiency, use Ginseng and Atractylodes Macrocephala Rhizome. If Phlegm is present, use Bamboo Juice and Ginger Juice, with Ginseng as the principal ingredient. For root deficiency, use Bu Zhong Yi Qi Tang (Middle-Warming and Qi-Boosting Decoction) combined with Wind-expelling agents.

Nourishing Blood: Use Si Wu Tang (Four Substances Decoction), adding a little Ginger Juice to avoid cloying Phlegm, then add Bamboo Juice. If the patient can eat, remove Bamboo Juice and add Schisandra Juice; if Ginger Juice is ineffective, administer Qingzhou Bai Wan Zi (Qingzhou White Pills) with decoction.

Opening Passages and Penetrating Muscle and Bone: For Yang patterns, use Zhi Bao Dan (Treasure of Ultimate Value Pill); for Yin patterns, use Ling Bao Dan (Spirit Treasure Pill). These are suitable for coma. Because Wind enters the bone marrow and cannot exit, substances like Dragon Brain (Borneol), Musk, Buffalo Horn, and Realgar are used, as they penetrate bone and muscle to expel Wind pathogens. These should not be used for Wind striking the Collaterals or Organs.

Jia Bao Dan: Treats all Wind syndromes, left flaccidity and right paralysis, limb atrophy and numbness, facial deviation, and pathogens entering bone marrow. It is unsuitable if the pathogen is only in the muscle and surface; otherwise, it draws Wind into the marrow, like oil entering dough, making expulsion impossible.
Ingredients: Aconitum Carlemanii Lateralis Radix Preparata (Chuanwu), Pinellia Tuber (Nanxing), Trogopterus Dung (Wulingzhi - processed with Ginger Juice, ground separately), Aconitum Kusnezoffii Root (Caowu) (each 6 liang); Bletilla Tuber (Baifuzi), Scorpio (Quanxie), Myrrh (Moyao), Cinnabar (Chensha) (each 2 liang); Notopterygium Rhizome (Qianghuo), Frankincense (Ruxiang), Bombyx Batryticatus (Jiangcan) (each 3 liang); Borneolum Syntheticum (Pian Nao) (1.5 liang); Gastrodia Rhizome (Tianma) (3 liang); Moschus (Shexiang) (1.25 liang); Pheretima (Dilong) (4 liang); Realgar (Xionghuang) (1 liang); Calomelas (Qingfen) (1 liang).
Grind into fine powder, take as powder mixed with liquid, or mix with honey into pills the size of a bullet, and dissolve in the mouth. For mere wind-induced numbness and wandering pain, joint pain, aphasia, or congestion, Tianma San (Gastrodia Powder) is suitable.

Reng Sheng Jiu Ku San (Like-Sage Salvation from Suffering Powder): Treats left flaccidity and right paralysis, wind-damp bi syndrome, and unceasing wandering pain. It is a seizing agent, used only for severe pain.
Ingredients: Papaveris Pericarpium (Yumi Qiao) (1 liang, top removed, stir-fried with honey), Tangerine Peel (Chenpi) (5 qian), Tiger Bone (Hu Gu) (roasted with butter), Frankincense (Ruxiang) (ground), Myrrh (Moyao) (ground), Licorice Root (Gancao) (each 2.5 qian).
Grind into fine powder. Take 3 qian per dose. Add 1.5 cups of water, boil to 0.8 cup, and drink hot with the dregs. For upper body ailments, take after meals; for lower body ailments, take before meals. During boiling, stir consistently in one direction.

Fangfeng Tianma San:
Ingredients: Saposhnikovia Root (Fangfeng), Gastrodia Rhizome (Tianma), Ligusticum Chuanxiong Rhizome (Chuanxiong), Angelica Dahurica Root (Baizhi), Aconitum Kusnezoffii Root (Caowu), Bletilla Tuber (Baifuzi), Schizonepeta Spike (Jingjie Sui), Angelica Sinensis Root (Danggui), Notopterygium Rhizome (Qianghuo) (each 0.5 liang); Licorice Root (Gancao), Talcum (Huashi).
Grind into powder. Dissolve with wine and a little honey, take 0.5 qian, increasing to 1 qian.

Guiding Phlegm and Unblocking Channels: Zhuli Tang (Bamboo Juice Decoction), Qingzhou Bai Wan Zi (Qingzhou White Pills), and Sansheng Yin (Three Lives Drink) all treat sudden stroke coma, facial deviation, hemiplegia, tidal Phlegm obstruction, and limb numbness. Baolong Wan (Embracing Dragon Pill) is also excellent, along with Sheng Feng Tang (Wind-Resolving Decoction) and Jingli Tang (Schisandra Juice Decoction). For pain in joints and fingers/toes, Shen You Wan (Divine Aid Pill) or similar purgatives are suitable.

Clearing Heat: Wind originates from Heat; excessive Fire and deficient Water fail to control it, leading to Yin deficiency and Yang excess, with Qi oppression. Use Shenxiong Wan (Spirit and Ligusticum Pill), Xuanming Xianshu Xiong San (Xuanming Immortal Gastrodia Powder), or Tong Sheng San (Universal Relief Powder). Patterns may also involve Dampness or Qi. For concurrent Blood Heat, use Fangfeng Tong Sheng San removing Ephedra, Mirabilite, and Rhubarb, adding Rehmannia Glutinosa Root (Shengdi Huang) and Coptis Chinensis Rhizome (Huanglian).

Moxibustion: Points Fengchi, Baihui, Quchi, Yifeng, Fengshi, Huantiao, Jianyu, etc., can be moxa-ed to open orifices and disperse Wind. Acupuncture guides Qi.

Fumigation: When Wind lodges in channels causing limb pain and immobility, decoct various Wind-dispersing herbs and fumigate according to protocol.

Application/Poultice: For Wind lodging in limbs causing Bi pain, apply powder of Ginger Juice, Mustard Seed, Angelica Dahurica Root, and Pinellia Tuber. For facial deviation, Croton Seed (Badou) is sometimes used.

Reng Sheng San:
Ingredients: Atractylodes Lancea Rhizome (Xianshu) (4 liang), Ligusticum Chuanxiong Rhizome (Chuanxiong), Saposhnikovia Root (Fangfeng), Angelica Dahurica Root (Baizhi) (each 2 liang), Asarum Root (Xixin) (1 liang), Ligusticum Chuanxiong Rhizome (Chuanxiong) (0.5 liang), Aconitum Kusnezoffii Root (Caowu) (1 liang), Gastrodia Rhizome (Tianma) (0.5 liang), Realgar (Xionghuang) (0.5 liang).
Grind into powder. Take 1 qian per dose, mixed with warm wine.

Medicinals Governing Each Channel: Liver (Ligusticum Chuanxiong Rhizome), Heart (Asarum Root), Spleen (Imperata Rhizome), Lung (Saposhnikovia Root), Kidney (Angelica Pubescens Root), Stomach (Imperata Rhizome), Large Intestine (Angelica Dahurica Root), Small Intestine (Ligusticum Wallichii Rhizome/Gaoben), Sanjiao (Scutellaria Baicalensis Root/Huangqin), Bladder (Notopterygium Rhizome), Pericardium (Ligusticum Chuanxiong Rhizome).