子和云诸风掉眩皆属肝木掉摇眩运目 筋急手搐螈 昏厥阴肝木之用也经云风淫所胜平
以卒
凉世何以热药治风邪予治惊风痫病屡用汗吐下三法随治愈木郁达之者吐之令其条达也汗者风
随汗出也下者推陈致新也失音闷乱口眼 斜可用三圣散吐之如牙关紧急鼻内灌之吐出涎口自
开也次用通圣散凉膈散大人参半夏丸甘露饮除热养液之寒药排而用之
按此法的系邪气卒中痰涎壅盛实热者可用否则不敢轻易也
丹溪曰今世所谓风病大率与诸痿证衮同论治良由局方多以治风之药通治痿也古圣论风痿
各有
条目源流不同治法亦异夫风病外感善行数变其病多实发表行滞有何不可局方治风之外又历述
神魂恍惚起便须人手足不随神志昏愦瘫痪 曳手足筋衰眩运倒仆半身不遂脚膝软弱四肢无力
颤掉拘挛不语语涩诸痿等证悉皆治之不思诸痿皆起于肺热传入五脏散为诸证其昏惑螈 瞀
闷
瞀昧暴病郁冒蒙昧暴喑 昧皆属于火曰四肢不举舌本强足痿不收痰涎有声皆属于土悉是湿热
之病当作诸痿论治若以外感风邪治之宁免虚虚实实之祸乎若夫岐伯仲景孙思邈之言风大意似
指外之感刘河间之言风明指内伤热证实与痿证所言诸痿生于热相合外感之邪有寒热虚实而挟
寒者多内热之伤皆是虚证无寒可散无热当作实可泻
谨按中风之病古方冠诸方首以其为人之大病也夫风乃六淫中之一天之邪气自外而入者也
古
人用药皆是发散表邪通行经络之剂以其自表而入亦当自表而出也至于东垣分在经在腑在脏而
有汗下调养之法可谓详备精密则又通表里中三法而治矣若刘河间以为热甚制金不能平木或湿
土过甚反兼木化皆非外中于风乃因内热而生迥出前古之论我先师丹溪先生谓数千年得经意者
河间一人耳由是观之若病从外邪而得元气壮实者当从古方发散之例但用药不宜小续命汤须分
所挟有寒热温凉之异受邪有脏腑经络之殊若病因内热而生者当从刘河间之论但有用药不宜如
子和专以吐汗下为法盖病邪有虚有实难一概论又况痿病实与内热所生相同医者须宜识此或问
外邪之感与内热之伤何者为多也丹溪曰西北气寒为风所中诚有之矣东南气温而地多湿有风病
者非风也皆湿生痰痰生热热生风也经曰亢则害承乃制是也治痿之法详见痿条此不赘及
Hezi (Zhang Yuansu's disciple, Zhang Congzheng) said: "All wind diseases causing tremors and dizziness belong to Liver Wood. Trembling, vertigo, visual disturbances, tendon stiffness, hand spasms, and syncope are manifestations of Yin meridian Liver Wood dysfunction. The *Classic* states: 'When Wind is excessive, treat it with coolness.' Why do people today use hot medicines to treat Wind pathogens? I have frequently used the sweating, vomiting, and purging methods to treat convulsive wind and epilepsy, achieving cures according to the syndrome. Regarding 'releasing Liver depression,' vomiting allows Qi mechanism to flow freely; sweating expels Wind pathogens through perspiration; purging eliminates old pathogenic factors and promotes renewal. For patients with aphonia, mental confusion, and deviation of the mouth and eyes, *Sansheng San* (Three Holy Powders) can be used for emesis. If the jaw is tightly closed, the medicine can be instilled into the nose; once phlegm-saliva is expelled, the mouth will open naturally. Subsequently, *Tongsheng San* (Universal Salvation Powder), *Liangge San* (Cool the Diaphragm Powder), *Daren Shen Banxia Wan* (Great Ginseng and Pinellia Pill), and *Ganlu Yin* (Sweet Dew Drink)—cold-natured drugs that clear heat and nourish fluids—should be used to eliminate heat."
Commentary: This is indeed applicable to cases where pathogenic factors strike suddenly, with abundant phlegm-saliva and excess-heat syndromes; otherwise, one dare not use these methods lightly.
Danxi said: "The so-called wind diseases in today's world are largely treated together with various Wei (flaccidity) syndromes. This is largely because the *Formulas of the Imperial Medical Bureau* (*Ju Fang*) uses wind-dispelling drugs to treat flaccidity generally. The ancient sages discussed Wind and Wei separately, with different origins and distinct treatment methods. Wind disease is caused by external pathogens, characterized by rapid movement and change, and its pathology is mostly excess. Therefore, using methods to release the exterior and move stagnation is appropriate. However, *Ju Fang*, besides treating wind, also lists symptoms such as spirit restlessness, need for assistance to rise or sit, paralysis of limbs, mental obtundation, hemiplegia, dragging of limbs, tendon atrophy, vertigo and falling, hemiplegia, weak knees and feet, limb weakness, tremors, spasms, mutism, and speech impediment, treating all these Wei syndromes indiscriminately. They fail to realize that all Wei syndromes originate from Lung Heat, which transmits to the five Zang organs and manifests as various syndromes. Symptoms like mental confusion, spasms, blurred vision, oppression, sudden illness with mental clouding, and sudden aphonia belong to Fire; inability to lift limbs, stiff tongue root, foot flaccidity, and audible phlegm belong to Earth. All are damp-heat diseases and should be treated as Wei syndromes. If treated as external Wind pathogens, would this not lead to the disaster of reinforcing excess and depleting deficiency? As for Qibo, Zhongjing, and Sun Simiao, their discussions on Wind seem to refer to external pathogens. Liu Hejian’s discussion on Wind clearly points to internal injury and heat-excess syndromes, which aligns with the statement that 'all Wei syndromes arise from heat.' External pathogens involve cold, heat, excess, and deficiency, often accompanied by cold; internal heat injuries are mostly deficiency syndromes, with no cold to disperse and no heat to purge as an excess condition."
Respectfully noted: The disease of Stroke (Zhong Feng) is listed first in ancient formulas because it is a major disease affecting humans. Wind is one of the Six Excessive Pathogens (Six Evils), a heavenly pathogenic factor entering from the exterior. Ancient medications were primarily dispersants for exterior pathogens and agents to unblock meridians, as the pathogen enters from the exterior and should exit via the exterior. Li Dongyuan distinguished between involvement of the meridians, fu organs, and zang organs, employing sweating, purging, and nourishing methods, which was detailed and precise, integrating exterior, interior, and middle jiao treatments. Liu Hejian argued that excessive heat controls Metal (Lung), failing to restrain Wood (Liver), or excessive damp-Earth mimics Wood transformation. These views suggest that the condition arises from internal heat rather than external Wind intrusion, differing significantly from ancient theories. My late teacher, Mr. Danxi, stated: "Among thousands of years, only Liu Hejian truly grasped the essence of the Classics." From this perspective, if the disease results from external pathogens and the patient has robust Yuan Qi, one should follow the ancient precedent of dispersion, but avoid using *Xuxing Tang* (Continued Survival Decoction); instead, differentiate based on accompanying cold, heat, warmth, or coolness, and the specific organ and meridian affected. If the disease arises from internal heat, one should follow Liu Hejian’s theory, but avoid using the sweating, vomiting, and purging methods exclusively as advocated by Hezi. Pathogenic factors can be deficient or excess, so they cannot be generalized. Furthermore, Wei syndromes are indeed similar to those generated by internal heat; physicians must recognize this. A question was raised: Which is more common, external pathogenic invasion or internal heat injury? Danxi replied: "In the northwest, the climate is cold, and being struck by Wind does occur. In the southeast, the climate is warm and the land is humid. Cases labeled as Wind disease there are not due to Wind, but rather Dampness generating Phlegm, Phlegm generating Heat, and Heat generating Wind-like symptoms. The *Classic* says: 'Excess leads to harm, restraint restores balance.' Methods for treating Wei syndromes are detailed in the Wei section; this topic is not repeated here."