秦子曰∶中风之症 卒然仆倒，昏不知人，若痰涎暂升，少顷即醒，此中之轻者。卒然
倒仆，昏不知人，痰涎壅盛，口噤失音，良久不醒，渐渐沉重，此中之重者。有外感，有内
伤。外感者，真中风也；内伤者，类中风也。
【中风之症】卒然倒仆，身热口噤，志乱神昏，四肢俱废，良久不省，《内经》名曰
风痱
《内经》名曰偏枯；东垣所谓中腑之稍轻者；外无六经寒热，内无便溺阻隔，无痰无喘，言
语分明，惟见皮肤不仁，或麻或木，口眼 斜，东垣所谓中血脉之最轻者。以上乃外感真中
风之症也。
【中风之因】或坐卧当风，风入五内，或衣单被薄，卒遇暴风，或披星戴月，风露袭
人，外邪乘虚入于诸经，而中风之症作矣。
【中风之脉】左关浮弦，病在足厥阴、少阳。左寸浮弦，病在手少阴、少阳。左尺浮
大，病在足少阴、太阳。右寸浮洪，病在手太阴、阳明。右关浮大，病在足太阴、阳明。右尺浮
【中风之治】初起宜祛风涤邪，有表者，小续命汤、羌活愈风汤汗之；有里者，三化
汤下之；表里俱见者，大秦艽汤、防风通圣散和之；痰涎壅盛者，竹沥二陈汤，合胆
星汤、牛黄
小续命汤 通治中风六经表症。后具河间六经加减、四时加减之法。
麻黄 人参 黄芩 白芍药 甘草 防风 杏仁 川芎 防己
春，加防风；夏，倍加石膏；秋，加知母；冬，加桂枝。身痛，加羌活、秦艽。
河间云∶凡中风，不审六经加减，虽治之不能去其邪。《内经》云，开则淅然寒，阖则
热而闷，知暴中风邪，宜以小续命汤，随症随经治之。
中风无汗，恶寒，脉浮紧，风中太阳经营也。以续命汤加后三味各一倍，名麻黄续命汤。
麻黄 防风 杏仁
宜针太阳少明，出昆仑阳跷穴血。
中风有汗恶风，脉浮缓，风中太阳经卫也，以续命汤加后三味各一倍，名桂枝续命汤。
桂枝 白芍药 杏仁
宜针风府。
中风无汗，身热不恶寒，脉洪长，风中阳明经症也，以续命汤加后三味各一倍，名曰石
石膏 知母 甘草
中风无汗，身热不恶风，脉缓长，风中阳明表症也。以续命汤加后三味各一倍，名干葛
葛根 桂枝 黄芩
宜刺厉兑，泻阳明之实清火也，针陷谷，云阳明之邪散表也。
中风无汗身凉，风中太阴经也，以续命汤加后三味各一倍，名附子续命汤。
熟附子 干姜 甘草
宜刺隐白，以去太阴之贼。
中风有汗，无热，以续命汤加后三味各一倍，名桂附续命汤。
桂枝 熟附子 甘草
宜针太溪，以去少阴之邪。
中风六经混淆，指节挛痛，麻木不仁，系手少阳、厥阴，羌活连翘续命汤。
小续命 羌活 连翘
宜刺厥阴之井大敦，以通其经，灸少阳之经绝骨，以引其热。又云，古之小续命，混淆
无六经之别，今各分经治，又立针刺之法。
中风外无六经形症，内无便溺阻隔，惟舌强难以言语，手足不能运动，知血弱不能养筋
，宜养血舒筋，大秦艽汤主之。
又云，中风外有六经形症，先以加减小续命诸方，随症随经治之。内有便溺阻隔，复以
三化汤下之。桢按∶以上诸症，乃西北真中风症，故立祛风散邪之法。以下内伤条内，有不
因外风而因于调养失宜，例如河间之论火，丹溪之论痰，而实系类中风之症，以其相类，故
同列之，然各有分别，不可混治。
羌活愈风汤 治表里已解，服此为善后条理。
羌活 防风 防己 川芎 独活 蔓荆子 麻黄 细辛 秦艽 柴胡 前胡 甘菊花
黄 枳壳 当归 芍药 苍术 黄芩 生地 半夏 白芷 知母 甘草 地骨皮 浓朴
三化汤 外无六经表症，内有便溺阻隔，以此方利之。
浓朴 大黄 枳实 羌活
虚人，加人参；痰多，加胆星、半夏。
大秦艽汤 治外无六经表症，内无便溺阻隔，惟手足言语不便者。
秦艽 石膏 甘草 川芎 当归 白芍药 羌活 独活 防风 黄芩 白术 白茯苓
生地 白芷 细辛 熟地
天寒，加生姜；心下痞，加枳实、川黄连；夏秋，加石膏、知母；冬，加桂枝。
防风通圣散 治表里未除，以此方和解。
麻黄 石膏 桔梗 黄芩 山栀 荆芥 滑石 白术 广皮 甘草 川芎 当归身 防
风大黄 芒硝 连翘 薄荷 白芍药
竹沥二陈汤 治中脘痰滞。
熟半夏 白茯苓 广皮 甘草 竹沥
寒，加生姜；热，加山栀、黄连。
胆星汤 治痰涎壅盛。
陈胆星 广橘红 苏子 钩藤 甘草 菖蒲
里热甚，加山栀、黄连；肝胆热，加青黛、海石。
牛黄清心丸 治痰迷心窍。
真牛黄 犀角 羚羊角 辰砂 陈胆星 天竺黄 麝香 薄荷 雄黄 防风 冰片
海藏清心丸 治积热迷心。
黄柏（二两） 黄连 麦冬（各一两） 龙脑（一钱）
炼蜜为丸。
Qin Zi said: In the syndrome of stroke (Zhong Feng), sudden collapse and unconsciousness occur. If phlegm-saliva temporarily rises and the patient awakens after a short while, this is a mild case of stroke. If there is sudden collapse, unconsciousness, excessive accumulation of phlegm-saliva, locked jaw, loss of voice, prolonged unconsciousness, and gradual worsening of the condition, this is a severe case of stroke. Stroke can be caused by external pathogens or internal injury. Those caused by external pathogens are called True Stroke (Zhen Zhong Feng); those caused by internal injury are called Pseudo-Stroke (Lei Zhong Feng).
[Symptoms of Stroke] Sudden collapse, fever, locked jaw, mental confusion, paralysis of all four limbs, and prolonged unconsciousness are named "Feng Fei" in the *Nei Jing* (Inner Canon); "Pian Ku" in the *Nei Jing*; the milder form of "Zhong Fu" (Stroke affecting the viscera) as described by Dong Yuan; where there are no exterior six-channel cold/heat symptoms, no interior constipation or urinary retention, no phlegm or wheezing, clear speech, but only numbness or insensitivity of the skin, or tingling and numbness, and deviation of the mouth and eyes. This is the mildest form of "Zhong Xue Mai" (Stroke affecting the collaterals) as described by Dong Yuan. The above constitute the symptoms of True Stroke caused by external pathogens.
[Causes of Stroke] Sitting or lying exposed to drafts allows wind to enter the five zang organs; wearing thin clothes or light quilts exposes one to sudden violent winds; traveling under stars and moon exposes one to wind and dew. External evil pathogens take advantage of deficiency to invade the various meridians, causing the syndrome of stroke.
[Pulse of Stroke] A floating and wiry pulse at the left Guan position indicates disease in the Foot Jueyin (Liver) and Foot Shaoyang (Gallbladder) meridians. A floating and wiry pulse at the left Cun position indicates disease in the Hand Shaoyin (Heart) and Hand Shaoyang (Sanjiao) meridians. A floating and large pulse at the left Chi position indicates disease in the Foot Shaoyin (Kidney) and Foot Taiyang (Bladder) meridians. A floating and surging pulse at the right Cun position indicates disease in the Hand Taiyin (Lung) and Hand Yangming (Large Intestine) meridians. A floating and large pulse at the right Guan position indicates disease in the Foot Taiyin (Spleen) and Foot Yangming (Stomach) meridians. A floating pulse at the right Chi... [Text cuts off here].
[Treatment of Stroke] At the onset, dispel wind and cleanse pathogens. For exterior syndromes, administer Xiao Xu Ming Tang (Minor Continuation of Life Decoction) or Qiang Huo Yu Feng Tang (Notopterygium Wind-Dispelling Decoction) to induce sweating. For interior syndromes, administer San Hua Tang (Three Transformations Decoction) to purge downward. For simultaneous exterior and interior syndromes, use Da Qin Jiao Tang (Major Gentian Decoction) or Fang Feng Tong Sheng San (Saposhnikovia Universal Benefit Powder) to harmonize. For excessive phlegm-saliva, use Zhu Li Er Chen Tang (Bamboo Juice Two-Chen Decoction), combined with Dan Xing Tang (Arisaema with Bile Decoction) or Niu Huang Qing Xin Wan (Calculus Bovis Heart-Clearing Pill).
Xiao Xu Ming Tang (Minor Continuation of Life Decoction): Universally treats exterior syndromes of the six channels in stroke. Below are He Jian's methods for six-channel modifications and seasonal modifications.
Ingredients: Ephedrae Herba (Mahuang), Ginseng Radix (Renshen), Scutellariae Radix (Huangqin), Paeoniae Radix Alba (Baishao), Glycyrrhizae Radix et Rhizoma (Gancao), Saposhnikoviae Radix (Fangfeng), Armeniacae Semen Amarum (Xingren), Chuanxiong Rhizoma (Chuanxiong), Stephaniae Tetrandrae Radix (Fangji).
Spring: Add Fangfeng. Summer: Double the dosage of Shigao (Gypsum Fibrosum). Autumn: Add Zhimu (Anemarrhenae Rhizoma). Winter: Add Guizhi (Cinnamomi Ramulus). Body pain: Add Qianghuo (Notopterygii Rhizoma et Radix) and Qinjiao (Gentianae Macrophyllae Radix).
He Jian stated: Regarding any stroke, if one does not examine the six channels for modifications, treatment cannot eliminate the pathogen. The *Nei Jing* states: When pores open, one shivers with cold; when they close, one feels hot and stifled. Knowing it is acute wind-stroke, one should use Xiao Xu Ming Tang, treating according to symptoms and channels.
Stroke with no sweat, aversion to cold, and floating-tight pulse indicates wind invading the Ying (Nutritive) level of the Taiyang channel. Use Xu Ming Tang adding the following three herbs, each doubled in dosage, named Mahuang Xu Ming Tang.
Ingredients: Mahuang, Fangfeng, Xingren.
Acupuncture: Suitable to needle Taiyang and Shaoyin channels, bleeding from Kunlun (BL60) and Yangqiao points.
Stroke with sweat, aversion to wind, and floating-slow pulse indicates wind invading the Wei (Defensive) level of the Taiyang channel. Use Xu Ming Tang adding the following three herbs, each doubled in dosage, named Guizhi Xu Ming Tang.
Ingredients: Guizhi, Baishao, Xingren.
Acupuncture: Suitable to needle Fengfu (DU16).
Stroke with no sweat, body heat without aversion to cold, and surging-long pulse indicates wind invading the Yangming channel syndrome. Use Xu Ming Tang adding the following three herbs, each doubled in dosage, named Shi... [Text cuts off, likely Shigao Xu Ming Tang].
Ingredients: Shigao (Gypsum Fibrosum), Zhimu, Gancao.
Stroke with no sweat, body heat without aversion to wind, and slow-long pulse indicates wind invading the exterior of the Yangming channel. Use Xu Ming Tang adding the following three herbs, each doubled in dosage, named Gange... [Text cuts off, likely Gegen Xu Ming Tang].
Ingredients: Gegen (Puerariae Lobatae Radix), Guizhi, Huangqin.
Acupuncture: Suitable to prick Liding (ST45) to drain excess fire and clear heat from the Yangming; needle Xangu (ST43) to scatter Yangming pathogens to the exterior.
Stroke with no sweat and cool body indicates wind invading the Taiyin channel. Use Xu Ming Tang adding the following three herbs, each doubled in dosage, named Fuzi Xu Ming Tang.
Ingredients: Prepared Aconiti Lateralis Radix (Shu Fuzi), Dried Ginger (Ganjiang), Gancao.
Acupuncture: Suitable to prick Yinbai (SP1) to remove the thief of the Taiyin.
Stroke with sweat and no heat indicates using Xu Ming Tang adding the following three herbs, each doubled in dosage, named Gui Fu Xu Ming Tang.
Ingredients: Guizhi, Shu Fuzi, Gancao.
Acupuncture: Suitable to needle Taixi (KI3) to remove pathogens of the Shaoyin.
Confusion of the six channels in stroke, with spasmodic pain in finger joints, numbness, and insensitivity, belongs to the Hand Shaoyang and Jueyin meridians. Use Qianghuo Lianqiao Xu Ming Tang.
Ingredients: Xiao Xu Ming Tang, Qianghuo, Lianqiao (Forsythiae Fructus).
Acupuncture: Suitable to prick the Jing-well point of the Jueyin channel, Dadun (LR1), to unblock the meridian; moxa the Jing-river point of the Shaoyang channel, Jiexgu (GB39), to draw out heat. It is also stated that ancient Xiao Xu Ming Tang was confused without distinction among the six channels; now treatments are separated by channel, and acupuncture methods are established.
Stroke with no exterior six-channel signs, no interior constipation or urinary retention, but only stiff tongue difficult for speech, and immobility of hands and feet, indicates blood deficiency failing to nourish tendons. One should nourish blood and relax tendons, primarily using Da Qin Jiao Tang.
It is also stated: If stroke presents with exterior six-channel signs, first treat with modified Xiao Xu Ming Tang formulas according to symptoms and channels. If there is interior constipation or urinary retention, subsequently purge with San Hua Tang. Zhen notes: The above syndromes are True Stroke symptoms of the Northwest region, hence the method of dispelling wind and scattering pathogens is established. In the following internal injury sections, there are cases not caused by external wind but by improper regimen, such as He Jian's discussion on fire and Danxi's discussion on phlegm, which actually belong to Pseudo-Stroke syndromes. Because they resemble True Stroke, they are listed together, yet they have distinct differences and must not be treated interchangeably.
Qiang Huo Yu Feng Tang (Notopterygium Wind-Dispelling Decoction): Treats cases where exterior and interior are resolved, used for post-recovery conditioning.
Ingredients: Qianghuo, Fangfeng, Fangji, Chuanxiong, Duhuo (Angelicae Pubescentis Radix), Manjingzi (Viticis Fructus), Mahuang, Xixin (Asari Radix et Rhizoma), Qinjiao, Chaihu (Bupleuri Radix), Qianhu (Peucedani Radix), Ganjuhua (Chrysanthemi Flos), Huangqi (Astragali Radix - inferred from context 'Huang'), Zhike (Aurantii Fructus Perforatus), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Cangzhu (Atractylodis Rhizoma), Huangqin, Shengdi (Rehmanniae Radix), Banxia (Pinelliae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Zhimu, Gancao, Digupi (Lycii Cortex), Houpo (Magnoliae Officinalis Cortex).
San Hua Tang (Three Transformations Decoction): Used when there are no exterior six-channel signs but interior constipation or urinary retention exists, to promote purgation.
Ingredients: Houpo, Dahuang (Rhei Radix et Rhizoma), Zhishi (Aurantii Fructus Immaturus), Qianghuo.
For deficient persons, add Renshen. For excessive phlegm, add Danxing (Arisaema cum Bile) and Banxia.
Da Qin Jiao Tang (Major Gentian Decoction): Treats cases with no exterior six-channel signs, no interior constipation/urinary retention, but only difficulty with limbs and speech.
Ingredients: Qinjiao, Shigao, Gancao, Chuanxiong, Danggui, Baishao, Qianghuo, Duhuo, Fangfeng, Huangqin, Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria), Shengdi, Baizhi, Xixin, Shudi (Prepared Rehmanniae Radix).
In cold weather, add Shengjiang (Fresh Ginger). For epigastric fullness, add Zhishi and Chuanlianzhong (Coptidis Rhizoma). In summer and autumn, add Shigao and Zhimu. In winter, add Guizhi.
Fang Feng Tong Sheng San (Saposhnikovia Universal Benefit Powder): Treats unresolved exterior and interior syndromes, used to harmonize.
Ingredients: Mahuang, Shigao, Jiegeng (Platycodonis Radix), Huangqin, Shanzhi (Gardeniae Fructus), Jingjie (Schizonepetae Herba), Huashi (Talcum), Baizhu, Guangpi (Citri Reticulatae Pericarpium), Gancao, Chuanxiong, Danggui Shen (Danggui Root Tip), Fangfeng, Dahuang, Mangxiao (Natrii Sulfas), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Baishao.
Zhu Li Er Chen Tang (Bamboo Juice Two-Chen Decoction): Treats phlegm stagnation in the middle jiao.
Ingredients: Shu Banxia (Processed Pinelliae Rhizoma), Baifuling, Guangpi, Gancao, Zhuli (Bamboo Juice).
For cold, add Shengjiang. For heat, add Shanzhi and Huanglian (Coptidis Rhizoma).
Dan Xing Tang (Arisaema with Bile Decoction): Treats excessive accumulation of phlegm-saliva.
Ingredients: Chen Danxing (Aged Arisaema with Bile), Guang Juhong (Citri Reticulatae Pericarpium Rubrum), Suzi (Perillae Fructus), Gouteng (Uncariae Ramulus cum Uncis), Gancao, Changpu (Acori Tatarinowii Rhizoma).
For severe interior heat, add Shanzhi and Huanglian. For Liver-Gallbladder heat, add Qingdai (Indigo Naturalis) and Haishi (Arionis Concha).
Niu Huang Qing Xin Wan (Calculus Bovis Heart-Clearing Pill): Treats phlegm confusing the heart orifices.
Ingredients: Zhen Niuhuang (Calculus Bovis), Xijiao (Rhinocerotis Cornu), Lingyangjiao (Saigae Tataricae Cornu), Chen Sha (Cinnabaris), Chen Danxing, Tianzhuhuang (Coicis Semen - Note: Usually Anemarrhenae or similar, but text says Tianzhuhuang which is Bambusae Caulis in some contexts or Coix, standard is often Coix or related, here strictly translating text term), Shexiang (Moschus), Bohe, Xionghuang (Realgar), Fangfeng, Bingpian (Borneolum Syntheticum).
Haizang Qing Xin Wan (Sea-Hoard Heart-Clearing Pill): Treats accumulated heat confusing the heart.
Ingredients: Huangbai (Phellodendri Cortex, 2 liang), Huanglian (Coptidis Rhizoma), Maidong (Ophiopogonis Radix, 1 liang each), Longnao (Borneolum).
Prepare pills with refined honey.