论中风 臌胀 痿症 食炭
天师曰∶远者，病得之年远，而徐以治之也。如中风已经岁月，臌胀已经年许，痿症而卧床者三
载，如癫痫食炭数
年是也。此等之症，卧床既久，起之最难卒效。然而治之得法，亦可起之于旦夕。如中风手足不仁，不
能起立行步者，但得胃气之健，而手足不致反张，便足 者，皆可起之。方用人参五两，白术半斤，薏仁
三两，肉桂三钱，附子一钱，茯苓一两，半夏一两，南星三钱，水二十碗，煎四碗。（〔批〕回生神丹。）
分作二次服，早晨服二碗，即卧，上以绵被盖之，令极热，汗出如雨，任其口呼大热，不可轻去其被，任
其自干。再用后二碗晚服，亦盖之如前，不可轻去其被。一夜必将湿气冷汗尽行外出，三日可步履矣。后
用八味地黄丸四料为丸，服完，永不再发。
肢胀经年而不死者。必非水臌。水臌之症，不能越于两年，未有皮毛不流水而死者。今二三年不死，
非水臌，乃气臌、血臌、食臌、虫臌也。但得小便利而胃口开者，俱可治。方用茯苓五两；人参一两，雷
丸三钱，甘草二钱，萝卜子一两、白术五钱，大黄一两，附子一钱，水十碗，煎汤二碗。（〔批〕消臌至
神汤。）早服一碗，必然腹内雷鸣，少顷必下恶物满桶，急拿出倾去，再换桶；即以第二碗继之，又大泻
大下，至黄昏而止，淡淡米饮汤饮之，不再泻。然人弱极矣。方用人参一钱，茯苓五钱，薏仁一两，山药
四钱，陈皮五分，白芥子一钱，水煎服。（〔批〕回春健脾丹。）一剂即愈。忌食盐者一月，犯则无生机
矣。先须断明，然后用药治之。
痿症久不效者，阳明火烧尽肾水也。然能不死长存者何。盖肾水虽涸，而肺金终得胃气以生之，肺金
有气，必下生肾水，肾虽干枯，终有露气，夜润肾经，常有生机，故存而不死也。方用麦冬半斤，熟地一
斤，元参七两，五味子一两。水二十碗，煎六碗。（〔批〕起废神丹。）早晨服三碗，下午服二碗，半夜
服二碗，一连二日，必能坐起。后改用熟地八两，元参
三两，麦冬四两，北五味三钱，山茱萸四钱，牛膝一两。水十碗，煎二碗。（〔批〕壮体丹。）早晨
一碗。晚服一碗，十日即能行步，一月即平复如旧矣。盖大滋其肺肾之水，则阳明之火不消而自消矣。
癫痫之症，亦累岁经年而未愈，乃痰入于心窍之间而不能出。喜食炭者，盖心火为痰所迷，不得发
泄，炭乃火之余，与心火气味相投，病患食之，竟甘如饴也。方用人参一两，南星三钱，鬼箭三钱，半
夏二钱，附子一钱，肉桂一钱，柴胡三钱，白芍三钱，菖蒲二钱，丹砂末二钱。（〔批〕启迷奇效汤。）
先将前药煎汤二碗，分作二服，将丹砂一半调入药中，与病患服之。彼不肯服，即以炭饴之，服了与汝炭
吃，彼必欣然服之索炭也，不妨仍与之炭。第二服亦如前法，则彼不若前之欣然，当令人急灌之，不听，
不妨打之以动其怒气，怒则肝木火起以生心，反能去痰矣，皆绝妙奇法，世人未见未闻者，吾救世心切，不
觉尽传无隐。此皆远治之法，最宜熟记。
张公曰；中风之有胃气，则脾健可知。但脾胃俱有根源，何难用药。天师所用之药，又是健脾之品，使
脾一旺，则气益旺可知。气旺则湿自难留。方中又全是去湿之药，湿去则痰消。又有消痰之品，痰消则寒
自失。而又有补火之剂，所以奏功也。然非大剂煎饮，则一 土安能止汪洋之水，而重筑其堤岸哉。
臌胀之症，年久不死，原是可救，所以用下药以成功，非土郁之中固有水积，若果水症，早早死矣，
安能三年之未死也。然而，虽非水症。而水必有壅阻之病。方中仍用茯苓为君，以雷丸、大黄为佐，不治
水而仍治水，所以奏功如神也。
痿症久不死，虽是肺经之润，亦由肾经之有根也。倘肾水无根，纵肺金有夜气之生，从何处生
起，吾见立槁而已矣。惟其有根，所以不死。故用大剂补肾之品，因之而病愈，亦因其有根可救而救之也。
癫痫之病，虽时尝食物，肠中有水谷之气，可以养生不死，亦其心之不死也。倘心早死，即无病之
人，食谷亦亡。况有癫痫之症，吾见其早亡，不能待于今日。惟其中心不死，不过胃痰有碍，一时癫痫，
其脾胃犹有生气也。故用人参以治心，加附子、菖蒲、肉桂温中以祛邪，加柴胡舒肝平木，加南星、鬼
箭、半夏逐痰荡邪，加丹砂定魂镇魄，自然邪气少而正气多也。皆天师未言，而予发其奥妙如此。方则天
师至神至奇，予不能赞一辞也。
华君曰∶予无此之多，各有小异，不必尽言、只言异处可也。臌胀方不同，传余之方，乃用甘遂三
钱，牵牛三钱，水三碗，煎半碗服之，则泻水一桶。泻极，用人参一钱，茯苓三钱，薏仁一两，山药五
钱，芡实一两，陈皮五分，白芥子一钱，水煎服。（〔批〕健脾分水汤。）一剂即愈，亦忌盐一月。
痿症方亦不同。方用元参一两，熟地三两，麦冬四两，山茱萸一两，沙参三两，五味子五钱，水煎
服。（〔批〕起痿神汤。）十日即可起床。予曾亲试之，神验。不知天师何故不传此方，而更传新方也。
想天道之薄而人身亦殊，用药更重也。
癫痫余未传方，然别有治癫之方，亦奇妙。方用柴胡五钱，白芍三
两，人参一两，半夏三钱，白芥子五钱，南星三钱，用牛胆制过者。附子一钱，茯神三钱，菖蒲三钱，水十
碗，煎二碗。（〔批〕天师曰∶亦奇妙方也，二方相较，彼更奇于此。）先与一碗服之，必倦怠，急再灌
一碗，必熟睡。有睡至一二日者，切不可惊醒，如死人一般，任其自醒。醒来病如失，即索饮
食，说从前之病，不可即与饮食，饿半日，与之米粥汤，内加人参五分，陈皮五分，煎粥与之。再用人参
三钱，白术一两，甘草一钱，茯苓五钱，陈皮五分，白芥子五钱，水煎与之，彼必欣然自服。（〔批〕加
减六君子汤。）服后再睡，亦听其自醒，则永不再发。亦奇妙法也。
天师曰∶此方未尝不佳妙。
[Background Information]
Book: Shishi Milu (Secret Records of the Stone Chamber)
Author: Chen Shiduo
Dynasty: Qing
Chapter: Yuan Zhi Fa (Distant Treatment Methods)
Category: Comprehensive
On Stroke, Distension, Flaccidity Syndrome, and Eating Charcoal
The Heavenly Master said: "What is meant by 'distant' is that the illness has persisted for a long time, requiring gradual treatment. For example, stroke lasting over a year, distension (abdominal swelling resembling a drum) persisting for more than a year, flaccidity syndrome (a condition characterized by limb weakness and atrophy, potentially leading to bedridden states) keeping one in bed for three years, as well as epilepsy (a disorder characterized by recurrent seizures) and pica (specifically eating charcoal) lasting for several years. These conditions, having been bedridden for a long time, are difficult to cure quickly. However, if the treatment method is appropriate, recovery can be achieved in a short period. For instance, in stroke patients with numbness and paralysis of the limbs who cannot stand or walk, as long as the Stomach Qi (functional activity of the stomach) is strengthened, the limbs will not exhibit opisthotonos (backward arching of the body), and such patients can recover. The prescription consists of Ren Shen (Ginseng Radix et Rhizoma) 5 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 0.5 jin, Yi Yi Ren (Coicis Semen) 3 qian, Rou Gui (Cinnamomi Cortex) 3 qian, Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian, Fu Ling (Poria) 1 liang, Ban Xia (Pinelliae Rhizoma) 1 liang, Nan Xing (Arisaematis Rhizoma) 3 qian. Add 20 bowls of water, decoct until 4 bowls remain. (Commentary: Hui Sheng Shen Dan - Divine Elixir of Returning Life.) Divide into two doses. Take 2 bowls in the morning, then lie down, cover with a cotton quilt to induce extreme heat, causing profuse sweating like rain. Even if the patient exhales hot air, do not remove the quilt lightly; allow it to dry naturally. Take the remaining 2 bowls in the evening, covering as before. Within one night, dampness and cold sweat will be completely expelled, and walking can resume within three days. Subsequently, take Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill) prepared from four doses of pills. After finishing the course, the disease will never recur.
If limb distension persists for years without death, it is certainly not Water Distension (edema primarily caused by fluid retention). In cases of Water Distension, survival rarely exceeds two years, and death does not occur without moisture exuding from the skin pores. Since the patient has survived for two or three years, it is not Water Distension, but rather Qi Distension (abdominal distension due to qi stagnation), Blood Distension (abdominal distension due to blood stasis), Food Distension (abdominal distension due to food accumulation), or Worm Distension (abdominal distension due to parasitic infection). If urination becomes unobstructed and appetite opens, all these conditions are treatable. The prescription uses Fu Ling (Poria) 5 liang, Ren Shen (Ginseng Radix et Rhizoma) 1 liang, Lei Wan (Holaspis) 3 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 2 qian, Luo Bo Zi (Raphani Semen) 1 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 5 qian, Da Huang (Rhei Radix et Rhizoma) 1 liang, Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian. Add 10 bowls of water, decoct until 2 bowls of soup remain. (Commentary: Xiao Gu Zhi Shen Tang - Divine Soup for Eliminating Distension.) Take 1 bowl in the morning; there will inevitably be borborygmus in the abdomen, followed by the expulsion of foul matter filling a bucket. Remove and discard it immediately, replace the bucket, and continue with the second bowl. This will cause severe diarrhea until dusk. Drink light rice water, and diarrhea will cease. At this point, the person is extremely weak. Use Ren Shen (Ginseng Radix et Rhizoma) 1 qian, Fu Ling (Poria) 5 qian, Yi Yi Ren (Coicis Semen) 1 liang, Shan Yao (Dioscoreae Rhizoma) 4 qian, Chen Pi (Citri Reticulatae Pericarpium) 5 fen, Bai Jie Zi (Sinapis Semen) 1 qian. Decoct in water and take. (Commentary: Hui Chun Jian Pi Dan - Spring-Returning Spleen-Strengthening Elixir.) One dose results in cure. Avoid salt for one month; violation leads to no hope. Diagnosis must be confirmed before medication.
Flaccidity syndrome that fails to respond to long-term treatment is due to Yangming Stomach Fire exhausting Kidney Water. However, the reason for prolonged survival without death lies in the fact that although Kidney Water is dried up, Lung Metal ultimately receives nourishment from Stomach Qi to generate itself. When Lung Metal has Qi, it necessarily generates Kidney Water downwards. Although the Kidneys are dry, they still receive nightly dew-like nourishment, maintaining vitality, thus surviving. The prescription uses Mai Dong (Ophiopogonis Tuber) 0.5 jin, Shu Di Huang (Rehmanniae Radix Praeparata) 1 jin, Yuan Shen (Scrophulariae Radix) 7 liang, Wu Wei Zi (Schisandrae Fructus) 1 liang. Add 20 bowls of water, decoct until 6 bowls remain. (Commentary: Qi Fei Shen Dan - Divine Elixir for Reviving the Disabled.) Take 3 bowls in the morning, 2 bowls in the afternoon, and 2 bowls at midnight. Continue for two consecutive days, and sitting up should be possible. Thereafter, change to Shu Di Huang (Rehmanniae Radix Praeparata) 8 liang, Yuan Shen (Scrophulariae Radix) 3 liang, Mai Dong (Ophiopogonis Tuber) 4 liang, Bei Wu Wei Zi (Schisandrae Fructus) 3 qian, Shan Zhu Yu (Corni Fructus) 4 qian, Niu Xi (Achyranthis Bidentatae Radix) 1 liang. Add 10 bowls of water, decoct until 2 bowls remain. (Commentary: Zhuang Ti Dan - Body-Strengthening Elixir.) Take 1 bowl in the morning and 1 bowl in the evening. Walking can resume in ten days, and full recovery occurs within one month. By greatly nourishing Lung and Kidney Water, Yangming Fire extinguishes itself without direct intervention.
Epilepsy persisting for years is due to phlegm entering the orifices of the Heart and being unable to exit. Patients who crave eating charcoal do so because Heart Fire is confused by phlegm and cannot vent. Charcoal, being residue of fire, shares affinity with Heart Fire's nature. When patients eat it, it tastes sweet like syrup. The prescription uses Ren Shen (Ginseng Radix et Rhizoma) 1 liang, Nan Xing (Arisaematis Rhizoma) 3 qian, Gui Jian (Aruncus chinensis branch) 3 qian, Ban Xia (Pinelliae Rhizoma) 2 qian, Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian, Rou Gui (Cinnamomi Cortex) 1 qian, Chai Hu (Bupleuri Radix) 3 qian, Bai Shao (Paeoniae Radix Alba) 3 qian, Chang Pu (Acori Tatarinowii Rhizoma) 2 qian, Dan Sha (Cinnabar) powder 2 qian. (Commentary: Qi Mi Qi Xiao Tang - Miraculous Soup for Awakening Confusion.) Decoct the first set of herbs into 2 bowls of soup, divide into two doses. Mix half the Cinnabar into the medicine and administer to the patient. If the patient refuses, tempt them with charcoal, promising charcoal after taking the medicine. They will likely accept happily and demand charcoal; comply. Repeat for the second dose. The patient may be less cooperative; force administration if necessary. Striking them to induce anger may help, as anger causes Liver Wood Fire to rise and generate Heart Fire, which helps dispel phlegm. These are exquisite and unique methods unseen by the world. Driven by urgency to save lives, I transmit them without reservation. These are distant treatment methods, best memorized.
Master Zhang said: If a stroke patient retains Stomach Qi, Spleen health is evident. Since both Spleen and Stomach have roots, medication is straightforward. The Heavenly Master's prescription contains spleen-strengthening herbs; once the Spleen flourishes, Qi strengthens. Strong Qi prevents dampness retention. The formula is rich in dampness-dispelling herbs; removing dampness eliminates phlegm. Phlegm-resolving agents further eliminate cold. Additionally, fire-warming agents contribute to efficacy. Without large-dose decoctions, how could a small amount of earth stop vast waters and rebuild dikes?
Distension persisting for years without death is curable. Downward-purgative herbs achieve success. This is not inherent water accumulation in Earth stagnation; true Water Distension would have caused early death, not survival for three years. However, even if not pure Water Distension, water obstruction exists. Using Fu Ling (Poria) as the sovereign herb, supported by Lei Wan (Holaspis) and Da Huang (Rhei Radix et Rhizoma), treats water indirectly, achieving miraculous results.
Flaccidity syndrome surviving long-term benefits from Lung Meridian moistening and Kidney Meridian rootfulness. Without Kidney Water roots, even Lung Night Qi cannot generate life; only withering remains. Rootfulness ensures survival. Large-dose Kidney-tonifying herbs facilitate recovery by addressing this root.
Epilepsy patients survive due to intestinal digestion providing nutrients and undying Heart Qi. If the Heart died, even healthy individuals would perish upon eating. Epileptic patients would have died earlier. Survival indicates intact Heart Qi, merely obstructed by Stomach phlegm temporarily. Thus, Ren Shen (Ginseng Radix et Rhizoma) treats the Heart; Fu Zi (Aconiti Lateralis Radix Praeparata), Chang Pu (Acori Tatarinowii Rhizoma), and Rou Gui (Cinnamomi Cortex) warm the middle and expel evil; Chai Hu (Bupleuri Radix) soothes the Liver; Nan Xing (Arisaematis Rhizoma), Gui Jian (Aruncus chinensis branch), and Ban Xia (Pinelliae Rhizoma) drive out phlegm and evil; Dan Sha (Cinnabar) calms the soul. This balances pathogenic factors and righteous Qi. These insights reveal the profound mechanisms behind the Heavenly Master's divine and unique prescriptions.
Master Hua said: My formulas differ slightly. Regarding Distension, my transmitted formula uses Gan Sui (Kansui Radix) 3 qian, Qian Niu (Pharbitidis Semen) 3 qian, decocted in 3 bowls of water to 0.5 bowl. It purges one bucket of water. Post-purge, use Ren Shen (Ginseng Radix et Rhizoma) 1 qian, Fu Ling (Poria) 3 qian, Yi Yi Ren (Coicis Semen) 1 liang, Shan Yao (Dioscoreae Rhizoma) 5 qian, Qian Shi (Euryales Semen) 1 liang, Chen Pi (Citri Reticulatae Pericarpium) 5 fen, Bai Jie Zi (Sinapis Semen) 1 qian. Decoct and take. (Commentary: Jian Pi Fen Shui Tang - Spleen-Strengthening Water-Separating Soup.) One dose cures; avoid salt for one month.
For Flaccidity Syndrome, my formula uses Yuan Shen (Scrophulariae Radix) 1 liang, Shu Di Huang (Rehmanniae Radix Praeparata) 3 liang, Mai Dong (Ophiopogonis Tuber) 4 liang, Shan Zhu Yu (Corni Fructus) 1 liang, Sha Shen (Glehniae Radix or Adenophorae Radix) 3 liang, Wu Wei Zi (Schisandrae Fructus) 5 qian. Decoct and take. (Commentary: Qi Wei Shen Tang - Divine Soup for Reviving Flaccidity.) Bedridden status resolves in ten days. I tested it personally with miraculous results. I wonder why the Heavenly Master did not transmit this but chose a new one. Perhaps heavenly principles vary with human constitutions, necessitating heavier dosages.
I did not transmit an Epilepsy formula, but another exists. It uses Chai Hu (Bupleuri Radix) 5 qian, Bai Shao (Paeoniae Radix Alba) 3 liang, Ren Shen (Ginseng Radix et Rhizoma) 1 liang, Ban Xia (Pinelliae Rhizoma) 3 qian, Bai Jie Zi (Sinapis Semen) 5 qian, Nan Xing (Arisaematis Rhizoma) 3 qian (processed with ox bile), Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian, Fu Shen (Poria with Hostwood) 3 qian, Chang Pu (Acori Tatarinowii Rhizoma) 3 qian. Decoct in 10 bowls of water to 2 bowls. (Commentary: Heavenly Master says: Also a miraculous formula; this one is more unique than the previous.) Administer 1 bowl initially; drowsiness ensues. Immediately administer the second bowl; deep sleep follows. Sleep may last 1-2 days; do not wake them abruptly, let them wake naturally like the dead. Upon waking, the illness vanishes; they request food. Do not feed immediately; fast for half a day, then give rice gruel with Ren Shen (Ginseng Radix et Rhizoma) 5 fen and Chen Pi (Citri Reticulatae Pericarpium) 5 fen. Follow with Ren Shen (Ginseng Radix et Rhizoma) 3 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 1 liang, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian, Fu Ling (Poria) 5 qian, Chen Pi (Citri Reticulatae Pericarpium) 5 fen, Bai Jie Zi (Sinapis Semen) 5 qian. Decoct and give. (Commentary: Modified Liu Jun Zi Tang - Six Gentlemen Decoction Modification.) They will happily take it. Sleep again, wake naturally, and the disease will not recur. A miraculous method.
The Heavenly Master said: This formula is indeed excellent and miraculous."