论曰。经云风者百病之始。善行而数变。行者动也。风本生于热。以热为本。以风为标。凡言风者热也。
叔和云。热则生风。冷生气。是以热则风动。宜以静胜其躁。是养血也。治须少汗。亦宜少下。多汗则虚其卫。
多下则损其荣。汗下各得其宜。然后宜治在经。虽有汗下之戒。而有中脏中腑之说。中腑者。宜汗之。中脏者。
宜下之。此虽合汗下。亦不可过也。仲景曰。汗多则亡阳。下多则亡阴。亡阳则损其气。亡阴则损其形。经曰
血气者人之神。不可不谨养也。初谓表里不和。须汗下之。表里已和。是宜治之在经也。其中腑者。面加五色。
有表证。脉浮而恶风恶寒拘急不仁。或中身之后。或中身之前。或中身之侧。皆曰中腑也。其治多易。中脏者。
唇吻不收。舌不转而失音。鼻不闻香臭。耳聋而眼瞀。大小便秘结。皆曰中脏也。其治多难。经曰六腑不和。
流经为痈。五脏不和。九窍不通。若外无留结。内无不通。必知在经也。初证既定。宜以大药养之。当顺时令
而调阴阳。安脏腑而和荣卫。察病机。审气宜。而少有不愈者。若风中腑者。先以加减续命汤。随证发其表。
若忽中脏者。则大便多秘涩。宜以三化汤通其滞。表里证已定。别无他变。故以大药和治之。大抵中腑者。多
着四肢。中脏者。多滞九窍。虽中腑者多兼中脏之证。至于舌强失音。久服大药。能自愈也。有中风湿者。
夏月多有之。其证身重如山。不能转侧。宜服除湿去热之药治之。不可用针。可用灸。今具六经续命汤。通治
八风五痹痿厥等疾。以一岁为总。以六经为别。春夏加石膏知母黄芩。秋冬加桂附。又于六经别药。随证细分
加减。自古名医。不能越此。
凡觉中风。必先审六经之候。慎勿用大热药乌附之类。故阳剂刚胜。积火燎原。为消狂疮肿之属。则天癸
竭而荣卫涸。是以中风有此诫。故经所谓邪风之至。疾如风雨。易曰。挠万物者。莫疾乎风。若感之浅者留于肌
肤。感之深者达于骨髓。盖祸患之机。藏于细微。非常人之豫见。及其至也。虽智者不能善其后。是以圣人之
教下。皆谓之虚邪贼风。避之有时。故中风者。俱有先兆之证。凡人如觉大拇指及次指麻木不仁。或手足不用。
或肌肉蠕动者。三年内必有大风之至。经曰肌肉蠕动。名曰微风。宜先服八风散愈风汤天麻丸。各一料为效。
故手大指次指手太阴阳明经。风多着此经也。先服祛风涤热之剂。辛凉之药。治内外之邪。是以圣人治未病。
不治已病。又曰。善治者治皮毛。是止于萌芽也。故初成获愈。固久者伐形。是治病之先也。
中风之人。如小便不利。不可以药利之。既得自汗。则津液外亡。小便自少。若利之。使荣卫枯竭。无以
制火。烦热愈甚。当候热退汗止。小便自行也。兼此证乃阳明。大忌利小便。须当识此。中风之人能食者。
凡中风病。多能食。盖甲己化土。脾盛故能食。由是多食则脾气愈盛。土克制肾水。水亏则病增剧也。病宜广
服药。不欲多食。病能自愈。中风多食。风木盛也。盛则克脾。脾受敌。求助于食。经曰实则梦与。虚则梦取。
是也。当泻肝木。治风安脾。脾安则食少。是其效也。
中风之人。不宜用龙麝犀珠。譬之提铃巡于街。使盗者伏而不出。益使风邪入于骨髓。如油入面。莫能出
也。此之类焉。若痰潮不省。昏愦不知事。宜用药下其痰涎。故风者乃百病之长。庸可忽诸。
小续命汤
麻黄（去节） 人参 黄芩 芍药 防己 桂枝 川芎 甘草（各一两） 防风（一两半） 附子（半两）
杏仁（一两）
上除附子杏仁外。捣为粗末。后入二味令匀。每服五七钱。
水一盏半。生姜五片。煎至一盏。去滓稍热服。食前。
凡中风。不审六经之加减。虽治之不能去其邪也。内经云。开则淅然寒。闭则热而闷。知暴中风邪。宜先
以加减续命汤。随证治之。
中风无汗恶寒。麻黄续命主之。
麻黄 防风 杏仁
根据本方添加一倍。宜针太阳至阴出血。昆仑阳跷。
中风有汗恶风。桂枝续命主之。
桂枝 芍药 杏仁
根据本方添加一倍。宜针风府。以上二证。皆太阳经中风也。
中风无汗身热。不恶寒。白虎续命主之。
石膏 知母（一料中各加二两） 甘草（根据本方加一倍）
中风有汗身热。不恶风。葛根续命主之。
葛根（二两） 桂枝 黄芩（根据本方加一倍）
宜针陷谷刺厉兑。针陷谷者。去阳明之贼。刺厉兑者。泻阳明经之实也。以上二证。阳明经中风也。
中风无汗身凉。附子续命主之。
附子（加一倍） 干姜（加二两） 甘草（加三两）
宜刺隐白穴。去太阴之贼也。此一证太阴经中风也。
中风有汗无热。桂枝续命主之。
桂枝 附子 甘草（根据本方加一倍）
宜针太溪。此证少阴经中风也。
中风六证混淆。系之于少阳厥阴。或肢节挛痛。或麻木不仁。宜羌活连翘续命主之。
小续命（八两） 加羌活（四两） 连翘（六两）
古之续命。混淆无六证之别。今各分经疗治。又分经针刺
法。厥阴之井大敦。刺以通其经。少阳之经绝骨。灸以引其热。是针灸同象法。治之大体也。
中风外无六经之形证。内无便溺之阻格。知血弱不能养筋。故手足不能运动。舌强不能言语。宜养血而筋
自荣。大秦艽汤主之。
秦艽（三两） 甘草（二两） 川芎（二两） 当归（二两） 白芍药（二两） 细辛（半两） 川羌活
防风 黄芩（各一两） 石膏（二两） 吴白芷（一两） 白术（一两） 生地黄（一两） 熟地黄（一两）
白茯苓（一两） 川独活（二两）
上十六味 。每服一两。水煎去渣。温服无时。如遇天阴。加生姜煎七八片。如心下痞。每两加枳实一钱
同煎。
中风外有六经之形证。先以加减续命汤。随证治之。内有便溺之阻格。复以三化汤主之。
浓朴 大黄 枳实 羌活（各等分）
上 如麻豆大。每服三两。水三升。煎至一升半。终日服之。以微利为度。无时。法曰四肢不举。俗曰瘫
痪。故经所谓太过则令人四肢不举。又曰土太过则敦阜。阜高也。敦浓也。既浓而又高。则令除去。此真所谓膏
粱之疾。非肝肾经虚。何以明之。经所谓三阳三阴发病。为偏枯痿易。四肢不举。王注曰。三阴不足。以发偏
枯。三阳有余。则为痿易。易谓变易。常用而痿弱无力也。其治则泻。令气弱阳衰土平而愈。或三化汤调胃承
气汤。选而用之。若脾虚则不用也。经所谓土不及则卑陷。卑下也。陷坑也。故脾病四肢不用。四肢皆禀气于
胃。而不能至经。必因于脾乃得禀受也。今脾不能与胃行其津液。四肢不能禀水谷气。气日以衰。脉道不利。
筋骨肌肉皆无气以生。故不用焉。其治可补。十全散加减四物。去邪留正。
愈风汤 中风证内邪已除。外邪已尽。当服此药。以行导诸经。久服大风悉去。纵有微邪。只从此药
加减治之。然治病之
法。不可失其通塞。或一气之微汗。或一旬之通利。如此为常治之法也。久则清浊自分。荣卫自和。如初觉风
动。服此不致倒仆。
羌活 甘草 防风 蔓荆子 川芎 细辛 枳壳 人参 麻黄 甘菊 薄荷 枸杞子 当归 知母 地骨皮
黄 独活 杜仲 吴白芷 秦艽 柴胡 半夏 前胡 浓朴 熟地黄 防己（各二两） 茯苓 黄芩（各三两）
石膏（四两） 芍药（三两） 生地黄 苍术（各四两） 桂枝（一两） 以上三十三味通七十四两
上 。每服一两。水二盏。煎至一盏。去渣温服。如遇天阴。加生姜煎。空心一服。临卧再煎药渣服。俱
要食远服。空心一服。 下二丹丸。为之重剂。临卧一服。 下四白丹。为之轻剂。动以安神。静以清肺。
假令一气之微汗。用愈风汤三两。麻黄一两。均作四服。一服加生姜五片。空心服。以粥投之。得微汗则佳。
如一旬之通利。用愈风三两。大黄一两。亦均作四服。如前煎。临卧服。得利则妙。常服之药。不可失四时之
转。如望春大寒之后。加半夏二两。通四两。柴胡二两。通四两。人参二两。通四两。谓迎而夺少阳之气也。
初夏之月。加石膏二两。通六两。黄芩二两。通五两。知母二两。通四两，谓迎而夺阳明之气也。季夏之月。
加防己二两。通四两。白术二两。茯苓二两。通五两。谓胜脾土之湿也。初秋大暑后。加浓朴二两。通四两。
藿香二两。桂一两。通二两。谓迎而夺太阴之气也。霜降之后望冬。加附子一两。桂一两。通二两。当归二两。
通四两。谓胜少阴之气也。得春减冬。四时类此。虽立法于四时之加减。又宜临病之际。审病之虚实热寒。土
地之宜。邪气之多少。此药具七情六欲四气。无使五脏偏胜。及不动于荣卫。如风秘服之。则永不燥结。如久
泻服之。则能自调。初觉风气。便能服此药。及新方中天麻丸各一料。相为表里。治未病之胜药也。及已病者。更宜常
服。无问男子妇人。及小儿惊痫搐急慢惊风等病。服之神效。如解利四时伤风。随四时加减法。又疗脾肾虚。
筋弱语言难。精神昏愦。及治内弱风湿。内弱者。乃风湿火。先体重者。乃风湿。土余内弱之为病。或一臂肢
体偏枯。或肥而半身不遂。或恐而健忘。喜以多思。故思忘之道。皆情不足也。是以心乱则百病生。心静则万
病悉去。故此能安心养神。调阴阳无偏胜及不动荣卫。
四白丹 能清肺气养魄。谓中风者。多昏冒。气不清利也。
白术（半两） 白芷（一两） 白茯苓（半两） 白檀（一两半） 人参（半两） 知母（三钱） 缩砂
仁（半两） 羌活（二钱半） 薄荷（三钱半） 独活（二钱半） 防风 川芎（各五钱） 细辛（二钱）
甘草（五钱） 甜竹叶（一两） 香附子（五钱炒） 龙脑（半钱另研） 麝香（一字另研） 牛黄（半钱）
藿香（一钱半）
上件二十味。计八两六钱一字为细末。炼蜜为丸。每两作十丸。临卧嚼一丸。分五七次嚼之。上清肺气。
下强骨髓。
二丹丸 治健忘。养神定志和血。内安心神。外华腠理。
丹参（一两半） 丹砂（二钱为衣） 远志（去心半两） 茯神（一两） 人参（五钱） 菖蒲（五钱）
熟地黄（一两半） 天门冬（一两半去心） 麦门冬（一两去心） 甘草（一两）
上为细末。炼蜜为丸。如桐子大。每服五十丸。至一百丸。空心食前常服安神定志。一药清肺。一药安神。
故清中清者归肺以助天真。清中浊者。坚强骨髓。血中之清。荣养于神。血中之浊。荣华腠理。如素有痰。久
病中风。津液涌溢在胸中。气所不利。用独圣散吐之。后用利气泻火之剂。本方在后。
泻青丸 治中风自汗昏冒。发热不恶寒。不能安卧。此是风热烦躁。
当归 龙胆 川芎 栀子 羌活 大黄 防风（各等分）
上为细末。炼蜜为丸。如弹子大。每服一丸。竹叶汤化下。
天麻丸 系新方中。
天麻（三两酒浸三日曝干秤） 牛膝（六两同上浸） 当归（十两） 杜仲（七两炒去丝） 玄参（六两）
羌活（十两） 萆 （六两别碾为细末秤） 生地黄（十六两） 附子（一两）
上为细末。炼蜜为丸。如桐子大。常服五七十丸。病大至百丸。空心食前温酒或白汤下。平明服药。至日
高饥则止服药。大忌壅塞。失于通利。故服药半月。稍觉壅。微以七宣丸轻疏之。使药再为用也。牛膝萆 治
筋骨。杜仲治筋骨相着。天麻羌活利风之胜药。当归地黄养血能和荣卫。玄参主用。附子佐之。行经也。
独圣散 治诸风膈实。诸痫痰涎。津液涌溢。杂病亦然。
瓜蒂（一两）
上 如麻豆大。炒令黄色。为细末。每服量虚实久新。或三钱药末。茶一钱。酸齑汁一盏调下。若用吐法。
天气晴明。阴晦毋用。如病卒暴者。不拘于此法。吐时辰巳午前。故内经曰。平旦至日中。天之阳。阳中之阳
也。论四时之气。仲景曰。大法春宜吐。是天气在上。人气亦在上。一日之气。寅卯辰之候也。故宜早不宜夜
也。先令病患隔夜不食。服药不吐。再用热齑水投之。如吐风痫病者。加全蝎半钱微炒。如有虫者。加狗油五
七点。雄黄末一钱。甚者加芫花末半钱。立吐其虫出。如湿肿满者。加赤小豆末一钱。故此不可常用。大要辨
其虚实。实则瓜蒂散。虚则栀子豉汤。满加浓朴。不可一概用之。吐罢可服降火利气安神定志之剂。治风痫病
不能愈者。从浓朴丸宜春秋加添外。又于每一料中。加人参 菖蒲 茯神（去木各一两半） 上根据浓朴丸春秋
加添法。和剂服饵。浓朴丸方。在吐论中。
防风通圣散
防风 川芎 当归 芍药 大黄 芒硝 连翘 薄荷
麻黄（不去节各半两） 石膏 桔梗 黄芩（各一两） 白术 山栀子 荆芥穗（各二钱半） 滑石（三两）
甘草（二两）
上为粗末。每服一两。生姜同煎。温服。日再服。劳汗当风。汗出为 。郁乃痤。劳汗出于玄府。脂液所
Commentary states: The medical classics record that wind is the beginning of all diseases. Wind moves freely and changes frequently. "Movement" implies motion. The essence of wind originates from heat, with heat as the root and wind as the manifestation. Whenever "wind" is mentioned, it actually refers to heat pathogen.
Wang Shuhe said: Heat generates wind, while cold generates qi. Therefore, heat causes wind movement, and one should use stillness to overcome restlessness; this is the principle of nourishing blood. Treatment requires avoiding excessive sweating and also appropriating mild purgation. Excessive sweating will weaken Wei Qi (Defensive Qi), while excessive purgation will damage Ying Blood (Nutritive Blood). Both sweating and purgation must be applied appropriately before treating at the meridian level. Although there are warnings against sweating and purgation, there remains a distinction between involvement of the Fu organs and the Zang organs. For disease involving the Fu organs, sweating is appropriate; for disease involving the Zang organs, purgation is appropriate. While this aligns with sweating and purgation principles, excess must be avoided. Zhang Zhongjing stated: Excessive sweating leads to loss of Yang Qi, while excessive purgation leads to loss of Yin fluids. Loss of Yang damages vital energy, and loss of Yin damages the physical form. The classics state: Blood and Qi are the spirit of humans and must be carefully nurtured. Initially, if exterior and interior are disharmonious, sweating or purgation is required; once exterior and interior are harmonized, treatment should focus on the meridians. In cases of Fu organ involvement, the face may show five colors, with exterior signs such as floating pulse, aversion to wind and cold, limb stiffness, numbness, and insensitivity. Whether affecting the posterior, anterior, or lateral aspects of the body, this is called "Wind striking the Fu organs." This condition is relatively easy to treat. In cases of Zang organ involvement, the lips and mouth may hang loose, the tongue may be immobile causing aphasia, the nose may lose smell, ears may become deaf, eyes may be dim, and bowel/bladder obstruction may occur. This is called "Wind striking the Zang organs." This condition is difficult to treat. The classics state: Disharmony in the six Fu organs leads to sores in the meridians; disharmony in the five Zang organs leads to blockage of the nine orifices. If there is no stagnation externally and no blockage internally, the disease is certainly located in the meridians. Once initial symptoms are confirmed, it is appropriate to use major tonics to nourish. One should adjust Yin and Yang according to seasons, settle the Zang and Fu organs, and harmonize Ying and Wei. By examining pathogenesis and assessing Qi suitability, few cases fail to heal. If wind strikes the Fu organs, first use Modified Xuming Decoction to release the exterior according to symptoms. If suddenly striking the Zang organs, stool is often constipated; Sanhua Decoction is appropriate to clear stagnation. Once exterior and interior signs are stable without other changes, major tonics are used for harmonious treatment. Generally, wind striking the Fu organs affects the four limbs, while wind striking the Zang organs blocks the nine orifices. Although Fu organ involvement often includes Zang organ symptoms, conditions like stiff tongue and aphasia can heal with long-term use of major tonics. Cases of wind-dampness are common in summer, presenting with heaviness like sitting in mountains, inability to turn over, treated with dampness-dispelling and heat-clearing herbs. Acupuncture is contraindicated; moxibustion is suitable. Now listing the Six Meridian Xuming Decoctions to generally treat Eight Winds, Five Obstructions, Atrophy, and Cold/Heat disorders. The annual cycle is the general framework, differentiated by six meridians. Add Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma), Huang Qin (Scutellariae Radix) in spring and summer; add Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Praeparata) in autumn and winter. Further sub-divide and modify based on specific meridian prescriptions. Ancient famous physicians could not exceed this scope.
Whenever stroke is suspected, one must first examine the six meridian patterns and strictly avoid using hot drugs like Wu Tou (Aconiti Radix) and Fu Zi (Aconiti Lateralis Radix Praeparata). Yang agents are too potent; accumulated fire spreads like a prairie fire, leading to conditions like Xiao Ke (Wasting and Thirsting), Kuang Zheng (Mania), Chuang Zhong (Sores and Swellings), causing Tian Gui (Menstruation/Reproductive Essence) to exhaust and Ying-Wei to dry up. Hence this warning for stroke. As the classics say, evil wind arrives swiftly like wind and rain. The I Ching says: Nothing agitates things faster than wind. If invasion is shallow, pathogens remain in skin and muscles; if deep, they reach bone marrow. Disaster hides in subtleties, unseen by ordinary people. When it arrives, even the wise cannot manage the aftermath. Thus, sages teach avoiding "empty evil and thief wind" at proper times. Stroke always has prodromal signs. If one feels numbness or insensitivity in the thumb and index finger, or limb immobility, or muscle twitching, severe wind disease will likely occur within three years. The classics state: Muscle twitching is called "Minor Wind." It is appropriate to first take Ba Feng San (Eight Wind Powder), Yu Feng Tang (Wind-Dispelling Decoction), and Tian Ma Wan (Gastrodia Pill), each one dose for efficacy. This is because the thumb and index finger belong to the Hand Taiyin Lung Meridian and Hand Yangming Large Intestine Meridian, where wind pathogens often lodge. First take wind-dispelling and heat-purging agents, acrid-cool herbs to treat internal and external pathogens. Thus, sages treat disease before it arises, not after. It is also said: A good healer treats the hair and skin, stopping disease at its萌芽 (bud stage). Early cure prevents long-term damage to the form, which is the priority in treatment.
For stroke patients with difficulty urinating, do not use diuretic drugs. Since spontaneous sweating has occurred, body fluids are lost externally, and urine volume naturally decreases. Diuretics would deplete Ying-Wei, failing to control fire, worsening irritability and heat. Wait for heat to subside and sweating to stop; urination will resume naturally. This pattern belongs to the Yangming Meridian; diuretics are strictly taboo. Recognize this. Stroke patients who can eat often have increased appetite due to Jia-Ji transforming into Earth, making Spleen Qi strong. Overeating strengthens Spleen Qi further; Earth controls Kidney Water. Water deficiency worsens the disease. During illness, widely administer medicine but restrict food intake to allow natural healing. Excessive eating in stroke indicates flourishing Wind-Wood. Wood excess attacks Spleen; Spleen seeks help from food. The classics state: Excess dreams of giving, deficiency dreams of taking. Treat by draining Liver Wood, calming wind, and protecting Spleen. When Spleen is calm, appetite decreases—this is the effect.
Stroke patients should not use Long Nao (Borneolum Syntheticum), She Xiang (Moschus), Xi Jiao (Rhinocerotis Cornu), or Zhu Sha (Cinnabar). This is like patrolling streets with bells, hiding thieves but allowing wind pathogens to enter bone marrow like oil in flour, impossible to remove. Such cases exist. If phlegm surges causing unconsciousness and confusion, use drugs to purge phlegm-saliva. Wind is the leader of hundred diseases; how can it be ignored?
Xiao Xuming Tang (Minor Continuation Life Decoction)
Ma Huang (Ephedrae Herba, removed nodes) Ren Shen (Ginseng Radix et Rhizoma) Huang Qin (Scutellariae Radix) Shao Yao (Paeoniae Radix) Fang Ji (Stephaniae Tetrandrae Radix) Gui Zhi (Cinnamomi Ramulus) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 1 liang) Fang Feng (Saposhnikoviae Radix) (1.5 liang) Fu Zi (Aconiti Lateralis Radix Praeparata) (0.5 liang)
Xing Ren (Armeniacae Semen Amarum) (1 liang)
Except for Fu Zi and Xing Ren, grind the others into coarse powder. Then mix in the two remaining ingredients evenly. Take 5-7 qian per dose.
Boil with 1.5 cups of water and 5 slices of fresh ginger until reduced to 1 cup. Strain and drink warm before meals.
If stroke is treated without examining six meridian modifications, pathogens cannot be expelled. The Neijing states: Open pores cause chills; closed pores cause fever and chest stuffiness. Knowing acute wind strike, first use Modified Xuming Decoction according to symptoms.
Stroke with no sweat and aversion to cold: Ma Huang Xuming Tang is indicated.
Ma Huang (Ephedrae Herba) Fang Feng (Saposhnikoviae Radix) Xing Ren (Armeniacae Semen Amarum)
Double the dosage of this formula. Acupuncture at Taiyang Meridian points Zhiyin (BL67) for bleeding, Kunlun (BL60), and Yang Qiao (BL62) is recommended.
Stroke with sweat and aversion to wind: Gui Zhi Xuming Tang is indicated.
Gui Zhi (Cinnamomi Ramulus) Shao Yao (Paeoniae Radix) Xing Ren (Armeniacae Semen Amarum)
Double the dosage. Acupuncture at Fengfu (DU16) is recommended. Both cases represent Taiyang Meridian stroke.
Stroke with no sweat, body heat, no aversion to cold: Bai Hu Xuming Tang is indicated.
Shi Gao (Gypsum Fibrosum) Zhi Mu (Anemarrhenae Rhizoma) (add 2 liang each to the base formula) Gan Cao (Glycyrrhizae Radix et Rhizoma) (double the base amount)
Stroke with sweat, body heat, no aversion to wind: Ge Gen Xuming Tang is indicated.
Ge Gen (Puerariae Lobatae Radix) (2 liang) Gui Zhi (Cinnamomi Ramulus) Huang Qin (Scutellariae Radix) (double the base amount)
Acupuncture at Xangu (ST43) and stimulation of Li Dui (ST45) are recommended. Puncturing Xangu removes the "thief" of the Yangming Meridian; stimulating Li Dui drains excess Yangming. These cases represent Yangming Meridian stroke.
Stroke with no sweat, cool body: Fu Zi Xuming Tang is indicated.
Fu Zi (Aconiti Lateralis Radix Praeparata) (double) Gan Jiang (Zingiberis Rhizoma) (add 2 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma) (add 3 liang)
Stimulate Yinbai (SP1) to remove the "thief" of the Taiyin Meridian. This case represents Taiyin Meridian stroke.
Stroke with sweat, no heat: Gui Zhi Xuming Tang is indicated.
Gui Zhi (Cinnamomi Ramulus) Fu Zi (Aconiti Lateralis Radix Praeparata) Gan Cao (Glycyrrhizae Radix et Rhizoma) (double the base amount)
Acupuncture at Taixi (KI3) is recommended. This case represents Shaoyin Meridian stroke.
Confusion of six stroke patterns attributed to Shaoyang and Jueyin meridians, with joint spasms/pain or numbness: Qiang Huo Lian Qiao Xuming Tang is indicated.
Xiao Xuming Tang (8 liang) + Qiang Huo (Notopterygii Rhizoma et Radix) (4 liang) + Lian Qiao (Forsythiae Fructus) (6 liang)
Ancient Xuming formulas lacked differentiation of six patterns. Now treated by meridian differentiation and acupuncture. Jueyin Jingwell point Dadun (LR1) is needled to unblock the meridian. Shaoyang point Jiegu (GB39) is moxa-ed to guide out heat. This is the principle of acupuncture-moxibustion correspondence.
Stroke with no exterior six-meridian signs and no internal bowel/bladder obstruction, knowing blood deficiency fails to nourish sinews causing limb immobility and stiff tongue: Nourish blood to restore sinew nutrition. Da Qin Jiao Tang is indicated.
Qin Jiao (Gentianae Macrophyllae Radix) (3 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma) (2 liang) Chuan Xiong (Ligustici Chuanxiong Rhizoma) (2 liang) Dang Gui (Angelicae Sinensis Radix) (2 liang) Bai Shao Yao (Paeoniae Radix Alba) (2 liang) Xi Xin (Asari Radix et Rhizoma) (0.5 liang) Chuan Qiang Huo (Notopterygii Rhizoma et Radix) Fang Feng (Saposhnikoviae Radix) Huang Qin (Scutellariae Radix) (each 1 liang) Shi Gao (Gypsum Fibrosum) (2 liang) Wu Bai Zhi (Angelicae Dahuricae Radix) (1 liang) Bai Zhu (Atractylodis Macrocephalae Rhizoma) (1 liang) Sheng Di Huang (Rehmanniae Radix) (1 liang) Shu Di Huang (Rehmanniae Radix Preparata) (1 liang) Bai Fu Ling (Poria) (1 liang) Chuan Du Huo (Angelicae Pubescentis Radix) (2 liang)
Sixteen ingredients. Take 1 liang per dose, decoct in water, strain, and drink warm at any time. On cloudy days, add 7-8 slices of fresh ginger. If epigastric fullness occurs, add Zhi Shi (Aurantii Fructus) 1 qian per liang of herbs.
Stroke with exterior six-meridian signs: First use Modified Xuming Tang according to symptoms. With internal bowel/bladder obstruction: Use Sanhua Tang.
Hou Po (Magnoliae Officinalis Cortex) Da Huang (Rhei Radix et Rhizoma) Zhi Shi (Aurantii Fructus) Qiang Huo (Notopterygii Rhizoma et Radix) (equal parts)
Crush to size of hemp seeds. Take 3 liang per dose, boil in 3 sheng of water until 1.5 sheng remains. Drink throughout the day. Aim for mild laxation. The method states: Inability to lift limbs is commonly called paralysis. Classics say: Excess causes limb immobility. Also: Earth excess leads to "Dun Fu" (high mounds). Dun means thick, Fu means high. High and thick earth must be cleared. This is truly a disease of rich food. How else to explain it? Classics state: Pathogenesis of Three Yang and Three Yin leads to hemiplegia, atrophy, and ease of change. Wang Bing notes: Yin deficiency causes hemiplegia; Yang excess causes atrophy. Yi means change; frequent use leads to weakness. Treatment involves purging to weaken Qi, reduce Yang, and balance Earth. Or use Sanhua Tang or Tiao Wei Cheng Qi Tang. Do not use if Spleen is deficient. Classics state: Earth deficiency leads to "Bei Xian" (low depressions). Thus Spleen disease causes limb immobility. Limbs receive Qi from Stomach but must pass through Spleen to reach meridians. Now Spleen cannot transport fluids from Stomach; limbs lack Grain Qi. Qi declines daily, meridians obstruct, sinews/bones/muscles lack Qi generation, hence immobility. Treatment can involve tonification: Shi Quan San modified with Si Wu Tang to expel evil and preserve righteousness.
Yu Feng Tang (Wind-Dispelling Decoction)
After internal evil is cleared and external evil exhausted, take this medicine to guide Qi through meridians. Long-term use eliminates major wind. Even minor pathogens are treated by modifying this formula. However, treatment methods must not lose the balance of unblocking and closing. Either induce slight sweating over a period, or promote mild laxation over ten days. This is standard therapy. Eventually, clear and turbid separate, Ying and Wei harmonize. If early wind signs appear, taking this prevents falling.
Qiang Huo (Notopterygii Rhizoma et Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma) Fang Feng (Saposhnikoviae Radix) Man Jing Zi (Viticis Fructus) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Xi Xin (Asari Radix et Rhizoma) Zhi Ke (Aurantii Fructus Immaturus) Ren Shen (Ginseng Radix et Rhizoma) Ma Huang (Ephedrae Herba) Gan Ju (Chrysanthemi Flos) Bo He (Menthae Haplocalycis Herba) Gou Qi Zi (Lycii Fructus) Dang Gui (Angelicae Sinensis Radix) Zhi Mu (Anemarrhenae Rhizoma) Di Gu Pi (Lycii Cortex) Huang [Missing Character?] Du Huo (Angelicae Pubescentis Radix) Du Zhong (Eucommiae Cortex) Wu Bai Zhi (Angelicae Dahuricae Radix) Qin Jiao (Gentianae Macrophyllae Radix) Chai Hu (Bupleuri Radix) Ban Xia (Pinelliae Rhizoma) Qian Hu (Peucedani Radix) Hou Po (Magnoliae Officinalis Cortex) Shu Di Huang (Rehmanniae Radix Preparata) Fang Ji (Stephaniae Tetrandrae Radix) (each 2 liang) Fu Ling (Poria) Huang Qin (Scutellariae Radix) (each 3 liang) Shi Gao (Gypsum Fibrosum) (4 liang) Shao Yao (Paeoniae Radix) (3 liang) Sheng Di Huang (Rehmanniae Radix) Cang Zhu (Atractylodis Rhizoma) (each 4 liang) Gui Zhi (Cinnamomi Ramulus) (1 liang)
Thirty-three ingredients totaling 74 liang.
Take 1 liang per dose, boil in 2 cups of water until 1 cup remains. Strain and drink warm. On cloudy days, add fresh ginger. Take one dose on an empty stomach, and another dose of the dregs before bed. Always take well away from meals. Empty stomach dose. Below are two Dan pills (heavy agents) taken before bed. Below is Si Bai Dan (light agent) for calming spirit and clearing lungs.
Assume slight sweating over a period: Use 3 liang Yu Feng Tang + 1 liang Ma Huang, divided into 4 doses. Add 5 slices ginger to one dose, take empty stomach, follow with congee. Mild sweating is ideal.
Assume mild laxation over ten days: Use 3 liang Yu Feng Tang + 1 liang Da Huang, divided into 4 doses. Decoct as above, take before bed. Obtaining stool is excellent.
Long-term medication must follow seasonal changes. After late winter/spring cold: Add Ban Xia 2 liang (total 4), Chai Hu 2 liang (total 4), Ren Shen 2 liang (total 4). This anticipates and drains Shaoyang Qi. Early summer: Add Shi Gao 2 liang (total 6), Huang Qin 2 liang (total 5), Zhi Mu 2 liang (total 4). This anticipates and drains Yangming Qi. Late summer: Add Fang Ji 2 liang (total 4), Bai Zhu 2 liang, Fu Ling 2 liang (total 5). This overcomes Spleen-Dampness. Early autumn after great heat: Add Hou Po 2 liang (total 4), Huo Xiang (Agastaches Herba) 2 liang, Gui Zhi 1 liang (total 2). This anticipates and drains Taiyin Qi. After Frost Descent/winter approach: Add Fu Zi 1 liang, Gui Zhi 1 liang (total 2), Dang Gui 2 liang (total 4). This overcomes Shaoyin Qi. Spring reduces Winter; seasons are similar. Although legislation follows seasonal additions/subtractions, one must assess deficiency/excess, heat/cold, local climate, and pathogen quantity during illness. This formula addresses Seven Emotions, Six Desires, and Four Qi, preventing Zang imbalance and maintaining Ying-Wei stability. For wind-type constipation, it prevents dryness. For chronic diarrhea, it regulates itself. Taking this upon early wind signs, along with Tian Ma Wan, forms a preventive strategy. It is also suitable for ongoing illness, regardless of gender or pediatric convulsions/spasms. It effectively treats seasonal wind-cold with seasonal modifications. It also treats Spleen/Kidney deficiency, weak sinews, speech difficulties, mental confusion, and internal wind-damp-fire. Internal weakness refers to wind-damp-fire; heaviness indicates wind-damp. Earth excess/internal weakness causes hemiplegia or obesity with hemiplegia, or fear-induced amnesia and excessive thinking. Thinking and forgetting stem from emotional insufficiency. Heart chaos breeds disease; heart calmness eliminates disease. This formula calms the mind, nourishes spirit, balances Yin-Yang, and stabilizes Ying-Wei.
Si Bai Dan (Four Whites Pill)
Clears Lung Qi and nourishes Po (Corporeal Soul). Stroke patients often suffer from dizziness and turbid Qi.
Bai Zhu (Atractylodis Macrocephalae Rhizoma) (0.5 liang) Bai Zhi (Angelicae Dahuricae Radix) (1 liang) Bai Fu Ling (Poria) (0.5 liang) Bai Tan (Santalum Album Lignum) (1.5 liang) Ren Shen (Ginseng Radix et Rhizoma) (0.5 liang) Zhi Mu (Anemarrhenae Rhizoma) (3 qian) Suo Sha Ren (Amomi Fructus) (0.5 liang) Qiang Huo (Notopterygii Rhizoma et Radix) (2.5 qian) Bo He (Menthae Haplocalycis Herba) (3.5 qian) Du Huo (Angelicae Pubescentis Radix) (2.5 qian) Fang Feng (Saposhnikoviae Radix) Chuan Xiong (Ligustici Chuanxiong Rhizoma) (each 5 qian) Xi Xin (Asari Radix et Rhizoma) (2 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (5 qian) Tian Zhu Ye (Phyllostachys Viridis Folium) (1 liang) Xiang Fu (Cyperi Rhizoma) (5 qian, stir-fried) Long Nao (Borneolum Syntheticum) (0.5 qian, separately ground) She Xiang (Moschus) (1 zi, separately ground) Niu Huang (Bovis Calculus) (0.5 qian) Huo Xiang (Agastaches Herba) (1.5 qian)
Twenty ingredients, total 8 liang 6 qian 1 zi. Grind to fine powder. Make pills with refined honey. Each liang makes 10 pills. Chew one pill before bed, dividing into 5-7 chews. Clears upper Lung Qi, strengthens lower bone marrow.
Er Dan Wan (Two Cinnabars Pill)
Treats amnesia, nourishes spirit, stabilizes will, harmonizes blood. Internally calms Heart Spirit, externally beautifies skin/flesh.
Dan Shen (Salviae Miltiorrhizae Radix) (1.5 liang) Dan Sha (Cinnabar) (2 qian, coating) Yuan Zhi (Polygalae Radix, heart removed) (0.5 liang) Fu Shen (Poria with Hostwood) (1 liang) Ren Shen (Ginseng Radix et Rhizoma) (5 qian) Chang Pu (Acori Tatarinowii Rhizoma) (5 qian) Shu Di Huang (Rehmanniae Radix Preparata) (1.5 liang) Tian Dong (Asparagi Radix, heart removed) (1.5 liang) Mai Dong (Ophiopogonis Radix, heart removed) (1 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 liang)
Grind to fine powder. Make pills with refined honey, size of paulownia seeds. Take 50-100 pills per dose. Take regularly on empty stomach before meals to calm spirit and stabilize will. One formula clears Lung, one calms Heart. Clear within clear goes to Lung to assist True Nature; clear within turbid strengthens bone marrow. Clear within blood nourishes Spirit; turbid within blood beautifies skin/flesh. If chronic phlegm exists in stroke with fluid surging in chest causing Qi obstruction, use Du Sheng San to vomit. Follow with Qi-promoting and fire-draining agents (formula below).
Xie Qing Wan (Drain Green Pill)
Treats stroke with spontaneous sweating, dizziness, fever without aversion to cold, inability to lie down. This is wind-heat irritability.
Dang Gui (Angelicae Sinensis Radix) Long Dan (Gentianae Radix) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Zhi Zi (Gardeniae Fructus) Qiang Huo (Notopterygii Rhizoma et Radix) Da Huang (Rhei Radix et Rhizoma) Fang Feng (Saposhnikoviae Radix) (equal parts)
Grind to fine powder. Make pills with refined honey, size of bullet. Take one pill per dose, dissolved in Bamboo Leaf Decoction.
Tian Ma Wan (Gastrodia Pill)
New formula.
Tian Ma (Gastrodiae Rhizoma) (3 liang, soaked in wine 3 days, dried, weighed) Niu Xi (Achyranthis Bidentatae Radix) (6 liang, soaked same way) Dang Gui (Angelicae Sinensis Radix) (10 liang) Du Zhong (Eucommiae Cortex) (7 liang, stir-fried, silk removed) Xuan Shen (Scrophulariae Radix) (6 liang) Qiang Huo (Notopterygii Rhizoma et Radix) (10 liang) Bi Xie (Dioscoreae Hypoglaucae Rhizoma) (6 liang, separately ground fine, weighed) Sheng Di Huang (Rehmanniae Radix) (16 liang) Fu Zi (Aconiti Lateralis Radix Praeparata) (1 liang)
Grind to fine powder. Make pills with refined honey, size of paulownia seeds. Take 50-70 pills normally, up to 100 for severe cases. Take with warm wine or plain water on empty stomach before meals. Take at dawn, stop when hungry later in the day. Strictly avoid stagnation and loss of unblocking. If feeling slightly clogged after half a month of use, lightly disperse with Qi Xuan Wan to restore drug efficacy. Niu Xi and Bi Xie treat sinews/bones; Du Zhong connects sinews/bones; Tian Ma and Qiang Huo are superior wind-draining herbs; Dang Gui and Di Huang nourish blood to harmonize Ying-Wei; Xuan Shen is primary; Fu Zi assists in channel circulation.
Du Sheng San (Single Sovereign Powder)
Treats various winds with diaphragmatic excess, epilepsy phlegm-saliva, fluid surging, and miscellaneous diseases.
Gua Di (Cucumeritis Fructus) (1 liang)
Crush to hemp seed size. Stir-fry until yellow, grind to fine powder. Take 3 qian powder, 1 qian tea, mixed with 1 cup sour pickle juice. For vomiting method, use only in clear weather, not in gloomy weather. For sudden/severe illness, ignore this restriction. Vomiting time should be before noon (Si hour). Neijing states: Dawn to midday is Heaven's Yang, Yang among Yang. Regarding seasonal Qi, Zhang Zhongjing says: Spring favors vomiting. Heaven's Qi is above, Human Qi is above. Daily Qi corresponds to Yin/Mao/Chen hours. Thus morning is better than night. Patient should fast overnight. If drug does not induce vomiting, give hot pickle water. For wind-epilepsy vomiting, add Quan Xie (Scorpio) 0.5 qian (lightly fried). If parasites present, add Dog Oil 5-7 drops, Xiong Huang (Realgar) 1 qian. Severe cases add Yuan Hua (Genkwa Flos) 0.5 qian to immediately expel worms. For damp swelling/fullness, add Chi Xiao Dou (Vigna Adzuki) 1 qian. Thus, do not use routinely. Crucially distinguish deficiency/excess. Excess: Gua Di San; Deficiency: Zhi Zi Chi Tang. Fullness adds Hou Po. Do not apply uniformly. After vomiting, take fire-draining, Qi-promoting, spirit-calming agents. For wind-epilepsy unresponsive to treatment, refer to Hou Po Wan, adding Ren Shen, Chang Pu, Fu Shen (heart removed, each 1.5 liang) in spring/autumn. Mix and administer according to Hou Po Wan seasonal modification method. Hou Po Wan formula is in the Vomiting Discourse.
Fang Feng Tong Sheng San (Saposhnikovia Unblocking Heroic Decoction)
Fang Feng (Saposhnikoviae Radix) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Dang Gui (Angelicae Sinensis Radix) Shao Yao (Paeoniae Radix) Da Huang (Rhei Radix et Rhizoma) Mang Xiao (Natrii Sulfas) Lian Qiao (Forsythiae Fructus) Bo He (Menthae Haplocalycis Herba)
Ma Huang (Ephedrae Herba, unremoved nodes, each 0.5 liang) Shi Gao (Gypsum Fibrosum) Jie Geng (Platycodonis Radix) Huang Qin (Scutellariae Radix) (each 1 liang) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Shan Zhi Zi (Gardeniae Fructus) Jing Jie Sui (Schizonepetae Spica) (each 2.5 qian) Hua Shi (Talcum) (3 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma) (2 liang)
Grind to coarse powder. Take 1 liang per dose, decoct with fresh ginger. Drink warm. Twice daily. Labor sweat exposed to wind causes "Fo" (prickly heat); stagnation leads to acne. Labor sweat exits via Xu Fu (pores), lipid fluids...