中后当如东垣法，分中血脉、中腑、中脏施治。
《灵枢经》云∶虚邪偏客于身半，其入深，内居荣卫，荣卫稍衰则真气去，邪气
独留，发为偏枯。故其邪气浅者，脉偏痛。又云∶偏枯，身偏不用而痛，言不变，
志不乱，病在分腠之间，巨针取之，益其不足，损其有余，乃可复也。痱之为病也，
身无痛者，四肢不收，志乱不甚，其言微，知可治。甚则不能言，不可治也。此《内
经》论中风之浅深也。其偏枯，身偏痛而言不变，志不乱者，邪在分腠之间，即仲
景、东垣所谓邪中腑是也。痱病无痛，手足不收，而言喑志乱者，邪入于里，即仲
景、东垣所谓邪中脏是也。
中血脉，外有六经之形症，则以小续命汤加减，及疏风汤治之。太阳经中风，
无汗恶寒，于续命汤中加麻黄、防风、杏仁一倍，针太阳经至阴出血，昆仑举跷。
有汗恶风，于续命汤中加桂枝、芍药、杏仁一倍，针风府。阳明经中风，无汗身热
不恶寒，于续命汤中加石膏二两，知母二两，甘草一两。有汗身热不恶风，于续命
汤中加葛根二两，桂枝、黄芩各一倍，针陷谷，刺厉兑。太阴经中风，无汗身凉，
于续命汤中加附子一倍，干姜加二两，甘草加三两，针隐白。少阴经中风，有汗无
热，于续命汤中加桂枝、附子、甘草各一倍，针太溪。凡中风无此四证，六经混淆，
系于少阳厥阴，或肢节挛痛，或麻木不仁，每续命八两，加羌活四两，连翘六两，
刺厥阴之井大敦以通其经，灸少阳之经绝骨以引其热。
中腑，内有便溺之阻隔，宜三化汤，或《局方》中麻仁丸通利之。
外无六经之形症，内无便溺之阻隔，知为血弱不能养筋，故手足不能运动，舌
强不能语言也。宜大秦艽汤养血而筋自荣。若内外症俱有之，先解表而后攻里。若
内邪已除，外邪已去，当服愈风汤以行中道。久服大风尽去，纵有微邪，只从愈风
汤加减治之。然治病之法，不可失于通塞，或一气之微汗，或一旬之通利，如此乃
常治之法也。久之清浊自分，荣卫自和矣。
中脏，痰涎昏冒，宜至宝丹、活命金丹之类。（若中血脉中腑之病，初不宜用龙脑、麝香、牛黄，
为麝香入脾治肉，牛黄入肝治筋，龙脑入肾治骨，恐引风深入骨髓，如油入面，莫之能出。）
中腑者多兼中脏∶如左关脉浮弦，面目青，左胁偏痛，筋脉拘急，目 ，头目
眩，手足不收，坐踞不得，此中胆兼中肝也。犀角散之类。如左寸脉浮洪，面赤，
汗多恶风，心神颠倒，言语謇涩，舌强口干，忪悸恍惚，此中小肠兼中心也。加味
牛黄散之类。如右关脉浮缓，或浮大，面唇黄，汗多恶风，口 语涩，身重怠惰嗜
卧，肌肤不仁，皮肉 动，腹胀不食，此中胃兼中脾也。防风散之类。如右寸脉浮
涩而短，鼻流清涕，多喘，胸中冒闷，短气自汗，声嘶，四肢痿弱，此中大肠
兼中肺也。五味子汤之类。如左尺脉浮滑，面目黧黑，腰脊痛引小腹，不能俯仰，
两耳虚鸣，骨节疼痛，足痿善恐，此中膀胱兼中肾也。独活散之类。治风之法，解
表、攻里、行中道，三法尽矣，然不可执也。如小续命汤，亦麻黄、桂枝之变，麻
黄、桂枝若不施于冬月即病之伤寒，而施于温热之症，未有不杀人者，其可执乎。
戴复庵云∶治风之法，初得之即当顺气，及其久也，即当活血。久患风疾，四物汤
吞活络丹愈者，正是此义。若先不顺气，遽用乌附，又不活血，徒用防风、天麻、
羌活辈，吾未见其能治也。然顺气之药则可，破气、泻气之药则不可。卒仆偏枯之
症，虽有多因，未有不因真气不周而病者，故黄 为必用之君药，防风为必用之臣
药。黄 助真气者也，防风载黄 助真气以周于身者也。亦有治风之功焉。许HT 宗
治王太后中风口噤，煎二药熏之而愈，况服之乎。多怒加羚羊角。渴加葛根汁、秦
艽。口噤口 亦加秦艽。恍惚错语加茯神、远志。不得睡加炒酸枣仁。不能言加竹
沥、荆沥、梨汁、陈酱汁、生葛汁、人乳汁。内热加梨汁、人乳、生地黄汁。痰多
加竹沥、荆沥，少佐以姜汁。予每治此症，用诸汁以收奇功，为其行经络，渗分肉，
捷于汤散故也。
【小便不利】《三因》白散子加木通、灯心、茅根煎，热盛去附子。
洁古云∶中风如小便不利，不可以药利之。既已自汗，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，当俟热退汗止，小便自行也。
【遗尿】浓煎参 汤，少加益智子频啜之。
【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。当泻肝木，治风安脾，脾安则食少，是其效也。此其
大略也，仍分症详着于后。
【痰涎壅盛】橘红一斤，逆流水五碗，煮数滚，去橘红，再煮至一碗顿服，白汤
导之，吐痰之圣药也。竹沥、荆沥少佐姜汁，加入二陈汤、星香散中，乃必用之药。
戴云∶肥人多中，以气盛于外而歉于内也。肺为气出入之道，人肥者必气急，气急
必肺邪盛，肺金克肝木，胆为肝之腑，故痰涎壅盛。所以治之必先理气为急，中后
气未尽顺，痰未尽降，调理之剂，唯当以藿香正气散和星香散煎服。此药非特可以
治中风之症，中气、中恶、霍乱尤宜。中后体虚有痰，宜四君子汤和星香散，或六
君子汤和之。脉沉伏无热者，用三生饮加全蝎一个。养正丹可以坠下痰涎，镇安元
气。气实者以星香汤吞之，气虚者以六君子汤吞之。
【口噤】以苏合香丸，或天南星、冰片末，或白梅末擦牙。以郁金、藜芦末搐
鼻。以黄 防风汤熏。针人中、颊车各四分。白矾半两，盐花一分，细研。揩点牙
根下，更以半钱匕绵裹，安牙尽头。用甘草比中指节截作五截，于生油内浸过，炭
火上炙，候油入甘草。以物斡开牙关，令咬定甘草，可人行十里许时，又换甘草一
截，后灌药极效。
【口眼 斜】经曰∶木不及曰委和。委和之纪，其动 戾拘缓。又云∶厥阴所至
为。盖 缩短也。木不及则金化缩短乘之，以胜木之条达也。戾者，口目 斜也。
拘者，筋脉拘强也。木为金之缩短牵引而 斜拘强也。缓者，筋脉纵也。木为金乘，
则土寡于畏，故土兼化缓纵，于其空隙而拘缓者，自缓也。故口目 斜者，多属胃
土，然有筋脉之分焉。经云∶足之阳明，手之太阳，筋急则口目为僻， 急不能卒
视，此胃土之筋为 斜也。又云∶胃足阳明之脉，挟口环唇，所生病者，口 唇斜，
此胃土之脉为 斜也。口目常动，故风生焉，耳鼻常静，故风息焉。治宜清阳汤、
秦艽升麻汤，或二方合用。黄 二钱，人参、当归、白芍药各一钱，甘草、桂枝各
五分，升麻、葛根、秦艽各一钱，白芷、防风、苏木、红花、酒黄柏各五分，水酒
各半煎，稍热服。初起有外感者，加莲须葱白三茎同煎，取微汗。第二服不用。外
以酒煮桂取汁一升，以故布浸 病右，右 上，上 左。筋急 斜，药之可愈。
脉急 斜，非灸不愈。目斜灸承泣，口 灸地仓，如未效，于人迎、颊车灸之。戴
云∶中而口眼 邪者，先烧皂角烟熏之，以逐去外邪。次烧乳香熏之，以顺其血脉。
【半身不遂】经云∶胃脉沉鼓涩，胃外鼓大，心脉小坚急，皆鬲偏枯，男子发左，
女子发右，不喑舌转可治，三十日起。其从者喑，三岁起。年不满二十者，三岁
死。盖胃与脾为表里，阴阳异位，更实更虚，更逆更从，或从内，或从外，是故
胃阳虚则内从于脾，内从于脾则脾之阴盛，故胃脉沉鼓涩也。涩为多血少气，胃之
阳盛则脾之阴虚，虚则不得与阳主内，反从其胃越出于部分之外，故胃脉鼓大于臂
外也。大为多气少血，心者元阳君主宅之，生血主脉，因元阳不足阴寒乘之，故心
脉小坚急。小者，阳不足也。坚急者，阴寒之邪也。夫如是，心胃之三等脉，凡有
其一，即为偏枯者何也。盖心是天真神机开发之本，胃是谷气充大真气之标，标本
相得，则胸膈间之膻中气海，所留宗气盈溢，分布四脏三焦，上下中外，无不周遍。
若标本相失，则不能致其气于气海，而宗气散矣。故分布不周于经脉则偏枯，不周
于五脏则喑。即此言之，是一条可为后之诸言偏枯者纲领也，未有不因真气不周而
病者也。故治疗之方，不用黄 为君，人参、当归、白芍药为臣，防风、桂枝、钓
藤、竹沥、荆沥、姜汁、韭汁、葛汁、梨汁、乳汁之属为之佐使，而杂沓乎乌、附、
羌、独之属，以涸荣而耗卫，如此死者，医杀之也。丹溪云∶大率多痰，在左挟死
血与无血，在右挟气虚与痰，亦是无本杜撰之谈，不必拘之。古方顺风匀气散、虎
骨散、虎胫骨酒、黄 酒皆可用。外用蚕沙两石，分作三袋，每袋可七斗。蒸热，
一袋着患处，如冷再换一袋，根据前法数数换易，百不禁，瘥止。须羊肚酿粳米、葱
白、姜、椒、豉等煮烂熟，日食一具，十日止。
【失音不语】《素问》云∶太阴所谓入中为喑者，阳盛已衰，故为喑也。内夺而
厥，则为喑痱，此肾虚也。少阴不至者，厥也。夫肾者藏精，主下焦地道之生育，
故冲任二脉系焉。二脉与少阴肾之大络，同出肾下，起于胞中。其冲脉因称胞络为
十二经脉之海，遂名海焉。冲脉之上行者，渗诸阳，灌诸精。下行者，渗三阴，
灌诸络而温肌肉，别络结于跗。因肾虚而肾络与胞络内绝，不通于上则喑，肾脉
不上循喉咙挟舌本，则不能言，二络不通于下则痱厥矣。如是者，以地黄饮子主之。
竹沥、荆沥、大梨汁（各三杯），生葛汁、人乳汁（各二杯），陈酱汁（半杯），和匀，
隔汤顿温服。有痰者，涤痰汤。内热者，凉膈散加石菖蒲、远志为末，炼蜜丸弹子大，
朱砂为衣。每服一丸，薄荷汤化下，名转舌膏。《宝鉴》诃子汤、正舌散、茯神散。
【四肢不举】有虚有实，实者脾土太过，泻令湿退土平而愈。虚者脾土不足，十
全散加减，去邪留正。（详见痿门。）
【身体疼痛】铁弹丸、十味锉散、（内有热药，无热者宜之）蠲痹汤。
【昏冒】活命金丹、至宝丹、至圣保命金丹、牛黄清心丸。
中风要分阴阳∶阴中颜青脸白，痰厥喘塞，昏乱眩晕， 斜不遂，或手足厥冷
不知人，多汗。阳中脸赤如醉怒，牙关紧急，上视，强直掉眩。《素问》云∶诸风掉
眩，支痛强直筋缩，为厥阴风木之气，自大寒至小满，风木君火二气之位。风主动，
善行数变，木旺生火，风火属阳，多为兼化。且阳明燥金主于紧敛缩劲，风木为病，
反见燥金之化，由亢则害，承乃制，谓已过极，则反似胜己之化，故木极似金。况
风能胜湿而为燥，风病势甚而成筋缩，燥之甚也。
有热盛生风而为卒仆偏枯者，以麻、桂、乌、附投之则殆，当以河间法冶之。
《绀珠经》云∶以火为本，以风为标。心火暴甚，肾水必衰。肺金既摧，肝木自旺。
治法先以降心火为主，或清心汤，或泻心汤，大作剂料服之，心火降则肝木自平矣。
次以防风通圣散汗之，或大便闭塞者，三化汤下之。内邪已除，外邪已尽，当以羌
活愈风汤常服之，宣其气血，导其经络。病自已矣。或舌謇不语者，转舌膏，或活
命金丹以治之，此圣人心法也。或有中风便牙关紧急，浆粥不入，急以三一承气汤
灌于鼻中，待药下则口自开矣，然后按法治之。
有元气素弱，或过于劳役，或伤于嗜欲，而卒然厥仆，状类中风者，手必散，
口必开，非大剂参 用至斤许，岂能回元气于无何有之乡哉。亦有不仆而但舌强语
涩痰壅，口眼 斜，肢体不遂者，作中风治必殆，以六君子汤加诸汁治之。
《宝鉴》云∶凡人初觉大指、次指麻木不仁，或不用者，三年内有中风之疾也。
宜先服愈风汤、天麻丸各一料，此治未病之法也。薛己云∶预防之理，当养气血，
节饮食，戒七情，远帏幕可也。若服前方以预防，适所以招风取中也。
After the onset of stroke (Zhong Feng), treatment should follow Li Dongyuan's method, differentiating and treating based on whether the pathogenic factor has invaded the blood vessels (Xue Mai), the fu organs (Fu Zang), or the zang organs (Zang Zang).
The *Ling Shu Jing* states: When deficient evil lingers on one side of the body and penetrates deeply, residing within Ying and Wei (Nutritive and Defensive Qi), if Ying and Wei become slightly deficient, then True Qi departs, leaving the evil to remain alone, resulting in hemiplegia (Pian Ku). Thus, when the evil is shallow, there is pain in the pulse on one side. It also states: In hemiplegia, one side of the body is immobile and painful, but speech remains unchanged and mind is not confused; the disease lies between the muscle intervals (Fen Cou). Treatment with large needles can restore balance by tonifying deficiency and reducing excess, allowing recovery. The disease called Fei (a severe type of stroke characterized by paralysis) presents with no body pain, inability to control the four limbs, slight confusion of mind, and weak speech, which is treatable. If severe, where speech is lost, it is untreatable. This is how the *Nei Jing* discusses the depth of stroke. Hemiplegia with unilateral pain but unchanged speech and stable mind indicates the evil is in the Fen Cou, corresponding to Zhang Zhongjing and Li Dongyuan's concept of "evil invading the Fu" (Xie Zhong Fu). Fei disease with no pain, inability to control hands and feet, but with aphasia and mental confusion, indicates the evil has entered the interior, corresponding to "evil invading the Zang" (Xie Zhong Zang).
When evil invades the blood vessels, presenting with exterior symptoms of the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin), treat with modified Xiao Xuming Tang (Minor Continuation Life Decoction) and Shufeng Tang (Wind-Dispersing Decoction). For Taiyang channel stroke with no sweat and aversion to cold, add Mahuang (Ephedrae Herba), Fangfeng (Saposhnikoviae Radix), and Xingren (Armeniacae Semen Amarum) in double dose to Xiao Xuming Tang; bleed the Zhiyin point of the Taiyang channel and needle Kunlun (BL60) lifting the foot. For those with sweat and aversion to wind, add Guizhi (Cinnamomi Ramulus), Shaoyao (Paeoniae Radix Alba), and Xingren in double dose to Xiao Xuming Tang; needle Fengfu (GV16). For Yangming channel stroke with no sweat, fever, and no aversion to cold, add Shigao (Gypsum Fibrosum) 2 liang, Zhimu (Anemarrhenae Rhizoma) 2 liang, and Gancao (Glycyrrhizae Radix et Rhizoma) 1 liang to Xiao Xuming Tang. For those with sweat, fever, and no aversion to wind, add Gegen (Puerariae Lobatae Radix) 2 liang, Guizhi and Huangqin (Scutellariae Radix) in double dose to Xiao Xuming Tang; needle Xangu (ST43) and prick Liding (ST45). For Taiyin channel stroke with no sweat and cool body, add Fuzi (Aconiti Lateralis Radix Praeparata) in double dose, Ganjiang (Zingiberis Rhizoma) 2 liang, and Gancao 3 liang to Xiao Xuming Tang; needle Yinbai (SP1). For Shaoyin channel stroke with sweat and no fever, add Guizhi, Fuzi, and Gancao in double dose to Xiao Xuming Tang; needle Taixi (KI3). For any stroke lacking these four presentations, where Six Channel symptoms are mixed and related to Shaoyang and Jueyin, or presenting with joint spasms/pain or numbness/anesthesia, use 8 liang of Xuming Tang, adding Qianghuo (Notopterygii Rhizoma et Radix) 4 liang and Lianqiao (Forsythiae Fructus) 6 liang; prick the Jing-well point Dacun (LR14) of the Jueyin channel to unblock the meridian, and moxa the Juegu (GB39) of the Shaoyang channel to draw out heat.
When evil invades the Fu organs, presenting with internal obstruction of bowel movements and urination, use Sanhua Tang (Three Transformations Decoction) or Maren Wan (Hemp Seed Pill) from the *Ju Fang* to promote unblocking.
If there are no exterior Six Channel symptoms and no internal obstruction of bowels/urine, knowing that blood deficiency fails to nourish the sinews, causing immobility of hands/feet and stiff tongue preventing speech, use Da Qinjiao Tang (Great Gentian Decoction) to nourish blood so sinews naturally flourish. If both interior and exterior symptoms exist, first resolve the exterior, then attack the interior. Once internal evil is cleared and external evil expelled, take Yufeng Tang (Wind-Preventing Decoction) to maintain the middle pathway. Long-term use eliminates wind completely; even if slight evil remains, adjust treatment based on Yufeng Tang. However, treatment methods must not neglect unblocking or astringing; sometimes inducing slight sweating over one qi cycle, or promoting unblocking over ten days, constitutes standard treatment. Over time, clear and turbid separate naturally, and Ying and Wei harmonize.
When evil invades the Zang organs, presenting with phlegm-saliva congestion and coma, use Zhibao Dan (Precious Treasure Pill) or Huoming Jindan (Golden Pill of Saving Lives). (Note: For initial stages of blood vessel or Fu organ invasion, Longnao (Borneolum Syntheticum), Shexiang (Moschus), and Niuhuang (Bovis Calculus) should be avoided initially, as Shexiang enters Spleen to treat flesh, Niuhuang enters Liver to treat sinews, and Longnao enters Kidney to treat bone; using them may draw wind deep into the marrow, like oil entering flour, impossible to remove.)
Fu organ invasion often accompanies Zang organ invasion: e.g., floating-stringy pulse at left Guan position, greenish face, left hypochondriac pain, sinew spasm, eye deviation, dizziness, limb paralysis, inability to sit upright—this is Gallbladder invasion accompanying Liver invasion; use Xijiao San (Rhinoceros Horn Powder). Floating-rapid pulse at left Cun position, red face, profuse sweat, aversion to wind, mental agitation, slurred speech, stiff tongue, dry mouth, palpitations, confusion—this is Small Intestine invasion accompanying Heart invasion; use Jiawei Niuhuang San (Modified Bovis Calculus Powder). Floating-slow or floating-large pulse at right Guan position, yellowish face/lips, profuse sweat, aversion to wind, locked jaw/slurred speech, heavy body, lethargy, skin numbness, twitching muscles, abdominal distension, anorexia—this is Stomach invasion accompanying Spleen invasion; use Fangfeng San (Saposhnikoviae Powder). Floating-choppy-short pulse at right Cun position, runny nose, frequent panting, chest oppression, shortness of breath, spontaneous sweat, hoarseness, limb flaccidity—this is Large Intestine invasion accompanying Lung invasion; use Wuweizi Tang (Schisandra Decoction). Floating-slippery pulse at left Chi position, dark complexion, lower back/spine pain radiating to lower abdomen, inability to bend/straighten, tinnitus, bone/joint pain, leg weakness, fearfulness—this is Bladder invasion accompanying Kidney invasion; use Duohuo San (Angelicae Pubescentis Powder). Treating wind involves resolving exterior, attacking interior, and regulating the middle; these three methods cover all approaches, yet one must not be rigid. For instance, Xiao Xuming Tang is a variation of Mahuang Tang and Guizhi Tang; applying Mahuang and Guizhi to warm-heat conditions instead of winter cold-injury will surely cause death. How can one be rigid?
Dai Fu'an stated: The method for treating wind is to regulate Qi initially, and invigorate Blood after a long duration. Cures of chronic wind diseases using Siwu Tang (Four Substances Decoction) swallowed with Huoluo Dan (Meridian-Unblocking Pill) exemplify this principle. If Qi is not regulated first, and Aconite (Wutou, Fuzi) is used hastily without invigorating Blood, merely using Fangfeng, Tianma (Gastrodiae Rhizoma), Qianghuo, etc., I have never seen it succeed. However, Qi-regulating herbs are acceptable; Qi-breaking or Qi-draining herbs are not. Sudden collapse and hemiplegia, though having multiple causes, invariably stem from True Qi failing to circulate fully. Therefore, Huangqi (Astragali Radix) is the essential Sovereign herb, and Fangfeng is the essential Minister herb. Huangqi assists True Qi; Fangfeng carries Huangqi to assist True Qi in circulating throughout the body, possessing its own wind-treating efficacy. Xu Shuai treated Empress Dowager Wang's stroke with locked jaw by fumigating with two decoctions, achieving cure; how much more effective would ingestion be? Add Lingyangjiao (Capricornis Cornu) for anger; Gegen juice and Qinjiao (Siegesbeckiae Caulis) for thirst; Qinjiao for locked jaw/deviation; Fushen (Poria Cum Radix Pini) and Yuanzhi (Polygalae Radix) for confusion/muttering; Chao Suanzaoren (Ziziphi Spinosae Semen Fried) for insomnia; Zhuli (Bambusa Textilis Cataphylla Sap), Jingli (Phyllostachys nigra Sap), Lizhi (Pyrus Sinkiangensis Juice), Chen Jiangzhi (Fermented Bean Curd Juice), Sheng Gezhi (Puerariae Radix Fresh Juice), Renru (Human Milk) for aphasia; Lizhi, Renru, Sheng Dihuangzhi (Rehmanniae Radix Fresh Juice) for internal heat; Zhuli, Jingli with少许 Jiangzhi (Zingiberis Rhizoma Fresh Juice) for excessive phlegm. I frequently achieve remarkable results with these juices because they rapidly penetrate meridians and muscle spaces, acting faster than decoctions or powders.
[Difficulty in Urination]: Baisanzi (White Scattered Pill) from *San Yin Fang*, added with Mutong (Akebiae Caulis), Dengxincao (Junci Medulla), and Maogen (Imperatae Rhizoma), decocted. Remove Fuzi if heat is intense.
Jiegau stated: If stroke presents with difficulty in urination, do not use diuretics. Since spontaneous sweating has occurred, body fluids are lost externally, leading to reduced urine volume. Diuresis would deplete Ying and Wei, failing to control fire, worsening irritability and heat. Wait for heat to subside and sweating to stop, then urination will resume naturally.
[Urinary Incontinence]: Decoct Renshen (Panax Ginseng) strongly, add少许 Yizhiren (Alpiniae Oxyphyllae Fructus), and sip frequently.
[Excessive Eating in Stroke]: Exuberant Wind-Wood attacks Spleen; Spleen, under attack, seeks relief through food.
The Classics state: Fullness leads to dreaming of giving; deficiency leads to dreaming of taking. One should drain Liver Wood, treat wind, and calm Spleen. When Spleen is calm, appetite decreases, indicating efficacy. This is a general overview; specific symptoms are detailed below.
[Excessive Phlegm-Saliva]: Ju Hong (Citri Reticulatae Pericarpium) 1 jin, boiled in 5 bowls of counter-flow water until boiling several times. Remove Ju Hong, boil remaining liquid to 1 bowl, take in one dose, guided by plain water. This is the supreme remedy for vomiting phlegm. Zhuli and Jingli with少许 Jiangzhi, added to Erchen Tang (Two-Chen Decoction) or Xingxiang San (Star-Aromatic Powder), are essential medicines.
Dai Yuanli said: Obese people are prone to stroke because Qi is abundant externally but deficient internally. The Lung is the pathway for Qi entry and exit; obese individuals inevitably have rapid breathing, leading to Lung evil excess. Lung Metal controls Liver Wood; Gallbladder is the paired Fu of Liver, hence phlegm-saliva congestion. Therefore, treatment must prioritize regulating Qi. Post-stroke, if Qi is not fully smooth and phlegm not fully descended, regulatory agents should be Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) combined with Xingxiang San. This medicine treats not only stroke but also Qi stagnation, Evil Qi invasion, and cholera. Post-stroke with deficiency and phlegm, use Sijunzi Tang (Four Gentlemen Decoction) or Liu Junzi Tang (Six Gentlemen Decoction) combined with Xingxiang San. For sinking/depressed pulse without heat, use Sansheng Yin (Three-Lives Decoction) plus Quanxie (Scorpio) 1 piece. Yangzheng Dan (Upright Qi Pill) can descend phlegm and stabilize Yuan Qi. For excess Qi patterns, swallow with Xingxiang Tang; for deficiency Qi patterns, swallow with Liu Junzi Tang.
[Jaw Lock]: Rub teeth with Suhexiang Wan (Styrax Pill), or powder of Tiannanxing (Arisaematis Rhizoma), Bingpian (Borneolum), or Bai Mei (Mume Fructus). Snuff powder of Yujin (Curcumae Radix) and Lilü (Veratrum Nigrum). Fumigate with Huangqi-Fangfeng Tang. Needle Renzhong (GV26) and Jiache (ST6) 0.4 cun. Grind Banfan (Alumen) 0.5 liang and Yanhua (Halitum) 0.1 fen finely. Apply to gum roots. Wrap half a coin-sized amount in cotton and place at the end of the teeth. Cut Gancao (Licorice Root) into five segments matching the middle finger joint, soak in sesame oil, roast over charcoal until oil penetrates. Pry open jaw, have patient bite Gancao segment; walk about 10 li, then replace with next segment. Subsequent medication administration is highly effective.
[Facial Deviation]: The Classics state: Deficiency of Wood is called Weihe. In Weihe era, movement involves spasms and flaccidity. Also: Jueyin manifests as spasms. "Chi" means shortening. Wood deficiency allows Metal's shortening nature to prevail, overcoming Wood's free flow. "Li" refers to facial deviation. "Ju" refers to sinew stiffness. Wood is pulled by Metal's shortening, causing deviation and stiffness. "Huan" refers to sinew flaccidity. When Wood is controlled by Metal, Earth lacks restraint, thus Earth transforms into flaccidity; in gaps, flaccidity prevails. Thus, facial deviation mostly belongs to Stomach Earth, but distinguishes between sinews and vessels. Classics say: Foot Yangming and Hand Taiyang sinew tension causes facial deviation and sudden blindness; this is Stomach Earth sinew deviation. Also: Foot Yangming Stomach meridian encircles lips; diseases include lip deviation; this is Stomach Earth vessel deviation. Mouth/eyes move constantly, generating wind; ears/nose are still, wind ceases. Treat with Qingyang Tang (Clear Yang Decoction) or Qinjiao Shengma Tang (Gentian and Cimicifuga Decoction), or both combined. Huangqi 2 qian, Renshen, Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba) 1 qian each, Gancao, Guizhi 0.5 qian each, Shengma (Cimicifugae Rhizoma), Gegen, Qinjiao 1 qian each, Baizhi (Angelicae Dahuricae Radix), Fangfeng, Sumu (Sappan Lignum), Honghua (Carthami Flos), Jiuhuangbai (Phellodendri Cortex Wine-processed) 0.5 qian each. Decoct with half water, half wine, drink warm. Initial stage with exterior contraction: add Lianxu (Nelumbinis Stamen) and Congbai (Allii Fistulosi Bulbus) 3 stalks, decoct together, induce slight sweat. Do not use for second dose. Externally: decoct Guizhi in wine to obtain 1 sheng juice, soak old cloth, apply to affected side (right deviation to right, left to left). Sinew stiffness deviation responds to herbs. Pulse-related deviation requires moxibustion. Needle Chengqi (ST1) for eye deviation, Dicang (ST4) for mouth deviation. If ineffective, moxa Yingchang (ST9) and Jiache (ST6). Dai Yuanli said: For stroke with facial deviation, first fumigate with burning Gaojiao (Gleditsiae Sinensis Fructus) smoke to expel external evil, then fumigate with burning Ruxiang (Olibanum) to smooth blood vessels.
[Hemiplegia]: Classics state: Stomach pulse sinking and choppy, or bulging large externally; Heart pulse small, firm, and urgent—all indicate diaphragmatic hemiplegia. Men manifest on left, women on right. If not aphasic and tongue moves, treatable, recovery in 30 days. If aphasic, recovery in 3 years. Under 20 years old, death in 3 years. Stomach and Spleen are interior-exterior pairs, differing in Yin-Yang positions, alternating fullness/emptiness, reversal/compliance. If Stomach Yang is deficient, it follows Spleen inward; Spleen Yin becomes excessive, causing sinking/choppy Stomach pulse. Choppy indicates much blood, little Qi. If Stomach Yang is excessive, Spleen Yin is deficient; deficiency prevents governing interior, following Stomach outward, causing bulging/large Stomach pulse externally. Large indicates much Qi, little blood. Heart houses Original Yang; generates blood, governs vessels. Due to Original Yang deficiency, Yin-Cold attacks, causing small/firm/urgent Heart pulse. Small indicates Yang deficiency; firm/urgent indicates Yin-Cold evil. Why does having any of these three heart/stomach pulses indicate hemiplegia? Heart is the root of Tianzhen Shenji development; Stomach is the mark of谷物 Qi enriching True Qi. When root and mark align, Zong Qi (Gathering Qi) in Danzhong/Qihai overflows, distributing to Four Zang, Three Jiao, upper/lower, inside/outside, everywhere. If root and mark mismatch, Qi cannot reach Qihai, Zong Qi scatters. Thus, uneven distribution to meridians causes hemiplegia; uneven distribution to Five Zang causes aphasia. This serves as a guideline for future discussions on hemiplegia: all cases stem from True Qi failing to circulate fully. Therefore, treatment formulas should use Huangqi as Sovereign, Renshen, Danggui, Baishao as Ministers, Fangfeng, Guizhi, Gouteng (Uncariae Ramulus cum Uncis), Zhuli, Jingli, Jiangzhi, Jiuji (Allii Tuberosi Juice), Gezhi, Lizhi, Ru (Milk) as Assistants/Envoys. Avoid mixing Wutou, Fuzi, Qianghuo, Duohuo, which deplete Ying and consume Wei. Death from such treatment is murder by the physician. Danxi stated: Mostly phlegm; left side involves dead blood/blood deficiency; right side involves Qi deficiency/phlegm. This is baseless fabrication; do not adhere strictly. Ancient formulas like Shunfeng Yunqi San, Hugu San, Hujinggu Jiu, Huangqi Jiu are usable. Externally: use 2 dan of Can Sha (Bombyx Batryticatus), divided into 3 bags, 7 dou each. Steam hot, apply to affected area; replace when cool. Repeat frequently until cured. Diet: Cook lamb stomach stuffed with Jingmi (Oryza Sativa Japonica Group), Congbai, Jiang, Jiao (Zanthoxyli Pericarpium), Chi (Sojae Semen Preparatum) until soft; eat one daily for 10 days.
[Aphasia]: *Su Wen* states: Taiyin entering interior causes aphasia due to decline of Yang excess. Internal depletion with厥 (Jue) causes aphasia and fei, indicating Kidney deficiency. Shaoyin failing to arrive causes Jue. Kidney stores Essence, governs Lower Jiao reproduction; Chong and Ren meridians connect here. These two meridians and the great Luo of Shaoyin Kidney emerge below Kidney, originating in Baozhong (Uterus). Chong meridian is called the Sea of Twelve Meridians. Ascending Chong seeps Yang, irrigates Essence. Descending Chong seeps Three Yin, irrigates collaterals, warms muscles, collaterals knot at dorsum. Due to Kidney deficiency, Kidney Luo and Bao Luo disconnect internally; blockage upward causes aphasia; Kidney meridian not ascending throat/tongue base causes inability to speak; blockage downward causes fei/Jue. Treat with Dihuang Yinzi (Rehmannia Decoction). Mix Zhuli, Jingli, Dali Zhi (Large Pear Juice) 3 cups each, Shenggezhi, Renru 2 cups each, Chen Jiangzhi 0.5 cup. Warm over water bath, take in one dose. With phlegm: Tidan Tang (Phlegm-Scouring Decoction). With internal heat: Liangge San (Cooling Diaphragm Powder) plus Shichangpu (Acori Tatarinowii Rhizoma), Yuanzhi powdered, honey-pilled size of beans, cinnabar-coated. Take one pill dissolved in Bohe Tang (Mint Decoction), named Zhanshe Gao (Tongue-Turning Paste). *Baojian* Hezi Tang, Zhengshe San, Fushen San.
[Inability to Raise Limbs]: Can be deficiency or excess. Excess: Spleen Earth too strong; drain to reduce dampness, level Earth, and cure. Deficiency: Spleen Earth insufficient; modify Shiquan San (Ten Complete Powder), eliminate evil, preserve righteousness. (See Wei Men).
[Body Pain]: Tiedan Wan (Iron Bullet Pill), Shiwei Cuosan (Ten-Ingredient Powder), Juanbi Tang (Bi-Pain-Dispelling Decoction). Note: Shiwei Cuosan contains hot herbs; suitable for non-heat patterns.
[Coma/Dizziness]: Huoming Jindan, Zhibao Dan, Zhisheng Baoming Jindan, Niuhuang Qingxin Wan (Bovis Calculus Clearing Heart Pill).
Stroke must differentiate Yin and Yang: Yin stroke features blue-white face, phlegm-Jue, wheezing/blockage, confusion/dizziness, deviation/paralysis, cold extremities/unconsciousness, profuse sweat. Yang stroke features red face like drunken anger, tight jaw, upward gaze, stiffness/tremors/dizziness. *Su Wen* states: All wind tremors/dizziness, limb pain/stiffness/sinus shortening belong to Jueyin Wind-Wood Qi, from Great Cold to Minor Fullness, positions of Wind-Wood and Sovereign Fire. Wind moves, changes quickly; Wood prosperity generates Fire; Wind/Fire are Yang, often co-transforming. Yangming Dry-Metal governs tightening/constriction; Wind-Wood disease shows Dry-Metal transformation due to "extreme excess causes harm, succession brings restraint." When exceeding extremes, it resembles controlling element, so extreme Wood resembles Metal. Moreover, Wind conquers Dampness becoming Dry; severe wind disease causes sinus shortening, extreme Dryness.
For stroke caused by Heat-Excess generating Wind leading to sudden collapse/hemiplegia, using Mahuang, Guizhi, Wutou, Fuzi is dangerous; treat according to Hejian's method. *Canzhu Jing* states: Fire is root, Wind is branch. Heart Fire suddenly surges, Kidney Water must decline. Lung Metal destroyed, Liver Wood self-prospers. Treatment prioritizes descending Heart Fire, using Qingxin Tang (Clear Heart Decoction) or Xiexin Tang (Drain Heart Decoction) in large doses; once Heart Fire descends, Liver Wood calms. Then induce sweat with Fangfeng Tongsheng San (Saposhnikoviae Unblocking Life Powder); if constipated, purge with Sanhua Tang. Once internal/external evil cleared, take Qianghuo Yufeng Tang (Notopterygium Wind-Preventing Decoction) regularly to circulate Qi/Blood, guide meridians. Disease resolves. For tongue stiffness/aphasia, use Zhanshe Gao or Huoming Jindan; this is sage methodology. For stroke with immediate jaw lock/inability to eat/drink, urgently灌 (instill) Sanyi Chengqi Tang (Three-One Receiving Qi Decoction) via nose; once medicine passes, mouth opens, then treat accordingly.
For those with inherent weak Yuan Qi, overwork, or sexual excess, sudden collapse resembling stroke with open mouth/spread hands requires massive doses of Renshen and Huangqi (up to 1 jin) to restore Yuan Qi from nothing. Those not collapsing but with stiff tongue/slurred speech/phlegm congestion/facial deviation/limb paralysis should not be treated as typical stroke (dangerous); use Liu Junzi Tang plus various juices.
*Baojian* states: Anyone initially feeling numbness/anesthesia or dysfunction in thumb/index finger will likely suffer stroke within three years. Preventively take Yufeng Tang and Tianma Wan (Gastrodia Pill) each one dose; this is treating before disease arises. Xue Ji stated: Prevention relies on nourishing Qi/Blood, moderating diet, guarding Seven Emotions, avoiding sexual indulgence. Using previous formulas for prevention actually attracts wind and invites stroke.