大意
风者。百病之始也。又曰。百病之长也。善行而数变。（内经）大法有四。曰偏枯。半身不遂也。曰风痱。四肢不举
也。曰风 。卒倒不语也。曰风痹。遍身疼痛也。（岐伯）四症为风家纲领。故首列之。
内因
人之元气强壮。荣卫和平。腠理致密。外邪焉能为害。惟七情饮食。劳伤色欲。致真元耗散。荣卫空疏。邪乘
虚入。（用和）所以气虚之人。肝木不平而内风易作。（汇补）
外候
为卒中昏倒。为窜视 斜。为搐搦反张。为骨痛筋急。入经瘫痪。入络肤顽。（入门）暴喑暴昧。语言蹇涩。痰涎
壅盛。皆中风之候也。（医鉴）随其经络脏腑俞穴而调之。所谓虚之所在。邪必凑之。（汇补）
中脏
中脏者。内滞九窍。故昏沉不语。唇缓痰壅。耳聋鼻塞。目合不开。大小便闭。（机要）乃邪滞三阴里分。为闭症。
实者三生饮以疏上窍。三化汤以利下窍。虚人中脏。见脱症者。急宜大补参、附、 、术之类。（东垣）
中腑
中腑者。外着四肢。故手足不随。拘急不仁。或中身前。或中身侧。痿不能动。有六经形症。头疼发热。恶风恶
寒。面见五色。脉浮而弦。或痰涎壅盛。喘声不息。然目犹能视。口犹能言。大小便不闭。仍中腑也。（机要）乃邪
着三阳表分。宜发汗以泄其邪。小续命汤主之。（东垣）
中经
中经者。外无六经形症。内无便溺阻格。但半身不遂。语言蹇涩。（丹溪）若兼口眼歪斜。痰涎不利。乃邪着于
血脉之中。宜养血舒筋。大秦艽汤主之。
按。中脏中腑中血脉。论病之浅深也。是以发明云。中血脉则歪口眼。中腑则肢节废。中脏则性命危。凡
中腑之后。幸而得生。若不戒酒色。避风寒。病必复中。中必在脏。由浅入深。虽有仓扁。亦难措手也。
卒倒不语
卒倒不语为风 。即中脏症也。（汇补）咽中噫噫。舌强难言。俗称急中风。乃其候耳。发汗。身软者生。汗不出。
身硬唇干者死。视其鼻人中左右上下。白者可治。一赤一黑。吐沫者死。（医贯）以涤痰汤、八味顺气散主之。
大汗出。六君子汤加黄 主之。
半身不遂
半身不遂为偏枯。即中经症也。（汇补）因虚邪偏客于身半。内居荣卫。荣卫衰。真气去。邪气独留。发为偏枯。
（灵枢）在左为瘫。在右为痪。瘫者。坦也。筋脉弛纵。坦然不收。痪者。涣也。气血涣散。筋骨不用。（医贯）其在左
者。属死血少血。在右者。属痰壅气虚。（丹溪）未尝必指于风而后能也。但兼风者。其身必痛。纯属虚者。其身不
痛。（入门）外症。言不变。志不乱。病在分腠之间。益其不足。损其有余。乃可复也。（灵枢）以理断之。左半虽主血。
非气以通之。则不流。右半虽主气。非血以丽之。则易散。气血左右。不可执泥其治。一偏之病者。法当从阴
引阳。从阳引阴。从左引右。从右引左。溉其未枯。旁枝自茂。大概男子在右易治。在左难治。女人在左易治。
在右难治。（喻嘉言）
四肢不举
四肢不举为风痱。即中经脉也。（汇补）舌强不能言。足痿不能行。（河间）轻者。志不乱。言微知。易治。甚则不
能言者。难治。（灵枢）分而言之。有湿痰内滞者。痰火流注者。有肾肝阴虚者。有命门火衰者。有血衰气虚者。（病机）
遍身疼痛
遍身疼痛。即风痹症也。（汇补）外症。一臂不遂时。复转移一臂。（灵枢）四肢肌肉。不为我用。似偏枯而多痛者
是也。（三锡）因风寒湿气错合而成。寒胜则血凝而不流。故筋骨掣痛。为痛痹。湿胜则血濡而不和。故重着
不行。为着痹。风胜则气纵而不收。故走注疼痛。为行痹。三气兼并。血滞而气不通。故周身疼痛。为周痹。久
风入中。腠理不营。故肌肉不仁。为顽痹。腰项不能俯仰。手足不能屈伸。（医贯）其邪在经隧而痛者。易治。若
举动即痛者。是无血以养筋。名曰筋枯。不治。（丹溪）
口眼歪斜
手足阳明之脉。挟口环唇。手足太阳之脉。抵目两 。（灵枢）风邪入经。邪气反缓。正气反急。牵引口眼。歪斜
或左或右。（大全）
口噤不开
手三阳之筋。结于颔颊。足阳明之筋。挟于唇口。风邪乘之则筋挛。故令牙关急而口噤。宜破棺散揩齿数
遍。牙热自开。
失音不语
脾脉连舌本。心脉系舌本。肾脉循喉咙夹舌本。故心脾受风。则舌强难言。肾虚脉萎。则口喑不语。二者虚
实各不同也。又有风中会厌者。痰塞喉中者。痰迷心窍者。口噤不开者。若风气入脏。见绝症而难言者危。
筋脉螈
螈者。筋脉急而缩。 者。筋脉缓而伸。或伸或缩。动摇不止。（纲目）螈属肝经风热血燥。或肝火妄动耗血。
属肝经血气不足。或肝火汗多亡血。以致手足抽搐不已。（立斋）所谓血枯木旺而生风也。
十指麻木
大经小络。贯串一身。谓之脉。脉布四肢。络联百节。脉者血之隧道。筋者血所荣养。脉皆起于手足指端。筋
皆会于手足肢节。故血气衰耗。痰涎凝滞。而作麻木。宜神效黄 汤。或补中、六君。俱加钩藤、竹沥、姜汁。（汇补）
预防中风
平人手指麻木。不时眩晕。乃中风先兆。须预防之。宜慎起居。节饮食。远房帏。调情志。更以十全大补汤加
羌活常服。自愈。若古法。用天麻、 、愈风等汤。开其玄府。漏其真液。适所以招风取中。预防云乎哉。（准绳）
辨真中风
凡中暑中寒中湿。痰厥气厥。食厥热厥。虚晕。皆卒倒不语。但风必有歪斜搐搦。或偏枯之症为异。（入门）就
诸类症之中。惟中气与中风尤相似。但中气身冷脉沉无痰涎。中风身温脉浮有痰涎也。（汇补）
辨闭脱症
凡卒仆暴厥。须分闭脱。牙关紧闭。两手握固。即是闭症。其病易治。如口开鼾睡。小便自遗。即是脱症。其病
难治。（准绳）闭者。邪气闭塞于外。元气犹然在内。但与开关利气。则邪自散。故治易。脱者。元气泄于外。邪气
混于内。虽与峻补。而脏已伤残。故治难。诸症皆然。不独中风也。（汇补）
死候
心绝口开。肺绝鼾睡。脾绝手撒。肝绝眼闭。肾绝遗尿。肉脱筋痛。发直头摇。吐沫直视。面赤如妆。汗出如珠。
吐血下血。皆为不治。（正传）若见一二症。尚可救疗。如口开者。不过一时死。（汇补）
脉法
中风脉浮滑兼痰气。其或沉滑。勿以风治。大法。浮迟沉缓者。吉。洪大急疾者。凶。又脾脉独缓而无力者。亦难
治。
总治
风症皆痰为患。宜化痰为先。初得之即当顺气。日久即当活血。（丹溪）盖风本于热。热胜则风动。宜以静胜
其燥。养血是也。（机要）故治风先治血。血行风自灭。（伊芳川）其虚者又当培脾滋肾。脾土旺而血自生。脾气运
而痰自化。肾水足而热自除。肾气固而痰归经也。（汇补）
审汗下法
其病气实而中腑中脏者。不可失其通塞。或一气之微汗。或一旬之通利。（心法）但须少汗。亦须少下。多汗
则虚其卫。多下则损其荣。（机要）
审探吐法
痰涎壅盛。不能言者。皆当用吐。一吐不已。则再吐。然亦有气血虚而不可吐者。（心法）若一旦尽去其痰。则
手足骨节皆枯。反成痿废。慎之。（仲景）
禁服丹剂
古方有用丹剂者。为风入骨髓。不能遽出。故用龙、麝、牛、雄、珀、珠之类。辛香走窜。为斩关夺门之将。原为
中脏之闭症设。若施于气虚脱绝之人。反掌杀人。如油入面。莫之能出。（发明）
利便宜戒
有阳虚自汗。津液外亡。因而小便短少者。若概用利药。使荣卫枯竭。无以制火。烦热愈甚。当俟热退汗止。
小便自行。（发明）
通导宜慎
中脏之症。因风痰闭塞脏腑。每多幽道不通。诚宜开导。然有气衰血弱。不能润泽致燥者。又当养血。（汇补）
救卒中法
卒中昏倒。不知人事。牙关紧闭。涎潮壅塞。急以大指掐人中。候醒。用通顶散吹鼻。即提起头发。有嚏可治。
无嚏不治。如口噤不开。以白盐梅蘸僵蚕擦之。如风痰顽结。诸药不入者。稀涎散吐之。如风邪闭固。服药
不入者。防 汤熏之。脉虚自汗。并见前脱症者。参橘汤。或参 膏。加竹沥、姜汁灌之。再灸丹田气海二三
十壮。亦有得活者。（汇补）
用药总法
古法。中血脉。用大秦艽汤。中腑。用小续命汤。中脏。用三化汤。又闭症。用三生饮。脱症。用参附汤。
大概顺气化痰为主。二陈汤加乌药、枳壳、竹沥、姜汁。有六经症。再为加减。如无汗拘急。加羌活、防风。有汗
体痛。加芍药、桂枝。恶寒身热。加柴胡、黄芩。头痛目瞀。加川芎、蔓荆。口眼歪斜。加全蝎、天麻。头眩烘热。加
甘菊、细茶。风痰壅盛。加南星、贝母。恍惚谵语。加菖蒲、远志、茯神、枣仁。手足抽搐。亦加僵蚕、天麻。筋急。
加木瓜。筋挛。加钩藤。在臂。加桂枝。在足。加牛膝。如风邪渐退。痰饮渐消。但半身不遂者。审是血虚。用二陈合
四物汤。气虚。用二陈合四君子汤。俱加秦艽、续断、竹沥、姜汁。其四肢不举。属湿痰者。三一承气汤泻之。属虚弱
者。十全大补汤补之。其大便不通。属痰实者。三化汤利之。属津涸者。四物麻仁汤润之。久而真气渐复。邪
气未除者。更用羌活愈风汤。史国公及长春浸酒等方。若中之轻者。自醒能言能食。惟身体不遂。或手足
挛蜷 曳者。亦用前浸酒二方。常服自愈。以上诸法。以疏风化痰为君。以补养气血为佐。以报使舒筋为
使。乃治真中风邪之剂也。若脾肾二经虚而中者。当滋化源。脾虚食少痰多者。六君子汤。中气倦怠而痰
多者。补中益气汤。加茯苓、半夏。心脾气虚而难言者。归脾汤。肾阴不足而难言者。六味地黄汤。肾经喑痱
者。地黄饮子。肝经血燥而拳蜷者。加味逍遥散。若病状虽减。而未能复元者。审其肝脾肾三家。何经气虚
血虚。阴虚阳虚。以六味、七味、八味丸、归脾丸、还少丹、虎潜丸服之。再以四君、六君、八珍、十全大补、补中益
气、归脾等汤。日服无间。纵有虚风。潜消默夺矣。
中风选方
通神散 治中风痰涎壅塞。用此吐之。
白僵蚕七枚。焙研为末。生姜汁调服。立吐风痰。少时。再用七枚。根据法再吐。仍用煨熟大黄。含津咽下。若
口不开者。用僵蚕煎汁。以竹管灌入鼻中。男左女右。
稀涎散 治中风痰壅。用此吐痰。（一方无江子）
江子仁（六粒） 猪牙皂（三钱切片） 明矾（一两）
先将矾化开。入二味和匀。待矾枯为末。每用一字。吹鼻内。则涎流口开。若痰涎塞喉者。以五分。灯心汤
调灌探吐。
破棺散 治中风切牙。无门下药。（五月五日午时合）
南星（半钱） 龙脑（二分半）
为末。频揩左右两傍大牙。令牙热自开。然后用药。
一法。用乌梅肉揉南星、细辛末。以中指蘸擦牙。自开。又用香油加麝香一二分灌之。或姜汁亦可。
开关散（宝鉴） 治中风痰盛。用此通关窍。
白僵蚕（炒去丝） 枯白矾（各等分）
为末。每服三钱。生姜蜜水调灌下。
涤痰汤 治中风痰迷心窍。舌强不语。中脏症。
胆星（姜制） 半夏（制各二钱五分） 枳实（麸炒） 茯苓（各二钱） 橘红（钱半） 菖蒲
人参（各一钱） 竹茹（七分） 甘草（五分）
加木香三分。生姜五片。水煎。
三化汤（洁古） 治中脏。风痰瘀塞脏腑。大便不通。人壮实者。
浓朴（姜炒） 枳实 大黄 羌活（各等分）
每服一两。水一升。煎半。终日服之。利下为度。
滋润汤 治中脏便燥。人虚血少。不任前下药者。用此润之。
当归（二钱） 杏仁（钱半） 桃仁 橘红 枳壳 浓朴（一钱） 苏子（钱） 牛膝（钱半）
水煎。调白蜜三匙服。
三生饮（易简） 治中脏闭症。口噤喉塞。两手握固。卒然昏倒。
南星（一两） 川乌（去皮） 生附（各五钱） 木香（二钱半）
每用半两。姜十片煎服。如遗尿手撒。口开鼾睡。为不治。用前药亦有得生者。夫三生饮乃行经络治寒
痰之圣药。有斩关夺旗之功。每服必用人参两许驾驱其邪。而补助正气。否则适足以取败耳。
防 蒸汗法（叔征） 治卒中风邪。药不能入口者。
防风 黄 （等分）
煮汤令沸。盆盛病患榻下。关闭门户。令药气熏蒸口鼻。盖以无形之气。透开有形之窍也。
小续命汤（千金） 治中风不省人事。半身不遂。口眼 斜。手足战掉。言语蹇涩。肢体顽麻。精神昏乱。头目
眩重。痰涎壅盛。筋脉拘挛。及香港脚缓弱。
麻黄（去节） 川芎 杏仁 甘草（炙） 人参 黄芩 芍药 防己（各一两） 桂枝（一两） 防风（两半） 附
子（炮五钱）
加生姜煎。热服取汗。如恍惚。加茯苓。如骨节疼痛。素有热。去附子。倍加芍药。烦燥大便闭。去附
子。倍芍药。加竹沥。大便利。素有寒。去黄芩。加白术、附子。骨节冷痛。加辣桂、附子。呕逆腹胀。加人
参、半夏。自汗。去麻黄。加芍药。大便结热。去附子。加枳壳、大黄。痰多。加南星炮切数片。风虚。加
[Major Principles]
Wind is the beginning of all diseases. It is also said that wind is the leader of all diseases. Wind pathogenic factors move swiftly and change frequently. The general principles in *Neijing* (*Classic of Internal Medicine*) categorize them into four types: 1) Pianku (hemiplegia), characterized by paralysis of half the body; 2) Fengfei, characterized by inability to lift the limbs; 3) Fengyin, characterized by sudden collapse and aphasia; 4) Fengbi, characterized by generalized body pain. The four symptoms described by Qibo serve as the outline for wind diseases and are listed first.
[Internal Causes]
When a person's Yuanqi (Original Qi) is strong, Yingwei (Nutritive and Defensive Qi) are harmonious, and Couli (interstices/pores) are dense, how can external pathogens cause harm? Only through the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright), improper diet, overexertion, or sexual indiscretion, leading to the depletion of Zhenyuan (True Origin/Qi), causing Yingwei to become empty and loose, allowing pathogens to enter via deficiency. Li Yonghe stated that thus, in people with Qi deficiency, Liver Wood becomes unbalanced, making internal wind easy to arise. Li Yongcui added this perspective.
[External Manifestations]
Manifestations include sudden collapse, strabismus or facial deviation, spasms and opisthotonos, bone pain and tendon stiffness. Pathogens entering the meridians cause paralysis; entering the collaterals causes skin numbness and hardness. Sudden aphonia, coma, dysarthria, and excessive phlegm-saliva are all signs of stroke. Treatment should follow the meridians, organs, and acupoints where the pathogens reside, as "where there is deficiency, pathogens gather."
[Pathogens Entering the Zang Organs]
When pathogens strike the Zang organs, they block the nine orifices internally, resulting in lethargy, aphasia, flaccid lips, excessive phlegm, deafness, nasal congestion, closed eyes, and constipation/urinary retention. This is due to pathogens stagnating in the interior of the Three Yin meridians, constituting a Bi (Closed) syndrome. For excess patterns, Sansheng Yin (Three Lives Decoction) may be used to open the upper orifices, and Sanhua Tang (Three Transformations Decoction) to clear the lower orifices. For deficiency patterns presenting with Tuo (Collapse) signs, urgent supplementation with Renshen (Ginseng Radix), Fuzi (Aconite Lateralis Radix Praeparata), Baizhu (Atractylodis Rhizoma), etc., is required.
[Pathogens Entering the Fu Organs]
When pathogens strike the Fu organs, they affect the four limbs, causing involuntary movement, stiffness, and insensitivity. Pathogens may attack the anterior or lateral aspects of the body, causing flaccidity and immobility, accompanied by Six Meridian symptoms such as headache, fever, aversion to wind/cold, abnormal facial colors, floating and wiry pulse, or excessive phlegm and continuous wheezing. However, if vision and speech remain intact and bowel/bladder functions are normal, it remains a Fu organ strike. This indicates pathogens attaching to the exterior of the Three Yang meridians. Sweating should be induced to release pathogens, primarily using Xiao Xuming Tang (Minor Continuation of Life Decoction).
[Pathogens Entering the Meridians]
When pathogens strike the meridians, there are no external Six Meridian symptoms nor internal obstruction of urination/defecation, only hemiplegia and dysarthria. If accompanied by facial deviation and difficult phlegm expectoration, it indicates pathogens in the blood vessels. Blood nourishment and tendon relaxation are indicated, primarily using Da Qinjiao Tang (Great Notopterygia Decoction).
Note: Striking Zang, Fu, or meridians discusses the depth of disease. Striking meridians causes facial deviation; striking Fu organs causes limb disability; striking Zang organs endangers life. After surviving a Fu organ strike, if one does not abstain from alcohol/sex and avoid wind/cold, relapse will occur, progressing to Zang organs. From shallow to deep, even masters like Cang Gong or Bian Que would find it difficult to treat.
[Sudden Collapse and Aphasia]
Sudden collapse and aphasia constitute Fengyin, i.e., Zang organ strike. Groaning sounds in the throat and stiff tongue are known as acute stroke. Prognosis: If sweating occurs and the body softens, survival is likely; if no sweat, body stiffens, and lips dry out, death ensues. Observation of the nose and Renzhong (GV26): white color is treatable; red on one side and black on the other with foaming indicates death. Treat with Dixtan Tang (Phlegm-Scouring Decoction) or Bawei Shunqi San (Eight-Ingredient Qi-Smooth Powder). For profuse sweating, use Liujunzi Tang (Six Gentlemen Decoction) plus Huangqi (Astragali Radix).
[Hemiplegia]
Hemiplegia is Pianku, i.e., meridian strike. Caused by deficient pathogens lodging in half the body, disrupting Yingwei. When Yingwei decline and True Qi departs, pathogens remain alone, causing Pianku. Left-side paralysis is called Tan (flaccid/relaxed tendons); right-side is called Huan (scattered Qi/blood). Left-sided cases often involve blood stasis and blood deficiency; right-sided cases involve phlegm obstruction and Qi deficiency. It is not always due to wind; if accompanied by wind, pain is present; if purely deficiency, no pain. Externally, speech and spirit remain unchanged, indicating the disease is in the interstices. Tonify deficiency, reduce excess. Treatment should draw from Yin to Yang, left to right, irrigating non-withered parts so branches flourish. Generally, men are easier to treat on the right, harder on the left; women are easier on the left, harder on the right.
[Inability to Lift Limbs]
Inability to lift limbs is Fengfei, i.e., meridian/channel strike. Stiff tongue, inability to speak, flaccid legs. Mild cases (clear mind, faint speech) are easy to treat; severe cases (inability to speak) are difficult. Differentiate into: damp-phlegm stagnation, phlegm-fire flow, Kidney-Liver Yin deficiency, Mingmen Fire decline, or blood/Qi deficiency.
[Generalized Body Pain]
Generalized body pain is Fengbi. Symptoms include alternating arm paralysis. Muscles are unusable, resembling Pianku but with more pain. Caused by mixed Wind-Cold-Damp. Cold dominance causes blood coagulation (Tongbi/Painful Bi); Damp dominance causes heaviness (Zhuobi/Adherent Bi); Wind dominance causes wandering pain (Xingbi/Wandering Bi). All three combined cause Zhoubi (Generalized Bi). Long-term wind causes Wanbi (Stubborn Bi) with muscle numbness. Inability to bend/extend waist/neck/hands/feet. Pain in meridians is easy to treat; pain upon movement indicates Jin Ku (Tendon Withering), which is untreatable.
[Facial Deviation]
Hand-Yangming and Foot-Yangming meridians surround the mouth/lips; Hand-Taiyang and Foot-Taiyang meridians reach the eyes. Wind pathogens cause slackness in affected areas and tension in healthy areas, pulling the face to one side.
[Jaw Lock]
Sinews of Hand-Triple Burner and Foot-Stomach meridians connect to the jaw/mouth. Wind invasion causes sinew spasm, locking the jaw. Use Pokuan San (Coffin-Breaking Powder) to rub teeth until warm/open.
[Aphonia]
Spleen, Heart, and Kidney meridians connect to the tongue root. Wind striking Heart/Spleen causes stiff tongue; Kidney deficiency causes aphonia. Also consider wind striking Huian (epiglottis), phlegm blocking throat, or phlegm confusing Heart orifices. Wind entering Zang organs with terminal signs is critical.
[Tendinous Spasms (Chizong)]
Chizi refers to alternating contraction and extension of tendons. Associated with Liver channel Wind-Fire, Blood Dryness, or Liver Fire consuming Blood. Results in continuous convulsions. Described as "Blood Withering, Wood Flourishing generating Wind."
[Numbness of Ten Fingers]
Meridians and collaterals permeate the body. Blood vessels are tunnels for blood; tendons are nourished by blood. Qi/Blood deficiency and phlegm stagnation cause numbness. Use Shenxiao Huangqi Tang (Miraculous Astragalus Decoction), Buzhong Yiqi Tang, or Liujunzi Tang, adding Gouteng (Uncariae Ramulus cum Uncis), Zhuli (Bambusa Sap), and Jiangzhi (Zingiberis Juice).
[Prevention of Stroke]
Numb fingers and dizziness are precursors. Prevent by regulating lifestyle, diet, sexual activity, and emotions. Take Shiquan Dabu Tang (Ten-Agent Great Supplement Decoction) plus Qianghuo (Notopterygii Rhizoma et Radix) regularly. Ancient methods using Tianma (Gastrodiae Rhizoma) etc., to open pores and leak fluids actually invite wind; do not use for prevention.
[Distinguishing True Stroke]
Heatstroke, coldstrike, dampstrike, Phlegm/Jue, Food/Heat Jue, and fainting all cause sudden collapse. True stroke is distinguished by facial deviation, spasms, or hemiplegia. Differentiate from Zhongqi (Qi Strike): Zhongqi has cold body, deep pulse, no phlegm; Stroke has warm body, floating pulse, phlegm.
[Distinguishing Closed vs. Collapse Syndromes]
Sudden collapse requires distinguishing Bi (Closed) vs. Tuo (Collapse). Bi: Jaw locked, fists clenched (pathogen blocked outside, Qi inside) – easier to treat. Tuo: Mouth open, snoring, urinary incontinence (Qi leaking out, pathogen inside) – difficult to treat.
[Signs of Death]
Heart failure: mouth open. Lung failure: snoring. Spleen failure: hands relaxed. Liver failure: eyes closed. Kidney failure: urinary incontinence. Muscle wasting, tendon pain, straight hair, head shaking, foaming, fixed gaze, ruddy complexion, pearl-like sweat, hematemesis/hematochezia are all untreatable. Seeing one or two signs may still be salvageable.
[Pulse Diagnosis]
Stroke pulses are Floating-Slippery (with phlegm/Qi) or Deep-Slippery. Do not treat solely as wind. Floating-Slow/Deep-Slow are auspicious; Surging-Large/Urgent are ominous. Spleen pulse alone slow and weak is difficult.
[General Treatment]
Wind diseases are caused by phlegm; resolve phlegm first. Initially regulate Qi; later invigorate Blood. Wind originates from Heat; calmness overcomes dryness/nourish Blood. "Treat Blood first to extinguish Wind." Deficiency requires strengthening Spleen/Kidney. Spleen generates Blood; Spleen transforms Phlegm; Kidney water clears Heat; Kidney Qi secures Phlegm.
[Reviewing Sweating and Purging Methods]
For excess patterns in Fu/Zang, do not miss opportunities to open/block. Use mild sweating or gentle purging. Excessive sweating damages Wei Qi; excessive purging damages Ying Blood.
[Reviewing Emetic Methods]
Excessive phlegm requiring emesis. Repeat if necessary. Contraindicated in Qi/Blood deficiency. Complete removal of phlegm may lead to flaccidity; be cautious.
[Contraindication of Mineral Pills]
Ancient formulas used mineral pills (Dragon brain/Musk/Ox gall/Antimony/Amber/Pearl) for wind in marrow. These are pungent/aromatic and penetrating, suitable only for Closed Zang syndromes. Using them in Qi-deficiency/Collapse patients is fatal ("oil entering flour").
[Caution on Diuretics]
Yang deficiency with spontaneous sweating and fluid loss causing scant urine: do not use diuretics blindly, as this depletes Ying/Wei and exacerbates heat/fire. Wait for heat/subside and sweat stop before urine regulates naturally.
[Caution on Cathartics]
Zang strikes with phlegm-blockage often have obstructed bowels; opening is appropriate. However, in Qi/Blood deficiency causing dryness, nourish Blood instead.
[Emergency Rescue Methods]
For sudden collapse, jaw lock, and phlegm tide: pinch Renzhong (GV26). Once awake, blow Tongding San (Upper-Reaching Powder) into nostrils and pull hair. Sneezing indicates treatability; absence indicates fatality. For jaw lock, rub teeth with Salt Plum and Cang'er (Bombyx Batryticatus). For stubborn phlegm, use Xitan San (Saliva-Flowing Powder) to induce vomiting. For sealed wind pathogens preventing oral medication, use Fangfeng Huangqi Tang fumigation. For deficiency/sweating/Collapse signs, use Shenju Tang or Shenfu Gao with Zhuli/Jiangzhi. Moxibustion on Dantian (CV17) and Qihai (CV6) may save lives.
[General Medication Principles]
Ancient rules: Meridian strike -> Da Qinjiao Tang; Fu strike -> Xiao Xuming Tang; Zang strike -> Sanhua Tang; Closed -> Sansheng Yin; Collapse -> Shenfu Tang. Base formula: Erchen Tang + Wuyao, Zhike, Zhuli, Jiangzhi. Additions based on Six Meridian symptoms: No sweat/stiffness -> Qianghuo, Fangfeng; Sweat/body ache -> Shaoyao, Guizhi; Aversion to cold/fever -> Chaihu, Huangqin; Headache/dizziness -> Chuanxiong, Manjingzi; Facial deviation -> Quanxie, Tianma; Hot dizziness -> Ganju, Xicha; Phlegm -> Nanxing, Beimu; Delirium -> Shichangpu, Yuanzhi, Fushen, Zaoren; Spasms -> Cang'er, Tianma; Tendon tightness -> Mugua; Sinew cramping -> Gouteng; Arm involvement -> Guizhi; Leg involvement -> Niuxi. As wind/phlegm recede, focus on hemiplegia: Blood deficiency -> Erchen + Siwu Tang; Qi deficiency -> Erchen + Sijunzi Tang. Add Qinjiao, Xuduan, Zhuli, Jiangzhi. For limb paralysis: Damp-phlegm -> Sanyi Chengqi Tang; Weakness -> Shiquan Dabu Tang. For constipation: Phlegm-excess -> Sanhua Tang; Fluid depletion -> Siwu Mahren Tang. For chronic recovery: Qianghuo Yufeng Tang, Shiguogong Wine, Changchun Wine. For mild cases: Self-recovery with wines. General principle: Dispel Wind/Resolve Phlegm as Sovereign; Tonify Qi/Blood as Minister; Guide/Relax Tendons as Envoy. For Spleen/Kidney deficiency origins: Spleen deficiency -> Liujunzi Tang; Qi fatigue/phlegm -> Buzhong Yiqi Tang + Fuling, Banxia; Heart/Spleen Qi deficiency/aphasia -> Guipi Tang; Kidney Yin deficiency/aphasia -> Liuwei Dihuang Tang; Kidney Yin/Yang deficiency -> Dihuang YinzI Tang; Liver Blood Dryness -> Jiawei Xiaoyao San. For incomplete recovery: Assess Liver/Spleen/Kidney deficiency patterns; use Liuwei, Qiwei, Bawei Wan, Guipi Wan, Huaishao Dan, Huqian Wan. Continue with Sijunzi, Liujunzi, Bazhen, Shiquan Dabu, Buzhong Yiqi, Guipi decoctions daily to subdue latent wind.
[Selected Formulas for Stroke]
Tongshen San: Induces vomiting for phlegm obstruction.
White Silkworm (Cang'er) 7 pieces, roasted/powdered. Mix with Ginger Juice. Vomits immediately. Repeat after short interval. Swallow roasted Rhubarb (Dahuang) juice. If mouth closed, instill Silkworm decoction via bamboo tube into nostril (Male Left/Female Right).
Xitan San: Induces vomiting for phlegm.
Jiangzi (Croton Seed) 6 grains; Zhu Ya Zao (Gleditsiae Fructus Spinosus) 3 qian slices; Mingfan (Alumen) 1 liang. Dissolve Alumen, mix with others, dry to powder. Blow 1 zi amount into nose to clear saliva. If throat blocked, mix 5 fen with Dengxin Tang and probe vomit.
Pokuan San: Treats jaw lock.
Nanxing (Arisaematis Rhizoma) 0.5 qian; Longnao (Borneolum Syntheticum) 0.25 qian. Powder. Rub molars until warm/open. Alternative: Smoked Plum flesh rubbed with Nanxing/Xixin powder applied with middle finger. Then administer Sesame Oil + Musk/Ginger Juice.
Kaiguan San: Opens orifices for heavy phlegm.
Cang'er (roasted/deveined) and Kubai Fan (Alumen calcined) in equal parts. Powder. 3 qian dose with Ginger-Honey water.
Dixtan Tang: Treats phlegm confusing Heart orifices, stiff tongue, Zang strike.
Danxing (Arisomatis Rhizoma Cum Bile) ginger-processed; Banxia (Pinelliae Rhizoma Praeparatum) ginger-processed, each 2.5 qian; Zhishi (Aurantii Fructus Immaturus) bran-roasted; Fuling (Poria) each 2 qian; Juhong (Citri Reticulatae Pericarpium) 1.5 qian; Shichangpu (Acori Tatarinowii Rhizoma) and Renshen (Ginseng Radix) each 1 qian; Zhuru (Bambusae Caulis in Taenia) 0.7 qian; Gancao (Glycyrrhizae Radix et Rhizoma) 0.5 qian. Add Muxiang (Aucklandiae Radix) 0.3 qian, Ginger 5 slices. Decoct.
Sanhua Tang: Treats Zang strike with phlegm-stasis blocking bowels in robust patients.
Houpo (Magnoliae Officinalis Cortex) ginger-fried; Zhishi; Dahuang (Rhei Radix et Rhizoma); Qianghuo (Notopterygii Rhizoma et Radix) equal parts. 1 liang dose, 1 sheng water, boil to half. Drink throughout day until purged.
Zirun Tang: Moistens dry bowels in deficiency/blood-depletion patients intolerant to harsh purges.
Danggui (Angelicae Sinensis Radix) 2 qian; Xingren (Armeniacae Semen Amarum) 1.5 qian; Taoren (Persicae Semen); Juhong; Zhike (Aurantii Fructus); Houpo each 1 qian; Suzi (Perillae Fructus) 1 qian; Niuxi (Achyranthis Bidentatae Radix) 1.5 qian. Decoct, mix with 3 spoons White Honey.
Sansheng Yin: Treats Closed Zang syndrome (jaw lock, throat obstruction, clenched fists, sudden collapse).
Nanxing 1 liang; Chuanwu (Aconiti Radix) peeled; Shengfuzi (Aconiti Lateralis Radix) each 5 qian; Muxiang 2.5 qian. 0.5 liang dose with 10 Ginger slices. Urine incontinence/relaxed hands/open mouth/snoring indicate untreatable status, though survival is possible. Sansheng Yin is potent for cold-phlegm; must accompany with large dose of Renshen to support Zheng Qi and drive pathogens, otherwise failure is certain.
Fangfeng Huangqi Steam Method: For stroke where oral meds are impossible.
Fangfeng (Saposhnikoviae Radix) and Huangqi (Astragali Radix) equal parts. Boil, place basin under bed. Close doors/windows. Steam fumes into nose/mouth. Uses invisible Qi to open visible orifices.
Xiao Xuming Tang: Treats unconsciousness, hemiplegia, facial deviation, tremors, dysarthria, numbness, confusion, dizziness, phlegm, tendon stiffness, and foot weakness.
Mahuang (Ephedrae Herba) de-jointed; Chuanxiong (Ligustici Chuanxiong Rhizoma); Xingren (Armeniacae Semen Amarum); Gancao (Glycyrrhizae Radix et Rhizoma) honey-fried; Renshen; Huangqin (Scutellariae Radix); Shaoyao (Paeoniae Radix Alba); Fangji (Stephaniae Tetrandrae Radix) each 1 liang; Guizhi (Cinnamomi Ramulus) 1 liang; Fangfeng 1.5 liang; Fuzi (Aconiti Lateralis Radix Praeparata) fried 5 qian. Add Ginger. Hot take to induce sweat. Modifications: Confusion add Fuling; Joint pain/heat remove Fuzi, double Shaoyao; Irritability/constipation remove Fuzi, double Shaoyao, add Zhuli; Loose stool/cold remove Huangqin, add Baizhu/Fuzi; Cold joint pain add Rougui/Fuzi; Vomiting/bloating add Renshen/Banxia; Spontaneous sweat remove Mahuang, add Shaoyao; Constipation/heat remove Fuzi, add Zhike/Dahuang; Excess phlegm add fried Nanxing; Wind-weakness add...