凡人初觉大指、次指麻木不仁,或手足少力、肌肉微掣,三年内有中风之疾,宜先服愈风汤、天麻丸各一
料,此治未病之先也。又云∶于未病之先,服竹沥枳术九,可祛去之。若与搜风顺气丸间服,何中风之有?
愈风汤 初觉风动,服此不致倒仆,此乃治未病之圣药也。又治中风症内邪已除,外邪已尽当服此药
,以导诸经。久服大风尽去,纵有微邪,只从此药加减治之。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。久则清浊自分、荣卫自和矣。
黄 (蜜炙) 人参(去芦) 当归(酒洗) 白芍(酒炒) 生地黄 枸杞子 杜仲(姜酒炒) 秦艽
肉桂 苍术(米泔洗) 羌活 独活 防风 薄荷 菊花 细辛 麻黄 蔓荆子 白芷 地骨皮 知母 石膏
柴胡 黄芩 枳壳(麸炒) 甘草
上锉,每服一两,生姜三片,水煎空心服。渣再煎,临卧服。一方加熟地黄、半夏、浓朴、前胡、防己、
茯苓,疗肾肝虚筋骨弱、语言謇涩、精神昏愦。此药安心养神,调理阴阳,使无偏胜,治中风内外无邪。服此药
以行中道,及治风湿内弱、风热体重,或瘦而肢体偏枯,或肥而半身不遂。
天麻丸 治风因热而生,热胜则风动,宜以静以胜其燥,是养血也。此药能行荣卫、壮筋骨,方治
足三阴亏损,风邪折伤致肢体麻木、手足不随等症,去附子加肉桂、熟地黄,名愈风丹。
天麻 牛膝(去芦,酒洗) 萆 玄参(各一两半) 杜仲(姜炒,一两七钱) 大附子(去皮脐,五
钱) 羌活(三两半) 当归(酒洗,一两半) 生地黄(酒洗,四两) 去肾间风,加独活一两半。
上为末,炼蜜为丸,如梧桐子大。每服七八十丸,空心
酒下,白汤亦可,良久则食。
竹沥枳术丸 化痰清火、顺气除湿、祛晕眩、疗麻木、养血、健脾胃。
白术(去芦,土炒) 苍术(泔制盐水炒。各二两) 枳实(麸炒) 陈皮(去白) 白茯苓(去皮)
半夏(白矾、皂角、生姜水煮干) 南星(制同上) 黄连(姜炒) 条芩(酒炒) 当归(酒洗) 山楂(去
核) 白芥子(炒) 白芍(酒炒。各二两) 人参(五钱) 木香(一钱)
上为细末,以神曲六两、姜汁一盏、竹沥一碗,煮糊为丸,如梧桐子大。每服百丸,食远淡姜汤送下。
搜风顺气丸 治肠胃积热,以致膈间痞闷、大便结燥、小便赤涩、肠风痔漏、腰膝酸疼、肢节顽麻、手
足瘫痪、行步艰辛、语言謇涩,三十六种风、七十二般气,无不效验。
大黄(五两,酒蒸九次、要黑) 火麻仁(微炒,去壳) 郁李仁(去壳,泡去皮,二两) 菟丝子(酒煮,
二两) 干山药(二两) 牛膝(去芦,酒洗,二两) 枳壳(麸炒,一两) 槟榔(二两) 车前子(炒,二
两半) 山茱萸(酒蒸,去核,二两)
上为末,炼蜜为丸,如梧桐子大。每服三十丸,茶酒任下,百无所忌,早晚各一服。
余屡试前方有效者,有不效者。不效者,多是脾肺之虚,肾气之弱,唯宜补中益气汤、六味地黄丸兼进之,
可免中风之患矣。(方见补益。)
大司寇三川刘公患卒倒,不省人事、口眼相引、手足战掉、一医作风治,一医作痰火治,俱罔效。余诊六
脉沉数,气口紧盛,此非风非痰火,乃气夹食也。其家人始悟曰∶适正食之际,被恼怒所触,遂致如此。用行气香
苏散加木香、青皮、山楂,一服即瘥。
桑环川、刘前溪,素皆与余善,年俱近五旬,而桑多欲、
刘嗜酒,其脉左右俱微,人迎盛,右脉滑大,时常手足酸麻、肌肉蠕动,此气血虚而风痰盛也。余谓三年内,俱
有瘫痪之患,二君宜谨慎,因劝其服药以免后患。桑然其言,每年制搜风顺气丸、延龄固本丹各一料,后果无
恙。其刘不听,愈纵饮无忌,未及三年,果中风卒倒,瘫痪言涩,求治于予曰∶悔不听君言,致有今日,愿君
竭力救我残喘则再造之恩也。予以养荣汤加减,并健步虎潜丸,二药兼服一年余始愈。
刘大尹素有疾,两臂顽麻、两目流泪,服搜风化痰药痰愈甚,臂反痛不能伸,手指俱挛。余曰∶麻属气虚,
误服前药,肝火炽盛,肝血干涸,筋无所养,虚而挛耳。当补脾肺滋肾水则风自去、热自退、痰自清,遂用六味
丸、补中益气汤,不三月而痊。(方见补益。)
凡是人刚开始感觉大拇指、食指麻木不仁,或者手脚无力、肌肉轻微抽搐,三年内会有中风疾病发作,应当先服用愈风汤、天麻丸各一料,这是治未病的预防方法。又说:在未病之前,服用竹沥枳术丸,可以祛除病邪。如果与搜风顺气丸交替服用,怎么还会得中风呢?
愈风汤:刚开始感觉到风邪发动时,服用此药不会导致昏倒仆地,这是治未病的圣药。又治疗中风症内部邪气已除、外部邪气已尽之后应当服用的药物,用来引导诸经气血。长期服用可使大风邪气尽去,即使有微小邪气,只从此药加减治疗即可。然而治病的方法,不可失于通利或闭塞。有时通过微汗解表,有时通过十日左右的通利二便,这才是常规的治疗方法。时间久了,清浊之气自然分明,营卫之气自然调和了。
药材:黄(蜜炙)、人参(去芦头)、当归(酒洗)、白芍(酒炒)、生地黄、枸杞子、杜仲(姜酒炒)、秦艽、肉桂、苍术(米泔水洗净)、羌活、独活、防风、薄荷、菊花、细辛、麻黄、蔓荆子、白芷、地骨皮、知母、石膏、柴胡、黄芩、枳壳(麸炒)、甘草。
以上药材切碎,每次服用一两,加生姜三片,水煎,空腹服用。药渣再煎,临睡前服用。另一配方加入熟地黄、半夏、浓朴、前胡、防己、茯苓,治疗肾肝虚损导致的筋骨软弱、语言謇涩、精神昏愦。此药能安心养神,调理阴阳,使阴阳没有偏胜,治疗中风内外无邪。服用此药以行中道,以及治疗风湿内弱、风热导致的身体沉重,或者消瘦而肢体偏枯,或者肥胖而半身不遂。
天麻丸:治疗因热而生风,热盛则风动,宜以静制动以战胜燥性,这是养血的方法。此药能运行营卫、强壮筋骨,方剂主治足三阴亏损,风邪折伤导致肢体麻木、手足不能随意活动等症状,去掉附子加入肉桂、熟地黄,名为愈风丹。
药材:天麻、牛膝(去芦头,酒洗)、萆薢、玄参(各一两半)、杜仲(姜炒,一两七钱)、大附子(去皮脐,五钱)、羌活(三两半)、当归(酒洗,一两半)、生地黄(酒洗,四两)。去除肾间风邪,加入独活一两半。
以上研为细末,炼蜜为丸,如梧桐子大小。每次服用七八十丸,空腹用酒送下,白开水也可以,过一会儿再进食。
竹沥枳术丸:化痰清火、顺气除湿、祛晕眩、疗麻木、养血、健脾胃。
药材:白术(去芦头,土炒)、苍术(泔水制,盐水炒。各二两)、枳实(麸炒)、陈皮(去白)、白茯苓(去皮)、半夏(白矾、皂角、生姜水煮干)、南星(炮制同上)、黄连(姜炒)、条芩(酒炒)、当归(酒洗)、山楂(去核)、白芥子(炒)、白芍(酒炒。各二两)、人参(五钱)、木香(一钱)。
以上研为细末,用神曲六两、姜汁一盏、竹沥一碗,煮糊为丸,如梧桐子大小。每次服用一百丸,饭后用淡姜汤送下。
搜风顺气丸:治疗肠胃积热,导致胸膈痞闷、大便结燥、小便赤涩、肠风痔漏、腰膝酸疼、肢节顽麻、手足瘫痪、行走艰难、语言謇涩,三十六种风、七十二般气,无不有效。
药材:大黄(五两,酒蒸九次,要蒸黑)、火麻仁(微炒,去壳)、郁李仁(去壳,泡去皮,二两)、菟丝子(酒煮,二两)、干山药(二两)、牛膝(去芦头,酒洗,二两)、枳壳(麸炒,一两)、槟榔(二两)、车前子(炒,二两半)、山茱萸(酒蒸,去核,二两)。
以上研为细末,炼蜜为丸,如梧桐子大小。每次服用三十丸,茶或酒送下均可,百无禁忌,早晚各一次。
我多次尝试前方,有的有效,有的无效。无效的,大多是脾肺之虚,肾气之弱,只宜补中益气汤、六味地黄丸兼进服用,可以避免中风的祸患。(方剂见补益篇。)
大司寇三川刘公患突然昏倒,不省人事、口眼歪斜、手足颤抖,一位医生按风证治疗,一位医生按痰火治疗,都无效。我诊察六脉沉数,气口紧盛,这不是风证也不是痰火,乃是气夹食积所致。他的家人这才醒悟说:刚才正在吃饭的时候,被恼怒所触动,于是导致这样。用行气香苏散加木香、青皮、山楂,一服药即痊愈。
桑环川、刘前溪,平时都与我交好,年龄都接近五十岁,而桑多欲、刘嗜酒,他们的脉象左右俱微,人迎脉盛,右脉滑大,时常手足酸麻、肌肉蠕动,这是气血虚而风痰盛也。我对他们说三年内,都会有瘫痪的祸患,二位君侯应该谨慎,因此劝他们服药以避免后患。桑听从了我的话,每年制作搜风顺气丸、延龄固本丹各一料,后果安然无恙。那个刘不听,更加放纵饮酒无忌,不到三年,果然中风突然昏倒,瘫痪言语謇涩,来求治我说:后悔不听您的话,导致今天这样,希望您竭力救我残喘,则是再造之恩啊。我用养荣汤加减,并配合健步虎潜丸,两种药兼服一年多才痊愈。
刘大尹平素有病,两臂顽麻、两目流泪,服用搜风化痰药后痰更厉害,手臂反而疼痛不能伸展,手指全部拘挛。我说:麻木属于气虚,误服前面的药,导致肝火炽盛,肝血干涸,筋脉无所滋养,虚而拘挛罢了。应当补脾肺滋肾水则风自去、热自退、痰自清,于是用六味丸、补中益气汤,不到三个月就痊愈了。(方剂见补益篇。)
Translation:
Whenever a person initially feels numbness and insensitivity in the thumb and index finger, or experiences weakness in the hands and feet, with slight twitching of muscles, there is a risk of stroke (Zhong Feng, 中风) within three years. It is advisable to first take one dose each of Yufeng Tang (Wind-Dispelling Decoction) and Tianma Wan (Gastrodia Pill). This is the method of treating disease before it arises (Zhi Wei Bing, 治未病). It is also said that before the onset of disease, taking Zhuli Zhizhu Wan (Bamboo Juice and Immature Bitter Orange Pill) can dispel pathogenic factors. If taken alternately with Soufeng Shunqi Wan (Wind-Searching and Qi-Circulating Pill), how could one suffer from stroke?
Yufeng Tang (Wind-Dispelling Decoction): When wind pathogens are initially felt to be stirring, taking this decoction prevents collapse and falling. It is considered a sacred medicine for preventing disease. It is also used after internal pathogens have been eliminated and external pathogens cleared in stroke cases, to guide Qi and Blood through the meridians. Long-term use eliminates major wind pathogens; even if minor pathogens remain, treatment can be adjusted based on this formula. However, therapeutic methods must not neglect either unblocking or securing. Sometimes inducing mild sweating is appropriate; sometimes promoting bowel movement over ten days is suitable. These are standard treatments. Over time, clear and turbid Qi will naturally separate, and Ying (Nutritive) and Wei (Defensive) Qi will harmonize.
Ingredients: Huangqi (Astragali Radix, honey-fried), Renshen (Ginseng Radix et Rhizoma, radix removed), Danggui (Angelicae Sinensis Radix, wine-washed), Baishao (Paeoniae Radix Alba, wine-stir-fried), Shengdihuang (Rehmanniae Radix), Gouqizi (Lycii Fructus), Duzhong (Eucommiae Cortex, ginger-wine stir-fried), Qinjiao (Gentianae Macrophyllae Radix), Rougui (Cinnamomi Cortex), Cangzhu (Atractylodis Rhizoma, washed with rice water), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Juhua (Chrysanthemi Flos), Xixin (Asari Radix et Rhizoma), Mahuang (Ephedrae Herba), Manjingzi (Vittariae Semen), Baizhi (Angelicae Dahuricae Radix), Digupi (Lycii Cortex), Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Zhike (Aurantii Fructus Immaturus, bran-fried), Gancao (Glycyrrhizae Radix et Rhizoma).
Crush the ingredients. Take 1 liang per dose, add 3 slices of fresh ginger, decoct in water, and take on an empty stomach. Decoct the dregs again and take before bed. Another prescription adds Shudihuang (Rehmanniae Radix Praeparata), Banxia (Pinelliae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Qianhu (Peucedani Radix), Fangji (Stephaniae Tetrandrae Radix), and Fuling (Poria), treating weakness of sinews and bones due to Kidney and Liver deficiency, slurred speech, and mental confusion. This medicine calms the mind, nourishes the spirit, regulates Yin and Yang to prevent imbalance, and treats stroke without internal or external pathogens. Taking this medicine maintains the middle pathway, and treats internal weakness from wind-dampness, heaviness from wind-heat, emaciation with hemiplegia, or obesity with half-body paralysis.
Tianma Wan (Gastrodia Pill): Treats wind generated by heat; when heat prevails, wind stirs. Stillness conquers dryness, which is the method of nourishing Blood. This medicine circulates Ying and Wei Qi, strengthens sinews and bones. The formula treats deficiency of the Three Yin Meridians of the Foot, where wind pathogens cause injury leading to limb numbness and immobility. Removing Fuzi (Aconiti Lateralis Radix Praeparata) and adding Rougui and Shudihuang creates Yufeng Dan (Wind-Dispelling Elixir).
Ingredients: Tianma (Gastrodiae Rhizoma), Niuxi (Achyranthis Bidentatae Radix, radix removed, wine-washed), Bibai (Dioscoreae Hypoglaucae Rhizoma), Xuanshen (Scrophulariae Radix) (each 1.5 liang), Duzhong (Eucommiae Cortex, ginger-fried, 1.7 qian), Dafuzi (Aconiti Lateralis Radix Praeparata, skin and navel removed, 5 qian), Qianghuo (Notopterygii Rhizoma et Radix, 3.5 liang), Danggui (Angelicae Sinensis Radix, wine-washed, 1.5 liang), Shengdihuang (Rehmanniae Radix, wine-washed, 4 liang). To remove wind from the Kidney region, add Duhuo (Angelicae Pubescentis Radix, 1.5 liang).
Grind into fine powder, mix with refined honey to make pills the size of paulownia seeds. Take 70-80 pills per dose on an empty stomach, washed down with wine; warm water is also acceptable. Eat after some time.
Zhuli Zhizhu Wan (Bamboo Juice and Immature Bitter Orange Pill): Resolves phlegm, clears fire, regulates Qi, removes dampness, alleviates vertigo, treats numbness, nourishes Blood, and strengthens Spleen and Stomach.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma, radix removed, earth-fried), Cangzhu (Atractylodis Rhizoma, rice-water processed, salt-water fried. Each 2 liang), Zhishi (Aurantii Fructus Immaturus, bran-fried), Chenpi (Citri Reticulatae Pericarpium, white pith removed), Baifuling (Poria, skin removed), Banxia (Pinelliae Rhizoma, boiled dry with Baifan, Gleditsiae Spina, and fresh ginger), Nanxing (Arisaematis Rhizoma, processed as above), Huanglian (Coptidis Rhizoma, ginger-fried), Tiaoqin (Scutellariae Radix, wine-fried), Danggui (Angelicae Sinensis Radix, wine-washed), Shanzha (Crataegi Fructus, core removed), Baijiezi (Sinapis Semen, fried), Baishao (Paeoniae Radix Alba, wine-fried. Each 2 liang), Renshen (Ginseng Radix et Rhizoma, 5 qian), Muxiang (Aucklandiae Radix, 1 qian).
Grind into fine powder. Use Liuku (Medicated Leaven, 6 liang), 1 cup of fresh ginger juice, and 1 bowl of bamboo juice to cook into a paste for making pills the size of paulownia seeds. Take 100 pills per dose, washed down with light ginger tea far from meals.
Soufeng Shunqi Wan (Wind-Searching and Qi-Circulating Pill): Treats accumulated heat in the Intestines and Stomach causing chest oppression, constipation, dark and scanty urination, intestinal wind and hemorrhoids, soreness and pain in waist and knees, stubborn numbness in limbs, paralysis of hands and feet, difficulty walking, and slurred speech. Effective for thirty-six types of wind and seventy-two types of Qi disorders.
Ingredients: Dahuang (Rhei Radix et Rhizoma, 5 liang, steamed nine times in wine until black), Huomaren (Cannabis Semen, lightly fried, shelled), Yuliren (Pruni Semen, shelled, soaked, skin removed, 2 liang), Tusizi (Cuscutae Semen, boiled in wine, 2 liang), Ganshan Yao (Dioscoreae Rhizoma, 2 liang), Niuxi (Achyranthis Bidentatae Radix, radix removed, wine-washed, 2 liang), Zhike (Aurantii Fructus Immaturus, bran-fried, 1 liang), Binglang (Arecae Semen, 2 liang), Cheqianzi (Plantaginis Semen, fried, 2.5 liang), Shanzhuyu (Corni Fructus, wine-steamed, cored, 2 liang).
Grind into powder, mix with refined honey to make pills the size of paulownia seeds. Take 30 pills per dose, with tea or wine as preferred, no dietary restrictions. Take once in the morning and once in the evening.
I have frequently tested the aforementioned formulas; some are effective, others are not. Ineffective cases are mostly due to Spleen and Lung deficiency and weak Kidney Qi. Only Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) should be taken together to prevent stroke. (Formulas see Tonification section.)
Grand Marshal Liu Sanchuan suffered sudden collapse, loss of consciousness, deviation of mouth and eyes, and trembling of hands and feet. One physician treated it as wind, another as phlegm-fire, but both were ineffective. I palpated the six pulses as deep and rapid, with the Qi Kou pulse tight and full. This was neither wind nor phlegm-fire, but Qi combined with food stagnation. His family then realized: "Just now, while eating, he was provoked by anger, leading to this condition." Using Xingqi Xiangsu San (Qi-Moving and Perilla Powder) added with Muxiang, Qingpi, and Shanzha, he recovered after one dose.
Sang Huanchuan and Liu Qianxi were both close friends of mine, nearing fifty years old. Sang had excessive desires, and Liu loved alcohol. Their pulses were both subtle on left and right, with Renying pulse full, and the right pulse slippery and large. They often experienced soreness and numbness in hands and feet, and muscle twitching. This indicates deficiency of Qi and Blood with excess wind-phlegm. I told them they would likely suffer paralysis within three years and advised caution and medication to prevent future illness. Sang followed my advice, preparing one dose each of Soufeng Shunqi Wan and Yanling Guben Dan (Longevity and Root-Firming Pill) annually, and remained healthy. Liu did not listen, indulging in alcohol without restraint. Within three years, he indeed suffered a stroke with sudden collapse, paralysis, and slurred speech. He sought my treatment saying, "I regret not listening to you, bringing me to this state. Please strive to save my remaining life, and your grace will be like giving me new life." I prescribed modified Yangrong Tang (Nourish the Blood Decoction) and Jianbu Huqian Wan (Strengthen Steps and Tiger-Hiding Pill), taken together for over a year before recovery.
Magistrate Liu had chronic illness with stubborn numbness in both arms and tearing eyes. After taking wind-searching and phlegm-resolving medicines, his phlegm worsened, arms became painful and unable to extend, and fingers contracted. I said, "Numbness belongs to Qi deficiency. Mistakenly taking previous medicines caused blazing Liver Fire and drying of Liver Blood, leaving sinews without nourishment, resulting in deficiency-induced contraction. One must tonify Spleen and Lung, nourish Kidney Water, so wind dissipates, heat retreats, and phlegm clears." Thus, using Liuwei Wan (Six-Ingredient Pill) and Bu Zhong Yi Qi Tang, he recovered in less than three months. (Formulas see Tonification section.)