气为阳，血为阴，阴阳配偶不参差，五脏调和脉斯正。惟是体格丰隆，一线之微阳，不足以敌硕肤之阴躯。
居恒服温补性味，殊觉相宜。寒凉性味，一滴逆口，由是气虚，是以脉虚耳。盖尝论之，气，无形者也，
血，有形者也。有形者，全赖无形者为之运用，而后足得以行，手得以握，耳得以聪，目得以明，鼻得以闻其香
臭，口得以知其五味。虽然，尤有进无形者，能运有形，而不知更有无形者，为之主宰，无形者，方得宣布于
四肢，充塞于五脏六腑。无形者何？真气是也（以其所运而言，曰真气；以其所居而言，曰谷神。《道德经
》∶“谷神不死，是谓元牝；元牝之门，是为天地之根。”手足耳目口鼻，皆根窍于元牝。元窍一闭，耳非不孔
窍玲珑，而不能听；目非不黑白分明，而不能视；鼻非不呼吸出入，而不闻香臭；口非不咀嚼珍蔬，而不知五
味；手足非不血光红润，而不握不行）。今为阴血所压，无形者馁矣；”无形者馁，则有形者亦馁矣。古今
卒中之症，大半患于体肥之人，职是故耳。方书所载中症，许多言说，徒事喧哗。
一言以蔽之曰∶“气脱。”其卒然而毙者，真气脱也；其毙复苏者，真气犹存。凡气一时不足以胜形体之任，
其手足不用不仁者，元窍闭也元窍闭，调治得宜（脉虚、脉芤脉迟经验方∶黄 、人参、焦术、附片、秦归、
抚芎、苡米、姜枣引。脉洪、脉数、脉细经验方∶熟地、人参、枸杞、秦归、苡米、丹皮、麦冬、五味。如初
中半身不遂，不省人事，筋急拘挛，口角 斜，语言蹇涩，脉弦而数，则以风论，小续命汤∶防风一钱二分、
桂枝、麻黄、杏仁、川芎、白芍、人参、甘草、黄芩、防己八分、附片），轻者亦有全愈，重者或苟延岁月。
调治失宜，真气亦不能久留，知几之士见其体肥脉虚，时常培养元阳（经验方∶附片、干姜、人参、黄 、焦
术、肉桂、秦归、炙草、姜枣引。鹿茸桂附丸∶附片、肉桂、鹿茸、熟地、淮药、丹皮、枣皮、泽泻、茯苓），
庶有裨焉。有形四大皆假合（潜确《内书》，四大，地、水、火、风也。地无坚性，水性不住，风性无碍，
火假缘生。《释典》∶骨肉为地，涕唾津液为水， 气为火，骨节转运为风。达者谓之幻身。古佛偈假借四大以
为身），无形中有主人翁（《性命圭旨》∶主人翁，姓金，号元晶，自虚无中来，居杳冥之乡）。
岐伯曰∶“中风大法有四∶一曰偏枯，半身不遂也；二曰风痱，身无疼痛，四肢不收；三曰风 ，奄忽不
知人也；四曰风痹，诸痹类风状也。”夫曰风痹，真风也。所谓偏枯、风痱、风 者，以其舌强口喑，卒倒无知，
形似乎风，因以风名。详究其义，实与风毫不相涉。就其症而言之，手撒，脾气绝矣；口开，心气绝矣；鼻
鼾，肺气绝矣；目闭，肝气
绝矣；遗溺，肾气绝矣。汗出如珠，发直如麻，面赤如妆，真阳鼓散于外矣。抉其精而穷其奥，总归宿于肾元。
盖肾为性命之根，如止见一二经，尚未伤及于肾，急相其肾之水亏、火亏，培之补之，而受伤之脏，自复其
初。朱丹溪以为痰则生火，火则生风，固属捕风捉影；李东垣以为本气自病，将风字涂抹，其于是症，亦似有
得，究未窥其底蕴；河间以为将息失宜，心火暴甚，而着地黄引子（熟地、枣皮、巴戟、附片、肉桂、苁蓉、
茯苓、麦冬、五味、石斛、菖蒲、远志），可谓抉出疾源矣。顾肾水火同宫，有痰涎上涌，水不足者；有面赤
烦渴，火不足者。地黄引子仅足补其火，赵养葵又补明水不足者，用地黄汤滋其水。庶岐伯不言之蕴，得以阐
明于世。治是症者，慎勿存一风字于胸中，斯得之矣。
气属于阳，血属于阴，阴阳相互匹配而没有偏差，五脏功能调和，脉象才能正常。只是那些体格丰满隆盛的人，体内仅存的一丝微弱阳气，不足以抵御庞大身躯中的阴气。
他们平时习惯服用性味温补的药物，觉得很适宜。遇到性味寒凉的药物，哪怕只是一滴也会抵触不适，因此导致气虚，所以脉象呈现虚弱之象。我曾经论述过：气，是无形的；血，是有形的。有形的物质，完全依赖无形的物质来运化推动，然后才能四肢行走、双手握持、耳朵听觉灵敏、眼睛视力清晰、鼻子能闻到香臭气味、嘴巴能辨别五味。虽然如此，更进一步说，无形者能运化有形者，但还有更深层的无形力量在主宰这一切，只有经过这种主宰，无形之气才能在四肢布散，在五脏六腑中充盈。这个无形的东西是什么？就是真气（从它运化的功能来说，称为真气；从它居住的地方来说，称为谷神。《道德经》说：“谷神不死，是谓元牝；元牝之门，是为天地之根。”手足耳目口鼻，都是根源于元牝这一窍穴。如果元窍闭塞，耳朵并非没有孔窍玲珑的结构，却无法听声；眼睛并非没有黑白分明的结构，却无法视物；鼻子并非没有呼吸出入的通道，却闻不到香臭；嘴巴并非不能咀嚼珍馐蔬菜，却不知道五味；手脚并非没有红润的血色，却无法握持和行走）。现在被阴血所压制，无形的真气就衰弱了；真气衰弱，有形的身体也随之衰弱。古今发生的卒中（中风）病症，大半发生在体格肥胖的人身上，就是这个原因。医书中关于卒中病症的许多说法，只是徒劳地喧哗争论。
用一句话概括，就是“气脱”。突然死亡的，是真气外脱；死亡后复苏的，是真气尚存。凡是气一时不足以承担形体负担的，出现手足不能活动、麻木不仁的情况，这是元窍闭塞。元窍闭塞时，若调治得当（针对脉虚、脉芤、脉迟的经验方：黄芪、人参、炒白术、附子片、当归、川芎、薏苡米，以生姜和大枣为引。针对脉洪、脉数、脉细的经验方：熟地黄、人参、枸杞子、当归、薏苡米、牡丹皮、麦冬、五味子。如果是初发半身不遂、昏迷不省人事、筋脉拘急挛缩、口角歪斜、语言蹇涩不利、脉弦而数的情况，则按风证论治，使用小续命汤：防风一钱二分、桂枝、麻黄、杏仁、川芎、白芍、人参、甘草、黄芩、防己八分、附子片），轻症也有痊愈的，重症或许能勉强维持岁月。若调治失当，真气也不能长久留存。洞察先机的医者见到患者体肥脉虚，时常培养元阳（经验方：附子片、干姜、人参、黄芪、炒白术、肉桂、当归、炙甘草，以生姜和大枣为引。鹿茸桂附丸：附子片、肉桂、鹿茸、熟地黄、山药、牡丹皮、山茱萸、泽泻、茯苓），这样才有益处。有形的四大（地、水、火、风）皆是假合而成的（参考潜确《内书》，四大指地、水、火、风。地没有坚硬的特性，水性流动不住，风性无障碍，火借缘而生。佛典说：骨肉属于地，涕唾津液属于水，气息属于火，骨节转动属于风。通达之人称之为幻身。古佛偈语借用四大来形容身体）。而在无形之中有着主人翁（《性命圭旨》说：主人翁姓金，号元晶，从虚无中来，居住在杳冥之乡）。
岐伯说：“中风的大法有四类：一是偏枯，即半身不遂；二是风痱，身体无疼痛，四肢无法收摄；三是风喑，突然昏倒不知人；四是风痹，各种痹证类似风证的状况。”所谓风痹，确实是真风邪所致。所谓的偏枯、风痱、风喑，是因为它们舌强口哑、突然倒下无知觉，形态似乎像风邪致病，因此以“风”命名。详细探究其义理，实际上与风邪毫不相干。就这些症状而言，手撒开，说明脾气已绝；口张开，说明心气已绝；鼻鼾声重，说明肺气已绝；眼睛闭合，说明肝气已绝；遗尿，说明肾气已绝。汗出如珠，头发直立如麻，面色红赤如化妆，这是真阳鼓动散越于体外。剖析其精微并穷究其奥妙，总归宿在于肾元。因为肾是性命的根本，如果只看到一二条经脉受损，尚未伤及肾脏，应紧急观察肾脏是水亏还是火亏，培补它，那么受伤的脏腑自然恢复如初。朱丹溪认为痰则生火，火则生风，这确实属于捕风捉影；李东垣认为是本气自病，将“风”字抹去，他对这个病症的看法似乎也有一定心得，但终究未窥探到其底蕴；刘河间认为是调养失宜，心火暴甚，并创制了地黄引子（熟地黄、山茱萸、巴戟天、附子片、肉桂、肉苁蓉、茯苓、麦冬、五味子、石斛、石菖蒲、远志），可以说是挖掘出了疾病的根源。但是肾中水火同居一宫，有因水不足导致痰涎上涌的；有因火不足导致面赤烦渴的。地黄引子仅足以补火，赵养葵又补充明水不足者，使用地黄汤滋补肾水。这样，岐伯未曾言说的深意，得以阐明于世。治疗这种病症的人，千万不要在心中存有“风”字的概念，这样才能掌握要领。
Qi belongs to Yang, Blood belongs to Yin. When Yin and Yang are matched without discrepancy, the Five Viscera (Zang organs) are harmonious, and the pulse becomes regular. However, for those with a robust and plump physique, the slender thread of weak Yang Qi within is insufficient to counteract the massive Yin body.
They habitually take tonifying medicines with warm properties and flavors, finding them quite suitable. They strongly reject medicines with cold properties and flavors; even a single drop causes aversion. Consequently, Qi deficiency arises, leading to a deficient pulse. I have previously discussed: Qi is formless, while Blood is formed. The formed relies entirely on the formless for its operation and movement, thereby enabling walking with the limbs, grasping with the hands, hearing clearly with the ears, seeing distinctly with the eyes, smelling odors with the nose, and tasting the five flavors with the mouth. Furthermore, although the formless operates the formed, there exists an even more profound formless entity that acts as the master. Only through this mastery can the formless Qi be distributed to the four limbs and fill the Five Viscera and Six Bowels. What is this formless entity? It is Zhen Qi (True Qi). From the perspective of its function of operating, it is called Zhen Qi; from the perspective of its residence, it is called Gu Shen (Valley Spirit). As stated in the *Daodejing*: "The Valley Spirit never dies; this is called the Mysterious Female. The gate of the Mysterious Female is called the root of Heaven and Earth." The hands, feet, ears, eyes, nose, and mouth all originate from the root orifice of the Mysterious Female. If this root orifice closes, the ears, though structurally delicate and perforated, cannot hear; the eyes, though distinct in black and white, cannot see; the nose, though capable of breathing in and out, cannot smell; the mouth, though able to chew delicacies, cannot taste; the hands and feet, though ruddy with blood, cannot grasp or move. Now, suppressed by Yin Blood, the formless Zhen Qi becomes emaciated; when the formless is emaciated, the formed also becomes emaciated. Most cases of Zhong Feng (Apoplexy/Stroke) throughout history occur in people with plump bodies, due to this very reason. Many descriptions of Zhong Feng in medical texts are merely noisy debates.
In summary, it is "Qi Collapse" (Qi Tu). Sudden death results from the collapse of Zhen Qi; survival after collapse indicates that Zhen Qi remains. Whenever Qi temporarily fails to support the burden of the body, resulting in immobility and numbness of the limbs, it signifies the closure of the Root Orifice. If treated appropriately during Root Orifice closure:
For a Xu (Deficient), Kou (Hollow), or Chi (Slow) pulse, use the Empirical Formula: Huang Qi (Astragali Radix), Ren Shen (Ginseng Radix), Jiao Zhu (Stir-fried Atractylodis Macrocephalae Rhizoma), Fu Pian (Prepared Aconiti Lateralis Radix), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Yi Mi (Coicis Semen), guided by Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus).
For a Hong (Surging), Shu (Rapid), or Xi (Fine) pulse, use the Empirical Formula: Shu Di Huang (Rehmanniae Radix Praeparata), Ren Shen, Gou Qi Zi (Lycii Fructus), Dang Gui, Yi Mi, Mu Dan Pi (Moutan Cortex), Mai Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Fructus).
If initially presenting with hemiplegia, unconsciousness, muscle spasm and contracture, deviation of the mouth and angle of the eye, dysarthria, and a Xuan (Wiry) and Shu (Rapid) pulse, treat it according to Wind patterns using Xiao Xu Ming Tang (Minor Decoction to Continue Life): Fang Feng (Saposhnikoviae Radix) 1 qian 2 fen, Gui Zhi (Cinnamomi Ramulus), Ma Huang (Ephedrae Herba), Xing Ren (Armeniacae Semen Amarum), Chuan Xiong, Bai Shao (Paeoniae Radix Alba), Ren Shen, Gan Cao (Glycyrrhizae Radix et Rhizoma), Huang Qin (Scutellariae Radix), Fang Ji (Stephaniae Tetrandrae Radix) 8 fen, Fu Pian. Mild cases may fully recover; severe cases may only prolong life for years.
If treatment is inappropriate, Zhen Qi cannot remain long. Discerning physicians, observing plump bodies with deficient pulses, should frequently cultivate Yuan Yang (Primordial Yang).
Empirical Formula: Fu Pian, Gan Jiang (Zingiberis Rhizoma), Ren Shen, Huang Qi, Jiao Zhu, Rou Gui (Cinnamomi Cortex), Dang Gui, Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), guided by Sheng Jiang and Da Zao.
Lu Rong Gui Fu Wan (Deer Antler Cinnamon and Aconitum Pill): Fu Pian, Rou Gui, Lu Rong (Cornu Cervi Pantotrichum), Shu Di Huang, Huai Yao (Dioscoreae Rhizoma), Mu Dan Pi, Shan Zhu Yu (Corni Fructus), Ze Xie (Alismatis Rhizoma), Fu Ling (Poria). This approach is beneficial.
The formed Four Elements (Earth, Water, Fire, Wind) are merely temporary aggregations (as per Qian Que's *Nei Shu*). Earth lacks firmness, Water flows away, Wind has no obstruction, Fire arises conditionally. Buddhist scriptures state: flesh and bones belong to Earth, mucus and saliva belong to Water, breath belongs to Fire, joint movement belongs to Wind. Wise men call this an illusory body. Within the formless resides the Master (as per *Xingming Guizhi*: The Master's surname is Jin, courtesy name Yuan Jing, coming from emptiness, dwelling in the obscure realm).
Qibo stated: "There are four major categories of Zhong Feng: First, Pian Ku (Hemiplegia), which is half-body paralysis; Second, Feng Fei (Wind Paralysis), characterized by no pain but inability to control the four limbs; Third, Feng Yin (Wind Aphasia), sudden loss of consciousness; Fourth, Feng Bi (Wind Bi), where various Bi syndromes resemble Wind patterns." True Wind refers specifically to Feng Bi. The terms Pian Ku, Feng Fei, and Feng Yin are named after "Wind" because their symptoms—stiff tongue, aphasia, sudden collapse, and unconsciousness—appear similar to Wind pathogenic factors. However, upon detailed examination, they have absolutely nothing to do with actual Wind pathogens. Regarding these symptoms: flaccid hands indicate the extinction of Pi Qi (Spleen Qi); open mouth indicates the extinction of Xin Qi (Heart Qi); snoring indicates the extinction of Fei Qi (Lung Qi); closed eyes indicate the extinction of Gan Qi (Liver Qi); urinary incontinence indicates the extinction of Shen Qi (Kidney Qi). Sweat like pearls, hair standing straight like hemp, and a ruddy face like makeup indicate the dispersion of True Yang outside. Analyzing the essence and exploring the profundity, everything returns to the Kidney Yuan (Primordial Source). Since the Kidney is the root of life and nature, if only one or two meridians are affected without involving the Kidney, urgently assess whether the Kidney suffers from Water Deficiency or Fire Deficiency, and tonify it accordingly; the injured viscera will naturally recover.
Zhu Danxi believed that Phlegm generates Fire, and Fire generates Wind; this is indeed chasing shadows. Li Dongyuan believed it was a disease of the original Qi itself, removing the concept of Wind; his insight into this syndrome seemed somewhat accurate, yet he did not penetrate its core. Liu Hejian believed it resulted from improper lifestyle management causing a violent surge of Heart Fire, and created Di Huang Yin Zi (Rehmannia Decoction): Shu Di Huang, Shan Zhu Yu, Ba Ji Tian (Morindae Officinalis Radix), Fu Pian, Rou Gui, Cong Rong (Cistanches Herba), Fu Ling, Mai Dong, Wu Wei Zi, Shi Hu (Dendrobii Caulis), Shi Chang Pu (Acori Tatarinowii Rhizoma), Yuan Zhi (Polygalae Radix). This could be said to have excavated the source of the disease. However, Water and Fire reside together in the Kidney. There are cases of phlegm-saliva surging upward due to Water insufficiency, and cases of red face and irritability/thirst due to Fire insufficiency. Di Huang Yin Zi only suffices to tonify Fire. Zhao Yangkui supplemented those with insufficient Bright Water (Kidney Yin) by using Di Huang Tang (Rehmannia Decoction) to nourish Water. Thus, the implicit meanings left unspoken by Qibo were elucidated in the world. Those treating this syndrome must strictly avoid harboring the concept of "Wind" in their minds; only then will they succeed.