门人问曰。金匮所称中风历节病。与伤寒论中之中风何以异。答曰。伤寒例中之中风。
其病
先犯太阳。逗留于肌表之间。治不如法。传变之后。方始入里。若金匮所指中风。外不见头
痛发热诸表证。总因络脉空虚。贼邪不泻。正气引邪。 僻不遂。邪在于络。肌肤不仁。
邪在于经。即重不胜。此犹浅者也。若邪入于腑。即不识人。邪入于脏。舌即难言。口吐涎
。则入之深矣。同一风因。而其间深浅缓急。迥乎不同。以金匮所指。不从太阳病起。不待
传变。故不入伤寒之例。
门人问曰。世俗所称伤风病。又何以别之。答曰。此病头痛恶寒发热。与伤寒例中之中
风同
。以其咳嗽鼻塞涕自出。是由皮毛以入于肺。与鬲间痰饮相合。并不传变。然人每视为寻常
感冒。病家医家。皆从忽略。殊不知此病一经误治。久而不愈。肺金立败。肺败则肾水之子
失荫。而肾亦与俱败。且本气既伤。日盗脾胃母气。以供其挹取。久之而中土亦败。其始不
觉。其继莫救者。比比皆然。徐灵胎曰。伤风之疾。由皮毛以入于肺。肺为娇脏。寒热皆所
不宜。太寒则邪气凝而不出。太热则火烁金而动血。太润则生痰饮太燥则耗精液。太泄则汗
出而阳虚。太涩则气闭而邪结。并有视为微疾。不避风寒。不慎饮食。经年累月。病机日深
。或成血症。或成肺痿。或成哮喘。或成怯弱。误治之害。不可胜数。至哉言也。
学生问道：“《金匮要略》中提到的中风历节病，与《伤寒论》中的中风有什么不同？”我回答说：“《伤寒例》中所说的中风，其病症首先侵犯太阳经，停留在肌表之间。如果治疗不当，在发生传变之后，才会进入体内。而《金匮要略》所指的中风，外部没有头痛、发热等表证，主要是因为络脉空虚，邪气未能排出，正气牵引邪气，导致口眼歪斜、肢体不能随意运动。邪气在络脉，肌肤麻木不仁；邪气在经脉，身体沉重难以抬举。这还算浅层的病情。如果邪气进入腑，就会神志不清不识人；邪气进入脏，就会舌强难言、口吐涎沫，这就深入了。同样是风邪致病，但其中深浅缓急的程度，截然不同。因为《金匮要略》所指的中风，不是从太阳病开始，也不等待传变过程，所以不属于《伤寒论》的范畴。”
学生又问：“世俗所称的伤风病，又该如何区分呢？”我回答说：“这种病症有头痛、恶寒、发热，与《伤寒例》中的中风相同。但因为伴有咳嗽、鼻塞、鼻涕自出，这是由皮毛侵入肺脏，与膈间的痰饮相结合，并不发生传变。然而人们往往把它视为普通的感冒，病人和医生都予以忽视。殊不知此病一旦误治，久治不愈，肺金功能立刻败坏。肺败则作为肺之子脏的肾水失去荫蔽，肾脏也会随之败坏。而且本气既已受伤，日久便会盗取脾胃（母脏）之气来供养自己。久而久之，中焦脾胃也会败坏。起初不易察觉，随后无法救治的情况，比比皆是。徐灵胎说：‘伤风之疾，由皮毛侵入肺脏。肺为娇脏，寒热皆不宜。太寒则邪气凝结而不能外出；太热则火灼金而迫血妄行；太润则生痰饮；太燥则耗伤精液；太泄则汗出而阳气虚；太涩则气闭而邪气结聚。再加上人们将其视为小病，不避风寒，不慎饮食，经年累月，病机日益加深，有的形成血症，有的形成肺痿，有的形成哮喘，有的形成怯弱症。误治的危害，不可胜数。’这话真是说得极好啊。”
A student asked, "How does the Wind-Stroke and Bi-Syndrome (Zhongfeng Lijie Bing) mentioned in *Jin Gui Yao Lue* differ from the Wind-Strike (Zhong Feng) in *Shang Han Lun*?" I replied, "The Wind-Strike described in the *Shang Han Li* first attacks the Taiyang channel (Taiyang Jing), lingering between the muscle and skin layers. If treated improperly, it only enters the interior after undergoing transmission. In contrast, the Wind-Stroke indicated by *Jin Gui Yao Lue* lacks exterior symptoms such as headache and fever. It is primarily due to emptiness in the collaterals, where pathogenic factors are not expelled, and the healthy qi draws the pathogen inward, leading to deviation of the mouth and eye and inability to move the limbs. When the pathogen is in the collaterals, there is numbness of the skin and muscles; when it is in the meridians, there is heaviness and inability to bear weight. These are still relatively superficial conditions. If the pathogen enters the Fu organs, there is confusion and inability to recognize people; if it enters the Zang organs, there is difficulty speaking and drooling, indicating a deep invasion. Although both are caused by wind pathogens, their depth and urgency are vastly different. Since the Wind-Stroke in *Jin Gui Yao Lue* does not originate from a Taiyang disease nor await transmission, it does not fall under the category of *Shang Han*."
Another student asked, "How should the common cold known as 'Shang Feng' (Wind Injury) be distinguished?" I replied, "This condition presents with headache, aversion to cold, and fever, similar to the Wind-Strike in the *Shang Han Li*. However, it is accompanied by cough, nasal congestion, and spontaneous runny nose. This occurs because the pathogen enters through the skin and hair into the Lung, combining with phlegm-fluids in the diaphragm area, without undergoing transmission. Yet, people often regard it as an ordinary cold, and both patients and physicians tend to overlook it. Little do they know that if this condition is mismanaged, it may persist for a long time, causing immediate failure of Lung Metal. Once the Lung fails, its child organ, Kidney Water, loses its nourishment, and the Kidneys also fail. Furthermore, since the original qi is damaged, over time it steals Qi from the Spleen and Stomach (the mother organs) to sustain itself. Eventually, the Middle Earth (Spleen/Stomach) also fails. Initially unnoticed, cases of being beyond saving later on are numerous. Xu Lingtai said: 'Wind Injury diseases enter the Lung via the skin and hair. The Lung is a delicate organ, unsuitable for either extreme cold or heat. Excessive cold causes pathogenic factors to coagulate and remain trapped; excessive heat scorches Metal and moves blood; excessive moisture generates phlegm-fluids; excessive dryness consumes essence and fluids; excessive purgation leads to sweating and Yang deficiency; excessive astringency causes Qi stagnation and pathogenic entrapment. Additionally, people treat it as a minor ailment, failing to avoid wind and cold or regulate diet. Over months and years, the pathological mechanism deepens, potentially resulting in blood disorders, Lung萎 (Fei Wei), asthma, or consumptive weakness. The harms of mismanagement are countless.' These words are truly profound."