风痹痿厥四论，《内经》言之详矣。今余又为之说，不亦赘乎！曰∶“非赘也
。”为近世不读《内经》者，指其差玄也。夫风痹痿厥四证，本自不同，而近世不能辨，一概作
风冷治之。下虚补之，此所以旷日弥年而不愈者也。夫四末之疾，动而或劲者为风，不仁或痛者为痹
，弱而不用者为痿，逆而寒热者为厥，此其状未尝同也。故其本源又复大异。风者，必风
热相兼；痹者，必风湿寒相合；痿者，必火乘金；厥者，或寒或热，皆从下起。今之治者，
不察其源，见其手足 曳，便谓之风。然《左传》谓风淫
末疾。岂不知风、暑、燥、湿、火、寒六气，皆能为四末之疾也哉！敢详条于下，有意于救物者，试择焉可也。
夫风之为状，善行而数变。《内经》曰∶诸风掉眩，皆属肝木。掉摇眩运，非风木之象
乎？纡曲劲直，非风木之象乎？手足掣颤，斜目 口，筋急挛搐，螈 惊痫，发作无时，角弓反张，
甚则吐沫，或泣或歌，喜怒失常，顿僵暴仆，昏不知人，兹又非风木之象乎？故善行而数变者
，皆是厥阴肝之用也。夫肝木所以自甚而至此者，非独风为然。盖肺金为心火所制，不能胜
木故也。此病之作，多发于每年十二月，大寒中气之后，及三月四月之交，九月十月之交。
何以言之？大寒中气之后，厥阴为主气，巳亥之月，亦属厥阴用事之月，皆风主之时也。故
三月四月之交，多疾风豪雨。振拉摧拔，其化为冰雹。九月十月之交，多落木发屋之变。故
风木郁极甚者，必待此三时而作。凡风病之人，其脉状如弓弦而有力，岂敢以热药投之，
更增其势哉！
今人论方者，偶得一方，间曾获效，执以为能。着灸施针，岂由病者！巧说病
人，使从己法。不问品味刚柔，君臣轻重，何脏何经，何部何气，凡见风证偏枯，口眼 斜
，涎潮昏愦，便服灵宝、至宝、清心、续命等药。岂知清心之杂以姜桂，灵宝之乱以起石、硫
磺，小续命汤藏以附子！惟夫至宝，其性尚温。《经》曰∶风淫于内，治以辛凉。如之何以
金石大热之药，以治风耶？有以热治热者，一之为甚，其可再乎！故今之刘河间自制防风通圣散、搜风丸
之类，程参政祛风丸、换骨丹，用之者获效者多矣。而谤议百出，以诬其实。余尝见《内经
·气交变论》中，言五郁之法，郁极则为病。况风病之作，仓卒之变生。尝治惊风痫病，屡用汗、下
、吐三法，随治随愈。《内经》中明有此法。五郁中木郁达之者，吐之令其条达也。汗者是风随
汗出也；下者是推陈致新也。此为汗、下、吐三法也。愈此风病，莫知其数，如之何废而不用也？余恐
来者侮此法，故表而出之。昔项开完颜氏风病搐，先右臂并右足，约搐六七十数，良久，左
臂并左足亦搐六、七十数，不瘥，两目直视，昏愦不识人。几月余，求治于余，先逐其寒
痰三、四升；次用导水禹功丸、散，泄二十余行；次服通圣散辛凉之剂，不数日而瘥，故书此以证之。
夫痹之为状，麻木不仁，以风湿寒三气合而成之。故《内经》曰∶风气胜者为行痹。
风则阳受之，故其痹行，旦剧而夜静。世俗莫知，反呼为走注疼痛虎咬之疾。寒气胜者为痛痹。
寒则阴受之，故其痹痛，旦静而夜剧。世俗不知，反呼为鬼忤。湿气胜者为着痹。湿胜则筋
脉皮肉受之，故其痹着而不去，肌肉削而着骨。世俗不知，反呼为偏枯。此疾之作，多在四时
阴雨之时，及三月九月，太阳寒水用事之月。故草枯水寒为甚，或濒水之地，劳力之人，辛
苦失度，触冒风雨，寝处津湿，痹从外入。况五方七地，寒暑殊气，刚柔异禀，饮食起居，
莫不相戾。故所受之邪，各有浅深。或痛或不痛，或仁或不仁，或筋屈而不能伸，或引而不
缩。寒则虫行，热则纵缓，不相乱也。皮痹不已，而成肉痹。肉痹不已，而成脉痹；脉痹
不已，而成筋痹；筋痹不已，而成骨痹；久而不已，内舍其合。若脏腑俱病，虽有智者，不
能善图也。凡病痹之人，其脉沉涩。
今人论方者，见诸痹证，遽作香港脚治之，岂知《内经》中
本无香港脚之说。或曰∶诸方亦有香港脚统论，又有香港脚方药，若止取《素问》，则诸方皆非耶！曰
∶痹病以湿热为源，风寒为兼，三气合而为痹。奈何治此者，不问经络，不分脏腑，不辨表里，
便作寒湿香港脚，乌之附之，乳之没之，种种燥热攻之；中脘灸之，脐下烧之，三里火之，
蒸之熨之，汤之炕之。以至便旋涩滞，前后俱闭，虚燥转甚，肌肤日削，食饮不入，邪气外
侵，虽遇扁、华，亦难措手。若此者何哉？胸膈间有寒痰之故也。痹病本不死，死者医之误
也。虽亦用蒸之法，必先涌去其寒痰，然后诸法皆效。《内经》曰∶五脏有俞穴，六腑有合
穴。循脉之本分，各有所发之源，以砭石补之，则痹病瘳。此其《内经》中明白具载，如之
何不读也？陈下酒监魏德新，因赴冬选，犯寒而行。真气元衰，加之坐卧冷湿，食饮失节，
以冬遇此，遂作骨痹。骨属肾也。腰之高骨坏而不用，两胯似折，面黑如炭，前后廉痛，痿
厥嗜卧。遍问诸医，皆作肾虚治之。余先以玲珑灶熨蒸数日，次以苦剂，上涌讫，寒痰三、二
升。下虚上实，明可见矣。次以淡剂，使白术除脾湿，令茯苓养肾水，责官桂伐风木。寒气
偏胜，则加姜、附，否则不加。又刺肾俞、太溪二穴，二日一刺。前后一月，平复如故。仆尝用
治伤寒汗、下、吐三法，移为治风痹痿厥之法，愈者多矣。
痿之为状，两足痿弱，不能行用。由肾水不能胜心火，心火上烁肺金。肺金受火制，六叶皆
焦，皮毛虚弱，急而薄着，则生痿 。 者，足不能伸而
。肾水者，乃肺金之子也。令肾水衰少，随火上炎。肾主两足，故骨髓衰竭，由使内太过而致。然《至真要大论》云
诸痿喘呕皆属于上者，上焦也。三焦者，手少阳相火也。痿、喘、呕三病，皆在膈上，属肺金
之部分也。故肌痹传为脉痿；湿痹不仁，传为肉痿；髓竭足 ，传为骨痿；房
室太过为筋痿，传为白淫。大抵痿之为病，皆因客热而成，好以贪色，强力过极，渐成痿疾。故痿
属肺，脉痿属心，筋痿属肝，肉痿属脾，骨痿属肾。总因肺受火热，叶焦之故，相传于四脏，痿病成
矣。直断曰痿病无寒。故痿之作也，五月、六月、七月，皆其时也。午者，少阴君火之位；
未者，湿土庚金伏火之地；申者，少阳相火之分。故痿发此三月之内，以为热也。故病痿之人，其脉
浮而大。
今之行药者，凡见脚膝痿弱，难于行步，或一足不伸，便作寒湿香港脚治之，骤用乌、
附、乳、没、自然铜、威灵仙之类，燔针、艾火，汤煮、袋蒸，痿弱转加，如此而死，岂亦天乎！夫
治痿与治痹，其治颇异。风寒湿痹，犹可蒸汤灸燔，时或一效。惟痿用之转甚者，何也？盖以痿，
肺热为本，叶焦而成痿，以此传于五脏，岂有寒者欤？若痿作寒治，是不刃而杀之也。夫痿
病不死，死者用药之误也。陈下一武弁宋子玉，因驻军息城，五、六月间，暴得痿病，腰胯
两足，皆不任用， 而不行，求治于予。察其两手，脉俱滑之而有力。予凭
《内经》火淫于内，治以咸寒，以盐水越其膈间寒热宿痰。新者为热，旧者为寒。或宿食
宿饮在上脘者，皆可涌之。
宿痰既尽，因而下之。节次数十行，觉神志日清，饮食日美，两足渐举，脚膝渐伸。心降
肾升，便继以黄连解毒汤，加当归等药，及泻心汤、凉膈散、柴胡饮子，大作剂煎，时时呷之
。《经》曰∶治心肺之病最近，用药剂不厌频而少；治肾肝之病最远，用药剂不厌顿而多。此法人皆怪
之。
然余治痿，寻常用之，如拾遗物。予若以此诳人，其如获罪于天何？此宋子玉之证，所
以不得不书也，且示信于来世。故《内经》谓治痿之法，独取阳明经。阳明经者，胃脉
也，五脏六腑之海也，主润养宗筋。宗筋主束骨。束骨在脐下阴毛际上是也。又主大利机关。机关者
，身中大关节也，以司曲伸。是以阳明虚则宗脉纵，宗脉纵则大脉不伸，两足痿弱。然取阳
明者，胃脉也。胃为水谷之海，人之四季，以胃气为本。本固则精化，精化则髓充，髓充则
足能履也。《阴阳应象论》曰∶形不足者，温之以气；精不足者，补之以味。味者，五味也
。五味调和，则可补精益气也。五味、五谷、五菜、五果、五肉，五味贵和，不可偏胜。又曰∶
恬虚无，真气从之，精神内守，病安从来？若用金石草木补之者，必久而增气，物化之常，气增
而久，夭之由也。所以久服黄连、苦参者，而反化为热，久服热药之人，可不为寒心哉？余尝用
汗、下、吐三法，治风痹痿厥，以其得效者众，其敢诬于后人乎！
厥之为状，手足及膝下或寒或热也。举世传香港脚寒湿之病，岂知《内经》中无香港脚之说？
王太仆亦云∶本无香港脚，后世广饰方论，而立此名。古之方谓厥者，即今所谓香港脚者也。然
厥当分两种，次分五脏。所谓两种者，有寒厥，亦有热厥。阳气衰于下则为寒厥；阴气衰于下则
为热厥。热厥为手足热也；寒厥为手足寒也。阳经起于足指之表；阴经起于足心之下。阳气
盛，足下热；阴气盛，足下寒。又曰∶阳主外而厥在内，阴主内而厥在外。若此者，阴
阳之气，逆而上行故也。夫春夏则阳多阴少；秋冬则阴壮阳衰。人或恃赖壮勇，纵情嗜欲于秋冬
之时，则阳夺于内，精气下溢，邪气上行。阳气既衰，真精又竭，阳不荣养，阴气独行，故
手足寒，发为寒厥也。人或醉饱入房，气聚于脾胃，主行津液，阴气虚，阳气入，则胃不和
，胃不和则精气竭，精气竭则四肢不荣，酒气与谷气相搏，则内热而溺赤，气壮而 悍。肾气
既衰，阳气独胜，故手足热，发而为热厥也。
厥亦有令人腹暴满不知人者，或一、二日稍知
人者，或卒然闷乱无觉知者。皆因邪气乱，阳气逆，是少阴肾脉不至也。肾气微少，精血奔逸
，使气促迫，上入胸膈，宗气反结心下，阳气退下，热归阴股，与阴相助，令身不仁，又五
络皆会于耳中，五络俱绝，则令人身脉皆动，而形体皆无所知，其状如尸，故曰尸厥。有涎
如拽锯声在喉咽中为痰厥；手足搐搦者为风厥；因醉而得之为酒厥；暴怒而得之为
气厥；骨痛爪枯为骨厥；两足指挛急，屈伸不得，爪甲枯结为臂厥；身强直如椽者为肝厥；喘而
者，狂走攀登为阳明厥，皆气逆之所为也。
今人
HT着掠着，此是何等语也？非徒其名之谬，因其名之谬，而乖其实也。既言HT 着、中着、掠着，必归
之风，此清心、灵宝、至宝，又为先驱矣！鼻中嗅药，身上 火。岂知厥之为病，如前所说者耶？顷西华季政
之病寒厥，其妻病热厥，前后十余年。其妻服逍遥十余剂，终无寸效。一日，命余诊之，二
人脉皆浮大而无力。政之曰∶“吾手足之寒，时时渍以热汤，渍而不能止。吾妇手足之热，终
日以冷水沃而不能已者，何也？”余曰∶“寒热之厥也，此皆得之贪饮食，纵嗜欲。遂出《内
经·厥论》证之。”政之喜曰∶“《内经》真圣书也！十余年之疑，今而释然，纵不服药，逾过半矣。”仆曰
∶热厥者，寒在上也。寒厥者，热在上也。寒在上者，以温剂补肺金；热在上者，以凉剂清心
火。分处二药，令服之不辍。不旬日，政之诣门谢曰∶寒热之厥皆愈矣。其妻当不过数月而
有娠，何哉？阴阳皆和故也。凡尸厥、痿厥、风厥、气厥、酒厥，可一涌而醒，次服降心火
，益肾水，通血和气之药，使粥食调养，无不瘥者。若其余诸厥，仿此行之，慎勿当疑似之间，便作风气，相去邈矣。
风、痹、痿、厥四种病证，《黄帝内经》中已经阐述得非常详细了。现在我又为它们作解说，难道不是多余的吗？回答说：“并不是多余的。”这是为了指出那些不读《黄帝内经》的近代医家所存在的偏差和玄虚之处。风、痹、痿、厥这四种病证，本源上本来是不同的，但近代医生不能辨别，一概当作风冷之邪来治疗。对于下焦虚损进行补益，这就是为什么病程旷日持久、经年累月而不能痊愈的原因。四肢的疾病，动作敏捷或强直劲急的是风证；感觉麻木或不仁且疼痛的是痹证；软弱无力且不能运动的是痿证；手足逆冷或发热的是厥证，这些症状从未相同过。因此它们的本源又大大不同。风证，必然是风热相兼；痹证，必然是风湿寒三气相合；痿证，必然是火邪克制肺金；厥证，或寒或热，都从下部发起。现在的医生，不考察其本源，看到手足牵引抖动，就说是风证。然而《左传》说风邪淫溢会导致四肢疾病。难道不知道风、暑、燥、湿、火、寒六气，都能导致四肢的疾病吗？现详细分条列述如下，有意救治世人的人，可以尝试选择其中合适的方法。
风的症状特点是善行而多变。《黄帝内经》说：各种风证的动摇眩晕，都属于肝木。动摇眩晕，不是风木之象吗？身体弯曲或强直，不是风木之象吗？手足抽搐颤抖，口眼歪斜，筋脉紧急挛缩，肌肉跳动惊痫，发作没有定时，角弓反张，严重时吐白沫，或哭或笑，喜怒失常，突然僵仆倒地，昏迷不知人，这又不是风木之象吗？所以善行而多变者，都是厥阴肝的功能表现。肝木之所以自盛而达到这种地步，并不仅仅是因为外风所致。大概是因为肺金被心火所制约，不能克制肝木的缘故。这种病的发生，多发于每年十二月大寒节气之后，以及三月四月之交、九月十月之交。为什么这样说呢？大寒节气之后，厥阴为主气，巳亥月份，也属于厥阴当令的月份，都是风主事的时节。所以三月四月之交，多有大风和暴雨，摧枯拉朽，化为冰雹。九月十月之交，多有落叶毁屋的变化。所以风木郁结极甚，必定要等到这三个时节才发作。凡是患风病的人，其脉象像弓弦一样有力，怎么敢用热药投治，从而增加病情之势呢！
现在讨论方剂的人，偶然得到一方，间或获得疗效，就固执地认为这是自己的本事。施灸扎针，哪里是由病人决定的呢？巧妙地劝说病人，使他们遵从自己的疗法。不问药物的品味刚柔、君臣轻重的配伍，不问涉及何脏何经、何部何气，凡见到风证导致的偏瘫、口眼歪斜、痰涎上涌、神志昏愦，就服用灵宝丹、至宝丹、清心丸、续命汤等药物。哪里知道清心丸中混杂了姜、桂，灵宝丹中乱加了代赭石、硫磺，小续命汤中藏有附子！只有至宝丹，其性质尚且温和。《黄帝内经》说：风邪淫溢于内，用辛凉之品治疗。怎么能用金石类大热之药来治疗风证呢？有以热治热的，一次已经很过分了，难道可以再来第二次吗！所以现在刘河间自制防风通圣散、搜风丸之类，程参政制作祛风丸、换骨丹，使用的人获得疗效的很多。却遭到百种诽谤议论，诬蔑其实效。我曾经在《黄帝内经·气交变大论》中看到，论述五郁的方法，郁结极甚就会生病。况且风病发作，往往产生仓促的变化。我曾经治疗惊风痫病，屡次使用汗、下、吐三法，随治随愈。《黄帝内经》中明确记载有此法。五郁中木郁应当疏达，吐法能使气机条达；汗法是风随汗出；下法是推陈致新。这就是汗、下、吐三法。治愈这种风病的数量无法统计，怎么能废弃而不使用呢？我担心后来者轻视这种方法，所以表彰并列出它。以前项开完颜氏患有风病抽搐，先是从右臂和右足开始，大约抽搐六七十次，过了很久，左臂和左足也抽搐六七十次，病情未缓解，两眼直视，神志昏愦不认识人。几个月后，求治于我，我先驱除他的寒痰三四升；接着使用导水禹功丸、散，泻下二十多次；接着服用通圣散这种辛凉的药剂，几天就好了，所以写下此案例以证明它。
痹的症状特点是麻木不仁，由风湿寒三气结合而成。所以《黄帝内经》说：风气胜者为行痹。风邪侵犯阳分，所以它的痹痛游走不定，早晨加重夜晚安静。世俗之人不知道，反而称之为走注疼痛如虎咬的疾病。寒气胜者为痛痹。寒邪侵犯阴分，所以它的痹痛固定，早晨安静夜晚加重。世俗之人不知道，反而称之为鬼忤。湿气胜者为着痹。湿邪胜则筋脉皮肉受病，所以它的痹痛附着不去，肌肉消瘦紧贴骨骼。世俗之人不知道，反而称之为偏枯。这种病的发生，多在四季阴雨之时，以及三月九月太阳寒水当令的月份。所以草木枯萎水寒冷时最为严重，或者在水边之地，从事体力劳动的人，辛苦过度，触犯风雨，睡卧在潮湿环境中，痹邪从外部侵入。何况五方七地，寒暑气候不同，禀赋刚柔各异，饮食起居，无不相互违背。所以所受的外邪，各有深浅。有的痛有的不痛，有的麻木有的不麻木，有的筋屈不能伸展，有的引伸不能收缩。寒则感觉虫行，热则筋脉纵缓，不会混淆。皮痹不愈，发展成肉痹；肉痹不愈，发展成脉痹；脉痹不愈，发展成筋痹；筋痹不愈，发展成骨痹；久治不愈，内传舍于相合的脏腑。如果脏腑都病了，即使有智慧的人，也不能妥善谋划了。凡是患痹病的人，其脉象沉涩。
现在讨论方剂的人，见到各种痹证，立刻当作香港脚（痛风/下肢关节病）来治疗，哪里知道《黄帝内经》中原本没有香港脚的说法。有人说：各方书中也有香港脚的统论，又有香港脚的方药，如果只取《素问》，那么其他方书都不对了吗？回答说：痹病以湿热为源头，风寒为兼夹，三气结合而成痹。为什么治疗此病的人，不问经络，不分脏腑，不辨表里，就当作寒湿香港脚，使用乌头、附子、乳香、没药等各种燥热之药攻伐；在中脘穴施灸，在脐下烧灼，在足三里穴用火，蒸熨，汤煮，炕烤。以至于小便涩滞，前后二便俱闭，虚燥更加严重，肌肤日渐消瘦，饮食不入，邪气外侵，即使遇到扁鹊、华佗，也难以措手。像这种情况为什么呢？这是因为胸膈间有寒痰的缘故。痹病本身不死，死的是医生的误治。虽然也用蒸法，但必须先涌吐去除寒痰，然后各种方法才有效。《黄帝内经》说：五脏有俞穴，六腑有合穴。顺着经脉的本分，各有所发之源，用砭石补之，则痹病痊愈。这在《黄帝内经》中明白记载，为什么不读呢？陈留县酒监魏德新，因赴冬季选拔考试，受寒而行。真气原本衰弱，加上坐卧冷湿，饮食失节，在冬天遭遇此邪，于是发生骨痹。骨属于肾。腰部高骨损坏不能活动，两胯像折断一样，面色黑如炭，前后廉穴处疼痛，痿弱厥冷嗜睡。遍访各位医生，都当作肾虚治疗。我先用玲珑灶熨蒸数日，接着用苦剂涌吐，吐出寒痰二三升。下虚上实，明显可见了。接着用淡渗之剂，使白术除去脾湿，让茯苓滋养肾水，责官桂伐除风木。寒气偏胜，则加生姜、附子，否则不加。又针刺肾俞、太溪两个穴位，两天刺一次。前后一个月，恢复如初。我曾经用汗、下、吐三法治疗伤寒，移用来治疗风痹痿厥，治愈的人很多。
痿的症状特点是两足痿弱，不能行走使用。由于肾水不能克制心火，心火上炎灼烁肺金。肺金受火邪制约，六叶皆焦，皮毛虚弱，紧缩贴附，则生痿躄。躄，是指足不能伸展而跛行。肾水是肺金之子。现在肾水衰少，随着火气上炎。肾主两足，所以骨髓衰竭，是由于房事过度所致。然而《至真要大论》说：各种痿证、喘证、呕证都属于上焦。三焦，是手少阳相火。痿、喘、呕三种病，都在膈上，属于肺金的部位。所以肌痹传变为脉痿；湿痹麻木不仁，传变为肉痿；髓竭足跛，传变为骨痿；房室过度为筋痿，传变为白淫。大抵痿之为病，都是因为客热而成，喜好贪色，强力过度，逐渐形成痿疾。所以痿属肺，脉痿属心，筋痿属肝，肉痿属脾，骨痿属肾。总因肺受火热，叶焦的缘故，相传于四脏，痿病就形成了。直接断言：痿病没有寒证。所以痿病的发作，五月、六月、七月，都是其时令。午月，是少阴君火之位；未月，是湿土庚金伏火之地；申月，是少阳相火之分。所以痿病发于这三个月内，认为是热证。所以患痿病的人，其脉象浮而大。
现在行医用药的人，凡见到脚膝痿弱，难以行走，或一足不能伸展，就当作寒湿香港脚治疗，骤然使用乌头、附子、乳香、没药、自然铜、威灵仙之类，燔针、艾火，汤煮、袋蒸，痿弱反而加重，如此而死，难道是天命吗！治疗痿病与治疗痹病，治疗方法颇不相同。风寒湿痹，还可以蒸汤灸燔，偶尔有一次疗效。唯独痿病使用这些方法反而加重，为什么呢？因为痿病，肺热为本，叶焦而成痿，以此传于五脏，哪里有寒的呢？如果把痿病当作寒证治疗，这不是不用刀杀人吗？痿病本身不死，死的是用药错误。陈留县一名武官宋子玉，因驻军息城，在五六月间，突然得痿病，腰胯两足，都不能使用，跛行不能走路，求治于我。察看他两手，脉象滑而有力。我凭借《黄帝内经》“火淫于内，治以咸寒”，用盐水越其膈间寒热宿痰。新产生的为热，旧的为寒。或者宿食宿饮在上脘的，都可以涌吐。宿痰既尽，接着用下法。次数多达几十次，觉得神志日益清醒，饮食日益美味，两足渐渐抬起，脚膝渐渐伸展。心火下降肾水上承，接着给予黄连解毒汤，加当归等药，以及泻心汤、凉膈散、柴胡饮子，大作剂煎服，时时呷饮。《黄帝内经》说：治疗心肺之病最近，用药剂量不厌频繁而量少；治疗肾肝之病最远，用药剂量不厌顿服而量大。这种方法大家都感到奇怪。然而我治疗痿病，经常使用，如同拾遗物。如果我以此欺骗人，对上苍有何交代？这就是记录宋子玉病例的原因，以此向后世示信。所以《黄帝内经》说治疗痿病的方法，独取阳明经。阳明经，是胃脉，是五脏六腑的海，主要润养宗筋。宗筋主要约束骨骼。束骨在脐下阴毛际上是也。又主要大利机关。机关，就是身中的大关节，主管屈伸。所以阳明虚则宗脉弛纵，宗脉弛纵则大脉不能伸展，两足痿弱。所谓取阳明者，即胃脉。胃是水谷之海，人的一年四季，以胃气为本。根本稳固则精化，精化则髓充，髓充则足能行走。《阴阳应象大论》说：形体不足的，用气来温补；精气不足的，用味来滋补。味，就是五味。五味调和，则可以补精益气。五味、五谷、五菜、五果、五肉，五味贵在调和，不可偏胜。又说：恬淡虚无，真气从之，精神内守，病安从来？如果用金石草木来补益，必然久而增气，这是物化的常理，气增加久了，就是夭折的原因。所以久服黄连、苦参，反而化为热，久服热药的人，能不寒心吗？我曾经用汗、下、吐三法，治疗风痹痿厥，因为获得疗效的人众多，怎敢欺骗后人呢！
厥的症状特点是手足及膝下或寒或热。举世流传香港脚寒湿之病，哪里知道《黄帝内经》中没有香港脚的说法？王太仆也说：原本没有香港脚，后世广泛修饰方论，才立此名。古方的方剂称厥者，就是今所谓的香港脚。然而厥应当分两种，其次分五脏。所谓两种，有寒厥，也有热厥。阳气衰于下则为寒厥；阴气衰于下则为热厥。热厥表现为手足热；寒厥表现为手足寒。阳经起于足趾表面；阴经起于足心之下。阳气盛，足下热；阴气盛，足下寒。又说：阳主外而厥在内，阴主内而厥在外。像这种情况，是阴阳之气逆而上行的缘故。春夏则阳多阴少；秋冬则阴壮阳衰。有人倚仗强壮勇武，在秋冬之时放纵情欲，则阳气被夺于内，精气下溢，邪气上行。阳气既衰，真精又竭，阳气不能荣养，阴气独行，所以手足寒，发为寒厥。有人醉饱入房，气聚于脾胃，脾胃主行津液，阴气虚，阳气入，则胃不和，胃不和则精气竭，精气竭则四肢不荣，酒气与谷气相搏，则内热而尿赤，气壮而慓悍。肾气既衰，阳气独胜，所以手足热，发而为热厥。
厥也有令人腹部突然胀满不知人的，或一两天稍知人的，或突然闷乱无知觉的。都是因为邪气扰乱，阳气逆乱，这是少阴肾脉不至。肾气微弱稀少，精血奔逸，使气促迫，上入胸膈，宗气反结于心下，阳气退下，热归阴股，与阴相助，令身体麻木不仁，又五络皆会于耳中，五络俱绝，则令人身脉皆动，而形体皆无所知，其状如尸体，所以叫尸厥。喉中有痰声如拽锯的为痰厥；手足搐搦的为风厥；因醉酒而得的为酒厥；暴怒而得的为气厥；骨痛爪枯的为骨厥；两足指挛急，屈伸不得，爪甲枯结的为臂厥；身强直如椽子的为肝厥；喘促且狂走攀登的为阳明厥，这些都是气逆所为。
现在的人胡乱说着，这是什么话呢！不仅名字谬误，因为名字的谬误，而背离了实质。既然说HT着、中着、掠着，必然归结为风，这就把清心、灵宝、至宝作为先锋了！鼻中嗅药，身上烧火。哪里知道厥之为病，像前面所说的那样呢？前不久西华季政之患寒厥，他的妻子患热厥，前后十多年。他的妻子服用逍遥散十余剂，最终毫无寸效。一天，让我诊脉，两人的脉象都浮大而无力。季政之说：“我的手足寒冷，时时用热水浸泡，浸泡也不能止住。我妻子的手足发热，整天用冷水浇淋也不能停止，为什么呢？”我说：“这是寒热之厥，这都是因为贪饮食，纵嗜欲所致。”于是出示《黄帝内经·厥论》来验证。季政之高兴地说：“《黄帝内经》真是圣书啊！十多年的疑惑，现在释然了，即使不服药，也好了一半了。”我说：“热厥者，寒在上；寒厥者，热在上。寒在上者，用温剂补肺金；热在上者，用凉剂清心火。分别处方两药，让他们不停服用。不到十天，季政之登门道谢说：寒热之厥都好了。他的妻子不过几个月就有孕了，为什么呢？阴阳皆和的缘故。凡是尸厥、痿厥、风厥、气厥、酒厥，可以一次涌吐而醒，接着服用降心火、益肾水、通血和气的药物，让喝粥食调养，没有不好的。至于其余诸厥，仿照此法施行，千万不要在疑似之间，就当作风气，相差太远了。”
The theories of Wind, Bi (Obstruction), Wei (Flaccidity), and Jue (Reversal/Cold-Heat Extremities) are detailed in the *Huangdi Neijing* (Yellow Emperor's Inner Canon). Why do I elaborate on them again? Is it not redundant? The answer is: "It is not redundant." It is to point out the deviations and obscurities made by contemporary physicians who do not study the *Huangdi Neijing*. These four conditions—Wind, Bi, Wei, and Jue—are fundamentally different. However, contemporary physicians fail to distinguish them and treat them all as Cold-Wind pathogens. They tonify deficiency at the lower jiao. This is why the disease persists for years without cure.
Diseases of the four extremities manifest differently: agile movements or stiffness indicate Wind; numbness or pain indicates Bi; weakness and inability to move indicate Wei; cold or heat in the hands and feet indicates Jue. Their presentations are never identical, nor are their origins. Wind involves a combination of Wind and Heat; Bi involves the confluence of Wind-Dampness and Cold; Wei involves Fire suppressing Lung Metal; Jue can be either Cold or Heat, originating from the lower body. Contemporary physicians, failing to investigate the origin, see limbs twitching and immediately diagnose Wind. Yet, the *Zuo Zhuan* states that excessive Wind causes diseases of the extremities. Do they not know that all six qi—Wind, Summer-heat, Dryness, Dampness, Fire, and Cold—can cause diseases of the four extremities? I detail them below for those interested in saving lives.
Wind is characterized by rapid movement and frequent changes. The *Neijing* states: "All wind disorders involving tremors and dizziness belong to Liver Wood." Are not tremors and dizziness manifestations of Wind-Liver? Are not bending and straightening manifestations of Wind-Liver? Twitching of hands and feet, deviation of eyes and mouth, tendon spasms, muscle twitching, epilepsy, sudden convulsions, opisthotonos, foaming at the mouth, crying or laughing uncontrollably, emotional instability, sudden collapse, and unconsciousness are all manifestations of Wind-Liver. Thus, rapid and changing symptoms are functions of the Jueyin Liver. The reason Liver Wood becomes excessive is not solely due to external Wind, but because Lung Metal is constrained by Heart Fire and cannot control Wood. This disease often occurs after the Major Cold solar term in December, and during the transitions of March-April and September-October. Why? After Major Cold, Jueyin governs the climate. Si and Hai months also belong to Jueyin. These are times when Wind dominates. In March-April, there are violent winds and rains, hail, and destruction. In September-October, there are fallen leaves and roof damage. Excessive stagnation of Wind-Liver must wait for these three seasons to manifest. Patients with Wind diseases have a pulse like a bowstring, forceful. How dare one use hot medicines to exacerbate this condition?
Contemporary physicians, having found one effective formula, cling to it as their own skill. They apply moxibustion and acupuncture regardless of the patient's needs, persuading patients to follow their methods. Without considering the nature of herbs (hard/soft, sovereign/minister), the involved organs and meridians, or the location and qi, whenever they see hemiplegia, facial paralysis, phlegm flooding, or confusion, they administer Lingbao Dan, Zhibao Dan, Qingxin Wan, or Xuming Tang. They fail to realize that Qingxin Wan contains Ginger and Cinnamon; Lingbao Dan contains Magnetite and Sulfur; Xuming Tang contains Aconite. Only Zhibao Dan is relatively warm. The *Classic* states: "For Wind invading internally, treat with Acrid-Cool substances." How can one use hot mineral drugs to treat Wind? Using heat to treat heat is already excessive; how can it be repeated? Therefore, Liu Hejian created Fangfeng Tongsheng San and Sofeng Wan, and Chancellor Cheng created Qufeng Wan and Huangu Dan. Many have benefited, yet they face slander. I recall the *Qi Jiao Bian Lun* chapter of the *Neijing*, which discusses the Five Stagnations. When stagnation reaches its extreme, disease arises. Wind diseases often arise suddenly. I have treated epilepsy using Sweating, Purging, and Vomiting methods with success. The *Neijing* explicitly supports this. For Wood Stagnation, one should vent it; vomiting promotes free flow. Sweating expels Wind; purging eliminates old and generates new. I have cured countless Wind diseases with these methods. Why abandon them? I record this to prevent future generations from despising these methods.
Case: Mr. Xian Kai of the Wanyan clan suffered from Wind-induced convulsions. Initially, his right arm and leg convulsed 60-70 times, followed by the left side. His eyes stared fixedly, and he was confused and unconscious. After months, he sought my treatment. I first induced vomiting to remove 3-4 sheng of cold-phlegm. Then I used Daoshui Yugong Wan/Powder to purge him over 20 times. Finally, I administered the Acrid-Cool Tongsheng San. He recovered in a few days.
Bi syndrome is characterized by numbness and insensitivity, caused by the combination of Wind, Dampness, and Cold. The *Neijing* states: "When Wind prevails, it is called Moving Bi." Wind affects Yang meridians, so the pain migrates and worsens in the morning while quieting at night. Laypeople mistakenly call this "tiger-bite pain." When Cold prevails, it is Painful Bi. Cold affects Yin meridians, so pain is fixed and worsens at night. Laypeople call this "ghost attack." When Dampness prevails, it is Fixed Bi. Dampness affects tendons, vessels, skin, and flesh, causing pain that adheres and does not move, with muscles wasting away. Laypeople call this hemiplegia. This disease occurs during rainy seasons or in March and September when Solar Cold Water governs. It is severe when grass withers and water freezes, or among laborers near water who suffer from exposure to wind and rain and sleep in dampness. Pathogens enter externally. Due to geographical differences and individual constitutions, pathogenic depth varies. Symptoms include pain or no pain, numbness or sensation, limited extension or flexion. Cold feels like insects crawling; Heat causes flaccidity. If Pi Bi (Skin Bi) persists, it becomes Rou Bi (Flesh Bi); then Mai Bi (Vessel Bi); then Jin Bi (Tendon Bi); then Gu Bi (Bone Bi). If untreated, it enters the interior organs. Once organs are affected, even a wise man cannot save the patient. The pulse in Bi disease is deep and choppy.
Contemporary physicians treat all Bi syndromes as Hongjiao (Gout/Lower Limb Arthritis), a term absent in the *Neijing*. Some argue that other texts discuss Hongjiao. However, Bi originates from Damp-Heat with Wind-Cold as concurrent factors. Physicians who ignore meridians and organs, treating it as Cold-Damp Hongjiao, use harsh hot drugs like Aconite, Ligusticum, Frankincense, and Myrrh. They apply moxibustion to Zhongwan, cauterize below the navel, and fire-acupuncture at Zusanli. This leads to urinary retention, constipation, worsening deficiency, emaciation, and death. This error stems from cold-phlegm in the chest and diaphragm. Bi itself is not fatal; misdiagnosis is. Even if using steaming therapy, one must first vomit out the cold-phlegm. The *Neijing* states that Shu points of Zang and He points of Fu can treat Bi with stone needles.
Case: Wei Dexin, a wine supervisor, traveled in winter cold with weak true qi, sitting/lying on cold/damp surfaces, and irregular diet. He developed Bone Bi (Kidney governs bone). His lumbar vertebrae were damaged, hips felt broken, face was black, and he suffered pain, flaccidity, and lethargy. Doctors diagnosed Kidney Deficiency. I first used a perforated stove for steaming, then induced vomiting to remove 2-3 sheng of cold-phlegm. The pattern was Lower Deficiency and Upper Excess. I used bland diuretics to dry Spleen Dampness (Atractylodes), nourish Kidney Water (Poria), and disperse Wind-Liver (Cassia Bark). If Cold prevailed, I added Ginger and Aconite. I also punctured Shenshu and Taixi every two days. He recovered in one month. I often adapt Sweating, Purging, and Vomiting methods for Wind, Bi, Wei, and Jue with great success.
Wei syndrome is characterized by weak legs unable to walk. It arises because Kidney Water fails to control Heart Fire, which scorches Lung Metal. Lung Metal dries up, skin becomes weak, and Wei Bi (flaccidity) occurs. Kidney Water is the child of Lung Metal; when deficient, it follows Fire upward. Kidney governs the legs; marrow depletion results from excessive sexual activity. The *Zhun Yao Da Lun* states: "All Wei, panting, and vomiting belong to the Upper Jiao." The Sanjiao is Hand-Shaoyang Ministerial Fire. These three conditions are above the diaphragm, belonging to Lung Metal. Muscle Bi transmits to Mai Bi; Damp Bi transmits to Rou Bi; Marrow exhaustion transmits to Gu Bi; excessive sex transmits to Jin Bi (White Turbidity). Generally, Wei diseases are caused by exogenous Heat, often linked to lust and overexertion. Wei belongs to Lung, Mai Bi to Heart, Jin Bi to Liver, Rou Bi to Spleen, Gu Bi to Kidney. All stem from Lung Heat drying the leaves. Directly stated: Wei disease has no Cold. It occurs in May, June, July (Fire and Damp months). The pulse is floating and large.
Contemporary physicians treat leg weakness as Cold-Damp Hongjiao, using hot drugs and fire therapies, worsening the condition. Treating Wei differs from Bi. Bi may respond to heat; Wei worsens with it because Wei is rooted in Lung Heat. Treating Wei as Cold is lethal. Wei itself is not fatal; medication errors are.
Case: Song Ziyu, a military officer, suddenly developed Wei syndrome in summer. His waist, hips, and legs were useless. His pulse was slippery and forceful. Following the *Neijing* ("For Fire invading internally, treat with Salty-Cold"), I used salt water to induce vomiting of phlegm. After purging, his spirit cleared, appetite improved, and legs strengthened. I then administered Huanglian Jiedu Tang, Danggui, Xiexin Tang, Liangge San, and Chaihu Yinzi frequently. The *Neijing* advises frequent small doses for Heart/Lung diseases and large single doses for Kidney/Liver diseases. People find this strange, but I use it successfully. The *Neijing* states: "For Wei, treat exclusively by taking the Yangming Meridian." Yangming is the Stomach meridian, the sea of the five zang and six fu, nourishing the Zongjin (major tendons) which bind bones and control joints. If Yangming is deficient, Zongjin relax, and legs become weak. The Stomach is the sea of grain and water; stomach qi is the root of life. Solid root generates essence, essence fills marrow, and legs can walk. The *Yin Yang Ying Xiang Lun* states: "For form deficiency, warm with Qi; for essence deficiency, tonify with Flavor." Flavors should be harmonious. One should maintain tranquility. Long-term use of minerals or bitter-cold herbs like Coptis and Picrorhiza can generate Heat. I have successfully used Sweating, Purging, and Vomiting for Wind, Bi, Wei, and Jue.
Jue syndrome involves cold or heat in the hands, feet, and below the knees. Contemporary people confuse it with Hongjiao, but the *Neijing* makes no such distinction. Wang Taiabu noted that Hongjiao is a later invention. Ancient "Jue" corresponds to modern Hongjiao. Jue is divided into two types: Cold Jue and Heat Jue. Yang deficiency at the lower jiao causes Cold Jue (cold extremities); Yin deficiency at the lower jiao causes Heat Jue (hot extremities). Yang meridians start at the toes; Yin meridians start at the sole. Yang excess causes heat in the soles; Yin excess causes cold. In spring/summer, Yang is abundant; in autumn/winter, Yin is strong. Indulgence in winter depletes Yang, leading to Cold Jue. Overeating and drinking alcohol before intercourse causes Stomach disharmony, depleting essence and causing internal heat, leading to Heat Jue.
Jue can also present as sudden abdominal fullness and unconsciousness (Shi Jue/Corpse Jue), due to rebellious qi blocking the Shaoyin Kidney pulse. Phlegm Jue has rattling phlegm; Wind Jue has convulsions; Wine Jue comes from drunkenness; Qi Jue from anger; Bone Jue from bone pain; Arm Jue from toe cramps; Liver Jue from rigidity; Yangming Jue from panting and climbing.
Contemporary physicians misuse terms and treatments. Case: Ji Zhengzhi had Cold Jue; his wife had Heat Jue for over ten years. Her Xiao Yao San failed. Their pulses were floating, large, and empty. Ji said his hands/feet were cold despite hot water baths; his wife's were hot despite cold water pours. I explained this was due to dietary and sexual excesses, citing the *Jue Lun*. I prescribed warming agents for Lung (for her Heat Jue/Cold above) and cooling agents for Heart (for his Cold Jue/Heat above). Both recovered within ten days. She conceived months later due to yin-yang harmony. Shi Jue, Wei Jue, Wind Jue, Qi Jue, and Wine Jue can be awakened by vomiting, followed by herbs to descend Heart Fire, tonify Kidney Water, and harmonize blood/qi. Other Jue types follow similar principles. Do not mistake them for Wind-Qi disorders.