口眼 斜者，俗工多与中风掉眩证一概治之，其药则灵宝、至宝、续命、
清心、一字急风乌犀铁弹丸，其方非不言治此病也，然而不愈者，何也？盖知窍而不知经，
知经而不知气故也。何谓知窍而不知经？盖人之首有七窍，如日月、五星、七政之在天也。故肝
窍目，目为肝之外候；肺窍鼻，鼻为肺之外候；心窍舌，舌无窍，心与肾合而寄窍于耳，故耳与
舌，俱为心之外候。俗工止知目病归之肝，口病归之脾，耳病归之肾，舌病归之心，更无改
张。岂知目之内 ，上、下二网，足太阳及足阳明起于此；目之锐 ，足少阳起于此，手少
阳至于此；鼻之左右，足阳明、手阳明侠乎此；口之左右，亦此两经还乎此。故七窍有病，
不可独归之五脏，当归之六阳经也。余曰∶俗工知窍而不知经者，此也。
何谓知经而不知气？盖世之
谈方药者，不啻千万人，止不过坚执《本草》性味，其知十二经所出所入，所循所环，所交所合，所过
所注，所起所会，所属所络，所上所下，所侠所贯，所布所散，所结所绕，所抵所连，所系
所约，所同所别，千万人中，或见一、二名明，可谓难其人矣！然而不过执此十二经，便为
病本，将阳经为热，阴经为寒，向《本草》中寻药，药架上检方而已矣。病之不愈，又何讶焉
？岂知《灵枢经》曰∶足之阳明，手之太阳，筋急则口目为僻，此十二经及受病之处也，非
为病者也。及为病者，天之六气也。六气者何？风、暑、燥、湿、火、寒是也。故曰∶俗工知经而不
知气者，此也。
然则口目 斜者，此何经也？何气也？足之太阳，足之阳明，左目有之，右目亦有之，足之
阳明，手之阳明，口左有之，口右亦有之。此两道也。《灵枢》又言∶足
阳明之筋，其病颊筋，有寒则急引颊移口，热则筋弛纵，缓不胜收，故僻。是左寒右热，则左急而
右缓；右寒左热，则右急而左缓。故偏于左者，左寒而右热；偏于右者，右寒而左热也。夫
寒不可径用辛热之剂，盖左中寒则逼热于右，右中寒则逼热于左，阳气不得宣行故也。而况
风者，甲乙木也。口眼阳明，皆为胃土。风偏贼之，此口目之所以僻也，是则然矣。
七窍惟口目 斜，而耳鼻独无此病者，何也？盖动则风生，静者风息，天地之常理
也。考之《易》象，有足相符者。震巽主动，坤艮主静。动者皆属木，静者皆属土。观卦者
，视之理也。视者，目之用也。目之上网则眨，下网则不眨。故观卦上巽而下坤。颐卦者，养之
理也。养者，口之用也。口之下颔则嚼，上颔则不嚼。故颐卦上艮而下震。口目常动，故风
生焉。耳鼻常静，故风息焉。当思目虽斜，而目之 眶未尝斜；口之 ，而
口之辅车未尝 ，此经之受病，非窍之受病明矣！而况目有风轮，唇有飞门者耶！
余尝治此证，未尝用世俗之药。非故与世参商，方凿圆枘，自然龃龉者。过颖，一长
吏病此，命予疗之。目之斜，灸以承泣；口之 ，灸以地仓，俱效。苟不效
者，当灸人迎。夫气虚风入而为偏，上不得出，下不得泄，真气为风邪所陷，故宜灸。《内
经》曰∶陷下则灸
之。正谓此也，所以立愈。又尝过东杞，一夫亦患此，予脉其两手，急数如弦之张，甚力而
实。其人齿壮气充，与长吏不同，盖风火交胜。予调承气汤六两，以水四升，煎作三升，分
四服，令稍热啜之，前后约泻四、五十行，去一、两盆，次以苦剂投之，解毒数服，以升降
水火，不旬日而愈。《脉诀》云∶热则生风。若此者，不可纯归其病于窗隙之间而得，亦风火素
感而然也。盖火胜则制金，金衰则木茂，木茂则风生。若东杞之人，止可流湿润燥，大下之后，
使加餐通郁为大。《灵枢》虽有马膏桂酒双涂之法，此但治其外耳，非治其内也。今人不知
其本，欲以单服热水，强引而行之，未见其愈者也。向之用姜附、乌、桂、起石、硫黄之剂
者，是耶？非耶？
口眼歪斜这一病症，世俗医生大多将其与中风引起的眩晕、震颤等症状混为一谈进行治疗。所用的药物包括灵宝丹、至宝丹、续命汤、清心丸、一字急风乌犀铁弹丸等。这些方剂并非没有提及治疗此病的方法，然而患者却不痊愈，为什么呢？这是因为医生只知窍穴而不知经络，或者只知经络而不知气机运行的缘故。
什么叫“知窍而不知经”？人的头部有七窍，就像天上的日月、五星和七政一样。所以肝开窍于目，眼睛是肝脏的外在表现；肺开窍于鼻，鼻子是肺脏的外在表现；心开窍于舌，但舌本身无窍，心与肾相合，将窍寄居于耳，所以耳朵和舌头都是心脏的外在表现。世俗医生只知道目病归属于肝，口病归属于脾，耳病归属于肾，舌病归属于心，墨守成规，不知变通。哪里知道眼睑的内侧上下两层，足太阳膀胱经和足阳明胃经起始于此；眼角的锐眦部位，足少阳胆经起始于此，手少阳三焦经也到达此处；鼻子的左右两侧，足阳明胃经和手阳明大肠经夹行于此；嘴巴的左右两侧，也是这两条经脉环绕于此。所以七窍患病，不能单独归咎于五脏，应当归咎于六条阳经。我说：世俗医生之所以知窍而不知经，就是这种情况。
什么叫“知经而不知气”？世上谈论方药的人，数以千万计，不过只是固执地坚持《本草》中的性味理论。那些真正懂得十二经脉的起止、循行、环抱、交接、会合、经过、灌注、所属、络属、上下走向、夹行贯穿、分布散布、结聚缠绕、抵达连接、维系约束、同异区别的人，在千万人中或许只能见到一两个明白人，可以说很难得啊！然而他们不过是拘泥于这十二条经脉，便认为是病的根本，将阳经视为热证，阴经视为寒证，然后在《本草》中寻药，在药架上找方罢了。病不痊愈，又有什么可惊讶的呢？哪里知道《灵枢经》说：“足阳明经和手太阳经的筋脉拘急，就会导致口眼歪斜”，这是十二经脉及受病的地方，而不是致病的原因。真正致病的，是天地的六气。六气是什么？就是风、暑、燥、湿、火、寒。所以说：世俗医生知经而不知气，就是这种情况。
那么口眼歪斜，究竟是哪条经脉受病？又是哪种气邪致病？足太阳经和足阳明经，左眼有之，右眼也有之；足阳明经和手阳明经，左边口角有之，右边口角也有之。这是两条路径。《灵枢》又说：足阳明经的筋脉，如果生病影响颊部的筋，受寒则筋脉拘急牵引嘴角移位，受热则筋脉弛缓纵伸，松弛而不能收摄，所以导致口眼歪斜。如果是左侧受寒右侧受热，则左侧筋脉拘急而右侧弛缓；右侧受寒左侧受热，则右侧拘急而左侧弛缓。所以偏瘫在左侧的，是左侧受寒而右侧受热；偏瘫在右侧的，是右侧受寒而左侧受热。寒气不可直接使用辛热药物治疗，因为左侧受寒如果用热药，会将热气逼迫到右侧；右侧受寒用热药，会将热气逼迫到左侧，导致阳气无法宣通运行。况且风属于甲乙木，口眼所在的阳明经都属于胃土。风邪偏贼侵袭，这就是口眼歪斜的原因，道理确实如此。
七窍中唯独口眼歪斜，而耳朵和鼻子没有这种病，为什么呢？大概是因为运动则生风，静止则风息，这是天地的常理。考察《易经》卦象，有相符之处。震卦和巽卦主主动，坤卦和艮卦主静。动的都属木，静的都属土。“观”卦，是视看的道理。视看是眼睛的功能。眼睛的上眼睑眨动，下眼睑不眨动。所以“观”卦上爻为巽（风/动），下卦为坤（地/静）。“颐”卦，是养育的道理。养育是嘴巴的功能。嘴巴的下颚咀嚼，上颚不咀嚼。所以“颐”卦上卦为艮（山/止），下卦为震（雷/动）。口和眼经常运动，所以风邪容易滋生。耳朵和鼻子经常静止，所以风邪难以停留。应当思考，虽然眼睛歪斜，但眼眶并没有歪斜；虽然嘴巴歪斜，但下颌骨（辅车）并没有歪斜，这说明是经络受病，而不是窍穴受病，这是很明显的！更何况眼睛有风轮（黑睛），嘴唇有飞门（唇口）呢！
我曾经治疗这个病症，从未使用世俗的药物。并不是故意要与世人格格不入，像方凿圆枘那样自然抵触。路过颍州时，一位长官得了这个病，让我治疗。眼睛歪斜，我灸承泣穴；嘴巴歪斜，我灸地仓穴，都见效了。如果无效，应当灸人迎穴。这是因为气虚导致风邪侵入，向上不能排出，向下不能泄出，真气被风邪陷遏，所以适宜用灸法。《内经》说：“脉气陷下的就用灸法。”正是说的这种情况，所以立刻痊愈。又曾路过东杞，有一位男子也患此病，我诊察他的两手脉象，急促数乱如张开的弓弦，非常有力且实。这个人牙齿壮实、气血充沛，与那位长官不同，大概是风火交争所致。我调配承气汤六两，用水四升，煎煮成三升，分四次服用，让患者稍热时喝下，前后大约排泄了四五十次，排出一两盆秽物，随后用催吐的苦剂投服，解毒数次，以升降水火，不到十天就痊愈了。《脉诀》说：“热极则生风。”像这种情况，不能单纯认为病邪是从门窗缝隙间侵入的，也是风火素来感应所致。大概火胜则克制金，金衰则木旺，木旺则风生。对于东杞这位患者，只可用流湿润燥之法，在大泻之后，使饮食通畅、郁结解除为大要。《灵枢》中虽然有马膏和桂酒双涂的方法，但这只是治疗外在症状，并非治疗内在病因。现在的人不知道根本，想要单靠喝热水，强行引导其运行，没见谁痊愈的。以前使用干姜、附子、乌头、肉桂、代赭石、硫黄等药物的方法，是对还是错呢？
Facial paralysis (Kou Yan Xie), commonly treated by lay physicians indiscriminately with syndromes of wind-stroke involving dizziness and tremors, is often medicated with formulas such as Lingbao Dan, Zhibao Dan, Xuming Tang, Qingxin Wan, and Yizi Jifeng Wuxi Tiedan Wan. Although these prescriptions claim to treat this disease, why do patients fail to recover? This is because practitioners know the orifices but not the meridians, or know the meridians but not the Qi dynamics.
What is meant by "knowing the orifices but not the meridians"? The human head has seven orifices, analogous to the sun, moon, five planets, and seven celestial bodies in the sky. Thus, the liver opens into the eyes; the eyes are the external manifestation of the liver. The lungs open into the nose; the nose is the external manifestation of the lungs. The heart opens into the tongue; however, since the tongue itself lacks an orifice, the heart combines with the kidneys and lodges its orifice in the ears. Therefore, both the ears and the tongue serve as external manifestations of the heart. Lay physicians merely associate eye diseases with the liver, mouth diseases with the spleen, ear diseases with the kidneys, and tongue diseases with the heart, adhering rigidly without variation. They fail to realize that the inner upper and lower eyelids are where the Foot-Taiyang Bladder Meridian and Foot-Yangming Stomach Meridian originate; the outer canthus is where the Foot-Shaoyang Gallbladder Meridian originates and the Hand-Shaoyang Sanjiao Meridian reaches; the left and right sides of the nose are flanked by the Foot-Yangming Stomach Meridian and Hand-Yangming Large Intestine Meridian; and the left and right sides of the mouth are also circled by these two meridians. Therefore, when diseases affect the seven orifices, they cannot be attributed solely to the five zang organs but must be attributed to the six yang meridians. I say: This is why lay physicians know the orifices but not the meridians.
What is meant by "knowing the meridians but not the Qi"? Among the millions discussing herbal prescriptions, few truly understand the origins, destinations, courses, loops, intersections, confluences, passages, acupoints, affiliations, collaterals, superior and inferior directions, parallel paths, distributions, scatterings, knots, winds, connections, ties, constraints, similarities, and distinctions of the twelve primary meridians. Such individuals are rare. Most simply cling to the twelve meridians as the root of disease, categorizing Yang meridians as heat and Yin meridians as cold, then searching for herbs in the *Bencao* (Materia Medica) and formulas on their shelves. Is it surprising that the disease does not heal? As stated in the *Ling Shu* (Spiritual Pivot): "Spasms of the tendons of the Foot-Yangming and Hand-Taiyang meridians cause deviation of the mouth and eyes." These are the locations of the twelve meridians and the sites of pathology, not the pathogenic factors themselves. The true pathogenic factors are the Six Qi of heaven: Wind, Summer-heat, Dryness, Dampness, Fire, and Cold. Thus, lay physicians know the meridians but not the Qi.
So, which meridian and which Qi are involved in facial paralysis? The Foot-Taiyang and Foot-Yangming meridians affect both the left and right eyes. The Foot-Yangming and Hand-Yangming meridians affect both the left and right corners of the mouth. These constitute two pathways. The *Ling Shu* further states: "When the tendons of the Foot-Yangming Meridian are diseased, affecting the cheek tendons, cold causes spasms pulling the mouth, while heat causes flaccidity and inability to contract, resulting in deviation." If the left side is cold and the right side hot, the left becomes spastic and the right flaccid; if the right is cold and the left hot, the right becomes spastic and the left flaccid. Therefore, left-sided deviation indicates left cold and right heat; right-sided deviation indicates right cold and left heat. One should not directly use pungent-hot agents for cold, as treating left-side cold with heat would force heat to the right, and vice versa, preventing the smooth circulation of Yang Qi. Moreover, Wind belongs to Wood (Jia/Yi). The mouth and eyes belong to the Yangming Stomach Earth. When Wind attacks parasitically, it causes deviation.
Why do only the mouth and eyes suffer from deviation among the seven orifices, while the ears and nose do not? Movement generates Wind, stillness extinguishes Wind; this is the constant principle of heaven and earth. Examining the *I Ching* (Book of Changes), there are correspondences: Zhen and Xun trigrams govern movement (Wood); Kun and Gen trigrams govern stillness (Earth). The Guan (View) hexagram relates to vision. Vision is the function of the eyes. The upper eyelid blinks (movement/Wind), while the lower eyelid does not (stillness/Earth). Hence, Guan has Xun above and Kun below. The Yi (Nourishment) hexagram relates to nourishment. Nourishment is the function of the mouth. The lower jaw chews (movement/Wind), while the upper jaw remains still (stillness/Earth). Hence, Yi has Gen above and Zhen below. Since the mouth and eyes are constantly moving, Wind arises. Since the ears and nose are relatively still, Wind does not settle. Note that although the eyes deviate, the eye sockets do not; although the mouth deviates, the mandible (Fu Che) does not. This clearly shows the meridians are diseased, not the orifices. Furthermore, the eyes have the "Wind Wheel" (cornea/pupil), and the lips have the "Flying Gate" (oral opening).
I have treated this condition without using common folk medicines, not to deliberately oppose society like a square peg in a round hole. Passing through Yingzhou, a magistrate suffered from this. His eye deviation was treated with moxibustion at Chengqi (ST1); his mouth deviation was treated with moxibustion at Dicang (ST4), both effective. If ineffective, Renying (ST9) should be moxibusted. This is due to Qi deficiency allowing Wind invasion, trapping true Qi, so moxibustion is indicated. The *Nei Jing* states: "Use moxibustion for sinking/collapsed Qi." This explains the immediate recovery. Later, passing through Dongqi, a man suffered from this. His pulse was rapid, taut like a drawn bowstring, strong and excess. He had strong teeth and abundant Qi, differing from the magistrate, indicating a conflict of Wind and Fire. I prescribed Chengqi Tang (Gut-Purging Decoction) 6 liang, decocted in 4 sheng of water to yield 3 sheng, divided into four doses, taken warm. He defecated 40-50 times, expelling basins of waste. Then I used bitter emetics and detoxifying herbs to regulate the ascending and descending of Water and Fire. He recovered within ten days. The *Mai Jue* says: "Heat generates Wind." Such cases are not merely caused by Wind entering through window cracks but by inherent Wind-Fire interaction. Fire overacting controls Metal; Metal deficiency allows Wood to flourish; Wood flourishing generates Wind. For the patient in Dongqi, moistening and purging were appropriate. After heavy purgation, restoring appetite and resolving stagnation was key. The *Ling Shu* mentions applying horse fat and cinnamon wine externally, but this treats only the exterior, not the interior root. Modern practitioners who ignore the root and rely solely on drinking hot water see no cures. Were the previous uses of Ginger, Aconite, Aconite (Wutou), Cinnamon, Magnetite, and Sulfur correct or incorrect?