详《格致余论》《局方发挥》《丹溪心法》《纂要》《日用》《医案
》及今《附余》，并各名家方书，如《巢氏病源》《好生书》《儒医纂要》，惜乎，未
中风卒倒分真似，
风为百病长，善行数变，为卒中昏倒，为窜视
僻，为搐搦反张，或为寒中，或为热中，或为疠风。入阳经则狂，入阴经则颠，入皮
肤则痒，入筋则挛急，入骨节则疼痛，入肉分与卫气相搏则不仁，与荣气相搏则半身不遂，
入经瘫痪，入络肤顽，入腑即不识人，入脏即舌强吐沫，挟热则痿缓，挟寒则拘挛，挟湿则
肿满。有真中者，有兼中、似中者。阳病身热，阴病身凉，乌、附行经，不可概用。
口眼 斜语话难；
风邪初入反缓，正气反急，牵引口眼 僻
，或左或右。急掐人中，拔顶发，炙耳垂珠，粟米大艾三五壮。外用南星、草乌各一两，白
芨一钱，僵蚕七枚为末，姜汁调涂 处，正
。内用正舌药，白附子、僵蚕、全蝎等分为末，酒调服二钱。不语有数端，有风中心脾者
资寿解语汤；有风中心经者，小续命汤去桂、附加菖蒲；有痰塞心窍者，导痰汤加菖蒲、
人参、竹茹，或芩、连；有舌本强硬，语言不正者，用蝎梢二钱半，茯苓一两，薄荷二两，为
末，酒调服二钱，或擦牙尤妙。又有风热壅者，有血虚、气虚者，有肾虚及老人忽言不出者
，十全大补汤去桂，加菖蒲、远志。
痰塞喉中声噫噫，
同上卒倒歪斜，不语名风喑，身软有汗者生，汗不出身直者死。痰由水化制火，
闭塞心窍不语。热者，凉膈散加黄连，或牛黄清心丸；虚者，星香散、三生饮、导痰汤、小
省风汤。
半身（或只一肢）不遂（此名偏枯，言不变，智不
，病在肤腠之间，温卧取汗）四肢瘫；
此名风痱，智乱不能言者，难治。其证身体无痛，缓则四肢不举，急则一身皆仰
，或左瘫右痪，或一臂不随，时复转移一臂。驱风化痰，调气养血为主，换骨丹、黑虎丹、
神仙飞步丹。有脾实者，膏粱之疾，非肝肾虚痿，搜风顺气丸；有脾虚者，十全大补汤、
独活寄生汤、万宝回春汤。
又有五痹类风状（见后），四证（风喑、风痱、偏
枯、痹风）全无莫浪猜。
中暑、中寒、中湿、痰厥、气厥、食厥、热厥、虚晕等证，皆卒倒不语，但风必
有歪斜搐搦之证为异，虽内伤兼中亦然。但四证见一便作风治，惟有轻重缓急之分。轻者发
过如故，或口舌无恙、手足颤拽者，大省风汤加人参、没药等分，水煎热服，得汗即愈。
或四肢无恙，口 语涩者，古防风汤，入麝
一厘调服；
或自醒能言能食，惟身体不遂者，地仙丹。
西北（风高）真中宜分治，东南（地湿）兼中（似中）审实虚；主火（河间）主气
垣）或主湿（丹溪），内伤兼（中）似
三子所主虽殊而实同也，况湿则中气不运而生痰，痰因火动而生风，又兼二子之见也。
气衰贼邪容易袭，
气血壮盛，腠理致密，邪不能入。惟中年气血始衰，腠理空疏，加以七情劳役饮
食，内伤元气，门巷贼风，乘虚袭入脏腑血脉，故有兼中者，东垣所谓非外邪径伤，乃本气
病也。有醉后当风，头面多汗善渴者，名曰漏风，宜黄 六一汤，加参、术、牡蛎、干葛。
有房劳中风，下体多汗，曰内风，十全大补汤加附子、防风。如入风府，曰脑风；入系头，曰
目风；在腠理，为泄风，与漏风同，但身尽疼耳；久则为肠风；食后曰胃风，又名夹食中风
，久则为下血。有伤食变为暴厥，亦类中风，但停食则胸中满闷，须探吐及理脾胃。有酒湿
病，亦类中风，当分消以泻湿毒。有内伤热证似中风者，有杂病虚证似中风者，均不可以风治。
火动气中无涎污。
中气脉沉身凉无痰涎为异耳。如思虑肉脱，忧愁肢废，悲哀筋挛，过喜皮槁，盛
怒腰瘠，即河间所谓将息失宜，五志过极，则心火暴甚，肾水难制，热气拂郁昏倒，筋骨不
用，久则瘫痪，忌服风药，宜藿香正气散合星香散。虚者，八味顺气散；实者，四七汤。
真中中腑着四肢，
手足拘挛，或中身前、身后、身侧，可治。脉浮有表，面见五色，恶寒，宜小续
命汤，或排风汤，风从汗散，通因通用是也。如脉浮不语者，用防风、黄 煎水一担，置床
下，熏入鼻中，良久能言进药。
中脏（闭）塞（九）窍多昏危；
中脏之络者，口眼俱闭，可治。如入脏深者，心绝口开，肝绝眼闭，脾绝手散，
肺绝痰如拽锯、鼾睡，肾绝遗尿，或大吐大泻，下血吐血者皆死。宜三化汤、搜风顺气丸、麻
子仁丸。凡攻里，忌脑、麝、牛黄引风入骨，芫花、甘遂损伤气血。如汗多尿少者，忌渗利
，荣竭无以制火，烦热愈甚，候热退汗止，小便自利。
中血脉（络也）则歪口眼，
或近于腑，外亦有六经形证，则从小续命汤加减微汗。或近于脏，内亦有便溺阻
隔，则从三化汤加减微利。
又有中经亦要知。内（无便溺阻隔）外无（六经形
）证从中治（不可汗下），
盖风本于热，热胜则风动，宜养血以胜燥，大秦艽汤分经加减，或天麻丸、羌活
愈风汤。如欲微汗，愈风汤加麻黄；欲微利，愈风汤加大黄。中腑虽宜汗，汗多则亡阳；中
脏虽宜下，下多则亡阴。若脏腑兼见者，或先汗而后利，或表里兼攻者，防风通圣散。
口不能言肢不持；
手足不能运动，乃血弱不能营筋与舌也。
左为死血（留滞经络）与少血，
四物汤少加防风、羌活主之。瘀血，加桃仁、红花。
痰与气虚身右居。
血虚则痰火流注于左而为瘫，气虚则痰火流注于右而为痪，急治则愈，久则痰火
郁结难治。痛者为实，先以二陈、省风之类治痰，后以防风通圣散、泻青丸之类泻火；不痛
为虚，血虚者，四物汤俱姜汁炒过，加竹沥、姜汁。肥人湿痰，少加附子行经；瘦人火动，
加黄柏；气虚者，四君子汤；虚甚，遗尿声鼾睡者，浓煎参、 ，加附子、姜汁；劳伤者，
补中益气汤加竹沥，兼治右痪。痰盛者，二陈汤加姜汁、竹沥；能食者，换荆沥。此丹溪杂
病通法也。
通治（南北）开关化涎沫，
开关散，吹鼻有嚏可治，无嚏者死。牙关紧急，入药不得者，用南星五分，龙脑
一字，端午日午时合，每用一字至五分，擦牙热自开。痰甚者，宜量虚实吐之。虚者，稀涎
散微微吐出冷涎。实者，用瓜蒂炒黄末五分或一钱，入全蝎末半分，吹入鼻中立吐；如不吐
，用酸齑汁调下；如再不吐，用热齑汁投之，此药不可轻用。吐后，宜服降火利气、安神定
志之药。吐法见伤寒，但中风大吐涎出，久则手足骨节皆枯，不能转动滑利，以药压下，
再归骨节可也，小儿惊搐亦然。
顺气活血风自祛。
风证，皆痰为患，故治以开关化痰为先，急则祛风，缓则顺气，久则活血。如真
气渐复，痰饮渐消，或尚有风邪未退，羌活愈风汤调之。实者，川芎茶调散；虚者，万宝回
春汤，未可全以风治也。抑论旧以西北风高，真中宜分脏腑经络调治；东南地湿，兼中、
似中宜分气血虚实、痰火多少调治。然真中、兼中，南北互有，且治脏腑者，可不分气血之
虚实乎？治气血者，又可不分脏腑经络之邪多少乎？大抵外感重而内伤轻者，先须分表里法，
祛风为主，次用气血痰法调治；内伤重而外感轻者，先用调补气血痰法为主，次分脏腑经络
祛风，此活法也。
若觉肤顽肌蠕动，
凡觉手足麻木，肌肉蠕动，如有虫行，心抑愦乱，宜乌药顺气散。
如眉棱骨痛者
，风之兆也，宜古防风汤加芩、连。
预防之法亦堪推。
御风丹、五参散、史国公浸酒方、单 丸。
冒风恶风多属肺，
肺主皮毛，通膀胱，最易感冒。新咳嗽恶风，鼻塞声重喷嚏是也，柴胡半夏汤、
参苏饮，寒月麻黄杏仁饮。重者，头疼身痛，寒热，咽干音哑，柴胡桂枝汤、防风冲和汤。
头痛甚者，川茶芎调散；痰多者，金沸草散；挟热，人参败毒散、升麻葛根汤；挟寒，十神
汤；挟寒湿，消风百解散；挟湿，神术散；挟暑，香葛汤；时行，柴胡升麻汤。
挟内慎勿专攻外；
服食过浓，素有痰火，时常鼻塞流涕，声重咳嗽，略被外感则甚者，防风通圣散
，或大黄、黄芩等分为丸，白水下。素虚者，只用防风、羌活、川芎，随宜加入补药、痰药
中。伤食，加白术、陈皮、青皮、山楂、麦芽；挟形寒饮冷，加姜、桂；挟房劳，加参、术
、归、地；挟劳役伤气者，补中益气汤加羌活、防风；风虚甚者，羌活丸、加味乌荆丸。
重则传变轻不传，
风重传里，一同伤寒治法。
久甚能为气血害。
风能燥血散气，故古用桂附、八物等汤。久不愈者，只宜三白汤加减敛之，切忌
疏泄，虽初起，非寒月无汗，麻黄禁用。
风邪是百病之首，其特性善行而多变，可导致卒中昏倒、眼球斜视、抽搐角弓反张，或表现为寒中、热中、疠风等。风邪侵入阳经则出现狂躁，侵入阴经则导致癫证，侵入皮肤则瘙痒，侵入筋脉则拘挛，侵入骨节则疼痛，侵入肌肉与卫气相搏则感觉麻木不仁，与营气相搏则半身不遂，侵入经脉则瘫痪，侵入络脉皮肤则顽痹，侵入腑则神志不清不识人，侵入脏则舌强吐沫，兼夹热邪则肢体痿软弛缓，兼夹寒邪则拘挛紧缩，兼夹湿邪则肿胀满闷。中风有真中风、兼夹中风、类似中风之分。阳经受邪身体发热，阴经受邪身体发凉，乌头、附子等辛热药物通行经络，不可一概使用。
口眼歪斜，言语困难：
风邪初袭时，患侧肌肉松弛，健侧肌肉相对紧张，牵引口眼歪向健侧，或向左或向右。急救时可重掐人中穴，拔除头顶头发，艾灸耳垂珠（耳垂），用粟米大小的艾炷灸三至五壮。外用天南星、草乌各一两，白及一钱，僵蚕七枚，研为细末，用姜汁调匀涂抹于患侧，可使口眼端正。内服正舌药，将白附子、僵蚕、全蝎等分研末，酒调服二钱。不语症有多种原因：风邪中心脾者，用资寿解语汤；风邪中心经者，用小续命汤去掉桂枝、附子，加入石菖蒲；痰浊堵塞心窍者，用导痰汤加入石菖蒲、人参、竹茹，或黄芩、黄连；舌根强硬，语言不正者，用蝎梢二钱半，茯苓一两，薄荷二两，研为细末，酒调服二钱，或者擦牙效果更佳。又有风热壅盛者，血虚者，气虚者，肾虚及老人突然不能说话者，用十全大补汤去掉桂枝，加入石菖蒲、远志。
痰浊阻塞喉中，发出噫噫声：
同上所述卒倒歪斜、不能说话称为风喑（中风失音）。身体柔软有汗者预后良好，无汗且身体僵硬者预后不良。痰由水液代谢失常化生，制约火邪，闭塞心窍导致不语。属热者，用凉膈散加黄连，或牛黄清心丸；属虚者，用星香散、三生饮、导痰汤、小省风汤。
半身（或仅一侧肢体）不遂（此名偏枯，指神志不变，智力正常，病位在肤腠之间，宜温覆取汗）四肢瘫：
此名风痱，神志混乱不能言语者，难治。其症状身体无痛，缓症则四肢不能抬起，急症则全身后仰，或左瘫右痪，或一臂不随，有时转移至另一臂。治疗以驱风化痰、调气养血为主，可用换骨丹、黑虎丹、神仙飞步丹。脾气实者，多因膏粱厚味所致，非肝肾虚痿，用搜风顺气丸；脾气虚者，用十全大补汤、独活寄生汤、万宝回春汤。
又有五痹类风状（见后文），四证（风喑、风痱、偏枯、痹风）全无，切勿胡乱猜测。
中暑、中寒、中湿、痰厥、气厥、食厥、热厥、虚晕等证，都会突然昏倒不能说话，但中风必有歪斜、抽搐等症状作为区别，即使是内伤兼夹中风也是如此。只要见到上述四证之一，就按中风治疗，只是有轻重缓急之分。轻者发作后如常人，或口舌无恙、手足颤抖者，用大省风汤加人参、没药等分，水煎热服，得汗即愈。或四肢无恙，口齿涩滞者，用古防风汤，入麝香一厘调服；或自行苏醒能言能食，惟身体不遂者，用地仙丹。
西北地区（风高）真中风宜分别治疗，东南地区（地湿）兼夹中风、类似中风需审察虚实；刘河间主火，李东垣主气，朱丹溪主湿，三位医家主张虽不同，实则相通。况且湿邪导致中气不运而生痰，痰因火动而生风，又兼采了另外两位医家的见解。
气血衰弱，贼邪容易侵袭：
气血壮盛，腠理致密，邪气不能侵入。只有中年以后气血开始衰退，腠理空疏，加上七情劳役饮食，内伤元气，门巷贼风乘虚侵袭脏腑血脉，所以有兼夹中风的情况，正如李东垣所说，并非外邪直接损伤，而是本气生病。有醉后当风，头面多汗善渴者，名为漏风，宜用黄芪六一汤，加人参、白术、牡蛎、干葛。有房事劳累后中风，下体多汗，称为内风，用十全大补汤加附子、防风。如风邪入风府穴，称为脑风；入系头部位，称为目风；在腠理，称为泄风，与漏风相同，只是全身疼痛；久则为肠风；食后发病称为胃风，又名夹食中风，久则便血。有伤食变为暴厥，也类似中风，但有停食则胸中满闷，须探吐及调理脾胃。有酒湿病，也类似中风，当分消以泻湿毒。有内伤热证似中风者，有杂病虚证似中风者，均不可以风邪论治。
火动气中无涎污：
中气脉沉身凉无痰涎是其区别。如思虑过度肌肉消瘦，忧愁导致肢体废用，悲哀导致筋脉拘挛，过喜导致皮肤干枯，盛怒导致腰部瘦削，这就是刘河间所说的调养失宜，五志过极，则心火暴甚，肾水难以制约，热气拂郁导致昏倒，筋骨不用，久则瘫痪，忌服风药，宜用藿香正气散合星香散。虚者，用八味顺气散；实者，用四七汤。
真中风中腑影响四肢：
手足拘挛，或中身前、身后、身侧，可治。脉浮有表证，面色五色显现，恶寒，宜用小续命汤，或排风汤，使风从汗散，这是通因通用的治法。如脉浮不语者，用防风、黄芪煎水一担，置于床下，熏蒸鼻中，良久能言语后进药。
中脏（闭证）阻塞九窍多昏危：
中脏之络者，口眼俱闭，可治。如入脏深者，心绝口开，肝绝眼闭，脾绝手散，肺绝痰声如拽锯、鼾睡，肾绝遗尿，或大吐大泻，下血吐血者皆死。宜用三化汤、搜风顺气丸、麻子仁丸。凡攻里，忌用麝香、牛黄引风入骨，忌用芫花、甘遂损伤气血。如汗多尿少者，忌用渗利药，因为营血枯竭无法制火，烦热会更严重，待热退汗止，小便自利后再治。
中血脉（络脉）则歪口眼：
或近于腑，外亦有六经形证，则从小续命汤加减微汗。或近于脏，内亦有便溺阻隔，则从三化汤加减微利。
又有中经也要知晓：内无便溺阻隔，外无六经形证，从中治（不可汗下），
盖风本于热，热胜则风动，宜养血以胜燥，用大秦艽汤分经加减，或天麻丸、羌活愈风汤。如欲微汗，愈风汤加麻黄；欲微利，愈风汤加大黄。中腑虽宜汗，汗多则亡阳；中脏虽宜下，下多则亡阴。若脏腑兼见者，或先汗而后利，或表里兼攻者，用防风通圣散。
左侧多为死血（留滞经络）与少血：
用四物汤少加防风、羌活主治。瘀血，加桃仁、红花。
右侧多为痰与气虚：
血虚则痰火流注于左而为瘫，气虚则痰火流注于右而为痪，急治则愈，久则痰火郁结难治。痛者为实，先以二陈汤、省风汤之类治痰，后以防风通圣散、泻青丸之类泻火；不痛为虚，血虚者，四物汤俱用姜汁炒过，加竹沥、姜汁。肥人湿痰，少加附子行经；瘦人火动，加黄柏；气虚者，用四君子汤；虚甚，遗尿声鼾睡者，浓煎人参、甘草，加附子、姜汁；劳伤者，用补中益气汤加竹沥，兼治右痪。痰盛者，用二陈汤加姜汁、竹沥；能食者，换用荆沥。这是朱丹溪治疗杂病的通法。
通治南北开关化涎沫：
开关散，吹鼻有喷嚏者可治，无喷嚏者死。牙关紧急，药不得入者，用南星五分，龙脑一字，端午日午时合制，每用一字至五分，擦牙热自开。痰甚者，宜量虚实吐之。虚者，用稀涎散微微吐出冷涎。实者，用瓜蒂炒黄末五分或一钱，入全蝎末半分，吹入鼻中立吐；如不吐，用酸醋汁调下；如再不吐，用热醋汁投之，此药不可轻用。吐后，宜服降火利气、安神定志之药。吐法见伤寒篇，但中风大吐涎出，久则手足骨节皆枯，不能转动滑利，以药压下，再归骨节可也，小儿惊搐亦然。
顺气活血风自祛：
风证，皆由痰引起，故治以开关化痰为先，急则祛风，缓则顺气，久则活血。如真气渐复，痰饮渐消，或尚有风邪未退，用羌活愈风汤调之。实者，用川芎茶调散；虚者，用万宝回春汤，不可全以风邪论治。抑论旧说西北风高，真中风宜分脏腑经络调治；东南地湿，兼中风、类似中风宜分气血虚实、痰火多少调治。然而真中风、兼中风，南北互有，且治脏腑者，可不分辨气血之虚实吗？治气血者，又可不分脏腑经络之邪多少吗？大抵外感重而内伤轻者，先须分表里法，祛风为主，次用气血痰法调治；内伤重而外感轻者，先用调补气血痰法为主，次分脏腑经络祛风，此为活法。
若觉肌肤顽麻肌肉蠕动：
凡觉手足麻木，肌肉蠕动，如有虫行，心中烦乱，宜用乌药顺气散。
冒风恶风多属肺：
肺主皮毛，通膀胱，最易感冒。新咳嗽恶风，鼻塞声重喷嚏是也，用柴胡半夏汤、参苏饮，寒月用麻黄杏仁饮。重者，头疼身痛，寒热，咽干音哑，用柴胡桂枝汤、防风冲和汤。头痛甚者，用川芎茶调散；痰多者，用金沸草散；挟热，用人参败毒散、升麻葛根汤；挟寒，用十神汤；挟寒湿，用消风百解散；挟湿，用神术散；挟暑，用香葛汤；时行瘟疫，用柴胡升麻汤。
挟内伤慎勿专攻外：
服食过浓，素有痰火，时常鼻塞流涕，声重咳嗽，略被外感则甚者，用防风通圣散，或大黄、黄芩等分为丸，白水下。素虚者，只用防风、羌活、川芎，随宜加入补药、痰药中。伤食，加白术、陈皮、青皮、山楂、麦芽；挟形寒饮冷，加姜、桂；挟房劳，加参、术、归、地；挟劳役伤气者，用补中益气汤加羌活、防风；风虚甚者，用羌活丸、加味乌荆丸。
久甚能为气血害：
风能燥血散气，故古用桂附、八物等汤。久不愈者，只宜三白汤加减敛之，切忌疏泄，虽初起，非寒月无汗，禁用麻黄。
Apoplexy sudden collapse requires differentiation between true apoplexy and false apoplexy.
Wind pathogen is the chief of a hundred diseases, its nature is agile and variable, leading to sudden collapse, strabismus, convulsions, opisthotonos, or manifesting as cold invasion, heat invasion, leprosy. When wind enters Yang meridians, mania occurs; when it enters Yin meridians, epilepsy occurs; when it enters skin, itching occurs; when it enters sinews, spasms occur; when it enters bone joints, pain occurs; when it enters muscle layers and struggles with Wei Qi (Defensive Qi), numbness occurs; when it struggles with Ying Qi (Nutritive Qi), hemiplegia occurs; when it enters meridians, paralysis occurs; when it enters collaterals and skin, stubborn bi-syndrome occurs; when it enters Fu organs, consciousness is lost and recognition fails; when it enters Zang organs, tongue stiffness and foaming at the mouth occur. Accompanied by Heat, limbs become flaccid and relaxed; accompanied by Cold, they become contracted and cramped; accompanied by Dampness, swelling and fullness occur. Apoplexy includes True Wind Stroke, Combined Wind Stroke, and Apparent Wind Stroke. Pathogens in Yang meridians cause body heat; pathogens in Yin meridians cause body coolness. Aconite (Fuzi) and Black Aconite (Wutou) are acrid-hot drugs that unblock meridians and should not be used indiscriminately.
Deviation of mouth and eyes, difficulty in speech:
When wind pathogen first invades, the affected side muscles are lax, while the healthy side muscles are relatively tense, pulling the mouth and eyes toward the healthy side, either left or right. Emergency treatment involves pressing strongly on the Ren-26 (Renzhong/Giant Vertebra) acupoint, plucking hair from the vertex, and moxibustion on the earlobe (earlobe pearl). Use mugwort cones the size of millet grains, three to five applications. Externally, use Rhizoma Arisaematis (Nanxing) and Radix Aconiti Kusnezoffii (Caowu) each one liang, Rhizoma Bletillae (Baiji) one qian, and Bombyx Batryticatus (Jiangcan) seven pieces, grind into fine powder, mix with ginger juice, and apply to the affected side to correct the deviation. Internally, take medicine for straightening the tongue: equal parts of Rhizoma Typhonii (Baifuzi), Bombyx Batryticatus (Jiangcan), and Scorpio (Quanxie) ground into powder, taken with wine, two qian per dose. Aphasia has several causes: Wind striking Heart and Spleen uses Zishou Jieyu Tang (Zishou Decoction for Resolving Speech); Wind striking Heart Meridian uses Xiao Xuming Tang (Minor Rescue Life Decoction) without Cinnamon Twig (Guizhi) and Prepared Aconite Root (Fuzi), adding Rhizoma Polygala (Shichangpu); Phlegm turbidity blocking Heart Orifice uses Daotan Tang (Phlegm-Resolving Decoction) adding Rhizoma Polygala (Shichangpu), Ginseng Radix et Rhizoma (Renshen), and Bamboo Sap (Zhuru), or Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian); Stiff tongue root and abnormal speech uses Scorpion Tail (Xeshao) two qian half, Poria (Fuling) one liang, and Menthae Haplocalycis Herba (Bohe) two liang, ground into powder, taken with wine, two qian per dose, or applied to teeth for better effect. Other cases include Phlegm-Heat congestion, Blood Deficiency, Qi Deficiency, Kidney Deficiency, and sudden inability to speak in the elderly, treated with Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) without Cinnamon Twig (Guizhi), adding Rhizoma Polygala (Shichangpu) and Polygalae Radix (Yuanzhi).
Phlegm obstructing throat with gurgling sound:
As described above, sudden collapse, deviation, and aphasia are called Fengyin (Wind Aphonia). Soft body with sweating indicates good prognosis; stiff body without sweating indicates poor prognosis. Phlegm transforms from water metabolism disorder, restraining Fire, blocking Heart Orifice causing aphasia. Heat type uses Liangge San (Cooling Diaphragm Powder) adding Coptidis Rhizoma (Huanglian), or Niuhuang Qingxin Wan (Calculus Bovis Clearing Heart Pill); Deficiency type uses Xingxiang San, Sansheng Yin, Daotan Tang, or Xiao Shengfeng Tang.
Hemiplegia (or only one limb) (this is named Pianku, meaning spirit unchanged, intelligence normal, disease location in skin and interstices, suitable for warming to induce sweat): Limb paralysis:
This is named Fengfei. Confusion and inability to speak indicate difficult treatment. Symptoms include no body pain; mild cases have limbs unable to lift; severe cases have whole body arching backward; or left hemiplegia right paralysis, or one arm non-responsive, sometimes shifting to the other arm. Treatment focuses on dispelling wind, resolving phlegm, regulating Qi, and nourishing Blood, using Huangu Dan, Heihu Dan, or Shenxian Feibu Dan. Excess Spleen Qi, often due to rich diet, not Liver/Kidney deficiency, uses Soushun Fengqi Wan. Deficient Spleen Qi uses Shiquan Dabu Tang, Duhuo Jisheng Tang, or Wanbao Huichun Tang.
There are also Five Bi syndromes resembling wind (see later). If none of the four syndromes (Fengyin, Fengfei, Pianku, Bi-feng) are present, do not guess rashly.
Heatstroke, Coldstrike, Dampness strike, Phlegm Jue, Qi Jue, Food Jue, Heat Jue, Deficiency dizziness, etc., all cause sudden collapse and aphasia, but Wind Stroke is distinguished by deviation and convulsions, even if combined with internal injury. If any of these four signs appear, treat as Wind Stroke, considering severity and urgency. Mild cases recover as usual, or with normal mouth/tongue but trembling limbs, use Dashengfeng Tang adding Ginseng Radix et Rhizoma (Renshen) and Myrrh (Moyao) in equal parts, decocted in water, taken hot; sweating leads to cure. If limbs are normal but speech is slurred, use Ancient Fangfeng Tang adding Musk (Shexiang) one li, mixed and taken. If self-awakened able to speak and eat but body paralyzed, use Dixian Dan.
Northwest (high wind) True Wind Stroke requires differentiated treatment; Southeast (damp land) Combined/Apparent Wind Stroke requires examination of Deficiency/Excess. Liu Hejian emphasized Fire, Li Dongyuan emphasized Qi, Zhu Danxi emphasized Dampness. Although their theories differ, they are essentially consistent. Moreover, Dampness causes middle Qi stagnation generating Phlegm, Phlegm moves with Fire generating Wind, incorporating views of the other two masters.
Qi and Blood decline, evil pathogens easily invade:
When Qi and Blood are robust and pores dense, pathogens cannot enter. Only after middle age when Qi and Blood begin to decline, pores become loose, combined with Seven Emotions, overwork, and diet damaging internal Yuan Qi, door/window draft winds invade viscera and blood vessels vacuously, hence Combined Wind Stroke. As Li Dongyuan stated, it is not direct external injury, but disease of the original Qi. Drinking alcohol then facing wind, with head/face sweating and thirst, is named Loufeng (Leaking Wind), treat with Huangqi Liuyi Tang adding Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Ostreae Concha (Muli), and Puerariae Radix (Gegen). Sexual exhaustion leading to stroke with lower body sweating is called Neifeng (Internal Wind), treat with Shiquan Dabu Tang adding Prepared Aconite Root (Fuzi) and Saposhnikoviae Radix (Fangfeng). Wind entering Fengfu (Du-16) is Naofeng (Brain Wind); entering head connections is Mufeng (Eye Wind); in pores is Xiefeng (Sweating Wind), same as Loufeng but with whole body pain; long-term becomes Changfeng (Intestinal Wind); post-prandial is Weifeng (Stomach Wind), also called Jiashi Zhongfeng (Food-Clinging Wind Stroke), long-term leads to bloody stool. Food stagnation transforming into sudden Jue resembles Wind Stroke but with chest fullness due to food retention, requiring emesis and Spleen/Stomach regulation. Alcohol-Dampness disease resembles Wind Stroke, requiring separation and draining of Damp-Toxin. Internal Heat patterns resembling Wind Stroke and miscellaneous disease Deficiency patterns resembling Wind Stroke should not be treated as Wind.
Fire moving, Qi strike without phlegm sputum:
The difference lies in deep pulse, cool body, and absence of phlegm sputum. Overthinking wastes flesh, sorrow disables limbs, grief cramps sinews, excessive joy withers skin, extreme anger thins waist. This is Liu Hejian's concept of improper rest, extreme Five Emotions causing violent Heart Fire uncontrollable by Kidney Water, heat stagnation causing collapse, sinews/bones unusable, long-term paralysis. Avoid wind-dispelling drugs; use Huoxiang Zhengqi San combined with Xingxiang San. Deficiency uses Bawei Shunqi San; Excess uses Siqi Tang.
True Wind Stroke affecting Fu organs impacts limbs:
Limb spasms, or affecting front/back/side of body, are treatable. Floating pulse with exterior syndrome, five colors on face, aversion to cold, use Xiao Xuming Tang or Paifeng Tang, dispersing wind through sweat, applying "treat obstruction with unblocking" method. Floating pulse with aphasia: decoct Fangfeng and Astragali Radix (Huangqi) in large amount of water, place under bed, fumigate nose; speech returns after some time, then administer medicine.
Zang organ strike (Closure syndrome) blocking nine orifices leads to coma and danger:
Collateral involvement in Zang organs, closed mouth and eyes, is treatable. Deep Zang invasion: Heart collapse open mouth, Liver collapse closed eyes, Spleen collapse scattered hands, Lung collapse sawing phlegm sound/snoring, Kidney collapse enuresis, or severe vomiting/diarrhea/hematemesis/hematochezia are fatal. Use Sanhua Tang, Soushun Fengqi Wan, or Maziren Wan. For purging interior, avoid Musk (Shexiang) and Calculus Bovis (Niuhuang) which draw wind into bones, and Genkwa Flos (Yuanhua) or Kansui Radix (Gansui) which damage Qi/Blood. If sweating is profuse and urine scant, avoid diuretics; Ying Blood exhaustion cannot control Fire, worsening irritability/heat. Wait for heat subsiding and sweating stopping, urination normalizing before treating.
Blood vessel/collateral strike causes mouth/eye deviation:
If near Fu organs, exterior Six Meridian symptoms exist, use modified Xiao Xuming Tang for slight sweating. If near Zang organs, interior fecal/urinary obstruction exists, use modified Sanhua Tang for slight purging.
Meridian strike must also be known: No interior fecal/urinary obstruction, no exterior Six Meridian symptoms, treat from center (no sweating/purging).
Wind originates from Heat; Heat excess generates Wind. Nourish Blood to overcome dryness, use Da Qin Jiao Tang modified by meridian, or Tianma Wan, or Qianghuo Yufeng Tang. For slight sweating, add Ephedrae Herba (Mahuang) to Yufeng Tang; for slight purging, add Rheum Palmatum (Dahuang) to Yufeng Tang. Fu strike allows sweating, but excessive sweating destroys Yang; Zang strike allows purging, but excessive purging destroys Yin. Mixed Zang/Fu symptoms: sweat then purge, or simultaneous exterior-interior attack, use Fangfeng Tongsheng San.
Inability to speak, limbs unable to bear weight:
Limbs unable to move due to weak Blood failing to nourish sinews and tongue.
Left side indicates Blood stasis (retained in collaterals) and Blood Deficiency:
Use Siwu Tang with slight addition of Saposhnikoviae Radix (Fangfeng) and Notopterygii Rhizoma et Radix (Qianghuo). For Blood stasis, add Persicae Semen (Taoren) and Carthami Flos (Honghua).
Right side indicates Phlegm and Qi Deficiency:
Blood Deficiency causes Phlegm-Fire flowing to left causing paralysis; Qi Deficiency causes Phlegm-Fire flowing to right causing flaccidity. Early treatment cures; late stage Phlegm-Fire stagnation is hard to treat. Pain indicates Excess: first treat Phlegm with Erchen Tang, Shengfeng Tang, etc., then clear Fire with Fangfeng Tongsheng San, Xieqing Wan, etc. Non-pain indicates Deficiency: Blood Deficiency uses Siwu Tang fried with ginger juice, adding Bamboo Sap (Zhulv) and Ginger Juice. Fat people with Damp-Phlegm add slight Aconite (Fuzi) to unblock meridians; thin people with Fire movement add Phellodendri Cortex (Huangbai); Qi Deficiency uses Sijunzi Tang; severe Deficiency with enuresis/snoring uses concentrated decoction of Ginseng Radix et Rhizoma (Renshen) and Glycyrrhizae Radix et Rhizoma (Gancao) adding Aconite (Fuzi) and Ginger Juice; Overwork injuries use Buzhong Yiqi Tang adding Bamboo Sap (Zhulv), treating right flaccidity. Profuse Phlegm uses Erchen Tang adding Ginger Juice and Bamboo Sap (Zhulv); those who can eat switch to Jingli. This is Zhu Danxi's general method for miscellaneous diseases.
General treatment North/South opening orifices resolving phlegm foam:
Kaiguan San blown into nose; sneezing indicates treatability, no sneezing indicates death. Locked jaw preventing medication entry: use Rhizoma Arisaematis (Nanxing) five fen, Borax (Longnao) one zi, prepared at noon on Dragon Boat Festival. Use one zi to five fen to rub teeth, heat opens naturally. Profuse Phlegm: induce vomiting based on Deficiency/Excess. Deficiency: Xixian San gently vomits cold phlegm. Excess: Gualati Fructus (Gua Di) roasted yellow powder five fen or one qian, plus Scorpio (Quanxie) powder half fen, blown into nose to induce immediate vomiting; if no vomiting, mix with sour vinegar juice; if still no vomiting, use hot vinegar juice. Do not use lightly. After vomiting, take Fire-clearing, Qi-regulating, Spirit-calming medicines. Vomiting method seen in Cold Damage chapter. Wind Stroke vomiting profuse phlegm leads to dried joints and immobility long-term; press down with medicine to restore joint mobility. Pediatric convulsions are similar.
Regulate Qi, invigorate Blood, Wind dispels itself:
Wind syndromes are caused by Phlegm. Treat opening orifices and resolving Phlegm first. Urgent: dispel Wind; slow: regulate Qi; long-term: invigorate Blood. As True Qi recovers and Phlegm-Fluid dissipates, if Wind pathogen remains, use Qianghuo Yufeng Tang. Excess: Chuanxiong Chatiao San; Deficiency: Wanbao Huichun Tang. Do not treat solely as Wind. Discussion: Old theory says Northwest high wind True Wind Stroke treats Zang/Fu/Meridians; Southeast damp Combined/Apparent Wind Stroke treats Qi/Blood Deficiency/Excess and Phlegm-Fire amounts. However, True/Combined Wind occur in both regions. Treating Zang/Fu requires distinguishing Qi/Blood Deficiency/Excess? Treating Qi/Blood requires distinguishing Zang/Fu/Meridian pathogen amounts? Generally, Heavy Exterior/Light Interior: first distinguish Exterior/Interior, prioritize Wind-dispelling, then Qi/Blood/Phlegm methods. Heavy Interior/Light Exterior: first tonify/regulate Qi/Blood/Phlegm, then differentiate Zang/Fu/Meridians to dispel Wind. This is flexible application.
If feeling skin numbness and muscle twitching:
Any sensation of limb numbness, muscle twitching like insects crawling, mental confusion, use Uyghur Smilacis Rhizoma (Wuyao) Shunqi San.
Eyebrow ridge pain:
Is a sign of Wind, use Ancient Fangfeng Tang adding Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian).
Prevention methods are worthy of promotion:
Yufeng Dan, Wushen San, Shi Guogong Infused Wine Formula, Dan [missing character] Wan.
Wind invasion and aversion to wind mostly belong to Lung:
Lung governs skin/hair, connects to Bladder, most susceptible to cold. New cough with aversion to wind, nasal congestion, heavy voice, sneezing: Chaihu Banxia Tang, Renshen Su Yin. Cold months: Mahuang Xingren Yin. Severe cases: headache/body pain, chills/fever, dry throat/hoarseness: Chaihu Guizhi Tang, Fangfeng Chonghe Tang. Severe headache: Chuanxiong Chatiao San; Profuse Phlegm: Jinfeicao San; Accompanied by Heat: Renshen Baidu San, Shengma Gengen Tang; Accompanied by Cold: Shishen Tang; Accompanied by Cold-Damp: Xiaofeng Baijie San; Accompanied by Damp: Shenzhu San; Accompanied by Summerheat: Xiangge Tang; Epidemic: Chaihu Shengma Tang.
Accompanied by Internal Injury: Do not exclusively attack Exterior:
Rich diet, chronic Phlegm-Fire, frequent nasal congestion/runny nose, heavy voice/cough, slightly exposed to exterior causing severity: Fangfeng Tongsheng San, or Rhubarb (Dahuang) and Scutellariae Radix (Huangqin) equal parts made into pills, taken with water. Constitutionally deficient: use only Saposhnikoviae Radix (Fangfeng), Notopterygii Rhizoma et Radix (Qianghuo), Ligusticum Chuanxiong Rhizoma (Chuanxiong), appropriately added to tonifying/phlegm-resolving medicines. Food stagnation: add Atractylodis Macrocephalae Rhizoma (Baizhu), Citri Reticulatae Pericarpium (Chenpi), Citri Reticulatae Viride (Qingpi), Crataegi Fructus (Shanzha), Hordeum Vulgare (Maiya); Accompanied by cold exposure/drinking cold: add Ginger (Shengjiang), Cinnamomi Ramulus (Guizhi); Accompanied by sexual fatigue: add Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix (Dihuang); Accompanied by overwork/Qi injury: Buzhong Yiqi Tang adding Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng); Severe Wind-Deficiency: Qianghuo Wan, Jiawei Wu Jing Wan.
Severe transmits, mild does not:
Severe Wind transmitting inward follows Cold Damage treatment methods.
Long-term harms Qi and Blood:
Wind dries Blood and scatters Qi, hence ancient use of Cinnamon Twig (Guizhi), Aconite (Fuzi), Bawe Tang, etc. Long-term non-healing: use Sanbai Tang modified to astringe. Strictly avoid dispersing/draining. Even at onset, unless cold month without sweat, Ephedrae Herba (Mahuang) is contraindicated.