一何书田太夫子世居青浦北竿山，本儒术，通轩岐之学，临证着手成春，日日远近就诊者，
门庭如市，时或舟车往来，吴会士大夫莫不争先延致。在嘉道间为吴下名医之冠。
一先生成功后不复进取，着述甚富，曾刻《竿山草堂诗文集》行世，暨江浙水利等书，为林文
忠公器识，文章经济推重当时，实为医名所掩耳。
一《医学妙谛》，先生手辑书也。仿《金匮要略》分门别款，每章之前专宗《内经》、《灵枢》《素
问》及采诸大家千古不磨之论为引证焉。并列各症条款，宜用汤剂，皆出先生平时阅历手定者
也。其病因治法，编为歌括，童而习之，以便口诵心维，为家塾读本也。
一予家世传幼科松承庭训，咸丰癸丑，奉家君命，业医须习大方脉，调理诸症，方称成技。于
是命松负笈，从平子夫子授业在门下，甫十月，适家君病足疾，书来促余辞归，临岐分袂，蒙夫子
执手殷殷论曰∶同事砚席未久，遽唱骊驹，未免耿耿。因袖出一编，语云∶此书我家习医秘术，即
以赠行。松老矣，回首师门，乌能自已！
光绪十九年岁次癸巳秋八月上浣谷旦小门人嘉定陈松谨识于四明需次
（大指次指麻木不仁，或肌肉微掣，即为中风之先兆）
中风之症治须思，审其所中善治之。中腑风邪四肢着，恶寒拘急脉浮迟。中脏唇缓滞九窍，鼻塞便闭不语
时。若中血脉口眼歪，又有中经亦要知。六经无病溺调和，口不能言肢不持。中脏当下腑当汗，中经补血养筋
宜。中血脉者无他治，养血通气效最奇。若中脏而兼中腑，伤寒两感症同危。东垣大率主气虚（中风虽缘外中之
风，亦因内气之虚也。虚则气多不贯，一为风所入而肢体于是乎废矣），河间肾虚兼火治（肾息失宜，心火盛而肾
水亏，故热郁而生痰，痰甚而发热，热痿相因而风生）。丹溪主湿内生痰，总是类中分明注。治之先用开关法，
皂半辛黎俱为未，和以麝香吹鼻中，有嚏则生无不活。醒后先投三合汤，陈甘茯半应相当，南蒌归桔芩连术，
竹沥姜汁共一汤。左瘫属血痪属气，血虚加芍芎生地（四物恐泥痰，宜用姜汁炒）。瘀血桃仁与红花（瘀血症小
便利，大便黑，或腹中怀痛），气弱参 也同剂。遗尿盗汗亦如之，小便不通不可利。僵蚕全蝎闭塞加，钩藤
可治牙关闭。肥人乌附以引经（乌头、附子、童便煮用），气实人参亦须忌（脉右寸有力，用参恐痰涎瘀经络）。
风盛自汗身体痛，羌活防风并薄桂。头目不利或头痛，芎芷蔓荆辛芥穗。无汗身疼加芷羌，穹防苍术秦艽配。心
血内亏神恍惚，茯神远志菖蒲合。或心动摇惊悸者，竹茹酸枣辰砂益。风痰炽甚
须胆星，防枳牙皂栝蒌仁。食伤曲麦山楂枳，便闭还须三化行（三化汤用枳实、川朴、大黄、羌活）。
肝肾虚内风动
胡麻 天麻 桂圆 黄 甘草 熟地 萸肉 远志 五味 苁蓉 当归 杞子 首乌 牡蛎 甘菊
蒺黎 虎骨 女贞 牛膝
阳虚卫疏
人参 当归 附子 桑叶 黄 天麻 于术 或玉屏风加减
卫虚络痹
桂枝 黄 附子 羌活 远志 姜黄
气虚
人参 黄 白术 炙草 当归 陈皮 天麻 姜枣
肝肾同治
人参 茯苓 蒺藜 甘菊 陈皮 半夏 枸杞 天麻 钩藤
风湿中脾络
六君子汤加南星 附子
肾阴虚肝风动
熟地 苁蓉 杞子 首乌 菊花 菖蒲
痰火阻窍
羚角 胆星 竹沥 钩藤 连翘 花粉 橘红 丹皮 菖蒲
液虚风动
复脉汤去姜桂，固本汤去熟地加龟版、五味，加虎骨、苁蓉、杞子、淮膝、黄柏。
包络热邪阻窍
至宝丹 犀角 朱砂 雄黄 琥珀 玳瑁 西黄 麝香 龙脑 金箔 安息
痰火上实，清窍为蒙，下虚上实，多致颠顶之痰。
陈曰∶凡中风症有肢体缓纵不收者，皆属阳明气虚，当以人参为主，附子、 、草之类佐之。若短缩牵挛，
则以逐邪为急。
朱丹溪曰∶麻为气虚，木是湿痰散血。
一、何书田太夫子世代居住于青浦北竿山，本修儒术，精通轩岐（指黄帝与岐伯，代指中医）之学，临证治疗往往手到病除，每日远近前来就诊的人，门庭若市。有时舟车往来，吴地及会稽地区的士大夫们无不争先恐后地聘请他。在嘉庆、道光年间，他是吴下名医之首。
一、先生成名后不再进取仕途，著述非常丰富，曾刻印《竿山草堂诗文集》流传于世，以及江浙水利等书籍，被林则徐公赏识器重，其文章经世致用之才为当时人所推崇，只是他的医学名声掩盖了这些成就罢了。
一、《医学妙谛》，是先生亲自编纂的书。仿照《金匮要略》分门别类，每章之前专门引用《内经》、《灵枢》、《素问》以及采集各位名家千古不朽的论述作为引证。并列出了各种症状条款，适宜使用的汤剂，都是先生平时临床经验亲手制定的。其病因治法，编成歌诀，从小学习诵读，以便口诵心记，作为家塾的读本。
一、我家世代传承儿科松承庭训，咸丰癸丑年，奉父亲命令，习医必须学习大方脉（内科），调理各种病症，才称得上技艺成熟。于是让陈松背着书箱，跟随平子夫子在门下受业，刚满十月，恰逢父亲患足疾，来信催促我辞别回家，临别之际，蒙夫子执手殷切谈论说：“共同在砚席间学习不久，突然唱起离别之歌，未免心中耿耿于怀。”因此从袖中取出一本书，说道：“这本书是我们家习医的秘术，就以此赠别。”陈松已老，回首师门，怎能控制自己！
光绪十九年岁次癸巳秋八月上旬吉日，小门人嘉定陈松恭敬识记于四明需次
（大拇指和食指麻木不仁，或者肌肉轻微抽搐，就是中风的前兆）
治疗中风的病症需要深思，审察其所中的部位才能善于治疗。风邪中于腑，四肢受累，恶寒拘急，脉象浮迟。风邪中于脏，口唇松弛，九窍滞塞，鼻塞便闭，不能言语。如果风邪中于血脉，口眼歪斜，还有中于经络的情况也要知晓。六经无病，小便调和，口不能言，肢体支撑不住。中脏应当攻下，中腑应当发汗，中经络应当补血养筋适宜。中血脉者没有其他治法，养血通气效果最奇妙。如果中脏兼有中腑，如同伤寒两感症一样危险。东垣大多主张气虚（中风虽然源于外来的风邪，但也因为内部气的虚弱。虚弱则气多不贯通，一旦为风邪侵入，肢体于是废用），河间主张肾虚兼火治疗（肾气失宜，心火盛而肾水亏，所以热郁而生痰，痰盛而发热，热痿相因而风生）。丹溪主张湿内生痰，总是类中（类中风）分明注明。治疗先用开关法，皂角、半夏、辛夷、黎芦都研为末，和以麝香吹入鼻中，有喷嚏就能生还，没有不活的。醒后先投三合汤，陈皮、甘草、茯苓、半夏应当相当，南星、瓜蒌、当归、桔梗、黄芩、黄连、白术，竹沥、姜汁共成一汤。左瘫属血，右痪属气，血虚加芍药、川芎、生地（四物汤恐怕滋腻碍痰，宜用姜汁炒制）。瘀血用桃仁与红花（瘀血症见小便利，大便黑，或腹中隐痛），气弱人参也同剂使用。遗尿盗汗也如此处理，小便不通不可利尿。僵蚕、全蝎用于闭塞加重，钩藤可治牙关紧闭。肥人用乌头、附子以引经（乌头、附子，用童便煮用），气实人参也必须忌用（脉右寸有力，用人参恐怕痰涎瘀阻经络）。风盛自汗身体痛，羌活、防风并薄桂。头目不利或头痛，川芎、白芷、蔓荆子、辛夷、芥穗。无汗身疼加白芷、羌活，独活、防风、苍术、秦艽配合。心血内亏神恍惚，茯神、远志、石菖蒲合用。或者心动摇惊悸者，竹茹、酸枣仁、辰砂益补。风痰炽盛须用胆南星，防风、枳实、牙皂、瓜蒌仁。食伤用神曲、麦芽、山楂、枳实，便闭还需三化汤行导（三化汤用枳实、厚朴、大黄、羌活）。肝肾虚内风动：胡麻、天麻、桂圆、黄芪、甘草、熟地、萸肉、远志、五味子、苁蓉、当归、杞子、首乌、牡蛎、甘菊、蒺藜、虎骨、女贞子、牛膝。阳虚卫疏：人参、当归、附子、桑叶、黄芪、天麻、于术，或玉屏风散加减。卫虚络痹：桂枝、黄芪、附子、羌活、远志、姜黄。气虚：人参、黄芪、白术、炙甘草、当归、陈皮、天麻、姜枣。肝肾同治：人参、茯苓、蒺藜、甘菊、陈皮、半夏、枸杞、天麻、钩藤。风湿中脾络：六君子汤加南星、附子。肾阴虚肝风动：熟地、苁蓉、杞子、首乌、菊花、菖蒲。痰火阻窍：羚角、胆星、竹沥、钩藤、连翘、花粉、橘红、丹皮、菖蒲。液虚风动：复脉汤去姜桂，固本汤去熟地加龟版、五味子，加虎骨、苁蓉、杞子、淮膝、黄柏。包络热邪阻窍：至宝丹、犀角、朱砂、雄黄、琥珀、玳瑁、西黄、麝香、龙脑、金箔、安息香。痰火上实，清窍为蒙，下虚上实，多致颠顶之痰。
陈氏说：凡是中风症有肢体缓纵不收的，都属于阳明气虚，当以人参为主，附子、黄芪、甘草之类佐助。如果短缩牵挛，则以逐邪为急。
1. Grand Master He Shutian resided for generations at Beiganshan, Qingpu. Originally versed in Confucian studies, he was proficient in Xuanqi (referring to the Yellow Emperor and Qibo, a metonymy for Traditional Chinese Medicine). In clinical practice, his hands brought spring (healed patients swiftly); daily, patients from near and far came for consultation, making his courtyard as busy as a market. Occasionally, with boats and carriages coming and going, scholars and officials from Wu and Kuaiji regions vied to invite him. During the Jiaqing and Daoguang reigns, he was the foremost famous physician in the Wu region.
2. After achieving fame, the Master did not pursue further official advancement but produced abundant writings. He had printed "Poetry and Prose Collection of Ganshan Cottage" for circulation, along with books on water conservancy in Jiangsu and Zhejiang. He was appreciated and valued by Lord Lin Zexu; his literary works and statecraft were highly praised by contemporaries, though his medical reputation overshadowed these achievements.
3. *Yixue Miaodi* (Subtle Truths of Medicine) is a book personally compiled by the Master. It imitates the categorization style of *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet). At the beginning of each chapter, it specifically cites theories from *Neijing* (Inner Canon), *Lingshu* (Spiritual Pivot), *Suwen* (Basic Questions), and collects immortal arguments from various great masters throughout history as references. It lists clauses for various symptoms and suitable decoctions, all determined by the Master's own clinical experience. The etiology and treatment methods are compiled into rhymed verses (Geke) for children to learn, facilitating oral recitation and mental retention, serving as a textbook for family schools.
4. My family has generational heritage in pediatrics known as Songcheng Family Instructions. In the Guiyou year of Xianfeng, following my father's order, I had to study internal medicine (Da Fangmai) to treat various conditions to be considered skilled. Thus, I, Chen Song, carried my books to study under Master Pingzi. After only ten months, my father fell ill with a foot disease, and a letter urged me to return home. At our parting, Master held my hand and earnestly said, "We have studied together for a short time, yet you suddenly sing the farewell song, leaving me somewhat unsettled." Therefore, he took out a manuscript from his sleeve and said, "This book contains the secret arts of our family's medical practice; please accept it as a farewell gift." Now old, looking back at my master's door, how can I restrain myself!
Recorded respectfully by junior disciple Chen Song of Jiading at Siming during the first ten days of the eighth month, autumn, in the year Guisi (1893).
(Numbness or insensitivity in the thumb and index finger, or slight twitching of muscles, are precursors to stroke.)
The treatment of stroke requires deep thought; one must examine where the pathogen strikes to treat it well. When wind evil strikes the Fu organs, the four limbs are affected, with aversion to cold, stiffness, and a floating, slow pulse. When wind evil strikes the Zang organs, the lips become flaccid, the nine orifices are obstructed, there is nasal congestion, constipation, and aphasia. If wind strikes the vessels and collaterals, there is facial paralysis (mouth and eye deviation); one must also know the case of striking the meridians. If the six meridians are unaffected and urination is harmonious, but speech is lost and limbs cannot support, [it indicates specific patterns]. Striking the Zang organs requires purgation; striking the Fu organs requires sweating; striking the meridians requires nourishing blood and tendons. For those struck in the vessels and collaterals, there is no other treatment than nourishing blood and promoting Qi circulation, which yields miraculous effects. If Zang and Fu are both struck, it is as critical as the simultaneous contraction of Taiyang and Shaoyin in Cold Damage diseases. Dong Yuan generally advocates for Qi deficiency (Although stroke originates from external wind, it is also due to internal Qi deficiency. Deficiency leads to poor Qi circulation; once invaded by wind, the limbs become useless). He Jian advocates treating Kidney deficiency combined with fire (Kidney Qi fails, Heart fire flourishes while Kidney water declines, leading to heat stagnation generating phlegm; severe phlegm causes fever, and heat/withering lead to wind generation). Danxi advocates that dampness internally generates phlegm, clearly noting this as "Lei Zhong" (Stroke-like illness). Treatment first uses an opening method: powdering Zaojiao (Gleditsiae Fructus), Banxia (Pinelliae Rhizoma), Xinyi (Magnoliae Flos), and Lilü (Veratri Radix), mixed with Shexiang (Moschus) and blown into the nose; if sneezing occurs, life is saved. After waking, administer Sanhe Tang: Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix), Fuling (Poria), and Banxia should be balanced; Nanxing (Arisaematis Cum Bile), Gualou (Trichosanthis Fructus), Danggui (Angelicae Sinensis Radix), Jiegeng (Platycodonis Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Zhuli (Bambusae Succus), and Jiangzhi (Zingiberis Rhizoma Recens Succus) form one decoction. Left hemiplegia belongs to Blood deficiency, right hemiplegia to Qi deficiency; add Shaoyao (Paeoniae Radix Alba), Chuanxiong (Chuanxiong Rhizoma), and Shengdi (Rehmanniae Radix) for Blood deficiency (Siwu Tang may cloy phlegm, so stir-fry with Ginger Juice). For blood stasis, use Taoren (Persicae Semen) and Honghua (Carthami Flos) (Stasis signs include clear urination, black stool, or abdominal pain). For weak Qi, Renshen (Ginseng Radix) is added. Enuresis and night sweats are treated similarly; obstruction of urination should not be treated with diuretics. Jiangcan (Bombyx Batryticatus) and Quanxie (Scorpio) are added for severe obstruction; Gouteng (Uncariae Ramulus cum Uncis) treats trismus. For obese patients, Wutou (Aconiti Radix) and Fuzi (Aconiti Lateralis Radix Praeparata) guide the channels (boiled with Child's Urine); for excess Qi, Renshen must be avoided (if the Right Cun pulse is forceful, using Ginseng may cause phlegm-saliva to block the collaterals). For wind excess with spontaneous sweating and body pain, use Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), and Houpo (Magnoliae Officinalis Cortex) or Bo Gui (Cinnamomi Ramulus). For head/eye discomfort or headache, use Chuanxiong, Baizhu, Manjingzi (Vitalbae Fructus), Xinyi, and Jiejie Sui (Schizonepetae Spica). For no sweat and body pain, add Baizhu and Qianghuo; Peiyao (Peucedani Radix), Fangfeng, Cangzhu (Atractylodis Rhizoma), and Qinjiao (Gentianae Macrophyllae Radix) are paired. For internal deficiency of Heart Blood causing spiritual confusion, use Fushen (Poria cum Pinus Radix), Yuanzhi (Polygalae Radix), and Shichangpu (Acori Tatarinowii Rhizoma). For palpitations and fright, add Zhuru (Bambusae Caulis in Taenia), Suanzaoren (Ziziphi Spinosae Semen), and Zhensha (Cinnabar). For excessive wind-phlegm, use Dansheng (Arisaematis Cum Bile); Fangfeng, Zhishi (Aurantii Fructus Immaturus), Yazao (Gleditsiae Spina), and Gualou Ren (Trichosanthis Semen). For food injury, use Shenqu (Massa Medicata Fermentata), Maiya (Hordei Fructus Germinatus), Shanzha (Crataegi Fructus), and Zhishi; for constipation, use Sanhua Tang (Sanhua Decoction uses Zhishi, Houpo, Dahuang (Rhei Radix et Rhizoma), and Qianghuo).
For Liver-Kidney deficiency stirring internal wind: Humaren (Sesami Fructus Niger), Tianma (Gastrodiae Rhizoma), Guiyuan (Longan Arillus), Huangqi (Astragali Radix), Gancao, Shudi (Rehmanniae Radix Preparata), Yurou (Corni Fructus), Yuanzhi, Wuweizi (Schisandrae Fructus), Rongrong (Cynomorii Herba), Danggui, Qizi (Lycii Fructus), Shouwu (Polygoni Multiflori Radix), Muli (Concha Ostreae), Ganju (Chrysanthemi Flos), Jili (Tribuli Fructus), Hugu (Ossis Tigridis), Nvzhen (Ligustri Lucidi Fructus), Niuxi (Achyranthis Bidentatae Radix).
For Yang deficiency with loose Wei defense: Renshen, Danggui, Fuzi, Sangye (Mori Folium), Huangqi, Tianma, Yuzhu (Atractylodis Macrocephalae Rhizoma), or modify Yupingfeng San (Jade Windscreen Powder).
For Wei deficiency with collateral obstruction: Guizhi (Cinnamomi Ramulus), Huangqi, Fuzi, Qianghuo, Yuanzhi, Jianghuang (Curcumae Longae Rhizoma).
For Qi deficiency: Renshen, Huangqi, Baizhu, Zhigancao (Prepared Licorice Root), Danggui, Chenpi, Tianma, Ginger and Jujube.
For simultaneous treatment of Liver and Kidney: Renshen, Fuling, Jili, Ganju, Chenpi, Banxia, Gouqi (Lycii Fructus), Tianma, Gouteng.
For Wind-Dampness striking Spleen collaterals: Liujunzi Tang (Six Gentlemen Decoction) plus Nanxing and Fuzi.
For Kidney Yin deficiency stirring Liver wind: Shudi, Rongrong, Qizi, Shouwu, Juhua (Chrysanthemi Indici Flos), Changpu (Acori Tatarinowii Rhizoma).
For Phlegm-Fire blocking orifices: Lingjiao (Rhinocerotis Cornu substitute), Dansheng, Zhuli, Gouteng, Lianqiao (Forsythiae Fructus), Huafen (Trichosanthis Radix), Juhong (Citri Reticulatae Pericarpium Rubrum), Danpi (Moutan Cortex), Changpu.
For Fluid deficiency stirring wind: Maishu Tang (Pulse Restoring Decoction) minus Jiang and Gui; Guben Tang (Root-Securing Decoction) minus Shudi, plus Guiban (Testudinis Carapax et Plastrum), Wuweizi, plus Hugu, Rongrong, Qizi, Huaixi (Achyranthis Bidentatae Radix), and Huangbai (Phellodendri Cortex).
For Heat evil blocking the Pericardium orifices: Zhibao Dan (Precious Treasure Pill), Xijiao (Rhinocerotis Cornu substitute), Zhusha (Cinnabar), Xionghuang (Realgar), Hupo (Electrum), Daimao (Hippopotamalis Dentibus et Ossibus), Xi Huang (Bovis Calculus), Shexiang, Naobing (Borneolum Syntheticum), Jinbo (Folium Aureum), Anxi (Resina Ambrae Griseae).
When Phlegm-Fire is excessive above, clouding the clear orifices, and deficiency below with excess above, it often leads to phlegm accumulating at the vertex.
Mr. Chen said: For stroke cases with flaccid, uncontrolled limbs, they belong to Stomach Qi deficiency; Renshen should be the main herb, assisted by Fuzi, Huangqi, and Gancao. If there is shortening and spasms, expelling the pathogen is urgent.
Zhu Danxi said: Numbness (Ma) is Qi deficiency; woodiness/stiffness (Mu) is damp-phlegm dispersing blood.