中风之症，有中腑、中脏、中血脉之殊。中腑者，中在表也，即仲景所谓太阳中风，桂
枝汤之类是也。外显六经之形证，即如伤寒三阳、三阴传变之证也。其见证既与伤寒同，
则其治法亦与伤寒传变无异矣。中脏者，中在里也。如不语，中心；唇缓，中脾；鼻塞，中
肺；目瞀，中肝；耳聋，中肾。此乃风邪直入于里，而有闭与脱之分焉。闭者，牙关紧急，
两手握固，药宜疏通开窍，热闭、牛黄丸，冷闭、橘半姜汁汤。其热闭极甚，胸满便结者，
或用三化汤以攻之。脱者，口张、心绝，眼合、肝绝，手撒、脾绝，声如鼾、肺绝，遗尿、
肾绝。更有发直、摇头、上撺、面赤如妆、汗出如珠，皆为脱绝之证。此际须用理中汤，加
参两余，以温补元气。若寒痰阻塞，或用三生饮加人参以灌之，庶救十中之二三。中血脉者
中在半表半里也，如口眼 斜，半身不遂之属是也，药宜和解，用大秦艽汤加竹沥、姜汁
、钩藤主之，而有气与血之分。气虚者，偏于右，佐以四君子汤。血虚者，偏于左，倍用四
物汤。气血俱虚者，左右并病，佐以八珍汤。此治中风之大法也。
或谓∶寒邪中脏，一于寒也；风邪中脏，而有寒、有热，何也？愚谓寒、阴邪也，阴主
静，故其中人特为寒中而已矣。风、阳邪也，阳主动，善行而数变，故其中人，或为寒中，
或为热中，初无定体也。然其所以无定体者，亦因乎人之脏腑为转移耳。何者？其人脏腑素
有郁热，则风乘火势，火借风威，热气拂郁，不得宣通，而风为热风矣。其人脏腑本属虚寒
则风水相遭，寒气冷冽，水冻冰凝，真阳衰败，而风为寒风矣。为热风，多见闭证，理宜
疏导为先；为寒风，多见脱证，理宜温补为急。夫同一中脏，而寒、热之别相隔千里。其中
所以为热、为寒之故，举世皆不求解，则三化汤之寒，三生饮之热，何以同出于书而屹然并
立？是以医道，贵精思审处而自得之，有非语言所能尽也。
中风这一病症，有中腑、中脏、中血脉的区别。中腑，病位在表，即张仲景所说的太阳中风，用桂枝汤之类的方剂治疗。外在表现为六经的证候，就像伤寒病在三阳、三阴之间传变的证候一样。既然见证与伤寒相同，那么治法也与伤寒传变无异。
中脏，病位在里。如失语，是风邪中心；口唇松弛，是风邪中脾；鼻塞，是风邪中肺；视物昏花，是风邪中肝；耳聋，是风邪中肾。这是风邪直接侵入体内，分为闭证和脱证两类。闭证，牙关紧闭，双手握固，用药宜疏通开窍，热闭用牛黄丸，冷闭用橘半姜汁汤。若热闭极重，胸满便秘者，可用三化汤攻下。脱证，口张心绝，眼合肝绝，手撒脾绝，声如打鼾肺绝，遗尿肾绝。更有头发直竖、摇头、身体后仰、面色红艳如妆、汗出如珠，都是脱绝的证候。此时须用理中汤，加入人参一两以上，以温补元气。若有寒痰阻塞，或用三生饮加人参灌服，或许能救活十分之二三。
中血脉，病位在半表半里，如口眼歪斜、半身不遂等属于此类，用药宜和解，用大秦艽汤加竹沥、姜汁、钩藤为主方，并区分气虚与血虚。气虚者，症状偏于右侧，佐以四君子汤。血虚者，症状偏于左侧，加倍使用四物汤。气血俱虚者，左右同时患病，佐以八珍汤。这是治疗中风的大法。
有人问：寒邪中脏，纯为寒性；风邪中脏，却有寒有热，为什么呢？我认为，寒是阴邪，阴主静，所以它伤人只是寒中而已。风是阳邪，阳主动，善于行走且变化多端，所以它伤人，有时为寒中，有时为热中，本来没有固定的形态。然而它之所以没有固定形态，也是随着人体脏腑的情况而转移的。为什么呢？如果此人脏腑素有郁热，则风乘火势，火借风威，热气拂郁，不得宣通，风就变成了热风。如果此人脏腑本属虚寒，则风水相遭，寒气冷冽，水冻冰凝，真阳衰败，风就变成了寒风。成为热风，多见闭证，理应疏导为先；成为寒风，多见脱证，理应温补为急。同样是中脏，寒与热的区别相隔千里。其中导致热或寒的原因，世人都未能探究明白，那么三化汤的寒性，三生饮的热性，为何同出一书却屹立并存？因此，医学之道，贵在精心思考、审慎处理而自得领悟，这不是语言所能完全表达的。
The syndrome of stroke (Zhong Feng) is distinguished into involvement of the Fu organs (Zang-Fu: hollow organs), Zang organs (Zang-Fu: solid organs), and the channels and vessels (Mai-Xue). Involvement of the Fu organs indicates the pathogen is at the exterior, corresponding to what Zhang Zhongjing termed "Taiyang Wind Strike" (Taiyang Zhong Feng), treated with formulas such as Guizhi Tang (Cinnamon Twig Decoction). The external manifestations present as syndromes of the Six Channels, similar to the transmission patterns between the Three Yang and Three Yin channels in Cold Damage (Shang Han). Since the clinical presentations are identical to those of Cold Damage, the treatment methods are also no different from the management of Cold Damage transmission.
Involvement of the Zang organs indicates the pathogen is at the interior. For instance, aphasia indicates strike upon the Heart; flaccid lips indicate strike upon the Spleen; nasal congestion indicates strike upon the Lung; visual blurring indicates strike upon the Liver; deafness indicates strike upon the Kidney. This results from wind pathogens directly invading the interior, categorized into Obstruction Syndrome (Bi Zheng) and Collapse Syndrome (Tuo Zheng). In Obstruction Syndrome, there is lockjaw and clenched fists; treatment should focus on unblocking orifices. For Heat Obstruction, Niuhuang Wan (Calculus Bovis Pill) is used; for Cold Obstruction, Ju Ban Jiang Zhi Tang (Citrus Peel, Pinellia, and Ginger Juice Decoction) is used. If Heat Obstruction is severe with chest fullness and constipation, Sanhua Tang (Three Transformations Decoction) may be used to purge. In Collapse Syndrome, an open mouth indicates Heart collapse; closed eyes indicate Liver collapse; relaxed hands indicate Spleen collapse; snoring voice indicates Lung collapse; urinary incontinence indicates Kidney collapse. Additionally, straightened hair, head shaking, opisthotonos (body arching backward), ruddy complexion like makeup, and sweat droplets like pearls are all signs of terminal collapse. At this stage, Lizhong Tang (Regulate the Middle Decoction) with more than one tael of Renshen (Ginseng Radix et Rhizoma) must be used to warm and tonify Yuan Qi (Primordial Qi). If cold phlegm obstruction exists, Sansheng Yin (Three Lives Infusion) added with Renshen may be administered via gavage, potentially saving two or three out of ten patients.
Involvement of the channels and vessels indicates the pathogen is at the half-exterior and half-interior, manifesting as facial deviation and hemiplegia. Treatment should harmonize, using Da Qin Jiao Tang (Great Gentian Decoction) added with Zhuli (Bamboo Sap), Jiang Zhi (Ginger Juice), and Gouteng (Uncariae Ramulus cum Uncis). Differentiation is made between Qi deficiency and Blood deficiency. Qi deficiency manifests predominantly on the right side, assisted by Sijunzi Tang (Four Gentlemen Decoction). Blood deficiency manifests predominantly on the left side, with doubled dosage of Siwu Tang (Four Substances Decoction). Combined Qi and Blood deficiency affects both sides, assisted by Bazhen Tang (Eight Treasures Decoction). These are the general principles for treating stroke.
One might ask: Cold pathogens striking the Zang organs are purely cold; why do wind pathogens striking the Zang organs present as either cold or heat? I posit that cold is a Yin pathogen, and Yin governs stillness; thus, it injures humans solely as Cold Strike. Wind is a Yang pathogen, and Yang governs movement; it travels swiftly and changes frequently. Therefore, when it injures humans, it may cause Cold Strike or Heat Strike, having no fixed form. However, its lack of fixed form depends on the state of the person's Zang-Fu organs. Why? If the person’s Zang-Fu organs harbor latent heat, the wind rides the fire’s momentum, and the fire borrows the wind’s power. Heat qi stagnates and cannot circulate freely, turning the wind into Hot Wind. If the person’s Zang-Fu organs are inherently deficient and cold, wind and water collide; cold qi is biting, water freezes and ice congeals, True Yang declines, and the wind becomes Cold Wind. Hot Wind often presents as Obstruction Syndrome, requiring dredging and unblocking as the priority. Cold Wind often presents as Collapse Syndrome, requiring warming and tonifying as the urgency. Although both involve striking the Zang organs, the distinction between cold and heat is vast. The reasons behind becoming hot or cold are not sought by the world; thus, how can the cold nature of Sanhua Tang and the hot nature of Sansheng Yin stand firmly together in the same book? Therefore, the medical Dao values profound contemplation and prudent judgment leading to personal insight, which cannot be fully expressed through language.