病起于骤然,或气逆面青,肢冷目暗, 俗称迷痧是也。或腹中绞痛,俗称绞肠痧是也。身上有
斑点,如痧,或用麻刮之,累累如朱砂,故名曰痧。此乃风寒湿邪,或山岚瘴气,袭于肌表之间,
而成此证。浅者刮之,深者刺之,宜急救。迟者邪干于脏,而气机不转,即不能救矣。
刺法
以针刺手腕中,足委中,及十指出血。(按∶手腕中,当是内关穴)
刮法
用手掌着热汤,重打手腕、足委中,至红紫有大斑如痘大。(按∶此刮法,实为拍打法也。)
中风之家,其人素有土湿木郁之病,土湿则脾弱,而气不能达四肢,手足或有时顽麻。
木郁则肝虚,而血不能荣诸筋,支节或有时枯硬。一旦猝受风邪,外而皮毛窍闭,内而经
藏气郁,其脏腑湿盛者,必至痰壅心肺,故神迷言拙,则痴喑之病作矣。其经络燥盛者,必至
火铄血脉,故筋挛支拳,则瘫痪之病成矣。人必本气先伤,而后风邪得以中之。故邪中于络,
口眼 斜。邪中于经,手足不遂。邪中于腑,语言错乱,即不识人。邪中于脏,舌即难言,
口吐涎。如中风之浅者,只口眼 邪,以驱风活血汤主之,此散微邪法也。如血分虚,而左半
偏枯者,以桂枝归苓汤主之。如气分虚而右半偏枯者,以黄 姜苓汤主之。如中风身体缓急,
口目不正,舌强不言,小续命汤主之。如风邪国中,手足不遂者,以祛风汤主之。如痰涎胶
塞,迷惑不清者,以葶苈散主之。此证明明是风,即可以风治之,不可与脱证相提并论。凡一切
补益之药,万勿轻施,庶可以治风病矣。
驱风活血汤
竹沥(五钱) 独活(三钱) 生地汁(五钱) 水煎大半杯,温服取微汗。
桂枝归苓汤
桂枝(三钱) 芍药(三钱) 甘草(二钱) 当归(三钱) 茯苓(三钱) 川芎(二钱)
生姜(三钱) 水煎大半杯,温服。中下寒,加干姜、附子。
黄 姜苓汤
黄 (三钱) 人参(三钱) 甘草(二钱) 茯苓(三钱) 半夏(三钱) 生姜(三钱)
杏仁(三钱) 麻黄(三钱) 水煎大半
杯,温服。中下寒,加干姜、附子。病重者,黄 、生姜可用一、二两。如中风血枯筋燥
,阿胶、首乌之类,亦可暂用,要当适可而止。如大便结燥者,宜用阿胶、苁蓉以滑大肠。
如风家,肢节拳缩,宜用熨法。右半用黄 、茯苓、生姜、附子,左半用首乌、茯苓、桂枝、附子
,研末用布包,外以布巾缚住,以火钏温之,汗出即舒矣。
小续命汤
麻黄(二钱) 防己(二钱) 防风(三钱) 芍药(二钱) 黄芩(二钱) 甘草(二钱)
生姜(五钱) 人参(二钱) 杏仁(二钱) 附子(二钱) 川芎(二钱) 桂枝(二钱) 水煎大半杯,温服。
如痰火太盛,附子可去。
祛风汤
防风(三钱) 桑叶(三钱) 秦艽(三钱) 天麻(三钱) 甘草(二钱) 茯苓(三钱)
半夏(三钱) 杏仁(三钱) 白芍(三钱) 生姜(三钱) 水煎大半杯,温服。
葶苈散
葶苈(三钱) 白芥子(三钱) 甘遂(一钱) 共研末,每服五分,宿痰即从便下。
病势发作突然,有的表现为气机上逆、面色发青、四肢冰冷、眼神昏暗,俗称“迷痧”。有的表现为腹部剧烈绞痛,俗称“绞肠痧”。身上出现斑点,类似痧疹,可以用麻线刮拭皮肤,刮出的痕迹累累如朱砂色,因此称为“痧”。这是由于风寒湿邪,或者山间的瘴气,侵袭于肌表之间,从而形成此证。病情浅表的用刮痧法治疗,病情深重的用针刺放血法治疗,应当紧急救治。如果延误时机,邪气内犯脏腑,导致气机阻滞不通,就无法救治了。
刺法
用针刺手腕内侧(按:此处应指内关穴)、足部委中穴,以及十个手指尖,使其出血。(按:手腕中,应当是内关穴)
刮法
用手掌蘸热汤,用力拍打手腕、足部委中穴,直到皮肤呈现红紫色,并出现像痘疮大小的红斑。(按:这种刮法,实际上是拍打法。)
患有中风的人,平素就有脾土湿气重、肝木郁结的病症。脾土湿气重则脾气虚弱,导致气不能通达四肢,手足有时会出现麻木不仁。肝木郁结则肝血亏虚,导致血液不能滋养筋脉,关节肢体有时会出现干枯僵硬。一旦突然受到风邪侵袭,外部皮毛腠理闭塞,内部经络脏腑气机郁滞,那些脏腑湿气偏盛的人,必然会导致痰浊壅塞心肺,所以出现神志昏迷、言语笨拙,痴哑的病证就发作了。那些经络燥热偏盛的人,必然会导致火热灼伤血脉,所以出现筋脉拘挛、手指握拳,瘫痪的病证就形成了。人一定是先有正气受损,然后风邪才能乘虚而入。所以风邪中于络脉,就会出现口眼歪斜;风邪中于经脉,就会出现手足不能随意运动;风邪中于腑,就会出现语言错乱,甚至不认识人;风邪中于脏,就会出现舌强难言,口吐涎沫。如果是病情较轻的中风,只是口眼歪斜,以驱风活血汤为主方,这是疏散轻微邪气的方法。如果是血分虚弱,导致左侧半身偏枯的,以桂枝归苓汤为主方。如果是气分虚弱,导致右侧半身偏枯的,以黄芪姜苓汤为主方。如果是中风后身体或缓或急,口眼不正,舌强不能言语,以小续命汤为主方。如果是风邪困阻体内,手足不能随意运动的,以祛风汤为主方。如果是痰涎胶固阻塞,神志迷惑不清的,以葶苈散为主方。这个病证明明是由风邪引起,就可以用治风的方法治疗,不可与脱证相提并论。凡是所有补益的药物,千万不要轻易使用,这样才能治好风病。
驱风活血汤
竹沥(五钱) 独活(三钱) 生地汁(五钱) 加水煎煮至大半杯,温服以取微汗。
桂枝归苓汤
桂枝(三钱) 芍药(三钱) 甘草(二钱) 当归(三钱) 茯苓(三钱) 川芎(二钱) 生姜(三钱) 加水煎煮至大半杯,温服。如果中焦下焦寒凉,加干姜、附子。
黄芪姜苓汤
黄芪(三钱) 人参(三钱) 甘草(二钱) 茯苓(三钱) 半夏(三钱) 生姜(三钱) 杏仁(三钱) 麻黄(三钱) 加水煎煮至大半杯,温服。如果中焦下焦寒凉,加干姜、附子。病情严重的,黄芪、生姜可用一两到二两。如果是中风导致血枯筋燥的,阿胶、何首乌之类,也可以暂时使用,但要适可而止。如果大便干结燥硬的,宜用阿胶、肉苁蓉来润滑大肠。如果是中风患者,肢节屈曲收缩,宜用熨法。右侧半身用黄芪、茯苓、生姜、附子,左侧半身用何首乌、茯苓、桂枝、附子,研成粉末用布包好,外面再用布巾缚住,用火钏温热它,出汗后就舒缓了。
小续命汤
麻黄(二钱) 防己(二钱) 防风(三钱) 芍药(二钱) 黄芩(二钱) 甘草(二钱) 生姜(五钱) 人参(二钱) 杏仁(二钱) 附子(二钱) 川芎(二钱) 桂枝(二钱) 加水煎煮至大半杯,温服。如果痰火太盛,可以去掉附子。
祛风汤
防风(三钱) 桑叶(三钱) 秦艽(三钱) 天麻(三钱) 甘草(二钱) 茯苓(三钱) 半夏(三钱) 杏仁(三钱) 白芍(三钱) 生姜(三钱) 加水煎煮至大半杯,温服。
The disease onset is sudden. In some cases, there is rebellious Qi with a bluish complexion, cold limbs, and dim vision, commonly known as "Misha" (Confusion Sha). In other cases, there is severe colic in the abdomen, commonly known as "Jiaochangsha" (Intestinal Twisting Sha). Spots appear on the body, resembling Sha rashes; scraping the skin with hemp threads produces marks that are numerous and vermilion-red like cinnabar, hence the name "Sha." This condition arises from Wind-Cold-Damp pathogenic factors or mountain miasma invading the muscle and surface layers. For superficial conditions, scraping therapy is indicated; for deep-seated conditions, pricking bloodletting is indicated, and urgent rescue is necessary. If treatment is delayed, the pathogen invades the Zang organs, causing stagnation of Qi mechanism, making it incurable.
Pricking Method
Prick the center of the wrist (Note: this refers to the Neiguan acupoint), Weizhong (BL-39) at the foot, and the tips of the ten fingers to induce bleeding. (Note: "Center of the wrist" should refer to the Neiguan acupoint.)
Scraping Method
Use the palm dipped in hot water to forcefully beat the wrists and Weizhong (BL-39) points until the skin turns red-purple and large spots the size of pustules appear. (Note: This scraping method is essentially a beating/patting technique.)
Individuals prone to Stroke (Zhongfeng) typically suffer from Spleen Earth Dampness and Liver Wood Stagnation. When Spleen Earth is damp, the Spleen Qi is weak and cannot reach the four limbs, causing occasional numbness in the hands and feet. When Liver Wood is stagnant, Liver Blood is deficient and cannot nourish the sinews, leading to occasional dryness and stiffness in the joints and extremities. Once suddenly attacked by Wind Pathogen, the exterior hair follicles and pores become closed, and the interior meridians and Zang-Fu organs experience Qi stagnation. In those with excessive Dampness in the Zang-Fu organs, Phlegm turbidity will inevitably obstruct the Heart and Lungs, resulting in coma and clumsy speech, manifesting as dementia and aphasia. In those with excessive Dryness-Heat in the meridians, Fire will scorch the blood vessels, resulting in sinew spasms and clenched fists, manifesting as paralysis. One must first have a deficiency of Original Qi before the Wind Pathogen can strike. Thus, when the pathogen strikes the Collaterals, there is deviation of the mouth and eye; when it strikes the Meridians, there is inability to move the hands and feet; when it strikes the Fu organs, there is disordered speech and failure to recognize people; when it strikes the Zang organs, there is stiff tongue with difficulty speaking and dribbling of saliva. For mild cases of Stroke presenting only with deviation of the mouth and eye, Qufeng Huoxue Tang (Wind-Dispersing and Blood-Invigorating Decoction) is the primary formula, which is a method to dissipate slight pathogens. For cases with Blood deficiency causing hemiplegia of the left side, Guizhi Guiling Tang (Cinnamon Twig and Angelica Poria Decoction) is used. For cases with Qi deficiency causing hemiplegia of the right side, Huangqi Jiangling Tang (Astragalus, Ginger, and Poria Decoction) is used. For Stroke with body tension varying between flaccid and rigid, deviation of the mouth and eyes, and stiff tongue with inability to speak, Xiao Xuming Tang (Minor Continuation of Life Decoction) is used. For cases where Wind Pathogen confines the interior causing inability to move the hands and feet, Qufeng Tang (Wind-Dispersing Decoction) is used. For cases with sticky Phlegm-fluids obstructing the interior causing confusion and lack of clarity, Tingli San (Descurainia Powder) is used. This condition is clearly caused by Wind, so it should be treated with Wind-dispersing methods and must not be confused with Collapse Syndromes (Tuo Zheng). All tonifying medicines should never be lightly administered; only then can Wind diseases be cured.
Qufeng Huoxue Tang (Wind-Dispersing and Blood-Invigorating Decoction)
Zhu Li (Bamboo Sap, 5 qian) Du Huo (Angelicae Pubescentis Radix, 3 qian) Sheng Di Zhi (Rehmanniae Juice, 5 qian) Decoct in water to obtain half a cup, take warm to induce slight sweating.
Guizhi Guiling Tang (Cinnamon Twig and Angelica Poria Decoction)
Guizhi (Cinnamomi Ramulus, 3 qian) Shaoyao (Paeoniae Radix, 3 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian) Danggui (Angelicae Sinensis Radix, 3 qian) Fuling (Poria, 3 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 2 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 qian) Decoct in water to obtain half a cup, take warm. If there is Cold in the Middle and Lower Jiao, add Ganjiang (Zingiberis Rhizoma, Dried) and Fuzi (Aconiti Lateralis Radix Praeparata).
Huangqi Jiangling Tang (Astragalus, Ginger, and Poria Decoction)
Huangqi (Astragali Radix, 3 qian) Renshen (Ginseng Radix, 3 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian) Fuling (Poria, 3 qian) Banxia (Pinelliae Rhizoma, 3 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 qian) Xingren (Armeniacae Semen Amarum, 3 qian) Mahuang (Ephedrae Herba, 3 qian) Decoct in water to obtain half a cup, take warm. If there is Cold in the Middle and Lower Jiao, add Ganjiang (Zingiberis Rhizoma, Dried) and Fuzi (Aconiti Lateralis Radix Praeparata). In severe cases, Huangqi (Astragali Radix) and Shengjiang (Zingiberis Rhizoma Recens) may be increased to 1–2 liang. For Stroke causing Blood depletion and sinew dryness, Ejiao (Asini Corii Colla) and Shouwu (Polygoni Multiflori Radix) may be temporarily used, but one must stop when appropriate. For constipation and dry stools, use Ejiao (Asini Corii Colla) and Congrong (Cynomorii Herba) to lubricate the Large Intestine. For Stroke patients with clenched and contracted joints, Moxibustion/Ironing therapy (Yun Fa) is suitable. For the right side, use Huangqi (Astragali Radix), Fuling (Poria), Shengjiang (Zingiberis Rhizoma Recens), and Fuzi (Aconiti Lateralis Radix Praeparata); for the left side, use Shouwu (Polygoni Multiflori Radix), Fuling (Poria), Guizhi (Cinnamomi Ramulus), and Fuzi (Aconiti Lateralis Radix Praeparata). Grind into powder, wrap in cloth, bind tightly with a cloth band, and apply heat with a hot iron/moxa warmer. Sweating will bring relief.
Xiao Xuming Tang (Minor Continuation of Life Decoction)
Mahuang (Ephedrae Herba, 2 qian) Fangji (Stephaniae Tetrandrae Radix, 2 qian) Fangfeng (Saposhnikoviae Radix, 3 qian) Shaoyao (Paeoniae Radix, 2 qian) Huangqin (Scutellariae Radix, 2 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian) Shengjiang (Zingiberis Rhizoma Recens, 5 qian) Renshen (Ginseng Radix, 2 qian) Xingren (Armeniacae Semen Amarum, 2 qian) Fuzi (Aconiti Lateralis Radix Praeparata, 2 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 2 qian) Guizhi (Cinnamomi Ramulus, 2 qian) Decoct in water to obtain half a cup, take warm. If Phlegm-Fire is excessive, remove Fuzi (Aconiti Lateralis Radix Praeparata).
Qufeng Tang (Wind-Dispersing Decoction)
Fangfeng (Saposhnikoviae Radix, 3 qian) Sangye (Mori Folium, 3 qian) Qinjiao (Gentianae Macrophyllae Radix, 3 qian) Tianma (Gastrodiae Rhizoma, 3 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian) Fuling (Poria, 3 qian) Banxia (Pinelliae Rhizoma, 3 qian) Xingren (Armeniacae Semen Amarum, 3 qian) Baishao (Paeoniae Radix Alba, 3 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 qian) Decoct in water to obtain half a cup, take warm.
Tingli San (Descurainia Powder)
Tingli (Descurainiae Semen seu Fructus, 3 qian) Baijiezi (Sinapis Semen Album, 3 qian) Gansui (Kansui Radix, 1 qian) Grind together into powder. Take 5 fen per dose; old Phlegm will be discharged via stool.