脑充血病之说倡自西人，而浅见者流恒讥中医不知此病，其人盖生平未见《内经》者也。尝读《内经》
至调经论，有谓“血之与气，并走于上，则为大厥，厥则暴死，气反则生，不反则
死”云云，非即西人所谓脑充血之证乎？所有异者，西人但言充
血，《内经》则谓血之与气并走于上。盖血必随气上升，此为一定之理。而西人论病皆得之剖解之余，是以
但见血充脑中，而不知辅以理想以深究病源，故但名为脑充血也。至《内经》所谓“气反则生，不反则死”
者，盖谓此证幸有转机，其气上行之极，复反而下行，脑中所充之血应亦随之下行，故其人可生；若其气
上行不反，升而愈升，血亦随之充而愈充，脑中血管可至破裂，所以其人死也。又《内经》厥论篇谓“巨阳之
厥则肿首，头重不能行，发为 （眩也）仆”、“阳明之厥，面赤而热，妄言妄见”、“少阳之厥，则暴
聋颊肿而热”，诸现象皆脑充血证也。推之秦越人治虢太子尸厥，谓“上有绝阳之络，下有破阴之纽”者，亦
脑充血证也。特是古人立言简括，恒但详究病源，而不细论治法。然既洞悉致病之由，即自拟治法不难也。愚
生平所治此证甚多，其治愈者，大抵皆脑充血之轻者，不至血管破裂也。今略举数案于下，以备治斯证者之参考。
在奉天曾治一人，年近五旬，因处境不顺，兼劳碌，渐觉头疼，日浸加剧，服药无效，遂入西人医院。治
旬日，头疼不减，转添目疼。又越数日，两目生翳，视物不明。来院求为延医。其脉左部洪长有力，自言脑
疼彻目，目疼彻脑，且时觉眩晕，难堪之情莫可名状。脉证合参，知系肝胆之火挟气血上冲脑部，脑中
血管因受冲激而膨胀，故作疼；目系连脑，脑中血管膨胀不已，故目疼，生翳且眩晕也。因晓之曰∶“此脑
充血证也。深考此证之原因，脑疼为目疼之根；而肝胆之火挟气血上冲，又为脑疼之根。欲治此证，当清火、
平肝、引血下行，头疼愈而目疼、生翳及眩晕自不难调治矣。”遂为疏方，用怀牛膝一两，生杭芍、生
尤骨、生牡蛎、生赭石各六钱，玄参、川楝子各四钱，龙胆草三钱，甘草二钱，磨取铁锈浓水煎药。服一剂，
觉头目之疼顿减，眩晕已无。即方略为加减，又服两剂，头疼目疼全愈，视物亦较
真。其目翳原系外障，须兼外治之法，为制磨翳药水一瓶，日点眼上五六次，徐徐将翳尽消。
在沧州治一人，六十四岁，因事心甚懊 ，于旬日前即觉头疼，不以为意。一日晨起，忽仆于地，状
若昏厥，移时苏醒，左手足遂不能动，且觉头疼甚剧。医者投以清火通络之剂，兼法王勋臣补阳还五汤之义，
加生黄 数钱，服后更觉脑中疼如锥刺，难忍须臾。求为诊视，其脉左部弦长，右部洪长，皆重按甚实。
询其心中，恒觉发热。其家人谓其素性嗜酒，近因心中懊 ，益以烧酒浇愁，饥时恒以酒代饭。愚曰，此
证乃脑充血之剧者，其左脉之弦长，懊 所生之热也。右脉之洪长，积酒所生之热也。二热相并，挟脏腑气
血上冲脑部。脑部中之血管若因其冲激过甚而破裂，其人即昏厥不复醒，今幸昏厥片时苏醒，其脑中血管当不
至破裂。或其管中之血隔血管渗出，或其血管少有罅隙，出血少许而复自止。其所出之血着于司知觉之神经，
则神昏；着于司运动之神经，则痿废。此证左半身偏枯，当系脑中血管所出之血伤其司右边运动之神经也。
医者不知致病之由，竟投以治气虚偏枯之药，而此证此脉岂能受黄 之升补乎？此所以服药后而头疼益
剧也。遂为疏方，亦约略如前。为其右脉亦洪实，因于方中加生石膏一两，亦用铁锈水煎药。服两剂，头疼
全愈，脉已和平，左手足已能自动。遂改用当归、赭石、生杭芍、玄参、天冬各五钱，生黄 、乳香、没药
各三钱，红花一钱，连服数剂，即扶杖能行矣。方中用红花者，欲以化脑中之瘀血也。为此时脉已和平，头已
不疼，可受黄 之温补，故方中少用三钱，以补助其正气，即借以助归、芍、乳、没以流通血脉，更可调
玄参、天冬之寒凉，俾药性凉热适均，而可多服也。
上所录二案，用药大略相同，而皆以牛膝为主药者，诚以牛
膝善引上部之血下行，为治脑充血证无上之妙品，此愚屡经试验
而知，故敢贡诸医界。而用治此证，尤以怀牛膝为最佳。
“脑充血”这一病名由西方人提出，但见识浅薄的人常常讥笑中医不了解这种病，这些人大概生平都没有读过《黄帝内经》。我曾阅读《黄帝内经·调经论》，其中有这样的话：“血与气一起向上冲逆，就会发生大厥证，厥证发作时会突然死亡，如果气能返回下行则生，不能返回则死。”这难道不就是西方人所说的脑充血证候吗？其中的不同之处在于，西方人只说充血，《黄帝内经》则说是血与气并走于上。因为血必然随着气上升，这是一定的道理。而西方人论述疾病多是从解剖观察中得出的，所以只见血液充满脑部，却不知道结合理论深入探究病因，因此只命名为脑充血。至于《黄帝内经》所说的“气反则生，不反则死”，意思是此证如果有转机，气上行到了极点，反而向下行，脑中充血的血液也应随之向下行，所以病人可以存活；如果气上行而不返回，升而又升，血液也随之更加充盈，脑部血管可能会破裂，所以病人死亡。另外，《黄帝内经·厥论篇》中说“太阳经的厥证会导致头部肿胀，头重脚轻不能行走，发为眩晕仆倒”、“阳明经的厥证，面色发红且发热，胡言乱语、幻视”、“少阳经的厥证，会突发耳聋、脸颊肿胀发热”，这些现象都是脑充血证的临床表现。推究秦越人（扁鹊）治疗虢太子尸厥时所说的“上部阳气断绝的络脉，下部阴气破损的纽结”，也是脑充血证。只是古人立言简练，往往详细探究病因，而不细致讨论治法。然而既然透彻了解了致病的原因，自己拟定治法就不难了。我生平治疗的这类病例很多，治愈的大多是脑充血的轻症，没有发展到血管破裂的程度。现在略举几例如下，供治疗此证者参考。
在奉天曾治疗一个人，年龄近五十岁，因处境不顺，加上劳累，逐渐感到头痛，一天比一天加重，服药无效，于是进入西医医院治疗。治疗十天，头痛不减，反而增添了眼痛。又过了几天，双眼生出翳膜，视物不清。家属来请我去诊治。其脉象左部洪大、长而有力，患者自述头痛牵连到眼睛，眼痛牵连到大脑，且时常感到眩晕，难受之情难以形容。脉证合参，知道是肝胆之火挟带气血上冲脑部，脑部血管因受冲击而膨胀，所以作痛；目系连接大脑，脑部血管不断膨胀，所以眼痛，出现翳膜和眩晕。于是告诉他说：“这是脑充血证。深入考察此证的原因，头痛是眼痛的根源；而肝胆之火挟带气血上冲，又是头痛的根源。要治疗此证，应当清火、平肝、引血下行，头痛痊愈后，眼痛、生翳及眩晕自然不难调理。”于是为他开方，用怀牛膝一两，生杭芍、生龙骨、生牡蛎、生赭石各六钱，玄参、川楝子各四钱，龙胆草三钱，甘草二钱，磨取铁锈浓水煎药。服用一剂，感觉头目疼痛顿时减轻，眩晕消失。随即对方剂稍作加减，又服两剂，头痛眼痛全愈，视物也变得真切。他的眼翳原是外障，需要兼用外治法，为他配制了一瓶磨翳药水，每天点眼五六次，慢慢将翳膜完全消除。
在沧州治疗一个人，六十四岁，因心事重重心中烦闷懊恼，十天前就感到头痛，没在意。一天早晨起床，忽然跌倒在地，状如昏厥，过了一会儿苏醒，左手足便不能活动，且感到头痛非常剧烈。医生投以清火通络的药剂，兼取王勋臣补阳还五汤的意思，加入生黄芪数钱，服用后更觉得脑中疼痛如锥刺，难以忍受片刻。求我为其诊视，其脉象左部弦长，右部洪长，都重按甚实。询问其心中感觉，常觉得发热。其家人说他平时嗜好饮酒，近期因心中烦闷懊恼，更加借烧酒浇愁，饥饿时常常以酒代饭。我说，此证是脑充血的重症，其左脉的弦长，是烦闷懊恼所生的热所致。右脉的洪长，是积久饮酒所生的热所致。两种热邪相并，挟带脏腑气血上冲脑部。脑部中的血管如果因其冲击过甚而破裂，人就会昏厥不再醒来，如今幸好昏厥片刻后苏醒，说明脑中血管应当没有破裂。或者是管中的血透过血管壁渗出，或者是血管有少许缝隙，出血少许后又自行停止。流出的血液附着在主管知觉的神经上，就会神志昏迷；附着在主管运动的神经上，就会导致痿废瘫痪。此证左半身偏枯，应当是脑中血管流出的血液损伤了主管右侧运动的神经。医生不知道致病的原因，竟然投以治疗气虚偏枯的药物，而这种证候和脉象怎么能承受黄芪的升提补益呢？这就是服药后头痛更加剧烈的原因。于是为他开方，也大致与前案相同。因为其右脉也洪实，所以在方中加入生石膏一两，也用铁锈水煎药。服用两剂，头痛全愈，脉象已平和，左手足已能自动。于是改用当归、赭石、生杭芍、玄参、天冬各五钱，生黄芪、乳香、没药各三钱，红花一钱，连续服用数剂，就能扶着拐杖行走了。方中使用红花，是想化解脑中的瘀血。因为此时脉象已平和，头已不疼，可以承受黄芪的温补，所以方中少用三钱，以补助正气，即借助它帮助当归、芍药、乳香、没药流通血脉，更能调和玄参、天冬的寒凉，使药性凉热适中，从而可以多服。
上面记录的这两个案例，用药大致相同，都以牛膝为主药，确实是因为牛膝善于引导上部的血液下行，是治疗脑充血证无上的妙品，这是我多次试验后知道的，所以敢献给医学界。而在治疗此证时，尤其以怀牛膝为最佳。
The concept of "cerebral hyperemia" (Nao Chong Xue Bing) was initiated by Westerners, yet those with superficial understanding often ridicule Traditional Chinese Medicine (TCM) for not knowing this disease. Such individuals have likely never read the *Huangdi Neijing* (Yellow Emperor's Inner Canon) in their lives. I once read the *Tiao Jing Lun* (Treatise on Regulating the Channels) in the *Neijing*, which states: "When blood and qi rush upward together, it results in Great Jue (Da Jue), a condition where sudden death occurs; if the qi returns downward, life is preserved; if it does not return, death ensues." Is this not precisely the syndrome described by Westerners as cerebral hyperemia? The difference lies in that Western medicine merely speaks of congestion, whereas the *Neijing* describes blood and qi rushing upward together. Since blood necessarily ascends following qi, this is an immutable principle. Western pathology is derived largely from autopsy observations; thus, they only see blood congested in the brain but fail to employ theoretical reasoning to deeply investigate the etiology, hence naming it merely "cerebral hyperemia." Regarding the *Neijing*'s statement "if qi returns, life is saved; if not, death follows," it implies that if this syndrome undergoes a favorable turn, the qi, having reached its peak of ascent, reverses and descends. The blood congested in the brain should then also descend, allowing the patient to survive. Conversely, if the ascending qi does not reverse but continues to rise, the blood will correspondingly become more congested, potentially causing rupture of the cerebral blood vessels, leading to death. Furthermore, the *Jue Lun* (Treatise on Jue) in the *Neijing* states: "Jue of the Taiyang (Greater Yang) channel causes head swelling, heaviness of the head making walking difficult, manifesting as dizziness and collapse"; "Jue of the Yangming (Yang Brightness) channel presents with red face and heat, delirious speech and visual hallucinations"; "Jue of the Shaoyang (Lesser Yang) channel presents with sudden deafness, swollen cheeks, and heat." All these phenomena are clinical manifestations of cerebral hyperemia. Extending this logic, Bian Que (Qin Yue Ren)'s treatment of the Crown Prince of Guo's "Shi Jue" (Corpse-like Jue), describing "interruption of yang collaterals above and rupture of yin ties below," also refers to cerebral hyperemia. However, ancient texts are concise, often detailing etiology while neglecting specific therapeutic methods. Nevertheless, once the cause of the disease is thoroughly understood, devising a treatment is not difficult. In my lifetime, I have treated many such cases; those cured were mostly mild cerebral hyperemia without vessel rupture. Here, I briefly present a few cases for reference.
In Fengtian, I treated a man near fifty years old. Due to unfavorable circumstances and overwork, he gradually experienced headaches that intensified daily. Medication proved ineffective, so he entered a Western hospital. After ten days of treatment, his headache persisted, and eye pain was added. Several days later, opacities formed in both eyes, impairing vision. His family sought my consultation. His pulse was vigorous, long, and surging on the left side. He reported that his headache radiated to his eyes and eye pain radiated to his brain, accompanied by frequent vertigo, unbearable in nature. Correlating pulse and symptoms, I determined this was liver and gallbladder fire carrying qi and blood upward to the brain. The cerebral vessels expanded due to this impact, causing pain. Since the optic nerves connect to the brain, continuous expansion of cerebral vessels caused eye pain, opacity, and vertigo. I explained to him: "This is cerebral hyperemia. Deep analysis reveals that headache is the root of eye pain; and liver/gallbladder fire carrying qi and blood upward is the root of headache. To treat this, one must clear fire, calm the liver, and guide blood downward. Once the headache resolves, treating eye pain, opacity, and vertigo will be straightforward." I prescribed Huai Niuxi (Radix Achyranthis Bidentatae) 1 liang, Sheng Hangshao (Radix Paeoniae Alba) 6 qian, Sheng Longgu (Os Draconis) 6 qian, Sheng Muli (Concha Ostreae) 6 qian, Sheng Zhe Shi (Haematitum) 6 qian, Xuanshen (Radix Scrophulariae) 4 qian, Chuan Lianzi (Fructus Toosendan) 4 qian, Longdancao (Herba Gentianae) 3 qian, and Gancao (Radix Glycyrrhizae) 2 qian, decocted in concentrated rust water. After one dose, head and eye pain decreased significantly, and vertigo ceased. I slightly modified the formula, and after two more doses, both pains resolved completely, and vision cleared. The eye opacity was an external cataract requiring topical treatment; I prepared a solution to dissolve opacities, applied 5-6 times daily, until the opacity fully dissipated.
In Cangzhou, I treated a 64-year-old man. Burdened by affairs, he felt deep mental restlessness (Ao Nu). Ten days prior, he noticed a headache but ignored it. One morning, he suddenly collapsed, appearing comatose. After regaining consciousness for a moment, his left hand and foot became immobile, and severe headache ensued. The attending physician administered formulas to clear fire and unblock collaterals, incorporating principles from Wang Xunchen's Buyang Huanwu Tang (Tonifying Yang Decoction to Restore Five Tenths), adding several qian of Sheng Huangqi (Radix Astragali). Upon ingestion, he felt stabbing pain in the brain, intolerable even for a moment. Seeking my diagnosis, his pulse was string-taut and long on the left, and surging and long on the right, both firm upon heavy pressure. He reported constant internal heat. His family noted his alcoholism; recently, due to mental distress, he drank heavily to drown sorrows, sometimes replacing meals with liquor. I stated: "This is a severe case of cerebral hyperemia. The string-taut, long left pulse indicates heat generated by mental restlessness. The surging, long right pulse indicates heat accumulated from chronic alcohol consumption. These two heats combine, carrying visceral qi and blood upward to the brain. If the cerebral vessels rupture due to excessive impact, the patient would remain comatose. Fortunately, he regained consciousness after a brief period, suggesting the vessels did not rupture. Blood may have leaked through the vessel walls or stopped bleeding from minor fissures. If this blood adheres to sensory nerves, it causes coma; if it adheres to motor nerves, it causes paralysis. His left-sided hemiplegia suggests blood from ruptured cerebral vessels damaged the nerves controlling right-side movement. The previous doctor, unaware of the etiology, used herbs for qi-deficiency hemiplegia. How could this pulse and syndrome tolerate the ascending tonification of Huangqi? This explains the worsening headache post-medication." I prescribed a formula similar to the previous case. Given the surging, full right pulse, I added 1 liang of Sheng Shigao (Gypsum Fibrosum) and decocted with rust water. After two doses, the headache resolved, the pulse normalized, and the left limbs moved spontaneously. I then switched to Danggui (Radix Angelicae Sinensis), Zhe Shi, Sheng Hangshao, Xuanshen, and Tian Dong (Radix Asparagi) each 5 qian, Sheng Huangqi, Ruxiang (Resina Frankincense), Moyao (Resina Myrrhae) each 3 qian, and Honghua (Flos Carthami) 1 qian. After several doses, he could walk with a cane. Honghua was used to resolve cerebral stasis. Since the pulse had normalized and pain ceased, he could tolerate the warm tonification of Huangqi. Three qian were used to support healthy qi, assisting Danggui, Shaoyao, Ruxiang, and Moyao in promoting blood circulation, while balancing the cold nature of Xuanshen and Tian Dong, ensuring balanced properties for prolonged administration.
The two recorded cases share similar medication, primarily using Niuxi (Radix Achyranthis Bidentatae). Indeed, Niuxi excels at guiding blood from the upper body downward, making it an unparalleled remedy for cerebral hyperemia, a fact confirmed by my repeated trials. Therefore, I dare to recommend it to the medical community. For treating this syndrome, Huai Niuxi is particularly superior.