一男子年五旬外患中风不语形盛火旺不省人事牙关紧急药不能入以蒺藜根炒黄为末用牙
皂煎汤调灌入鼻孔中过一二时辰随吐痰涎半斗方得作声后用涤痰汤数服遂安
一妇人年逾六十形肥盛右手足麻软无力不能举动舌本强硬此湿痰为患用苍术威灵仙熬膏
和
丹溪云大率多因痰结 郁怒 风热 中邪 夫癫狂之病亦名心风盖为惊忧郁怒心受风邪
或因思想以逆其气或因心虚以中其邪而有积热生痰结于心肺之间以致神不守舍精神恍惚妄言
狂叫歌笑不已骂詈奔走甚则不避亲疏举止失常此皆痰迷心窍而然也若证见一二速当求治否则
经
经曰癫病始发意不乐直视僵仆狂之始发少卧而不饥自高贤也自辨智也自贵倨也妄笑好歌
乐妄言不休是也此患盖因痰热热盛而类风也故名心风治宜顺气降火豁痰养心甚则大吐以去其
痰或大下以通其气使痰清而心自宁矣
丹溪曰风狂之脉虚浮者易治实大者难痊 重阳者狂谓阳部中有见洪大滑数之脉者是重阳
脉也病必发狂 重阴者癫谓阴部中有见沉涩微短之脉者是重阴脉也病必发癫
脉诀云寸口滑疾痰蓄于心发为心风又曰中邪之脉乍大乍小乍短乍长
一癫风狂病先量人元气虚实得病久近用药庶不混治亦无差失
一狂病眼斜妄言狂走形盛气实者先宜吐痰用藜芦散 三圣散
一心风是心受邪热精神昏乱狂笑多言此因积想以动心火而生热热盛生痰宜用 清心养神
汤追风祛痰丸
一狂风形实叫骂奔走不识亲疏形体不避宜大下之用 滚痰丸 泻心汤 保命丹
一癫狂痰盛不识人歌唱不已神昏狂乱不避水火先宜吐痰后用 定志豁痰汤 牛黄清心丸
一风癫病发则目瞪作吐耳如蝉鸣此心虚血少宜养心化痰用 养心汤
一因惊怒发病狂乱无时神不守舍恍惚不宁宜用 引神归舍丹
一心风狂乱日久吐下之后心胆虚怯语言不定神衰脉弱宜用 补心汤合 温胆汤
一气心风因恼怒郁结日久生痰邪于心肺妄言狂叫胸闷乱不饥目常斜视而语中多怒此肝气
伤于心经宜用 平肝顺气汤
一心风邪病须用灸法
一位五十多岁的男子患中风,不能说话,形体壮实,火气旺盛,神志不清,牙关紧闭,药物无法喂入。用蒺藜根炒黄研成末,用牙皂煎汤调匀灌入鼻孔中,过了一两个时辰后,随呕吐出痰涎半斗,方才能够发声。之后服用涤痰汤数次,病情遂得安宁。
一位六十多岁的妇人,形体肥胖,右手足麻木软弱无力,不能活动,舌体强硬,这是湿痰为患。用苍术、威灵仙熬膏和……
丹溪说:大率多因痰结、郁怒、风热、中邪所致。癫狂之病又名心风,大概是因为惊忧郁怒,心受风邪;或因思虑导致气机逆乱;或因心虚而中邪,产生积热生痰,结聚于心肺之间,致使神不守舍,精神恍惚,妄言狂叫,歌笑不止,骂詈奔走,甚至不避亲疏,举止失常。这都是痰迷心窍所致。如果证候出现一二,应当迅速求治,否则……
《内经》说:癫病开始发作时,心情不乐,目直视,突然僵倒;狂病开始发作时,睡眠少而不觉得饥饿,自认为贤能,自认为聪明,自认为尊贵傲慢,无故发笑,喜欢唱歌音乐,胡言乱语不停。这个病患大概是因为痰热、热盛而类似中风,所以名叫心风。治疗宜顺气降火、豁痰养心,严重时则用大吐法以去除痰浊,或用大下法以通畅气机,使痰清而心神自然安宁。
丹溪说:风狂之脉象若虚浮者易治,实大者难愈。“重阳者狂”,指阳部脉象中出现洪大滑数的脉象,称为重阳脉,病必发狂;“重阴者癫”,指阴部脉象中出现沉涩微短的脉象,称为重阴脉,病必发癫。
《脉诀》说:寸口脉滑疾,是痰蓄于心,发为心风。又说:中邪的脉象乍大乍小,乍短乍长。
一、癫风狂病,先要衡量患者元气的虚实,以及患病时间的久近,用药才不至于混淆治疗,也不会有差错失误。
一、狂病,眼斜视,妄言狂走,形体壮实,气机充实者,先宜用吐法祛痰,用藜芦散、三圣散。
一、心风,是心受邪热,精神昏乱,狂笑多言。这是因为积想扰动心火而生热,热盛生痰。宜用清心养神汤、追风祛痰丸。
一、狂风,形体壮实,叫骂奔走,不识亲疏,形体行为不顾忌。宜用大下法,用滚痰丸、泻心汤、保命丹。
一、癫狂痰盛,不认识人,歌唱不止,神昏狂乱,不避水火。先宜用吐法祛痰,后用定志豁痰汤、牛黄清心丸。
一、风癫病发作时,眼睛瞪视,作呕,耳如蝉鸣。这是心虚血少,宜养心化痰,用养心汤。
一、因惊怒发病,狂乱无时,神不守舍,恍惚不宁。宜用引神归舍丹。
一、心风狂乱日久,经过吐下之后,心胆虚怯,语言不定,神衰脉弱。宜用补心汤合温胆汤。
一、气心风,因恼怒郁结日久生痰,邪气客于心肺,妄言狂叫,胸闷,饮食不知饥,眼睛常斜视,言语中多含怒气。这是肝气伤及心经,宜用平肝顺气汤。
A man over fifty years old suffered from wind-stroke, unable to speak. His physique was robust with excessive fire-heat, he was unconscious, and his jaw was tightly clenched, preventing the administration of medicine. Jili root (Tribuli Radix) was stir-fried until yellow, ground into powder, mixed with a decoction of Yizao (Galla Chinensis), and instilled into the nostrils. After one or two hours, he vomited half a dou of phlegm and saliva, after which he could finally produce sounds. Subsequently, several doses of Ditang Tang (Phlegm-Draining Decoction) were administered, leading to recovery.
A woman over sixty years old had a fat physique, numbness and weakness in her right hand and foot, inability to move, and a stiff tongue. This was caused by damp-phlegm. Cangzhu (Atractylodis Rhizoma) and Weilingxian (Clematidis Radix et Rhizoma) were decocted into a paste and...
Danxi stated: Generally, it is mostly due to phlegm accumulation, repressed anger, wind-heat, or invasion by evil pathogens. The disease of dian-kuang (mania and depression) is also called Xin Feng (Wind affecting the Heart). It is generally because of fright, depression, anger, and wind-evil invading the heart; or due to excessive thinking causing qi stagnation and rebellion; or due to heart deficiency allowing evil pathogens to invade, generating accumulated heat and phlegm that knots between the heart and lungs. This causes the spirit to lose its residence, resulting in mental confusion, hallucinations, delirious speech, manic shouting, singing and laughing incessantly, cursing and running about, even ignoring kinship ties and behaving abnormally. All these are caused by phlegm confusing the orifices of the heart. If symptoms appear, treatment should be sought immediately; otherwise...
The Classic says: When Dian disease begins, the patient feels unhappy, stares fixedly, and suddenly falls rigid. When Kuang disease begins, the patient sleeps little, does not feel hungry, considers themselves virtuous, clever, and noble, laughs without reason, enjoys singing and music, and speaks nonsense incessantly. This patient’s condition was likely similar to wind-stroke due to phlegm-heat and excessive heat, hence named Xin Feng (Wind affecting the Heart). Treatment should focus on smoothing qi, descending fire, resolving phlegm, and nourishing the heart. In severe cases, emesis should be induced to remove phlegm, or purgation should be used to unblock qi, clearing the phlegm so the heart spirit naturally calms.
Danxi said: For wind-mania, if the pulse is deficient and floating, it is easy to treat; if excess and large, it is difficult to cure. "Double Yang leads to Kuang" refers to the appearance of surging, large, slippery, and rapid pulses in the yang positions, known as Double Yang pulse, which inevitably leads to mania. "Double Yin leads to Dian" refers to the appearance of deep, choppy, fine, and short pulses in the yin positions, known as Double Yin pulse, which inevitably leads to depression.
The Pulse Canon states: A slippery and rapid pulse at the Cun position indicates phlegm accumulating in the heart, manifesting as Xin Feng. It also states: The pulse of pathogen invasion fluctuates, appearing suddenly large, small, short, or long.
1. For Dian-Feng-Kuang diseases, first assess the patient's Yuan Qi (primordial qi) deficiency or excess, and the duration of the illness, to avoid misdiagnosis and error in treatment.
2. For Kuang disease with deviated eyes, delirious speech, manic walking, robust physique, and excess qi, induce vomiting to expel phlegm using Lilu San (Veratrum Powder) or Sansheng San (Three Sages Powder).
3. Xin Feng involves heart invasion by pathogenic heat, causing mental confusion, manic laughter, and excessive talking. This arises from prolonged thoughts stirring heart fire, generating heat, which then produces phlegm. Use Qingxin Yangshen Tang (Heart-Clearing and Spirit-Nourishing Decoction) and Zhuifeng Qutan Wan (Wind-Chasing and Phlegm-Resolving Pill).
4. For Kuang-Feng with robust physique, cursing, running, ignoring kinship, and reckless behavior, use strong purgation with Tun Tan Wan (Rolling Phlegm Pill), Xiexin Tang (Drain the Heart Decoction), or Baoming Dan (Life-Preserving Elixir).
5. For Dian-Kuang with excessive phlegm, inability to recognize people, incessant singing, mental confusion, manic disorder, and disregard for fire and water, first induce vomiting to expel phlegm, then use Dingzhi Huotan Tang (Will-Calming and Phlegm-Resolving Decoction) or Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill).
6. For Feng-Dian disease presenting with staring eyes, retching, and tinnitus like cicadas, this indicates heart deficiency and blood insufficiency. Nourish the heart and resolve phlegm using Yangxin Tang (Heart-Nourishing Decoction).
7. For illness caused by fright and anger, manifesting as unpredictable manic disorder, unsettled spirit, and mental agitation, use Yinsheng Guishe Dan (Spirit-Guiding Home Return Elixir).
8. For chronic Xin Feng manic disorder, after vomiting and purgation, if there is heart and gallbladder deficiency timidity, unstable speech, spirit depletion, and weak pulse, use Buxin Tang (Heart-Supplementing Decoction) combined with Wendan Tang (Warm the Gallbladder Decoction).
9. For Qi-Xin Feng caused by long-term anger and depression generating phlegm, with evil pathogens lodging in the heart and lungs, manifesting as delirious speech, manic shouting, chest fullness, lack of appetite, deviated eyes, and angry speech, this indicates liver qi injuring the heart meridian. Use Pinggan Shunqi Tang (Liver-Calming and Qi-Smoothing Decoction).
10. For Xin Feng pathogenic diseases, moxibustion therapy is required.