（严用和）
治中风偏身顽麻，骨节疼痛，步履艰难，语言謇涩，口眼 斜，喉中气急有痰（风胜则
气壅，壅于皮肤则顽麻，壅于骨节则烦痛，壅于经络则语涩行难，壅于口面则 斜，壅于胸
喉则痰
乌药 橘红（二钱） 麻黄（去节） 川芎 白芷 桔梗 枳壳（炒。一钱） 僵蚕（去
丝嘴
加防
此手太阴、足厥阴药也。风盛则火炽，故有痰火冲逆而上，此里气逆也；然中风必由外
感风寒而发
白芷，头面之药，散风而活血（血活则风散）；枳桔利气行痰（顺气正以行痰，橘红兼能发
表）；僵蚕清化散结（蚕病风则僵；得清化之气，故因以治风，能散相火逆结之痰）；黑姜温
经通阳；甘草和中泻火；乌药能通行邪滞诸气。此乃先解表气而兼顺里气者，气顺则风散。
风邪卒中，当先治标，若气虚病久者，非所宜也（厥逆痰壅，口噤脉伏，身温为中风，身冷
为中气。中风多痰涎，中气无痰涎，以此为辨。中气因怒而得者尤多，《局方》用此治之。
许学士云∶暴怒伤阴，暴喜伤阳，忧愁不已，气多厥逆，往往得中气之证，不可作中风治。
喻嘉言曰∶中风证多挟中气。严用和曰∶人之元气强壮，外邪焉能为害，必真气先虚，荣卫
空疏，邪乃乘虚而入；若内因心情得者，法当调气，不当治风，外因六淫得者，亦先当治气，
后根据所感六气治之，此良法也，宜八味顺气散，方用人参、白术、茯苓、甘草、陈皮、青皮、
白芷、乌药，并不用前方桔梗、麻黄、僵蚕风药，正先治气后治风之妙旨，后人或谓不当，
杂入白芷，不知白芷香而不燥，正和荣卫之善药也。《局方》合两方用人参、白术、陈皮、
甘草、干姜、川芎、浓朴、桔梗、麻黄、白芷，更加葛根治感风头痛鼻塞声重，尚为合宜。
《玉机微义》曰∶严氏此论，迥出前人，其用药则未也，何也。四君子补脾胃药，更加白芷
去手阳明经风，乌药通肾胃间气，陈皮理肺气，青皮泄肝气，若风果在于手阳明肺肝胃肾而
气实者可用；但经有十二，五脏之气，互有胜负，此方安能尽其变乎，况真气先虚之人，亦
难用也）。
（严用和）
治疗中风导致的半身麻木不仁，骨节疼痛，行走困难，言语不清，口眼歪斜，喉中气急且伴有痰鸣。（这是因为风邪偏盛导致气机壅滞：气壅于皮肤则表现为麻木不仁，壅于骨节则表现为烦痛，壅于经络则导致言语涩滞、行动艰难，壅于口面部则导致口眼歪斜，壅于胸喉则产生痰涎。）
乌药、橘红（二钱）、麻黄（去节）、川芎、白芷、桔梗、枳壳（炒，一钱）、僵蚕（去丝嘴）。
加防风。
这是属于手太阴肺经和足厥阴肝经的药物。风邪盛则火炽盛，因此有痰火冲逆而上，这是里气逆乱；然而中风必定是由外感风寒而诱发。
白芷是头面部的药物，能疏散风邪并活血（血行通畅则风邪自散）；枳壳和桔梗能利气行痰（顺气正是为了行痰，橘红兼能发散表邪）；僵蚕能清热化痰、消散结聚（蚕因患风病而僵硬；因其具有清化之气，故用来治疗风病，能消散相火逆结之痰）；黑姜温通经脉、通达阳气；甘草调和脾胃、泻火；乌药能通行各种邪气阻滞的气机。此方是先解除表气之邪，同时兼顾理顺里气，气机顺畅则风邪自散。
若是风邪突然中客，应当先治其标证；但对于气虚且病程长久者，则不适用。（四肢厥冷、痰涎壅盛、牙关紧闭、脉象伏匿，身体温热者为中风，身体寒冷者为中气。中风多伴有痰涎，中气则无痰涎，以此作为鉴别依据。因愤怒而导致的中气证尤为多见，《局方》使用此方治疗。许学士说：暴怒伤阴，暴喜伤阳，忧愁不已，气机多发生厥逆，往往出现中气证，不可当作中风来治疗。喻嘉言说：中风证多夹杂中气。严用和说：人的元气强壮，外邪怎么能成为危害？必定是真气先虚，营卫空虚疏泄，邪气才乘虚而入；如果是内因情志因素导致的，治法应当调理气机，不应当治疗风邪；如果是外因六淫邪气导致的，也应当先调理气机，然后根据所感受的六气进行治疗，这是很好的方法，宜用八味顺气散，方中用人参、白术、茯苓、甘草、陈皮、青皮、白芷、乌药，并不使用前方中的桔梗、麻黄、僵蚕等风药，这正是先治气后治风的精妙旨意。后人有的认为不妥，杂入白芷，却不知道白芷香气浓郁而不燥烈，正是调和营卫的好药。《局方》将两方合用，用人参、白术、陈皮、甘草、干姜、川芎、浓朴、桔梗、麻黄、白芷，再加上葛根治疗感受风邪引起的头痛、鼻塞、声音重浊，还算适宜。《玉机微义》说：严氏的这个理论，远超前人，但他的用药却未必完美，为什么呢？四君子汤是补益脾胃的药，再加白芷去除手阳明经的风邪，乌药疏通肾胃之间的气机，陈皮调理肺气，青皮疏泄肝气，如果风邪确实位于手阳明、肺、肝、胃、肾经，且气实者可以使用；但是经络有十二条，五脏之气，互有胜负，这个方子怎么能穷尽其变化呢？况且真气先虚的人，也难以使用）。
(Yan Yonghe)
Treats hemiplegic numbness and stiffness, pain in bone joints, difficulty in walking, slurred speech, deviation of the mouth and eyes, rapid breathing with phlegm in the throat caused by Wind-stroke (Stroke). (This is because excess Wind causes Qi stagnation: when Qi stagnates in the skin, it manifests as numbness; when it stagnates in bone joints, it causes painful discomfort; when it stagnates in meridians, it leads to slurred speech and difficult movement; when it stagnates in the face and mouth, it causes deviation of the mouth and eyes; when it stagnates in the chest and throat, it generates phlegm.)
Wuyao (Linderae Radix), Juhong (Citri Reticulatae Pericarpium Rubrum, 2 qian), Mahuang (Ephedrae Herba,節 removed), Chuanxiong (Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus Immaturus, stir-fried, 1 qian), Jiangcan (Bombyx Batryticatus, silk mouth removed).
Add Fangfeng (Saposhnikoviae Radix).
These are herbs belonging to the Hand-Taiyin Lung Meridian and Foot-Jueyin Liver Meridian. When Wind is excessive, Fire blazes, causing Phlegm-Fire to rush upward; this indicates rebellion of Interior Qi. However, Stroke must be triggered by external contraction of Wind-Cold.
Baizhi acts on the head and face, dispersing Wind and invigorating Blood (when Blood flows freely, Wind dissipates); Zhike and Jiegeng promote Qi circulation and resolve Phlegm (regulating Qi is essential for resolving Phlegm; Juhong also aids in releasing the Exterior); Jiangcan clears Heat, transforms Phlegm, and dissipates nodules (silkworms become rigid due to Wind disease; possessing the nature of clearing and transforming, it treats Wind diseases and dissipates Phlegm caused by rebellious Ministerial Fire); Heijiang (Black Ginger) warms the meridians and unblocks Yang; Gancao (Glycyrrhizae Radix et Rhizoma) harmonizes the Middle Jiao and drains Fire; Wuyao promotes the circulation of various Qi obstructions caused by pathogenic factors. This formula first releases the Exterior Qi while simultaneously smoothing Interior Qi; when Qi flows smoothly, Wind dissipates.
In cases of sudden invasion by Wind pathogens, one should first treat the branch (symptoms); however, this is not suitable for patients with Qi deficiency and chronic illness. (Cold limbs, copious phlegm obstruction, locked jaw, hidden pulse, and warm body indicate Stroke; cold body indicates Qi Strike [Zhong Qi]. Stroke is often accompanied by saliva/phlegm, whereas Qi Strike lacks phlegm/saliva; this serves as a differentiation criterion. Qi Strike caused by anger is particularly common; Ju Fang uses this formula to treat it. Xu Xueshi stated: Violent anger injures Yin, violent joy injures Yang, and persistent worry leads to Qi rebellion, often resulting in Qi Strike syndrome, which should not be treated as Stroke. Yu Jiayan stated: Stroke syndromes often involve Qi Strike. Yan Yonghe stated: If a person's Yuan Qi is strong, how can external pathogens cause harm? It must be that True Qi is deficient first, and Ying-Wei (Nutritive and Defensive Qi) are sparse, allowing pathogens to enter through the deficiency. If caused by internal emotional factors, the treatment method should regulate Qi, not treat Wind; if caused by external Six Excesses (Six Evils), one should first regulate Qi, and then treat according to the specific Six Qi contracted. This is an excellent method, recommending Bawei Shunqi San, which contains Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao, Chenpi (Citri Reticulatae Pericarpium), Qingpi (Citri Reticulatae Pericarpium Viride), Baizhi, and Wuyao, without using the Wind-dispersing herbs like Jiegeng, Mahuang, or Jiangcan from the previous formula. This embodies the profound principle of treating Qi first and Wind second. Some later practitioners objected, suggesting the addition of Baizhi, unaware that Baizhi is aromatic but not drying, making it an excellent herb for harmonizing Ying-Wei. Ju Fang combines both formulas, using Renshen, Baizhu, Chenpi, Gancao, Ganjiang (Zingiberis Rhizoma), Chuanxiong, Houpo (Magnoliae Officinalis Cortex), Jiegeng, Mahuang, Baizhi, and adding Gegen (Puerariae Lobatae Radix) to treat headache, nasal congestion, and heavy voice caused by contracted Wind, which remains appropriate. Yují Wei Yi states: Yan’s theory here surpasses predecessors, but his herbal selection is not perfect. Why? Si Junzi Tang supplements Spleen and Stomach; adding Baizhi removes Wind from the Hand-Yangming meridian, Wuyao unblocks Qi between Kidney and Stomach, Chenpi regulates Lung Qi, and Qingpi vents Liver Qi. If Wind truly resides in the Hand-Yangming, Lung, Liver, Stomach, or Kidney meridians, and the patient has Qi excess, it may be used. However, there are twelve meridians, and the Qi of the five Zang organs fluctuate in dominance; how can this single formula account for all variations? Moreover, it is difficult to use in individuals whose True Qi is already deficient.)