人有卒暴僵仆。或偏枯。或四肢不举。或不知人。或死。或不死者。世以中风呼之。而方书
亦以中风治之。余尝考诸内经。则曰风者。百病之始也。又曰风者。百病之长也。至其变
化。乃为他病。无常方。又曰风者。善行而数变。又曰风之伤人也。或为寒热。或为热中。
或为寒中。或为疠风。或为偏枯。或为风也。其卒暴僵仆。不知人。四肢不举者。并无所论
。止有偏枯一语而已。及观千金方。则引岐伯曰。中风大法有四。一曰偏枯。二曰风痱。三
曰风懿。四曰风痹。解之者。曰。偏枯者。半身不随。风痱者。身无痛。四肢不收。风懿者
。奄忽不知人。风痹者。诸痹类风状。金匮要略中风篇曰。寸口脉浮而紧。紧则为寒。浮则
为
虚。寒虚相搏。邪在皮肤。浮者血虚。络脉空虚。贼邪不泻。或左或右。邪气反缓。正气即
急。正气引邪。 僻不遂。邪在于络。肌肤不仁。邪在于经。即重不胜。邪入于腑。即不识
人。邪入于脏。舌即难言。口吐涎沫。由是观之。知卒暴僵仆。不知人。偏枯。四肢不举等
证。固为因风而致者矣。故用大小续命。西州续命。排风。八风等诸汤散治之。及近代刘河
间李东垣朱彦修三子者出。所论始与昔人异矣。河间曰。中风瘫痪者。非谓肝木之风实甚
。而卒中之。亦非外中于风。由乎将息失宜。心火暴甚。肾水虚衰不能制之。则阴虚阳实。
而热气怫郁。心神昏冒。筋骨不用。而卒倒无所知也。多因喜怒思悲恐五志有所过极而卒
中者。由五志过极。皆为热甚故也。俗云。风者。言末而忘其本也。东垣曰。中风者。非外
来风邪。乃本气病也。凡人年逾四旬气衰之际。或因忧喜忿怒伤其气者。多有此疾。壮岁之
时无有也。若肥盛则间有之。亦是形盛气衰而如此。彦修曰。西北气寒为风所中。诚有之矣。
东南气温而地多湿。有风病者非风也。皆湿土生痰。痰生热。热生风也。三子之论。河间主乎
火
。东垣主乎气。彦修主于湿。反以风为虚象。而大异于昔人矣。吁。昔人也。三子也。果孰
是欤。果孰非欤。以三子为是。昔人为非。则三子未出之前。固有从昔人而治愈者矣。以
昔人为是。三子为非。则三子已出之后。亦有从三子而治愈者矣。故不善读其书者。往往致
乱。以予观之。昔人三子之论。皆不可偏废。但三子以相类中风之病。视为中风而立论。故
使后人狐疑而不能决。殊不知因于风者。真中风也。因于火。因于气因于湿者。类中风。而
非中风也。三子所论者。自是因火。因气。因湿。而为暴病。暴死之证。与风何相干哉。如
内经所谓。三阴三阳发病为偏枯痿易。四肢不举。亦未尝必因于风。而后能也。夫风火气湿
之殊。望闻问切之异。岂无所辨乎。辨之为风。则从昔人以治。辨之为火气湿。则从三子以
治。
如此。庶乎析理明。而用法当矣。惟其以因火。因气。因湿之证。强因风而合论之。
所以真伪不分。而名实相紊。若以因火。因气。因湿证分出之则真中风病彰矣。所谓西北有
中风东南无中风者。其然欤。否欤。
有人突然僵硬倒仆，或者半身不遂，或者四肢无法抬起，或者神志不清，或者死亡，或者未死的。世人称之为“中风”，而医方书籍也按照“中风”来治疗。我曾经考证《黄帝内经》，其中说：风，是百病的起始；又说：风，是百病之长。至于它的变化，就会变成其他疾病，没有固定的规律。又说：风，善于游走且变化迅速。又说：风邪伤人，有的表现为寒热，有的表现为热中（热邪内蕴），有的表现为寒中（寒邪内蕴），有的表现为疠风（麻风病），有的表现为偏枯（半身不遂），有的表现为风病。但是，对于突然僵硬倒仆、神志不清、四肢无法抬起这些症状，《内经》并没有专门论述，只提到了“偏枯”这一种情况。
等到观看《千金方》，它引用岐伯的话说：中风的大法有四种。一是偏枯，二是风痱（肢体瘫痪但无疼痛），三是风懿（突然昏厥不知人），四是风痹（各种痹症类似风状）。解释的人说：偏枯，是半身不随；风痱，是身体无痛，四肢不能收持；风懿，是突然昏迷不知人事；风痹，是各种痹症类似风的形状。
《金匮要略·中风篇》说：寸口脉浮而紧，紧则代表寒，浮则代表虚。寒与虚相互搏结，邪气在皮肤。浮脉表示血虚，络脉空虚，贼邪不得宣泄，或左或右，邪气所在的一侧肌肉松弛，正气所在的一侧紧张，正气牵引邪气，导致口眼歪斜、肢体不能随意运动。邪气在络脉，肌肤麻木不仁；邪气在经脉，即感沉重难以胜任；邪气进入腑，即不识人；邪气进入脏，舌即难言，口吐涎沫。
由此看来，知道突然僵硬倒仆、神志不清、偏枯、四肢无法抬起等症状，固然认为是因风所致。所以使用大小续命汤、西州续命汤、排风汤、八风散等诸汤散来治疗。到了近代，刘河间、李东垣、朱彦修三位先生出现后，他们的论述才开始与古人不同。
河间说：中风瘫痪，并不是因为肝木之风实盛而突然中伤，也不是外感风邪。而是因为调养失宜，心火暴盛，肾水虚衰不能制约，导致阴虚阳实，热气郁结，心神昏冒，筋骨不用，从而突然倒下失去知觉。多是因为喜怒思悲恐五志有所过极而突然中风的，由于五志过极，都化为热盛之故。世俗所说的“风”，是说末节而忘记了根本。
东垣说：中风，不是外来风邪，而是本气病变。凡是年过四十、气衰之际，或因忧喜忿怒损伤其气的人，多有此疾。壮年时没有这种情况。如果形体肥盛，偶尔也有，也是形盛气衰才这样。
彦修说：西北气候寒冷，被风所中，确实存在。东南气候温暖且地多湿气，有风病的人并非风邪所致，都是湿土生痰，痰生热，热生风。
这三位的论述，河间主于火，东垣主于气，彦修主于湿，反而把风看作虚象，这与古人的观点大相径庭。唉！古人和这三位，究竟谁对谁错呢？如果认为三位是对的，古人是错的，那么在三位出现之前，本来就有遵循古人而治愈的案例。如果认为古人是正确的，三位是错的，那么在三位出现之后，也有遵循三位而治愈的案例。所以不善于读书的人，往往导致混乱。
依我看来，古人和三位的论述，都不可以偏废。只是三位将症状相似的中风病，视为中风而立论，使得后人狐疑而不能决断。殊不知，因于风的，是真中风；因于火、因于气、因于湿的，是类中风，而不是真中风。三位所论述的，自然是因为火、因于气、因于湿而导致的暴病、暴死之证，与风有什么关系呢？如《内经》所说，三阴三阳发病导致偏枯、痿易、四肢不举，也未尝一定要因于风才能发生。
风、火、气、湿的不同，望闻问切的差异，难道没有区别吗？辨别为风，就遵循古人的方法治疗；辨别为火、气、湿，就遵循三位的方法治疗。这样，才能分析道理明确，用法得当。正是因为把因火、因气、因湿的证候，强行归因于风而合在一起讨论，所以真伪不分，名实相混。如果把因火、因气、因湿的证候区分出来，那么真中风的病症就彰显出来了。所谓“西北有中风，东南无中风”，是这样吗？还是不是呢？
There are cases where people suddenly stiffen and fall, or suffer from hemiplegia (hemiplegia), or cannot lift their limbs, or lose consciousness, or die, or survive. The world calls this "Zhong Feng" (Wind Stroke), and medical texts also treat it as such. I once examined the *Huangdi Neijing* (Yellow Emperor's Inner Canon), which states: "Wind is the beginning of all diseases." It also says: "Wind is the chief of all diseases." Regarding its changes, it transforms into other diseases without a fixed pattern. It further states: "Wind moves swiftly and changes frequently." And again: "When wind pathogen attacks humans, it may manifest as cold-heat alternation, heat in the middle jiao (internal heat accumulation), cold in the middle jiao (internal cold accumulation), leprosy (Lifeng), hemiplegia, or wind disease. However, regarding sudden stiffness and falling, loss of consciousness, and inability to move limbs, there is no specific discussion, except for the mention of hemiplegia."
Upon reviewing the *Qianjin Fang* (Prescriptions Worth a Thousand Gold), it quotes Qibo stating that there are four major categories of Zhong Feng: one is hemiplegia; two is Feng Fei (wind ataxia/paralysis); three is Feng Yi (wind stupor/coma); four is Feng Bi (wind bi-syndrome). Explanations clarify: Hemiplegia involves half-body immobility; Feng Fei involves body painlessness with flaccid limbs; Feng Yi involves sudden unconsciousness; Feng Bi refers to various Bi syndromes resembling wind patterns.
The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) chapter on Zhong Feng states: "If the pulse at the cunkou position is floating and tight, tight indicates cold, and floating indicates deficiency. Cold and deficiency interact, placing the pathogen in the skin. Floating indicates blood deficiency, leaving collateral vessels empty. The thief pathogen cannot be expelled. Whether on the left or right, the pathogen side becomes relaxed, while the healthy qi side becomes tense. Healthy qi pulls toward the pathogen, causing deviation and inability to control movement. If the pathogen is in the collaterals, there is numbness of skin and muscles. If in the meridians, there is heaviness and weakness. If entering the fu organs, there is loss of recognition. If entering the zang organs, speech becomes difficult, and saliva foams from the mouth."
From this, we know that symptoms like sudden stiffness and falling, loss of consciousness, hemiplegia, and limb paralysis are indeed considered caused by wind. Therefore, formulas such as Da Xueming Tang (Large Continuation Life Decoction), Xiao Xueming Tang (Small Continuation Life Decoction), Xizhou Xueming Tang (Xizhou Continuation Life Decoction), Paifeng Tang (Expel Wind Decoction), and Bafeng San (Eight Winds Powder) were used for treatment.
Later, during the modern era, Liu Hejian, Li Dongyuan, and Zhu Yanxiu emerged, and their theories began to differ from those of the ancients.
Hejian stated: Paralysis due to Zhong Feng is not caused by excessive liver wood wind striking suddenly, nor is it an external wind attack. Instead, it arises from improper lifestyle management leading to a violent surge of heart fire. When kidney water is deficient and fails to control it, yin deficiency and yang excess occur, causing heat qi to stagnate. This leads to mental confusion and stupor, rendering tendons and bones useless, resulting in sudden collapse and unconsciousness. This often happens when the five emotions (joy, anger, worry, thought, fear) reach extremes, as extreme emotional states generate intense heat. The common term "wind" addresses the symptom but forgets the root cause.
Dongyuan stated: Zhong Feng is not an external wind pathogen but a disorder of the fundamental qi. People over forty, during periods of qi decline, especially if injured by sorrow, joy, anger, or indignation, often suffer from this disease. Young adults rarely experience it. Even among the obese, it occurs occasionally, but this is still due to robust form with deficient qi.
Yanxiu stated: In the northwest, where the climate is cold, being struck by wind is indeed possible. However, in the southeast, where the climate is warm and dampness is prevalent, so-called wind diseases are not caused by wind. Rather, damp earth generates phlegm, phlegm generates heat, and heat generates wind.
Among these three scholars, Hejian emphasized fire, Dongyuan emphasized qi, and Yanxiu emphasized dampness. They regarded wind as a false image, differing significantly from ancient views. Alas! Between the ancients and these three, who is correct and who is wrong? If we consider the three correct and the ancients wrong, then before the three appeared, there were certainly cases cured by following the ancients. If we consider the ancients correct and the three wrong, then after the three appeared, there were also cases cured by following them. Thus, those who do not read their books well often become confused.
In my opinion, neither the ancient nor the three scholars' theories should be discarded entirely. However, the three scholars treated similar conditions as Zhong Feng to formulate their theories, causing later generations to hesitate. They failed to realize that cases caused by wind are true Zhong Feng, whereas those caused by fire, qi, or dampness are "pseudo-Zhong Feng" (Lei Zhong Feng) and not true Zhong Feng. The conditions discussed by the three scholars naturally refer to acute illnesses and sudden deaths caused by fire, qi, and dampness, having nothing to do with wind. As the *Neijing* states, diseases of the three yin and three yang meridians can lead to hemiplegia, flaccidity, and limb paralysis without necessarily involving wind.
The distinctions between wind, fire, qi, and dampness, reflected in the four diagnostic methods (inspection, auscultation/olfaction, inquiry, palpation), are certainly discernible. If identified as wind, follow the ancients' treatment; if identified as fire, qi, or dampness, follow the three scholars' treatment. This way, principles are clarified, and applications are appropriate. The reason for the confusion between true and false, and the mixing of names and realities, lies in forcing the differentiation of fire, qi, and dampness syndromes into a single discussion under the label of wind. If these syndromes are separated, true Zhong Feng will be clearly distinguished. Is it true that "the northwest has Zhong Feng, while the southeast does not"? Or is it otherwise?