刘子仪曰经有急风候又有卒中风候又有风 候夫急风与卒中理固无二指风而言则谓之急
风指
病而言则谓之卒中其风 盖出于急风之候也何者经云奄然忽不知人咽中塞窒然舌强不能言如
此则是中急风而生其候也发汗身软者生汗不出身直者死若痰涎壅盛者当吐之视其鼻人中左右
上白者可治一黑一赤吐沫者死
风痱者身无痛也病在脏四肢不收智不乱一旦臂不随者风痱也能言微有知则可治不能言者
不可
治足如履霜肘如入汤股胫淫铄眩闷头痛时呕短气汗出久则悲喜不常三年死凡欲治此病根据先后
次第不得妄投汤药以失机宜非但杀人因兹遂为痼疾当先服竹沥饮子(鸡峰普济方)
经有风痉候又有风角弓反张候痉者身体强直口噤如发痫状角弓反张者腰背反折不能俯仰
二者皆曰风邪伤于阳之经而然也治法一同(同上)
经称 腿风者为四肢不收身体疼痛肌肉虚满是也以风邪侵于肌肉之间流于血脉之内既云
肌肉
虚满即风邪入肾之经络而然也水气论曰诸肿俱属于肾是也治法当兼理肾为得一云不治变为水
气(同上)
夫风眩之病起于心气不足胸中蓄热实故有高风面热之所为也痰热相感而动风风心相乱则
闷瞀
故谓之风眩闷瞀大人曰癫小儿则为痫一说头风目眩者由血气虚风邪入脑而牵引目系故也五脏
六腑之精气皆上注于目血气与脉并上为目系属于脑后出于项中血脉若虚则为风邪所伤入脑则
转而目系急故成眩也诊其脉洪大而长者风眩也凡人病发宜急与续命汤困急时但度灸穴便宜针
之无不瘥者初得针了便灸最良(同上)
刘子仪说:医经中有“急风”的证候,又有“卒中风”的证候,还有“风痱”的证候。所谓“急风”与“卒中”,在道理上本来没有区别。从风邪侵袭的角度来说,称为“急风”;从疾病发作的角度来说,称为“卒中”。这种“风痱”大概是由“急风”的证候发展而来的。为什么呢?医经中说:“突然昏倒,不知人事,咽喉中堵塞窒闷,舌体僵硬不能言语。”像这样的情况,就是中了急风而产生的证候。如果发汗后身体变软,预后良好(可生);如果发汗后身体依然僵直,则预后不良(主死)。如果痰涎壅盛,应当采用涌吐法治疗。观察患者鼻翼和人中部位,如果左右两侧呈现白色,可以治愈;如果一侧黑、一侧红,且口吐白沫,则预后不良(主死)。
所谓“风痱”,是指身体没有疼痛感,病位在脏腑,四肢无法收持使用,但神智清醒不乱。如果一旦手臂不能随意活动,这就是风痱。如果能说话,神志尚存些许知觉,就可以治愈;如果不能说话,则不可治愈。症状表现为脚踩霜雪般寒冷,手肘如入沸汤般灼热,大腿和小腿肌肉消瘦枯萎,眩晕头闷,头痛,时常呕吐,气短,出汗。病程长久者,会出现情绪悲喜无常的症状,三年后死亡。凡是想要治疗此病,必须根据病情的先后次第进行,不得胡乱投用汤药,以免错失治疗时机。这不仅会致人死亡,还会因此演变成顽固难愈的疾病。应当先服用竹沥饮子(出自《鸡峰普济方》)。
医经中有“风痉”的证候,又有“风角弓反张”的证候。“痉”是指身体强直,牙关紧闭,如同癫痫发作的样子;“角弓反张”是指腰背向后反折,不能前俯后仰。这两种情况都是因为风邪伤害了阳经所致。治疗方法相同(同上书)。
医经称“风痱”(注:原文此处可能有误或特指某种风症,结合上下文描述为四肢不收、身体疼痛、肌肉虚满,通常风痱无痛,此处依原文翻译),是指四肢无法收持使用,身体疼痛,肌肉虚胀满是。这是因为风邪侵入肌肉之间,流窜于血脉之内。既然提到“肌肉虚满”,那就是风邪进入了肾的经络所致。《水气论》中说:“各种水肿都归属于肾”,就是这个道理。治疗方法应当兼顾调理肾脏,这样才能取得疗效。另一种说法是如果不治,会转变为水气病(同上书)。
所谓“风眩”这种病,起因于心气不足,胸中蓄积热邪实证,所以会有“高风面热”的表现。痰热相互感应而动风,风心相乱则导致胸闷昏蒙,所以称为“风眩”。也有人说,“头风目眩”是由于血气虚弱,风邪侵入脑部并牵引目系所致。五脏六腑的精气都向上灌注于眼睛,血气与经脉一起上行形成目系,连接脑后,出于项中。如果血脉虚弱,就会被风邪所伤,邪气入脑则导致头部转动,进而使目系紧张,从而形成眩晕。诊察其脉象,如果脉象洪大而长,即为风眩。大凡人患病初期,应当立即给予续命汤治疗。病情危急时,只需酌情施灸穴位,方便时进行针刺,没有不痊愈的。初次治疗后,紧接着艾灸效果最好(同上书)。
Liu Ziyi stated: The medical classics mention the syndrome of "Jifeng" (Acute Wind), the syndrome of "Zu Zhongfeng" (Sudden Stroke), and the syndrome of "Fengfei" (Wind Paralysis). In principle, there is no distinction between Jifeng and Zu Zhongfeng. From the perspective of wind pathogen invasion, it is called Jifeng; from the perspective of disease onset, it is called Zu Zhongfeng. This Fengfei likely originates from the syndrome of Jifeng. Why? The classics state: "Suddenly fainting, losing consciousness, obstruction in the throat, tongue stiffness, and inability to speak." Such cases indicate contracting acute wind and developing these symptoms. If the body becomes soft after sweating, the prognosis is good (survival); if the body remains rigid after sweating, the prognosis is poor (death). If phlegm and saliva are excessive, emesis should be induced. Observing the alae nasi and philtrum: if both sides appear white, the condition is treatable; if one side is black and the other red, accompanied by foaming at the mouth, the prognosis is poor (death).
Fengfei is characterized by the absence of body pain, with the pathology located in the zang organs, resulting in the inability to control the four limbs while mental clarity remains intact. If the arms suddenly become immobile, this is Fengfei. If the patient can speak and retains some awareness, it is treatable; if unable to speak, it is untreatable. Symptoms include feet feeling cold as if walking on frost, elbows feeling hot as if immersed in boiling water, wasting and shrinking of the thighs and calves, dizziness and chest oppression, headache, frequent vomiting, shortness of breath, and sweating. In chronic cases, emotional instability such as uncontrolled weeping or laughing may occur, leading to death within three years. To treat this disease, one must follow the sequential order of pathology and must not administer decoctions arbitrarily, lest the opportunity for treatment be missed. Failure to do so not only leads to death but also results in stubborn, incurable diseases. One should first administer Zhuli Yinzi (Bamboo Juice Drink) (from *Jifeng Puji Fang*).
The classics mention the syndrome of "Fengjing" (Wind Spasm) and the syndrome of "Feng Jiaogong Fanzhang" (Wind Opisthotonos). Jing refers to body rigidity, locked jaw, resembling epilepsy; Jiaogong Fanzhang refers to backward arching of the waist and back, preventing flexion and extension. Both conditions result from wind pathogens injuring the Yang meridians. The treatment methods are identical (ibid.).
The classics refer to a condition where the four limbs cannot be controlled, accompanied by body pain and muscle distension/fullness, as caused by wind pathogens invading between the muscles and flowing into the blood vessels. Since muscle distension/fullness is mentioned, this indicates wind pathogens entering the meridians of the Kidney. *Shuiqi Lun* states: "All edema belongs to the Kidney," which applies here. The treatment should simultaneously regulate the Kidney to achieve efficacy. Another view holds that if untreated, it transforms into Shuiqi (Water Qi/Edema) disease (ibid.).
The disease of "Fengxuan" (Wind Vertigo/Dizziness) arises from insufficiency of Heart Qi and excess heat accumulation in the chest, manifesting as "Gao Feng Mian Re" (High Wind and Facial Heat). Phlegm-heat interaction generates wind; when wind and Heart qi interfere with each other, it causes chest stuffiness and confusion, hence termed Fengxuan. Alternatively, "Tou Feng Mu Xuan" (Head Wind and Dazzling Eyes) is attributed to deficiency of Blood and Qi, allowing wind pathogens to enter the brain and pull on the Eye System (Muxi). The essence of the five zang and six fu organs all ascends to nourish the eyes; Blood and Qi ascend with the meridians to form the Eye System, connecting to the back of the head and emerging from the nape. If the blood vessels are deficient, they are susceptible to wind pathogens. Pathogens entering the brain cause head rotation, tightening the Eye System, thus resulting in vertigo. Diagnosis reveals a Hong Da Er Chang (Vigorous, Large, and Long) pulse for Fengxuan. Upon initial onset of illness, Xuming Tang should be administered urgently. In critical situations, moxibustion should be applied to appropriate acupoints based on convenience, followed by acupuncture if possible; recovery is assured. Acupuncture followed immediately by moxibustion yields the best results (ibid.).