枣一枚,葱一根,煎八分,食远服。
清心散 即凉膈散加黄连。 上水盏半,加竹叶十片,煎八分,去渣,入蜜少许温服。头痛加川芎、防风、石
膏。 按∶中风证,大势风木合君相二火主病,多显膈热之证。古方用凉膈散最多,不但二方已也,如转舌膏,用凉膈
散加菖蒲、远志。如活命金丹,用凉膈散加青黛、蓝根。盖风火之势上炎,胸膈正燎原之地,所以清心宁神、转舌活命,
凉膈之功居多。不可以宣通肠胃之法,轻訾之也。
地黄饮子宣明方 治舌喑不能言,足废不能用,肾虚弱,其气厥,不至舌下。 熟地黄 巴戟(去心) 山茱
萸肉苁蓉(酒浸焙) 石斛 附子(炮) 五味子 白茯苓 菖蒲 远志(去骨) 官桂 麦冬(各等分)上为末,
每服三钱。生姜五片,枣一枚,薄荷七叶,水一盏半,煎八分,服无时。 按∶肾气厥,不至舌下,乃藏真之气,不上
荣于舌本耳。至其浊阴之气,必横格于喉舌之间,吞咯维艰,昏迷特甚,又非如不言之证,可以缓调。方中所用附、桂、
巴、苁,原为驱逐浊阴而设,用方者不可执己见而轻去之也。
《三因》白散子 治肝肾中风,涎潮壅塞不语,呕吐痰沫,头目眩晕。兼治阴症伤寒,六脉沉伏,及霍乱吐泻,
小便淋滴不通。 大附子(去皮脐生) 滑石(桂府者各五钱) 制半夏(七钱半) 上为末,每服二钱,水二盏,姜
七片,蜜半匙,煎七分,空心冷服。 按∶此方甚超,但不明言其所以然。且引兼治阴症伤寒、霍乱吐泻等证为言,转
觉泛而不精矣。盖此即上条昌所论浊阴上逆之证,缘肝肾之气,厥逆而上。是以涎即壅塞,舌喑不语,痰沫吐咯难出,
头目重眩。故非附子不能驱其浊阴,然浊阴走下窍者也。浊阴既上逆,其下窍必不通,故用滑石之重,引浊阴仍顺走前
阴之窍。亦因附子雄入之势,而利导之也。更虑浊阴遇胸中之湿痰,两相留恋,再加半夏以开其痰。庶涎沫与浊阴俱下,
方中具有如此之妙义,而不明言以教后人,殊可惜也。
二丹丸 治风邪健忘,养神定志和血,内安心神,外华腠理,得睡。 丹参 熟地黄 天门冬(去心各两半)
朱砂 人参 菖蒲 远志(各五钱) 茯神 麦门冬 甘草(各一两) 上为细末,炼蜜为丸,桐子大。每服五十丸至
一百丸,空心食前服。 按∶中风证,心神一虚,百骸无主,风邪扰乱,莫繇驱之使出。此方安神益虚,养血清热息
风,服之安睡,功见一斑矣。相传用愈风汤吞下,殊失立方之意。
丸 治风气肾肝,四肢麻痹,骨痛膝弱,风湿诸疮。 上以 草,五月五日、六月六日。采叶,九蒸九
曝。凡蒸用酒蜜洒,晒干为末,蜜丸桐子大。空心酒下百丸。 按∶ 者猪也,其畜属亥。乃风木所生之始,故取用其
叶以治风。凡肾藏生风之证,服此其效最着。江宁节度使成讷,知益州张咏,两以方药进献至尊,讷以弟研中风伏枕五
年,一道人传此方服之愈。咏以掘地得碑,制服千服,髭须乌黑,筋力轻健。见都押衙罗守一中风坠马,失音不语。与
药十服,其病立瘥。又和尚智严年七十,或患偏风,口眼 斜,时时吐涎,与十服亦便得痊。古今用此获效者最多,然
莫知其所以然也。其妙处全在气味之 劣,与肾中之腥臊,同气相求,故能入肾,而助其驱逐阴风之力也。因治肾风之
方,百不得一,特录此丸。合前天麻丸,两发其义也。
黑锡丹 治真元虚惫,阳气不固,阴气逆冲,三焦不和,冷气刺痛,饮食无味,腰背沉重,膀胱久冷,夜多小
便。女人血海久冷,赤白带下。及阴证阴毒,四肢厥冷,不省人事,急用枣汤吞一百粒。即便回阳,此药大能升降阴阳,
补虚益元,坠痰除湿破癖。 沉香 葫芦巴(酒浸炒) 附子(炮) 阳起石(研细水飞各一两) 肉桂(半两) 破
故纸 舶茴香 肉豆蔻(面裹煨) 木香 金铃子(蒸去皮核各一两) 硫黄 黑锡(去滓各二两) 上用铁盏,或铁
铫,内如常法。结黑锡硫黄砂,于地上出火毒,研令极细,余药并细末和匀,自朝至暮,以研至黑光色为度,酒糊丸,
如梧子大,阴干入布袋内擦令光莹。每四十丸,空心盐姜汤或枣汤下,女人艾枣汤下,急症用百丸。按∶此方用黑锡水
之精,硫黄火之精,二味结成灵砂为君,诸香燥纯阳之药为臣,用金铃子苦寒一味为反佐,用沉香引入至阴之分为使。
凡遇阴火逆冲,真阳暴脱,气喘痰鸣之急症,舍此药再无他法可施。昌每用小囊佩带随身,恐遇急症,不及取药,且欲
以吾身元气温养其药,借手效灵,厥功历历可纪。即如小儿布痘,与此药迥不相涉,然每有攻之太过,如用蜈蚣、穿山
甲、桑虫之类,其痘虽勃然而起,然头面遍身,肿如瓜匏疮形湿烂难干,乃至真阳上越,气喘痰鸣,儿医撤手骇去。昌
投此丸,领其阳气下入阴中,旋以大剂地黄汤峻补其阴,以留恋夫真阳,肌肤之热反清,肿反消,湿烂反干而成浓靥。
如此而全活者,不知凡几,因附本方项下,以广用方者之识。
三建二香汤 治男妇中风,六脉俱虚,舌强不语,痰涎壅盛,精神如痴,手足偏废。此等不可攻风,只可补虚。
天雄 附子 乌头(各二钱俱去皮脐生用) 沉香 木香(各一钱俱水磨汁) 上作二服,每服水盏半,姜十片,煎七
分,食前服。 按∶此方天雄、附子、乌头,同时并用其生者,不加炮制,惟恐缚孟贲之手,莫能展其全力耳。必因
其人阴邪暴甚,埋没微阳,故用此纯阳无阴,一门三将,领以二香,直透重围,驱逐极盛之阴,拯救将绝之阳。此等大
关,虽有其方,能用者罕。方下妄云治中风六脉俱虚,又云不可攻风,只可补虚。全是梦中说梦,误人最大。当知此证
其脉必微而欲绝,不可以虚之一字,漫无着落者言脉,其方更猛悍毒厉。不可以补虚二字,和平无偏者言方,此方书所
为以盲引盲耶。
星附散 治中风能言,口不歪而手足 曳者。 南星 半夏(各制) 茯苓 僵蚕(炒) 川乌(去皮脐) 人
参黑附子 白附子(各八分) 上水二盏,煎八分,食远热服,得汗愈。 按∶此方乃治虚风寒痰之主药也。风虚则
炽,痰寒则壅,阻遏脾中阳气,不得周行,故手足为之 曳。用此方热服,以助脾中之阳,俾虚风寒痰,不相互结。乃
至得汗,则风从外出,痰从下出,分解而病愈矣。凡用附子药,多取温冷服,谓热因寒用也。此用乌头、附子、人参,
一派温补,绝无发散之药,向非加以热服,亦胡繇而得汗耶?佩服!佩服!
《古今录验》续命汤 治中风痱,身体不能自收,口不能言,冒昧不知痛处,或拘急不得转侧。 麻黄 桂
枝当
归人参 石膏 干姜 甘草(各三两) 芎 杏仁(四十枚) 上九味,以水一斗,煮取四升,温服一升。当小汗,
薄复脊,凭几坐,汗出则愈。不汗更服,无所禁,勿当风。并治但伏不得卧,咳逆上气,面目浮肿。 按∶此合
后三方,《金匮》取用之意,已发之于本条下。今细玩此方,细详其证,乃知痱即痹之别名也。风入而痹其荣卫,即身
体
不能自收,口不能言,冒昧不知痛处,或拘急不能转侧也。然荣卫有虚有实,虚者自内伤得之,实者自外感得之。此方
则治外感之痹其荣卫者,故以得小汗为贵。然已变越婢之制,而加芎、归养血,人参益气矣。其内伤而致荣卫之痹者,
于补气血药中,略加散风药为制,更可知矣。
《千金》三黄汤 治中风手足拘急,百节疼痛,烦热心乱恶寒,经日不欲饮食。 麻黄(五分) 独活(四分)
细辛(二分) 黄 (二分) 黄芩(三分) 上五味,以水六升,煮取二升。分温三服,一服小汗,二服大汗。心热
加大黄二分。腹满加枳实一枚。气逆加人参三分。悸加牡蛎三分。渴加栝蒌根三分。先有寒,加附子一枚。(分字当作去
声读)。 按∶此方治风入荣卫肢节之间,扰乱既久,证显烦热恶寒不食,邪盛正虚可知。其用麻黄为君者,以麻黄能通
阳气而开痹也,故痹非得汗不开。然内虚当虑,须用参 以佐之。而虚复有寒热之不同,虚热则用黄芩,虚寒则加附子,
此仲景所以深取之也。
《近效》白术附子汤 治风虚,头重眩苦极,不知食味。暖肌补中益精气。 白术(二两) 附子(一枚半炮
去皮脐) 甘草(一两炙) 上三味锉。每五钱,姜五片,枣一枚,水盏半,煎七分,去滓服。 按∶此方治肾气空虚
之人,外风入肾,恰似乌洞之中,阴风惨惨,昼夜不息。风挟肾中浊阴之气,厥逆上攻,其头间重眩之苦,至极难耐。
兼以胃气亦虚,不知食味。故方中全不用风门药,但用附子暖其水藏,白术、甘草暖其土藏。水土一暖,则浊阴之气,
尽趋于下,而头苦重眩,及不知食味之证除矣。试观冬月井中水暖,土中气暖。其阴浊之气,且不能出于地,岂更能加
于天乎。制方之义,可谓精矣。此所以用之而获近效耶。
史国公浸酒方 治诸风五痹,左瘫右痪,口眼 斜,四肢疼痛。七十二般风,二十四般气,其效不可尽述。 当
归虎胫骨(酥油炙) 川羌活 川萆 防风(各二两) 秦艽(四两) 鳖甲(一两醋炙) 川牛膝(酒浸) 松
节晚蚕沙(炒各二两) 枸杞子(五两) 干茄根(八两饭上蒸熟) 苍耳子(四两炒捶碎) 上十三味,用无灰酒
一大坛,将绢袋盛药,悬于酒内,密封固。候十四日后,开坛取酒,取时不可面对坛口,恐药气冲人面目。每饮一盏,
勿令药力断绝。饮尽病痊,将药渣晒为末,米糊丸,梧桐子大。每服八十丸,空心温酒下,忌食动风辛热之物,此药可
以常服。 按∶治风治痹,药酒方亦不可少,此方平中之奇,功效颇着。后有增入白花蛇一条者,此又以肠胃试其毒,
吾所不取。
枣一枚,葱一根,煎煮至八分满,在饭后服用。
清心散:即凉膈散加入黄连。取水一盏半,加入竹叶十片,煎煮至八分满,滤去药渣,加入少许蜂蜜,温服。若头痛,加川芎、防风、石膏。
按语:中风证,大势上是风木与君火、相火二火共同致病,多表现为胸膈有热的症状。古方中多用凉膈散,不仅限于上述两个方子,例如转舌膏,是用凉膈散加石菖蒲、远志;又如活命金丹,是用凉膈散加青黛、蓝根。大概因为风火之势向上炎升,胸膈正是烈火燎原之地,所以清心宁神、转舌活命的功效,主要归功于凉膈散的清热作用。不可以用宣通肠胃的方法来轻易贬低它。
地黄饮子(出自《宣明论方》):治疗舌喑不能说话,足废不能使用,肾气虚弱,其气厥逆,不能上达舌下。熟地黄、巴戟天(去心)、山茱萸肉、肉苁蓉(酒浸焙干)、石斛、附子(炮制)、五味子、白茯苓、石菖蒲、远志(去骨)、官桂、麦冬(各等分)。以上药物研为细末,每次服用三钱。生姜五片,枣一枚,薄荷七叶,水一盏半,煎煮至八分满,随时服用。
按语:肾气厥逆,不能上达舌下,这是脏真之气不能上荣于舌本所致。至于其浊阴之气,必然横格阻于喉舌之间,吞咽咯吐非常艰难,昏迷特别严重,这又不像不能说话的证候,可以缓慢调治。方中所用的附子、肉桂、巴戟天、肉苁蓉,原本是为了驱逐浊阴而设的,使用此方的人不可固执己见而轻易去掉这些药。
《三因方》白散子:治疗肝肾中风,涎潮壅塞导致不语,呕吐痰沫,头目眩晕。兼治阴症伤寒,六脉沉伏,以及霍乱吐泻,小便淋滴不通。大附子(去皮脐,生用)、滑石(桂府产者,各五钱)、制半夏(七钱半)。以上药物研为细末,每次服用二钱,水二盏,生姜七片,蜜半匙,煎煮至七分,空腹冷服。
按语:这个方子很高超,但没有明确说明其中的道理。而且引用兼治阴症伤寒、霍乱吐泻等证来说明,反而觉得泛泛而不精当。这其实就是上一条喻昌所论述的浊阴上逆的证候,原因是肝肾之气厥逆而上。因此涎液壅塞,舌喑不语,痰沫吐咯难出,头目沉重眩晕。所以非附子不能驱除浊阴,但浊阴是走下窍的。浊阴既然上逆,其下窍必然不通,所以用滑石的沉重之性,引导浊阴仍顺从前阴之窍排出。也是借助附子雄烈入里的势头,来利导它。更担心浊阴遇到胸中的湿痰,两者相互留恋,再加半夏以开通痰结。这样涎沫与浊阴才能一同下行,方中具有这样的妙义,却不明白地教导后人,实在可惜。
二丹丸:治疗风邪导致的健忘,养神定志和血,内安心神,外润肤理,使人安睡。丹参、熟地黄、天门冬(去心,各一两半)、朱砂、人参、石菖蒲、远志(各五钱)、茯神、麦门冬、甘草(各一两)。以上药物研为细末,炼蜜为丸,如梧桐子大小。每次服用五十丸至一百丸,空腹食前服用。
按语:中风证,心神一旦虚弱,全身肢体便失去主宰,风邪扰乱,无法将其驱除外出。此方能安神补虚,养血清热息风,服用后能安睡,功效可见一斑了。相传用愈风汤送服,这完全失去了立方的本意。
[缺字]丸:治疗风气伤及肾肝,四肢麻痹,骨痛膝弱,风湿诸疮。以上述草(此处原文缺失草名,据上下文推测可能指猪苓或特定草药,但原文仅留空格),五月五日、六月六日采集叶子,九蒸九晒。凡蒸制时用酒蜜喷洒,晒干后研为细末,蜜丸如梧桐子大小。空腹酒送服一百丸。
按语:“[缺字]”是指猪,其畜属亥。乃是风木所生之始,所以取用其叶来治疗风病。凡是肾藏生风的证候,服用此方效果最显著。江宁节度使成讷,知益州张咏,两次将此方药进献给皇帝。成讷是因为弟弟研究中风伏案五年,一道人传授此方服用后痊愈。张咏是因为掘地得到碑文,照此方服用千次,胡须变黑,筋骨轻健。见到都押衙罗守一中风坠马,失音不语,给他服药十次,病立刻痊愈。又有和尚智严七十岁,患偏风,口眼歪斜,时时吐涎,给他十服药也便痊愈。古今用此方获效者最多,然而没有人知道其中的道理。其妙处全在于气味之劣,与肾中之腥臊,同气相求,所以能入肾,而帮助其驱逐阴风的力量。因为治疗肾风的方子,百不得一,特意记录此丸。结合前面的天麻丸,两发其义理。
黑锡丹:治疗真元虚惫,阳气不固,阴气逆冲,三焦不和,冷气刺痛,饮食无味,腰背沉重,膀胱久冷,夜多小便。女人血海久冷,赤白带下。以及阴证阴毒,四肢厥冷,不省人事,急用枣汤吞服一百粒。便能回阳,此药大能升降阴阳,补虚益元,坠痰除湿破癖。沉香、葫芦巴(酒浸炒)、附子(炮制)、阳起石(研细水飞,各一两)、肉桂(半两)、破故纸、舶茴香、肉豆蔻(面裹煨)、木香、金铃子(蒸去皮核,各一两)、硫黄、黑锡(去滓,各二两)。以上药物用铁盏,或铁铫,按常法操作。结成黑锡硫黄砂,在地上退去火毒,研令极细,其余药物并研为细末混合均匀,从早到晚,研磨至黑光色为止,酒糊为丸,如梧桐子大小,阴干后装入布袋内擦拭使其光莹。每次四十丸,空腹盐姜汤或枣汤送下,女人艾枣汤送下,急症用一百丸。
按语:此方用黑锡为水之精,硫黄为火之精,二味结成灵砂为君药,各种香燥纯阳之药为臣药,用金铃子苦寒一味为反佐,用沉香引入至阴之分为使药。凡是遇到阴火逆冲,真阳暴脱,气喘痰鸣的急症,除了此药再无其他方法可施。喻昌经常用小囊佩带随身,恐怕遇到急症来不及取药,并且想用我身体的元气温养此药,借我的手发挥灵验,其功劳历历可记。就像小儿布痘,与此药毫不相干,然而每每有攻伐太过,如用蜈蚣、穿山甲、桑虫之类,虽然痘疹勃然而起,然而头面遍身,肿如瓜匏,疮形湿烂难干,乃至真阳上越,气喘痰鸣,儿科医生撤手惊骇离去。喻昌投以此丸,引领其阳气下入阴中,随即以大剂地黄汤峻补其阴,以留恋真阳,肌肤之热反而清凉,肿反而消退,湿烂反而干燥而成脓靥。如此保全性命者,不知有多少,因此附在本方项下,以广用方者的见识。
三建二香汤:治疗男女中风,六脉俱虚,舌强不语,痰涎壅盛,精神如痴,手足偏废。此类病症不可攻风,只可补虚。天雄、附子、乌头(各二钱,均去皮脐生用)、沉香、木香(各一钱,均水磨汁)。以上作二服,每服用清水一盏半,生姜十片,煎煮至七分,食前服用。
按语:此方天雄、附子、乌头,同时并用其生者,不加炮制,是唯恐束缚孟贲之手,不能施展全力。必定是因为其人阴邪暴甚,埋没微阳,所以用此纯阳无阴,一门三将,领以二香,直透重围,驱逐极盛之阴,拯救将绝之阳。这种大关隘,虽然有此方,能用的人很少。方下妄称治疗中风六脉俱虚,又说不可攻风,只可补虚。完全是梦中说梦,误人最大。应当知道此证其脉必微而欲绝,不可以“虚”的一个字,漫无着落地言脉;其方更猛悍毒厉,不可以“补虚”二字,和平无偏地言方,这就是方书所为以盲引盲的原因。
星附散:治疗中风能说话,口不歪而手足牵引者。南星、半夏(各制过)、茯苓、僵蚕(炒)、川乌(去皮脐)、人参、黑附子、白附子(各八分)。以上用水二盏,煎煮至八分,饭后热服,得汗则愈。
按语:此方是治疗虚风寒痰的主药。风虚则炽盛,痰寒则壅滞,阻遏脾中阳气,不得周行,所以手足为之牵引。用此方热服,以助脾中之阳,使得虚风寒痰,不相互结聚。以至于得汗,则风从外出,痰从下出,分解而病愈了。凡是使用附子药,多取温冷服,说是热因寒用。此方用乌头、附子、人参,一派温补,绝无发散之药,若非加以热服,又怎么能得汗呢?佩服!佩服!
《古今录验》续命汤:治疗中风痱,身体不能自收,口不能言,冒昧不知痛处,或拘急不得转侧。麻黄、桂枝、当归、人参、石膏、干姜、甘草(各三两)、川芎、杏仁(四十枚)。以上九味,用水一斗,煮取四升,温服一升。应当小汗,薄复脊,凭几坐,汗出则愈。不汗再服,无所禁忌,勿当风。并治但伏不得卧,咳逆上气,面目浮肿。
按语:此合后三方,《金匮要略》取用之意,已发之于本条下。现在仔细玩味此方,详细详察其证,才知道痱即是痹的别名。风入而痹阻其营卫,即身体不能自收,口不能言,冒昧不知痛处,或拘急不能转侧。然而营卫有虚有实,虚者自内伤得之,实者自外感得之。此方则是治疗外感之痹阻营卫者,所以以得小汗为贵。然而已变越婢汤之制,而加川芎、当归养血,人参益气。其内伤而致营卫之痹者,于补气血药中,略加散风药为制,就更可以知道了。
《千金方》三黄汤:治疗中风手足拘急,百节疼痛,烦热心乱恶寒,经日不欲饮食。麻黄(五分)、独活(四分)、细辛(二分)、黄芪(二分)、黄芩(三分)。以上五味,用水六升,煮取二升。分温三服,一服小汗,二服大汗。心热加大黄二分。腹满加枳实一枚。气逆加人参三分。悸加牡蛎三分。渴加栝蒌根三分。先有寒,加附子一枚。(分字当作去声读)。
按语:此方治疗风入营卫肢节之间,扰乱既久,证显烦热恶寒不食,可知邪盛正虚。其用麻黄为君药,是因为麻黄能通阳气而开痹,所以痹非得汗不开。然而内虚应当顾虑,须用人参、黄芪以佐助之。而虚复有寒热之不同,虚热则用黄芩,虚寒则加附子,这就是仲景所以深取之的原因。
《近效方》白术附子汤:治疗风虚,头重眩苦极,不知食味。暖肌补中益精气。白术(二两)、附子(一枚半,炮去皮脐)、甘草(一两,炙)。以上三味锉碎。每五钱,生姜五片,枣一枚,水一盏半,煎七分,去滓服。
按语:此方治疗肾气空虚之人,外风入肾,恰似乌洞之中,阴风惨惨,昼夜不息。风挟肾中浊阴之气,厥逆上攻,其头间重眩之苦,至极难耐。兼以胃气亦虚,不知食味。所以方中全不用风门药,只用附子暖其水藏,白术、甘草暖其土藏。水土一暖,则浊阴之气,尽趋于下,而头苦重眩,及不知食味之证除矣。试观冬月井中水暖,土中气暖。其阴浊之气,尚且不能出于地,岂更能加于天乎。制方之义,可谓精矣。这就是之所以用之而获近效的原因。
史国公浸酒方:治疗诸风五痹,左瘫右痪,口眼歪斜,四肢疼痛。七十二般风,二十四般气,其效不可尽述。当归、虎胫骨(酥油炙)、川羌活、川萆薢、防风(各二两)、秦艽(四两)、鳖甲(一两,醋炙)、川牛膝(酒浸)、松节、晚蚕沙(炒,各二两)、枸杞子(五两)、干茄根(八两,饭上蒸熟)、苍耳子(四两,炒捶碎)。以上十三味,用无灰酒一大坛,将绢袋盛药,悬于酒内,密封固。候十四日后,开坛取酒,取时不可面对坛口,恐药气冲人面目。每饮一盏,勿令药力断绝。饮尽病痊,将药渣晒为末,米糊丸,梧桐子大。每服八十丸,空腹温酒下,忌食动风辛热之物,此药可以常服。
按语:治风治痹,药酒方亦不可少,此方平中之奇,功效颇着。后有增入白花蛇一条者,此又以肠胃试其毒,吾所不取。
One jujube, one stalk of green onion, decocted until reduced to 80% volume, taken after meals.
Qingxin San (Clear Heart Powder): This is Liangge San (Cool the Diaphragm Decoction) with added Huanglian (Coptidis Rhizoma). Take one and a half cups of water, add ten leaves of Zhuye (Bambusae Folium), decoct until reduced to 80% volume, strain, add a small amount of honey, and take warm. If headache occurs, add Chuanxiong (Ligustici Chuanxiong Rhizoma), Fangfeng (Saposhnikoviae Radix), and Shigao (Gypsum Fibrosum).
Commentary: In stroke syndrome, the general trend involves Wind-Wood combining with Ministerial Fire and Sovereign Fire to cause disease, often manifesting as heat in the diaphragm. Ancient formulas use Liangge San most frequently, not limited to just the two mentioned above. For example, Zhuanshe Gao (Tongue-Turning Paste) uses Liangge San plus Shichangpu (Acori Tatarinowii Rhizoma) and Yuanzhi (Polygalae Radix). Huoming Jindan (Life-Saving Golden Pill) uses Liangge San plus Qingdai (Indigo Naturalis) and Lan Gen (Isatidis Radix). Generally, because the momentum of Wind-Fire flares upward, the chest and diaphragm are like a prairie fire; thus, the functions of clearing the heart, calming the spirit, turning the tongue, and saving life rely largely on the cooling power of Liangge San. One should not lightly disparage it by using methods that merely promote intestinal unblocking.
Dihuang Yinzi (Rehmannia Decoction, from *Xuanming Lunfang*): Treats aphasia (loss of speech due to tongue paralysis) where the patient cannot speak, and foot paralysis where the legs cannot be used, caused by Kidney deficiency, Qi rebellion, and failure of Qi to reach below the tongue. Shudihuang (Rehmanniae Radix Preparata), Bajitian (Morindae Officinalis Radix) [decentered], Shanzhuyu (Corni Fructus), Rongrong (Cynomorii Herba) [soaked in wine and baked], Shihu (Dendrobii Caulis), Fuzi (Aconiti Lateralis Radix Preparata), Wuweizi (Schisandrae Fructus), Baifuling (Poria), Shichangpu (Acori Tatarinowii Rhizoma), Yuanzhi (Polygalae Radix) [bone removed], Guanzi Gui (Cinnamomi Cortex), Maidong (Ophiopogonis Radix) [equal parts]. Grind all into fine powder. Each dose takes three qian. Add five slices of Shengjiang (Zingiberis Rhizoma Recens), one jujube, seven leaves of Bohe (Menthae Haplocalycis Herba), and one and a half cups of water. Decoct until reduced to 80% volume. Take at any time.
Commentary: Kidney Qi rebelling and failing to reach below the tongue indicates that the Zhenqi (True Qi) of the viscera fails to nourish the root of the tongue. Meanwhile, its turbid Yin qi must obstruct horizontally between the throat and tongue, making swallowing and expectoration extremely difficult, with severe coma. This is unlike simple aphasia, which can be treated slowly. The Fuzi, Rougui (Cinnamomi Ramulus), Bajitian, and Rongrong in this formula were originally intended to expel turbid Yin. Users of this formula must not arbitrarily remove these herbs based on personal prejudice.
Baisanzi (White Scattering Powder) from *San Yin Fang*: Treats Liver-Kidney wind-stroke, where saliva floods and obstructs causing aphasia, vomiting of phlegm foam, dizziness of head and eyes. Also treats Yin-pattern Cold Damage with deep-hidden six pulses, and Huoluan (cholera-like disorder) with vomiting and diarrhea, or dribbling urinary obstruction. Da Fuzi (Aconiti Radix) [skin and umbilicus removed, raw], Huashi (Hualshi) [from Guifu, each 5 qian], Zhibanxia (Pinelliae Rhizoma Preparatum) [7.5 qian]. Grind all into fine powder. Each dose takes 2 qian, with two cups of water, seven slices of Shengjiang, and half a spoonful of honey. Decoct until reduced to 70% volume. Take cold on an empty stomach.
Commentary: This formula is excellent but does not explicitly explain its rationale. Citing concurrent treatments for Yin-pattern Cold Damage and Huoluan makes it seem vague rather than precise. This actually corresponds to the "turbid Yin counterflow" syndrome discussed previously by Yu Chang. It arises from Liver-Kidney Qi rebelling upward. Thus, saliva obstructs, aphasia occurs, phlegm foam is hard to expectorate, and the head feels heavy and dizzy. Therefore, only Fuzi can drive out turbid Yin, yet turbid Yin naturally flows downward through the lower orifices. Since turbid Yin has rebelled upward, the lower orifices must be blocked. Hence, the heaviness of Huashi is used to guide turbid Yin back down through the anterior yin orifice (urethra). This also leverages the potent penetrating force of Fuzi to facilitate drainage. Furthermore, fearing that turbid Yin might linger with damp-phlegm in the chest, Banxia is added to open phlegm obstructions. Only then can saliva and turbid Yin descend together. Such profound meaning exists in the formula, yet it is not clearly taught to later generations, which is truly a pity.
Er Dan Wan (Two Dan Pills): Treats forgetfulness caused by Wind pathogen, nourishes the spirit, stabilizes will, harmonizes blood, calms the heart-mind internally, beautifies the skin externally, and promotes sleep. Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Shudihuang, Tianmendong (Asparagi Radix) [decentered, each 1.5 liang], Zhusha (Cinnabar), Renshen (Ginseng Radix et Rhizoma), Shichangpu, Yuanzhi [each 5 qian], Fushen (Poria cum Radix), Maidong, Gancao (Glycyrrhizae Radix et Rhizoma) [each 1 liang]. Grind all into fine powder, refine honey to make pills the size of paulownia seeds. Each dose takes 50 to 100 pills, taken on an empty stomach before meals.
Commentary: In stroke syndrome, if the Heart-Mind becomes deficient, the whole body loses its master, and Wind pathogen disturbs without being able to expel it. This formula calms the spirit, benefits deficiency, nourishes blood, clears heat, and extinguishes wind. Taking it leads to peaceful sleep, demonstrating its efficacy. It is rumored to be taken with Yufeng Tang (Wind-Expanding Decoction), which completely misses the original intent of the prescription.
[Missing Character] Wan: Treats Wind-Qi affecting Kidney and Liver, causing limb numbness and paralysis, bone pain, weak knees, and various rheumatic sores. Use [Missing Character] grass, harvested on the 5th day of the 5th lunar month or the 6th day of the 6th lunar month. Collect leaves, steam nine times, and sun-dry nine times. For steaming, sprinkle with wine and honey, dry, grind to powder, and make honey pills the size of paulownia seeds. Take 100 pills with wine on an empty stomach.
Commentary: "[Missing Character]" refers to the pig, whose earthly branch is Hai. This marks the beginning of Wood generating Wind, hence its leaves are used to treat Wind diseases. For syndromes of Wind generated within the Kidney storehouse, this formula is most effective. Cheng Ne, Military Governor of Jiangning, and Zhang Yong, Prefect of Yizhou, both presented this formula to the Emperor. Cheng Ne’s brother suffered from stroke for five years; a Daoist transmitted this formula, and he recovered. Zhang Yong found a stele while digging, followed the prescription for a thousand doses, resulting in black hair and vigorous strength. He treated Luo Shouyi, a military officer who fell from a horse due to stroke, lost his voice, and could not speak; ten doses cured him immediately. Monk Zhiyan, aged 70, suffered from hemiplegia, facial deviation, and salivation; ten doses cured him. Many have succeeded with this formula古今, yet few know the reason. Its miracle lies in its inferior odor, which resonates with the fishy smell of the Kidneys (Same Qi Attracts), allowing it to enter the Kidney and assist in driving out Yin-Wind. Since formulas treating Kidney-Wind are rare, this pill is recorded here. Combined with the previous Tianma Wan, it elucidates the principle.
Heixi Dan (Black Tin Pill): Treats exhaustion of True Yuan, insecure Yang Qi, counterflow of Yin Qi, disharmony of the Triple Burner, stabbing pain from cold qi, loss of taste, heavy waist and back, chronic cold bladder, frequent nocturia. In women, chronic cold in the Blood Sea, red and white leukorrhea. Also treats Yin-pattern Yin-Toxin, cold limbs, unconsciousness. For emergencies, swallow 100 pills with Jujube Decoction. It quickly restores Yang. This herb greatly regulates the ascending and descending of Yin and Yang, tonifies deficiency, benefits Yuan, settles phlegm, removes dampness, and breaks masses. Chenxiang (Aquilariae Lignum Resinatum), Hubalu (Trigonellae Semen) [wine-soaked and fried], Fuzi [prepared], Yangqishi (Yangqishi) [finely ground and water-washed, each 1 liang], Rougui [half liang], Poguzhi (Psoraleae Fructus), Bohuixiang (Foeniculi Fructus), Roudoukou (Myristicae Semen) [baked in flour], Muxiang (Aucklandiae Radix), Jinlingzi (Meliosmae Fructus) [steamed, skin and core removed, each 1 liang], Liuhuang (Sulfur), Heixi (Plumbum) [purified, each 2 liang]. Use an iron cup or iron pot. Process according to standard methods to form Black Tin Sulfur Sand. Remove fire toxicity on the ground, grind extremely fine. Mix with other finely ground powders uniformly. Grind from morning to night until it shines black. Make pills with wine paste, size of paulownia seeds. Dry in shade, rub in cloth bags until glossy. Each dose takes 40 pills, taken on an empty stomach with Salt-Ginger Decoction or Jujube Decoction. Women use Mugwort-Jujube Decoction. Emergency doses take 100 pills.
Commentary: This formula uses Heixi (Water Essence) and Liuhuang (Fire Essence) to form Lingsha (Spirit Cinnabar) as the Sovereign herb. Various aromatic, drying, pure-Yang herbs serve as Ministers. Jinlingzi (bitter-cold) serves as an Adjuvant/Counter-agent. Chenxiang guides to the deepest Yin level as the Envoy. For emergencies involving Yin-Fire counterflow, sudden collapse of True Yang, wheezing, and rattling phlegm, there is no other method besides this drug. I always carry it in a small pouch to avoid delay in emergencies and to let my body's Yuan Qi warm and nourish the medicine, ensuring its efficacy. Although unrelated to smallpox treatment, when excessive attacking agents (like Wugong, Chuanshanjia, Sangchong) cause swelling like gourds, wet ulcers, and rising Yang with wheezing—causing pediatricians to flee—I administer this pill to lead Yang Qi down into Yin, followed by large doses of Dihuang Tang to severely tonify Yin and retain True Yang. The skin heat clears, swelling subsides, and ulcers dry into crusts. Countless lives have been saved this way. I append this to broaden practitioners' understanding.
Sanjian Erxiang Tang (Three Jian Two Fragrance Decoction): Treats male and female wind-stroke with deficient six pulses, stiff tongue and aphasia, abundant phlegm-saliva, dementia-like spirit, and hemiplegia. Such cases must not attack Wind; they must only tonify deficiency. Tianxiong (Aconiti Kusnezoffii Radix), Fuzi, Wutou (Aconiti Radix) [each 2 qian, skin and umbilicus removed, raw], Chenxiang, Muxiang [each 1 qian, water-ground juice]. Divide into two doses. Each dose uses one and a half cups of water, ten slices of Shengjiang, decoct to 70%. Take before meals.
Commentary: This formula uses raw Tianxiong, Fuzi, and Wutou simultaneously without processing, fearing that processed herbs would bind the hands of Meng Ben (a legendary strongman) and prevent full exertion. It is necessary because the patient suffers from violent Yin-Evil burying slight Yang. Thus, pure-Yang, Yin-free herbs ("Three Generals of One House") led by two fragrant herbs pierce through encirclements to expel extreme Yin and save dying Yang. Though the formula exists, few can use it correctly. The text claims it treats stroke with deficient pulses and says "do not attack wind, only tonify deficiency." This is dreaming within a dream and misleads people greatly. One must know that the pulse here is minute and near-extinction; describing it merely as "deficient" is vague. The formula is fierce, toxic, and harsh; describing it as "tonifying deficiency" implies mildness, which is incorrect. This is how medical texts lead the blind leading the blind.
Xingfu San (Star and Aconite Powder): Treats stroke where the patient can speak, mouth is not deviated, but limbs are dragged/pulled. Nanxing (Arisaematis Rhizoma Preparatum), Banxia [prepared], Fuling, Jiangcan (Bombyx Batryticatus) [fried], Chuanwu (Aconiti Radix) [skin and umbilicus removed], Renshen, Hei Fuzi, Baifuzi (Saussureae Radix) [each 8 fen]. Use two cups of water, decoct to 80%. Take hot after meals. Recovery comes with sweating.
Commentary: This is the main drug for treating Deficiency-Cold-Wind-Phlegm. Wind deficiency causes blazing heat; Phlegm-cold causes obstruction, blocking Spleen Yang circulation, causing limb dragging. Taking this formula hot assists Spleen Yang, preventing Deficiency-Cold-Wind-Phlegm from knotting. Sweating allows Wind to exit outward and Phlegm to exit downward, resolving the disease. Usually, Aconite drugs are taken warm/cold ("Heat used via Cold"). Here, Wutou, Fuzi, and Renshen are purely warming/tonifying with no dispersing herbs. Without hot administration, how could sweating occur? Admirable! Admirable!
Xuming Tang (Continuing Life Decoction) from *Gu Jin Lu Yan*: Treats stroke fei (paralysis), inability to control the body, aphasia, confusion/unawareness of pain, or spasms preventing turning over. Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Danggui (Angelicae Sinensis Radix), Renshen, Shigao, Ganjiang (Zingiberis Rhizoma), Gancao [each 3 liang], Xiong (Chuanxiong), Xingren (Armeniacae Semen Amarum) [40 pieces]. Nine ingredients. Use one dou of water, boil to four sheng. Take one sheng warm. Should produce slight sweat. Lie flat, support back, sit leaning on table. Sweat means recovery. If no sweat, take again. No restrictions. Avoid wind. Also treats inability to lie flat, cough/wheezing, facial edema.
Commentary: Combined with the following two formulas, the intent of *Jin Gui Yao Lue* is explained herein. Studying this formula and symptoms reveals that Fei is another name for Bi (Obstruction). Wind enters and obstructs Ying and Wei, causing inability to control the body, aphasia, confusion, or spasms. Ying and Wei can be deficient or excess. Deficiency comes from internal injury; Excess from external contraction. This formula treats External Contraction obstructing Ying and Wei, hence slight sweat is prized. It modifies Yuebi Tang by adding Xiong and Danggui to nourish blood, and Renshen to boost Qi. For Internal Injury causing Ying-Wei Bi, adding slight wind-dispersing herbs to blood/Qi tonics would be the approach.
Sanhuang Tang (Three Yellow Decoction) from *Qian Jin Fang*: Treats stroke with limb spasms, joint pain, vexation, heat, mental chaos, aversion to cold, and days of anorexia. Mahuang [5 fen], Duhuo (Angelicae Pubescentis Radix) [4 fen], Xixin (Asari Radix et Rhizoma) [2 fen], Huangqi (Astragali Radix) [2 fen], Huangqin (Scutellariae Radix) [3 fen]. Five ingredients. Use six sheng of water, boil to two sheng. Divide into three warm doses. First dose: slight sweat. Second dose: heavy sweat. Heart heat: add Dahuang [2 fen]. Abdominal fullness: add Zhishi [one piece]. Qi rebellion: add Renshen [3 fen]. Palpitations: add Muli [3 fen]. Thirst: add Gualougen [3 fen]. Pre-existing cold: add Fuzi [one piece]. (Read "fen" as departing tone).
Commentary: This treats Wind entering Ying-Wei and joints, disturbing for a long time, showing vexation, heat, cold, and anorexia, indicating Excess Evil and Deficient Righteousness. Mahuang is Sovereign because it opens Yang Qi and resolves Bi; Bi requires sweat to open. However, internal deficiency must be considered, so Renshen and Huangqi assist. Deficiency varies by Heat/Cold: Heat uses Huangqin, Cold adds Fuzi. This is why Zhongjing values it deeply.
Baizhu Fuzi Tang (Atractylodes Macrocephala and Aconite Decoction) from *Jin Xiao Fang*: Treats Wind-Deficiency, severe heavy dizziness/dizziness causing suffering, loss of taste. Warms muscles, tonifies Middle, benefits Jing and Qi. Baizhu (Atractylodis Macrocephalae Rhizoma) [2 liang], Fuzi [1.5 pieces, prepared, skin/umbilicus removed], Gancao [1 liang, honey-fried]. Three ingredients. Cut. Each 5 qian, with five slices of Shengjiang, one jujube, one and a half cups of water. Decoct to 70%, strain, take.
Commentary: This treats those with empty Kidney Qi where External Wind enters the Kidney, like cold Yin wind blowing endlessly in a dark cave. Wind carries Kidney turbid Yin Qi, rebelling upward, causing unbearable heavy dizziness. Stomach Qi is also deficient, causing loss of taste. Thus, no Wind-expelling herbs are used. Only Fuzi warms the Water Storehouse, Baizhu and Gancao warm the Earth Storehouse. Once Water and Earth are warm, turbid Yin sinks downward, curing dizziness and anorexia. Observe winter well water and soil warmth; even Yin-turbid qi cannot rise from earth, let alone heaven. The formulation logic is exquisite. This explains why it yields "near effects."
Shi Guogong Infused Wine Formula: Treats various Winds and Five Bi, left/right hemiplegia, facial deviation, limb pain. Effects on 72 types of Wind and 24 types of Qi cannot be fully described. Danggui, Hu Jinggu (Tigriopis Tibia) [burnt with butter], Chuan Qianghuo (Notopterygii Rhizoma et Radix), Chuan Bixie (Dioscoreae Hypoglaucae Rhizoma), Fangfeng [each 2 liang], Qinjiao (Gentianae Macrophyllae Radix) [4 liang], Biejia (Testudinis Carapax et Plastrum) [1 liang, vinegar-fried], Chuan Niuxi (Achyranthis Bidentatae Radix) [wine-soaked], Songjie (Pinus Massoniana Node), Wancansha (Bombyx Cacumen) [fried, each 2 liang], Gouqizi (Lycii Fructus) [5 liang], Gan Qiegen (Solanis Lycopersici Radix) [8 liang, steamed over rice], Cang'erzi (Xanthii Fructus) [4 liang, fried and crushed]. Thirteen ingredients. Use one large jar of non-grain alcohol. Place herbs in silk bag, suspend in wine, seal tightly. After 14 days, open and drink. Do not face the jar opening to avoid fumes hitting eyes/face. Drink one cup per time, do not let medicinal power cease. When drunk and cured, dry residue, grind to powder, make pills with rice paste, paulownia seed size. Take 80 pills on empty stomach with warm wine. Avoid Wind-moving spicy/hot foods. Can be taken regularly.
Commentary: For treating Wind and Bi, medicinal wines are indispensable. This is a wonder among mild formulas with notable efficacy. Later additions included Baihua She (Bungarus multicinctus); I reject this as testing toxicity on the gut.