金溪令净涵臧公尊堂太夫人，以季春眉寿，连看戏文二十余本，且多食鱼腥虾蟹，偶发
寒热
，三日不退。第四日，左耳前后及颊车皆红肿。第五日，右边亦肿。第六日，肿及满头，
红大如斗，眼合无缝，昏愦不知人事，谵语若有邪崇，粒米不进者八日。举家惊惶，逆予为
治。诊其脉，六部皆洪长而数。予曰∶此大头疫也。即以贯众、石膏各六钱，柴胡、葛根各
三钱，赤芍药
、天花粉各二钱，甘草一钱，黑豆四十九粒，水煎服之。日进二帖，脉始减半，第九日，方进
粥饮半盅。前药除石膏，又四帖而安。是役也，人皆为予危之，谓八十之尊年，八日之绝粒
，头大如斗，体热如燔炭，昏愦谵语，乃不去而治，何冥行不知止如此!而其婿闵怀海亦言
病势如此，吾心亦危疑，见先生安闲而甘寝食，赖以少慰。予曰∶此疾为阳明、少阳二经热
壅而然。夫阳明多气多血之经也，以高年故不敢用硝黄，惟投以轻清解散之剂，使因微汗而解
。症脉相对，虽重可生。假如人言以高年病危而弃不治，岂惟非医之存心，于病家相托之意
亦孤矣，可乎哉？
丙申夏，见所潘公谒予于海阳邑邸，时霪浃旬，邑市水涨。公至，予惊问曰∶公贵倨也
者，
何堪此？公曰∶与君间者阔矣，且先君服阕，秋当北上，不卜补任南下，谒求一诊，他何计？
予究何疾。公曰∶无，第年甫逾疆，微觉阳萎。次早诊毕，语其随行俞金二字曰∶公脉上盛
下虚，上盛为痰与火，下虚为精元弱，切宜戒色慎怒，剂宜清上补下。不然，三年内恐中风
不免。盖由痰生热，热生风也，谨之识之，乃为立方。别去，公亦未暇制服。公次年八月，
往返武林，不无劳怒，又届中秋，连宵酒色。平常色后，辍用鹿角胶三钱，人参一钱，酒送
下。以连宵有犯，乃用鹿角胶五钱，人参三钱，空心服之，十七日薄暮，偶与社友谈诗，
筵
间，左手陡然颤动，把捉不住，随归房，左手重不能举，十八日早，左边半体手足皆不为用
矣。亟令人逆予，予适在前丘吴宅，及至，公惊喜交集曰∶君何先见若此也，先少保患在左
体不遂者，三年而殁，不佞今亦左体，其风水致然欤？第先少保年七十余，不佞四十有七；
先少保不能遇先生，不佞赖有先生，或可企无恙也。予始观面色赤，口微 向右，唇麻，手
足拽，已成瘫痪。诊其脉，左弦大，右滑大。先用乌药顺气散一帖，服后昏睡半日，醒觉
面更加赤， 也稍加，知痰盛使然。即以二陈汤加全蝎、僵蚕、天麻、黄芩、石菖蒲、红花
、秦艽、水煎。临服加竹沥一小酒杯，生姜汁五茶匙，一日两进，晚更与活络丹。服至第六
日
，手指梢头略能运动，足可倚棹而立。予喜曰∶机动矣!改用归芍六君子汤，加红花、钩藤
、天麻、竹沥、姜汁，服二十帖，行可二十步矣，手指先麻木不知痛痒，至是能执物。继用
天麻丸，兼服全鹿丸，调理百日，病去十之九，次年二月，北上补任永清。公以病后，能戒
色断酒，自知培养，故药功获奏。此症予历治历效者，良由先为疏通经络，活血调气，然后
以补剂收功。惟经络疏通，宿痰磨去，新痰不生，何疾不瘳。此治类中风之法也。
金溪县令净涵臧公的母亲太夫人，在季春时节庆祝寿辰，连续看了二十多本戏曲，并且多吃了鱼腥虾蟹等食物，偶然出现了寒热交替的症状，三天没有退去。第四天，左耳前后及颊车穴周围都红肿。第五天，右边也肿了。第六天，肿胀蔓延到整个头部，红肿大如斗，眼睛紧闭无缝隙，神志昏迷不省人事，胡言乱语好像有鬼神作祟，八天粒米未进。全家惊慌失措，急忙请我诊治。诊察其脉象，六部脉皆洪大、长而数。我说：这是大头疫（一种以头面焮肿为特征的急性传染病）。立即使用贯众、石膏各六钱，柴胡、葛根各三钱，赤芍药、天花粉各二钱，甘草一钱，黑豆四十九粒，水煎服。每天服用两帖，脉象才开始减半，到了第九天，才喝下半盅粥汤。去掉前药中的石膏，又服四帖后病情安定。这场病中，大家都为我感到危险，认为八十高龄，绝食八天，头大如斗，身体热得像燃烧的炭火，神志昏迷胡言乱语，还不离开现场去治疗，为何像盲人走路不知道停止一样！而他的女婿闵怀海也说病情如此严重，我心里也感到担忧怀疑，但见先生安闲自在且饮食正常，依靠这点稍微得到安慰。我说：这种病是由于阳明经、少阳经两经热邪壅滞所致。阳明经是多气多血的经络，因为患者年事已高，不敢使用芒硝、大黄等峻下之品，只投以轻清解散的方剂，使通过微汗而解。症状与脉象相符，虽然病情重也可以治愈。假如人们说因为年老病危就放弃不治疗，这不仅是违背医生救人的初心，也辜负了病家托付的心意，怎么可以呢？
丙申年夏天，潘见所公在海阳县衙拜访我，当时连绵阴雨整整十天，县城集市水位上涨。潘公到来时，我惊讶地问：您身份尊贵傲慢，怎么能忍受这种环境？潘公说：与您分别已经很久了，而且先父守丧期满，秋天应当北上，不确定是否补任南下，特来拜见求我一诊，还有什么可计较的？我问是什么病。潘公说：没什么大病，只是年纪刚过五十，微微觉得阳痿。第二天早上诊脉完毕，对他的随行人员俞金（字）说：潘公脉象上盛下虚，上盛是痰与火，下虚是精元虚弱，务必戒除色欲、谨慎发怒，用药宜清上补下。不然，三年内恐怕难免中风。这是因为痰生热，热生风啊，要谨慎记住这一点，于是为他开立方剂。告别离去后，潘公也没来得及制作服用。次年八月，潘公往返于杭州，不免劳累愤怒，又正值中秋，连日饮酒女色。平常房事后，停用鹿角胶三钱、人参一钱，用酒送下。因为连日犯戒，于是使用鹿角胶五钱、人参三钱，空腹服用。十七日傍晚，偶然与社友谈诗，宴席间，左手突然颤抖，控制不住，随即回房，左手沉重不能举起，十八日早上，左边半身手足都不能使用了。急忙派人来接我，我当时恰好在前面丘吴宅，等到赶到，潘公惊喜交集地说：您怎么预知得这么准？先少保患左侧肢体不遂，三年后去世，我现在也是左侧肢体，难道是风水导致的吗？只是先少保七十多岁，我四十七岁；先少保没能遇到先生，我有幸有先生，或许可以期望无恙吧。我开始观察面色红赤，口角轻微向右歪斜，嘴唇麻木，手脚牵引拘急，已成瘫痪。诊其脉象，左侧弦大，右侧滑大。先用乌药顺气散一帖，服后昏睡半天，醒来觉得面部更加红赤，口歪稍加重，知道是痰盛所致。立即使用二陈汤加全蝎、僵蚕、天麻、黄芩、石菖蒲、红花、秦艽，水煎。临服时加入竹沥一小酒杯，生姜汁五茶匙，一天两次服用，晚上再给予活络丹。服用到第六天，手指梢头略能运动，脚可以扶着船桨站立。我高兴地说：机转动了！改用归芍六君子汤，加红花、钩藤、天麻、竹沥、姜汁，服用二十帖，可以行走二十步了，手指先前麻木不知痛痒，到现在能执物。继用天麻丸，兼服全鹿丸，调理百日，病去十分之九，次年二月，北上补任永清。潘公因病后，能戒色断酒，自知调养，所以药效得以奏效。这个病症我屡次治疗屡次有效，确实是因为先疏通经络，活血调气，然后用补剂收功。只有经络疏通，宿痰磨去，新痰不生，什么病治不好呢。这是治疗类中风的方法。
Zang Gong Jinghan, the magistrate of Jinxian County, brought his mother, the Lady Tai, to me for treatment. During the late spring season, while celebrating her birthday, she had watched over twenty plays and consumed a large amount of fish, shrimp, and crab. She suddenly developed alternating chills and fever (Han Re) that did not subside after three days. On the fourth day, the areas around the left ear and the Jiache acupoint became red and swollen. By the fifth day, the right side also swelled. On the sixth day, the swelling spread to the entire head; it was as red and large as a dou (a unit of volume), with eyes closed so tightly there were no gaps. She fell into a coma, lost consciousness, spoke deliriously as if possessed by evil spirits, and had eaten nothing for eight days. The whole family was panicked and urgently summoned me. Upon palpating her pulse, all six positions were surging, long, and rapid. I said: This is Datou Yi (Big Head Epidemic). I immediately prescribed Guanzhong (Scrophulariae Radix) and Shigao (Gypsum Fibrosum), each 6 qian; Chaihu (Bupleuri Radix) and Gegen (Puerariae Lobatae Radix), each 3 qian; Chi Shaoyao (Paeoniae Radix Rubra) and Tianhuafen (Trichosanthis Radix), each 2 qian; Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian; and 49 Heidou (Sojae Semen Nigrum). Decocted in water and taken orally. After taking two doses per day, the pulse began to halve in force. By the ninth day, she could only drink half a cup of thin porridge. Removing the Shigao from the previous prescription, she took four more doses before stabilizing. During this illness, everyone considered my situation dangerous, saying that at eighty years old, having fasted for eight days, with a head swollen like a dou, body heat like burning charcoal, and delirious coma, one should not stay and treat but leave immediately. Why act blindly without stopping! Her son-in-law, Min Huaihai, also said that given the severity of the illness, he too felt anxious and doubtful. However, seeing Mr. Sun acting leisurely and sleeping and eating well, he found some comfort. I replied: This disease is caused by the accumulation of heat in the Yangming and Shaoyang meridians. The Yangming meridian is rich in qi and blood. Due to her advanced age, I dared not use harsh purgatives like Xiaokunxiao (Natrii Sulfas) or Dahuang (Rhei Radix et Rhizoma). Instead, I used light and clear dispersing agents to resolve the condition through slight sweating. When symptoms and pulse correspond, even severe cases can be cured. If people argue that an elderly patient in critical condition should be abandoned and untreated, this would not only violate the physician's intent to save lives but also betray the trust placed in us by the family. How could this be acceptable?
In the summer of Bing Shen year, Pan Jiansuo visited me at the Haiyang county residence. It had rained continuously for ten days, causing floodwaters in the market area. When Mr. Pan arrived, I asked in surprise: You are of noble status; how can you endure this? Mr. Pan replied: It has been a long time since we last met. My father's mourning period has ended, and I am scheduled to travel north in autumn, though my reassignment south is uncertain. I came specifically to seek your diagnosis; what else matters? I asked about his ailment. He said: Nothing serious, merely feeling slight impotence (Yang Wei) now that I have just passed fifty. The next morning, after finishing the consultation, I told his attendant, Yu Jin: Your master's pulse is excess above and deficiency below. Excess above indicates phlegm and fire; deficiency below indicates weak essence and yuan qi. He must strictly abstain from sexual activity and guard against anger. The treatment should clear the upper and tonify the lower. Otherwise, within three years, stroke (Zhong Feng) is inevitable. This is because phlegm generates heat, and heat generates wind. Please remember this carefully. I then formulated a prescription. After parting, Mr. Pan did not have the time to prepare the medicine. In August of the following year, Mr. Pan traveled back and forth to Wulin (Hangzhou), experiencing fatigue and anger. Coinciding with the Mid-Autumn Festival, he indulged in wine and women for consecutive nights. Normally, after sexual intercourse, he would take Lujiaojiao (Colla Cornu Cervi Gelatinum) 3 qian and Renshen (Ginseng Radix) 1 qian, washed down with wine. Because he violated abstinence repeatedly, he increased the dosage to Lujiaojiao 5 qian and Renshen 3 qian, taken on an empty stomach. On the evening of the 17th, while chatting poetry with friends at a banquet, his left hand suddenly trembled uncontrollably. Returning to his room, his left arm felt heavy and could not be lifted. By the morning of the 18th, the left side of his body, both hands and feet, were paralyzed. He urgently sent someone to fetch me. I happened to be at the Wu residence in Qianqiu. Upon my arrival, Mr. Pan was filled with surprise and joy, saying: How could you foresee this so accurately? Former Vice Minister suffered from paralysis on the left side and died three years later. Now I suffer from the same on the left side. Is it due to wind and water factors? However, the former Vice Minister was over seventy, whereas I am only forty-seven. The former Vice Minister did not meet you, but I am fortunate to have you; perhaps I can hope for recovery. Upon examination, his face was red, the mouth deviated slightly to the right, lips were numb, and limbs were drawn and stiff, indicating established paralysis. His pulse was wiry and large on the left, and slippery and large on the right. I first administered Yowao Shunqi San (Aucklandiae Radix Powder for Smooth Qi) one dose. After taking it, he slept deeply for half a day. Upon waking, his face appeared redder, and the mouth deviation worsened, confirming that excessive phlegm was the cause. I immediately prescribed Erchen Tang (Two-Cured Decoction) modified with Quanxie (Scorpio), Jiangcan (Bombyx Batryticatus), Tianma (Gastrodiae Rhizoma), Huangqin (Scutellariae Radix), Shichangpu (Acori Tatarinowii Rhizoma), Honghua (Carthami Flos), and Qinjiao (Gentianae Macrophyllae Radix), decocted in water. Just before administration, I added one small wine glass of Zhuli (Bambusae Caulis in Taenia) and five teaspoons of Shengjiangzhi (Zingiberis Rhizoma Recens Juice). He took this twice daily. At night, he was also given Huoluo Dan (Meridian-Activating Pill). By the sixth day of medication, the tips of his fingers could move slightly, and he could stand holding onto an oar. I rejoiced, saying: The mechanism has turned! I changed the prescription to Guishao Liujunzi Tang (Angelica Sinensis and Paeonia lactiflora Six-Gentlemen Decoction), adding Honghua, Gouteng (Uncariae Ramulus cum Uncis), Tianma, Zhuli, and Shengjiangzhi. After twenty doses, he could walk about twenty steps. His fingers, previously numb and insensitive to pain or itch, could now grasp objects. Subsequently, he took Tianma Wan (Gastrodia Pill) and Quanlu Wan (Whole Deer Pill) concurrently for one hundred days of regulation. Ninety percent of the illness was eliminated. In February of the next year, he traveled north to assume his post in Yongqing. Because Mr. Pan abstained from sex and alcohol after the illness and consciously nurtured his health, the medicinal effects were successful. This case demonstrates my consistent success in treating similar conditions. The key lies in first unblocking the meridians, invigorating blood, and regulating qi, followed by tonifying agents to conclude the treatment. Once the meridians are unblocked, old phlegm is ground away, and new phlegm does not form. What disease cannot be cured? This is the method for treating Lei Zhong Feng (Stroke-like Syndrome).