脉微而数。中风使然。风邪中人。六脉多沉伏。亦有脉随气奔。指下洪盛者。夹寒则脉
带浮迟。夹暑则脉虚。夹湿则脉浮涩。大法浮迟者吉。急疾大数者凶。
风者百病之长也。即内经所谓偏枯、风痱、风懿、风痹是也。而有中腑、中脏、中血脉
、中
经络之分焉。夫中腑者为在表。中脏者为在里。中血脉、中经络俱为在中。在表者宜微汗
在里者宜微下。在中者宜调荣。中腑者。多着四肢。手足拘急不仁。恶风寒。为在表也。
其治多易。用疏风汤之类。中脏者。多滞九窍。唇缓失音。耳聋。目瞀。二便闭涩。为在
里
也。其治多难。用滋润汤之类。中血脉者。外无六经之形症。内无便溺之阻隔。肢不能举。
口不能言。为在中也。用养荣汤之类。中经络者。则口眼 斜。亦在中也。用复正汤之类。
其间又有血气之分焉。血虚而中者。由阴血虚而贼风袭之。则左半身不遂。用四物汤。加钩
藤、竹沥、姜汁。以补血之剂为主。气虚而中者。由元气虚而贼风袭之。则右半身不遂。用
六君子汤。加钩藤、竹沥、姜汁。以补气之剂为主。气血俱虚而中者。则左右手足皆不遂。
用八珍汤。加钩藤、竹沥、姜汁。或用上池饮。乃治诸风左瘫右痪之神方也。然则类中风者
如中寒、中暑、中湿、中火、中气、食厥、劳伤、房劳等症。如中于寒者。谓冬月卒中寒
气。昏冒口噤。肢挛恶寒。脉浮紧也。用理中汤之类。中于暑者。谓夏月卒暴炎暑。昏冒痿
厥。吐泻喘满。用十味香薷饮之类。中于湿者。乃丹溪所谓东南之人。多因湿土生痰。痰生
热。热生风也。用清燥汤之类。加竹沥、姜汁。中于火者。河间所谓肝木之风内中。非六淫
之邪外侵。良由五志过极。火盛水衰。气热怫郁。昏冒而作也。用六味地黄丸、四君子汤之
类。内有恚怒伤肝。火动上炎者。用小柴胡汤之类。中于气者。由七情过极。气厥昏冒。或
牙关紧闭。急用苏合香丸。或藿香正气散之类。若误作风治者死也。食厥者。过于饮食。胃
气自伤。不能运化。故昏冒也。用六君子汤加木香之类。劳伤者。过于劳役。耗损元气脾胃
虚
衰。不任风寒。故昏冒也。用补中益气汤之类。伤于房劳者。因肾虚精耗。气不归元。故昏
冒也。用六味地黄丸之类。此皆类中风也。盖内经主于风。河间主于火。东垣主于气。丹溪
主于湿。而为暴病暴死之症。类中风。非真中风也。治者详之。有卒中昏冒。口眼 斜。痰
气上壅。咽喉有声。六脉沉伏。此真气虚而风邪所乘。用三生饮一两。加人参一两。煎服即
苏。若遗尿手撒。口开鼻鼾者不治。用前药亦有得生者。是乃行经络祛寒痰之药。有斩关夺
旗之功。每服必用人参少许。以祛其邪。而补助真气。否则不收效矣。有因虚火与湿。痰涎
壅盛。口眼 斜。不能言语。牙关紧闭。昏倒不知人事。将病患足大指中间。半甲半肉上。
并人中。各重掐一下至体。即用夺命通关散搐鼻。候有嚏可治。无嚏不治。如牙噤不开。用
乌梅肉揉和南星、细辛末。以中指蘸药擦牙。自开。随以蜜汤调夺命通关散二匙。即吐其痰。
以通经络。亦上涌意也。得嚏气转。即进摄生饮。或清热导痰汤之类。皆效。人事稍醒。关
节动活。且先以理气为急。中后气未尽顺。痰未尽消。调理之剂。惟当以藿香正气散。加南
星、木香、当归、防风。一二剂之后。次随症而调之。予观古人之方。多用攻击之剂。施于
北
方风土刚劲之人。间或可也。用于南方风土柔弱之人。恐难当耳。予约补古人之缺略。以备
天下之通宜。若天地之南北。人身之虚实。固有不同。其男子妇人。大略相似。学人当变通
而治之。慎毋胶柱以调瑟也。
理中汤（见中寒） 十味香薷饮（见中暑） 清燥汤（见痿 ） 四君子汤（见补益）
\x小柴胡
脉象微细而数，这是中风导致的。风邪侵袭人体，六部脉象多呈现沉伏之象；也有因气机逆乱奔涌，导致指下感觉洪大盛实的情况。若兼夹寒邪，则脉象带浮迟；兼夹暑邪，则脉象虚软；兼夹湿邪，则脉象浮涩。治疗的大法中，脉象浮迟者预后较好，脉象急疾大数者预后凶险。
风是百病之长，即《内经》所说的偏枯、风痱、风懿、风痹就是这类病症。而有中腑、中脏、中血脉、中经络的区别。所谓中腑，病位在表；中脏，病位在里；中血脉和中经络，都属于病位在中。病在表的，适宜用微汗法解表；病在里的，适宜用微下法通里；病在中的，适宜调和营卫。中腑的病症，多表现在四肢，出现手足拘挛紧急、麻木不仁、怕风怕冷等症状，属于病在表，治疗相对容易，可用疏风汤之类的方剂。中脏的病症，多阻滞九窍，出现口唇松弛、失音、耳聋、视物模糊、大小便闭塞不通等症状，属于病在里，治疗较为困难，可用滋润汤之类的方剂。中血脉的病症，外部没有六经病的形证，内部没有二便阻隔的症状，肢体不能抬起，口不能言语，属于病在中，可用养荣汤之类的方剂。中经络的病症，则出现口眼歪斜，也属于病在中，可用复正汤之类的方剂。
其中又有血虚中风和气虚中风的区别。血虚而中风的，是由于阴血亏虚，贼风乘袭所致，表现为左半身不遂，用四物汤，加钩藤、竹沥、姜汁，以补血药剂为主。气虚而中风的，是由于元气虚弱，贼风乘袭所致，表现为右半身不遂，用六君子汤，加钩藤、竹沥、姜汁，以补气药剂为主。气血俱虚而中风的，则左右手足都不遂，用八珍汤，加钩藤、竹沥、姜汁，或者用上池饮，这是治疗各种风症导致左瘫右痪的神效方剂。
至于类中风，如中寒、中暑、中湿、中火、中气、食厥、劳伤、房劳等病症。如果是中于寒的，是指冬季突然遭受寒气侵袭，出现昏闷、牙关紧闭、肢体痉挛、怕冷、脉象浮紧等症状，用理中汤之类的方剂。中于暑的，是指夏季突然遭遇酷热，出现昏闷、痿软厥逆、呕吐腹泻、气喘胸满等症状，用十味香薷饮之类的方剂。中于湿的，正如丹溪所说，东南地区的人，多因湿气困脾生痰，痰生热，热生风，用清燥汤之类的方剂，加竹沥、姜汁。中于火的，正如河间所说，是肝木之风内中，并非六淫邪气外侵，确实是因为五志过极，火盛水衰，气热郁结，导致昏闷发作，用六味地黄丸、四君子汤之类的方剂。如果内有恚怒伤肝，火动上炎的，用小柴胡汤之类的方剂。中于气的，是由于七情过极，气机逆乱昏闷，或者牙关紧闭，急需使用苏合香丸，或藿香正气散之类的方剂。如果误当作真中风治疗，会导致死亡。食厥者，是因为饮食过度，损伤胃气，不能运化，所以昏闷，用六君子汤加木香之类的方剂。劳伤者，是因为过度劳累，耗损元气，脾胃虚衰，不能耐受风寒，所以昏闷，用补中益气汤之类的方剂。伤于房劳的，是因为肾虚精耗，气不归元，所以昏闷，用六味地黄丸之类的方剂。这些都属于类中风。大概《内经》主张治风，河间主张治火，东垣主张治气，丹溪主张治湿，这些都是导致暴病暴死的症状，称为类中风，并非真正的中风。医者应当仔细辨别。
如果有突然卒中昏闷、口眼歪斜、痰气上壅、咽喉有声、六脉沉伏的，这是真气虚弱而风邪乘虚而入，用三生饮一两，加人参一两，煎服后即可苏醒。如果出现遗尿、手撒、口开、鼻鼾的，属于不治之症，但使用前药也有救活的。这是行经络、祛寒痰的药物，有斩关夺旗的功效。每服必须用人参少许，以祛除邪气并补助真气，否则难以见效。
有的因为虚火与湿，痰涎壅盛，口眼歪斜，不能言语，牙关紧闭，昏倒不知人事，将病患足大指中间，半甲半肉处，以及人中穴，各重掐一下至身体反应，随即用夺命通关散搐鼻，候有喷嚏可治，无喷嚏不治。如果牙关紧闭不开，用乌梅肉揉和南星、细辛末，以中指蘸药擦牙，自会张开。随后用蜜汤调服夺命通关散两匙，即可吐出痰液，以通经络，这也是上涌吐痰的意思。得到喷嚏且气息回转，即可进服摄生饮，或清热导痰汤之类的方剂，都有效。人事稍醒，关节活动灵活，且先以理气为急务。中风后气未尽顺，痰未尽消，调理的药剂，只应当用藿香正气散，加南星、木香、当归、防风，一二剂之后，再随症状进行调理。
我观察古人的方子，多用攻伐之剂，施用于北方风土刚劲之人，偶尔还可以；用于南方风土柔弱之人，恐怕难以承受罢了。我约略补充古人的缺略，以备天下通用的适宜之法。既然天地南北不同，人身虚实固有差异，男子妇人，大体相似，学习者应当变通治疗，千万不要胶柱鼓瑟（死守成规）啊。
Pulse is faint and rapid. This is caused by wind stroke (Zhong Feng). When wind pathogen invades the human body, the six pulses are mostly deep and hidden; there are also cases where the pulse surges with qi, feeling full and vigorous under the fingers. If accompanied by cold, the pulse carries floating and slow characteristics; if accompanied by summerheat, the pulse is deficient; if accompanied by dampness, the pulse is floating and choppy. The general principle states that a floating and slow pulse indicates a favorable prognosis, while a rapid and large pulse indicates an unfavorable one.
Wind is the chief of all diseases, referring to what is mentioned in the *Neijing* as hemiplegia (Pian Ku), flaccid paralysis (Feng Fei), aphasia (Feng Yi), and wind bi (Feng Bi). These conditions are further classified into invasion of the fu organs (Zhong Fu), invasion of the zang organs (Zhong Zang), invasion of the vessels and collaterals (Zhong Xue Mai), and invasion of the meridians (Zhong Jing Luo). Invasion of the fu organs implies the disease is at the exterior level; invasion of the zang organs implies the disease is at the interior level; invasion of the vessels/collaterals and meridians implies the disease is at the intermediate level. For diseases at the exterior, mild diaphoresis (sweating) is appropriate; for diseases at the interior, mild purgation is appropriate; for diseases at the intermediate level, harmonizing Ying and Wei (nutritive and defensive qi) is appropriate.
Invasion of the fu organs often manifests in the four limbs, with symptoms such as stiffness and spasms of the hands and feet, numbness, aversion to wind and cold, indicating an exterior condition. Treatment is relatively easy, using formulas like Shufeng Tang (Dispersing Wind Decoction). Invasion of the zang organs often obstructs the nine orifices, manifesting as relaxed lips, loss of voice, deafness, blurred vision, and constipation/urinary retention, indicating an interior condition. Treatment is difficult, using formulas like Runzi Tang (Moistening Decoction). Invasion of the vessels/collaterals presents without exterior six-channel syndromes or interior obstruction of urination/defecation, but with inability to move limbs and speak, indicating an intermediate condition. Treatment uses Yangrong Tang (Nourishing Ying Decoction). Invasion of the meridians presents with deviation of the mouth and eyes, also an intermediate condition, treated with Fuzheng Tang (Restoring Uprightness Decoction).
Among these, there is a distinction between blood deficiency wind stroke and qi deficiency wind stroke. Blood deficiency wind stroke arises from yin-blood deficiency allowing thief-wind to invade, manifesting as left-sided hemiplegia. Use Siwu Tang (Four Substances Decoction) plus Gouteng (Uncariae Ramulus cum Uncis), Zhuli (Bambusae Succus), and Jiangzhi (Zingiberis Rhizoma Recens Sucus), focusing on blood-nourishing agents. Qi deficiency wind stroke arises from yuan-qi deficiency allowing thief-wind to invade, manifesting as right-sided hemiplegia. Use Liujunzi Tang (Six Gentlemen Decoction) plus Gouteng, Zhuli, and Jiangzhi, focusing on qi-tonifying agents. Combined qi and blood deficiency wind stroke results in bilateral limb paralysis. Use Bazhen Tang (Eight Treasures Decoction) plus Gouteng, Zhuli, and Jiangzhi, or Shangchi Yin (Upper Pool Drink), which is a miraculous formula for treating various wind syndromes causing left flaccidity and right hemiplegia.
Regarding "similar wind stroke" (Lei Zhong Feng), including cold strike, summerheat strike, dampness strike, fire strike, qi strike, food syncope, fatigue injury, and sexual exhaustion:
Cold strike refers to sudden winter cold invasion causing coma, locked jaw, limb spasms, aversion to cold, and floating-tight pulse. Treat with Lizhong Tang (Regulate the Middle Decoction).
Summerheat strike refers to sudden intense summer heat causing coma, flaccidity, syncope, vomiting, diarrhea, wheezing, and chest fullness. Treat with Shiwei Xiangru Yin (Ten-Ingredient Mosla Decoction).
Dampness strike, as Danxi stated, is common in southeastern people due to damp-earth generating phlegm, phlegm generating heat, and heat generating wind. Treat with Qingzao Tang (Clear Dryness Decoction) plus Zhuli and Jiangzhi.
Fire strike, as Hejian stated, is internal wind of liver wood, not external six excess pathogens, but due to extreme emotional excess, excessive fire and deficient water, leading to qi heat and depression causing coma. Treat with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) or Sijunzi Tang (Four Gentlemen Decoction). If anger injures the liver causing fire to flare upward, use Xiaochaihu Tang (Minor Bupleurum Decoction).
Qi strike is due to extreme emotional excess causing qi syncope and coma, or locked jaw. Urgently use Suhexiang Wan (Styrax Pill) or Huoxiang Zhengqi San (Agastache Powder for Rectifying Qi). Misdiagnosing this as true wind stroke leads to death.
Food syncope is due to overeating injuring stomach qi, impairing transformation and transportation, causing coma. Treat with Liujunzi Tang plus Muxiang (Aucklandiae Radix).
Fatigue injury is due to overwork depleting yuan qi, causing spleen/stomach deficiency, inability to resist wind/cold, leading to coma. Treat with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
Sexual exhaustion injury is due to kidney deficiency and essence depletion, with qi failing to return to its source, causing coma. Treat with Liuwei Dihuang Wan.
These are all similar wind strokes. Generally, *Neijing* emphasizes wind, Hejian emphasizes fire, Dongyuan emphasizes qi, and Danxi emphasizes dampness. These cause sudden severe illness and death, termed similar wind stroke, not true wind stroke. Physicians must distinguish them carefully.
For sudden coma, deviation of mouth/eyes, phlegm-qii obstruction, throat rattling, and deep-hidden pulses, this is true qi deficiency with wind pathogen invasion. Use Sansheng Yin (Three Lives Decoction) 1 liang plus Ren Shen (Ginseng Radix et Rhizoma) 1 liang, decocted and taken orally, to restore consciousness. If there is urinary incontinence, hand relaxation, open mouth, and snoring, it is untreatable, though prior medicines may occasionally save life. This medicine travels through meridians and dispels cold-phlegm, having the power of breaking through gates and capturing flags. Each dose must include a small amount of Ren Shen to expel evil and tonify true qi; otherwise, efficacy will be poor.
For cases with deficient fire and dampness causing abundant phlegm-saliva, deviation of mouth/eyes, inability to speak, locked jaw, and unconsciousness, firmly pinch the midpoint of the big toe (half nail, half flesh) and the Renzhong point (GV26) until the body reacts. Then use Mingtong Guan Pass Powder (Duoming Tongguan San) insufflated into the nose. A sneeze indicates treatability; no sneeze indicates untreatability. If the jaw is locked, mix dried plum meat (Wumei Rou) with powder of Tian Nan Xing (Arisaematis Rhizoma Preparatum) and Xi Xin (Asari Radix et Rhizoma), dip the middle finger in the mixture, and rub the teeth to open the jaw. Then, mix two spoonfuls of Duoming Tongguan San with honey water to induce vomiting of phlegm, unblocking meridians via the emetic method. Once a sneeze occurs and qi returns, administer Shengsheng Yin (Life-Preserving Drink) or Qingre Daotan Tang (Clear Heat and Guide Out Phlegm Decoction), both effective. As consciousness returns and joints move freely, prioritize regulating qi first. After wind stroke, if qi is not yet smooth and phlegm not yet cleared, use Huoxiang Zhengqi San plus Tian Nan Xing, Muxiang, Dang Gui (Angelicae Sinensis Radix), and Fangfeng (Saposhnikoviae Radix) for one to two doses, then adjust according to symptoms.
I observe that ancient formulas often used attacking/draining agents, suitable occasionally for people in the north with tough constitutions due to their climate. However, applying them to people in the south with soft constitutions is likely intolerable. I have summarized and supplemented ancient omissions to provide universally applicable methods. Since north and south climates differ, and individual constitution varies, though men and women are largely similar, students must adapt treatment flexibly. Do not play the lute with fixed pegs (be inflexible).
Lizhong Tang (see Cold Strike) Shiwei Xiangru Yin (see Summerheat Strike) Qingzao Tang (see Flaccidity Syndrome) Sijunzi Tang (see Tonification) Xiaochaihu Tang