此病皆因房事、六欲、七情所伤。真气虚,为风邪所乘,客于五脏之俞,则为中风偏枯等证。若中脾胃之
俞,则右手足不用;中心肝之俞,则左手足不用。大抵能任用,但少力麻痹者为轻,能举而不能用者稍轻,全
不能举动者最重。邪气入脏则废九窍,甚者卒中而死。入腑则坏四肢,或有可愈者。
治法∶先灸关元五百壮,五日便安。次服保元丹一二斤,以壮元气;再服八仙丹、八风汤则终身不发。若
不灸脐下,不服丹药,虽愈不过三五年,再作必死。然此证最忌汗、吐、下,损其元气必死。大凡风脉,浮而
迟缓者生,急疾者重,一息八九至者死。(中风之证,古方书虽有中脏、中
腑、中经脉之别,然其要不过闭证与脱证而已。闭证虽属实,而虚者不少,或可用开关通窍行痰疏气之剂。关
窍一开,痰气稍顺,急当审其形藏,察其气血,而调治之。更视其兼证之有无,虚实之孰胜,或补或泻;再佐
以先生之法,庶几为效速,而无痿废难起之患矣。至若脱证,唯一于虚,重剂参附或可保全,然不若先生之丹
艾为万全也。予见近时医家,脱证已具三四,而犹云有风有痰,虽用参附而必佐以秦艽、天麻、胆星、竹沥冰
陷疏散。是诚不知缓急者也,乌足与论医道哉。)
治验
一人病半身不遂,先灸关元五百壮,一日二服八仙丹,五日一服换骨丹,其夜觉患处汗出,来日病减四分,
一月痊愈。再服延寿丹半斤,保元丹一斤,五十年病不作。千金等方,不灸关元,不服丹药,惟以寻常药治之,
虽愈难久。
一人患左半身不遂,六脉沉细无力。余曰∶此必服峻利之药,损其真气,故脉沉细。病者云∶前月服捉虎
丹,吐涎二升,此后稍轻,但未全愈耳。余叹曰∶中风本因元气虚损,今服吐剂,反伤元气,目下虽减,不数
日再作,不复救矣,不十日果大反复,求治于余,虽服丹药竟不能起。
这种病都是因为房事过度、六欲(眼、耳、鼻、舌、身、意六种欲望)和七情(喜、怒、忧、思、悲、恐、惊七种情绪)所损伤。真气虚弱,被风邪侵袭,停留在五脏的背俞穴,就会形成中风偏枯等证候。如果风邪中伤脾胃的背俞穴,则右手右脚不能活动;如果中伤心肝的背俞穴,则左手左脚不能活动。大致来说,能够使用但力量不足、伴有麻木感的病情较轻;能够举起但不能灵活使用的病情稍轻;完全不能活动的病情最重。邪气侵入内脏会导致九窍功能废用,严重的会突然昏倒死亡。邪气侵入腑则会损坏四肢,或许还有治愈的可能。
治疗方法:先灸关元穴五百壮,五天后身体即可安宁。接着服用保元丹一两斤,以壮大元气;再服用八仙丹、八风汤,则可以终身不再发作。如果不灸脐下的穴位,不服用丹药,即使痊愈,不过三五年也会复发,一旦复发必然死亡。然而此证最忌讳发汗、催吐、泻下法,因为这些方法会损伤元气,导致死亡。大凡中风脉象,浮而迟缓的预后良好,急疾的病情严重,一呼一吸间脉搏跳动八九次的为死证。(关于中风的证候,古方书中虽然有中脏、中腑、中经脉的区别,但其要点不过是闭证与脱证而已。闭证虽然属实证,但虚证也不少见,或许可以使用开关通窍、行痰理气的药剂。关窍一旦开通,痰气稍微顺畅,应当立即审视其形体脏腑,察辨其气血状况,从而进行调治。再观察是否有兼夹证候,虚实孰强,或补或泻;再辅以窦材先生的方法,大概能奏效迅速,而没有痿废难起的祸患。至于脱证,纯粹属于虚证,重用参附类药物或许可以保全生命,但不如窦材先生的丹药艾灸那样万无一失。我见到近时的医家,在患者已经具备三四成脱证表现时,还声称有风有痰,虽然使用了人参、附子,却必定佐以秦艽、天麻、胆南星、竹沥等疏散之品。这实在是不知轻重缓急的表现,哪里足以谈论医学之道呢?)
治疗案例
有一人患半身不遂,先灸关元穴五百壮,每天服用两次八仙丹,每五天服用一次换骨丹,当晚感觉患处出汗,第二天病情减轻四分之三,一个月后痊愈。随后服用延寿丹半斤,保元丹一斤,五十年内疾病未再发作。千金方等常规方剂,不灸关元穴,不服用丹药,仅用普通药物治疗,即使痊愈也难以持久。
另一人患左半身不遂,六脉沉细无力。我说:这一定是服用了峻烈通利药物,损伤了真气,所以脉象沉细。病人说:上个月服用了捉虎丹,吐出涎液两升,此后症状稍减,但未完全痊愈。我叹息道:中风本来是因为元气虚损,现在服用吐剂,反而损伤元气,眼下虽然减轻,不出几天就会再次发作,无法救治了。果然不到十天病情大幅反复,来找我求治,虽然服用了丹药最终也无法挽回。
This disease is caused by excessive sexual activity, the six desires (the six sensory and mental faculties: sight, hearing, smell, taste, touch, and mind), and the seven emotions (joy, anger, worry, thought, grief, fear, and fright). When the True Qi (Zhen Qi) is deficient, it is invaded by Wind Pathogens, which lodge in the Back-Shu points of the Five Zang Organs, resulting in conditions such as stroke with hemiplegia. If the Wind strikes the Back-Shu points of the Spleen and Stomach, the right hand and foot become unusable; if it strikes the Back-Shu points of the Heart and Liver, the left hand and foot become unusable. Generally speaking, cases where movement is possible but accompanied by weakness and numbness are mild; cases where lifting is possible but manipulation is impaired are slightly more severe; cases where movement is completely impossible are the most severe. If the pathogenic factor enters the Zang organs, the nine orifices will be disabled, and severe cases may result in sudden collapse and death. If it enters the Fu organs, the four limbs will be damaged, though there may be a chance of recovery.
Treatment method: First, moxa-apply the Guanyuan CV4 point for 500 moxa cones (zhuang); the patient will feel at ease within five days. Next, take Baoyuan Dan (Preserve the Original Qi Pill) one to two jin (approx. 500-1000g) to strengthen the Original Qi; then take Baxian Dan (Eight Immortals Pill) and Bafeng Tang (Eight Winds Decoction) to prevent recurrence for life. If one does not moxa-apply below the navel or take alchemical pills, even if recovered, relapse will occur within three to five years, and subsequent relapse will be fatal. However, this condition strictly forbids diaphoresis (sweating), emesis (vomiting), and purgation (downward draining), as these methods damage the Original Qi and lead to death. In general, regarding the pulse of wind-stroke: a floating and slow/relaxed pulse indicates survival; a rapid and urgent pulse indicates severity; a pulse rate of eight to nine beats per breath cycle indicates death. (Regarding stroke syndromes, although ancient texts distinguish between involvement of the Zang, Fu, and meridians, the essence boils down to Closed Syndrome and Collapsed Syndrome. Although Closed Syndrome is typically excess, deficiency is also common; perhaps agents that open the orifices, resolve phlegm, and regulate Qi can be used. Once the orifices are opened and phlegm/Qi flow improves, one must immediately examine the physical constitution and Zang-Fu status, assess Qi and Blood, and treat accordingly. Observing for concurrent syndromes and determining whether excess or deficiency prevails allows for tonification or sedation; combined with Mr. Dou's methods, efficacy can be achieved rapidly without the risk of permanent paralysis. As for Collapsed Syndrome, it is purely deficiency; heavy doses of Ginseng and Aconite might preserve life, but they are inferior to Mr. Dou's pills and moxibustion for absolute safety. I have observed contemporary physicians who, when patients exhibit signs of collapse, still claim the presence of Wind and Phlegm. Even when using Ginseng and Aconite, they inevitably add herbs like Qinjiao (Gentiana Macrophylla Root), Tianma (Gastrodia Rhizome), Danning Xing (Arisaema cum Bile), and Zhuli (Bamboo Sap) for dispersal. This demonstrates a lack of understanding of urgency and priority, making them unworthy of discussing the Way of Medicine.)
Clinical Cases
One patient suffered from hemiplegia. He first received 500 moxa cones applied to Guanyuan CV4, took Baxian Dan twice daily, and took Huangu Dan (Bone-Replacing Pill) once every five days. That night, he felt sweating in the affected area. The next day, his condition improved by four parts out of five. He recovered completely within one month. Subsequently, he took Yan Shou Dan (Life-Extending Pill) half a jin and Baoyuan Dan one jin, and did not suffer from the disease again for fifty years. Qianjin Fang and other standard prescriptions, which do not involve moxa-application to Guanyuan or the use of alchemical pills, rely only on ordinary medicines; even if effective, the cure is rarely durable.
Another patient suffered from left-sided hemiplegia. His six pulses were deep, thin, and weak. I said: "This is certainly due to the consumption of True Qi by harsh, draining medications, hence the deep and thin pulse." The patient said: "Last month, I took Zhuohu Dan (Tiger-Catching Pill), vomited two sheng (approx. 2 liters) of saliva, after which my symptoms lessened somewhat, but I was not fully cured." I sighed and said: "Stroke originates from the deficiency and damage of Original Qi. Taking emetics now further damages the Original Qi. Although symptoms may lessen temporarily, relapse will occur within a few days, and it will be incurable." Indeed, within ten days, the condition severely relapsed. He sought treatment from me, but despite taking alchemical pills, he could not be saved.