【歌】卒倒原从气分虚，湿痰能中右边肢。左边死血并无血，不语涎多吐最宜。口噤筋挛风热甚，四肢不
举属于脾。更兼痿 与麻痹，休作风邪真中医。
【论】河间云∶风病多因热盛。俗云风者，言末而忘其
本也。有风者，亦非外中之风，良由将息失宜而心火暴甚，肾虚不能制，则阴虚阳实，热气怫郁，心神昏冒，
故卒倒无知。亦由喜、怒、悲、忧、恐五者过极而卒中，皆为热。微则僵仆，气血流通，筋脉不挛，发过如故。
甚则热气太盛，郁滞不通，阴气暴绝，阳气后竭而死。故痰涎者，偏枯者，口噤者，筋急者，筋反纵者，皆为
燥热之证，故主乎火也。西北气寒，为风所中诚有之。东南气温多湿，有病风者，非风也，皆由湿生痰，痰生
热，热生风，经所谓∶亢则害，承乃制也。古方以风、痿混同论治，故多以治风药通治痿疾。殊不知痿因肺热
叶焦，传入五脏，散为诸痿，如四肢不举，舌本强，足痿不收，痰涎有声，悉属于土，为湿热，以风治之非也，
故主乎湿。东垣云∶言中风者，皆由元气不足，则邪凑之，益气则风自除。故卒倒僵仆皆由气虚，故主乎气。
许学士云∶暴怒伤阴，暴喜伤阳，忧愁不已，气多厥逆，往往得此疾，便觉涎潮昏塞，牙关紧急，脉伏身寒，
此名中气。若中风，则身温为异耳。然诸家之说，皆非外中之风，故曰类中风。
气虚 附血虚。
僵仆卒倒，气虚也，六君子汤加黄 、竹沥、姜汁，或浓煎人参汤，加竹沥、姜汁。
血虚，八珍汤，地黄须用姜汁炒则不泥膈。
六君子汤
八珍汤（二方并见气虚证。）
四君子加竹沥姜汁方
人参（三钱） 白术（一钱） 茯苓（二钱） 甘草（五分） 竹沥（半盏） 姜汁（五匙）
按∶丹溪曰∶半身不遂，在右者，属气虚，以此方主
之。气虚者，宜补之以甘，故用参、术、茯、甘四件。称其为君子者，谓其甘平有冲和之德，而无克伐之性也。
其加竹沥，为能行痰。其加姜汁，所以行竹沥之滞，而共成伐痰之功耳。
四物加桃仁红花竹沥姜汁方
当归（酒洗） 川芎（酒洗，去芦） 白芍（酒炒） 熟地（酒蒸） 桃仁（去皮尖） 红花（各等分）
竹沥（半盏） 姜汁（五匙）
按∶丹溪曰∶半身不遂，在左者，属瘀血，以此方主之。用芎、归、芍、地，生血药也，新血生，则瘀血
滑而易去。用桃仁、红花，消瘀药也，瘀血消，则新血清而易生。然亦加夫竹沥、姜汁者，以痰之物靡所不之，
无分左、右而为患也。
中气
痰气，若厥逆身冷，脉沉伏，勿作中风。治以苏合香丸灌醒，然后调治，续用乌药顺气散、八味顺气散。
苏合香丸
治男、妇中风、中气，牙关紧闭，口眼 斜，不省人事，并传尸骨蒸劳瘵，卒暴心疼，鬼魅瘴疟，小儿急、
慢惊搐，妇人产后中风，赤白痢疾，一切气暴之证，最能顺气化痰。
沉香 木香 丁香 白檀香 麝香（另研） 香附 白术 安息香（酒熬膏） 诃子肉 荜茇 朱砂（水飞）
乌犀角（镑，各一两） 乳香 片脑 苏合香油（入安息香内酒熬，各五钱）
上为末，研匀，用安息香膏并炼白蜜和剂。每服旋丸如桐子大，取井花水，温冷任意，下四丸，老人、小
儿服一丸，温酒化下。
按∶病患国中风，喉中痰塞，水壅难通，非香窜不能开
窍，故集诸香以利窍。非辛热不能通塞，故用诸辛为佐使。犀角虽凉，凉而不滞。诃梨虽涩，涩而生津。世人
用此方于国中之时，每每取效。丹溪谓辛香走散真气，又谓麝、脑能引风入骨，如油入面，莫可解也，医者但
当用之以救急，慎勿令人多服也。
乌药顺气散（方见前真中条。）
八味顺气散
治中风正气虚，痰壅盛者，此方主之。
白术（土炒） 茯苓 青皮（炒） 陈皮（去白） 乌药 白芷 人参（各一钱） 甘草（五分）
按∶经曰∶邪之所凑，其气必虚。故用四君子以补气。治痰之法，利气为先，故用青皮、陈皮、台乌、白
芷以顺气，气顺则痰行，而无壅塞之患矣。此标本兼施之法也。
痰火
痰涎盛，偏枯口噤，筋急拘挛，筋反纵，脉数，燥火为病，牛黄清心丸主之。在表，防风通圣散。在上，
凉膈散。昏冒发热，不恶寒，不安卧，此风热烦躁，泻青丸。痰火炽盛，烦渴便秘，脉数大，三黄枳实汤、滚痰丸。
牛黄清心丸（方见痫证。）
防风通圣散
治中风，一切风热，大便秘结，小便赤涩，头面生疮，眼目赤痛；或热生风，舌强口噤；或鼻生紫赤风刺、
瘾疹，而为肺风；或成风疠，而世俗呼为大风；或肠风而为痔漏；或肠郁而为诸热谵妄惊狂，并皆治之。
防风 川芎 当归 赤芍药（酒炒） 连翘 薄荷 麻黄（各四分） 石膏（ ） 桔梗 黄芩（各八分）
白术 山栀子（酒炒黑） 荆芥（各三分） 滑石（二钱四分） 大黄 芒硝（各四分） 甘草（一钱）
上，姜、葱、豆豉同煎。
自汗去麻黄，自利去大黄、芒硝。
按∶本方有防风、麻黄，解表药也，风热之在皮肤者，得之由汗而泄。荆芥、薄荷，清上药也，风热之在
巅顶者，得之由鼻而泄。大黄、芒硝，通利药也，风热之在肠胃者，得之由后而泄。滑石、栀子，水道药也，
风热之在决渎者，得之由溺而泄。风淫于膈，肺肤受邪，石膏、桔梗，清肺肤也。而连翘、黄芩，又所以祛诸
经之游火。风之为患，肝木主之，芎、归、芍药，和肝血也。而甘草、白术，又所以和胃气而健脾焉。
凉膈散
泻青丸（二方并见火证条下。）
三黄枳实汤
黄芩 黄连 大黄（煨，各一钱） 浓朴 甘草（各五分） 枳实（二钱）
上，水煎热服，不拘时。
礞石滚痰丸（方见痰饮条下。）
湿痰
口眼 斜，半身不遂，涎多不语。中于右，属痰，稀涎散吐之。痰盛胸满，导痰汤。肥人痰厥，口眼 斜，
手麻木，化痰丸。四肢不收，心神恍惚，不知人事，六君子汤加竹沥、姜汁。热多，荆沥汤，或加二陈汤，或
青州白丸子。痰火甚，滚痰丸。
稀涎散（方见前真中风条。）
导痰汤
即二陈加南星、枳壳。
六君子汤（方见脾胃。）
二陈汤（方见痰饮。）
竹沥汤
治中风四肢不收，心神恍惚，不知人，不能言。
竹沥（二升） 生葛汁（一升） 生姜汁（三合）
相合，作三服。
荆沥汤
治中风有痰多热，宜常服此。
荆沥（二升） 竹沥（二升） 生姜汁（二合）
相合温服。
青州白丸子
治小儿惊风，大人诸风，牙关紧急，或痰喘体麻。
生半夏（七两） 生白附（二两） 生川乌（去皮，五钱） 生南星（二两）
上为细末，盛绢袋中，以井水中摆出末，更将手时揉之令出。如有渣，再为末，再入绢袋中，再摆揉，以
尽为度。放瓷盆中，日晒夜露，每朝晨要换新鲜水，春五日，夏三日，秋七日，冬十日，去水晒干如玉片，研
细，以大米粉熬粥饮，丸如绿豆大，每服三、五丸，薄荷汤下，风瘫温酒下，服不拘时。
达按∶前证若少壮之人，气血未虚，真水未竭，适因怒，动肝火，火畏水，不能上升，所以身凉无痰涎然。
须臾便醒者，水旺足以制火也，此名中气。老衰之人，气血俱虚，真水已竭，适因怒，动肝火，火寡于畏，得
以上升，所以身温有痰涎然。多不能治者，水竭无以降火也，此名中痰。虽然少壮之人亦有不治者，男子乃色
欲过多，下元水亏，不能治火；女人乃经后、产后，去血过多，不能配气。适因忿怒动火，而阳气无所根据附，
则随火而发越矣。阴也，血也，岂不为阳气之根本乎？
【歌诀】突然昏倒原本是因为气分虚弱，湿痰容易侵袭右侧肢体。左侧半身不遂多因死血（瘀血）阻滞而无血行，出现不语、涎多症状时，最适宜使用吐法。口噤（牙关紧闭）、筋脉拘挛说明风热邪气严重，四肢无法抬起则归属于脾虚。如果同时伴有痿证与麻痹，切勿将其当作真中风（外感风邪所致）来治疗，这才是真正的中医诊疗思路。
【论述】刘河间说：风病大多因为热盛引起。世俗所说的“风”，是只看到了表象而忘记了根本。所谓的“风”，也不是外界侵入的风邪，确实是由于调养失当导致心火突然亢盛，肾虚无法制约，从而造成阴虚阳实，热气郁结，心神昏乱冒昧，所以突然昏倒失去知觉。也是因为喜、怒、悲、忧、恐这五种情绪过度极端而导致卒中，这些都属于热证。轻微的情况只是僵硬仆倒，气血依然流通，筋脉不痉挛，发作过后如同常人。严重的情况则是热气太盛，郁滞不通，阴气突然断绝，阳气随后耗尽而死。所以痰涎壅盛、偏枯（半身不遂）、口噤、筋脉紧急、筋脉反常松弛，都是燥热证候，因此主治关键在于“火”。西北方气候寒冷，被风邪中伤确实存在。东南方气温较高且多湿气，患有风病的，并非风邪，都是由湿生痰，痰生热，热生风，正如经典所说：亢盛就会为害，承制才能平衡。古方将风和痿证混同论治，所以多用治风药通治痿疾。却不知道痿证是因为肺热叶焦，传入五脏，散变为各种痿证，如四肢不能抬起、舌根强硬、足部痿软不收、痰涎有声，这些都归属于土（脾），属于湿热，用治风的方法治疗是错误的，所以主治关键在于“湿”。李东垣说：所谓的中风，都是因为元气不足，邪气才凑集入侵，补益元气则风邪自然消除。所以突然昏倒僵仆都是因为气虚，因此主治关键在于“气”。许学士说：暴怒损伤阴，暴喜损伤阳，忧愁不已，气机多发生厥逆，往往得此病，便觉得涎潮昏塞，牙关紧急，脉象沉伏身体发冷，这叫作中气。如果是中风，身体发热则是例外罢了。然而各家学说，都认为不是外来的风邪，所以称为类中风。
气虚兼附血虚。
突然僵倒昏仆，是气虚的表现，用六君子汤加黄芪、竹沥、姜汁，或者浓煎人参汤，加竹沥、姜汁。
血虚，用八珍汤，地黄必须用姜汁炒制以免滋腻碍胃。
六君子汤
八珍汤（这两个方剂并见气虚证章节。）
四君子加竹沥姜汁方
人参（三钱） 白术（一钱） 茯苓（二钱） 甘草（五分） 竹沥（半盏） 姜汁（五匙）
按语：朱丹溪说：半身不遂，在右侧的，属于气虚，以此方主治。气虚的人，宜用甘味药物补益，所以用人参、白术、茯苓、甘草四味药。称它们为“君子”，是说它们味甘性平，具有冲和的德行，而没有克伐的性质。加入竹沥，是因为它能行痰。加入姜汁，是为了防止竹沥的凝滞，共同完成祛除痰浊的功效。
四物加桃仁红花竹沥姜汁方
当归（酒洗） 川芎（酒洗，去芦头） 白芍（酒炒） 熟地黄（酒蒸） 桃仁（去皮尖） 红花（各等分）
竹沥（半盏） 姜汁（五匙）
按语：朱丹溪说：半身不遂，在左侧的，属于瘀血，以此方主治。使用川芎、当归、白芍、地黄，是生血药，新血生成，则瘀血滑利而易于去除。使用桃仁、红花，是消瘀药，瘀血消除，则新血清纯而易于生成。但也加入竹沥、姜汁，是因为痰这种病理产物无处不到，不分左右而为患。
中气
痰气上逆，如果厥逆身冷，脉象沉伏，不要当作中风治疗。用苏合香丸灌服使其苏醒，然后进行调理，后续使用乌药顺气散、八味顺气散。
苏合香丸
治疗男、女中风、中气，牙关紧闭，口眼歪斜，不省人事，以及传尸骨蒸劳瘵，突然剧烈心痛，鬼魅瘴疟，小儿急惊、慢惊抽搐，妇人产后中风，赤白痢疾，一切气机暴乱的证候，最能顺气化痰。
沉香 木香 丁香 白檀香 麝香（另研细） 香附 白术 安息香（酒熬成膏） 诃子肉 荜茇 朱砂（水飞） 乌犀角（镑片，各一两） 乳香 片脑（冰片） 苏合香油（入安息香内酒熬，各五钱）
以上制成粉末，研匀，用安息香膏和炼过的白蜜调和成药。每次现搓丸如梧桐子大，取井花水，温冷随意，送服四丸，老人、小儿服一丸，温酒化下。
按语：患者得了中风，喉中痰塞，水液壅滞难通，非芳香开窍之品不能开通窍道，所以汇集诸种香药以利窍。非辛热之品不能通达闭塞，所以用诸辛味药作为佐使。犀角虽然性凉，但凉而不凝滞。诃子虽然味涩，但涩能生津。世人在治疗中风时使用此方，每每取得疗效。丹溪认为辛香走散真气，又说麝香、冰片能引风入骨，如油入面，不可解脱，医生只应当用它来救急，千万不要让人多服。
乌药顺气散（方剂见前真中风条。）
八味顺气散
治疗中风正气虚，痰壅盛者，以此方主治。
白术（土炒） 茯苓 青皮（炒） 陈皮（去白） 乌药 白芷 人参（各一钱） 甘草（五分）
按语：经典说：邪气所聚集的地方，正气必然虚弱。所以用四君子汤来补气。治痰的方法，以理气为先，所以用青皮、陈皮、台乌（乌药）、白芷来顺气，气顺则痰行，而没有壅塞的祸患了。这是标本兼施的方法。
痰火
痰涎盛，偏枯口噤，筋脉紧急拘挛，筋脉反常松弛，脉数，燥火致病，用牛黄清心丸主治。病在表，用防风通圣散。病在上焦，用凉膈散。昏冒发热，不恶寒，不安卧，这是风热烦躁，用泻青丸。痰火炽盛，烦渴便秘，脉数大，用三黄枳实汤、滚痰丸。
牛黄清心丸（方剂见痫证条。）
防风通圣散
治疗中风，一切风热，大便秘结，小便赤涩，头面生疮，眼目赤痛；或者热生风，舌强口噤；或者鼻生紫赤风刺、瘾疹，而为肺风；或者成为风疠，而世俗呼为大风；或者肠风而为痔漏；或者肠郁而为各种热证谵妄惊狂，都一并治疗。
防风 川芎 当归 赤芍药（酒炒） 连翘 薄荷 麻黄（各四分） 石膏（煅） 桔梗 黄芩（各八分）
白术 山栀子（酒炒黑） 荆芥（各三分） 滑石（二钱四分） 大黄 芒硝（各四分） 甘草（一钱）
以上，加姜、葱、豆豉同煎。
自汗者去掉麻黄，自利者去掉大黄、芒硝。
按语：本方有防风、麻黄，是解表药，风热在皮肤者，借此由汗而泄。荆芥、薄荷，是清上药，风热在巅顶者，借此由鼻而泄。大黄、芒硝，是通利药，风热在肠胃者，借此由后（大便）而泄。滑石、栀子，是水道药，风热在决渎（水道）者，借此由溺（小便）而泄。风淫于膈，肺肤受邪，石膏、桔梗，清肺肤。而连翘、黄芩，又是用来祛除各经游走的火邪。风之为患，由肝木主司，川芎、当归、芍药，调和肝血。而甘草、白术，又是用来和胃气而健脾。
凉膈散
泻青丸（这两个方剂并见火证条下。）
三黄枳实汤
黄芩 黄连 大黄（煨，各一钱） 厚朴 甘草（各五分） 枳实（二钱）
以上，水煎热服，不拘时间。
礞石滚痰丸（方剂见痰饮条下。）
湿痰
口眼歪斜，半身不遂，涎多不语。中于右侧，属于痰，用稀涎散催吐。痰盛胸满，用导痰汤。肥人痰厥，口眼歪斜，手麻木，用化痰丸。四肢不收，心神恍惚，不知人事，用六君子汤加竹沥、姜汁。热多，用荆沥汤，或加二陈汤，或青州白丸子。痰火甚，用滚痰丸。
稀涎散（方剂见前真中风条。）
导痰汤
即二陈汤加天南星、枳壳。
六君子汤（方剂见脾胃条。）
二陈汤（方剂见痰饮条。）
竹沥汤
治疗中风四肢不收，心神恍惚，不知人，不能言。
竹沥（二升） 生葛汁（一升） 生姜汁（三合）
混合，分三次服用。
荆沥汤
治疗中风有痰多热，宜常服此方。
荆沥（二升） 竹沥（二升） 生姜汁（二合）
混合温服。
青州白丸子
治疗小儿惊风，大人诸风，牙关紧急，或者痰喘体麻。
生半夏（七两） 生白附子（二两） 生川乌（去皮，五钱） 生天南星（二两）
以上制成细末，装入绢袋中，在井水中摆动出末，再用手揉搓令其出来。如果有渣滓，再磨成末，再放入绢袋中，再摆动揉搓，直到尽为止。放在瓷盆中，日晒夜露，每天早晨换新鲜水，春季五日，夏季三日，秋季七日，冬季十日，去水晒干如玉片，研细，用大米粉熬粥饮，丸如绿豆大，每次服三、五丸，薄荷汤送下，风瘫用温酒送下，服药不拘时间。
达按：前述证候如果是少壮之人，气血未虚，真水未竭，恰好因为愤怒，动肝火，火畏水，不能上升，所以身凉无痰涎。不久便醒来的，是水旺足以制火，这叫中气。老衰之人，气血俱虚，真水已竭，恰好因为愤怒，动肝火，火寡于畏（缺乏制约），得以上升，所以身温有痰涎。多不能治愈的，是水竭无以降火，这叫中痰。虽然少壮之人也有不能治愈的，男子是因为色欲过多，下元水亏，不能治火；女人是因为经后、产后，失血过多，不能配气。恰好因为忿怒动火，而阳气无所依附，则随火而发越了。阴，血，难道不是阳气的根本吗？
[Verse] Sudden collapse originates from deficiency in the Qi aspect; damp-phlegm easily strikes the right side of the body. Left-sided hemiplegia is due to stagnant blood (stasis) with no blood flow; when aphasia and excessive salivation occur, emesis is most appropriate. Lockjaw and tendon contraction indicate severe wind-heat; inability to lift the four limbs belongs to Spleen deficiency. If accompanied by flaccidity syndrome and numbness, do not treat it as true wind-stroke (disease caused by exogenous wind pathogens); this is the essence of authentic TCM practice.
[Discussion] Liu Hejian stated: Wind diseases are mostly caused by excessive heat. The colloquial term "wind" refers to the manifestation while forgetting the root. The so-called "wind" here is not an exogenous wind pathogen invading from outside; rather, it is indeed due to improper lifestyle management causing a sudden surge of Heart Fire. Kidney Yin deficiency fails to control it, resulting in Yin deficiency and Yang excess. Heat qi becomes depressed and stagnant, clouding the Spirit and causing sudden collapse with loss of consciousness. It also occurs when the five emotions—joy, anger, sorrow, worry, and fear—reach extreme levels, leading to stroke, all belonging to heat syndromes. Mild cases involve only stiffness and falling, with Qi and Blood still flowing, tendons and vessels not contracting, and recovery to normal after the episode. Severe cases involve excessive heat, stagnation blocking flow, sudden extinction of Yin Qi, followed by exhaustion of Yang Qi leading to death. Therefore, excessive phlegm-saliva, hemiplegia, lockjaw, tendon urgency, and abnormal tendon relaxation are all dry-heat syndromes, thus primarily governed by Fire. In the northwest, where the climate is cold, being struck by wind does indeed exist. In the southeast, where the climate is warm and humid, diseases labeled as "wind" are not due to wind, but arise from dampness generating phlegm, phlegm generating heat, and heat generating wind. As the classics state: "Excess causes harm; restraint brings balance." Ancient formulas confused wind and flaccidity syndromes in treatment, often using wind-dispelling medicines to treat flaccidity diseases indiscriminately. They did not realize that flaccidity arises from Lung heat scorching the leaves, transmitting to the Five Zang organs, and dispersing into various flaccidity types. Symptoms such as inability to move the four limbs, stiff tongue base, foot flaccidity and inability to grasp, and audible phlegm-saliva all belong to Earth (Spleen), representing damp-heat; treating them with wind-dispelling methods is incorrect, thus primarily governed by Dampness. Li Dongyuan stated: What is called wind-stroke is actually due to insufficiency of Yuan Qi, allowing pathogens to gather; tonifying Qi causes wind to eliminate itself. Therefore, sudden collapse and stiffness are due to Qi deficiency, thus primarily governed by Qi. Xu Xueshi stated: Violent anger damages Yin; violent joy damages Yang; endless worry leads to Qi reversal. People often suffer this disease, feeling tidal phlegm, mental blockage, tight jaw, hidden pulse, and cold body; this is named Qi Stroke. If it were wind-stroke, a warm body would be the exception. However, all these theories agree that it is not exogenous wind, hence termed "Similar Wind-Stroke" (Lei Zhong Feng).
Qi Deficiency (with attached Blood Deficiency).
Sudden stiffness and collapse indicate Qi deficiency. Use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Huang Qi (Astragalus Root), Zhu Li (Bamboo Sap), and Jiang Zhi (Ginger Juice), or strong decoction of Ren Shen Tang (Ginseng Decoction) plus Zhu Li and Jiang Zhi.
Blood Deficiency: Use Ba Zhen Tang (Eight Treasures Decoction). Shu Di Huang (Prepared Rehmannia Root) must be stir-fried with Ginger Juice to prevent cloying the Stomach.
Liu Jun Zi Tang (Six Gentlemen Decoction)
Ba Zhen Tang (Eight Treasures Decoction) (Both formulas see Qi Deficiency Syndrome.)
Si Jun Zi Plus Zhu Li and Jiang Zhi Formula
Ren Shen (Ginseng Radix et Rhizoma) (3 qian), Bai Zhu (Atractylodis Rhizoma) (1 qian), Fu Ling (Poria) (2 qian), Gan Cao (Licorice Root) (5 fen), Zhu Li (Bamboo Sap) (half zhan), Jiang Zhi (Ginger Juice) (5 chi).
Note: Danxi said: Hemiplegia on the right side belongs to Qi deficiency, treated with this formula. For Qi deficiency, sweet flavors should be used for tonification; thus, Ginseng, Atractylodes, Poria, and Licorice are used. They are called "Gentlemen" because they are sweet and neutral, possessing harmonious virtue without destructive nature. Adding Bamboo Sap is to promote phlegm resolution. Adding Ginger Juice is to prevent the stagnation of Bamboo Sap, jointly achieving the effect of dispelling phlegm.
Si Wu Plus Tao Ren, Hong Hua, Zhu Li, and Jiang Zhi Formula
Dang Gui (Angelicae Sinensis Radix, wine-washed), Chuan Xiong (Ligustici Chuanxiong Rhizoma, wine-washed, radix removed), Bai Shao (Paeoniae Radix Alba, wine-fried), Shu Di Huang (Rehmanniae Radix Praeparata, wine-steamed), Tao Ren (Persicae Semen), Hong Hua (Carthami Flos) (each equal parts).
Zhu Li (Bamboo Sap) (half zhan), Jiang Zhi (Ginger Juice) (5 chi).
Note: Danxi said: Hemiplegia on the left side belongs to blood stasis, treated with this formula. Using Ligusticum, Angelica, Paeonia, and Rehmannia are blood-generating herbs; when new blood is generated, stasis becomes slippery and easy to remove. Using Persica and Carthamus are blood-invigorating herbs; when stasis is eliminated, new blood becomes pure and easy to generate. However, Bamboo Sap and Ginger Juice are also added because phlegm, as a pathological product, travels everywhere, causing trouble regardless of left or right sides.
Qi Stroke
Phlegm-Qi rebellion, if accompanied by cold limbs and hidden pulse, should not be treated as wind-stroke. Treat with Su He Xiang Wan (Styrax Pill)灌服 to restore consciousness, then regulate. Subsequently use Wu Yao Shun Qi San (Tso-yao Qi-Regulating Powder) and Ba Wei Shun Qi San (Eight-Ingredient Qi-Regulating Powder).
Su He Xiang Wan (Styrax Pill)
Treats men and women with wind-stroke or Qi stroke, lockjaw, facial deviation, unconsciousness, as well as tuberculosis consumption, sudden severe heart pain, miasma malaria, pediatric acute/chronic convulsions, postpartum wind-stroke in women, dysentery, and all sudden Qi disorders. It best regulates Qi and resolves phlegm.
Chen Xiang (Aquilariae Lignum Resinatum), Mu Xiang (Aucklandiae Radix), Ding Xiang (Caryophylli Flos), Bai Tan Xiang (Santalum Album Lignum), She Xiang (Moschus, separately ground), Xiang Fu (Cyperi Rhizoma), Bai Zhu (Atractylodis Rhizoma), An Xi Xiang (Styrax, boiled into paste with wine), He Zi Rou (Terminalia Chebula Retius), Bi Bo (Piperis Longi Fructus), Zhu Sha (Cinnabaris, water-ground), Xi Jiao (Rhinocerotis Cornu, sliced, each 1 liang), Ru Xiang (Olibanum), Pian Nao (Borneolum Syntheticum), Su He Xiang You (Styrax Oil, mixed with An Xi Xiang paste and boiled with wine, each 5 qian).
Grind into powder, mix evenly, and form pills with An Xi Xiang paste and refined white honey. Each pill is sized like a paulownia seed. Take well water, temperature optional, swallow four pills. Elderly and children take one pill, dissolved in warm wine.
Note: When patients suffer wind-stroke, phlegm blocks the throat, making swallowing difficult. Only aromatic opening agents can unblock orifices, hence gathering various aromatics to benefit orifices. Only pungent-hot substances can unblock obstructions, hence using pungent substances as assistants. Xi Jiao (Rhinoceros Horn) is cool but not stagnant. He Zi (Chebula Fruit) is astringent but generates fluids. People using this formula for stroke often achieve results. Danxi argued that pungent aromatics scatter True Qi, and claimed She Xiang (Musk) and Pian Nao (Borneol) can draw wind into bones like oil into flour, irretrievable. Doctors should only use them for emergencies and caution against frequent use.
Wu Yao Shun Qi San (Tso-yao Qi-Regulating Powder) (Formula see previous True Wind-Stroke section.)
Ba Wei Shun Qi San (Eight-Ingredient Qi-Regulating Powder)
Treats wind-stroke with deficient Zheng Qi and abundant phlegm obstruction; this formula is indicated.
Bai Zhu (Atractylodis Rhizoma, earth-fried), Fu Ling (Poria), Qing Pi (Citri Reticulatae Pericarpium Viride, fried), Chen Pi (Citri Reticulatae Pericarpium, pith removed), Wu Yao (Tsaoko Fructus), Bai Zhi (Angelicae Dahuricae Radix), Ren Shen (Ginseng Radix et Rhizoma) (each 1 qian), Gan Cao (Licorice Root) (5 fen).
Note: The classics state: "Where pathogens gather, Qi must be deficient." Thus, Si Jun Zi Tang (Four Gentlemen Decoction) is used to tonify Qi. The method for treating phlegm prioritizes regulating Qi; thus, Qing Pi, Chen Pi, Wu Yao, and Bai Zhi are used to smooth Qi. When Qi is smooth, phlegm moves, avoiding obstruction. This is a method treating both root and branch.
Phlegm-Fire
Abundant phlegm-saliva, hemiplegia, lockjaw, tendon urgency and contraction, abnormal tendon relaxation, rapid pulse, dry-fire disease. Niu Huang Qing Xin Wan (Calculus Bovis Clearing Heart Pill) is indicated. If in the exterior, Fang Feng Tong Sheng San (Saposhnikovia Unblocking the Exterior Powder) is used. If in the upper jiao, Liang Ge San (Cooling the Diaphragm Powder) is used. Confusion, fever, aversion to cold absent, inability to sleep indicates wind-heat irritability; Xie Qing Wan (Draining Green Pill) is used. Excessive phlegm-fire, irritability, thirst, constipation, rapid-large pulse: San Huang Zhi Shi Tang (Three Yellows and Immature Bitter Orange Decoction) or Gun Tan Wan (Rolling Phlegm Pill) are used.
Niu Huang Qing Xin Wan (Calculus Bovis Clearing Heart Pill) (Formula see Epilepsy section.)
Fang Feng Tong Sheng San (Saposhnikovia Unblocking the Exterior Powder)
Treats wind-stroke, all wind-heat conditions, constipation, dark/scanty urination, sores on head/face, red/painful eyes; or heat generating wind, stiff tongue, lockjaw; or purple-red acne on nose, urticaria, constituting Lung Wind; or becoming leprosy-like, commonly called Great Wind; or intestinal wind causing hemorrhoids/fistulas; or intestinal depression causing various heat delirium/manic madness. All are treated.
Fang Feng (Saposhnikoviae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chi Shao Yao (Paeoniae Radix Rubra, wine-fried), Lian Qiao (Forsythiae Fructus), Bo He (Menthae Haplocalycis Herba), Ma Huang (Ephedrae Herba) (each 4 fen), Shi Gao (Gypsum Fibrosum, calcined), Jie Geng (Platycodonis Radix), Huang Qin (Scutellariae Radix) (each 8 fen).
Bai Zhu (Atractylodis Rhizoma), Shan Zhi Zi (Gardeniae Fructus, wine-fried black), Jing Jie (Schizonepetae Spica) (each 3 fen), Hua Shi (Talcum) (2 qian 4 fen), Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas) (each 4 fen), Gan Cao (Licorice Root) (1 qian).
Decoct together with fresh ginger, green onion, and fermented soybean.
If spontaneous sweating, remove Ma Huang. If spontaneous diarrhea, remove Da Huang and Mang Xiao.
Note: This formula contains Fang Feng and Ma Huang, exterior-releasing drugs; wind-heat in the skin is released via sweat. Jing Jie and Bo He are upper-clearing drugs; wind-heat at the vertex is released via the nose. Da Huang and Mang Xiao are purgative drugs; wind-heat in the intestines/stomach is released via defecation. Hua Shi and Zhi Zi are water-drainage drugs; wind-heat in the water passages is released via urination. Wind invading the diaphragm, affecting Lung skin: Shi Gao and Jie Geng clear the Lung skin. Lian Qiao and Huang Qin dispel wandering fire in the meridians. Wind pathology is governed by Liver Wood; Chuan Xiong, Dang Gui, and Shao Yao harmonize Liver Blood. Gan Cao and Bai Zhu harmonize Stomach Qi and strengthen the Spleen.
Liang Ge San (Cooling the Diaphragm Powder)
Xie Qing Wan (Draining Green Pill) (Both formulas see Fire Syndrome section.)
San Huang Zhi Shi Tang (Three Yellows and Immature Bitter Orange Decoction)
Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Da Huang (Rhei Radix et Rhizoma, baked) (each 1 qian), Hou Po (Magnoliae Officinalis Cortex), Gan Cao (Licorice Root) (each 5 fen), Zhi Shi (Aurantii Fructus Immaturus) (2 qian).
Decoct in water, take hot, anytime.
Meng Shi Gun Tan Wan (Calcined Calamine Rolling Phlegm Pill) (Formula see Phlegm-Fluids section.)
Damp-Phlegm
Facial deviation, hemiplegia, excessive saliva, aphasia. Striking the right side indicates phlegm; Xi Xian San (Thin Saliva Powder) induces vomiting. Abundant phlegm with chest fullness: Dao Tan Tang (Guiding Phlegm Decoction). Obese person with phlegm syncope, facial deviation, hand numbness: Hua Tan Wan (Resolve Phlegm Pill). Four limbs unable to grasp, mental confusion, unconsciousness: Liu Jun Zi Tang (Six Gentlemen Decoction) plus Zhu Li (Bamboo Sap) and Jiang Zhi (Ginger Juice). If heat predominates: Jing Li Tang (Vitex Sap Decoction), or add Er Chen Tang (Two Aged Ingredients Decoction), or Qing Zhou Bai Wan Zi (Qingzhou White Pills). Severe phlegm-fire: Gun Tan Wan (Rolling Phlegm Pill).
Xi Xian San (Thin Saliva Powder) (Formula see previous True Wind-Stroke section.)
Dao Tan Tang (Guiding Phlegm Decoction)
Er Chen Tang (Two Aged Ingredients Decoction) plus Nan Xing (Arisaematis Rhizoma) and Zhi Ke (Aurantii Fructus).
Liu Jun Zi Tang (Six Gentlemen Decoction) (Formula see Spleen/Stomach section.)
Er Chen Tang (Two Aged Ingredients Decoction) (Formula see Phlegm-Fluids section.)
Zhu Li Tang (Bamboo Sap Decoction)
Treats wind-stroke with four limbs unable to grasp, mental confusion, unconsciousness, inability to speak.
Zhu Li (Bamboo Sap) (2 sheng), Sheng Ge Zhi (Puerariae Radix Juice) (1 sheng), Sheng Jiang Zhi (Fresh Ginger Juice) (3 he).
Mix, divide into three doses.
Jing Li Tang (Vitex Sap Decoction)
Treats wind-stroke with abundant phlegm and heat; suitable for regular use.
Jing Li (Vitex Sap) (2 sheng), Zhu Li (Bamboo Sap) (2 sheng), Sheng Jiang Zhi (Fresh Ginger Juice) (2 he).
Mix and take warm.
Qing Zhou Bai Wan Zi (Qingzhou White Pills)
Treats pediatric convulsive wind, adult various winds, lockjaw, or phlegm-panting and body numbness.
Sheng Ban Xia (Pinelliae Rhizoma, raw) (7 liang), Sheng Bai Fu Zi (Typhonii Rhizoma, raw) (2 liang), Sheng Chuan Wu (Aconiti Kusnezoffii Radix, peeled) (5 qian), Sheng Nan Xing (Arisaematis Rhizoma, raw) (2 liang).
Grind into fine powder, place in silk bag, wash in well water to extract powder, knead by hand to release more. If dregs remain, regrind, put back in silk bag, wash again until exhausted. Place in porcelain basin, sun-dry by day, dew-exposed by night. Change fresh water every morning: Spring 5 days, Summer 3 days, Autumn 7 days, Winter 10 days. Remove water, dry until jade-like, grind fine. Mix with rice porridge drink, form pills like mung beans. Take 3-5 pills per dose, down with mint tea. For wind paralysis, down with warm wine. Anytime administration.
Da Note: If the aforementioned symptoms occur in young and strong individuals, whose Qi and Blood are not yet deficient, and True Water is not exhausted, and who happen to be angry, stirring Liver Fire: Fire fears Water and cannot ascend, so the body is cool without phlegm-saliva. Awakening shortly after indicates Water abundance sufficient to control Fire; this is named Qi Stroke. In elderly and weak individuals, whose Qi and Blood are both deficient, and True Water exhausted, who happen to be angry, stirring Liver Fire: Fire lacks restraint and can ascend, so the body is warm with phlegm-saliva. Often untreatable because Water exhaustion fails to descend Fire; this is named Phlegm Stroke. Although some young and strong individuals are also untreatable: Men due to excessive sexual desire, lower Yuan Water deficiency failing to control Fire; Women due to excessive blood loss after menstruation or postpartum, failing to match Qi. Happening upon anger stirring Fire, Yang Qi has no foundation and follows Fire to flare out. Yin and Blood, are they not the root of Yang Qi?