河间《原病式》曰∶凡人风病，多因热甚，而风燥者，为其兼化，以热为其主也。俗云
风者，言末而忘其本也。所以中风瘫痪者，非谓肝木之风实甚而卒中之也。亦非外中于风尔
。由乎将息失宜而心火暴甚，肾水虚衰，不能制之，则阴虚阳实而热气怫郁，心神昏冒，筋
骨不用，而卒倒无所知也。多因喜、怒、思、悲、恐五志有所过极而卒中者，皆为热甚故也
。若病微则但僵仆，气血流通，筋脉不挛。缓者发过如故。或热气太甚，郁结壅滞，气血不
能宣通，阴气暴绝，则阳气后竭而死。
据河间此论，谓非肝木之风，亦非外中之风，由乎将息失宜，此独得之见，诚然善矣。
然皆谓为热甚，则不然也。凡将息失宜，五志过极，本属劳伤证也。而劳伤血气者，岂皆火
证？又岂无阳虚病乎？经曰∶喜怒伤气，寒暑伤形，暴怒伤阴，暴喜伤阳。夫伤阴者，水亏
也。伤阳者，火虚也。以虚作火，鲜不危矣。
又河间曰∶其中腑者，面加五色，有表证，脉浮而恶寒，拘急不仁，皆曰中腑也。其治
多易。中脏者，唇吻不收，舌不转而失音，鼻不闻香臭，耳聋而眼瞀，大小便闭结，皆曰中
脏也。其治多难。大抵中腑者多着四肢，中脏者多滞九窍。若风中腑者，先以加减续命汤，
随证发其表；若忽中脏者，则大便多秘涩，宜以三化汤通其滞。表里证已定，别无他证，故
以大药和治之。
据此云脉浮恶寒，拘急不仁等证，本皆伤寒之类也。何又名为中腑？唇不收，舌不转，
失音耳聋等证，本皆厥夺之类也。何又名为中脏？自中脏中腑之说并列为言，而内伤外感之
证，斯无辨而混乱矣。且续命汤、三化汤之属，但可以散风寒，攻实热。若所云将息失宜者
，岂尚堪治之以此？
刘河间在《原病式》中说：大凡风病，大多因为热邪极盛所致，而所谓“风燥”，只是热邪兼夹的化生表现，以热邪作为主导。世俗所说的“风”，是只看到了表象而忘记了根本。所以中风导致瘫痪的人，并不是因为肝木之风实盛而突然中击人体，也不是外感风邪所致。而是因为调养失当导致心火突然亢盛，肾水虚衰，不能制约心火，从而出现阴虚阳亢、热气郁结闭塞，心神昏乱蒙蔽，筋骨失去功能，于是突然昏倒且不知人事。大多是因为喜、怒、思、悲、恐这五种情志过度极端而导致猝然中风的，都是因为热邪极盛的原因。如果病情轻微，则只是突然跌倒，但气血流通，筋脉不痉挛。病情较轻缓的，发作过后如同常人。或者热邪太盛，郁结壅滞，气血不能宣通，阴气突然断绝，那么阳气随后竭尽而死。
根据河间的这一论述，他说不是肝木之风，也不是外感之风，而是由于调养失当，这是独到的见解，确实很好。然而都归结为热邪极盛，就不对了。凡是调养失当、五志过极，本来属于劳损内伤的证候。而劳损导致血气亏虚的，难道都是火证吗？又难道没有阳虚的病吗？《内经》说：喜怒损伤气机，寒暑损伤形体，暴怒损伤阴分，暴喜损伤阳分。损伤阴分的，是水液亏损；损伤阳分的，是火气虚弱。将虚证当作火证来治，很少有不危险的。
另外河间说：其中于腑的，面色呈现五色变化，有表证，脉象浮而恶寒，肢体拘急麻木不仁，都称为中腑。治疗大多容易。中于脏的，口唇松弛不收，舌体转动失灵而失音，鼻子闻不到香臭，耳聋眼花，大小便闭结不通，都称为中脏。治疗大多困难。大致上中腑的病多表现在四肢，中脏的病多在九窍阻滞。如果是风中于腑，先用加减续命汤，根据证候发散表邪；如果忽然中于脏，则大便多秘涩，宜用三化汤通导积滞。表里证候确定后，没有其他兼证，所以用大药调和治疗。
根据这些描述，像脉浮恶寒、拘急不仁等证候，本都属于伤寒之类。为什么又命名为中腑？口唇不收、舌不转、失音耳聋等证候，本都属于厥脱之类。为什么又命名为中脏？自从将中脏和中腑的说法并列提出以来，内伤和外感的证候，就没有了辨别而变得混乱了。况且续命汤、三化汤这类方剂，只能疏散风寒、攻逐实热。如果是所谓调养失当导致的疾病，哪里还能承受用这些方法治疗呢？
Liu Hejian stated in *Yuan Bing Shi* (Treatise on the Origin of Diseases): Generally, wind diseases are mostly caused by extreme heat. The so-called "wind-dryness" is merely a secondary transformation combined with heat, with heat as the primary factor. The common parlance regarding "wind" focuses on the superficial aspect while forgetting the root cause. Therefore, stroke resulting in paralysis is not due to an excess of Liver Wood wind striking suddenly, nor is it caused by external wind invasion. It arises from improper lifestyle management leading to a sudden surge of Heart Fire, coupled with deficiency and decline of Kidney Water, which fails to control the fire. This results in Yin deficiency and Yang excess, with hot qi becoming stagnant and depressed. The spirit becomes confused and obscured, tendons and bones lose their function, leading to sudden collapse and loss of consciousness. Most cases of sudden stroke are caused by the excessive extremes of the five emotions—joy, anger, worry, sorrow, and fear—all due to extreme heat. If the condition is mild, there may only be a sudden fall, but Qi and Blood flow smoothly, and tendons and vessels do not spasm. In milder or slower-progressing cases, the patient returns to normal after the episode. However, if the heat is too severe, causing stagnation and obstruction where Qi and Blood cannot circulate freely, Yin Qi may suddenly cease, followed by the exhaustion of Yang Qi, leading to death.
Based on Hejian's discussion, his assertion that these conditions are neither Liver Wind nor external wind, but rather result from improper lifestyle management, is a unique insight and indeed commendable. However, attributing everything to extreme heat is incorrect. Improper lifestyle management and excessive emotional extremes essentially belong to patterns of consumptive injury (Lao Shang). Are all cases of Qi and Blood depletion due to consumption fire? Is there no such thing as Yang deficiency disease? The Classics state: Joy and anger injure Qi; cold and heat injure the form; violent anger injures Yin; violent joy injures Yang. Injury to Yin implies a deficiency of Water. Injury to Yang implies a deficiency of Fire. Treating deficiency as fire will rarely fail to lead to danger.
Furthermore, Hejian stated: When the pathogen enters the Fu organs, the face shows five colors, there are exterior symptoms, the pulse is floating with aversion to cold, and there is stiffness and numbness; this is called "Stroke of the Fu organs." Treatment is generally easier. When the pathogen enters the Zang organs, there is flaccidity of the lips and mouth, inability to move the tongue resulting in aphonia, anosmia, deafness, blurred vision, and constipation of both bowels and bladder; this is called "Stroke of the Zang organs." Treatment is generally difficult. Generally, stroke of the Fu organs manifests more in the four limbs, while stroke of the Zang organs causes stagnation in the nine orifices. If wind strikes the Fu organs, one should first use Jia Jian Xu Ming Tang (Modified Life-Sustaining Decoction) to release the exterior according to the syndrome. If suddenly struck in the Zang organs, bowel movements are often constipated and dry, so San Hua Tang (Three Transformations Decoction) should be used to unblock the stagnation. Once the interior and exterior syndromes are clarified and no other complications exist, major herbs are used for harmonious treatment.
According to these descriptions, symptoms such as a floating pulse, aversion to cold, stiffness, and numbness originally belong to the category of Cold Damage (Shang Han). Why are they named Stroke of the Fu organs? Symptoms such as flaccid lips, immobile tongue, aphonia, and deafness originally belong to the category of Jue (Cold Extremities/Reversal) and collapse. Why are they named Stroke of the Zang organs? Since the concepts of Stroke of the Zang and Fu organs were presented together, the distinction between internal injury and external contraction became blurred and chaotic. Moreover, formulas such as Xu Ming Tang and San Hua Tang can only disperse wind-cold and attack excess heat. How can diseases caused by improper lifestyle management endure treatment with these methods?