要略云脉微而数中风使然又云头痛脉滑者中风风脉虚弱也又寸口脉浮而紧寸口脉缓而迟
皆曰中风也
脉经云浮而大者风又浮而缓皮肤不仁风寒入肌肉又滑而浮散者瘫痪风又诊人被风不仁痿
蹶其脉虚者生坚急疾者死
发直吐沫摇头上窜直视口开手撒眼合遗尿不知人或面赤如妆或头面青黑汗缀如珠声如鼾
睡皆不可治
病机机要云风本为热热胜则风动宜以静胜其燥是养血也治须少汗亦宜少下多汗则虚其卫
多下
则损其荣宜治在经虽有汗下之戒而有中脏中腑之分中腑者多着四肢有表证而脉浮恶风寒拘急
不仁中脏者多滞九窍唇缓失音耳聋鼻塞目瞀大便结秘中腑者宜汗之中脏者宜下之表里已和宜
治之在经当以大药养之
发明云中血脉则口眼 斜中腑则支节废中脏则性命危三治各不同中血脉外有六经之形证
则从
小续命加减中腑内有便溺之阻隔宜三化汤等通利之外无六经之形证内无便溺之阻隔宜养血通
气大秦艽汤羌活愈风汤主之
按此分在表在里在经之三证立汗下调养之三法可谓开后世之盲聋但所用诸方学人宜详审
发明云治风当通因通用惟宜宣发以散之不可便以苦寒之药妄下龙麝朱砂牛黄诸镇坠之药泻之
按此言风本外邪惟宜宣散此风在表之时也如伤寒中风传入于胃亦未尝不可下论中便字妄
字可见其意便者有早与急之义妄者谓有不当下之义
《金匮要略》中说：脉象微而数，是中风所致；又说头痛且脉滑的，也是中风，因为风邪致病的脉象多为虚弱。还有寸口脉浮紧、寸口脉缓迟的，都称为中风。
《脉经》说：脉浮大的，是风邪致病；若又见脉浮缓，皮肤麻木不仁，这是风寒侵入肌肉；脉象滑而浮散的，是瘫痪风。诊察被风邪所伤导致肢体麻木、痿厥的病人，脉象虚弱的可以生还，脉象坚急疾速的则死亡。
头发竖起、吐白沫、摇头、眼球上窜、直视、口开、手撒、眼闭、遗尿、神志不清，或者面色红如化妆（戴阳证），或者头面部青黑、汗出如珠、声音像打鼾一样，这些都属于不可治愈的危重症。
《卫生宝鉴·病机机要》中说：风本属热，热盛则风动，应当以静胜其燥，这就是养血的方法。治疗时发汗不宜过多，攻下也不宜过频。发汗过多会耗伤卫气，攻下过多会损伤营血。虽然治疗应在经络层面进行，虽有发汗和攻下的禁忌，但仍有中脏和中腑的区别。中腑的病证多表现在四肢，有表证，脉浮，恶风寒，肢体拘急麻木；中脏的病证多阻滞九窍，表现为口唇松弛失音、耳聋、鼻塞、视物模糊、大便秘结。中腑者适宜用发汗法，中脏者适宜用攻下法。若表里已调和，则应在经络层面治疗，当用大剂量的药物来调养身体。
《医学发明》中说：病在中血脉，会出现口眼歪斜；病在中腑，会导致四肢关节废用；病在中脏，则会危及生命。这三种情况的治疗方法各不相同。病在中血脉，外部有六经形证，则用小续命汤加减治疗；病在中腑，内部有大便小便阻隔，宜用三化汤等方剂通利二便；若外部没有六经形证，内部也没有二便阻隔，宜用大秦艽汤或羌活愈风汤主之，以养血通气。
按语：此处将病症分为在表、在里、在经三种证候，确立了发汗、攻下、调养三种治法，可谓开启了后世医家的眼界。但所用各方，学习者应当仔细审察。
《医学发明》还说：治疗风邪应当“通因通用”，只适宜宣散发散，不可轻易使用苦寒药物妄加攻下，也不可用龙脑、麝香、朱砂、牛黄等重镇坠降的药物泻之。
按语：此言风邪本是外邪，只适宜宣散，这是在风邪尚在体表之时说的。如果像伤寒中风传入胃腑，也并非不可以攻下。文中使用的“便”字有早急之意，“妄”字指不该下而下，可见其用意所在。
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: A pulse that is faint and rapid indicates stroke caused by wind. It also states that headache with a slippery pulse indicates stroke, as the pulse associated with wind pathogenic factors is typically deficient. Furthermore, a cun-kou pulse that is floating and tight, or one that is slow and delayed, are all referred to as stroke.
The *Mai Jing* (Pulse Classic) states: A floating and large pulse indicates wind. If it is also floating and moderate, accompanied by numbness of the skin and flesh, this indicates wind-cold invading the muscles. A pulse that is slippery, floating, and scattered indicates flaccidity paralysis due to wind. When examining patients suffering from wind-induced numbness and flaccidity tetany, those with a deficient pulse may survive, while those with a firm, urgent, and rapid pulse will die.
Symptoms such as straightened hair, foaming at the mouth, shaking of the head, upward deviation of the eyes, staring fixedly, open mouth, relaxed hands, closed eyes, urinary incontinence, loss of consciousness, or a face red as if painted (floating yang), or a blue-black complexion on the head and face, sweat beading like pearls, and a snoring-like voice, are all considered incurable critical conditions.
The *Bing Ji Yao Yao* (Essentials of Pathogenesis) in *Wei Sheng Bao Jian* (Treasures for Maintaining Health) states: Wind is fundamentally heat; when heat prevails, wind moves. One should use stillness to overcome dryness, which is the method of nourishing blood. Treatment requires avoiding excessive sweating and excessive purgation. Excessive sweating depletes Wei Qi (Defensive Qi), and excessive purgation damages Ying Qi (Nutritive Qi). Although treatment should focus on the meridians, and there are taboos against sweating and purging, there is a distinction between Zhong Zang (Stroke involving the Zang organs) and Zhong Fu (Stroke involving the Fu organs). Zhong Fu manifestations often affect the four limbs, presenting with exterior syndrome signs such as a floating pulse, aversion to wind and cold, limb stiffness, and numbness. Zhong Zang manifestations often obstruct the nine orifices, presenting with flaccid lips and aphonia, deafness, nasal congestion, blurred vision, and constipation. Zhong Fu is suitable for diaphoresis (sweating therapy), while Zhong Zang is suitable for purgation. Once the interior and exterior are harmonized, treatment should focus on the meridians, using substantial medicinal tonification to nourish the body.
The *Yi Xue Fa Ming* (Inventions in Medicine) states: Disease in the blood vessels and collaterals leads to facial paralysis (deviation of the mouth and eyes); disease in the Fu organs leads to limb joint dysfunction; disease in the Zang organs endangers life. The treatments for these three categories differ. For disease in the blood vessels and collaterals, where exterior Six Channels (Liu Jing) patterns are present, Xiao Xu Ming Tang (Minor Decoction to Extend Life) should be used with modifications. For disease in the Fu organs, where there is obstruction of bowel and bladder movements, San Hua Tang (Three Transformations Decoction) or similar formulas should be used to promote unblocking. If there are no exterior Six Channels patterns and no internal obstruction of bowel and bladder movements, Da Qin Jiao Tang (Major Gentian Decoction) or Qiang Huo Yu Feng Tang (Notopterygium Decoction for Expelling Wind) should be used primarily to nourish blood and promote qi circulation.
Commentary: This classification divides symptoms into exterior, interior, and meridian syndromes, establishing sweating, purging, and nourishing methods. This can be said to have opened the eyes and ears of later generations. However, practitioners should carefully examine the formulas used.
The *Yi Xue Fa Ming* further states: In treating wind, one should employ "treating obstruction with unblocking agents" (Tong Yin Yong Tong), relying solely on dispersing and scattering methods. One should not recklessly use bitter-cold herbs to purge internally, nor use heavy sedative and descending drugs such as Long Nao (Borneol), She Xiang (Musk), Zhu Sha (Cinnabar), and Niu Huang (Calculus Bovis) to drain downward.
Commentary: This statement emphasizes that wind is an external pathogen and is suitable for dispersion only when the wind is still at the exterior level. Similar to how Tai Yang wind-cold transmits to the Stomach, purgation is not entirely forbidden. The use of the character "bian" (convenient/early) implies acting too early or hastily, and "wang" (reckless/wrong) implies purging when it is inappropriate, revealing the author's intent.