，无使倾移，其形乃彰，生气乃长，命曰圣王。故《大要》曰∶无代化，无违时，必养必和
，待其来复，此之谓也。”
（呕涌溢食不下）
呕涌、溢食不下∶火气炎上，胃膈热甚，则传化失常也。
（目 不明）
目 不明，目赤肿痛，翳膜 疡，皆为热也；及目瞑，俗谓之眼黑，亦为热也，然平白
目无所见者，热气郁之甚也。或言目 为肝肾虚冷者，误也。是以妄谓肝主于目，肾主瞳子
，故妄言目 为虚而冷也。然肾水冬阴也，虚则当热。肝木春阳也，虚则当凉。肾阴肝阳
，岂能同虚而为冷者欤？或通言肝肾之中阴实阳虚，而无由目 也。俗妄谓肝肾之气衰少，
而不能至于目也。不知《经》言热甚目瞑眼黑也。岂由寒尔？又如仲景言。“伤寒病，热极则不识人
，”乃目盲也。《正理》曰∶“由热甚怫郁于目，而致之然也。”
然皮肤之汗孔者，谓泄气液之孔
窍也，一名气门，谓泄气之门也。一名腠理者，谓气液出行之腠道纹理也；一名鬼神门者，
谓幽冥之门也；一名玄府者，谓玄微府也。然玄府者，无物不有，人之脏腑、皮毛、肌肉、筋膜、骨髓、爪牙，至于世
之万物，尽皆有之，乃气出入升降之道路门户也。夫气者，形之主，神之母，三才之本，万物之元，道
之变也。故元阳子解《清静经》曰∶大道无形，非气不足以长养万物，由是气化则物生，气
变则物易，气甚即物壮，气弱即物衰，气正即物和，气乱即物病，气绝即物死。《经》曰∶“出入
废，则神机化灭。升降息，则气立孤危。故非出入则无以生、长、化、收、藏。是以升降出入，无器不有。”人之眼、耳、
鼻、舌、身、意、神识，
能为用者，皆由升降出入之通利也，有所闭塞者，不能为用也。若目无所见，耳无所闻，鼻
不闻臭，舌不知味，筋痿骨痹，齿腐，毛发堕落，皮肤不仁，肠不能渗泄者，悉由热气怫郁
，玄府闭密而致，气液、血脉、荣卫、精神。不能升降出入故也。各随郁结微甚，而察病之
轻重也。
故知热郁于目，无所见也。故目微昏者，至近则转难辨物，由目之玄府闭小也，隔缣视物之象也。或视如蝇翼者，
玄府有所闭合者也。或目昏而见黑花者，由热气甚，而发之于目，亢则害承乃制，而反出其
泣，气液昧之，以其至近，故虽视而亦见如黑花也，及冲风泣而目暗者，由热甚而水化制之
也。故《经》言∶“厥则目无所见。夫人厥则阳气并于上，阴气并于下。阳气并于上，则火烛光也
；阴气并于下则足寒，足寒则胀也。夫一水不胜五火，故目 盲，是以冲风泣下而不止。夫
风之中于目也，阳气内守于睛，是火气燔目，故见风泣下。”
（暴注）
暴注，卒泻∶君火义同。
（ ）
∶惕跳动也。火主动，故夏热则脉洪大而长， 之象也。况脉者，心火
之所养也。
（暴病暴死）
暴病暴死∶火性疾速故也。斯由平日衣服饮食，安处动止，精魂神志，性情好恶 ，不
循其宜而失其常，久则气变兴衰而为病也。或心火暴甚，而肾水衰弱，不能制之，热气怫郁
，心神昏冒，则筋骨不用，卒倒而无所知，是为僵仆也。
甚则水化制火，热盛而生涎，至极则死。微则发过如故，至微者，但眩瞑而已，俗云暗风，由火甚制金不能平木，
故风木自甚也。
或风热甚而筋惕螈 ，僵仆，口出涎沫，俗云风痫病也。欲知病有兼风者，阴阳变化之
道也。故阴阳相搏，刚柔相摩，五行相错，六气相荡，变而为病，则无穷矣。大法我子能制
鬼贼，则己当自实。而与子同为病者，不必皆然，由乎六气阴阳同异不等故也。
故经曰风热火同阳也，寒燥湿同阴也。又燥湿小异也，然燥金虽属秋阴而异于寒湿，故
反同其风热也；故火热胜，金衰而风生，则风能胜湿，热能耗液而反燥。阳实阴虚，则风热
胜于水湿为燥也。
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
于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、恐之五志，有所过极，而卒中者，由五志过极
，皆为热甚故也！
若微则但僵仆，气血流通，筋脉不挛，缓者发过如故。或热气太盛，郁结
壅滞，气血不能宣通，阴气暴绝，则阳气后竭而死。俗谓中，不过尔。
或即不死而偏枯者，由经络左右双行，而热甚郁结，气血不得宣通，郁极乃发。若一侧得通，则痞者痹而瘫痪也
。其人已有怫热郁滞，而气血偏行，微甚不等，故《经》言∶汗出偏沮，令人偏枯。然汗偏不出
者，由怫热郁结，气血壅滞故也！人卒中则气血不通，而偏枯也。
所谓肥人多中风者，盖人之肥瘦，由血气虚实使之然也，气为阳而主轻微，血为阴而主形体。故西方金、北方水为
阴而刚也，东方木、南方火为阳而柔也。故血实气虚则肥，气实血虚则瘦。所以肥者能寒不能
热，瘦者能热不能寒，由寒则伤血，热则伤气。损其不足，则阴阳愈偏，故不能也；损其有
余者平调，是故能之矣！故瘦者腠理疏通而多汗泄，血液衰少而为燥热，故多为劳嗽之疾也
。俗以为卒暴病甚而为热劳，徐久病微而为冷劳者，是以迟缓为言，而病非冷也，识其证候
为热明矣，但热有微甚而已。
或言肥人多中风由于虚，非也。所谓腠理致密而多郁滞，气血
难以通利，若阳热又甚而郁结，故卒中也，故肥人反劳者，由暴然亡液，损血过极故也，瘦
人反中风者，由暴然阳热太甚而郁结不通故也。
所谓中风口噤筋脉紧急者，由阳热暴甚于内，亢则害，承乃制，津液涌溢，聚于胸膈，
热燥以为痰涎。初虞世言∶涎者，乃遍身之脂脉津液也。然阳实阴虚而风热太甚，以胜水湿
，因而成燥，肝主于筋而风气自甚，又燥热加之，热还聚于胸膈，则筋太燥也，然燥金主于
收敛劲切紧涩，故为病筋脉劲强紧急而口噤也。
或破伤中风亦同，但以从微至甚而不偏枯也。夫破伤中风之由者，因疮热甚郁结，而荣卫不得宣通，怫热因之，遍
体故多发白痂，是时疮口闭塞，气难通泄，故阳热易为郁结，而热甚则生风也，不已则表传于里，亦由面首触冒
寒邪，而怫热郁甚，周身似为伤寒之疾，不解则表传于里者也。但有风热微甚兼化，故殊异
矣。
大法破伤中风，风热燥甚，怫郁在表而里气尚平者，善伸数欠，筋脉拘急，或时恶寒，
或筋惕而搐，脉浮数而弦也。宜以辛热治风之药，开冲结滞，荣卫宣通而愈。犹伤寒表热怫
郁，而以麻黄汤辛热发散者也。凡用辛热开冲风热转甚也；犹《伤寒论》热药发表不中效，则热转甚也。故发热用麻黄、
桂枝汤类热药发表，须加寒药，不然则热甚发黄或斑出矣。故发表诸方，佐以黄芩、石膏、知母、柴胡
、地黄、芍药、栀子、茵陈、葱白、豆豉之类寒药消息用之。如世以甘草、滑石、葱、豉寒
药发散甚妙，是以甘草甘能缓急，湿能润燥，滑石淡能利窍，滑能通利；葱辛甘微寒；豉咸
寒润燥，皆散结，缓急、润燥、除热之物。
因热服之，因热而玄府郁结得通，而怫热无由再作，病势虽甚，而不得顿愈者，亦获小
效，而无加害耳！此方散结，无问上下中外，但有益而无损矣。散结之方，何必辛热而已耶！
若破伤中风表不已而渐入于里，则病势渐甚。若里未太盛而脉在肌肉者，宜以退风热，开郁
滞之寒药调之，或以微加治风辛热，亦得以意消息，不可妄也。此犹伤寒病势，半在表半在
里，而以小柴胡汤和解之也。若里势已甚而舌强口噤，项背反张，惊搐惕搦，涎唾稠粘，胸
腹满塞，而成便溺秘结，或时汗出，脉洪数而弦也。
然汗出者，由风热郁甚于里，而表热稍
罢，则腠理疏泄，而心火热甚，故汗出也。大法风热怫郁，因汗当解。今不解者，若里热出
之于表，因汗而结散热去，则气和而愈也。今风热郁甚于里，而非出之于表，故虽汗泄，而
热不退，则不能解也。犹阳明证热甚于里，而日晡潮热，大汗虽出，热不退而不能解也，故
当大承气汤下之。其里热也，是以亢则害，承乃制。而今火热极甚，筋劲急而口噤尔！风热
加之，故惊而搐也。
风、热、燥并郁甚于里，故烦满而或 结也。法宜除风散结，寒药下之，以使郁滞流通
，而后以退风热、开结滞之寒药调之，而热退结散，则风自愈矣。呜呼！俗医所治破伤中
风，不明浅深，但以辛热燥药，任其天命而已！
若始觉风热郁结于表，而里尚平者可也，或
以寒物佐之亦佳。如灵宝丹治风痹，虽用硫磺、钟乳、木香、桂心之类辛热，是亦能令开结
也，佐以牛黄、脑子、苦参、芒硝之类寒物，以使结散而无复郁也，况至宝丹乃散风热郁痹
之寒药也。凡治风热结滞，宜戒热药过盛，凡破伤中风，宜早令导引摩按，自不能者，令人
以屈伸按摩挽之，使筋脉稍得舒缓，而气得通行，及频以橛斡牙关，勿令口噤，若紧噤之，则常以橛当之，
及频斡之，勿损牙齿，免致口噤不开，而粥药
不能下也。及风痫之发作者，由热甚，而风燥为其兼化，涎溢胸膈，燥热而螈 、昏冒、僵
仆也，或惊风者，亦由心火暴甚而制金，不能平木，故风火相搏，而昏冒、惊悸、潮搐也。
凡此诸证，皆由热甚而生风燥，各有异者，由风、热、燥各微甚不等故也。
所谓中风或筋缓者，因其风热胜湿而为燥，乃燥之甚也。然筋缓不收而痿痹，故诸
郁病痿，皆属金肺，乃燥之化也！如秋深燥甚，则草木痿落而不收，病之象也。是以手得
血而能握，足得血而能步。夫燥之为病，血液衰少也，而又气血不能通畅，故病然也。或云
筋挛有力，则为实热，筋缓不收，则为虚寒者；或谓寒主收引，而热主舒缓，则筋挛为寒，
筋缓为热者∶皆误也。凡治诸风方，通言主疗筋脉挛缓，岂分寒热虚实之异耶！但有微甚而
已。故诸筋挛虽势恶而易愈也。诸筋缓者，难以平复，明可知也。
或云中风为肝木实甚，则
大忌脏腑脱泄，若脾胃土气虚损，则土受肝木鬼贼之邪，而当死也。当以温脾补胃，令其土
实，肝木不能克，乃治未病之法也。所谓似是而非者也。或云脾为中州而当温者， 亦误也
；所以寒、暑、燥、湿、风、火之六气，应于十二经络脏腑也，以其本化，则能补之，相反
之者，则能泄之。然脾胃土本湿也，湿气自甚，则为积饮痞隔，或为肿满，以药燥去其湿，
是谓泻其脾胃土之本也；或病燥热太甚，而脾胃干涸成消渴者，土湿之气衰也，宜以寒温之
药，补阴泄阳、除湿润燥，而土气得其平，是谓补其脾土之本也。故仲景言伤寒里热太甚，
而胃中干涸烦渴者。急下之，救其胃气，方用甘草、大黄、芒硝大寒之药，谓之调胃承气汤
者，达其至理也。
所以阴阳异用，而寒湿同性，然土为阴，故异于风、热、燥也。土为万物
之母，水为万物之元。故水土同在于下，而为万物之根本也，地干而无水湿之性，则万物根本不润，而枝叶衰
矣。《经》言∶“动物神机为根在于中”，故食入于胃，而脾为变磨，布化五味，以养五脏之气，而养荣百骸，固其根本，
则胃中水谷润泽而已。亦不可水湿过与不及，犹地之旱涝也，故五脏六腑，四肢百骸，受气皆在于脾胃，土湿润而已。
《经》言，积湿成热，岂可以温药补于湿土也？温属春木，正以胜其湿土耳！
或以脏腑不分六气，而为假令之湿，一概言阳气甚而热为实，
阳气衰而寒为虚者，乃寒热阴阳之虚实，而非五行兴衰克伐之道也！然脏腑经络，不必本气
兴衰，而能为其病，六气互相干而病也。假令胃寒为虚冷者，是胃中阴水实而阳火虚也，当
以温补胃中阳火之虚。而退其阴水之实，非由胃土本虚，而补其湿也。夫补泻脾胃之本者，
燥其湿则为泻，润其燥则为补。今夫土本湿也，若阳实阴虚，风热胜其水湿而成燥者，则为
水湿衰也，可以退风散热，养液润燥，而救其已衰之阴湿，若反以温补，欲令脏腑而无壅塞
。不亦妄谬之甚耶！
或言中风由肾水虚冷者，误也。盖阴水既衰，则阳火自甚而热，岂能反
为寒者耶？以证验之，则为热明矣。或云中风既为热甚，治法或用乌附之类热药，何也？答曰
∶欲令药气开通经络，使气血宣行，而无壅滞也！然亦以消风热、开结滞之类寒药佐之，可
以制其药之热也，若服峻热药而热证转加者，不可服也。郁结不通，而强以攻之，则阴气暴
绝而死矣。故诸方之中，至宝，灵宝丹最为妙药。
今详本草言至宝丹之药味，合而为一，乃寒药尔；灵宝丹虽用温热之味，而复用寒药制
之，参而为一，亦平药也。况皆能散风壅、开结滞，而使气血宣通，怫热除而愈矣。此方虽
有治风之热药，当临时消息，适其所宜，扶其不足，损其有余。慎不可但以峻热攻痹，而反
绝其已衰之阴气也。
不要使（人体气机）发生偏倾移位，这样形体才能显现，生机才能生长，这被称为圣明的君王。所以《大要》说：“不要替代自然的变化，不要违背时令的规律，必须养护、调和，等待其自我恢复，说的就是这个道理。”
（呕吐、水液上溢、饮食不下）
呕吐、水液上溢、饮食不下：这是因为火气炎上，胃与膈部热势严重，导致传化功能失常。
（眼睛视物不明）
眼睛视物不明、眼睛红赤肿痛、眼睑生翳膜溃疡，都是由于热邪所致；还有闭目昏花，俗称“眼黑”，也是由于热邪所致，然而如果是平白无故完全看不见东西，那是热气郁结非常严重的表现。有人说眼睛视物不明是肝肾虚冷造成的，这是错误的。因此有人妄称肝主司眼睛，肾主司瞳孔，所以妄言眼睛视物不明是由于虚寒。然而肾水属于冬季之阴，虚弱时应当表现为热；肝木属于春季之阳，虚弱时应当表现为凉。肾阴与肝阳，怎么可能同时虚弱而表现为寒冷呢？或者笼统地说肝肾之中阴实阳虚，也没有理由导致眼睛视物不明。世俗之人妄称肝肾之气衰少，不能上达于眼睛。他们不知道《内经》中说热邪严重会导致闭目昏花、眼睛发黑，这难道是寒邪造成的吗？又如张仲景说：“伤寒病，热邪极盛时会神志不清不认识人”，这就是眼睛失明（或视物不见）。《正理》说：“这是由于热邪严重怫郁于眼部，从而导致这种情况。”
至于皮肤的汗孔，是指排泄气液的孔窍，又称气门，意思是排泄气的门户。又称腠理，是指气液出行的纹理通道；又称鬼神门，意思是幽深隐秘的门；又称玄府，意思是玄微之府。然而玄府，无处不在，人的脏腑、皮毛、肌肉、筋膜、骨髓、爪牙，以至于世间万物，全都具备，它是气出入升降的道路门户。气，是形体的主宰，精神的母亲，天地人三才的根本，万物的本源，道的变化体现。所以元阳子解释《清静经》说：“大道无形，没有气不足以长养万物，由是气化则物生，气变则物易，气盛则物壮，气弱则物衰，气正则物和，气乱则物病，气绝则物死。”《内经》说：“出入停止，则神机化灭。升降息止，则气立孤危。所以没有出入就没有生、长、化、收、藏。因此升降出入，没有哪个器用是不具备的。”人的眼、耳、鼻、舌、身、意、神识，能够发挥作用，都是因为升降出入通畅便利，如果有闭塞不通，就不能发挥作用。如果眼睛看不见，耳朵听不到，鼻子闻不到气味，舌头尝不出味道，筋脉痿软、骨骼痹痛，牙齿腐烂，毛发脱落，皮肤麻木不仁，肠道不能渗透排泄，这些都是由于热气怫郁，玄府闭密而导致的气液、血脉、营卫、精神不能升降出入的缘故。根据郁结程度的轻重，来观察疾病的轻重。
因此知道热邪郁结于眼睛，就会视物不见。如果眼睛轻微昏花，凑近看反而更难分辨物体，这是因为眼睛的玄府闭塞变小，就像隔着细绢看物体的景象一样。或者视物如蝇翅飞舞，是因为玄府有闭合之处。或者眼睛昏花且看见黑花，是由于热气极盛，发散于眼部，亢盛则有害，承制则制约，从而反而出泪，气液浑浊，因为距离极近，所以虽然能看见，但也像看见黑花一样。以及迎风流泪导致眼睛昏暗，是由于热邪极盛而被水气所制约。所以《内经》说：“厥证则眼睛看不见。人患厥证时，阳气并聚于上部，阴气并聚于下部。阳气并聚于上部，就像火光烛照；阴气并聚于下部则脚冷，脚冷则会胀满。一水不能胜五火，所以眼睛失明，因此迎风流泪不止。风邪中于眼睛，阳气内守于睛明穴，这是火气焚烧眼睛，所以见风流泪。”
（急性腹泻）
暴注，即突然腹泻：君火的病义与此相同。
（惕跳动）
惕跳动，即惊恐跳动。火性主动，所以夏季炎热时脉象洪大而长，这是惕动的脉象。况且脉，是由心火所滋养的。
（突发疾病突然死亡）
暴病暴死：是因为火性疾速的缘故。这往往是由于平日穿衣饮食、起居动静、精气魂魄神志、性情好恶，不遵循适宜之道而失去常态，久而久之气机变化兴衰而致病。或者心火暴盛，而肾水衰弱，不能制约它，热气怫郁，心神昏冒，筋骨不能使用，突然倒下而不省人事，这就是僵仆。
严重时水气制约火气，热盛而生涎沫，到了极点就会死亡。轻微时发作后如同常人，最轻微的只是眩晕而已，俗称暗风，是由于火邪太甚制约了金气，不能平抑木气，所以风木自盛。
或者风热严重导致筋脉跳动抽搐，僵仆，口吐涎沫，俗称风痫病。要知道疾病是否兼夹风邪，这是阴阳变化的道理。所以阴阳相搏，刚柔相摩，五行相错，六气相荡，变化而成疾病，那就无穷无尽了。大法则是：我（土）之子（金）能克制鬼贼（木），那么我自身就会充实。而与子同病的，不一定都如此，这是由于六气阴阳同异不等造成的。
所以《内经》说风、热、火同属阳，寒、燥、湿同属阴。又燥与湿略有不同，然而燥金虽然属于秋阴，却不同于寒湿，所以反而与风热同类；因此火热胜则金衰而生风，风能胜湿，热能耗液而反燥。阳实阴虚，则风热胜于水湿而为燥。
凡人的风病，多因热邪严重，而风燥是其兼化，以热为主因。世俗所说的风，是说末节而忘记了根本。所以中风瘫痪的人，并不是因为肝木之风实盛而突然中伤。也不是外感风邪，而是因为调养失宜导致心火暴盛；肾水虚衰不能制约，则阴虚阳实，热气怫郁，心神昏冒，筋骨不用，突然倒下而不省人事。多因喜、怒、思、悲、恐五志过度，突然中风的，是由于五志过极，都化为热邪严重所致！
如果轻微则只是僵仆，气血流通，筋脉不挛缩，缓慢者发作后如同常人。或者热气太盛，郁结壅滞，气血不能宣通，阴气突然断绝，则阳气随后竭尽而死。世俗所谓的中风，不过如此。
或者立即不死而半身不遂的，是由于经络左右双行，而热邪严重郁结，气血不得宣通，郁积到极点才发作。如果一侧得以通畅，则另一侧痞塞痹阻而瘫痪。那人已有怫热郁滞，而气血偏行，轻重不等，所以《内经》说：“汗出偏沮（半身无汗），使人半身不遂。”然而汗出不均，是由于怫热郁结，气血壅滞的缘故！人突然中风则气血不通，而半身不遂。
所谓肥胖人多中风，大概人的肥瘦，是由血气的虚实使之然也，气为阳而主轻微，血为阴而主形体。所以西方金、北方水为阴而刚，东方木、南方火为阳而柔。所以血实气虚则胖，气实血虚则瘦。所以胖人能耐寒不能耐热，瘦人能耐热不能耐寒，因为寒伤血，热伤气。损伤不足，则阴阳更加偏颇，所以不能耐受；损伤有余者则平调，所以能耐受！所以瘦人腠理疏通而多汗泄，血液衰少而为燥热，所以多为劳嗽的疾病。世俗认为突然暴病严重的是热劳，缓慢久病轻微的是冷劳，是以迟缓而言，但病并非冷，识别其证候为热是很明显的，只是热有轻重而已。
有人说肥胖人多中风是由于虚，这是不对的。所谓腠理致密而多郁滞，气血难以通利，如果阳热又盛而郁结，所以突然中风，所以肥胖人反而出现劳损，是由于突然亡失津液，损伤血液过极的缘故；瘦人反而中风，是由于突然阳热太盛而郁结不通的缘故。
所谓中风口噤、筋脉紧急的，是由于阳热突然盛于内部，亢盛则有害，承制则制约，津液涌溢，聚于胸膈，热燥以为痰涎。初虞世说：涎，是遍布全身的脂脉津液。然而阳实阴虚而风热太甚，以胜水湿，因而成燥，肝主筋而风气自盛，又加燥热，热还聚于胸膈，则筋太燥。然而燥金主收敛劲切紧涩，所以生病时筋脉劲强紧急而口噤。
或者破伤中风也相同，只是从轻微到严重但不半身不遂。破伤中风的原因，是因为疮疡热邪严重郁结，而营卫不得宣通，怫热因此遍体，所以多发白痂，这时疮口闭塞，气难通泄，所以阳热容易郁结，而热盛则生风，不停止则表传于里，也像头面部触犯寒邪，而怫热郁甚，周身似为伤寒的疾病，不解则表传于里。只是有风热轻重的兼化，所以殊异。
大法治疗破伤中风，风热燥邪严重，怫郁在表而里气尚平和的，善伸数欠（喜欢伸展打哈欠），筋脉拘急，有时怕冷，或者筋脉跳动抽搐，脉浮数而弦。宜用辛热治风的药，开冲结滞，营卫宣通则愈。就像伤寒表热怫郁，用麻黄汤辛热发散。凡是使用辛热开冲，风热转甚；就像《伤寒论》中热药发表不中效，则热转甚。所以发热用麻黄、桂枝汤类热药发表，须加寒药，不然则热盛发黄或斑出。所以发表诸方，佐以黄芩、石膏、知母、柴胡、地黄、芍药、栀子、茵陈、葱白、豆豉之类寒药斟酌使用。如世人用甘草、滑石、葱、豉等寒药发散很妙，是以甘草甘能缓急，湿能润燥，滑石淡能利窍，滑能通利；葱辛甘微寒；豉咸寒润燥，皆散结，缓急、润燥、除热的药物。
因热服之，因热而玄府郁结得通，而怫热无由再作，病势虽重，而不能顿愈的，也能获得小效，而无加害！此方散结，无论上下中外，只有益处而没有损害。散结的方剂，何必只是辛热呢！
如果破伤中风表证不已而逐渐入里，则病势渐重。如果里未太盛而脉在肌肉的，宜用退风热、开郁滞的寒药调理，或者稍微加一点治风的辛热药，也可以凭心意斟酌，不可妄为。这就像伤寒病势，半在表半在里，用小柴胡汤和解。如果里势已盛而舌强口噤，项背反张，惊搐惕搦，涎唾稠粘，胸腹满塞，而成便溺秘结，或者有时出汗，脉洪数而弦。
然而出汗的，是由于风热郁甚于里，而表热稍罢，则腠理疏泄，而心火热盛，所以出汗。大法风热怫郁，因汗当解。现在不解的，如果里热出于表，因汗而结散热去，则气和而愈。现在风热郁甚于里，而非出于表，所以虽然汗泄，而热不退，则不能解。就像阳明证热甚于里，而日晡潮热，大汗虽出，热不退而不能解，所以当用大承气汤下之。其里热也，所以亢则害，承乃制。而现在火热极盛，筋劲急而口噤！风热加之，所以惊而搐。
风、热、燥并郁甚于里，所以烦满或者结滞。法宜除风散结，用寒药下之，以使郁滞流通，而后用退风热、开结滞的寒药调理，而热退结散，则风自愈了。唉！世俗医生所治疗的破伤中风，不明白浅深，只用辛热燥药，听天由命罢了！
如果始觉风热郁结于表，而里尚平和的可以，或者用寒物佐之也很好。如灵宝丹治风痹，虽然用硫磺、钟乳、木香、桂心之类辛热，这也是能令开结，佐以牛黄、脑子、苦参、芒硝之类寒物，以使结散而无复郁，何况至宝丹乃是散风热郁痹的寒药。凡是治疗风热结滞，宜戒热药过盛，凡是破伤中风，宜早令导引摩按，自己不能做的，让人以屈伸按摩挽之，使筋脉稍得舒缓，而气得通行，以及频繁用橛斡牙关，勿令口噤，如果紧噤的，则常用橛当之，以及频繁斡之，勿损牙齿，免致口噤不开，而粥药不能下。以及风痫之发作的，由于热盛，而风燥为其兼化，涎溢胸膈，燥热而抽搐、昏冒、僵仆，或者惊风的，也由心火暴盛而制金，不能平木，所以风火相搏，而昏冒、惊悸、潮搐。
凡此诸证，都由热盛而生风燥，各有不同的，是由于风、热、燥各轻重不等造成的。
所谓中风或者筋缓的，因其风热胜湿而为燥，乃燥之甚。然而筋缓不收而痿痹，所以诸郁病痿，皆属金肺，乃燥之化！如秋深燥甚，则草木痿落而不收，病的景象。所以手得血而能握，足得血而能步。夫燥之为病，血液衰少，而又气血不能通畅，所以病这样。或者说筋挛有力，则为实热，筋缓不收，则为虚寒的；或者说寒主收引，而热主舒缓，则筋挛为寒，筋缓为热的：都是错误的。凡是治疗诸风的方，通言主疗筋脉挛缓，岂分寒热虚实之异耶！只是有轻重而已。所以诸筋挛虽然势恶而易愈。诸筋缓者，难以平复，明可知也。
或者说中风为肝木实盛，则大忌脏腑脱泄，如果脾胃土气虚损，则土受肝木鬼贼之邪，而当死。当以温脾补胃，令其土实，肝木不能克，乃治未病之法。所谓似是而非者也。或者说脾为中州而当温的，也是错误的；所以寒、暑、燥、湿、风、火之六气，应于十二经络脏腑也，以其本化，则能补之，相反之者，则能泄之。然而脾胃土本湿也，湿气自盛，则为积饮痞隔，或者为肿满，以药燥去其湿，是谓泻其脾胃土之本；或者病燥热太盛，而脾胃干涸成消渴的，土湿之气衰也，宜以寒温之药，补阴泄阳、除湿润燥，而土气得其平，是谓补其脾土之本。所以仲景说伤寒里热太盛，而胃中干涸烦渴的。急下之，救其胃气，方用甘草、大黄、芒硝大寒之药，谓之调胃承气汤的，达其至理也。
所以阴阳异用，而寒湿同性，然而土为阴，故异于风、热、燥也。土为万物之母，水为万物之元。故水土同在于下，而为万物之根本也，地干而无水湿之性，则万物根本不润，而枝叶衰矣。《内经》说：“动物神机为根在于中”，所以食入于胃，而脾为变磨，布化五味，以养五脏之气，而养荣百骸，固其根本，则胃中水谷润泽而已。也不可水湿过与不及，犹地之旱涝也，所以五脏六腑，四肢百骸，受气皆在于脾胃，土湿润而已。《内经》说，积湿成热，岂可以用温药补于湿土也？温属春木，正以胜其湿土耳！
或者以脏腑不分六气，而为假令之湿，一概言阳气盛而热为实，阳气衰而寒为虚的，乃寒热阴阳之虚实，而非五行兴衰克伐之道也！然而脏腑经络，不必本气兴衰，而能为其病，六气互相干而病也。假令胃寒为虚冷的，是胃中阴水实而阳火虚也，当以温补胃中阳火之虚。而退其阴水之实，非由胃土本虚，而补其湿也。夫补泻脾胃之本者，燥其湿则为泻，润其燥则为补。今夫土本湿也，若阳实阴虚，风热胜其水湿而成燥的，则为水湿衰也，可以退风散热，养液润燥，而救其已衰之阴湿，若反以温补，欲令脏腑而无壅塞。不亦妄谬之甚耶！
或者说中风由肾水虚冷造成的，是错误的。盖阴水既衰，则阳火自盛而热，岂能反为寒者耶？以证验之，则为热很明显了。或者说中风既然为热盛，治法或用乌附之类热药，为什么呢？回答说：欲令药气开通经络，使气血宣行，而无壅滞也！然而也以消风热、开结滞之类寒药佐之，可以制其药之热也，如果服峻热药而热证转加的，不可服也。郁结不通，而强以攻之，则阴气暴绝而死矣。所以诸方之中，至宝，灵宝丹最为妙药。
现在详细考察本草言至宝丹的药味，合而为一，乃是寒药尔；灵宝丹虽然用温热之味，而复用寒药制之，参而为一，亦是平药也。何况都能散风壅、开结滞，而使气血宣通，怫热除而愈矣。此方虽然有治风的热药，当临时消息，适其所宜，扶其不足，损其有余。慎不可但以峻热攻痹，而反绝其已衰之阴气也。
Do not allow (the body's Qi mechanism) to deviate or shift; thus the form will be manifest, and the vital energy will grow. This is called the Sage King. Therefore, *Da Yao* states: "Do not substitute for natural transformation, do not violate the seasons; one must nourish and harmonize, waiting for recovery. This is what is meant."
(Vomiting, overflowing fluids, inability to eat)
Vomiting, overflowing fluids, and inability to eat: This occurs because Fire Qi flares upward, causing severe heat in the Stomach and Diaphragm, leading to dysfunction of transmission and transformation.
(Blurred vision)
Blurred vision, red and swollen eyes, eyelid pterygium, and ulcers are all due to Heat; closing the eyes and experiencing darkness (colloquially called "eye black") is also due to Heat. However, if one suddenly loses sight completely without prior symptoms, it indicates severe stagnation of Heat. Some claim that blurred vision is caused by deficiency-cold of the Liver and Kidney, which is erroneous. They falsely assert that the Liver governs the eyes and the Kidney governs the pupils, thus claiming that visual impairment is due to deficiency-cold. Yet, Kidney Water belongs to Winter Yin; when deficient, it should manifest as Heat. Liver Wood belongs to Spring Yang; when deficient, it should manifest as Coolness. How can Kidney Yin and Liver Yang simultaneously be deficient and manifest as Cold? Or, generally speaking, even if there is Excess-Yin and Deficiency-Yang within the Liver and Kidney, there is no reason for visual impairment. Laypeople falsely claim that the Qi of the Liver and Kidney declines and fails to reach the eyes. They fail to know that the *Classic* states that severe Heat causes eye closure and darkness, not Cold. Furthermore, Zhang Zhongjing stated: "In Shanghan disease, extreme Heat leads to confusion and inability to recognize people," which constitutes blindness or loss of vision. *Zheng Li* states: "This is caused by severe Heat stagnating in the eyes."
Regarding the sweat pores of the skin, they are apertures for discharging Qi and fluids, also known as Qi Gates (men of Qi discharge). They are also called Couli (interstices), referring to the channels and textures through which Qi and fluids exit. They are also called Ghost and Spirit Gates, meaning gates of the obscure and profound. They are also called Xuanfu (Mysterious Mansion), meaning the mansion of subtle mysteries. The Xuanfu exists everywhere: in human Zang-Fu organs, skin, hair, flesh, sinews, bones, nails, and indeed in all things of the world. It is the pathway and gate for the entry, exit, ascent, and descent of Qi. Qi is the master of form, the mother of spirit, the root of the Three Powers (Heaven, Earth, Man), the origin of all things, and the manifestation of Dao. Thus, Yuan Yang Zi explained the *Qingjing Jing*: "The Great Dao is formless; without Qi, it cannot nourish all things. Through Qi transformation, things are born; through Qi change, things alter; when Qi is abundant, things flourish; when Qi is weak, things decline; when Qi is upright, things are harmonious; when Qi is chaotic, things become diseased; when Qi ceases, things die." The *Classic* says: "If entry and exit cease, the Shen Ji (spiritual mechanism) perishes. If ascent and descent stop, the Qi Li (Qi establishment) stands alone in danger. Therefore, without entry and exit, there is no birth, growth, transformation,收 (harvest), or storage. Thus, ascent, descent, entry, and exit are present in every vessel." The functions of human eyes, ears, nose, tongue, body, mind, and consciousness rely on the smooth flow of ascent, descent, entry, and exit. If blocked, they cannot function. If one cannot see with the eyes, hear with the ears, smell with the nose, taste with the tongue, suffers from sinew atrophy and bone bi, decaying teeth, falling hair, insensate skin, or intestinal failure to permeate and excrete, all these are caused by Heat stagnation, where the Xuanfu becomes closed and dense, preventing the ascent, descent, entry, and exit of Qi, fluids, blood vessels, Ying-Wei, and spirit. By observing the severity of the stagnation, one can assess the severity of the disease.
Therefore, knowing that Heat stagnating in the eyes causes blindness: if vision is slightly blurred, objects are harder to distinguish up close, because the Xuanfu in the eyes has narrowed, resembling viewing objects through fine silk. Seeing flies flying may indicate partial closure of the Xuanfu. Blurred vision with seeing black spots is due to severe Heat emanating from the eyes; when Excess leads to harm, Control (Cheng) acts to restrain it, causing tears to flow. The turbidity of Qi and fluids makes vision unclear; since the distance is near, vision appears as black spots. Crying in the wind leading to dim vision is due to severe Heat being controlled by Water. Thus, the *Classic* says: "Jue syndrome results in loss of vision. In Jue syndrome, Yang Qi gathers above, and Yin Qi gathers below. Yang Qi gathering above is like fire illuminating; Yin Qi gathering below causes cold feet, and cold feet cause distension. One water cannot overcome five fires, hence blindness, and continuous tearing in the wind. When Wind strikes the eyes, Yang Qi remains internally guarding the Jingming acupoint; this is Fire burning the eyes, hence tearing upon exposure to wind."
(Sudden diarrhea)
Baozhu (sudden projectile diarrhea): The principle is the same as Jun Huo (Monarch Fire).
(Trembling/Jumping)
Trembling/jumping refers to palpitations or twitching. Fire moves, so in summer heat, the pulse is surging, large, and long, which is the image of trembling. Moreover, the pulse is nourished by Heart Fire.
(Sudden illness and sudden death)
Sudden illness and sudden death: This is due to the rapid nature of Fire. It often arises from improper clothing, diet, rest, movement, and emotional states (essence, soul, spirit, will, temperament, likes/dislikes) over time, violating proper norms and losing constancy. Long-term deviation causes Qi changes, leading to decline and disease. For instance, if Heart Fire becomes violently excessive while Kidney Water is weak and unable to control it, Heat stagnates, confusing the Heart Spirit. The sinews and bones lose function, leading to sudden collapse and unconsciousness, known as Jiangpu (rigid fall).
In severe cases, Water controls Fire; excessive Heat generates phlegm/saliva, and at the extreme, death occurs. In mild cases, the patient recovers as before; in very mild cases, only dizziness occurs, colloquially called "An Feng" (Hidden Wind), caused by Fire excessively controlling Metal, failing to subdue Wood, so Wind-Wood becomes excessive.
Or, severe Wind-Heat causes sinew twitching and convulsions, rigid falls, and foaming at the mouth, colloquially called Wind Epilepsy. To know if a disease involves Wind is to understand the way of Yin-Yang transformation. Thus, Yin and Yang contend, Hard and Soft rub against each other, Five Phases intermix, and Six Qi interact; transformations into disease are infinite. The general rule is: If my "Child" (Metal) controls the "Ghost Thief" (Wood), then I (Earth) will naturally become substantial. Diseases involving the Child are not always like this, due to inequalities in the Six Qi and Yin-Yang.
Thus, the Classic states: Wind, Heat, and Fire belong to Yang; Cold, Dryness, and Dampness belong to Yin. Dryness and Dampness differ slightly; although Dryness-Metal belongs to Autumn Yin, it differs from Cold-Dampness, so it aligns more with Wind-Heat. Therefore, when Fire-Heat prevails, Metal declines, generating Wind; Wind can overcome Dampness, and Heat consumes fluids, causing Dryness. Yang Excess and Yin Deficiency mean Wind-Heat surpasses Water-Dampness to create Dryness.
Most Wind diseases in humans are due to severe Heat, with Wind-Dryness as a secondary transformation, where Heat is primary. Laypeople speak of "Wind," focusing on the branch and forgetting the root. Therefore, stroke paralysis is not due to excessive Liver-Wind striking suddenly, nor is it external Wind invasion. It is due to improper care leading to violent Heart Fire; Kidney Water is deficient and cannot control it, resulting in Yin Deficiency and Yang Excess, Heat stagnation, confused Heart Spirit, loss of sinew/bone function, and sudden collapse. This is often triggered by extremes of the Five Emotions (Joy, Anger, Worry, Sorrow, Fear); extremes of the Five Emotions all generate severe Heat!
If mild, only rigid fall occurs, Qi and Blood flow, sinews do not spasm, and the patient recovers. If Heat is too severe, stagnation blocks Qi and Blood, Yin Qi suddenly cuts off, followed by Yang exhaustion and death. Colloquial "stroke" is merely this.
If one does not die immediately but suffers hemiplegia, it is because meridians run bilaterally, but severe Heat stagnation blocks Qi and Blood. When the stagnation erupts, if one side opens, the other becomes blocked and paralyzed. The person already has stagnant Heat, with uneven Qi and Blood distribution. Hence, the Classic says: "Uneven sweating leads to hemiplegia." Uneven sweating is due to stagnant Heat blocking Qi and Blood. Sudden stroke causes Qi-Blood blockage and hemiplegia.
Obese people often suffer stroke because obesity results from Blood Excess and Qi Deficiency. Qi is Yang and light; Blood is Yin and forms the body. West Metal and North Water are Yin and firm; East Wood and South Fire are Yang and flexible. Thus, Blood Excess/Qi Deficiency leads to obesity; Qi Excess/Blood Deficiency leads to thinness. Obese people tolerate Cold but not Heat; thin people tolerate Heat but not Cold, because Cold injures Blood and Heat injures Qi. Damaging deficiency increases Yin-Yang imbalance, making tolerance impossible; balancing excess restores harmony. Thin people have open Couli, sweat easily, have deficient Blood, and suffer Dryness-Heat, often leading to consumptive cough. Laypeople call acute severe illness "Heat Consumption" and chronic mild illness "Cold Consumption"; however, the disease is Heat, varying only in degree.
Claiming obese people get stroke due to Deficiency is wrong. Their Couli are dense with stagnation; if Yang-Heat is excessive and stagnant, sudden stroke occurs. Obesity turning into consumption is due to sudden fluid loss and extreme Blood damage. Thin people getting stroke is due to sudden extreme Yang-Heat stagnation.
Stroke with jaw lock and tight sinews is due to sudden internal Yang-Heat excess. Excess harms, Control restrains; fluids surge, gathering in the chest/diaphragm, drying into phlegm-saliva. Chu Yushi said saliva is the lipid-fluid of the whole body. With Yang Excess/Yin Deficiency and severe Wind-Heat overcoming Water-Dampness to create Dryness, Liver governs sinews and Wind is strong; added Dryness-Heat concentrates in the chest, drying sinews. Dryness-Metal governs contraction and tension, causing stiff sinews and jaw lock.
Traumatic wind-stroke is similar but progresses from mild to severe without hemiplegia. Traumatic wind-stroke arises from severe Heat in wounds stagnating, blocking Ying-Wei, causing pervasive stagnant Heat and white scabs. Closed wound pores trap Qi, allowing Yang-Heat to stagnate and generate Wind. If unchecked, exterior transmits to interior, similar to head/face exposed to Cold causing systemic stagnant Heat. Differences lie in the degree of Wind-Heat transformation.
General rule for traumatic wind-stroke: If Wind-Heat-Dryness is severe, stagnant in the Exterior with Interior peaceful, symptoms include frequent stretching/yawning, sinew stiffness, occasional chills, or twitching, with floating-rapid-wiry pulse. Use pungent-hot Wind-dispelling drugs to open stagnation and restore Ying-Wei flow, curing the disease. Similar to Shanghan exterior Heat stagnation treated with Mahuang Tang. However, using pungent-hot drugs may intensify Wind-Heat, as seen in Shanghan Lun where hot exterior-releasing drugs fail and Heat worsens. Therefore, when using Mahuang/Guizhi Tang for fever, add Cold drugs; otherwise, severe Heat causes jaundice or rashes. Exterior-releasing formulas should be assisted with Huangqin, Shigao, Zhimu, Chaihu, Dihuang, Shaoyao, Zhizi, Yinchen, Congbai, Douchi, etc., used judiciously. Using Gancao, Huashi, Cong, Douchi as cold dispersants is excellent: Gancao is sweet, easing urgency and moistening dryness; Huashi is bland, opening apertures and promoting flow; Cong is pungent-sweet-mildly cold; Douchi is salty-cold, moistening dryness and dissipating knots. These are agents that ease urgency, moisten dryness, and clear Heat.
Taking them due to Heat allows the Xuanfu to open, preventing further stagnant Heat recurrence. Even if the condition is severe and not instantly cured, minor benefits are gained without harm. This formula dissipates knots anywhere in the body, beneficial and harmless. Why must knot-dissolving formulas be only pungent-hot?
If traumatic wind-stroke exterior symptoms persist and move inward, the condition worsens. If Interior is not too full and the pulse is at the muscle level, use Cold drugs to reduce Wind-Heat and open stagnation, or slightly add pungent-hot Wind drugs, adjusting carefully. This is like Shanghan half-exterior/half-interior stage treated with Xiaochaihu Tang. If Interior is severely full with stiff tongue, jaw lock, opisthotonos, convulsions, thick saliva, chest/abdominal fullness, urinary/fecal retention, occasional sweating, and surging-rapid-wiry pulse: Sweating occurs because Wind-Heat stagnates deeply in the Interior, while Exterior Heat subsides, opening Couli; Heart Fire is severe, causing sweat. Generally, Wind-Heat stagnation should resolve with sweat. If it does not, and Interior Heat emerges to the Exterior, sweat dissipates Heat and cures the disease. But if Wind-Heat is deeply stagnant in the Interior and does not emerge to the Exterior, sweat will not resolve the Heat. This is like Yangming syndrome with severe Interior Heat and tidal fever; despite heavy sweating, Heat persists, requiring Dachengqi Tang to purge. The Interior Heat follows the principle: Excess harms, Control restrains. Now Fire is extremely excessive, causing stiff sinews and jaw lock. Added Wind-Heat causes convulsions.
Wind, Heat, and Dryness all stagnate severely in the Interior, causing irritability, fullness, and binding. The method is to dispel Wind, dissipate knots, and purge with Cold drugs to unblock stagnation, then regulate with Cold drugs reducing Wind-Heat and opening knots. Once Heat retreats and knots scatter, Wind heals itself. Alas! Lay doctors treating traumatic wind-stroke ignore depth/shallowness, using only pungent-hot-dry drugs, leaving fate to chance!
If initially feeling Wind-Heat stagnating in the Exterior with Interior peaceful, it is acceptable, or assisting with Cold substances is good. Lingbao Dan treats Wind-Bi; although it uses sulfur, zhongru, muxiang, guixin (pungent-hot), it opens knots. Assisted by Niuhuang, naozi, Kushen, mangxiao (Cold), it dissipates knots without re-stagnation. Zhibao Dan is a Cold drug for dispersing Wind-Heat stagnation. When treating Wind-Heat knot-stagnation, avoid excessive Hot drugs. For traumatic wind-stroke, early guidance, massage, and manipulation are advised. If the patient cannot do it themselves, others should assist with flexion-extension massage to relax sinews and promote Qi flow. Frequently use a wedge to pry the jaw open to prevent lockjaw, ensuring medicine/food can enter. Wind epilepsy attacks are due to severe Heat with Wind-Dryness as secondary transformation; saliva floods the chest/diaphragm, Dryness-Heat causes convulsions, confusion, and rigid falls. Convulsive wind is also due to violent Heart Fire controlling Metal, failing to subdue Wood, so Wind-Fire contend, causing confusion, palpitations, and tidal convulsions.
All these syndromes arise from severe Heat generating Wind-Dryness; differences depend on the varying degrees of Wind, Heat, and Dryness.
Stroke with flaccid sinews is due to Wind-Heat overcoming Dampness to create Dryness, an extreme of Dryness. Flaccid sinews failing to contract lead to Wei-Bi syndromes. All stagnation-induced Wei syndromes belong to Metal-Lung, the transformation of Dryness. Just as late autumn dryness causes plants to wither and drop leaves, so does disease. Hands grasp due to Blood; feet walk due to Blood. Dryness disease is Blood deficiency combined with poor Qi-Blood circulation. Claiming tense sinews are Excess-Heat and flaccid sinews are Deficiency-Cold is wrong. Claiming Cold causes contraction and Heat causes relaxation, thus tense sinews are Cold and flaccid are Heat, is also wrong. All Wind formulas treat sinew/tendon tension or flaccidity without distinguishing Cold/Heat or Excess/Deficiency; it is only a matter of degree. Tense sinews, though severe, are easy to cure; flaccid sinews are hard to recover, which is obvious.
Claiming stroke is due to excessive Liver-Wood warns against organ leakage; if Spleen-Stomach Earth is deficient, it suffers from Liver-Wood "Ghost Thief" evil and dies. Treating by warming Spleen and tonifying Stomach to strengthen Earth, preventing Liver conquest, is "treating disease before it arises." This is specious reasoning. Claiming Spleen, as Central Earth, should be warmed is also wrong. The Six Qi correspond to the Twelve Meridians and Zang-Fu; their original transformation can tonify, while contrary ones can drain. Spleen-Stomach Earth is originally Damp; excessive Dampness causes fluid accumulation, obstruction, or edema. Using drying drugs to remove Dampness drains the Spleen-Stomach Earth. If Dryness-Heat is excessive, causing Spleen-Stomach dryness and Xiao Ke (wasting-thirst), the Dampness of Earth is depleted. Using Cold-Warm drugs to tonify Yin, drain Yang, clear Heat, and moisten Dryness balances Earth, tonifying its root. Thus, Zhang Zhongjing said for Shanghan with severe Interior Heat causing stomach dryness and thirst, urgent purging saves Stomach Qi using Gancao, Dahuang, Mangxiao (great Cold) in Tiaowei Chengqi Tang, reaching the ultimate truth.
Yin and Yang have different uses, but Cold and Dampness share similarity. Earth is Yin, differing from Wind, Heat, and Dryness. Earth is the mother of all things; Water is the origin. Water and Earth reside below, forming the root. If earth is dry without Water-Dampness, roots do not moisten, and branches decline. The Classic says: "Animal Shen Ji has its root in the Middle." Food enters the Stomach, Spleen grinds and transforms flavors to nourish Zang-Fu Qi and blood the body, securing the root, keeping stomach contents moist. Water-Dampness must not be excessive or insufficient, like drought or flood. All Zang-Fu and limbs receive Qi from Spleen-Stomach, relying on Earth's moisture. The Classic says: Accumulated Dampness becomes Heat; how can Warm drugs tonify Damp-Earth? Warmth belongs to Spring Wood, which overcomes Dampness!
Some confuse Zang-Fu with the Six Qi, treating hypothetical Dampness as if Yang Excess is Heat-Excess and Yang Deficiency is Cold-Deficiency. This confuses Cold/Heat Yin-Yang Excess/Deficiency with the Five Phases' rise/fall and mutual restraint. Zang-Fu meridian diseases need not stem from original Qi decline but from Six Qi interference. For example, Stomach Cold as Deficiency-Cold means Stomach Yin-Water is Excess and Yang-Fire is Deficient. One should warm-tonify Stomach Yang-Fire deficiency and reduce Yin-Water excess, not because Stomach Earth is originally deficient and needs Dampness tonification. Tonifying/draining Spleen-Stomach root: drying Dampness is draining; moistening Dryness is tonifying. Earth is originally Damp. If Yang Excess/Yin Deficiency causes Wind-Heat to overcome Water-Dampness creating Dryness, Water-Dampness is depleted. One should reduce Wind-Heat, nourish fluids, moisten Dryness, and save depleted Yin-Dampness. Conversely, using Warm-tonics to prevent organ congestion is highly erroneous!
Claiming stroke is due to Kidney-Water deficiency-cold is wrong. Since Yin-Water is depleted, Yang-Fire naturally becomes excessive and Hot; how can it reverse to Cold? Clinical evidence confirms Heat. If stroke is due to severe Heat, why use Hot drugs like Wu Tou/Fu Zi? Answer: To open meridians and promote Qi-Blood flow without stagnation. However, assist with Cold drugs like Wind-Heat reducers and knot-openers to counteract the drug's heat. If severe Hot drugs worsen Heat signs, they must not be used. Forcing treatment on blocked stagnation causes sudden Yin Qi cutoff and death. Among formulas, Zhibao Dan and Lingbao Dan are best.
Examining Bencao, Zhibao Dan combines Cold drugs. Lingbao Dan uses Warm-Hot ingredients but is controlled by Cold drugs, resulting in a neutral formula. Both disperse Wind congestion, open knots, promote Qi-Blood flow, eliminate stagnant Heat, and cure. Although containing Wind-treating Hot drugs, they must be adjusted appropriately, supporting deficiency and reducing excess. Do not solely use severe Hot drugs to attack Bi, thereby cutting off already depleted Yin Qi.