张曰∶脉无实结，何可妄攻？且病患素有脾病，大便常五六日一行，而艰苦异常。乃令先试以糜饮，以流动肠
胃之枢机，日进六君子汤，每服用人参二钱，煎成顿热，分三次服。四剂后，大便自通。再四剂，自能起坐，
数日间可扶掖徐行。因戒其左右，慎防步履，以病患气虚痰盛故也。
吕东庄治沈凝芝内人，时当就卧，忽作寒热，至夜半，即不能言，喘急。或以为感伤，或以为气逆痰结，
用乌药顺气散不效。诊之，声如曳锯，手撤遗尿，口开不能言，有汗如雨，曰∶此类中风也。已伤脏，不可治
矣。凝芝曰∶即无救理，应用何药？曰∶初发即当用易简附子散，今无及矣。乃自进之，喘声忽止，且稍
发语，疑尚可救。曰∶五脏俱绝，今得参、附，气少苏耳，终无济也。果三日而殁。
韩贻丰治司空徐元正风气，满面浮虚，口角流涎不已，语含糊不能出喉，两腿沉重，足趑趄不克逾户
限。脉之，曰∶此症非针不可。遂呼燃烛，举手向顶门欲用针。徐公及其令孙皆大惶骇云∶此处安可用火攻？
强之再三，终究不允而罢。后闻韩之针颇神，复邀，与针百会、神庭、肾门、命门、环跳、风市、三里、涌泉
诸穴道，俱二十一针。方针之初下也，以为不知当作如何痛楚，及药 气氤氲，不可名状，连声赞叹，以为美
效。积久周身之病，一时顿去。（《神针心法》。）
柴屿青治考功吴景星太翁，卒中昏愦，满面油光，两关弦紧，投以附子理中汤。次日，心中明白，面上浮
光即敛。调理数月而康。
蓟州牧杨芋，丙寅春，五旬余，卒中肢废，口不能言，大小便难，中府而兼中脏也。初进通幽汤不应，加
大黄、麻仁，二剂始通，舌稍转动。又用加减大秦艽汤，数剂始能言，但舌根尚硬。后用地黄饮子，及参、 、
术等兼服，舌柔胃强，左手足尚不能举动。此由心境不堪，兼之参饵调服也。今庚午秋，闻其在楚，已痊愈。
大司寇阿年已七旬，偶患胃痛延治，至则其势已减，其六脉平和，两尺神完气足。如此禀浓者，不可多见。
乃以曾经口眼 邪，至今面部微有不正为患，曰∶阳脏之脉，前因心火暴盛无制，遂流经络而然，惟有壮水之
主，以镇阳光，常服丸剂，可保期颐。
薛立斋治靳太师夫人，先胸胁胀痛，后四肢不遂，自汗如雨，小便自遗，大便不实，口紧目 ，饮食颇进
十余日。或以为中脏。曰∶非也。若风既中脏，真气将脱，恶症已见，祸在反掌，安能延至十日？乃候其色，
面目俱赤而或青。诊其脉，左三部洪数，惟肝尤甚。乃知胸乳胀痛，肝经血虚，肝气否塞也。四肢不收，肝经
血虚，不能养筋也。自汗不止，肝经血热，津液妄泄也。小便自遗，肝经热甚，阴挺失职也。大便不实，肝木
炽盛克脾土也。用犀角散四剂，诸症顿愈。又用加味逍遥散调理而安。后因郁怒，前症复作，兼发热吐呕，饮
食少思，月经不止，此木盛克土，而脾不能摄血也。用加味归脾为主，佐以逍遥散而愈。后每遇怒，或睡
中手搐搦，复用前药愈。
大参朱云溪母，于九月忽仆地，痰壅不省人事，唇口 邪，左目紧小。或用痰血之剂，其势稍缓。至次年
四月初，其病复作，仍进前药，势亦渐缓。至六月终，病乃大作，小便自遗，或谓风中于脏，以为不治。诊之，
左关洪弦而数，此属肝火血燥也。遂用六味丸加五味、麦冬、芎、归，一剂而饮食顿进，小便顿调。随用补中
益气加茯苓、山栀、钩藤、丹皮而安。至十月，复以伤食，腹痛作泻，左目仍小，两关尺脉弦洪鼓指，以六君
加木香、吴茱、升麻、柴胡，一剂而痛泻俱缓。以六君加肉果、故纸，一剂诸脉顿平，痛泻俱止。夫左关弦洪，
由肝火血燥，故左目燥小；右关弦洪，由肝邪乘脾，故唇 口邪，腹痛作泻；二尺鼓指，由元气下陷。设以目
紧口 ，误作中风，投以风药；以腹痛泄泻，误作积滞，投以峻攻，复耗元气，为害甚矣。以阳虚恶寒，围火
过热，致增痰喘，误服寒剂而卒。
一妇人，因怒仆地，语言謇涩，口眼 邪，四肢拘急，汗出遗溺，六脉洪大，肝脉尤甚。皆由肝火炽盛，
盖肝主小便，因热甚而自遗也，（经云∶肝虚者善溺。）用加味逍遥散加钩藤，及六味丸寻愈。（亦可入气厥。）
一妇人经行，口眼 邪，痰涎壅盛。此血虚而肝火动，用加味逍遥散加丹皮，治之寻愈。后因饮食停滞，
日吐痰涎。此脾气虚，不能摄涎归经也，用六君子二十余剂而安。
一妇人因怒，口眼 邪，痰涎上涌，口噤发搐。此脾肺气虚而肝木旺，用六君子加木香、钩藤、柴胡，治
之渐愈。又用加味归脾汤调理而安。
一妇人，元气素虚，劳则体麻发热，痰气上攻。或用乌药顺气散、祛风化痰丸之类，肢体痿软，痰涎自出，
面色痿黄，形体倦怠，而脾肺二脉虚甚。此气虚而类风，朝用补中益气汤，夕用十全大补汤，渐愈。又用加味
归脾汤调理寻愈。
一妇人，口眼 邪，四肢拘急，痰涎不利而恶风寒，其脉浮紧。此风寒客于手足阳明二经，先用省风汤二
剂，后用秦艽升麻而愈。
王海藏云∶某黄门，卒中风，病发时服紫菀丸，泄出恶脓四升，赤黄水一升，一肉虫如乱发，愈。（方见痨风门）
姚僧垣治大将军乐平公窦集，暴感风疾，精神瞀乱，无所知觉。诸医先视者，皆云已不可救。僧垣后
至，曰∶困则困矣，终当不死。若专以见付，当为治之。其家欣然，请受方术。僧垣为合汤散，所患即瘳。大
将军永世公叱伏列椿，时苦痢疾而不废朝谒。燕公尝问僧垣曰∶乐平、永世俱有痼疾，若永世差轻。对曰∶夫
患有浅深，时有克杀。乐平虽困，终当保全；永世虽轻，必不免死。谨曰∶君言必死，当在何时？对曰∶不出
四月。果如其言，谨叹异之。（《周书》。）
高祖亲戍东征，至河阴遇疾，口不能言，脸垂覆目，不复瞻视，一足短缩，又不得行。僧垣以为诸脏俱病，
不可并治。军中之要，莫先于语。乃处方进药，帝遂得言。次又治目，目疾便愈。末乃治足，足疾亦瘳。比至
华州，帝已痊复。（同上。）
李季虬曰∶予乙卯春，正月三日，忽患口角歪邪，右目及右耳根俱痛，右颊浮肿。仲淳曰∶此内热生风及
痰也。治痰先清火，清火先养阴，最忌燥剂。苏子、橘红、天冬、花粉、鲜沙参、甘菊花各三钱，贝母、白芍
各四钱，麦冬五钱，甘草七分，天麻一钱，连翘二钱，加竹沥、童便各半杯，霞天膏四五钱，日服二剂。初四
至初九日，加生地三钱；初十加牛膝四钱，黄柏二钱；十三日去连翘，加石斛三钱五分，五味子七分，扁豆二
钱，干葛八分；十八日去连翘、天麻、干葛、扁豆，加莲肉四十粒。二十二日定方∶天冬、甘菊、沙参各三钱，
麦冬、生地、牛膝各五钱，炙草一钱，贝母、苏子、橘红、花粉各二钱，枣仁六钱，五味八分、莲肉四十
粒。二月十二日定方∶天冬、茯苓、贝母、沙参各三钱，麦冬、枣仁、牛膝各五钱，苏子、橘红、甘菊各二钱
五分，黄柏、甘草各一钱五分，花粉、玄参各二钱，五味七分，生地、白芍各四钱，莲肉六十粒。十日后，去
花粉，后又去玄参，加石斛三钱。至五月尽，病始痊愈。（前方中曾加参二钱，服二剂反觉浮大上升，即去之。）
先时合成丸药，病中仲淳以为可服。方用人参十两，乳浸，饭上蒸；五味子十两，蜜蒸烘干；山萸八两；沙蒺藜
十二两，半炒为末，一半打糊和药；巴戟天八两，以甘菊花、枸杞子同酒浸蒸晒干；莲须六两；枸杞子十二两；
川牛膝十两；酒蒸天冬六两；莲肉十二两；炒白茯苓八两；黄柏四两；蜜炙砂仁二两；生地十二两；鹿角霜十
二两，酥拌炒如飞面；鹿茸六两；菟丝子末八两；甘菊花六两。炼蜜和蒺藜糊，和丸桐子大。每服六钱，空心饥
时各一服，淡盐汤送下。过百日后，更定丸方∶黑芝麻三斤，桑叶酒拌蒸晒三斤，何首乌九蒸九晒三斤，苍
术黑豆拌蒸三次二斤，牛膝如蒸苍术法二斤，甘菊花二斤，大生地三斤，天冬酒蒸二斤，柏子仁二斤，枸杞子二斤。
沈明生治潘子芬，躯干魁梧，素无恙。然室多姬外家，且纵饮，皆致疾之媒也。乙巳夏，忽患类中风，项强
胸满，不良于行，说举足即觉首重而欲仆地。或知其嗜酒及内，病由上盛下虚，即用参、附峻补，治久转剧。
诊之，六部沉滑有力，殊非肾家不足之象。然病患舍补而别商，则纷然辨难，弃不用矣。因语之曰∶病本不足，
更无可疑，但补虚而不去病，甚于攻克也，今当分途治之。汤剂以补虚，吾立方而君自制服丸剂以去病。则有
家秘神方，未可明告，奉馈服之两旬，必奏殊功。潘以刻期甚迩，欣然见从。煎方以六君、理中加减，而不用
附子，别制大剂消痰丸，服十日而项强若失，陆续去痰积稠粘甚多。潘惟恐其虚，复生犹豫。乃谓之曰∶大便
虽行，神气日旺，况有参、术以培补养脾元，何虑之有？去痰莫如尽，此之谓也。勉其尽剂，果越两月而步履
复康矣。
黄锦芳治曹姓儿，年十余岁，脉伏不见，牙关紧急，口不能言，手足俱厥，口红而燥，大便数日不解，手
足牵引不伸，并有痛楚不可着手之象。知其素有内热，被暴风寒邪束其筋骨，不急为之里外双解，无以救其卒
暴之厄。用吹药以开其关举，方用麻黄、防风各一钱，细辛三分，牙皂一钱，桂枝二钱，以解其外；杏仁十粒，
乌药一钱，枳实八分，川浓朴二钱，黄连五分，大黄三钱，以通其内。服二剂，手足颇活，大便未行，口有臭
气，舌有燥胎，脉微见，身有潮热。原方加干葛、黄芩，服之厥退，手足皆热，大便顿解而愈。
徐灵胎曰∶今之患中风偏痱等病者，百无一愈，十死其九。非其症不治，皆医者误之也。凡古圣定病之名，
必指其实，名曰中风，则其病属风可知。既为风病，则主病之方，必以治风为本，故仲景侯氏黑散、风引汤、
防己地黄汤，及唐人大小续命汤，皆多风药，而因症增减。盖以风入经络，则内风与外风相煽，以致痰火一时
壅塞，惟宜先驱其风，继清痰火，而后调其气血，则经脉可以渐通。今人一见中风等症，即用人参、熟地、附
子、肉桂等纯补、温热之品，将风火痰热，尽行补住，轻者变重，重者即死。或有元气未伤，而感邪浅者，亦
必迁延时日，以成偏枯永废之人。此非医者误之耶？或云邪之所凑，其气必虚，故补正即所以驱邪，此大谬也。
惟其正虚而邪凑，尤当急驱其邪，以卫其正。若更补其邪气，则正气益不能支矣。即使正气全虚，不能托邪于
外，亦宜于驱风药中少加扶正之品，以助驱邪之力，未有纯用温补者。譬之盗贼入室，定当先驱盗贼，而后固
其墙垣。未有盗贼未去，而先固其墙垣者。或云补药托邪，犹之增家人以御盗也。是又不然。盖服纯补之药，
断无专补正不补邪者之理，非若家人之专于御盗也。是不但不驱盗，并助盗矣。况治病之法，凡久病属虚，骤
病属实。所谓虚，谓正气虚也；所谓实者，谓邪实也。中风乃急暴之症，其为邪实无疑。天下未有行动如常，
忽然大虚而仆者，岂可不以实邪治之哉？其中或有阴虚阳虚，感热感寒之别，则于治风方中，随所现之症加减
之，汉唐诸法俱在，可取而观也。故凡中风之类，苟无中脏之绝症，未有不可治者。余友人患此症者，遵余治
法，病一二十年而今尚无恙者甚多。惟服热药者，无一存者矣。
徐灵胎曰∶病有一定之传变，有无定之传变。一定之传变，如伤寒太阳传阳明，及《金匮》见肝之病，知
肝传脾之类。又如痞病变臌，血虚变浮肿之类，医者可预知而防之。无定之传变，或其人本体先有受伤之处，
或天时不和又感时行之气，或调理失宜更生他病，则无病不可变，医者不能预知而为防者也。总之，人有一病，
皆当加意谨慎，否则病后增病，则正虚而感益重，病亦变危矣。至于既传之后，则标本缓急，先后分合，用药
必两处兼顾，而又不杂不乱，则诸病亦可渐次平复，否则新病日增，无所底止矣。至于药误之处，正复多端，
或过于寒凉而成寒中之病，或过服温燥而成热中之病，或过于攻伐而元气大虚，或过于滋润而脾气不实，不可
胜举。近日害人最深者，大病之后，邪未全退，又不察病气所伤何处，即用附子、肉桂、熟地、麦冬、人参、
白术、五味、萸肉之类，将邪火尽行补涩。始若相安，久之气逆痰升，胀满昏沉，如中风之状，邪气与元气相
并，诸药无效而死。医家病家，犹以为病后大虚症所致，而不知乃邪气固结而然也。余见甚多，可不深戒？
尤在泾曰∶中风者，风从外入，天地之邪气也；类中风者，风自内生，肝脏之厥气也。肝之生气，暴
而病速。肝气既厥，诸气从之，诸液又从之。诸气化火，诸液化痰，辐凑上焦，流溢经络，如风雨之骤至，如
潮汐之骤涌，而不可当也，岂特如景岳所谓气血虚败而已哉。昔贤于此症，或云火，或云痰，或云气虚，诚俱
张景岳说：脉象没有实邪结聚，怎么可以盲目使用攻下法？况且病人平素就有脾病，大便经常五六天排一次，而且排便极其艰难痛苦。于是让他先尝试喝米汤，以流通肠胃的气机，每天服用六君子汤，每次用人参二钱，煎好后趁热顿服，分三次喝完。服用四剂后，大便自然通畅。再服用四剂，就能自己坐起，几天之内就可以扶着慢慢行走。因此告诫他的随从，小心防止跌倒，因为病人气虚且痰湿盛。
吕东庄治疗沈凝芝的妻子，当时正准备睡觉，突然感到忽冷忽热，到了半夜，就不能说话，气喘急促。有人认为是外感伤风，有人认为是气逆痰结，使用乌药顺气散无效。诊察时，听到声音像拖锯一样粗重，手松开遗尿，口张开不能说话，出汗如雨，吕东庄说：这是中风病。已经损伤内脏，无法治愈了。沈凝芝说：即使没有救理，应该用什么药？吕东庄说：初发时应当用易简附子散，现在来不及了。于是沈凝芝自行进服此药，喘声忽然停止，并且稍微能发出声音，怀疑还可以救治。吕东庄说：五脏功能都已衰竭，现在得到人参、附子，气稍微复苏罢了，终究无济于事。果然三天后去世。
韩贻丰治疗司空徐元正的风疾，满面浮肿虚弱，口角流涎不止，言语含糊不能从喉咙发出，双腿沉重，走路趔趄不能跨过门槛。诊脉后说：这个病症非针灸不可。于是叫人点燃蜡烛，举手向头顶百会穴准备施针。徐公和他的孙子都非常惊恐地说：这里怎么能用火攻（指艾灸或针刺产生的热感）？强行要求多次，最终不答应而作罢。后来听说韩某的针灸很神奇，又邀请他，为他针刺百会、神庭、肾门、命门、环跳、风市、足三里、涌泉等穴位，共二十一针。刚开始下针时，以为不知道会有多痛，等到药气氤氲弥漫，难以形容，连声赞叹，认为效果极好。积累已久的周身疾病，一时之间全部去除。（《神针心法》。）
柴屿青治疗考功吴景星老先生，突然中风昏迷，满面油光，两手关脉弦紧，投以附子理中汤。第二天，心中明白，面上浮光收敛。调理数月后康复。
蓟州牧杨芋，丙寅年春天，五十多岁，突然中风肢体废用，口不能言，大小便困难，属于中腑兼中脏的病症。起初服用通幽汤无效，加入大黄、麻仁，两剂后才通便，舌头稍微转动。又用加减大秦艽汤，数剂后才能说话，但舌根仍然僵硬。后来用地黄饮子，以及人参、白术等兼服，舌头变柔软，胃气增强，但左手足尚不能活动。这是因为心境不佳，加上人参滋补调理所致。如今庚午年秋天，听说他在湖北，已经完全痊愈。
大司寇阿，年纪七十多岁，偶然患胃痛延请治疗，到他那里时病情已减轻，六脉平和，两尺脉神完气足。像这样禀赋浓厚的人，不多见。他说：曾经患有口眼歪斜之邪，至今面部微有不正作为病患，说：阳脏的脉象，前因心火暴盛无法制约，遂流入经络所致，只有壮水之主（滋阴），以镇阳光（抑制阳亢），常服丸剂，可以保到百岁。
薛立斋治疗靳太师的夫人，先出现胸胁胀痛，后四肢不能随意运动，自汗如雨，小便失禁，大便不成形，口紧目闭，饮食颇进持续十余日。有人认为是中脏。薛立斋说：不对。如果风邪既中入脏腑，真气将脱，恶症已现，祸在旦夕，怎么能拖延到十天？于是观察她的面色，面目都红或者发青。诊察她的脉象，左三部洪数，唯独肝脉尤其严重。于是知道胸乳胀痛，是肝经血虚，肝气郁塞；四肢不收，是肝经血虚，不能滋养筋脉；自汗不止，是肝经血热，津液妄泄；小便自遗，是肝经热甚，阴器失职；大便不实，是肝木炽盛克制脾土。使用犀角散四剂，诸症顿时痊愈。又用加味逍遥散调理而安。后来因为郁怒，前症复发，兼发热呕吐，饮食少思，月经不止，这是木盛克土，而脾不能摄血。用加味归脾为主，佐以逍遥散而愈。后来每次遇到愤怒，或者睡梦中手脚抽搐，再次用前药治愈。
大参朱云溪的母亲，在九月突然倒地，痰壅不省人事，唇口歪斜，左眼紧闭变小。有人用化痰活血的药剂，病情稍缓。到次年四月初，病复发，仍进前药，势头也渐缓。到六月末，病大作，小便失禁，有人说风中的脏腑，认为无法治疗。诊察时，左关脉洪弦而数，这属于肝火血燥。于是用六味丸加五味子、麦冬、川芎、当归，一剂后饮食顿进，小便顿调。随即用补中益气汤加茯苓、山栀、钩藤、丹皮而安。到十月，又因伤食，腹痛作泻，左眼仍小，两关尺脉弦洪鼓指，用六君子汤加木香、吴茱萸、升麻、柴胡，一剂后痛泻俱缓。用六君子汤加肉豆蔻、故纸（补骨脂），一剂后诸脉顿平，痛泻俱止。左关弦洪，由肝火血燥，所以左眼干燥变小；右关弦洪，由肝邪乘脾，所以唇口歪斜，腹痛作泻；两尺鼓指，由元气下陷。假如把眼紧口歪误作中风，投以风药；把腹痛泄泻误作积滞，投以峻猛攻下药，反复耗损元气，危害很大。因为阳虚恶寒，围火过热，导致增加痰喘，误服寒凉药剂而死。
一个妇人，因为愤怒倒地，语言謇涩，口眼歪斜，四肢拘急，汗出遗尿，六脉洪大，肝脉尤其严重。都是由肝火炽盛引起，盖因肝主小便，因热甚而自遗。（《内经》说：肝虚者善溺。）用加味逍遥散加钩藤，及六味丸寻获痊愈。（也可以归入气厥范畴。）
一个妇人在经期，口眼歪斜，痰涎壅盛。这是血虚而肝火动，用加味逍遥散加丹皮，治之寻获痊愈。后来因为饮食停滞，每日吐痰涎。这是脾气虚，不能摄涎归经，用六君子汤二十余剂而安。
一个妇人因为愤怒，口眼歪斜，痰涎上涌，口噤发搐。这是脾肺气虚而肝木旺，用六君子汤加木香、钩藤、柴胡，治之渐愈。又用加味归脾汤调理而安。
一个妇人，元气素虚，劳累则身体麻木发热，痰气上攻。有人用乌药顺气散、祛风化痰丸之类，导致肢体痿软，痰涎自出，面色萎黄，形体倦怠，而脾肺二脉虚甚。这是气虚而类似中风，早晨服用补中益气汤，晚上服用十全大补汤，渐愈。又用加味归脾汤调理寻获痊愈。
一个妇人，口眼歪斜，四肢拘急，痰涎不利而恶风寒，其脉浮紧。这是风寒客于手足阳明二经，先用省风汤二剂，后用秦艽升麻而愈。
王海藏说：某黄门官，突然中风，发病时服用紫菀丸，泄出恶脓四升，赤黄水一升，一条肉虫如乱发，痊愈。（方剂见于痨风门）
姚僧垣治疗大将军乐平公窦集，暴感风疾，精神昏乱，无所知觉。其他医生先看过的，都说已经不可救。姚僧垣后至，说：困顿是困顿了，终究不会死。如果专门托付给我，我会为他治疗。他家欣然同意，请求接受方术。姚僧垣为他合制汤散，所患即愈。大将军永世公叱伏列椿，当时苦于痢疾但不妨碍上朝谒见。燕公曾问姚僧垣说：乐平、永世都有痼疾，如果永世较轻。回答说：患病有浅深，时有克杀。乐平虽然困顿，终究会保全；永世虽然轻，必定不免于死。谨问：你说必死，应当在何时？回答说：不出四月。果然如其所言，谨感叹奇异。（《周书》。）
高祖亲自戍守东征，至河阴遇病，口不能言，脸下垂覆盖眼睛，不再瞻视，一只脚短缩，又不能行走。姚僧垣认为诸脏俱病，不可并治。军中之要，莫过于言语。于是处方进药，皇帝于是能说话。其次又治眼，眼疾便愈。最后才治脚，脚疾也好了。等到华州，皇帝已痊愈。（同上。）
李季虬说：我在乙卯年春天，正月三日，突然患口角歪斜，右眼及右耳根俱痛，右颊浮肿。仲淳说：这是内热生风及痰。治痰先清火，清火先养阴，最忌燥剂。苏子、橘红、天冬、花粉、鲜沙参、甘菊花各三钱，贝母、白芍各四钱，麦冬五钱，甘草七分，天麻一钱，连翘二钱，加竹沥、童便各半杯，霞天膏四五钱，日服二剂。初四至初九日，加生地三钱；初十加牛膝四钱，黄柏二钱；十三日去连翘，加石斛三钱五分，五味子七分，扁豆二钱，干葛八分；十八日去连翘、天麻、干葛、扁豆，加莲肉四十粒。二十二日定方：天冬、甘菊、沙参各三钱，麦冬、生地、牛膝各五钱，炙草一钱，贝母、苏子、橘红、花粉各二钱，枣仁六钱，五味八分、莲肉四十粒。二月十二日定方：天冬、茯苓、贝母、沙参各三钱，麦冬、枣仁、牛膝各五钱，苏子、橘红、甘菊各二钱五分，黄柏、甘草各一钱五分，花粉、玄参各二钱，五味七分，生地、白芍各四钱，莲肉六十粒。十日后，去花粉，后又去玄参，加石斛三钱。至五月尽，病始痊愈。（前方中曾加人参二钱，服二剂反觉浮大上升，即去掉。）
先前合成丸药，病中仲淳认为可服。方用人参十两，乳浸，饭上蒸；五味子十两，蜜蒸烘干；山萸八两；沙蒺藜十二两，半炒为末，一半打糊和药；巴戟天八两，以甘菊花、枸杞子同酒浸蒸晒干；莲须六两；枸杞子十二两；川牛膝十两；酒蒸天冬六两；莲肉十二两；炒白茯苓八两；黄柏四两；蜜炙砂仁二两；生地十二两；鹿角霜十二两，酥拌炒如飞面；鹿茸六两；菟丝子末八两；甘菊花六两。炼蜜和蒺藜糊，和丸桐子大。每服六钱，空心饥时各一服，淡盐汤送下。过百日后，更定丸方：黑芝麻三斤，桑叶酒拌蒸晒三斤，何首乌九蒸九晒三斤，苍术黑豆拌蒸三次二斤，牛膝如蒸苍术法二斤，甘菊花二斤，大生地三斤，天冬酒蒸二斤，柏子仁二斤，枸杞子二斤。
沈明生治疗潘子芬，躯干魁梧，平素无病。然而家中多有姬妾在外家，且纵欲饮酒，都是致病的原因。乙巳年夏天，突然患类中风，项强胸满，行走不便，抬脚就觉得头重欲倒地。有人知道他嗜酒及房事，病由上盛下虚，即用参、附峻补，治疗久转剧。诊察时，六部沉滑有力，绝非肾家不足之象。然而病人舍弃补法而另商方案，则纷然辨难，弃不用了。于是对他说：病本不足，更无可疑，但补虚而不祛病，甚于攻克也，现在应当分途治之。汤剂以补虚，我立方而你自制服丸剂以祛病。则有家秘神方，未可明告，奉馈服之两旬，必奏殊功。潘某因为期限很近，欣然听从。煎方以六君、理中加减，而不用附子，别制大剂消痰丸，服十日而项强若失，陆续去痰积稠粘甚多。潘某惟恐其虚，复生犹豫。于是对他说：大便虽行，神气日旺，况有参、术以培补养脾元，何虑之有？去痰莫如尽，此之谓也。勉其尽剂，果越两月而步履复康矣。
黄锦芳治疗曹姓儿子，年十余岁，脉伏不见，牙关紧急，口不能言，手足俱厥，口红而燥，大便数日不解，手足牵引不伸，并有痛楚不可着手之象。知其素有内热，被暴风寒邪束其筋骨，不急为之里外双解，无以救其卒暴之厄。用吹药以开其关举，方用麻黄、防风各一钱，细辛三分，牙皂一钱，桂枝二钱，以解其外；杏仁十粒，乌药一钱，枳实八分，川浓朴二钱，黄连五分，大黄三钱，以通其内。服二剂，手足颇活，大便未行，口有臭气，舌有燥胎，脉微见，身有潮热。原方加干葛、黄芩，服之厥退，手足皆热，大便顿解而愈。
徐灵胎说：当今患中风偏瘫等病的人，百无一愈，十死其九。不是病症不治，都是医者误之也。凡是古圣定病之名，必指其实，名曰中风，则其病属风可知。既为风病，则主病之方，必以治风为本，所以张仲景的侯氏黑散、风引汤、防己地黄汤，及唐代的大小续命汤，皆多用风药，而因症增减。盖因风入经络，则内风与外风相煽，以致痰火一时壅塞，只宜先驱其风，继清痰火，而后调其气血，则经脉可以渐通。今人一见中风等症，即用人参、熟地、附子、肉桂等纯补、温热之品，将风火痰热，尽行补住，轻者变重，重者即死。或有元气未伤，而感邪浅者，亦必迁延时日，以成偏枯永废之人。这不是医者误之吗？有人说邪之所凑，其气必虚，故补正即所以驱邪，这大谬也。正因为正虚而邪凑，尤当急驱其邪，以卫其正。若更补其邪气，则正气益不能支矣。即使正气全虚，不能托邪于外，也宜于驱风药中少加扶正之品，以助驱邪之力，未有纯用温补者。譬如盗贼入室，定当先驱盗贼，而后固其墙垣。未有盗贼未去，而先固其墙垣者。有人说补药托邪，犹之增家人以御盗也。这又不然。盖服纯补之药，断无专补正不补邪者之理，非若家人之专于御盗也。是不但不驱盗，并助盗矣。况且治病之法，凡久病属虚，骤病属实。所谓虚，谓正气虚也；所谓实者，谓邪实也。中风乃急暴之症，其为邪实无疑。天下未有行动如常，忽然大虚而仆者，岂可不以实邪治之哉？其中或有阴虚阳虚，感热感寒之别，则于治风方中，随所现之症加减之，汉唐诸法俱在，可取而观也。所以凡中风之类，苟无中脏之绝症，未有不可治者。我友人患此症者，遵余治法，病一二十年而今尚无恙者甚多。惟服热药者，无一存者矣。
徐灵胎说：病有一定之传变，有无定之传变。一定之传变，如伤寒太阳传阳明，及《金匮》见肝之病，知肝传脾之类。又如痞病变臌，血虚变浮肿之类，医者可预知而防之。无定之传变，或其人本体先有受伤之处，或天时不和又感时行之气，或调理失宜更生他病，则无病不可变，医者不能预知而为防者也。总之，人有一病，皆当加意谨慎，否则病后增病，则正虚而感益重，病亦变危矣。至于既传之后，则标本缓急，先后分合，用药必两处兼顾，而又不杂不乱，则诸病亦可渐次平复，否则新病日增，无所底止矣。至于药误之处，正复多端，或过于寒凉而成寒中之病，或过服温燥而成热中之病，或过于攻伐而元气大虚，或过于滋润而脾气不实，不可胜举。近日害人最深者，大病之后，邪未全退，又不察病气所伤何处，即用附子、肉桂、熟地、麦冬、人参、白术、五味、萸肉之类，将邪火尽行补涩。始若相安，久之气逆痰升，胀满昏沉，如中风之状，邪气与元气相并，诸药无效而死。医家病家，犹以为病后大虚症所致，而不知乃邪气固结而然也。余见甚多，可不深戒？
尤在泾说：中风者，风从外入，天地之邪气也；类中风者，风自内生，肝脏之厥气也。肝之生气，暴而病速。肝气既厥，诸气从之，诸液又从之。诸气化火，诸液化痰，辐凑上焦，流溢经络，如风雨之骤至，如潮汐之骤涌，而不可当也，岂特如景岳所谓气血虚败而已哉。昔贤于此症，或云火，或云痰，或云气虚，诚俱
Zhang [Jingyue] said: The pulse shows no excess or knotted qualities; how can one blindly employ purgative methods? Moreover, the patient has a chronic spleen condition, with bowel movements occurring only once every five to six days, and defecation is extremely difficult and painful. Therefore, he was instructed to first try drinking rice gruel to facilitate the movement of qi mechanism in the intestines and stomach. He was prescribed Liujunzi Tang (Six Gentlemen Decoction) daily, with two qian of Renshen (Ginseng Radix et Rhizoma) per dose, taken hot in divided doses three times a day. After four doses, bowel movements naturally resumed. After another four doses, the patient could sit up independently, and within a few days could walk slowly with support. Thus, his attendants were warned to prevent falls, as the patient suffered from qi deficiency and abundant phlegm-dampness.
Lv Dongzhuang treated the wife of Shen Ningzhi. As she was preparing to sleep, she suddenly experienced alternating chills and fever. By midnight, she lost her ability to speak and developed rapid breathing. Some attributed it to external pathogenic invasion, others to rebellious qi and phlegm obstruction. Wuyao Shunqi San (Aucklandia Decoction for Directing Qi) proved ineffective. Upon examination, her voice sounded like a saw being dragged, her hands relaxed leading to urinary incontinence, her mouth was open unable to speak, and she sweated profusely like rain. Lv stated: This is stroke (Zhongfeng). The internal organs have been damaged; it is incurable. Shen Ningzhi asked: If there is no hope of cure, what medicine should be used? Lv replied: At the onset, Yijian Fuzi San (Simple Aconite Powder) should have been used; it is too late now. Shen administered it himself. Suddenly, the wheezing stopped, and she could utter a few words, suggesting possible recovery. Lv remarked: The functions of the five zang organs are exhausted. The slight revival of qi is due to Renshen and Fuzi, but ultimately it will be of no avail. Indeed, she died three days later.
Han Yifeng treated Xu Yuanzheng, Grand Commandant, for wind disease. His face was swollen and deficient-looking, saliva flowed continuously from the corners of his mouth, speech was indistinct and stuck in the throat, legs felt heavy, and gait was unsteady, unable to cross the threshold. Palpating the pulse, Han said: This condition requires acupuncture. Candles were lit, and he raised his hand towards the Baihui point on the vertex to needle. Mr. Xu and his grandson were terrified, asking: How can fire therapy (acupuncture/moxibustion heat) be used here? Despite repeated requests, they refused, and the matter was dropped. Later, hearing of Han's miraculous acupuncture skills, they invited him again. He needled points including Baihui (GV20), Shenting (GV24), Shenmen (EX-B1), Mingmen (GV4), Huantiao (GB30), Fengshi (GB31), Zusanli (ST36), and Yongquan (KI1), totaling twenty-one needles. Initially fearing severe pain, they were amazed by the indescribable sensation of the medicinal energy spreading, praising the excellent effect. Chronic ailments accumulated over time were instantly resolved. (From *Shenzhen Xinfa*.)
Chai Yuqing treated Wu Jingxing, Elder Official, who suffered sudden stroke with coma and oily sheen on the face. The guan positions of both wrists were wiry and tight. He was given Fuzi Lizhong Tang (Aconite Decoction for Regulating the Middle). The next day, his mind cleared, and the oily sheen subsided. After months of regulation, he recovered.
Yang Yu, Prefect of Jizhou, in the spring of Bingyin year, aged over fifty, suffered sudden stroke with limb paralysis, aphasia, and difficulty with urination and defecation, indicating involvement of both fu and zang organs. Tongyou Tang (Unblocking the Intestines Decoction) initially failed. Dahuang (Rhubarb Root and Rhizome) and Mahuangren (Ephedra Seed) were added; after two doses, bowels opened slightly, and the tongue moved somewhat. Then, Jiajia Daqin Jiao Tang (Modified Large Qin Jiao Decoction) allowed him to speak after several doses, though the root of the tongue remained stiff. Later, Dihuang Yinzi (Rehmannia Infusion) combined with Renshen, Baizhu (Atractylodes Macrocephala Rhizome), etc., softened the tongue and strengthened the stomach, but the left limbs remained immobile. This was due to poor mental state and excessive ginseng tonification. In autumn of gengwu year, it was reported that he had fully recovered in Chu.
A, Grand Minister of Justice, aged seventy, sought treatment for occasional stomach pain. Upon arrival, symptoms had subsided; pulses were harmonious, and chi positions showed robust spirit and qi. Such strong constitution is rare. He mentioned past facial deviation (wind-stroke sequelae). He explained: With a yang-organ constitution, previous unrestrained heart-fire flowed into meridians. Only by nourishing water (yin) to control sunlight (yang hyperactivity) via regular pill intake can longevity be ensured.
Xue Lizaizhai treated the wife of Grand Preceptor Jin. She first experienced chest and hypochondriac distension and pain, followed by limb paralysis, profuse spontaneous sweating, urinary incontinence, loose stools, tight mouth, closed eyes, yet maintained appetite for over ten days. Some diagnosed it as zang stroke. Xue said: Incorrect. If wind struck the zang organs, true qi would be collapsing, ominous signs would appear, and death would be imminent within moments, not ten days. Observing her complexion, her face and eyes were red or bluish. Palpating the pulse, the left san cun positions were surging and rapid, especially the liver pulse. He deduced: Chest/breast distension indicates liver blood deficiency and qi stagnation; limb flaccidity indicates liver blood deficiency failing to nourish sinews; spontaneous sweating indicates liver blood heat causing fluid leakage; urinary incontinence indicates severe liver heat impairing yin organ function; loose stools indicate liver wood overacting on spleen earth. He prescribed Xijiao San (Rhino Horn Decoction) for four doses, resolving all symptoms. Subsequently, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) regulated her health. Later, due to depression and anger, symptoms recurred with fever, vomiting, poor appetite, and menorrhagia, indicating wood overacting on earth and spleen failing to control blood. Jiawei Guipi Tang (Modified Spleen-Restoring Decoction) with Xiaoyao San cured her. Recurrences triggered by anger or nocturnal convulsions also responded to these formulas.
The mother of Grand Commissioner Zhu Yunxi collapsed suddenly in September with phlegm obstruction and unconsciousness, facial deviation, and a small, tight left eye. Phlegm-resolving and blood-invigorating herbs provided slight relief. Relapse occurred in early April of the following year; previous herbs offered gradual relief. By end of June, illness worsened with urinary incontinence; some declared it fatal zang stroke. Pulse at left guan was surging, wiry, and rapid, indicating liver fire and blood dryness. Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Wuweizi (Schisandra Fruit), Maidong (Ophiopogon Tuber), Chuanxiong (Sichuan Lovage Rhizome), and Danggui (Angelica Sinensis Radix) improved diet and urination in one dose. Buzhong Yiqi Tang (Middle-Warming and Qi-Boosting Decoction) plus Fuling (Poria), Zhizi (Gardenia Fruit), Gouteng (Uncaria Ramulus cum Uncis), and Danpi (Moutan Cortex) stabilized her. In October, food stagnation caused abdominal pain and diarrhea, with persistent small left eye and wiry/surging chi/guan pulses. Liujunzi Tang plus Muxiang (Aucklandia Root), Wuzhuyu (Evodia Fruit), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix) relieved pain/diarrhea in one dose. Liujunzi Tang plus Rouguou (Myristica Seed) and Guzhi (Psoralea Fructus) normalized pulses and stopped symptoms. Left guan wiry/surging indicated liver fire/blood dryness causing eye issues; right guan indicated liver invading spleen causing facial deviation/diarrhea; chi positions indicated sinking yuan qi. Misdiagnosing facial deviation as wind-stroke and treating with wind-dispelling herbs, or misdiagnosing diarrhea as stagnation and using harsh purgatives, would deplete yuan qi severely. Another case involved misusing cold herbs for cold intolerance exacerbated by heating pads, leading to fatal phlegm-wheezing.
A woman collapsed in anger, presenting with slurred speech, facial deviation, limb spasms, sweating, urinary incontinence, and surging pulses (especially liver). Caused by blazing liver fire affecting bladder control (as per Classic: "Liver deficiency leads to frequent urination"). Jiawei Xiaoyao San plus Gouteng and Liuwei Wan cured her. (Also classifiable under Qi Collapse.)
Another woman during menstruation presented with facial deviation and copious phlegm-saliva. Blood deficiency with moving liver fire. Jiawei Xiaoyao San plus Danpi cured her. Later, food stagnation caused daily phlegm-vomiting due to spleen qi deficiency failing to manage fluids. Liujunzi Tang for over twenty doses restored health.
A woman with anger-induced facial deviation, surging phlegm, locked jaw, and convulsions. Spleen/lung qi deficiency with flourishing liver wood. Liujunzi Tang plus Muxiang, Gouteng, Chaihu improved her; Jiawei Guipi Tang consolidated recovery.
A woman with inherent yuan qi deficiency experienced numbness and fever upon exertion, with phlegm-qi attacking upward. Previous use of Wuyao Shunqi San and Qufeng Huatan Wan led to limb flaccidity, spontaneous phlegm, sallow complexion, fatigue, and very deficient spleen/lung pulses. This was qi deficiency mimicking wind. Morning Buzhong Yiqi Tang, evening Shiquan Dabu Tang gradually improved her; Jiawei Guipi Tang completed recovery.
A woman with facial deviation, limb spasms, difficult phlegm, aversion to wind/cold, and floating-tight pulse. Wind-cold invading Hand-Foot Yangming meridians. Shengfeng Tang for two doses, then Qinjiao Shengma Tang cured her.
Wang Haicang recorded: A palace official suffered sudden stroke. Taking Ziwan Wan (Astera Pill) expelled four sheng of foul pus, one sheng of red-yellow fluid, and a flesh worm resembling tangled hair. He recovered. (Formula found in Tuberculous Wind section.)
Yao Sengyuan treated General Le Ping Gong Dou Ji, who suffered acute wind disease with mental confusion and loss of sensation. Other physicians deemed him incurable. Yao arrived later, stating: Though critical, he will not die. Entrust him to me. Yao prepared decoctions/powders, and the patient recovered. Changling Duke Chi Fulie Chun suffered dysentery but could still attend court. Prince Yan asked Yao: Both Le Ping and Yong Shi have chronic illnesses; Yong Shi seems milder. Yao replied: Illnesses vary in depth and timing of fatality. Le Ping, though critical, will survive; Yong Shi, though mild, will die. When asked when, Yao predicted within April. It happened exactly as stated. (From *Book of Zhou*.)
Emperor Gaozu fell ill while campaigning eastward at Heyin, unable to speak, eyelids drooping covering eyes, one leg shortened and immobile. Yao noted multi-organ involvement requiring prioritized treatment. Speech was paramount in military context. He prescribed medicine enabling speech, then treated eyes, finally feet. By Huazhou, the Emperor had recovered. (Ibid.)
Li Jiqiu recounted: In spring of Yimao year, Jan 3rd, I suffered facial deviation, right eye/ear root pain, and right cheek swelling. Zhongchun diagnosed: Internal heat generating wind and phlegm. Treat phlegm by clearing fire; clear fire by nourishing yin; avoid drying agents. Formula included Suzi, Juhong, Tiandong, Huafen, Xianshashen, Ganjuhua, Beimu, Baishao, Maidong, Gancao, Tianma, Lianqiao, Zhuli, Tongbian, Xiatiangao. Adjustments added Shengdi, Niuxi, Huangbai, Shibei, Wubeizi, BianDou, Gegen, Lianrou over weeks. Final formula stabilized. Recovery achieved by end of May. (Note: Adding Renshen caused floating pulse, so it was removed.) Previously prepared pills contained Renshen, Wuweizi, Shanzhuyu, Bashili, Bajitian, Lianxu, Gouqi, Niuxi, Tiandong, Lianrou, Baifuling, Huangbai, Sharen, Shengdi, Lu Jiaoshuang, Lu Rong, Tusizi, Ganjuhua. Honey-pilled. Taken on empty stomach with light salt water. After 100 days, revised pill formula included Heihema, Sangye, Heshouwu, Cangzhu, Niuxi, Ganjuhua, Dashengdi, Tiandong, Baiziren, Gouqi.
Shen Mingsheng treated Pan Zifen, a burly man previously healthy but indulging in concubines and alcohol. Summer of Yisi year, sudden pseudo-stroke with neck stiffness, chest fullness, difficulty walking, head heaviness threatening collapse. Knowing his lifestyle caused upper excess/lower deficiency, others used heavy Renshen/Fuzi tonics, worsening condition. Pulses were deep, slippery, forceful—not kidney deficiency. Patient rejected alternative diagnosis. Shen advised: Deficiency exists, but tonifying without eliminating pathogen is worse than attacking. We treat separately: Decoction for tonification, Pills for pathogen removal. Secret pill formula given for two weeks yielded great results. Decoction modified Liujunzi/Lizhong without Fuzi. Pills removed thick phlegm; neck stiffness vanished. Patient feared deficiency; Shen reassured: Bowels moving, spirit rising, supported by Renshen/Baizhu. Complete phlegm removal essential. Patient finished course; walked normally after two months.
Huang Jinfang treated a Cao boy, ~10 years old. Pulse hidden, locked jaw, aphasia, cold extremities, red/dry lips, constipation, limb traction/pain. Known internal heat bound by violent wind-cold. Urgent interior-exterior resolution needed. Blowing powder to open jaw. External release: Mahuang, Fangfeng, Xixin, Yacao, Guizhi. Internal clearance: Xingren, Wuyao, Zhishi, Houpo, Huanglian, Dahuang. Two doses improved limb mobility, but no bowel movement, bad breath, dry coating, faint pulse, tidal fever. Added Gegen, Huangqin. Cold retreated, limbs warmed, bowels opened, cured.
Xu Lingtai commented: Today, stroke patients rarely recover; nine out of ten die. Not because untreatable, but due to medical error. Ancient names reflect reality: "Stroke" implies wind pathogen. Wind diseases require wind-dispersing bases. Zhang Zhongjing's Houji Heisan, Fengyin Tang, Fangji Dihuang Tang, and Tang Dynasty Xuyuming Tangs all use wind herbs, adjusted by symptoms. Wind entering meridians stirs internal wind, causing phlegm-fire obstruction. Must disperse wind first, clear phlegm-fire, then regulate qi-blood. Modern doctors immediately use pure tonics/warmers (Renshen, Shudi, Fuzi, Rougui), trapping wind-fire-phlegm. Mild cases worsen, severe die. Even mild cases become permanent hemiplegia if delayed. Claiming "deficiency attracts evil, so tonify to expel" is wrong. When deficiency invites evil, expel evil urgently to protect right qi. Tonifying evil aids it. Even with total deficiency, add slight right-qi support to wind-dispersing herbs, never pure warm-tonics. Analogy: Expel thieves before reinforcing walls. Tonics do not selectively tonify right qi; they aid evil. Acute stroke is excess syndrome, not sudden deficiency. Variations in yin/yang or cold/heat allow adjustments within wind-formulas. Han/Tang methods exist. Without fatal zang involvement, stroke is treatable. Friends following my method survived decades; those taking hot herbs died.
Xu Lingtai further stated: Disease transmission has fixed and variable patterns. Fixed: Taiyang to Yangming in Shanghan; Liver transmitting to Spleen in Jingui. Physicians can predict/prevent. Variable: Pre-existing injury, seasonal pathogens, or improper care cause unpredictable changes. All diseases require caution post-onset to prevent worsening. Post-transmission, address root/branch, urgency, sequence carefully. Medication errors include excessive cold (causing cold-middle), excessive warm/dry (causing heat-middle), excessive purging (depleting yuan qi), excessive moistening (weakening spleen qi). Recently, deepest harm comes from post-illness tonification before pathogen clears. Using Fuzi, Rougui, Shudi, Maidong, Renshen, Baizhu, Wuweizi, Shanzhuyu seals evil fire. Initially stable, later qi rebellion, phlegm rising, distension, coma resembling stroke. Evil and right qi merge; drugs fail. Families blame deficiency, not realizing evil consolidation. Many such cases seen; beware!
You Zaijing stated: Stroke involves external wind (heaven-earth evil); Pseudo-stroke involves internal wind (liver jue qi). Liver qi generation is violent/fast. Once jue occurs, other qi/fluids follow. Qi transforms to fire, fluids to phlegm, converging on upper jiao, flooding meridians like sudden storms/tides. It is not merely Jingyue's "qi-blood exhaustion." Past scholars cited fire, phlegm, or qi deficiency. Truly...