《内经》曰∶厥逆者，寒湿之起也。《千金方》及董及之谓此即香港脚。似矣。香港脚有风
湿、
寒湿之不同。风湿，多挟热也。又有奔豚，亦下焦寒湿证。皆邪气自下部鼓肝、肾之虚阳上
冲于心，使真气离根而上浮，最为危急之候。其故由于风、寒、湿邪，自足心涌泉穴窜入，
或自腰脐窜入。其缓者，菀为湿热，化内风而上冲；其急者，是风胜也，不待化热，而即上
冲。久延不愈，遂结为肾积之奔豚，所谓猪癫风也，是膀胱气逆也。又有一种本无外邪，肝
肾内冷，阴风鼓动水邪，上掩心肝生阳，迫闷卒厥，神昏不醒，舌强不语，口眼 僻，四肢
螈拘急者，亦奔豚之类，急证也。宜温宣重镇，如黑锡丹之类主之。其轻者，拟方如下∶
熟附片、 龙骨各四钱，乌药、九节菖蒲各三钱，桂枝、牛膝各二钱，木瓜、吴萸各一钱，
细辛、沉香各六分。此方宣通心肺清阳，温化肝肾伏阴，即《金匮要略》首条所叙之证治也
。《金匮》曰∶见肝之病，知肝传脾，即当实脾；脾能伤肾，肾气微弱，则水不行；水不行
，则心火气盛，则伤肺；肺被伤，则金气不行；金气不行，则肝气盛，则肝自愈。此治肝补
脾之要妙也。肝虚则用此法，实则不在用之。此谓肝之阴气，挟肾之水邪，上胜脾阳，治当
健脾之阳，制肾之水，水退火升，则肺金清肃之令不行，而肝木生发之令得矣。此专指肝肾
虚冷言，故曰肝虚用此法也。后人不识其义，疑误疑衍，亦昧矣。故中风有一种纯寒无阳之
证，其根发于里，即寒湿香港脚、奔豚之类，于东垣、河间、丹溪所称痰火之中风，渺不相涉
。历来论中风者，泥于三家，不暇及此矣。喻嘉言《医门法津》中寒篇末，发明许叔微椒附
汤方证，其义与此相发，当详玩之。
《黄帝内经》说：厥逆这种病证，是由寒湿邪气引起的。《千金方》以及董及之认为这就是香港脚（一种以足部肿痛、麻木或上行攻心为特征的疾病）。这种说法似乎有道理。香港脚有风湿和寒湿的不同类型。风湿型的，多夹杂热邪。还有奔豚（一种自觉有气从少腹上冲胸咽的病症），也属于下焦寒湿证候。这些都是邪气自下部鼓动肝肾的虚阳上冲于心，导致真气脱离根本而上浮，是最为危急的病候。其病因在于风、寒、湿邪，从足心的涌泉穴窜入，或者从腰脐部位窜入。病情较缓的，郁结化为湿热，化生内风而上冲；病情急骤的，是风邪偏胜，不待化热，就直接上冲。拖延日久不愈，便结聚成为肾积之奔豚，也就是所谓的“猪癫风”，这是膀胱之气上逆所致。又有一种情况，原本没有外邪侵袭，而是肝肾内部寒冷，阴风鼓动水邪，向上掩盖心肝的生发阳气，逼迫导致突然昏厥，神志昏迷不醒，舌体僵硬不能言语，口眼歪斜，四肢抽搐拘急的，也属于奔豚一类，属于急症。适宜用温通宣散、重镇安神的方法治疗，如黑锡丹之类的方剂主治。病情较轻的，拟定方剂如下：熟附片、龙骨各四钱，乌药、九节菖蒲各三钱，桂枝、牛膝各二钱，木瓜、吴茱萸各一钱，细辛、沉香各六分。此方能宣通心肺的清阳，温化肝肾潜伏的阴寒，这正是《金匮要略》首条所叙述的证治内容。《金匮要略》说：发现肝脏有病，知道肝病会传变至脾，就应当先充实脾土；如果脾能制约肾，肾气微弱，则水液不能正常运行；水液运行不畅，则心火气盛，进而损伤肺金；肺被损伤，则金气不能正常肃降；金气不行，则肝气相对偏盛，这样肝病反而自愈。这是治疗肝病补益脾土的奥妙所在。肝虚时才使用这种方法，肝实则不适用。这里所说的肝虚，是指肝的阴气挟带肾的水邪，向上胜过脾阳，治疗应当健脾助阳，制约肾水；肾水退去，心火上升，则肺金清肃的功能不再受抑（注：原文逻辑此处意指打破恶性循环，恢复脏腑平衡，使肝木生发之令得以实现），而肝木生发的功能也就恢复了。这专门针对肝肾虚冷的情况而言，所以说肝虚才用此法。后世的人不理解其中的含义，怀疑有误或是衍文，也是愚昧的。因此中风有一种纯寒无阳的证型，其根源发于体内，即寒湿香港脚、奔豚之类，与东垣、河间、丹溪所称的痰火之中风，毫无关联。历来论述中风的医家，拘泥于这三家的观点，无暇顾及此类证候了。喻嘉言在《医门法律》寒篇末尾，阐发许叔微椒附汤的方证，其义理与此相互印证，应当详细研读。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Jue-ni (Jue syndrome, characterized by cold extremities and reversal of qi) arises from Cold-Dampness. The *Qianjin Fang* (Prescriptions Worth a Thousand Gold) and Dong Jizhi consider this to be Hong Kong Foot (a disease characterized by swelling, pain, or numbness in the feet, potentially ascending to affect the heart). This view seems plausible. Hong Kong Foot differs in that it can be Wind-Damp or Cold-Damp. Wind-Damp often carries Heat. There is also Ben Tun (Panic Disease, characterized by a sensation of qi rushing upward from the lower abdomen), which is also a Lower Jiao Cold-Damp syndrome. In all these cases, pathogenic factors stir up the deficient Yang of the Liver and Kidneys from the lower part, causing it to rush upward to the Heart, leading to the True Qi losing its root and floating upward; this is an extremely critical condition. The cause lies in Wind, Cold, and Damp pathogens invading from the Yongquan acupoint (KI1, located on the sole of the foot) at the soles of the feet, or invading from the waist and umbilical region. In slower-progressing cases, stagnation transforms into Damp-Heat, generating Internal Wind that rushes upward; in acute cases, Wind predominates, rushing upward directly without needing to transform into Heat. If prolonged and unresolved, it consolidates into Ben Tun of Kidney Accumulation, also known as "Zhu Dian Feng" (Pig Epileptic Wind), which is rebellious Qi of the Bladder. Another type involves no external pathogens initially, but rather internal Cold in the Liver and Kidneys. Yin-Wind stirs up Water Pathogens, which ascend to cover and suppress the Sheng-Yang (generative Yang) of the Heart and Liver, forcing sudden Jue (reversal/coma), unconsciousness with inability to wake, stiff tongue with aphasia, deviation of the mouth and eyes, and convulsive spasms of the four limbs. This also belongs to the category of Ben Tun and is an emergency. Treatment should employ warming, dispersing, and heavy sedation methods, such as Hei Xi Dan (Black Tin Pill). For milder cases, the following prescription is proposed: Prepared Aconite Root (Shu Fu Pian) and Dragon Bone (Long Gu) each 4 qian, Lindera Root (Wu Yao) and Nine-Joint Acorus (Jiu Jie Chang Pu) each 3 qian, Cinnamon Twig (Gui Zhi) and Achyranthes Root (Niu Xi) each 2 qian, Betel Nut Seed (Mu Gua) and Evodia Fruit (Wu Yu) each 1 qian, Siberian Wormwood Herb (Xi Xin) and Agarwood (Chen Xiang) each 6 fen. This formula promotes the clear Yang of the Heart and Lungs, and warms/transforms latent Yin-Cold of the Liver and Kidneys. This corresponds exactly to the syndrome and treatment described in the first article of the *Jinkui Yaolue* (Essential Prescriptions of the Golden Cabinet). The *Jinkui Yaolue* states: When observing liver disease, one knows it will transmit to the Spleen; therefore, one must strengthen the Spleen. If the Spleen can control the Kidney, and Kidney Qi becomes weak, then Water fails to circulate. If Water fails to circulate, Heart Fire becomes excessive, thereby damaging Lung Metal. If Lung Metal is damaged, Metal Qi fails to descend. If Metal Qi fails to descend, Liver Wood Qi becomes excessive, and thus the Liver disease heals itself. This is the subtle essence of treating the Liver by tonifying the Spleen. This method is used when the Liver is Deficient; it is not used when the Liver is Excess. Here, "Liver Deficiency" refers to Liver Yin-Qi carrying Kidney Water Pathogens to overpower Spleen Yang. Treatment should tonify Spleen Yang and restrain Kidney Water. As Water recedes and Fire ascends, the inhibitory effect on Lung Metal's clearing and descending function is removed, allowing Liver Wood's generating function to resume. This specifically refers to Liver-Kidney Deficient-Cold, hence it says "use this method for Liver Deficiency." Later scholars failed to understand its meaning, suspecting errors or interpolations, which was ignorant. Therefore, there is a type of Zhong Feng (Wind Stroke) that is purely Cold without Yang, rooted internally, similar to Cold-Damp Hong Kong Foot or Ben Tun. This is completely unrelated to the Phlegm-Fire Zhong Feng described by Dong Yuan, He Jian, and Dan Xi. Historically, commentators on Zhong Feng have been stuck on the views of these three masters, neglecting this aspect. Yu Jiayan, in the final section on Cold in *Yimen Falü* (Legal Methods of Medicine), elucidates the syndrome and prescription of Xu Shuwei's Jiao Fu Tang (Pepper and Aconite Decoction); its principles resonate with this text and should be studied in detail.