(有图见卷三○以下李仙槎着)
公孙为父通冲脉。内关母与阴维接。四经会合胃心胸。心脾有病治堪适。
头面颈项四肢风。后溪申脉当详核。二穴督脉阳跷通。兼属夫妻自和悦。
临泣称男带脉连。外关女与阳维一。气贯耳颊肩颈目。四肢风痛病如失。
若遇喉风藏病凶。客寻照海主列缺。列缺原来任脉通。阴跷照海本同辙。
九种心疼延闷。结胸翻胃难停。胎衣不下血迷心法泻公孙立应。积块坚横胁抢。心胸痞
胀肠鸣。伤寒不解病深沉。疟疾内关可定
手足背腰疼痛。中风不语痫癫。头眩眼肿项腮牵且向后溪穴针。痈毒四肢麻木。耳聋身
肿绵延。头疼鼻衄泪涟涟申脉针时可痊。
中风手足不举。腿疼胁胀拘挛。头风咽肿项腮连。临泣亟须针砭 肢节肿疼膝冷。背胯
内外筋牵。伤寒盗汗热难捐主客外关有验。
痔疟便肿泄痢。吐红溺血咳痰。死胎不下膈中寒列缺并医噎咽 喉塞便淋酒积昏迷临产
艰难膈中气核并心烦照海行针可散。
寸口脉浮而缓。浮则为风。缓则为虚。营缓则为亡血卫缓则为中风。邪气中经络脉空
虚。
贼邪不泻。或左或右。邪气反缓。正气即急。正气引邪。 僻不遂。邪在于络肌肤不仁。邪
在于经。即重不胜。邪入于府即不识人。邪入于藏。舌即难言。口吐涎 寸口脉浮而紧。紧
则为寒。浮则为风。寒风相搏。邪在皮肤。则身痒而瘾疹。心气不足。邪气入中。则胸满而
短气。(金匮原文从医宗金鉴)
喻嘉言曰。伤寒症太阳经之中风者。乃风寒暑湿之风。自外而入者也。真中风之风。乃
人身
自有之风。平素蕴蓄。而一旦内出者也。素问云。阳之气。以天地之疾风名之可见真中风之
病。乃人之数扰其阳所致。数扰其阳惟房室一事为最。房室过勤。纵阴不走而阳气则已动。
动而不已。必渐积于空 之所。而手微麻。足或微瘅。舌或微蹇风信已至。而扰其阳者方未
已。一旦乘虚横发。与大块噫气。林木振响黄沙蔽天。白浪翻海者初无少异矣。其人安得不
卒倒乎。迨至卒倒。而世医方引风寒暑湿之风为治一误再误。外风入而与内风交煽。任凭躯
伟体坚。经年不能少减。而成废人者比比。甚有不旬日而告毙矣。可胜悲哉。大法风既自内
而生。还须自内而熄欲自内而熄。何物是熄风之药。养血乎。风亦与之俱养补气乎。风亦与
之俱补。实腠理乎。风亦与之俱实。将何所取耶养血补气。自不可少。而实腠理之药。断不
可用进而求之于法。然后不患于无药也。盖天地间之风得雨则熄。所以素问又曰。阳之汗。
以天地之雨名之。以雨治风。不言治而治在其中。以故内风之人。腠理断不可实。实则汗不
能出也。气血不可不补。虚则不足供汗之用也。要使元气足以拒风于腠理之间。务如大病退
后之人。饮汤则汗。食粥则汗。如此旬日以听风之自熄然后为当其妙全在助阳而通血脉。不
取驱风散邪为义。与荆防柴葛之轻药绝不相干。世传以羌防等药发散一食顷者此但可治偶感
之风耳。以治内风。不去百分之一岂有经年累积之风。而取办一药。且仅攻皮肤之理哉。中
风病多见于富贵之人。而贫贱绝少。贫贱之人。非无房室也。以其劳苦奔走。身中之气时为
蒸动。才有微风。便从汗解。而富贵之人。身既安逸。内风已炽。尚图乘风纳凉沐泉饮水。
以解其热。致阳气愈遏不舒。加以浓酒浓味之热挟郁阳而为□痰闭塞经络一旦卒然而中漫不
知病所由来古今成方虽多。辨症全不清切盍观平人饮醇食爆。积至无算。全不见其热者阳气
有权。嘿为运出耳。阳气遏郁无权。势必转蒸饮食之物为痰。痰与风相结。迨发之时。其体
盛之人病反加重。盖体盛则阳多。阳多则风与痰俱多也孰知其风为本。而痰为标耶。孰知其
阳气为本。而风痰为标耶。风痰为标。可汗可吐而或者见其昏迷舌蹇。以为邪入心藏。用牛
黄清心之类。驱风散痰。致阳气愈遏。而成不治甚多。夫阳遏在内之人。脏腑有如火烙。平
素喜生冷。临病又投金石。覆辙相寻。明哲罔悟。亦独何耶。阳气为本。势必绝欲而不更扰
其阳。病根始拔。然而阳气素动。习惯渐近自然。多不乐于安养。风痰才得少息。往往思及
欲事。略一举动。复从本及末。蔓而难图矣。古今无人深论及此惟善保生者。见体中痰多风
炽。无俟病发。预为绝欲可矣。
按中风者。乃为风邪所中。卒倒无知之症。西北气寒有之。东南无。中风者。此惟中气
虚惫。
故肝风内煽。东垣主虚是也。虚则无根之火发焉。逆上之痰生焉。河间主火。丹溪主痰是也
。其卒倒痰壅。皆与真中风相似。故曰类中。但无六经形症为异耳。如牙关紧闭。两手握固
者。乃邪气闭塞于外。元气犹存。宜与开关利窍治法。至若口开为心绝。眼闭为肝绝手撒为
脾绝。遗尿为肾绝。鼻鼾为肺绝。此五脏气脱也。心绝者。不过一时死。更有发直头摇。吐
沫面赤。汗出如珠者。皆不治矣。间有中气者。为七情所伤。气厥无痰。宜用苏合香丸灌之
。
（插图见卷三，以下由李仙槎著）
公孙穴通于冲脉，为父；内关穴联络阴维脉，为母。这四条经脉会合于胃、心、胸部。若心、脾有病，治疗此二穴适宜。
头面、颈项及四肢的风邪病证，后溪穴与申脉穴应当仔细辨证。这两穴分别通于督脉和阳跷脉。二者配合如同夫妻和谐，疗效自佳。
临泣穴属男，连带脉；外关穴属女，联络阳维脉。气机贯通耳颊、肩颈及眼部。四肢风痛之病，针刺后可如失般痊愈。
若遇到喉风等凶险病症，客经取照海穴，主经取列缺穴。列缺穴原本通任脉，阴跷脉的照海穴与之本同路径。
九种心痛延续胸闷，结胸、翻胃难以停止。胎衣不下、血迷心神，泻公孙穴立竿见影。积块坚硬横亘胁部抢痛，心胸痞闷胀满、肠鸣。伤寒未解，病势深沉，疟疾取内关穴可定。
手足背腰疼痛，中风不语、癫痫发作，头晕目眩、眼肿、项腮牵引向后，针刺后溪穴可愈。痈毒、四肢麻木、耳聋、身体肿胀绵延，头痛、鼻衄、流泪不止，针刺申脉穴时可痊愈。
中风导致手足不能抬起，腿疼、胁胀、拘挛。头风、咽肿、项腮牵连，急需针刺临泣穴。肢节肿痛、膝冷，背部胯部内外筋脉牵拉，伤寒盗汗、热难消除，主客配穴取外关穴有验效。
痔疮、疟疾、便肿、泄痢，吐血、尿血、咳痰，死胎不下、膈中寒，列缺穴兼治噎嗝、咽喉阻塞、小便淋沥、酒积昏迷，临产艰难、膈中气核并心烦，针刺照海穴可消散。
寸口脉浮而缓，浮则代表风邪，缓则代表虚证。营气缓则亡血，卫气缓则中风。邪气侵入经络，脉象空虚。贼邪滞留不去，或偏左或偏右。邪气所在之处肌肉弛缓，正气所在之处肌肉急缩，正气牵引邪气，导致口眼歪斜、肢体不遂。邪气在络脉，肌肤麻木不仁；邪气在经脉，肢体沉重不能举；邪气入于腑，神志不清不识人；邪气入于脏，舌强难言，口吐涎沫。
寸口脉浮而紧，紧则代表寒邪，浮则代表风邪。风寒相搏，邪气在皮肤，则身痒且起瘾疹。心气不足，邪气入中，则胸满而短气。（出自《金匮要略》原文，参考《医宗金鉴》）
喻嘉言说：伤寒症中太阳经的中风，是风寒暑湿之风从外侵入的。真中风的风，是人体自身固有的风，平素蕴蓄在内，一旦从内发出的。《素问》说：阳气可以用天地的疾风来命名，可见真中风的病，是人多次扰动阳气所致。多次扰动阳气，以房事最为严重。房事过勤，虽然阴精不走泄，但阳气已经动越。动而不止，必然逐渐积聚于空虚之处，于是手微麻，脚微热，舌微蹇涩。风信已至，而扰动阳气的事还没停止，一旦乘虚横发，就像大地呼气、林木振响、黄沙蔽天、白浪翻海一样，没有什么不同。那人怎么能不突然昏倒呢？等到突然昏倒，世间的医生才引用风寒暑湿之风来治疗，一误再误。外风进入与内风交煽，任凭躯体伟岸坚实，长年不能稍减，成为废人的比比皆是，甚至不到十天就死亡的也有。可悲啊！大法则是：风既然从内生，还须从内熄灭。想要从内熄灭，什么药能熄风呢？养血吗？风也随着血一起养；补气吗？风也随着气一起补；充实腠理吗？风也随着腠理一起实。那该取法什么呢？养血补气，自然不可少，但充实腠理的药，绝对不能用。进而求之于法，然后就不担心没有药了。大概天地间的风，得雨则熄灭。所以《素问》又说：阳气的汗，用天地的雨来命名。用雨治风，不说治而治在其中。因此内风之人，腠理绝对不可实，实了汗就不能出。气血不可不补，虚了则不足以供汗之用。要使元气足以在腠理之间抵御风邪，务必像大病退后的人，喝汤则出汗，吃粥则出汗。如此十天，听任风邪自行熄灭，这才是其奥妙全在于助阳而通血脉，不取驱风散邪的意思。这与荆芥、防风、柴胡、葛根等轻药绝不相干。世间流传用羌活、防风等药发散，吃一顿饭功夫就见效的，这只可治偶然感受的风邪罢了。用来治内风，去不了百分之一。哪有经年累积的风，靠一味药就能解决，况且只攻皮肤的纹理呢？中风病多见于富贵之人，贫贱之人极少。贫贱之人并非没有房事，因为他们劳苦奔走，身上的气时常蒸动，稍有微风，便从汗而解。而富贵之人，身体安逸，内风已炽盛，还图谋乘风纳凉、沐泉饮水，来解其热，致使阳气更加遏抑不舒。加上浓酒厚味的热，挟持郁阳化为痰，闭塞经络，一旦突然中风，漫不知病所由来。古今成方虽多，辨证全不清晰切当。何不观察普通人喝美酒吃辛辣，积累无数，全不见其发热者，是因为阳气有权力，默默运出罢了。阳气遏郁无权，势必蒸腾饮食之物为痰。痰与风相结合，等到发作时，体形壮盛的人病反而加重。因为体盛则阳多，阳多则风与痰俱多。谁知道风是本，而痰是标呢？谁知道阳气是本，而风痰是标呢？风痰是标，可汗可吐。或者见到病人昏迷舌蹇，以为邪入心脏，用牛黄清心之类，驱风散痰，致使阳气更加遏抑，成为不治之症的很多。那些阳气遏抑在内的人，脏腑如火烙，平素喜生冷，临病又投金石类药物，覆辙相寻，明智的人也不醒悟，这又是为什么呢？阳气为本，必须断绝欲望而不更扰动其阳，病根才能拔除。然而阳气素来妄动，习惯渐近自然，大多不乐于安养。风痰才得少息，往往思及欲事，略微一动，又从本及末，蔓延难图。古今无人深论及此，只有善于保养生命的人，见体内痰多风炽，不等病发，预先断绝欲望就可以了。
按语：中风者，是被风邪所中，突然昏倒无知觉的病证。西北气候寒冷地区有之，东南地区无。所谓中风，这里是指中气虚惫，所以肝风内煽。李东垣主张虚，这是对的。虚则无根之火发焉，逆上之痰生焉。刘河间主张火，朱丹溪主张痰，也是对的。其突然昏倒、痰壅，都与真中风相似，所以叫类中。只是没有六经症状作为区别罢了。如牙关紧闭、两手握固，是邪气闭塞于外，元气犹存，宜用开关利窍的治法。至于口开是心绝，眼闭是肝绝，手撒是脾绝，遗尿是肾绝，鼻鼾是肺绝，这是五脏气脱。心绝者，不过一时死。更有发直头摇、吐沫面赤、汗出如珠的，都是不治之症。间或有中气者，为七情所伤，气厥无痰，宜用苏合香丸灌服。
(See illustrations in Volume 3, authored below by Li Xiancha)
Gongsun (PC4) connects to the Chong Mai (Penetrating Vessel), acting as the "Father"; Neiguan (PC6) connects with the Yin Wei Mai (Yin Linking Vessel), acting as the "Mother". These four meridians converge in the stomach, heart, and chest. When there is disease in the Heart or Spleen, treating these two acupoints is appropriate.
For wind pathogenic factors affecting the head, face, neck, and limbs, Houxi (SI3) and Shenmai (BL62) should be carefully examined. These two acupoints connect to the Du Mai (Governor Vessel) and Yang Qiao Mai (Yang Heel Vessel), respectively. Their combination is harmonious like husband and wife, ensuring efficacy.
Linqi (GB41) belongs to the male aspect and connects to the Dai Mai (Girdle Vessel); Waiguan (TE5) belongs to the female aspect and connects to the Yang Wei Mai (Yang Linking Vessel). Qi penetrates the ears, cheeks, shoulders, neck, and eyes. Wind-pain diseases of the limbs can be cured instantly upon needling.
In cases of severe throat wind or other ominous internal diseases, the guest meridian point Zhaohai (KI6) and the master meridian point Lieque (LU7) are selected. Lieque originally connects to the Ren Mai (Conception Vessel), and Zhaohai of the Yin Qiao Mai shares the same pathway.
Nine types of heart pain extending to chest tightness, Jie Xiong (Chest Binding), Fan Wei (Reversal of Stomach Qi) that are difficult to stop. For retained placenta and blood confusing the mind, draining Gongsun yields immediate results. For hard masses obstructing the hypochondrium, chest and epigastric fullness/distension, and borborygmus. When Shang Han (Cold Damage) is unresolved and the disease is deep, Naoyi (Malaria) can be stabilized by selecting Neiguan.
Pain in the dorsum of hands and feet, back, aphasia due to Zhong Feng (Stroke), epilepsy, dizziness, swollen eyes, and neck/jaw traction backward; needling Houxi brings cure. For carbuncles, limb numbness, deafness, persistent body swelling, headache, epistaxis, and excessive tearing, needling Shenmai brings recovery.
Zhong Feng causing inability to raise hands and feet, leg pain, hypochondriac distension, and spasm. Head wind, sore throat, and neck/jaw involvement require urgent needling of Linqi. Swelling and pain in joints, cold knees, and tendon traction inside and outside the back and hips. For Shang Han with night sweats and unrelenting heat, the master-guest pair Waiguan is effective.
Hemorrhoids, malaria, swollen bowels, dysentery, hematemesis, hematuria, and coughing up phlegm. For retained dead fetus and cold in the diaphragm, Lieque also treats Yie (Dysphagia), throat obstruction, strangury, alcohol accumulation with coma, difficult labor, diaphragmatic qi nodules, and irritability; needling Zhaohai dissipates these.
The pulse at Cun Kou (Radial Artery) is floating and slow. Floating indicates Wind; slow indicates Deficiency. A slow Ying (Nutrient) pulse indicates loss of blood; a slow Wei (Defensive) pulse indicates Zhong Feng (Stroke). Pathogenic factors invade the collaterals and meridians, resulting in an empty pulse. The thief pathogen remains lodged, either on the left or right. The side affected by the pathogen becomes flaccid, while the healthy side becomes tense; the healthy side pulls toward the diseased side, causing deviation of the mouth and eye and inability to move the limbs. If the pathogen is in the collaterals, there is numbness of the skin and muscles. If in the meridians, there is heaviness and inability to lift the limbs. If entering the Fu organs, there is unconsciousness and inability to recognize people. If entering the Zang organs, there is stiff tongue and difficulty speaking, with foaming at the mouth.
The pulse at Cun Kou is floating and tight. Tight indicates Cold; floating indicates Wind. Wind and Cold struggle together; the pathogen is in the skin, causing itching and urticaria. If Heart Qi is deficient and the pathogen enters the interior, there is chest fullness and shortness of breath. (Original text from *Jin Gui Yao Lue*, referenced from *Yi Zong Jin Jian*)
Yu Jiayan stated: In Shang Han syndromes, the "Zhong Feng" of the Tai Yang Meridian refers to wind from wind-cold, wind-heat, wind-dampness, etc., entering from the exterior. The "Wind" of true Zhong Feng is the wind inherent within the human body, accumulated internally over time and suddenly erupting inward. As stated in *Su Wen*: "Qi/Yang energy is named after the swift winds of heaven and earth." Thus, true Zhong Feng is caused by repeatedly disturbing Yang Qi. Among all activities, sexual intercourse most severely disturbs Yang. Excessive sexual activity may not deplete Yin essence immediately, but it agitates Yang Qi. Unrestrained agitation accumulates in void spaces, leading to slight hand numbness, slight foot heat, and slight tongue stiffness. Once the signs of wind appear, if the disturbance of Yang continues, a sudden eruption occurs when deficiency allows it, akin to the earth exhaling, trees shaking, yellow sand obscuring the sky, and white waves overturning the sea. How could the person not collapse suddenly? Yet, physicians often treat this by addressing external wind-cold-wind-heat-wind-dampness, making repeated errors. External wind joins with internal wind, and despite a robust physique, the condition persists for years, rendering the patient disabled, or even fatal within ten days. How tragic! The fundamental principle is: since wind arises from within, it must be extinguished from within. What medicine extinguishes wind? Nourishing Blood nourishes the wind along with it; tonifying Qi supplements the wind along with it; consolidating the Cou Li (skin pores) consolidates the wind along with it. So what method should be adopted? While nourishing Blood and tonifying Qi are indispensable, medicines that consolidate the Cou Li must absolutely be avoided. By seeking the correct method, one will not lack remedies. Generally, wind in the world is extinguished by rain. Thus, *Su Wen* states: "Sweat of Yang is named after the rain of heaven and earth." Using rain to treat wind implies treatment without explicitly stating it. Therefore, in internal wind, the Cou Li must never be consolidated, as consolidation prevents sweating. Qi and Blood must be supplemented; deficiency fails to provide the material for sweat. The goal is to ensure Yuan Qi (Primal Qi) is sufficient to resist wind at the Cou Li, similar to how a person recovering from severe illness sweats after drinking soup or eating porridge. After such practice for ten days, allowing the wind to extinguish itself is the profound妙 (wonder). The essence lies in assisting Yang and unblocking blood vessels, not in expelling wind and dispersing pathogens. This differs completely from light herbs like Jing Jie (Schizonepeta), Fang Feng (Saposhnikovia), Chai Hu (Bupleurum), and Ge Gen (Kudzu). Folklore claims that dispersing agents like Qiang Huo (Notopterygium) and Fang Feng work within a meal's time; this only treats occasional external wind exposure. It removes less than one percent of internal wind accumulated over years. Can a single drug resolve wind accumulated over years, attacking only the skin texture? Zhong Feng is more common among the wealthy and rare among the poor. The poor do engage in sex, but their labor keeps their Qi steaming and moving; any slight wind is released through sweat. The wealthy, however, live in comfort, allowing internal wind to blaze. They seek cool breezes, springs, and drinks to relieve heat, further suppressing Yang Qi. Combined with rich foods and alcohol generating heat, this traps Yang into Phlegm, blocking the meridians, leading to sudden stroke with unknown origin. Although ancient prescriptions abound, syndrome differentiation is often imprecise. Consider ordinary people consuming large amounts of fine wine and spicy food without fever; this is because Yang Qi has power to silently transport it out. When Yang Qi is suppressed and powerless, it inevitably steams food into Phlegm. Phlegm binds with wind. Upon eruption, those with robust constitutions suffer worse symptoms because robustness implies more Yang, which means more wind and phlegm. Who realizes that Wind is the Root and Phlegm is the Branch? Who realizes that Yang Qi is the Root and Wind-Phlegm is the Branch? Since Wind-Phlegm is the branch, it can be treated by sweating or vomiting. However, seeing coma and stiff tongue, some assume pathogen invasion of the Heart and use Niuhuang Qingxin Wan (Calculus Bovis Clearing Heart Pill) to disperse wind and phlegm, further suppressing Yang Qi, leading to many incurable cases. Those with suppressed Yang have burning internal organs; they prefer raw/cold foods normally, yet receive mineral drugs during illness, repeating mistakes. Wise people fail to realize this. Yang Qi is the Root; one must abstain from desires to stop disturbing Yang, thereby uprooting the disease. However, since Yang Qi is habitually active, people rarely enjoy rest. Once wind-phlegm subsides slightly, thoughts of desire arise, slight movement triggers recurrence from root to branch, becoming difficult to manage. No one in history has deeply discussed this. Only those skilled in preserving life, seeing abundant phlegm and blazing wind before onset, should proactively abstain from desires.
Note: Zhong Feng is a syndrome of sudden collapse and unconsciousness caused by wind pathogen invasion. It occurs in the cold northwest but not in the southeast. Here, "Zhong Feng" refers to deficiency of Middle Qi leading to internal stirring of Liver Wind. Li Dongyuan emphasized deficiency, which is correct. Deficiency causes rootless fire to flare and rebellious phlegm to rise. Liu Wanju emphasized fire, and Zhu Danxi emphasized phlegm, both being correct. The sudden collapse and phlegm obstruction resemble true Zhong Feng, hence called Lei Zhong (Simulated Stroke). The difference lies in the absence of Six Meridian manifestations. Jaw clenching and clenched fists indicate pathogen blockage externally with intact Yuan Qi; treat with opening apertures methods. Mouth open indicates Heart exhaustion; eyes closed indicate Liver exhaustion; limp hands indicate Spleen exhaustion; urinary incontinence indicates Kidney exhaustion; snoring indicates Lung exhaustion. These are exhaustion of the Five Zang Qi. Heart exhaustion leads to death shortly. Hair standing straight, head shaking, foaming, red face, and pearl-like sweat are all untreatable. Occasionally, Qi Jue (Qi Collapse) caused by Seven Emotions occurs without phlegm; treat with Su He Xiang Wan (Styrax Pill).