奉新张希良，卒倒不知人，头破出血，喉中痰鸣，遗溺，汗大出，两手两
不顺适，众医咸知为脱，已煎参附汤矣。余望其色，面赤而光，切其脉，浮大而缓，急止参
附，投白虎汤一剂而痰静，再剂而渐醒，次日左手足能动，而右则否，始知偏枯在右矣。因
连服数剂，右手亦愈，但不思食，众疑服药过凉，止之弗听，再服清凉数剂，乃大饥能食，
倍于平日，而病全愈。或曰∶何以断其必夹火，而面赤之必非戴阳乎？为虚阳上脱，其脉必
散，断不能缓，故确知（细急不分至数者为散，若见此脉，须桂、附以纳之）。
新建刘四美，猝不知人，目闭痰鸣，只右手动，余不动，无汗，医者投以参附，三日后
遂头
筋急不能屈伸，竟废。
南昌卢生，病如刘四美，误服参附已六日矣。亦用前方三帖而苏，再用原方加减，八帖
而全愈。可知此症，多受补药之害。
安义尉白映升，年六十余，尚健如壮年，从不服药。癸酉夏月，赴城隍庙烧香，忽跪不
起，口中喃喃，语不明白，一家谓受神谴也。舁归，则喉中痰鸣，已僵矣。余视其舌，如错
而黑，用大秦艽汤倍生地、加石膏，三日而尽五剂乃苏，而左半不能动，再用十剂，仍无效
，因尽去风药，专用元参、天冬、麦冬、生地、酒芍、白菊、知母，服两月而愈。
奉新李荣光，体肥多痰，生平好服 、术，虽当归亦不敢服，一日猝倒不知人，口 ，
右手不动，舌黑而干焦，用白虎汤加麦冬、元参、生地、当归、白芍、白菊，四剂而苏，右
亦渐
靖安辛文祥，好服补药，因而泄泻。医者谓其脾虚火衰也（时已年六十二），极力温补，
而泻愈甚，肌肉消尽而泄，食入即出，卧床一月矣。继而猝不知人，口眼 斜，不能言，右半
不
一日尽一帖，二日而苏，再服至六七日，而手足亦动，仍不能言耳。再服一二日，而大便胀
急不得出（已十余日不大便），于是改用承气汤加薄荷，服二帖大便通，而手足皆灵，语言亦
出矣。再服前方（即生地、麦冬），一月全愈（计服生地三十斤，麦冬十余斤）。或问其故，
曰∶人身肠胃有三十六曲，岂能食入即出，此明是温通太过，三焦气化转运太速，即火泄也
。热积于内，而犹行温补，以致内热感召外风，故猝中邪风。用润药以缓其传送，故泄止，
以解其内热，故风息。
姑录数案，以明中风多热病，乃确有所见，非从纸上空谈，且可知一切俗书不足信也。
彼《景
其诳，而不辨耶。
奉新县的张希良，突然昏倒不省人事，头部破裂出血，喉间有痰鸣音，大小便失禁，大汗淋漓，双手双脚活动不便。众医生都知道这是脱证（正气虚极欲脱的危重证候），已经煎好参附汤（人参、附子组成的回阳救逆方剂）。我观察他的面色，面红而光亮；切按他的脉象，浮大而缓。急忙制止使用参附汤，投予白虎汤一剂，痰鸣停止；再服一剂，逐渐苏醒；第二天左手脚能活动，但右手不能动，这才知道是右侧偏枯（中风后遗症之一，半身不遂）。于是连续服用数剂，右手也痊愈了，只是不想吃东西，众人怀疑服药过于寒凉，建议停药，但他不听，继续服用几剂清凉药后，反而感到极度饥饿且食欲大增，超过平日，病情完全痊愈。有人问：“为什么断定他必定夹火（火热之邪），而且面红一定不是戴阳证（虚阳上浮导致的假热证）呢？”因为如果是虚阳上脱，脉象必定散乱无根，断然不会呈现缓象，所以我确切知道（细急不分至数者为散，若见此脉，须桂、附以纳之）。
新建县的刘四美，突然昏迷不省人事，眼睛闭合，喉间痰鸣，只有右手能动，其余部位不动，无汗。医生给他投用参附汤，三天后导致头颈部筋脉拘急，不能屈伸，最终废用。
南昌的卢生，病症如同刘四美，误服参附汤已经六天了。我也用前面的方子（指清热化痰类方剂，结合上下文应为类似白虎汤或大秦艽汤加减的清热方，此处原文指前文提到的正确治法思路，具体方名未明示，但根据“苏”及后续描述，实为清热之法，此处依原文直译：亦用前方三帖而苏）三帖后苏醒，再用原方加减，八帖后完全痊愈。可知这类病症，多因受补药之害所致。
安义县尉白映升，六十多岁，身体健壮如壮年，向来不服药。癸酉年夏季，去城隍庙烧香，突然跪下起不来，口中喃喃自语，言语不清，家人认为是受到神灵谴责。抬回家后，喉间已有痰鸣，身体僵硬。我看他的舌苔，像错杂一样黑，用大秦艽汤（祛风养血通络方剂）加倍生地黄，加入石膏，三天服完五剂后苏醒，但左半身不能动，再用十剂，仍然无效，于是去掉所有风药，专门使用玄参、天冬、麦冬、生地黄、酒白芍、白菊花、知母，服用两个月后痊愈。
奉新县李荣光，体型肥胖多痰，生平喜欢服用白术、苍术等燥湿药，虽然当归也不敢服用。一天突然昏倒不省人事，口眼歪斜，右手不能动，舌苔黑而干燥焦枯，用白虎汤加麦冬、玄参、生地黄、当归、白芍、白菊花，四帖后苏醒，右手也逐渐恢复正常。
靖安县辛文祥，喜欢服用补药，因此导致泄泻。医生认为他是脾虚火衰（当时已六十二岁），极力温补，结果腹泻更加严重，肌肉消瘦殆尽，进食即吐出，卧床一个月了。随后突然昏迷不省人事，口眼歪斜，不能说话，右半身不能活动。每天服一帖药，两天后苏醒，再服用到六七天后，手脚也能活动了，只是仍不能说话。又服用一两天，大便胀急排不出（已经超过十多天没有大便），于是改用承气汤（峻下热结方剂）加薄荷，服两帖后大便通畅，手脚灵活，语言也恢复了。再服用前方（即生地黄、麦冬等滋阴药），一个月完全痊愈（共计服用地黄三十斤，麦冬十余斤）。有人问其中的缘故，回答说：“人的肠胃有三十六个弯曲，怎么可能食入即出？这明显是温通太过，三焦气化转运太快，也就是火泄（火热迫注大肠导致的泄泻）。热积于体内，却还进行温补，导致内热感召外风，所以突然中邪风。用润药来减缓其传导速度，所以泄泻停止；用润药解除内热，所以风邪平息。”
姑且记录这几个医案，以说明中风多属热病，这是我确实有所见地，并非从纸上空谈，而且可以知道一切世俗书籍不足信。那些《景岳全书》……（原文残缺）……欺骗人，而不辨别吗。
Zhang Xiliang from Fengxin County suddenly collapsed and lost consciousness, with a lacerated head bleeding, phlegm rattling in the throat, urinary incontinence, profuse sweating, and discomfort/inability to move both hands and feet. All physicians knew this as a condition of Collapse (a critical syndrome characterized by extreme deficiency of Zheng Qi leading to collapse). They had already prepared Shenfu Tang (Ginseng and Aconite Decoction). I observed his complexion: his face was red and shiny. I palpated his pulse: it was floating, large, and slow. I urgently stopped the use of Shenfu Tang and administered one dose of Baihu Tang (White Tiger Decoction), after which the phlegm sound subsided. After another dose, he gradually regained consciousness. The next day, his left hand and foot could move, but the right could not; only then did I realize he suffered from hemiplegia on the right side. Consequently, he took several more doses, and his right hand also recovered. However, he had no appetite. Others suspected the medication was too cooling and advised stopping it, but he refused. He continued taking several doses of cooling medicine, after which he felt extreme hunger and ate significantly more than usual, leading to a complete recovery. Someone asked, "How did you determine that there must be夾 Fire (Fire pathogen) involved, and why is the red face definitely not Dai Yang (Floating Yang/False Heat due to deficient Yang floating upward)?" Because if it were deficient Yang floating upward, the pulse would necessarily be Scattered (San Mai, a pulse indicating dispersion of vital energy, lacking root and distinctness), and certainly not Slow (Huan Mai). Therefore, I was certain that (when the pulse is indistinct and rapid without clear rate, it is called Scattered; if such a pulse appears, Cinnamon Twig and Aconite should be used to anchor it).
Liu Simei from Xinjian County suddenly lost consciousness, with eyes closed and phlegm rattling in the throat. Only his right hand moved; the rest of his body was immobile, and he had no sweat. The physician administered Shenfu Tang. Three days later, his neck tendons became tight and rigid, unable to flex or extend, resulting in permanent disability.
Lu Sheng from Nanchang suffered from symptoms identical to Liu Simei and had mistakenly taken Shenfu Tang for six days. I also used the previous formula (referring to the correct cooling/clearing formula implied in context, though not explicitly named in this specific sentence, it refers to the successful treatment method described earlier) for three doses, after which he revived. Using the original formula with modifications for eight doses led to a full recovery. This shows that such syndromes are often harmed by tonic medicines.
Bai Yingsheng, the magistrate's assistant from Anyi County, was over sixty years old but still vigorous like a young man, having never taken medicine. In the summer of the Guiyou year, while kneeling to burn incense at the City God Temple, he suddenly could not rise, muttering incoherently. His family believed he was being punished by the gods. When carried home, he had phlegm rattling in his throat and was stiff. I examined his tongue: it was black and coated like a mesh. I prescribed Da Qin Jiao Tang (Great Qinjiao Decoction) with doubled Sheng Di Huang (Rehmanniae Radix) and added Shi Gao (Gypsum Fibrosum). After finishing five doses in three days, he revived, but his left half-body remained immobile. After ten more doses, there was still no effect. Thus, I removed all wind-dispelling herbs and used exclusively Xuan Shen (Scrophulariae Radix), Tian Dong (Asparagi Rhizoma), Mai Dong (Ophiopogonis Radix), Sheng Di Huang (Rehmanniae Radix), Jiu Bai Shao (Wine-processed Paeoniae Radix Alba), Bai Ju Hua (Chrysanthemi Flos), and Zhi Mu (Anemarrhenae Rhizoma). After two months of administration, he recovered.
Li Rongguang from Fengxin County was obese and prone to Phlegm. Throughout his life, he liked taking Bai Zhu (Atractylodis Rhizoma) and Cang Zhu (Atractylodis Rhizoma), and even dared not take Dang Gui (Angelicae Sinensis Radix). One day, he suddenly collapsed and lost consciousness, with deviation of the mouth and eye, immobility of the right hand, and a black, dry, and scorched tongue. I prescribed Baihu Tang (White Tiger Decoction) with added Mai Dong (Ophiopogonis Radix), Xuan Shen (Scrophulariae Radix), Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), and Bai Ju Hua (Chrysanthemi Flos). After four doses, he revived, and his right hand gradually returned to normal.
Xin Wenxiang from Jing'an County liked taking tonic medicines, which led to diarrhea. Physicians attributed this to Spleen Deficiency and Fire Decline (at that time, he was 62 years old) and vigorously applied warming and tonifying methods. Consequently, the diarrhea worsened, muscles wasted away, food was vomited immediately after eating, and he had been bedridden for a month. Subsequently, he suddenly lost consciousness, with deviation of the mouth and eye, inability to speak, and immobility of the right half-body. He took one dose per day. On the second day, he revived. After continuing for six or seven days, his hands and feet could move, although he still could not speak. After one or two more days, he experienced abdominal distension and urgency to defecate but could not pass stool (having not passed stool for over ten days). At this point, I switched to Chengqi Tang (Chengqi Decoction, a purgative formula) with added Bo He (Menthae Haplocalycis Herba). After two doses, his bowels moved, his limbs became agile, and his speech returned. He then continued taking the previous formula (consisting of Sheng Di Huang and Mai Dong) for one month and fully recovered (total consumption: 30 jin of Sheng Di Huang and over 10 jin of Mai Dong). Someone asked for the reason. I replied: "The human intestines and stomach have thirty-six curves; how can food enter and exit immediately? This clearly indicates that excessive warming and unblocking caused the Qi transformation and transportation of the San Jiao (Triple Burner) to be too fast, which is essentially Fire Leakage (diarrhea caused by heat forcing fluids into the large intestine). Heat accumulated internally, yet warming tonics were still applied, causing internal heat to attract external Wind, resulting in sudden stroke from evil Wind. Using moistening herbs slowed down the transportation, thus stopping the diarrhea; using them to resolve internal heat extinguished the Wind."
I have tentatively recorded these few cases to clarify that Stroke (Zhong Feng) is mostly a Heat disease. This is based on my definite observations, not empty talk from books. It also shows that all popular medical books are unreliable. Those [from] Jingyue Quanshu... [text missing] ...deceive people, and do they not discern this?