凡脉浮弦无力为风,浮滑不清为痰,浮数有力为火,沉弦有力为气,沉实有力为便
结,沉涩而数为血凝。凡下元无根,则两肾脉不应,或沉滑微细,若尺浮而无力,肾气
不足,尺洪而弦数,肾阴大亏。若痰塞气满,并逆于上,有升无降,则虚弦搏急,一
如沸釜,或精气元气一时暴绝,则虚散而欲绝。脉来缓滑或浮滑或滑数,有神者,易
治;或弦滑或浮数。或洪大者,难治。若两脉绝无,下元已绝,寸关虚豁而空大,真气
已散,或举之搏大,按之绝无,孤阳无根据者死。
口开手撒遗尿者属气虚,为阳暴绝也,速宜大料参附补救之。如因无血而不能滋养
其筋,是以举动则痛者,为筋枯也,不治诸中或未苏或已苏,或初病或久病,忽吐出
紫红色者死。
一凡中风口开为心绝,手撒为脾绝,眼合为肝绝,遗尿为肾绝,气喘面黑鼻鼾为肺
绝,及吐沫直视,喉如鼾睡,肉脱筋痛,面赤如装,发直摇头上窜,或头面青黑,汗如
缀珠,并脉大数无伦者死。
治中风口噤,单蛾双蛾。
江子仁(六粒,每粒分作二片) 牙皂(三钱,切片) 明矾(一两) 先将矾化开,后
入二味搅匀,待矾枯为末,每用三分吹入,诸病皆愈。痰涎壅盛者,灯心汤下五分,在
喉者即吐,在膈者即下。
凡是脉象浮而弦且无力,属于风邪;脉象浮而滑且不清晰,属于痰湿;脉象浮而数且有力,属于火邪;脉象沉而弦且有力,属于气滞;脉象沉而实且有力,属于大便干结;脉象沉而涩且数,属于血瘀凝滞。凡是下元(肾与命门)根基不固,则两尺部(肾脉部位)脉搏不应指,或者呈现沉滑微细之象;如果尺部脉浮而无力,说明肾气不足;尺部脉洪大且弦数,说明肾阴严重亏损。如果痰浊阻塞、气机壅满,并逆乱于上焦,只有升发没有下降,脉象就会虚弦搏动急促,就像沸腾的锅一样;或者是精气元气一时突然断绝,脉象就会虚散且近乎消失。脉象来势缓滑,或者浮滑,或者滑数,且脉有神气的,容易治疗;如果是弦滑,或者浮数,或者洪大的,难以治疗。如果两手脉搏完全摸不到,说明下元已绝;寸部和关部脉象虚豁且空大,说明真气已经散失;或者轻取时脉搏搏动大而重按却完全摸不到,这是孤阳无根的表现,预后不良,主死。
口张手撒(手指松开)且遗尿的,属于气虚,是阳气突然暴脱的表现,应当立即使用大剂量的参附汤进行补救。如果是由于无血而不能滋养筋脉,导致活动时疼痛的,属于筋枯,无法治愈。各种中风病证,无论尚未苏醒或已经苏醒,无论是初发病还是久病,忽然吐出紫红色血液的,预后不良,主死。
凡是中风患者,口张开是心气绝,手撒开是脾气绝,眼睛闭合是肝气绝,遗尿是肾气绝,气喘、面色黑、鼻鼾声重是肺气绝,以及吐沫、直视、喉咙发出如熟睡般的鼾声、肌肉消瘦、筋脉疼痛、面色红赤如化妆一般、头发直立、摇头且头部向上窜动、或者头面部青黑、汗出如珠串般滴落,并且脉象宏大数乱无度的,预后不良,主死。
治疗中风牙关紧闭(口噤),单蛾喉痹,双蛾喉痹。
巴豆仁(六粒,每粒分成两片),皂角(三钱,切片),明矾(一两)。先将明矾溶化,然后加入另外两味药搅拌均匀,待明矾干枯后研成粉末,每次取三分吹入鼻腔,各种病症皆可痊愈。痰涎壅盛的患者,用灯心草汤送服五分,痰在咽喉的随即吐出,在胸膈的随即下行排出。
Whenever the pulse is floating, wiry, and weak, it indicates Wind; floating, slippery, and indistinct indicates Phlegm; floating, rapid, and forceful indicates Fire; deep, wiry, and forceful indicates Qi stagnation; deep, solid, and forceful indicates constipation; deep, choppy, and rapid indicates blood stasis. Whenever the lower origin (Kidney and Mingmen) lacks root, the pulses at both Chi positions (Kidney pulse sites) may be imperceptible, or appear deep, slippery, slightly fine; if the Chi position is floating and weak, Kidney Qi is insufficient; if the Chi position is surging, wiry, and rapid, Kidney Yin is severely deficient. If phlegm obstructs and Qi is full, reversing upwards with only ascending and no descending, the pulse will be empty, wiry, beating rapidly, resembling a boiling cauldron; or if Essence and Original Qi suddenly cut off at once, the pulse will be empty, scattered, and nearly absent. A pulse that comes slowly and smoothly, or floating and smooth, or slippery and rapid, possessing Shen spirit (vitality), is easy to treat; however, if it is wiry and smooth, or floating and rapid, or surging and large, it is difficult to treat. If both radial pulses are completely absent, the lower origin has perished; if the Cun (inch) and Guan (bar) positions are empty and hollowly large, True Qi has dispersed; or if superficial pressure reveals a large, beating pulse but deep pressure finds none, this is solitary Yang without foundation, indicating death.
An open mouth, relaxed hands (dropped limbs), and urinary incontinence belong to Qi deficiency, representing sudden violent collapse of Yang; immediate rescue with a large dose of Renshen Fuzi Tang (Ginseng and Aconite Decoction) is required. If movement causes pain due to lack of blood failing to nourish the sinews, this is dried-up sinews, which is untreatable. In various stroke conditions, whether not yet recovered consciousness or already recovered, whether newly ill or chronically ill, sudden vomiting of purple-red blood indicates death.
In stroke, an open mouth indicates Heart Qi exhaustion; relaxed hands indicate Spleen Qi exhaustion; closed eyes indicate Liver Qi exhaustion; urinary incontinence indicates Kidney Qi exhaustion; panting, black complexion, and snoring indicate Lung Qi exhaustion. Also, spitting foam, fixed gaze, throat sounds like sleeping, emaciated flesh, painful sinews, face red as if painted, hair standing erect, shaking head with upward jerking, or blue-black head and face, sweat dripping like beads, combined with a pulse that is large, rapid, and boundless, all indicate death.
Renshen (Ginseng Radix et Rhizoma) (1 liang), Fuzi (Aconiti Lateralis Radix Praeparata) (half, used raw). Decoct in water and take warm.
Treats stroke with locked jaw (Kou Jin), single tonsillar swelling (Dan E), and double tonsillar swelling (Shuang E).
Jiangziren (Crotonis Fructus / Semen Crotonis) (6 grains, each split into two slices), Yazao (Gleditsiae Sinensis Fructus cum Spina) (3 qian, sliced), Mingfan (Alumen). First dissolve the alum, then add the other two ingredients and stir evenly. Wait until the alum dries and becomes powder. Use 3 fen per application blown into the nose; all diseases will heal. For patients with excessive phlegm-saliva, administer 5 fen with Dengxin Tang (Juncus Decoction); if phlegm is in the throat, it will induce vomiting; if in the diaphragm, it will cause downward discharge.