横置开上,令三合,其状如 形,复以朱涂两端毕,三处同时起火灸之,各一百壮愈。
〔河〕凡觉中风,必先审六经之候,慎勿用大热药乌、附之类,故阳剂刚胜,积若燎原,
为消狂疮肿之属,则天癸绝而荣涸矣。
〔罗〕云∶中风人初觉,不宜服脑、麝,恐引风入骨髓,如油入面,不能得出,如潮痰盛
,不省人事烦热者,宜用下痰,神效。
〔洁〕云∶中风如小便不利,不可以药利之。既已自汗,则津液外亡,小便自少。若利之
,使荣卫枯竭,无以制火,烦热愈盛。当候热退汗室,小便自行也。
〔丹〕治中风方,续命、排风、越婢等,悉能除去,而《千金》多用麻黄,令人不得虑虚
。以风邪不得汗,则不能泄也。然此治中风不汗者为宜。若自汗者,更用麻黄则津液转脱,
反为大害。中风自汗,仲景虽处以桂枝汤,至于不住发搐口眼 动,遍身汗出者,岂胜
对治。此时独活汤、续命煮散,能复荣卫,却风邪,不可缺也。(独活、续命散,方风螈
条)
〔《千》〕治中风,无密室者,不可疗。强人居室不密,尚中风邪,况服药之人乎。服汗
剂,必根据此法。
〔丹〕寒则筋急,热则筋缓。缓因于弛长,缩因于短促。若受湿则弛,弛因于宽而长。然
寒与湿,未尝不挟热,三者皆因于湿。然外湿,非内湿无以启之,不能成疾。致湿之由,酒
面为多,鱼与肉继以成之。若甘滑、烧炙香辛硬物,皆致湿之因,戒之慎之。药中肯綮
矣。若将理失宜,虽圣医,不治也。天产作阳,气浮发热,先哲格言。但是患痿之人,若不
能淡薄食味,吾知其必不能安全也(丹溪断痱病为痿)。凡人初觉食指次指麻木不仁,或不用
者,三年内必中风之候也。宜先服愈风汤、天麻丸各一两料,此治之先也。是以圣人治未病
,不治已病。中风人能食,盖甲己化土,脾盛故能多食。此脾愈盛,下克肾水,肾水亏则病
增,宜广服药,不欲多食,病能自愈。中风多食,风木盛也。盛则克脾,脾受敌,求助于食
。经曰∶实则梦与,虚则梦取。当泻肝木,治风安脾,脾安则食少,是其养矣。
肺脉微缓,为痿 偏风,头以下汗出不可止(全文见治虚实法)。脾脉微缓,为风痿
,四肢不用,心慧然若无病。(同上。经云∶脉缓者多热,盖风痿即风痱之类)
〔《素》〕胃脉沉鼓涩,胃外鼓大,心脉小坚急,皆鬲偏枯,男子发左,女子发右,不喑
舌转可治,三十日起。其从者喑,三岁起。年不满二十者,三岁死。(大奇论。王注
云∶从谓男发左女发右也)
〔《玄》〕中风不语者,为病在心脏。脉反沉者,治难见效。凡病脉不应病者危。
〔丹〕《脉诀》内言不治证见,则不可治。筋枯,不治。动则筋痛者,是谓筋枯。以其无
血滋润筋骨也。
将艾炷横置,开口向上,令其容纳三合(容量单位),形状像“”形(原文此处可能有缺字或异体字,通常指特定形状的艾炷或容器,依文意译为保持原状),再用朱砂涂抹两端完毕,在三处同时起火施灸,每处各灸一百壮即可痊愈。
〔河间〕凡是感觉中风征兆时,必须先审察六经的证候,千万不要使用乌头、附子等大热药物。因为阳热药性刚烈猛烈,若体内积热如烈火燎原,会导致消渴、发狂、疮肿等病症,致使天癸枯竭、营血干涸。
〔罗谦甫〕说:中风患者初起时,不宜服用麝香、冰片等开窍药,恐怕引风邪深入骨髓,如同油渗入面粉中,无法再取出。如果痰涎壅盛,神志昏迷,烦躁发热者,适宜使用下痰法,效果极佳。
〔洁古〕说:中风患者如果出现小便不利,不可以用利尿药物治疗。既然已经自汗,津液已从体表流失,小便自然减少。如果使用利尿药,会使营卫之气枯竭,无法制约虚火,导致烦躁发热更加严重。应当等待热退汗止后,小便自然会通畅。
〔丹溪〕治疗中风的方剂,如续命汤、排风汤、越婢汤等,都应全部去除。而《千金方》中多用麻黄,让人不必顾虑正气虚弱的问题。因为风邪郁闭,若无汗出,则邪气不能宣泄。然而这些方法只适用于中风无汗的情况。如果是自汗的患者,再用麻黄则会进一步耗伤津液,反而造成大害。对于中风自汗的情况,虽然张仲景处以桂枝汤,但对于那些抽搐不止、口眼歪斜、遍身出汗的患者,岂能仅靠对治之法解决?此时独活汤、续命煮散能够恢复营卫,驱除风邪,是不可缺少的。(独活汤、续命散见“风痓”条)
〔《千金方》〕治疗中风,如果没有严密的居室,是无法治疗的。普通人居住在不密闭的房屋中,尚且容易受风邪侵袭,何况是服药调理的病人呢?服用发汗剂,必须依据此法进行防护。
〔丹溪〕寒邪导致筋脉拘急,热邪导致筋脉弛缓。弛缓是因为筋脉松弛延长,拘缩是因为筋脉短促收缩。如果感受湿邪则筋脉弛缓,这是因为湿性宽缓而长。然而寒与湿,未尝不夹杂热邪,这三种情况都因湿而起。但是外感湿邪,若无内湿作为诱因,也不能成病。导致内湿的原因,多为饮酒和面食,鱼肉继之而成。至于甘甜滑腻、烧烤香辛坚硬的食物,都是致湿的因素,务必戒慎。用药切中肯綮了。如果调护失宜,即使是圣医也无法治愈。天然产动物属阳,气浮易发热,这是先哲的格言。只是患痿证的人,如果不能饮食清淡,我知道他一定不能平安无事(丹溪断痱病为痿证)。凡人刚开始觉得食指和次指麻木不仁,或者不能活动时,三年内必有中风发作的迹象。应当预先服用愈风汤、天麻丸各一两的量,这是治疗在先。所以圣人治未病,不治已病。中风患者如果能进食,是因为甲己化土,脾土旺盛故能多食。但这脾土愈盛,就会克制肾水,肾水亏虚则病情加重,应当广泛服药,不想多食,病才能自愈。中风患者多食,是风木过盛所致。木盛则克脾,脾受克制,求助于食物摄取。《内经》说:实证梦见给予,虚证梦见索取。应当泻肝木,治风安脾,脾安则食欲减少,这才是调养之道。
肺脉微缓,为痿证偏风,头部以下汗出不止(全文见治虚实法章节)。脾脉微缓,为风痿,四肢不能活动,心中清醒好像没病一样。(同上。《内经》说:脉缓者多热,大概风痿即属于风痱之类)
〔《素问》〕胃脉沉取鼓涩,胃脉外显鼓大,心脉小坚急,都是膈塞偏枯之症。男子发于左侧,女子发于右侧,如果不失音,舌头转动灵活,可以治疗,三十日起效。如果伴有失音,三年才起效。年龄不满二十岁的,三年后死亡。(出自《大奇论》。王冰注解说:从是指男子发左、女子发的规律)
Lay the moxa cone horizontally with the opening facing upward, allowing it to hold three *he* (a unit of volume), shaped like [character missing/variant]. After finishing coating both ends with cinnabar, ignite fire simultaneously at three locations for moxibustion. Each location receives one hundred *zhuang* (moxa cones) until recovery.
[He Jian] Whenever one feels the onset of wind-stroke, one must first examine the manifestations of the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin). Do not use overly hot medicines such as Aconitum carmichaelii root (Wutou) or Aconitum lateral root (Fuzi). Since yang-tonifying agents are rigid and potent, if accumulated heat spreads like a prairie fire, it will lead to conditions such as wasting-thirst (Xiao Ke), mania, sores, and swellings, causing Tian Gui (reproductive essence) to cease and Ying Blood (nutritive blood) to dry up.
[Luo Qianfu] stated: When a patient initially perceives wind-stroke, they should not take aromatic opening-orifice drugs like Moschus (Shexiang) or Borneolum Syntheticum (Bingpian), lest they draw the wind pathogen into the bone marrow. This is like oil penetrating flour; once inside, it cannot be extracted. If phlegm-turbidity is abundant, consciousness is lost, and there is irritability and fever, it is appropriate to use methods to purge phlegm, which yields miraculous effects.
[Jie Gu] stated: If a wind-stroke patient experiences difficulty in urination, diuretic drugs should not be used. Since spontaneous sweating has already occurred, body fluids have been lost externally, and urine output naturally decreases. Using diuretics would deplete Ying and Wei (defensive) qi, leaving no means to control fire, thereby exacerbating irritability and fever. One should wait for the fever to subside and sweating to stop, after which urination will normalize spontaneously.
[Dan Xi] Therapeutic formulas for wind-stroke, such as Xuming Tang (Cinnamon Twig Decoction for Continuation), Paifeng Tang (Wind-Expelling Decoction), and Yuespi Tang (Dispersing Spleen Decoction), should all be discarded. The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) often uses Ephedrae Herba (Mahuang, 麻黄), leading people to worry unnecessarily about deficiency. This is because if wind-pathogens do not induce sweating, they cannot be vented. However, these methods are suitable only for wind-stroke without sweating. For patients with spontaneous sweating, using Mahuang further depletes body fluids, causing greater harm. Although Zhang Zhongjing prescribed Guizhi Tang (Cinnamon Twig Decoction) for wind-stroke with sweating, for those with continuous convulsions, deviation of the mouth and eye, and generalized sweating, how can simple symptomatic treatment suffice? At this stage, Duhuo Tang (Angelica Pubescens Decoction) and Xuming Zhusan (Continuation Medicine Boiled Powder) are indispensable as they restore Ying and Wei qi and expel wind-pathogens. (See "Wind Convulsion" section for formulas).
[*Qianjin Fang*] Wind-stroke cannot be treated if the living quarters are not sealed tightly. Ordinary people living in non-sealed rooms are still susceptible to wind-pathogens, let alone patients taking medication. When administering diaphoretic (sweat-inducing) agents, one must strictly adhere to this method of protection.
[Dan Xi] Cold causes sinews to contract; heat causes sinews to relax. Relaxation results from elongation and laxity; contraction results from shortening and tension. Exposure to dampness leads to relaxation due to its expansive and lengthening nature. However, cold and dampness often harbor heat; all three factors relate to dampness. External dampness requires internal dampness to initiate pathology; otherwise, disease does not form. Causes of internal dampness include excessive alcohol and wheat products, followed by fish and meat. Sweet, slippery, roasted, spicy, and hard foods are also causes of dampness; one must beware and abstain. Medicinal intervention hits the mark precisely. However, if nursing care is improper, even a sage physician cannot cure the disease. Animal products are yang in nature, causing floating qi and fever—this is an ancient maxim. For patients with flaccidity syndrome (Wei Bing), if they cannot maintain a bland diet, I know they cannot remain safe. (Dan Xi diagnosed Fei Bing as Wei Bing). When a person initially feels numbness or loss of function in the index and middle fingers, wind-stroke will likely occur within three years. It is advisable to preemptively take Yu Feng Tang (Wind-Resolving Decoction) and Tianma Wan (Gastrodia Pill), each for one liang dose. This represents treating before the disease manifests. Thus, sages treat disease before it arises, not after it occurs. Wind-stroke patients who can eat well do so because Jia-Ji transforms into Earth, indicating strong Spleen Qi. However, excessive Spleen strength overacts on Kidney Water, causing Kidney Yin deficiency and worsening the condition. Extensive medicinal treatment is needed, and reducing food intake aids self-healing. Excessive eating in wind-stroke indicates hyperactive Liver Wood. Wood excess attacks the Spleen; the Spleen, under attack, seeks relief through food. The Classic states: "Excess dreams of receiving; deficiency dreams of taking." One should drain Liver Wood, treat wind, and soothe the Spleen. When the Spleen is calm, appetite decreases, marking proper nourishment.
A slightly slow Lung pulse indicates flaccidity syndrome with hemiplegia, characterized by unstoppable sweating below the head (see full text in "Treating Deficiency and Excess"). A slightly slow Spleen pulse indicates wind-flaccidity, with inability to move the four limbs, while the mind remains clear as if healthy. (Ibid. The Classic states: "Slow pulses often indicate heat"; generally, wind-flaccidity belongs to the category of wind-fei).
[*Suwen*] A Stomach pulse that is deep, forceful yet choppy, or externally forceful and large, combined with a small, firm, and urgent Heart pulse, indicates diaphragm obstruction and hemiplegia. In men, it appears on the left; in women, on the right. If aphasia is absent and the tongue moves freely, it is treatable, with recovery beginning after thirty days. If accompanied by aphasia, recovery begins after three years. Those under twenty years old will die after three years. (From *Da Qi Lun*. Wang Bing's commentary notes: 'Cong' refers to the pattern of men affecting the left and women the right).
[*Xuanzhu*] Aphasia in wind-stroke indicates the disease resides in the Heart. If the pulse is paradoxically deep, treatment is difficult to effect. Any case where the pulse does not match the disease is critical.
[Dan Xi] Conditions listed as untreatable in *Mai Jue* (Pulse Categories) are indeed incurable when present. Sinew withering is untreatable. Pain in sinews upon movement is termed "sinew withering," caused by a lack of blood to nourish the sinews and bones.