国中倒时随即醒者,宜治。若不醒者,宜掐人中至醒。若痰涎壅盛者,宜吐之。口噤者
,亦宜吐之。若口开手撒遗尿者,为阳暴绝,速宜大料参 补接之。若眼戴上者,宜灸之。
〔《本》〕∶治中风忽然昏倒若醉,形体昏闷,四肢不收,风涎潮于上,膈气闭不通,宜救
急稀涎散。
猪牙皂角(四梃,肥实不蛀者,去黑皮) 晋矾(光明者,一两)
上为细末,研匀。轻者五分,重者三字匕,温水调灌下。不大呕吐,但微微令涎出一二
升,便得醒。醒后缓缓调治,不可便大投药饵,恐过伤人。
治中风同前症胜金丸。
生薄荷(半两) 猪牙皂角(二两,槌碎,水一升,二味一处,浸取汁研成膏) 瓜蒂(末,一两)
藜芦(二两) 朱砂(半两,研)
上将朱砂末二分,与二味末研匀,用膏子搜和丸,如龙眼大,以朱砂为衣。温酒化下一
丸,甚者二丸,以吐为度。得吐即醒,不醒者不可治。《必用方》论中风无吐法,引金虎碧
霞为戒,且如卒暴涎生,声如引锯,牙关紧急,气闭不行,汤药不能入,命在须臾者,执以
无吐法,可乎?但不当用银粉药,恐损脾坏人四肢尔。
予用此二方,每每有验。(罗谦甫方,有粉霜铅粉,无藜芦,治法同)
治急中风,口闭涎上,欲垂死者,一服即瘥。
江子(二粒,去皮膜) 白矾(如拇指大,一块,为末)
上将二味,在于新瓦上 ,令江子焦赤为度,为末,炼蜜丸,如鸡豆大。每服一丸。用
绵裹放患人口中近喉处,良久吐痰立愈。
中倒后口噤,牙关紧急,治法另见后口噤门。(亦用吐法)
〔《玄》〕风病口开手撒,眼合遗尿,鼻声如鼾者,五脏气绝也。盖口开者心绝,手撒者
脾绝,眼合者肝绝,遗尿者肾绝,声如鼾者肺绝也。若见一,犹可用工。若面赤时黑,主阳
上散,肾水反克心火,兼遗尿、口开、气喘者,断不救也。
五脏气绝,速宜大料参、 煎浓汤灌之,及脐下大艾灸之,亦可转死回生也。
〔罗〕治中风,眼上戴不能视者,灸第二椎骨,第五椎上,各七壮。一齐下火,炷如半枣
核大,立愈。
国中(指中原地区或泛指国内)出现卒中症状随即苏醒的,适宜进行治疗。如果不能苏醒的,适宜掐按人中穴直到患者苏醒。如果痰涎壅盛堵塞气道的,适宜采用催吐法排出痰涎。牙关紧闭(口噤)的,也适宜采用催吐法。如果口张不开、手松撒、遗尿的,这是阳气暴脱绝灭的表现,必须迅速使用大剂量的参类药材进行补益接续。如果眼球上翻(眼戴上)的,适宜施灸治疗。
〔《本草》/医典〕:治疗中风突然昏倒如同醉酒一般,身体昏沉闷乱,四肢不能收持约束,风痰涌向头部上方,膈部气机闭塞不通畅,适宜使用救急稀涎散。
猪牙皂角(四根,肥大结实且无虫蛀的,去掉黑皮) 晋矾(即白矾,色泽明亮的,一两)
将上述药物研成细末,研磨均匀。病情轻的用五分重,病情重的用三字匕(一种量具),用温水调匀后灌服。不一定非要引起剧烈呕吐,只需微微让痰涎排出一二升,患者就能苏醒。苏醒后缓缓调理治疗,不可立即大量投喂其他药物,恐怕过度损伤人体正气。
生薄荷(半两) 猪牙皂角(二两,捣碎,用水一升,将这两味药放在一起,浸泡取汁,研磨成膏状) 瓜蒂(研成末,一两) 藜芦(二两) 朱砂(半两,研成末)
先将朱砂末二分,与其他两味药的药末研磨均匀,用之前制备的膏子调和搓丸,如龙眼大小,以朱砂粉为衣。用温酒化开服用一丸,病情严重的服用两丸,以吐出痰涎为限度。吐出痰涎后即苏醒,如果不苏醒的,则无法救治。《必用方》论述中风没有催吐的方法,引用“金虎碧霞”作为警戒,但是像突然暴发痰涎涌生,声音像拉锯一样,牙关紧急,气机闭塞不通,汤药无法进入,生命在顷刻间就要结束的危急情况,坚持认为没有催吐法,可以吗?只是不应当使用含有银粉的药物,恐怕会损伤脾胃、毁坏四肢罢了。
我使用这两个方剂,每每都有疗效。(罗谦甫的方子,含有粉霜和铅粉,没有藜芦,治疗方法相同)
江子(即巴豆,二粒,去掉皮膜) 白矾(如拇指大小的一块,研成末)
将上述两味药放在新瓦上,加热至江子烧焦变红为止,研成末,用炼蜜制成丸药,如鸡豆大小。每次服用一丸。用棉布包裹放在患者口中靠近喉咙处,良久之后吐出痰涎立刻痊愈。
卒中昏倒后牙关紧闭,牙关紧急,治疗方法另见后文“口噤门”。(也使用催吐法)
〔《玄珠密语》〕:风病表现为口张开、手松撒、眼睛闭合、遗尿、鼻息声如打鼾的,是五脏之气断绝的表现。大概口张开的是心气绝,手松撒的是脾气绝,眼睛闭合的是肝气绝,遗尿的是肾气绝,声音如打鼾的是肺气绝。如果见到其中一种症状,还可以用心治疗。如果面色赤红时而发黑,主因阳气上浮散越,肾水反克心火,兼有遗尿、口开、气喘的症状,断定无法救治。
五脏之气断绝,必须迅速使用大剂量的参类药材煎煮浓汤灌服,并在脐下大穴施灸,也可以使死者复生。
〔罗谦甫〕:治疗中风,眼球上翻不能视物的,灸第二椎骨下方、第五椎骨上方的穴位,各七壮。同时点燃艾炷,艾炷大小如半个枣核,立刻痊愈。
In the region, if a patient suffering from apoplexy (stroke) regains consciousness immediately, it is appropriate to treat them. If they do not regain consciousness, it is appropriate to pinch the Ren-26 (Renzhong) acupoint until they wake up. If there is an abundance of phlegm and saliva obstructing the airway, it is appropriate to induce vomiting to expel the phlegm. In cases of trismus (lockjaw), inducing vomiting is also appropriate. If the mouth is open, hands are limp and scattered, and there is urinary incontinence, this indicates a sudden collapse of Yang Qi; it is urgent to use a large dose of Ginseng decoction to tonify and reconnect the Qi. If the eyes are deviated upwards, moxibustion is appropriate.
[From Medical Classics]: To treat sudden apoplexy resembling drunkenness, with a heavy and confused body, limbs unable to be controlled, wind-phlegm surging upwards, and blockage of Qi in the diaphragm making it unsmooth, Jiují Xīxián Sǎn (Emergency Rescue Thin Saliva Powder) is appropriate.
Zyzyphi Spinosae Fructus (Siyá Zàojiǎo): Four pods, plump, solid, free from insect damage, with black skin removed. Borneol Alumen (Jìnfán): Bright white alum, one liang.
Grind the above ingredients into a fine powder and mix evenly. For mild cases, administer five fen; for severe cases, administer three zishi (a traditional measure). Mix with warm water and administer orally. It is not necessary to induce violent vomiting; merely allowing one or two sheng of phlegm to drain out slightly will result in awakening. After awakening, regulate and treat slowly; do not immediately administer large doses of other medicines, as this may excessively harm the healthy Qi.
For apoplexy presenting with symptoms identical to those described above, Shèngjīn Wán (Victory Gold Pill) is used.
Menthae Haplocalycis Herba (ShēngBòhe): Half a liang. Zyzyphi Spinosae Fructus (Siyá Zàojiǎo): Two liang, crushed. Soak in one sheng of water, extract the juice, and grind into a paste. Cucumeris Fructus (Guādì): One liang, powdered. Veratri Radix et Rhizoma (Lílú): Two liang. Cinnabar (Zhūshā): Half a liang, powdered.
Take two parts of the Cinnabar powder and mix evenly with the powders of the other two ingredients. Use the prepared paste to bind and form pills the size of a longan fruit, coated with Cinnabar powder. Dissolve one pill in warm wine and administer; for severe cases, administer two pills. The treatment should cease once vomiting occurs. Awakening after vomiting indicates recovery; if awakening does not occur, the condition is incurable. *Bi Yong Fang* argues that there is no vomiting method for treating apoplexy, citing "Jinhu Bixia" as a warning. However, in cases of sudden onset with excessive phlegm, a sound like sawing, tight lockjaw, blocked Qi preventing the entry of decoctions, and life hanging by a thread, insisting on the absence of a vomiting method is unjustifiable. One should simply avoid using medicines containing silver powder, lest they damage the Spleen and ruin the four limbs.
I have used these two formulas frequently with verified efficacy. (The formula by Luo Qianfu contains Frost of Tin and Lead (Fénshuāng, Qiānfěn) but lacks Veratri Radix et Rhizoma; the treatment method is the same.)
To treat acute apoplexy with closed mouth and surging phlegm, approaching death, one dose results in immediate cure.
Crotonis Fructus (Jiāngzǐ / Bàdòu): Two seeds, skin and membrane removed. Alumen (Báifán): A piece the size of a thumb, powdered.
Place the two ingredients on a new tile and heat until the Crotonis Fructus turns scorched and red. Grind into powder. Bind with refined honey to form pills the size of a soybean. Administer one pill per dose. Wrap the pill in cotton cloth and place it near the throat inside the patient's mouth. After a while, vomiting of phlegm occurs, leading to immediate recovery.
For post-apoplectic trismus and tight lockjaw, see the treatment methods in the section on Trismus later in the text. (Vomiting method is also applicable.)
[From *Xuanzhu Miyu*]: Wind disease manifesting as open mouth, limp hands, closed eyes, urinary incontinence, and snoring nasal sounds indicates the exhaustion of the Five Zang organs' Qi. Specifically, an open mouth indicates Heart Qi exhaustion; limp hands indicate Spleen Qi exhaustion; closed eyes indicate Liver Qi exhaustion; urinary incontinence indicates Kidney Qi exhaustion; and snoring sounds indicate Lung Qi exhaustion. If any one of these signs is present, treatment can still be attempted. However, if the face appears red yet intermittently black, indicating floating and dispersal of Yang Qi, with Kidney Water counter-attacking Heart Fire, accompanied by urinary incontinence, open mouth, and panting, the prognosis is fatal and cannot be saved.
When the Qi of the Five Zang organs is exhausted, it is urgent to administer a large dose of Ginseng decoction concentrated and灌ed into the patient, and apply strong moxibustion below the navel. This can also bring the dead back to life.
[Luo Qianfu]: To treat apoplexy where the eyes are deviated upwards and vision is lost, moxa is applied to the points below the second thoracic vertebra and above the fifth thoracic vertebra, seven moxa cones each. Ignite all simultaneously. The moxa cone should be the size of half a jujube pit. Recovery is immediate.