治中风
防风（六钱） 真辽人参（四钱，另炖同服，或用野台参七钱代之，高丽参不宜用） 清半夏（三钱）
生石膏（八钱） 僵蚕（二钱） 柿霜饼（五钱，冲服） 麝香（一分，药汁送服）
中风之证，多因五内大虚，或秉赋素虚，或劳力劳神过度，风自经络袭入，直透膜原而达脏腑，令脏腑各
失其职。或猝然昏倒，或言语謇涩，或溲便不利，或溲便不觉，或兼肢体痿废偏枯，此乃至险之证。中之轻者，
犹可迟延岁月，中之重者，治不如法，危在翘足间也。故重用防风引以麝香，深入脏腑以搜风。犹恐元气虚弱，
不能运化药力以逐风外出，故用人参以大补元气，扶正即以胜邪也。用石膏者，因风蕴脏腑多生内热，人参补
气助阳分亦能生热，石膏质重气轻性复微寒，其重也能深入脏腑，其轻也能外达皮毛，其寒也能祛脏腑之热，
而即解人参之热也。用僵蚕者，徐灵胎谓邪之中人，有气无形，穿经入络，愈久愈深，以气类相反之药投之则
拒而不入，必得与之同类者和入诸药使为向导，则药至病所，而邪与药相从，药性渐发，邪或从毛孔出，从二
便出，不能复留，此从治之法也。僵蚕因风而僵，与风为同类，故善引祛风之药至于病所成功也。用半夏、柿
霜者，诚以此证皆痰涎壅滞，有半夏以降之，柿霜以润之，而痰涎自息也。
此证有表不解，而浸生内热者，宜急用发汗药，解其表，而兼清其内热。又兼有内风煽动者，可与后内
中风治法汇通参观，
于治外感之中兼有熄内风之药，方为完善。
中风之证，有偏寒者，有偏热者，有不觉寒热者。拙拟此方治中风之无甚寒热者也。若偏热者，宜《金
匮》风引汤加减（干姜、桂枝宜减半）。若偏寒者，愚别有经验治法。曾治一媪，年五十许，于仲冬忽然中风
昏倒，呼之不应，其胸中似有痰涎壅滞，大碍呼吸。诊其脉，微细欲无，且迟缓，知其素有寒饮，陡然风寒袭
入，与寒饮凝结为恙也。急用胡椒三钱捣碎，煎两三沸，取浓汁多半茶杯灌之，呼吸顿觉顺利。继用干姜六钱，
桂枝尖、当归各三钱，连服三剂，可作呻吟，肢体渐能运动，而左手足仍不能动。又将干姜减半，加生黄 五
钱，乳香、没药各三钱，连服十余剂，言语行动遂复其常。
若其人元气不虚，而偶为邪风所中，可去人参，加蜈蚣一条、全蝎一钱。若其证甚实，而闭塞太甚者，或
二便不通，或脉象郁涩，可加生大黄数钱，内通外散，仿防风通圣散之意可也。
徐灵胎曾治一人，平素多痰，手足麻木，忽昏厥遗尿、口噤手拳、痰声如锯。医者进参附、熟地等药，
煎成末服。诊其脉，洪大有力，面赤气粗。此乃痰火充实，诸窍皆闭，服参附立危。遂以小续命汤去桂附，加
生军一钱为末，假称他药纳之，恐旁人之疑骇也。三剂而有声，五剂而能言。然后以养血消痰之药调之，一月
后，步履如初。此案与愚所治之案对观，则凉热之间昭然矣。又遗尿者多属虚，而此案中之遗尿则为实，是知
审证者，不可拘于一端也。然真中风证极少，类中风者极多，中风证百人之中真中风不过一二人。审证不确即
凶危立见，此又不可不慎也。
治疗中风病。
防风（六钱），真辽人参（四钱，单独炖煮后与其他药汁混合服用，或者用七钱野台参代替，不宜使用高丽参），清半夏（三钱），生石膏（八钱），僵蚕（二钱），柿霜饼（五钱，冲服），麝香（一分，用药汁送服）。
中风这一病证，多因五脏内部极度虚弱，或者先天禀赋素来虚弱，或者过度劳累、思虑，导致风邪从经络侵袭进入，直接穿透膜原（半表半里之隙）而到达脏腑，致使脏腑各自失去正常职能。有的突然昏倒，有的言语謇涩（说话不流利），有的小便大便不通利，有的对大小便失去知觉，有的兼有肢体痿软废用或半身不遂，这些都是极其危险的证候。中风的轻症，还可以拖延岁月；重症如果治疗不得法，危险就在眨眼之间。所以重用防风并引导以麝香，深入脏腑以搜剔风邪。又担心元气虚弱，不能运化药力将风邪驱逐外出，所以用人参来大补元气，扶助正气从而战胜邪气。使用石膏的原因，是因为风邪蕴结在脏腑多会产生内热，人参补气助阳分也能生热，石膏质地重而气味轻，性质微寒，它的“重”能深入脏腑，它的“轻”能外达皮毛，它的“寒”能祛除脏腑的热，同时解除人参带来的热性。使用僵蚕的原因，徐灵胎认为邪气中人，是有气无形之物，穿过经脉进入络脉，时间越久越深，如果用与邪气性质相反的药投喂，邪气会拒绝进入，必须得到与邪气同类的药物作为向导混入诸药中，那么药才能到达病所，邪气与药相随，药性逐渐发挥，邪气或许从毛孔排出，从大小便排出，不能再停留，这是从治（顺其性而治）的方法。僵蚕因为风邪而僵硬，与风属于同类，所以善于引导祛风药物到达病所从而取得成功。使用半夏和柿霜，确实是因为此证都有痰涎壅滞，有半夏来降逆化痰，柿霜来润燥，痰涎自然平息。
此证如果有表证未解，进而产生内热的，应当紧急使用发汗药，解除表邪，同时清解内热。又兼有内风煽动的，可以与后面内中风的治法汇通参考，在治疗外感的同时兼用熄止内风的药物，方为完善。
中风病证，有偏寒的，有偏热的，有不觉寒热的。我拟定的这个方子用于治疗中风无明显寒热倾向的。如果偏热的，宜用《金匮要略》的风引汤加减（干姜、桂枝宜减半）。如果偏寒的，我有别的经验治法。曾治疗一位五十岁左右的老年妇女，在仲冬时节忽然中风昏倒，呼叫不应，感觉她胸中似有痰涎壅滞，严重阻碍呼吸。诊察她的脉搏，微弱细弱几乎摸不到，且迟缓，知道她素有寒饮（寒性水饮），陡然风寒侵袭进入，与寒饮凝结致病。紧急使用胡椒三钱捣碎，煎煮两三沸，取浓汁大半茶杯灌服，呼吸顿时觉得顺利。继而又用干姜六钱，桂枝尖、当归各三钱，连续服用三剂，可以发出呻吟声，肢体渐渐能运动，但左手足仍然不能动。又将干姜减半，加生黄芪五钱，乳香、没药各三钱，连续服用十余剂，言语行动于是恢复常态。
如果其人元气不虚，只是偶尔被邪风所中，可以去掉人参，加蜈蚣一条、全蝎一钱。如果证候非常实盛，闭塞太严重的，或者大小便不通，或者脉象郁涩，可加生大黄数钱，内通外散，仿照防风通圣散的意思即可。
徐灵胎曾治疗一个人，平素多痰，手足麻木，忽然昏厥遗尿、牙关紧闭手握拳、痰声如锯。医生进用参附、熟地等药，煎成末服用。诊察他的脉象，洪大有力，面色红赤气息粗重。这是痰火充实，诸窍皆闭，服用参附药立刻会有危险。于是用小续命汤去掉桂枝、附子，加生大黄一钱为末，假称是其他药物纳入其中，恐怕旁人怀疑惊骇。三剂后有了声音，五剂后能说话。然后用养血消痰的药物调理，一个月后，步履如初。此案与我治疗的案例对照观看，则凉热之间的区别就显而易见了。另外，遗尿大多属于虚证，而此案中的遗尿则是实证，由此可知审察证候的人，不可拘泥于一端。然而真正的中风证极少，类似中风的证候极多，中风证百人之中真正的中风不过一二人。审察证候不确切就会立即见到凶险危急，这又不可不谨慎啊。
Treatment of Zhong Feng (Wind Stroke).
Fangfeng (Radix Saposhnikoviae, 6 qian), Zhen Liaoshenren (Ginseng Radix et Rhizoma from Liaodong region, 4 qian, decocted separately and mixed with other decoctions for administration; alternatively, Yetaishenren [Ginseng Radix] can be used at 7 qian; Gaolishenren [Korean Ginseng] is not suitable), Qing Banxia (Rhizoma Pinelliae Preparatum, 3 qian), Sheng Shigao (Gypsum Fibrosum, 8 qian), Jiangcan (Bombyx Batryticatus, 2 qian), Shishuang Bing (Pyrus Sinkiangensis Frost, 5 qian, dissolved in the decoction), Shexiang (Moschus, 1 fen, taken with decoction).
The syndrome of Zhong Feng (Wind Stroke) is mostly caused by extreme deficiency within the five Zang organs, or innate constitutional weakness, or excessive physical labor and mental exertion. Wind pathogen invades via the meridians, penetrates directly through the Membranous Origin (the space between the exterior and interior) to reach the Zang-Fu organs, causing each organ to lose its normal function. Symptoms may include sudden collapse into unconsciousness, dysarthria (slurred speech), difficulty in urination and defecation, loss of sensation over urination and defecation, or accompanied by flaccid paralysis or hemiplegia. These are extremely critical syndromes. Mild cases of Zhong Feng may linger for years; severe cases, if treated improperly, face imminent danger. Therefore, a heavy dose of Fangfeng (Radix Saposhnikoviae) guided by Shexiang (Moschus) is used to penetrate deeply into the Zang-Fu organs to search out and expel wind. Fearing that the Yuan Qi (Primary Qi) is too weak to transform the medicinal power to drive out the wind, Renshen (Radix Ginseng) is used to greatly tonify the Yuan Qi, supporting the Righteous Qi to overcome the Pathogenic Qi. Shigao (Gypsum Fibrosum) is used because wind stagnating in the Zang-Fu often generates internal heat; furthermore, Renshen (Radix Ginseng) tonifies Qi and assists Yang, which can also generate heat. Shigao (Gypsum Fibrosum) is heavy in substance but light in aroma, with a slightly cold nature. Its heaviness allows it to penetrate deeply into the Zang-Fu organs; its lightness allows it to reach the skin and hair externally; its coldness clears heat from the Zang-Fu organs and simultaneously resolves the heat generated by Renshen (Radix Ginseng). Jiangcan (Bombyx Batryticatus) is used because Xu Lingtai stated that when pathogens enter the human body, they are "Qi-like but formless," penetrating meridians and collaterals, becoming deeper over time. If drugs with opposite properties to the pathogen are administered, the pathogen will reject them. It is necessary to use drugs of the same category as the pathogen to act as guides among the other herbs. Then, when the medicine reaches the disease site, the pathogen follows the medicine. As the medicinal properties gradually take effect, the pathogen may exit through the pores or via urination and defecation, unable to remain. This is the method of "concordant treatment" (treating according to the nature of the pathogen). Jiangcan (Bombyx Batryticatus) becomes stiff due to wind and belongs to the same category as wind; thus, it is good at guiding wind-expelling medicines to the disease site to achieve success. Banxia (Rhizoma Pinelliae Preparatum) and Shishuang Bing (Pyrus Sinkiangensis Frost) are used because this syndrome invariably involves phlegm-fluid retention. Banxia (Rhizoma Pinelliae Preparatum) descends and transforms phlegm, while Shishuang Bing (Pyrus Sinkiangensis Frost) moistens dryness, allowing the phlegm-fluids to subside naturally.
If this syndrome presents with unresolved exterior symptoms progressing to internal heat, sweating agents should be urgently used to release the exterior while simultaneously clearing internal heat. If there is also agitation of internal wind, one should refer to the treatment methods for Internal Zhong Feng (Internal Wind Stroke) discussed later, integrating them. The formula should include herbs that extinguish internal wind alongside those treating external pathogens to be complete.
Zhong Feng (Wind Stroke) syndromes can be biased towards cold, biased towards heat, or show no obvious cold or heat. This formula I proposed is intended for Zhong Feng without significant cold or heat tendencies. If biased towards heat, Fengyin Tang (Wind-Driving Decoction) from *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) should be modified (reduce doses of Ganjiang [Zingiberis Rhizoma] and Guizhi [Ramulus Cinnamomi Cassiae]). If biased towards cold, I have other empirical methods. I once treated an elderly woman, around fifty years old, who suddenly collapsed into unconsciousness due to Zhong Feng in mid-winter. She did not respond to calls, and her chest seemed obstructed by phlegm-fluids, severely hindering respiration. Her pulse was faint, thin, almost imperceptible, and slow. Knowing she had chronic cold-fluid retention, the sudden invasion of wind-cold combined with the cold-fluid to cause illness. Urgently, Hu Jiao (Fructus Piperis Nigris, 3 qian) was crushed and decocted for two or three boils. Half a teacup of thick juice was administered, and respiration immediately improved. Subsequently, Ganjiang [Zingiberis Rhizoma] (6 qian), Guizhi Jian [Ramulus Cinnamomi Cassiae tips] (3 qian), and Danggui [Radix Angelicae Sinensis] (3 qian) were used. After three doses, she could groan, and limb movement gradually returned, though the left hand and foot remained immobile. The dose of Ganjiang [Zingiberis Rhizoma] was then halved, and Sheng Huangqi [Radix Astragali Membranacei] (5 qian), Rushenxiang [Resina Olibani] (3 qian), and Moyao [Resina Myrrhae] (3 qian) were added. After more than ten doses, speech and movement returned to normal.
If the patient's Yuan Qi (Primary Qi) is not deficient and has merely been struck by pathogenic wind, Renshen (Radix Ginseng) can be omitted, and Wugong (Scorpio, 1 unit) and Quanxie (Scorpius, 1 qian) can be added. If the syndrome is very excess and obstruction is severe, such as inability to urinate or defecate, or a choppy and stagnant pulse, Sheng Dahuang [Radix et Rhizoma Rhei] (several qian) can be added to promote internal unblocking and external dispersal, following the principle of Fangfeng Tongsheng San (Saposhnikovia Powder to Unblock and Safeguard).
Xu Lingtai once treated a man who usually had much phlegm and numbness in his hands and feet. He suddenly fainted, lost urine control, had locked jaws and clenched fists, and produced rattling sounds like sawing. The physician administered Shenfu Wan (Decoction of Ginseng and Aconite) and Shudi (Prepared Rehmannia Root) etc., ground into powder. His pulse was surging, large, and forceful; his face was red, and his breath was coarse. This indicated fullness of Phlegm-Fire closing all orifices; administering Shenfu Wan (Decoction of Ginseng and Aconite) would lead to immediate danger. Thus, Xiao Xuming Tang (Minor Continuation of Life Decoction) was used with Guizhi [Ramulus Cinnamomi Cassiae] and Fuzi [Radix Aconiti Lateralis Preparata] removed, and Sheng Dahuang [Radix et Rhizoma Rhei] (1 qian) added and ground into powder. It was falsely claimed to be another medicine to avoid suspicion or shock from bystanders. After three doses, he made sounds; after five doses, he could speak. Thereafter, blood-nourishing and phlegm-resolving medicines were used for regulation. After one month, his gait returned to normal. Comparing this case with my own case makes the distinction between cooling and warming therapies evident. Additionally, enuresis (urinary incontinence) mostly belongs to deficiency, but the enuresis in this case was due to excess. This shows that those examining syndromes must not be rigidly attached to one aspect. However, true Zhong Feng (Wind Stroke) is extremely rare, while Zhong Feng-like syndromes are very common. Among every hundred Zhong Feng cases, only one or two are true Zhong Feng. Inaccurate syndrome differentiation leads to immediate peril; this must be approached with utmost caution.