治中风痱, 身体不能自收, 口不能言, 冒昧不知痛处,
或拘急不得转侧.
麻黄 桂枝 石膏 干姜 杏仁四十枚 川芎 当归 人参 甘草各
三两, 右九昧, 以水一斗, 煮取四升, 温服一升, 当小汗. 薄覆脊,
凭几坐, 汗出自愈. 不汗更服. 无所禁, 勿当风. 并治脉伏不得卧,
咳逆上气, 面目浮肿.
【集注】赵良曰: 痱病者, 营卫气血, 不养于内外, 故身体不用, 机
关不利, 精神不治. 然是证有虚, 有实. 虚者自饮食房劳七情感之,
如『内经』所谓内夺而厥, 则为瘖痱之类是也. 实者自风寒暑湿感之
.虚者不可以实治, 治之则愈散其气血. 今此方明言中风痱, 是属营
卫之实邪也, 故用续命. 续命乃麻黄汤之变者, 加干姜以开血受寒邪
,石膏以解肌受风邪, 当归和血, 人参益气, 川芎行血散风也. 其并
治咳逆上气, 面浮者, 亦以为风寒所致也.
南星 ( 生用 ) 一两 川乌 ( 去皮, 生用 ) 五钱 附子 ( 去皮,
生用 ) 五钱 木香二钱, 右每服五钱, 姜水煎; 加人参一两.
【集注】柯琴曰: 风为阳邪, 风中无寒, 不甚伤人, 惟风中挟寒, 害
始剧矣. 寒轻而在表者, 宜发汗以逐邪; 寒重而入里者, 非温中补虚
终不可救, 此取三物之大辛, 大热者, 且不炮不制, 更佐以木香, 乘
其至刚, 至锐之气而用之, 非专以治风兼以治寒也. 然邪之所凑, 其
气必虚, 但知勇于攻邪, 若正气虚而不支, 能无倒戈之患乎? 必用人
参两许以驾驭其邪, 此薛己真知确见, 立于不败之地, 而收万全之效
者也. 若在庸手, 必谓补住邪气而不敢用, 此谨熟阴阳, 毋与众谋 ,
岐伯所以叮咛致告耳. 观其每服五钱, 必四服而邪始出; 今之男事者
,用乌, 附分数, 必制熟而后敢用, 更以芩连监制之, 乌能挽回如是
之危证哉? 古今人不相及, 信然. 本方去乌, 附即星香散, 治痰厥,
气厥足矣.
【续命汤】治疗中风痱证，表现为身体无法自主控制，口不能言语，神志昏蒙不知疼痛部位，或者肢体拘急僵硬无法翻身侧卧。
处方组成：麻黄、桂枝、石膏、干姜、杏仁（四十枚）、川芎、当归、人参、甘草，各三两。以上九味药，用水一斗，煎煮至四升，每次温服一升，服药后应当微微出汗。服药后背部覆盖薄被，靠着几案坐起，汗出后病自愈。若未出汗，可再次服用。服药期间没有特别禁忌，但要注意避免受风。本方同时治疗脉象伏匿不起、不能平卧、咳嗽气逆上冲、面目浮肿的症状。
【集注】赵良说：所谓痱病，是因为营卫气血不能濡养身体的内外，所以身体不能使用，关节机关不利，精神神志紊乱。然而这种病症有虚证和实证之分。虚证是由于饮食不节、房劳过度或七情内伤所致，正如《内经》所说的“内夺而厥，则为瘖痱”之类即是。实证则是由于感受风寒暑湿邪气所致。虚证不能用实证的方法治疗，如果用实证方法治疗，就会进一步耗散其气血。现在这个方子明确说是治疗中风痱，属于营卫的实邪，所以使用续命汤。续命汤是麻黄汤的变方，加入干姜以开通血脉中受的寒邪，加入石膏以解除肌肉中受的风邪，当归调和血液，人参补益元气，川芎行血散风。它同时治疗的咳嗽气逆、面浮等症状，也是认为由风寒引起。
【三生饮】治疗猝然中风口眼歪斜、半身不遂，以及痰厥、气厥昏迷不醒。
处方组成：天南星（生用）一两，川乌（去皮，生用）五钱，附子（去皮，生用）五钱，木香二钱。以上药物，每次取五钱，用生姜水煎煮；另加人参一两。
【集注】柯琴说：风是阳邪，风中若无寒邪，伤害尚不严重，只有风中挟带寒邪，危害才剧烈。寒邪轻而在表者，适宜发汗以驱除邪气；寒邪重而入里者，如果不温中补虚，最终不可救治。此方选取三物（天南星、川乌、附子）大辛大热的药材，而且不经过炮制加工，更佐以木香，凭借它们至刚至锐的气性来使用，这不仅仅是专门治风，同时也兼治寒邪。然而，邪气聚集的地方，正气必然虚弱，如果只知道勇于攻伐邪气，而正气虚弱支撑不住，难道不会发生倒戈（病情恶化或反噬）的祸患吗？必须用人参大量来驾驭邪气，这是薛己真知灼见，立于不败之地，从而收到万全的效果。如果在庸医手中，必定认为补益会留住邪气而不敢使用，这正是岐伯所叮咛告诫的“谨熟阴阳，毋与众谋”。看这个方子每服五钱，必须服用四次邪气才能排出；现在的男性医者，使用乌头、附子的分量，一定要炮制成熟后才敢使用，再用黄芩、黄连来监制它们，怎么能挽回如此危急的证候呢？古人和今人相比不及，确实如此。本方去掉乌头、附子就是星香散，治疗痰厥、气厥已经足够了。
[Suming Decoction] Treats stroke fei (stroke with flaccidity), characterized by the body's inability to control itself, inability to speak, mental confusion with unawareness of pain locations, or limb stiffness and rigidity preventing turning over.
Prescription composition: Ephedrae Herba (Mahuang), Cinnamon Twig (Guizhi), Gypsum Fibrosum (Shigao), Dried Ginger (Ganjiang), Apricot Seed (Xingren, 40 seeds), Ligusticum Chuanxiong Rhizome (Chuanxiong), Angelica Sinensis Radix (Danggui), Ginseng Radix (Renshen), Licorice Root (Gancao), each 3 liang. The above nine ingredients are decocted in 10 dou of water until reduced to 4 sheng. Take 1 sheng warm per dose; a slight sweating should occur after administration. Cover the back lightly with a thin cloth, sit leaning against a table; recovery occurs when sweat appears. If no sweat occurs, administer again. There are no specific dietary restrictions, but avoid exposure to wind. It also treats conditions with hidden pulse, inability to lie flat, cough with rebellious qi, and edema of the face and eyes.
[Collected Annotations] Zhao Liang stated: Fei disease is caused by Ying-Wei Qi and Blood failing to nourish the interior and exterior of the body, resulting in the body's dysfunction, joint immobility, and disordered spirit. However, this syndrome has deficiency and excess types. Deficiency type arises from improper diet, sexual exhaustion, or emotional injury, as described in the *Neijing*: "Internal depletion leading to syncope results in aphasia and fei." Excess type arises from contraction of Wind-Cold-Damp-Heat pathogens. Deficiency syndromes must not be treated as excess; treating them as such would further scatter their Qi and Blood. This formula explicitly states it treats stroke fei due to excess pathogens in Ying-Wei, hence the use of Suming Decoction. Suming Decoction is a modification of Mahuang Tang, adding Dried Ginger to open blood vessels affected by Cold, Gypsum to release muscle-level Wind, Angelica Sinensis Radix to harmonize blood, Ginseng Radix to tonify Qi, and Ligusticum Chuanxiong Rhizome to move blood and scatter Wind. The concomitant treatment of cough, rebellious qi, and facial edema is also attributed to Wind-Cold.
[Sansheng Yin] Treats sudden stroke with facial deviation, hemiplegia, as well as Phlegm Jue (syncope due to phlegm) and Qi Jue (syncope due to qi stagnation).
Prescription composition: Arisaemae Rhizoma (Tian Nanxing, raw) 1 liang, Aconitum Carmichaelii Radix Preparata (Chuan Wu, peeled, raw) 5 qian, Aconiti Lateralis Radix Preparata (Fuzi, peeled, raw) 5 qian, Costus Root (Muxiang) 2 qian. For each dose, take 5 qian of these herbs, decoct in ginger water; add Ginseng Radix (Renshen) 1 liang.
[Collected Annotations] Ke Qin stated: Wind is a Yang pathogen; if Wind exists without Cold, the damage is not severe. Harm becomes severe only when Wind carries Cold. If Cold is mild and located in the exterior, diaphoresis is suitable to expel the pathogen; if Cold is severe and enters the interior, warming the middle and tonifying deficiency are indispensable for salvation. This formula selects three substances (Arisaema, Chuan Wu, Fuzi) that are extremely pungent and hot, used unprocessed, assisted by Costus Root, utilizing their extreme rigidity and sharpness. This is not merely for treating Wind but also concurrently treating Cold. However, where pathogens gather, Zheng Qi (Upright Qi) must be deficient. If one only knows how to courageously attack pathogens while Zheng Qi is too weak to support, will there not be the risk of counterattack? One must use a large amount of Ginseng Radix to control the pathogen. This is Xue Ji's profound insight, establishing an invincible position to achieve complete efficacy. Incompetent physicians, fearing that tonification would retain pathogens, dare not use it. This aligns with Qibo's admonition: "Carefully master Yin and Yang, do not consult with the multitude." Observing that each dose is 5 qian, four doses are required for the pathogen to exit; modern practitioners, using Wu Tou and Fu Zi, often process them thoroughly before use and monitor them with Scutellaria Baicalensis Root (Huangqin) and Gardenia Fruit (Zhuzi). How can they rescue such critical conditions? The ancients were superior to the moderns, truly so. Removing Wu Tou and Fu Zi from this formula yields Xingxiang San, which is sufficient for treating Phlegm Jue and Qi Jue.