叙曰∶风者,百病之长,得行天之象,故其发也暴。然上世论风,主于外感;乃河间主
火,东垣主气,丹溪主湿,而末世之论纷然矣。今考名方二十三首,为风,为火,为气,为
湿,皆时出而主之,初不泥于一说也。
病患国中风筋急,口噤不开,便以铁物开之,恐伤其齿,宜用乌梅肉擦其牙关,牙关酸
软,则易开矣!此酸先入筋之故也。其有中风证而口开不噤者,筋先绝也,不治。
猪牙皂角(四条,去果皮,炙) 白矾(一两,枯)
共为末,每进三字,水下。
病患国中风,暴仆,痰涎涌盛,此药与之,频吐涎沫,壅塞少疏,续进他药。
清阳在上,浊阴在下,则天冠地履,无暴仆也。若浊邪风涌而上,则清阳失位而倒置矣
,故令人暴仆。所以痰涎壅塞者,风盛气涌而然也。经曰∶病发而不足,标而本之,先治其
标,后治其本。故不与疏风补虚,而先为之吐其涎沫。白矾之味咸苦,咸能软顽痰,苦能吐
涎沫;皂角之味辛咸,辛能利气窍,咸能去污垢。名之曰稀涎,固夺门之兵也。师曰∶凡吐
中风之痰,使咽喉疏通,能进汤液便止。若攻尽其痰,则无液以养筋,能令人挛急偏枯,此
大戒也!
藜芦 生甘草 川芎 细辛 人参(各一钱) 石膏(五钱)
共为末。
病患国中风,不知人事,口噤不能开,用此药一字,吹入鼻中。有嚏者,肺气未绝,可
治。
中风,不知人事,病则急矣。以平药与之,不能开其壅塞,故用藜芦与人参、细辛相反
,使其相反而相用也,肺苦气上逆,故用石膏之重以坠之,甘草之平以缓之;乃川芎之用,
取其清气利窍而已。
叙曰:风,是各种疾病的先导,它顺应天象运行,所以发病往往突然而猛烈。然而上古时期论述风病,主要侧重于外感;到了后来,刘河间主张风由火生,李东垣主张风由气虚所致,朱丹溪主张风由湿邪引起,导致后世关于风的理论纷繁复杂。如今考证著名的方剂二十三首,分别针对风、火、气、湿致病,都是根据当时具体情况灵活选用,绝不拘泥于某一种学说。
患者患中风病出现筋脉拘急,牙关紧闭无法张开,如果用铁器强行撬开,恐怕会损伤牙齿,适宜用乌梅肉擦拭其牙关,因为酸味能入筋,使牙关感到酸软,这样就容易张开了!这是酸味先作用于筋的缘故。那些患有中风证但口张开而不能闭合的,说明筋脉已经衰竭,属于不治之症。
猪牙皂角(四条,去除果皮,炒炙) 白矾(一两,煅至枯干)
共同研磨成粉末,每次服用三字的量,用水送服。
患者患中风病,突然昏倒,痰涎涌盛,给予此药,使其频繁吐出涎沫,壅塞症状稍缓解后,再续用其他药物。
清阳之气居上,浊阴之气居下,就像天在上地在下一样,就不会发生突然昏倒。如果浊邪随风气上涌,那么清阳就会失去正常位置而颠倒错乱,所以使人突然昏倒。因此痰涎壅塞,是由于风盛气逆造成的。《内经》说:疾病发作时正气不足,应当先治其标,后治其本。所以不先用疏风补虚的方法,而是先让患者吐出痰涎。白矾味道咸苦,咸味能软化顽固之痰,苦味能催吐涎沫;皂角味道辛咸,辛味能通利气窍,咸味能去除污垢。将此方命名为“稀涎散”,就像是夺取城门的先锋军队。老师说:凡是催吐中风患者的痰液,只要使咽喉疏通,能够进食汤药就停止。如果将痰完全攻尽,则没有津液来滋养筋脉,会导致肢体挛急、偏瘫枯瘦,这是极大的禁忌!
藜芦 生甘草 川芎 细辛 人参(各一钱) 石膏(五钱)
共同研磨成粉末。
患者患中风病,神志不清,牙关紧闭不能张开,用此药一字量的药粉,吹入鼻中。如果打喷嚏,说明肺气未绝,可以治疗。
中风病导致神志不清,病情非常紧急。如果用平和的药物,不能开通壅塞,所以使用藜芦与人参、细辛相反相成的特性,利用它们相反的药性来达到治疗目的。肺喜欢气机顺畅而不喜欢气逆,所以用重镇的石膏来降逆,用平和的甘草来缓急;至于川芎的使用,只是为了取其清气通窍的作用罢了。
Preface: Wind is the leader of all diseases; it follows the patterns of nature, so its onset is sudden and violent. However, in ancient times, discussions on wind primarily focused on external contraction. Later, Liu Hejian emphasized fire, Li Dongyuan emphasized qi deficiency, and Zhu Danxi emphasized dampness, leading to a proliferation of theories regarding wind in later generations. Herein, twenty-three famous formulas are examined, addressing causes related to wind, fire, qi, and dampness. They are applied flexibly according to the specific circumstances at hand, without adhering rigidly to any single theory.
When a patient suffers from stroke with tendon tension and locked jaw (trismus), using iron tools to pry open the mouth may damage the teeth. It is advisable to rub the jaw joint with meat of a dried plum (Wumei). The sour flavor enters the tendons, causing the jaw to feel sore and relaxed, making it easy to open. This is due to the property of sour flavors affecting the tendons first. If a stroke patient presents with an open mouth that cannot close, it indicates the exhaustion of the tendons, which is incurable.
Suiyu Zaojiao (Toxicus Fructus Gleditsiae Sinensis, four strips, skin removed, roasted) and Mingfan (Alumen, one liang, calcined to dryness).
Grind together into powder. Administer three zhi per dose, taken with water.
For a patient suffering from stroke with sudden collapse and profuse phlegm-saliva, administer this medicine to induce frequent vomiting of phlegm-saliva. Once the obstruction is slightly relieved, continue with other medications.
Clear yang resides above, and turbid yin resides below, resembling heaven above and earth below, thus preventing sudden collapse. If turbid pathogens surge upward with wind, clear yang loses its proper position and becomes inverted, causing sudden collapse. Therefore, the accumulation of phlegm-saliva is caused by excessive wind and surging qi. The Classics state: "When disease manifests with deficiency, treat the branch (symptoms) first, then the root." Thus, instead of initially dispersing wind and tonifying deficiency, we first induce vomiting to expel phlegm-saliva. Alumen tastes salty and bitter; saltiness can soften stubborn phlegm, and bitterness can induce vomiting of phlegm-saliva. Toxicus Fructus Gleditsiae Sinensis tastes acrid and salty; acridity can unblock orifice passages, and saltiness can remove filth. Named "Xi Xian San" (Thin Saliva Powder), it acts like vanguard troops seizing a gate. The Master said: "Whenever inducing vomiting of phlegm in stroke patients, stop once the throat is cleared and the patient can take liquid food. If all phlegm is completely expelled, there will be no fluids to nourish the tendons, leading to spasms and hemiplegic emaciation. This is a major prohibition!"
Liblu (Veratrum Nigrum Rhizoma), Sheng Gancao (Raw Radix Glycyrrhizae), Chuanxiong (Rhizoma Chuanxiong), Xixin (Herba Asari), Renshen (Radix Ginseng) (each one qian), Shigao (Gypsum Fibrosum) (five qian).
Grind together into powder.
For a patient suffering from stroke with loss of consciousness and locked jaw, blow one zhi of this powder into the nose. If the patient sneezes, it indicates that Lung Qi has not yet failed, and the condition is treatable.
Stroke resulting in loss of consciousness is an urgent condition. Mild medicines cannot resolve the obstruction, so Liblu is used in opposition to Renshen and Xixin, utilizing their contradictory properties for therapeutic effect. The Lung dislikes rebellious Qi, so heavy Gypsum Fibrosum is used to descend it, and mild Raw Radix Glycyrrhizae is used to moderate it. The use of Rhizoma Chuanxiong is merely to utilize its ability to clear Qi and unblock orifices.