麻黄（去节） 人参（去芦） 黄芩（酒炒） 芍药（酒炒） 川芎 炙甘草 杏仁（去
皮，炒）
分）
古人以此方混治中风，未详其证。昆谓麻黄、杏仁，麻黄汤也，仲景以之治太阳证之伤
寒。桂枝、芍药，桂枝汤也，仲景以之治太阳证之中风。如此言之，则中风而有头疼、身热、
脊强者，皆在所必用也。人参、甘草，四君子之二也，《局方》用之以补气；芍药、川芎，
四物汤之二也，《局方》用之以养血。如此言之，则中风而有气虚、血虚者，皆在所必用也。
风淫末疾，故佐以防风；湿淫腹疾，故佐以防己；阴淫寒疾，故佐以附子；阳淫热疾，故佐
以黄芩。盖病不单来，杂揉而至，故其用药，亦兼该也。
热者，去附子，用白附子；筋急语迟、脉弦者，倍人参，加薏苡、当归，去黄芩、芍药
以避中寒；烦躁、不大便，去附、桂，倍加芍药、竹沥；日久大便不行、胸中不快，加枳壳、
大黄；语言謇涩，手足颤掉，加石菖蒲、竹沥；口渴，加麦门冬、栝蒌、天花粉；身疼、发
搐，加羌活；烦渴、多惊，加犀角、羚羊角；汗多，去麻黄；舌燥，加石膏，去附、桂。
秦艽（去芦） 石膏（生用） 当归（酒洗） 芍药（酒炒） 羌活（去芦） 防风（去
芦） 黄芩
（酒炒） 生 （洗去土，音胡，即生地） 熟 甘草（炙） 川芎（洗） 白术（酒炒）
白芷 茯
苓（去皮） 独活（各一钱） 北细辛（去土，五分）
中风，手足不能运动，舌强不能言语，风邪散见不拘一经者，此方主之。
中风，虚邪也。许学士云∶留而不去，其病则实，故用驱风养血之剂兼而治之。用秦艽
为君者，以其主宰一身之风，石膏所以去胃中总司之火，羌活去太阳百节之风疼，防风为诸
风药中之军卒。三阳数变之风邪，责之细辛；三阴内淫之风湿，责之苓、术。去厥阴经之风，
则有川芎；去阳明经之风，则有白芷。风热干乎气，清以黄芩；风热干乎血，凉以生 。独
活疗风湿在足少阴，甘草缓风邪上逆于肺。乃当归、芍药、熟 者，所以养血于疏风之后，
一以济风药之燥，一使手得血而能握，足得血而能步也。
麻黄（去除节段） 人参（去除芦头） 黄芩（用酒炒制） 芍药（用酒炒制） 川芎 炙甘草 杏仁（去除皮，炒制）
古人将此方混合用于治疗中风病，但未详细辨析其具体证候。我认为：麻黄、杏仁，这是麻黄汤的组成，张仲景用它来治疗太阳病（太阳经受邪所致的病证）中的伤寒证。桂枝、芍药，这是桂枝汤的组成，张仲景用它来治疗太阳病中的中风证。这样说来，那么中风病伴有头痛、身体发热、脊柱强直的症状，都是必须使用这些药物的情况。人参、甘草，这是四君子汤（补气基础方）中的两味药，《太平惠民和剂局方》用它来补益元气；芍药、川芎，这是四物汤（补血基础方）中的两味药，《太平惠民和剂局方》用它来滋养血液。这样说来，那么中风病伴有气虚、血虚症状的，也都是必须使用这些药物的情况。风邪侵袭四肢末端导致疾病，所以辅助使用防风；湿邪侵袭腹部导致疾病，所以辅助使用防己；阴寒之邪侵袭导致寒性疾病，所以辅助使用附子；阳热之邪侵袭导致热性疾病，所以辅助使用黄芩。大概因为疾病不是单独到来的，而是混杂而至，所以该方的用药也是兼顾全面的。
若表现为热象，去掉附子，改用白附子；若筋脉拘急、言语迟缓、脉象弦紧，加倍使用人参，加入薏苡仁、当归，去掉黄芩、芍药以避免损伤中焦阳气；若烦躁、大便不通，去掉附子、桂枝，加倍增加芍药、竹沥；若病程日久大便不通、胸中不适，加入枳壳、大黄；若语言蹇涩、手足颤抖，加入石菖蒲、竹沥；若口渴，加入麦门冬、栝蒌、天花粉；若身体疼痛、抽搐，加入羌活；若烦渴、易受惊吓，加入犀角、羚羊角；若汗出过多，去掉麻黄；若舌面干燥，加入石膏，去掉附子、桂枝。
秦艽（去除芦头） 石膏（生用） 当归（用酒清洗） 芍药（用酒炒制） 羌活（去除芦头） 防风（去除芦头） 黄芩（用酒炒制） 生地黄（清洗去土，音胡，即生地） 熟地黄 甘草（炙制） 川芎（清洗） 白术（用酒炒制） 白芷 茯苓（去除皮） 独活（以上各一钱） 北细辛（去除泥土，五分）
中风病，表现为手足不能运动，舌体僵硬不能言语，风邪散在出现而不局限于某一经络的，此方主治。
中风病，属于虚邪致病。许学士说：邪气停留不去，病情就会转为实证，所以使用驱风养血的药物兼而治之。使用秦艽作为君药，是因为它能主宰一身之风邪；石膏用来清除胃中总司之火；羌活清除太阳经百节的风痛；防风是各种风药中的卒伍（指广泛作用）。三阳经多变的风邪，归责于细辛的作用；三阴经内侵的风湿，归责于茯苓、白术的作用。清除厥阴经的风邪，则有川芎；清除阳明经的风邪，则有白芷。风热侵犯气分，用黄芩清热；风热侵犯血分，用生地黄凉血。独活治疗足少阴经的风湿，甘草缓解风邪上逆于肺。至于当归、芍药、熟地黄，是在疏风之后滋养血液，一方面救济风药的燥性，一方面使手得到血液滋养就能握持，脚得到血液滋养就能行走。
Ephedrae Herba (Mahuang, 麻黄) [devoid of nodes], Ginseng Radix et Rhizoma (Renshen, 人参) [devoid of rhizome], Scutellariae Radix (Huangqin, 黄芩) [stir-fried with wine], Paeoniae Radix (Shaoyao, 芍药) [stir-fried with wine], Chuanxiong Rhizoma (Chuanxiong), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao, 炙甘草), Armeniacae Semen Amarum (Xingren, 杏仁) [devoid of skin, stir-fried].
In ancient times, this formula was used indiscriminately to treat Stroke (Zhongfeng, 中风), without detailed differentiation of syndromes. I argue: Ephedrae Herba and Armeniacae Semen Amarum constitute Ma Huang Tang (Cinnamon Twig and Ephedra Decoction); Zhang Zhongjing used it to treat Cold Damage (Shanghan, 伤寒) in Taiyang Disease (Taiyang Bing, 太阳病). Cinnamon Twig (Guizhi, 桂枝) and Paeoniae Radix constitute Gui Zhi Tang (Cinnamon Twig Decoction); Zhang Zhongjing used it to treat Wind Strike (Zhongfeng, 中风) in Taiyang Disease. Thus, for Stroke presenting with headache, fever, and spinal rigidity, these herbs are essential. Ginseng Radix et Rhizoma and Glycyrrhizae Radix et Rhizoma Preparata are two ingredients of Si Jun Zi Tang (Four Gentlemen Decoction); the *Jufang* uses them to tonify Qi; Paeoniae Radix and Chuanxiong Rhizoma are two ingredients of Si Wu Tang (Four Substances Decoction); the *Jufang* uses them to nourish Blood. Thus, for Stroke accompanied by Qi deficiency or Blood deficiency, these herbs are essential. When Wind pathogen invades the extremities causing disease, Fang Feng (Saposhnikoviae Radix) is added as an assistant; when Dampness pathogen invades the abdomen causing disease, Fang Ji (Akebiae Caulis) is added as an assistant; when Yin-Cold pathogen causes cold diseases, Fu Zi (Aconiti Lateralis Radix Preparata) is added as an assistant; when Yang-Heat pathogen causes heat diseases, Huangqin is added as an assistant. Generally, pathogens do not arrive alone but mix together; therefore, the medication in this formula is comprehensive.
If Heat signs are present, remove Fu Zi and use Bai Fu Zi (Typhonii Radix). If tendons are tight, speech is slow, and the pulse is Wiry (Xian, 弦), double the dosage of Renshen, add Coicis Semen (Yiyi, 薏苡) and Danggui (Angelicae Sinensis Radix), and remove Huangqin and Shaoyao to avoid damaging Middle Jiao Cold. If there is irritability and constipation, remove Fu Zi and Guizhi, and significantly increase Shaoyao and Zhuli (Bamboo Juice). If the disease has persisted for a long time with no bowel movement and chest discomfort, add Zhike (Aurantii Fructus) and Dahuang (Rhei Radix et Rhizoma). If speech is slurred and hands/feet tremble, add Shichangpu (Acori Tatarinowii Rhizoma) and Zhuli. If thirsty, add Maimendong (Ophiopogonis Radix), Gualou (Trichosanthis Fructus), and Tianhuafen (Trichosanthis Radix). If body aches and convulsions occur, add Qianghuo (Notopterygii Rhizoma et Radix). If there is vexatious thirst and frequent fright, add Xijiao (Rhino Ceratostigma) and Lingyangjiao (Saiga Antelope Horn). If sweating is excessive, remove Mahuang. If the tongue is dry, add Shigao (Gypsum Fibrosum) and remove Fu Zi and Guizhi.
Qinjiao (Gentianae Macrophyllae Radix), Shigao (Gypsum Fibrosum) [raw], Danggui (Angelicae Sinensis Radix) [washed with wine], Shaoyao (Paeoniae Radix) [stir-fried with wine], Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix) [stir-fried with wine], Shengdihuang (Rehmanniae Radix) [washed to remove soil, pronounced 'Hu', i.e., raw Rehmannia], Shudihuang (Prepared Rehmannia Root), Gancao (Glycyrrhizae Radix et Rhizoma Preparata], Chuanxiong (Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) [stir-fried with wine], Baizhi (Angelicae Dahuricae Radix], Fuling (Poria), Duhuo (Angelicae Pubescentis Radix] [each 1 qian], Beixixin (Asari Radix et Rhizoma) [cleaned of dirt, 5 fen].
For Stroke manifesting as inability to move limbs, stiff tongue unable to speak, and wind pathogens appearing scattered without being confined to a single meridian, this formula is indicated.
Stroke is caused by deficient evil pathogens. Scholar Xu stated: "If the pathogen remains and does not depart, the condition becomes excess; therefore, formulas that expel wind and nourish blood are used to treat both aspects." Qinjiao is used as the Sovereign herb because it governs wind throughout the body; Shigao clears the fire governed by the Stomach; Qianghuo expels wind-pain in the joints of the Taiyang meridian; Fangfeng acts as the common soldier among wind-expelling herbs. For wind pathogens frequently changing in the Three Yang meridians, the responsibility lies with Xixin (Asari Radix et Rhizoma); for wind-dampness invading internally from the Three Yin meridians, the responsibility lies with Fulings (Poria) and Baizhu (Atractylodis Macrocephalae Rhizoma). To expel wind from the Jueyin meridian, Chuanxiong is used; to expel wind from the Yangming meridian, Baizhi is used. If wind-heat harasses Qi, it is cleared with Huangqin; if wind-heat harasses Blood, it is cooled with Shengdihuang. Duhuo treats wind-dampness in the Foot-Shaoyin meridian; Gancao moderates the counterflow of wind pathogens to the Lung. As for Danggui, Shaoyao, and Shudihuang, they nourish blood after expelling wind, one purpose being to mitigate the dryness of wind-expelling herbs, and the other ensuring that hands can grasp when nourished by blood and feet can walk when nourished by blood.