菊花四十分 防风 白术十分 桔梗八分 人参 茯苓 当归 川芎 干姜 桂枝 细
辛牡蛎 矾石三分
上末,用温酒调方寸匕,服二十日;再冷服四十日,共六十日止。则药积腹中矣。
此方佳处,全在平肝息风。内风不动,则不与外风勾结,此便是阻截之法。喻西江盛称
其用牡蛎、矾石堵御之妙。予请为进一解,当实卫气以为城垣,当养营血以坚壁垒。若使药
积腹中,以为堵截,吾恐风不得入者,气血亦由此不通。无怪误解填塞空窍者之滋议也。
秦艽 石膏二两 当归(酒洗) 白芍(酒炒) 川芎 生地(酒洗) 熟地 白术(土
炒) 茯苓 甘草(炙) 防风 黄芩(酒炒) 羌活 独活 白芷一两 细辛五钱
每服一两。
此方刘宗浓与喻嘉言俱谓其风药太多,不能养血、益筋骨;汪 庵又谓∶用此方者,取
效甚多。各执一见。予谓方中四物咸备,不可谓无血药也,若中风初起,表邪重者,用之尚
可取效。然石膏、细辛二味必须减去。
生南星一两 生川乌(去皮)五钱 生附子(去皮)五钱 木香二钱
每服一两,加人参一两煎。
“邪之所凑,其气必虚”是也,然邪往从之,虚处转实,又何说邪?东垣谓∶中风非外
风,乃本气自病,太属偏执。此等峻猛之药,虽有人参,气虚者能任受耶?如喻嘉言之加减
为宜。
菊花四十分,防风、白术各十分,桔梗八分,人参、茯苓、当归、川芎、干姜、桂枝、细辛、牡蛎、矾石各三分。
将上述药物研为细末,用温酒调服一方寸匕的量,连续服用二十天;然后再改为冷服四十天,总共六十天停药。这样药物就会积聚在腹中。
这个方剂的精妙之处,全在于平抑肝风、熄风止痉。体内的内风如果不妄动,就不会与外来的外风相互勾结,这就是所谓的阻截之法。喻西江极力称赞使用牡蛎和矾石进行堵御的巧妙之处。我请允许我再作进一步的解释:应当充实卫气(运行于体表、具有防御作用的气)以作为城墙,应当滋养营血(行于脉中、具有营养作用的血)以加固壁垒。如果仅仅依靠药物积聚在腹中来进行堵截,我担心风邪不得入内时,气血也会因此变得不通畅。难怪那些误解“填塞空窍”理论的人会受到广泛的非议。
秦艽、石膏各二两,当归(用酒清洗)、白芍(用酒炒制)、川芎、生地(用酒清洗)、熟地、白术(用土炒制)、茯苓、甘草(炙烤)、防风、黄芩(用酒炒制)、羌活、独活、白芷一两、细辛五钱。
每次服用一两。
这个方剂,刘宗浓和喻嘉言都认为其中的风药(祛风解表药)太多,不能养血、补益筋骨;汪昂又说:使用这个方子的人,取得疗效的很多。大家各执己见。我认为方中已经备齐了四物汤(由当归、川芎、白芍、熟地黄组成的补血基础方)的所有成分,不能说没有养血药。如果是中风初起,且表邪(外感病邪)较重的情况,使用它还可以取得疗效。然而,石膏和细辛这两味药必须减去。
生南星一两,生川乌(去皮)五钱,生附子(去皮)五钱,木香二钱。
每次服用一两,加入人参一两一起煎煮。
“邪气所聚集的地方,正气必然虚弱”,这是对的。然而邪气随之侵入,虚损之处反而显得实证突出,这又该如何解释呢?李东垣认为:中风并非外风所致,而是本气自病(自身元气病变),这太过偏执。这类峻猛的药物,虽然有人参配合,气虚的人真的能承受吗?不如像喻嘉言那样进行加减变化为宜。
Chrysanthemi Flos (Juhua, 菊花) 40 fen, Fangfeng Rhizoma (Saposhnikoviae Radix, 防风), Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) each 10 fen, Platycodonis Radix (Jiegeng, 桔梗) 8 fen, Ginseng Radix et Rhizoma (Renshen, 人参), Poria (Fuling, 茯苓), Angelicae Sinensis Radix (Danggui, 当归), Chuanxiong Rhizoma (Chuanxiong, 川芎), Zingiberis Rhizoma Recens (Ganjiang, 干姜), Cinnamomi Ramulus (Guizhi, 桂枝), Asari Radix et Rhizoma (Xixin, 细辛), Ostrea Concha (Muli, 牡蛎), and Alumen (Fanshi, 矾石) each 3 fen.
Grind the above herbs into fine powder. Take one cunbi (a square-inch measure) mixed with warm wine for twenty days; then switch to cold administration for forty days, totaling sixty days of treatment. This allows the medicinal residue to accumulate in the abdomen.
The excellence of this formula lies entirely in calming the Liver and extinguishing Wind. If internal Wind does not move recklessly, it will not collude with external Wind; this constitutes the method of interception. Yu Xijiang highly praised the ingenuity of using Muli and Fanshi for blocking and defending. I would like to offer a further interpretation: one should replenish Wei Qi (Defensive Qi) to serve as city walls, and nourish Ying Blood (Nutritive Blood) to strengthen ramparts. If one relies merely on drug accumulation in the abdomen for interception, I fear that while Wind may be prevented from entering, Qi and Blood circulation may also become obstructed thereby. No wonder those who misunderstand the concept of "filling empty orifices" face widespread criticism.
Qinjiao Radix Gentianae Macrophyllae (Qin Jiao, 秦艽) and Gypsum Fibrosum (Shigao, 石膏) each 2 liang, Dang Gui (washed with wine), Bai Shao (stir-fried with wine), Chuan Xiong, Di Huang (washed with wine), Shu Di Huang, Bai Zhu (stir-fried with soil), Fu Ling, Gan Cao (roasted), Fang Feng, Huang Qin (stir-fried with wine), Qiang Huo, Du Huo, Bai Zhi 1 liang, and Xi Xin 5 qian.
Take 1 liang per dose.
Regarding this formula, Liu Zongnong and Yu Jiayan both argued that there are too many Wind-dispelling herbs, which cannot nourish Blood or benefit sinews and bones; Wang Ang stated, conversely, that many users have achieved good results with it. Each holds their own view. I contend that the formula contains all components of Si Wu Tang (Four Substances Decoction), so it cannot be said to lack Blood-nourishing herbs. In cases of initial stroke onset with heavy exterior pathogenic factors, its use can still yield results. However, Shi Gao and Xi Xin must be removed.
Nan Xing (Raw Arisaematis Rhizoma, 生南星) 1 liang, Chuan Wu (Raw Aconiti Radix, 生川乌, peeled) 5 qian, Fu Zi (Raw Aconiti Lateralis Radix Praeparata, 生附子, peeled) 5 qian, and Mu Xiang 2 qian.
Take 1 liang per dose, decocted together with 1 liang of Renshen.
"The place where pathogens gather, Qi must be deficient," is correct. Yet if pathogens follow and the deficient area turns into excess, how should this be explained? Li Dongyuan claimed that stroke is not caused by external Wind but is a disease of the original Qi itself, which is overly biased. Such harsh and potent drugs, even with the assistance of Renshen, can truly be tolerated by those with Qi deficiency? It is more appropriate to modify them as Yu Jiayan suggested.