六淫，风寒暑湿燥火也。六者之中，风淫为首，故经曰∶风者，百病之长也。至其变化
，乃
而闷
重则
其
生
而
溪尝
（《千金》）
治中风不省人事，神气溃乱，半身不遂，筋急拘挛，口眼 斜，语言謇涩，风湿腰痛，
痰火并多，六经中风，及刚柔二痉（阴虚火旺，痰随火涌，故不省人事；血虚风中左体，为
左不遂，气虚风中右体，为右不遂，风中筋脉则拘急，风中口面则 斜，风中舌本则语涩，
风湿中腰则腰痛；痉者项背强直，手足反张也；伤风有汗为柔痉，以风能散气也；伤寒无汗
为刚痉，以寒能涩血也；亦有血虚筋无所荣养而成痉者。凡中风口开为心绝，手撒为脾绝，
眼合为肝绝，遗尿为肾绝，鼻鼾为肺绝，吐沫直视、发直头摇、面赤如妆、汗缀如珠者，皆
不治；或只见一二证，尚有得生者。《金匮》中风篇曰∶寸口脉浮而紧，紧则为寒，浮则为
虚，虚寒相搏，邪在皮肤，浮者血虚，脉络空虚，贼邪不泻，或左或右，邪气反缓，正气则
急；正气引邪， 僻不遂；邪在于络，肌肤不仁；邪在于经，脊重不伸；邪入于腑；则不识
人；邪入于脏，舌即难言，口吐涎沫。释曰∶中络者邪方入卫，尚在经络之外，故但肌肤不
仁；中经则入荣脉之中，骨肉皆失所养，故身体重着；至中腑中脏，则离外而内邪入深矣。
中腑必归于胃者，胃为六腑之总司也；中脏必归于心者，心为神明之主也；风入胃中，胃热
必盛，蒸其津液，结为痰涎，胃之大络入心，痰涎壅盛，堵其出入之窍，故中腑则不识人也；
诸脏受邪，进入于心，则神明无主，故中脏者，舌纵难言，廉泉开而流涎沫也。廉泉穴在舌
下，窍通于肾，津液之所出也）。
防风（一钱二分） 桂枝 麻黄 杏仁（去皮尖。炒研） 芎 （酒洗） 白芍（酒炒）
人参
煎。筋急语迟脉
倍芍药，加竹沥；日久不大便，胸中不
子，加白术；呕逆加半夏；语言謇涩，
加麦冬、花粉；烦渴多惊加犀角，羚羊
膏。
此六经中风之通剂也。吴鹤皋曰∶麻黄、杏仁，麻黄汤也，治太阳伤寒；桂枝、芍药，
桂枝汤也，治太阳中风；此中风寒有表证者所必用也。人参、甘草补气，川芎、芍药补血，
此中
芩。病来杂扰，故药亦兼赅也（按∶中风有解表、攻里、行中道三法。内外证俱有者，先解
表而后攻里。《医贯》曰∶此治冬月直中风寒之的方，亦麻黄、桂枝之变法。六经有余之表
证，须从汗解。如有便溺阻隔，宜三化汤、麻仁丸通利之。然邪之所凑，其气必虚，世间内
伤者多，此方终不可轻用也。昂按∶此方为治风套剂，今人罕用，然古今风方多从此方损益
为治。喻嘉言曰∶中风之脉，必有所兼，兼寒则浮紧，兼风则浮缓，兼热则浮数，兼痰则浮
滑，兼气则浮涩，兼火则盛大，兼阳虚则脉微，兼阴虚则脉数或细如丝；虚滑为头痛，缓迟
为营卫衰。然虚浮迟缓，正气不足，尚可补救；急大数疾，邪不受制，必死无疑；若数大未
至急疾，尚有不死者。《保命集》曰∶厥阴泻痢不止，脉沉迟，手足厥逆，脓血稠粘，此为
难治，宜麻黄汤、小续命汗之；谓有表邪宿于内，当散表邪，则脏腑自安矣。又曰∶厥阴风
泻，以
易老六经加减法；本方倍麻黄、杏仁、防风，名麻黄续命汤∶治太阳中风，无汗恶寒。
本方
知母
续命
太阴
活、
仁（《玉机微义》曰∶此方无分经络，不辨寒热虚实，虽多亦奚以为易老治分六经，庶乎活
法）。本方去防风、防己、附子、白芍，加当归、石膏，即《古今录验》续命汤∶治中风痱
（音肥）身不自收，口不能言，冒昧不知痛处，或拘急不能转侧。《录验》方去人参，加干
姜、黄芩、荆
六淫，是指风、寒、暑、湿、燥、火六种外感病邪。在这六种邪气中，风邪居于首位，所以医经中说：风邪是各种疾病的首领。至于它的变化，有的轻则导致身体沉重，有的重则导致……（原文此处有缺漏）……溪尝……
（出自《千金方》）
治疗中风导致的神志昏迷、神气涣散、半身不遂、筋脉拘急挛缩、口眼歪斜、言语謇涩，以及风湿腰痛、痰火俱多、六经中风，还有刚痉和柔痉。（解释：阴虚火旺，痰随火势上涌，所以神志昏迷；血虚受风侵袭左侧躯体，导致左侧肢体不遂；气虚受风侵袭右侧躯体，导致右侧肢体不遂；风邪中于筋脉则拘急；风邪中于口面则歪斜；风邪中于舌根则言语涩滞；风湿中于腰部则腰痛；痉证是指项背强直、手足向后反张。伤风有汗的称为柔痉，因为风能耗散阳气；伤寒无汗的称为刚痉，因为寒性能凝涩血液；也有因血虚筋脉失于荣养而成为痉证的。凡是中风患者口开合不拢为心气绝，手撒手不握为脾气绝，眼睛闭合不睁为肝气绝，遗尿为肾气绝，鼻鼾声重为肺气绝，吐白沫、直视、头发直立、头摇动、面色赤红如化妆、汗珠如油滴者，都是不治之症；如果只出现其中一两个症状，尚有存活的可能。《金匮要略》中风篇说：寸口脉浮而紧，紧脉主寒，浮脉主虚，虚与寒相互搏结，邪气在皮肤，浮脉表示血虚，脉络空虚，贼邪不能排出，或偏左或偏右，邪气所在的一侧经脉弛缓，正气所在的一侧经脉紧急；正气牵引邪气，导致口眼歪斜、肢体不遂；邪气在于络脉，肌肤麻木不仁；邪气在于经脉，脊背沉重不能伸展；邪气进入腑，则不识人；邪气进入脏，舌头僵硬难以言语，口吐涎沫。解释：中络者，邪气刚刚侵入卫分，还在经络之外，所以只是肌肤麻木不仁；中经者，邪气进入荣脉之中，骨肉都失去滋养，所以身体沉重；至于中腑和中脏，则是邪气由表入里，深入体内了。中腑必然归于胃，因为胃是六腑的总司；中脏必然归于心，因为心是神明之主；风邪入胃，胃热必然旺盛，蒸腾津液，凝结为痰涎，胃的大络脉进入心脏，痰涎壅盛，堵塞出入的窍道，所以中腑就不识人；各脏受邪，传入心中，则神明无主，所以中脏者，舌纵难言，廉泉穴开放而流涎沫。廉泉穴在舌下，窍通于肾，是津液发出的地方）。
防风（一钱二分）、桂枝、麻黄、杏仁（去皮尖，炒研）、川芎（酒洗）、白芍（酒炒）、人参……煎服。若筋急、言语迟缓，脉象……倍用芍药，加竹沥；日久不大便，胸中……加白术；呕逆加半夏；言语謇涩，加麦冬、天花粉；烦渴多惊加犀角、羚羊角、石膏。
这是治疗六经中风的通用方剂。吴鹤皋说：麻黄、杏仁，是麻黄汤，治疗太阳伤寒；桂枝、芍药，是桂枝汤，治疗太阳中风；这是治疗中风兼有表证者所必须使用的。人参、甘草补气，川芎、芍药补血，这是治疗……芩。病来势杂乱，所以药物也兼收并蓄。（按语：中风有解表、攻里、行中道三法。内外证候俱有的，先解表而后攻里。《医贯》说：这是治疗冬季直接感受风寒的确切方剂，也是麻黄汤、桂枝汤的变法。六经有余的表证，须从汗解。如果有大小便阻隔，宜用三化汤、麻子仁丸通利。然而邪气聚集之处，正气必定虚弱，世间内伤者多，此方终究不可轻易使用。汪昂按语：此方为治风的套方，今人很少使用，但古今治风方剂多从此方增减而来。喻嘉言说：中风的脉象，必有所兼夹，兼寒则脉浮紧，兼风则脉浮缓，兼热则脉浮数，兼痰则脉浮滑，兼气则脉浮涩，兼火则脉盛大，兼阳虚则脉微，兼阴虚则脉数或细如丝；虚滑为头痛，缓迟为营卫衰败。然而虚浮迟缓，正气不足，尚可补救；急大数疾，邪气不受制约，必死无疑；如果数大但未至急疾，尚有不死者。《保命集》说：厥阴泻痢不止，脉沉迟，手足厥冷，脓血稠粘，此为难治，宜用麻黄汤、小续命汤发汗；谓有表邪宿留于内，当发散表邪，则脏腑自然安宁。又说：厥阴风泻，以……易老六经加减法；本方倍用麻黄、杏仁、防风，名为麻黄续命汤：治疗太阳中风，无汗恶寒。本方……知母……续命……太阴……活……仁（《玉机微义》说：此方不分经络，不辨寒热虚实，虽然多用又有什么用呢？易老治疗分六经，算是灵活的方法）。本方去掉防风、防己、附子、白芍，加入当归、石膏，即《古今录验》续命汤：治疗中风痱（音肥），身体不能自主控制，口不能言语，昏蒙不知疼痛部位，或拘急不能转侧。《录验》方去掉人参，加入干姜、黄芩、荆……
The Six Excesses (Liu Yin) refer to Wind, Cold, Summerheat, Dampness, Dryness, and Fire. Among these six pathogens, Wind is primary; thus, the classics state: "Wind is the leader of a hundred diseases." Regarding its variations, mild cases may cause heaviness, while severe cases lead to... (text missing)... Xi once...
(From *Qianjin Fang*)
Treats stroke leading to loss of consciousness, dispersion of spirit and qi, hemiplegia, muscle spasm and contracture, deviation of the mouth and eyes, dysarthria, wind-damp lower back pain, excessive phlegm-fire, stroke affecting the Six Channels, as well as rigid and flaccid spasms. (Explanation: Yin deficiency with hyperactive fire causes phlegm to surge upward with the fire, resulting in loss of consciousness; blood deficiency with wind invading the left side of the body leads to left-sided hemiplegia; qi deficiency with wind invading the right side leads to right-sided hemiplegia; wind striking the sinews causes spasms; wind striking the face and mouth causes deviation; wind striking the root of the tongue causes speech impediment; wind-damp striking the waist causes lower back pain; spasm refers to stiffness of the neck and back, and opisthotonos of the hands and feet. Flaccid spasm occurs with sweating due to wind dispersing qi; rigid spasm occurs without sweating due to cold constricting blood; there are also cases of spasm caused by blood deficiency failing to nourish the sinews. If a stroke patient has an open mouth, it indicates Heart Qi exhaustion; a hand that falls limp indicates Spleen Qi exhaustion; closed eyes indicate Liver Qi exhaustion; urinary incontinence indicates Kidney Qi exhaustion; stertorous breathing indicates Lung Qi exhaustion; vomiting froth, staring fixedly, hair standing erect, head shaking, face red like makeup, and sweat beading like pearls all indicate incurable conditions. If only one or two symptoms appear, survival is still possible. The chapter on Stroke in *Jin Gui Yao Lue* states: "The pulse at the Cun position is floating and tight. Tight indicates Cold, floating indicates Deficiency. When Deficiency and Cold contend, the pathogen is in the skin. Floating indicates Blood Deficiency and emptiness of the collaterals. The thief pathogen cannot be expelled, affecting either the left or right side. The side affected by the pathogen becomes relaxed, while the side of the righteous qi becomes tense. The righteous qi pulls toward the pathogen, causing deviation of the mouth and limbs not moving freely. If the pathogen is in the collaterals, the skin and flesh become numb. If the pathogen is in the channels, the spine feels heavy and cannot extend. If the pathogen enters the Fu organs, the person loses awareness. If the pathogen enters the Zang organs, the tongue becomes stiff and difficult to move, and saliva foams from the mouth. Explanation: In 'Zhong Luo' (Stroke of Collaterals), the pathogen has just entered the Wei level, remaining outside the channels, hence only skin numbness occurs. In 'Zhong Jing' (Stroke of Channels), the pathogen enters the Ying vessels, causing both bone and flesh to lose nourishment, hence the body feels heavy. As for 'Zhong Fu' (Stroke of Fu organs) and 'Zhong Zang' (Stroke of Zang organs), the pathogen has moved from exterior to interior, becoming deep. Zhong Fu necessarily involves the Stomach, as the Stomach is the master of the Six Fu organs; Zhong Zang necessarily involves the Heart, as the Heart is the master of Spirit. Wind entering the Stomach causes intense Stomach heat, steaming fluids into phlegm-saliva. The great collateral of the Stomach enters the Heart; when phlegm-saliva is abundant, it blocks the orifices, so Zhong Fu results in loss of awareness. When pathogens from various Zang organs enter the Heart, Spirit loses its master, so Zhong Zang results in tongue relaxation and difficulty speaking, with the Lianquan point opening and saliva flowing. The Lianquan acupoint is under the tongue, connecting to the Kidney, where fluids emerge.)
Fangfeng (1 qian 2 fen), Guizhi, Mahuang, Xingren (skin and tips removed, stir-fried and ground), Chuanxiong (washed with wine), Baishao (stir-fried with wine), Renshen... decocted. For muscle spasm and delayed speech, increase Baishao dosage, add Zhuli; if constipation persists for days with chest discomfort, add Baizhu; for retching, add Banxia; for dysarthria, add Maidong and Huafen; for irritability, thirst, and frequent fright, add Xijiao, Lingyangjiao, and Shigao.
This is a general formula for stroke affecting the Six Channels. Wu Hegao stated: Mahuang and Xingren constitute Mahuang Tang, treating Taiyang Cold Damage; Guizhi and Baishao constitute Guizhi Tang, treating Taiyang Wind Strike; these are essential for stroke patients presenting with exterior syndromes. Renshen and Gancao tonify Qi; Chuanxiong and Baishao nourish Blood; this treats... Qin. The disease presents chaotically, so the herbs are comprehensive. (Note: There are three methods for treating stroke: releasing the exterior, purging the interior, and regulating the middle. When both interior and exterior symptoms exist, release the exterior first, then purge the interior. *Yi Guan* states: This is the precise formula for direct wind-cold invasion in winter, a variation of Mahuang Tang and Guizhi Tang. Exterior excess syndromes of the Six Channels must be resolved through sweating. If there is obstruction of urination or defecation, use Sanhua Tang or Maren Wan to promote unblocking. However, where pathogen gathers, Qi is necessarily deficient; internal injury is common, so this formula should not be used lightly. Wang Ang notes: This is a standard formula for treating wind, rarely used today, but many ancient and modern wind formulas are derived from it. Yu Jiayan states: The pulse in stroke always has accompanying characteristics. Accompanying Cold makes it floating and tight; accompanying Wind makes it floating and slow; accompanying Heat makes it floating and rapid; accompanying Phlegm makes it floating and slippery; accompanying Qi stagnation makes it floating and choppy; accompanying Fire makes it large and rapid; accompanying Yang deficiency makes it faint; accompanying Yin deficiency makes it rapid or fine as a thread. Faint and slippery indicates headache; slow and迟 indicates decline of Ying and Wei. However, if floating and slow with insufficient righteous Qi, recovery is possible; if rapid, large, and frantic, the pathogen is uncontrollable, and death is certain; if rapid and large but not frantic, survival is possible. *Bao Ming Ji* states: For Jueyin dysentery that does not stop, with a deep, slow pulse, cold extremities, and thick sticky pus and blood, this is difficult to treat. Use Mahuang Tang or Xiao Xuming Tang to induce sweating; this implies that if exterior pathogen lingers internally, dispersing the exterior pathogen will calm the Zang-Fu organs. It also states: For Jueyin wind-diarrhea, apply Yi Lao's Six-Channel modification method. Doubling Mahuang, Xingren, and Fangfeng in this formula creates Mahuang Xuming Tang, treating Taiyang Wind Strike with no sweat and aversion to cold. [Text missing] ...Zhimu... Xuming... Taiyin... Huo... Ren (*Yuji Weiyi* states: This formula does not distinguish channels, nor differentiate between Cold, Heat, Deficiency, and Excess; what good is it even if used often? Yi Lao's differentiation by Six Channels represents flexible methods). Removing Fangfeng, Fangji, Fuzi, and Baishao, and adding Danggui and Shigao from this formula yields the *Gu Jin Lu Yan* Xuming Tang, treating stroke feib (feib syndrome), characterized by inability to control the body, inability to speak, confusion without awareness of pain location, or stiffness preventing turning over. The *Lu Yan* formula removes Renshen and adds Ganjiang, Huangqin, and Jingjie...