世传左为瘫右为痪此说尤非何者经既有偏中半身不遂之候即瘫痪之候当以左右俱中者名
之又
说以春夏得之难治秋冬得之易疗春夏者阳气上腾火力方盛风火相得而王故难治也秋冬者阳气
降下渐微即易疗也此说亦未可必惟其中之浅深为难易尔治法兼理肝肾为得盖肝主筋肾主骨风
中肝肾则筋骨瘫痪也(鸡峰方)
阳虚侯相赵章病召臣意众医皆以为寒中臣意诊其脉曰 风(音洞言彻入四肢) 风者饮食
(音益谓喉下也)而辄出不留法曰五日死而后十日乃死病得之酒所以知赵章之病者臣意切其脉
脉来滑是内风气也饮食下嗌而辄出不留者法五日死皆为前分界法后十日乃死所以过期者其人
嗜粥故中脏实中脏实故过期师言曰安谷者过期不安谷者不过期(出史记)
齐淳于司马病臣意切其脉告曰当病 风 之状饮食下嗌辄后之(后曰如厕)病得之饱食而
疾走
淳于司马曰我之王家食马肝饱甚见酒来即走去驱疾至舍即泄数十出臣意告曰为火齐米汁饮之
七八日而当愈时医秦信在旁臣意去信谓左右阁都尉曰意以淳于司马病为何曰以为 风可治信
即笑曰是不知也淳于司马病法当后九日死即后九日不死其家复召臣意臣意往问之尽如意诊臣
即为一火齐米汁使服之七八日病已所以知之者诊其脉时切之尽如法其病顺故不死(史记同上)
世人相传左边瘫痪叫“瘫”,右边瘫痪叫“痪”,这种说法尤其不正确。为什么呢?因为经典中已有“偏枯”(半身不遂)的记载,那么瘫痪的症状应当以左右两侧都受累的情况来命名。
另外有一种说法认为,春夏季节患此病难治,秋冬季节患此病易疗。理由是:春夏时节阳气上升,火力正盛,风与火相互助长而旺盛,所以难治;秋冬时节阳气下降,逐渐微弱,所以容易治疗。这种说法也不一定可靠,关键在于病邪侵入的深浅程度决定了治疗的难易。治疗方法兼补肝肾才是得当的,因为肝主筋、肾主骨,风邪侵袭肝肾,就会导致筋骨瘫痪。(出自《鸡峰方》)
阳虚侯相赵章患病,召臣意(淳于意)诊治。众医生都认为他是寒邪内中。臣意诊察他的脉象说:“这是风洞(音同‘洞’,意为邪气彻入四肢)。”所谓风洞,是指饮食咽下后随即吐出而不滞留。医法预测五日死,但后来过了十日才死。这病是由于饮酒引起的。之所以知道赵章的病,是因为臣意切按其脉,脉象滑利,这是内有风气的表现;饮食咽下后随即吐出而不滞留,按医法应五日死。之所以超过五日而死,是因为此人嗜食粥类,故五脏充实,五脏充实所以过期而死。老师曾说:“能进食者则超过预期期限而死,不能进食者则不超过预期期限而死。”(出自《史记》)
齐国淳于司马患病,臣意切按其脉告他说:“你将患有风洞之症,表现为饮食咽下后随即排泄(后指如厕)。这病是由于饱食后急速奔走所致。”淳于司马说:“我前往王家,吃了马肝,吃得很饱,见酒来了就立刻走开,驱马疾驰回家,随即腹泻数十次。”臣意告诉他:“服用火齐米汁,七八日就会痊愈。”当时医生秦信在旁,臣意离开后,秦信对左右阁都尉说:“臣意认为淳于司马的病是什么?”回答说:“认为是风洞,可以治愈。”秦信便笑着说:“这是不懂医术。”淳于司马的病按法当在九日后死,结果九日后没死,其家人又召请臣意。臣意前去询问病情,完全像他诊断的那样。于是再次给予火齐米汁让他服用,七八日后病愈。之所以能预知,是因为切脉时脉象完全符合法度,病情顺从,所以不死。(《史记》同上)
It is widely believed that paralysis on the left side is called "Tan" and on the right side "Huan," but this view is particularly incorrect. Why? Because the classics already record the condition of "Pian Ku" (hemiplegia or half-body immobility); therefore, the symptoms of Tan Huan should be named for cases where both the left and right sides are affected.
Another theory states that contracting this disease in spring and summer is difficult to treat, while in autumn and winter it is easier. The reasoning is: in spring and summer, Yang Qi ascends, and the fire energy is strong; wind and fire mutually reinforce each other and become dominant, making treatment difficult. In autumn and winter, Yang Qi descends and gradually weakens, making treatment easier. However, this view is not necessarily certain; the key lies in the depth of the pathogenic invasion determining the difficulty of treatment. The appropriate therapeutic method involves simultaneously regulating the Liver and Kidney, as the Liver governs the sinews and the Kidneys govern the bones; when Wind strikes the Liver and Kidneys, it leads to paralysis of the sinews and bones. (From *Jifeng Fang*)
Zhao Zhang, Chancellor of Yangxu Hou, fell ill and summoned Chen Yi (Chunyu Yi) for diagnosis. All other physicians believed he suffered from Cold invading the interior. Chen Yi palpated his pulse and said, "This is Feng Dong (sound 'dong', meaning pathogenic factors penetrating thoroughly into the four limbs)." Feng Dong refers to a condition where food and drink are swallowed but immediately regurgitated without staying. According to medical laws, death would occur in five days, yet he died after ten days. This illness resulted from drinking alcohol. I knew Zhao Zhang's condition because, upon palpating his pulse, it was slippery, indicating internal Wind Qi; combined with the symptom of immediate regurgitation after swallowing, the law predicts death in five days. The reason he survived past the predicted time is that he had a preference for congee, which kept his Zang organs full. Since his Zang organs were full, he survived longer. The master said: "Those who can digest food will survive beyond the expected period; those who cannot will die within the expected period." (From *Shiji*)
Sima, the Marquis of Qi, fell ill. Chen Yi palpated his pulse and informed him, "You will suffer from Feng Dong, characterized by defecation immediately after swallowing food and drink. This illness was caused by walking rapidly after a full meal." Sima said, "I went to the King's residence, ate horse liver, felt very full, saw wine being served, and immediately left. I drove my chariot swiftly home and then experienced diarrhea dozens of times." Chen Yi told him, "Drink Huo Ji Mi Zhi (Fire-Regulated Rice Juice), and you will recover in seven to eight days." At that time, Physician Qin Xin was present. After Chen Yi left, Qin Xin asked the attendants of the Ge Duwei, "What did Chen Yi diagnose Sima's illness as?" He replied, "He diagnosed it as Feng Dong, which is curable." Qin Xin laughed and said, "He knows nothing about medicine." By the law, Sima should have died nine days later, but he did not. His family summoned Chen Yi again. Chen Yi went to inquire about the condition, which matched his previous diagnosis exactly. He prescribed Huo Ji Mi Zhi again, and Sima recovered after seven to eight days. The reason I could predict this is that the pulse palpation fully accorded with the laws, and the disease pattern was favorable, hence survival. (*Shiji* ibid.)