经义
诸风掉眩，皆属于肝。○东方生风，风生木。（《素问》）
哲言
《经》云∶诸风掉眩，皆属于肝。肝主风，风主动。脾主四肢，四肢者，诸阳之本，木气鼓之，故动，
所谓风淫末疾也。此证在壮年，属热极生风；若病后、老年，属血液衰少，不能营养故也。（《张氏医通》）
肝为风木之脏，相火内寄，体阴用阳，其性刚，主动主升，全赖肾水以涵之，血液以濡之，肺金清肃下
降之令以平之，中宫敦阜之土气以培之，则刚劲之质得为和柔之体，遂其条达畅茂之性，何病之有！倘津液有
亏，肝阴不足，血燥生热，热则风阳上升，窍络阻塞，头目不清，眩晕跌仆，甚则螈 痉厥矣。治当缓肝之急
以熄风，滋肾之液以驱热，如虎潜丸、地黄饮子、复脉等方，是介以潜之，酸以收之，浓味以填之，或用清上
实下之法。若思虑烦劳，身心过动，风阳内扰，则营热心悸，惊怖不寐，胁中动跃。治以酸枣仁汤、补心丹、
枕中丹，清营中之热，佐以敛摄神志。若因动怒郁勃，痰火风交炽，则有二陈、龙荟。风木过动，必犯中宫，
则呕吐不食，法用泄肝安胃，或填补阳明。他如辛甘化风、甘酸化阴、清金平木，种种治法，未能备叙。然肝
风一证，患者甚多，从古无此病名，医每忽略，特为拈出，以便后学考核云。○肝为风木之脏，将军之官，性
急而动，故肝脏之病，较之他脏为多，而于妇女尤甚。肝病必犯土，是侮其所胜也。本脏见证，仲景云∶厥阴
之为病，消渴，气上撞心，心中疼热，饥不欲食，食则吐蛔。又《内经》所载肝病，难以尽述。大概其脉
必弦，胁或胀或痛，偏寒偏热，或先厥后热。若一犯胃，则干呕吐酸，脘痞不食；克脾则腹胀肢麻，便或溏或
不爽。治法有阴阳虚实之殊。若肝阴胃汁未亏，肝阳亢逆犯胃，用药则远柔用刚，泄肝如吴萸、椒、桂，通胃
如半夏、姜、附，加益智、枳、朴等，则兼运脾阳。中虚必用人参，如大半夏汤、附子粳米汤、进退黄连；泻
心、治中，温胆等汤是也。若肝阴胃汁已虚，木火炽盛，风阳
扰胃，用药忌刚用柔。养肝则阿胶、生地、白芍、麻仁、木瓜，养胃则人参、麦冬、粳米。至于平治之法，则
刚柔寒热兼用，乌梅丸、安胃丸、逍遥散。若四君、六君、异功、戊己，则必加泄肝之品。用桑叶、丹皮者，
桑叶轻清，清泄少阳之气热，丹皮苦辛，清泄肝胆之血热。用金铃子散者，川楝苦寒，直泄肝阳，延胡专理气
滞血涩之痛。如呕吐不食，胁胀脘痞，医者但认为脾胃之病，不知实由肝邪所致。且世人但知风、劳、鼓、膈
为四大证，不知土败木贼，延至不救者多矣。（《临证指南》）
【经典理论】
各种风病引起的肢体震颤、头晕目眩，都归属于肝脏。○东方产生风，风对应木行。（出自《素问》）
【名家论述】
《黄帝内经》说：各种风病引起的肢体震颤、头晕目眩，都归属于肝脏。肝主司风，风具有主动的特性。脾主司四肢，四肢是诸阳经的根本，木气（肝气）鼓动它，所以出现动摇，这就是所说的“风邪侵袭四肢末端导致的疾病”。这种证候如果在青壮年人身上，属于热极生风；如果是大病之后或老年人身上，则属于血液衰少，不能滋养筋脉所致。（出自《张氏医通》）
肝是风木之脏，体内寄居着相火，其体属阴而用属阳，性质刚强，主运动、主升发，完全依赖肾水来涵养它，血液来濡润它，肺金清肃下降的机能来平抑它，中焦脾胃敦厚厚重的土气来培育它，这样刚劲的体质才能变为和柔的状态，顺应其条达畅茂的本性，怎么会有疾病呢！倘若津液亏损，肝阴不足，血燥而生热，热盛则风阳上升，窍络阻塞，头目不清爽，出现眩晕跌倒，甚至发生抽搐、痉挛、昏厥。治疗应当舒缓肝之急迫以熄风，滋补肾之阴液以驱热，如虎潜丸、地黄饮子、复脉汤等方剂，这是用介类药潜镇，酸味药收敛，浓味厚腻药填补，或者采用清上实下的方法。如果因思虑烦劳，身心过度活动，导致风阳在内扰动，就会出现营分发热、心悸、惊恐不安、失眠、胁下跳动。治疗用酸枣仁汤、补心丹、枕中丹，清除营分之热，辅以收敛神志的药物。如果因愤怒抑郁，痰火与风邪交炽，则可用二陈汤、龙胆泻肝汤。风木之气过动，必然侵犯中焦脾胃，就会出现呕吐、不能进食，治法应泄肝安胃，或者填补阳明胃气。其他如辛甘化风、甘酸化阴、清金平木等各种治法，未能详尽叙述。然而肝风这一证候，患者很多，从古至今没有这个病名，医生往往忽略，特意提出此证，以便后学考核研究。○肝是风木之脏，称为将军之官，性情急躁而好动，所以肝脏的疾病，比其他脏腑更多，而在妇女身上尤为严重。肝病必然侵犯脾土，这是侮其所胜（反向克制）。本脏的表现，张仲景说：厥阴病的症状，包括消渴，气向上冲撞心脏，心中疼痛灼热，饥饿但不想吃东西，吃了就吐蛔虫。另外《内经》所载的肝病，难以全部叙述。大概其脉象必定弦，胁部或胀或痛，偏寒偏热，或者先厥冷后发热。如果一旦侵犯胃，就会干呕、吐酸水，胃脘痞塞不想进食；克伐脾脏则腹胀、四肢麻木，大便或溏薄或不爽利。治疗方法有阴阳虚实的区别。如果肝阴和胃汁未亏损，肝阳亢逆犯胃，用药则远离柔润而使用刚燥，泄肝药用吴茱萸、花椒、肉桂，通胃药用半夏、生姜、附子，加上益智仁、枳实、厚朴等，则兼运脾阳。中气虚弱必须用人参，如大半夏汤、附子粳米汤、进退黄连汤、泻心汤、治中汤、温胆汤等方剂。如果肝阴和胃汁已经虚弱，木火炽盛，风阳扰乱胃腑，用药忌讳刚燥而使用柔润。养肝药用阿胶、生地、白芍、麻仁、木瓜，养胃用人参、麦冬、粳米。至于平和治理的方法，则刚柔寒热兼用，如乌梅丸、安胃丸、逍遥散。如果是四君子汤、六君子汤、异功散、戊己丸，则必须加入泄肝的药物。使用桑叶、丹皮的，桑叶轻清，清泄少阳经的气热，丹皮苦辛，清泄肝胆的血热。使用金铃子散的，川楝子苦寒，直泄肝阳，延胡索专门调理气滞血涩的疼痛。如果出现呕吐不食、胁胀胃痞，医生只认为是脾胃的病，不知道实际上是由肝邪所致。而且世人只知道风、劳、鼓、膈为四大重症，不知道土败木贼（脾虚肝乘），拖延至无法救治的情况有很多。（出自《临证指南医案》）
[Classic Theory]
All wind diseases characterized by tremors and dizziness belong to the Liver. ○ The East generates Wind, and Wind generates Wood. (From *Suwen*)
[Masters' Discourse]
The *Classic* states: All wind diseases characterized by tremors and dizziness belong to the Liver. The Liver governs Wind, and Wind is characterized by movement. The Spleen governs the four limbs; the four limbs are the root of all Yang meridians. When Wood Qi (Liver Qi) stirs them, movement occurs. This is referred to as "wind invading the extremities causing disease." If this syndrome occurs in young adults, it belongs to extreme heat generating wind; if it occurs after illness or in the elderly, it belongs to the deficiency of blood failing to nourish the sinews. (From *Zhangshi Yitong*)
The Liver is the organ of Wind and Wood, with Ministerial Fire residing within. Its substance is Yin, while its function is Yang. Its nature is rigid, governing movement and ascending. It relies entirely on Kidney Water to nourish it, Blood to moisten it, the descending and purifying command of Lung Metal to level it, and the thick and abundant Earth Qi of the Middle Jiao to cultivate it. In this way, the rigid quality becomes a soft and flexible body, complying with its nature of free flow and flourishing. How could there be disease! However, if Body Fluids are deficient, Liver Yin is insufficient, dryness in the Blood generates Heat, and excessive Heat causes Wind-Yang to ascend. The orifices and collaterals become blocked, leading to unclear head and eyes, vertigo, and falling. Severe cases may result in convulsions (*Jingluo*, 筋挛), spasms, and coma. Treatment should soothe the Liver's urgency to extinguish wind, and nourish Kidney fluids to drive out heat. Formulas such as *Hujian Wan* (Tiger Crouching Pill), *Dihuang Yinzi* (Rehmannia Decoction), and *Fumai Tang* (Pulse-Regulating Decoction) are used. These employ shell-based substances to subdue, sour substances to astringe, and rich/heavy substances to fill. Alternatively, methods of clearing the upper and solidifying the lower may be used. If due to excessive mental worry and fatigue, causing overexertion of body and mind, internal disturbance of Wind-Yang leads to Ying-level fever, palpitations, fear, insomnia, and throbbing in the hypochondrium. Treatment uses *Suanzaoren Tang* (Ziziphus Decoction), *Buxin Dan* (Heart-Nourishing Pill), and *Zhenzhong Dan* (Brain-Fortifying Pill) to clear Ying-level heat and assist in calming and gathering the Shen (Spirit). If due to anger and depression, where Phlegm-Fire and Wind blaze together, *Erchen Tang* (Two-Cured Decoction) or *Longdan Xiegan Tang* (Gentian Decoction to Drain the Liver) may be used. Excessive movement of Wind-Wood must invade the Middle Jiao (Spleen/Stomach), leading to vomiting and anorexia. The method involves draining the Liver to calm the Stomach, or tonifying the Yangming Stomach. Other methods such as transforming wind with acrid-sweet herbs, transforming Yin with sweet-sour herbs, and clearing Metal to level Wood are too numerous to list exhaustively. However, regarding the syndrome of Liver Wind, patients are numerous. Since ancient times, there has been no specific disease name for this, and physicians often overlook it. It is specifically highlighted here for future scholars to examine. ○ The Liver is the organ of Wind-Wood, known as the "General Officer." Its nature is impatient and prone to movement. Therefore, Liver diseases are more frequent than those of other organs, especially in women. Liver disease inevitably invades Earth (Spleen), which is insulting what it normally controls. Manifestations of the primary organ, according to Zhang Zhongjing: The disease of the Jueyin Meridian includes thirst, Qi rushing up to strike the heart, pain and burning sensation in the chest, hunger without desire to eat, and vomiting roundworms after eating. Furthermore, the Liver diseases described in the *Neijing* cannot be fully enumerated. Generally, the pulse must be Wiry (Xian), with distension or pain in the hypochondrium, tendencies toward cold or heat, or initial cold followed by heat. If it invades the Stomach, there is dry heaving, acid regurgitation, epigastric fullness, and anorexia; if it attacks the Spleen, there is abdominal distension, limb numbness, and loose or unsatisfactory stools. Treatment methods differ based on Yin/Yang and Deficiency/Excess. If Liver Yin and Stomach Juice are not yet depleted, but Liver Yang is hyperactive and invading the Stomach, medications should avoid soft/moistening agents and use rigid/drying ones. To drain the Liver, use Evodia (Wuzhuyu), Zanthoxylum (Huajiao), and Cinnamon (Guizhi); to unblock the Stomach, use Pinellia (Banxia), Ginger (Shengjiang), and Aconite (Fuzi). Adding Alpinia Oxyphylla (Yizhiren), Immature Bitter Orange (Zhishi), and Magnolia Bark (Houpo) also helps transport Spleen Yang. For central deficiency, Ginseng (Renshen) is essential, as seen in formulas like *Dabanxia Tang* (Major Pinellia Decoction), *Fuzi Jingmi Tang* (Aconite and Rice Decoction), *Jintui Huanglian Tang* (Advance-Retreat Coptis Decoction), *Xiexin Tang* (Drain the Epigastrium Decoction), *Zhizhong Tang* (Regulate the Middle Decoction), and *Wendan Tang* (Warm the Gallbladder Decoction). If Liver Yin and Stomach Juice are already deficient, and Wood-Fire is blazing with Wind-Yang disturbing the Stomach, medications should avoid rigidity and use softness. To nourish the Liver, use Donkey-hide Gelatin (Ejiao), Rehmannia Root (Shengdi), White Peony Root (Baishao), Hemp Seed (Maren), and Quince (Mugua); to nourish the Stomach, use Ginseng (Renshen), Ophiopogon (Maidong), and Rice (Jingmi). For balanced treatment, rigid/soft and cold/hot agents are combined, such as *Wumei Wan* (Mume Pill), *Anwei Wan* (Stomach-Calming Pill), and *Xiaoyao San* (Free and Easy Wanderer Powder). For *Sijunzi Tang* (Four Gentlemen Decoction), *Lijunzi Tang* (Six Gentlemen Decoction), *Yigong San* (Extraordinary Skill Powder), or *Wuji Wan* (Earth-Liver Pill), ingredients that drain the Liver must be added. When using Mulberry Leaf (Sangye) and Moutan Cortex (Danpi): Mulberry leaf is light and clear, clearing Qi-heat of the Shaoyang meridian; Moutan cortex is bitter and acrid, clearing Blood-heat of the Liver and Gallbladder. When using *Jinlingzi San* (Melia Dispersion): Melia Fruit (Chuanlianzi) is bitter and cold, directly draining Liver Yang; Corydalis Rhizome (Yanhusuo) specifically regulates pain from Qi stagnation and Blood stasis. If vomiting, anorexia, hypochondriac distension, and epigastric fullness occur, physicians may mistakenly attribute them solely to Spleen-Stomach disease, unaware that they are actually caused by pathogenic factors from the Liver. Moreover, people only know Wind, Consumption, Drum-Tympany, and Dysphagia as the four major severe syndromes, not realizing that many cases of Earth failure and Wood aggression (Spleen deficiency with Liver invasion) progress to incurable stages. (From *Linzheng Zhinan Yian*)