凡伤寒时疫。不问阴阳老幼妊妇。误服药饵。困重垂死。脉沉伏。不省人事。
七日以后。皆可服之。百不失一。此名夺命散。又名复脉汤。人参一两。水二
钟。紧火煎一钟。以井水浸冷服之。少顷鼻梁有汗出。脉复立瘥。苏韬光侍
郎云。用此救数十人。出王KT 百一选方。
凡伤寒遗毒。发于耳之前后及项下肿硬。用见肿消草、生白芨、生白蔹、生
大黄、生大蓟根、野苎麻根。捣成饼。入芒硝一钱。和贴留头。干即易之。若加
金线重楼。及山茨菇尤妙。出伤寒蕴要。
窃尝怪凡病皆以所感名之。惟中风则以其象名之。遂启后人之惑也。试
观夫中风者。恒于密室中。行住坐卧之顷。卒然仆倒。或痰涎上涌。昏不知
人。或肢体痿废。足不任身。或手足瘫痪。身半不遂。或口眼 僻。筋脉牵引。
斯时未尝有风。而何从中之。即令虚邪贼风偶犯。亦不过现六经之症。侵
冒肌肤已耳。何至昏倒不省。若斯之甚也。然则中风究何从而名焉。盖人
身譬犹树也。人之四肢。犹树之枝干也。人之七情五志。犹天之疾风豪雨
也。人之饥饱劳逸。犹树之日剥月削也。人之忧愁思虑。犹树之蠹蛀侵蚀
也。人之恣欲不节。犹树之斧斤砍伐也。假令一树也。而剥之削之。侵之蚀
之砍之伐之。即不待夫疾风豪雨。而罔不倾仆矣。偶遇大风拔木。而咎之
于风可乎。人之中风。不犹是乎。河间谓五志过极。言其因也。东垣谓本气
自病。言其本也。丹溪谓湿热生痰。言其标也。而究其根。则在于肾元不足
所致。盖肾元无亏。五志过极。即显五志之证。元气不足。即显虚损之证。湿
热生痰。即显痰热之证。惟根本既亏。而五志乘之。劳役乘之。痰热乘之。而
卒然仆倒。遂莫之支尔。斯时也。逐其痰。痰愈炽。降其气。气愈逆。惟牙关紧
闭者。暂用稀涎散开之。究无当于实际。立斋用三生饮投人参一两。驱驾
其邪而补助真气。真斩关夺门之将也。河间立地黄饮子。治舌喑不言。足
痿不行。专固其本。已顶门下一针矣。余每临斯症。细求其故。未有不从心
肾不交而得。盖心不下交于肾。则用归脾汤养育心神为主。而以八味丸
为佐。肾不上交于心。则用地黄饮子补益真阴为主。而以独参汤为佐。又
必令病患却七情。绝帏幕。轻者可复。重者可延。继以岁月。鲜不安痊。若以
风药痰药间之。舍本求末。安望其能生哉。
按中风肥人多见之。而瘦者间有。然肥人多气虚。气虚则生痰。苟根本
不实。犹树之扶疏而中空。则易于倒仆矣。治之须大进参术。佐以痰药。
后补其肾可也。瘦人多血虚。血虚则有火。苟忧愁太过。犹树之枝枯而
叶萎。则无以滋养矣。治之须培益真阴。佐以开郁。后补其气可也。盖脾
肺肾肝。既有阴阳气血之殊。自应分酌而治。矧心为神机开发之本。胃
是谷气充大之标。苟心思不遂。则饮食少用。而无以益其血脉。胃气不
充。则五脏少资。而无以灌其百骸。则是心与胃。又所宜讲求者也。噫。中
风一症。大率膏粱者多出于逸乐。则宜固其肾肝。盖肾主闭藏而肝主
疏泄也。藜藿者每见于萦愁。则宜助其心脾。盖心主忧而脾主思虑也。
此孰非医者之权衡。所当潜心而体会哉。不然一遇此症。不求其因。识
浅技穷。辄进牛黄丸。几曾见有用之而得生者。不大可悟也夫
一中风五绝之症。如口开眼合。手撒遗尿。声如 睡者不治。治之无益。
一中风 僻瘫痪。分左右之道路。而大补气血。佐以舒筋豁痰。十补勿一泻之。
一中风痱痿不用。宜八味十补还少等丹丸选用。佐以补中六君归脾等
汤调之。慎勿误治。以夭人命。
一中气中寒中暑中食。分别以治。不可误认作中风一例而看。
稀涎散
江子仁（六粒每粒分作两半） 牙皂（三钱细切） 明矾（一两）
先将矾熔开。入二味搅匀。待矾枯为末。每用三分。
三生饮
生南星（一两） 生川乌（半两去皮） 生附子（半两去皮） 木香（二钱）
每用共一两。加人参一两。水煎。
地黄饮子
怀熟地 巴戟（去心） 山茱萸（去核） 肉苁蓉（酒净） 附子（制） 石菖蒲
五味子（杵） 茯苓 麦门冬（去心） 远志肉（去心甘草汤净） 石斛（盐水焙） 紫肉桂
各等分。每服五钱。入薄荷少许。姜枣水煎。
凡是伤寒或时行疫病，不论患者是阴证还是阳证、老人还是儿童、孕妇还是常人，如果误服了药物导致病情危重、濒临死亡，出现脉象沉伏、神志昏迷不省人事的症状。在发病七日以后，都可以服用夺命散（又名复脉汤）。此方百发百中，极少失误。方用人参一两，加水两钟，用猛火煎煮至一钟，放入井水中浸冷后服用。不久鼻梁处会有汗出，脉搏随即恢复，病症立刻好转，患者苏醒。苏韬光侍郎说，曾用此方救活了几十人，该方出自王肯堂《百一选方》。
凡是伤寒遗留的毒邪，发作于耳前耳后及颈部下方，表现为肿胀坚硬。使用见肿消草、生白芨、生白蔹、生大黄、生大蓟根、野苎麻根，捣烂成饼状，加入芒硝一钱，调和后贴敷患处，注意不要完全封死（留头），干燥了就更换。如果加上金线重楼和山茨菇，效果尤其好。该法出自《伤寒蕴要》。
我私下常常感到奇怪，一般的疾病都是以感受的外邪来命名，唯独中风是以其症状表现来命名。这开启了后世人的困惑。试看那些患中风的人，经常在密闭的房间中，在行走、站立、坐着、躺卧之际，突然仆倒在地。有的痰涎上涌，昏不知人；有的肢体痿软废用，脚不能支撑身体；有的手足瘫痪，半身不遂；有的口眼歪斜，筋脉牵引。在这个时候，并没有风邪存在，风是从哪里侵入的呢？即使确实是虚邪贼风偶然侵犯，也不过表现出六经的症状，侵袭肌肤罢了。怎么会严重到昏倒不省人事如此地步呢？那么，中风究竟是根据什么来命名的呢？大概人身就像树木一样。人的四肢，就像树的枝干；人的七情五志，就像天上的疾风暴雨；人的饥饱劳逸，就像树木每天每月遭受的剥蚀；人的忧愁思虑，就像树木被虫蛀侵蚀；人的纵欲无度，就像树木被斧斤砍伐。假设有一棵树，既被剥蚀又被砍伐，既受侵扰又遭腐蚀，还不等待疾风暴雨到来，没有不倾倒的。偶尔遇到大风拔起树木，能归咎于风吗？人患中风，不也是这样吗？刘河间说“五志过极”，是指病因；李东垣说“本气自病”，是指根本原因；朱丹溪说“湿热生痰”，是指表象。但究其根源，在于肾元不足所致。如果肾元没有亏损，即使五志过极，也只显现五志的病证；元气不足，只显现虚损的病证；湿热生痰，只显现痰热的病证。只有当根本已经亏损，而五志、劳役、痰热乘虚而入，才突然仆倒，无法支撑。此时，驱逐痰浊，痰反而更盛；降逆气，气反而更逆。只有牙关紧闭者，暂时用稀涎散开通。但这终究不符合实际治疗原则。薛立斋用三生饮加入人参一两，驱除邪气并补助真气，真是像斩关夺门的将领一样勇猛。刘河间创立地黄饮子，治疗舌强不语、足痿不行，专门巩固根本，已是在头顶门下一针（指治本）。我每次面对这种病症，仔细探究其缘故，没有不是从心肾不交而得的。如果心火不能下交于肾，就用归脾汤养育心神为主，以八味丸为辅佐；如果肾水不能上交于心，就用地黄饮子补益真阴为主，以独参汤为辅佐。还必须让病人排除七情干扰，隔绝房事，轻症可以康复，重症可以延缓病程，经过岁月调养，很少有不痊愈的。如果用风药、痰药夹杂其中，舍本逐末，怎么指望他能生存呢？
按：中风多见于肥胖之人，瘦人也有。但肥胖人多气虚，气虚则生痰。如果根本不实，就像树木枝叶繁茂但内部中空，就容易倾倒仆地。治疗必须大剂量进用参、术，佐以化痰药，之后再补肾即可。瘦人多血虚，血虚则有火。如果忧愁过度，就像树木枝条干枯、叶子萎黄，就无法得到滋养。治疗必须培补真阴，佐以开郁，之后再补气即可。因为脾、肺、肾、肝，既有阴阳气血的不同，自然应该分别斟酌治疗。况且心是神机开发的本源，胃是谷气充盛的标象。如果心思不顺，则饮食减少，而无法益养血脉；胃气不充，则五脏缺乏资助，而无法灌溉全身百骸。所以心和胃，又是应当深入探讨的。唉，中风这一病症，大体上吃精细食物的人多因安逸享乐所致，适宜固护肾肝，因为肾主闭藏而肝主疏泄；吃粗劣食物的人多因忧愁萦绕所致，适宜助益心脾，因为心主忧而脾主思虑。这些哪不是医者应当潜心体会的权衡标准呢？否则一遇到这种病症，不探究原因，见识浅薄、技术穷尽，就随意进用牛黄丸，何曾见过用了就能存活的？这不是很值得醒悟吗？
关于中风五绝之症，如口开眼合、手撒遗尿、声音如鼾睡者，属于不治之症，治疗无效。
关于中风口眼歪斜、瘫痪，分左右经络，以大补气血为主，佐以舒筋豁痰，宜补不宜泻，十分补益中不要有一分泻法。
关于中风痱痿不用，宜选用八味丸、十补还少丹等丸剂，佐以补中益气汤、六君子汤、归脾汤等汤剂调理。千万不要误治，以致夭折人命。
关于中气、中寒、中暑、中食，分别进行治疗，不可错误地当作中风一类来看待。
稀涎散
江子仁（六粒，每粒分成两半） 牙皂（三钱，细切） 明矾（一两）
先将明矾熔化，加入另外两味搅匀，待明矾枯干后研为粉末。每次服用三分。
三生饮
生南星（一两） 生川乌（半两，去皮） 生附子（半两，去皮） 木香（二钱）
每次共取一两，加入人参一两，水煎服。
地黄饮子
怀熟地 巴戟天（去心） 山茱萸（去核） 肉苁蓉（酒洗净） 附子（制） 石菖蒲
五味子（捣碎） 茯苓 麦门冬（去心） 远志肉（去心，甘草汤洗净） 石斛（盐水焙） 紫肉桂
各等分。每次服用五钱，加入少许薄荷，姜枣水煎服。
Whenever suffering from Cold Damage (Shanghan) or epidemic febrile diseases, regardless of whether the patient presents with Yin or Yang patterns, is an elderly person, a child, or a pregnant woman, if mistaken administration of drugs leads to critical illness nearing death, with deep and hidden pulse (Chen Fu) and unconsciousness, one may take Du Ming San (Life-Grabbing Powder), also known as Fu Mai Tang (Pulse-Recovering Decoction), after seven days have passed. This prescription is effective in nearly all cases without failure. It consists of Ren Shen (Ginseng Radix et Rhizoma) 1 liang, decocted in 2 zhong of water with strong fire until reduced to 1 zhong. After cooling it in well water, administer orally. Soon, sweat will appear on the nasal bridge, the pulse will recover immediately, and the condition will improve significantly, with the patient regaining consciousness. Su Taoguang, Vice Minister, stated that he used this formula to save dozens of people. It originates from Wang Kentang's *Bai Yi Xuan Fang*.
Regarding residual toxins from Cold Damage manifesting as swelling and hardness in front of, behind, and below the ears, use Jian Zhong Xiao Cao, Sheng Bai Ji (Bletilla Rhizoma), Sheng Bai Lian (Ampelopsis Rhizoma), Sheng Da Huang (Rhei Radix et Rhizoma), Sheng Da Ji Gen (Cirsii Japonici Radix), and Ye Zhu Ma Gen (Boehmeriae Caulis). Pound into a paste, add Mang Xiao (Natrii Sulfas) 1 qian, mix, and apply externally to the affected area, leaving the center open (Liu Tou). Change when dry. Adding Jin Xian Chong Lou (Paris Polyphylla Rhizoma) and Shan Ci Gu (Fritillaria Cirrhosa Bulbus) is particularly excellent. This method comes from *Shang Han Yun Yao*.
I have often wondered why most diseases are named after the pathogenic factors they contract, while "Zhong Feng" (Wind Stroke) is named after its symptoms, thus confusing later generations. Observe those suffering from Wind Stroke: they often collapse suddenly while walking, standing, sitting, or lying in a closed room. Some experience surging phlegm-saliva and loss of consciousness; some suffer flaccid paralysis of limbs, unable to support their body weight; some have hemiplegia; some present with deviation of the mouth and eye, and tendon pulling. At such times, there is no actual wind present, so how could it strike? Even if deficient evil or thief wind accidentally invades, it merely manifests as symptoms of the Six Channels (Liu Jing), affecting the skin and muscles. How could it lead to such severe unconsciousness? Then, what is the basis for naming it Wind Stroke? The human body is like a tree. The four limbs are like branches and trunks; the Seven Emotions and Five Wills are like violent winds and heavy rains; hunger, fullness, fatigue, and exertion are like daily erosion; worry and overthinking are like insect borings; excessive desires are like axe cuts. If a tree is eroded, cut, invaded, corroded, and chopped, it will fall even without violent wind. If a great wind uproots trees, can we blame the wind? Human Wind Stroke is no different. Liu Hejian said "extreme excess of the Five Wills," referring to the cause; Li Dongyuan said "disease of the original Qi," referring to the root; Zhu Danxi said "damp-heat generating phlegm," referring to the branch. However, the root lies in insufficiency of Kidney Yuan (Original Energy). If Kidney Yuan is not deficient, extreme emotions only show emotional disorders; insufficient Original Qi only shows deficiency syndromes; damp-heat phlegm only shows phlegm-heat syndromes. Only when the root is already deficient do the Five Wills, labor, and phlegm-heat take advantage, causing sudden collapse. At this moment, expelling phlegm makes it worse; descending Qi makes it more rebellious. Only in cases of locked jaw should Xi Xian San (Saliva-Thinning Powder) be temporarily used to open it, but this does not address the reality. Xue Lizhai used San Sheng Yin (Three Raw Decoction) with 1 liang of Ren Shen to drive out evil and tonify true Qi, acting like a general breaching gates. Liu Hejian created Di Huang Yin Zi (Rehmannia Decoction) to treat aphasia and leg weakness, specifically consolidating the root, which is like treating the disease at its source. Whenever I encounter this syndrome, upon careful investigation, it invariably stems from Heart-Kidney non-interaction. If Heart Fire fails to descend to the Kidney, use Gui Pi Tang (Restore the Spleen Decoction) to nourish Heart Spirit primarily, assisted by Ba Wei Wan (Eight-Ingredient Pill). If Kidney Water fails to ascend to the Heart, use Di Huang Yin Zi to tonify True Yin primarily, assisted by Du Shen Tang (Single Ginseng Decoction). Furthermore, patients must eliminate emotional disturbances and abstain from sexual activity. Mild cases can recover, severe cases can be prolonged, and with time, few fail to heal. Using wind-dispelling or phlegm-resolving drugs interferes with this, seeking the branch rather than the root; how can survival be expected?
Note: Wind Stroke is common in obese individuals, though rare in thin ones. Obese people often have Qi deficiency, leading to phlegm generation. If the root is unstable, like a tree with lush foliage but a hollow trunk, it falls easily. Treatment requires large doses of Ren Shen and Bai Zhu, assisted by phlegm-resolving herbs, followed by Kidney tonification. Thin people often have Blood deficiency, leading to internal heat. If worried excessively, like a tree with withered branches and leaves, nourishment is lost. Treatment requires cultivating True Yin, assisted by soothing depression, followed by Qi tonification. Since Spleen, Lung, Kidney, and Liver differ in Yin-Yang and Qi-Blood, treatments must be adjusted accordingly. Moreover, the Heart is the root of spiritual activity, and the Stomach is the source of grain Qi. If mental distress reduces appetite, blood vessels lack nourishment; if Stomach Qi is insufficient, the Five Zang organs lack support, failing to irrigate the body. Thus, the Heart and Stomach require attention. Alas, Wind Stroke mostly affects those consuming rich foods due to leisure, requiring consolidation of Kidney and Liver (Kidney stores essence, Liver ensures free flow); those eating coarse food due to sorrow require assisting Heart and Spleen (Heart governs worry, Spleen governs thought). These are the standards physicians must deeply understand. Otherwise, encountering this syndrome without investigating causes, lacking insight and skill, and blindly administering Niu Huang Wan (Calculus Bovis Pill) rarely saves lives. This should be a wake-up call.
Regarding the Five Terminal Signs of Wind Stroke: open mouth and closed eyes, relaxed hands with urinary incontinence, and snoring sounds indicate untreatable conditions; treatment is futile.
For facial deviation and paralysis, distinguishing left and right meridians, prioritize massive tonification of Qi and Blood, assisted by tendons-soothing and phlegm-expelling methods. Use ten parts tonification, never one part purgation.
For Wind Stroke flaccidity and inability to move, select pills like Ba Wei Wan or Shi Bu Huan Shao Dan, assisted by tonics like Bu Zhong Yi Qi Tang, Liu Jun Zi Tang, or Gui Pi Tang. Do not mistreat, lest you shorten lives.
Differentiate between Qi Strike, Cold Strike, Summerheat Strike, and Food Retention; treat separately. Do not mistakenly categorize them all as Wind Stroke.
Xi Xian San
Jiang Zi Ren (6 seeds, each halved) Ya Zao (3 qian, finely sliced) Ming Fan (1 liang)
Melt the alum first, add the other two ingredients, stir evenly. Wait until the alum dries and becomes powder. Take 3 fen per dose.
San Sheng Yin
Sheng Nan Xing (1 liang) Sheng Chuan Wu (0.5 liang, peeled) Sheng Fu Zi (0.5 liang, peeled) Mu Xiang (2 qian)
Take 1 liang of the above mixture, add Ren Shen 1 liang, decoct in water.
Di Huang Yin Zi
Huai Shu Di Ba Ji Tian (decentered) Shan Zhu Yu (pitted) Rou Cong Rong (wine-cleaned) Fu Zi (processed) Shi Chang Pu
Wu Wei Zi (crushed) Fu Ling Mai Men Dong (decentered) Yuan Zhi Rou (decentered, cleaned in Licorice decoction) Shi Hu (salt-water roasted) Zi Rou Gui
Equal parts. Take 5 qian per dose, add a little Bo He (Menthae Haplocalycis Herba), decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus).