间使(二穴,在掌外横纹后三寸,两筋陷中,灸五壮。治癫狂。) 人中(一穴,在鼻下,
小炷灸之,治癫狂卒倒。)两手足大拇指甲(甲肉之半处,灸七壮。其法,以二指并缚一处灸之,四处着火。)
春甫考心风病,诸书鲜有载之,而多附癫痫门候,混同论治。心风虽出于世俗之称,深中
病情,诚为切当。古人谓∶风善行而数变,风痹为不仁。此曰心风者,非若外风入中,甚言其
变常无定,恍惚不仁。而心之病,诚若风之魔也。此皆七情五志久逆所生,而与癫痫则又不同矣。癫狂
痫证主于火炽,风痰之盛,而寝延及于心,属实者多;心风则由七情五志久逆不遂,戴人所谓
肝屡谋,胆屡不决,屈无所申,怒无所泄。心之官则思,甚则心血日涸,脾液不行,痰迷心窍,
则成心风,属虚者多。治法须以七情相胜,五志遂心,养血豁痰,引神归舍,标本兼治,此疾
可愈矣。致若混同癫痫攻治,是谓虚虚,而速其死也,噫。
脉寸关微间而歇,至者死。微而滑者生。
浮而涩者难治。(乃血气不足,而神荡于外。)弦大者可攻之。
虚而无力者宜补。
滑疾者痰甚,在寸宜吐之,关滑可下。
心风初作,多属虚候,何则?思虑伤脾,则谷气浸少,血液日亏,则心神慢散,神不守舍,
卒成心风。故
知其始皆属虚也,归脾汤养心汤、定志丸之类。至于病久,则心志变而美恶不知,无思无虑,饮
食如故,杀气颇增,病根已固。郁痰不解者,可用子和法治之,随证调理,无不愈也。
间使穴(共两穴,位于手掌外侧横纹后三寸处,两条肌腱之间的凹陷中,艾灸五壮。主治癫狂病。)人中穴(一穴,位于鼻唇沟上三分之一与下三分之二交界处,用细小的艾炷施灸,主治癫狂突然昏倒。)双手足大拇指指甲根部甲肉各半处(共四穴,每穴艾灸七壮。操作方法:将两个手指并拢绑在一起,在四个部位同时点火施灸。)
徐春甫考证“心风”这一病症,各类医书中很少专门记载,大多附在癫痫门类中,混淆在一起讨论治疗。“心风”虽然出自世俗称呼,但深刻切中病情,确实非常恰当。古人说:“风邪善于游走且变化多端,风痹会导致肢体麻木不仁。”这里所说的“心风”,并非像外感风邪侵入体内那样,而是强调其变化无常、没有定规,表现为精神恍惚、感觉迟钝或丧失。心的病变,确实如同被风魔侵扰一样。这些症状都是由七情(喜、怒、忧、思、悲、恐、惊)和五志(怒、喜、思、忧、恐)长期逆乱所产生,这与癫痫是不同的。癫、狂、痫这类证候主要由于火邪炽盛、风痰旺盛,进而拖延波及到心脏,多属于实证;而心风则是由于七情五志长期郁结不畅所致,正如张从正(戴人)所说:“肝屡次谋划却犹豫不决,胆屡次决断却优柔寡断,委屈无处申诉,愤怒无处发泄。”心的功能是主思考,过度思虑则心血日渐枯竭,脾的津液运行停滞,痰浊迷蔽心窍,从而形成心风,多属于虚证。治疗方法必须运用五行相胜的情志疗法,使五志舒畅顺心,养血以祛除痰浊,引导神气回归本位,标本兼治,此病是可以治愈的。如果将其混同为癫痫进行攻伐治疗,这就叫做“虚虚”(使虚者更虚),会加速死亡,唉。
脉象在寸、关部微弱且间歇停顿,若脉搏出现即停止不再恢复,为死证。脉象微弱但滑利者,可生。脉象浮而涩者,难治。(这是因为气血不足,神气涣散于体外。)脉象弦大者,可以攻逐邪气。脉象虚弱而无力的,适宜补益。脉象滑而疾速者,说明痰邪严重,若在寸部,宜用涌吐法;若在关部滑利,可用泻下法。
心风初发时,多属于虚证,为什么呢?因为思虑过度损伤脾气,导致水谷精微之气逐渐减少,血液日益亏损,心神慢慢涣散,神气不能安居于心舍,最终形成心风。所以知道其起始阶段都属于虚证,可用归脾汤、养心汤、定志丸之类的方剂。至于病程日久,则心的意志发生改变,不知美丑善恶,没有思虑,饮食如常,杀气颇增,病根已经稳固。对于郁结之痰无法化解的情况,可以使用张从正(子和)的治疗方法,随证调理,没有不痊愈的。
Jianshi (PC5) acupoint (two points, located three cun posterior to the transverse crease of the palm, in the depression between the two tendons; moxibustion five zhuang. Treats mania and epilepsy.) Renzhong (GV26) acupoint (one point, located in the philtrum; use small moxa cones for moxibustion; treats sudden collapse due to mania or epilepsy.) The half-way points on the fingernails/toenails of both thumbs and big toes (at the junction of the nail and flesh; moxibustion seven zhuang per site. Method: bind two fingers together and apply fire at all four sites simultaneously.)
Chunfu examined the disease known as "Heart Wind" (Xin Feng). Few medical texts record it specifically; instead, it is mostly appended to the section on epilepsy, where diagnosis and treatment are confused with those of epilepsy. Although "Heart Wind" is a term originating from popular usage, it accurately reflects the pathological condition and is indeed appropriate. The ancients stated: "Wind pathogens move freely and change frequently; wind-bi leads to numbness." The "Heart Wind" mentioned here does not refer to external wind invading the body, but rather emphasizes its unpredictable nature and constant changes, manifesting as mental confusion and insensibility. Diseases of the heart truly resemble being possessed by wind demons. These conditions arise from the long-term reversal and stagnation of the Seven Emotions (joy, anger, worry, thought, grief, fear, fright) and Five Wills (anger, joy, thought, worry, fear), which differs from epilepsy. Epilepsy, mania, and convulsive disorders are primarily caused by blazing fire and excessive wind-phlegm, which eventually affect the heart, and are mostly excess syndromes. In contrast, Heart Wind results from the long-term frustration and stagnation of the Seven Emotions and Five Wills. As Zhang Congzheng (Zihe) stated: "The Liver plans repeatedly but hesitates; the Gallbladder decides repeatedly but lacks resolve; there is no outlet for grievance, nor release for anger." The function of the Heart is to govern thought. Excessive thinking depletes Heart Blood day by day, and Spleen fluids fail to circulate. Phlegm confuses the Heart orifices, leading to Heart Wind, which is mostly a deficiency syndrome. Treatment must employ the theory of emotional counteraction (using one emotion to overcome another), allow the Five Wills to be satisfied, nourish blood and resolve phlegm, guide the Shen (Spirit) back to its residence, and treat both root and branch. With this approach, the disease can be cured. If it is mistakenly treated like epilepsy using purgative methods, this constitutes "treating deficiency as if it were excess" (making the deficient even more deficient), accelerating death. Alas.
If the pulse at the Cun and Guan positions is faint and intermittent, and the beat ceases without returning, it indicates a fatal prognosis. If the pulse is faint yet slippery, survival is possible. If the pulse is floating and choppy, it is difficult to treat (indicating insufficiency of Qi and Blood, with the Shen dissipating externally). If the pulse is wiry and large, it can be treated with attacking methods. If the pulse is weak and forceless, tonification is appropriate. If the pulse is slippery and rapid, it indicates severe phlegm; if located at the Cun position, emesis should be induced; if slippery at the Guan position, purgation may be used.
When Heart Wind first manifests, it mostly belongs to deficiency patterns. Why? Because excessive thought damages the Spleen, causing the essence derived from food and drink to gradually decrease. As blood becomes increasingly deficient, the Heart Shen slowly scatters, failing to reside within the Heart, ultimately resulting in Heart Wind. Therefore, it is known that the initial stage belongs to deficiency. Formulas such as Guipi Tang (Restore the Spleen Decoction), Yangxin Tang (Nourish the Heart Decoction), and Dingzhi Wan (Calm the Will Pill) are suitable. However, if the disease persists for a long time, the Heart's will changes, and the patient loses the ability to discern beauty from ugliness or good from evil. They have no thoughts or worries, eat normally, but exhibit increased aggressive tendencies, and the root of the disease has become solidified. For cases where stagnant phlegm cannot be resolved, the methods of Zhang Zihe (Zihe) can be employed. By adjusting treatment according to the specific manifestations, recovery is assured.