《病机机要》云∶风本为热,热盛则风动,宜以静胜其燥,是养血也。治须少汗,亦
须少下。多汗则虚其卫,多下则损其荣。宜治在经。虽有汗下之戒,而有中脏中腑之
分。中腑者,多着四肢,有表证而脉浮恶风寒,拘急不仁。中脏者,多滞九窍,唇缓失音,
耳聋鼻塞,目瞀,大便秘结。中腑者,宜汗之。中脏者,宜下之。表里已和,宜治之
在经,当以大药养之。
《发明》云∶中血脉则口眼 斜,中腑则肢节废,中脏则性命危,三治俱不同。
中血脉,外有六经之形证,则从小续命汤加减。中脏内有便溺之阻隔,宜三化汤等通之。
外无六经之形证,内无便溺之阻隔,宜养血通气,大秦艽汤,羌活愈风汤主之。
许学士云∶世言气中者,虽不见方书,然暴怒伤阴,暴喜伤阳,忧愁不已,气多厥
逆,往往得此疾。便觉涎潮昏塞,牙关紧急。若便作中风用药,多致杀人。惟宜苏合香
丸灌之便醒。然后随寒热虚实而调之,无不愈者。经曰∶无故而喑,肺不至,不治自
已,谓气暴逆也,气复则已。审如是,虽不服药亦可。
《玉机微义》云∶中气即七情内火之动,气厥逆,由其本虚故也。用苏合香丸,通
行经络,其决烈之性,如
摧枯拉朽,恐气血虚者,非所宜也。后云不治自复之意,盖警用药之失,实胜误于庸医
之所为也。
《病机机要》说:风邪本质上属于热邪,热势亢盛则引发肝风内动,治疗应当以静制动来克服燥烈之性,这就是通过养血来实现的。治疗时需要避免过度发汗,也要避免过度攻下。过度发汗会耗伤卫气,过度攻下会损伤营血。治疗重点应在经络层面。虽然有关于发汗和攻下的禁忌,但病情仍有中腑和中脏的区别。中腑的病证,多表现在四肢,有表证且脉象浮、恶风寒,肢体拘急麻木不仁。中脏的病证,多阻滞于九窍,表现为口唇松弛、失音,耳聋鼻塞,视物模糊,大便秘结。对于中腑者,适宜采用发汗法;对于中脏者,适宜采用攻下法。待表里症状调和后,适宜在经络层面进行治疗,应当用大剂量的药物进行调养。
《发明》说:邪中血脉会导致口眼歪斜,邪中腑会导致肢体功能废用,邪中脏则会危及生命,这三种情况的治疗方法完全不同。邪中血脉,外部有六经的症状表现,则使用小续命汤加减治疗。邪中脏内部有大便和小便的阻隔,适宜使用三化汤等方剂通导。如果外部没有六经的症状表现,内部也没有二便的阻隔,适宜养血通气,以大秦艽汤或羌活愈风汤为主治方剂。
许学士(许叔微)说:世人所说的“气中”病,虽然在方书典籍中没有明确记载,但暴怒会损伤阴气,暴喜会损伤阳气,忧愁不止会导致气机逆乱,往往因此患上此病。患者突然感觉痰涎上涌、昏闷堵塞,牙关紧闭。如果此时误当作中风用药治疗,大多会导致死亡。只适宜灌服苏合香丸,患者便会苏醒。然后根据其寒热虚实的不同情况进行调理,没有不能治愈的。医经说:无缘无故出现失音,是因为肺气不能到达,若气机恢复则自愈,这是指气机突然逆乱所致,气机恢复后病症即止。如果确实如此,即使不服药也可以痊愈。
《玉机微义》说:中气病即是七情内火扰动所致,气机厥逆,是因为根本虚弱的原因。使用苏合香丸,可以通行经络,其药性猛烈决绝,如同摧枯拉朽一般,恐怕气血虚弱的人并不适宜使用。后面提到不治自复的意思,大概是警示用药失误,实际上胜过庸医误治造成的危害。
*Ji Bing Ji Yao* (Essentials of Pathogenesis) states: Wind pathogen is essentially heat; when heat is excessive, wind moves. Treatment should employ stillness to overcome dryness, which refers to nourishing the blood. Treatment requires avoiding excessive sweating and also avoiding excessive purgation. Excessive sweating will deficiency the Wei Qi (Defensive Qi), while excessive purgation will damage Ying Blood (Nutritive Blood). Treatment should focus on the meridians. Although there are contraindications for sweating and purgation, there is a distinction between involvement of the Fu organs (Hollow Organs) and the Zang organs (Solid Organs). Involvement of the Fu organs often affects the four limbs, presenting with exterior syndrome symptoms such as floating pulse, aversion to wind and cold, stiffness, and numbness. Involvement of the Zang organs often stagnates in the nine orifices, presenting with flaccid lips, loss of voice, deafness, nasal congestion, blurred vision, and constipation. For involvement of the Fu organs, diaphoresis (sweating method) is appropriate. For involvement of the Zang organs, purgation is appropriate. Once the interior and exterior are harmonized, treatment should focus on the meridians, using substantial medicinal tonics for nourishment.
*Fa Ming* (Elucidations) states: Invasion of the vessels and collaterals leads to deviation of the mouth and eyes; invasion of the Fu organs leads to disability of the joints and limbs; invasion of the Zang organs endangers life. The treatments for these three conditions are entirely different. For invasion of the vessels and collaterals, if there are exterior manifestations of the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin), modify Xiao Xuming Tang (Minor Cinnamon Twig Decoction). For invasion of the Zang organs, if there is obstruction of stool and urine internally, use Sanhua Tang (Three Transformations Decoction) or similar formulas to unblock. If there are no exterior manifestations of the Six Channels and no internal obstruction of stool and urine, nourish blood and promote Qi circulation, primarily using Da Qinjiao Tang (Greater Gentian Root Decoction) or Qianghuo Yufeng Tang (Notopterygium Decoction for Preventing Wind).
Xu Xuwei (Scholar Xu) states: What the world calls "Qi Zhong" (Stroke caused by Qi disorder), although not explicitly recorded in medical formularies, arises from sudden anger damaging Yin, sudden joy damaging Yang, and persistent worry causing Qi rebellion. One often contracts this disease. The patient suddenly feels saliva surging, dizziness, and blockage, with tight jaw. If treated immediately with stroke medications, it often leads to death. It is only appropriate to administer Suhexiang Wan (Styrax Pill), after which the patient will awaken. Then, regulate according to cold, heat, deficiency, and excess, and all cases can be cured. The Classics state: Sudden aphonia without cause occurs because Lung Qi does not reach its destination; if untreated, it heals itself, referring to sudden Qi rebellion. When Qi returns to normal, the condition resolves. If this is indeed the case, medication may even be unnecessary.
*Yu Ji Wei Yi* (Subtle Meanings of the Jade Machine) states: Qi Zhong is caused by the movement of internal fire due to the Seven Emotions. Qi rebellion occurs due to underlying deficiency. Using Suhexiang Wan (Styrax Pill) can unblock the meridians and collaterals; its fierce and decisive nature is like destroying dry wood and pulling apart rotten timber, which is likely unsuitable for those with deficient Qi and Blood. The later statement about self-recovery without treatment serves as a warning against medication errors, actually surpassing the harm caused by incompetent physicians' mistakes.