中风暴仆瘫痪等证，古昔所论，皆为外中风寒有余之证，而用大小续命八方等汤，辛热
疏散
之药。及刘河间出，以为中风瘫痪者，非肝之风实，亦非外中之风邪，良由将息失宜，心火
暴甚，肾水虚衰，不能制之，则阴虚阳实，热气怫郁，心神昏冒，筋骨不用，而卒倒无知。
亦由喜怒忧恐惊，五志过极，皆为热甚。俗云风者，言末而忘其本也。至东垣则又云∶中风
非风，乃本气病也。凡人年逾四旬，气衰之际，或因忧喜忿怒伤其气者，多有此证，壮岁之
时无有也。若肥盛者间有之，亦是形盛气衰所致。然亦有贼风袭虚而中风者，有三焉∶中府
者
，病在表，多着四肢，故肢节废；中脏者，病在里，多滞九窍，故性命危；中血脉者，病在
半表半里，故口眼 斜。丹溪则论之曰∶诸书则谓外中风邪，惟刘河间作将息失宜，水火不
济，极是。若真中风邪，则东垣中腑中脏中经之说甚好，然地有不同，西北气寒，真为风所
中者有之。东南气温，皆是湿生痰，痰生热，热生风耳。有血虚，有气虚。血虚者，左手足
不仁；气虚者，右手足不仁。此三子之论，异于古说者也。至王安道出，推河间；东垣非风
之说，丹溪湿痰之言，遂以古论为真风。三子论为类风，愚窃有疑焉。夫河间既曰中风非风
，又曰风者言末而忘其本也，就风末言则有风存之意，及用防风通圣，药品虽泻火而实以治
风。东垣既曰中风，何又辨有三中之异？及致详于治风之法，丹溪既云湿生痰热，而何以又
曰生风，予因知皆未尝外于风，今别之为类风者，又何足以尽三子之旨乎？予考六经中善行
数变者，莫如风也。挟寒而为风寒，挟暑而为风暑，燥为风燥，湿为风湿，兼热则成火兼郁
则类气。古昔类风止作风寒，而不及招风取中之因，冷热虚实之变，有非辛热之可通治。故
诸
子之论，各明其因也。所谓非风者，是矫饰之辞耳，何则。凡外邪之中人，皆由气体先虚。
经曰∶邪之所凑，其气必虚。且古之通称风从汗散，而不审虚极者，难施辛散之药，恐泄其
真气，愈虚其虚，是以东垣发气本之论。俾学人知风因虚而中，当分虚实以治。又风虽为凉
气，若因火热自甚，肝风燥动，腠理疏豁，风乘热中，从火为邪，岂可例用辛温，是以出火
热之论。深知世俗止知风末，而不知有火邪之本也。又东南二地，素鲜烈风寒，虽风不易中
，间有中者，悉皆火热内盛，因虚而致。非若北地常有大风甚寒，人体略虚，衣或单薄，纯
被风寒逼中也。是以丹溪深韪河间之说，以西北真为风所中者有之。东南之人，多由痰热生
风也。风本无意中人，人自取于风也。故风本一邪，有内外出入寒热虚实之异，诸子各 精
论，何尝外于真风，而别为类风哉。但当以古论为风寒邪实外至之证，是天致病于人也。三
子论为痰热气虚内致之因，是人取病于天也。本乎外者，内轻而外重，取法于古；因于内者
，内重而外轻，始从三子定中风论。
中风突然仆倒、半身不遂等病症，古代医家的论述，都认为这是外感风寒邪气有余的实证，因此使用大小续命汤等八方，采用辛热疏散的药物进行治疗。到了刘河间（刘完素）出现后，他认为中风口眼歪斜、半身不遂，并非肝脏的风实证，也不是外来的风邪侵袭，确实是因为调养失当，导致心火突然亢盛，肾水虚弱衰少，不能制约心火，从而造成阴虚阳实，热气郁结，心神昏乱蒙蔽，筋骨失去功能，于是突然跌倒且不知人事。这也是由于喜、怒、忧、恐、惊这五种情志过度极端，都会导致火热极盛。世俗所说的“风”，只是谈论了表象而忘记了根本。到了李东垣（李杲），他又说：中风并非风邪所致，而是人体本气发生的病变。凡是人年过四十，处于元气衰退之际，或者因为忧愁、喜悦、愤怒损伤了正气的人，大多会有这种病症，而在壮年时期是没有的。如果是身体肥胖的人偶尔也有，也是形体盛实但正气衰弱所导致的。然而也有因贼风侵袭虚弱部位而中风的，分为三种：中于腑的，病位在表，多侵犯四肢，所以肢体关节废用；中于脏的，病位在里，多阻滞九窍，所以危及生命；中于血脉的，病位在半表半里，所以口眼歪斜。朱丹溪则论述道：各种书籍都说外感中风邪，只有刘河间认为是调养失当，水火不济，非常正确。如果是真正的中风邪，那么李东垣关于中腑、中脏、中经的说法很好。然而地域不同，西北气候寒冷，确实有被风邪直中的情况。东南气候温暖，都是湿气生痰，痰生热，热生风罢了。有的属于血虚，有的属于气虚。血虚的，左手足麻木不仁；气虚的，右手足麻木不仁。这三位的论述，与古代说法不同。到了王安道出现，推崇刘河间和李东垣非风的说法，以及朱丹溪湿痰的理论，于是将古代论述定为真中风，将三位的论述定为类中风，我私下对此有疑问。刘河间既然说中风不是风，又说所谓风是言末忘本，就风之末节而言似乎还有存留风的意思，等到使用防风通圣散时，药品虽然泻火，但实际上是以治风为主。李东垣既然说中风，为什么又要辨析三种中风的差异？等到详细阐述治风的方法时，朱丹溪既然说湿生痰热，为什么又说是生风？我因此知道他们都没有脱离风的概念，现在将其别称为类风，又怎么足以穷尽三位先贤的宗旨呢？我考察六经中善于运行变化多端的，没有比得上风的了。挟带寒邪成为风寒，挟带暑邪成为风暑，燥邪结合成为风燥，湿邪结合成为风湿，兼夹热邪则成火，兼夹郁滞则类似气滞。古代所谓的类风只当作风寒，而没有涉及招致风邪入侵的原因，以及冷热虚实的变化，有不是辛热药物可以通用治疗的。所以各位先贤的论述，各自阐明了病因。所谓“非风”，是一种矫饰的辞藻罢了，为什么呢？凡是外邪侵入人体，都是因为人体正气先虚。《内经》说：邪气聚集的地方，正气必定虚弱。而且古代通用的说法是风邪从汗液发散，如果不审察正气极度虚弱的情况，难以施用辛散药物，恐怕会泄露真气，使虚者更虚，因此李东垣提出了基于本气的理论。使学习者知道风因虚而中，应当分辨虚实来治疗。另外，风虽然是凉气，但如果因火热自身亢盛，肝风燥动，腠理疏松敞开，风乘热势侵入，从火化为邪气，难道可以一律使用辛温药物吗？因此提出了火热论。深知世俗只知道风之末节，而不知道火邪为本。另外东南两地，素来缺少猛烈风寒，虽然风不易中入，偶尔有中风的，全都是火热内盛，因虚而致。不像北方常有狂风严寒，人体稍微虚弱，衣服单薄，纯粹被风寒逼迫中伤。因此朱丹溪深深赞同刘河间的说法，认为西北地区确实有被风邪直中的情况。东南地区的人，多由痰热生风。风本来无意中人，是人自己招致风邪的。所以风本是一个邪气，有内外出入、寒热虚实的区别，各位先贤各自精辟论述，何曾脱离真风，而另立类风之说呢？只应当将古代论述作为风寒邪气实盛外至的病症，这是天致病于人。三位先贤的论述作为痰热气虚内生的原因，是人取病于天。源于外部的，内部轻而外部重，效法古代；源于内部的，内部重而外部轻，才开始依据三位先贤确立中风理论。
Symptoms such as sudden collapse and paralysis in stroke were discussed in ancient times as excess syndromes caused by external invasion of Wind-Cold (Wind-Cold), and treatments used decoctions like Da Xuming Tang (Great Continuation Life Decoction) and Xiao Xuming Tang (Small Continuation Life Decoction), employing acrid-hot dispersing herbs. When Liu Hejian (Liu Wansu) emerged, he argued that stroke with paralysis was not due to Liver Wind excess, nor external Wind pathogen invasion, but rather resulted from improper lifestyle management leading to sudden暴甚 (sudden hyperactivity) of Heart Fire, and deficiency decline of Kidney Water, failing to control the Fire. This results in Yin deficiency and Yang excess, with stagnant heat causing oppression, clouding the Shen (Spirit) and rendering sinews and bones useless, leading to sudden collapse and unconsciousness. It is also due to the five emotions—Joy, Anger, Worry, Fear, and Shock—being excessive, all generating intense heat. The common term "Wind" refers only to the superficial manifestation while forgetting the root. Later, Dongyuan (Li Gao) stated: Stroke is not Wind, but a disease of the Ben Qi (Root Qi). Anyone past forty, when Qi declines, or whose Qi is damaged by sorrow, joy, or anger, often suffers this condition; it is absent in youth. Even in obese individuals, it is caused by abundant form but deficient Qi. However, there are cases where Zephyr Wind (Zephyr Wind) invades deficiency, categorized into three types: Invasion of Fu Organs affects the exterior, mostly involving the four limbs, causing limb dysfunction; Invasion of Zang Organs affects the interior, mostly obstructing the nine orifices, endangering life; Invasion of Channels and Collaterals affects the half-exterior half-interior, causing deviation of the mouth and eyes. Danxi (Zhu Zhenheng) commented: Most texts attribute stroke to external Wind pathogen, which Liu Hejian correctly identified as improper management leading to disharmony between Water and Fire. If it were true Wind pathogen, Dongyuan’s theory of Fu/Zang/Channel invasion is excellent. However, geography differs: Northwest is cold, so true Wind invasion occurs. Southeast is warm, where dampness generates Phlegm, Phlegm generates Heat, and Heat generates Wind. There is Blood deficiency and Qi deficiency. Blood deficiency causes numbness in the left limbs; Qi deficiency causes numbness in the right limbs. These three scholars’ theories differ from ancient ones. Wang Andao later promoted Liu Hejian and Dongyuan’s “Non-Wind” theory and Danxi’s “Damp-Phlegm” theory, classifying ancient views as True Wind and the three scholars’ views as Similar Wind. I have doubts. Liu Hejian said stroke is not Wind, yet mentioned Wind’s superficial aspects, and used Fangfeng Tongsheng San (Saposhnikovia Unblocking the Intestines Powder), which clears Fire but treats Wind. Dongyuan spoke of Stroke but distinguished three types of invasion. Danxi said Dampness generates Phlegm-Heat, yet also mentioned generating Wind. Thus, they did not depart from Wind. Why classify them as Similar Wind? I observe that among the Six Channels, Wind is most agile and changeable. Combined with Cold, it becomes Wind-Cold; with Summerheat, Wind-Summerheat; with Dryness, Wind-Dryness; with Dampness, Wind-Dampness; combined with Heat, it becomes Fire; combined with Stagnation, it resembles Qi stagnation. Ancient Similar Wind was treated only as Wind-Cold, ignoring causes and variations of Cold/Heat/Deficiency/Excess, which cannot be universally treated with acrid-hot herbs. Each scholar clarified specific etiologies. “Non-Wind” is merely rhetorical. Why? External pathogens invade only when Zheng Qi (Upright Qi) is deficient. The Classic states: Where pathogen gathers, Qi must be deficient. Anciently, Wind was dispersed via sweating, but if Qi is extremely deficient, acrid-dispersing herbs are contraindicated to avoid leaking Zhen Qi (True Qi) and worsening deficiency. Hence Dongyuan proposed the Root Qi theory, teaching that Wind invades due to deficiency, requiring differentiation of Deficiency/Excess. Although Wind is cool, if internal Fire is strong, Liver Wind dries and moves, pores open, and Wind enters with Heat, becoming a Fire pathogen; thus, acrid-warm herbs are inappropriate, leading to the Fire Theory. This highlights that people know Wind’s surface but ignore Fire’s root. In the Southeast, fierce Wind-Cold is rare; even if Wind invades, it is due to internal Heat excess and deficiency, unlike the North where strong Wind-Cold penetrates thin clothing and weak bodies. Thus, Danxi agreed with Liu Hejian: Northwest has true Wind invasion; Southeast has Wind generated from Phlegm-Heat. Wind does not intend to harm humans; humans invite it. Wind is one pathogen, differing in internal/external, Cold/Heat, Deficiency/Excess. Scholars discussed these nuances without departing from True Wind, hence no need for “Similar Wind.” We should regard ancient texts as describing external Wind-Cold Excess (Heaven causing disease in Man), and the three scholars as describing internal Phlegm-Heat-Qi Deficiency (Man inviting disease from Heaven). Exterior-originating cases are externally heavy, internally light, following ancient methods. Interior-originating cases are internally heavy, externally light, adopting the three scholars’ framework for Stroke theory.