风之为病，最易误治。误治者，在不明其表里耳。盖外风者，八方之所中；内风者，五
脏之
本病也。八方自外而入，先有发热恶寒，头痛身痛之证，此因于外者，显然有可察也。五风
由内而病，则绝无外证，而忽病如风，其由内伤可知也，然既非外感，而经曰∶诸暴强直，
皆属于风。诸风掉眩，皆属于肝。何也？盖肝为东方之脏，其藏血，其主风，血病则无以养
筋，筋病则掉眩强直之类，诸变百出，此皆肝木之化，故云皆属于风。谓之属者，以五气各
有所主，如诸湿肿满，皆属于脾之类，其义同也。盖有所中者，谓之中外感也。无所中者，
谓
之类中内伤也。故王安道有类中真中之辨，后世不明此义，不惟以类风者认为真风，而且以
内夺暴厥等证，俱认为风，误亦甚矣！夫外盛者，邪袭肌表，故多阳实。内伤者，由于酒色
劳役七情口腹，致伤脏气，故多阴虚。凡脏气受伤，脾虚者，病在四肢，或多痰饮；肾病者
，或如在髓，或在二阴；心病者，或在血脉，或在神志；肺病者，或在营卫，或在声音；肝
病者，或在筋瓜，或在胁肋。故东垣曰∶有中风卒然昏愦不省人事者，此非外来之邪，乃本
气自病也。夫人生于阳而根于阴，凡阳虚则气衰耗，故病在元神，神志为之昏乱；阴亏则则
形体坏，病在精血，故肢体为之废弛。俗以神离形坏之证，不求根本之虚，而以风治，鲜
不危矣？然外感者，非云绝无虚证，气虚则虚也；内伤者，非曰必无实证，有滞则实也。治
虚者，当察其在阴在阳，而直补之；治实者，当察其因痰因气，而暂开之。此于内伤外感虚
实攻补之间，最当审其有无微甚，而配其治也。甚至有元气素弱，猝然仆倒，上无痰，下失
禁， 目昏沉，此厥竭之证，尤与风邪无涉。使非大剂参附，或七年之艾，破格挽回，又安
望其复真气于将绝之顷哉？倘不察表邪，不辨虚实，但以之为名，多用风药，不知风药
皆燥，燥复伤真阴，风药皆散，散复伤元气，以内伤为外感，以不足作有余，此促人之死也
。可不慎哉！
风邪致病，最容易误治。误治的原因，在于不清楚病证是表证还是里证罢了。外风，是由八方（外界环境）侵袭人体所致；内风，则是五脏内部病变产生的根本疾病。外风从外部侵入，起初会有发热、恶寒、头痛、身体疼痛等症状，这种由外因引起的，明显是可以观察到的。内风由内部产生病变，则完全没有外在的表证表现，而是突然发病如同中风一般，由此可知这是由内伤引起的。然而既然不是外感病，为什么《黄帝内经》中说：“所有突然发生的肢体强直僵硬，都归属于风”？“各种风气引起的震颤眩晕，都归属于肝”呢？这是因为肝是位于东方的脏器，它贮藏血液，主管风木之气，如果血液有病就无法滋养筋脉，筋脉有病就会出现震颤、眩晕、强直僵硬等种种变化，这些都是肝木之气异常变化的结果，所以说都归属于风。之所以说“属于”，是因为五行中的五气各自有所主司，例如“各种湿邪引起的肿胀腹满，都归属于脾”，其中的道理是相同的。所谓“中”，是指中外感（外感风邪）。所谓“不中”，是指类中（类似中风但属内伤）和内伤。所以王安道提出了类中与真中（真正的外感中风）的辨别，后世的人不明白这个道理，不仅把类风证当作真风证来治疗，而且把元气内夺导致的暴厥等证候，也都当作风邪致病，错误非常严重了！外感盛实的，是邪气侵袭肌表，所以多表现为阳实证。内伤的，是由于饮酒、房劳、过度劳累、七情失调、饮食不节等原因，导致损伤脏腑之气，所以多表现为阴虚证。凡是脏腑之气受伤，脾虚的，病症在四肢，或者伴有痰饮；肾病的，病位或在骨髓，或在前后二阴；心病的，或在血脉，或在神志；肺病的，或在营卫，或在声音；肝病的，或在筋脉，或在胁肋。所以李东垣说：“有中风突然昏倒、不省人事的，这不是外来邪气，而是本脏元气自病。”人生于阳气而根于阴精，凡是阳气虚弱则气机衰耗，所以病在元神，神志因此昏乱；阴精亏损则形体败坏，病在精血，所以肢体因此废弛无力。世俗之人面对神志离形、形体败坏的证候，不去探求根本的虚损，反而用治风的方法治疗，很少有不陷入危境的。然而外感病，并非绝对没有虚证，气虚就是虚证；内伤病，也并非绝对没有实证，有阻滞就是实证。治疗虚证，应当察明是在阴分还是在阳分，而直接予以补益；治疗实证，应当察明是因痰还是因气滞，而暂时予以开泄疏通。这在处理内伤与外感、虚证与实证、攻法与补法之间，最应当审慎判断其有无及轻重程度，从而配合相应的治疗方法。甚至有元气素来虚弱，突然仆倒在地，上部无痰涎，下部失禁，眼睛昏沉，这是厥脱竭绝的证候，尤其与风邪无关。如果不是使用大剂量的参附汤，或者灸取七年之陈艾，破格全力挽回，又怎么指望在真气即将断绝之时恢复元气呢？如果不察辨表邪，不分辨虚实，仅仅因为病名中有“风”字，就多用祛风药，不知道祛风药大多燥烈，燥烈会再次损伤真阴，祛风药大多发散，发散会再次损伤元气，把内伤当作外感，把不足当作有余，这是加速人的死亡啊。能不谨慎吗！
Diseases caused by Wind are most prone to misdiagnosis and mistreatment. The cause of such errors lies in the failure to distinguish between exterior (Biao) and interior (Li) patterns. External Wind is contracted from the eight directions (external environment); Internal Wind is a fundamental disease arising from the dysfunction of the five Zang organs. External Wind enters from the outside, initially presenting with symptoms such as fever, aversion to cold, headache, and body ache; this type, caused by external factors, is clearly observable. Internal Wind arises from internal pathology, presenting without any exterior signs, but rather with sudden onset resembling wind-stroke; thus, it can be known that this originates from internal injury. However, since it is not an external contraction, why does the *Huangdi Neijing* (Yellow Emperor's Inner Canon) state: "All sudden stiffness and rigidity belong to Wind"? And "All wind-induced tremors and vertigo belong to the Liver"? This is because the Liver is the organ associated with the East, it stores Blood, and governs Wind Wood Qi. When Blood is diseased, it fails to nourish the sinews (tendons); when sinews are diseased, various manifestations such as tremors, vertigo, stiffness, and rigidity emerge. These are all transformations of Liver Wood Qi, hence they are said to "belong to Wind." The term "belong to" implies that each of the Five Qi has its specific domain, similar to how "all dampness-induced swelling and fullness belong to the Spleen"; the principle is the same. "Zhong" (Struck/Midst) refers to external contraction (Exogenous Wind). "Bu Zhong" (Not Struck) refers to Lei Zhong (Stroke-like syndrome due to internal injury) and internal damage. Therefore, Wang Andao distinguished between Lei Zhong (stroke-like) and Zhen Zhong (true wind-stroke). Later generations failed to understand this principle, not only treating Lei Feng (wind-like) syndromes as true Wind, but also attributing conditions like sudden syncope due to depletion of vital energy to Wind pathogenic factors, which is a grave error! When external pathogens are prevalent, evil qi invades the muscle and surface, resulting mostly in Yang Excess patterns. Internal injuries result from alcohol consumption, sexual excess, overwork, emotional disturbances, or dietary indiscretion, damaging Zang Qi, resulting mostly in Yin Deficiency patterns. When Zang Qi is damaged: Spleen deficiency manifests in the four limbs or with phlegm-fluid retention; Kidney disease may manifest in the marrow or the two yin openings; Heart disease may manifest in the blood vessels or spirit/mind; Lung disease may manifest in Ying-Wei (Nutritive-Defensive) levels or voice; Liver disease may manifest in the sinews or hypochondrium. Thus, Li Dongyuan stated: "In cases of sudden stroke with coma and loss of consciousness, this is not an external pathogen, but a disease of the original Qi itself." Humans are born from Yang and rooted in Yin. When Yang is deficient, Qi declines and dissipates, causing disease in the Yuan Shen (Original Spirit), leading to mental confusion; when Yin is depleted, the physical form deteriorates, causing disease in Jing-Xue (Essence-Blood), leading to flaccidity and paralysis of the limbs. Laypeople, facing conditions where the spirit departs from the form and the body decays, fail to seek the root deficiency and instead treat with wind-dispelling methods, rarely avoiding critical danger. However, external contractions do not absolutely exclude deficiency patterns; Qi deficiency constitutes a deficiency pattern. Internal injuries do not absolutely exclude excess patterns; stagnation constitutes an excess pattern. To treat deficiency, one must ascertain whether the deficiency is in Yin or Yang and tonify directly. To treat excess, one must ascertain whether it is due to Phlegm or Qi stagnation and temporarily open/unblock it. In managing the interplay of internal vs. external, deficiency vs. excess, and purgative vs. tonifying treatments, it is crucial to carefully assess the presence and severity of these factors to match the treatment accordingly. There are even cases where the Original Qi is inherently weak, leading to sudden collapse, with no phlegm above, incontinence below, and blurred vision. This is a syndrome of Jue-Jie (collapse and exhaustion), which has little to do with Wind pathogenic factors. Unless large doses of Shenfu Tang (Ginseng and Aconite Decoction) or moxibustion with seven-year-old mugwort (Qi Nian Zhi Ai) are used to break protocol rules and rescue the patient, how can one hope to restore True Qi at the moment it is about to perish? If one fails to examine for exterior pathogens and differentiate between deficiency and excess, yet merely uses wind-dispelling herbs because the disease name contains "Wind," one ignores the fact that wind-dispelling herbs are mostly drying, and drying further injures True Yin; wind-dispelling herbs are mostly dispersing, and dispersing further injures Original Qi. Treating internal injury as external contraction, and insufficiency as sufficiency, is hastening death. Can one not be cautious?