中风口噤不得开,灸机关(《翼》名颊车)二穴。穴在耳下八分小近前,灸五壮,即得
语,又灸,随年壮。僻者逐僻,左右灸之。中风失喑不能言语,缓纵不随,先灸天窗五十壮,
息火仍移灸百会五十壮,毕还灸天窗五十壮者。始发先灸百会,则风气不得泄。内攻五脏,
喜闭伏仍失音也。所以先灸天窗,次百会佳。一灸五十壮悉泄火势,复灸之,视病轻重,重
者一处三百壮大效。凡中风服药益剧者,但是风穴悉皆灸之三壮,无不愈也。
论曰∶风寒之气客于中,滞而不能发,故喑不能言及喉痹失音,皆风邪所为也,入脏皆
能杀人。故附之于治风之末。凡尸厥而死脉动如故,此阳脉下坠,阴脉上争,气闭故也。针
百会入三分,补之,炙熨斗熨两胁下,又灶突墨弹丸大,浆水和服之。又针足中趾头去甲如
韭叶,又刺足大趾甲下内侧去甲三分。
治猝失音方。
浓煮桂汁服一升,覆取汗。亦可末桂着舌下,渐渐咽汁。
又方 浓煮大豆汁,含亦佳,无豆用豉。
治猝不得语方∶
酒五合,和人乳汁中半分,分为二服。
论曰∶夫眼 动口唇偏 ,皆风入脉,急与小续命汤、附子散、摩神明膏(见前七卷脚
气门)、丹参膏(见二十四卷痈疽门),根据穴灸之,喉痹舌缓亦然。风入脏,使人喑哑卒死,
口眼相引,牙车急,舌不转 僻者,伏龙肝散和鸡冠血及鳖血涂,干复涂之,并灸吻边横文
赤白际,逐左右,随年壮报之至三报,三日不瘥,更报之。
中风导致口噤(牙关紧闭)无法张开,可艾灸机关穴(《千金翼方》中称为颊车穴)两个穴位。该穴位位于耳下八分处,略微靠前,灸五壮即可恢复言语功能;也可继续施灸,壮数根据患者年龄而定。若出现口眼歪斜,则应针对患侧进行施灸,左右两侧依病情施治。
中风导致失音、不能言语,且肢体弛缓无力、运动不遂者,应先艾灸天窗穴五十壮,待火势熄灭后,再移至百会穴灸五十壮,完成后再次回到天窗穴灸五十壮。若在发病初期先灸百会穴,则风气无法外泄,反而内攻五脏,容易导致气机闭塞伏匿而失音。因此,先灸天窗穴,再灸百会穴较为适宜。一次灸五十壮可完全泄去火势,若需再次施灸,应根据病情的轻重决定,重症者在某一处累计灸三百壮效果显著。凡是中风服药后病情反而加重的,只要是风穴,全部各灸三壮,没有不痊愈的。
论述说:风寒之气侵袭人体中部,停滞而不能发散,所以导致失音不能说话及喉痹失音,这都是风邪所致,侵入脏腑都能致人死亡。因此将其附在治疗风病的篇章末尾。凡是尸厥而死但脉搏跳动如常者,这是阳脉下坠,阴脉上争,气机闭塞所致。针刺百会穴进针三分,用补法;用熨斗在两胁下熨烫;又取灶突上的烟墨如弹丸大小,用水调和服用。又针刺足中趾尖端,距离指甲如韭菜叶宽处;又刺足大趾甲下内侧,距离指甲三分处。
治疗突然失音的方剂:
浓煮桂枝汁,服用一升,覆盖衣被取汗。也可以将桂枝研末放在舌下,慢慢咽下汁液。
另一个方子:浓煮大豆汁,含在口中也很好,若无大豆可用豆豉代替。
治疗突然不能说话的方剂:
酒五合,加入人乳汁半合,分为两次服用。
论述说:凡见眼球转动异常、口唇歪斜,都是风邪入脉所致,应立即给予小续命汤、附子散、摩神明膏(见前七卷脚气门)、丹参膏(见二十四卷痈疽门),并根据穴位进行施灸,喉痹舌缓的情况也是如此。风邪入脏,使人失音猝然死亡,口眼相互牵引,牙关紧急,舌头转动不灵、歪斜者,用伏龙肝散混合鸡冠血及鳖血涂抹,干了再涂,并灸嘴唇边缘横纹红白交界处,左右两侧依病情施治,壮数随年龄而定,报之至三次,三天若不痊愈,再重复施灸。
For stroke manifesting as trismus (lockjaw) with inability to open the mouth, moxa two points of Jiguan (known as Jiache in *Qianjin Yifang*). The point is located 8 fen below the ear, slightly anterior. Moxa five Zhuang, and speech will be restored; alternatively, continue moxibustion according to the patient's age. For facial deviation, treat the affected side, moxa on both left and right as indicated. For stroke causing aphonia (loss of voice) and inability to speak, accompanied by flaccidity and loss of motor control, first moxa Tianchuang for fifty Zhuang. After the fire subsides, move to Baihui for fifty Zhuang, then return to Tianchuang for another fifty Zhuang. If Baihui is moxaed at the onset, the pathogenic wind cannot dissipate but instead attacks the internal Zang organs, leading to closure and stagnation resulting in aphonia. Therefore, it is better to moxa Tianchuang first, followed by Baihui. One session of fifty Zhuang fully dissipates the heat/fire; if repeated, adjust based on severity. For severe cases, three hundred Zhuang at one location yields excellent results. For all stroke patients whose condition worsens after taking medicine, moxa all Wind points for three Zhuang each; there are no failures in cure.
Discussion: When Wind-Cold Qi invades the middle, stagnates, and fails to disperse, it causes aphonia, inability to speak, and throat Bi (obstruction) with loss of voice, all caused by Wind pathogen. Invasion into the Zang organs can be fatal. Hence, this is appended to the end of the chapter on treating Wind. In cases of corpse-like syncope where the pulse remains active, this is due to the descent of Yang pulses and contention of Yin pulses, resulting in Qi closure. Puncture Baihui to a depth of 3 fen, apply tonification method; moxa/iron the bilateral hypochondrium with a hot iron; also take soot from the stove chimney, size of a bullet, mix with water, and administer. Also puncture the tip of the middle toe of the foot, distance from the nail like a leek leaf; also pierce the medial aspect under the nail of the great toe, 3 fen from the nail.
Prescription for sudden aphonia:
Boil Cinnamon Twig juice concentrated, drink one Sheng, cover to induce sweating. Alternatively, powder Cinnamon Twig and place under the tongue, slowly swallowing the juice.
Another prescription: Boil Soybean juice concentrated, hold in the mouth; this is also good. If beans are unavailable, use Fermented Soybean (*Douchi*).
Prescription for sudden inability to speak:
Wine 5 He, mixed with human milk 0.5 He, divide into two doses.
Discussion: Abnormal eye movements and deviation of the lips/mouth indicate Wind entering the vessels. Immediately administer Xiao Xuming Tang (Minor Continuation Life Decoction), Fuzi San (Aconite Powder), Mo Shenming Gao (see Vol. 7, Foot Gate section), Danshen Gao (see Vol. 24, Carbuncle and Ulcer section). Moxa according to the acupoints. Throat Bi with tongue flaccidity is treated similarly. Wind entering the Zang organs causes aphonia and sudden death, with pulling of the mouth and eyes, tightness of the jaw, immobility and deviation of the tongue. Apply Fuslonggan San (Dragon Kiln Earth Powder) mixed with rooster comb blood and softshell turtle blood to the affected area; reapply when dry. Also moxa the junction of red and white skin along the horizontal lines at the corners of the mouth, treating left or right as needed, with Zhuang count based on age, repeating up to three times. If not cured in three days, repeat treatment.