中脏者死。中腑者。饮食便溺艰涩。中经络者。重则成废人。轻可调理而瘳。治之之法。先以解
散风邪为急。次则补养气血。此真中外来风邪之候也。若大江以南。天地之风气既殊。人之所禀
亦异。其地绝无刚猛之风。而多湿热之气。质多柔脆。往往多热多痰。真阴既亏。内热弥甚。煎
熬津液。凝结为痰。壅塞气道。不得通利。热甚生风。亦致卒然僵仆。类中风证。或不省人事。
或语言謇涩。或口眼 斜。或半身不遂。其将发也。外必先显内热之候。或口干舌苦。或大便闭
涩。小便短赤。此其验也。河间所谓此证全是将息失宜。水不制火。丹溪所谓湿热相火中痰中气
是也。此即内虚暗风。确系阴阳两虚。而阴虚者为多。与外来风邪迥别。法当清热顺气开痰以治
标。次当补养气血以治本。设若误用真中风风燥之剂。则轻者变重。重则必死。故凡内燥生风。
及痰中之证。治痰先清火。清火先养阴。最忌燥剂。
张介宾曰。风之为病最多。误治者。在不明其表里耳。盖外风者。八方之所中也。内风者。五
脏之本病也。八风自外而入。必先有发热恶寒。头疼身热等证。显然可察也。五风由内而病。则
绝无外证。而忽病如风。其由内伤可知也。虽既非外感。而经曰诸暴强直。皆属于风。诸风掉眩。
皆属于肝。何也。盖肝主风而藏血。血病则无以养筋。筋病掉眩强直。
诸变百出。此皆肝木之化。故云皆属于风。后世不明此义。不惟类风认为真中。而且以内夺暴厥
等证俱认为风。误亦甚矣。夫外感者。邪袭肌表。故多阳实。内伤者。由于七情。故多阴虚。凡
脏气受伤。脾病者。病在肢体。或多痰饮。肾病者。或在骨髓。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。或在筋爪。或在血脉。此五脏之类风。未有
不由阴虚而然者。惟东垣独得其义。曰。有中风者。卒然昏愦。不省人事。此非外来风邪。乃本
气自病也。人年四十而阴气自半。起居衰矣。故多犯之。岂非阴虚之病乎。夫人生于阳。而根于
阴。根本衰。则人必病。根本败。则人必危。所谓根本者。真阴也。人知阴虚唯一。而不知阴虚
有二。如阴中之水虚。则病在精血。阴中之火虚。则病在神气。盖阳衰则气去。故神志为之昏乱。
非火虚乎。阴亏则形坏。故肢体为之废弛。非水虚乎。今以神离形坏之证。乃不求水火之源。而
犹以风治。鲜不危矣。试以天道言之。其象亦然。凡旱则多燥。燥则生风。是风木之化从乎燥。
燥则阴虚之候也。故凡治类风者。专宜培补真阴以救根本。则风燥自除矣。然外感者。非曰绝无
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。但察其因痰因气而暂开之。此于内伤外感。及虚实攻补之间。是当审其有无微甚而酌其
治也。甚至有元气素亏。卒然仆倒。上无痰。下失禁。瞑目昏沉。此厥竭之证。尤与风邪无涉。
设非大剂参、附。安望其复真气于将绝之顷哉。倘不能察其表里。又不能辨其虚实。但以风之为
名。多用风药。不知风药皆燥。燥复伤阴。风药皆散。散复招风。以内伤作外感。以不足为有余。
是促人之死也。景岳全书曰。凡类中风之多痰者。悉由中虚而然。夫痰即水也。其本在肾。其标
在脾。在肾者。以水不归源。水泛为痰也。在脾者。以食饮不化。土不制水也。故治痰而不知实
脾堤水。非其治也。余尝闻之俗传云。痰在周身。为病莫测。
凡瘫痪螈 。半身不遂等证。皆伏痰留滞而然。若此。痰饮岂非邪类。不去痰邪。病何由愈。余
曰。汝知痰之所自乎。凡经络之痰。盖即津血之所化也。使果营卫和调。则津自津。血自血。何
痰之有。唯是元阳亏损。神机耗败。则水中无气。而津凝血败。皆化为痰耳。此果痰也。果津血
也。岂以津血之外。而别有所谓痰者耶。若谓痰在经络。非攻不去。则必并津血而尽去之。庶乎
可也。否则安有独攻其痰。而津血自可无动乎。津血复伤。元气愈竭。随去随化。痰必愈甚。此
所以治痰者不能尽。而所尽者惟元气也。矧复有本无痰气。而妄指为痰。以误攻之者。又何其昧
之甚也。故凡治痰之药。在元气无伤而有壅滞者。乃可暂用分消。岂云无效。若病及元气。而但
知治标。则未有日用而不日败者矣。李士材曰。凡中风须辨血脉腑脏。中血脉则口眼 斜。中腑
则肢节废。中脏则性命危。三者之治各不同。中血脉。外有六经之形证。则从小续命加减。中腑。
内有便溺之阻隔。宜三化汤通利之。若表里证俱见。先与解表。而后攻里。若外邪已解。内邪已
除。而语言謇涩。半身不遂。未能即愈。以六君子加黄 、桂心、归、芍。久久服之。营卫自和。
即古所称大药也。因脾胃虚而四肢不举者。慎不可杂以风药。风热痰盛者。但加姜汁、竹沥。肥
人多湿痰。少加制附子行经。病在半表半里。外无六经之形证。内无便溺之阻隔。知为血弱不能
养筋。故手足不能运动。舌强不能语言。古法用大秦艽汤。然不若十全大补、大建中、人参养荣
选用。肾脏虚热生风。天麻丸。大抵治风之法。初得之盒饭顺气。及其久也。即当治血。若先不
顺气。遽用乌、附。又不活血。徒用羌、防、天麻辈。吾未见其能治也。然顺气之药则可。破气
降气之药则不可。若老人虚人。治须少汗。亦宜少下。多汗则虚其卫。多下则损其营。宜治在经。
当以大药养之。凡治风须分阴阳。阴中者。面色青。或白或黑。痰喘昏乱。眩晕多汗。甚者手足
厥冷。阳中者。面色赤。唇焦。牙关紧急。上视强直。
掉眩烦渴。阴中危者多见脱证。宜三生饮倍加人参及竹沥、姜汁灌之。阳中剧者多见闭证。若初
中痰涎壅盛。昏愦不省。语言謇涩。螈 不遂。一切痰气闭塞。牛黄清心丸。若暴中神昏不语。
痰塞心包。口角涎流。烦热气急。一切痰热闭遏。清心牛黄丸。寒热互结。痰气壅塞。局方至宝
丹。然中气之证。亦多卒倒昏迷。不省人事。不可误用牛黄丸。宜苏合香丸。姜汤调化灌之。抉
口不开。不可进药。以细辛、牙皂为末。吹鼻取嚏即苏。无嚏不治。痰涎壅盛者宜吐之。用稀涎
散三四钱。温水调灌。不大呕吐。但微微令涎自口角流出即苏。或橘红一味。大剂煎汤灌之。即
吐。凡中风。或未苏。或已苏。或初病。或久病。忽然吐紫红色者死。卒然中倒。轻者实时苏醒。
重者不省人事。慎不可以滴水入喉。入则其涎永系于心络不去。即成废人。俟稍苏醒。察其有表
证。小续命汤加减。痰涎壅盛而脉数有热。省风汤。痰逆呕泄而脉沉厥冷。大省风汤。不效。顽
痰愈盛。或转增困重。三生饮。肥人多有中病。以其气盛于外。而歉于内也。元气素弱。或遇劳
役嗜欲而卒然厥仆。状类中风。手必撒。口必开。非大剂参、 。岂能回元气于无何有之乡哉。
亦有不仆。而但舌强语涩痰壅。口眼 斜。肢体不遂者。作中风治必殆。六君子汤加天麻、姜汁、
竹沥治之。中后体虚有痰。亦用上法。中而口眼 斜。先烧牙皂烟熏之以逐外邪。次烧乳香熏之
以顺血脉。若前证多怒。此风动肝气。宜小续命加羚羊角。热渴。去附子加秦艽。恍惚错语。加
茯神、远志。不得睡。加熟枣仁。不能言。加竹沥。脉虚无力。去麻黄加茯苓。口眼 斜耳鼻
常静。故风息焉。口目常动。故风生焉。风淫则血液衰耗。无以荣筋。故筋脉拘急。口目为僻。
灵枢云。足阳明之筋病。颊筋有寒则急。引颊移口。有热则筋弛纵。缓不胜收。故僻。按左寒右
热。则左急而右缓。右寒左热。则右急而左缓。盖左中寒。则逼热于右。右中寒。则逼热于左。
阳气不得宣行故也。又金匮云。极寒伤经。极热伤络。则
知经受寒而急。则络必热而缓。即素问大筋软短。小筋弛长之谓也。凡口之 。灸地仓。目之斜。
灸承泣。苟不效。当灸人中。去气虚风入则为偏。上不得出。下不得泄。真气为风邪所陷。故宜
灸。经曰。陷下者灸之。至于用药。宜润燥。则风自息。古法用大秦艽汤。今改用十全大补。尤
妥。又曰。足之阳明手之太阳经急。则口目为僻。 急不能卒视。又口眼 斜。须分左右。盖邪
盛则急。正虚则缓。左急者。属血中有邪。舒筋三圣散加姜、枣。病久气虚者。去延胡索加人参。
名参归三圣散。易人参者以正虚不胜耗血之品。故借阳生阴长之力。流动经脉。勿疑左半属血。
不当用参以助其气。右急者。属气分受邪。八味顺气散去青皮加羌活。又法。桂枝三两。酒煎浓
液。以布渍之。左 搭右。右 搭左。若口眼 斜而一臂不仁者。千金附子散。
口噤不开 千金谓之风懿。经云。足阳明颔颊之脉急。则口噤不能开。肝风乘胃故也。皂
荚、乳香、黄 、防风煎汤熏之。然须大作汤液。如蒸如雾。乃得力耳。风邪乘虚。入其筋则挛。
故令口眼 斜。牙关急而口噤也。秦艽升麻汤。风寒客于会厌。卒然无音。虚则地黄饮子。痰则
涤痰汤。实则凉膈散加犀角、黄连。一法。南星、半夏为末。擦其牙龈。郁金、藜芦搐鼻。
痰涎壅盛 此证宜先吐之以稀涎散。后用星香、二陈、导痰、涤痰之类。盖治痰以顺气为
先也。挟虚者。必用参、 、竹沥。挟寒者。加桂、附、姜汁。上盛下虚。痰涎壅盛者。六君子
加星、香。送黑锡丹。
语言謇涩 经曰。足太阴之脉。连舌本。散舌下。是动则病舌本强。又心之别脉。系舌本。
又曰。足少阴之脉。其直者循喉咙。挟舌本。又曰。所谓入中为喑者。阳盛已衰。故为喑也。内
夺而厥。则为喑痱。此肾虚也。少阴不至者。厥也。千金
云。心脾二脏受风邪。舌强不得语者。独活汤。专治风懿不能言。四肢不收。手足 曳。肾虚而
肾络与胞络内绝。不通于上则喑。肾脉不上循喉咙挟舌本。则不能言。二络不通于下。则痱厥矣。
急宜地黄饮子。庶可挽回一二。如脾土不足。痰涎壅盛而謇涩者。是痰火壅塞上窍。气虚不能上
营。则舌机不转。宜六君子加星、香、菖、远、枳实、竹茹。若口眼 斜不能言。遇风寒则四肢
拘急。脉浮而紧。此手足阳明经虚风所乘。秦艽升麻汤。若口喑不能言。足痿不能行。属肾气虚
弱。名曰痱证也。地黄饮子。卒然晕倒。口眼 斜。口角流涎者。气虚挟痰也。六君子加秦艽、
天麻、姜汁、竹沥。血弱舌痿不能言。手足不能举。十全大补汤。风热上壅。痰盛不能言。凉膈
散加菖蒲、远志、辰砂。惊痰堵塞。舌本强硬。语言不正。正舌散加薄荷。舌麻语涩不能言。省风
汤加沉香。脾缓舌强不能言。半身不遂。解语汤。脉虚无力。加参、苓、白术。心血衰少。惊悸
不能言。得之于暴者。祛风定志汤。血衰心失滋养。语言不出。叩之不应。十全大补加菖蒲、远
志。痰迷心窍。昏愦口噤不能言。涤痰渴。有热。加芩、连、姜汁、竹沥。舌喑脉洪。口角流涎。
喜笑不休者。导痰加白术、芩、连、竹沥、姜汁。肥人舌根强硬。作湿痰治。瘦人舌根强硬。作
心火治。虽病久正虚。不可纯用补药。壅滞经络中之痰火。若饮食如常。但失音不语。俗呼哑风。
小续命去桂、附加菖蒲、直中心经。哑不能言。口开面赤者。必死勿治。
左瘫右痪 左半身不遂。或伤血。致目昏耳聩头眩乏力。四物加羌、防、肉桂、红花、桃仁、
生姜。病久气虚不应。宜参归三圣散。右半身不遂。四肢无力。痰涎壅盛。或一臂不遂。时复转
移一臂。千金附子散。下半体疼重软弱。甄权防风汤。并用针灸法。偏风。其脉沉细。是风与痰
饮在上焦。并宜导痰汤加羌活、白术。不应。宜六君子汤加当归。寒。加桂心。热。加竹沥。半
身不遂。口眼 斜。手足战掉。语言謇涩。明显风从外入。身热无汗恶寒。宜小续命加减。自汗。
不宜服。然又有病发左半。口往右 者。盖大筋短缩。筋属肝。肝病故左半身不遂。舌筋亦短而謇
于言。左畔之小筋弛长。故口从左而 于右。治宜从右引左。大理右半脾胃之气。以运出左半之热
痰虚风。当以四君子加羚羊角、柴胡、姜汁、竹沥。冬月稍加炮姜、熟附以从治。夏月须用知母、
石膏。此正治也。半身不遂而多汗神昏。痰涎上涌者。大剂参、 。补中益气、十全大补、人参养
营、大建中选用。半身不遂。骨节离解。口面 邪。便利无度。麻黄附子汤加桂心、干姜、芎 。
然又有身半以上俱无恙。身半以下软弱麻痹。小便或涩或遗。此足三阴虚证也。当用地黄饮子补
其下元。慎不可用澡湿攻痰药。若果痰盛。星香散、二陈汤。湿盛。薏苡仁汤。兼气虚者。六君
子汤。兼血虚者。大秦艽汤。皆为合剂。又酒湿为病作痹证。口眼 斜。半身不遂。浑似中风。
舌强不正。当泻利湿热。不可作风治而汗之也。
角弓反张 风气乘虚入于诸阳之经。则腰背反折。挛急如角弓之状。宜小续命加减。千金
中脏（内脏受邪）者预后不良，多致死。中腑（六腑受邪）者，表现为饮食、大小便排泄困难。中经络（经脉受邪）者，重则成为废人，轻症可通过调理治愈。治疗原则，首先急当疏散风邪，其次补养气血。这是真正由外来风邪侵袭的证候。
然而大江以南地区，天地风气不同，人的体质禀赋也各异。该地区绝无刚猛之风，而多湿热之气。当地人质体柔脆，往往多热多痰。真阴既已亏损，内热炽盛，煎熬津液，凝结为痰，壅塞气道，导致不通利。热极生风，也会导致突然僵仆倒地。这类中风证候，有的不省人事，有的语言謇涩，有的口眼歪斜，有的半身不遂。其发作前，外在必先显现内热的征象，如口干舌苦，或大便闭涩，小便短赤，这就是验证。正如刘河间所说，此证完全是因调养失宜，水不制火；朱丹溪所说湿热相火、中痰、中气也是这个意思。这即是内虚暗风，确属阴阳两虚，而以阴虚为主，与外来风邪截然不同。治法应当清热、顺气、开痰以治标，其次补养气血以治本。如果误用治疗真中风的风燥药物，则轻症变重，重症必死。所以凡是内燥生风，及痰中之证，治痰先清火，清火先养阴，最忌用燥剂。
张介宾说：风病种类繁多，误治的原因在于不明表里罢了。外风是八方之风从外部侵袭人体；内风则是五脏的本病。八风从外而入，必然先发有发热恶寒、头痛身热等证，这些症状明显可察。五风由内而生病，则完全没有外感症状，却忽然发病像中风一样，可知是由内伤引起。虽然并非外感，但《内经》说“诸暴强直，皆属于风”，“诸风掉眩，皆属于肝”，为什么呢？因为肝主风而藏血，血病则无法滋养筋脉，筋脉病变出现抖动眩晕、强直等症状，变化百出，这都是肝木之气的变化，所以说都归属于风。后世不明白这个道理，不仅把类中风当作真中风，而且把内夺暴厥等证也都认为是风，错误太严重了。外感病，邪气侵袭肌表，所以多为阳实证；内伤病，由于七情所伤，所以多为阴虚证。凡是脏气受伤，脾病者，病在肢体，或多痰饮；肾病者，或在骨髓，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，或在筋爪，或在血脉。这些五脏的类风证，没有不是由阴虚引起的。只有李东垣独自领悟了这个道理，他说：有中风者，突然昏愦，不省人事，这不是外来风邪，而是本气自病。人年四十岁阴气自然减半，起居功能衰退，所以容易患此病，难道不是阴虚的病吗？人生于阳，而根于阴，根本衰弱，人必定生病；根本败坏，人必定危险。所谓根本，就是真阴。人们知道阴虚只有一种，却不知道阴虚有两种：如阴中之水虚，则病在精血；阴中之火虚，则病在神气。阳气衰则气去，所以神志为之昏乱，这不是火虚吗？阴亏则形体败坏，所以肢体为之废弛，这不是水虚吗？现在面对神离形坏的证候，却不探究水火之源，仍然用治风的方法，很少有不危险的。试从天道来比喻，现象也是如此。大旱则多燥，燥则生风，这是风木的变化顺应于燥，燥是阴虚的征候。所以凡是治疗类中风，专门适宜培补真阴以救根本，那么风燥自然消除。然而外感病，并非绝对没有虚证，气虚就是虚；内伤病，并非绝对没有实证，有阻滞就是实。治疗虚证，应当考察其在阴还是在阳而直接补益；治疗实证，只要考察是因痰还是因气而暂时开通。这对于内伤外感，以及虚实攻补之间，应当审察其有无、微甚而斟酌治疗。甚至有元气素来亏虚，突然仆倒，上无痰涎，下失禁固，闭目昏沉，这是厥竭的证候，尤其与风邪无关。如果不是大剂量人参、附子，怎么能指望在真气将绝之时恢复呢？如果不能察辨表里，又不能辨别虚实，仅仅因为名叫风病，就多用风药，不知道风药都是燥性的，燥性再次损伤阴液；风药都是散性的，散性再次招引风邪。把内伤当作外感，把不足当作有余，这是促使人死亡啊。
《景岳全书》说：凡是类中风多痰的，全是因为中焦虚损所致。痰就是水，其本源在肾，其标末在脾。在肾方面，是因为水不归源，水泛溢而为痰；在脾方面，是因为饮食不化，土不能制水。所以治痰如果不懂得实脾堤水，就不是正确的治法。我曾听民间流传的说法：“痰在周身，致病莫测。凡瘫痪、抽搐、半身不遂等证，都是伏痰留滞造成的。”如果是这样，痰饮岂不是邪类？不去除痰邪，病怎么能好？我说：你知道痰的来源吗？凡是经络中的痰，其实就是津血所化生的。如果营卫调和，那么津就是津，血就是血，哪里有痰呢？唯有元阳亏损，神机耗败，则水中无气，而津凝血败，都化为痰罢了。这果真是痰吗？果真是津血吗？难道在津血之外，还另有所谓的痰吗？如果说痰在经络，不攻逐就不能去除，那就必须连同津血一起全部去除，才可以。否则，哪有单独攻逐痰，而津血就能不受损伤的道理？津血再次受伤，元气更加衰竭，痰随去随生，痰必定更盛。这就是为什么治痰的人不能完全治好，而最终耗尽的只是元气罢了。况且还有本来没有痰气，却妄指为痰，从而错误攻伐的，又是多么愚昧啊！所以凡是治痰的药物，只有在元气未受损伤而有壅滞的情况下，才可以暂时使用分消之法，不能说无效。如果病已涉及元气，而只知道治标，就没有不每天恶化下去的了。
李士材说：凡是中风必须辨明血脉和脏腑。中血脉则口眼歪斜，中腑则肢节废用，中脏则性命危险。这三者的治疗各不相同。中血脉，外有六经的形证，则用小续命汤加减；中腑，内有大小便的阻隔，宜用三化汤通利。如果表里证俱见，先解表，而后攻里。如果外邪已解，内邪已除，而语言謇涩，半身不遂，不能立即痊愈，可用六君子汤加黄芪、桂心、当归、芍药，长期服用，营卫自然调和，这就是古时所称的大药。因为脾胃虚而四肢不能举动的，千万不要混杂风药。风热痰盛者，只加姜汁、竹沥。肥人多湿痰，少加制附子行经。病在半表半里，外无六经的形证，内无大小便的阻隔，知道是血弱不能养筋，所以手足不能运动，舌强不能言语。古法用大秦艽汤，然而不如十全大补汤、大建中汤、人参养荣汤选用合适。肾脏虚热生风，用天麻丸。大抵治风的方法，初得之时应当顺气，等到日久，就应当治血。如果先不顺气，急忙用乌头、附子，又不活血，徒用羌活、防风、天麻之类，我没见过能治好的。然而顺气的药可以用，破气降气的药则不可以。如果是老人、虚人，治疗须少发汗，也宜少攻下。多汗则使其卫气虚，多下则损伤其营血。适宜治在经，应当用大药滋养。凡是治风必须分阴阳。阴中者，面色青，或白或黑，痰喘昏乱，眩晕多汗，严重时手足厥冷。阳中者，面色赤，唇焦，牙关紧急，上视强直，抖动眩晕，烦渴。阴中危重者多见脱证，宜用三生饮倍加人参及竹沥、姜汁灌服。阳中剧烈者多见闭证，如果初起痰涎壅盛，昏愦不省人事，语言謇涩，抽搐不遂，一切痰气闭塞，用牛黄清心丸。如果暴中神昏不语，痰塞心包，口角流涎，烦热气急，一切痰热闭遏，用清心牛黄丸。寒热互结，痰气壅塞，用局方至宝丹。然而中气之证，也多突然仆倒昏迷，不省人事，不可误用牛黄丸，宜用苏合香丸，姜汤调化灌服。如果张口不开，不能进药，用细辛、牙皂研末，吹鼻取嚏即苏醒。无嚏者不治。痰涎壅盛者宜吐之，用稀涎散三四钱，温水调灌。不大呕吐，只要微微令涎自口角流出即苏醒。或者单用橘红一味，大剂煎汤灌服，即可吐出。凡是中风，或未苏醒，或已苏醒，或初病，或久病，忽然吐出紫红色血液的死亡。突然中风倒下，轻者实时苏醒，重者不省人事，千万不要往喉咙里滴水，入喉则涎液永远系于心络不去，即成废人。等待稍苏醒后，察其有表证，用小续命汤加减。痰涎壅盛而脉数有热，用省风汤。痰逆呕泄而脉沉厥冷，用大省风汤。不效，顽痰愈盛，或转增困重，用三生饮。肥人多有中病，因为其气盛于外，而歉于内。元气素弱，或因劳累、房事过度而突然厥仆，状似中风，手必撒开，口必张开，如果不是大剂量人参、附子，怎么能回元气于无何有之乡呢？也有不仆倒，只是舌强语涩痰壅，口眼歪斜，肢体不遂的，作中风治必危险，用六君子汤加天麻、姜汁、竹沥治疗。中风后体虚有痰，也用上述方法。中风而口眼歪斜，先烧牙皂烟熏之以驱逐外邪，次烧乳香熏之以顺血脉。如果前述证候多怒，这是风动肝气，宜小续命汤加羚羊角。热渴，去附子加秦艽。恍惚错语，加茯神、远志。不得睡，加熟枣仁。不能言，加竹沥。脉虚无力，去麻黄加茯苓。口眼歪斜耳鼻常静，说明风息了；口目常动，说明风生了。风淫则血液衰耗，无以荣养筋脉，所以筋脉拘急，口目歪斜。《灵枢》说：足阳明之筋病，颊筋有寒则急，牵引脸颊移口；有热则筋弛纵，缓不胜收，所以歪斜。按左寒右热，则左边急右边缓；右寒左热，则右边急左边缓。大概左边中寒，则逼热于右边；右边中寒，则逼热于左边，阳气不得宣行的缘故。又《金匮要略》说：极寒伤经，极热伤络，则知经受寒而急，则络必热而缓，即《素问》所说大筋软短，小筋弛长的意思。凡是口歪，灸地仓穴；目斜，灸承泣穴。如果无效，当灸人中穴。至于气虚风入则为偏枯，上不得出，下不得泄，真气为风邪所陷，所以宜灸。《内经》说：陷下者灸之。至于用药，宜润燥，则风自息。古法用大秦艽汤，今改用十全大补汤，尤为妥当。又说：足阳明经和手太阳经急，则口目歪斜，眼睛急不能卒视。又口眼歪斜，须分左右。大概邪盛则急，正虚则缓。左急者，属血中有邪，用舒筋三圣散加姜、枣。病久气虚者，去延胡索加人参，名参归三圣散。换用人参是因为正虚不胜耗血之品，故借阳生阴长之力，流动经脉，不要怀疑左半属血，不当用参以助其气。右急者，属气分受邪，用八味顺气散去青皮加羌活。又一法：桂枝三两，酒煎浓液，用布浸渍，左歪搭右，右歪搭左。如果口眼歪斜而一臂麻木不仁，用千金附子散。
口噤不开，《千金方》称为风懿。《内经》说：足阳明颔颊之脉急，则口噤不能开，是肝风乘胃的缘故。用皂荚、乳香、黄芪、防风煎汤熏之。然而须大作汤液，如蒸如雾，才得力。风邪乘虚，入其筋则挛缩，所以令口眼歪斜，牙关急而口噤。用秦艽升麻汤。风寒客于会厌，突然失音，虚证用地黄饮子。痰证用涤痰汤。实证用凉膈散加犀角、黄连。一法：南星、半夏为末，擦其牙龈；郁金、藜芦搐鼻。
痰涎壅盛：此证宜先用稀涎散吐之，后用星香、二陈、导痰、涤痰之类。盖治痰以顺气为先。挟虚者，必用人参、黄芪、竹沥。挟寒者，加桂枝、附子、姜汁。上盛下虚，痰涎壅盛者，六君子汤加南星、沉香，送服黑锡丹。
语言謇涩：《内经》说：足太阴之脉，连舌本，散舌下，是动则病舌本强。又心之别脉，系舌本。又说：足少阴之脉，其直者循喉咙，挟舌本。又说：所谓入中为喑者，阳盛已衰，故为喑也。内夺而厥，则为喑痱，这是肾虚。少阴不至者，厥也。《千金方》说：心脾二脏受风邪，舌强不得语者，用独活汤，专治风懿不能言，四肢不收，手足曳引。肾虚而肾络与胞络内绝，不通于上则喑，肾脉不上循喉咙挟舌本，则不能言。二络不通于下，则痱厥矣。急宜地黄饮子，庶可挽回一二。如脾土不足，痰涎壅盛而謇涩者，是痰火壅塞上窍，气虚不能上营，则舌机不转，宜六君子汤加南星、沉香、石菖蒲、远志、枳实、竹茹。若口眼歪斜不能言，遇风寒则四肢拘急，脉浮而紧，这是手足阳明经虚风所乘，用秦艽升麻汤。若口喑不能言，足痿不能行，属肾气虚弱，名曰痱证，用地黄饮子。突然晕倒，口眼歪斜，口角流涎者，气虚挟痰也，用六君子汤加秦艽、天麻、姜汁、竹沥。血弱舌痿不能言，手足不能举，用十全大补汤。风热上壅，痰盛不能言，用凉膈散加石菖蒲、远志、辰砂。惊痰堵塞，舌本强硬，语言不正，用正舌散加薄荷。舌麻语涩不能言，用省风汤加沉香。脾缓舌强不能言，半身不遂，用解语汤。脉虚无力，加人参、茯苓、白术。心血衰少，惊悸不能言，得之于暴者，用祛风定志汤。血衰心失滋养，语言不出，叩之不应，用十全大补加石菖蒲、远志。痰迷心窍，昏愦口噤不能言，用涤痰汤。有热，加黄芩、黄连、姜汁、竹沥。舌喑脉洪，口角流涎，喜笑不休者，导痰汤加白术、黄芩、黄连、竹沥、姜汁。肥人舌根强硬，作湿痰治。瘦人舌根强硬，作心火治。虽病久正虚，不可纯用补药，以免壅滞经络中之痰火。若饮食如常，但失音不语，俗呼哑风，用小续命汤去桂枝、附子加石菖蒲，直中心经。哑不能言，口开面赤者，必死勿治。
左瘫右痪：左半身不遂，或伤血，致目昏耳聩头眩乏力，用四物汤加羌活、防风、肉桂、红花、桃仁、生姜。病久气虚不应，宜参归三圣散。右半身不遂，四肢无力，痰涎壅盛，或一臂不遂，时复转移一臂，用千金附子散。下半体疼重软弱，用甄权防风汤。并用针灸法。
偏风：其脉沉细，是风与痰饮在上焦，并宜导痰汤加羌活、白术。不应，宜六君子汤加当归。寒，加桂心。热，加竹沥。半身不遂，口眼歪斜，手足战抖，语言謇涩，明显风从外入，身热无汗恶寒，宜小续命汤加减。自汗，不宜服。然又有病发左半，口往右歪者，盖大筋短缩，筋属肝，肝病故左半身不遂，舌筋亦短而謇于言，左畔之小筋弛长，故口从左而歪于右，治宜从右引左，调理右半脾胃之气，以运出左半之热痰虚风，当以四君子汤加羚羊角、柴胡、姜汁、竹沥。冬月稍加炮姜、熟附以从治，夏月须用知母、石膏，此正治也。半身不遂而多汗神昏，痰涎上涌者，大剂量人参、黄芪，补中益气汤、十全大补汤、人参养荣汤、大建中汤选用。半身不遂，骨节离解，口面歪斜，便利无度，用麻黄附子汤加桂心、干姜、川芎。然又有身半以上俱无恙，身半以下软弱麻痹，小便或涩或遗，这是足三阴虚证，当用地黄饮子补其下元，慎不可用燥湿攻痰药。若果痰盛，用星香散、二陈汤。湿盛，用薏苡仁汤。兼气虚者，用六君子汤。兼血虚者，用大秦艽汤，皆为合剂。又酒湿为病作痹证，口眼歪斜，半身不遂，浑似中风，舌强不正，当泻利湿热，不可作风治而汗之也。
Zang (internal organs) involvement indicates a fatal prognosis. Fu (six fu organs) involvement presents with difficulty in eating, drinking, and defecation/urination. Jingluo (meridians and collaterals) involvement may result in disability if severe, or recovery with mild regulation if light. The treatment principle is to first urgently dispel wind pathogenic factors, followed by nourishing Qi and Blood. This describes the syndrome of true exogenous wind invasion.
However, in regions south of the Yangtze River, the climatic winds differ, and human constitutions vary accordingly. In these areas, there are no fierce winds, but rather abundant damp-heat qi. People here tend to have delicate constitutions and often suffer from excess heat and phlegm. Since True Yin is deficient, internal heat becomes intense, boiling body fluids into phlegm, which obstructs airways and impedes flow. Extreme heat generates wind, leading to sudden collapse. These "similar stroke" syndromes may present as unconsciousness, slurred speech, facial deviation, or hemiplegia. Prior to onset, signs of internal heat must appear externally, such as dry mouth and bitter taste, constipation, or scanty dark urine; this serves as verification. As Liu Hejian stated, this syndrome results entirely from improper lifestyle management where Water fails to control Fire. Zhu Danxi’s concepts of damp-heat ministerial fire, phlegm obstruction, and qi obstruction also apply. This is "internal deficiency hidden wind," truly belonging to both Yin and Yang deficiency, predominantly Yin deficiency, distinct from exogenous wind. The method should be to clear heat, regulate qi, and resolve phlegm to treat the branch, then nourish Qi and Blood to treat the root. If one mistakenly uses drying wind-dispelling agents for true stroke, light cases worsen, and severe cases become fatal. Therefore, for internal dryness generating wind and phlegm-obstruction syndromes, treating phlegm requires clearing fire first, and clearing fire requires nourishing Yin first. Drying agents are strictly contraindicated.
Zhang Jiebin said: Wind diseases are numerous; misdiagnosis stems from failing to distinguish exterior and interior. Exogenous wind comes from the eight directions invading from outside; endogenous wind arises from disorders of the five Zang organs. Eight winds enter from outside, necessarily presenting with obvious symptoms like fever, aversion to cold, headache, and body heat. Five winds arise internally without external symptoms, yet suddenly manifest like wind, indicating internal injury. Although not an external contraction, the Classic states "all sudden stiffness belongs to Wind" and "all wind tremors and vertigo belong to Liver." Why? Because the Liver governs Wind and stores Blood. When Blood is diseased, it cannot nourish sinews; sinew disease causes tremors, vertigo, and stiffness. These myriad changes are transformations of Liver Wood, hence attributed to Wind. Later generations misunderstood this, mistaking similar strokes for true strokes, and even classifying internal depletion syncope as wind, a grave error. External contractions involve pathogens attacking the muscle-surface, thus tending toward Yang excess. Internal injuries stem from Seven Emotions, thus tending toward Yin deficiency. When Zang Qi is injured: Spleen disease affects limbs or involves phlegm-fluids; Kidney disease affects marrow or the two lower orifices; Heart disease affects vessels or spirit/mind; Lung disease affects Ying-Wei or voice; Liver disease affects sinews/claws or vessels. All these Zang-related wind syndromes originate from Yin deficiency. Only Li Dongyuan grasped this truth: Stroke patients who suddenly faint and lose consciousness are not suffering from exogenous wind, but from disorder of their own vital Qi. At forty, Yin Qi naturally halves, and daily functions decline, making them prone to this condition—is it not a Yin deficiency disease? Humans are born of Yang but rooted in Yin. When the root weakens, illness occurs; when the root fails, danger ensues. The root is True Yin. People know only one type of Yin deficiency, unaware there are two: deficiency of Water within Yin affects Essence and Blood; deficiency of Fire within Yin affects Spirit and Qi. Yang decline leads to Qi loss, causing mental confusion—is this not Fire deficiency? Yin depletion leads to physical decay, causing limb flaccidity—is this not Water deficiency? Facing such separation of spirit and decay of form, yet seeking no source of Water and Fire, but treating as wind, inevitably leads to peril. Consider the heavens: drought brings dryness, dryness generates wind. Thus, Wind-Wood transformation follows Dryness, which is a sign of Yin deficiency. Therefore, treating similar stroke requires specifically cultivating True Yin to save the root, thereby eliminating wind and dryness. However, external contractions are not devoid of deficiency; Qi deficiency is deficiency. Internal injuries are not devoid of excess; stagnation is excess. Treating deficiency requires observing whether it is Yin or Yang and tonifying directly. Treating excess requires observing if due to Phlegm or Qi and temporarily opening/resolving. Regarding internal vs. external, and excess vs. deficiency, one must assess presence and severity to determine treatment. Even those with chronic Yuan Qi deficiency may suddenly collapse with no upper phlegm, lower incontinence, closed eyes, and lethargy—this is Jue exhaustion, unrelated to wind. Without large doses of Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata), how can one restore Qi at the brink of death? If one cannot discern exterior/interior or excess/deficiency, yet uses many wind-dispelling drugs because of the name "wind," one ignores that wind drugs are drying (further injuring Yin) and dispersing (attracting more wind). Mistaking internal injury for external contraction, and insufficiency for excess, is hastening death.
*Jingyue Quanshu* states: Similar stroke patients with much phlegm all suffer from middle Jiao deficiency. Phlegm is water; its root is in the Kidney, its branch in the Spleen. In the Kidney, water fails to return to its source, flooding as phlegm. In the Spleen, food/drink fails to transform, Earth fails to control Water. Thus, treating phlegm without strengthening the Spleen to dam water is incorrect. I have heard folk sayings: "Phlegm throughout the body causes unpredictable diseases. Paralysis, convulsions, and hemiplegia are caused by latent phlegm stagnation." If so, is phlegm a pathogen? Should it not be expelled for cure? I ask: Do you know the origin of phlegm? Phlegm in meridions/collaterals is transformed from Jin-Ye (body fluids) and Blood. If Ying-Wei harmonize, Jin-Ye remains Jin-Ye, Blood remains Blood; where is phlegm? Only when Yuan Yang declines and Shen-Ji (spiritual mechanism) exhausts does Water lack Qi, causing Jin-Ye coagulation and Blood deterioration, transforming into phlegm. Is this truly phlegm? Or truly Jin-Ye/Blood? Is there phlegm separate from Jin-Ye/Blood? If one claims phlegm in meridions requires attack, one must remove all Jin-Ye and Blood together. Otherwise, how can one attack phlegm alone while leaving Jin-Ye/Blood untouched? Further injury to Jin-Ye/Blood exhausts Yuan Qi; phlegm regenerates as fast as removed, becoming worse. This is why phlegm treatments fail, exhausting only Yuan Qi. Moreover, some have no phlegm but are wrongly diagnosed and attacked, showing great ignorance. Thus, phlegm-resolving drugs should only be used temporarily for stagnation without Yuan Qi damage. If the disease affects Yuan Qi, treating only the branch leads to daily deterioration.
Li Shicai said: Stroke must differentiate blood vessels and Zang organs. Invasion of blood vessels causes facial deviation; invasion of Fu organs causes limb paralysis; invasion of Zang organs threatens life. Treatments differ. For blood vessel invasion with six-channel manifestations, modify Xiao Xuming Tang. For Fu organ invasion with bowel/bladder obstruction, use Sanhua Tang to unblock. If exterior and interior signs coexist, release exterior first, then purge interior. If exterior resolved and interior cleared, but slurred speech/hemiplegia persist, use Liujunzi Tang plus Huangqi (Astragali Radix), Guixin (Cinnamomi Ramulus), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba); long-term use harmonizes Ying-Wei, acting as a great tonic. For limb paralysis due to Spleen/Stomach deficiency, avoid wind drugs. For wind-heat/phlegm abundance, add Jiangzhi (Zingiberis Recens Juice) and Zhuli (Bambusae Caulis in Taenia Succus). For obese patients with damp-phlegm, add small amounts of Zhifuzi (Aconiti Lateralis Radix Praeparata) to move channels. For half-exterior/half-interior disease without six-channel signs or bowel/bladder obstruction, recognizing blood weakness failing to nourish sinews (causing immobility and tongue stiffness), Daqin Jiao Tang is ancient method, but Shiquan Dabu Tang, Dajianzhong Tang, or Renshen Yangrong Tang are preferable. For Kidney deficiency-heat generating wind, use Tianma Wan. Generally, early stroke treatment regulates qi; later stages treat blood. Rushing to use Wutou/Aconite without regulating qi or moving blood, relying solely on Qianghuo/Saposhnikoviae Radix, Fangfeng/Saposhnikoviae Radix, Tianma/Gastrodiae Rhizoma, is ineffective. Regulating qi drugs are acceptable; breaking/descending qi drugs are not. For elderly/deficient patients, sweating and purging must be minimal. Excessive sweating depletes Wei Qi; excessive purging damages Ying Blood. Treatment should focus on meridians using strong tonics. Differentiate Yin/Yang stroke: Yin stroke features blue/pale/black complexion, phlegm-wheezing, confusion, vertigo, sweating, cold extremities. Yang stroke features red face, dry lips, locked jaw, upward gaze, stiffness, tremors, thirst. Severe Yin stroke shows collapse signs; use Sansheng Yin with extra Renshen, Zhuli, Jiangzhi. Severe Yang stroke shows closure signs; for initial phlegm-heat closure with coma/slurred speech/convulsions, use Niuhuang Qingxin Wan. For sudden coma with phlegm blocking Heart Pericardium, drooling, irritability, rapid breathing, use Qingxin Niuhuang Wan. For cold-heat intermingling with phlegm obstruction, use Ju Fang Zhibao Dan. Note: Middle Qi syndrome also causes sudden collapse/coma; do not misuse Niuhuang Wan; use Suhexiang Wan with ginger juice. If mouth won't open, blow Xixin (Asari Radix) and Yazao (Gleditsiae Sinensis Spina) powder into nose to induce sneezing; no sneeze means untreatable. For abundant phlegm, induce vomiting with Xiyuan San mixed in warm water until slight salivation flows from corners of mouth, or use large dose Juhong (Citri Reticulatae Pericarpium) decoction. If stroke patients, awake or asleep, new or old, suddenly vomit purple-red blood, they die. Sudden collapse: light cases recover instantly; severe cases remain unconscious. Never drip water into throat; it binds to heart collaterals, causing permanent disability. Once slightly awake, check for exterior signs: use Xiao Xuming Tang modifications. For phlegm-heat with rapid pulse, use Shengfeng Tang. For phlegm-reversal/vomiting with deep/cold pulse, use Da Shengfeng Tang. If ineffective with worsening phlegm/heaviness, use Sansheng Yin. Obese patients often suffer this due to external Qi excess but internal deficiency. Chronic Yuan Qi weakness or overexertion/libido leading to sudden collapse with open mouth/hands suggests extreme deficiency; only large doses Renshen/Fuzi can restore Qi. Cases without collapse but with tongue stiffness/slurred speech/phlegm/facial deviation/limb paralysis are dangerous if treated as stroke; use Liujunzi Tang plus Tianma, Jiangzhi, Zhuli. Post-stroke deficiency with phlegm uses same method. For facial deviation, smoke Yazao to expel external wind, then Xurong (Frankincense) to smooth blood flow. If anger-driven (Liver wind), add Lingyangjiao (Saiga Tataricae Cornu) to Xiao Xuming Tang. For heat/thirst, remove Fuzi, add Qin Jiao (Gentianae Macrophyllae Radix). For confusion, add Fushen (Poria Cum Radix), Yuanzhi (Polygalae Radix). For insomnia, add Shu Zaoren (Ziziphi Spinosae Semen Preparatum). For muteness, add Zhuli. For weak pulse, remove Mahuang (Ephedrae Herba), add Fuling (Poria). Static ears/nose indicate wind cessation; moving eyes/mouth indicate wind generation. Wind excess depletes blood, failing to nourish sinews, causing stiffness/deviation. *Ling Shu* states: Foot Yangming sinus disease, cold causes tension pulling mouth; heat causes flaccidity. Left cold/right heat means left tense/right loose. Cold forces heat to opposite side, blocking Yang Qi flow. *Jin Gui Yao Lue* states: Extreme cold injures meridians (tension); extreme heat injures collaterals (flaccidity), matching *Su Wen*: large sinews shorten, small sinews lengthen. For mouth deviation, moxa Dicang (ST4); for eye deviation, moxa Chengqi (ST1). If ineffective, moxa Renzhong (GV26). For Qi deficiency with wind sinking, moxibustion is indicated per "sunken conditions require moxa." Medicinally, moisten dryness to extinguish wind. Ancient Daqin Jiao Tang is now replaced by Shiquan Dabu Tang for better safety. Foot Yangming and Hand Taiyang channel tension causes deviation. Differentiate left/right: Evil excess causes tension; Deficiency causes flaccidity. Left tension implies blood evil; use Shujin Sansheng San plus Ginger/Jujube. For chronic Qi deficiency, remove Yanhusuo, add Renshen (Shengui Sansheng San) to leverage Yang generating Yin. Right tension implies Qi evil; use Bawei Shunqi San remove Qingpi, add Qianghuo. Another method: Boil Guizhi (Cinnamomi Ramulus) in wine, soak cloth, apply left-to-right or right-to-left for deviation. For deviation with arm anesthesia, use Qianjin Fuzi San.
Locked jaw (*Feng Yi*): Foot Yangming mandible channel tension prevents opening, caused by Liver wind attacking Stomach. Smoke Zaoguang (Gleditsiae Sinensis Spina), Xurong, Huangqi, Fangfeng decoction heavily as steam. Wind entering sinews causes spasms. Use Qin Jiao Shengma Tang. Wind-cold at epiglottis causes sudden aphonia; deficiency uses Dihuang Yinzi. Phlegm uses Ditan Tang. Excess uses Liangge San plus Xijiao (Rhinocerotis Cornu substitute), Huanglian (Coptidis Rhizoma). Alternative: Nanxing (Arisaematis Rhizoma Preparatum)/Banxia (Pinelliae Rhizoma) powder on gums; Yujin (Curcumae Radix)/Lilu (Veratri Nigrum Rhizoma) snuff.
Abundant phlegm: Induce vomiting with Xiyuan San first, then use Nanxing-Chenxiang, Erchen, Daotan, or Ditan formulas. Regulate qi first. With deficiency, add Renshen, Huangqi, Zhuli. With cold, add Guizhi, Fuzi, Jiangzhi. Upper excess/lower deficiency with phlegm: Liujunzi Tang plus Nanxing, Chenxiang, deliver Heixi Dan.
Slurred speech: *Classic* states Foot Taiyin connects to tongue base; movement causes stiffness. Heart collateral connects to tongue. Foot Shaoyin runs up throat beside tongue. "Entering middle causes aphonia" due to Yang excess declining. Internal depletion with Jue causes aphonia-flaccidity (Kidney deficiency). *Qianjin Fang*: Wind in Heart/Spleen causes tongue stiffness; use Duhuo Tang. Kidney meridian/collarbone connection blockage causes aphonia/flaccidity; urgent Dihuang Yinzi. Spleen deficiency with phlegm-fire blocking orifices: Liujunzi Tang plus Nanxing, Chenxiang, Shichangpu (Acori Tatarinowii Rhizoma), Yuanzhi, Zhishi (Aurantii Fructus Immaturus), Zhuru (Bambusae Caulis in Taenia). Yangming deficiency wind with cold aggravation: Qin Jiao Shengma Tang. Aphonia-leg weakness (Fei syndrome): Dihuang Yinzi. Sudden collapse with drooling: Qi deficiency with phlegm, Liujunzi Tang plus Qin Jiao, Tianma, Jiangzhi, Zhuli. Blood weakness tongue flaccidity: Shiquan Dabu Tang. Wind-heat/phlegm head congestion: Liangge San plus Shichangpu, Yuanzhi, Zhensha (Cinnabaris). Shock-phlegm blockage: Zhengshe San plus Bohe (Menthae Haplocalycis Herba). Tongue numbness/slurred speech: Shengfeng Tang plus Chenxiang (Aquilariae Lignum Resinatum). Spleen flaccidity/tongue stiffness/hemiplegia: Jieyu Tang. Weak pulse: Add Renshen, Fuling, Baizhu (Atractododis Macrocephalae Rhizoma). Heart blood deficiency palpitations/muteness: Qufeng Dingzhi Tang. Heart blood deficiency unresponsiveness: Shiquan Dabu Tang plus Shichangpu, Yuanzhi. Phlegm confusing Heart orifice/coma: Ditan Tang. With heat: Add Huangqin (Scutellariae Radix), Huanglian, Jiangzhi, Zhuli. Tongue aphonia/hot pulse/drooling/laughing: Daotan Tang plus Baizhu, Huangqin, Huanglian, Zhuli, Jiangzhi. Obese stiff tongue base: Treat as damp-phlegm. Thin stiff tongue base: Treat as Heart fire. Long-term deficiency: Do not use pure tonics to avoid trapping phlegm-fire. Muteness with normal appetite ("Silent Wind"): Xiao Xuming Tang remove Guizhi/Fuzi, add Shichangpu. Muteness with open mouth/red face: Fatal.
Left hemiplegia/blood injury/dizziness: Siwu Tang plus Qianghuo, Fangfeng, Rougui (Cinnamomi Cortex), Honghua (Carthami Flos), Taoren (Persicae Semen), Shengjiang (Zingiberis Rhizoma Recens). Chronic Qi deficiency: Shengui Sansheng San. Right hemiplegia/weakness/phlegm: Qianjin Fuzi San. Lower body pain/weakness: Zhenquan Fangfeng Tang. Acupuncture recommended.
Biased wind (pulse deep/thin, wind-phlegm in Upper Jiao): Daotan Tang plus Qianghuo, Baizhu. Ineffective: Liujunzi Tang plus Danggui. Cold: Add Guixin. Heat: Add Zhuli. Hemiplegia/facial deviation/tremors/slurred speech with external wind signs (fever/no sweat/aversion to cold): Xiao Xuming Tang modifications. Not for spontaneous sweating. Left-sided onset with rightward mouth deviation: Large sinews short (Liver), left hemiplegia, tongue short/slurred, left small sinews long pulling mouth right. Treat by guiding right to left, regulating Right Spleen/Stomach Qi to move Left heat-phlegm/wind. Sijunzi Tang plus Lingyangjiao, Chaihu (Bupleuri Radix), Jiangzhi, Zhuli. Winter: Add Paojiang (Zingiberis Rhizoma Preparatum), Shufu (Aconiti Lateralis Radix Preparata). Summer: Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsi Fibrosus). This is direct treatment. Hemiplegia with sweating/confusion/rising phlegm: Large dose Renshen/Huangqi, Buzhong Yiqi Tang, Shiquan Dabu Tang, Renshen Yangrong Tang, Dajianzhong Tang. Hemiplegia/joint separation/facial deviation/diarrhea: Mahuang Fuzi Tang plus Guixin, Ganjiang (Zingiberis Rhizoma), Xiong (Chuanxiong Rhizoma). Half-body below weakness/numbness/urinary issues: Foot Three Yin deficiency, Dihuang Yinzi. Avoid damp-draining/phlegm-purging. Phlegm heavy: Xingxiang San, Erchen Tang. Damp heavy: Yiyiren Tang. Qi deficiency: Liujunzi Tang. Blood deficiency: Daqin Jiao Tang. Alcohol-damp Bi syndrome mimicking stroke: Clear damp-heat, do not sweat.
Opisthotonos: Wind entering Yang channels causes back arching/spasm. Xiao Xuming Tang modifications. *Qianjin Fang*