风有真风、类风,不可不辨。凡风寒之中于外者,乃为风邪。如《九宫八风篇》之风占
病候,《岁露论》之虚风实风,《金匮真言论》之四时风证,《风论》之脏腑中风,《玉机
真脏论》之风痹、风瘅、痹论,《贼风篇》之风邪为痹,《疟论》《岁露论》之疟生于风,
《评热病论》之风厥、劳风,《骨空论》之大风,《热病篇》之风痉,《病能论》之酒风,
《咳论》之感寒咳嗽,是皆外感风邪之病也。其有不由外感而亦各为风者。如病机所云∶诸
暴强直,皆属于风;诸风掉眩,皆属于肝之类。是皆属风而实非外中之风也。
何以见之?盖有所中者谓之中,无所中者谓之属。夫既无所中,何谓之属?此以五运之气
,各有所主。如诸湿肿满,皆属于脾;诸寒收引,皆属于肾,是皆以所属为言,而风之属于
肝者,即此谓也。盖肝为东方之脏,其藏血,其主风,肝病则血病而筋失所养。筋病则掉眩
强直之类无所不至,而属风之证百出,此所谓皆属于肝,亦皆属于风也。夫中于风者,即真
风也;属于风者,即木邪也。真风者,外感之表证也;属风者,内伤之里证也,即厥逆内夺
之属也。
夫曰中曰属,此在《内经》固已显然,各有所谓。即如年辰之属鼠属牛,岂即为牛为鼠
乎?而后世不能明辨,遂致方论混传,表里误治。千古之弊,莫此为甚。第在《内经》则原
无真中、类中之分,而王安道始有此论,予甚善之。第惜其辨有未尽,故复述之,以详其说
。凡欲明此义者,但当于中风、属风、表证、里证四者之间。默而思之,当自见其真矣。
风有真风和类风,不可不加以辨别。凡是风寒侵袭体表的,才称为风邪。例如《九宫八风篇》中关于风邪致病的占候,《岁露论》中的虚风与实风,《金匮真言论》中的四时风证,《风论》中的脏腑中风,《玉机真脏论》中的风痹、风瘅及痹论,《贼风篇》中风邪导致的痹症,《疟论》和《岁露论》中认为疟疾生于风,《评热病论》中的风厥和劳风,《骨空论》中的大风,《热病篇》中的风痉,《病能论》中的酒风,《咳论》中感受寒邪引起的咳嗽,这些都是外感风邪所致的疾病。
其中有些并非由外感引起,但也表现为“风”象。如《素问·至真要大论》病机十九条所说:“各种突然发生的强直拘急,都归属于风;各种风证的震颤眩晕,都归属于肝。”这些虽然名为属风,但实际上并不是外来的风邪。
为什么这样区分呢?因为被风邪侵袭的叫做“中”,没有外邪侵袭而表现为风象的叫做“属”。既然没有外邪侵袭,为何称为“属”?这是因为五运之气各有其主司的脏腑。例如“各种湿邪导致的肿胀满闷,都归属于脾;各种寒邪导致的收缩牵引,都归属于肾”,这都是以所属关系而言的。同理,风归属于肝,也是这个意思。肝是东方之脏,主藏血,主风。肝病则血病,筋脉失去滋养。筋脉病变就会出现震颤、眩晕、强直等症状,导致属于风的证候层出不穷,这就是所谓“皆属于肝”,也即“皆属于风”。
侵袭于风的,就是真风;归属于风的,就是木邪(肝木之邪)。真风,是外感的表证;属风,是内伤的里证,也就是厥逆、内夺之类的病症。
说“中”说“属”,这在《内经》中已经很清楚,各有其含义。就像年份属鼠或属牛,难道这一年就是牛或鼠吗?但后世不能明辨,导致方剂理论混淆流传,表里误治。千古以来的弊端,没有比这更严重的了。只是在《内经》中原无真中与类中之分,直到王安道才提出这种论点,我非常赞同他。只是可惜他的辨析还不够详尽,所以我重新阐述,以详细说明这一学说。凡是要明白这个道理的人,只应当在“中风”、“属风”、“表证”、“里证”这四者之间,默默思考,自然就能见到真相了。
Wind can be categorized as "True Wind" (Zhen Feng) or "Resembling Wind" (Lei Feng), and the distinction between them must not be overlooked. When wind-cold pathogens invade from the exterior, they are termed Wind Pathogens (Feng Xie). For instance, the disease patterns related to wind in the *Jiu Gong Ba Feng* Chapter, the concepts of Deficient Wind (Xu Feng) and Excess Wind (Shi Feng) in the *Sui Lu* Chapter, the four-season wind syndromes in the *Jin Gui Zhen Yan Lun*, organ-specific wind strokes in the *Feng Lun*, wind-bi and wind-dan syndromes in the *Yu Ji Zhen Zang Lun*, wind-induced bi-syndromes in the *Zeifeng* Chapter, malaria arising from wind in the *Nue Lun* and *Sui Lu* Chapters, wind-jue and lao-feng in the *Ping Re Bing Lun*, great wind in the *Gu Kong Lun*, wind-spasm in the *Re Bing* Chapter, wine-wind in the *Bing Neng Lun*, and cold-induced coughs in the *Ke Lun*—all these refer to diseases caused by exogenous wind pathogens.
However, some conditions manifest as wind without being caused by external invasion. As stated in the *Suwen: Zhi Zhen Yao Da Lun* (Basic Questions: Essential Meaning of Disease Mechanisms): "All sudden spasms and rigidity belong to wind; all wind-related tremors and vertigo belong to the Liver." These are classified under wind but are not actually exogenous wind pathogens.
Why is this distinction made? That which is invaded by an external pathogen is called "Zhong" (Stroke/Invasion); that which lacks such invasion but presents with wind-like symptoms is called "Shu" (Belongs to/Associated with). If there is no external invasion, why use the term "Shu"? This refers to the dominance of the Five Movements (Wu Yun) over specific organs. For example, "All dampness-related swelling and fullness belong to the Spleen; all cold-related contraction and pulling belong to the Kidney." These descriptions emphasize the associative relationship. Similarly, wind is associated with the Liver. The Liver is the zang-organ of the East, it stores blood, and it governs wind. When the Liver is diseased, blood pathology occurs, leading to a loss of nourishment for the sinews. Sinew pathology results in various manifestations such as tremors, vertigo, and rigidity, giving rise to numerous wind-associated syndromes. Thus, it is said that "they all belong to the Liver," which also means "they all belong to wind."
Pathogens invading from the outside constitute True Wind (Zhen Feng); internal wind manifestations constitute Wood Evil (Mu Xie, referring to Liver Wood pathogenicity). True Wind represents an exterior syndrome due to exogenous factors; Resembling Wind represents an interior syndrome due to endogenous injury, falling under categories such as jue-ni (reversal cold/heat) and nei-duo (internal depletion).
The terms "Zhong" and "Shu" are clearly distinguished in the *Neijing* (*Huangdi Neijing*), each having its specific meaning. Just as a year may be associated with the Rat or the Ox, it does not mean the year itself is a rat or an ox. However, later generations failed to distinguish them clearly, leading to confusion in formulas and theories, and resulting in misdiagnosis regarding exterior and interior syndromes. No error in medical history has been more detrimental than this. Although the *Neijing* did not originally distinguish between True Stroke and Resembling Stroke, Wang Andao was the first to propose this theory, which I greatly approve of. However, his analysis was not exhaustive; therefore, I restate it to elaborate on the argument. To truly understand this principle, one should silently contemplate the distinctions among Four Concepts: Wind Stroke (Zhong Feng), Resembling Wind (Shu Feng), Exterior Syndromes (Biao Zheng), and Interior Syndromes (Li Zheng), and the truth will become apparent.