以苏合香丸、牛黄、至宝之类灌之。如见脱证。惟宜以大剂理中汤灌之。及灸脐下。虽曰不治。亦可望救十中
之一。若误投苏合、牛黄等药。即终难活矣。盖斩关夺门之将。原为闭证设也。若施之脱证。如人既入井。又
下之石矣。世人陷此弊而死者。不可胜数。（《医林绳墨》）（周京曰∶凡遇脱症，法在不治，惟大进参附，
或可冀其万一。按∶《医学纲目》曰∶五脏气绝，速宜大料参、 煎浓汤灌之，及脐下大艾灸之，亦可转死回
生也。《女科准绳》辨闭脱证治，凑合《绳墨》、《纲目》二书，但牛黄、至宝之类，改作三生饮之类却误，
《医宗必读》全取《绳墨》。）
按卒仆暴厥之证，不论男子妇人，风寒气食痰湿，但要分得闭与脱二证明白。（《女科准绳》）
闭者，邪气闭塞于外，元气犹然在内，但与开关利气，则邪自散，故治易。脱者，元气泄于外，邪气混于
内，虽与峻补，而脏已伤残，故治难。诸证皆然，不独中风也。（《证治汇补》）
冷热虚实 六脉沉伏或指下浮盛二脉，正有阴中阳中之分，正经谓之寒中热中是也。若脉见沉急，颜
青脸白，如懈如怠，此为寒中，治法则有天雄、附子例，三建汤、星附汤之类是也。脉见浮洪而急，颧赤脸赭，
如醉如怒，此为热中，治法则有防风、独活例，大小省风汤、紫豆汤之类是也。（《续易简方后集》）（按∶
《永类钤方》稍同。热中更有牙关紧急，上视强直掉眩。）
《外台秘要》云∶凡国中风，四肢不收，扬手掷足，心神昏愦，眼不识人，言不退场门，烦闷恶衣，喷药闷
乱，此等疾证多由热起，王叔和云热积生风是也。（按∶此所引当考出典）故先圣用至宝丹、红雪通中散、龙
脑芎犀丸、薄荷煎、牛黄清心丸以对之。亦有单饮竹沥及大小竹沥汤、败毒散加防风、荆芥煎服亦效。若不审
是热积生风，例以三生饮、三建汤、养正丹投之，则祸不旋踵。（《管见良方》）
中风手足软弱，不能举动，外证自汗者，虚中风也。若手足强急，口眼 斜，伸缩痛者，实中也。（《寿
世保元》）
中风中气之别（宜参气病门） 中气与中风相似，所以别者，风中身温，气中身冷。（《证治要诀》）
又有中气与中风相类，语言謇涩，涎潮昏塞，不知人事，牙关紧急，但手足不偏废为异耳。（《奇效良方》）
气中即俗谓之气厥也，脉必沉，若浮则风脉也。中风与类中风，身温且多痰涎；中气，身冷且无痰涎。
（《丹溪纂要》）
风中脉浮洪，气中脉沉涩。（《医约》）
中风与中气，形同而病异。中风因人元气衰弱，腠理空疏，风邪所袭，卒然中倒，其形身强而热。中气乃
七情所伤，气厥而晕，必身寒气冷，而无强挛之苦，既苏之后，气逆不已。（《原病集》）
相类证（更有痰厥食厥等，见厥及痰涎伤食中。） 手足沉重，状若风者，此证其源起于脾胃虚，荣
卫不足。胃为水谷之海，脾气磨而消之，水谷之精，化为荣卫，以养四肢。若起居失节，饮食不时，则致脾胃
之气不足，既荣卫之气润养不周，风邪乘虚而干之。盖脾胃主四肢，其脉连舌本而终于唇口，故四肢与唇口
俱痹，语言謇涩也。治法宜多用脾胃药，少服去风药，则可取安矣。若久久不治，则变为痿疾，经所谓治痿独
取阳明是也，阳明者胃之经也。（《鸡峰》）
有无故口眼 斜，投以中风药剂不效，盖缘骨虚中受风所致，当于此求之，不可例作寻常中风治之，川乌
一味决不可少，宜炮熟用。（《证治要诀》）
有元气素弱，或过于劳役，或伤于嗜欲，而卒然厥仆，状类中风者，手必散，口必开，非大剂参 用至斤
许，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。（《证
治准绳》）
丹溪治王从一四十二岁，十指尽麻木并面麻，乃气虚症，补中益气汤加木香、附子各五分愈。（《名医类
案》）
祝橘泉治英国公病左瘫不语，气上壅。医以为中风，用顺气祛风之剂弗效。祝曰∶此痰火湿热所致。与之
清燥化痰，前后饮竹沥数升愈。（同上）
死证 中风之病，鼻下赤黑相兼，吐沫而身直者，七日死也。（《中藏经》）
病风入脉紧数浮沉，有汗出不止，呼吸有声者死，不然则生。（同上）
若摇头直视，心肾脱绝。盖诸阳独留，诸阴悉尽，故直视摇头，心藏绝，真藏病也，鲜有再生。（《朱氏
集验方》）
王硕曰∶但口开手散，眼合遗尿，声如鼾睡者，并难治疗。若此立说，则五证中凡见一证，遽皆不治，此
岂可哉。按经言之，身虚急卒中，至五脏闭绝，脉道不通，气不往来，譬如堕溺，不可与期。何则？口开者心
气闭绝也，手撒者脾气闭绝也，眼合者肝气闭绝也，遗尿者肾气闭绝也，鼻鼾者肺气闭绝也，备此五者，始不
可治。若见其一，犹当审余证，详余脉，以施救疗。盖以国中眼合者多，痰上鼻鼾者亦多，惟遗尿口开二证俱
见为恶。心为五脏之君主，肾为一身之根本，诚不可闭绝也。（《续易简方后集》）
诸中或未苏，或已苏，或初病，或久病，忽吐出紫红色者死。（《证治要诀》）
预防法（宜参前先兆条） 宝鉴云∶凡人初觉大指次指麻木不仁或不用者，三年内有中风之疾也，宜
先服愈风汤、天麻丸各一料，此治未病之法也。（按∶此本出《保命集》）薛己云∶预防之理，当养气血，节
饮食，戒七情，远帏幕可也。若服前方以预防，适所以招风取中也。（《准绳》）
若风病既愈，而根株未能悉拔，隔一二年或数年必再发，发则必加重，或至丧命。故平时宜预防之，第一
防房劳
暴怒郁结，调气血，养精神；又常服药以维持之，庶乎可安。（《沈氏尊生书》）
治法概略 按中风之候，当先辨其真中类中，及在经络脏腑之别，更察其阴阳左右寒热气血之偏虚，
湿痰之症据，然后立法施治。其治之大略，不外攻风逐痰，收气灸脱，开关通闭，涌吐活络，清火养血，润燥
培元，补气回阳等法。（《医级》）
昏沉不省人事，口噤不可进药，急以生半夏为末，吹入鼻中，或用细辛皂角为末，吹入喉，喷嚏则苏。
（按此法本出《易简方》）此可以验其受病深浅，则知其可治不可治。若稍得苏省者，八味顺气散便服治风药
，然未遽绝治气药，小续命汤煎熟去滓，调苏合香丸一粒。或五积散加麝香少许，或星香散，或醒风汤加木香
一钱。如服前药不效，其人顽涎愈盛，或前证不解，或增困重，宜星附汤，或三生饮加全蝎三个，间磨沉香汤
下养正丹。（《要诀》）（按∶五积散加麝香本出《百一选方》）
治当调气活血 治疗之法，当推其所自。若内因七情而得之者，法当调气，不当治风。外因六淫而得
之者，亦先当调气，然后根据所感六气随证治之，此良法也。（《济生方》）
治之之法，调气为先。经云∶善治风者，以气理风。气顺则痰消，徐理其风，庶可收效。先用麻油调苏合
香丸，或用姜汁，或用自汤调。如口噤，抉开灌之，稍苏则进八味顺气散。（《要诀》）
治风之法，初得之，即当顺气，及其久也，即当活血，此万古不易之理。久患风疾，四物汤吞活络丹愈者，正是此
义。若先不顺气，遽用乌附，又不活血，徒用防风、天麻、羌活辈，吾未见其能治也。（同上）（《准绳》又
曰∶然顺
气之药则可，破气泻气之药则不可。）
此症予历治历效者，良由先为疏通经络，活血调气，然后以补剂收功。惟经络疏通，宿痰磨去，新痰不生
，何疾不决瘳。（《赤水玄珠》）
大剂久服 凡中风，用续命、排风、风引、竹沥诸汤及神精丹、茵芋酒之类，更加以灸，无不愈者。
然此疾积习之久，非一日所能致，皆大剂久而取效。《唐书》载王太后中风，喑默不语，医者蒸黄 数斛以熏
之得差，盖此类也。今人服三五盏便求效，责医也亦速矣。孟子曰七年之病，三年之艾，久而后知尔。（《本
事方》）
开关方法 卒然口噤目张，两手握固，痰壅气塞，无门下药，此为闭证。闭则宜开，不开则死，搐鼻
、揩齿、探吐，皆开法也。（《金匮翼》）
经验方治急中风，目瞑牙噤，无门下药者，以中指点散子揩齿三二十，揩大牙左右，其口自开，始得下药
。龙脑、天南星等分为末，乳钵内研，只用一字至半钱，名开关散。（《本草》）
《简要济众》如牙关不开，用白梅揩齿，口开即灌药。（同上皂荚条）《圣济》名白神散（又有白矾散
，用白矾、盐花二味。）
治中风牙关紧急方
甘草（比中指节，截作五截，于生油内浸过，炭火上炙，候油入甘草用。）
上一味，以物斡开牙关，令咬定甘草，可如人行一里时候，又换甘草一截，后灌药极效。（《圣济》）
男子妇人中风，涎潮于心，卒然中倒，当实时扶入暖室中，扶策正坐，当面作好醋炭熏之，令醋气冲入口
鼻内。良久，其涎潮聚于心者，自收归旧，轻者实时苏省，重者亦省
人事，惟不可吃一滴水汤入喉也。如吃汤水，则其涎永系于心络不能去，必成废人。今只以醋炭熏之，既得涎
离于心，渐渐苏省，当以生料五积散加麝香煎服之。（《澹寮集验方》引《传心方》）
初病卒倒，危急不醒，但察其有无死证。如无死证，而形气不脱，又无痰气，但扶定掐其人中，自当渐醒
。或以白汤姜汤，徐徐灌之亦可。待其苏醒，然后察证治之。（《景岳全书》）
通窍方法 风邪中人，与痰气相搏，闭其经隧，神暴昏，脉暴绝者，急与苏合、至宝之属以通之。盖
惟香药，为能达经隧通神明也。（《金匮翼》）
苏合香丸。
苏合香 白术 朱砂 沉香 诃子肉 丁香 木香
香附子 白檀香 乌犀角 乳香 荜茇 安息香（各一两） 麝香 龙脑（各半两）
上为末，炼蜜丸，如鸡头实大，每服一丸，温酒嚼下，人参汤亦得。此方大家皆有，恐未知其神验耳。本
出《广济方》，谓之白术丸，后人编入《外台》。（按∶此出《外台·鬼魅精魅及古今诸家丸方》中）《和剂
局方》苏合香油（入安息香膏内）、薰陆香（别研）、龙脑（研各一两）、青木香、白术、白檀香、丁香、朱
砂（研水飞）、沉香、香附子（炒去毛）、乌犀（镑屑）、荜茇、安息香（别为末用无灰酒一升熬膏）、麝香
（研）、诃黎勒（煨取皮各二两）。上为细末，入研药匀，用安息香膏并炼白蜜和剂，每服旋丸，如梧桐子大，
早朝取井花水，温冷任意，化服四丸，老人小儿可服一丸，温酒化服亦得，并空心服之。去龙脑，名麝香
苏合香丸。苏合香丸古方多以酒调服，是以往往服者不能奏
功；若以人参汤佐之，其功倍于常也。凡中风不省人事，牙关紧急者，用此丸旋加麝香一二分，以真麻油调灌
之，无不吐痰而苏者。盖麻油最能化痰，试滴痰上，须臾痰化为水。若口开脉绝者不救。（《续医说》）（按
∶麝香、麻油本出《是斋》）
治中风不计缓急，潮涎瞀闷，不知人事，七宝丸。
朱砂 牛黄 水银 龙脑 腻粉 麝香（各一分） 金箔（二十一大片）
上件药一处同研，水银星尽，用枣肉为丸，如绿豆大，病轻者分作四服，患重者只作一服，温水或化破服
之。利下涎后，平气丸散，渐服慢治风药。（《传家秘宝》）（按∶此方似宜入宁神中，然据其主证，姑列于斯。）
治痰方法 人之胃中，必有涎液为养。风内动而气上逆，则涎随气上，而为痰嘶。风中虽属挟虚，半
是痰邪为患，虚痰实痰，治有分别。若窒碍不通，必先治标为急，所以涌吐、开通、豁降之治，在所必需也。
（《医级》）
或因风而动痰，或因痰而致风，或邪风多附顽痰，或痰病有如风病。是以掉摇、眩晕、倒仆、昏迷等证，
风固有之，痰亦能然，要在有表无表、脉浮脉滑为辨耳。风病兼治痰则可，痰病兼治风则不可。（《金匮翼》）
《必用方》论中风无吐法，引金虎碧霞为戒。且如卒暴涎生，声如引锯，牙关紧急，气闭不行，汤药不能
入，命在须臾者，执以无吐法可乎。但不当用银粉药，恐损脾坏人四肢尔。（《本事方》）
治痰之法，凡非风初病而痰气不甚者，必不可猜其为痰而妄用痰药，此大戒也。若果痰涎壅盛，填塞胸膈
，汤液俱不能入，则不得不先开其痰，以通药食之道。而开痰之法，
惟吐为捷，如古方之独圣散、茶调散、稀涎散之属，皆吐痰之剂也。但恐元气太虚，不能当此峻利之物，或但
用新方之吐法为妥，或用牛黄丸、抱龙丸之类。但使咽喉气通，能进汤饮即止，不可尽攻其痰，致令危困，则
最所当慎。以故治痰之法，又必察其可攻与否，然后用之，斯无误也。（按∶新方吐法系萝卜子及盐汤二方）
若其眼直切牙，肢体拘急，面赤，强劲有力者，虽见昏沉，亦为可治。先用粗箸之类挖开其口，随以坚实
笔杆KT 住牙关，乃用淡淡姜盐汤徐徐灌之，然后以中食二指探入喉中，徐引其吐。若指不能入，则以鹅翎蘸
用苏合香丸、牛黄、至宝丹之类的药物灌服。如果见到脱证（正气虚极欲脱的危重证候），只宜用大剂量的理中汤灌服，并灸脐下穴位。虽然说是难以治愈，但也还有十分之一的希望获救。如果误投苏合香丸、牛黄等药，就最终难以救活了。因为苏合香丸等是“斩关夺门”的猛将，原本是为闭证（邪气闭塞心窍的实证）设立的。如果施用于脱证，就像人已经掉进井里，又往下扔石头一样。世人陷入这种弊端而死亡的，不可胜数。（《医林绳墨》）（周京说：凡是遇到脱症，治法上认为难以治愈，只有大量进用人参、附子，或许可以希冀万分之一的生机。按：《医学纲目》说：五脏之气断绝，速宜用大剂量人参煎浓汤灌服，并在脐下用大艾炷灸之，也可以转死回生。《女科准绳》辨析闭证和脱证的治疗，凑合了《绳墨》、《纲目》两书的内容，但把牛黄、至宝之类改为三生饮之类却是错误的，《医宗必读》完全采用了《绳墨》的观点。）
按：猝然仆倒、暴厥的证候，不论男女，无论是风寒、气滞、食积、痰湿，关键在于要把闭证和脱证分辨清楚。（《女科准绳》）
闭证，是邪气闭塞于外，元气还在内，只要给予开关利气的治疗，邪气自然消散，所以容易治疗。脱证，是元气泄散于外，邪气混杂在内，即使给予峻补，脏腑已经伤残，所以难治。各种证候都是这样，不仅仅是中风。（《证治汇补》）
寒热虚实：六脉沉伏或指下浮盛二脉，正有阴中阳中之分，正经称之为寒中、热中。如果脉象见沉急，面色青白，神情懈怠懒散，这是寒中，治法法则有天雄、附子为例，如三建汤、星附汤之类。脉象见浮洪而急，颧骨赤红脸色深红，像喝醉又像发怒，这是热中，治法法则有防风、独活为例，如大小省风汤、紫豆汤之类。（《续易简方后集》）（按：《永类钤方》与此稍同。热中还有牙关紧急，眼球上视、强直、震颤眩晕等症状。）
《外台秘要》说：凡是中风，四肢不能收持，扬手掷足，心神昏乱迷糊，眼睛不认识人，言语不清，烦躁闷乱厌恶衣物，喷药时感到闷乱，这些疾病多由热引起，王叔和说热积生风就是这种情况。（按：此处所引应当考证出处）所以先圣使用至宝丹、红雪通中散、龙脑芎犀丸、薄荷煎、牛黄清心丸来对治它。也有单饮竹沥及大小竹沥汤、败毒散加防风、荆芥煎服也有效。如果不审察是热积生风，一律用三生饮、三建汤、养正丹投予，那么灾祸立刻就会降临。（《管见良方》）
中风导致手足软弱，不能举动，外证自汗的，是虚中风。如果手足强直拘急，口眼歪斜，伸缩疼痛的，是实中。（《寿世保元》）
中风与中气的区别（宜参考气病门） 中气与中风相似，区别在于，风中则身体温热，气中则身体寒冷。（《证治要诀》）
又有中气与中风相类似，语言謇涩，涎潮昏塞，不知人事，牙关紧急，只是手足不偏废作为不同之处。（《奇效良方》）
气中即俗谓的气厥，脉象必沉，如果脉浮则是风脉。中风与类中风，身体温热且多痰涎；中气，身体寒冷且无痰涎。（《丹溪纂要》）
风中脉象浮洪，气中脉象沉涩。（《医约》）
中风与中气，外形相同而病因不同。中风是因为人体元气衰弱，腠理空疏，风邪侵袭，猝然中倒，其形态身体强直而发热。中气乃是七情所伤，气机逆乱而晕厥，必定身体寒冷，而没有强直抽搐的痛苦，苏醒之后，气逆不止。（《原病集》）
相类证（更有痰厥、食厥等，见厥及痰涎伤食中。） 手足沉重，状似中风，此证的根源起于脾胃虚弱，营卫不足。胃为水谷之海，脾气磨碎消化它，水谷的精微，化为营卫，以滋养四肢。如果起居没有节制，饮食不定时，就会导致脾胃之气不足，既然营卫之气滋润养育不周全，风邪乘虚而入。大概脾胃主管四肢，其经脉连系舌根而终于唇口，所以四肢与唇口都麻痹，语言謇涩。治法宜多用脾胃药，少服去风药，就可以取得安宁。如果久久不治疗，就会变为痿疾，经所谓治疗痿疾独取阳明经是对的，阳明经就是胃的经脉。（《鸡峰》）
有无故口眼歪斜，投以中风药剂无效，大概是因为骨虚中受风所致，应当在此处寻求原因，不可一概当作寻常中风治疗，川乌一味药决不可少，宜炮熟后使用。（《证治要诀》）
有元气素来虚弱，或过度劳役，或损伤于嗜欲，而猝然厥仆，状似中风的，手必松开，口必张开，不是大剂量的人参用到一斤左右，怎么能挽回元气于虚无缥缈之乡呢。也有不仆倒但舌强语涩痰壅，口眼歪斜，肢体不遂的，作中风治疗必然危险。（《证治准绳》）
朱丹溪治疗王从一，四十二岁，十指全部麻木并面部麻木，这是气虚症，用补中益气汤加木香、附子各五分治愈。（《名医类案》）
祝橘泉治疗英国公患病左瘫不语，气上壅塞。医生认为是中风，用顺气祛风的药剂无效。祝橘泉说：这是痰火湿热所致。给他服用清燥化痰的药，前后饮用竹沥几升后痊愈。（同上）
死证 中风的病，鼻下赤黑相间，吐沫且身体僵直的，七日死。（《中藏经》）
病风入脉紧数浮沉，有汗出不止，呼吸有声的死亡，否则则生。（同上）
如果摇头直视，心肾脱绝。大概诸阳独留，诸阴悉尽，所以直视摇头，心脏气绝，真脏病显现，很少有再生的。（《朱氏集验方》）
王硕说：只要口开手散，眼合遗尿，声如鼾睡的，都难治疗。如果这样说，那么五证中凡见一证，立刻都不治，这怎么可以呢？按经典所说，身体虚弱急卒中，至于五脏闭绝，脉道不通，气不往来，譬如堕溺，不可期望。为什么呢？口开者心气闭绝也，手撒者脾气闭绝也，眼合者肝气闭绝也，遗尿者肾气闭绝也，鼻鼾者肺气闭绝也，具备这五种情况，才开始不可治。如果见到其中一种，还应当审查其余证候，详查其余脉象，以施救疗。大概国中眼合的多，痰上鼻鼾的也多，只有遗尿口开二证俱见为恶。心为五脏之君主，肾为一身之根本，确实不可闭绝也。（《续易简方后集》）
各种中或未苏醒，或已苏醒，或初病，或久病，忽然吐出紫红色血的死亡。（《证治要诀》）
预防法（宜参前先兆条） 宝鉴说：凡人刚开始觉得大拇指、食指麻木不仁或不能用的，三年内会有中风的疾病，宜先服愈风汤、天麻丸各一料，这是治未病的方法。（按：这原本出自《保命集》）薛己说：预防的道理，当调养气血，节制饮食，戒除七情，远离房事就可以了。如果服用前方来预防，恰恰是招致风邪取中。（《准绳》）
如果风病既愈，而根株未能完全拔除，隔一二年或数年必然复发，发作则必然加重，甚至丧命。所以平时宜预防，第一防止房劳、暴怒、郁结，调气血，养精神；又常服药以维持它，才可以安宁。（《沈氏尊生书》）
治法概略 按中风的证候，应当先辨别是真中还是类中，以及在经络脏腑的区别，更观察其阴阳、左右、寒热、气血的偏虚，湿痰的症状依据，然后立法施治。其治疗的大略，不外乎攻风逐痰，收气灸脱，开关通闭，涌吐活络，清火养血，润燥培元，补气回阳等方法。（《医级》）
昏沉不省人事，口噤不可进药，急以生半夏研末，吹入鼻中，或用细辛皂角研末，吹入喉，喷嚏则苏醒。（按此法本出《易简方》）这可以验证受病的深浅，从而知道可治不可治。如果稍微得苏醒的，八味顺气散便服治风药，然而不要立即停止治气药，小续命汤煎熟去滓，调苏合香丸一粒。或五积散加麝香少许，或星香散，或醒风汤加木香一钱。如果服用前药无效，其人顽涎愈盛，或前证不解，或增困重，宜星附汤，或三生饮加全蝎三个，间磨沉香汤下养正丹。（《要诀》）（按：五积散加麝香本出《百一选方》）
治当调气活血 治疗之法，当推究其来源。如果是内因七情而得的，治法当调气，不当治风。外因六淫而得的，也先当调气，然后根据所感的六气随证治之，这是良法。（《济生方》）
治之之法，调气为先。经云：善治风者，以气理风。气顺则痰消，慢慢调理其风，才可能收效。先用麻油调苏合香丸，或用姜汁，或用白汤调。如果口噤，撬开灌服，稍苏醒则进八味顺气散。（《要诀》）
治风之法，初得病，就应当顺气，等到久了，就应当活血，这是万古不易的道理。久患风疾，用四物汤吞活络丹痊愈的，正是这个意思。如果先不顺气，遽用乌头附子，又不活血，徒用防风、天麻、羌活之辈，我没见过能治好的。（同上）（《准绳》又说：然而顺气的药可以，破气泻气的药不可以。）
此症我历次治疗历次见效，良好原因在于先疏通经络，活血调气，然后用补剂收功。只有经络疏通，宿痰磨去，新痰不生，什么病不能痊愈。（《赤水玄珠》）
大剂久服 凡中风，用续命、排风、风引、竹沥诸汤及神精丹、茵芋酒之类，再加上灸，没有不愈的。然而此病积累习染之久，非一日所能造成，都是大剂久而取效。《唐书》记载王太后中风，喑默不语，医者蒸黄芪数斛来熏她得以痊愈，大概是这一类。今人服三五盏便求效，责备医生也太快了。孟子说七年之病，三年之艾，久后才知这个道理。（《本事方》）
开关方法 猝然口噤目张，两手握固，痰壅气塞，无门下药，此为闭证。闭则宜开，不开则死，搐鼻、揩齿、探吐，都是开法。（《金匮翼》）
经验方治急中风，目瞑牙噤，无门下药的，用中指点散子揩齿三二十次，揩大牙左右，其口自开，始得下药。龙脑、天南星等分为末，乳钵内研，只用一字至半钱，名开关散。（《本草》）
《简要济众》如牙关不开，用白梅揩齿，口开即灌药。（同上皂荚条）《圣济》名白神散（又有白矾散，用白矾、盐花二味。）
甘草（比中指节，截作五截，于生油内浸过，炭火上炙，候油入甘草用。）
上一味，用物斡开牙关，令咬定甘草，可持续如一行人走一里的时间，又换甘草一截，后灌药极效。（《圣济》）
男子妇人中风，涎潮于心，猝然中倒，当时实时扶入暖室中，扶策正坐，当面作好醋炭熏之，令醋气冲入口鼻内。良久，其涎潮聚于心者，自收归旧，轻者实时苏醒，重者亦省人事，惟不可吃一滴水汤入喉也。如吃汤水，则其涎永系于心络不能去，必成废人。今只以醋炭熏之，既得涎离于心，渐渐苏醒，当以生料五积散加麝香煎服之。（《澹寮集验方》引《传心方》）
初病卒倒，危急不醒，但察其有无死证。如无死证，而形气不脱，又无痰气，但扶定掐其人中，自当渐醒。或以白汤姜汤，徐徐灌之亦可。待其苏醒，然后察证治之。（《景岳全书》）
通窍方法 风邪中人，与痰气相搏，闭其经隧，神暴昏，脉暴绝的，急与苏合、至宝之属以通之。大概只有香药，才能达经隧通神明也。（《金匮翼》）
苏合香丸。
苏合香 白术 朱砂 沉香 诃子肉 丁香 木香
香附子 白檀香 乌犀角 乳香 荜茇 安息香（各一两） 麝香 龙脑（各半两）
上为末，炼蜜丸，如鸡头实大，每服一丸，温酒嚼下，人参汤亦得。此方大家皆有，恐未知其神验耳。本出《广济方》，谓之白术丸，后人编入《外台》。（按：此出《外台·鬼魅精魅及古今诸家丸方》中）《和剂局方》苏合香油（入安息香膏内）、薰陆香（别研）、龙脑（研各一两）、青木香、白术、白檀香、丁香、朱砂（研水飞）、沉香、香附子（炒去毛）、乌犀（镑屑）、荜茇、安息香（别为末用无灰酒一升熬膏）、麝香（研）、诃黎勒（煨取皮各二两）。上为细末，入研药匀，用安息香膏并炼白蜜和剂，每服旋丸，如梧桐子大，早朝取井花水，温冷任意，化服四丸，老人小儿可服一丸，温酒化服亦得，并空心服之。去龙脑，名麝香苏合香丸。苏合香丸古方多以酒调服，是以往往服者不能奏功；若以人参汤佐之，其功倍于常也。凡中风不省人事，牙关紧急者，用此丸旋加麝香一二分，以真麻油调灌之，无不吐痰而苏者。大概麻油最能化痰，试滴痰上，须臾痰化为水。若口开脉绝者不救。（《续医说》）（按：麝香、麻油本出《是斋》）
朱砂 牛黄 水银 龙脑 腻粉 麝香（各一分） 金箔（二十一大片）
上件药一处同研，水银星尽，用枣肉为丸，如绿豆大，病轻者分作四服，患重者只作一服，温水或化破服之。利下涎后，平气丸散，渐服慢治风药。（《传家秘宝》）（按：此方似宜入宁神中，然据其主证，姑列于斯。）
治痰方法 人之胃中，必有涎液为养。风内动而气上逆，则涎随气上，而为痰嘶。风中虽属挟虚，半是痰邪为患，虚痰实痰，治有分别。如果窒碍不通，必先治标为急，所以涌吐、开通、豁降之治，在所必需也。（《医级》）
或因风而动痰，或因痰而致风，或邪风多附顽痰，或痰病有如风病。是以掉摇、眩晕、倒仆、昏迷等证，风固有之，痰亦能然，要在有表无表、脉浮脉滑为辨耳。风病兼治痰则可，痰病兼治风则不可。（《金匮翼》）
《必用方》论中风无吐法，引金虎碧霞为戒。且如卒暴涎生，声如引锯，牙关紧急，气闭不行，汤药不能入，命在须臾者，执以无吐法可乎。但不当用银粉药，恐损脾坏人四肢尔。（《本事方》）
治痰之法，凡非风初病而痰气不甚者，必不可猜其为痰而妄用痰药，这是大戒。如果果痰涎壅盛，填塞胸膈，汤液俱不能入，则不得不先开其痰，以通药食之道。而开痰之法，
惟吐为捷，如古方之独圣散、茶调散、稀涎散之属，皆吐痰之剂也。但恐元气太虚，不能当此峻利之物，或但用新方之吐法为妥，或用牛黄丸、抱龙丸之类。但使咽喉气通，能进汤饮即止，不可尽攻其痰，致令危困，则最所当慎。以故治痰之法，又必察其可攻与否，然后用之，斯无误也。（按：新方吐法系萝卜子及盐汤二方）
如果其眼直切牙，肢体拘急，面赤，强劲有力者，虽见昏沉，亦为可治。先用粗箸之类挖开其口，随以坚实笔杆KT 住牙关，乃用淡淡姜盐汤徐徐灌之，然后以中食二指探入喉中，徐引其吐。若指不能入，则以鹅翎蘸
Use Suhexiang Wan (Suhexiang Pill), Niuhuang (Calculus Bovis), Zhibao Dan (Zhibao Pill) and similar medicines to administer orally. If signs of Tuozheng (a critical syndrome characterized by the collapse of vital energy) are observed, only large doses of Lizhong Tang (Regulate the Middle Decoction) should be administered, along with moxibustion applied below the navel. Although it is said to be incurable, there is still a one-in-ten chance of rescue. If Suhexiang Wan or Niuhuang are mistakenly administered, survival will be impossible. These potent agents, described as "generals breaking through gates," are originally intended for Bizheng (a excess syndrome characterized by obstruction of the heart orifices). Applying them to Tuozheng is like dropping stones on someone who has already fallen into a well. Countless people have died due to this error. (*Yilin Shengmo*) (Zhou Jing stated: In cases of Tuo syndrome, treatment is generally considered futile; only massive administration of Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata) might offer a slim hope. Note: *Yixue Gangmu* states: When the Qi of the five Zang organs fails, large doses of Renshen should be decocted into a thick liquid and administered immediately, and strong moxibustion should be applied below the navel; this can also reverse death and restore life. *Nuke Zhunsheng* analyzes the treatment of Bi and Tuo syndromes, combining content from *Shengmo* and *Gangmu*, but changing Niuhuang and Zhibao to Sansheng Yin (Sansheng Decoction) is incorrect. *Yizong Bidu* fully adopts the view of *Shengmo*.)
Regarding sudden collapse and violent syncope, regardless of gender, whether caused by Wind-Cold, Qi stagnation, Food retention, Phlegm-Dampness, the key is to clearly distinguish between Bi syndrome and Tuo syndrome. (*Nuke Zhunsheng*)
Bi syndrome involves pathogenic factors obstructing the exterior while Yuanqi (Original Qi) remains within; treating with methods to open orifices and regulate Qi allows pathogens to dissipate naturally, making it easier to treat. Tuo syndrome involves the leakage of Yuanqi to the exterior and mixing of pathogens within; even with drastic tonification, the Zang organs are already damaged, making it difficult to treat. This applies to all such syndromes, not just stroke. (*Zhengzhi Huibu*)
Cold, Heat, Deficiency, and Excess: The six pulses being deep and hidden or floating and vigorous at the fingertips indicate the distinction between Yin-within-Yang and Yang-within-Yin, referred to in classics as Hanzhong (Cold Stroke) and Rezong (Heat Stroke). If the pulse is deep and rapid, with a blue-white complexion and a slack, lethargic demeanor, this is Hanzhong. Treatment principles include using Tianxiong (Aconitum) and Fuzi, such as Sanjian Tang (Three Jian Decoction) and Xingfu Tang (Pinellia and Aconite Decoction). If the pulse is floating, surging, and rapid, with red cheekbones and a dark-red face, appearing drunk or angry, this is Rezong. Treatment principles include using Fangfeng (Saposhnikoviae Radix) and Duhuo (Angelicae Pubescentis Radix), such as Da Xiao Shengfeng Tang (Large and Small Wind-Dispersing Decoctions) and Zidou Tang (Purple Bean Decoction). (*Xu Yijian Fang Houji*) (Note: *Yonglei Qianfang* is slightly similar. Rezong may also present with locked jaw, upward gaze, stiffness, tremors, and vertigo.)
*Waitai Mi Yao* states: Regarding stroke, where limbs cannot hold themselves, hands and feet flail, spirit is confused and dull, eyes do not recognize people, speech is slurred, restlessness and aversion to clothing occur, and administering medicine causes confusion, these diseases mostly arise from Heat. Wang Shuhe stated that accumulated heat generates Wind. (Note: The source of this citation should be verified.) Therefore, ancient sages used Zhibao Dan, Hongxue Tongzhong San (Red Snow Unblocking Middle Powder), Longnao Xiongxi Wan (Borneol and Rhinoceros Horn Pill), Bohe Jian (Mint Decoction), and Niuhuang Qingxin Wan (Calculus Bovis Clear Heart Pill) to treat it. Drinking Zhuli (Bamboo Sap) alone or Da Xiao Zhuli Tang (Large and Small Bamboo Sap Decoctions), or Baidu San (Defeat Toxin Powder) added with Fangfeng and Jingjie (Schizonepetae Herba) decocted and taken orally is also effective. If one fails to ascertain that it is Heat accumulating to generate Wind, and indiscriminately administers Sansheng Yin, Sanjian Tang, or Yangzheng Dan (Nourish Righteousness Pill), disaster will follow immediately. (*Guanjian Liangfang*)
Stroke causing weak limbs and inability to move, accompanied by spontaneous sweating, is Xu Zhongfeng (Deficiency Stroke). If limbs are stiff and spasmodic, with facial paralysis and pain upon extension/flexion, it is Shi Zhong (Excess Stroke). (*Shoushi Baoyuan*)
Distinction between Zhongfeng (Wind Stroke) and Zhongqi (Qi Stroke) (Refer to Qi Disease Section): Zhongqi resembles Zhongfeng; the difference is that in Wind Stroke the body is warm, while in Qi Stroke the body is cold. (*Zhengzhi Yaojue*)
There is also Zhongqi resembling Zhongfeng, with slurred speech, flooding saliva, coma, locked jaw, differing only in that limbs are not paralyzed. (*Qixiao Liangfang*)
Zhongqi is commonly known as Qi Jue (Qi Collapse); the pulse must be deep, whereas a floating pulse indicates Wind. Zhongfeng and Lei Zhongfeng (Similar Wind Stroke) present with a warm body and much phlegm-saliva; Zhongqi presents with a cold body and no phlegm-saliva. (*Danxi Zuanyao*)
Wind Stroke pulse is floating and surging; Qi Stroke pulse is deep and choppy. (*Yiyue*)
Zhongfeng and Zhongqi have similar appearances but different etiologies. Zhongfeng occurs due to weakened Yuanqi and loose interstices, allowing Wind pathogen to strike suddenly, resulting in collapse with a stiff and hot body. Zhongqi is caused by emotional injury, leading to Qi collapse and fainting, necessarily with a cold body and without stiffness/spasms; after regaining consciousness, rebellious Qi persists. (*Yuanbing Ji*)
Similar Syndromes (Also see Jue and Phlegm-Food Retention sections): Heavy limbs resembling wind stroke originate from Spleen-Stomach deficiency and insufficient Ying-Wei (Nutritive and Defensive Qi). The Stomach is the sea of water and grain; the Spleen grinds and digests it, transforming essence into Ying-Wei to nourish the four limbs. Irregular lifestyle and diet lead to Spleen-Stomach Qi deficiency, causing inadequate nourishment by Ying-Wei, allowing Wind pathogen to invade. Since the Spleen governs the limbs and its meridians connect to the tongue root and end at the lips/mouth, both limbs and mouth/lips become numb, causing slurred speech. Treatment should prioritize Spleen-Stomach herbs and minimize Wind-dispelling herbs to achieve stability. Untreated long-term, it becomes Wei Ji (Atrophy Syndrome), as the Classics state: "Treat Atrophy by focusing solely on the Yangming channel," which refers to the Stomach meridian. (*Jifeng*)
Unexplained facial paralysis unresponsive to stroke medication is likely due to bone deficiency allowing Wind invasion; seek cause here rather than treating as ordinary stroke. Chuanwu (Aconiti Radix) is essential, properly processed. (*Zhengzhi Yaojue*)
Those with inherent weak Yuanqi, overwork, or sexual indulgence may suffer sudden collapse resembling stroke, with open mouth and relaxed hands. Only massive doses of Renshen (up to one jin/catty) can restore Yuanqi. Cases without collapse but with stiff tongue, slurred speech, phlegm obstruction, facial paralysis, and limb immobility treated as stroke will likely result in danger. (*Zhengzhi Zhunsheng*)
Danxi treated Wang Congyi, aged 42, with numbness in all ten fingers and face, diagnosed as Qi deficiency. Healed with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Muxiang (Aucklandiae Radix) and Fuzi each 0.5 fen. (*Mingyi Leian*)
Zhu Juquan treated the Duke of Ying with left-sided hemiplegia, aphasia, and Qi congestion. Physicians thought it was stroke and used Qi-regulating/Wind-dispelling formulas without effect. Zhu stated it was caused by Phlegm-Fire and Damp-Heat. He prescribed clearing dryness and resolving phlegm; drinking several sheng of bamboo sap cured him. (Same source)
Death Signs: In stroke, if the area below the nose shows mixed red and black, with foaming and rigid body, death occurs in seven days. (*Zhongzang Jing*)
If the pulse in wind disease is tight, rapid, floating, or deep, with incessant sweating and audible breathing, death ensues; otherwise, survival. (Same source)
Head shaking and fixed gaze indicate Heart-Kidney collapse. With Yang remaining alone and Yin exhausted, fixed gaze and head shaking signify Heart Qi failure and True Zang pathology; regeneration is rare. (*Zhushi Jiyuan Fang*)
Wang Shuo stated: Open mouth, relaxed hands, closed eyes, urinary incontinence, and snoring sound indicate difficult-to-treat cases. However, saying any single sign means incurability is wrong. Classics state that when severe stroke leads to five Zang closure, meridians block, and Qi stops, it is like falling from height; expectation is futile. Why? Open mouth = Heart Qi closure; relaxed hands = Spleen Qi closure; closed eyes = Liver Qi closure; incontinence = Kidney Qi closure; snoring = Lung Qi closure. Only when all five are present is it incurable. If only one is seen, examine other signs/pulses for rescue. Closed eyes and snoring are common; only combined incontinence and open mouth are ominous. Heart is ruler of Zang; Kidney is root of body; their closure is truly dangerous. (*Xu Yijian Fang Houji*)
Any stroke patient, whether unconscious, conscious, newly ill, or chronically ill, suddenly vomiting purple-red blood indicates death. (*Zhengzhi Yaojue*)
Prevention Method (Refer to Prodrome Section): *Baojian* states: If one initially feels numbness or loss of function in the thumb and index finger, stroke will occur within three years. Preventively take Yufeng Tang (Wind-Preserving Decoction) and Tianma Wan (Gastrodia Pill) for one course. This is treating disease before it arises. (Note: Originally from *Baoming Ji*). Xue Ji stated: Prevention relies on nourishing Qi and Blood, regulating diet, controlling emotions, and avoiding sexual activity. Using preventive formulas merely attracts Wind. (*Zhunsheng*)
If wind disease heals but roots remain, recurrence in 1-2 years or more is inevitable, worsening each time, potentially fatal. Thus, prevention is crucial: avoid sexual exhaustion, rage, and depression; regulate Qi/Blood, nourish Spirit; maintain with regular medication for stability. (*Shenshi Zunsheng Shu*)
General Treatment Principles: Assess true vs. similar stroke, meridian vs. Zang-Fu involvement, and imbalances in Yin/Yang, Left/Right, Cold/Heat, Qi/Blood, and Damp-Phlegm evidence before prescribing. General methods include expelling Wind/driving out Phlegm, consolidating Qi/moxa for collapse, opening orifices/resolving obstruction, inducing vomiting/unblocking collaterals, clearing Fire/nourishing Blood, moistening dryness/tonifying Origin, and tonifying Qi/restoring Yang. (*Yiji*)
For coma, aphagia, and locked jaw: Immediately blow powdered raw Banxia (Pinelliae Rhizoma) into the nose, or powder of Xixin (Asari Radix) and Zhaojiao (Gleditsiae Sinensis Fructus Spina) into the throat. Sneezing restores consciousness. (Note: From *Yijian Fang*). This tests depth of illness to determine prognosis. If slightly conscious, administer Bawei Shunqi San (Eight-Ingredient Qi-Regulating Powder) with wind-dispelling herbs, but do not stop Qi-regulating herbs. Use Xiaoxuming Tang (Minor Xu-Ming Decoction) strained, mixed with one pill of Suhexiang Wan. Or Wujie San (Five Accumulations Powder) with Musket (Moschus), or Xingxiang San (Pinellia and Aucklandia Powder), or Xingfeng Tang with Muxiang 1 qian. If ineffective, with increased stubborn phlegm or worsening symptoms, use Xingfu Tang or Sansheng Yin with Quanxie (Scorpio) 3 units, alternating with Chenxiang (Aquilaria) soup and Yangzheng Dan. (Note: Wujie San with Moschus from *Baiyi Xuanfang*). (*Yaojue*)
Treatment Should Regulate Qi and Invigorate Blood: Determine etiology. Internal causes (Seven Emotions) require Qi regulation, not Wind treatment. External causes (Six Climates) also start with Qi regulation, then treat based on specific climatic factors. This is a good method. (*Jisheng Fang*)
Treatment prioritizes Qi regulation. Classics say: "Skillful treatment of Wind regulates Wind via Qi." Smooth Qi eliminates Phlegm; gradually address Wind for efficacy. First, mix Suhexiang Wan with Sesame Oil, Ginger Juice, or plain water. If locked jaw, pry open and administer. Upon slight recovery, give Bawei Shunqi San. (*Yaojue*)
Treating Wind: Initially regulate Qi; later invigorate Blood. This is an eternal principle. Chronic wind disease cured by Simo Siwu Tang (Four Substances Decoction) swallowing Huoluo Dan (Collateral-Activating Pill) exemplifies this. Without prior Qi regulation, rashly using Wu Tou (Aconitum) and Fu Zi without invigorating Blood, or merely using Fangfeng, Tianma, Qianghuo, etc., is ineffective. (Same source) (*Zhunsheng* adds: Regulating Qi herbs are acceptable; breaking/reducing Qi herbs are not.)
My successful treatments relied on first unblocking meridians, invigorating Blood, and regulating Qi, then concluding with tonics. Once meridians are clear and old phlegm removed, new phlegm won't form; what disease won't heal? (*Chishui Xuanzhu*)
Large Doses and Long-Term Administration: For stroke, using Xuming, Paifeng, Fengyin, Zhuli decotions, Shenjing Dan, Yinyu Jiu, plus moxibustion, ensures cure. This disease accumulates over time; large doses over long periods are needed. *Book of Tang* records Empress Dowager Wang with stroke aphasia cured by steaming several hu of Huangqi (Astragali Radix) for fumigation. Modern patients expect results from 3-5 cups, demanding too fast results. Mencius said: "Seven-year illness requires three-year mugwort"; patience is key. (*Benshi Fang*)
Opening Orifices Methods: Sudden locked jaw, open eyes, clenched fists, phlegm-Qi obstruction preventing medication is Bi syndrome. Bi requires opening; failure to open leads to death. Nasal insufflation, tooth wiping, and induced vomiting are opening methods. (*Jingui Yi*)
Empirical formula for acute stroke with closed eyes/locked jaw: Use Zhongzhi (Middle Finger) to apply Sanzi powder to wipe teeth 20-30 times, wiping molars left/right until mouth opens. Then administer medicine. Longnao (Borneolum Syntheticum) and Tiannanxing (Arisaematis Rhizoma) equal parts, ground in mortar, dose 1 zi to half qian, named Kaiguan San (Open Orifice Powder). (*Bencao*)
*Jianyao Jizhong*: For locked jaw, wipe teeth with Bai Mei (White Plum); once open, administer medicine. (*Shengji* names this Baishen San; another Baifan San uses Baifan and Yanhua.)
Formula for Stroke Locked Jaw:
Gancao (Licorice Root): Cut to length of middle finger joint, into 5 pieces, soak in raw sesame oil, roast over charcoal fire until oil penetrates.
Take this single herb, use instrument to pry jaw open, let patient bite Gancao for duration of walking one li, replace piece, then administer medicine effectively. (*Shengji*)
Male/Female stroke with phlegm flooding Heart, sudden collapse: Immediately move to warm room, sit upright, burn vinegar-soaked charcoal near face to inhale vapor. After time, phlegm returns to normal; mild cases recover instantly, severe cases regain some awareness. **Crucial**: Do not allow any water/broth down throat. Water binds phlegm to heart collaterals permanently, causing permanent disability. Vinegar fumigation separates phlegm from Heart; gradual recovery follows. Then administer Shengliao Wujie San (Raw Material Five Accumulations Powder) with Moschus decocted and taken orally. (*Danliao Jiyuan Fang* citing *Chuanxin Fang*)
Initial sudden collapse, critical unconsciousness: Check for death signs. If none, and constitution/Qi intact without phlegm-Qi obstruction, press Renzhong (GV26) firmly; gradual awakening expected. Alternatively, slowly administer plain water or ginger water. Wait for recovery, then diagnose and treat. (*Jingyue Quanshu*)
Unblocking Orifices Methods: Wind pathogen attacking body, combing with Phlegm-Qi, blocking meridians, sudden spirit dimming and pulse cutoff: urgently use Suhexiang, Zhibao type herbs to unblock. Only aromatic herbs can reach meridians and clarify spirit. (*Jingui Yi*)
Suhexiang Wan.
Ingredients: Suhexiang (Styrax), Baizhu (Atractylodis Macrocephalae Rhizoma), Zhusha (Cinnabar), Chenxiang (Aquilaria Resina), Hezi Rou (Terminalia Chebula Pericarpium), Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), Xiangfuzi (Cyperi Rhizoma), Bantanxiang (Santalum Album Lignum), Wuxijiao (Rhinocerotis Cornu - substitute Buffalo Horn), Ruxiang (Olibanum), Bibo (Long Pepper), Anshixiang (Benzoin), Muxiang (Moschus), Longnao (Borneolum Syntheticum). Dosages provided.
Process: Grind to powder, honey pills size of chicken egg. Take one pill, chew with warm wine or Renshen Tang. Widely available but efficacy unknown. Originally *Guangji Fang* called Baizhu Wan, later included in *Waitai*. (*Heji Jufang* variation provided). Ancient formulas used wine; often ineffective. Adding Renshen Tang doubles efficacy. For stroke coma/locked jaw, add 1-2 fen Moschus, mix with pure sesame oil, administer. Sesame oil transforms phlegm effectively. If mouth open and pulse absent, incurable. (Note: Moschus/Sesame oil from *Shizhai*).
Seven Treasure Pill for Stroke regardless of urgency, with phlegm flooding, confusion, unconsciousness.
Ingredients: Zhusha, Niuhuang, Shuiyin (Mercurius), Longnao, Nifen (Calomel), Muxiang, Jinbo (Gold Foil).
Process: Grind together until Mercury disappears, form pills with Jujube flesh size of mung bean. Mild cases divide into 4 doses; severe cases single dose. Warm water or dissolve. After phlegm clears, use Pingqi Wan/San, gradually treat wind. (*Chuanjia Mibao*)
Treating Phlegm Methods: Stomach contains saliva for nourishment. Internal Wind movement and rebellious Qi cause saliva to rise as Phlegm-rattle. Wind stroke involves deficiency but half is Phlegm pathogen. Deficient vs. Excess Phlegm treated differently. If obstruction is severe, treat branch/symptom urgently; thus inducing vomiting, opening, and descending Phlegm is necessary. (*Yiji*)
Wind moves Phlegm; Phlegm generates Wind; Wind attaches to stubborn Phlegm; Phlegm disease mimics Wind. Tremors, vertigo, collapse, coma can be Wind or Phlegm. Differentiate by presence of exterior signs and floating/slipping pulse. Treating Wind with Phlegm resolution is okay; treating Phlegm with Wind dispersal is not. (*Jingui Yi*)
*Biyong Fang* argues against vomiting in stroke, citing Jinhu Bixia as warning. But for sudden phlegm surge, sawing sound, locked jaw, Qi blockage, imminent death, refusing vomiting is unreasonable. Just avoid Silver Powder (Calomel) to prevent spleen damage and limb harm. (*Benshi Fang*)
Treating Phlegm: For non-wind initial illness with mild phlegm-Qi, never guess Phlegm and misuse Phlegm-resolving drugs; this is a major taboo. If Phlegm is excessive, filling chest/diaphragm, preventing food/medicine intake, must first resolve Phlegm to open passage. Vomiting is fastest method. Ancient formulas: Dusheng San, Chatiao San, Xixian San are emetics. Caution: If Yuanqi is very deficient, harsh emetics are dangerous. Safer to use new formulas (Radish seed, Salt water) or Niuhuang Wan, Baolong Wan. Stop once throat opens and swallowing resumes; do not exhaust all Phlegm causing crisis. Must assess if attackable before using. (Note: New formulas refer to Radish seed and Salt water).
If eyes fixed, teeth grinding, limb spasm, red face, strong strength, though comatose, treatable. Pry mouth open with chopsticks, secure jaw with pen handle, slowly pour weak ginger-salt water, then induce vomiting with two fingers. If fingers cannot enter, use goose feather dipped...