经曰∶风者,百病之长也。风性轻而善走,无微不入,其中人也易,其发病也速,故为百病之长。人惟卫能捍
外,营能固内,腠理秘密,毛窍不开,斯贼风外邪,无能侵犯。否则正气一虚,外风乘间伺隙,由表入里,而病
亦由浅入深矣。卫气不能捍外,则风入于肌肉,故手指麻木,而肌肉不仁,若是者名曰中络。营血不能固
内,则风入于经脉,故身体重着,步履艰难,若是者名曰中经。由此而深入则为中腑。腑者胃腑也。胃为六
腑之长,职司出纳。风入于胃,胃火炽盛,水谷之气,不生津液而化痰涎,痰随火升,阻塞灵窍,故昏不知人
也。由此而深入,则是中脏。脏者,心脏也。心体纯阳,风性 举,风火上扰,神明散乱,故舌不能言,而口流涎
沫。此偏枯症中由浅入深之次第也。论治者,河间主火,东垣主气,丹溪主痰,是因火召风,因气召风,因痰
召风,反以火气痰为主,而风往从之,标本倒置。诚如喻嘉言之所讥,盖其人有火气痰偏胜之处,因中于
风,则有火者为风火;有气者为风气;有痰者为风痰。风为主,而火与气与痰,乃与风合并交作,方为标本
分明。惟侯氏黑散,填空窍以堵截外风一节,后人每多误解,以为空窍之处,惟肠与胃,若将肠胃之空窍
填塞,则水谷且不得通行,人将何以自立。若有形之水谷,仍能灌输,则无形之邪风,岂反不能直走,蓄此
疑者,不知凡几。殊不思邪害空窍,《内经》已明明言之。所谓空窍者,乃指毛窍及腠理而言。故侯氏黑散
中,用牡蛎、矾石等收涩之药,欲令腠理秘密,毛窍固闭,正如暴寇当前,加筑城垣以堵截之,使不得入耳;
非欲将肠胃之空窍一并窒塞也。只因误会一填字,遂将空窍二字亦一齐错解,故特为明白剖析,庶几
积惑可除。且侯氏黑散中,尚有精义,未经揭出,兹再为表章之。其用牡蛎矾石,为堵截之计,固也。而其尤
要者,则在于收涩敛肝,使在内之肝风不动;今先去其内应,而勾结之患除,虽有邪风,孤立无援,亦将自
退矣。因思保障灵府之法,无如治脾胃以实中州。脾气旺,则积湿尽去,而痰气不生;胃气和,则津液上行,
而虚火自降。治病大法,无过于斯。至仓猝之时,病势危急;则又当逆而折之,虽峻猛之剂,不得不随症而
施矣。
《内经》说:风,是各种疾病的先导。风的性质轻扬且善于游走,无孔不入,人容易受其侵袭,发病迅速,所以被称为百病之长。人体只有卫气能抵御外邪,营血能固守内里,腠理致密,毛孔闭合,这样贼风外邪就无法侵犯。否则正气一旦虚弱,外风就会乘虚而入,由表入里,疾病也就由浅入深了。如果卫气不能抵御外邪,风邪侵入肌肉,就会出现手指麻木、肌肉感觉迟钝的症状,这种情况称为中络。如果营血不能固守内里,风邪侵入经脉,就会出现身体沉重、行走困难的症状,这种情况称为中经。由此再深入则为中腑。腑指的是胃腑。胃为六腑之首,主管饮食的纳受与排泄。风邪侵入胃中,导致胃火炽盛,水谷之气不能化生津液反而生成痰涎,痰随火势上逆,阻塞清窍,所以出现昏迷不省人事的症状。由此再深入,则是中脏。脏指的是心脏。心体属纯阳,风性升举,风火相互煽动上扰,导致神明散乱,所以出现舌强不能言语、口流涎沫的症状。这是偏枯症(半身不遂)由浅入深的次第过程。论述治疗的人中,刘河间主张治火,李东垣主张治气,朱丹溪主张治痰,这是因为火招引风、因气招引风、因痰招引风,反而以火、气、痰为主,而风邪随之,这是标本倒置。正如喻嘉言所讥讽的那样,大概是因为这些人本身有火、气、痰偏胜的情况,又中了风邪,所以有火者成为风火,有气者成为风气,有痰者成为风痰。风是主因,而火、气、痰与风合并交作,这才是标本分明。只有侯氏黑散中“填空窍以堵截外风”这一节,后人往往多有误解,认为空窍之处只有肠和胃,如果把肠胃的空窍填塞住,那么水谷就不能通行,人将如何生存。如果有形的水谷仍能灌输,那么无形的邪风难道反而不能直走吗?持有这种疑惑的人不知有多少。殊不知邪害空窍,《内经》已经明确说过。所谓空窍,是指毛窍及腠理而言。所以侯氏黑散中,使用牡蛎、矾石等收敛涩滞的药物,是想让腠理致密,毛孔固闭,就像面对暴寇当前,加筑城墙来堵截它,使其不得进入;并不是想把肠胃的空窍一并堵塞。只因误解了一个“填”字,遂将“空窍”二字也一起错解,所以特意明白剖析,希望消除积久的困惑。而且侯氏黑散中还有精义,未曾揭示出来,现在再为表彰阐明。其中使用牡蛎、矾石作为堵截之计,固然正确。但其中尤为重要的,在于收敛涩肝,使体内的肝风不动;如今先去除了内部的呼应,勾结之患消除,即使有邪风,孤立无援,也将自行退去。因而想到保障灵府(心神居所)的方法,没有比调理脾胃以充实中州更好的了。脾气旺盛,则积湿尽去,痰气不生;胃气和顺,则津液上行,虚火自降。治病的大法,没有超过这个的了。至于仓促之间,病势危急,则应当逆势折挫病情,即使是峻猛的药剂,也不得不根据症状施用。
The *Neijing* states: Wind is the leader of all diseases. The nature of wind is light and agile, penetrating everywhere without exception; it easily invades humans and causes rapid onset of disease, thus being called the leader of a hundred diseases. In the human body, only when Wei Qi (Defensive Qi) can defend the exterior and Ying Blood (Nutritive Blood) can secure the interior, with dense Couli (interstices) and closed Maoqiao (pores), can evil winds and external pathogens fail to invade. Otherwise, once Zheng Qi (Upright Qi) becomes deficient, external wind takes advantage of gaps, entering from the exterior to the interior, causing the disease to progress from shallow to deep levels. If Wei Qi fails to defend the exterior, wind enters the muscles, resulting in numbness of the fingers and insensitivity of the muscles; this condition is named Zhong Luo (Stroke affecting the collaterals). If Ying Blood fails to secure the interior, wind enters the meridians, resulting in heaviness of the body and difficulty in walking; this condition is named Zhong Jing (Stroke affecting the channels). Proceeding deeper from here leads to Zhong Fu (Stroke affecting the fu organs). The fu refers to the Stomach fu organ. The Stomach is the head of the six fu organs, responsible for receiving and discharging. When wind enters the Stomach, Stomach fire flares up vigorously; the qi of food and drink fails to generate body fluids but instead transforms into phlegm-saliva. Phlegm rises with the fire, blocking the spiritual orifices, leading to coma and unconsciousness. Proceeding even deeper leads to Zhang Zang (Stroke affecting the zang organs). The zang refers to the Heart. The substance of the Heart is purely yang; the nature of wind is uplifting. Wind and fire harass upwards, scattering the Shen (Spirit), leading to an inability to speak due to tongue stiffness and drooling saliva. This is the sequence of progression from shallow to deep in the syndrome of Pian Ku (hemiplegia). Regarding treatment theories, Liu Hejian emphasized Fire, Li Dongyuan emphasized Qi, and Zhu Danxi emphasized Phlegm. This approach treats Fire, Qi, and Phlegm as primary, with Wind following them, thereby reversing the root and branch relationship. As criticized by Yu Jiayan, generally speaking, if a person has a predisposition to excess Fire, Qi, or Phlegm and then contracts Wind, the result is Wind-Fire, Wind-Qi, or Wind-Phlegm respectively. Wind is the primary cause, while Fire, Qi, and Phlegm combine and interact with Wind, clearly distinguishing root and branch. Only in the formula Hou Shi Hei San (Marquis Hou's Black Powder), specifically the section on "filling the empty orifices to block external wind," have later generations often misunderstood. They assumed that "empty orifices" referred only to the intestines and stomach. If the empty orifices of the intestines and stomach were blocked, food and water could not pass through, and how would the person survive? If有形 (solid) food and water can still be transported, why would无形 (formless) pathogenic wind be unable to move directly? There are countless such doubts. However, one overlooks that the *Neijing* explicitly states that evil harms the empty orifices. The term "empty orifices" here refers to Maoqiao (pores) and Couli (interstices). Therefore, in Hou Shi Hei San, astringent herbs such as Muli (Oyster Shell) and Fanshi (Alum) are used to make the Couli dense and the Maoqiao closed, akin to building city walls to block invaders when facing a sudden raid, preventing entry; it is not intended to block the empty orifices of the intestines and stomach. Due to a misunderstanding of the character "fill," the term "empty orifices" was also wrongly interpreted. Thus, a clear analysis is provided to dispel long-standing confusion. Furthermore, there is profound meaning in Hou Shi Hei San that has not yet been revealed, which I now wish to highlight. While using Muli and Fanshi as a blocking strategy is correct, the most crucial aspect lies in astringing and consolidating the Liver to prevent internal Liver Wind from stirring. By first eliminating the internal resonance, the danger of collusion is removed; even if external wind exists, isolated and unsupported, it will recede on its own. Thus, I reflect that the method to protect the Lingfu (residence of the Spirit) is none other than regulating the Spleen and Stomach to solidify the Middle Jiao. When Spleen Qi is vigorous, accumulated dampness is eliminated, and phlegm-qi does not arise; when Stomach Qi is harmonious, body fluids ascend, and deficiency fire naturally subsides. The general principle of treating disease exceeds nothing else. However, in sudden emergencies where the disease condition is critical, one must counteract and break the momentum; even potent and harsh preparations must be administered according to symptoms.