如小便少不可以药利之既以自汗则津液外亡小便自少若利之使荣卫枯竭无以制火烦热愈
甚当俟热退汗止小便自行也兼此证乃阳明经大忌利小便
元戎云酒湿之为病亦能作痹证口眼 斜半身不遂浑似中风舌强不正当泻湿毒不可作风病
治之而汗也衍义论甚当易简所言与此相同
按此则知口眼 邪半身不遂之病岂止风之一端而已况六气皆能中人其证亦有纵急搐搦不
知人等证不可不以脉证分别
严用和云人之元气强壮荣卫和平腠理致密外邪焉能为害或因七情饮食劳役致真气先虚荣
卫空
疏邪气乘虚而入故致此疾若内因七情而得者法当调气不当治风外因六淫而得者亦当先调气后
根据所感六气治之此良法也宜八味顺气散
按此说真气先虚荣卫空疏邪气乘虚而入扩前人所未发但既曰虚矣邪又入矣补虚散邪理所
当然
而止曰调者意其谓因病而气壅不通调其通畅条达则真气自复邪气自行之义惜乎不能详也况中
风治法岂止一端而已
许学士云世言气中者虽不见于方书然暴怒伤阴暴喜伤阳忧愁不已气多厥逆往往得此疾便
觉涎
潮昏塞牙关紧急若便作中风用药多致杀人惟宜苏合香丸灌之便醒然后随寒热虚实而调之无不
愈者经云无故而喑脉不至不治自已谓气暴逆也气复则已审如是虽不服药自可
按气中之说即七情内火之动气厥逆由其本虚故也用苏合香丸通行经络其决烈之性如推枯
拉朽恐血气虚者非所宜也后云不治自复之意盖儆用药之失实胜误于庸医之手也
如果小便量少，就不可以用药物来通利小便。既然已经有自汗，津液就会从体表外泄，导致小便自然减少；如果此时再用利尿药，会使营气和卫气枯竭，无法制约火邪，烦热症状会更加严重。应当等待热退、汗止之后，小便自然会恢复正常。兼有此证候时，是阳明经治疗的大忌，不可使用利小便的方法。
元戎说：酒湿引起的疾病也能导致痹证，出现口眼歪斜、半身不遂等症状，看起来很像中风，但舌体僵硬、言语不清。这是因为泻下湿毒所致，不能当作风病来治疗而使用发汗法。《衍义论》的说法非常恰当，《易简方》中的观点与此相同。
按此分析可知，口眼歪斜、半身不遂这类疾病，岂止是风邪一种病因所致？况且六淫之气都能侵袭人体，其症状也有抽搐强直、昏迷不知人事等表现，因此不能不通过脉象和症状进行辨别。
严用和说：人的元气强壮，营卫调和，腠理致密，外邪怎么能侵害呢？有的因为七情（喜、怒、忧、思、悲、恐、惊）、饮食或劳役过度，导致真气先虚，营卫空虚疏漏，邪气乘虚而入，从而引发这种疾病。如果是内因七情致病，治法应当调理气机，而不当单纯治风；如果是外因六淫致病，也应当先调理气机，然后再根据所感受的六淫邪气进行治疗。这是很好的方法，适宜使用八味顺气散。
按此说法，“真气先虚，营卫空疏，邪气乘虚而入”扩充了前人的理论，但既然已经提到“虚”且“邪已入”，补虚散邪是理所当然的。文中只说“调”，意思是因病导致气机壅滞不通，调理使其通畅条达，则真气自然恢复，邪气自行消散。可惜解释得不够详尽。况且中风的治法岂止这一种而已。
许学士说：世人所说的“气中”，虽然在方书中没有明确记载，但暴怒伤阴，暴喜伤阳，忧愁不已导致气机多呈厥逆状态，往往容易得上这种病。发病时突然觉得涎沫上涌，昏塞牙关紧急。如果立即当作中风用药，往往会导致死亡。只宜用苏合香丸灌服，病人苏醒后，再根据寒热虚实情况进行调理，没有不痊愈的。《内经》说：“无故失音，脉搏摸不到，不治也会自愈。”这是指气机暴逆所致，气机恢复就好了。审视这种情况，即使不服药，身体也可自行恢复。
关于“气中”的说法，即是七情内动之火，导致气机厥逆，因其本虚所致。使用苏合香丸通行经络，其猛烈之性如同推倒枯木、折断朽木，恐怕气血虚弱的人并不适宜。后面说“不治自复”的意思，大概是警示用药失误，实际上胜于被庸医误治。
If the urine volume is low, diuretic drugs should not be used to promote urination. Since spontaneous sweating (Zihan) has already occurred, body fluids (Jinye) are lost from the exterior, causing urine output to decrease naturally. If diuretics are administered at this time, Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) will become depleted, failing to control Fire pathogenic factors, thereby exacerbating irritability and heat. One should wait for the fever to subside and sweating to cease, after which urination will normalize on its own. In cases with these concurrent symptoms, promoting urination is a major contraindication in the treatment of Yangming Channel diseases.
Yuan Rong stated: Diseases caused by dampness from alcohol can also manifest as Bi syndrome (Obstruction Syndrome), presenting with deviation of the mouth and eye, hemiplegia, and symptoms resembling Wind stroke. However, tongue stiffness and speech impediment result from the expulsion of damp-heat toxins; thus, it should not be treated as a Wind disease using diaphoretic methods. The discussion in *Yanyi Lun* is highly appropriate, and the views in *Yijian Fang* are consistent with this.
Based on this analysis, it is evident that conditions such as deviation of the mouth and eye and hemiplegia are not solely caused by Wind pathogens. Furthermore, all six climatic pathogens (Six Evils) can invade the human body, presenting with symptoms such as spasms, convulsions, and loss of consciousness. Therefore, differentiation must be strictly based on pulse signs and clinical manifestations.
Yan Yonghe stated: When a person's Yuan Qi (Primal Qi) is strong, Ying and Wei Qi are harmonious, and the interstices (Couli) are dense, how can external pathogens cause harm? However, due to emotional disturbances (Seven Emotions), improper diet, or overwork, the True Qi may first become deficient, leaving Ying and Wei Qi empty and the defensive barrier lax, allowing pathogens to enter through the deficiency and cause disease. If the etiology is internal (Seven Emotions), the treatment should focus on regulating Qi rather than treating Wind. If the etiology is external (Six Excesses), one should first regulate Qi and then treat according to the specific Six Excesses involved. This is an excellent method, and Bawei Shunqi San (Eight-Ingredient Decoction to Smooth Qi) is suitable.
In my opinion, the concept that "True Qi becomes deficient first, Ying and Wei Qi become lax, and pathogens enter through the deficiency" expands upon previous theories. Given that both deficiency and pathogenic invasion exist, tonifying deficiency and dispersing pathogens is logically necessary. The text mentions only "regulating," implying that because pathology causes Qi stagnation and obstruction, regulating it to restore smooth flow allows True Qi to recover spontaneously and pathogens to dissipate. Unfortunately, this explanation is not detailed enough. Moreover, the treatment of Zhongfeng (Wind Stroke) is not limited to this single approach.
Scholar Xu stated: What is commonly referred to as "Qi Zhong" (Qi Obstruction) is not explicitly recorded in medical formularies. However, violent anger injures Yin, excessive joy injures Yang, and persistent sorrow leads to Qi rebellion (Jue Ni). Such individuals often contract this disease, suddenly experiencing flooding of saliva, coma, and tight closure of the jaw. If treated immediately with medications for Wind Stroke, death often results. It is advisable to administer Suhexiang Wan (Styrax Pill) to induce awakening, followed by regulation based on Cold, Heat, Deficiency, and Excess patterns, leading to complete recovery. The *Classic of Difficult Issues* states: "Sudden aphonia without apparent cause, with absent pulse, will resolve without treatment." This refers to sudden Qi rebellion; once Qi returns to normal, the condition resolves. Examining this, even without medication, the body can recover spontaneously.
The theory of "Qi Zhong" refers to the movement of internal Fire caused by Seven Emotions, leading to Qi rebellion due to underlying deficiency. Using Suhexiang Wan to unblock meridians relies on its potent nature, akin to pushing over dry wood or breaking rotten timber; this is likely unsuitable for those with deficient Blood and Qi. The statement that "non-treatment leads to self-recovery" serves as a warning against therapeutic errors, suggesting that doing nothing is preferable to being mismanaged by incompetent physicians.