丹溪云大风病是受得天地间杀物之风古人谓之疠风以其酷烈暴悍可畏尔人得之者须分在
上在
下夫在上者以醉仙散取臭涎恶血于齿缝中出在下者以通天再造散取恶物陈虫于谷道中出所出
虽有上下道路之异然皆不外乎阳明一经治此病者须知此意看其疙瘩与疮上先见者上体多者在
上也下先见者下体多者在下也上下同得者在上后在下也阳明经胃与大肠也无物不受此风之入
人也气受之则在上多血受之则在下多血气俱受者甚重自非医者有神病者有铁心罕有免者夫或
从上或从下以渐而来者皆可治病患见其病势之缓多忽之虽按此法施治病已全然脱体若不能绝
味绝色后必发再发则终于不救矣某曾治五人矣中间唯一妇人得免以其贫甚无物可吃也余四人
三两年后皆再发孙真人曰吾尝治四五百人终无一人免于死非孙真人之不能治也盖无一人能守
禁忌耳此一妇治本病外又是千余帖加减四物汤半年之上方得月经行而十分安全
谨按疠风古方谓之大风恶疾以其疮痍荼毒脓汁淋漓眉须堕落手足指脱顽痹痛痒鼻塌眼烂
齿豁
唇揭病势之可畏耳若专以房劳嗜欲饮食积毒之所致何为遽至于是故丹溪先生亦谓之受得杀毒
之风也盖其风毒之伤与夫内毒所致人皆安得而知之及其病证显露方始归咎于此其于外受之风
内积之毒岂可得而分治之也故内经刺肌肉刺骨髓以泄荣卫之怫热灵枢以锐针刺肿上按出恶气
恶血子和用汗吐下出血之法河间用疏风泄热之剂俱不分病之所因随其病之所在以调之也至于
丹溪分在上在下气血受病多少其用药取涎下毒虽皆前人之法亦可谓深得病情而善用其法者矣
学人宜细观之若夫用药之外守禁忌谨调养清心寡欲独淡内观又在乎人而不在乎医也孙真人戒
之深矣其可忽乎
丹溪先生说，大风病是感受了天地间能够杀伤万物的风邪，古人称之为疠风，因为这种风气酷烈暴悍，令人畏惧。人一旦感染此病，必须分辨病位是在上部还是下部。病在上部的，用醉仙散促使臭涎和恶血从齿缝中排出；病在下部的，用通天再造散促使恶物和陈年虫体从肛门（谷道）中排出。虽然排出的途径有上下之分，但都不外乎阳明经这一条经络。治疗此病的人必须明白这个道理：看疙瘩与疮疡先出现在哪里，如果上体多见，则病位在上；如果下体先见且多见，则病位在下；如果上下同时发病，则是先病于上而后及于下。
阳明经包括胃和大肠，无所不纳，因此风邪侵入人体，气受之则病多在上，血受之则病多在下，气血俱受之则病情严重。如果不是医生有神妙之术，患者有钢铁般坚定的意志，很少有能免除死亡的。如果是从上或从下逐渐发作的，都可以治愈。但如果患者见到病势缓和，就忽视它，即使按照这种方法施治，病已完全脱离身体，如果不能断绝滋味、戒除色欲，日后必然复发，再发则最终无法救治。
我曾治疗过五个人，其中只有一位妇人得以幸免，因为她非常贫穷，没有什么东西可吃（从而间接起到了节制饮食的作用）。其余四人在三两年后都复发了。孙思邈说：“我曾经治疗四五百人，最终没有一人免于死亡。”这并不是孙真人不能治病，而是因为没有一个人能遵守禁忌。这位妇人除了治疗本病外，又服用了千余帖加减四物汤，历时半年，才使月经通畅并达到十分安全的状态。
谨按：疠风在古代方书中被称为大风、恶疾，因为其疮痍荼毒，脓汁淋漓，眉须脱落，手足手指脱失，顽痹痛痒，鼻梁塌陷，眼睛溃烂，牙齿松动，嘴唇翻卷，病势确实令人畏惧。如果认为这仅仅是由房劳嗜欲、饮食积毒所致，为何会迅速发展到如此地步？所以丹溪先生也称之为感受了杀毒之风。大概其风毒的伤害与内毒所致，人们怎么能知道其中的区别呢？等到病证显露，才开始归咎于此。至于外受的风邪和内积的毒素，难道可以分开治疗吗？
因此，《内经》主张刺肌肉、刺骨髓以泄营卫的郁热；《灵枢》主张用锐针刺肿处，按压排出恶气、恶血；子和（张从正）使用汗、吐、下、出血的方法；河间（刘完素）使用疏风泄热的药剂。他们都并不区分病因，而是随着病邪所在之处进行调理。至于丹溪先生区分病在上下、气血受病的多少，以及用药取涎、下毒的方法，虽然都是前人的方法，但也称得上是深得病情而善于运用这些方法的人了。学习者应该仔细观察。至于用药之外，遵守禁忌，谨慎调养，清心寡欲，独守清淡，内观自省，这在于患者自己，而不在于医生。孙真人对此告诫得很深，怎么可以忽视呢？
Danyang stated that the "Great Wind" disease is contracted from the wind in heaven and earth that can kill all things, which the ancients called *Li Feng* (Leprosy/Plague Wind) because its nature is cruel, fierce, violent, and terrifying. Once a person contracts this disease, one must distinguish whether the pathology is located in the upper or lower part of the body. For those with pathology in the upper part, *Zuixian San* (Intoxicating Immortal Powder) is used to induce the discharge of foul saliva and evil blood from between the teeth. For those with pathology in the lower part, *Tongtian Zaizao San* (Sky-Penetrating Re-creation Powder) is used to induce the discharge of evil substances and old worms from the anus (valve road). Although the pathways of discharge differ between upper and lower, they are not outside the scope of the Yangming Meridian alone. Those treating this disease must understand this principle: observe where the nodules and sores first appear. If manifestations are predominantly on the upper body, the disease is in the upper part; if they first appear and are predominantly on the lower body, the disease is in the lower part; if both upper and lower are affected simultaneously, it indicates the disease originated in the upper part and subsequently spread to the lower part.
The Yangming Meridian comprises the Stomach and Large Intestine, accepting nothing without being influenced. Thus, when wind pathogen invades the human body, Qi involvement leads to pathology primarily in the upper part, while Blood involvement leads to pathology primarily in the lower part. Simultaneous involvement of Qi and Blood results in severe conditions. Unless the physician possesses divine skill and the patient has an iron will, few escape death. If the disease arises gradually from above or below, it can be cured. However, if patients neglect the condition due to its seemingly mild progression, even treatment according to this method may fail once the disease has ostensibly left the body. If one cannot abstain from rich flavors and sexual desires, relapse is inevitable; subsequent relapses lead ultimately to incurability.
I have treated five cases, among whom only one woman survived because she was extremely poor and had little food available to eat [implying dietary restriction]. The other four relapsed after three or two years. Sun Simiao said, "I have treated four or five hundred people, yet not one escaped death." This is not because Sun Simiao lacked therapeutic ability, but because no one could adhere to the taboos. This particular woman, besides receiving treatment for the primary disease, took over a thousand modified prescriptions of *Siwu Tang* (Four Substances Decoction) over half a year, until her menstruation became regular and she reached a state of complete safety.
In strict accordance with ancient texts, *Li Feng* is referred to as Great Wind or Malignant Disease because its sores cause devastation, pus flows profusely, eyebrows and beard fall out, hands and feet fingers detach, stubborn numbness and pain/itching occur, the nasal bridge collapses, eyes rot, teeth loosen, and lips evert. The severity of the disease is indeed fearsome. If one assumes it is caused solely by sexual excess, cravings, and accumulated toxins from diet, why does it progress so rapidly? Therefore, Mr. Danyang also termed it as contracting a killing wind. How can people know the distinction between the injury caused by external wind-toxin and internal toxin accumulation? Only when symptoms manifest do people attribute the cause to these factors. Can external wind and internal toxins truly be treated separately?
Therefore, the *Neijing* advocates piercing muscles and bone marrow to drain stagnated heat from Ying and Wei. The *Lingshu* advocates using sharp needles to puncture swellings and pressing out evil qi and blood. Hezi (Zhang Congzheng) employed sweating, vomiting, purging, and bleeding methods. Hejian (Liu Wansu) used formulas to disperse wind and drain heat. None distinguished the etiology but rather regulated based on the location of the pathology. As for Danyang’s differentiation of upper/lower pathology and the degree of Qi/Blood involvement, along with methods to extract phlegm and purge toxins, although these are methods of predecessors, they can be said to deeply grasp the disease condition and skillfully apply these methods. Students should observe them carefully. Beyond medication, adhering to taboos, cautious nursing, clearing the heart and reducing desires, maintaining simplicity, and introspection depend on the patient, not the physician. Sun Simiao warned deeply about this; how can it be neglected?