《内经》论中风，皆指外中于风者，只是隐伤天地不正之气，如前所谓阴虚者，感温升
之气
而发病；阳虚者，感敛肃之气而发病是也。荣血耗燥，不与卫气相维，卫气衰散，无力自主
，遂隐为空气暗风所持矣。张景岳毅然发“非风”之论，直指为即古之“煎厥”，其理固是
，而情形究有不同。天地之间，空中转运之大气，即风也。其力甚锐，岂必拔木扬沙哉?庄
子曰∶人在风中。仲景曰∶人因风气而生长。皆谓空气即风也。当中风发病时，其周身脉络
皆有空气驰骤乎?其中非如厥证之专为本气内乱也。《内经》又谓∶阳之气，以天地之疾风
名之。此“风”字与外风全不相涉，正合厥证机括。中风之风，虽亦有此亢阳之气，而其发
病，究因感于空气，窜入筋脉也。故前人治法，总兼散风之意，不为无见。其与痉、厥、癫
痫异者∶风为之病，其伤在筋，故有口眼 斜，肢节痿缓之象；厥之为病，其伤在气，血虚
气逆，加以外寒，束于皮肤，逆气内迫上奔而发病也，故气复即醒，醒即如常，而无迁延之
患，以其在气分故也。但正当气逆之时，血未尝不随之而逆，故昏不知人。其形静者，气机
窒塞之甚也。其有放血而愈者，邪不在血，血未瘀败也；若血败而色全黑，及血瘀而放不得
出者，死矣。癫痫之病，其伤在血，寒、热、燥、湿之邪，杂然凝滞于血脉，血脉通心，故
发必昏闷，而又有抽掣叫呼者，皆心肝气为血困之象，即所谓天地之疾风是也。厥有一愈不
发，癫痫必屡发难愈者，正以在血故也。《内经》谓厥成为癫疾。气病日久，亦将滞入血脉
也。痉之为病，亦伤在筋，而暴因风、寒、湿之外邪，其来也骤，筋中之本气未亏，故证见
邪正格拒之象，而愈后并无似中风之余患也。一为筋中之血虚，而暗风走之；一为筋中之气
滞，而外邪持之也。其热病血不养筋而痉者，乃转筋之败证，血竭气衰，但略见口噤、齿
、螈 ，而无脊反、头摇、目赤、格拒之象也。中恶客忤而卒死者，即厥也。但所感或挟空
中秽恶之气，故其治或放血，或汗，或下，皆以泄气血中有余之邪也。要之，此四病者，虽
有病机病体之不同，而吾有一言以该之，归于调肝也。经谓十一脏取决于胆，肝胆一气也。
肝胆之气充足条畅，嘘吸停匀，其根不空，其标不折，断不致有仓皇逆乱之事。故治法虽各
因其脏，各因其气，而总必寓之以调肝。肝者，贯阴阳，统血气，居贞元之间，握升降之枢
者也。木曰曲直，肾阴不燥，则肝能曲而藏，而心得下交；脾阳不陷，则肝能直而伸，而心
得外照。世谓脾为升降之本，非也。脾者，升降所由之径；肝者，升降发始之根也。
又有所谓五尸者、飞尸、伏尸、遁尸、风尸、疰尸。其发也，或目光一眩而厥仆，或身
上胸
内一处急痛，如刺如裂，瞬息攻心，而即厥仆。或怒而发，或忧而发，或劳而发，或惊而发
，或食恶味而发，或闻秽气而发，或入庙、入墓、问病、见尸、见孝服而发，或闻哭而发，
或自悲哭而发，或见血而发，或遇大风骤寒而发。此皆风、寒、燥、湿杂合之邪，刺入血脉
，内伤五脏之神也。自古医书，未有确指病根者，以泰西医说考之，乃逆气鼓激，恶血上攻
于脑也。其先痛而后厥者，由脑气筋而渐感于脑也。所谓脑气筋者，如脂如膜，发原于髓，
资养于血。故邪伏于营血之分而不散，以致血络有变，一经外有所触，感动其邪，与血相激
，其机如电之迅而病作矣。《内经》曰∶血气者，人之神也。又曰∶血者，神气也。故血乱
而神即失常也。此皆痼疾，与癫痫同类。治之总以疏肝、宣心、濡血、搜筋为法；肝气舒、
心气畅、血流通、筋条达、而正气不结，邪无所容矣。其用药，大致多生津、化瘀也。津充
则五脏皆润，瘀行则百脉皆通。而古书只有祛痰、理气之议，宜其百无一效耳!
《内经》论述中风，都是指外感风邪所致，这仅仅是隐性地损伤了天地间不正之气。就像前面所说的，阴虚之人，感受温升之气而发病；阳虚之人，感受敛肃之气而发病。营血耗损干燥，不能与卫气相互维系，卫气衰败散乱，无力自主控制，于是被空气中的暗风所持留。张景岳坚决提出“非风”的论点，直接指出这就是古代的“煎厥”，其道理固然正确，但具体情形终究有所不同。天地之间，空中运转的大气，就是风。它的力量非常锐利，难道一定要拔起树木、扬起沙尘才算吗？庄子说：“人在风中。”仲景说：“人因风气而生长。”都是说空气就是风。当中风发病时，全身的脉络都有空气在奔驰急骤吗？其中不像厥证那样专门是本气内部混乱。《内经》又说：“阳之气，用天地的疾风来命名。”这个“风”字与外风完全不相干，正符合厥证的机理。中风的风，虽然也有这种亢盛的阳气，但其发病，终究是因为感受了空气，窜入筋脉所致。所以前人治疗的方法，总是兼有疏散风邪的意思，并非没有见识。它与痉病、厥证、癫痫不同的地方在于：风邪致病，伤害在筋，所以有口眼歪斜、肢体关节痿软迟缓的现象；厥证致病，伤害在气，血虚气逆，加上外寒束缚皮肤，逆气向内逼迫向上奔涌而发病，所以气机恢复就苏醒，醒来后就像平常一样，没有迁延不愈的祸患，因为病变在气分。但在气逆的时候，血未尝不随之而逆，所以昏迷不省人事。形体安静的，是气机窒塞得很严重。那些通过放血而痊愈的，是因为邪气不在血分，血液没有瘀败；如果血液败坏颜色全黑，以及血液瘀滞放不出血的，就会死亡。癫痫之病，伤害在血，寒、热、燥、湿的邪气，混杂凝滞在血脉中，血脉通于心，所以发病必定昏闷，并且有抽搐掣动、呼叫的症状，这都是心肝之气被血困阻的现象，也就是所谓的“天地之疾风”。厥证有一种好了不再发作，癫痫必定屡次发作难以痊愈的，正是因为在血分的原因。《内经》说厥成为癫疾。气病日久，也将滞入血脉。痉病之病，也伤害在筋，但是突然因为风、寒、湿的外邪，来得迅速，筋中的本气没有亏损，所以症状表现为邪正格拒的现象，而且痊愈后并没有像中风那样的后遗症。一个是筋中的血虚，暗风走窜；一个是筋中的气滞，被外邪持留。那些热病导致血不养筋而痉挛的，是转筋的败证，血竭气衰，只是略微见到牙关紧闭、牙齿咬合、肌肉跳动，而没有脊背反折、头摇、目赤、邪正格拒的现象。中恶客忤而突然死亡的，就是厥证。只是所感受的可能夹杂空中的秽恶之气，所以治疗或者放血，或者发汗，或者攻下，都是以泄除气血中有余的邪气。总之，这四种病，虽然有病机病体的不同，但我有一句话来概括它们，归结于调理肝脏。经文说十一脏取决于胆，肝胆是一气相通的。肝胆之气充足条畅，呼吸均匀，其根基不空虚，其枝节不折断，绝不会发生仓皇逆乱的事情。所以治疗方法虽然各依其脏腑，各依其气机，但总必须寓含调理肝脏之意。肝，贯通阴阳，统摄血气，居于贞元之间，掌握升降的枢纽。木的特性是曲直，肾阴不燥，则肝能曲而藏，心得以下交；脾阳不陷，则肝能直而伸，心得以外照。世人说脾是升降的根本，不对。脾，是升降所经过的路径；肝，是升降发起的根源。
又有所谓五尸者，即飞尸、伏尸、遁尸、风尸、疰尸。它们的发作，有时目光一眩而昏厥仆倒，有时身上胸内一处急痛，如刺如裂，瞬息攻心，随即昏厥仆倒。有时因愤怒而发作，有时因忧愁而发作，有时因劳累而发作，有时因惊恐而发作，有时因吃恶味食物而发作，有时因闻到秽气而发作，有时进入庙宇、墓地、探病、见尸体、见孝服而发作，有时听到哭声而发作，有时自己悲伤哭泣而发作，有时见到血而发作，有时遇到大风骤寒而发作。这些都是风、寒、燥、湿杂合的邪气，刺入血脉，内伤五脏的神志。自古以来的医书，没有确切指出病根的，用泰西医说来考证，乃是逆气鼓动激荡，恶血上攻于脑。先痛而后昏厥的，是由脑神经逐渐感应到脑部。所谓脑神经，像脂像膜，发源于骨髓，依靠血液滋养。所以邪气潜伏在营血之分而不消散，导致血络发生变化，一旦外部有所触动，感动其邪气，与血液相激，其机制像闪电一样迅疾而病作。《内经》说：“血气，是人的神志。”又说：“血，是神气。”所以血乱而神志就失常了。这些都属于痼疾，与癫痫同类。治疗它们总以疏肝、宣通心气、濡润血液、搜剔筋邪为法则；肝气舒展、心气通畅、血液流通、筋脉条达，而正气不结聚，邪气无处容身。其用药，大致多是生津、化瘀。津液充足则五脏都滋润，瘀血化行则百脉都通畅。而古书只有祛痰、理气的议论，难怪百无一效！
The *Neijing* (Classic of Internal Medicine) discusses stroke (*Zhongfeng*, Wind Strike), referring all to external wind invasion. This merely implies a hidden injury from the abnormal qi of heaven and earth, as previously stated: those with yin deficiency contract disease upon sensing the warming and ascending qi; those with yang deficiency contract disease upon sensing the condensing and肃 (descending/clearing) qi. When Ying blood is consumed and dried, it cannot maintain mutual support with Wei qi. As Wei qi declines and scatters, losing its ability to govern itself, it becomes held by the "dark wind" within the air. Zhang Jingyue firmly proposed the theory of "Non-Wind," directly identifying it as the ancient "Jian Jue" (Frying Syncope). While his reasoning is sound, the clinical presentation differs. The great atmosphere circulating in the air between heaven and earth is wind. Its force is extremely sharp; does it necessarily need to uproot trees and raise sand? Zhuangzi said, "Humans exist within the wind." Zhongjing said, "Humans grow due to the qi of wind." Both imply that air is wind. When stroke occurs, does air gallop through all meridians and collaterals of the body? It is not like Jue syndrome, which is specifically caused by internal chaos of the original qi. The *Neijing* also states, "The qi of Yang is named after the swift wind of heaven and earth." This character "wind" has no relation to external wind, perfectly fitting the mechanism of Jue syndrome. The "wind" of stroke, although involving this hyperactive yang qi, ultimately arises from contracting atmospheric air that invades the sinews and vessels. Therefore, previous treatments always incorporated the intent of dispersing wind, which was not without merit. The difference between stroke and spasm (*Jing*), syncope (*Jue*), and epilepsy (*Dianxian*) lies in the site of injury: wind pathogenicity injures the sinews, resulting in facial deviation and flaccidity/slowness of limbs and joints. Jue pathogenicity injures the qi; with blood deficiency and rebellious qi, compounded by external cold binding the skin, the rebellious qi forces upward internally, causing disease. Thus, upon the restoration of qi, consciousness returns, and the patient returns to normal, without lingering complications, because the pathology resides in the qi level. However, during qi rebellion, blood inevitably rebels with it, leading to unconsciousness. Cases where the form is quiet indicate severe obstruction of qi mechanisms. Those cured by bloodletting do so because the pathogen is not in the blood, and the blood is not yet coagulated/decayed; if the blood is decayed and black, or if blood stasis prevents bleeding, death ensues. Epilepsy injures the blood; pathogens of cold, heat, dryness, and dampness congeal and stagnate in the blood vessels. Since blood vessels connect to the heart, attacks involve dizziness and confusion, accompanied by convulsions and shouting. These are signs of heart and liver qi being trapped by blood, representing the "swift wind of heaven and earth." Some cases of Jue do not recur after recovery, whereas epilepsy recurs frequently and is hard to cure, precisely because the pathology is in the blood. The *Neijing* states that Jue can transform into epilepsy. Long-standing qi pathology will eventually stagnate into the blood vessels. Spasm (*Jing*) also injures the sinews, but suddenly due to external pathogens of wind, cold, and dampness arriving swiftly. The original qi within the sinews remains intact, presenting signs of struggle between pathogen and healthy qi, and healing leaves no sequelae like stroke. One case involves blood deficiency in sinews with dark wind wandering; the other involves qi stagnation in sinews held by external pathogens. In heat diseases, spasms caused by blood failing to nourish sinews represent a deteriorated state of muscle cramping, with exhausted blood and declining qi, showing only slight jaw clenching, teeth grinding, and twitching, without spinal opisthotonos, head shaking, red eyes, or pathogen-healthy qi struggle. Sudden death from *Zhong'e* (Poisonous Qi Invasion) or *Keyu* (Guest Intolerance) is essentially Jue. However, the contracted pathogen may include foul air, so treatment involves bloodletting, sweating, or purging to drain excess pathogens from qi and blood. In summary, although these four diseases differ in mechanism and constitution, I summarize them with one principle: regulating the Liver. The Classics state that the eleven zang-fu organs depend on the Gallbladder; Liver and Gallbladder share one qi. If Liver-Gallbladder qi is sufficient and smooth, breathing is even, the root is not empty, and the branches do not break, preventing chaotic rebellion. Thus, while treatments vary by organ and qi, they must invariably incorporate Liver regulation. The Liver penetrates yin and yang, commands blood and qi, resides in the foundation of truth and origin, and holds the pivot of ascent and descent. Wood is characterized by bending and straightening. If Kidney yin is not dry, the Liver can bend and store, allowing the Heart to descend; if Spleen yang does not sink, the Liver can straighten and extend, allowing the Heart to shine externally. The world says the Spleen is the root of ascent and descent; this is incorrect. The Spleen is the pathway of ascent and descent; the Liver is the root from which ascent and descent originate.
There is also what is called the "Five Corpses": Flying Corpse, Hidden Corpse, Escaping Corpse, Wind Corpse, and Tethered Corpse. Their onset may involve sudden dizziness followed by fainting and collapse, or acute pain in the chest or body, feeling like stabbing or tearing, attacking the heart instantly, leading to fainting. They may be triggered by anger, sorrow, fatigue, fright, eating bad-tasting food, smelling foul odors, entering temples or tombs, seeing corpses or mourning clothes, hearing crying, weeping oneself, seeing blood, or encountering sudden strong winds and cold. These are mixed pathogens of wind, cold, dryness, and dampness piercing the blood vessels and injuring the spirit of the five zang organs. Ancient medical texts have never accurately identified the root cause. Examining this through Western medicine, it appears to be rebellious qi agitating and evil blood attacking the brain. Cases with pain preceding fainting involve gradual sensation from the cerebral nerves to the brain. The so-called cerebral nerves resemble fat or membrane, originating from marrow and nourished by blood. Thus, pathogens hide in the Ying-blood level without dispersing, causing changes in blood collaterals. Once touched externally, the pathogen is stirred, exciting the blood, with a mechanism as swift as lightning, causing disease. The *Neijing* says, "Blood and qi are the spirit of humans." It also says, "Blood is the spirit qi." Therefore, when blood is chaotic, the spirit loses its order. These are chronic diseases, similar to epilepsy. Treatment generally follows methods of soothing the Liver, venting the Heart, moistening the blood, and searching out sinew pathogens. When Liver qi is relaxed, Heart qi is free, blood flows smoothly, and sinews are supple, healthy qi does not knot, and pathogens have no place to reside. Medications mostly focus on generating fluids and resolving stasis. Abundant fluids moisturize the five zang organs; resolved stasis unblocks the hundred vessels. Ancient texts only discussed dispelling phlegm and regulating qi, which explains why they were largely ineffective!