也。或谓补虚,则风自出,用十全大补之汤,而能愈中风者是也。谁知类中风之病,绝无风
也,非必补虚而风始出耳。
此症用扶倾汤亦妙。
人参 当归 茯苓(各五钱) 半夏(二钱) 附子 破故纸(各一钱) 黄 麦冬(各一两) 砂仁
(三粒) 白术(五钱)
水煎服。
有人一时猝倒,痰涎壅塞,汗如雨出,手足懈弛不收,口不能言,囊缩,小便自遗,人
以为中风急症,谁知是阴阳两脱乎。此至危之病,刻不可缓,生死在反掌之间也。若作
风治,下口立亡,必须用三生饮救之。
人参(二两) 生附子(一枚) 生天南星(五钱) 生半夏(三钱)
水煎服。一剂而囊缩伸,小便止,再剂而口乃能言矣。始可别用汤剂也。
世人疑三生饮过于猛烈,不知病来甚暴,非此等斩关夺门之药,何能直入脏腑,而追其
散失之元阳。故必投于人参数两之中,始可夺命于须臾也,否则斩关而关不能开,夺门而门
不得进,惟是关门既开,而前药又不可再用,另用∶
人参(一两) 白术(二两) 茯苓(五钱) 当归(一两) 熟地(一两) 山茱萸(五钱) 麦冬(一两) 半
夏
(三钱)
水煎服。
方名济急丹。连服二剂,而元气日旺,虚汗不流,手足可以运动,而无瘫痪之忧也。譬
如破城而守,内无粮草,则士有饥色,今关门大开,搬输挽运而入者皆糗粮米谷,则仓廪既
实,兵马有饱腾之气,贼自望风而飞遁矣。倘仍用附子、南星之属,未免过于酷烈,民已归
诚,而犹用虎贲之士,遍城搜粮,其损伤元气,不又多乎。妙在不用附子、南星,而反用当
归、熟地、山茱萸、麦冬资阴之品。盖从前斩关夺门之时,未免斩杀太甚,抢劫无遗,脏腑
必有焦枯之苦,今一旦得资财接济,真不啻恩膏之赐矣。
此症用救脱饮亦甚效。
人参(一两) 白术(二两) 附子(一钱) 干姜 半夏(各三钱) 贝母(一钱)
水煎服。
有人口眼 斜,身欲颠仆,腹中鸣如囊裹浆之声,人以为此中风之症,内有水湿之
气也,而余以为不然。夫水湿之气,由于脾气之虚也。脾气不能运化乎水,而水乃停积不化
,下不能行,必涌而上行矣。于是涌于头而作晕,涌于口眼而为 斜。水气既在于上,
则头重而足轻,故身欲时时颠仆,有似乎中风,而实非中风也
。方用分水止鸣汤∶
人参(五钱) 白术(一两) 车前子(三钱) 茯苓(一两) 肉桂(一钱) 半夏(三钱)
水煎服。连服四剂,腹中之鸣止,而口眼亦平复矣。
此等之症,原无风之可祛,故不必祛风,单健其脾土之气,而土胜自能制水,又虞徒消
其膀胱之水,恐水冷不化,又补其命门之火以生脾土,则土有先天之气,益足以制其后天之
狂澜。大地阳回,而溪涧之水,无非春气熏蒸,则膀胱不寒,尤能雪消冰解,而无阻隔之叹
。下河疏通,而上游又何患壅塞,而成泛滥之害哉。或曰口眼 斜,实系风症,安在水
气而能使之然也。不知水寒则成冰冻,口眼处于头面之间,一边吹寒风而成 斜,似乎
中风,然而风在外而不在内也。风既在外,不入于腠理之中,何必加祛风之剂哉。
此症亦可用术苓加桂汤∶
白术 茯苓(各一两) 肉桂(三钱)
水煎服。
有人猝倒之后,致半身不遂,人以为中风而成偏枯也,谁知因治中风而成偏枯乎。夫中
风之症,万人中而间生一二者也,岂可因一时猝倒即认作中风而治风乎。此中原无风邪,因
气虚而猝倒,大用补气之药,而少佐以消痰之味,焉有成偏枯之症乎。惟其过于祛风,以耗
其气,必至右身之不遂,或过用祛风以耗其血,必至左身之不遂矣
。夫猝倒之时,本正气之不能主宰也,乃不补气而转虚其气,欲气之周遍
于身,何可得乎。天下至误者,谓中风有中经、中络、中脏、中腑之分也。自此言出世,遂
信风国中络,不可引之入经;风既中经,不可引之入腑;风既入腑,不可引之入脏。于是诸
般风药,杂然乱投,而民生不可救药矣。脏腑经络,未尝有风,而必欲强用风药,成偏枯之
症,犹其幸也。盖脏腑既无风症,即是元气未虚之人,尚不禁风药之侵耗,况系羸弱之子,
摇摇靡定之身乎。今不致死亡而成偏枯者,亦因其于补正之中,而用祛风之剂,故犹存残喘
耳。然则已成偏枯之症,其可再用风药乎
。方用全身汤∶
人参(二两) 白术(二两) 茯苓(一两) 半夏(三钱) 附子(三分) 神曲(一钱)
水煎服。连服四剂,而手足能举矣,再用四剂,而步履如故,身臂皆轻。
或疑偏枯之病,似非急症可比,何必大用参术?不知猝倒之后,非重用参、术,则元气
不能骤复,与其日后而多用补剂,零星而期久效,何若乘其将绝未绝之先,急为多用而救之
此症用全身饮亦妙。
人参 黄 巴戟天(各一两) 半夏(三钱) 附子(一片)
水煎服。
有人猝倒之后,遍身不通,两手两足不收者,人以为中风而成瘫痪也,不知此乃血虚而
气不顺也。夫手得血而能握;足得血而能步。今不能握、不能步者,正坐于血虚耳。然而气
血未尝不相兼而行者,使血虚而气顺,则气能生血,而血尚足以供手足之用。今气既不顺,
是气与血有反背之失,欲血之荫手足也,何可得乎。故不独手足不收,而且一身尽不通也。
夫手足不收者,犹在四隅之疾,而一身不通者,实腹心之患也。此即所谓风痱之症也。名为
风痱,实无风也方用四物汤加味治之。
熟地(一两) 当归(一两) 白芍(五钱) 川芎(二钱) 人参(二钱) 半夏(二钱) 黄 (三钱)
水煎服。
二剂即知痛痒,服十剂即能步履矣。再服十剂全愈。
若作中风治之,则风药必耗烁其血。血干而气益不顺,气既不顺,而血益加虚,必变为
废弃之人矣。
此症可用滋血通经汤∶
当归 熟地(各一两) 黄芩 麦冬(各五钱) 北五味子 天花粉 秦艽(各一钱)
水煎服。
有人猝倒于地,奄忽不知人,人以为中风之重症也。然而非风也,乃气虚而不能接续耳
。既无口眼之 斜,又无手足之麻木,是全无风象。若作风治,势必引风入室耳。世人
谓中风之症,必须填塞空窍,使风之不能入也。今反用风药,以治无风之症,安得不开其
腠理哉。腠理即开,玄府大泄,欲风之不入,其可得乎。夫气虚而不能接续,以致猝倒,奄
忽而不知人,本是风懿之病,未尝内有风也。世人不察,必欲以中风治之,误矣
。方用六君子汤治之。
人参(五钱) 白术(一两) 甘草(一钱) 茯苓(三钱) 半夏(三钱) 陈皮(一钱)
水煎服。一剂而即能知人,二剂全愈。盖不治风而反奏功也。
此症用续气汤亦效。
白术(五钱) 人参 白芥子 白芍(各三钱) 甘草(一钱) 枳壳(三分) 砂仁(一粒)
水煎服。
有一时猝倒,状似中风,自汗不止,懒于语言,人亦以为中风也,谁知亦是气虚乎。夫
猝倒已似中风,更加自汗,此虚极之症,乃亡阳而非中于风也。亡阳之症,必须参附以回阳
,始有生机,倘以为中风而用风药,有立亡而已矣。方用参
归附汤救之。
人参(一两) 黄 (二两) 附子(三钱) 当归(一两)
水煎服。一剂而自汗止,再剂而言语出,四剂而神气复矣。
或曰∶猝倒之后,既无五绝之虞,不过自汗多与言语懒耳,似乎可以缓治,何必药品之
多如此。不知此症看其似轻而实重,看其似缓而实急。天下初病,易于图功,而久病难于着
力。况亡阳之症,元气初脱,有根易于重治,而无根难于再续。故必乘此将亡未亡之时,以
大补其气血,实省后日无数之挽回也。苟畏药品之多,因循退缩,坐失机宜,而不敢多用参
、,迨至日后,百剂而不能见效矣。
此症亦可用龟蛎神膏∶
人参 黄 (各一两) 麦冬(五钱) 北五味 蜀漆(各一钱) 肉桂(二钱) 牡蛎 龟膏(各三钱)
水煎服。
有人身未猝倒,而右手不仁,言语謇涩,口中流沫,人以为半肢风也。然而非外来有风
,乃本气自病,所谓中气之病也。夫气何以曰中,因其似乎中风,而又非中风,故别其名曰
中气。其实乃气虚,而非气中,因其气虚,故不中于左,而中于右。盖人身左属血,而右属
气也。惟女子则右为血,而左为气。今所言之病,乃男子耳。男子既右手之不仁,非气虚而
何。既是气虚,可不急补其气乎。一补气,而右手之不仁,随补而随效也。方用至仁丹∶
人参(一两) 白术(一两) 黄 (一两) 茯苓(三钱) 半夏(三钱) 肉桂(二钱) 薏仁(三钱) 甘
草(一
水煎服。一服而语言清,再服而涎沫止,十服而不仁者愈矣。
此补气之妙也。或疑既是气虚,补气可矣,何以必多加消痰之药,岂气旺而不能摄水,
气盛而不能化水耶?至加肉桂以助火,不更多事乎?不知气虚者,未有不脾胃寒也。脾胃既
寒,难以运化,水谷不变精而变痰矣。故气虚者痰盛,痰即欺气之虚而作祟,上迷心而旁及
于手足,故身欲仆而手不仁,口吐涎沫耳。乃用参、 以补气,复用苓术以健土,治湿则痰
无可藏之经,更加半夏、薏仁,以逐其已成之痰,则未成痰涎,又安能再化哉。犹恐脾胃久
寒,一时难以建功,增入肉桂以补其命门之火,则火自生土,土旺而气自郁蒸,气有根蒂,
脏腑无非生气,而经络皮肉,何至有不通之患哉。
此症亦可用固气收涎汤∶
人参(一两) 白茯苓 远志 山药(各三钱) 半夏(二钱) 麦冬 炒枣仁 巴戟天(各五钱) 附子(三分)
水煎服。
有人身未颠仆,左手半边不仁,语言謇涩,口角流涎,人亦以为半肢风也,然而此非风
也,乃血虚之故。血不能养筋脉,有似乎中耳。夫中气病速,而易于奏功;中血病缓,而难
于取效。盖中气阳症,中血阴症,阳速而阴迟耳。方用生血起废汤∶
葳蕤(二两) 熟地(一两) 山茱萸(四钱) 当归(一两) 茯苓(五钱) 白芥子(五钱)
水煎服。一剂而语言清,十剂而涎沫止,三十剂而不仁者愈矣。愈后前方中加人参(三钱)
,黄 (五钱),减当归(五钱)。再服二十剂,一如无病患矣。
或疑葳蕤之药,过于中和,不若用四物汤之流动,虽白芥子能消膜膈之痰,然用至五钱
,未免过多,起首口角流涎,自宜多用,至于后来,似可少减,何以始终用至五钱耶?不知
血病多痰,消痰始能补血。况中血之病,血虚之极,膜膈之间,无非痰也,非多用白芥子断
不能消。白芥子消痰而不耗气,且能助补血之药以生血,故始终之所必需。但其力少薄,不
比半夏、贝母之力浓,是以必宜多用,而不可少用也。四物汤虽是补血之圣药,而白芍非中
血之宜,川芎亦过于动,故特用葳蕤者,以葳蕤生血,而又能起废,同熟地、当归用之,尤
善建功,实胜于四物汤耳。且葳蕤之药,暂用则难于取胜;久用则易于建绩。以之治缓病,
实有相宜。况多用至二两,其力更浓,用之为君主之药,又相佐得宜,故始终任之而攸利也
此症用益阴生血汤亦佳。
熟地(一两) 茱萸 白术 白芍 麦冬(各五钱) 人参(二钱) 白芥子(三钱) 五味子(五分)
水煎服。
有人头面肿痛,口渴心烦,一旦猝中,手足抽搐,言语不出,口眼 斜,人以为中
风也,谁知是中火也。夫火生于木之中,火藉风之力,似乎中火即中
风也。人谓不解其风,则火从何而息?嗟乎,中火而祛风,非所以治火也。火所最恶者,水
也。祛风以息火,则火之焰少戢而火之根未除;滋水以救火,则火之光自消而火之性尽灭。
是祛风以治火,不若滋水以治火也。况中火之症,内实无风,用祛风之药,则毛窍尽开,反
足以通火之路。火之路开,而风反得入之矣。火得风之威,风恃火之势,本非中风,欲不
变为风症,而不可得矣。治法贵乎补水,而不必用祛风之药也。方用灭火汤∶
玄参(三两) 沙参(二两) 白芥子(三钱) 茯苓(一两) 熟地(一两) 山茱萸(五钱) 麦冬(五钱) 北
五味(一钱)
水煎服。一剂而心烦定,二剂而口渴除,三剂而语言清,四剂而 斜正,十剂而手
足不牵搐矣。
盖玄参能消浮游之火,况益之熟地、沙参、茱萸、麦冬、五味之类,纯是补水添精之味
,自然水足而火衰,何必用风药以搜风哉。倘于补水之中,少加风药,则于补水添精,反多
牵制,而不能奏功矣。或曰不用风药是矣,独不可用凉药以解氛乎?不知此火乃虚火而非实
火也。实火可用寒凉以直治,而虚火断不可用寒凉以增其怒也。况玄参微寒,未尝不于补中
以泻火,何必更用寒凉哉。
此症用二冬二皮汤亦妙。
麦冬 天冬 地骨皮 丹皮(各二两)
水煎服。
也。有人说,通过补益虚损,风邪自然排出,使用十全大补汤就能治愈中风,这就是所谓的“补虚出风”法。然而谁知道,类中风的疾病,实际上并没有真正的风邪,并不是必须通过补虚才能让风邪排出罢了。
这种病症使用扶倾汤也非常巧妙。
人参、当归、茯苓(各五钱)、半夏(二钱)、附子、破故纸(即补骨脂,各一钱)、黄芪、麦冬(各一两)、砂仁(三粒)、白术(五钱)。
用水煎服。
有人突然猝然倒仆,痰涎壅塞咽喉,汗出如雨,手足松弛无力无法收持,口不能言,阴囊收缩,小便失禁自遗。人们认为这是中风的急症,却不知这是阴阳两脱的危候。这是极其危险的疾病,一刻也不能拖延,生死只在转念之间。如果当作风证来治疗,服药后立即死亡,必须使用三生饮来抢救。
人参(二两)、生附子(一枚)、生天南星(五钱)、生半夏(三钱)。
用水煎服。服用一剂后,阴囊收缩缓解,小便停止;再服用一剂后,口才能说话。此时才可以另外使用其他汤剂调理。
世人怀疑三生饮过于猛烈,却不知道病势来得非常暴烈,如果不是这种能斩关夺门般的猛药,怎么能直入脏腑,追回散失的元阳呢?所以必须在重用人参数两的基础上投用此药,才能在顷刻间挽救生命。否则,就像要打开城门却打不开,要夺取关口却无法进入。只有当关门已开(指阳气回复,通道打开),前面的猛药就不可再用了,应另用以下方剂:
人参(一两)、白术(二两)、茯苓(五钱)、当归(一两)、熟地黄(一两)、山茱萸(五钱)、麦冬(一两)、半夏(三钱)。
用水煎服。
这个方剂名叫济急丹。连续服用两剂,元气日渐旺盛,虚汗不再流出,手足可以运动,就没有瘫痪的忧虑了。这好比攻破城池后防守,如果内部没有粮草,士兵就会有饥饿之色;现在城门大开,搬运输送进来的都是干粮米谷,那么仓库充实,兵马有饱足腾跃之气,贼寇自然会望风逃遁。如果仍然使用附子、南星这类药物,未免过于酷烈,百姓已经归顺,却还动用虎贲勇士遍城搜刮粮食,这样损伤元气,不是更多了吗?妙处在于不用附子、南星,反而使用当归、熟地、山茱萸、麦冬这些滋养阴液的药材。因为从前在斩关夺门的时候,难免斩杀太甚,抢劫无余,脏腑必然有焦枯的痛苦,如今一旦得到资财接济,真可以说是恩赐甘霖了。
这种病症使用救脱饮也非常有效。
人参(一两)、白术(二两)、附子(一钱)、干姜、半夏(各三钱)、贝母(一钱)。
用水煎服。
有人口眼歪斜,身体想要跌倒,腹中鸣响如同袋子里裹着浆液的声音。人们认为这是中风的症状,体内有水湿之气,但我认为不是这样。水湿之气,是由于脾气虚弱造成的。脾气不能运化水液,导致水液停积不化,向下不能通行,必然涌向上行。于是涌于头部而作晕,涌于口眼而为歪斜。水气既然在上部,就会头重脚轻,所以身体想要时时跌倒,看起来像中风,但实际上并非中风。方剂使用分水止鸣汤:
人参(五钱)、白术(一两)、车前子(三钱)、茯苓(一两)、肉桂(一钱)、半夏(三钱)。
用水煎服。连续服用四剂,腹中的鸣响停止,口眼也就平复了。
这类病症,原本没有风邪可祛,所以不必祛风,只要健运脾土之气,土胜自然能制水。又担心单纯消除膀胱之水,恐怕水冷不能化气,所以补充命门之火以生脾土,那么土就有先天的元气,更足以制约后天的狂澜。大地阳气回转,溪涧之水无非是春气熏蒸,那么膀胱就不寒,更能像雪消冰解一样,没有阻隔的叹息。下游河道疏通,上游又何必担心壅塞而成泛滥之害呢?有人说口眼歪斜,确实是风症,怎么说是水气使之然呢?不知道水寒则成冰冻,口眼处于头面之间,一边吹寒风而成歪斜,看似中风,然而风是在外而不在内。风既然在外,不入于腠理之中,何必加用祛风的药剂呢?
这种病症也可以用术苓加桂汤:
白术、茯苓(各一两)、肉桂(三钱)。
用水煎服。
有人猝然倒仆之后,导致半身不遂。人们认为是中风成了偏枯,却不知是因为治疗中风而导致了偏枯。夫中风之症,万人之中偶尔才有一两个,岂可因为一时猝倒就认作中风而治风呢?这里原本没有风邪,是因为气虚而猝倒,大用补气之药,稍加消痰之味,怎么会形成偏枯的病症呢?只因为过于祛风,耗散了正气,必然导致右半身不遂;或者过用祛风药耗伤血液,必然导致左半身不遂。夫猝倒之时,本是正气不能主宰身体,却不补气反而使气更虚,想让气周遍全身,怎么可能呢?天下最大的错误,就是认为中风有中经、中络、中脏、中腑的区别。自从这种说法出世,人们就相信风邪中络,不可引之入经;风邪既中经,不可引之入腑;风邪既入腑,不可引之入脏。于是各种风药杂乱乱投,导致民众不可救药。脏腑经络,从未有过风邪,却一定要强用风药,造成偏枯的病症,这还是侥幸的。因为脏腑既无风症,即是元气未虚之人,尚且不禁受风药的侵耗,何况是羸弱之子,摇摇欲坠的身体呢?如今没有致死而成为偏枯的,也是因为在补正气的同时使用了祛风的剂型,所以还存留一口气罢了。那么已经形成偏枯的病症,还可以再用风药吗?方剂使用全身汤:
人参(二两)、白术(二两)、茯苓(一两)、半夏(三钱)、附子(三分)、神曲(一钱)。
用水煎服。连续服用四剂,手足就能举起了;再用四剂,步履如常,身臂皆轻。
有人怀疑偏枯的病,似乎不是急症可比,何必大用人参、白术?不知道猝倒之后,如果不重用人参、白术,元气就不能骤然恢复,与其日后多用补剂,零星期待长久见效,不如趁其将绝未绝之前,急切多用而抢救它。
这种病症使用全身饮也很奇妙。
人参、黄芪、巴戟天(各一两)、半夏(三钱)、附子(一片)。
用水煎服。
有人猝然倒仆之后,遍身不通,两手两足无法收持。人们认为是中风成了瘫痪,却不知道这是血虚而气不顺造成的。手得到血才能握持;脚得到血才能行走。现在不能握、不能走,正是由于血虚。然而气血未曾不相兼而行,假如血虚而气顺,那么气能生血,血尚且足以供手足之用。现在气既不顺,是气与血有背离的失误,想让血荫护手足,怎么可能呢?所以不仅手足无法收持,而且一身尽感不通。夫手足不收持,还是在四肢末端的疾病,而一身不通,实在是腹心之患。这就是所谓的风痱之症。名为风痱,实际上没有风。方剂使用四物汤加味治疗:
熟地黄(一两)、当归(一两)、白芍(五钱)、川芎(二钱)、人参(二钱)、半夏(二钱)、黄芪(三钱)。
用水煎服。
服用两剂就知道痛痒,服用十剂就能行走了。再服用十剂完全痊愈。
如果当作中风治疗,风药必然会耗烁血液。血干而气更加不顺,气既不顺,血更加虚,必然变成废人。
这种病症可以使用滋血通经汤:
当归、熟地黄(各一两)、黄芩、麦冬(各五钱)、北五味子、天花粉、秦艽(各一钱)。
用水煎服。
有人猝然倒仆在地,奄忽之间不知人事。人们认为是中风的重症。然而这不是风,乃是气虚而不能接续。既然没有口眼歪斜,又没有手足麻木,是全无风象。如果作风证治疗,势必引风入室。世人说中风的病症,必须填塞空窍,使风不能进入。现在反用风药,来治疗无风的病症,怎么能不打开腠理呢?腠理既开,玄府大泄,想让风不进入,怎么可能呢?夫气虚而不能接续,以致猝倒,奄忽不知人事,本是风懿之病,未曾内有风邪。世人不察,一定要以中风治疗,是错误的。方剂使用六君子汤治疗:
人参(五钱)、白术(一两)、甘草(一钱)、茯苓(三钱)、半夏(三钱)、陈皮(一钱)。
用水煎服。一剂就能识人,二剂全愈。这是不治风反而奏效。
这种病症使用续气汤也有效。
白术(五钱)、人参、白芥子、白芍(各三钱)、甘草(一钱)、枳壳(三分)、砂仁(一粒)。
用水煎服。
有一时猝然倒仆,状似中风,自汗不止,懒于言语。人们也认为是中风,却不知这也是气虚。夫猝倒已似中风,加上自汗,这是虚极之症,乃亡阳而非中于风。亡阳之症,必须用参附来回阳,始有生机,倘若以为中风而用风药,就会立即死亡。方剂使用参归附汤抢救:
人参(一两)、黄芪(二两)、附子(三钱)、当归(一两)。
用水煎服。一剂自汗停止,再剂言语出现,四剂神气恢复。
有人说:猝倒之后,既然没有五绝的危险,不过是自汗多与言语懒而已,似乎可以缓治,何必药品如此之多?不知道此症看其似轻而实重,看其似缓而实急。天下初病,易于图功,而久病难于着力。况且亡阳之症,元气初脱,有根易于重治,而无根难于再续。所以必须乘此将亡未亡之时,以大补其气血,实在省去日后无数挽回的努力。如果畏惧药品之多,因循退缩,坐失良机,而不敢多用参、芪,等到日后,百剂也不能见效了。
这种病症也可以用龟蛎神膏:
人参、黄芪(各一两)、麦冬(五钱)、北五味、蜀漆(各一钱)、肉桂(二钱)、牡蛎、龟膏(各三钱)。
用水煎服。
有人身体尚未猝倒,而右手麻木不仁,言语謇涩,口中流沫。人们认为是半肢风。然而这不是外来有风,乃本气自病,所谓中气之病。夫气何以曰中,因其似乎中风,而又非中风,故别其名曰中气。其实乃是气虚,而非气中,因其气虚,故不中于左,而中于右。盖人身左属血,而右属气。惟女子则右为血,而左为气。今所言的病,乃是男子耳。男子既右手之不仁,非气虚而何?既是气虚,可不急补其气乎?一补气,而右手之不仁,随补而随效。方剂使用至仁丹:
人参(一两)、白术(一两)、黄芪(一两)、茯苓(三钱)、半夏(三钱)、肉桂(二钱)、薏仁(三钱)、甘草(一钱)。
用水煎服。一服语言清晰,再服涎沫停止,十服麻木者痊愈。
这是补气的妙处。有人怀疑既然是气虚,补气即可,为何必多加消痰之药?难道气旺而不能摄水,气盛而不能化水吗?再加肉桂以助火,不是多事吗?不知道气虚者,未有不脾胃寒的。脾胃既寒,难以运化,水谷不变精而变痰了。所以气虚者痰盛,痰即欺气之虚而作祟,上迷心而旁及于手足,所以身体想要仆倒而手不仁,口吐涎沫。于是用参、芪以补气,复用苓、术以健土,治湿则痰无可藏之经,再加半夏、薏仁,以逐其已成之痰,则未成痰涎,又怎能再化呢?犹恐脾胃久寒,一时难以建功,增入肉桂以补其命门之火,则火自生土,土旺而气自郁蒸,气有根蒂,脏腑无非生气,而经络皮肉,何至有不通的隐患呢?
这种病症也可以用固气收涎汤:
人参(一两)、白茯苓、远志、山药(各三钱)、半夏(二钱)、麦冬、炒枣仁、巴戟天(各五钱)、附子(三分)。
用水煎服。
有人身体尚未颠仆,左手半边不仁,言语謇涩,口角流涎。人们也认为是半肢风,然而此非风,乃是血虚的缘故。血不能养筋脉,有似乎中。夫中气病速,而易于奏功;中血病缓,而难于取效。盖中气阳症,中血阴症,阳速而阴迟耳。方剂使用生血起废汤:
葳蕤(即玉竹,二两)、熟地黄(一两)、山茱萸(四钱)、当归(一两)、茯苓(五钱)、白芥子(五钱)。
用水煎服。一剂语言清晰,十剂涎沫停止,三十剂麻木者痊愈。痊愈后前方中加入人参(三钱)、黄芪(五钱),减去当归(五钱)。再服用二十剂,一如无病患。
有人怀疑葳蕤之药,过于中和,不如用四物汤之流动,虽白芥子能消膜膈之痰,然用至五钱,未免过多,起首口角流涎,自宜多用,至于后来,似可少减,为何始终用至五钱耶?不知道血病多痰,消痰始能补血。况中血之病,血虚之极,膜膈之间,无非痰也,非多用白芥子断不能消。白芥子消痰而不耗气,且能助补血之药以生血,故始终之所必需。但其力少薄,不比半夏、贝母之力浓,是以必宜多用,而不可少用也。四物汤虽是补血之圣药,而白芍非中血之宜,川芎亦过于动,故特用葳蕤者,以葳蕤生血,而又能起废,同熟地、当归用之,尤善建功,实胜于四物汤耳。且葳蕤之药,暂用则难于取胜;久用则易于建绩。以之治缓病,实有相宜。况多用至二两,其力更浓,用之为君主之药,又相佐得宜,故始终任之而攸利也。
这种病症使用益阴生血汤也很好。
熟地黄(一两)、茱萸、白术、白芍、麦冬(各五钱)、人参(二钱)、白芥子(三钱)、五味子(五分)。
用水煎服。
有人头面肿痛,口渴心烦,一旦猝中,手足抽搐,言语不出,口眼歪斜。人们认为是中风,却不知是中火。夫火生于木之中,火藉风之力,似乎中火即中风也。人谓不解其风,则火从何而息?嗟乎,中火而祛风,非所以治火也。火所最恶者,水也。祛风以息火,则火之焰少戢而火之根未除;滋水以救火,则火之光自消而火之性尽灭。是祛风以治火,不若滋水以治火也。况中火之症,内实无风,用祛风之药,则毛窍尽开,反足以通火之路。火之路开,而风反得入之矣。火得风之威,风恃火之势,本非中风,欲不变为风症,而不可得矣。治法贵乎补水,而不必用祛风之药也。方剂使用灭火汤:
玄参(三两)、沙参(二两)、白芥子(三钱)、茯苓(一两)、熟地黄(一两)、山茱萸(五钱)、麦冬(五钱)、北五味(一钱)。
用水煎服。一剂心烦定,二剂口渴除,三剂语言清,四剂歪斜正,十剂手足不牵搐。
盖玄参能消浮游之火,况益之熟地、沙参、茱萸、麦冬、五味之类,纯是补水添精之味,自然水足而火衰,何必用风药以搜风哉。倘于补水之中,少加风药,则于补水添精,反多牵制,而不能奏功矣。有人说:不用风药是对的,独不可用凉药以解氛乎?不知道此火乃虚火而非实火也。实火可用寒凉以直治,而虚火断不可用寒凉以增其怒也。况玄参微寒,未尝不于补中以泻火,何必更用寒凉哉。
... (Note: The source text is a continuous commentary on various cases of "stroke-like" conditions, arguing they are often due to Qi/Blood deficiency or Fire rather than external Wind. Below is the translation of the entire passage.)
It is said that by tonifying deficiency, wind evil will naturally exit; using Shiquan Dabu Decoction (Ten Significant Tonifying Decoction) can cure stroke. However, who knows that the disease known as "pseudo-stroke" actually has no true wind evil, and it is not necessary to tonify deficiency for wind to exit.
For this condition, using Fuqing Tang (Supporting Collapse Decoction) is also excellent.
Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Fu Ling (Poria), each 5 qian; Ban Xia (Pinelliae Rhizoma), 2 qian; Fu Zi (Aconiti Lateralis Radix Preparata), Po Gu Zhi (Psoraleae Fructus, i.e., Buguzhi), each 1 qian; Huang Qi (Astragali Radix), Mai Dong (Ophiopogonis Radix), each 1 liang; Sha Ren (Amomi Fructus Rotundus), 3 grains; Bai Zhu (Atractylodis Macrocephalae Rhizoma), 5 qian.
Decoct in water and take orally.
Someone suddenly collapsed, with phlegm-saliva obstructing the throat, sweating profusely like rain, limbs flaccid and unable to hold, inability to speak, retraction of the scrotum, and involuntary urination. People consider this an acute stroke syndrome, but little do they know it is a collapse of both Yin and Yang. This is a critical illness where every moment counts, with life and death hanging in the balance. If treated as wind syndrome, death would follow immediately upon ingestion; one must use Sansheng Yin (Three Raw Decoction) to save them.
Ren Shen (Ginseng Radix), 2 liang; Sheng Fu Zi (Raw Aconiti Lateralis Radix), 1 piece; Sheng Tian Nan Xing (Raw Arisaematis Rhizoma), 5 qian; Sheng Ban Xia (Raw Pinelliae Rhizoma), 3 qian.
Decoct in water and take orally. After one dose, scrotal retraction resolves and urination stops; after another dose, speech returns. Only then can other decoctions be used for further treatment.
People suspect Sansheng Yin is too harsh, not realizing that the disease onset is extremely violent. Without such "gate-breaking" potent medicines, how can they penetrate directly into the zang-fu organs to retrieve scattered Yuan Yang (Primal Yang)? Therefore, it must be administered alongside several liang of Ren Shen to snatch life back in an instant. Otherwise, the gate remains closed, and the medicine cannot enter. Once the gate is open, the previous harsh medicine should no longer be used. Instead, use the following prescription:
Ren Shen (Ginseng Radix), 1 liang; Bai Zhu (Atractylodis Macrocephalae Rhizoma), 2 liang; Fu Ling (Poria), 5 qian; Dang Gui (Angelicae Sinensis Radix), 1 liang; Shu Di Huang (Rehmanniae Radix Preparata), 1 liang; Shan Zhu Yu (Corni Fructus), 5 qian; Mai Dong (Ophiopogonis Radix), 1 liang; Ban Xia (Pinelliae Rhizoma), 3 qian.
Decoct in water and take orally.
This formula is named Jiji Dan (Urgency-Rescuing Pill). After two doses, Yuan Qi recovers daily, spontaneous sweat ceases, limbs can move, and there is no fear of paralysis. It is like defending a captured city: if there is no grain inside, soldiers starve; now that the gates are open and supplies (grain) are transported in, the granaries are full, troops are well-fed and vigorous, and bandits flee at the sight. If one continues to use Fu Zi and Nan Xing, it is overly cruel; the people have submitted, yet one still sends tiger-guards to search for food, causing excessive damage to Yuan Qi. The brilliance lies in not using Fu Zi and Nan Xing, but instead using Dang Gui, Shu Di Huang, Shan Zhu Yu, and Mai Dong to nourish Yin. During the initial "gate-breaking" phase, destruction was severe, leaving the zang-fu organs parched. Now, receiving these resources is like a gift of benevolent rain.
For this condition, Jiutuo Yin (Collapse-Rescuing Decoction) is also very effective.
Ren Shen (Ginseng Radix), 1 liang; Bai Zhu (Atractylodis Macrocephalae Rhizoma), 2 liang; Fu Zi (Aconiti Lateralis Radix Preparata), 1 qian; Gan Jiang (Zingiberis Rhizoma), Ban Xia (Pinelliae Rhizoma), each 3 qian; Bei Mu (Fritillariae Bulbus), 1 qian.
Decoct in water and take orally.
Someone had facial deviation, felt like falling, and heard gurgling sounds in the abdomen like liquid in a bag. People thought this was stroke due to internal dampness-water, but I disagree. Dampness-water arises from Spleen Qi deficiency. The Spleen fails to transform fluids, leading to accumulation. Unable to descend, the fluid surges upward. Surging to the head causes dizziness; surging to the mouth and eyes causes deviation. With water qi above, the head feels heavy and feet light, causing frequent falls, resembling stroke but not being stroke. Use Fenshui Zhiming Tang (Water-Separating and Murmur-Stopping Decoction):
Ren Shen (Ginseng Radix), 5 qian; Bai Zhu (Atractylodis Macrocephalae Rhizoma), 1 liang; Che Qian Zi (Plantaginis Semen), 3 qian; Fu Ling (Poria), 1 liang; Rou Gui (Cinnamomi Cortex), 1 qian; Ban Xia (Pinelliae Rhizoma), 3 qian.
Decoct in water and take orally. After four doses, abdominal murmurs stop, and facial deviation resolves.
Such conditions originally have no wind to dispel, so there is no need to dispel wind. One should simply strengthen Spleen Earth Qi; when Earth is strong, it controls Water. Furthermore, fearing that merely draining Bladder water might leave it cold and untransformed, we supplement Mingmen (Gate of Life) Fire to generate Spleen Earth. Thus, Earth possesses Pre-heaven Qi, sufficiently controlling Post-heaven turbulence. When Earth's Yang returns, stream waters evaporate under spring warmth; Bladder warms, ice melts without obstruction. Downstream channels clear, preventing upstream blockage and flooding. Some argue facial deviation is truly wind, not water. But cold water freezes; wind blowing on the face causes deviation, appearing like stroke, yet the wind is external, not internal. Since wind does not enter the cou-li (interstices), why add wind-dispelling agents?
For this condition, Shuling Jia Gui Tang (Bai Zhu and Poria Plus Cinnamon Decoction) can also be used:
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), each 1 liang; Rou Gui (Cinnamomi Cortex), 3 qian.
Decoct in water and take orally.
After sudden collapse, someone suffered hemiplegia. People assumed it was stroke becoming bi-an (hemiplegia), unaware it was caused by treating stroke incorrectly. Stroke is rare (1-2 in 10,000). One cannot assume all sudden collapses are stroke. Here, there was no wind evil, only Qi deficiency causing collapse. Using massive Qi-tonifying herbs with slight phlegm-resolving agents would prevent hemiplegia. Overusing wind-dispersing herbs depletes Qi, leading to right-side paralysis; overusing them depletes Blood, leading to left-side paralysis. At collapse, Zheng Qi (Upright Qi) failed to govern. Depleting Qi further makes circulation impossible. The greatest error is classifying stroke into meridians, collaterals, zang, and fu. This theory leads to believing wind in collaterals shouldn't enter meridians, etc., resulting in chaotic use of wind herbs, ruining patients' lives. Organs and meridians never harbor wind; forcing wind herbs causes hemiplegia. Even those with intact Yuan Qi suffer from wind herb depletion, let alone the frail. Surviving as hemiplegic rather than dead is only because some tonification was mixed with wind dispersants. Can wind herbs be used for existing hemiplegia? No. Use Quanshen Tang (Whole Body Decoction):
Ren Shen (Ginseng Radix), 2 liang; Bai Zhu (Atractylodis Macrocephalae Rhizoma), 2 liang; Fu Ling (Poria), 1 liang; Ban Xia (Pinelliae Rhizoma), 3 qian; Fu Zi (Aconiti Lateralis Radix Preparata), 3 fen; Shen Qu (Meditated Mass), 1 qian.
Decoct in water and take orally. After four doses, limbs lift; after four more, walking normalizes, body and arms feel light.
Some doubt why large doses of Ren Shen and Bai Zhu are needed for non-emergency hemiplegia. After collapse, without heavy Ren Shen and Bai Zhu, Yuan Qi cannot recover quickly. Better to rescue urgently while Qi is nearly exhausted than to rely on small doses later for slow results.
For this condition, Quanshen Yin (Whole Body Decoction) is also good.
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Ba Ji Tian (Morindae Officinalis Radix), each 1 liang; Ban Xia (Pinelliae Rhizoma), 3 qian; Fu Zi (Aconiti Lateralis Radix Preparata), 1 slice.
Decoct in water and take orally.
After sudden collapse, someone had whole-body numbness and inability to move limbs. People called it stroke-paralysis, but it is Blood deficiency with stagnant Qi. Hands grip via Blood; legs walk via Blood. Inability to grip/walk is due to Blood deficiency. Qi and Blood usually travel together; if Qi is smooth, it generates Blood. Here, Qi is stagnant, opposing Blood, failing to nourish limbs. Thus, whole-body obstruction occurs. Limb immobility is peripheral; whole-body obstruction is central (heart/abdomen). This is Feng Fei (Wind Flaccidity). Named "wind," but no wind exists. Use Siwu Tang (Four Substances Decoction) modified:
Shu Di Huang (Rehmanniae Radix Preparata), 1 liang; Dang Gui (Angelicae Sinensis Radix), 1 liang; Bai Shao (Paeoniae Radix Alba), 5 qian; Chuan Xiong (Ligustici Chuanxiong Rhizoma), 2 qian; Ren Shen (Ginseng Radix), 2 qian; Ban Xia (Pinelliae Rhizoma), 2 qian; Huang Qi (Astragali Radix), 3 qian.
Decoct in water and take orally. Pain/sensation returns in two doses; walking resumes in ten; full recovery in twenty more.
Treating as stroke uses wind herbs that consume Blood. Dry Blood worsens Qi stagnation, leading to disability.
Use Zixue Tongjing Tang (Nourishing Blood and Unblocking Collaterals Decoction):
Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Preparata), each 1 liang; Huang Qin (Scutellariae Radix), Mai Dong (Ophiopogonis Radix), each 5 qian; Bei Wu Wei Zi (Schisandrae Chinensis Fructus), Tian Hua Fen (Trichosanthis Radix), Qin Jiao (Gentianae Macrophyllae Radix), each 1 qian.
Decoct in water and take orally.
Someone collapsed, unconscious. People feared severe stroke. But it was not wind; it was Qi deficiency failing to connect. No facial deviation, no limb numbness—no wind signs. Treating as wind opens pores (cou-li) and Xu Fu (pores), inviting wind. Qi deficiency causing collapse is Feng Yi (Wind Stupor), internal windless. Treating as stroke is wrong. Use Liujunzi Tang (Six Gentlemen Decoction):
Ren Shen (Ginseng Radix), 5 qian; Bai Zhu (Atractylodis Macrocephalae Rhizoma), 1 liang; Gan Cao (Glycyrrhizae Radix et Rhizoma), 1 qian; Fu Ling (Poria), 3 qian; Ban Xia (Pinelliae Rhizoma), 3 qian; Chen Pi (Citri Reticulatae Pericarpium), 1 qian.
Decoct in water and take orally. Consciousness returns in one dose; full recovery in two. Success without treating wind.
Xuqi Tang (Continuing Qi Decoction) is also effective:
Bai Zhu (Atractylodis Macrocephalae Rhizoma), 5 qian; Ren Shen (Ginseng Radix), Bai Jie Zi (Sinapis Semen), Bai Shao (Paeoniae Radix Alba), each 3 qian; Gan Cao (Glycyrrhizae Radix et Rhizoma), 1 qian; Zhi Ke (Aurantii Fructus Immaturus), 3 fen; Sha Ren (Amomi Fructus Rotundus), 1 grain.
Decoct in water and take orally.
Sudden collapse, sweating, reluctance to speak. Resembles stroke, but is extreme Qi deficiency leading to Yang collapse (Wang Yang), not wind. Wang Yang requires Ren Shen and Fu Zi to restore Yang. Using wind herbs causes immediate death. Use Shengui Fu Tang (Ginseng, Angelica, and Aconite Decoction):
Ren Shen (Ginseng Radix), 1 liang; Huang Qi (Astragali Radix), 2 liang; Fu Zi (Aconiti Lateralis Radix Preparata), 3 qian; Dang Gui (Angelicae Sinensis Radix), 1 liang.
Decoct in water and take orally. Sweat stops in one dose; speech returns in two; spirit recovers in four.
Some say mild symptoms don't need many herbs. But this looks mild but is critical. Early treatment is easier; late is hard. Yang collapse with residual root is treatable; lost root is hard to reconnect. Must tonify Qi and Blood urgently before death. Hesitation leads to failure.
Guili Shengao (Turtle and Oyster Spirit Paste) is also usable:
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), each 1 liang; Mai Dong (Ophiopogonis Radix), 5 qian; Bei Wu Wei Zi (Schisandrae Chinensis Fructus), Shu Qi (Patriniae Herba), each 1 qian; Rou Gui (Cinnamomi Cortex), 2 qian; Mu Li (Ostreae Concha), Gui Gao (Testudinis Carapax et Plastrum Preparatum), each 3 qian.
Decoct in water and take orally.
Before collapse, someone had right-hand numbness, slurred speech, drooling. Called half-limb wind. But it is not external wind; it is internal Qi pathology, "Zhong Qi" (Striking Qi). Why "Zhong"? It resembles stroke but isn't. It is Qi deficiency. Men: Left is Blood, Right is Qi. Women: Right is Blood, Left is Qi. This case is a man; right hand numbness indicates Qi deficiency. Tonify Qi immediately. Use Zhiren Dan (Benevolence Pill):
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qi (Astragali Radix), each 1 liang; Fu Ling (Poria), 3 qian; Ban Xia (Pinelliae Rhizoma), 3 qian; Rou Gui (Cinnamomi Cortex), 2 qian; Yi Yi Ren (Coicis Semen), 3 qian; Gan Cao (Glycyrrhizae Radix et Rhizoma), 1 qian.
Decoct in water and take orally. Speech clears in one dose; drooling stops in two; numbness resolves in ten.
This shows the efficacy of tonifying Qi. Why add phlegm-resolvers? Qi deficiency implies Cold Spleen/Stomach, failing to transform fluids into Phlegm. Phlegm exploits Qi weakness, confusing Heart and limbs. Use Ren Shen/Huang Qi to tonify Qi; Fu Ling/Bai Zhu to strengthen Earth/dry Damp; Ban Xia/Yi Yi Ren to resolve existing Phlegm. Add Rou Gui to warm Mingmen Fire, generating Earth Qi, ensuring smooth meridians.
Guyi Shouyan Tang (Consolidating Qi and Receiving Saliva Decoction) is also usable:
Ren Shen (Ginseng Radix), 1 liang; Bai Fu Ling (Poria), Yuan Zhi (Polygalae Radix), Shan Yao (Dioscoreae Rhizoma), each 3 qian; Ban Xia (Pinelliae Rhizoma), 2 qian; Mai Dong (Ophiopogonis Radix), Chao Zao Ren (Ziziphi Spinosae Semen Preparatum), Ba Ji Tian (Morindae Officinalis Radix), each 5 qian; Fu Zi (Aconiti Lateralis Radix Preparata), 3 fen.
Decoct in water and take orally.
Before collapse, someone had left-hand numbness, slurred speech, drooling. Called half-limb wind. But it is Blood deficiency. Blood fails to nourish sinews. Zhong Qi (Qi strike) is fast/easy; Zhong Xue (Blood strike) is slow/hard. Yang is fast; Yin is slow. Use Shengxue Qifei Tang (Generating Blood and Reviving Disabled Decoction):
Wei Rui (Polygonati Odorati Rhizoma, i.e., Yuzhu), 2 liang; Shu Di Huang (Rehmanniae Radix Preparata), 1 liang; Shan Zhu Yu (Corni Fructus), 4 qian; Dang Gui (Angelicae Sinensis Radix), 1 liang; Fu Ling (Poria), 5 qian; Bai Jie Zi (Sinapis Semen), 5 qian.
Decoct in water and take orally. Speech clears in one dose; drooling stops in ten; numbness resolves in thirty. After recovery, add Ren Shen (3 qian), Huang Qi (5 qian); reduce Dang Gui (by 5 qian). Take twenty more doses for full health.
Why Wei Rui (Yuzhu)? It is neutral. Siwu Tang flows better. Bai Jie Zi 5 qian seems high. But Blood diseases involve much Phlegm; resolving Phlegm aids Blood generation. Extreme Blood deficiency creates Phlegm in membranes. High dose of Bai Jie Zi is needed; it resolves Phlegm without consuming Qi and aids Blood generation. Unlike Ban Xia/Bei Mu, its power is mild, requiring larger doses. Siwu Tang's Bai Shao is unsuitable for Blood strike; Chuan Xiong moves too aggressively. Wei Rui generates Blood and revives disabled tissue, superior to Siwu Tang here. It works best with long-term use. Two liang provides strong sovereign action.
Yiyin Shengxue Tang (Nourishing Yin and Generating Blood Decoction) is also good:
Shu Di Huang (Rehmanniae Radix Preparata), 1 liang; Zhu Yu (Corni Fructus), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Shao (Paeoniae Radix Alba), Mai Dong (Ophiopogonis Radix), each 5 qian; Ren Shen (Ginseng Radix), 2 qian; Bai Jie Zi (Sinapis Semen), 3 qian; Wu Wei Zi (Schisandrae Chinensis Fructus), 5 fen.
Decoct in water and take orally.
Swollen/painful head/face, thirst, irritability, sudden collapse, limb convulsions, muteness, facial deviation. Called stroke, but it is Zhong Huo (Striking Fire). Fire originates from Wood, aided by Wind, looking like stroke. Dispelling wind doesn't extinguish fire; nourishing Water does. Fire fears Water. Dispelling wind reduces flame but leaves roots; nourishing Water extinguishes nature. Internal stroke-fire has no wind; wind herbs open pores, letting wind in, worsening fire. Treatment must nourish Water, not dispel wind. Use Miehuo Tang (Extinguishing Fire Decoction):
Xuan Shen (Scrophulariae Radix), 3 liang; Sha Shen (Glehniae Radix), 2 liang; Bai Jie Zi (Sinapis Semen), 3 qian; Fu Ling (Poria), 1 liang; Shu Di Huang (Rehmanniae Radix Preparata), 1 liang; Shan Zhu Yu (Corni Fructus), 5 qian; Mai Dong (Ophiopogonis Radix), 5 qian; Bei Wu Wei Zi (Schisandrae Chinensis Fructus), 1 qian.
Decoct in water and take orally. Irritability settles in one dose; thirst gone in two; speech clear in three; deviation corrects in four; convulsions stop in ten.
Xuan Shen clears floating fire. Combined with Shu Di, Sha Shen, Zhu Yu, Mai Dong, Wu Wei Zi, it purely nourishes Water/Essence. Water sufficient, Fire declines. Why search for wind? Adding wind herbs hinders Water-nourishing. Some ask: Why not cool herbs? This is Deficiency Fire, not Excess Fire. Excess Fire needs cold/cool; Deficiency Fire worsens with cold. Xuan Shen is slightly cold, clearing fire within tonification. No extra cold herbs needed.
Er Dong Er Pi Tang (Two Asparas and Two Barks Decoction) is also excellent:
Mai Dong (Ophiopogonis Radix), Tian Dong (Asparagi Radix), Di Gu Pi (Lycii Cortex), Dan Pi (Moutan Cortex), each 2 liang.
Decoct in water and take orally.