夫风之为病。当半身不遂。或但臂不遂者。此为痹。脉微而数。中风使然。
风彻于上下。故半身不遂。痹闭于一处。故但臂不遂。以此见风重而痹轻。风动而痹着也。风从
虚入。故脉微。风发而成热。故脉数。曰中风使然者。谓痹病亦是风病。但以在阳者则为风。而在阴
者则为痹耳。寸口脉浮而紧。紧则为寒。浮则为虚。寒虚相搏。邪在皮肤。浮者血虚。络脉空虚。贼
邪不泻。或左或右。邪气反缓。正气即急。正气引邪。 僻不遂。邪在于络。肌肤不仁。邪在于经。
即重不胜。邪入于腑。即不识人。邪入
于脏。舌即难言。口吐涎。
寒虚相搏者。正不足而邪乘之。为风寒初感之诊也。浮为血虚者。气行脉外而血行脉中。脉浮者
沉不足。为血虚也。血虚则无以充灌皮肤。而络脉空虚。并无以捍御外气。而贼邪不泻。由是或左或
右。随其空处而留着矣。邪气反缓。正气即急者。受邪之处。筋脉不用而缓。无邪之处。正气独治而
急。缓者为急者所引。则口目为僻。而肢体不遂。是以左 者邪反在右。右 者邪反在左。然或左或
右。则有邪正缓急之殊。而为表为里。亦有经络脏腑之别。经云。经脉为里。支而横者为络。络之小
者为孙。是则络浅而经深。络小而经大。故络邪病于肌肤。而经邪病连筋骨。甚而入腑。又甚而入脏。
则邪递深矣。盖神藏于脏。而通于腑。腑病则神窒于内。故不识人。诸阴皆连舌本。脏气厥不至舌下。
则机息于上。故舌难言。而涎自出也。
侯氏黑散 治大风四肢烦重。心中恶寒不足者。
菊花（四十分） 白术 防风（各十分） 桔梗（八分） 黄芩（五分） 细辛 干姜 人参
茯苓 当归 川芎 牡蛎 矾石 桂枝（各三分）
上十四味。杵为散。酒服方寸匕。日一服。初服二十日。温酒调服。禁一切鱼肉大蒜。常宜冷食。
六十日止。即药积腹中不下也。热食即下矣。冷食自能助药力。
此方亦孙奇等所附。而去风除热。补虚下痰之法具备。以为中风之病。莫不由是数者所致云尔。
学人得其意。毋泥其迹可也。
寸口脉迟而缓。迟则为寒。缓则为虚。营缓则为亡血。卫缓则为中风。邪气中经。则身痒而瘾疹。
心气不足。邪气入中。则胸满而短气。
迟者行之不及。缓者至而无力。不及为寒。而无力为虚也。沉而缓者为营不足。浮而缓者为卫中
风。卫在表而营在里也。经不足而风入之。血为风动。则身痒而瘾疹。心不足而风中之。阳用不布。
则胸满而短气。经行肌中。而心处胸间也。
风引汤 除热瘫痫。
大黄 干姜 龙骨（各四两） 桂枝（三两） 甘草 牡蛎（各二两） 寒水石 滑石 赤石脂
白石脂 紫石英 石膏（各六两）
上十二味。杵粗筛。以韦囊盛之。取三指撮。井花水三升。煮三沸。温服一升。治大人风引。少
小惊痫 日数发。医所不疗。除热方。巢氏云。香港脚宜风引汤。
此下热清热之剂。孙奇以为中风多从热起。故特附于此欤。中有姜、桂、石、脂、龙、蛎者。盖
以涩驭泄。以热监寒也。然亦猛剂。用者审之。
防己地黄汤 治病如狂状。妄行。独语不休。无寒热。其脉浮。
防己 甘草（各一分） 桂枝 防风（各三分）
上四味。以酒一杯。渍之。绞取汁。生地黄二斤。 咀。蒸之如斗米饭久。以铜器盛药汁。更绞
地黄汁和。分再服。
狂走谵语。身热脉大者。属阳明也。此无寒热。其脉浮者。乃血虚生热。邪并于阳而然。桂枝、防
风、防己、甘草。酒浸取汁。用是轻清。归之于阳。以散其邪。用生地黄之甘寒。熟蒸使归于阴。以
养血除热。盖药生则散表。熟则补衰。此煎煮法。亦表里法也。（赵氏）
头风摩散
大附子（一枚） 盐（等分）
上二味。为散。沐了。以方寸匕。摩疾上。令药力行。
寸口脉沉而弱。沉即主骨。弱即主筋。沉即为肾。弱即为肝。汗出入水中。如水伤心。历节痛。
黄汗出。故曰历节。
此为肝肾先虚。而心阳复郁。为历节黄汗之本也。心气化液为汗。汗出入水中。水寒之气。从汗
孔入侵心脏。外水内火。郁为湿热。汗液则黄。浸淫筋骨。历节乃痛。历节者。遇节皆痛也。盖非肝
肾先虚。则虽得水气。未必便入筋骨。非水湿内侵。则肝肾虽虚。未必便成历节。仲景欲举其标。而
先究其本。以为历节多从虚得之也。
按、后水气篇中云。黄汗之病。以汗出入水中浴。水从汗孔入得之。合观二条。知历节、黄汗。
为同源异流之病。其瘀郁上焦者。则为黄汗。其并伤筋骨者。则为历节也。
趺阳脉浮而滑。滑则谷气实。浮则汗自出。少阴脉浮而弱。弱则血不足。浮则为风。风血相搏。
即疼痛如掣。盛人脉涩小。短气。自汗出。历节疼。不可屈伸。此皆饮酒汗出当风所致。
趺阳脉浮者风也。脉滑者谷气盛也。汗生于谷。而风性善泄。故汗自出。风血相搏者。少阴血虚
而风复扰之。为疼痛如掣也。趺阳少阴二条合看。知阳明谷气盛者。风入必与汗偕出。少阴血不足者。
风入遂着而成病也。盛人脉涩小短气者。形盛于外。而气歉于内也。自汗出。湿复胜也。缘酒客湿本
内积。而汗出当风。则湿复外郁。内外相召。流入关节。故历节痛不可屈伸也。合三条观之。汗出入
水者。热为湿郁也。风血相搏者。血为风动也。饮酒汗出当风者。风湿相合也。历节病因。有是三者
不同。其为从虚所得则一也。
诸肢节疼痛。身体 羸。脚肿如脱。头眩短气。温温欲吐。桂枝芍药知母汤主之。
诸肢节疼痛。即历节也。身体 羸。脚肿如脱。形气不足。而湿热下甚也。头眩短气。温温欲吐。
湿热且从下而上冲矣。与香港脚冲心之候颇同。桂枝、麻黄、防风。散湿于表。芍药、知母、甘草。除
热于中。白术、附子。驱湿于下。而用生姜最多。以止呕降逆。为湿热外伤肢节。而复上冲心胃之治
法也。
桂枝芍药知母汤方
桂枝（四两） 芍药（三两） 甘草 麻黄（各二两） 附子（二枚炮） 白术 知母 防风（各
四两） 生姜（五两）
上九味。以水七升。煮取二升。温服七合。日三服。
味酸则伤筋。筋伤则缓。名曰泄。咸则伤骨。骨伤则痿。名曰枯。枯泄相搏。名曰断泄。营气不
通。卫不独行。营卫俱微。三焦无所御。四属断绝。身体羸瘦。独足肿大。黄汗出。胫冷。假令发热。
便为历节也。
此亦内伤肝肾。而由于滋味不节者也。枯泄相搏。即筋骨并伤之谓。曰断泄者。言其生气不续。而
精神时越也。营不通因而卫不行者。病在阴而及于阳也。不通不行。非壅而实。盖即营卫涸流之意。
四属、四肢也。营卫者。水谷之气。三焦受气于水谷。而四肢禀气于三焦。故营卫微。则三焦无气而
四属失养也。由是精微不化于上。而身体羸瘦。阴浊独注于下。而足肿胫冷黄汗出。此病类似历节黄
汗。而实非水湿为病。所谓肝肾虽虚。未必便成历节者是也。而虚病不能发热。历节则未有不热者。故
曰假令发热。便为历节。后水气篇中又云。黄汗之病。两胫自冷。假令发热。此属历节。盖即黄汗历
节而又致其辨也。详见本文。
病历节不可屈伸。疼痛。乌头汤主之。
此治寒湿历节之正法也。寒湿之邪。非麻黄、乌头不能去。而病在筋节。又非如皮毛之邪。可一
汗而散者。故以黄 之补。白芍之收。甘草之缓。牵制二物。俾得深入而去留邪。如卫 监钟邓入蜀。
使其成功
而不及于乱。乃制方之要妙也。
乌头汤 亦治香港脚疼痛。不可屈伸。
麻黄 芍药 黄 甘草（各三两炙） 乌头（五枚 咀以蜜二升煎取一升即出乌头）
上四味。以水三升。煮取一升。去滓。内蜜煎中。更煎之。服七合。不知。尽服之。
矾石汤 治香港脚冲心。
矾石（二两）
上一味。以浆水一斗五升。煎三五沸。浸脚良。
香港脚之病。湿伤于下。而气冲于上。矾石味酸涩性燥。能却水收湿解毒。毒解湿收。上冲自止。
附方
古今录验续命汤 治中风痱。身体不能自收持。口不能言。冒昧不知痛处。或拘急不得转侧。
麻黄 桂枝 甘草 干姜 石膏 当归 人参（各三两） 杏仁（四十粒） 川芎（一两五钱）
上九味。以水一斗。煮取四升。温服一升。当小汗。薄覆脊。凭几坐。汗出则愈。不汗更服。无
所禁。勿当风。并治但伏不得卧。咳逆上气。面目浮肿。
痱者废也。精神不持。筋骨不用。非特邪气之扰。亦真气之衰也。麻黄、桂枝所以散邪。人参、
当归所以养正。石膏合杏仁助散邪之力。甘草合干姜为复气之需。乃攻补兼行之法也。
千金三黄汤 治中风。手足拘急。百节疼痛。烦热心乱。恶寒。经日不欲饮食。
麻黄（五分） 独活（四分） 细辛 黄 （各二分） 黄芩（三分）
上五味。以水六升。煮取二升。分温三服。一服小汗出。二服大汗出。心热加大黄二分。腹满加
枳实一枚。气逆加人参三分。悸加牡蛎三分。渴加栝蒌根三分。先有寒。加附子一枚。
近效术附汤 治风虚。头重眩。苦极。不知食味。暖肌补中。益精气。
白术（一两） 附子（一枚半炮去皮） 甘草（一两炙）
上三味 。每五钱匕。姜五片。枣一枚。水盏半。煎七分。去滓温服。
崔氏八味丸 治香港脚上入少腹不仁。
熟地黄（八两） 山茱萸 山药（各四两） 泽泻 茯苓 牡丹皮（各三两） 桂枝 附子（各
一两炮）
上八味。末之。炼蜜和丸梧子大。酒下十五丸。日再服。肾之脉。起于足而入于腹。肾气不治。湿
寒之气。随经上入。聚于少腹。为之不仁。是非驱湿散寒之剂所可治者。须以肾气丸补肾中之气。以
为生阳化湿之用也。
千金越婢加术汤 治肉极热。则身体津脱。腠理开。汗大泄。厉风气。下焦脚弱。
麻黄（六两） 石膏（半斤） 生姜（二两） 甘草（二两） 白术（四两） 大枣（十五枚）
上六味。以水六升。先煮麻黄。去上沫。内诸药。煮取三升。分温三服。恶风加附子一枚。炮。
风邪致病，应当出现半身不遂。如果仅仅是手臂不能活动，这属于痹证。脉象微而数，这是中风所致。
风邪充斥于上下全身，所以导致半身不遂；痹邪闭阻于一处局部，所以仅仅手臂不能活动。由此可以看出，风邪病重而痹邪病轻，风邪善动而痹邪凝着。风邪从虚处侵入，所以脉象微；风邪发作化热，所以脉象数。说“这是中风所致”，意思是痹病也是风病，只是邪气在阳分（表、外）则为风，而在阴分（里、内）则为痹罢了。
寸口脉浮而紧，紧脉主寒，浮脉主虚。寒邪与虚邪相互搏结，邪气停留在皮肤。浮脉表示血虚，络脉空虚，贼邪无法排出。邪气或侵袭左侧，或侵袭右侧，受邪之处筋脉弛缓无力，未受邪的正气部位则拘急紧张。正气牵引邪气，导致口眼歪斜、肢体不能随意运动。邪气在络脉，肌肤麻木不仁；邪气在经脉，身体沉重难以抬举；邪气入腑，神志昏迷不识人；邪气入脏，舌强语言困难，口吐涎沫。
寒邪与虚邪相互搏结，是正气不足而邪气乘虚而入，这是风寒初感时的脉象。浮脉为血虚，是因为气行于脉外，血行于脉中，脉浮说明沉取不足，故为血虚。血虚则不能充盈灌溉皮肤，络脉因而空虚，也就无法抵御外邪，贼邪便滞留不去。因此邪气或左或右，随着气血空虚之处而停留。受邪之处，筋脉失去功能而弛缓；无邪之处，正气独自运行而拘急。弛缓的一侧被拘急的一侧牵引，就会导致口眼歪斜，肢体瘫痪。所以左侧瘫痪者，邪气反而在右侧；右侧瘫痪者，邪气反而在左侧。然而无论左右，都有邪正缓急的区别，以及表里、经络脏腑的不同。经书说：经脉在里，分支横出的为络脉，络脉细小的为孙络。这样看来，络脉浅而经脉深，络脉小而经脉大。所以络脉受邪病在肌肤，经脉受邪病连筋骨。更甚则入腑，再甚则入脏，邪气层层深入。大概神志藏于脏，而通于腑。腑病则神志窒塞于内，所以不识人。所有阴经都连系舌根，脏气厥逆不至舌下，则机关息止于上，所以舌强难言，涎液自出。
侯氏黑散，治疗大风引起的四肢烦重，心中恶寒感觉不足。
菊花（四十分） 白术 防风（各十分） 桔梗（八分） 黄芩（五分） 细辛 干姜 人参 茯苓 当归 川芎 牡蛎 矾石 桂枝（各三分）
以上十四味药，捣碎研成散剂。用酒送服一方寸匕，每日一次。刚开始服药二十天，用温酒调服。禁止食用一切鱼肉大蒜。平时宜冷食，六十天为止，这样药物积聚在腹中不下泄。热食则会使其下行。冷食能自然帮助药力。
此方也是孙奇等人所附载的，但祛风除热、补虚化痰的方法都具备。认为中风之病，没有不是由这几方面原因导致的。学习的人领会其意旨即可，不要拘泥于形式。
寸口脉迟而缓，迟脉主寒，缓脉主虚。营气缓则为亡血，卫气缓则为中风。邪气中伤经脉，则身体瘙痒并出现瘾疹。心气不足，邪气入中，则胸满短气。
迟脉是运行不及，缓脉是至而无力。不及为寒，无力为虚。沉而缓者为营气不足，浮而缓者为卫气中风。卫在表而营在里。经脉不足而风邪侵入，血被风邪扰动，则身体瘙痒并出现瘾疹。心气不足而风邪中伤，阳气不能布散，则胸满短气。经脉行于肌中，而心位于胸间。
风引汤，清除热邪引起的瘫痫。
大黄 干姜 龙骨（各四两） 桂枝（三两） 甘草 牡蛎（各二两） 寒水石 滑石 赤石脂 白石脂 紫石英 石膏（各六两）
以上十二味药，捣碎粗筛，用韦囊盛装。取三指撮的药量，用井花水三升，煮三沸，温服一升。治疗大人风引，小儿惊痫每日多次发作，医生无法治疗的除热方。巢元方说，脚气病适宜用风引汤。
这是下热清热的方剂。孙奇认为中风多从热起，所以特别附于此。方中有姜、桂、石、脂、龙、蛎等，大概是用涩味驾驭泻下，用温热监制寒凉。但这毕竟是猛剂，使用者要审慎。
防己地黄汤，治疗病状像发狂，胡乱行走，独自说话不停，无寒热症状，脉象浮。
防己 甘草（各一分） 桂枝 防风（各三分）
以上四味药，用一杯酒浸泡，绞取汁液。生地黄二斤，切碎，蒸得像斗米饭那么久，用铜器盛装药汁，再次绞取地黄汁混合。分两次服用。
狂走谵语，身热脉大者，属于阳明病。此症无寒热，脉浮，乃是血虚生热，邪气并入阳分所致。桂枝、防风、防己、甘草，用酒浸取汁，取其轻清之气，归于阳分以疏散邪气。用生地黄的甘寒，熟蒸使其归于阴分，以养血除热。大概药生则发散表邪，药熟则补益衰损。这种煎煮方法，也是表里治法。（赵氏注）
头风摩散
大附子（一枚） 盐（等分）
以上两味药，研成散剂。洗头后，用一方寸匕，摩擦患处，使药力运行。
寸口脉沉而弱，沉脉主骨，弱脉主筋。沉即为肾，弱即为肝。出汗时进入水中，如水伤心，历节疼痛，黄汗出，所以称为历节。
这是因为肝肾先虚，而心阳又复郁结，这是历节黄汗的根本原因。心气化液为汗，出汗时进入水中，水寒之气从汗孔入侵心脏。外水内火，郁结为湿热，汗液变黄，浸淫筋骨，历节乃痛。历节，就是遇节皆痛。大概如果不是肝肾先虚，即使得水气，未必就会侵入筋骨；如果不是水湿内侵，即使肝肾虽虚，也未必就会形成历节。张仲景想要列举其标症，而先探究其本因，认为历节多从虚损得到。
按：后文水气篇中说，黄汗之病，是因为出汗时进入水中沐浴，水从汗孔进入而得病。结合这两条来看，可知历节和黄汗，是同源异流的病。瘀郁在上焦的，则为黄汗；并伤筋骨的，则为历节。
趺阳脉浮而滑，滑脉则谷气实，浮脉则汗自出。少阴脉浮而弱，弱脉则血不足，浮脉则为风。风血相搏，即疼痛如掣。形体壮盛之人脉涩小，短气，自汗出，历节疼，不可屈伸，这都是饮酒后汗出当风所致。
趺阳脉浮是风邪，脉滑是谷气盛。汗生于谷，而风性善于泄，所以汗自出。风血相搏，是少阴血虚而风邪又扰动它，导致疼痛如掣。趺阳和少阴两条合看，可知阳明谷气盛者，风入必随汗一起出来；少阴血不足者，风入遂附着而成病。形体壮盛之人脉涩小短气，是外形壮盛而内气亏歉。自汗出，是湿邪又胜。因为酒客湿气本已内积，而汗出当风，则湿气又外郁，内外相召，流入关节，所以历节痛不可屈伸。合三条来看，汗出入水者，是热为湿郁；风血相搏者，是血为风动；饮酒汗出当风者，是风湿相合。历节的病因，有这三种不同，但其都是从虚损所得这一点是一致的。
诸肢节疼痛，身体消瘦，脚肿如脱落感，头眩短气，恶心欲吐，用桂枝芍药知母汤主治。
诸肢节疼痛，就是历节。身体消瘦，脚肿如脱，是形气不足，而湿热下注严重。头眩短气，恶心欲吐，是湿热且从下而上冲。这与脚气冲心的症状颇为相同。桂枝、麻黄、防风，发散体表之湿；芍药、知母、甘草，清除内部之热；白术、附子，驱除下部之湿；而使用生姜最多，以止呕降逆。这是针对湿热外伤肢节，而复上冲心胃的治疗方法。
桂枝芍药知母汤方
桂枝（四两） 芍药（三两） 甘草 麻黄（各二两） 附子（二枚炮制） 白术 知母 防风（各四两） 生姜（五两）
以上九味药，用水七升，煮取二升，温服七合，每日三次。
味酸则伤筋，筋伤则弛缓，名为泄。味咸则伤骨，骨伤则痿弱，名为枯。枯与泄相互搏结，名为断泄。营气不通，卫气不能独行，营卫俱微弱，三焦无所统御，四肢断绝联系，身体消瘦，唯独足部肿大，黄汗出，小腿冷。假如发热，便为历节。
这也是内伤肝肾，而由于饮食滋味不节制所致。枯泄相搏，就是筋骨并伤的意思。叫作断泄，是说生气不续，精神时时越失。营气不通因而卫气不行，是病在阴而波及于阳。不通不行，并非壅滞实证，大概即是营卫涸流的意思。四属，指四肢。营卫是水谷之气，三焦受气于水谷，而四肢禀气于三焦。所以营卫微弱，则三焦无气而四肢失养。由此精微不能化生于上，而身体消瘦；阴浊独注于下，而足肿、小腿冷、黄汗出。此病类似历节黄汗，而实际上不是水湿为病，所谓肝肾虽虚，未必便成历节的就是这种情况。而虚病不能发热，历节则无不发热的，所以说假如发热，便为历节。后文水气篇中又说，黄汗之病，两胫自冷。假如发热，此属历节。大概就是在黄汗和历节之间加以辨别。详见本文。
病历节不可屈伸，疼痛，用乌头汤主治。
这是治疗寒湿历节的正法。寒湿之邪，非麻黄、乌头不能去除。而病在筋节，又不像皮毛之邪，可以一汗而散。所以用黄芪的补益，白芍的收敛，甘草的缓和，来牵制麻黄、乌头，使得它们能深入而去留邪，就像卫玠监钟邓入蜀，使其成功而不至于乱，这是制方的要妙。
乌头汤，也治疗脚气疼痛，不可屈伸。
麻黄 芍药 黄芪 甘草（各三两炙） 乌头（五枚 切碎，用蜜二升煎取一升，即取出乌头）
以上四味药，用水三升，煮取一升，去滓，加入蜜煎中，再煎。服七合。若无效，全部服完。
矾石汤，治疗脚气冲心。
矾石（二两）
以上一味药，用浆水一斗五升，煎三五沸，浸脚良效。
脚气之病，湿伤于下，而气冲于上。矾石味酸涩性燥，能退水收湿解毒。毒解湿收，上冲自然停止。
附方
古今录验续命汤，治疗中风痱，身体不能自主控制，口不能言，昏昧不知痛处，或拘急不得转侧。
麻黄 桂枝 甘草 干姜 石膏 当归 人参（各三两） 杏仁（四十粒） 川芎（一两五钱）
以上九味药，用水一斗，煮取四升，温服一升。应当微微出汗，薄覆脊背，凭几而坐，汗出则愈，不出汗再服。无所禁忌，勿当风。并治疗只能伏卧不能仰卧，咳逆上气，面目浮肿。
痱者废也。精神不能持守，筋骨不能使用，不仅是邪气扰乱，也是真气衰败。麻黄、桂枝所以散邪，人参、当归所以养正。石膏合杏仁助散邪之力，甘草合干姜为恢复元气所需，这是攻补兼行的方法。
千金三黄汤，治疗中风，手足拘急，百节疼痛，烦热心乱，恶寒，经日不欲饮食。
麻黄（五分） 独活（四分） 细辛 黄芪（各二分） 黄芩（三分）
以上五味药，用水六升，煮取二升，分温三服。一服小汗出，二服大汗出。心热加大黄二分，腹满加枳实一枚，气逆加人参三分，悸加牡蛎三分，渴加栝蒚根三分，先有寒，加附子一枚。
近效术附汤，治疗风虚，头重眩晕，痛苦至极，不知食物味道，暖肌补中，益精气。
白术（一两） 附子（一枚半炮制去皮） 甘草（一两炙）
以上三味药，每用五钱匕，姜五片，枣一枚，水一盏半，煎至七分，去滓温服。
崔氏八味丸，治疗脚气上入少腹不仁。
熟地黄（八两） 山茱萸 山药（各四两） 泽泻 茯苓 牡丹皮（各三两） 桂枝 附子（各一两炮制）
以上八味药，研末，炼蜜和丸如梧子大，酒送下十五丸，每日两次。肾之脉，起于足而入于腹。肾气不治，湿寒之气，随经上入，聚于少腹，为之不仁。这不是驱湿散寒的方剂所能治疗的，必须以肾气丸补肾中之气，以作为生阳化湿的作用。
千金越婢加术汤，治疗肉极热，则身体津液脱失，腠理开，汗大泄，厉风气，下焦脚弱。
麻黄（六两） 石膏（半斤） 生姜（二两） 甘草（二两） 白术（四两） 大枣（十五枚）
以上六味药，用水六升，先煮麻黄，去掉上面浮沫，加入其他药，煮取三升，分温三服。恶风加附子一枚，炮制。
Wind pathogen causing disease should present with hemiplegia (hemiplegia). If only the arm is unable to move, this is considered Bi syndrome (obstruction syndrome). The pulse is faint and rapid; this is caused by wind stroke.
Wind pathogen pervades the upper and lower body, thus causing hemiplegia. Bi pathogen blocks a single area, thus causing only the arm to be immobile. From this, we see that wind disease is heavy while Bi disease is light; wind moves while Bi adheres. Wind enters from deficiency, thus the pulse is faint. Wind manifests and generates heat, thus the pulse is rapid. Saying "this is caused by wind stroke" means that Bi disease is also a wind disease; it is simply that when in the Yang aspect (exterior/outer), it is called wind, and when in the Yin aspect (interior/inner), it is called Bi.
The Cun Kou (radial artery) pulse is floating and tight. Tight indicates cold; floating indicates deficiency. Cold and deficiency interact, with the pathogen residing in the skin. Floating indicates blood deficiency, and the collateral vessels are empty. The thief pathogen cannot be expelled. The pathogen may affect either the left or the right side. The affected side becomes flaccid and slow, while the healthy side's righteous Qi becomes tense and urgent. The righteous Qi pulls the pathogen, resulting in deviation of the mouth and eyes and inability to move freely. If the pathogen is in the collaterals, the skin and muscles are numb. If in the meridians, the body feels heavy and difficult to lift. If entering the Fu organs, consciousness is lost and one does not recognize people. If entering the Zang organs, the tongue becomes stiff and speech is difficult, with drooling.
Cold and deficiency interacting indicates righteous Qi is insufficient and the pathogen takes advantage. This is the pulse diagnosis for initial contraction of wind-cold. Floating indicates blood deficiency because Qi moves outside the vessels and Blood moves inside; a floating pulse indicates insufficiency upon deep pressure, hence blood deficiency. Blood deficiency fails to nourish the skin, making the collaterals empty, and failing to defend against external pathogens, allowing the thief pathogen to linger. Thus, the pathogen stays in areas of emptiness, whether left or right. On the affected side, tendons and vessels lose function and become flaccid; on the unaffected side, righteous Qi operates alone and becomes tense. The flaccid side is pulled by the tense side, causing deviation of the mouth and eyes and limb paralysis. Therefore, if the left side is paralyzed, the pathogen is actually on the right; if the right side is paralyzed, the pathogen is on the left. However, regardless of left or right, there are differences in pathogen/righteous Qi tension, and distinctions between exterior/interior and meridians/collaterals/Zang-Fu. The Classics state: Meridians are interior; branching horizontal vessels are collaterals; small collaterals are Sun collaterals. Thus, collaterals are shallow and meridians deep; collaterals are small and meridians large. So collateral pathogens affect skin and muscle, while meridian pathogens affect sinews and bones. Worse, it enters the Fu organs, and even worse, the Zang organs, with the pathogen penetrating deeper layer by layer. Spirit resides in the Zang organs and connects to the Fu organs. Fu organ disease obstructs spirit internally, so one does not recognize people. All Yin meridians connect to the root of the tongue. If Zang Qi reverses and does not reach under the tongue, the mechanism rests above, so speech is difficult and saliva flows out.
Hou Shi Hei San treats severe wind causing heaviness in the four limbs and a feeling of coldness and insufficiency in the heart.
Chrysanthemi Flos (40 parts) Atractylodis Rhizoma Sapida (Bai Zhu) Saposhnikoviae Radix (Fang Feng) (each 10 parts) Platycodonis Radix (Jie Geng) (8 parts) Scutellariae Radix (Huang Qin) (5 parts) Asari Radix et Rhizoma (Xi Xin) Zingiberis Rhizoma Recens (Gan Jiang) Ginseng Radix (Ren Shen) Poria (Fu Ling) Angelicae Sinensis Radix (Dang Gui) Chuanxiong Rhizoma (Chuan Xiong) Ostrea Concha (Mu Li) Alum (Fan Shi) Cinnamomi Ramulus (Gui Zhi) (each 3 parts)
These fourteen ingredients are crushed into powder. Take one cubic inch spoonful with wine, once daily. For the first twenty days of treatment, take with warm wine. Avoid all fish, meat, and garlic. Prefer cold food for sixty days to prevent the medicine from passing down immediately. Hot food causes it to pass down. Cold food naturally aids the medicinal power.
This formula was also appended by Sun Qi and others, but it comprehensively includes methods to dispel wind, clear heat, tonify deficiency, and descend phlegm. It is believed that wind stroke diseases arise from these factors. Students should grasp its intent without being rigidly attached to its form.
Cun Kou pulse is slow and relaxed. Slow indicates cold; relaxed indicates deficiency. Relaxed Ying Qi indicates loss of blood; relaxed Wei Qi indicates wind stroke. Pathogen striking the meridians causes body itching and urticaria. Insufficient Heart Qi allows pathogen to enter centrally, causing chest fullness and shortness of breath.
Slow means movement is inadequate; relaxed means arrival is weak. Inadequacy is cold; weakness is deficiency. Deep and relaxed indicates Ying insufficiency; floating and relaxed indicates Wei struck by wind. Wei is exterior and Ying is interior. When meridians are insufficient and wind enters, blood is stirred by wind, causing itching and urticaria. When Heart is insufficient and wind strikes, Yang fails to distribute, causing chest fullness and shortness of breath. Meridians run through muscles, and the Heart resides in the chest.
Feng Yin Tang clears heat and treats paralysis and epilepsy.
Rhei Radix et Rhizoma (Da Huang) Zingiberis Rhizoma Recens (Gan Jiang) Longgu (each 4 liang) Cinnamomi Ramulus (Gui Zhi) (3 liang) Glycyrrhizae Radix et Rhizoma (Gan Cao) Ostrea Concha (Mu Li) (each 2 liang) Aquum Frigidum Lapis (Han Shui Shi) Talcum (Hua Shi) Red Halloysitum (Chi Shi Zhi) White Halloysitum (Bai Shi Zhi) Purpuritum (Zi Shi Ying) Gypsum Fibrosum (Shi Gao) (each 6 liang)
These twelve ingredients are coarsely crushed and sifted, stored in a leather bag. Take three finger-pinches, boil in three sheng of well water for three boils, take one sheng warm. Treats adult wind-drawing, pediatric convulsions and epilepsy occurring frequently, unresponsive to other treatments. Chao Yuanfang states Jiaoqi (foot weakness) is suitable for Feng Yin Tang.
This is a formula for purging and clearing heat. Sun Qi believed wind stroke often originates from heat, hence appended here. It contains Ginger, Cinnamon, Stones, Halloysite, Dragon Bone, Oyster Shell, likely using astringency to control purgation and warmth to moderate cold. It is a potent formula; users must exercise caution.
Fang Ji Di Huang Tang treats conditions resembling mania, wandering aimlessly, talking to oneself incessantly, without chills or fever, with a floating pulse.
Stephaniae Tetrandrae Radix (Fang Ji) Glycyrrhizae Radix et Rhizoma (Gan Cao) (each 1 fen) Cinnamomi Ramulus (Gui Zhi) Saposhnikoviae Radix (Fang Feng) (each 3 fen)
These four ingredients are soaked in one cup of wine, squeezed to extract juice. Raw Rehmanniae Radix (Sheng Di Huang) two jin is chopped, steamed until like cooked rice, placed in a copper vessel with the wine juice, then mixed with the squeezed juice of the steamed Rehmannia. Divide into two doses.
Wandering and delirium with body heat and large pulse belong to Yangming. This case has no chills/fever and a floating pulse, indicating heat generated from blood deficiency, with pathogen merging into Yang. Gui Zhi, Fang Feng, Fang Ji, Gan Cao soaked in wine extract their light and clear qualities to return to Yang and disperse pathogen. Raw Di Huang's sweet and cold nature, steamed to return to Yin, nourishes blood and clears heat. Generally, raw herbs disperse exterior; cooked herbs tonify deficiency. This decoction method reflects exterior-interior principles. (Note by Zhao)
Tou Feng Mo San
Aconiti Lateralis Radix Praeparata (Da Fu Zi) (one piece) Salt (equal parts)
These two ingredients are powdered. After washing hair, apply one cubic inch spoonful to the affected area and massage to promote medicinal action.
Cun Kou pulse is deep and weak. Deep governs bones; weak governs sinews. Deep corresponds to Kidney; weak corresponds to Liver. Sweating and entering water damages the Heart, causing Li Jie pain and yellow sweat, hence called Li Jie.
This is due to prior Liver-Kidney deficiency and subsequent stagnation of Heart Yang, forming the root of Li Jie and yellow sweat. Heart Qi transforms fluid into sweat. Entering water while sweating allows cold water Qi to invade the Heart through pores. External water and internal fire stagnate into damp-heat, turning sweat yellow, infiltrating sinews and bones, causing Li Jie pain. Li Jie means pain at every joint. Without prior Liver-Kidney deficiency, water Qi would not easily enter sinews/bones; without internal damp-water invasion, Liver-Kidney deficiency alone would not necessarily cause Li Jie. Zhang Zhongjing lists the branch symptoms first to investigate the root cause, believing Li Jie mostly arises from deficiency.
Note: Later in the Water Qi chapter, it says yellow sweat disease occurs when sweating and bathing in water, with water entering through pores. Combining these two passages shows Li Jie and yellow sweat are diseases from the same source but different manifestations. Stagnation in the Upper Jiao causes yellow sweat; involvement of sinews and bones causes Li Jie.
Fu Yang pulse is floating and slippery. Slippery indicates abundant grain Qi; floating indicates spontaneous sweating. Shao Yin pulse is floating and weak. Weak indicates blood insufficiency; floating indicates wind. Wind and blood struggle, causing pain like pulling. In robust individuals with choppy-small pulses, shortness of breath, spontaneous sweating, Li Jie pain, and inability to flex/extend, this is caused by sweating after drinking alcohol and exposure to wind.
Fu Yang floating indicates wind; slippery indicates abundant grain Qi. Sweat is born from grain, and wind tends to leak, hence spontaneous sweating. Wind-blood struggle occurs when Shao Yin blood is deficient and wind disturbs it, causing pulling pain. Comparing Fu Yang and Shao Yin passages: when Yangming grain Qi is abundant, wind exits with sweat; when Shao Yin blood is insufficient, wind attaches and causes disease. Robust individuals with choppy-small shortness of breath have external robustness but internal Qi deficiency. Spontaneous sweating indicates dampness prevailing. Wine drinkers have internal dampness accumulation; sweating and wind exposure cause external damp stagnation. Internal and external call each other, flowing into joints, causing Li Jie pain and immobility. Comparing the three passages: sweat/water entry causes heat damp-stagnation; wind-blood struggle causes blood disturbance by wind; wine/sweat/wind causes wind-damp combination. Li Jie etiologies differ in these three aspects, but all stem from deficiency.
Pain in all limb joints, emaciated body, swollen feet as if detached, dizziness, shortness of breath, nausea, treated with Gui Zhi Shao Yao Zhi Mu Tang.
Pain in all limb joints is Li Jie. Emaciation and foot swelling indicate insufficient form/Qi and severe downward damp-heat. Dizziness, shortness of breath, and nausea indicate damp-heat rising from below. This resembles Jiaoqi rushing to the Heart. Gui Zhi, Ma Huang, Fang Feng disperse dampness externally; Shao Yao, Zhi Mu, Gan Cao clear heat internally; Bai Zhu, Fu Zi drive dampness downward; abundant Sheng Zhi stops vomiting and directs rebellion downward. This treats damp-heat affecting limbs/joints and rising to Heart/Stomach.
Gui Zhi Shao Yao Zhi Mu Tang Formula
Cinnamomi Ramulus (Gui Zhi) (4 liang) Paeoniae Radix Alba (Shao Yao) (3 liang) Glycyrrhizae Radix et Rhizoma (Gan Cao) Ephedrae Herba (Ma Huang) (each 2 liang) Aconiti Lateralis Radix Praeparata (Fu Zi) (two pieces, processed) Atractylodis Macrocephalae Rhizoma (Bai Zhu) Anemarrhenae Rhizoma (Zhi Mu) Saposhnikoviae Radix (Fang Feng) (each 4 liang) Zingiberis Rhizoma Recens (Sheng Jiang) (5 liang)
Nine ingredients. Boil in seven sheng water, reduce to two sheng. Take seven ge warm, three times daily.
Sour taste injures sinews; injured sinews become flaccid, named Xie. Salty taste injures bones; injured bones become weak, named Ku. Ku and Xie struggle, named Duan Xie. Ying Qi does not circulate, Wei Qi cannot move alone. Ying and Wei both diminish, Three Jiao loses control, Four Belongings sever. Body becomes emaciated, feet swell, yellow sweat appears, calves feel cold. If fever occurs, it is Li Jie.
This is internal Liver-Kidney injury due to dietary excess. Ku-Xie struggle means simultaneous sinew-bone injury. Duan Xie means vital energy fails to continue, spirit wanders. Ying blockage leads to Wei stagnation; disease in Yin affects Yang. Blockage/stagnation here implies depletion rather than excess. Four Belongings refer to the four limbs. Ying-Wei are Qi of grain and water; Three Jiao receives Qi from grain/water, and limbs receive Qi from Three Jiao. Thus, diminished Ying-Wei leaves Three Jiao without Qi and limbs without nourishment. Essence/fluids fail to transform upward, causing emaciation; Yin turbidity sinks downward, causing foot swelling, cold calves, yellow sweat. This resembles Li Jie/yellow sweat but is not water-damp disease. As stated, Liver-Kidney deficiency does not always cause Li Jie. Deficiency diseases do not cause fever; Li Jie always involves heat. Hence, "if fever occurs, it is Li Jie." Later in Water Qi chapter: Yellow sweat disease has cold calves; if fever occurs, it belongs to Li Jie. This distinguishes yellow sweat from Li Jie. See text.
Li Jie with immobility and pain, treated with Wu Tou Tang.
This is the standard treatment for cold-damp Li Jie. Cold-damp pathogens require Ma Huang and Wu Tou to remove. Since disease is in sinews/joints, unlike exterior pathogens, it cannot be dispersed with one sweat. Thus, Huang Qi tonifies, Shao Yao astringes, Gan Cao moderates, restraining Ma Huang and Wu Tou to allow deep penetration to remove lingering pathogens, like Wei Yi supervising Zhong Deng entering Shu, ensuring success without chaos. This is the subtlety of formula formulation.
Wu Tou Tang also treats Jiaoqi pain with immobility.
Ephedrae Herba (Ma Huang) Paeoniae Radix Alba (Shao Yao) Astragali Membranacei Radix (Huang Qi) Glycyrrhizae Radix et Rhizoma (Gan Cao) (each 3 liang, honey-fried) Aconiti Radix (Wu Tou) (five pieces, chopped, decocted in two sheng honey to yield one sheng, then remove Wu Tou)
Four ingredients. Boil in three sheng water, reduce to one sheng, strain, add to honey decoction, boil again. Take seven ge. If ineffective, consume all.
Fan Shi Tang treats Jiaoqi rushing to Heart.
Alumen (Fan Shi) (2 liang)
One ingredient. Decoct in fifteen sheng sour rice water for three-five boils. Soak feet.
Jiaoqi disease: dampness injures below, Qi rushes above. Fan Shi is sour/astringent/dry, expelling water, absorbing dampness, resolving toxicity. With toxin resolved and dampness absorbed, upward rush stops.
Appendix Formulas
Gu Jin Lu Yan Xu Ming Tang treats wind stroke fei (paralysis), body unable to hold itself, inability to speak, confusion/unawareness of pain, or stiffness preventing turning.
Ephedrae Herba (Ma Huang) Cinnamomi Ramulus (Gui Zhi) Glycyrrhizae Radix et Rhizoma (Gan Cao) Zingiberis Rhizoma Recens (Gan Jiang) Gypsum Fibrosum (Shi Gao) Angelicae Sinensis Radix (Dang Gui) Ginseng Radix (Ren Shen) (each 3 liang) Armeniacae Semen Amarum (Xing Ren) (40 grains) Chuanxiong Rhizoma (Chuan Xiong) (1.5 liang)
Nine ingredients. Boil in ten sheng water, reduce to four sheng. Take one sheng warm. Should induce slight sweat. Cover back lightly, sit leaning on table. Sweat resolves disease; if no sweat, repeat. No restrictions, avoid wind. Also treats inability to lie flat, cough/wheezing, facial edema.
Fei means waste. Spirit cannot sustain, sinews/bones unusable. Not just pathogen disturbance, but true Qi decline. Ma Huang/Gui Zhi disperse pathogen; Ren Shen/Dang Gui nourish righteousness. Shi Gao/Xing Ren assist dispersal; Gan Cao/Gan Jiang restore Qi. This is attacking and tonifying simultaneously.
Qian Jin San Huang Tang treats wind stroke, spasms in hands/feet, pain in all joints, vexation/heart disorder, chills, anorexia for days.
Ephedrae Herba (Ma Huang) (5 fen) Dictamni Radix (Du Huo) (4 fen) Asari Radix et Rhizoma (Xi Xin) Astragali Membranacei Radix (Huang Qi) (each 2 fen) Scutellariae Radix (Huang Qin) (3 fen)
Five ingredients. Boil in six sheng water, reduce to two sheng. Divide into three warm doses. First dose slight sweat; second dose heavy sweat. Add Rhei Radix et Rhizoma (Da Huang) 2 fen for heart heat; Zhaishi (Fructus Trichosanthis) one piece for abdominal fullness; Ginseng Radix (Ren Shen) 3 fen for rebellious Qi; Ostrea Concha (Mu Li) 3 fen for palpitations; Trichosanthis Radix (Gua Lou Gen) 3 fen for thirst; Aconiti Radix (Fu Zi) one piece for pre-existing cold.
Jin Xiao Zhu Fu Tang treats wind-deficiency, heavy head/dizziness, extreme suffering, loss of taste, warming muscles, tonifying middle, benefiting essence/Qi.
Atractylodis Macrocephalae Rhizoma (Bai Zhu) (1 liang) Aconiti Lateralis Radix Praeparata (Fu Zi) (1.5 pieces, processed, peeled) Glycyrrhizae Radix et Rhizoma (Gan Cao) (1 liang, honey-fried)
Three ingredients. Use five qian bi per dose, with five slices of ginger and one jujube. Boil in half a cup of water to 70%, strain, take warm.
Cui Shi Ba Wei Wan treats Jiaoqi ascending to lower abdomen with insensitivity.
Rehmanniae Radix Preparata (Shu Di Huang) (8 liang) Corni Fructus (Shan Zhu Yu) Dioscoreae Rhizoma (Shan Yao) (each 4 liang) Alisma Rhizoma (Ze Xie) Poria (Fu Ling) Moutan Cortex (Mu Dan Pi) (each 3 liang) Cinnamomi Ramulus (Gui Zhi) Aconiti Lateralis Radix Praeparata (Fu Zi) (each 1 liang, processed)
Eight ingredients. Powder, mix with honey pills size of wu zi seeds. Take 15 pills with wine, twice daily. Kidney meridian starts at foot and enters abdomen. Kidney Qi dysfunction allows damp-cold to ascend along meridian, gathering in lower abdomen causing insensitivity. This requires Kidney Qi Pill to tonify Kidney Qi, generating Yang to transform dampness.
Qian Jin Yue Bi Jia Shu Tang treats extreme flesh heat, fluid loss, open pores, profuse sweating, severe wind pathogen, lower Jiao foot weakness.
Ephedrae Herba (Ma Huang) (6 liang) Gypsum Fibrosum (Shi Gao) (half jin) Zingiberis Rhizoma Recens (Sheng Jiang) (2 liang) Glycyrrhizae Radix et Rhizoma (Gan Cao) (2 liang) Atractylodis Macrocephalae Rhizoma (Bai Zhu) (4 liang) Ziziphi Jujubae Fructus (Da Zao) (15 pieces)
Six ingredients. Boil in six sheng water. First boil Ma Huang, remove foam. Add other herbs, boil to three sheng. Divide into three warm doses. Add Fu Zi (processed) if aversion to wind.