（中风之病。内经论之甚详。而读者每苦不得其要。且多与痹合论。同中之异。更
不可以不辨。）夫风之为病。（中人彻于上下。故）当半身不遂。或（着于一处。）但
臂不遂者。此（不为风而）为痹。（此风与痹之大分别也。然风从虚入。热从风发。故
诊其）脉（虚为）微而（热为）数。（可以一言定之曰。）中风（既成之证）使然。（
若未中之前。国中之顷。则不尽然也。）
此一节先辨风与痹之殊。后之脉微而数中风使然八字。提出中风之大纲。如大海行
舟。茫茫无际。中按罗经。以定子午。则所向自无差错。余注之曰。风从虚入。指阳虚
而言也。阳字指太阳而言。太阳虚。则
不能卫外而为固。故脉微。余又注之曰。热从风发。以其人素有内热。而风中之。风为
阳邪。内热外风。风火交煽。故脉数。学人当知此八个字。是大慈大悲菩萨。立于云端
指示。以下止有四方。首方则为国中时邪未侵心者。示一堵塞法。次方为既中后邪已入
心为瘫痫者。示一下热法。三方为邪已入心。病如狂状者。示一表里兼治法。四方为风
攻于头而不去。示一外治法。细绎方意。无非着眼于少阴。少阴兼手足而言。寒从水化
而归于下。以足少阴为主。风从火化而归于上。以手少阴为主。知其真证。便得真方。
学人当于引而不发之中。得其跃如之妙。
（虽然。风从虚入。虚则脉微。热从风发。热则脉数。此为风证之既成。从少阴而化热者言之
也。若论其初。风不挟寒。则为和风。唯其挟寒。则伤人甚速。始伤皆由营卫。心营肺
卫。必以寸口为凭。若中风而偏于寒者。）寸口脉浮而紧。紧则为寒。浮则为虚。寒虚
相搏。邪在皮肤。（正不足而邪乘之也。气行脉外。血行脉中。浮而有余者。必沉而不
足。故以）浮者（断为）血虚。（血虚则无以充皮肤而养络。故）络脉空虚。（又无以
循常度以御邪。故）贼邪不泻。或左或右。邪气（所伤。则筋脉不用而）反缓。（无邪
之处。则其）正气（独治而）即急。正气引邪。（其口目） 僻不遂。（左 者邪反在
右。右 者邪反在左。不可不知也。虽然。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。若）邪在于络。（络邪病表。故）肌肤不仁。邪在于经。（经邪病
里。）即（筋骨）重（滞而）不胜。邪入于腑。（则胃腑燥热。其支脉络心。大妨神气
之出入。）即不识人。邪入于脏。（心肾二脏。俱连舌本。脏气厥而不至舌下。故）舌
即难言。（且廉泉亦开。）口（必）吐涎。
此为初病中风之偏于寒者。而详其证之递深也。师未出方。徐忠可云、节下侯氏黑
散即次之。疑系此证之方。然余谓四肢烦重。心中寒甚者为的剂。若风火交煽。喻嘉言
取用驱风至宝膏甚妙。方用防风二两半白术一两半芍药二两半芒硝五钱生石膏一两滑石
三两当归二两半黄芩一两甘草二两
大黄五钱连翘五钱川芎三两半麻黄五钱天麻一两山栀子五钱荆芥五钱黄柏五钱桔梗一两
薄荷五钱熟地黄一两羌活一两人参一两全蝎五钱细辛五钱黄连五钱独活一两。共二十六
味为末。炼蜜丸弹子大。每服一丸。细嚼。茶酒任下。临卧服。但此方医者病患。或疑
其散。或疑其攻。或疑其杂。往往不肯服而死。盖有命焉。不可强也。吕纯阳大丸更效。
又按、风中经络与腑者。可用驱风至宝膏。若入脏。最防迸入于心。宜用侯氏黑散。
于驱补之中。行其堵截之法。至于风引汤。按法用之。无往不利。
侯氏黑散 治大风。四肢烦重。心中恶寒不足者。（外台治风癫 此方主补虚以
熄其风）
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。
徐忠可云、此为中风家挟寒而未变热者治法之准则也。谓风从外入。挟寒作势。此
为大风。证见四肢烦重。岂非四肢为诸阳之本。为邪所痹。而阳气不运乎。然但见于四
肢。不犹愈体重不胜乎。证又见心中恶寒不足。岂非渐欲凌心乎。然燥热犹未乘心。不
犹愈于不识人乎。故侯氏黑散用参苓归芎。补其气血为君。菊花白术牡蛎。养肝脾肾为
臣。而加防风桂枝。以行痹着之气。细辛干姜。以驱内伏之寒。兼
桔梗黄芩。以开提肺热为佐。矾石所至。除湿解毒。收涩心气。酒力营运周身为使。庶
旧风尽出。新风不受。且必为散。酒服至六十日止。又常冷食。使药积腹中不下。盖邪
渐侵心。不恶热而恶寒。其由阴寒可知。若胸中之阳不治。风必不出。（太阳之气。行于
胸中。徐氏此注。精细之至。）故先以药填塞胸中之空窍。壮其中气。而邪不内入。势
必外消。此即内经所谓塞其空窍。是为良工之理。若专治其表里。风邪非不外出。而重
门洞开。出而复入。势将莫御耳。
男（元犀）按、徐氏煞此九个字。真阅历有得之言。不可顺口读去。
喻嘉言云、方中取用矾石以固涩诸药。使之积留不散。以渐填空窍。必服之日久。
风自以渐而息。所以初服二十日。不得不用温酒调下。以开其痹着。以后则禁诸热食。
惟宜冷食。如此再四十日。则药积腹中不下。而空窍塞矣。空窍填则旧风尽出。新风不
受矣。盖矾惟得冷即止。得热即行。故嘱云热食即下矣。冷食有能助药力。抑何用意之
微耶。
愚按、风家挟寒。虽未变热。而风为阳邪。其变甚速。观此方除热之品。与祛寒之
品并用。可见也。高明如尤在泾。尚有疑义。甚矣读书之难也。余每用此方。病家惑于
人言而不敢服。辄致重证莫救。不得已遵喻嘉言法。用驱风至宝膏。或借用后卷妇人门
竹叶汤。一日两服多效。然亦有不得不用此散者。亦必预制以送。不明告其方。以杜庸
俗人之论说也。
（又有中风而偏于风者。亦辨其脉于寸口。）寸口脉迟而缓。迟（者。行之不及。
不及）则为寒。缓（者。至而无力。无力）则为虚。营（行脉中。沉而见）缓则为亡
血。卫（行脉
外。浮而见）缓则为中风。（然营卫俱在肤表与肌腠。尚未中经也。若）邪气中经。
（营卫气弱。津血凝滞。）则身痒而瘾疹。（若）心气不足。邪气入中。则（邪混胸
中。阻遏正气。为）胸满而短气。
此为中风之偏于风者。而详其证之递深也。风为阳邪。其脉主缓。师未出方。徐忠
可云、此节下即以风引汤次之。疑系此证之方。余甚服其识。然与驱风至宝膏互服亦妙。
此节以迟脉 出缓脉。言迟则为寒者。以扇动之气虽寒。而自人受之。则为阳邪。
故分疏营卫二句。单承缓而不言迟。则可知其所独重矣。
风引汤 除热瘫痫。（此方主清热以除其风）
大黄 干姜（愚按应减半用） 龙骨（各四两） 桂枝 甘草 牡蛎（各二两愚按
此品应加倍） 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。小儿惊痫螈 。日数发。医所不疗。除热方。巢氏云、香港脚宜风引汤。
徐忠可云、风邪内迸。则火热内生。五脏亢甚。迸归入心。故以桂甘龙牡。通阳气
安心肾。为君。然厥阴风木。与少阳相火同居。火发必风生。风生必挟木势侮其脾土。
故脾气不行。聚液成痰。流注四末。因成瘫痪。故用大黄以荡涤风火湿热之邪。为臣。
随用干姜之止而不行者以补之。为反佐。又取滑石石膏。清金以伐其木。赤白石脂。
浓土以除其湿。寒水石以助肾水之阴。紫石英以补心神之虚。为使。故大人小
儿风引惊痫。皆主之。何后世以为石药过多而不用。反用脑麝以散真气。花蛇以增恶毒耶。
愚按、用前方而尚恐其不及者。宜黄连阿胶汤。从少阴之本以救之。余热不除。虚
羸少气。近于痿证者。以竹叶石膏汤清补之。二方如神。
按喻嘉言云、本文有正气引邪。 僻不遂等语。故立方即以风引名之。
（更有）防己地黄汤。治（风迸入心。风乘火势。火藉风威。其）病如狂状。妄行。
独语不休。（热迸于内。而外反）无热。（浮为风之本脉。而风火交煽。）其脉（益
）浮。此亦风迸入心之治法也。徐灵胎云、此方他药轻而生地独重。乃治血中之风也。
此等法最宜细玩。愚按、金匮书寥寥数语。读者疑其未备。然而所包者广也。中风以少
阴为主。此节言风迸手少阴之证。出其方治。曰病如狂状。妄行。独语不休者。盖以手
少阴心火也。阳邪迸之。则风乘火势。火借风威。其见证无非动象。曰无热者。热归于
内。外反无热。即伤寒论桂枝二越婢一汤证。外无大热之例也。曰其脉浮者。风火属阳之
本象也。然有正面。即有对面。手足少阴。可一而二之。实二而一之者也。考之唐宋后
各家之论中风。曰昏迷不醒等证。其不为狂状可知也。曰猝倒口噤等证。其不为妄行独
语可知也。曰面如 朱。可知寒盛于下。格阳于上。不能无热也。曰冷汗不止。可知其
四肢厥逆。不止无热也。曰脉脱。曰无脉。又将何以言浮乎。盖以足少阴肾水也。阴邪
迸之。则寒水相遭。寒冰彻骨。其见证无非静象。方书用三生饮一两。薛立斋又加人参
一两者。盖指此也。若痰涎如涌。三因白散可用。真阳上脱。气喘痰鸣。黑锡丹可用。
凡此皆为四逆证之例。究非中风之本证。其证散见于伤寒论中。金匮辟之于中风门外。
所以示立法之纯也。
防己地黄汤方
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。（按。此方表里兼治。后人驱风至宝膏方。从此方悟出。
）
头风摩散方
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。
此言偏头风之治法也。附子辛热以劫之。盐之咸寒以清之。内服恐助其火。火动而
风愈乘其势矣。兹用外摩之法。法捷而无他弊。且躯壳之病。内经多用外法。如马膏桑
钩。及熨法皆是。今人不讲久矣。
愚按、中风。大证也。内经与风痹风懿等证并论。读者莫得其要。后世主火主气主
血主痰主虚。纷纷不一。而且以真中类中分门。张景岳又以非风另立一门。而中风究系
何病。究用何方。茫然无据。每致患者十难救一。今读金匮此论。以风字专指八方之风。
中字从外入内。如矢之射人一般。病从太阳而起。在外在腑者为浅。在内在脏者为
深。迸于少阴者为较重。何等明亮。何等直捷。何等精粹。间有言之未尽者。余于小注
总注。遵先生之大旨而补之。庶无驳而不纯。偏而不举之憾。其云邪在于络二句。言络
邪病表。在六经之表也。其云邪在于经二句。言经邪病里。在六经之里也。其云邪入于
腑。即不识人二句。腑指阳明之胃腑也。其云邪入于脏。舌即难言二句。脏指少阴之脏
也。均以风引汤为主。余又以驱风至宝膏佐之。本卷附方。亦可消息而借用之。但不可
令喧客夺主耳。而第一方侯氏黑散。为逐风填窍之神剂。凡中风证初患未经变热者宜之。
病后尤赖以收功。免致再患。为终身之废疾。金匮论只七节。方只四首。其实论外有
论。方外有方。所贵读者之善悟也。江西喻嘉言喜读仲景书。着医门法律。全录金匮原
文。而参以时说。以致夺朱乱雅。其中有彼善于此者。如资寿解语汤。治中风脾缓。舌
强不语。半身不遂等症。方用防风炮附子天麻酸枣仁各一钱。肉桂羚羊角各八分。羌活
甘草各五分。水煎。入竹沥二匙。姜汁一滴服。又于此方去羌活。加熟地黄枸杞子菊花
胡麻仁天门冬。治肾虚风入不语。以少阴脉萦舌本也。又补录地黄饮子方。治舌喑不能言。
足废不能用。以肾虚气厥不至舌下。方用熟地黄巴戟天山茱萸肉苁蓉石斛炮附子五味
子白茯苓石菖蒲远志肉桂麦冬各五分。加生姜五片。枣二枚。薄荷五叶。水一杯半。煎
八分服。嘉言引此数方。大与金匮所论相反。后人遵其法而多误。医学梯阶。讥其驳杂。
信不诬也。余在直隶供职。着金匮浅注。此一证稿经三易。忽于防己地黄汤证。从对
面反面处会悟。遂不禁拍案大呼曰。风为阳邪。烂熟语。大有精义。他若阴邪为病。如
三生饮三因白散黑锡丹等法。当辟之于中风门外。即如加味六君子汤。嘉言注云、治四
肢不举。属于脾土虚者。须用此以治其本。不可加入风药。方用人参白术茯苓甘草陈皮
半夏各一钱。麦门冬三钱。姜三片。枣二枚。水二杯
煎六分。加竹沥一小盏温服。口渴者。去半夏。加葳蕤石膏。虚甚不热者。加附子。此
亦主虚而立论。或为善后调理之法则可。若中风时。藉此汤培元气以胜邪。亦何异于闭
（关于中风的病症，《黄帝内经》论述得非常详细，但读者往往苦于抓不住要领。而且常将中风与痹证混为一谈，其中相同点中的差异，更是不可以不去辨别。）风邪致病，（侵袭人体贯穿上下，所以）应当出现半身不遂。或者（风邪只停留在一个部位，）只是手臂不能随意活动的，这（不是风邪所致而是）属于痹证。（这是风病与痹病的重大区别所在。然而风邪从虚处侵入，热邪随风邪而发，所以在诊察时）脉象（虚弱表现为）微细而（有热表现为）数脉。（可以用一句话来概括判定：）中风（已经形成的证候）就是这样的。（如果在尚未中风的之前，体内正气尚存的片刻，则不一定如此。）
这一段先辨别风病与痹病的不同，后面“脉微而数，中风使然”八个字，提出了中风的大纲，就像在大海中行船，茫茫无际，中间依靠罗盘，来确定子午方向，那么航向自然就不会出错。我注释说：风从虚处侵入，指的是阳虚而言。阳字指太阳经而言。太阳经气虚，就不能卫护体表而固密，所以脉象微细。我又注释说：热随风邪而发，是因为这个人平素就有内热，又受到风邪侵袭。风为阳邪，内热与外风相合，风火相互煽动，所以脉象数急。学者应当知道这八个字，是大慈大悲的菩萨站在云端指示迷津。以下只有四个方剂，第一个方剂是针对体内正气未受邪气侵扰心脏的人，示以堵塞法；第二个方剂是针对已经中风后邪气已入心成为瘫痪癫痫的人，示以下热法；第三个方剂是针对邪气已入心，病情像发狂状态的人，示以表里兼治的方法；第四个方剂是针对风邪攻袭头部而不消散的情况，示以外治法。仔细推敲方义，无非是着眼于少阴经。少阴包括手少阴和足少阴而言。寒邪从水化而归于下部，以足少阴为主；风邪从火化而归于上部，以手少阴为主。知道了真正的证候，就能得到真正的方剂。学者应当在引而不发的教导中，领悟其跃如生动的妙处。
（虽然如此，风从虚处侵入，虚则脉微；热随风邪而发，热则脉数。这是针对风证已经形成，从少阴经化热的情况而言的。如果论及其初期，风不挟带寒邪，则为和风；唯有挟带寒邪，则伤人非常迅速。开始受伤都涉及营卫，心主血属营，肺主气属卫，必须以寸口脉作为凭据。如果是中风而偏于寒邪的。）寸口脉浮而紧，紧脉代表寒，浮脉代表虚。寒与虚相互搏结，邪气在皮肤。（正气不足而邪气乘虚而入。气运行在脉外，血运行在脉中。浮取有余的，沉取必然不足。所以）浮脉（判断为）血虚。（血虚则无法充盈皮肤而滋养络脉，所以）络脉空虚。（又无法遵循常规度数以抵御邪气，所以）贼邪不能排出。或者在左边，或者在右边，邪气（所伤之处，则筋脉弛缓而）反而松弛。（没有邪气的地方，则其）正气（独自发挥作用而）拘急。正气牵引邪气，（导致口眼）歪斜且不能随意活动。（左侧歪斜者邪气反在右侧，右侧歪斜者邪气反在左侧，不可不知道这一点。虽然如此，或左或右，则有邪正、松弛与拘急的不同，而为表为里，也有经络脏腑的区别。如果）邪气在于络脉。（络脉邪气病在表，所以）肌肤麻木不仁。邪气在于经脉。（经脉邪气病在里。）就（筋骨）沉重（滞涩而）难以支撑。邪气进入腑。（则胃腑燥热，其支脉络通于心，大大妨碍神气的出入。）就不认识人。邪气进入脏。（心和肾两脏，都连系舌根，脏气厥逆而不能到达舌下，所以）舌头就难以说话。（且廉泉穴也张开。）口（必定）流口水。
这是初患中风而偏于寒邪的情况，并详细阐述其证候逐渐加深的过程。老师没有开出方剂，徐忠可说：本节下的侯氏黑散紧接着，怀疑是这个证候的方剂。然而我认为，对于四肢烦重、心中寒冷不适者，才是确切的对症之药。如果是风火相互煽动，喻嘉言采用驱风至宝膏非常巧妙。方用防风二两半、白术一两半、芍药二两半、芒硝五钱、生石膏一两、滑石三两、当归二两半、黄芩一两、甘草二两、大黄五钱、连翘五钱、川芎三两半、麻黄五钱、天麻一两、山栀子五钱、荆芥五钱、黄柏五钱、桔梗一两、薄荷五钱、熟地黄一两、羌活一人参一两、全蝎五钱、细辛五钱、黄连五钱、独活一两。共二十六味研为末，炼蜜制成梧桐子大的丸药。每次服用一丸，细细咀嚼，茶或酒送服均可，临睡前服用。但是这个方子，医生和病人，有的怀疑它发散，有的怀疑它攻下，有的怀疑它杂乱，往往不肯服用而死。这大概是有命运决定的，不可以勉强。吕纯阳的大丸效果更好。
另外按语：风邪中于经络和腑的，可以使用驱风至宝膏。如果进入脏，最防止迸入于心，宜用侯氏黑散。在驱邪与补益之中，施行其堵塞截断的方法。至于风引汤，按照方法使用，无往不利。
侯氏黑散：治疗大风，四肢烦重，心中恶寒不足者。（《外台秘要》治疗风癫，此方主要补虚以熄风）
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，捣碎研为散。用酒送服一方寸匕，每天一次。初服二十天，用温酒调服。禁止食用一切鱼肉大蒜，平时适宜冷食，六十天为止。这样药物积聚在腹中不下行。热食就会下行。冷食自然能助长药力。
徐忠可说：这是中风患者挟带寒邪而未化热的治法准则。说风从外侵入，挟带寒邪作势，这称为大风。证见四肢烦重，难道不是四肢为诸阳之本，被邪气痹阻，而阳气不运吗？然而仅仅见于四肢，不还是比身体沉重难以支撑好吗？证候又见心中恶寒不足，难道不是逐渐想要凌犯心脏吗？然而燥热还没有乘虚侵犯心脏，不还是比不认识人好吗？所以侯氏黑散用人参、茯苓、当归、川芎，补益气血作为君药；菊花、白术、牡蛎，滋养肝脾肾作为臣药；并加入防风、桂枝，以通行痹阻之气；细辛、干姜，以驱除内伏之寒；兼用桔梗、黄芩，以开提肺热作为佐药；矾石所到之处，除湿解毒，收敛心气；酒力营运周身作为使药。这样旧风尽出，新风不受。并且必须制成散剂，用酒送服直到六十天停止，又经常冷食，使药物积聚在腹中不下行。大概邪气逐渐侵扰心脏，不厌恶热而厌恶寒，由此可知是由阴寒引起的。如果胸中的阳气不治疗，风邪一定出不去。（太阳之气，运行于胸中，徐氏的这个注释，精细到了极点。）所以先用药物填塞胸中的空窍，壮大其中的中气，而邪气就不向内侵入，势头必然向外消散。这就是《内经》所说的“塞其空窍”，这是高明医生的道理。如果专门治疗其表里，风邪并非不能外出，但是重门洞开，出去后又重新进入，势头将无可抵挡。
男（元犀）按语：徐氏说的这九个字，真是阅历丰富有所得的话，不可以顺口读过去。
喻嘉言说：方中取用矾石以固涩各种药物，使之积聚停留不散，以逐渐填填空窍。必须服药日久，风邪自然会逐渐平息。所以初服二十天，不得不使用温酒调下，以开通其痹阻。以后则禁止各种热食，只适宜冷食。这样再过四十天，则药物积聚在腹中不下行，而空窍就塞满了。空窍填满则旧风尽出，新风不受。大概矾石遇到冷就停止，遇到热就运行。所以嘱咐说热食就会下行。冷食能够助长药力，用意多么微妙啊！
我按语：风家挟带寒邪，虽然未化热，但风为阳邪，其变化非常快。看这个方子清热之品与祛寒之品并用，就可以看出来。像尤在泾这样高明的人，还有疑义，读书之难啊！我每次使用这个方子，病人受他人言论迷惑而不敢服用，往往导致重症无法救治。不得已遵照喻嘉言的方法，使用驱风至宝膏，或者借用后卷妇人门的竹叶汤，一天服用两次，效果很好。然而也有不得不用这个散剂的，也必须预先制备好送给他们，不明告其方名，以杜绝庸俗之人的议论。
（又有中风而偏于风邪的，也在寸口辨别其脉象。）寸口脉迟而缓，迟脉（意味着，运行不及，）不及（速度）则为寒，缓脉（意味着，脉搏到来而无力，无力）则为虚。营气（运行在脉中，沉取可见）缓则代表亡血，卫气（运行在）脉外，浮取可见）缓则代表中风。（然而营卫都在肤表与肌腠之间，尚未中入经脉。如果）邪气中入经脉，（营卫气弱，津血凝滞。）则身体瘙痒而起瘾疹。（如果）心气不足，邪气入中，则（邪气混杂胸中，阻遏正气，造成）胸满而短气。
这是中风偏于风邪的情况，并详细阐述其证候逐渐加深的过程。风为阳邪，其脉象主缓。老师没有开出方剂，徐忠可说：本节下紧接着就是风引汤，怀疑是这个证候的方剂。我非常佩服他的见识。然而与驱风至宝膏交替服用也很奇妙。这一节以迟脉引出缓脉，说迟则为寒，是以扇动的风气虽寒，但从人感受来说，则为阳邪。所以分述营卫两句，单独承接缓脉而不提迟脉，就可以知道其所侧重的了。
风引汤：清除热邪，治疗瘫痫。（此方主要清热以除风）
大黄 干姜（我按语认为应减半使用） 龙骨（各四两） 桂枝 甘草 牡蛎（各二两，我按语认为此药应加倍） 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，小儿惊痫抽搐。每天发作数次，医生无法治疗的，此为除热方。巢元方说：脚气病宜用风引汤。
徐忠可说：风邪内迸，则火热内生，五脏亢盛至极，迸归入心。所以用桂枝、甘草、龙骨、牡蛎，通阳气安心肾，作为君药。然而厥阴风木，与少阳相火同居，火发必生风，风生必挟带木势侮害脾土。所以脾气不行，聚液成痰，流注四肢末端，因而成为瘫痪。所以用大黄来荡涤风火湿热之邪，作为臣药。随即用干姜的止而不行之性来补益，作为反佐。又取滑石、石膏，清金以伐木；赤石脂、白石脂，厚土以除湿；寒水石以助肾水之阴；紫石英以补心神之虚，作为使药。所以大人小儿的风引惊痫，都主治。为什么后世认为石药过多而不用，反而用脑麝以散真气，用花蛇以增加恶毒呢？
我按语：使用前方还恐怕力度不够的，宜用黄连阿胶汤，从少阴的根本来救治。余热不除，虚羸少气，近于痿证的，用竹叶石膏汤清补。这两个方子如神效。
按喻嘉言说：本文有“正气引邪，僻不遂”等语句，所以立方即以“风引”命名。
（更有）防己地黄汤，治疗（风邪迸入心，风乘火势，火借风威，其）病像发狂的样子，胡乱行走，独自说话不停。（热邪迸于内，而外表反而）没有发热。（浮脉为风的基本脉象，而风火相互煽动。）其脉（更加）浮。这也是风邪迸入心的治疗方法。徐灵胎说：这个方子其他药轻而生地独重，是治疗血中之风的方法。这些方法最值得仔细玩味。我按语：《金匮》书中寥寥数语，读者怀疑其不完善，然而所包含的内容很广。中风以少阴为主。这一节讲风邪迸入手少阴的证候，提出其方治，说病像发狂样子，胡乱行走，独自说话不停的，因为手少阴心火。阳邪迸之，则风乘火势，火借风威，其见证无非是动象。说“无热”，是因为热归于内，外表反而无热，即《伤寒论》桂枝二越婢一汤证，外表无大热的例子。说“其脉浮”，是因为风火属阳的基本象。然而有正面，就有反面。手足少阴，可以一分为二，实则是二合一。考证唐宋后各家关于中风的论述，说昏迷不醒等证，其不为发狂样子可知。说猝倒口噤等证，其不为胡乱行走、独自说话可知。说面色如朱红，可知寒盛于下，格阳于上，不能无热。说冷汗不止，可知其四肢厥逆，不止无热。说脉脱，说无脉，又将何以言浮呢？大概足少阴肾水。阴邪迸之，则寒水相遭，寒冰彻骨，其见证无非是静象。方书用三生饮一两，薛立斋又加人参一两的，大概是指这个。如果痰涎如涌，三因白散可用；真阳上脱，气喘痰鸣，黑锡丹可用。凡是这些都属于四逆证的例子，终究不是中风的本证。其证散见于《伤寒论》中，《金匮》将其辟之于中风门外，所以显示立法之纯正。
防己地黄汤方
防己 甘草（各一分） 桂枝 防风（各三分）
以上四味药，用酒一杯浸泡，绞取汁液。生地黄二斤，切碎蒸透，像蒸斗米饭那样久。用铜器盛装药汁，再绞取地黄汁，混合分两次服用。（按：此方表里兼治，后人驱风至宝膏方，从此方悟出。）
头风摩散方
大附子（一枚） 盐（等分）
以上两味药研为散。洗头后，用一方寸匕涂抹于患处。令药力运行。
这是讲偏头风的治疗方法。附子辛热以劫夺邪气，盐之咸寒以清解。内服恐怕助其火，火动而风愈乘其势。这里用外摩的方法，法捷而无其他弊端。而且躯壳的疾病，《内经》多用外法，如马膏桑钩，以及熨法等都是。现在人不讲究很久了。
我按语：中风，是大证。《内经》与风痹、风懿等证并论，读者莫得其要领。后世主张火、主张气、主张血、主张痰、主张虚，纷纷不一。而且以真中、类中分门，张景岳又以非风另立一门。而中风究竟是何病，究竟用何方，茫然无据。每每导致患者十难救一。现在读《金匮》此论，以“风”字专指八方之风，“中”字从外入内，像箭射中人一般。病从太阳而起，在外在腑者为浅，在内在脏者为深。迸于少阴者为较重。何等明亮，何等直捷，何等精粹。间有言之未尽的，我在小注总注中，遵循先生的大旨而补充之。庶几没有驳杂而不纯粹，偏颇而不周全的遗憾。其说“邪在于络”两句，是说络脉邪气病在表，在六经之表。其说“邪在于经”两句，是说经脉邪气病在里，在六经之里。其说“邪入于腑，即不识人”两句，腑指阳明之胃腑。其说“邪入于脏，舌即难言”两句，脏指少阴之脏。均以风引汤为主，我又以驱风至宝膏辅助之。本卷附方，也可以斟酌而借用。但不可以让客喧宾夺主。而第一方侯氏黑散，为逐风填窍的神剂。凡中风证初患未经变热者适宜。病后尤其依赖它来收功，避免再次患病，成为终身废疾。《金匮》论只有七节，方只有四首。其实论外有论，方外有方，所贵在读者善于领悟。江西喻嘉言喜欢读仲景书，著《医门法律》，全录《金匮》原文，而参以当时之说，以致夺朱乱雅。其中有彼善于此的，如资寿解语汤，治疗中风脾缓，舌强不语，半身不遂等症。方用防风、炮附子、天麻、酸枣仁各一钱，肉桂、羚羊角各八分，羌活、甘草各五分，水煎，入竹沥二匙，姜汁一滴服。又于此方去羌活，加熟地黄、枸杞子、菊花、胡麻仁、天门冬，治疗肾虚风入不语，以少阴脉萦舌本也。又补录地黄饮子方，治疗舌喑不能言，足废不能用，以肾虚气厥不至舌下。方用熟地黄、巴戟天、山茱萸、肉苁蓉、石斛、炮附子、五味子、白茯苓、石菖蒲、远志、肉桂、麦冬各五分，加生姜五片，枣二枚，薄荷五叶，水一杯半，煎八分服。嘉言引用这几个方子，大与《金匮》所论相反。后人遵其法而多误。《医学梯阶》讥讽其驳杂，确实不诬。我在直隶供职，著《金匮浅注》，这一个证稿经过三次修改。忽然在防己地黄汤证，从对面反面处会悟，于是忍不住拍案大呼曰：风为阳邪，烂熟语，大有精义。他若阴邪为病，如三生饮、三因白散、黑锡丹等法，当辟之于中风门外。即如加味六君子汤，嘉言注云：治疗四肢不举，属于脾土虚者，须用此以治其本，不可加入风药。方用人参、白术、茯苓、甘草、陈皮、半夏各一钱，麦门冬三钱，姜三片，枣二枚，水二杯煎六分。加竹沥一小盏温服。口渴者，去半夏，加葳蕤、石膏。虚甚不热者，加附子。这也是主虚而立论，或许可以作为善后调理的法则是可以的。如果中风时，借此汤培元气以胜邪，又何异于闭……
(Regarding the disease of wind stroke, *Huangdi Neijing* discusses it in great detail, yet readers often struggle to grasp the essentials. Moreover, it is frequently discussed together with Bi syndrome (obstruction syndrome). The differences within the similarities must not be ignored.) Wind pathogen causing disease (invades the human body from top to bottom, therefore) should present with hemiplegia (paralysis of one side of the body). Or (if the pathogen stays in one area,) only the arm cannot move freely; this (is not caused by wind but) belongs to Bi syndrome (obstruction syndrome). (This is the major distinction between wind disease and Bi syndrome. However, wind enters through deficiency, and heat arises from wind. Therefore, upon diagnosis,) the pulse (weakness manifests as) fine and (heat manifests as) rapid. (It can be summarized in one sentence:) The established pattern of wind stroke (Zhong Feng) causes this. (Before the wind stroke occurs, while the internal righteous qi is still intact, it is not necessarily so.)
This section first distinguishes between wind disease and Bi syndrome. The eight characters "pulse is fine and rapid, caused by wind stroke" later on propose the general outline of wind stroke, like sailing a boat in the vast ocean without boundaries; relying on the compass in the middle to determine the north-south direction ensures the course will not go astray. I annotate: "Wind enters through deficiency" refers to Yang deficiency. The character "Yang" refers to the Taiyang (Greater Yang) channel. When Taiyang is deficient, it cannot protect the exterior and maintain solidity, hence the pulse is fine. I further annotate: "Heat arises from wind" because the person usually has internal heat, which is then invaded by wind. Wind is a Yang pathogen; internal heat combined with external wind creates a mutual incitement of wind and fire, hence the pulse is rapid. Students should understand that these eight characters are like a Bodhisattva of great compassion standing in the clouds pointing out the way. Below, there are only four formulas. The first formula is for those whose internal righteous qi has not been invaded by pathogens affecting the heart, demonstrating a method of blocking/occlusion. The second formula is for those who have already suffered wind stroke with pathogens entering the heart, resulting in paralysis or epilepsy, demonstrating a method of purging heat downwards. The third formula is for when pathogens have entered the heart and the condition resembles mania, demonstrating a method of treating both exterior and interior simultaneously. The fourth formula is for wind attacking the head and failing to dissipate, demonstrating an external treatment method. Carefully analyzing the intent of the formulas, they all focus on the Shaoyin (Lesser Yin) channels. Shaoyin includes both Hand Shaoyin and Foot Shaoyin. Cold transforms from water and returns to the lower part, primarily governed by Foot Shaoyin. Wind transforms from fire and returns to the upper part, primarily governed by Hand Shaoyin. Knowing the true pattern leads to obtaining the true formula. Students should perceive the vivid essence within the teaching that guides without forcing.
(Even so, wind enters through deficiency, deficiency leads to a fine pulse; heat arises from wind, heat leads to a rapid pulse. This speaks of the established wind pattern transforming into heat from Shaoyin. If discussing its initial stage, if wind does not carry cold, it is gentle wind; only when it carries cold does it injure people very quickly. Initial injury always involves Ying (Nutritive) and Wei (Defensive) Qi. Heart governs Blood belonging to Ying, Lung governs Qi belonging to Wei; one must rely on the Cun Kou (Radial) pulse. If wind stroke leans towards cold,) the Cun Kou pulse is floating and tight. Tight indicates cold, floating indicates deficiency. Cold and deficiency interact, with the pathogen in the skin. (Righteous qi is insufficient, allowing evil to take advantage. Qi moves outside the vessels, blood moves inside the vessels. Floating with excess implies sinking with insufficiency. Therefore,) floating pulse (is judged as) blood deficiency. (Blood deficiency fails to fill the skin and nourish the collaterals, thus) collateral vessels are empty. (Unable to follow normal measures to resist pathogens, thus) treacherous pathogens are not expelled. They may affect the left or the right. Where the pathogen injures, the sinews and vessels become flaccid and (instead) relaxed. Where there is no pathogen, the (righteous qi acts alone and becomes) tense. Righteous qi pulls the pathogen, causing (mouth and eyes to deviate and become immobile). (If deviation is to the left, the pathogen is actually on the right; if to the right, the pathogen is on the left; this must be known. Although there are differences in pathogen/righteousness and flaccidity/tension depending on left or right, regarding exterior/interior, there are also distinctions in meridians and zang-fu organs. If) the pathogen is in the collaterals. (Collateral pathology is at the exterior, thus) the skin and muscles feel numb. If the pathogen is in the meridians. (Meridian pathology is at the interior.) then the (bones and sinews feel) heavy (and stiff, making them) unbearable. If the pathogen enters the fu organs. (Then the stomach fu becomes dry and hot; its branches connect to the heart, greatly hindering the entry and exit of spirit.) then the person does not recognize others. If the pathogen enters the zang organs. (The Heart and Kidney both connect to the root of the tongue; if organ qi rebels and fails to reach under the tongue, thus) the tongue becomes difficult to speak. (And the Lianquan acupoint opens.) The mouth (will) dribble saliva.
This describes the initial stage of wind stroke leaning towards cold, detailing the progressive deepening of symptoms. The Master did not prescribe a formula. Xu Zhongke said: Hou's Black Powder follows this section, suspected to be the formula for this pattern. However, I believe it is the precise formula for cases with heavy limbs and severe cold sensation in the chest. If wind and fire incite each other, Yu Jiayan's use of Qu Feng Zhi Bao Gao (Wind-Dispersing Precious Ointment) is excellent. The formula uses Fangfeng (Saposhnikoviae Radix) 2.5 liang, Baizhu (Atractylodis Macrocephalae Rhizoma) 1.5 liang, Shaoyao (Paeoniae Radix) 2.5 liang, Mangxiao (Natrii Sulfas) 5 qian, Sheng Shigao (Gypsum Fibrosum) 1 liang, Huashi (Talcum) 3 liang, Danggui (Angelicae Sinensis Radix) 2.5 liang, Huangqin (Scutellariae Radix) 1 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang, Dahuang (Rhei Radix et Rhizoma) 5 qian, Lianqiao (Forsythiae Fructus) 5 qian, Chuanxiong (Ligustici Chuanxiong Rhizoma) 3.5 liang, Mahuang (Ephedrae Herba) 5 qian, Tianma (Gastrodiae Rhizoma) 1 liang, Shanzhizi (Gardeniae Fructus) 5 qian, Jingjie (Schizonepetae Spica) 5 qian, Huangbai (Phellodendri Cortex) 5 qian, Jiegeng (Platycodonis Radix) 1 liang, Bohe (Menthae Haplocalycis Herba) 5 qian, Shu Dihuang (Rehmanniae Radix Praeparata) 1 liang, Qianghuo (Notopterygii Rhizoma et Radix) 1 liang, Renshen (Ginseng Radix et Rhizoma) 1 liang, Quanxie (Scorpio) 5 qian, Xixin (Asari Radix et Rhizoma) 5 qian, Huanglian (Coptidis Rhizoma) 5 qian, Duohuo (Angelicae Pubescentis Radix) 1 liang. Twenty-six ingredients ground into powder, refined honey pills the size of a bullet. Take one pill per dose, chew finely, swallow with tea or wine as preferred, taken before bed. However, doctors and patients may suspect it is dispersing, purging, or too complex, often refusing to take it and dying. Fate dictates this; it cannot be forced. Lv Chunyang's large pill is even more effective.
Furthermore: For wind invading collaterals and fu organs, Qu Feng Zhi Bao Gao can be used. If it enters the zang organs, one must prevent it from bursting into the heart; Hou's Black Powder is suitable. It employs blocking methods amidst dispersing and tonifying. As for Fengyin Tang (Wind-Dragging Decoction), used according to method, it is universally effective.
Hou's Black Powder: Treats severe wind, heavy limbs, and feeling of cold/insufficiency in the chest. (*Waitai Miyao* treats wind epilepsy; this formula mainly tonifies deficiency to extinguish wind.)
Juhua (Chrysanthemi Flos) 40 fen, Baizhu (Atractylodis Macrocephalae Rhizoma), Fangfeng (Saposhnikoviae Radix) (each 10 fen), Jiegeng (Platycodonis Radix) 8 fen, Huangqin (Scutellariae Radix) 5 fen, Xixin (Asari Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Muli (Ostreae Concha), Fanshi (Alumen), Guizhi (Cinnamomi Ramulus) (each 3 fen).
These fourteen ingredients are pounded into powder. Take one cun bi (square inch measure) with wine, once daily. For the first twenty days, take with warm wine. Avoid all fish, meat, garlic. Prefer cold food for sixty days. This prevents the medicine from passing down immediately. Hot food causes it to pass down. Cold food naturally aids the medicinal power.
Xu Zhongke said: This is the criterion for treating wind stroke patients with cold pathogen that has not transformed into heat. Wind enters from outside, carrying cold to create momentum, called severe wind. Symptoms of heavy limbs imply the limbs, being the root of all Yang, are obstructed by pathogens, preventing Yang qi circulation. Yet appearing only in limbs is better than whole-body heaviness. Symptoms of cold/insufficiency in the chest imply gradual encroachment on the heart. Yet dry-heat has not yet attacked the heart, which is better than not recognizing people. Thus, Hou's Black Powder uses Renshen, Fuling, Danggui, Chuanxiong to tonify Qi and Blood as Sovereign herbs; Juhua, Baizhu, Muli to nourish Liver, Spleen, Kidney as Minister herbs; plus Fangfeng, Guizhi to move obstructed Qi; Xixin, Ganjiang to drive internal cold; Jiegeng, Huangqin to lift Lung heat as Assistant herbs; Fanshi to remove dampness, detoxify, and astringe Heart Qi; Wine to circulate throughout the body as Envoy herb. Thus old wind exits completely, new wind is not accepted. It must be taken as powder with wine for sixty days, preferring cold food to keep medicine accumulated in the abdomen. Since the pathogen gradually invades the heart, disliking heat but disliking cold indicates Yin-cold origin. If Chest Yang is not treated, wind will not exit. (Taiyang Qi circulates in the chest; Xu's annotation is extremely detailed.) Therefore, first use medicine to fill the empty spaces in the chest, strengthen Middle Qi, so pathogens do not enter internally, and inevitably dissipate externally. This is what *Neijing* means by "blocking the empty spaces," the principle of skilled physicians. If treating only exterior/interior, wind may exit, but with gates wide open, it re-enters, becoming uncontrollable.
Yuanxi notes: Xu's nine words here are truly words gained from experience; do not read them casually.
Yu Jiayan said: Using Fanshi in the formula to astringe the medicines, keeping them accumulated and不散 (not dispersing), to gradually fill the empty spaces. Long-term administration is necessary for wind to subside gradually. Hence, for the first twenty days, warm wine is used to open obstructions. Afterwards, hot foods are forbidden, only cold food is suitable. After another forty days, medicine accumulates in the abdomen, filling the empty spaces. Once filled, old wind exits, new wind is excluded. Fanshi stops when cold, moves when hot. Hence the instruction: hot food makes it pass down. Cold food aids medicinal power. How subtle the intention!
I note: Wind patients with cold pathogen, though not yet transformed into heat, since wind is a Yang pathogen, changes rapidly. The co-use of heat-clearing and cold-dispelling herbs in this formula shows this. Even highly intelligent scholars like You Zaijing had doubts; reading is indeed difficult. Whenever I use this formula, patients hesitate due to others' remarks and dare not take it, leading to untreatable severe conditions. Reluctantly following Yu Jiayan's method, I use Qu Feng Zhi Bao Gao, or borrow Zhuye Tang (Bamboo Leaf Decoction) from the Women's section later in the volume, taking twice daily with good effect. However, some cases require this powder; I prepare it secretly without revealing the name to avoid vulgar criticism.
(There are also wind strokes leaning towards wind pathogen, distinguished by pulse at Cun Kou.) Cun Kou pulse is slow and moderate. Slow (means movement is insufficient, insufficient speed) indicates cold. Moderate (means arrival is weak, weakness) indicates deficiency. Ying Qi (moves inside vessels, seen on deep pressure) moderate indicates loss of blood. Wei Qi (moves outside vessels, seen on superficial pressure) moderate indicates wind stroke. (However, Ying and Wei are at the skin surface and muscle interstices, not yet entering meridians. If) pathogen enters meridians, (Ying and Wei Qi are weak, Jin-Ye and blood stagnate.) then the body itches and urticaria appears. (If) Heart Qi is insufficient, pathogen enters centrally, then (pathogen mixes in the chest, obstructing righteous Qi, causing) chest fullness and shortness of breath.
This details the progressive deepening of wind stroke leaning towards wind pathogen. Wind is a Yang pathogen, its pulse is moderate. The Master did not prescribe a formula. Xu Zhongke said: Fengyin Tang follows this section, suspected to be the formula. I admire his insight. Alternating with Qu Feng Zhi Bao Gao is also wonderful. This section introduces moderate pulse via slow pulse, stating slow indicates cold. Although the moving air is cold, from the human perspective, it is a Yang pathogen. Thus, distinguishing Ying and Wei, focusing solely on moderate and ignoring slow reveals the emphasis.
Fengyin Tang (Wind-Dragging Decoction): Clears heat, treats paralysis and epilepsy. (This formula clears heat to dispel wind.)
Dahuang (Rhei Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma) (I note should be halved), Longgu (Fossilia Ossis Mastodi et Scapulae) (each 4 liang), Guizhi (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma), Muli (Ostreae Concha) (each 2 liang, I note should be doubled), Hanshuishi (Halloysit Rubrum), Huashi (Talcum), Chishizhi (Halloysit Rubra), Baishizhi (Halloysit Alba), Zhiyingshi (Psilomelane), Shigao (Gypsum Fibrosum) (each 6 liang).
Twelve ingredients pounded, coarsely sieved. Stored in leather bag. Take three fingers' pinch, boil in 3 sheng of well water for three boils. Warm drink 1 sheng. Treats adult wind-dragging, pediatric convulsions/spasms. Occurs several times daily, unresponsive to medical treatment. This is the heat-clearing formula. Chao Yuanfang said: Jiaoxie (Foot soreness) suits Fengyin Tang.
Xu Zhongke said: Internal wind bursting generates internal fire, five zang organs become hyperactive, bursting into the Heart. Thus Guizhi, Gancao, Longgu, Muli regulate Yang Qi, calm Heart and Kidney as Sovereign. Jueyin Wind-Wood and Shaoyang Minister-Fire reside together; fire generation produces wind, wind carries Wood energy to insult Spleen-Earth. Spleen Qi fails to transport, fluids gather into phlegm, flowing to limbs, causing paralysis. Thus Dahuang sweeps away wind-fire-damp-heat as Minister. Ganjiang's non-moving nature supplements as Counter-assistant. Huashi, Shigao clear Metal to control Wood; Chishizhi, Baishizhi thicken Earth to remove dampness; Hanshuishi assists Kidney Water Yin; Zhiyingshi tonifies Heart Spirit as Envoy. Thus it treats adult/pediatric wind-dragging and epilepsy. Why later generations avoided it due to excessive mineral drugs, instead using Musk/Amber to scatter True Qi and Flower Snakes to increase toxicity?
I note: If the previous formula is insufficient, use Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction) to save from the root of Shaoyin. For residual heat, emaciation, shortness of breath resembling Wei syndrome (flaccidity), use Zhuyegashitang (Bamboo Leaf and Gypsum Decoction) to clear and tonify. Both are miraculous.
According to Yu Jiayan: The text mentions "righteous qi pulls pathogen, deviation and immobility," hence the formula is named "Wind-Dragging."
(Furthermore,) Fangji Dihuang Tang (Stephania and Rehmannia Decoction) treats (wind bursting into Heart, wind riding fire, fire borrowing wind power, the) condition resembling mania, wild walking, continuous solitary talking. (Heat bursts internally, yet externally there is) no fever. (Floating is the fundamental pulse of wind, and wind-fire incite each other.) The pulse (increases in) floating. This is also a treatment method for wind bursting into the Heart. Xu Lingtai said: Other herbs are light, but Dihuang is heavy; this treats wind in the Blood. These methods deserve careful study. I note: *Jinkui* has few words, readers doubt incompleteness, but it covers broadly. Wind stroke focuses on Shaoyin. This section discusses wind bursting into Hand Shaoyin, presenting its formula: condition resembling mania, wild walking, continuous talking. Hand Shaoyin is Heart Fire. Yang pathogen bursts in, wind rides fire, fire borrows wind power; manifestations are dynamic. "No fever" means heat is internal, exterior is cool, similar to *Shanghan Lun* Guizhi Er Yuebi Yi Tang pattern where exterior lacks significant heat. "Pulse floating" is the fundamental image of Wind-Fire as Yang. However, there is a reverse side. Hand/Foot Shaoyin can be divided into two, yet are essentially one. Examining post-Tang/Song theories on wind stroke: coma implies not mania; sudden collapse/jaw clenching implies not wild walking/talking; red face implies cold below repelling Yang above, implying heat; cold sweat implies limb coldness, implying lack of heat; pulse disappearance implies no floating. Foot Shaoyin is Kidney Water. Yin pathogen bursts in, cold water meets, ice penetrates bones; manifestations are static. Formulas use Sansheng Yin (Three Lives Decoction) 1 liang, Xue Lizhai adds Renshen 1 liang, referring to this. If phlegm surges, Sanyin Baisan (Three Causes White Powder) is usable; if True Yang escapes, panting/phlegm rattle, Heixi Dan (Black Tin Pill) is usable. All these are examples of Sini patterns (Four Reversals), ultimately not the original pattern of wind stroke. Their manifestations appear in *Shanghan Lun*; *Jinkui* excludes them from the Wind Stroke chapter to show pure legislation.
Fangji Dihuang Tang Formula
Fangji (Stephaniae Tetrandrae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 fen), Guizhi (Cinnamomi Ramulus), Fangfeng (Saposhnikoviae Radix) (each 3 fen).
Four ingredients soaked in 1 cup of wine, strained to extract juice. Sheng Dihuang (Rehmanniae Radix) 2 jin, chopped and steamed until done like rice in a steamer. Place medicinal juice in copper vessel, squeeze Dihuang juice again, mix and divide for two doses. (Note: This formula treats interior and exterior simultaneously; later Qu Feng Zhi Bao Gao was inspired by this.)
Toufeng Mo San (Head Wind Massage Powder)
Da Fuzi (Aconiti Lateralis Radix Praeparata) (1 piece), Yan (Sal) (equal parts).
Two ingredients ground into powder. After washing hair, massage diseased area with one cun bi. Let medicinal power act.
This discusses treatment for lateral head wind. Fuzi is pungent-hot to attack; Yan is salty-cold to clear. Internal use might aid fire, making wind stronger. Here, external massage is used, swift without other drawbacks. Body diseases in *Neijing* often use external methods, such as Horse Fat/Mulberry Hook, and moxibustion/warming methods. People neglect this now.
I note: Wind stroke is a major pattern. *Neijing* discusses it with wind-Bi, wind-yi, etc. Readers miss the point. Later schools emphasize fire, Qi, blood, phlegm, deficiency, creating confusion. Dividing into True Wind and Simulated Wind, Zhang Jingyue created Non-Wind category. What is wind stroke really? What formula to use? Uncertainty leads to high mortality. Reading *Jinkui*, "Wind" refers to winds from eight directions; "Zhong" means entering from outside, like an arrow hitting a person. Disease starts from Taiyang; exterior/fu is shallow, interior/zang is deep; bursting into Shaoyin is heavier. How bright, direct, and pure! Where explanations are incomplete, I supplement in annotations following the Master's main idea, avoiding impurity or bias. "Pathogen in collaterals" means collateral pathology at exterior (Taiyang exterior). "Pathogen in meridians" means meridian pathology at interior (Taiyang interior). "Pathogen enters fu, does not recognize people" refers to Yangming Stomach fu. "Pathogen enters zang, tongue hard to speak" refers to Shaoyin zang. Mainly use Fengyin Tang, assisted by Qu Feng Zhi Bao Gao. Appendix formulas can be borrowed cautiously, not letting guests usurp hosts. First formula, Hou's Black Powder, is divine for expelling wind and filling orifices. Suitable for early wind stroke before heat transformation. Crucial for recovery after illness to prevent recurrence and lifelong disability. *Jinkui* has seven sections, four formulas. But beyond theory is theory, beyond formula is formula; the key is reader's comprehension. Yu Jiayan from Jiangxi loved Zhang Zhongjing's books, wrote *Yimen Falü*, copying *Jinkui* text with contemporary comments, causing confusion. Some were better, like Zishou Jieyu Tang for wind stroke spleen laxity, tongue stiffness, hemiplegia. Uses Fangfeng, Paofuzi, Tianma, Suanzaoren each 1 qian, Rougui, Lingyangjiao each 8 fen, Qianghuo, Gancao each 5 fen, decoct, add Zhulv (Bamboo Juice) 2 spoons, Jiangzhi (Ginger Juice) 1 drop. Removing Qianghuo, adding Shudihuang, Gouqizi, Juhua, Humaren, Tiandong treats Kidney deficiency wind entering speechlessness (Shaoyin pulse connects to tongue root). Also recorded Dihuang Yinzi for tongue aphasia and leg inability to use (Kidney deficiency Qi rebellion not reaching tongue root). Uses Shudihuang, Bajitian, Shanzhuyu, Rongrou, Shihu, Paofuzi, Wuweizi, Baifuling, Shichangpu, Yuanzhi, Rougui, Maidong each 5 fen, add Shengjiang 5 slices, Zao 2 pieces, Bohe 5 leaves, decoct in 1.5 cups water to 0.8 cups. Jiayan cited these, contradicting *Jinkui*. Later followers erred. *Yixue Tijie* criticized complexity, rightly so. While serving in Zhili, writing *Jinkui Qiannzhu*, revised this manuscript three times. Suddenly realized from the opposite/reverse aspect of Fangji Dihuang Tang syndrome, slammed table shouting: Wind is Yang pathogen, familiar phrase but profound meaning. Other Yin pathogen diseases, like Sansheng Yin, Sanyin Baisan, Heixi Dan, should be excluded from Wind Stroke chapter. Like Jiawei Liujunzi Tang, Jiayan noted: Treats limbs unable to rise due to Spleen Earth deficiency, treat root, do not add wind-dispersing herbs. Uses Renshen, Baizhu, Fuling, Gancao, Chenpi, Banxia each 1 qian, Maimendong 3 qian, Shengjiang 3 slices, Zao 2 pieces, decoct 2 cups water to 0.6 cups. Add Zhulv 1 small cup warm. Thirsty: remove Banxia, add Weirui, Shigao. Very deficient/no heat: add Fuzi. This establishes theory based on deficiency, perhaps suitable for post-recovery regulation. But during wind stroke, using this to tonify Yuan Qi to overcome pathogen is akin to closing...