(2) Wind Strike, Chapter Two 中風第二 on Medical Three-Character Classic 醫學三字經 (Yi Xue San Zi Jing)
(2) Wind Strike, Chapter Two 中風第二
人百病 首中風 《内經》云∶風爲百病之长也. 昔醫云∶中臟多滞九窍，有唇緩, 失音, 耳聋, 目瞀, 鼻塞, 便難之症；中腑多着四肢；中經则口眼 斜；中血脉则半身不遂.
Of the hundred
human diseases, wind stroke is paramount. The Inner Canon (Neijing) states: "Wind is the
leader of the hundred diseases." The physicians of old said: "When
[wind] strikes the viscera (zang), it generally obstructs the nine orifices,
giving rise to symptoms such as slackened lips, loss of voice, deafness,
blurred vision, nasal congestion, and difficulty with urination or defecation.
When it strikes the bowels (fu), it generally manifests in the four limbs; when
it strikes the channels (jing), the mouth and eyes become crooked and deviated;
when it strikes the blood vessels (xuemai), hemiplegia (paralysis of one side
of the body) results."
骤然得 八方通 中風病骤然昏倒，不省人事，或痰涌, 掣搐, 偏枯等症. 八方者，谓東, 西, 南, 北, 東北, 西北, 東南, 西南也.
Striking
suddenly- it reaches through all eight directions. In wind stroke, the
patient suddenly collapses and loses consciousness, and there may be symptoms
such as surging phlegm, convulsive tugging, and hemiplegia. The "eight
directions" are east, west, south, north, northeast, northwest, southeast,
and southwest.
閉与脱 大不同 風善行而數變，其所以變者，亦因人之臟腑寒热爲转移. 其人臟腑素有鬱热，则風乘火势，火借風威，而風爲热風矣. 其人臟腑本属虚寒, 则風水相遭，寒冰彻骨，而風爲寒風矣. 热風多見閉症, 宜疏通爲先；寒風多見脱症，宜温補爲急.
"Blockage" (bi) and "collapse"
(tuo) are vastly different. Wind moves readily and
changes frequently; the reason it changes is that it shifts according to the
cold or heat present in a person's viscera and bowels (zangfu). If a person's
zangfu habitually harbor stagnant heat, then the wind rides upon the momentum
of fire, and fire borrows the force of wind, so that the wind becomes
"heat wind." If a person's zangfu are by nature deficient and cold,
then wind and water encounter each other, and the cold penetrates to the bone
like ice, so that the wind becomes "cold wind." Heat wind generally
manifests as a blockage pattern (bi zheng), for which dispersing and freeing
[the obstruction] should come first; cold wind generally manifests as a
collapse pattern (tuo zheng), for which warming and tonifying is the urgent
priority.
开邪閉 續命雄 小續命湯，風症之雄師也. 根据六經見症加减治之，专主驱邪. 閉者宜开, 或开其表，如續命湯是也；或开其里，如三化湯是也；或开其壅滞之痰，如稀涎散, 涤痰湯是也.
To open a blockage caused by pathogenic evil, Xuming
Tang (Life-Continuing Decoction) is the hero. Xiao
Xuming Tang (Minor Life-Continuing Decoction) is the mighty army for wind
patterns. It is modified according to the symptoms manifesting in the Six
Channels (liu jing), with the sole aim of expelling pathogenic evil. Blockage
patterns should be opened — sometimes by opening the exterior (biao), as with
Xuming Tang; sometimes by opening the interior (li), as with Sanhua Tang (Three
Transformations Decoction); and sometimes by opening [a path through]
congested, stagnant phlegm, as with Xixian San (稀涎散, Drool-Thinning
Powder) and Ditan Tang (涤痰湯, Phlegm-Flushing Decoction).
固氣脱 参附功 脱者宜固，参附湯固守腎氣，术附湯固守脾氣，耆附湯固守衛氣，歸附湯固守营氣. 先固其氣, 次治其風. 若三生飮一两加人参一两, 则爲标本并治之法. 正虚邪盛, 必遵此法.
To secure qi against collapse, Shenfu Tang
(Ginseng-Aconite Decoction) does its work. Collapse
patterns (tuo zheng) should be secured [firmly held in place]: Shenfu (Ginseng-Aconite
Decoction) Tang secures and holds the Kidney qi; Zhufu Tang
(Atractylodes-Aconite Decoction) secures and holds the Spleen qi; Qifu Tang
(Astragalus-Aconite Decoction) secures and holds the Defensive qi (wei qi);
Guifu Tang (Chinese Angelica-Aconite Decoction) secures and holds the Nutritive
qi (ying qi). First secure the qi, and only afterward treat the wind. If one
liang of Sansheng Yin (Three Raw Ingredients Beverage) is combined with one
liang of ginseng, this becomes a method that treats both root (ben) and branch
(biao) together. When the righteous qi (zheng qi) is deficient and the
pathogenic evil is exuberant, this method must be followed.
顾其名 思其义 名之曰風，明言八方之風也；名之曰中，明言風自外入也. 后人议論穿凿，俱不可從.
Consider the name, and ponder its meaning. It is called "wind" (feng) because this clearly refers to
wind coming from the eight directions; it is called "striking"
(zhong) because this clearly indicates that the wind enters from outside [the
body]. The theories of later scholars, which strain and force interpretations
[beyond what the text supports], are none of them worth following.
若舍風 非其治 既名中風，则不可舍風而别治也.
If [treatment] discards wind entirely, it is not
proper treatment. Since the disease is named
"wind stroke" (zhongfeng), one cannot discard wind and treat
something else in its place.
火氣痰 三子备 刘河间举五志过极，动火而卒中，皆因热甚，故主乎火. 大法∶用防風通聖散之类；亦有引火歸源，如地黄飮子之类. 李東垣以元氣不足而邪凑之, 令人卒倒如風状，故主乎氣虚. 大法∶補中益氣湯加减. 朱丹溪以東南氣温多湿, 有病風者，非風也；由湿生痰，痰生热，热生風，故主乎湿. 大法∶以二陳湯加苍术, 白术, 竹沥, 薑汁之类.
Fire, Qi, and Phlegm — the Three Masters' Theories
Complete. English: Liu Hejian (劉河間) held that when the five emotions become excessive, they stir fire
and cause sudden collapse, all due to intense heat; therefore he emphasized
fire. Main method: use formulas such as Fang Feng Tong Sheng San (防風通聖散, Saposhnikovia Sage-Inspired Powder); there is also the approach of
leading fire back to its source, as with Di Huang Yin Zi (地黃飲子, Rehmannia Beverage). Li Dongyuan (李東垣) held that
when original qi is insufficient, pathogenic factors gather and exploit the
deficiency, causing sudden collapse resembling wind-stroke; therefore he
emphasized qi deficiency. Main method: modify Bu Zhong Yi Qi Tang (補中益氣湯, Center-Supplementing Qi-Boosting Decoction). Zhu Danxi (朱丹溪) held that in the warm, humid climate of the southeast, those who
suffer from "wind" disease do not actually have wind; dampness
generates phlegm, phlegm generates heat, and heat generates wind; therefore he
emphasized dampness. Main method: add Cang Zhu (蒼朮,
Atractylodes), Bai Zhu (白朮, White Atractylodes), Zhu Li (竹瀝, Bamboo Sap), and Jiang Zhi (薑汁, Ginger
Juice) to Er Chen Tang (二陳湯, Two Matured Ingredients
Decoction).
不爲中 名爲类 中者，自外而入于内也. 此三者，既非外来之風，则不可仍名爲中，時贤名爲类中風.
Not "Strike" — Named
"Wind-Like" "Strike" (中) means a
pathogen entering from outside into the interior. Since these three causes are
not wind coming from outside, they cannot properly be called
"strike"; contemporary scholars have named this "wind-like
stroke" (類中風, lei zhong feng).
合而言 小家伎 虞天民云∶古人論中風，言其症也. 三子論中風，言其因也. 盖因氣, 因湿, 因火，挟風而作，何嚐有眞中, 类中之分.
Taken Together — [the Distinction Is But] a Minor
Skill. Yu Tianmin (虞天民) said: the ancients, in discussing wind-stroke,
spoke of its symptoms; the Three Masters, in discussing wind-stroke, spoke of
its causes. Whether due to qi, dampness, or fire, the disease arises
accompanied by wind — so how could there ever truly be a distinction between
"true strike" and "wind-like strike"?
喑 斜 昏仆地 喑者，不能言也. 斜者，口眼不正也. 昏仆地者，不省人事，猝倒于地也. 口开, 目合，或上视, 撒手, 遗尿, 鼾睡, 汗出如油者，不治.
Muteness, Deviation, and Collapse to the Ground. "Muteness" (喑) means the
inability to speak. "Deviation" (斜) means
crookedness of the mouth and eyes. "Collapse to the ground" (昏仆地) means loss of consciousness with sudden falling. When the mouth
hangs open, the eyes are closed, or there is upward staring of the eyes, limp
open hands, enuresis, snoring, or sweating like oil — these are untreatable.
急救先 柔润次 柔润熄風，爲治中風之秘法. 喻嘉言加味六君子湯, 資壽解語湯甚妙.
Emergency Rescue First, Softening and Moistening Next: Softening and moistening to extinguish wind is the secret method
for treating wind-stroke. Yu Jiayan's (喻嘉言) Jia Wei Liu Jun Zi Tang (加味六君子湯, Augmented Six Gentlemen Decoction) and Zi Shou Jie Yu Tang (資壽解語湯, Life-Prolonging Speech-Returning Decoction) are excellent.
填窍方 宗金匱《内經》云∶邪害空窍. 《金匱》中有侯氏黑散, 風引湯，驱風之中，兼填空窍. 空窍滿则内而舊邪不能容，外而新風不复入矣. 喻嘉言曰∶仲景取藥积腹中不下，填窍以熄風. 后人不知此义，每欲开窍以出其風. 究竟窍空而風愈炽，长此安穷哉? 三化湯, 愈風湯, 大秦艽湯皆出《机要方》中，云是通眞子所撰，不知其姓名. 然则无名下士，煽亂后人見聞，非所谓一盲引众盲耶.
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