《金匮要略》"中风痱"考辨OA

The"apoplectic aphasia"recorded in the Synopsis of the Golden Chamber is an essential component of ZHANG Zhongjing's syndrome differentiation and treatment system for stroke.Since the Song Dynasty,owing to the flourishing of diverse perspectives and the rise of the internal wind theory,controversies have existed regarding the confusion between its name and essence,the authenticity of its articles,and misinterpretations of formula-syndrome relationships.Through systematic textual research using textual exegesis,edition comparison,and mutual verification of formula-syndrome,this paper draws the following conclusions:"apoplectic aphasia"originated from the"fei syndrome"in the Miraculous Pivot,which is fundamentally different from"yin-fei"in the Plain Questions in terms of pathogenesis and clinical manifestations.Later generations confused the two or grouped them with"hemiplegia,""flaccidity syndrome,"and"arthralgia,"which deviated from their original meanings.The Xuming Decoction from Ancient and Modern Records,which is indicated for"apoplectic aphasia,"may be a lost formula of ZHANG Zhongjing rather than a new addition by scholars of the Song Dynasty.Its articles belong to ZHANG Zhongjing's original text system and hold the same status as the main text.The core pathogenesis of this disease is healthy qi deficiency with lingering pathogen,nutrient qi,defensive qi,qi and blood disorder,and intermingled cold and heat in both exterior and interior.The views that emerged after the Jin and Yuan Dynasties,which one-sidedly attributed it to exogenous wind and denied the clinical value of Xuming Decoction,are largely biased.Modern researches have demonstrated the therapeutic effects and mechanisms of Xuming Decoction in neurological disorders,strongly verifying the core pathogenesis and corresponding therapeutic principles of the"apoplectic aphasia"proposed in this article,providing scientific evidence for the application of ancient remedies in modern times.