寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Wind

Pung

한글 풍  ·  Pinyin Feng

The longest chapter in the book — stroke, the three impediments, joint-running wind and lockjaw, and four centuries of argument about whether wind comes from outside at all

風

Sixty-seven sections, a hundred and eighty-nine prescriptions and thirty-eight simples: the Wind chapter is the largest in the Donguibogam and the one where its compiler had the most to reconcile. Four diseases are gathered here under one heading because the tradition called them all wind — the stroke, the impediments, joint-running wind and lockjaw — and the chapter's first forty sections are about the first of them. They open not with treatment but with prodrome: if a man finds his index and middle fingers numb, he will have a stroke within three years, and the medicine for that is given at once. That is a chapter beginning with prevention, and it is the best thing in it. What follows is the great Jin-Yuan quarrel set out in order. The older view held that wind came from outside; Liu Wansu said it was fire, Li Dongyuan that it was the body's own qi failing, Zhu Danggye that it was damp generating phlegm and phlegm generating heat and heat generating wind. Wang Anddao then divided the two, calling the first true wind stroke and the rest wind-like, and the Bogam's compiler — citing the Jeongjeon — declines to choose: the ancients described the signs, the three masters described the causes, and both are needed. That refusal is the chapter's intellectual position and it governs everything after it, which is why Soseungmyeong-tang's sweating and Danggye's phlegm-clearing and Dongyuan's qi-supplementing all stand side by side without apology. The clinical writing is uneven and in places extraordinary: the prodrome, the sneezing test for prognosis, the staged protocol for lockjaw borrowed whole from the cold-damage tradition, the allodynia of trigeminal neuralgia described exactly, the distinction between the acute stroke that may be sweated and the wasted limb that must not be. The pharmacy is the chapter's weakness. Raw aconite, cinnabar, realgar, croton seed with the oil left in, tiger bone and rhinoceros horn recur throughout, and a great many of these formulas cannot be prepared at all. Perhaps a dozen survive into present practice — Gyeonjeong-san for facial palsy, Jihwang-eumja for post-stroke speech loss, Jeokdam-tang for aphasia, Sambi-tang and Hwallak-dan for the joints, Okjin-san for lockjaw — and the rest is a record of what the best physicians of four centuries tried against a disease they could describe far better than they could treat.

1.1 The Faint Beginnings of Wind Stroke 中風微漸

1.1.1
Source원문

凡人初覺食指次指麻木不仁, 或不用者, 三年內必中風之候也. 宜先服愈風湯ㆍ天麻丸《方幷見下》各一兩料, 此治之先. 《丹心》

Translation영역
Whenever a person first notices that the index and middle fingers are numb and insensible, or will not be used, it is the sign that within three years he will certainly have a wind stroke. Yupung-tang and Cheonma-hwan should be taken first, 1 nyang's worth of each; this is the first thing in the treatment.

Danggye Simbeop 丹心

1.1.2
Source원문

聖人治未病之病, 知未來之疾, 此其良也. 其中風者必有先兆之證: 覺大拇指及次指麻木不仁, 或手足少力, 或肌肉微掣者, 此先兆也, 三年內必有大風. 宜調其榮衛, 先服愈風湯ㆍ天麻丸, 或加減防風通聖散《方見下》, 可以預防. 《丹心》

Translation영역
The sage treats the disease that is not yet a disease and knows the illness that is still to come; this is his excellence. One who is to have a wind stroke will certainly have signs that forewarn it: he notices that the thumb and index finger are numb and insensible, or that the hands and feet have little strength, or that the flesh twitches slightly — these are the forewarning signs, and within three years there will certainly be a great wind. The construction and defence should be regulated, and Yupung-tang and Cheonma-hwan taken first, or a modified Bangpung-tongseong-san, which can prevent it.

Danggye Simbeop 丹心

1.1.3
Source원문

竹瀝枳朮丸《方見痰飮》與搜風順氣丸《方見大便》相間服之, 亦可預防. 《醫鑑》

Translation영역
Jungnyeok-jichul-hwan and Supung-sungi-hwan taken alternately can also prevent it.

Uihak Jeonggam 醫鑑

1.1.4
Source원문

凡人手足漸覺不隨, 或臂膊及髀股指節麻痺不仁, 或口眼喎斜ㆍ言語蹇澁, 或胸膈迷悶ㆍ吐痰相續, 或六脉浮滑而虛軟無力, 雖未致於倒仆, 其爲中風暈厥之候可指日而定矣. 早當從丹溪之法調治之. 《正傳》

Translation영역
Whenever a person gradually notices that the hands and feet do not follow him, or that the upper arm and the thigh and the finger joints are numb, impeded and insensible, or that the mouth and eye are deviated and the speech halting and rough, or that the chest and diaphragm are confused and oppressed and phlegm is brought up one spell after another, or that the six pulses are floating and slippery yet vacuous, soft and without strength — then although he has not yet come to falling down, the sign of his wind stroke and clouding collapse can be fixed to a day. Danggye's method should be followed early to regulate and treat it.

Uihak Jeongjeon 正傳

1.1.5
Source원문

初覺風氣, 便服愈風湯及天麻丸, 相爲表裏, 乃治未病之聖藥也. 《易老》

Translation영역
As soon as the wind qi is noticed, Yupung-tang and Cheonma-hwan should be taken, the two standing to each other as exterior and interior; these are the sage medicines for treating what is not yet a disease.
Clinical note임상 주석
The chapter opens on prevention rather than treatment, and it opens well. Numbness of the index and middle fingers, weakness of the hands, twitching flesh, slurred speech, transient confusion — that list, given twice over in slightly different words, is a recognizable account of transient ischaemic events and small-vessel warning signs, and the three-year window attached to it is not far from the modern figures for stroke risk after a TIA. What the tradition did with the observation is the limitation: two warming, wind-dispelling prescriptions taken as a course. But the clinical instinct — that a stroke announces itself and that the announcement is the moment to act — is sound, and the Bogam's compiler put it first in his longest chapter for that reason.

Yiro 易老

1.2 Regulating Treatment and Prevention 調治預防

1.2.1
Source원문

左半身不遂ㆍ左手脉不足者, 以四物湯《方見血門》爲主治. ○右半身不遂ㆍ右手脉不足者, 以四君子湯《方見氣門》爲主治. ○痰盛者, 二陳ㆍ導痰等湯《方見痰飮》兼用之. ○氣血兩虛而挾痰者, 八物湯《方見虛勞》加南星ㆍ半夏ㆍ枳實ㆍ竹瀝ㆍ薑汁之類. ○若眞元漸復ㆍ痰飮漸消, 或覺風邪未退者, 仍以羌活愈風湯ㆍ防風通聖散加減調治而安. 《正傳》

Translation영역
Where the left half of the body is paralysed and the pulse of the left hand is insufficient, Samul-tang governs the treatment. Where the right half of the body is paralysed and the pulse of the right hand is insufficient, Sagunja-tang governs the treatment. Where phlegm is exuberant, Ijin-tang and Dodam-tang and the like are used alongside. Where qi and blood are both vacuous and phlegm is carried with them, Palmul-tang with arisaema, pinellia, bitter orange, bamboo sap and ginger juice and the like added. If the true origin is gradually recovering and the phlegm-rheum gradually dispersing, and a wind evil is still felt not to have retreated, Yupung-tang or Bangpung-tongseong-san with modifications continues the regulating treatment until the patient is well.

Uihak Jeongjeon 正傳

1.2.2
Source원문

更加灸法尤好.

Translation영역
To add moxibustion as well is better still.
Clinical note임상 주석
The chapter's treatment algorithm, set out in five lines, and it is organized by the left-blood right-qi scheme that the 手足癱瘓 section later builds two formulas on. The pulse is what decides: an insufficient left pulse with left-sided paralysis sends you to the four-substance decoction, an insufficient right pulse with right-sided paralysis to the four gentlemen. The lateralization does not hold anatomically, but the structure of the reasoning — nourish what the pulse says is empty, clear the phlegm alongside, and only return to the wind drugs once the root is recovering — is a coherent treatment sequence and is the closest thing in the chapter to a protocol.

Donguibogam · Pung

1.3 Heat Generates Wind 熱生風

1.3.1
Source원문

凡濕生痰, 痰生熱, 熱生風. 《丹心》

Translation영역
In general damp generates phlegm, phlegm generates heat, and heat generates wind.

Danggye Simbeop 丹心

1.3.2
Source원문

風病多因熱甚. 俗云風者, 言末而忘其本也. 非謂肝木之風實甚而卒中之, 亦非外中於風, 良由將息失宜而心火暴盛ㆍ腎水虛衰不能制之, 則陰虛陽實而熱氣怫鬱ㆍ心神昏冒ㆍ筋骨不用而卒倒無所知也. 多因五志《喜ㆍ怒ㆍ思ㆍ悲ㆍ恐》過極而卒中者, 由五志過極皆爲熱甚故也. 《河間》

Translation영역
Wind disease is mostly caused by severe heat. That the common saying calls it wind is to speak of the branch and forget the root. It is not that the wind of liver wood is replete and severe and strikes suddenly, nor is it a striking by wind from outside; it is truly because nurture has gone wrong so that the heart fire is suddenly exuberant and the kidney water vacuous and declined and unable to restrain it; then the yin is vacuous and the yang replete, the heat qi is pent up and constrained, the heart spirit is clouded and stupefied, the sinews and bones will not be used, and the patient falls suddenly and knows nothing. That many are struck suddenly through excess of the five minds — joy, anger, thought, sorrow, fear — is because excess of any of the five minds amounts to severe heat.

Hagan 河間

1.3.3
Source원문

熱者, 風之體也; 風生於熱, 以熱爲本而風爲標也. 凡有風者, 卽風熱病也. 《河間》

Translation영역
Heat is the substance of wind; wind arises from heat, heat being the root and wind the branch. Whoever has wind has a wind heat disease.

Hagan 河間

1.3.4
Source원문

鄕里有人忽覺心腹中熱甚, 服治風藥而愈. 後到夷陵, 見一太守, 夏月忽患熱甚, 不免以水灑地, 設簟卧其上, 令人扇之; 次日急中風, 數日而殂. 及到澧陽, 見一老婦, 夏中亦患熱, 夜出卧廳上; 次日中風, 其子煎飮小續命湯, 更召醫調治, 數日而愈. 始知人之中風因心腹中多大熱而後作也. 熱生風, 信哉. 《資生》

Translation영역
There was a man in my village who suddenly felt severe heat in the heart and abdomen and recovered on taking wind-treating medicine. Later, arriving at Yiling, I saw a prefect who in the summer months suddenly suffered severe heat, and could not help sprinkling water on the ground, laying a bamboo mat on it and lying there with someone fanning him; the next day he was urgently struck by wind, and in a few days he died. And on reaching Liyang I saw an old woman who also suffered heat in the middle of summer and went out at night to lie in the hall; the next day she was struck by wind, and her son decocted Soseungmyeong-tang for her to drink and called in a physician besides to regulate and treat her, and in a few days she recovered. So I came to understand that a man's wind stroke arises after there has been much great heat in the heart and abdomen. Heat generates wind — it is true indeed.
Clinical note임상 주석
Liu Wansu's doctrine stated and then argued from cases. The theoretical passage is the turning point of the whole literature: it is not liver wind and it is not wind from outside, but heart fire exuberant with kidney water too weak to restrain it, and the five emotions in excess are all heat. Set beside that, the three case notes from the Jasaeng are the better reading — a prefect who lay on a wet mat being fanned in high summer and had a stroke the next day, an old woman who slept in an open hall on a hot night and had one too. Heat exposure, dehydration and sudden cooling do precipitate cerebrovascular events, and whoever collected these three cases was watching the right thing even if the mechanism he inferred was wrong.

Jasaeng Gyeonghyobang 資生

1.4 Stout People Are Often Struck by Wind 肥人多中風

1.4.1
Source원문

所謂肥人多中風者, 肥則腠理緻密而多鬱滯, 氣血難以通利, 故多卒中也. 《河間》

Translation영역
As to what is said, that stout people are often struck by wind — when a man is stout the interstices are close and dense and there is much constraint and stagnation, so that the qi and blood pass and flow with difficulty, and therefore he is often struck suddenly.

Hagan 河間

1.4.2
Source원문

凡人年逾五旬ㆍ氣衰之際, 多有此疾; 壯歲之人無有也. 若肥盛則間有之, 亦是形盛氣衰而然也. 《東垣》

Translation영역
Whenever a man has passed fifty years and his qi is in decline, this disease is common; men in their prime do not have it. If a man is stout and abundant it occurs among them too, and that likewise is because the form is abundant and the qi declined.

Dongwon 東垣

1.4.3
Source원문

肥人多中風者, 以其氣盛於外而歉於內也. 肺爲氣出入之道, 人胖者氣必急, 氣急則肺邪盛, 肺金克木, 膽爲肝之府, 故痰涎壅盛. 治法, 先須理氣爲急, 藿香正氣散《方見寒門》加南星ㆍ木香ㆍ防風ㆍ當歸, 非特治中風之證, 中惡ㆍ中氣尤宜. 《醫鑑》

Translation영역
Stout people are often struck by wind because their qi is abundant without and wanting within. The lung is the road by which the qi goes out and in, and a fat man's breathing is necessarily hurried; when the breathing is hurried the lung evil is exuberant, and lung metal restrains wood — the gallbladder being the bowel of the liver — and so phlegm drool congests and is exuberant. As to the method of treatment, regulating the qi must come first and urgently: Gwakhyang-jeonggi-san with arisaema, costus, saposhnikovia and tangkuei added, which not only treats the wind stroke pattern but suits malign stroke and qi stroke still better.
Clinical note임상 주석
Three authorities on one risk factor, and between them they get obesity, age and breathlessness. Dongyuan's line — past fifty, when the qi is in decline, this disease is common; men in their prime do not have it — is a correct statement of the age gradient of stroke, and the Jeonggam's observation that a fat man's breathing is hurried, with the phlegm that follows, reads like an account of obesity hypoventilation and the sleep-disordered breathing now known to carry cerebrovascular risk. The five-phase chain through which it is explained is decoration; the three clinical observations underneath it are not.

Uihak Jeonggam 醫鑑

1.5 What Wind Stroke Arises From 中風所因

1.5.1
Source원문

內經曰, 風者百病之長也, 至其變化乃爲他病. 故有偏風ㆍ腦風ㆍ目風ㆍ漏風ㆍ內風ㆍ首風ㆍ腸風ㆍ泄風, 又有肺風ㆍ心風ㆍ肝風ㆍ脾風ㆍ腎風ㆍ胃風ㆍ勞風等證. 《詳見本經》

Translation영역
The Neijing says: wind is the chief of the hundred diseases, and when it changes and transforms it becomes other diseases. Hence there are hemilateral wind, brain wind, eye wind, leaking wind, internal wind, head wind, intestinal wind and effusing wind; and also lung wind, heart wind, liver wind, spleen wind, kidney wind, stomach wind and taxation wind, and other patterns besides.

Naegyeong 內經

1.5.2
Source원문

河間曰, 風病多因熱盛. 《詳見上》 ○東垣曰, 中風者非外來風邪, 乃本氣病也. 《詳見上》

Translation영역
Hagan says: wind disease is mostly caused by exuberant heat. Dongwon says: wind stroke is not a wind evil come from outside but a disease of the body's own qi.

Hagan 河間 · Dongwon 東垣

1.5.3
Source원문

丹溪曰, 風之爲病, 西北氣寒爲風所中者誠有之, 東南氣溫而地多濕, 有風者非風也, 皆濕生痰ㆍ痰生熱ㆍ熱生風也. 經曰, 亢則害, 承乃制. 河間曰, 土極似木. 數千年得經意者, 河間一人耳.

Translation영역
Danggye says: as to wind as a disease, in the north-west the qi is cold and there are indeed those struck by wind; but in the south-east the qi is warm and the land is much damp, and those who have wind do not have wind — in all of them damp generates phlegm, phlegm generates heat and heat generates wind. The classic says: when a thing is at its height it does harm, and what succeeds it restrains it. Hagan says: earth at its extreme resembles wood. In thousands of years, the one man who grasped the classic's meaning was Hagan alone.

Danggye Simbeop 丹心

1.5.4
Source원문

王安道曰, 昔人主乎風, 河間主乎火, 東垣主乎氣, 丹溪主乎濕, 反以風爲虛象而大異於昔人. 以予觀之, 昔人三子之論皆不可偏廢. 殊不知因于風者眞中風也, 因火ㆍ因氣ㆍ因于濕者類中風而非中風也.

Translation영역
Wang Anddao says: the ancients took wind to be the governing cause, Hagan took fire, Dongwon took qi, Danggye took damp, and he even made wind out to be an appearance of vacuity, differing greatly from the ancients. As I see it, neither the ancients' doctrine nor the three masters' can be set aside for the other. What they failed to see is that what is caused by wind is true wind stroke, and what is caused by fire, by qi or by damp is wind-stroke-like and not wind stroke.

Wang Anddao 王安道

1.5.5
Source원문

王安道有論三子與昔人論風之不同而立眞中ㆍ類中之目, 愚竊疑焉. 夫中風之證, 蓋因先傷於內而後感於外之候也, 但有標本輕重之不同耳. 假如百病皆有因有證, 古人論中風者言其證也, 三先生論中風者言其因也. 知乎此, 則中風之候可得而詳論矣. 《正傳》

Translation영역
Wang Anddao, discoursing on the difference between the three masters and the ancients on wind, set up the categories of true stroke and stroke-like; I privately doubt it. For the wind stroke pattern is in fact a sign of being first damaged within and afterwards affected from without, and there is only a difference of branch and root, of light and heavy. Just as the hundred diseases all have a cause and have signs, so the ancients in discoursing on wind stroke spoke of its signs, and the three masters in discoursing on wind stroke spoke of its cause. Knowing this, the signs of wind stroke can be discussed in detail.
Clinical note임상 주석
The chapter's intellectual centre, and the Bogam's compiler shows his hand by what he puts last. Four positions are laid out — the ancients' external wind, Liu Wansu's fire, Li Dongyuan's qi, Zhu Danggye's damp-phlegm — then Wang Anddao's attempt to settle the quarrel by splitting the disease into true stroke and stroke-like, and finally the Jeongjeon's refusal of that split: the ancients described the signs, the three masters described the causes, and the two are not rivals. That is the position the whole chapter then works from, and it is why formulas built on four incompatible theories sit together in it without comment. Danggye's geography is also worth noting on its own — cold dry north-west, warm damp south-east, different diseases in each — as an early statement that the same name covers different illnesses in different places.

Uihak Jeongjeon 正傳

1.6 The Great Signs of Wind Stroke 中風大證

1.6.1
Source원문

風中於人, 曰卒中ㆍ曰暴仆ㆍ曰暴瘖ㆍ曰蒙昧ㆍ曰口眼喎僻ㆍ曰手足癱瘓ㆍ曰不省人事ㆍ曰語言蹇澁ㆍ曰痰涎壅盛. 《醫鑑》

Translation영역
When wind strikes a man there is what is called sudden stroke, sudden falling, sudden loss of voice, clouding and stupor, deviation of the mouth and eye, paralysis of the hands and feet, loss of consciousness, halting and rough speech, and phlegm drool congesting and exuberant.
Clinical note임상 주석
Nine terms in one line, and they are the chapter's table of contents: sections 1.18 through 1.24 take them in turn, each with its own formulas. As a symptom list for acute stroke it is close to complete — sudden collapse, loss of consciousness, aphasia, dysarthria, facial palsy, hemiplegia, secretions — and the only thing missing is the visual field. Having it stated this compactly, before any of the treatment, is what makes the chapter navigable.

Uihak Jeonggam 醫鑑

1.7 Robber Wind and Vacuity Evils Striking a Man 賊風虛邪中人

1.7.1
Source원문

黃帝問曰, 余聞四時八風之中人也, 故有寒暑. 寒則皮膚急而腠理閉, 暑則皮膚緩而腠理開. 賊風邪氣因得以入乎? 將必須八正虛邪乃能傷人乎? 少師曰, 不然. 賊風邪氣之中人也不得以時, 然必因其開也, 其入深, 其內極, 其病人也卒暴; 因其閉也, 其入淺以留, 其病也徐以遲.

Translation영역
The Yellow Emperor asked: I have heard that the eight winds of the four seasons strike a man, and that there is accordingly cold and summerheat. In cold the skin is tight and the interstices closed; in summerheat the skin is slack and the interstices open. Is it that the robber wind and evil qi get in on that account? Or must it be the vacuity evils of the eight orients that are able to injure a man? Shaoshi said: it is not so. The robber wind and evil qi strike a man without regard to season; but when they come upon the interstices open, their entry is deep, their reach within is extreme, and the sickening of the man is sudden and violent; when they come upon them closed, their entry is shallow and they linger, and the sickening is slow and late.

Yeongchu 靈樞

1.7.2
Source원문

帝曰, 有寒溫和適ㆍ腠理不開, 然有卒病者, 其故何也? 少師曰, 人與天地相參也, 與日月相應也. 故月滿則海水西盛, 人血旣積, 肌肉充, 皮膚緻, 毛髮堅, 腠理郄, 烟垢着; 當是之時, 雖遇賊風, 其入淺不深. 至其月郭空, 則海水東盛, 人氣血虛, 其衛氣去, 形獨居, 肌肉減, 皮膚縱, 腠理開, 毛髮殘, 膲理薄, 烟垢落; 當是之時, 遇賊風則其入深, 其病人也卒暴. 《靈樞》

Translation영역
The Emperor said: there are those in whom cold and warmth are harmonious and suitable and the interstices are not open, and yet they fall suddenly ill — what is the reason? Shaoshi said: man is of a piece with heaven and earth and corresponds with the sun and moon. Therefore when the moon is full the sea's water is abundant in the west, a man's blood is accumulated, the flesh is filled out, the skin is close, the hair is firm, the interstices are narrowed and the soot-grime adheres; at such a time, though he meet a robber wind, its entry is shallow and not deep. When the moon's orb is empty, the sea's water is abundant in the east, a man's qi and blood are vacuous, his defence qi has departed and the form dwells alone, the flesh is diminished, the skin loose, the interstices open, the hair sparse, the membranous tissue thin and the soot-grime falling away; at such a time, if he meets a robber wind its entry is deep, and the sickening of the man is sudden and violent.

Yeongchu 靈樞

1.7.3
Source원문

邪風之至, 疾如風雨. 故善治者治皮毛, 其次治肌膚, 其次治筋脉, 其次治六府, 其次治五藏. 治五藏者半死半生也. 《內經》

Translation영역
The arrival of an evil wind is as swift as wind and rain. Therefore the good physician treats the skin and hair; the next treats the flesh and skin; the next treats the sinews and vessels; the next treats the six bowels; the next treats the five viscera. He who treats the five viscera saves half and loses half.

Naegyeong 內經

1.7.4
Source원문

邪乗虛入, 是謂虛邪. 《內經》 ○邪之所湊, 其氣必虛; 留而不去, 其病則實. 《內經》

Translation영역
An evil enters riding on vacuity; this is what is meant by a vacuity evil. Where an evil gathers, the qi there is necessarily vacuous; and when it lodges and does not depart, the disease becomes replete.
Clinical note임상 주석
The classical substrate underneath everything the chapter later argues about, and two sentences of it are still quoted daily. Where an evil gathers, the qi there is necessarily vacuous — that is the whole of Li Dongyuan's position in advance, and it is why the Neijing could be cited by all four of the chapter's rival schools. The moon-and-tide passage is cosmology rather than physiology, but the clinical point it is reaching for is real enough: the same exposure harms a depleted person and passes over a robust one. The stepped list of good physicians — skin and hair first, viscera last, and he who treats the viscera saves half — is a statement about catching disease early, which is what section 1.1 was about.

Naegyeong 內經

1.8 The Great Scheme of Wind Stroke Has Four Kinds 中風大法有四

1.8.1
Source원문

一曰偏枯, 半身不遂; 二曰風痱, 身無痛ㆍ四肢不擧; 三曰風懿, 奄忽不知人; 四曰風痺, 諸痺類風狀. 《千金》

Translation영역
The first is called withered hemilateral, in which half the body is paralysed. The second is called wind paralysis, in which the body is without pain and the four limbs are not lifted. The third is called wind stupor, in which the patient is suddenly unaware of people. The fourth is called wind impediment, in which the various impediments resemble the form of wind.
Clinical note임상 주석
Sun Simiao's four-part division, and it is the frame the next four sub-sections fill in. Read as a clinical classification it holds up remarkably well: hemiplegia with wasting, flaccid quadriparesis without pain, sudden loss of consciousness, and the impediments — which is to say three grades of stroke by what they leave behind, plus the joint diseases that were grouped with them by name alone. The fourth is immediately set aside as having a whole section of its own further on, which is the Bogam's way of admitting that it does not belong with the other three.

Cheongeumbang 千金

1.8.1 Withered Hemilateral 偏枯

1.8.1.1
Source원문

血氣偏虛, 半身不遂ㆍ肌肉枯瘦ㆍ骨間疼痛, 謂之偏枯. 《直指》

Translation영역
Where the blood and qi are vacuous on one side, half the body is paralysed, the flesh is withered and emaciated and there is pain between the bones — this is called withered hemilateral.

Injae Jijibang 直指

1.8.1.2
Source원문

虛邪偏客于身半, 其入深, 內居榮衛; 榮衛稍衰則眞氣去ㆍ邪氣獨留, 發爲偏枯. 《仲景》

Translation영역
A vacuity evil lodges as a guest on one half of the body; its entry is deep and it dwells within the construction and defence. When the construction and defence are somewhat declined, the true qi departs and the evil qi alone remains, and it breaks out as withered hemilateral.

Jungyeong 仲景

1.8.1.3
Source원문

偏枯者, 半身不遂ㆍ肌肉偏不用而痛, 言不變ㆍ智不亂, 病在分腠之間. 宜溫卧取汗, 且巨鍼取之. 《仲景》

Translation영역
In withered hemilateral, half the body is paralysed and the flesh of one side is unused and painful, but the speech is unaltered and the wits are not disordered; the disease is in the space between the divisions and interstices. Lying warm to draw out sweat is appropriate, and a large needle should also be used on it.

Jungyeong 仲景

1.8.1.4
Source원문

偏枯者, 手足爲邪氣阻塞脉道而然; 痿病則陽明虛ㆍ宗筋縱ㆍ帶脉不引而然. 痱病有言變志亂之證, 痿病則無之. 蓋痱病發于擊仆之暴, 痿病發于怠惰之漸, 明是兩疾也. 《綱目》

Translation영역
In withered hemilateral the hands and feet are so because an evil qi obstructs and blocks the vessel pathways; in wilting disease it is because yangming is vacuous, the ancestral sinew is slack and the girdling vessel does not draw. Wind paralysis has the signs of altered speech and disordered wits, and wilting disease does not. For wind paralysis breaks out from the suddenness of being struck down, and wilting disease breaks out from the gradualness of indolence: clearly they are two illnesses.
Clinical note임상 주석
The sharpest differential in the chapter. Hemiplegia with preserved speech and intact wits is one thing; hemiplegia with aphasia and confusion is another; and the gradual wasting of a wilting disease is a third. The Gangmok's criterion for separating the last from the first two is the onset — sudden for a stroke, gradual for a wilting — and it is exactly the criterion a modern clinician uses to separate a vascular event from a degenerative or myopathic process. Zhongjing's treatment here, lying warm to sweat with large needles, is the method the chapter's 全生虎骨散 entry later explicitly forbids once the limb has wasted.

Uihak Gangmok 綱目

1.8.2 Wind Paralysis 風痱

1.8.2.1
Source원문

神智不亂ㆍ身體無痛ㆍ四肢不擧ㆍ一臂不遂, 謂之風痱. 《直指》

Translation영역
Where the spirit and wits are not disordered, the body is without pain, the four limbs are not lifted and one arm is paralysed — this is called wind paralysis.

Injae Jijibang 直指

1.8.2.2
Source원문

痱之爲病, 身無痛ㆍ四肢不收ㆍ志亂不甚, 其言微知可治; 甚則不能言, 不可治. 《仲景》

Translation영역
Wind paralysis as a disease is the body without pain, the four limbs not gathered in and the wits not severely disordered; if his speech shows a little understanding it can be treated, and if it is severe so that he cannot speak it cannot be treated.

Jungyeong 仲景

1.8.2.3
Source원문

風痱者, 緩者四肢不擧, 急則一身皆仰, 或左癱右瘓, 或一臂不遂, 智亂不能言者難治. 宜換骨丹ㆍ神仙飛步丹. 脾實者膏粱之疾, 宜踈風順氣元《方見大便》; 脾虛者十全大補湯《方見虛勞》ㆍ八寶回春湯. 《入門》

Translation영역
In wind paralysis, where it is slow the four limbs are not lifted, and where it is urgent the whole body is thrown back; or the left is palsied and the right paralysed, or one arm is paralysed; and where the wits are disordered and he cannot speak it is difficult to treat. Hwangol-dan or Sinseon-bibo-dan is appropriate. Where the spleen is replete it is the disease of rich food, and Sopung-sungi-won is appropriate; where the spleen is vacuous, Sipjeon-daebo-tang or Palbo-hoechun-tang.

Uihak Immun 入門

1.8.2.4
Source원문

痱, 廢也, 卽偏枯之邪氣深者. 痱與偏枯是二疾: 其偏枯, 身偏痛而言不變ㆍ志不亂, 邪在分腠之間, 卽東垣所謂邪中府也; 痱病, 身無痛ㆍ手足不遂而言瘖ㆍ志亂者, 邪入于裏, 卽東垣所謂邪中藏也. 《綱目》

Translation영역
Bi means disabled; it is the withered hemilateral in which the evil qi is deep. Wind paralysis and withered hemilateral are two illnesses: in withered hemilateral the body is painful on one side but the speech is unaltered and the wits are not disordered, the evil being in the space between the divisions and interstices — that is what Dongwon calls an evil striking the bowels; in wind paralysis the body is without pain, the hands and feet are paralysed and the speech is mute and the wits disordered, the evil having entered the interior — that is what Dongwon calls an evil striking the viscera.
Clinical note임상 주석
Prognosis by speech, and it is the entry's most useful line: if there is a little understanding in what he says the case can be treated, and if he cannot speak at all it cannot. Language and consciousness as the markers of depth — that is the right pair of markers, and it is why this section and the next can be read as a crude stroke-severity scale: hemiplegia with speech intact, then paralysis with speech lost, then stupor. The Gangmok then maps the scale onto Dongyuan's bowel-and-viscus scheme, which is the chapter tying its classification systems together.

Uihak Gangmok 綱目

1.8.3 Wind Stupor 風懿

1.8.3.1
Source원문

忽然迷仆ㆍ舌强不語ㆍ喉中窒塞ㆍ噫噫有聲, 謂之風懿. 《直指》

Translation영역
Suddenly confused and falling down, the tongue stiff and speechless, the throat choked and blocked and a rattling sound in it — this is called wind stupor.

Injae Jijibang 直指

1.8.3.2
Source원문

風癔者《一作懿》, 卒倒ㆍ喎斜ㆍ不語, 身軟有汗者生, 汗不出ㆍ身直者死. 由痰水制火ㆍ閉塞心竅而不語. 熱者牛黃淸心元, 虛者導痰湯《方見痰飮》. 《入門》

Translation영역
In wind stupor — also written with the other character — the patient falls suddenly, the mouth is deviated and he does not speak; where the body is soft and there is sweat he lives, and where no sweat comes out and the body is rigid he dies. It is because phlegm water restrains the fire and shuts and blocks the orifice of the heart, so that he does not speak. Where there is heat, Uhwang-cheongsim-won; where there is vacuity, Dodam-tang.

Uihak Immun 入門

1.8.3.3
Source원문

風懿者, 奄忽不知人ㆍ咽中塞ㆍ窒窒然ㆍ舌强不能言, 病在藏府. 汗出ㆍ身軟者生; 汗不出ㆍ身直者七日死. 《得效》

Translation영역
In wind stupor the patient is suddenly unaware of people, the throat is blocked and choked tight and the tongue stiff and unable to speak; the disease is in the viscera and bowels. Where sweat comes out and the body is soft he lives; where no sweat comes out and the body is rigid he dies in seven days.
Clinical note임상 주석
A prognostic sign stated twice in two sources, which in this book means it was relied on: sweating with a soft body means survival, no sweating with a rigid body means death. Read physiologically that is the distinction between a patient whose autonomic function and muscle tone are intact and one who is decerebrate and shut down, and it remains a correct reading of a comatose patient's prospects. The seven-day figure from the Deughyobang is the kind of number that gets attached to such observations. The throat choked and rattling is airway compromise with secretions, and both of the formulas offered are phlegm formulas, which is at least addressed at the right problem.

Uibang Yuchwi 得效

1.8.4 Wind Impediment 風痺

1.8.4.1
Source원문

有全門在下.

Translation영역
There is a whole section on it below.
Clinical note임상 주석
A single line, and it is the Bogam's quiet admission that the fourth of Sun Simiao's four wind diseases does not belong with the first three. The impediments get sections 1.36 through 1.46 to themselves, twenty pages further on, and nothing in them concerns the brain at all.

Donguibogam · Pung

1.9 The Names of Wind Stroke Are Each Different 中風之名各不同

1.9.1
Source원문

其卒然仆倒者, 經稱爲擊仆, 世稱爲卒中, 乃初中之證也. ○其口眼喎斜ㆍ半身不遂, 經稱爲偏枯, 世稱爲癱瘓及腲腿風, 乃中倒後之證也. ○其舌强不言ㆍ唇吻不收, 經稱爲痱病, 世稱爲風懿ㆍ風氣, 亦中倒後之證也. ○凡病偏枯必先仆倒, 故內經連名稱爲擊仆偏枯也. 《綱目》

Translation영역
The sudden falling down the classic calls being struck down and the world calls sudden stroke; it is the sign of the first striking. The deviation of the mouth and eye with half the body paralysed the classic calls withered hemilateral and the world calls palsy or slack-legged wind; it is the sign of the period after the fall. The tongue stiff and speechless with the lips not gathered in the classic calls wind paralysis and the world calls wind stupor or wind qi; it is likewise the sign of the period after the fall. Whoever suffers withered hemilateral must first have fallen down, and so the Neijing joins the names and calls it struck-down withered hemilateral.
Clinical note임상 주석
A glossary and a chronology at once, and the chronology is the point: the classical terms and the colloquial ones name not three diseases but three moments in one illness — the collapse, and then two kinds of deficit left behind by it. Whoever suffers hemiplegia must first have fallen down. Setting the nomenclature out this way lets a reader of the chapter see that 卒中, 偏枯 and 痱病 in the formula indications refer to different stages of the same event, which is otherwise easy to miss across sixty-seven sections.

Uihak Gangmok 綱目

1.10 The Pulse 脉法

1.10.1
Source원문

凡中風脉無不大者, 非熱也, 是風脉也. 《得效》

Translation영역
In wind stroke there is no pulse that is not large; it is not heat but the wind pulse.

Uibang Yuchwi 得效

1.10.2
Source원문

寸口脉浮而緊, 緊則爲寒, 浮則爲虛. 寒虛相搏, 邪在皮膚; 絡脉空虛, 賊邪不瀉, 或左或右, 邪氣反緩ㆍ正氣卽急, 正氣引邪, 喎僻不遂. 邪在于絡, 肌膚不仁; 邪在于經, 卽重不勝; 邪入于府, 卽不識人; 邪入于藏, 舌卽難言ㆍ口吐涎沫. 《仲景》

Translation영역
The cun kou pulse is floating and tight: tight means cold and floating means vacuity. Cold and vacuity contend together and the evil is in the skin; the network vessels are empty and vacuous, the robber evil is not drained, and on one side or the other the evil qi is slack while the upright qi is tight, and the upright qi draws the evil, so that the mouth is deviated and the limb paralysed. Where the evil is in the network vessels the flesh and skin are insensible; where the evil is in the channels the limb is heavy and cannot be borne; where the evil enters the bowels the patient does not recognize people; where the evil enters the viscera the tongue cannot speak and the mouth brings up foam and drool.

Jungyeong 仲景

1.10.3
Source원문

中風口噤, 遲浮吉, 急實大數三魂孤. 《脉訣》 ○中風脉遲浮可治, 大數而極者死. 《丹心》

Translation영역
In wind stroke with the jaw clenched, slow and floating is auspicious; urgent, replete, large and rapid leaves the three souls solitary. A wind stroke pulse that is slow and floating can be treated; one that is large and rapid in the extreme means death.

Maekgyeol 脉訣 · Danggye Simbeop 丹心

1.10.4
Source원문

中風脉浮滑兼痰氣, 其或沉滑勿以風治; 或浮或沉而微而虛, 扶危溫痰風未可踈. 《脉訣》

Translation영역
A wind stroke pulse floating and slippery has phlegm qi with it; where it is sunken and slippery, do not treat it as wind. Where it is floating or sunken and faint and vacuous, support the patient in danger and warm the phlegm, for the wind may not yet be dispersed.

Maekgyeol 脉訣

1.10.5
Source원문

大法, 浮遲者吉, 急疾者凶. ○脉浮而遲者易治, 大數而急者死. 《脉經》 ○脉浮而大者曰風. ○脉浮而數, 中風使然. 《仲景》

Translation영역
By the great rule, floating and slow is auspicious and urgent and swift is inauspicious. A pulse floating and slow is easy to treat; one large, rapid and urgent means death. A pulse floating and large is called wind. A pulse floating and rapid — wind stroke has made it so.
Clinical note임상 주석
The one prognostic variable the chapter returns to again and again, and it is consistent across five sources: slow is survivable, fast is not. A large rapid urgent pulse in a collapsed patient means death, and that is correct — tachycardia in acute stroke marks raised intracranial pressure, autonomic storm or a cardiac source, and all three carry a worse outcome. Zhongjing's passage is doing something different and cleverer: it grades the depth of the lesion by what is lost, from insensible skin through a heavy limb to unrecognized faces and finally a mute tongue with frothing at the mouth. That is a severity scale built from the examination, and it is the best piece of reasoning in the section.

Maekgyeong 脉經 · Jungyeong 仲景

1.11 Wind Differs in Striking the Blood Vessels, the Bowels and the Viscera 風有中血脉中腑中藏之異

1.11.1
Source원문

中血脉則口眼喎斜, 中府則肢節廢, 中藏則性命危. 三者治各不同. 《東垣》

Translation영역
When it strikes the blood vessels the mouth and eye are deviated; when it strikes the bowels the limbs and joints are disabled; when it strikes the viscera life itself is in danger. The treatment of the three is different in each case.

Dongwon 東垣

1.11.2
Source원문

中府者, 面顯五色ㆍ有表證而脉浮ㆍ惡風寒ㆍ拘急不仁, 或中身之後, 或中身之前, 或中身之側, 皆曰中府, 其病多易治. ○中藏者, 唇吻不收ㆍ舌不轉而失音ㆍ鼻不聞香臭ㆍ耳聾而眼瞀ㆍ大小便秘結, 皆曰中藏, 其病多難治. ○大抵中府者多着四肢, 中藏者多滯九竅. 《易老》

Translation영역
In striking the bowels the five colours show on the face, there are exterior signs and the pulse is floating, there is aversion to wind and cold, and tightness and insensibility; whether it strikes the back of the body, or the front, or the side, all are called striking the bowels, and the disease is mostly easy to treat. In striking the viscera the lips are not gathered in, the tongue does not turn and the voice is lost, the nose does not smell fragrance or stench, the ears are deaf and the eyes dim, and the stool and urine are bound; all are called striking the viscera, and the disease is mostly difficult to treat. On the whole, striking the bowels attaches mostly to the four limbs, and striking the viscera lodges mostly in the nine orifices.

Yiro 易老

1.11.3
Source원문

中血脉而外有六經之形證, 則從小續命湯加減及踈風湯治之. ○中府者, 先以加減續命湯隨證發其表; 如兼中藏則內有便尿之阻隔, 宜以三化湯或局方麻仁丸《方見大便》ㆍ滋潤湯. 外無六經之形證ㆍ內無便尿之阻隔, 宜養血通氣, 大秦芃湯ㆍ羌活愈風湯ㆍ養榮湯. ○中藏者痰塞昏冒, 宜至寶丹之類鎭墜, 或活命金丹ㆍ牛黃定志丸ㆍ祛風至寶丹. ○風中五藏ㆍ舌瘖ㆍ眼瞀, 宜排風湯ㆍ加減排風湯. ○但手足不遂ㆍ言語蹇澁, 當從愈風湯以行中道, 久服大風悉去. 治病之法, 不可失于通塞: 或一氣之微汗, 加麻黃 一錢; 或一旬之通利, 加大黃 二錢. 此爲常治之法, 久則淸濁自分ㆍ榮衛自和矣. 《易老》

Translation영역
Where it has struck the blood vessels and there are the formal signs of the six channels without, treat it by Soseungmyeong-tang with modifications, or by Sopung-tang. In striking the bowels, first use Gagam-seungmyeong-tang to break out at the exterior according to the signs; and if the viscera are struck as well, so that within there is obstruction of stool and urine, Samhwa-tang or the Jufang's Main-hwan or Jayun-tang are appropriate. Where there are no formal signs of the six channels without and no obstruction of stool and urine within, the blood should be nourished and the qi freed with Daejingyo-tang, Ganghwal-yupung-tang or Yangyeong-tang. In striking the viscera, with phlegm blocking and clouding and stupor, Jibo-dan and its kind are appropriate to settle and weigh it down, or Hwalmyeonggeum-dan, Uhwang-jeongji-hwan or Geopung-jibo-dan. Where wind has struck the five viscera with a mute tongue and dim eyes, Baepung-tang or Gagam-baepung-tang are appropriate. But where only the hands and feet are paralysed and the speech halting and rough, Yupung-tang should be followed so as to travel the middle road, and on long taking the great wind will wholly depart. In the method of treating disease one must not err over freeing and blocking: for a slight sweat over one breath's span, add 1 don of ephedra; for a loosening over ten days, add 2 don of rhubarb. This is the method of ordinary treatment, and in time the clear and the turbid divide of themselves and the construction and defence harmonize of themselves.
Clinical note임상 주석
The chapter's longest and most important section, and the one place it gives a complete treatment algorithm rather than a list of formulas. Zhang Yuansu's three-tier scheme — blood vessels, bowels, viscera — is a severity grading, and the clinical descriptions attached to it are good: the bowel stroke has exterior signs, a floating pulse and affected limbs and is mostly treatable; the visceral stroke has a mute tongue, lost smell, deafness, dim eyes and a shut bowel and is mostly not. Limbs versus the nine orifices is the summary, and it corresponds roughly to a cortical or subcortical lesion versus a brainstem one. Eleven formulas are then assigned to the tiers in order, and the closing instruction is the practical heart of the whole chapter: do not err over freeing and blocking, adding a don of ephedra for a slight sweat or two don of rhubarb for a loosening. Titrating the exits is what the long convalescent course came down to.

Yiro 易老

1.12 Emergency Rescue in Sudden Wind Stroke 卒中風救急

1.12.1
Source원문

初中倒時, 隨卽醒者宜治; 若不醒者, 宜搯人中至醒. 若痰涎壅塞者宜吐之, 口噤者亦宜吐之. 若口開ㆍ手散ㆍ遺尿者, 爲陽暴絶, 速宜大料參芪補接之. 若眼戴上者宜灸之. 《綱目》

Translation영역
When he first falls at the striking, one who wakes immediately after should be treated; one who does not wake should have the renzhong pressed hard until he wakes. If phlegm drool congests and blocks, he should be made to vomit; and if the jaw is clenched, he should likewise be made to vomit. If the mouth is open, the hands are slack and there is incontinence of urine, the yang is suddenly cut off, and large quantities of ginseng and astragalus should quickly be used to supplement and join it up again. If the eyes are turned upward, moxibustion should be used.

Uihak Gangmok 綱目

1.12.2
Source원문

氣虛卒倒, 濃煎人參黃芪湯加竹瀝ㆍ薑汁服. 《丹心》

Translation영역
For sudden collapse from qi vacuity, decoct Insam-hwanggi-tang thick and take it with bamboo sap and ginger juice added.

Danggye Simbeop 丹心

1.12.3
Source원문

卒中昏倒不省ㆍ牙噤ㆍ涎潮ㆍ口眼喎斜ㆍ精神恍惚, 倉卒之際, 以手大指搯刻人中卽省. 或急令人將病者兩手兩足從上而下頻頻趕出, 四肢痰氣卽散, 免致攻心卽醒. 或急以三稜鍼刺手十指甲角十井穴, 將去惡血, 就以氣鍼刺合谷二穴ㆍ人中一穴, 皆是良法. 如未效, 用通關散吹鼻, 卽提起頭頂髮, 候有嚏可治. 如口噤不開, 以破棺散擦之, 口卽開, 多灌香油加麝香 一二分, 或用薑汁及攝生飮之類. 若風痰壅結ㆍ諸藥不效, 奪命散一服立愈. 《醫鑑》

Translation영역
For sudden stroke with clouding collapse and loss of awareness, the teeth clenched, drool rising, the mouth and eye deviated and the spirit confused: in the haste of the moment, press the renzhong hard with the thumbnail and he wakes at once. Or quickly have someone take the patient's two hands and two feet and drive repeatedly from above downward, and the phlegm qi in the four limbs disperses at once, so that it is kept from assaulting the heart and he wakes. Or quickly prick the ten jing points at the nail corners of the ten fingers with a three-edged needle to let out the malign blood, and then needle the two hegu points and the one renzhong point with a qi needle — all are good methods. If there is no effect, blow Tonggwan-san into the nose and pull up the hair at the crown of the head, and if there is sneezing the case can be treated. If the jaw is clenched and will not open, rub it with Pagwan-san and the mouth opens at once; pour in plenty of sesame oil with 1 or 2 fun of musk added, or use ginger juice and Seopsaeng-eum and the like. If wind phlegm is congested and bound and no medicine has effect, one dose of Talmyeong-san cures at once.

Uihak Jeonggam 醫鑑

1.12.4
Source원문

凡中風之證, 多是老年因怒而成. 蓋怒火上升, 所以昏仆不省ㆍ痰涎壅盛. 治宜豁痰ㆍ瀉火: 豁痰宜省風湯, 瀉火宜防風通聖散《方見下》. 《丹心》

Translation영역
The wind stroke pattern is mostly formed in the aged through anger. For the fire of anger ascends, and so there is clouding collapse without awareness and phlegm drool congesting and exuberant. The treatment should sweep out phlegm and drain fire: to sweep out phlegm, Seongpung-tang; to drain fire, Bangpung-tongseong-san.

Danggye Simbeop 丹心

1.12.5
Source원문

卒中昏倒, 卽用開噤ㆍ噴嚏法, 次用攝生飮煎湯調蘇合香元 三丸灌下. 痰盛者加全蝎. 《直指》

Translation영역
For sudden stroke with clouding collapse, at once use the methods of opening the clenched jaw and of provoking a sneeze; next decoct Seopsaeng-eum, stir three pills of Sohaphyang-won into it and pour it down. Where phlegm is exuberant, add scorpion.

Injae Jijibang 直指

1.12.6
Source원문

卒中風不省, 通用至寶丹ㆍ牛黃淸心元ㆍ龍腦蘇合元《方見氣門》ㆍ牛黃金虎丹, 以竹瀝ㆍ薑汁ㆍ香油ㆍ童便調和灌下. 《俗方》

Translation영역
For sudden wind stroke with loss of awareness, Jibo-dan, Uhwang-cheongsim-won, Yongnoe-sohap-won or Uhwang-geumho-dan are used generally, mixed with bamboo sap, ginger juice, sesame oil and boy's urine and poured down.
Clinical note임상 주석
The chapter's emergency protocol, and parts of it are still done. Press hard on the renzhong — the philtrum point — until he wakes: that is a noxious stimulus to test and provoke arousal, and it survives in Chinese first aid to this day. Prick the ten finger-tip jing-well points to let blood; needle hegu and renzhong. Stroke the limbs downward from above. Then the insufflations and the gum applications for a locked jaw, and only then the medicines. The sequence runs from the hand to the needle to the powder to the draught, which is the right order for a patient who cannot swallow, and the whole section is written at the speed of the emergency it describes. Danggye's aetiology — mostly the aged, through anger, the fire of anger ascending — is a fair description of a hypertensive haemorrhage precipitated by a surge of blood pressure. Against that, pouring sesame oil and musk into the mouth of an unconscious patient is aspiration, and making a patient with a clenched jaw vomit is the single most dangerous instruction in the chapter.

Sokbang 俗方

1.13 The Method of Opening the Clenched Jaw 開噤法

1.13.1
Source원문

卒中風口噤不開, 難於下藥, 宜用開關散ㆍ破棺散ㆍ巴豆熏法ㆍ龜尿解噤法.

Translation영역
In sudden wind stroke with the jaw clenched and not opening, it is hard to get medicine down; Gaegwan-san, Pagwan-san, the croton fumigation method and the tortoise urine method of resolving the clenched jaw should be used.

Donguibogam · Pung

1.13.2
Source원문

口噤者, 以烏梅肉和南星ㆍ細辛末, 以中指蘸藥擦牙, 口自開. 《直指》

Translation영역
Where the jaw is clenched, mix mume flesh with powdered arisaema and asarum, dip the middle finger in the medicine and rub it on the teeth, and the mouth opens of itself.

Injae Jijibang 直指

1.13.3
Source원문

三陽之筋幷絡入頷頰ㆍ挾於口, 諸陽爲風寒所客則筋急, 故口噤不開. 《資生》

Translation영역
The sinews of the three yang channels all enter the jaw and cheek in network and flank the mouth; when the yang channels are lodged in by wind cold the sinews tighten, and so the jaw is clenched and will not open.
Clinical note임상 주석
A real clinical problem given its own section, which is unusual and sensible: nothing in the chapter's pharmacy can be delivered to a patient whose jaw is locked, so the chapter stops and deals with the jaw first. Four methods are offered, three of them applied to the gums or the nose rather than swallowed. The mume-arisaema-asarum rub is the gentlest: mume is sour and provokes salivation, arisaema and asarum are acrid irritants, and rubbing the mixture along the teeth is a reasonable attempt at a reflex opening. The channel explanation at the end is also sound in its own terms — the trigeminal and facial distributions do run through the jaw and cheek.

Jasaeng Gyeonghyobang 資生

1.13.1 The Croton Fumigation Method 巴豆熏法

1.13.1.1
Source원문

治卒中風口噤不省. 巴豆去殼, 紙包槌油, 去豆, 以紙作撚條, 送入鼻內; 或加皂角末尤良. 或以前紙撚燒烟熏鼻內, 亦可. 《回春》

Translation영역
Treats sudden wind stroke with the jaw clenched and loss of awareness. Husk croton seeds, wrap them in paper and pound out the oil, discard the seeds, twist the paper into a taper and insert it into the nose; adding gleditsia pod powder is better still. Or burn the same paper taper and fumigate the inside of the nose with the smoke, which will also do.
Clinical note임상 주석
A clever and dangerous piece of improvisation: the croton is pounded in paper so that the oil soaks the paper and the seeds themselves are thrown away, and it is the oil-soaked paper that goes up the nose or is burnt under it. Croton oil is a severe mucosal irritant and that is precisely the point — the aim is a violent sneeze or an arousal response. The method also keeps the lethal seed out of the patient entirely, which is more care than several of the chapter's draughts take. It should not be reproduced; croton oil blisters skin and burning it produces an irritant smoke.

Manbyeong Hoechun 回春

1.13.2 Tortoise Urine to Resolve the Clenched Jaw 龜尿解噤

1.13.2.1
Source원문

治中風口噤不語. 取烏龜尿少許, 點舌下, 神妙. 取尿法: 以龜坐荷葉上, 用猪鬃鼻內刺之. 《類聚》

Translation영역
Treats wind stroke with the jaw clenched and speechless. Take a little urine of a black tortoise and drop it under the tongue, with wonderful effect. The method of obtaining the urine: set the tortoise on a lotus leaf and prick inside its nose with a pig's bristle.
Clinical note임상 주석
The method of collection is the whole entry, and it is a small masterpiece of practical absurdity: set the tortoise on a lotus leaf so the urine can be recovered, and prick its nostril with a pig's bristle to make it void. Whatever one thinks of the remedy, somebody worked that procedure out and wrote it down, and it is the kind of detail that makes the single-simple literature worth reading. A drop under the tongue is at least a route that does not risk the airway.

Uibang Yuchwi 類聚

1.14 The Method of Provoking a Sneeze 取嚏法

1.14.1
Source원문

卒中風不省, 先以皂角ㆍ細辛末或南星ㆍ半夏末吹入鼻中, 候有嚏可治, 無嚏不可治. 《直指》

Translation영역
In sudden wind stroke with loss of awareness, first blow powdered gleditsia pod and asarum, or powdered arisaema and pinellia, into the nose; if there is sneezing the case can be treated, and if there is no sneezing it cannot.

Injae Jijibang 直指

1.14.2
Source원문

卒中昏悶, 先用通關散探鼻令噴嚏, 次用蘇合香元行氣《方見氣門》, 徐服順氣ㆍ踈風ㆍ豁痰等藥. 其有牙關緊閉, 亦用通關散搐鼻噴嚏, 卽開. 《得效》

Translation영역
For sudden stroke with clouding and oppression, first use Tonggwan-san probed into the nose to make him sneeze; next use Sohaphyang-won to move the qi; and then give slowly the medicines that normalize the qi, disperse wind and sweep out phlegm. Where the jaw is tightly shut, Tonggwan-san too is insufflated into the nose to make him sneeze, and it opens at once.

Uibang Yuchwi 得效

1.14.3
Source원문

取嚏宜用通頂散ㆍ搐鼻通天散.

Translation영역
For provoking a sneeze, Tongjeong-san or Chukbi-tongcheon-san should be used.
Clinical note임상 주석
The sneezing test, stated here as plainly as it is anywhere in the literature: if there is sneezing the case can be treated, if there is no sneezing it cannot. That is a brainstem reflex used as a prognostic sign, and it is the chapter's single best piece of bedside assessment — the same information a modern clinician gets from a gag or corneal reflex, obtained with a pinch of powder. The sequence that follows is also well ordered: provoke the reflex, then the aromatic to move the qi, then slowly the real medicines. Insufflating powder into an unconscious patient's nose nevertheless risks aspiration, which is the method's standing objection.

Donguibogam · Pung

1.15 The Method of Provoking Vomiting 取吐法

1.15.1
Source원문

卒中風ㆍ暴仆ㆍ昏悶不省人事, 或痰涎壅塞ㆍ舌强不語, 兩寸脉浮大而實, 急以瓜蔕ㆍ藜蘆等藥吐之, 以遏其勢. 《正傳》

Translation영역
In sudden wind stroke with sudden falling and clouding oppression and loss of consciousness, or phlegm drool congesting and blocking with the tongue stiff and speechless, and the two cun pulses floating, large and replete, quickly make him vomit with melon pedicel or veratrum and the like, so as to check its force.

Uihak Jeongjeon 正傳

1.15.2
Source원문

卒中風痰壅盛者ㆍ口眼喎斜者ㆍ不能言者, 皆當用吐法. 輕者用瓜蔕 一錢, 或稀涎散, 或鰕汁; 重者《一作急》用藜蘆 五分或三分, 加麝香少許爲末, 虀汁調和灌入鼻內, 吐痰出. 如口不噤者, 灌入口內, 吐痰出. 一吐不效, 再吐之. 亦有虛而不可吐者. 《丹心》

Translation영역
In sudden wind stroke with phlegm congesting and exuberant, with the mouth and eye deviated, or unable to speak, the vomiting method should be used in every case. For the light, use 1 don of melon pedicel, or Huiyeon-san, or shrimp broth; for the heavy — one text has 'the urgent' — use 5 fun or 3 fun of veratrum with a little musk added, powdered and mixed with pickle brine and poured into the nose, and the phlegm is vomited out. Where the jaw is not clenched, pour it into the mouth and the phlegm is vomited out. If one vomiting has no effect, make him vomit again. There are also those too vacuous to be made to vomit.

Danggye Simbeop 丹心

1.15.3
Source원문

痰盛者吐之, 宜稀涎散ㆍ瓜蔕散《方幷見吐門》ㆍ皂角散ㆍ巴豆丸.

Translation영역
Where phlegm is exuberant, make him vomit; Huiyeon-san, Gwache-san, Jogak-san or Padu-hwan are appropriate.
Clinical note임상 주석
The worst method in the chapter, and the chapter half knows it. Inducing emesis in an unconscious stroke patient — or worse, in one whose jaw is locked, by pouring brine up the nose — is the surest way to fill the lungs, and the section's own closing caution, that there are also those too vacuous to be made to vomit, is the only limit set on it. The reasoning behind the method is consistent with the chapter's phlegm doctrine: audible secretions mean phlegm, and phlegm must come out. The grading by severity, light cases on melon pedicel and heavy on veratrum, shows it was practised with some discrimination; that does not make it safe. Clearing an obstructed airway is right, and provoking vomiting is not how it is done.

Donguibogam · Pung

1.16 The Fumigation Method 熏法

1.16.1
Source원문

唐王太后中風不能言, 脉沉而口噤. 許胤宗曰, 旣不能下藥, 宜以湯氣熏之, 藥入腠理, 周時可差. 濃煎黃芪防風湯數斛, 置于床下, 氣如烟霧熏之, 其夕便得語. 《衍義》

Translation영역
The empress dowager of Tang had a wind stroke and could not speak; her pulse was sunken and her jaw clenched. Xu Yinzong said: since medicine cannot be got down, she should be fumigated with the steam of a decoction, and the medicine will enter the interstices and in a day's round she may recover. Several hu of Hwanggi-bangpung-tang were decocted thick and set beneath her bed, and the vapour fumigated her like smoke and mist; that very evening she was able to speak.

Yeonui 衍義

1.16.2
Source원문

中風脉沉ㆍ口噤, 非大補不可. 若用有形湯藥, 緩不及事; 熏以黃芪防風湯, 使口鼻俱受之, 此非智者通神之法不能回也. 蓋人之口通乎地, 鼻通乎天; 口以養陰, 鼻以養陽. 天主淸, 故鼻不受有形而受無形; 地主濁, 故口受有形而兼乎無形也. 《丹心》

Translation영역
In wind stroke with a sunken pulse and the jaw clenched, nothing but great supplementation will do. If a decoction having form is used, it is too slow for the case; fumigating with Hwanggi-bangpung-tang so that the mouth and nose both receive it — without a wise man's method of reaching the spirit, this cannot be turned back. For a man's mouth communicates with earth and his nose with heaven; the mouth nourishes the yin and the nose the yang. Heaven governs the clear, and so the nose does not receive what has form but receives what has no form; earth governs the turbid, and so the mouth receives what has form and also what has none.
Clinical note임상 주석
The best story in the chapter and a genuinely original idea: the patient cannot swallow, so put the medicine in the air. Several hu of thick decoction under the bed, steaming like smoke and mist, and by evening she could speak. Whether the astragalus did anything is doubtful; a room full of warm humidified air around a patient with secretions and a blocked airway might very well have. Danggye's gloss — the nose receives what has no form, the mouth what has form — is the tradition reasoning its way to inhaled therapy from first principles, and of everything in the chapter's emergency sections this is the one method that could be reproduced today without harm.

Danggye Simbeop 丹心

1.17 The Signs That Cannot Be Treated 不治證

1.17.1
Source원문

卒中風, 口開ㆍ手散ㆍ眼合ㆍ遺尿ㆍ鼻聲如鼾者, 五藏氣絶也. 蓋口開者心絶, 手散者脾絶, 眼合者肝絶, 遺尿者腎絶, 聲如鼾者肺絶也. 若見一, 猶可用工; 若面赤時黑, 主陽氣上散ㆍ腎水反克心火, 兼遺尿ㆍ口開ㆍ氣喘者, 斷不可救也. 《綱目》

Translation영역
In sudden wind stroke, the mouth open, the hands slack, the eyes closed, urine passed and the breath sounding like snoring — these are the five viscera's qi cut off. For the open mouth is the heart cut off, the slack hands the spleen cut off, the closed eyes the liver cut off, the passed urine the kidney cut off, and the snoring sound the lung cut off. If one of them is seen, work may still be attempted; but if the face is red and at times black, which means the yang qi is scattering upward and kidney water is restraining heart fire in reverse, and there is incontinence of urine and an open mouth and panting as well, he certainly cannot be saved.

Uihak Gangmok 綱目

1.17.2
Source원문

五藏氣絶, 速宜大料參芪濃煎湯救之, 及臍下大艾炷多灸之, 亦可轉死回生也. 《綱目》

Translation영역
Where the five viscera's qi is cut off, a thick decoction of ginseng and astragalus in large quantity should quickly be used to rescue him, and a large moxa cone below the navel burnt many times; death may still be turned back to life.

Uihak Gangmok 綱目

1.17.3
Source원문

肉脫ㆍ筋痛ㆍ髮直ㆍ搖頭上竄ㆍ面赤如粧ㆍ汗綴如珠ㆍ吐沫直視者, 皆不可治. 《丹心》

Translation영역
Flesh fallen away, sinews painful, hair standing straight, the head shaking and jerking upward, the face red as if painted, sweat strung on it like beads, foam brought up and a fixed stare — all these cannot be treated.

Danggye Simbeop 丹心

1.17.4
Source원문

中藏之絡者, 口眼俱閉可治; 如口開ㆍ眼合ㆍ手散ㆍ遺尿ㆍ鼻聲如鼾, 及大吐ㆍ大瀉ㆍ下血ㆍ吐血者, 皆死. 《入門》

Translation영역
Where the network vessels of the viscera are struck, if the mouth and eyes are both shut the case can be treated; but where the mouth is open, the eyes closed, the hands slack, urine passed and the breath sounding like snoring, and where there is great vomiting, great diarrhoea, blood passed below or blood vomited, all die.

Uihak Immun 入門

1.17.5
Source원문

口開者心氣閉絶也, 遺尿者腎氣閉絶也, 手散者脾氣閉絶也, 眼合者肝氣閉絶也, 鼻鼾者肺氣閉絶也, 皆不治. 五證中纔見一證猶可治. 蓋初中則眼合者多, 痰上則鼻鼾者亦多; 惟遺尿ㆍ口開俱見爲惡. 心爲五藏主, 腎爲五藏根, 誠不可閉絶也. 《得效》

Translation영역
The open mouth is the heart qi shut and cut off; the passed urine the kidney qi shut and cut off; the slack hands the spleen qi shut and cut off; the closed eyes the liver qi shut and cut off; the snoring nose the lung qi shut and cut off — and none of them can be treated. Where only one of the five signs is seen the case may still be treated. For at the first striking the eyes are often closed, and when phlegm rises the nose often snores as well; it is only when incontinence of urine and an open mouth are seen together that it is malign. The heart is the governor of the five viscera and the kidney their root, and these truly must not be shut off.

Uibang Yuchwi 得效

1.17.6
Source원문

動止筋痛, 名曰筋枯, 不治; 無血滋筋故也. 又肝木克脾土ㆍ大便洞泄者, 亦不治. 《丹心》

Translation영역
Where there is pain in the sinews on moving or stopping, it is called withered sinew and cannot be treated, because there is no blood to enrich the sinews. And where liver wood restrains spleen earth so that the stool pours out, that too cannot be treated.
Clinical note임상 주석
The most clinically valuable section in the chapter, and the one that needs no translation into modern terms to be read: an open mouth, slack hands, closed eyes, incontinence and stertorous breathing. That is a deep coma with loss of tone, loss of sphincter control and an obstructed airway, and the Deughyobang's refinement is what makes the list a usable scale — at the first striking the eyes are often closed and the nose often snores, so those two alone mean little, but incontinence together with an open mouth is malign. Counting the signs, and weighting them, is precisely how a modern coma score works. The grimmer list from Danggye adds a fixed stare, beaded sweat, a painted red face and hair standing on end, which are signs of brainstem failure and autonomic storm. And having declared the case hopeless, the Gangmok still prescribes thick ginseng and moxa below the navel, because a physician at a deathbed does something.

Danggye Simbeop 丹心

1.18 Sudden Falling 暴仆

1.18.1
Source원문

與卒中風救急同參看.

Translation영역
To be read together with the section on emergency rescue in sudden wind stroke.
Clinical note임상 주석
A cross-reference and nothing more. 暴仆 is the first of the nine great signs listed in section 1.6, and rather than repeat the emergency protocol the Bogam simply points back to it — the only one of the nine handled this way, because the collapse itself is what the rescue section is about.

Donguibogam · Pung

1.19 Sudden Loss of Voice 暴瘖

1.19.1
Source원문

凡語澁皆屬風. 《綱目》

Translation영역
All rough speech belongs to wind.

Uihak Gangmok 綱目

1.19.2
Source원문

腎虛爲厲風所傷, 語音蹇吃, 或口喎ㆍ脚胻枯細ㆍ緩弱, 或耳聾ㆍ腰背相引痛. 腎瀝湯ㆍ地黃飮子主之.

Translation영역
Where the kidney is vacuous and injured by a severe wind, the speech is halting and stammering; or the mouth is deviated, the shins withered and thin, slack and weak; or there is deafness and pain drawing between the lower back and the back. Sinryeok-tang and Jihwang-eumja govern it.

Donguibogam · Pung

1.19.3
Source원문

內經曰, 內奪而厥則爲瘖痱, 此腎虛也; 少陰不至者, 厥也. 註曰, 痱, 廢也; 腎氣內奪則舌瘖ㆍ足廢.

Translation영역
The Neijing says: when there is inward plunder and reversal, there is mutism and paralysis — this is kidney vacuity; where the shaoyin does not arrive, there is reversal. The commentary: bi means disabled; when the kidney qi is plundered within, the tongue is mute and the legs disabled.

Naegyeong 內經

1.19.4
Source원문

中風瘖瘂, 宜用淸心散ㆍ加味轉舌膏ㆍ轉舌膏《方幷見言語》ㆍ正舌散ㆍ解語丸ㆍ淸神解語湯ㆍ資壽解語湯.

Translation영역
For wind stroke with mutism, Cheongsim-san, Gami-jeonseol-go, Jeonseol-go, Jeongseol-san, Haeeo-hwan, Cheongsin-haeeo-tang or Jasu-haeeo-tang should be used.
Clinical note임상 주석
The section separates two kinds of speech loss without saying so outright. The first is the kidney-vacuity picture — halting stammering speech with wasted shins, deafness and back pain — which is the chronic, slowly progressive case, and the two formulas given for it are both supplementing. The second is the acute mutism of the stroke, and the seven formulas listed at the end are orifice-opening and phlegm-clearing. The Neijing citation that joins them is the key one for the whole section: a mute tongue above and disabled legs below, from the kidney qi plundered within. That pairing recurs in Jihwang-eumja's own indication and is the tradition's way of marking a lesion with both bulbar and motor involvement.

Donguibogam · Pung

1.20 The Spirit Clouded and Stupefied 精神蒙昧

1.20.1
Source원문

風中藏昏冒, 宜用至寶丹ㆍ牛黃淸心元《方幷見上》.

Translation영역
Where wind has struck the viscera with clouding and stupor, Jibo-dan or Uhwang-cheongsim-won should be used.

Donguibogam · Pung

1.20.2
Source원문

蒙昧者, 卽昏冒茫昧也; 精神不爽, 如有物以蒙蔽也. 《綱目》

Translation영역
Clouded and stupefied means clouded, stupefied, vague and dim; the spirit is not bright, as if something had veiled and covered it.

Uihak Gangmok 綱目

1.20.3
Source원문

中風者多昏冒ㆍ氣不淸利, 宜四白丹ㆍ二參丹ㆍ牛黃定志丸ㆍ活命金丹ㆍ祛風至寶丹.

Translation영역
In wind stroke there is often clouding and stupor with the qi not clear and free; Sabaek-dan, Isam-dan, Uhwang-jeongji-hwan, Hwalmyeonggeum-dan or Geopung-jibo-dan are appropriate.
Clinical note임상 주석
The Gangmok's definition is the whole value of the section: the spirit is not bright, as if something had veiled and covered it. That is the clouded sensorium of a stroke patient who is neither comatose nor clear — the state a modern note would call drowsy or confused — and giving it a name of its own, distinct both from the deep coma of 1.17 and from the forgetfulness that Isam-dan treats, is a real clinical distinction. The five formulas offered are all heavy aromatic pills, four of them containing cinnabar or arsenic, which is the section's failing rather than its reasoning.

Donguibogam · Pung

1.21 Deviation of the Mouth and Eye 口眼喎斜

1.21.1
Source원문

風中血脉則口眼喎斜. 《東垣》

Translation영역
When wind strikes the blood vessels, the mouth and eye are deviated.

Dongwon 東垣

1.21.2
Source원문

自其邪氣之入人也, 邪氣反緩ㆍ正氣反急, 正氣引邪, 爲喎僻ㆍ爲竄視ㆍ爲掣縱ㆍ爲搐搦ㆍ爲癱瘓ㆍ爲反張. 在於陽則皮膚緩, 在於陰則腹皮急; 緩則四肢不能收, 急則一身不能仰. 《直指》

Translation영역
From the moment the evil qi enters a man, the evil qi becomes slack and the upright qi becomes tight, and the upright qi draws the evil — whence the deviation, the darting gaze, the jerking and slackening, the convulsion, the paralysis and the arching backward. Where it is in the yang the skin is slack; where it is in the yin the skin of the abdomen is tight; when slack, the four limbs cannot be gathered in, and when tight, the whole body cannot be raised.

Injae Jijibang 直指

1.21.3
Source원문

風邪初入, 反緩ㆍ正氣反急, 以致口眼喎斜, 或左或右. 急搯人中ㆍ拔頂髮ㆍ灸耳垂珠下三五壯; 外用南星ㆍ草烏 各一兩, 白芨 一錢, 白殭蚕 七枚, 爲末, 薑汁調塗喎處, 正卽洗去; 內用正舌藥: 白附子ㆍ白殭蚕ㆍ全蝎 等分爲末, 酒調二錢服. 《入門》

Translation영역
When the wind evil first enters, it becomes slack while the upright qi becomes tight, so that the mouth and eye are deviated, to the left or to the right. Quickly press the renzhong hard, pull the hair at the crown and burn three to five moxa cones below the earlobe; externally use arisaema and aconite kusnezoffii, 1 nyang each, bletilla, 1 don, and seven silkworms, powdered and mixed with ginger juice and smeared on the deviated place, washed off as soon as it straightens; and internally use the tongue-rectifying medicine — typhonium, silkworm and whole scorpion in equal parts, powdered and 2 don taken stirred into wine.

Uihak Immun 入門

1.21.4
Source원문

口眼喎斜者, 多屬胃土; 風木不及, 金乗之, 土寡于畏也. 內經曰, 木不及曰委和; 委和之紀, 其動緛戾ㆍ拘緩. 緛者縮短也, 戾者口目喎斜也, 拘者筋脉拘强也, 緩者筋脉弛縱也. 木爲金乗則縮短牽引而喎斜ㆍ拘强也; 木弱則土寡于畏, 故土兼化而緩縱也. 《綱目》

Translation영역
Deviation of the mouth and eye mostly belongs to stomach earth: wind wood falls short, metal rides upon it, and earth has little to fear. The Neijing says: when wood falls short it is called withered harmony; and in the epoch of withered harmony its movements are shrinking and awry, bound and slack. Shrinking is contraction and shortening; awry is the deviation of mouth and eye; bound is the sinews and vessels tight and stiff; slack is the sinews and vessels loose and flaccid. When wood is ridden by metal there is contraction and drawing, hence deviation and tight stiffness; and when wood is weak earth has little to fear, and so earth transforms in addition and there is slackness and flaccidity.

Uihak Gangmok 綱目

1.21.5
Source원문

口眼喎斜之證, 大率在胃而有筋脉之分. 經云, 足陽明ㆍ手太陽筋急則口目爲僻ㆍ眥急不能卒視, 此胃土之筋爲邪也. 經云, 足陽明脉挾口環唇, 所生病者口喎ㆍ唇斜, 此胃土之脉爲邪也. 《綱目》

Translation영역
The pattern of deviation of the mouth and eye is for the most part in the stomach, but there is a division between the sinews and the vessels. The classic says: when the sinews of the foot yangming and the hand taiyang are tight, the mouth and eye are deviated and the canthus is tight so that one cannot see suddenly — here it is the sinew of stomach earth that is affected by the evil. The classic says: the foot yangming vessel flanks the mouth and encircles the lips, and the diseases it generates are a deviated mouth and slanted lips — here it is the vessel of stomach earth that is affected by the evil.

Uihak Gangmok 綱目

1.21.6
Source원문

口眼喎斜, 宜用淸陽湯ㆍ秦芃升麻湯ㆍ不換金丹ㆍ牽正散ㆍ理氣祛風散ㆍ淸痰順氣湯ㆍ犀角升麻湯ㆍ天仙膏.

Translation영역
For deviation of the mouth and eye, Cheongyang-tang, Jingyo-seungma-tang, Bulhwangeum-dan, Gyeonjeong-san, Igi-geopung-san, Cheongdam-sungi-tang, Seogak-seungma-tang or Cheonseon-go should be used.
Clinical note임상 주석
The section's best line is the Jijibang's, and it is a piece of real observation: the evil qi becomes slack and the upright qi tight, and the upright qi draws the evil. That describes exactly what facial palsy looks like — the sound side pulls and the affected side hangs, so the face appears drawn toward the healthy half — and it is the correct explanation of a sign that is easy to read backwards. From it the Gangmok builds a channel localization to the foot yangming, flanking the mouth and encircling the lips, which is the right territory for the facial nerve's lower branches. The moxa point below the earlobe is the stylomastoid region where the facial nerve emerges, and treating there is still done. Five-phase withered harmony aside, this is among the better-reasoned sections in the chapter.

Donguibogam · Pung

1.22 Paralysis of the Hands and Feet 手足癱瘓

1.22.1
Source원문

凡風中府則肢節廢. 又云, 中府者多着四肢. 《易老》

Translation영역
Whenever wind strikes the bowels, the limbs and joints are disabled. It is also said that striking the bowels attaches mostly to the four limbs.

Yiro 易老

1.22.2
Source원문

左不遂曰癱, 右不遂曰瘓, 因氣血虛而痰火流注也. 血虛則痰火流注於左而爲左癱, 氣虛則痰火流注於右而爲右瘓. 急治則愈, 久則痰火鬱結而難治. 治法: 左癱宜補血兼散痰火, 四物湯《方見血門》加竹瀝ㆍ薑汁ㆍ桃仁ㆍ紅花ㆍ白芥子; 右瘓宜補氣兼散痰火, 四君子湯《方見氣門》合二陳湯《方見痰飮》加竹瀝ㆍ薑汁ㆍ白芥子. 《丹心》

Translation영역
Paralysis of the left is called tan and of the right pa, and it is caused by vacuity of qi and blood with phlegm fire pouring down. Where the blood is vacuous, phlegm fire pours into the left and there is left palsy; where the qi is vacuous, phlegm fire pours into the right and there is right paralysis. Treated urgently it is cured; left long, the phlegm fire becomes constrained and bound and it is difficult to treat. As to the method: for left palsy the blood should be supplemented while the phlegm fire is dispersed, with Samul-tang plus bamboo sap, ginger juice, peach kernel, safflower and white mustard seed; for right paralysis the qi should be supplemented while the phlegm fire is dispersed, with Sagunja-tang combined with Ijin-tang plus bamboo sap, ginger juice and white mustard seed.

Danggye Simbeop 丹心

1.22.3
Source원문

痛者爲實, 先用二陳湯, 後用防風通聖散或河間換骨丹之類; 不痛者爲虛, 左癱服四物湯, 右瘓服四君子湯, 俱加竹瀝ㆍ薑汁. 《入門》

Translation영역
Where there is pain it is repletion: use Ijin-tang first and afterwards Bangpung-tongseong-san or Hagan's Hwangol-dan and the like. Where there is no pain it is vacuity: for left palsy give Samul-tang and for right paralysis Sagunja-tang, both with bamboo sap and ginger juice added.

Uihak Immun 入門

1.22.4
Source원문

中風皆半身不遂, 其有遷延歲月不死者, 何也? 曰, 如木之根本未甚枯而一邉之枝幹先萎耳. 經曰, 根于中者命曰神機, 神去則機息. 夫神機未息, 亦猶氣化之未絶耳; 故半身雖不運用, 然亦未至於機息而死也. 《正傳》

Translation영역
In wind stroke half the body is always paralysed; why is it that some linger on through years and months without dying? The answer: it is as when the root and trunk of a tree are not yet much withered but the branches on one side wither first. The classic says: what is rooted within is called the spirit mechanism, and when the spirit departs the mechanism ceases. Now while the spirit mechanism has not ceased, it is as though the transformation of qi had not been cut off; and so although half the body is not used, it has not come to the mechanism ceasing and death.

Uihak Jeongjeon 正傳

1.22.5
Source원문

癱者, 坦也, 筋脉弛縱ㆍ坦然而不擧也. 瘓者, 渙也, 血氣散漫ㆍ渙然而不用也. 《正傳》

Translation영역
Tan means level: the sinews and vessels are loose and flaccid, lying level and not lifted. Pa means dispersed: the blood and qi are scattered and diffuse, dispersed and not used.

Uihak Jeongjeon 正傳

1.22.6
Source원문

中風大法: 一曰偏枯ㆍ半身不遂; 二曰風痱ㆍ四肢不擧, 卽全身不遂也. 《千金》 ○半身不遂ㆍ失音不語, 亦謂之腲腿風. 《三因》

Translation영역
By the great scheme of wind stroke: the first is withered hemilateral, with half the body paralysed; the second is wind paralysis, with the four limbs not lifted, that is, the whole body paralysed. Half the body paralysed with loss of voice and speech is also called slack-legged wind.

Cheongeumbang 千金 · Samin Geukil Byeongjeungbangnon 三因

1.22.7
Source원문

半身不遂, 男女皆有此患, 但男尤忌左ㆍ女尤忌右. 若得此疾, 風藥不宜暫闕, 常宜身上有灸瘡可也. 《資生》

Translation영역
Both men and women suffer paralysis of half the body, but in a man the left is the more to be feared and in a woman the right. If a man contracts this disease, the wind medicines should not be lacking even for a moment, and it is well that there should always be a moxa sore on the body.

Jasaeng Gyeonghyobang 資生

1.22.8
Source원문

宜用加減潤燥湯ㆍ祛風除濕湯ㆍ加味大補湯ㆍ天台散ㆍ星附散ㆍ換骨丹《方見下》ㆍ全生虎骨散ㆍ舒筋保安散ㆍ秘方ㆍ踈風順氣湯.

Translation영역
Gagam-yunjo-tang, Geopung-jeseup-tang, Gami-daebo-tang, Cheontae-san, Seongbu-san, Hwangol-dan, Jeonsaeng-hogol-san, Seogeun-boan-san, the secret formula, or Sopung-sungi-tang should be used.
Clinical note임상 주석
The left-blood right-qi doctrine in its fullest statement, and the two formulas it generated — Gagam-yunjo-tang and Geopung-jeseup-tang — are the chapter's most-copied pair. The lateralization is wrong: hemiplegia follows the side of the lesion and has nothing to do with blood or qi. But two things in the section are not wrong. The first is the pain-versus-no-pain rule in the Immun's line, which separates a spastic painful limb from a flaccid painless one and treats them oppositely; that distinction is sound and still useful. The second is the Jeongjeon's answer to the question of why some patients live on for years after a stroke, which is the best image in the chapter: the root and trunk of the tree are not much withered, only the branches on one side. Half the brain may be destroyed and the person remain, and the tradition had no better way of saying so.

Donguibogam · Pung

1.23 Jerking and Slackening and Convulsion of the Four Limbs Are Wind Diseases 四肢瘈瘲搐搦爲風疾

1.23.1
Source원문

瘛者, 筋脉急也; 瘲者, 筋脉緩也. 急則引而縮, 緩則縱而伸; 或縮或伸ㆍ動而不止, 名曰瘛瘲, 俗謂之搐者是也. 《類聚》

Translation영역
Che is the sinews and vessels tight; jong is the sinews and vessels slack. When tight they draw and contract; when slack they loosen and extend. Now contracting, now extending, moving without cease — this is called chejong, and it is what the world calls a convulsion.

Uibang Yuchwi 類聚

1.23.2
Source원문

瘛瘲者, 令肌肉跳動也; 搐搦者, 瘛瘲之甚也. 瘛爲縮, 瘲爲伸. 《河間》

Translation영역
Chejong makes the flesh leap and move; convulsion is chejong at its height. Che is contraction and jong is extension.

Hagan 河間

1.23.3
Source원문

搐搦者, 手足牽引ㆍ一伸一縮也. 《回春》

Translation영역
In convulsion the hands and feet are drawn, now extending and now contracting.

Manbyeong Hoechun 回春

1.23.4
Source원문

四肢漐習者, 爲四肢動而不止ㆍ似瘛瘲而無力ㆍ不得伸縮者也. 《類聚》

Translation영역
The four limbs in a tremor are the four limbs moving without cease, resembling chejong but without strength and unable to extend or contract.

Uibang Yuchwi 類聚

1.23.5
Source원문

中風搐搦之時, 不可捉住手足; 捉住則涎不歸手足, 當不隨, 但寬抱之可也. 《得效》

Translation영역
While a wind stroke patient is convulsing, the hands and feet must not be seized and held; if they are held the drool does not return to the hands and feet, which will then not follow him. He should only be loosely held.
Clinical note임상 주석
Four authorities on the terminology and then one instruction that matters: do not seize and hold the limbs of a convulsing patient, only hold him loosely. That is correct first aid, and it is correct for the reason the Deughyobang could not have known — restraining a convulsing limb causes fractures and dislocations and does nothing to stop the seizure. The explanation offered, that the drool will not return to the limbs, is wrong; the instruction is right, and somebody must have seen the harm. The distinction drawn in the last passage, between the forceful alternating contraction of a convulsion and the weak ceaseless movement of a tremor, is also a real one.

Uibang Yuchwi 得效

1.24 Phlegm Drool Congesting and Exuberant 痰涎壅盛

1.24.1
Source원문

風病皆痰爲患, 故治以開關ㆍ化痰爲先. 急則祛風, 緩則順氣, 久則活血. 如眞氣漸復ㆍ痰飮漸消, 尙有風邪未退, 以羌活愈風湯調之. 《入門》

Translation영역
In wind disease it is always phlegm that is the trouble, and so in treating it, opening the pass and transforming phlegm come first. Where the case is urgent, dispel wind; where it is slow, normalize the qi; where it is long-standing, quicken the blood. If the true qi is gradually recovering and the phlegm-rheum gradually dispersing and a wind evil has still not retreated, regulate it with Ganghwal-yupung-tang.

Uihak Immun 入門

1.24.2
Source원문

初中痰壅盛者, 當先吐之, 吐後用他藥. 《吐法見上》

Translation영역
Where at the first striking phlegm congests and is exuberant, vomiting should come first, and other medicines be used after.

Donguibogam · Pung

1.24.3
Source원문

凡人骨節皆有涎, 所以轉動滑利. 中風則涎上潮ㆍ咽喉中衮響, 以藥壓下, 涎再歸骨節可也. 不可大吐出, 時間快意, 非久枯了手足, 不可不戒. 《得效》

Translation영역
Every man's bones and joints have drool in them, which is why they turn and move smoothly. In wind stroke the drool surges upward and rolls rattling in the throat; it is right to press it down with medicine so that the drool returns again to the bones and joints. It must not be vomited out in quantity: there is a moment's relief, but before long the hands and feet are withered, and one cannot fail to guard against it.

Uibang Yuchwi 得效

1.24.4
Source원문

風痰壅盛, 宜用導痰湯《方見痰飮》ㆍ加減導痰湯ㆍ滌痰湯ㆍ大省風湯ㆍ沉香半夏湯ㆍ三生飮ㆍ靑州白元子ㆍ加味靑州白元子ㆍ蝎麝白元子ㆍ龍星丹ㆍ蘇靑元.

Translation영역
Where wind phlegm congests and is exuberant, Dodam-tang, Gagam-dodam-tang, Jeokdam-tang, Dae-seongpung-tang, Chimhyang-banha-tang, Samsaeng-eum, Cheongju-baegwonja, Gami-cheongju-baegwonja, Galsa-baegwonja, Yongseong-dan or Socheong-won should be used.
Clinical note임상 주석
The Immun's opening line is the chapter's treatment sequence in eleven characters: urgent, dispel wind; slow, normalize the qi; long-standing, quicken the blood. Those three stages map onto the acute stroke, the convalescence and the chronic deficit, and a physician following them would be doing something sensible at each point. What follows is stranger and better: the Deughyobang's argument that every joint has drool in it which is why it moves smoothly, that in a stroke this drool surges upward, and that it must be pressed back down rather than vomited out, because vomiting it gives a moment's relief and leaves the limbs withered. Synovial fluid is a real thing and the reasoning here is the tradition's nearest approach to it. And whatever the mechanism, the conclusion contradicts the vomiting section two pages earlier — which is the chapter arguing with itself, and on this occasion the cautious side is right.

Donguibogam · Pung

1.25 The Heat Pattern of Wind Stroke 中風熱證

1.25.1
Source원문

風者百病之始也, 善行而數變. 行者動也; 風因熱生, 熱勝則風動, 宜以靜勝其躁, 是養血也. 宜大秦芃湯《方見上》ㆍ天麻丸. 若藏府兼見, 或表裏兼攻, 宜防風通聖散. 《入門》

Translation영역
Wind is the beginning of the hundred diseases; it travels readily and changes often. Travelling is movement; wind arises through heat, and when heat prevails the wind stirs. Stillness should be used to overcome its restlessness, and that means nourishing the blood. Daejingyo-tang or Cheonma-hwan are appropriate. If viscera and bowels are both seen, or if exterior and interior are both to be attacked, Bangpung-tongseong-san is appropriate.

Uihak Immun 入門

1.25.2
Source원문

風熱宜用小通聖散ㆍ人參羌活散ㆍ川芎石膏散ㆍ淸氣宣風散ㆍ透氷丹.

Translation영역
For wind heat, Sotongseong-san, Insam-ganghwal-san, Cheongung-seokgo-san, Cheonggi-seonpung-san or Tubing-dan should be used.
Clinical note임상 주석
Use stillness to overcome its restlessness, and that means nourishing the blood. The treatment principle is stated as a paradox and resolved in the same breath, and it is the Jin-Yuan position at its most compact: wind is movement, movement comes of heat, and the answer to heat is not a cooling attack but the substance heat has consumed. That is why Cheonma-hwan, a rehmannia-led formula, stands under a heat-pattern heading, and why Bangpung-tongseong-san is reserved for the case where both exterior and interior must be attacked at once.

Donguibogam · Pung

1.26 The Vacuity Pattern of Wind Stroke 中風虛證

1.26.1
Source원문

凡中風年逾五旬ㆍ氣衰之際多有此疾; 壯年肥盛者亦有之, 亦是形盛氣衰而然也. 宜用萬金湯《一作全》ㆍ八寶回春湯.

Translation영역
Wind stroke is common past fifty years, when the qi is in decline; it occurs in the stout and abundant of their prime years also, and that likewise is because the form is abundant and the qi declined. Mangeum-tang — one text writes the name with the other character — or Palbo-hoechun-tang should be used.
Clinical note임상 주석
The shortest treatment section in the chapter and a near-verbatim repetition of section 1.4, which is the Bogam's way of making the point twice: the vacuity pattern and the stoutness that predisposes to stroke are the same observation seen from two sides. Both formulas offered are large mild supplementing decoctions, which is what a vacuity pattern calls for and what the rest of the chapter mostly does not give.

Donguibogam · Pung

1.27 In Wind Stroke the Qi Should Be Regulated 中風宜調氣

1.27.1
Source원문

治風良劑, 小續命湯爲上, 排風湯次之. 然二藥主風不主氣, 須以人參順氣散ㆍ烏藥順氣散佐助其間. 氣一流行, 則風亦踈散矣. 《直指》

Translation영역
Of the good prescriptions for treating wind, Soseungmyeong-tang is the first and Baepung-tang the next. But these two medicines govern the wind and do not govern the qi, and Insam-sungi-san and Oyaksungi-san must be used alongside to assist them. Once the qi is flowing, the wind too is dispersed.

Injae Jijibang 直指

1.27.2
Source원문

調氣宜用蘇合香元《方見氣門》ㆍ八味順氣散ㆍ勻氣散.

Translation영역
For regulating the qi, Sohaphyang-won, Palmi-sungi-san or Ungi-san should be used.
Clinical note임상 주석
The third doctrinal position of the chapter, after external wind and internal phlegm, and the Jijibang states it as a correction rather than a rival: the two great wind formulas govern the wind and do not govern the qi, so pair them with a qi formula. Once the qi is flowing, the wind too is dispersed. In practice that meant a mild lindera- or ginseng-based powder given alongside the harsh wind decoctions, which would have made the whole regimen more tolerable — and the formulas of this section, Ungi-san in particular, are among the few in the chapter still prescribed as written.

Donguibogam · Pung

1.28 Wind Is Not Removed Without a Great Sweat 風非大汗則不除

1.28.1
Source원문

風從汗散, 故治風多用發汗之藥也.

Translation영역
Wind disperses with the sweat, and so in treating wind the medicines that break out sweat are much used.

Donguibogam · Pung

1.28.2
Source원문

續命ㆍ排風ㆍ越婢等悉能治風, 而千金多用麻黃, 蓋以風邪不得汗則不能治也. 若自汗更用麻黃, 則反爲大害; 此時續命煮散復榮衛ㆍ却風邪, 不可缺也. 《丹心》

Translation영역
Seungmyeong-tang, Baepung-tang, Wolbi-tang and the rest can all treat wind, and the Qianjin much uses ephedra, because a wind evil that cannot be sweated cannot be treated. But if there is spontaneous sweating and ephedra is used besides, it becomes a great harm instead; at such a time Seungmyeongja-san, which restores the construction and defence and drives off the wind evil, cannot be dispensed with.

Danggye Simbeop 丹心

1.28.3
Source원문

治中風無密室不可療. 平人居室不密, 尙中風邪, 況服藥發汗之人乎. 《千金》

Translation영역
Wind stroke cannot be treated without a tightly closed room. If an ordinary man lives in a room that is not tight he may still be struck by a wind evil — how much more one who is taking medicine to break out sweat.

Cheongeumbang 千金

1.28.4
Source원문

治風發汗, 宜用換骨丹ㆍ去風丹.

Translation영역
For treating wind by breaking out sweat, Hwangol-dan or Geopung-dan should be used.
Clinical note임상 주석
The doctrine and its own refutation, in that order. Wind is not removed without a great sweat — hence the ephedra in every formula of the Prolong Life family — and then Danggye's qualification: if the patient is already sweating spontaneously, ephedra becomes a great harm, and Seungmyeongja-san is what to give instead. The Qianjin's practical point, that a patient being sweated must be in a tightly closed room, is the kind of detail that shows the method was actually carried out. Sweating an acute stroke patient is wrong by modern lights, and the chapter's own 白朮防風湯 entry exists to treat the cases where it was overdone.

Donguibogam · Pung

1.29 In Wind Disease a Relapse Must Be Guarded Against 風病須防再發

1.29.1
Source원문

風病雖愈, 必再發; 再發則必重, 常須服藥以防之. 《類聚》

Translation영역
Though a wind disease is cured, it will certainly recur; and when it recurs it will certainly be severe, so medicine must constantly be taken to prevent it.

Uibang Yuchwi 類聚

1.29.2
Source원문

小續命湯, 風人宜常服以防瘖瘂. 《方見上ㆍ丹心》

Translation영역
Soseungmyeong-tang should be taken constantly by one who has had wind, to prevent mutism.

Danggye Simbeop 丹心

1.29.3
Source원문

愈風湯, 如覺風動便服此, 不致倒仆. 《易老》

Translation영역
Yupung-tang: as soon as the wind is felt to stir, take this at once and he will not come to falling down.

Yiro 易老

1.29.4
Source원문

宜服定風餠子. ○最忌房室, 如道釋修養可也. 《資生》

Translation영역
Jeongpung-byeongja should be taken. Sexual intercourse is most to be avoided; to cultivate oneself as the Daoists and Buddhists do is well.
Clinical note임상 주석
Secondary prevention, and the clinical observation behind it is exactly right: a wind disease recurs, and when it recurs it is worse. Recurrent stroke is both common and more disabling, and a chapter that says so plainly and then prescribes continuous medication to prevent it is reasoning the way a modern stroke service does. What was given — a sweating, aconite-containing decoction taken indefinitely — is the wrong medicine for the right purpose. The instruction to take Yupung-tang the moment the wind is felt to stir belongs with section 1.1 and makes the same point about acting on warning signs.

Jasaeng Gyeonghyobang 資生

1.30 A Minor Stroke Need Not Be Treated Deeply 小中不須深治

1.30.1
Source원문

中風須大作湯劑方有成效. 若風歸手足, 名曰小中, 不宜用正風藥深治, 但用平和湯劑. 雖未能爲全人, 亦可留連歲月. 戒之, 戒之. 《得效》

Translation영역
In wind stroke a decoction must be made up in great quantity for there to be any effect. But if the wind has gone to the hands and feet, it is called a minor stroke, and the proper wind medicines should not be used to treat it deeply; only mild and harmonious decoctions should be used. Though he cannot be made a whole man, he may yet linger on through years and months. Be warned, be warned.
Clinical note임상 주석
Twice-repeated warning at the end, and it is the most humane paragraph in the chapter. A stroke whose damage has settled into the limbs is not to be treated with the harsh wind medicines; give mild decoctions instead. He will not be made a whole man, but he may live on for years. That is a statement about the limits of treatment and about not harming a stable patient in pursuit of a cure, and in a chapter so full of aconite and cinnabar it reads as hard-won. Be warned, be warned — the compiler is addressing physicians, not patients.

Uibang Yuchwi 得效

1.31 Wind Stroke Patients Who Can Eat 中風能食

1.31.1
Source원문

中風人多能食. 蓋甲己化土ㆍ脾盛故能多食. 此脾氣愈盛ㆍ下克腎水, 腎水虧則病增劇. 宜廣服藥ㆍ不欲多食, 病能自愈.

Translation영역
Wind stroke patients are often able to eat. For jia and ji transform into earth and the spleen is exuberant, and so they can eat much. This makes the spleen qi still more exuberant, so that it restrains kidney water below; and when kidney water is depleted the disease grows more severe. Medicine should be taken broadly and much eating not desired, and the disease can cure itself.

Donguibogam · Pung

1.31.2
Source원문

中風多食者, 風木盛也; 木盛則克脾, 脾受敵ㆍ求助于食. 經曰, 實則夢與, 虛則夢取. 當瀉肝木ㆍ治風安脾; 脾安則食少, 是其養矣. 《寶鑑》

Translation영역
A wind stroke patient who eats much — it is wind wood that is exuberant; and when wood is exuberant it restrains the spleen, and the spleen, under attack, seeks help from food. The classic says: in repletion one dreams of giving, in vacuity one dreams of taking. The liver wood should be drained and the wind treated so as to quiet the spleen; when the spleen is quiet the eating lessens, and that is its nourishment.
Clinical note임상 주석
A small oddity given its own section, which argues that somebody found it worth recording: stroke patients often eat a great deal. Whether this is the post-stroke hyperphagia now described in some frontal and hypothalamic lesions, or simply a patient with nothing else to do, the observation is unusual and specific. Both explanations offered run through the spleen — exuberant in the first, under attack in the second — and they contradict each other, which the Bogam leaves standing. The practical advice in both is the same: do not let him eat much.

Dongwon Boggam 寶鑑

1.32 The Pattern of Injury by Wind 傷風證

1.32.1
Source원문

傷風則涕流ㆍ鼻塞ㆍ聲重. 《入門》

Translation영역
Where wind has done injury there is a running nose, blocked nostrils and a heavy voice.

Uihak Immun 入門

1.32.2
Source원문

傷風證屬肺者多, 宜辛溫或辛凉之劑散之. 戴氏云, 新咳嗽ㆍ鼻塞ㆍ聲重是也. 宜參蘇飮ㆍ衝和散ㆍ防風衝和湯《方幷見寒門》.

Translation영역
The pattern of injury by wind mostly belongs to the lung, and acrid warm or acrid cool prescriptions should be used to disperse it. Dai says: it is a new cough with blocked nostrils and a heavy voice. Samso-eum, Chunghwa-san or Bangpung-chunghwa-tang are appropriate.

Uihak Immun 入門

1.32.3
Source원문

有汗而惡風, 此眞感風證也. 《入門》

Translation영역
Where there is sweating with aversion to wind, this is the true pattern of being affected by wind.
Clinical note임상 주석
The common cold, inserted into the middle of a stroke chapter because both were called wind. Running nose, blocked nostrils, a heavy voice and a new cough: that is the whole clinical picture, and it is correct. Its presence here is the clearest single illustration of the chapter's organizing problem — one word covering an upper respiratory infection and a cerebral haemorrhage — and the Bogam deals with it in three lines and moves on.

Uihak Immun 入門

1.33 The Names of the Various Wind Diseases 諸風病名

1.33.1
Source원문

頭風, 多饒白屑. ○毒風, 面上生瘡. ○刺風, 狀如鍼刺ㆍ腰痛如錐. ○癎風, 急倒作聲ㆍ發搐急緩. ○頑風, 不識痛痒. ○癧風, 頸項斑剝. ○暗風, 頭旋眼黑ㆍ不辨東西. ○㾴風, 面生朱點. ○肝風, 鼻悶ㆍ眼瞤ㆍ兩瞼赤爛. ○偏風, 口眼喎斜. ○節風, 肢節續斷ㆍ指甲脫落. ○脾風, 心多嘔逆. ○酒風, 行步不前. ○肺風, 鼻塞ㆍ項疼. ○膽風, 令人不睡. ○氣風, 肉如虫行. ○腎風, 耳內蟬鳴ㆍ陰間濕痒ㆍ寒濕脚氣. ○癱風, 半身不遂. ○瘓風, 手足拳攣. ○胃風, 不伏水土. ○虛風, 風寒濕痒. ○腸風, 脫肛瀉血. ○腦風, 頭旋偏痛. ○賊風, 發聲不響. ○産風, 四肢疼痛. ○骨風, 膝腫如槌. ○膝風, 腿寒骨痛. ○心風, 健忘多驚. ○盛風, 言語蹇澁. ○髓風, 臂膊痠疼. ○藏風, 夜多盜汗. ○血風, 陰囊濕痒. ○烏風, 頭面腫塊. ○皮風, 赤白癜癬. ○肌風, 遍身瘙痒. ○體風, 身生腫毒. ○閉風, 大便燥澁. ○軟風, 四肢不擧. ○綠風, 瞳人開大. ○靑風, 吐極靑盲. ○虎風, 發吼羊呌. ○大風, 成片爛瘡. 《醫說》

Translation영역
Head wind: much white scurf. Toxin wind: sores arising on the face. Stabbing wind: like being pricked with needles, with lower back pain as if by an awl. Epileptic wind: falling suddenly with a cry, with convulsions now urgent and now slack. Obstinate wind: not knowing pain or itch. Scrofulous wind: mottling and peeling on the neck and nape. Hidden wind: the head whirling and the eyes black, unable to tell east from west. Blotch wind: vermilion spots arising on the face. Liver wind: the nose stuffed, the eyes twitching, both lids red and raw. Hemilateral wind: the mouth and eye deviated. Joint wind: the limb joints severed one after another and the nails falling off. Spleen wind: the heart often retching and bringing up. Wine wind: unable to step forward in walking. Lung wind: the nostrils blocked and the nape painful. Gallbladder wind: making a man unable to sleep. Qi wind: the flesh as if insects were crawling in it. Kidney wind: cicadas chirping within the ear, damp itching about the genitals, cold damp leg qi. Palsy wind: half the body paralysed. Paralysis wind: the hands and feet clenched and cramped. Stomach wind: not tolerating the water and soil. Vacuity wind: wind, cold, damp and itching. Intestinal wind: prolapse of the rectum and blood in the stool. Brain wind: the head whirling with one-sided pain. Robber wind: the voice coming out without resonance. Birth wind: pain in the four limbs. Bone wind: the knee swollen like a mallet. Knee wind: the thigh cold and the bones painful. Heart wind: forgetfulness and much fright. Exuberant wind: speech halting and rough. Marrow wind: the upper arm aching and sore. Visceral wind: much night sweating. Blood wind: damp itching of the scrotum. Crow wind: swollen lumps on the head and face. Skin wind: red and white vitiligo and ringworm. Flesh wind: itching over the whole body. Body wind: swollen toxin arising on the body. Shut wind: the stool dry and rough. Soft wind: the four limbs not lifted. Green wind: the pupils opened wide. Blue wind: blue blindness at the height of vomiting. Tiger wind: roaring and bleating like a goat. Great wind: ulcerating sores in sheets.
Clinical note임상 주석
Forty-two diseases with wind in the name, each defined in four characters, and the list is the chapter's own demonstration of how much the word had come to cover. Half of them are not neurological at all: prolapse with rectal bleeding, vitiligo, ringworm, a stuffed nose, blepharitis, night sweats, scrotal itch, constipation. Several are recognizable from the definition alone — green wind with widely opened pupils is acute glaucoma, great wind with ulcerating sores in sheets is leprosy, tiger wind roaring and bleating is a seizure cry, epileptic wind is a generalized convulsion with a cry and a fall. Reading the list straight through is the quickest way to understand why the chapter needed its long argument about what wind is: the category had stopped meaning anything.

Uiseol 醫說

1.34 The Method of Treating Wind Disease 風病治法

1.34.1
Source원문

靈樞曰, 眞氣者, 所受於天ㆍ與穀氣幷而充身者也; 邪氣者, 虛風之賊傷人也. 虛邪之中人, 洒淅動形ㆍ起毫毛而發腠理.

Translation영역
The Lingshu says: the true qi is what is received from heaven and, together with the grain qi, fills the body; the evil qi is the robbery of a vacuity wind injuring a man. When a vacuity evil strikes a man, it chills and shakes the form, raises the fine hairs and opens the interstices.

Yeongchu 靈樞

1.34.2
Source원문

邪之中人, 或中於陰ㆍ或中於陽, 上下左右無有恒常. 人方虛時及新用力, 若飮食汗出ㆍ腠理開而中於邪: 中於面則下陽明, 中於項則下太陽, 中於頰則下少陽; 其中於膺ㆍ背ㆍ兩脇, 亦中其經. 《醫說》

Translation영역
When an evil strikes a man it may strike the yin or the yang, and above or below, left or right, there is no constancy in it. When a man is just then vacuous, or has newly exerted himself, or if after eating and drinking the sweat comes out and the interstices open, he is struck by an evil: struck on the face it descends by the yangming, struck on the nape it descends by the taiyang, struck on the cheek it descends by the shaoyang; and struck on the chest, the back or the two flanks, it likewise strikes those channels.

Uiseol 醫說

1.34.3
Source원문

風有中藏ㆍ中府之分: 中府者宜汗之, 中藏者宜下之. 汗亦不可過多也. 表裏不和則須汗下之; 表裏已和, 是宜治之在經也. 《易老》

Translation영역
Wind is divided into striking the viscera and striking the bowels: in striking the bowels, sweating is appropriate; in striking the viscera, purging. Nor may the sweating be excessive. Where exterior and interior are not harmonized, sweating and purging are needed; where exterior and interior are already harmonized, it is right to treat it in the channels.

Yiro 易老

1.34.4
Source원문

風者百病之始也, 善行而數變. 行者動也; 治須少汗, 亦宜少下. 汗下得宜, 然後可治. 《易老》

Translation영역
Wind is the beginning of the hundred diseases; it travels readily and changes often. Travelling is movement; in treating it there must be a little sweating and also a little purging. Only when the sweating and purging are rightly judged can it be treated.

Yiro 易老

1.34.5
Source원문

大率治風, 主氣血虛ㆍ有痰. 氣虛者, 獨參湯《方見氣門》加竹瀝ㆍ薑汁; 血虛者, 四物湯《方見血門》地黃薑汁浸炒, 加竹瀝ㆍ薑汁. 肥人多濕, 少加附子ㆍ烏頭行經. 《丹心》

Translation영역
In treating wind generally, the governing causes are vacuity of qi and blood with phlegm present. For qi vacuity, Doksam-tang with bamboo sap and ginger juice added; for blood vacuity, Samul-tang with the rehmannia steeped in ginger juice and fried, plus bamboo sap and ginger juice. In the stout there is much damp, and a little aconite or aconite root may be added to travel the channels.

Danggye Simbeop 丹心

1.34.6
Source원문

凡人春服小續命湯 五劑, 夏服腎瀝湯 三劑, 秋服黃芪元《方見局方》 一兩劑, 冬服藥酒 兩三劑. 此法終身常爾, 則風病不生矣. 《得效》

Translation영역
In spring a man should take five courses of Soseungmyeong-tang, in summer three courses of Sinryeok-tang, in autumn one or two courses of Hwanggi-won, and in winter two or three courses of medicinal wine. If this method is followed constantly through life, wind disease will not arise.
Clinical note임상 주석
The chapter's general treatment doctrine, and its best line is Zhang Yuansu's warning about measure: a little sweating and also a little purging, and only when the sweating and purging are rightly judged can it be treated. That is the whole of the chapter's pharmacological skill — not which exit to open but how far. Danggye's reduction of everything to qi vacuity, blood vacuity and phlegm is the Jin-Yuan simplification at its plainest, and the two formulas he gives for it are ginseng alone and the four substances. The Deughyobang's seasonal regimen at the end — five courses in spring, three in summer, one or two in autumn, medicinal wine in winter, for life — is prophylaxis as a way of living, and it is the kind of advice a physician gives a wealthy patient.

Uibang Yuchwi 得效

1.35 Formulas That Treat All Winds Alike 諸風通治

1.35.1
Source원문

宜用通氣驅風湯ㆍ秘傳順氣散ㆍ烏藥順氣散ㆍ木香保命丹ㆍ禦風丹ㆍ烏龍丹ㆍ一粒金丹ㆍ換骨丹ㆍ鐵彈元ㆍ辟巽錠子.

Translation영역
Tonggi-gupung-tang, Bijeon-sungi-san, Oyaksungi-san, Mokhyang-bomyeong-dan, Eopung-dan, Oryong-dan, Illyeokgeum-dan, Hwangol-dan, Cheoltan-won or Byeokson-jeongja should be used.
Clinical note임상 주석
A section that is nothing but a list, which is how the Bogam marks a catch-all category. Ten formulas for all winds alike, and the group is unusually consistent: two mild qi-moving powders at the head and then eight aconite-and-cinnabar pills, most of them imperial or dispensary preparations. A physician who could not place his patient in any of the chapter's thirty-four preceding categories reached in here, and what he reached for was usually a pill from a shelf rather than a decoction made up for the case.

Donguibogam · Pung

1.36 How Wind Impediment Begins 風痺之始

1.36.1
Source원문

內經曰, 汗出而風吹之, 血凝於膚者則爲痺.

Translation영역
The Neijing says: when the sweat has come out and a wind blows upon it, the blood congeals in the skin and there is impediment.

Naegyeong 內經

1.36.2
Source원문

風之爲病, 當半身不遂; 或但臂不遂者, 此爲痺. 《內經》

Translation영역
Wind as a disease should paralyse half the body; where only the arm is paralysed, this is impediment.

Naegyeong 內經

1.36.3
Source원문

邪之所湊, 其氣必虛; 留而不去, 其病則實. 《內經》 ○虛邪中人, 留而不去則爲痺; 衛氣不行則爲不仁. 《內經》

Translation영역
Where an evil gathers, the qi there is necessarily vacuous; and when it lodges and does not depart, the disease becomes replete. When a vacuity evil strikes a man and lodges without departing, there is impediment; and when the defence qi does not move, there is insensibility.

Naegyeong 內經

1.36.4
Source원문

不仁者, 何以明之? 仁者, 柔也; 不仁, 謂不柔和也. 痛痒不知ㆍ寒熱不知ㆍ灸刺不知, 是謂不仁也. 《類聚》

Translation영역
Insensibility — how is it to be made clear? Ren means supple; insensible means not supple and harmonious. Not knowing pain or itch, not knowing cold or heat, not knowing moxa or needle — this is what is meant by insensibility.
Clinical note임상 주석
The impediments begin here, and the distinction drawn in the second passage is the one that justifies their being a separate disease: wind should paralyse half the body, so if only the arm is affected it is not wind but impediment. That is a correct separation of a central lesion from a peripheral one by the extent of the deficit. The definition of insensibility in the last passage is the best in the chapter and is a clinical test: not knowing pain or itch, not knowing cold or heat, not knowing moxa or needle. Three modalities checked in order, which is how sensory loss is still mapped.

Uibang Yuchwi 類聚

1.37 The Three Impediments 三痺

1.37.1
Source원문

內經曰, 黃帝曰, 痺之安生? 歧伯對曰, 風ㆍ寒ㆍ濕三氣雜至, 合而爲痺也. 其風氣勝者爲行痺, 寒氣勝者爲痛痺, 濕氣勝者爲着痺.

Translation영역
The Neijing: the Yellow Emperor said, how does impediment arise? Qibo answered: the three qi of wind, cold and damp arrive mingled together and, combining, make impediment. Where the wind qi prevails there is moving impediment; where the cold qi prevails, painful impediment; where the damp qi prevails, fixed impediment.

Naegyeong 內經

1.37.2
Source원문

行痺宜防風湯, 痛痺宜茯苓湯, 着痺宜川芎茯苓湯ㆍ三痺湯.

Translation영역
For moving impediment, Bangpung-tang; for painful impediment, Bokryeong-tang; for fixed impediment, Cheongung-bokryeong-tang or Sambi-tang.
Clinical note임상 주석
The most durable classification in Chinese medicine, and it is still taught in exactly these words: wind, cold and damp arrive together, and whichever prevails names the impediment. Wandering pain, fixed severe pain, heavy numb swelling — those are three real and distinguishable presentations of joint and nerve disease, and sorting an arthritis by which of them it resembles remains clinically useful whatever one thinks of the aetiology. The three formulas assigned are correspondingly differentiated, two of them near-identical with the warming drug swapped.

Donguibogam · Pung

1.38 The Five Impediments 五痺

1.38.1
Source원문

帝曰, 其有五者何也? 歧伯曰, 以冬遇此者爲骨痺, 以春遇此者爲筋痺, 以夏遇此者爲脉痺, 以至陰遇此者爲肌痺, 以秋遇此者爲皮痺. 《內經》

Translation영역
The Emperor said: and what of its having five kinds? Qibo said: he who meets with it in winter has bone impediment; in spring, sinew impediment; in summer, vessel impediment; in the extreme yin season, flesh impediment; in autumn, skin impediment.

Naegyeong 內經

1.38.2
Source원문

帝曰, 內舍五藏六府, 何氣使然? 歧伯曰, 五藏皆有合, 病久而不去者, 內舍於其合也. 故骨痺不已ㆍ復感於邪, 內舍於腎; 筋痺不已ㆍ復感於邪, 內舍於肝; 脉痺不已ㆍ復感於邪, 內舍於心; 肌痺不已ㆍ復感於邪, 內舍於脾; 皮痺不已ㆍ復感於邪, 內舍於肺. 所謂痺者, 各以其時重感於風寒濕之氣也. 《內經》

Translation영역
The Emperor said: it lodges within in the five viscera and six bowels — what qi makes it so? Qibo said: the five viscera all have their couplings, and where the disease is long-standing and does not depart it lodges within in its coupling. Thus bone impediment unresolved, and affected by an evil again, lodges within in the kidney; sinew impediment unresolved, and affected again, lodges within in the liver; vessel impediment, in the heart; flesh impediment, in the spleen; skin impediment, in the lung. What is called impediment is in each case a repeated affection by the qi of wind, cold and damp in its own season.

Naegyeong 內經

1.38.3
Source원문

帝曰, 其客於六府者何也? 歧伯曰, 此亦其飮食居處爲其病本也. 六府亦各有兪《兪卽穴也》, 而食飮應之, 循兪而入ㆍ各舍其府也. 《內經》

Translation영역
The Emperor said: and what of its lodging as a guest in the six bowels? Qibo said: in this too it is the patient's food and drink and dwelling that are the root of the disease. The six bowels also each have their shu points — shu meaning acupoints — and food and drink answer to them, so that it follows the shu points inward and lodges each in its own bowel.

Naegyeong 內經

1.38.4
Source원문

淫氣喘息, 痺聚在肺; 淫氣憂思, 痺聚在心; 淫氣遺尿, 痺聚在腎; 淫氣乏竭, 痺聚在肝; 淫氣肌絶, 痺聚在脾. 諸痺不已, 亦益內也. 註曰, 淫氣謂氣之妄行者也; 從外不去則益深而至於身內. 《內經》

Translation영역
Where the excessive qi gives panting breath, the impediment gathers in the lung; where it gives sorrow and brooding, in the heart; where it gives incontinence of urine, in the kidney; where it gives exhaustion and depletion, in the liver; where it gives wasting of the flesh, in the spleen. Where the impediments are unresolved, they also go deeper within. The commentary: excessive qi means qi moving recklessly; if it does not depart from without it goes ever deeper and reaches the inside of the body.

Naegyeong 內經

1.38.5
Source원문

宜用五痺湯ㆍ增味五痺湯ㆍ行濕流氣散.

Translation영역
Obi-tang, Jeungmi-obi-tang or Haengseup-ryugi-san should be used.
Clinical note임상 주석
The second classification of the impediments, this one by tissue rather than by weather: bone, sinew, vessel, flesh, skin. Stripped of the seasonal correspondences it is a statement about depth — a complaint in the skin, in the muscle, in the vessels, in the tendons, in the bone — and that is a useful way to examine a limb. The Neijing then adds what is in effect a staging: an impediment left unresolved and affected again lodges in the viscus coupled to its tissue, and the signs of each are given. Panting for the lung, brooding for the heart, incontinence for the kidney, wasting for the spleen — these are the systemic features of a chronic inflammatory disease, and the recognition that joint disease left long enough stops being local is the passage's real content.

Donguibogam · Pung

1.39 The Impediment Pulse 痺脉

1.39.1
Source원문

脉澁而緊, 爲痺痛. 《脉經》 ○脉大而澁, 爲痺; 脉來急, 亦爲痺. 《玉機》 ○風寒濕氣合而爲痺, 浮ㆍ澁而緊, 三脉乃備. 《脉訣》

Translation영역
A pulse rough and tight means impediment pain. A pulse large and rough means impediment; a pulse coming urgently also means impediment. Wind, cold and damp qi combine to make impediment, and floating, rough and tight — the three pulses are then complete.
Clinical note임상 주석
Three pulses for three causes, matched one to one: floating for the wind, rough for the damp, tight for the cold. When all three are present the diagnosis of a combined impediment is complete, which makes this the chapter's neatest piece of pulse reasoning — each quality assigned to one agent, and the combination read by addition.

Maekgyeong 脉經 · Okgi 玉機 · Maekgyeol 脉訣

1.40 The Forms and Signs of Impediment Disease 痺病形證

1.40.1
Source원문

內經曰, 帝曰, 痺或痛ㆍ或不痛ㆍ或不仁ㆍ或寒ㆍ或熱ㆍ或燥ㆍ或濕, 其故何也? 歧伯曰, 痛者寒氣多也, 有寒故痛也. 其不痛不仁者, 病久入深ㆍ榮衛之行澁ㆍ經絡時踈, 故不痛; 皮膚不營, 故爲不仁. 其寒者, 陽氣少ㆍ陰氣多ㆍ與病相益, 故寒也. 其熱者, 陽氣多ㆍ陰氣少ㆍ病氣勝ㆍ陽乗陰, 故爲痺熱. 其多汗而濡者, 此其逢濕甚也; 陽氣少ㆍ陰氣盛ㆍ兩氣相感, 故汗出而濡也.

Translation영역
The Neijing: the Emperor said, impediment is sometimes painful, sometimes not painful, sometimes insensible, sometimes cold, sometimes hot, sometimes dry, sometimes damp — what is the reason? Qibo said: where it is painful the cold qi is abundant, and because there is cold there is pain. Where it is not painful but insensible, the disease is long-standing and has entered deep, the movement of construction and defence is rough and the channels and network vessels are at times sparse, and so there is no pain; and the skin is not constructed, and so there is insensibility. Where it is cold, the yang qi is scant and the yin qi abundant and they add to the disease, and so there is cold. Where it is hot, the yang qi is abundant and the yin scant, the disease qi prevails and yang rides upon yin, and so there is impediment heat. Where there is much sweating and dampness, this is its meeting with severe damp; the yang qi is scant and the yin abundant and the two qi affect each other, and so sweat comes out and there is dampness.

Naegyeong 內經

1.40.2
Source원문

病在筋, 筋攣ㆍ節痛ㆍ不可以行, 名曰筋痺; 病在肌膚, 肌膚盡痛, 名曰肌痺; 病在骨, 骨重不可擧ㆍ骨髓痠疼ㆍ寒氣至, 名曰骨痺. 《內經》

Translation영역
Where the disease is in the sinews, with the sinews cramping, the joints painful and walking impossible, it is called sinew impediment; where it is in the flesh and skin, with the flesh and skin wholly painful, it is called flesh impediment; where it is in the bone, with the bone heavy and unable to be lifted, the marrow aching and sore and a cold qi arriving, it is called bone impediment.

Naegyeong 內經

1.40.3
Source원문

帝曰, 痺之爲病不痛何也? 歧伯曰, 痺在骨則重, 在於脉則血凝而不流, 在於筋則屈而不伸, 在於肉則不仁, 在皮則寒. 故具此五者則不痛也. 凡痺之類, 逢寒則急, 逢熱則縱. 《內經》

Translation영역
The Emperor said: how is it that impediment as a disease is sometimes without pain? Qibo said: impediment in the bone gives heaviness; in the vessels the blood congeals and does not flow; in the sinews there is flexion without extension; in the flesh there is insensibility; in the skin there is cold. So where these five are present there is no pain. In every kind of impediment, meeting with cold it tightens and meeting with heat it loosens.
Clinical note임상 주석
The best clinical passage in the impediment sections and one of the best in the chapter. Why is some impediment painful and some not? Because where the disease is long-standing and has gone deep the nerve supply fails, and what is left is numbness rather than pain. That is the natural history of a progressive neuropathy stated correctly, and the five tissue-specific signs that follow — heaviness in bone, congealed blood in the vessels, flexion without extension in the sinews, insensibility in the flesh, cold in the skin — are a usable examination. The closing line is the single most practical sentence in the section: meeting with cold it tightens, meeting with heat it loosens. Every patient with chronic joint or nerve pain knows it, and it is the reason the chapter's treatments are warm.

Naegyeong 內經

1.41 The Good and Bad Outcomes of Impediment Disease 痺病吉凶

1.41.1
Source원문

內經曰, 帝曰, 痺其時有死者ㆍ或疼久者ㆍ或易已者, 其故何也? 歧伯曰, 其入藏者死, 其留筋骨間者疼久, 其留皮膚間者易已.

Translation영역
The Neijing: the Emperor said, in impediment there are those who die at the time, and those whose pain is long, and those who are easily cured — what is the reason? Qibo said: where it enters the viscera they die; where it stays between the sinews and bones the pain is long; where it stays between the skin they are easily cured.
Clinical note임상 주석
Prognosis by depth, in one sentence: skin, easily cured; sinew and bone, long pain; viscera, death. It is the same logic as the five-impediment staging two sections earlier, and read against modern rheumatology it is not wrong — a cutaneous or soft-tissue complaint resolves, an erosive arthritis does not, and systemic involvement of the organs is what kills in the connective-tissue diseases.

Naegyeong 內經

1.42 Impediment Disease Is Often Accompanied by Numbness and Deadness 痺病多兼麻木

1.42.1
Source원문

麻是氣虛, 木是濕痰死血. 蓋麻猶痺也, 雖不知痛痒, 尙覺氣微流行; 在手多兼風濕, 在足多兼寒濕. 木則非惟不知痛痒, 氣亦不覺流行. 《入門》

Translation영역
Ma is qi vacuity; mok is damp phlegm and dead blood. For ma is like impediment: although pain and itch are not known, the qi is still felt to flow a little; in the hand it is mostly combined with wind damp, in the foot mostly with cold damp. In mok, not only are pain and itch not known, but the qi too is not felt to flow.
Clinical note임상 주석
Two grades of sensory loss separated by a single criterion, and the criterion is the patient's own report: in ma the limb is numb but something is still felt moving in it, in mok nothing is felt at all. That is the distinction between paraesthesia and anaesthesia, and it is the right one to draw — the first is irritative and often reversible, the second is loss of function. The Immun also notes the pattern by site, wind damp in the hand and cold damp in the foot, which is an observation about distal lower-limb involvement that a diabetic neuropathy would bear out.

Uihak Immun 入門

1.43 Wind Impediment and Wilting Resemble Each Other 風痺與痿相類

1.43.1
Source원문

靈樞曰, 病在陽者命曰風, 病在陰者命曰痺, 陰陽俱病命曰風痺. 陽者表與上也, 陰者裏與下也.

Translation영역
The Lingshu says: where the disease is in the yang it is called wind; where it is in the yin it is called impediment; where both yin and yang are diseased it is called wind impediment. Yang is the exterior and the upper part, yin the interior and the lower.

Yeongchu 靈樞

1.43.2
Source원문

痺者, 氣閉塞不通流也. 或痛ㆍ痒ㆍ或麻痺ㆍ或手足緩弱, 與痿相類. 但痿因血虛ㆍ火盛ㆍ肺焦而成, 痺因風寒濕氣侵入而成. 又痺爲中風之一, 但純乎中風則陽受之; 痺兼風寒濕三氣則陰受之, 所以爲病更重. 《入門》

Translation영역
Impediment is the qi shut and blocked and not flowing through. There may be pain, or itch, or numbness and impediment, or the hands and feet slack and weak, and it resembles wilting. But wilting is formed through blood vacuity, exuberant fire and a scorched lung, while impediment is formed by the invasion of wind, cold and damp qi. And impediment is one of the wind strokes; but in pure wind stroke the yang receives it, while impediment combines the three qi of wind, cold and damp and the yin receives it, which is why the disease is more severe.
Clinical note임상 주석
The differential the chapter most needed to make, since slack weak limbs can come from either disease. The Immun's criterion is aetiological rather than clinical — wilting from blood vacuity and a scorched lung, impediment from invading wind cold damp — which is less useful at the bedside than the Gangmok's criterion of onset in section 1.8.1. What it does give is the correct observation that the two look alike and have been confused, and that confusion is the complaint of the next section.

Uihak Immun 入門

1.44 Impediment Disease Is Difficult to Treat 痺病難治

1.44.1
Source원문

痺之爲證, 有筋攣不伸ㆍ肌肉不仁, 與風絶相似, 故世俗與風痿通治, 此千古之弊也. 大抵固當分其所因: 風則陽受之, 痺則陰受之, 爲病多重痛沉着, 患者難易得去. 如錢仲陽爲宋之一代名醫, 自患周痺, 止能移於手足, 爲之偏廢, 不能盡去. 可見其爲難治也. 《玉機》

Translation영역
The impediment pattern has cramping sinews that will not extend and insensible flesh, which is utterly like wind, and so the common run of practitioners treat it together with wind and wilting — this has been the error of a thousand years. On the whole its cause ought certainly to be distinguished: in wind the yang receives it, in impediment the yin, and the disease is mostly heavy, painful and deeply fixed, so that the sufferer is not easily rid of it. Thus Qian Zhongyang, the foremost physician of his age under the Song, himself suffered circuit impediment, and could only shift it into his hands and feet, leaving him crippled on one side, and was unable to get rid of it entirely. One may see from this how difficult it is to treat.
Clinical note임상 주석
The error of a thousand years, which is exactly the complaint the whole chapter's structure embodies: impediment looks like wind and so has been treated as wind, and it is not. And then the case that proves it, which is the most human passage in the chapter — Qian Yi, the greatest paediatrician of the Song and the author of the first specialist text on children's medicine, had this disease himself, and the best he could do was push it out into his limbs and live crippled. A physician recording his own failure to cure himself is worth more than any number of formula claims, and the next section follows it up.

Okgi 玉機

1.45 The Method of Treating Impediment Disease 痺病治法

1.45.1
Source원문

痺之初起, 驟用參ㆍ芪ㆍ歸ㆍ地則氣血滯而邪鬱不散, 只以行濕流氣散主之. 《入門》

Translation영역
At the first onset of an impediment, to use ginseng, astragalus, tangkuei and rehmannia precipitately makes the qi and blood stagnate so that the evil is constrained and does not disperse; Haengseup-ryugi-san alone should govern it.

Uihak Immun 入門

1.45.2
Source원문

三氣襲人經絡, 久而不已則入五藏或入六府; 隨其藏府之兪合以施鍼灸, 仍服逐三氣發散等藥, 則病自愈矣. 《玉機》

Translation영역
When the three qi assail a man's channels and network vessels and are long unresolved, they enter the five viscera or the six bowels; needling and moxibustion should be applied at the shu and he points of the affected viscus or bowel, and the medicines that expel the three qi and break them out taken as well, and the disease cures of itself.

Okgi 玉機

1.45.3
Source원문

痺證因虛而感風寒濕之邪, 旣着體不去, 則須製對證藥日夜飮之. 雖留連不愈, 能守病禁ㆍ不令入藏, 庶可扶持也. 如錢仲陽取茯苓其大逾斗者, 以法啖之, 閱月乃盡; 由此雖偏廢而氣骨堅悍如無疾者, 壽八十二而終. 惜乎其方無傳. 《玉機》

Translation영역
The impediment pattern arises through vacuity and the affection of a wind, cold and damp evil; and once it has attached to the body and will not go, a medicine answering to the pattern must be made up and drunk day and night. Though it linger unresolved, if the prohibitions of the disease can be kept and it is not let into the viscera, the patient may yet be supported. Thus Qian Zhongyang took a poria larger than a peck measure and ate it by a method of his own, finishing it over a month; and from this, though crippled on one side, his qi and bones were firm and strong as though he had no illness, and he lived to eighty-two and died. It is a pity that his prescription was not handed down.
Clinical note임상 주석
The sequel to Qian Yi's case, and the best account of chronic-disease management in the chapter. He could not cure himself, so he settled for being supported: a poria larger than a peck measure, eaten over a month by a method of his own, and though he remained crippled his strength held and he lived to eighty-two. What the section draws from it is the right conclusion — in an incurable impediment, make up a medicine that answers the pattern, take it day and night, keep the prohibitions, and above all do not let the disease into the viscera. That is management rather than cure, and the compiler's closing regret, that the prescription was not handed down, is the sigh of a man who has looked for it. The Immun's opening caution is also sound: do not supplement an acute impediment, because tonics make an active inflammation worse.

Okgi 玉機

1.46 The Names of the Impediment Patterns and the Medicines for Them 痺證病名及用藥

1.46.1
Source원문

風痺ㆍ濕痺ㆍ寒痺, 俱宜附子湯; 冷痺宜蠲痺湯; 周痺宜大豆糵散; 骨痺ㆍ筋痺ㆍ脉痺ㆍ肌痺ㆍ皮痺ㆍ行痺ㆍ痛痺ㆍ着痺, 俱宜三痺湯ㆍ五痺湯ㆍ增味五痺湯ㆍ行濕流氣散ㆍ防風湯ㆍ茯苓湯ㆍ川芎茯苓湯《七方幷見上》; 熱痺宜升麻湯; 血痺宜五物湯.

Translation영역
For wind impediment, damp impediment and cold impediment alike, Buja-tang; for cold impediment of the severe kind, Gyeonbi-tang; for circuit impediment, Daedu-eol-san; for bone, sinew, vessel, flesh, skin, moving, painful and fixed impediment alike, Sambi-tang, Obi-tang, Jeungmi-obi-tang, Haengseup-ryugi-san, Bangpung-tang, Bokryeong-tang or Cheongung-bokryeong-tang; for heat impediment, Seungma-tang; for blood impediment, Omul-tang.

Donguibogam · Pung

1.46.2
Source원문

筋痺宜用羚羊角湯. ○風寒痺宜用烏藥順氣散踈痛氣道《方見上》.

Translation영역
For sinew impediment, Yeongyanggak-tang should be used. For wind cold impediment, Oyaksungi-san should be used to disperse and open the pathways of the qi.
Clinical note임상 주석
The chapter's prescribing index for the impediments, and it shows how the two classification schemes were actually used: the three weather types and the five tissue types are collapsed together and given the same seven formulas, while the four named patterns outside those schemes — cold, circuit, heat and blood impediment — each get a specific. That is a fair reflection of practice. The first eight names shared one group of prescriptions because the distinctions between them did not change the treatment; the four that did get their own formulas are the ones with distinctive clinical pictures, which is why Omul-tang and Seungma-tang are the two most interesting entries in the impediment sections.

Donguibogam · Pung

1.47 The Causes of Joint-Running Wind 歷節風病因

1.47.1
Source원문

歷節之痛, 皆由汗出入水, 或飮酒汗出當風所致. 《仲景》

Translation영역
The pain of joint-running is in every case brought about by going into water when the sweat is out, or by drinking wine and then standing in a wind while sweating.

Jungyeong 仲景

1.47.2
Source원문

歷節風, 古方謂之痛痺, 今人謂之痛風也. 《綱目》

Translation영역
Joint-running wind: the old prescriptions call it painful impediment and people today call it painful wind.

Uihak Gangmok 綱目

1.47.3
Source원문

痛風者, 大率因血受熱已自沸騰, 其後或涉冷水ㆍ或立濕地ㆍ或坐卧當風取凉, 熱血得寒ㆍ汚濁凝澁, 所以作痛; 夜則痛甚, 行於陰也. 治宜辛溫之劑, 流散寒濕ㆍ開發腠理, 血行氣和, 其病自安. 《丹心》

Translation영역
In painful wind, generally the blood has received heat and is already of itself seething; afterwards the patient wades into cold water, or stands on damp ground, or sits and lies in a wind to take the cool, and the hot blood meets cold so that it is fouled and congealed and rough, and that is why it gives pain. At night the pain is severe, because it travels in the yin. The treatment should be acrid warm prescriptions, which disperse the cold and damp and open out the interstices; the blood moves and the qi harmonizes, and the disease settles of itself.

Danggye Simbeop 丹心

1.47.4
Source원문

古之痛痺卽今之痛風也. 諸書又謂之白虎歷節風, 以其走痛於四肢骨節ㆍ如虎咬之狀而名之也. 《正傳》

Translation영역
The painful impediment of old is the painful wind of today. The books also call it white tiger joint-running wind, naming it so because the pain runs in the bones and joints of the four limbs as though a tiger had bitten them.

Uihak Jeongjeon 正傳

1.47.5
Source원문

痛風之證, 以其循歷遍身曰歷節風, 甚如虎咬曰白虎風. 痛必夜甚, 行於陰也. 《入門》

Translation영역
The painful wind pattern: because it passes over the whole body it is called joint-running wind, and because at its height it is like a tiger's bite it is called white tiger wind. The pain is always worse at night, because it travels in the yin.

Uihak Immun 入門

1.47.6
Source원문

白虎歷節亦是風寒濕三氣乗之, 或飮酒當風ㆍ汗出入水亦成斯疾. 久而不已, 令人骨節蹉跌. 《醫鑑》

Translation영역
White tiger joint-running is likewise the three qi of wind, cold and damp riding upon a man; and drinking wine in a wind, or going into water when the sweat is out, also forms this disease. Left long unresolved, it makes a man's bones and joints give way and slip.
Clinical note임상 주석
The disease is gout and the chapter nearly says so. Wine is named as a cause in three of the six passages; the pain is always worse at night, which is the single most characteristic feature of an acute gouty attack; it bites like a tiger; and left long unresolved it makes the bones and joints give way, which is the destruction of a chronic tophaceous arthropathy. Against that, the hot blood meeting cold water and congealing is a guess — though a patient who has had a first attack after a night's drinking and a cold bed will not find it a foolish one. 痛風 is still the Korean and Japanese word for gout, and it was coined here.

Uihak Jeonggam 醫鑑

1.48 The Signs of Joint-Running Wind 歷節風證狀

1.48.1
Source원문

歷節風之狀, 短氣ㆍ自汗ㆍ頭眩ㆍ欲吐ㆍ手指攣曲ㆍ身體瘣㿔, 其腫如脫ㆍ漸至摧落, 其痛如掣ㆍ不能屈伸. 蓋由飮酒當風ㆍ汗出入水, 或體虛膚空ㆍ掩護不謹, 以致風寒濕之邪遍歷關節ㆍ與血氣搏而有斯疾也. 其痛如掣者爲寒多, 其腫如脫者爲濕多, 肢節間黃汗出者爲風多. 遍身走注ㆍ徹骨疼痛ㆍ晝靜夜劇ㆍ狀如虎咬者, 謂之白虎歷節. 久不治, 令人骨節蹉跌, 須當大作湯丸, 不可拘以尋常淺近之劑. 《得效》

Translation영역
The form of joint-running wind: shortness of breath, spontaneous sweating, a whirling head, the urge to vomit, the fingers cramped and bent, the body lumpy and swollen, the swelling as though the part would come away and gradually collapsing, the pain as though the part were being pulled, and unable to bend or stretch. It arises from drinking wine in a wind and going into water when the sweat is out, or from a vacuous body with empty skin not carefully covered and guarded, so that the evil of wind, cold and damp passes over all the joints and contends with the blood and qi, and this disease results. Where the pain is as of pulling, cold is abundant; where the swelling is as though the part would come away, damp is abundant; where yellow sweat comes out between the limb joints, wind is abundant. Where it runs and pours over the whole body with pain piercing to the bone, quiet by day and severe at night, in the manner of a tiger's bite, it is called white tiger joint-running. Left untreated for long it makes a man's bones and joints give way and slip, and decoctions and pills must be made up in quantity; one must not be bound to the shallow ordinary prescriptions.
Clinical note임상 주석
A single long passage and one of the finest clinical descriptions in the book. The fingers cramped and bent, the body lumpy and swollen, a swelling so tense it seems the part will come away, the joints gradually collapsing, pain piercing to the bone, worse at night — that is chronic tophaceous gout or a destructive inflammatory arthritis, observed over years. Even the three-way differential works: pulling pain for cold, tense swelling for damp, yellow sweat between the joints for wind. And the closing instruction is the right one for a destructive disease: make the medicines up in quantity and do not be bound to the shallow ordinary prescriptions.

Uibang Yuchwi 得效

1.49 The Method of Treating Joint-Running Wind 歷節風治法

1.49.1
Source원문

痛風多屬血虛, 血虛然後寒熱得以侵之. 多用芎ㆍ歸, 佐以桃仁ㆍ紅花ㆍ薄桂ㆍ威靈仙, 或用趂痛散. 《東垣》

Translation영역
Painful wind mostly belongs to blood vacuity; the blood is vacuous and only then can cold and heat invade it. Chuanxiong and tangkuei are much used, assisted by peach kernel, safflower, thin cassia and clematis; or Jintong-san is used.

Dongwon 東垣

1.49.2
Source원문

丹溪治痛風法, 主血熱ㆍ血虛ㆍ血汚, 或挾痰, 皆不離四物ㆍ潛行ㆍ黃栢ㆍ牛膝ㆍ生甘草ㆍ桃仁ㆍ陳皮ㆍ蒼朮ㆍ薑汁, 隨證加減, 可謂發前人之所未發也. 《綱目》

Translation영역
Danggye's method of treating painful wind takes blood heat, blood vacuity and fouled blood, with or without phlegm, as the governing causes, and in all of them he does not depart from the four substances, Jamhaeng-san, phellodendron, achyranthes, raw licorice, peach kernel, tangerine peel, atractylodes lancea and ginger juice, modified according to the signs; it may be said that he brought out what his predecessors had not brought out.

Uihak Gangmok 綱目

1.49.3
Source원문

治痛風大法: 蒼朮ㆍ南星ㆍ川芎ㆍ白芷ㆍ當歸ㆍ酒芩; 在上加羌活ㆍ威靈仙ㆍ桂枝ㆍ桔梗, 在下加牛膝ㆍ防己ㆍ木通ㆍ黃栢. 《丹心》

Translation영역
The great method of treating painful wind: atractylodes lancea, arisaema, chuanxiong, angelica dahurica, tangkuei and wine-treated scutellaria; for the upper body add notopterygium, clematis, cinnamon twig and platycodon, and for the lower add achyranthes, stephania, akebia and phellodendron.

Danggye Simbeop 丹心

1.49.4
Source원문

薄桂治痛風, 無味而薄者, 能橫行手臂, 領南星ㆍ蒼朮等至痛處. 《丹心》

Translation영역
Thin cassia treats painful wind: the sort that is thin and without taste can travel crosswise into the arm and lead arisaema, atractylodes lancea and the rest to the painful place.

Danggye Simbeop 丹心

1.49.5
Source원문

風寒濕入於經絡, 以致氣血凝滯ㆍ津液稽留, 久則怫鬱堅牢ㆍ阻碍榮衛難行ㆍ正邪交戰, 故作痛也. 須氣味辛烈暴悍之藥, 開鬱ㆍ行氣ㆍ破血ㆍ豁痰, 則怫鬱開ㆍ榮衛行而病方已也. 《方廣》

Translation영역
When wind, cold and damp enter the channels and network vessels, the qi and blood congeal and stagnate and the fluids are held back; and in time these become pent up, constrained, hard and fixed, obstructing the construction and defence so that they travel with difficulty, and the upright and the evil join battle — and so there is pain. Medicines of acrid, fierce, violent and bold qi and flavour are needed, to open the constraint, move the qi, break the blood and sweep out phlegm; then the constraint opens, the construction and defence travel, and the disease at last resolves.

Bang Gwang 方廣

1.49.6
Source원문

痛風宜用大羌活湯ㆍ蒼朮復煎散ㆍ防風天麻散ㆍ踈風活血湯ㆍ四妙散ㆍ麻黃散ㆍ潛行散ㆍ二妙散ㆍ龍虎丹ㆍ活絡丹ㆍ五靈丸. ○歷節風宜用神通飮ㆍ定痛散ㆍ虎骨散ㆍ加減虎骨散ㆍ麝香元ㆍ乳香黑虎丹ㆍ乳香定痛丸ㆍ捉虎丹. ○肢節腫痛宜用靈仙除痛飮. ○痰飮注痛宜用芎夏湯ㆍ控涎丹《方見痰飮》ㆍ消痰茯苓丸《方見手部》ㆍ半夏芩朮湯. ○痛風熨烙宜用拈痛散ㆍ當歸散.

Translation영역
For painful wind, Dae-ganghwal-tang, Changchul-bokjeon-san, Bangpung-cheonma-san, Sopung-hwalhyeol-tang, Samyo-san, Mahwang-san, Jamhaeng-san, Imyo-san, Yongho-dan, Hwallak-dan or Oryeong-hwan should be used. For joint-running wind, Sintong-eum, Jeongtong-san, Hogol-san, Gagam-hogol-san, Sahyang-won, Yuhyang-heukho-dan, Yuhyang-jeongtong-hwan or Chakho-dan. For swollen painful limb joints, Yeongseon-jeotong-eum. For pain poured in by phlegm-rheum, Gungha-tang, Gongyeon-dan, Sodam-bokryeong-hwan or Banha-geumchul-tang. For ironing and searing painful wind, Nyeomtong-san or Danggwi-san.
Clinical note임상 주석
The chapter's second-largest prescribing section, twenty-four formulas sorted into five uses, and the sorting is what makes it usable: general painful wind, the severe joint-running form, swollen and painful joints, pain attributed to phlegm, and the external hot compresses. Zhu Danggye's own method, quoted at second hand by the Gangmok, is the one worth following — the four substances with phellodendron, achyranthes and peach kernel, modified by signs — and the Gangmok's praise of it is deserved, since treating gout by moving the blood and draining damp heat rather than by expelling wind was the real advance. Danggye's note on thin cassia, which travels crosswise into the arm and leads the other drugs to the painful place, is also the clearest statement in the chapter of what a guiding drug was thought to do.

Donguibogam · Pung

1.50 Prohibitions 禁忌法

1.50.1
Source원문

凡味酸傷筋則緩, 味醎傷骨則痿, 令人發熱ㆍ變爲痛痺ㆍ麻木等證. 愼疾者須戒魚腥ㆍ麪ㆍ將ㆍ酒ㆍ醋. 肉屬陽, 大能助火, 亦可量喫. 痛風ㆍ諸痺皆然. 《入門》

Translation영역
Sour flavours injure the sinews, and then they slacken; salty flavours injure the bones, and then they wilt; and they make a man feverish and turn into painful impediment, numbness and the like. One who is careful of his illness must abstain from fishy foods, wheat flour, soybean paste, wine and vinegar. Meat belongs to the yang and is greatly able to assist fire, and it too should be eaten by measure. This holds for painful wind and all the impediments.
Clinical note임상 주석
The most striking page in the chapter, because the list is nearly the modern one. Abstain from fishy foods, wheat flour, soybean paste, wine and vinegar, and eat meat only by measure: fish, fermented soy products, alcohol and red meat are precisely the purine-rich and fermentation-derived foods a gout patient is still told to limit. Nobody in 1613 knew about uric acid, and the explanation given — sour injures the sinews, salty injures the bones — is wrong. The dietary advice is right, and it can only have come from watching which meals brought on an attack.

Uihak Immun 入門

1.51 The Causes of Lockjaw 破傷風病因

1.51.1
Source원문

破傷風者, 多由亡血ㆍ筋無所營, 故邪得以襲之. 所以傷寒汗下過多, 與夫病瘡人及産後致斯病者, 槩可見矣. 《三因》

Translation영역
Lockjaw is mostly due to loss of blood, so that the sinews have nothing to construct them, and therefore an evil can assail them. That is why those who have been sweated and purged excessively in cold damage, and those with sores, and women after childbirth, come to this disease — it may be seen in general.

Samin Geukil Byeongjeungbangnon 三因

1.51.2
Source원문

破傷風者, 初因擊破皮肉, 視爲尋常, 殊不知風邪乗虛而襲, 變爲惡候. 或諸瘡久不合口ㆍ風邪內襲, 或用湯淋洗, 或着艾焚灸, 其火毒之氣亦與破傷風邪無異也. 其證寒熱間作, 甚則口噤ㆍ目斜ㆍ身體强直如角弓反張之狀, 死在朝夕. 《正傳》

Translation영역
In lockjaw, at first the skin and flesh are struck and broken and it is looked on as an ordinary thing; what is not understood is that a wind evil rides on the vacuity and assails it and turns into a malign outcome. Or sores long fail to close their mouths and a wind evil assails within; or a decoction is used to douche and wash them, or mugwort is set on and burnt, and the qi of that fire toxin is likewise no different from the lockjaw evil. Its signs are cold and heat alternating, and at its height the jaw is clenched, the eyes are turned aside and the body is rigid like a bow drawn back, with death a morning or an evening away.

Uihak Jeongjeon 正傳

1.51.3
Source원문

痓病者是難治也, 多是血氣內虛ㆍ風痰盛而成痓病. 凡傷寒雜病汗吐後入風, 亦成痓病; 大發濕家汗, 亦成痓; 發瘡家汗, 亦成痓; 産後去血多, 亦成痓; 有跌磕打傷ㆍ瘡口未合貫風者, 亦成痓. 此名破傷風也. 《回春》

Translation영역
Tetany is difficult to treat; it is mostly from blood and qi vacuous within and wind phlegm exuberant that tetany is formed. Whenever wind enters after sweating or vomiting in cold damage or a miscellaneous disease, tetany is formed too; greatly breaking out the sweat of a damp patient also forms tetany; breaking out the sweat of a patient with sores also forms tetany; losing much blood after childbirth also forms tetany; and where there has been a fall, a knock or a blow and the mouth of the wound has not closed and wind has pierced it, tetany is formed too. This is called lockjaw.

Manbyeong Hoechun 回春

1.51.4
Source원문

破傷風有四因: 一者卒暴傷損ㆍ風邪襲虛; 二者諸瘡湯洗ㆍ艾灸ㆍ逼毒妄行; 三者瘡口不合ㆍ貼膏留孔ㆍ風襲; 四者熱鬱遍身ㆍ白痂瘡口閉塞ㆍ氣難通泄ㆍ傳播經絡. 《入門》

Translation영역
Lockjaw has four causes. The first is a sudden violent injury with a wind evil assailing the vacuity. The second is washing sores with decoctions or burning them with mugwort, so that the toxin is driven and travels recklessly. The third is the mouth of a wound not closing and, a plaster being applied that leaves a hole, wind assailing it. The fourth is heat constrained over the whole body, with a white scab shutting and blocking the mouth of the sore so that the qi cannot pass out and is transmitted and spread into the channels and network vessels.
Clinical note임상 주석
The aetiology is as good as it could be without the germ theory. A wound, looked on as an ordinary thing, which admits something that turns into a malign outcome; a wound whose mouth does not close; a plaster that leaves a hole; a scab that seals the surface so the qi cannot pass out. Every one of those is a correct risk factor for tetanus — Clostridium tetani is an anaerobe and a sealed or deep wound is exactly what it needs — and the fourth cause is in effect a description of why a closed-over puncture is more dangerous than an open one. The Hoechun's list adds the postpartum and post-surgical cases, which are the other classical routes. What they could not know is that the agent was alive and came from the soil; everything else about the entry is sound.

Uihak Immun 入門

1.52 Chi and Gyeong Are Both Called Lockjaw 痓與痙通稱破傷風

1.52.1
Source원문

痙者, 筋勁强直而不柔和也. 《河間》 ○痓病者, 口噤ㆍ角弓反張者是也. 《丹心》

Translation영역
Gyeong is the sinews stiff, strong and rigid and not supple and harmonious. Chi is the disease in which the jaw is clenched and the body arched like a drawn bow.
Clinical note임상 주석
Two characters for one thing, and the Bogam disposes of the terminology in two lines. The definitions themselves are precise: generalized muscular rigidity, and trismus with opisthotonos. Those are the two cardinal signs of tetanus and they are named here without a word wasted.

Hagan 河間 · Danggye Simbeop 丹心

1.53 The Forms and Signs of Lockjaw 破傷風形證

1.53.1
Source원문

夫人之筋各隨經絡結束於身, 血氣內虛ㆍ外爲風寒濕熱之氣所中則成痓. 故寒則緊縮, 熱則弛張, 風則弦急, 濕則弛緩. 風散氣, 故有汗而不惡寒; 寒澁血, 故無汗而惡寒; 熱消氣, 故爲瘈縱; 濕溢血, 故爲緩弱. 經所謂大筋緛短ㆍ小筋弛張, 皆濕熱不攘之所爲也. 原其所因, 多由亡血ㆍ筋無所營, 故邪得以襲之. 所以傷寒汗下過多, 與夫病瘡人及産後致斯病, 槩可見矣. 《三因》

Translation영역
A man's sinews each follow the channels and network vessels and are bound into the body; and when the blood and qi are vacuous within and the body is struck from without by the qi of wind, cold, damp or heat, tetany is formed. Hence cold makes them tight and contracted; heat makes them loose and stretched; wind makes them taut and urgent; damp makes them loose and slack. Wind scatters the qi, and so there is sweating without aversion to cold; cold roughens the blood, and so there is no sweating and there is aversion to cold; heat consumes the qi, and so there is jerking and slackening; damp floods the blood, and so there is slackness and weakness. What the classic calls the great sinews shrinking short and the small sinews loose and stretched is in every case the work of damp heat not driven off. Tracing its cause, it is mostly due to loss of blood so that the sinews have nothing to construct them, and therefore an evil can assail them. That is why those sweated and purged excessively in cold damage, and those with sores, and women after childbirth come to this disease.

Samin Geukil Byeongjeungbangnon 三因

1.53.2
Source원문

筋脉相引而急, 名曰瘈瘲, 俗謂之搐是也. 《綱目》

Translation영역
The sinews and vessels drawing on each other and tightening is called chejong, and it is what the world calls a convulsion.

Uihak Gangmok 綱目

1.53.3
Source원문

諸熱瞀瘈, 皆屬于火. 熱勝風搏ㆍ倂于經絡, 風主動而不寧, 風火相乗, 是以瞀瘈生矣. 治宜祛風ㆍ滌熱之劑, 折其火熱可立愈; 若妄加艾火或發其表, 則死不旋腫. 《河間》

Translation영역
All the heat cases of dimness and jerking belong to fire. Heat prevails and wind contends, and they combine in the channels and network vessels; wind governs movement and is never at rest, and when wind and fire ride upon each other, dimness and jerking arise. The treatment should be prescriptions that dispel wind and wash away heat, and breaking its fire heat can cure at once; but if mugwort fire is recklessly applied, or the exterior broken out, death comes before the swelling has turned.
Clinical note임상 주석
A warning in the last line that the chapter earns the right to give: do not apply moxa to this, and do not try to sweat it, for death comes before the swelling has turned. Both interventions were standard for a wound, and both are named in section 1.51 as causes of the disease. The Sanyin's four-way scheme — cold contracts, heat stretches, wind makes taut, damp slackens — is also a real attempt to sort rigidity by what accompanies it, and the pairing of sweating with absence of aversion to cold against no sweating with aversion to cold is the cold-damage method applied to the problem.

Hagan 河間

1.54 The Lockjaw Pulse 破傷風脉

1.54.1
Source원문

痓脉, 按之緊如弦ㆍ直上下行. 《仲景》 ○痓脉皆伏ㆍ沉ㆍ弦ㆍ緊. 《三因》

Translation영역
The tetany pulse, pressed, is tight like a bowstring and runs straight up and down. The tetany pulse is in every case hidden, sunken, wiry and tight.

Jungyeong 仲景 · Samin Geukil Byeongjeungbangnon 三因

1.54.2
Source원문

痓脉弦直, 或沉細些; 汗後欲解, 脉潑如蛇; 弦緊尙可, 伏堅傷嗟. 《回春》

Translation영역
The tetany pulse is wiry and straight, or somewhat sunken and fine; after sweating, when it is about to resolve, the pulse scatters like a snake; wiry and tight may still do, but hidden and hard is cause for grief.

Manbyeong Hoechun 回春

1.54.3
Source원문

痓脉浮而無力, 太陽也; 長而有力, 陽明也; 浮而弦小, 少陽也. 《正傳》

Translation영역
A tetany pulse floating and without strength is taiyang; long and with strength is yangming; floating, wiry and small is shaoyang.

Uihak Jeongjeon 正傳

1.54.4
Source원문

凡痓脉如雨濺散出指外者, 立死. 《入門》

Translation영역
Whenever the tetany pulse is like rain splashing, scattering out beyond the finger, death is immediate.
Clinical note임상 주석
The wiry tight pulse running straight up and down is what a vessel feels like in a patient whose whole musculature is rigid, so the finding is consistent even if the inference is not. The two prognostic images are the memorable part: a pulse scattering like a snake as the disease resolves, and a pulse like rain splashing out beyond the finger, which means immediate death. The second is a chaotic irregular pulse in a patient in autonomic crisis, and in tetanus that is indeed terminal.

Uihak Immun 入門

1.55 The Method of Treating Lockjaw 破傷風治法

1.55.1
Source원문

破傷風者, 諸瘡久不合口, 因熱甚鬱結而榮衛不得宣通, 怫熱因之遍體, 故多白痂. 是時瘡口閉塞ㆍ氣難宣通, 故熱甚而生風也. 先辨瘡口: 平無汁者, 中風也; 邉自出黃水者, 中水也. 幷欲作痓, 急治之. 又痛不在瘡處者, 傷經絡, 亦死證也. 初覺瘡腫起ㆍ白痂ㆍ身寒熱, 急用玉眞散貼之; 傷在頭面, 急用水調膏和雄黃付瘡上, 腫漸消爲度. 若腰脊反張ㆍ四肢强直ㆍ牙噤ㆍ通身冷ㆍ不知人, 急用蜈蚣細末擦牙, 吐出涎沫立甦; 亦宜按摩導引. 《綱目》

Translation영역
In lockjaw, sores long fail to close their mouths; because the heat is severe and constrained and bound, the construction and defence cannot diffuse and pass, and the pent-up heat on that account spreads over the body, and so there is often a white scab. At such a time the mouth of the sore is shut and blocked and the qi cannot diffuse and pass, and so the heat is severe and generates wind. First distinguish the mouth of the sore: level and without discharge, it is struck by wind; with yellow water coming out of itself at the edge, it is struck by water. Both are about to turn into tetany and must be treated urgently. And where the pain is not at the site of the sore, the channels and network vessels are injured, and that too is a fatal sign. At the first notice of the sore swelling up, of a white scab and of chills and fever in the body, quickly apply Okjin-san; where the injury is on the head or face, quickly use Sujo-go mixed with realgar applied over the sore, until the swelling gradually subsides. If the lower back and spine are arched, the four limbs rigid, the teeth clenched, the whole body cold and the patient unaware of people, quickly rub finely powdered centipede on the teeth, and when the foam and drool are vomited out he revives at once; massage and guided stretching are also appropriate.

Uihak Gangmok 綱目

1.55.2
Source원문

痙病口噤ㆍ背反張, 速灌小續命湯. 《資生》

Translation영역
In tetany with the jaw clenched and the back arched, pour in Soseungmyeong-tang at once.

Jasaeng Gyeonghyobang 資生

1.55.3
Source원문

若眼牽ㆍ觜扯ㆍ手足戰搖ㆍ伸縮者, 是風痰痓; 若身冷ㆍ手足冷ㆍ脉沉細, 名爲陰痓: 俱宜參歸養榮湯. 若身熱ㆍ喘嗽ㆍ生痰ㆍ脉滑數, 名爲痰火痓, 宜用瓜蔞枳實湯. 不可全用風藥散氣, 死之速矣. 《回春》

Translation영역
If the eyes are drawn, the mouth pulled aside and the hands and feet trembling and shaking, extending and contracting, it is wind phlegm tetany; if the body is cold and the hands and feet cold and the pulse sunken and fine, it is called yin tetany — for both, Samgwi-yangyeong-tang is appropriate. If the body is hot with panting and coughing and phlegm produced and the pulse slippery and rapid, it is called phlegm fire tetany, and Gwaru-jisil-tang should be used. Wind medicines must not be used throughout to scatter the qi, or death comes the faster.

Manbyeong Hoechun 回春

1.55.4
Source원문

破傷風, 如在表則辛以散之, 在裏則苦以下之, 兼散之. 汗下後通利榮血ㆍ祛逐風邪: 防風通聖散《方見風門》 一兩加荊芥穗ㆍ大黃 各二錢, 煎水調全蝎末ㆍ羌活末 各一錢服之. 《河間》

Translation영역
In lockjaw, where it is in the exterior disperse it with the acrid; where it is in the interior purge it with the bitter, dispersing as well. After the sweating and purging, free the constructive blood and drive off the wind evil: 1 nyang of Bangpung-tongseong-san with 2 don each of schizonepeta spike and rhubarb added, decocted in water, and 1 don each of powdered scorpion and powdered notopterygium stirred in and taken.

Hagan 河間

1.55.5
Source원문

破傷風多死, 宜用防風ㆍ全蝎之類, 全蝎散最妙. 《入門》

Translation영역
In lockjaw most die; saposhnikovia and scorpion and their kind should be used, and Jeongal-san is the most wonderful.

Uihak Immun 入門

1.55.6
Source원문

破傷風口喎ㆍ噤ㆍ肢體反張ㆍ須臾欲死, 宜用全蝎散ㆍ大蜈蚣散; 風盛者二烏丸; 風痰者玉眞散ㆍ烏蛇散; 手足戰掉宜朱砂指甲散; 血凝昏悶者烏鴉散. 《入門》

Translation영역
In lockjaw with the mouth deviated and clenched and the limbs arched backward and death moments away, Jeongal-san or Dae-ogong-san should be used; where wind is exuberant, Io-hwan; where there is wind phlegm, Okjin-san or Osa-san; where the hands and feet tremble, Jusa-jigap-san; where the blood is congealed and the patient clouded and oppressed, Oa-san.

Uihak Immun 入門

1.55.7
Source원문

破傷風宜用香膠散ㆍ一字散ㆍ退風散.

Translation영역
For lockjaw, Hyanggyo-san, Ilja-san or Toepung-san should be used.

Donguibogam · Pung

1.55.8
Source원문

大凡破傷風, 在頭面則白芷爲君ㆍ防風頭佐之; 在身體及四肢則以防風爲君ㆍ隨身梢用; 在下部則以獨活佐之. 《丹心》

Translation영역
Generally in lockjaw, where it is on the head and face angelica dahurica is the sovereign and the head of the saposhnikovia root assists it; where it is on the body and the four limbs, saposhnikovia is the sovereign and the body or the tail of the root is used according to the part; where it is in the lower body, pubescent angelica assists it.

Danggye Simbeop 丹心

1.55.9
Source원문

諸瘡欲變痓, 宜急風散ㆍ防風散. 發汗多成痓, 宜防風當歸散. 亡血多成痓, 宜當歸地黃湯.

Translation영역
Where sores are about to turn into tetany, Geuppung-san or Bangpung-san is appropriate. Where excessive sweating has formed tetany, Bangpung-danggwi-san. Where much loss of blood has formed tetany, Danggwi-jihwang-tang.
Clinical note임상 주석
The chapter's longest treatment section after 歷節風, and the examination of the wound is the part worth keeping. Level and without discharge means one thing, yellow water weeping from the edge another, and pain away from the site of the wound means the channels are involved and is a fatal sign. That last is correct and important: pain remote from the injury in a patient with a healing wound is the first sign of tetanus spreading, and naming it as a fatal sign is a real piece of prognostication. The Hoechun's three-way split — wind phlegm tetany, yin tetany, phlegm fire tetany — comes with an explicit warning not to use wind medicines throughout, which the Bogam records because the wind medicines were what everyone reached for. Danggye's guiding-drug rule at the end is a clean statement of regional prescribing: angelica dahurica for the head, saposhnikovia for the trunk and limbs with the part of the root chosen to match, pubescent angelica below.

Donguibogam · Pung

1.56 Lockjaw Is Treated by the Three Methods of Cold Damage 破傷風之治同傷寒三法

1.56.1
Source원문

破傷風有在表ㆍ在裏ㆍ半表半裏三者之不同, 故不離乎汗ㆍ下ㆍ和三法也. 《正傳》

Translation영역
Lockjaw differs in being in the exterior, in the interior, or half in the exterior and half in the interior, and so it does not depart from the three methods of sweating, purging and harmonizing.

Uihak Jeongjeon 正傳

1.56.2
Source원문

發汗過多因致痓, 身熱ㆍ足寒ㆍ項强ㆍ頭搖ㆍ口噤ㆍ背反張者, 太陽痓也: 無汗宜汗之, 有汗宜止之. 若頭低視下ㆍ手足牽引ㆍ肘膝相搆者, 陽明痓也. 若一目或左右視, 幷一手一足搐搦者, 少陽痓也. 《海藏》

Translation영역
Where excessive sweating has brought on tetany, with the body hot, the feet cold, the nape stiff, the head shaking, the jaw clenched and the back arched, it is taiyang tetany: where there is no sweating it should be sweated, and where there is sweating the sweating should be stopped. If the head hangs low with the gaze downward, the hands and feet are drawn and the elbows and knees meet each other, it is yangming tetany. If one eye looks to the left or the right, and one hand and one foot convulse, it is shaoyang tetany.

Haejang 海藏

1.56.3
Source원문

背後搐者, 太陽也; 身前搐者, 陽明也; 兩傍搐者, 少陽也. 《河間》

Translation영역
Where the convulsion is at the back it is taiyang; where it is at the front of the body it is yangming; where it is at the two sides it is shaoyang.

Hagan 河間

1.56.4
Source원문

河間曰, 太陽宜汗, 陽明宜下, 少陽宜和. 若明此三法而不中病者, 未之有也. 《正傳》

Translation영역
Hagan says: taiyang should be sweated, yangming purged, shaoyang harmonized. If one is clear on these three methods and still fails to hit the disease, such a thing has not been.

Uihak Jeongjeon 正傳

1.56.5
Source원문

按河間只論三陽而不論三陰者, 蓋傳入陰經其證已危; 若腹滿ㆍ自利ㆍ口燥咽乾ㆍ舌卷卵縮, 皆無可生之理, 故置而不論也. 《正傳》

Translation영역
Note that Hagan discusses only the three yang and not the three yin, because once it has been transmitted into the yin channels the pattern is already critical; and where there is abdominal fullness, spontaneous diarrhoea, a dry mouth and parched throat, a curled tongue and retracted testicles, there is no ground for living at all, and so he set these aside and did not discuss them.

Uihak Jeongjeon 正傳

1.56.6
Source원문

破傷風在表, 則以辛熱發散之, 宜防風湯ㆍ羌活防風湯ㆍ小續命湯《方見上》ㆍ九味羌活湯《方見寒門》. 在半表半裏, 以辛凉和解之, 宜羌麻湯ㆍ防風通聖散《方見上》. 在裏, 則以寒藥下之, 宜小芎黃湯ㆍ大芎黃湯ㆍ左龍丸. 《河間》

Translation영역
Where lockjaw is in the exterior, break it out and disperse it with the acrid hot: Bangpung-tang, Ganghwal-bangpung-tang, Soseungmyeong-tang or Gumi-ganghwal-tang. Where it is half in the exterior and half in the interior, harmonize and resolve it with the acrid cool: Gangma-tang or Bangpung-tongseong-san. Where it is in the interior, purge it with cold medicines: Sogunghwang-tang, Daegunghwang-tang or Jwaryong-hwan.

Hagan 河間

1.56.7
Source원문

破傷風雖宜發汗, 若自汗多則宜用白朮湯ㆍ白朮防風湯.

Translation영역
Although lockjaw should be sweated, where there is much spontaneous sweating Baekchul-tang or Baekchul-bangpung-tang should be used.
Clinical note임상 주석
The most systematic section in the chapter: the cold-damage model of exterior, half-exterior and interior applied whole to lockjaw, with a method, a channel and a group of formulas at each stage. What makes it more than a scheme is the clinical content attached. Liu Wansu's localization by where the convulsion pulls — back for taiyang, front for yangming, sides for shaoyang — is an observational criterion, not a theoretical one. Wang Haejang's three descriptions are better still: nape stiff with the back arched; head hanging with elbows and knees drawn together; one eye deviated with one hand and one foot convulsing. Those are opisthotonos, flexion posturing and a focal seizure, and distinguishing them is worth doing. And the Jeongjeon's note on why the three yin are not discussed is the chapter being honest: a curled tongue and retracted testicles with diarrhoea leave no ground for living, so there is nothing to say.

Donguibogam · Pung

1.57 Tetany Has Two Patterns, Hard and Soft 痓有剛柔二證

1.57.1
Source원문

痓證寒熱類傷寒, 但脉沉遲弦細ㆍ搖頭ㆍ露眼ㆍ噤口ㆍ手足搐搦ㆍ項强ㆍ背反張ㆍ如發癎終日不醒爲異. 因傷寒發汗過多, 或大發濕家汗, 皆作痓. 風性勁, 故爲剛痓而無汗; 濕性緩, 故爲柔痓而有汗. 《入門》

Translation영역
The tetany pattern has chills and fever resembling cold damage, differing only in the pulse being sunken, slow, wiry and fine, and in the head shaking, the eyes staring open, the jaw clenched, the hands and feet convulsing, the nape stiff, the back arched, and the patient as though in an epileptic fit, not waking all day long. Through sweating excessively in cold damage, or greatly breaking out the sweat of a damp patient, tetany is formed in both cases. Wind's nature is stiff, and so it makes hard tetany, with no sweating; damp's nature is slack, and so it makes soft tetany, with sweating.

Uihak Immun 入門

1.57.2
Source원문

無汗爲剛痓, 有汗爲柔痓. 《海藏》

Translation영역
Without sweating it is hard tetany; with sweating it is soft tetany.

Haejang 海藏

1.57.3
Source원문

剛柔二痓, 幷可與小續命湯《方見上》. 柔痓去麻黃; 有熱減半桂枝; 冬月去黃芩. 《海藏》

Translation영역
For both hard and soft tetany, Soseungmyeong-tang may be given. For soft tetany, remove the ephedra; where there is heat, halve the cinnamon twig; in the winter months, remove the scutellaria.

Haejang 海藏

1.57.4
Source원문

剛柔不分, 亦用小續命湯加附子(生). 《入門》

Translation영역
Where hard and soft are not distinguished, Soseungmyeong-tang with raw aconite added is also used.

Uihak Immun 入門

1.57.5
Source원문

剛痓之病, 胸滿ㆍ口噤ㆍ卧不着席ㆍ脚攣急, 必齘齒, 可與大承氣湯《方見寒門》下之. 《仲景》

Translation영역
In the disease of hard tetany, the chest is full, the jaw clenched, the patient lies without touching the mat and the legs are cramped and urgent, and he will certainly grind his teeth; Daeseunggi-tang may be given to purge him.

Jungyeong 仲景

1.57.6
Source원문

剛柔二痓, 通用九味羌活湯. 《入門》

Translation영역
For both hard and soft tetany, Gumi-ganghwal-tang is used generally.
Clinical note임상 주석
Zhongjing's hard-and-soft division, and the criterion is a single sign: sweating or not. His own description of hard tetany is the best sentence in the section and needs no interpretation — the patient lies without touching the mat, the legs cramped, grinding his teeth. That is opisthotonos so complete that only head and heels rest on the bed, and anyone who has seen it will recognize the description. The modifications given for Soseungmyeong-tang are also instructive as pharmacy: remove the ephedra for the sweating case, halve the cinnamon twig where there is heat, drop the scutellaria in winter. A single formula adjusted three ways by sign and season is the classical method at its most competent.

Uihak Immun 入門

1.58 Tetany Resembles Epilepsy but Is Truly Different, and It Must Not Be Treated as Wind 痓與癎相似而實不同又不可作風治

1.58.1
Source원문

痓與癎不同: 癎病身軟ㆍ時醒, 痓病身强直ㆍ反張ㆍ不時醒, 甚有昏冒而遂亡者. 《丹心》

Translation영역
Tetany and epilepsy are not the same: in epilepsy the body is soft and the patient wakes in time, while in tetany the body is rigid and arched backward and he does not wake in time, and in severe cases he is clouded and stupefied and then dies.

Danggye Simbeop 丹心

1.58.2
Source원문

痓與癎相似, 比癎爲虛. 切不可作風治而純用風藥, 宜帶補. 多是氣虛ㆍ有火ㆍ兼痰, 宜服參ㆍ芪ㆍ芎ㆍ歸ㆍ竹瀝之類. 《丹心》

Translation영역
Tetany resembles epilepsy but is more vacuous than epilepsy. It must on no account be treated as wind with wind medicines alone; supplementation should be carried with it. It is mostly qi vacuity with fire and phlegm besides, and ginseng, astragalus, chuanxiong, tangkuei and bamboo sap and the like should be taken.
Clinical note임상 주석
The differential is exactly right and is stated in one line: in epilepsy the body is soft between the fits and the patient comes round; in tetany the body stays rigid and he does not. Post-ictal recovery is still the criterion that separates a seizure from a tetanic or dystonic state, and a reader of this section would not confuse the two. Danggye's treatment conclusion then runs against the whole chapter around it — do not treat this as wind, carry supplementation with it — and the formulas he names are ginseng, astragalus and the blood drugs. Having said that lockjaw mostly kills, the chapter closes its argument by advising against the medicines it has spent thirty pages describing.

Danggye Simbeop 丹心

1.59 The Inauspicious Signs of Lockjaw 破傷風凶證

1.59.1
Source원문

痓病有灸瘡, 難治. 《仲景》

Translation영역
Where a tetany patient has a moxa sore, it is difficult to treat.

Jungyeong 仲景

1.59.2
Source원문

痓病戴眼ㆍ反折ㆍ瘈瘲ㆍ汗出如珠, 或反張離席一掌許, 小兒離席二指許者, 皆死. 《入門》

Translation영역
In tetany, the eyes turned upward, the body bent back, jerking and slackening and sweat coming out in beads; or the arching such that the back is a hand's breadth clear of the mat, and in a child two fingers' breadth — all these die.

Uihak Immun 入門

1.59.3
Source원문

破傷風宜早治; 若入藏則難治. 有四般死證不可治: 一者頭面靑黑色, 二者額上有汗珠不流, 三者眼小目瞪, 四者身上汗出如油. 《回春》

Translation영역
Lockjaw should be treated early; once it has entered the viscera it is difficult to treat. There are four fatal signs that cannot be treated: first, a blue-black colour on the head and face; second, beads of sweat on the forehead that do not run; third, the eyes small and staring; fourth, sweat coming out over the body like oil.

Manbyeong Hoechun 回春

1.59.4
Source원문

太陽風痓之證, 始則發熱ㆍ腹痛ㆍ喘息ㆍ涎浮, 次則牙緊ㆍ頭搖ㆍ十指微搖, 漸加項背强直ㆍ轉側不仁, 甚者昏困ㆍ失音ㆍ目睛直視ㆍ滑泄不禁ㆍ身腰反張. 如此則十不救一. 《直指》

Translation영역
In the taiyang wind tetany pattern, at first there is fever, abdominal pain, panting breath and drool rising; next the teeth are tight, the head shakes and the ten fingers tremble slightly; gradually there is added rigidity of the nape and back and insensibility on turning; and in the severe case clouding and exhaustion, loss of voice, the eyes staring straight ahead, uncontrollable diarrhoea and the body and lower back arched backward. When it is like this, not one in ten is saved.

Injae Jijibang 直指

1.59.5
Source원문

痓病目瞪ㆍ口開ㆍ神氣昏冒ㆍ不知人者, 斷死無疑也. 《回春》

Translation영역
In tetany, where the eyes stare, the mouth is open, the spirit qi is clouded and stupefied and the patient does not know people, death is certain beyond doubt.
Clinical note임상 주석
The Jijibang's staged account is the most valuable thing in the lockjaw sections, because it records the progression in order: fever and abdominal pain first, then clenched teeth with a shaking head and trembling fingers, then rigidity of the neck and back, and finally clouding, mutism, a fixed stare, diarrhoea and complete opisthotonos, with one survivor in ten. That is the clinical course of tetanus as a modern text would set it out, trismus and nuchal rigidity in the right place and at the right stage. The measurement of the arch — a hand's breadth clear of the mat in an adult, two fingers' breadth in a child — is severity quantified by the only instrument available, and the four fatal signs of the Hoechun, a blue-black face and sweat standing on the forehead or running like oil, are the signs of terminal autonomic failure.

Manbyeong Hoechun 回春

1.60 Simples 單方

1.60.1
Source원문

凡三十七種. 有禦風膏ㆍ五加皮酒ㆍ竹瀝湯ㆍ豆淋酒ㆍ虎骨酒.

Translation영역
Thirty-seven kinds in all. There are Eopung-go, Ogapi-ju, Jungnyeok-tang, Dulim-ju and Hogol-ju.
Clinical note임상 주석
Thirty-eight simples, and taken together they are a fair picture of what a household actually used for wind: eleven herbs of the standard pharmacy (acorus, chrysanthemum, atractylodes, the two angelicas, saposhnikovia, ligusticum, gastrodia, schizonepeta, mint, siegesbeckia), four preparations in wine or sap, and then a long tail of foods and animals — pear, black soybean, scallion white, apricot kernel, mulberry-twig tea, black chicken, magpie, wild goose fat, crow, bear fat, fresh venison, swamp eel, pit viper, centipede, chafer grub, silkworm droppings, pigeon droppings. The animal remedies are concentrated here rather than in the formula sections, which is where folk practice usually shows through. Five of the thirty-seven are registered as compound preparations and the Bogam names them at the head of the section; the rest are in the herb dictionary. Several — tiger bone, pit viper, bear fat — are from protected species and cannot be used.

Donguibogam · Pung

1.61 Needling and Moxibustion 鍼灸法

1.61.1
Source원문

治中風莫如續命湯之類, 然此可扶持初病; 若欲要收全功, 火艾爲良. 中風皆因脉道不利ㆍ血氣閉塞也, 灸則喚醒脉道而血氣得通, 故可收全功. 《肘後》

Translation영역
For treating wind stroke there is nothing like Seungmyeong-tang and its kind, but these can only support the patient in the early disease; if one would gather the full effect, fire and mugwort are best. Wind stroke is in every case because the vessel pathways are not free and the blood and qi are shut and blocked; and moxibustion calls the vessel pathways awake so that the blood and qi can pass, and therefore the full effect may be gathered.

Juhu Bigeupbang 肘後

1.61.2
Source원문

中風痰盛ㆍ聲如曳鋸ㆍ服藥不下, 宜灸臍下氣海ㆍ關元 二三百壯, 亦可轉死回生. 五藏氣絶危證, 亦宜灸之. 《綱目》

Translation영역
In wind stroke with phlegm exuberant and the breath sounding like a saw being drawn, and medicine will not go down, two or three hundred cones should be burnt below the navel at qihai and guanyuan, and death may yet be turned back to life. In the critical pattern of the five viscera's qi cut off, moxibustion is likewise appropriate.

Uihak Gangmok 綱目

1.61.3
Source원문

凡人非時足脛上及手食指次指忽痠疼麻痺ㆍ良久方解, 此將中風之候. 急灸三里ㆍ絶骨 各三壯, 春秋報灸, 常令兩脚有灸瘡爲妙. 《資生》

Translation영역
Whenever a man out of season has sudden aching, pain, numbness and impediment on the shin and in the index and middle fingers, which only resolves after a good while, this is the sign of an approaching wind stroke. Quickly burn three cones each at zusanli and xuanzhong, repeat the moxibustion in spring and autumn, and it is best that there should always be moxa sores on both legs.

Jasaeng Gyeonghyobang 資生

1.61.4
Source원문

凡人不信此法ㆍ不肯灸, 忽然卒死, 是謂何病? 曰, 風入藏故也. 風病者不可不知. 《綱目》

Translation영역
Whenever a man does not believe in this method and will not be moxaed, and then suddenly dies — what disease shall this be called? The answer: it is because wind has entered the viscera. One who has wind disease cannot afford not to know this.

Uihak Gangmok 綱目

1.61.5
Source원문

凡覺手足或麻或痛ㆍ良久乃已, 此將風中府之候, 宜灸百會ㆍ曲鬢ㆍ肩髃ㆍ曲池ㆍ風市ㆍ三里ㆍ絶骨. 《資生》 ○凡覺心中憒亂ㆍ神思不怡, 或手足麻痺, 此將風中藏之候, 宜灸百會ㆍ風池ㆍ大顀ㆍ肩井ㆍ曲池ㆍ間使ㆍ三里. 《資生》

Translation영역
Whenever the hands and feet are felt to be numb or painful and only cease after a good while, this is the sign of wind approaching the bowels, and baihui, qubin, jianyu, quchi, fengshi, zusanli and xuanzhong should be moxaed. Whenever there is felt a muddle and disorder in the heart and the spirit and thought are not glad, or the hands and feet are numb, this is the sign of wind approaching the viscera, and baihui, fengchi, dazhui, jianjing, quchi, jianshi and zusanli should be moxaed.

Jasaeng Gyeonghyobang 資生

1.61.6
Source원문

治風七穴: 百會ㆍ耳前髮際ㆍ肩井ㆍ風市ㆍ三里ㆍ絶骨ㆍ曲池. 一方加有風池ㆍ合谷ㆍ肩髃ㆍ環跳, 凡九穴. 《資生》 凡中風皆灸之.

Translation영역
The seven points for treating wind: baihui, the hairline before the ear, jianjing, fengshi, zusanli, xuanzhong and quchi. One version adds fengchi, hegu, jianyu and huantiao, making nine points in all. In wind stroke all of them are moxaed.

Jasaeng Gyeonghyobang 資生

1.61.7
Source원문

卒中風喎斜ㆍ涎塞ㆍ不省, 宜灸聽會ㆍ頰車ㆍ地倉ㆍ百會ㆍ肩髃ㆍ曲池ㆍ風市ㆍ三里ㆍ絶骨ㆍ耳前髮際ㆍ大顀ㆍ風池, 凡十二穴. 《本事》

Translation영역
In sudden wind stroke with deviation, drool blocking and loss of awareness, moxa tinghui, jiache, dicang, baihui, jianyu, quchi, fengshi, zusanli, xuanzhong, the hairline before the ear, dazhui and fengchi — twelve points in all.

Boje Bonsabang 本事

1.61.8
Source원문

中風目戴上不能視, 灸第二顀骨ㆍ第五顀骨上 各七壯, 一齊下火, 立愈. 《綱目》

Translation영역
In wind stroke with the eyes turned upward and unable to see, burn seven cones each on the second and the fifth vertebrae, setting the fire to both at once, and it is cured at once.

Uihak Gangmok 綱目

1.61.9
Source원문

口眼喎斜, 宜灸聽會ㆍ頰車ㆍ地倉. 又法: 喎向右者灸左喎陷中, 喎向左者灸右喎陷中, 各二七壯, 立愈. 《綱目》

Translation영역
For deviation of the mouth and eye, moxa tinghui, jiache and dicang. Another method: where the deviation is toward the right, moxa the hollow of the deviation on the left; where it is toward the left, moxa the hollow on the right — fourteen cones each, and it is cured at once.

Uihak Gangmok 綱目

1.61.10
Source원문

半身不遂, 宜灸百會ㆍ顖會ㆍ風池ㆍ肩髃ㆍ曲池ㆍ合谷ㆍ環跳ㆍ風市ㆍ三里ㆍ絶骨. 《資生》 ○半身不遂, 環跳爲要穴. 《綱目》

Translation영역
For paralysis of half the body, moxa baihui, xinhui, fengchi, jianyu, quchi, hegu, huantiao, fengshi, zusanli and xuanzhong. For paralysis of half the body, huantiao is the essential point.

Jasaeng Gyeonghyobang 資生 · Uihak Gangmok 綱目

1.61.11
Source원문

口噤, 宜鍼人中ㆍ頰車ㆍ百會ㆍ承漿ㆍ合谷ㆍ翳風, 灸亦可. 《綱目》 ○失音不語, 宜鍼瘂門ㆍ人中ㆍ天突ㆍ涌泉ㆍ神門ㆍ支溝ㆍ風府. 《綱目》

Translation영역
For a clenched jaw, needle renzhong, jiache, baihui, chengjiang, hegu and yifeng; moxibustion will also do. For loss of voice and speech, needle yamen, renzhong, tiantu, yongquan, shenmen, zhigou and fengfu.

Uihak Gangmok 綱目

1.61.12
Source원문

治中風偏枯大接經: 從陽引陰, 至陰與涌泉ㆍ中衝與關衝ㆍ竅陰與大敦ㆍ少商與商陽ㆍ厲兊與隱白ㆍ少衝與少澤. ○大接經從陰引陽: 少商與商陽ㆍ厲兊與隱白ㆍ少衝與少澤ㆍ至陰與涌泉ㆍ中衝與關衝ㆍ竅陰與大敦. 凡此十二經井穴也. 羅謙甫治趙僧判中藏, 刺十二井穴愈; 又治張安撫中藏, 灸十二井穴愈. 《寶鑑》

Translation영역
For treating wind stroke with withered hemilateral, the great joining of the channels. Drawing yin from yang: zhiyin with yongquan, zhongchong with guanchong, qiaoyin with dadun, shaoshang with shangyang, lidui with yinbai, shaochong with shaoze. The great joining of the channels drawing yang from yin: shaoshang with shangyang, lidui with yinbai, shaochong with shaoze, zhiyin with yongquan, zhongchong with guanchong, qiaoyin with dadun. All these are the jing-well points of the twelve channels. Luo Qianfu treated the magistrate-monk Zhao for a visceral stroke and cured him by pricking the twelve jing-well points; and he treated the commissioner Zhang for a visceral stroke and cured him by moxaing the twelve jing-well points.

Dongwon Boggam 寶鑑

1.61.13
Source원문

骨痺取大谿ㆍ委中; 筋痺取大衝ㆍ陽陵泉; 脉痺取大陵ㆍ少海; 肉痺取太白ㆍ三里; 皮痺取大淵ㆍ合谷. 《綱目》

Translation영역
For bone impediment take taixi and weizhong; for sinew impediment taichong and yanglingquan; for vessel impediment daling and shaohai; for flesh impediment taibai and zusanli; for skin impediment taiyuan and hegu.

Uihak Gangmok 綱目

1.61.14
Source원문

痺病宜燔鍼ㆍ劫刺, 以知爲數ㆍ以痛爲兪. 言鍼後以應效爲度數, 痛處爲兪穴, 非取諸經定穴也. 《靈樞》

Translation영역
In impediment disease the heated needle and the seizing insertion are appropriate, taking the patient's feeling as the count and the pain as the point. That is to say, after needling the response is taken as the number of treatments and the painful place is taken as the point; it is not a matter of using the fixed points of the channels.

Yeongchu 靈樞

1.61.15
Source원문

治歷節風亦如上法, 但於痛處灸三七壯亦佳. 《千金》 ○百節痠疼ㆍ實無所知, 以三稜鍼刺絶骨出血, 立愈. 《東垣》

Translation영역
Joint-running wind is treated as in the method above, but burning twenty-one cones at the painful place is also good. Where all the hundred joints ache and there is truly no knowing where, prick xuanzhong with a three-edged needle to let out blood, and it is cured at once.
Clinical note임상 주석
The chapter's final section and in several ways its most practical. The Lingshu's rule for the impediments is the one that has lasted: take the patient's feeling as the count and the pain as the point, not the fixed points of the channels. Treat where it hurts and stop when it answers — the whole of trigger-point practice is in that line. Beside it sits a set of recipes that could hardly be more different: the twelve jing-well points for a visceral stroke, with two named cases cured by Luo Tianyi, and the standard seven or nine or twelve points for wind, moxaed in the hundreds of cones. Two things stand out as still current. One is the prophylactic moxibustion in the third passage, prompted by exactly the prodrome of section 1.1 — numbness of the shin and the index and middle fingers — and repeated in spring and autumn for life. The other is the choice of huantiao as the essential point for hemiplegia, which is where a practitioner still begins. And the most honest note is the Juhu's opening: the decoctions can support the patient in the early disease, but for the full effect you need the needle and the moxa.

Cheongeumbang 千金 · Dongwon 東垣

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 2, Wind chapter. The Chinese text is collated against a transcription of the Kyujanggak printed edition carrying its leaf numbers and first-edition collation notes; original character forms (脉, 人參, 踈) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.