中風之臨床經驗

Clinical Experience in Stroke

「中風」即今西醫之腦血管疾病。中醫治療中風，首先區分為(1)外風，(2)內風二大類。外風為外邪侵襲，臨床上又別為甲：寒中，是因寒邪外中。病例：林女士，七十歲，左半身不遂，證現風寒外客，以小續命湯加味治之。乙：熱中，是因實熱中風。病例：羅女士，六十歲，發熱昏迷，四肢癱瘓，證現熱盛，以涼膈散加減及祛風至寶丹加減，配合牛黃治之。內風為內火織盛。病例，周高女士，六十六歲，突發昏迷嗜睡，左偏癱，痰多，證現痰火內發；用清熱滌痰湯加減及牛黃清心丸治之。此外，不論外風與內風，診治上都還要辨識「虛證」或「實證」，才能對證處方。中國歷代醫家針中風提出許多不同的見解與治驗，本文亦稍予論述之。

Stroke, seen in western medicine as cerebrovascular disease is traditionally attributed to wind in Chinese medicine. Successful treatment according to traditional methods requires differentiation of external wind from internal wind and identification of the presence of cold, heat, vacuity, and repletion. This paper offers some clinical experience in dealing with stroke and refers to classical literature of stroke in Chinese medicine that has traditionally been the subject of much debate. (1) External Wind Cold Pattern: Lin, female, aged 70, hemiplegia of the right side of the body, with signs of wind-cold lodging in the exterior. Treatment: modified hsiao hsu ming decoction (小續命湯). Heat Pattern: Luo, female, aged 60, fever, coma, tetraplegia, with signs of exuberant repletion heat. Treatment: variations of hang ke powder (涼膈散) and ch'u feng chih pao pill (怯風至寶丹). (2) Internal Wind Intense Internal Heat: Chou, female, aged 66, sudden loss of consciousness and left side hemiplegia with copious sputum. Treatment: variations of ch'ing jeh ti tang decoction (清熱滌痰湯) and niu huang ching hsin pill (牛黃清心丸).