张仲景认为,中风主要原因在于"外风",病机为"内虚邪中",治疗上注重肝脾同治、重镇熄风、扶正祛风;而叶天士认为,中风主要原因在于肝肾阴亏,病机为"阳化内风",治疗上在肝脾同治、肝胃同治的同时,注重四时养治,随时施治.从仲景"外风"到叶天士"阳化内风"不但体现了中风论治的多个不同角度,更体现了中风病机的发展历程.
According to ZHANG Zhong-jing, the main reason for the stroke was the "exogenous wind", and the most important pathogenesis was the "deficiency of qi and exogenous pathogenic factor". Three methods are stressed to cure the stroke: the equal treatment focused on the liver and the spleen, the use of tranquilizing medicine to stop the "wind", and the use of strengthening body resistance to get rid of the exogenous pathogenic factors. While YE Tian-shi considered that the main reason for stroke was the deficiency of liver-yin and kidney-yin. The chief pathogenesis in stroke was the "yang transforms to the interior wind". There are three therapeutic features in the treatment: the equal treatment focused on the liver and the spleen, the synchronous treatment of the liver and stomach, and select the medicine according to the four seasons climate. ZHANG Zhong-jing's theory of "exogenous wind" and YE Tian-shi's theory of "yang transforms to the interior wind" not only reflect the different angles in treatment for stroke, but also reflect the development of pathogenesis of stroke in the history.