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Wind-stroke (Shangfeng) is a condition where wind pathogen lodges in the Couli (interstices of skin and muscle). It presents with shivering and aversion to cold, sneezing, yawning, headache, and fever, resembling Cold Damage (Shanghan). The patient fears wind and cold upon exposure, but the symptoms are not severe. This is the nature of the condition.

The pulse is floating on the Yang position and weak on the Yin position. Generally, a floating pulse in the Lung region serves as a key differentiator.

Modified Xiangsu Decoction (Jiawei Xiangsu Yin)
Chuanxiong Rhizome (Chuanxiong), Perilla Leaf (Zisu), Notopterygium Rhizome and Root (Qianghuo), Saposhnikovia Root (Fangfeng), Atractodes Rhizome (Cangzhu), Cyperus Rhizome (Xiangfu), Licorice Root (Gancao), Schizonepeta Spike (Jingjie), Angelica Dahurica Root (Baizhi) (each 3 qian); Pueraria Root (Gegen), Peucedanum Root (Qianhu) (each 1 qian). Add ten scallion heads and three slices of fresh ginger to the above ingredients. Decoct and take orally. Cover with blankets until sweating is achieved.

If this is considered a minor ailment and left untreated, the wind pathogen will enter the Lungs over time, inevitably leading to cough. At that stage, treatment and regulation will require considerable effort. When initially contracting wind pathogen, Poria Sclerotium (Fuling) should be avoided because its flavor is bland and it promotes drying and leaching out. Administering it when exterior signs are present may guide the pathogen into the Yin meridians. If tonification, phlegm resolution, or food stagnation resolution is indicated, Modified Xiangsu Decoction should serve as the principal formula, modified according to specific symptoms. Detailed elaboration on every variation is unnecessary.

(Attached: Stroke Syndrome)
A person who appears healthy but suddenly suffers from stroke—could this be due to causes arising overnight? Fundamentally, internal corruption must occur first before worms can breed; soil must collapse first before water can breach it; wood must wither first before wind can destroy it. How much more so for humans!
The Classics state: Where pathogenic factors gather, Qi must be deficient. How can wind strike a person independently? It is the person’s own deficiency that allows them to be affected by wind. If internal Qi is sufficient and spirit is consolidated, Ying and Wei (Nutritive and Defensive Qi) will be harmonious, and the Couli will be tightly closed. Even if wind exists, how could it enter? Only because one fails to guard against violent anger, fails to regulate sexual desire, eats without satiety when hungry, dresses inadequately when cold, indulges in alcohol and lust, works tirelessly neglecting the body, bathes while exposed to wind, engages in intercourse while profusely sweating, sleeps uncovered due to heat, or runs in the rain, the True Yuan (Original Qi) is exhausted, and Blood and Qi are depleted. The major and collateral meridians accumulate deficiency year after year. Usually, there is little pain, yet Ying and Wei are empty, leaving only the shell of the body. It is like a heartless tree, about to break but not yet broken; or a wall without foundation, about to collapse but not yet collapsed. The situation is already unsustainable, yet the person considers themselves well, remaining deluded and unguarded. Once attacked by treacherous wind, it is like wearing a helmet and wielding a blade, entering undefended territory. The momentum is like splitting bamboo; within moments, everything collapses. Thus, between sipping wine and chatting, or shifting steps, one suddenly falls and becomes disabled. Is this not deeply regrettable? From this perspective, although caused by external wind, the root cause is internal Qi deficiency. However, the entire body does not necessarily suffer from uniform deficiency in interior, exterior, upper, or lower regions. Deficiency accumulates in specific areas where Qi circulation is obstructed and pressure is uneven. Therefore, once wind enters, the limbs become paralyzed. Speaking of Zang-Fu organs, each has distinct manifestations. Stroke affecting the Zang organs often blocks the nine orifices, presenting with flaccid lips and drooling, nasal congestion, deafness, blurred vision, and constipation. Stroke affecting the Fu organs often impacts the four limbs, presenting with hemiplegia, inability to move hands and feet freely, and left-side paralysis or right-side flaccidity. Stroke affecting the collaterals (Blood-Vessels) presents without the six-meridian exterior signs or internal obstruction of urination and defecation, manifesting only as facial deviation to the left or right. Limb movement, daily activities, eating, and breathing remain normal. Cases where the thigh cannot be raised and speech is lost, without other symptoms, constitute Stroke affecting the Meridians. This is milder than Zang/Fu involvement but more severe than collateral involvement. Regarding treatment: For Zang involvement, purgation is suitable; for Fu involvement, diaphoresis is suitable; for Meridian involvement, tonifying Blood to nourish tendons is suitable; for collateral involvement, nourishing Blood to promote Qi circulation is suitable. These are all treatable conditions, though difficulty varies. Zang involvement is most difficult, followed by Fu, then Meridian. Collateral involvement can be cured with medication. However, if contraindications are ignored, recurrence is likely, and subsequent strikes will affect the Zang organs. Each strike increases deficiency and severity. Although Fu involvement is treatable, if it progresses from collateral/Meridian to Fu, it becomes difficult to treat. Zang involvement is inherently difficult; if it progresses from Fu to Zang, it is incurable. If Fu involvement combines with Zang involvement, what difference is there from Cold Damage with simultaneous exterior and interior involvement? Survival is unlikely. In stroke, an open mouth indicates Heart Qi exhaustion; relaxed hands indicate Spleen Qi exhaustion; closed eyes indicate Liver Qi exhaustion; urinary incontinence indicates Kidney Qi exhaustion; snoring-like sounds indicate Lung Qi exhaustion; oily sweat indicates internal exhaustion of Original Qi; tendon pain indicates lack of Blood; hair standing on end and moving upward, flushed face like makeup, and bead-like sweat are all signs of incurability. Some die immediately upon onset; why such urgency? The Five Zang organs regard the Heart as the Monarch. The Heart governs the whole body. Among the Five Zang, the Heart is the hardest to fail. Thus, after death, when Qi ceases and the body cools, the chest remains warm because the Heart dies last. Those with Zang stroke who do not die immediately do so because although the Qi of the four other Zang organs has failed, the Heart has not. Once the Heart is struck, before a cup of wine is finished or a few words spoken, the soul departs. Even with medicines capable of reviving the dead, they would be useless. The general principle for stroke states that all symptoms belong to Wind-Phlegm. Upon onset, regardless of whether the pathogen is in the exterior or interior, resolving Phlegm and expelling Wind must be the primary approach. Only after the patient regains consciousness should the meridians be examined and Blood/Qi differentiated for treatment. One must not abruptly use tonics simply because internal Qi is deficient. During stroke, pathways are blocked by Phlegm; even if tonification is desired, there is no route for it to enter. If the case truly involves extreme deficiency, characterized by no facial deviation, no limb paralysis, no urinary/fecal obstruction, but continuous sweating, dizziness, weakness in limbs, and shortness of breath, Ginseng Decoction (Dushen Tang) may be used, assisted by Citrus Reticulata Peel (Juhong), Ginger Juice (Jiangzhi), and Bamboo Sap (Zhuli). Without these moderating agents, temporary recovery might occur, but unresolved Phlegm will cause future harm, potentially leading to carbuncles and ulcers with no remedy.