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*Ji Bing Ji Yao* (Essentials of Disease Mechanisms) states: In treating wind diseases, one must distinguish whether the pathogen is in the Zang organs, Fu organs, or meridians. It is held that wind originates from heat; when heat prevails, wind moves. One should use stillness (Yin) to overcome dryness, which refers to nourishing the blood. Treatment requires inducing little sweating and using purgatives sparingly. Excessive sweating will weaken Wei Qi (Defensive Qi), while excessive purgation will damage Ying Qi (Nutritive Qi). It is appropriate to treat disorders in the meridians. Although there are contraindications for sweating and purging methods, there remains a distinction between Zhong Zang (Stroke involving Zang organs) and Zhong Fu (Stroke involving Fu organs). Zhong Fu typically manifests in the four limbs, presenting with exterior syndrome symptoms such as floating pulse, aversion to wind, limb stiffness, numbness, and lack of sensation. Zhong Zang typically causes obstruction of the nine orifices, characterized by flaccid lips, loss of speech, deafness, nasal congestion, blurred vision, and constipation. For Zhong Fu, diaphoresis (sweating method) is suitable; for Zhong Zang, purgation is suitable. If both exterior and interior conditions have harmonized, treatment should focus on the meridians, employing major tonifying herbs to nourish the body.

*Fa Ming* (Inventions/Elucidations) states: When pathogens strike the blood vessels, facial paralysis (deviation of mouth and eyes) occurs; when they strike the Fu organs, limb joints become useless; when they strike the Zang organs, life is endangered. Treatments differ accordingly. For pathogens striking the blood vessels, if there are exterior manifestations corresponding to the Six Meridians, Xiao Xuming Tang (Minor Continuation of Life Decoction) should be modified and used. For pathogens striking the Fu organs, if there is internal obstruction of defecation and urination, Sanhua Tang (Three Transformations Decoction) or similar formulas should be used to promote unblocking and lubrication. If there are no exterior Six Meridian manifestations and no internal obstruction of excretion, nourishing blood and promoting Qi circulation is indicated, primarily using Da Qinjiao Tang (Major Gentian Root Decoction) or Qianghuo Yufeng Tang (Notopterygium Wind-Dispelling Decoction).

Liu Zongnong states: By classifying these into three syndromes—exterior, interior, and meridian—and establishing three treatment methods—diaphoresis, purgation, and regulation/nourishment—it can be said that this approach opened the eyes and ears of later generations. However, practitioners should carefully examine the various formulas employed.

Hejian (Liu Wansu) states: Wind diseases are often caused by extreme heat. The common term "wind" describes the terminal symptoms while forgetting the root cause. Therefore, stroke patients with paralysis are not suffering from an excess condition of Liver Wood wind suddenly striking the body, nor are they affected by external wind invasion. Rather, it is indeed due to improper regimen leading to a sudden flare-up of Heart Fire, coupled with deficiency and decline of Kidney Water, which fails to control the fire. This results in Yin deficiency and Yang excess, with hot qi stagnating and郁结 (depressing/stagnating), causing the Heart Spirit to become confused and overwhelmed, leading to sudden collapse and loss of consciousness due to the dysfunction of sinews and bones. This is mostly caused by the five emotions (joy, anger, sorrow, worry, fear) reaching their extremes. Such sudden strokes are all due to extreme heat. If mild, there is only temporary rigidity and falling, but Qi and Blood flow freely, and sinews do not spasm. In milder cases, the patient returns to normal after the episode; however, if heat becomes extremely abundant and stagnates without relief, Yin Qi may suddenly cease, followed by the exhaustion of Yang Qi, leading to death.

Phlegm and saliva arise because extreme heat causes Water to be controlled by Fire, thereby generating phlegm.

Hemiplegia (partial paralysis) occurs when one side of the meridians is obstructed; Bi syndrome (obstruction) leads to paralysis.

Stiffness and spasms of the oral muscles occur because wind-heat is too severe, overcoming dampness. Additionally, if body fluids stagnate in the chest and diaphragm, forming phlegm, the sinews become excessively dry. Since Dryness Metal governs contraction, it results in forceful tension. Conversely, if sinews become flaccid, it is due to excessive dryness and depletion of blood. Sinew spasms are easy to cure, whereas sinew flaccidity is difficult to recover from, indicating the severity of dryness.

Danxi (Zhu Zhenheng) states: Reviewing texts below *Neijing* (The Inner Canon), all attribute this to external wind-stroke pathogens. However, geography differs between north and south, so generalizations are inappropriate. Previously, Liu Shouzhen (Liu Wansu) argued that improper regimen leads to water failing to control fire, which is very accurate. Speaking from the present perspective, in the northwest regions, there are indeed cases of true wind-stroke, though they are rare. People in the southeast are mostly affected by damp earth generating phlegm, phlegm generating heat, and heat generating wind. Where evil gathers, Qi must be deficient; wind pathogens injure the Lung organ most frequently.

Xu Xueshi (Xu Shumi) states: Qi Zhong (illness caused by emotional disturbance) also involves injury from the Seven Emotions. The pulse may be weak and rapid, or floating and tight, or slow and delayed. A slow and floating pulse is treatable; a large, rapid, and extreme pulse indicates death. If it is truly an external wind strike, it aligns with Dongyuan's (Li Gao) principles of striking blood vessels, Fu organs, or Zang organs. Regarding inability to move the four limbs, there are similarities with Wei Syndrome (Flaccidity Syndrome), which must be carefully differentiated. *Ju Fang* (Formulas of the Bureau) treating wind and flaccidity together is a major error, as detailed extensively in *Fa Hui*. Zihe (Zhang Congzheng) uses the three methods (sweating, vomiting, purging); these are applicable only if it is indeed a sudden strike by evil qi with abundant phlegm and excess heat; otherwise, they should not be used.

Hejian states: Stroke patients should not use Long Nao (Borneol), She Xiang (Musk), Xi Jiao (Rhinoceros Horn), or Zhu Sha (Cinnabar). Using them is like patrolling the streets with a bell, causing thieves to hide and not emerge, which instead allows the pathogen to penetrate into the bone marrow, becoming inseparable like oil entering dough. This is an example of such harm. If phlegm surges and the patient loses consciousness, appearing comatose and unaware, it is appropriate to use medication to purge the phlegm. Thus, wind is the leader of a hundred diseases. Even with careful examination of meridian theories, doubts inevitably remain. Alas! It is difficult for physicians who do not understand the subtleties of Yun Qi (Five Movements and Six Qi), creation/transformation, geography, and disease mechanisms to apply flexible and adaptive treatments!