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Qi and blood, along with phlegm and fluid retention, are pathogenic factors originating from within the body; wind, cold, summer-heat, and dampness are pathogenic factors originating from outside. When a person's Qi and blood become deficient, Yin and Yang lose their balance.
Irregularities in diet and lifestyle, uncontrolled desires, lying exposed to wind or on the ground, and lack of proper care lead to empty and loose meridians, and open pores. Wind pathogens take advantage of this deficiency to invade. Stroke (Zhong Feng) and various wind diseases are all of this nature. As a pathogen, wind is characterized by its mobility and rapid changes. It strikes suddenly, causing dizziness, inducing floating of saliva, and disturbing the spirit.
When accompanied by heat, it leads to flaccidity and weakness; when accompanied by cold, it causes acute pain and spasms. Regarding the invasion of pathogens: the area affected by the pathogen becomes relaxed, while the area governed by healthy Qi becomes tense. The tension of healthy Qi pulling against the pathogen results in deviation of the mouth and eyes (Pian Pi), strabismus (Chuan Shi), jerking movements (Che Zong), convulsions (Chuo Nuo), paralysis (Tan Huan), and opisthotonos (Fan Zhang).
If the pathogen is in the Yang aspect (exterior), the skin becomes relaxed; if in the Yin aspect (interior), the abdomen becomes tense. Relaxation leads to the inability to control the limbs, while tension prevents the body from lying supine. Symptoms vary according to the depth and location (exterior/interior) of the pathogen. Although there are many types, they can be broadly categorized into four.
1. Hemiplegia (Pian Ku): Caused by deficiency of Qi and blood, characterized by hemiplegia, emaciated muscles, and bone pain.
2. Wind Fei (Feng Fei): Characterized by clear consciousness, absence of body pain, inability to lift the limbs, and one arm being useless. (Prognosis is good if speech is preserved.)
3. Wind An (Feng Yin): Sudden collapse, stiff tongue with inability to speak, throat obstruction, and hiccuping sounds. (Prognosis is good if the body is soft and sweating occurs.)
4. Wind Bi (Feng Bi): Caused by the combination of wind, cold, and dampness. The patient has thick flesh and numbness without sensation of pain or itch. Excess wind causes wandering pain; excess cold causes severe pain; excess dampness causes heaviness. If in the sinews, they contract and cannot extend; if in the vessels, blood stagnates; if in the flesh, there is insensibility; if in the bones, there is difficulty urinating and heaviness. This is called Wind Bi.
Wind Strike (Shang Feng): Characterized by fever, irritability, headache, shiny face, aversion to wind, and spontaneous sweating. Since wind disperses Qi, sweating occurs.
Diagnosis by pulse: Floating pulse indicates exterior disease; Excess pulse indicates interior disease; Deficient pulse indicates Zang organ disease; Rapid/Climaxing pulse indicates upper body disease.
Treatment principles: Floating pulse requires dispersing methods; Excess pulse requires draining/discharging methods; Deficient pulse requires warming methods. If the pulse is climaxing in the upper body and the patient is robust with phlegm-rushing sensations in the chest and throat, Gua Di San (Melon Stalk Powder) should be used in small amounts to induce vomiting.
Commonly, it is said that heat generates wind, which is generally true. However, wind is often generated from extreme deficiency of Stomach Qi, general Qi, or Blood. In such deficiency cases, Tian Xiong (Aconitum Kusnezoffii Radix), Fu Zi (Prepared Aconite Root), Guan Gui (Cinnamon Bark), and Chuan Wu (Aconitum Carmichaelii Radix) are indispensable.
The general principle of treatment is to eliminate phlegm and regulate Qi first. To regulate Qi, use Nan Mu Xiang (Costus Root) and Su He Xiang Wan (Styrax Pill); to eliminate phlegm, use Nan Xing (Arisaema Cum Bile), Ban Xia (Pinellia Tuber), Xi Xin (Asarum), and Jiang Can (Bombyx Batryticatus).
Agents such as Shi Lv (Malachite), Tie Yan (Iron Calx), Shui Yin (Mercury), Qing Fen (Calomel), Qian Shuang (Lead Subcarbonate), and Po Xiao (Mirabilite) must never be used recklessly. Cold toxins entering the stomach cause blood vessel stagnation and depletion of True Qi, leading to disability shortly thereafter.
For treating wind, Xiao Xu Ming Tang (Minor Continuation of Life Decoction) is the best formula, followed by Pai Feng Tang (Expelling Wind Decoction). However, these two formulas primarily treat wind rather than Qi. They must be assisted by Ren Shen Shun Qi San (Ginseng Qi-Regulating Powder) and Wu Yao Shun Qi San (Lindera Qi-Regulating Powder). Once Qi circulation is restored, wind will also dissipate.
Signs of untreatable conditions include: mouth open and hands scattered, bloody stool and urinary incontinence, eyes closed and unable to open, no sweat despite fever, frothy sputum and coarse breathing, snoring-like sounds, red or black complexion, erect hair and head tremors, cold extremities/mouth/nose, locked jaw with rapid and tight pulse. These are all signs of incurability.
For other types of wind diseases, please refer to my detailed discussion in "Ying Er Jing Feng Zhi Yao" (Essentials for Infant Convulsions).