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Those with locked jaw (Jaw lock) and inability to speak, some have tongue flaccidity (Tongue flaccidity) with slurred speech and inability to speak; some have numb tongue with dysarthria and inability to speak. How can these details not be carefully distinguished!

Locked jaw is a disease of the Foot-Yangming Meridian, treated by the Jiache acupoint. The Yangming meridians surround the mouth and lips, passing through Jiache, while all Yang muscle sinews ascend to the head. The sinews of the Three Yang meridians connect to the mandible and cheeks, flanking the mouth. When wind-cold invades the meridian due to deficiency, the sinews become spasmodic and tight, causing tension in the teeth and jaws, resulting in locked jaw. Additionally, excessive wind-heat and phlegm-fluid stagnation in the diaphragm can cause this; wind tends to injure the Liver, which also dries substances, leading to dry, stiff sinews that force the jaw shut. These are all diseases caused by excess pathogens, belonging to the Closed Syndrome within the Wind-Stroke category. In contrast, in the Collapsing Syndrome, the Qi of all Yang meridians has collapsed, leaving the body without control, resulting in an open mouth and protruding tongue that cannot retract.

The Kidney stores essence and governs the generative function of the lower Jiao's earth qi; thus, the Chong and Ren vessels are connected to the Kidney. These two vessels share the large collateral of the Kidney, originating from the uterus (Bao Zhong). The Chong vessel is therefore called the Bao Luo (Uterine Collateral), serving as the Sea of the Twelve Meridians, hence named "Sea." The ascending branch of the Chong vessel seeps into the Yang meridians and irrigates the various channels; the descending branch seeps into the Three Yin meridians, irrigates the collaterals, and warms the muscles. Its separate collaterals knot at the dorsum of the foot. If Kidney deficiency causes internal blockage of the Bao Luo preventing connection upwards, the Kidney meridian, which follows the throat and clings to the root of the tongue, results in inability to speak. If the two collaterals fail to connect downwards, Fei Jue (Flaccidity and Vertigo) occurs.

Wind-stroke is mostly caused by insufficiency of Liver Yin and depletion of Kidney Water, allowing deficient fire to rush upward, causing sudden collapse without warning. Without nourishment for the sinews and bones, hemiplegia and paralysis ensue. Therefore, nourishing the Kidney and tonifying the Liver is the most essential method for treating the root. However, the saying "the Liver has no tonification method" prevails in the world, where everyone focuses on subduing and calming the Liver. They do not realize that what cannot be tonified refers to Liver Qi, not Liver Blood. The Jueyin Liver is the organ of Wind-Wood, preferring free flow and hating depression; thus, the Classic states: "When Wood is depressed, it should be dispersed." The Liver stores blood; when one sleeps, blood returns to the Liver. Thus, what nourishes the Liver is blood. When Liver Blood is deficient, Liver Fire becomes hyperactive; when Liver Fire is hyperactive, Liver Qi rebels. Rebellious Liver Qi leads to excess Qi, which represents pathological excess. It is unknown that while excess Liver Qi indeed cannot be tonified (as tonification would cause Qi stagnation and discomfort), it does not mean Liver Blood cannot be tonified. Deficiency of Liver Blood leads to sinew spasms, opisthotonos, convulsions, vertigo, brittle nails, headache, hypochondriac and lower abdominal pain, and hernia—all symptoms of Liver Blood failing to nourish. Thus, even apparent excess of Liver Qi actually stems from deficiency of Liver Blood; how can it not be tonified? Moreover, nothing tonifies Liver Blood better than nourishing Kidney Water, as Water is the mother of Wood. When the mother is strong, the child is robust; therefore, one must nourish the source of transformation. Liver Blood deficiency also arises from the lack of nourishment by Kidney Water. If one claims the Liver has no tonification method and focuses on subduing it, the more one disperses, the more deficient it becomes, leading to incurable conditions.

For wind-stroke, one should follow the theories of Jiegu and Dongyuan, using involvement of the Fu organs, Zang organs, or Blood-Vessels as the key to differentiation. Jiegu stated: Involvement of Fu organs manifests mostly in the four limbs; involvement of Zang organs manifests mostly in the nine orifices. Dongyuan stated: Involvement of Fu organs leads to limb dysfunction; involvement of Zang organs endangers life; involvement of Blood-Vessels leads to facial deviation. Straight-running pulses are Jing (Meridians); branching ones are Luo (Collaterals). There are twelve Jing and fifteen Luo. Additionally, the Yang Qiao passes through six Zang organs, governing the exterior; the Yin Qiao connects through five Zang organs, governing the interior. The large collateral of the Spleen connects all meridians of the Zang-Fu, Yin-Yang, interior-exterior, upper-lower, named Da Luo, totaling fifteen. However, medical texts often vaguely mention external Six-Meridian symptoms, prioritizing Xiao and Da Xuming Decoction. The human body has twelve meridians associated with Zang-Fu: Hand has Three Yang and Three Yin; Foot has Three Yang and Three Yin. Regarding the six-meridian symptoms in wind-stroke: are they Hand or Foot? Six-Meridian symptoms belong only to Cold Damage (Shanghan). Some claim wind-stroke six-meridian symptoms are identical to cold damage six-meridian symptoms, even citing cold damage symptoms to explain wind-stroke symptoms, which is greatly erroneous. Cold damage affects only the Foot meridians, not the Hand meridians: Day 1 Taiyang, Day 2 Yangming, Day 3 Shaoyang, then transmitting to Foot Three Yin: Day 4 Foot Taiyin, Day 5 Foot Shaoyin, Day 6 Foot Jueyin, progressing gradually from exterior to interior. Hence, Zhang Zhongjing used methods like Mahuang Tang, Guizhi Tang, and Da/Minor Chengqi Decoctions. Wind-stroke, being a sudden acute collapse, makes it difficult to distinguish meridians; there are only distinctions between Zang/Fu and Blood/Vessels. It may affect the Foot Six Meridians or Hand Six Meridians, unlike the sequential transmission in cold damage. Therefore, discussing wind-stroke involves all Twelve Meridians, not just the Foot Six.

Enuresis is due to extreme deficiency of Primordial Yang True Qi. One must heavily use Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), and Fuzi (Prepared Aconite Root), combined with Yizhiren (Alpinia Oxyphylla Fruit) and Wuweizi (Schisandra Berry), to preserve the collapsing Yuan Yang. Frequent administration to replenish and connect is truly the first critical pass for preserving life. What sustains human life is this Yang Qi. Once deficient, it can collapse at any time; thus, tonifying medicines should be administered frequently to maintain continuity. This must not be neglected or ignored.

Dongyuan’s theory focuses primarily on Qi deficiency. Even if wind pathogens exist, they invade due to deficiency. The Classic says: "Where pathogenic factors gather, Qi must be deficient." At such times, can ordinary herbs penetrate up and down? Urgently administering large doses of Renshen, Wutou (Aconite Mother Root), and Fuzi can restore consciousness, demonstrating the power to unblock meridians and collaterals, breaking through barriers. Each dose requires about one tael of Renshen to supplement True Qi and drive out pathogens; otherwise, it brings harm rather than benefit. Observing the decoctions of ancients like Fushen Tang reveals this principle. For enuresis, hand release, open mouth, and snoring—though considered untreatable—patients often survive with the aforementioned medicines. Yu Jiayan said: Zang organs are Yin and can withstand pure Yang medicines; Fu organs are Yang and require one or two Yin herbs to restrain rebellious heat. For superficial channel diseases, harmonize Ying and Wei and add guiding herbs. Liu’s theory posits wind as the branch and fire as the root; however, excess fire stems from Wood deficiency. Liu originally focused on tonifying the Kidney, as seen in Dihuang Yinzi. But in critical wind-stroke cases, one must prioritize pure Yang tonification, as Yang is the root of life. When Yang grows, Yin naturally increases. Tonifying Yin is slow and may be too late. Moreover, with severe Yang deficiency, even if false fire exists, adding Yin herbs might extinguish this shadow-fire abruptly, worsening the trend toward Yang collapse, making rescue impossible. Only when the crisis stabilizes should one tonify True Yin. Yin deficiency has two types: deficiency of Water within Yin, and deficiency of Fire within Yin. For Fire deficiency, use Hejian’s Dihuang Yinzi exclusively; for Water deficiency, use Liuwei Dihuang Wan. Thus, the most appropriate treatment always prioritizes securing Yang for survival, followed by tonifying essence and blood as the foundation for removing disease. Wind arises from fire; fire arises from Yin deficiency. Once Yin and blood are restored, wind and fire subside. Many die from wind-dryness because they ignore this.

Sinews bind bones everywhere; pulses originate at the tips of fingers and toes, hence the Twelve Meridians are named after hands and feet. Pulses are tunnels for blood; when Ying is harmonious, it is soft; when deficient, movement fails; when hot, it relaxes; when cold, it contracts. Thus, *Zhunsheng* states: All wind-bi and hemiplegia arise from the failure of True Qi to circulate. Treatment must use Huangqi (Astragalus Root) as the sovereign herb, Renshen, Danggui (Angelica Sinensis Root), and Baishao (White Peony Root) as ministers, and Fangfeng (Saposhnikovia Root), Guizhi (Cinnamon Twig), Gouteng (Uncaria Ramulus) as assistants. Using only Wutou, Fuzi, Qianghuo (Notopterygium Rhizome), and Duhuo (Angelica Pubescens Root) depletes Ying and consumes Wei, never achieving cure. When spirit is short and exertion is excessive, connections break suddenly, causing unexpected collapse. If innate truth is not exhausted and the Chi pulse has a root, recovery is swift. If innate truth is exhausted and the Chi pulse lacks a root, Yang collapses, eyes open, snoring occurs, enuresis and sweating manifest, indicating complete collapse with little hope of survival. Therefore, maintaining the root daily and balancing water and fire ensures harmonious Qi and blood, preventing disease. If illness occurs but the root is not severely damaged, proper regulation restores water and fire harmony, allowing gradual Qi and blood recovery. Ignoring this, during extreme Qi and blood deficiency when Yuan Yang scatters, treating spasms as wind or phlegm accumulation as phlegm reduces symptoms but further injures Zheng Qi. Severe cases lead to sudden death; mild cases become chronic. Understanding the basis of water and fire and the source of Qi and blood growth allows one to remain unmoved by deceptive external manifestations. As *Ling Shu* states: When empty pathogens dwell on one side deeply, residing in Ying and Wei, their disease causes True Qi to depart, leaving pathogen alone, resulting in hemiplegia. Shallow pathogens cause unilateral pulse pain. Also: Fei disease presents with no pain, loss of limb control, mild confusion, and faint speech (treatable); severe cases involve inability to speak (untreatable). This confirms that true Qi departure and pathogen retention are key. Cases where spirit is undisturbed and speech is faint are treatable; those with confused spirit and inability to speak are untreatable. Thus, knowing that true deficiency is the root and external pathogen is the branch applies to only 10-20% of cases. Why cling to specific wind-stroke formulas? Humans are formed by true water and fire, developing Zang-Fu, sinews, bones, and body. The root of Zang-Fu lies in true water and fire; Yin-Yang interaction generates Qi and blood, circulating through Zang-Fu and irrigating the body. Thus, water and fire are the root; Qi and blood are the branch. Extreme deficiency of true Yin and Yang allows pathogens to strike directly into Zang, damaging internal organs and threatening life. If Qi and blood are insufficient but not critically depleted, pathogens cannot reach the interior deeply, affecting only Fu organs or blood-vessels, causing hemiplegia or atrophy. Extreme true Yang deficiency allows internal cold to accumulate and attack, not necessarily external cold. Extreme true Yin deficiency allows internal wind-fire to move and attack, not necessarily external wind-fire. Internal wind arises from internal fire. Identifying the branch and targeting the root is the comprehensive key to treatment. In critical deficiency and imminent death, focusing on deceptive wind-phlegm-Qi phenomena loses the fundamental Jing-Qi-Shen, rendering treatment ineffective. Dispelling wind leaks Yuan Shen; clearing fire destroys Yang Qi; resolving phlegm consumes deficient true Yin; regulating Qi floats Dan Tian, exacerbating rootless deficient Yang, turning closed syndrome into collapsing syndrome. (Closed syndrome: jaw lock, clenched fists, treatable. Collapsing syndrome: open mouth, relaxed hands, closed eyes, enuresis, snoring, untreatable.) These errors belong to those treating the branch. (Zhang) studied wind-stroke extensively, never failing, with cases recorded separately.

People assume sudden collapse and unconsciousness is wind-stroke, sudden death is Zang involvement, and copious phlegm is Phlegm Jue. They do not know that 80-90% are due to extremely weak True Qi with floating phlegm-fire. If deficiency is extreme and Yang violently collapses, death follows via urine loss. At this moment, formless Shen Qi is near extinction; urgent large doses of Renshen, Baizhu, and Fuzi can save lives. Treating wind-fire-phlegm as tangible diseases and using random drugs leads to death. Beware!

Regarding hemiplegia, must the left side be Blood and the right side Qi? Not necessarily. The body divides Yin-Yang and Water-Fire. Men: Left is Water, Right is Fire. Women: Left is Fire, Right is Water. Men with hemiplegia often affect the left; women often affect the right, indicating Yin deficiency predominance. Also, if the upper body is normal but the lower body is weak and numb, with urinary issues, is this Qi or Blood? It is deficiency of the Foot Three Yin meridians. The Classic says: Ying deficiency causes numbness (loss of sensation); Wei deficiency causes immobility (limbs unusable). One does not divide Qi and Blood by left/right. Qi and Blood flow seamlessly; why assume Qi flows only right and Blood only left?

Heaven and Earth’s way: Spring Qi starts left, ends right; Autumn Qi starts right, ends left; Summer Qi starts top, ends bottom; Winter Qi starts bottom, ends top. The human body is similar; all Yang meridians start at hands/feet and traverse the body. Wind-cold lodging in skin/muscle stops at deficiency points, easily attacking areas with poor Qi/Blood circulation. Insufficient Qi/Blood leads to uneven operation, hence "hemiplegia." *Nei Jing* mentions left/right as pathways of Yin-Yang, not dividing Qi/Blood by side. Qi and Blood flow throughout the body; Qi is like a bellows, Blood like waves; Qi moves Blood, Blood accompanies Qi, Yin-Yang sustain each other in endless cycles. Where is the division of left/right? Since Danxi argued hemiplegia left is Blood deficiency and right is Qi deficiency, this distinction began. While it is acceptable to say right-side hemiplegia relates to Spleen/Lung (located right) and left-side to Kidney/Liver (located left), insisting strictly on Right=Qi/Left=Blood separates Qi and Blood unnaturally. Qi and Blood move together; stagnation in one stagnates the other. If Blood deficiency, tonify Qi (to generate Blood); if Qi deficiency, tonify Blood (to harmonize Qi). Treating them separately worsens Yin-Yang disharmony, failing to heal hemiplegia.

The Classic says: Liver governs sinews; all sinews attach to joints. Movement depends on sinews. Sinews are hard but become soft via Qi/Blood nourishment, evident in youth vs. old age. After major illness or cold damage sweating/purging, Qi deficiency and Blood weakness leave sinews unsupported, causing spasms. In cholera/vomiting-diarrhea, sudden fluid loss causes tendon contraction. Fat-white people often have damp-phlegm stagnation; dark-thin people often have blood depletion. Symptoms include gradual limb weakness, numbness in arms/thighs/fingers, facial deviation, dysarthria, chest stuffiness, continuous phlegm, limb weakness, muscle twitching, or wiry-slippery yet weak pulses. Though not yet collapsed, wind-stroke syncope is imminent. Prevention via diet, emotional regulation, and sexual abstinence is crucial. Medication: If Chi pulses are weak, use Liuwei Dihuang Wan or Bajun Dihuang Wan to tonify Liver/Kidney. If Cun/Guan pulses are weak, use Liujunzi Tang or Shiquan Dabu Tang to urgently tonify Spleen/Lung. Using wind-dispelling or phlegm-clearing herbs invites wind-strike. If already struck and Qi is deficient, protect Qi, do not expel pathogen. With True Yin lost and solitary Yang flying, only Guizhi and Fuzi can recover scattered Yuan Yang. Rising phlegm indicates Water not returning to source; red face/thirst indicates Fire not returning to source. Only Guizhi and Fuzi guide Fire back to origin. Once Water and Fire return, Water generates Wood, Wood does not generate Wind, and Wind subsides. For excess pathogens like Bi syndrome, support Zheng Qi but use mild expelling herbs like Yilao Tianma Wan. Spasms vary: heat-dried sinews, cold-contracted sinews, Blood-deficient sinews, or pathogen-stagnated joints. Careful differentiation is needed!

Yin deficiency has two types: Water deficiency within Yin (disease in essence/blood); Fire deficiency within Yin (disease in spirit/Qi). Yang decline causes Qi collapse and mental confusion; Yin亏 causes physical decay and limb flaccidity. True Fire is the root of Yang; True Water is the root of Yin. If Water/Fire are unstable, Yin/Yang perish. Internal spirit loss invites external pathogens; root destruction leads to withered branches.

In wind-stroke, difficulty urinating is either due to dried fluids in Zang-Fu or fluid loss from sweating. Treat accordingly. If urination is frequent/profuse, avoiding diuretics prevents further fluid loss and Yuan Yang leakage. Urgent, uncontrollable urination indicates extreme True Qi deficiency failing to secure. Extreme collapse leads to enuresis. All limbs rely on Qi/Blood for moisture and Spirit for control. Central True Yuan decline and external Spirit scattering cause loss of bodily mastery. Desire to move but unable indicates Zheng deficiency. Stillness resembling spontaneous movement is a false wind image. Lying rigid like a corpse indicates Shen Qi nearing departure but not gone. Restoring Yang and securing the root preserves life. Nourishing Zheng removes evil daily; exploring roots eliminates disease. Attacking first then tonifying follows popular preference, ignoring disease principles.

After slight improvement in wind-stroke, increased appetite occurs because Wood (Liver) overacts on Earth (Spleen), seeking help from food. One should drain Liver and regulate wind to calm Spleen; once Spleen is calm, appetite normalizes. However, this is also due to exhaustion of Zang-Fu fat/grease, having Yang without Yin, so solitary Yang acts like Middle Xiao (Middle Burner Diabetes). Though eating much, it doesn't create essence; food merely offsets consumption. Tonifying essence and blood restores grease and normalcy; why drain Liver and regulate wind?