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The term "True Wind Stroke" (Zhen Zhong Feng) is used to distinguish it from similar conditions. "Wind" refers to pathogenic wind evils originating from the eight directions. "Zhong" (Stroke/Hit) indicates that the pathogen enters from the exterior into the interior. There are distinctions among stroke of the meridians (Zhong Jing), stroke of the fu organs (Zhong Fu), stroke of the zang organs (Zhong Zang), and stroke of the vessels and collaterals (Zhong Xue Mai). These few sentences are largely similar to, yet slightly different from, those in the *Su Wen* chapter on Pathogenesis (*Bing Ji Yao Jie Ming*), each having its own linguistic or logical flaws. I have corrected them based on my elucidation of medical principles: Stroke of the meridians manifests externally with symptoms of the Six Meridians; stroke of the fu organs presents internally with obstruction of urination and defecation; stroke of the zang organs endangers life; stroke of the vessels and collaterals has neither external symptoms of the Six Meridians nor internal obstruction of urination and defecation.

Let us first discuss stroke of the meridians. Stroke of the meridians presents with symptoms of the Six Meridians: Taiyang meridian involvement causes headache and stiffness of the spine; Yangming meridian involvement causes eye pain, dry nose, body heat, and inability to sleep; Shaoyang meridian involvement causes chest fullness, bitter taste in the mouth, hypochondriac pain, deafness, and alternating chills and fever; Taiyin meridian involvement causes spontaneous diarrhea, abdominal pain, or difficulty in defecation; Shaoyin meridian involvement causes thirst and occasional cold limbs; Jueyin meridian involvement causes retraction of the scrotum, urinary incontinence, cold limbs, and the complexion also displays colors diagnosticable by the Five Colors method. This represents a superficial stage of wind stroke, for which Xiao Xuming Tang (Minor Continuation Life Decoction) modified is appropriate as the main prescription.

Xiao Xuming Tang (Formula see *Shi Fang Miao Yong*)

If wind stroke presents with no sweat and aversion to cold, double the dosage of Ephedrae Herba (Mahuang), Armeniacae Semen Amarum (Xingren), and Saposhnikoviae Radix (Fangfeng) according to this formula. It is suitable to prick Zhiyin (BL67) to bleed. (The acupoint is located at the lateral corner of the nail of the fifth toe, pricked two fen deep). Kunlun (BL60). (The acupoint is located posterior to the calcaneus at the lateral malleolus, needled through to Taixi (KI3)).

If wind stroke presents with sweat and aversion to wind, double the dosage of Cinnamon Twig (Guizhi), White Peony Root (Shaoyao), and Armeniacae Semen Amarum (Xingren) according to this formula. It is suitable to needle Fengfu (GV16). (The acupoint is located one cun posterior to the hairline at the nape. Needled three fen deep, moxibustion is prohibited).

The above two cases are both wind stroke of the Taiyang meridian.

If wind stroke presents with sweat, body heat, but no aversion to cold, add Gypsum Fibrosum (Shigao) and Anemarrhenae Rhizoma (Zhimu) each two qian to the base formula, double the Licorice Root (Gancao), and remove Aconitum Lateralis Preparatum (Fuzi).

If wind stroke presents with sweat, body heat, but no aversion to wind, add Puerariae Radix (Gegen) and Cinnamon Twig (Guizhi), and double the Scutellariae Radix (Huangqin). It is suitable to needle Xiangu (ST41), (located in the depression distal to the metatarsophalangeal joint between the second and third toes, needled five fen deep), to eliminate the thief of the Yangming meridian, and simultaneously pierce Lidui (ST45), (located at the tip of the second toe, about the width of a leek leaf from the nail), to drain excess from the Yangming meridian.

The above two cases are both wind stroke of the Yangming meridian.

If wind stroke presents with no sweat and cool body, double the Aconitum Lateralis Preparatum (Fuzi), double the dried Ginger (Ganjiang) twice, and double the Licorice Root (Gancao) according to this formula. It is suitable to pierce Yinbai (SP1), (located on the medial side of the big toe, about the width of a leek leaf from the nail corner), to eliminate the thief of the Taiyin meridian.

This is wind stroke of the Taiyin meridian.

If wind stroke presents with sweat but no heat, double the Cinnamon Twig (Guizhi), Aconitum Lateralis Preparatum (Fuzi), and Licorice Root (Gancao) according to this formula. It is suitable to needle Taixi (KI3). (Located in the depression posterior to the medial malleolus at the calcaneus, needled through to Kunlun (BL60)).

This is wind stroke of the Shaoyin meridian.

If wind stroke involves confusion of the Six Meridians, attributed to Shaoyang and Jueyin, or if there is spasmodic pain in the joints, or numbness and insensitivity, add Notopterygii Rhizoma et Radix (Qianghuo) and Forsythiae Fructus (Lianqiao) to the base formula. Moxa the Juegu (GB39) point of the Shaoyang meridian, (three cun above the lateral malleolus, five moxa cones), to guide out the heat. Pierce the Jing-Well point Dazhun (LR1) of the Jueyin meridian, (between the hairs on the big toenail), to unblock the meridian.

This is wind stroke of the Shaoyang and Jueyin meridians.

Regarding stroke of the fu organs, it is slightly similar to fu organ syndromes in Cold Damage. Internally, there is obstruction of urination and defecation, so Sanhua Tang (Three Transformations Decoction) is suitable to unblock it. If accompanied by meridian symptoms, Fangfeng Tongsheng San (Saposhnikovia Unblocking Hero Powder) is suitable for simultaneous release of exterior and interior.

Regarding stroke of the zang organs, stroke of the zang organs often leads to stagnation of the nine orifices, presenting with symptoms such as flaccid lips, loss of voice, deafness, blurred vision, nasal congestion, and difficulty in urination and defecation. Or sudden collapse with loss of consciousness, distinguished into Closed Syndrome (Bi Zheng) and Collapsing Syndrome (Tuo Zheng).

If the mouth is open, it indicates Heart Qi exhaustion; if the eyes are closed or looking upward, it indicates Liver Qi exhaustion; if the hands are relaxed and open, it indicates Spleen Qi exhaustion; if there is urinary incontinence, it indicates Kidney Qi exhaustion; if sweat is like oil and the sound resembles snoring sleep, it indicates Lung Qi exhaustion. Also, a face red as if painted, and an urgent, large pulse, are all signs of extreme deficiency and Yang collapse, which are untreatable. Only by using Sansheng Yin (Three Lives Decoction) one liang, added with Ginseng Radix et Rhizoma (Renshen) one liang, decocted separately into a thick juice, mixed and灌 (administered orally), might one save one in ten. If the jaw is tightly clenched, wipe the teeth with plum fruit soaked in vinegar; if phlegm obstructs the throat, use Xixian San (Thin Saliva Powder) to induce vomiting. For loss of consciousness, blow Pinelliae Rhizoma Processatum (Banxia) powder into the nose. This method is designed to open the orifices so that medicinal juice can be administered, not to cure the disease by inducing vomiting of phlegm.

Note by Nan Yuanxi: Loss of consciousness must be differentiated into Closed Syndrome and Collapsing Syndrome. Misidentifying these two syndromes and prescribing accordingly will determine life or death immediately.

The *Neijing* states: "Wind is the chief of all diseases, moving swiftly and changing frequently." It may become Cold Middle or Heat Middle.

For individuals with a Yang constitution who inherently possess internal fire, if attacked by wind evil, the wind rides the fire's momentum, and the fire borrows the wind's power, leading to sudden collapse and loss of consciousness, tight jaw clenching, and clenched fists. Although there may be phlegm sounds, they are not the gurgling water sounds, nor is there a surging tendency. One can use Citrus Reticulatae Pericarpium (Chenpi) one liang, Pinelliae Rhizoma (Banxia) one liang, with a little fresh ginger juice, decocted and taken orally; or induce vomiting after taking it, followed by Ditang Tang (Phlegm-Clearing Decoction) added with Gastrodiae Rhizoma (Tianma), Salviae Miltiorrhizae Radix et Rhizoma (Danshen), and Acori Tatarinowii Rhizoma (Shichangpu), along with Bamboo Juice (Zhuli) and ginger juice to open the orifices. If external heat is severe and urination/defecation are blocked, Fangfeng Tongsheng San, Liangge San (Cooling Diaphragm Powder) added with Shichangpu, Polygalae Radix (Yuanzhi), Danshen, and Sanhua Tang can be used for simultaneous release of exterior and interior.

For individuals with a Yin constitution who inherently possess internal cold, if attacked by wind evil, wind and water collide, ice penetrates the bones, also leading to sudden collapse and loss of consciousness, open mouth, relaxed hands, urination, cold umbilical region, gurgling phlegm sounds resembling boiling water. Urgently use Sansheng Yin added with Renshen, or use Renshen two liang, Fuzi one liang, raw Banxia three qian, decocted into one zhong, added with half a spoon of ginger juice and honey (one clam shell volume) for administration; some may survive. If Dan Nanting (Arisaema cum Bile) and other phlegm-clearing and wind-dispelling medicines are used, it is like throwing a stone into a well where someone has fallen.

After recovery from either syndrome, speech and movement will definitely not return to normal. Observe whether Water (Yin) or Fire (Yang) is deficient. Take Liuwei Wan (Six-Ingredient Pill with Rehmannia) or Shenqi Wan (Eight-Ingredient Pill with Rehmannia) early in the morning, three to four qian. In the afternoon, take Liujunzi Tang (Six-Gentlemen Decoction) added with Ophiopogonis Radix (Maidong) three qian, dried Mulberry Leaf (Sangye) one qian, and Zhuli two clam shell volumes. This is excellent. Because moistening and extinguishing wind is the secret method for treating wind diseases.

Regarding stroke of the vessels and collaterals: Stroke of the vessels and collaterals has no external symptoms of the Six Meridians and no internal obstruction of urination/defecation. It is neither exterior nor interior, the pathogen has no fixed abode, affecting either the left or right side, causing facial deviation and hemiplegia. The treatment method prohibits sweating and purging methods. Only use moistening medicines to nourish dryness, and calming medicines to nourish blood, then the wind will naturally disappear. Da Qinjiao Tang (Major Gentian Decoction) is suitable as the main prescription. For those affected on the right, use Liujunzi Tang added with Zhuli and ginger juice to tonify qi, move phlegm, and dispel wind. For those affected on the left, use Siwu Tang (Four-Substance Decoction) added with Peach Kernel (Taoren), Carthami Flos (Honghua), Zhuli, ginger juice, Tianma, and Saiga Tataricae Cornu (Lingyangjiao) to nourish blood, move blood, resolve phlegm, and dispel wind. For dual deficiency of qi and blood, use Bazhen Tang (Eight-Treasure Decoction) or Shiquan Dabu Tang (Ten Significant Tonifying Decoction) added with Uncariae Ramulus cum Uncis (Gouteng), Zhuli, and ginger juice for vigorous tonification.

Da Qinjiao Tang
Qinjiao (Gentianae Macrophyllae Radix), Shigao (Gypsum Fibrosum, raw), each one and a half qian; Gancao (Licorice Root); Chuanxiong (Chuanxiong Rhizome); Danggui (Angelicae Sinensis Radix); Qianghuo (Notopterygii Rhizoma et Radix); Duhuo (Angelicae Pubescentis Radix); Fangfeng (Saposhnikoviae Radix); Huangqin (Scutellariae Radix); Shaoyao (White Peony Root, wine-fried); Baizhi (Angelicae Dahuricae Radix); Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried); Shengdi (Rehmanniae Radix); Shudi (Rehmanniae Radix Preparata); Fuling (Poria), each one qian; Beixixin (Asari Radix et Rhizoma, three fen).
Decoct in water and take orally.

Ditang Tang
Is Liujunzi Tang minus Baizhu, added with Nanting (Arisaema cum Bile), Zhishi (Aurantii Fructus Immaturus), Shichangpu (Acori Tatarinowii Rhizoma), and Zhuru (Bambusae Caulis in Taenia). Treats wind stroke with phlegm confusing the Heart orifice, stiff tongue, and inability to speak.

For facial deviation, Qianzheng San (Straightening Powder) is the main prescription. Additionally, apply loach blood to the healthy side to pull the affected side back to normal.

Another condition is hemiplegia (Piangu), like a tree losing a branch, where fluids cannot circulate and irrigate. It is suitable to treat with Liujunzi Tang added with Zhuli, etc., over a long period hoping for recovery. Alternatively, use Liuwei Wan or Shenqi Wan added with Sangjisheng (Taxilli Cacumen), Wujiapi (Acanthopanacis Cortex), Niuxi (Achyranthis Bidentatae Radix), and Duzhong (Eucommiae Cortex), made into pills with self-made Tiger Bone Glue (Hugu Jiao - note: modern substitutes should be used due to conservation laws). Swallow five qian in the morning, delivered with yellow wine; take the previous decoction in the evening. This may save one or two in ten.