Library

A question arises: Aphasia (loss of speech) differs among the Heart, Spleen, and Kidney meridians; furthermore, Wind-Cold invading the epiglottis also causes aphasia. How can these be distinguished? I hold that the Heart is the Sovereign Official, from which Spirit (Shen) emerges. If aphasia results from the Heart meridian being affected, there must be complete coma and unconsciousness, or accompanied by symptoms such as staring fixedly and shaking the head. This is because the Heart does not easily accept pathogenic factors; if it does, the condition is perilous, representing a critical failure syndrome. If the Pericardium (Bao Luo) accepts the pathogen, the patient may alternate between coma and consciousness, or laugh spontaneously at times. If aphasia results from the Spleen meridian, the patient remains mentally clear, but may present with flaccid lips, drooling from the corner of the mouth, and slurred speech. If aphasia results from the Kidney meridian, there will be flaccidity and numbness in the waist and feet, or deafness and urinary incontinence; these serve as the basis for differentiation. As for Wind-Cold invading the epiglottis, this merely belongs to cases of hoarseness when shouting. The mouth can close, the tongue can move, and the pivot mechanism remains unobstructed; only sound production is impaired. Such cases can be treated with acrid-diffusing methods.

Zhong Feng (Stroke), refers to True Stroke. Lei Zhong Feng (Stroke-like Syndrome) refers to conditions resembling stroke but are not true stroke. However, True Stroke may have concurrent Lei Zhong features, and Lei Zhong may have concurrent True Stroke features. Differentiating them clinically is most difficult, so methods must be established to handle them. Generally, Zhong Feng syndromes are divided into involvement of the Fu organs, Zang organs, and Channels and Collaterals, as detailed in previous discussions. It is crucial to distinguish carefully between Lei Zhong and True Stroke. True Stroke involves invasion of the Taiyang channel, consistent with the transmission patterns of external contraction Cold damage (Shang Han). If it affects the channels and collaterals, there must be hemiplegia (Pian Gu) and facial deviation (Xie Bi). Although involvement of the Zang organs implies an interior location, it must also be accompanied by signs of channel/collateral hemiplegia. In contrast, Lei Zhong caused by Cold presents with cold extremities, vomiting, diarrhea, and sudden pain; caused by Summerheat, it presents as sudden collapse while walking under the scorching sun; caused by Dampness, it presents with excessive phlegm-saliva accumulation and obstruction; caused by Fire, it presents with red face, irritability, thirst, dry lips, and constipation; caused by Food Retention, it results from overeating leading to chest fullness and stuffiness; caused by Qi Stagnation, it results from extreme anger leading to obstruction and silence; caused by Malicious/Noxious influences (such as visiting tombs or temples, or lingering in cold houses), it presents as sudden cyanosis of the head and face; caused by Deficiency, it presents with pale complexion and faint nasal breathing. These manifestations differ distinctly from the hemiplegia and facial deviation of True Stroke. Where symptoms may appear similar, it indicates a combination of True and Lei Zhong. When symptoms combine, each must be clearly differentiated. One must observe the predominance and co-occurrence of factors, discern the root and branch, and the urgency and slackness of the condition. With proper assessment, applying time-honored effective formulas will yield immediate results.