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The concept of "cerebral hyperemia" (Nao Chong Xue Bing) was initiated by Westerners, yet those with superficial understanding often ridicule Traditional Chinese Medicine (TCM) for not knowing this disease. Such individuals have likely never read the *Huangdi Neijing* (Yellow Emperor's Inner Canon) in their lives. I once read the *Tiao Jing Lun* (Treatise on Regulating the Channels) in the *Neijing*, which states: "When blood and qi rush upward together, it results in Great Jue (Da Jue), a condition where sudden death occurs; if the qi returns downward, life is preserved; if it does not return, death ensues." Is this not precisely the syndrome described by Westerners as cerebral hyperemia? The difference lies in that Western medicine merely speaks of congestion, whereas the *Neijing* describes blood and qi rushing upward together. Since blood necessarily ascends following qi, this is an immutable principle. Western pathology is derived largely from autopsy observations; thus, they only see blood congested in the brain but fail to employ theoretical reasoning to deeply investigate the etiology, hence naming it merely "cerebral hyperemia." Regarding the *Neijing*'s statement "if qi returns, life is saved; if not, death follows," it implies that if this syndrome undergoes a favorable turn, the qi, having reached its peak of ascent, reverses and descends. The blood congested in the brain should then also descend, allowing the patient to survive. Conversely, if the ascending qi does not reverse but continues to rise, the blood will correspondingly become more congested, potentially causing rupture of the cerebral blood vessels, leading to death. Furthermore, the *Jue Lun* (Treatise on Jue) in the *Neijing* states: "Jue of the Taiyang (Greater Yang) channel causes head swelling, heaviness of the head making walking difficult, manifesting as dizziness and collapse"; "Jue of the Yangming (Yang Brightness) channel presents with red face and heat, delirious speech and visual hallucinations"; "Jue of the Shaoyang (Lesser Yang) channel presents with sudden deafness, swollen cheeks, and heat." All these phenomena are clinical manifestations of cerebral hyperemia. Extending this logic, Bian Que (Qin Yue Ren)'s treatment of the Crown Prince of Guo's "Shi Jue" (Corpse-like Jue), describing "interruption of yang collaterals above and rupture of yin ties below," also refers to cerebral hyperemia. However, ancient texts are concise, often detailing etiology while neglecting specific therapeutic methods. Nevertheless, once the cause of the disease is thoroughly understood, devising a treatment is not difficult. In my lifetime, I have treated many such cases; those cured were mostly mild cerebral hyperemia without vessel rupture. Here, I briefly present a few cases for reference.

In Fengtian, I treated a man near fifty years old. Due to unfavorable circumstances and overwork, he gradually experienced headaches that intensified daily. Medication proved ineffective, so he entered a Western hospital. After ten days of treatment, his headache persisted, and eye pain was added. Several days later, opacities formed in both eyes, impairing vision. His family sought my consultation. His pulse was vigorous, long, and surging on the left side. He reported that his headache radiated to his eyes and eye pain radiated to his brain, accompanied by frequent vertigo, unbearable in nature. Correlating pulse and symptoms, I determined this was liver and gallbladder fire carrying qi and blood upward to the brain. The cerebral vessels expanded due to this impact, causing pain. Since the optic nerves connect to the brain, continuous expansion of cerebral vessels caused eye pain, opacity, and vertigo. I explained to him: "This is cerebral hyperemia. Deep analysis reveals that headache is the root of eye pain; and liver/gallbladder fire carrying qi and blood upward is the root of headache. To treat this, one must clear fire, calm the liver, and guide blood downward. Once the headache resolves, treating eye pain, opacity, and vertigo will be straightforward." I prescribed Huai Niuxi (Radix Achyranthis Bidentatae) 1 liang, Sheng Hangshao (Radix Paeoniae Alba) 6 qian, Sheng Longgu (Os Draconis) 6 qian, Sheng Muli (Concha Ostreae) 6 qian, Sheng Zhe Shi (Haematitum) 6 qian, Xuanshen (Radix Scrophulariae) 4 qian, Chuan Lianzi (Fructus Toosendan) 4 qian, Longdancao (Herba Gentianae) 3 qian, and Gancao (Radix Glycyrrhizae) 2 qian, decocted in concentrated rust water. After one dose, head and eye pain decreased significantly, and vertigo ceased. I slightly modified the formula, and after two more doses, both pains resolved completely, and vision cleared. The eye opacity was an external cataract requiring topical treatment; I prepared a solution to dissolve opacities, applied 5-6 times daily, until the opacity fully dissipated.

In Cangzhou, I treated a 64-year-old man. Burdened by affairs, he felt deep mental restlessness (Ao Nu). Ten days prior, he noticed a headache but ignored it. One morning, he suddenly collapsed, appearing comatose. After regaining consciousness for a moment, his left hand and foot became immobile, and severe headache ensued. The attending physician administered formulas to clear fire and unblock collaterals, incorporating principles from Wang Xunchen's Buyang Huanwu Tang (Tonifying Yang Decoction to Restore Five Tenths), adding several qian of Sheng Huangqi (Radix Astragali). Upon ingestion, he felt stabbing pain in the brain, intolerable even for a moment. Seeking my diagnosis, his pulse was string-taut and long on the left, and surging and long on the right, both firm upon heavy pressure. He reported constant internal heat. His family noted his alcoholism; recently, due to mental distress, he drank heavily to drown sorrows, sometimes replacing meals with liquor. I stated: "This is a severe case of cerebral hyperemia. The string-taut, long left pulse indicates heat generated by mental restlessness. The surging, long right pulse indicates heat accumulated from chronic alcohol consumption. These two heats combine, carrying visceral qi and blood upward to the brain. If the cerebral vessels rupture due to excessive impact, the patient would remain comatose. Fortunately, he regained consciousness after a brief period, suggesting the vessels did not rupture. Blood may have leaked through the vessel walls or stopped bleeding from minor fissures. If this blood adheres to sensory nerves, it causes coma; if it adheres to motor nerves, it causes paralysis. His left-sided hemiplegia suggests blood from ruptured cerebral vessels damaged the nerves controlling right-side movement. The previous doctor, unaware of the etiology, used herbs for qi-deficiency hemiplegia. How could this pulse and syndrome tolerate the ascending tonification of Huangqi? This explains the worsening headache post-medication." I prescribed a formula similar to the previous case. Given the surging, full right pulse, I added 1 liang of Sheng Shigao (Gypsum Fibrosum) and decocted with rust water. After two doses, the headache resolved, the pulse normalized, and the left limbs moved spontaneously. I then switched to Danggui (Radix Angelicae Sinensis), Zhe Shi, Sheng Hangshao, Xuanshen, and Tian Dong (Radix Asparagi) each 5 qian, Sheng Huangqi, Ruxiang (Resina Frankincense), Moyao (Resina Myrrhae) each 3 qian, and Honghua (Flos Carthami) 1 qian. After several doses, he could walk with a cane. Honghua was used to resolve cerebral stasis. Since the pulse had normalized and pain ceased, he could tolerate the warm tonification of Huangqi. Three qian were used to support healthy qi, assisting Danggui, Shaoyao, Ruxiang, and Moyao in promoting blood circulation, while balancing the cold nature of Xuanshen and Tian Dong, ensuring balanced properties for prolonged administration.

The two recorded cases share similar medication, primarily using Niuxi (Radix Achyranthis Bidentatae). Indeed, Niuxi excels at guiding blood from the upper body downward, making it an unparalleled remedy for cerebral hyperemia, a fact confirmed by my repeated trials. Therefore, I dare to recommend it to the medical community. For treating this syndrome, Huai Niuxi is particularly superior.