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2. The pulse at the Cun Kou (Inch Port) appears level, yet the patient suddenly dies from stroke; this is because the vital Qi alone is severed and violently depleted. The Qi of the five Zang organs vanishes within a few breaths, like falling from a height or drowning—how could one predict the time of death? If the pulse beats seven or eight times per respiration, and is neither large nor small, it can still be treated. If the pulse is excessively large, excessively small, floating (indicating death during the day), or deep (indicating death at night), with the pulse cut off and unapproachable, death is beyond doubt. When collapse syndromes appear simultaneously, they are all signs of impending death: shaking of the head, Qi rushing upward, long sighing, panting with sweat like oil, phlegm rattling like a saw, emaciated muscles, painful sinews, and dry, straight hair.
[Note] "Cun Kou pulse level" refers to a person whose Cun, Guan, and Chi pulses are all level, who suddenly dies from stroke. This is due to severe pathogenic invasion blocking the nine orifices, preventing the innate Qi from communicating with the body's vital Qi, thus becoming severed internally. It is like falling or drowning; how could one anticipate death? A pulse beating seven or eight times per respiration, being neither large nor small, indicates that although the condition is critical, it is treatable. If the pulse is chaotic and large, or thin and minute, a floating pulse indicates death by day, and a deep pulse indicates death by night; these are untreatable. When symptoms of collapse of three or four Zang organs appear together, along with shaking of the head and upward Qi rush, these are all signs of impending death.

Tongguan San (Pass-the-Gate Powder), Kaiguan San (Open-the-Gate Powder), Nasal Fumigation Method, Jie Yu Fa (Method to Restore Speech)
3. Tongguan San consists of Tian Nan Xing (Arisaema Cum Bile), Zao Jiao (Gleditsia Sinensis Fruit), Xi Xin (Asarum), Bo He (Mentha Haplocalyx), and Sheng Ban Xia (Pinellia Rhizoma Recens). Kaiguan San consists of Wu Mei Rou (Mume Fructus Flesh), Bing Pian (Borneolum Syntheticum), and Sheng Nan Xing (Arisaema Rhizoma Recens). Castor oil paper rolled with Zao Jiao powder is burned for nasal fumigation. Turtle urine applied under the tongue treats difficulty in speech.
[Note] Tongguan San: Arisaema Cum Bile, Gleditsia Sinensis Fruit, Asarum, Mentha Haplocalyx, and Pinellia Rhizoma Recens are ground into powder and insufflated into the nose; if sneezing occurs, the condition is treatable. Kaiguan San: Mume Fructus Flesh, Borneolum Syntheticum, and Arisaema Rhizoma Recens are ground into powder and rubbed on the teeth to open trismus. Castor oil paper rolled with Gleditsia Sinensis Fruit powder is burned, and the smoke is inhaled to restore consciousness. Applying turtle urine under the tongue facilitates speech.

Sansheng San (Three Saints Powder), Goudi San (Melon Seed Powder), Quanxie San (Scorpion Powder), Wuyuan San (Five Origins Powder), Bafan Wan (Croton-Alum Pill)
4. For absence of sweating, use Sansheng San (Fang Feng, Libi, Gou Ti) for vomiting/emesis. For presence of sweating, use Goudi San (Gou Ti, Vigna Angularis) or Quanxie San (Goudi San plus Scorpio). For heavy cases, use Wuyuan San (Libi, Vigna Angularis, Bai Fan, Zao Jiao, Dan Fan). For phlegm obstruction, use Bafan Wan (Ba Dou, Ku Bai Fan) for emesis.
[Note] With excessive phlegm-saliva and exterior excess (no sweating), use Sansheng San (Saposhnikoviae Radix, Veratrum Viride Rhizoma, Cucumis Melo Var. Flexuosus Fructus) to induce emesis. With interior excess (sweating present), use Goudi San (Cucumis Melo Var. Flexuosus Fructus, Vigna Angularis); or Quanxie San (Goudi San plus Scorpio) to induce emesis. These are mild emetic agents. In severe cases, use Wuyuan San (Veratrum Viride Rhizoma, Vigna Angularis, Alum, Gleditsia Sinensis Fruit, Chalcanthite). Bafan Wan consists of Crotonis Fructus and Calcined Alum, used to induce emesis.

Wuyao Shunqi San
5. Wuyao Shunqi San treats Excess Syndrome of Wind invading the Collaterals, characterized by facial deviation, numbness, and pain in bone joints due to wind. Ingredients include Ma Huang, Zhi Ke, Jie Geng, Wu Yao, Jiang Can, Bai Zhi, Gan Jiang, Chen Pi, Gan Cao, Chuan Xiong.
[Note] "Excess syndrome of wind invading collaterals" refers to individuals with robust constitution affected by wind pathogens in the collaterals. "Facial deviation" refers to crooked mouth and eyes. "Numbness" refers to insensitivity of skin and flesh. "Wind-injected pain" refers to pain in bone joints caused by wind attacking. This formula contains Saposhnikoviae Radix, Aurantii Fructus Immaturus, Platycodonis Radix, Linderae Radix, Bombyx Batryticatus, Angelicae Dahuricae Radix, Tangerine Peel, Dried Ginger, Licorice Root, and Ligustici Chuanxiong Rhizoma.

Da Qin Jiao Tang
6. Da Qin Jiao Tang treats Deficiency Syndrome of Wind invading the Collaterals, characterized by facial deviation and hemiplegia. It is based on Bazhen Tang (Eight Treasures Decoction) minus Ren Shen, adding Qin Jiao, Sheng Di Huang, Shi Gao, Qiang Huo, Du Huo, Bai Zhi, Fang Feng, Xi Xin, and Huang Qin.
[Note] "Deficiency syndrome of wind invading collaterals" refers to individuals with weak constitution affected by wind pathogens in the collaterals. "Hemiplegia" refers to paralysis of half the body. "Minus Ren Shen [from Bazhen Tang]" means removing Ginseng Radix from the Eight Treasures Decoction and adding Gentianae Macrophyllae Radix, Rehmanniae Radix Preparata, Gypsum Fibrosum, Notopterygii Rhizoma et Radix, Lepidii Semen, Angelicae Dahuricae Radix, Saposhnikoviae Radix, Asari Radix et Rhizoma, and Scutellariae Radix. Hemiplegia is a syndrome of wind invading the meridians but is treatable because this formula nourishes blood and benefits sinews, serving as a conditioning agent for chronic wind diseases.

Huangu Dan
7. For Excess Syndrome of Wind invading the Meridians, Huangu Dan is indicated for facial deviation and paralysis. Ingredients include Bai Zhi, Chuan Xiong, Fang Feng, Bing Pian, She Xiang, Zhu Sha, Mu Xiang, Huai Jiao, Ku Shen, Wu Wei Zi, Ling Zhi Xian, Ren Shen, Ma Huang Gao, He Shou Wu, Man Jing Zi, Cang Zhu, Sang Bai Pi.
[Note] "Excess syndrome of wind invading meridians" refers to individuals with robust constitution affected by wind pathogens in the meridians. Paralysis (Tan) refers to left-side immobility; flaccidity (Huan) refers to right-side immobility. Huangu Dan consists of Angelicae Dahuricae Radix, Ligustici Chuanxiong Rhizoma, Saposhnikoviae Radix, Borneolum Syntheticum, Moschus, Cinnabaris, Aquilariae Lignum Resinatum, Sophorae Fructus, Sophorae Flavescentis Radix, Schisandrae Chinensis Fructus, Sparagii Ramulus, Ginseng Radix, Ephedrae Herba Paste, Polygoni Multiflori Caulis, Viticis Fructus, Atractylodis Rhizoma, and Morus Albae Cortex Radix. Ma Huang Gao is made by boiling Ephedrae Herba into a paste, mixed with other herbs into pills, and coated with Cinnabaris.

8. Xiao Xuming Tang treats Deficiency Syndrome of Wind affecting meridians and collaterals, effective for Eight Winds and Five Bi syndromes. Ma Huang, Xing Ren, Gui Zhi, and Bai Shao harmonize Ying and Wei. Ren Shen, Gan Cao, Dang Gui, and Chuan Xiong promote Qi and Blood. Fang Feng addresses Wind excess; Huang Qin addresses Heat excess; Fu Zi addresses Cold excess. Add Shi Gao and Zhi Mu in spring/summer; increase Gui Zhi and Fu Zi in autumn/winter.
[Note] "Deficiency of meridians" refers to individuals with weak constitution affected by wind pathogens in meridians and collaterals. "Eight Winds" refers to pathogenic winds from eight directions. "Five Bi" is detailed in the Bi Syndrome Essentials section.

Huangqi Wuwu Tang
9. Huangqi Wuwu Tang treats Deficiency Syndrome of Wind affecting meridians, characterized by hemiplegia, weakness, and flaccid paralysis. Clear mind with slurred speech due to soft tongue indicates deficiency; stiff tongue with turbid spirit indicates Fire-Phlegm. Bu Wei (Tonify Defensive Qi) uses Huang Qi (to restore movement); Yi Ying (Nourish Nutritive Qi) uses Gui Zhi, Bai Shao, Da Zao, and Sheng Jiang. Add Dang Gui for left-sided symptoms; add Niu Xi for knee weakness; add Gu Jia for bone weakness; add Mu Gua for tendon stiffness; add Pao Fu Zi for meridian blockage or cold.
[Note] Huangqi Wuwu Tang treats hemiplegia caused by deficiency inviting wind into meridians and collaterals. However, if the patient has a stiff tongue, difficulty speaking, and unclear spirit, it is a Phlegm-Water disease, and this formula is unsuitable. If the mind is clear, speech is slurred, and the tongue is soft and weak, it is a deficiency of Ying and Wei, and this formula is appropriate. The Classic states: "Deficiency of Wei leads to immobility; deficiency of Ying leads to insensitivity." This formula uses Huang Qi as the sovereign herb to tonify Wei and restore movement; Gui Zhi and Bai Shao as minister herbs to nourish Ying and treat insensitivity; Sheng Jiang and Da Zao as assistant herbs to harmonize Ying and Wei. Insensitivity and immobility on the right belong to Qi; increase Huang Qi. On the left, they belong to Blood; add Dang Gui. Softness in both legs and knees requires Niu Xi. Bone weakness requiring inability to stand long requires Gu Jia. Tendon stiffness requiring difficulty in flexion and extension requires Mu Gua. Blockage in meridians on either side of the body requires Pao Fu Zi, also added for cold. This formula is highly effective, focusing on tonifying the exterior; thus, it does not use Ren Shen to tonify the interior or Gan Cao to tonify the middle.

Sanhua Tang, Soushun Fengqi Wan
10. Sanhua Tang treats Excess Syndrome of Wind invading the Fu organs, characterized by coma and constipation/fullness. Use Xiao Cheng Qi Tang plus Qiang Huo. For combined Qi and Form deficiency and Wind-Dryness, use Soushun Fengqi Wan for natural recovery.
[Note] "Excess syndrome of wind invading Fu organs" refers to individuals with robust constitution affected by wind pathogens in the Fu organs. "Coma" refers to loss of consciousness. "Constipation and fullness" refers to obstruction of bowel and bladder with abdominal distension. Xiao Cheng Qiang refers to Xiao Cheng Qi Tang (Magnoliae Officinalis Cortex, Aurantii Fructus Immaturus, Rhei Radix et Rhizoma) plus Notopterygii Rhizoma et Radix, which constitutes Sanhua Tang. If the patient has combined Qi and Form deficiency, treat slowly with Soushun Fengqi Wan for natural recovery. Chronic wind patients often have dry stools, called Wind-Dryness. Over-sweating with Xuming Tang or over-purging with Sanhua Tang can deplete fluids, causing dryness. For any disease involving meridians, collaterals, Zang, or Fu organs, if there is bowel/bladder obstruction and insufficient Qi/Form making purgatives intolerable, this method is suitable to search out wind from the six Fu organs and regulate Qi in the intestines and stomach, allowing normal bowel and bladder function.

Niuhuang Qingxin Wan
11. Niuhuang Qingxin Wan treats Excess Syndrome of Wind invading the Zang organs, characterized by phlegm obstruction, coma, aphasia, facial deviation, robust Qi/Form, clenched hands, and locked jaw.
[Note] Niuhuang Qingxin Wan treats individuals with wind pathogens invading the Zang organs and robust constitution. Symptoms include excessive phlegm-saliva, coma, aphasia, facial deviation, fullness of Qi and Form, clenched hands, and emergency locking of the jaw (Closed Syndrome). It is suitable for these conditions.

Shenfu Tang
12. Shenfu Tang treats Deficiency Syndrome of Wind invading the Zang organs, characterized by relaxed lips, drooling, aphasia, coma, hemiplegia. If Five Collapse Syndromes appear, double the dose of Ren Shen.
[Note] Shenfu Tang consists of Ginseng Radix and Aconiti Lateralis Radix Preparata. It treats individuals with wind pathogens invading the Zang organs and weak constitution. Symptoms include relaxed lips, flowing phlegm-saliva, coma, aphasia, hemiplegia, or simultaneous appearance of Five Collapse Syndromes. Use a large dose of Ginseng Radix first to secure against collapse, then treat the wind pathogen.

Qianjin Huanhun Tang
13. Qianjin Huanhun Tang treats Closed Syndrome of meridians/collaterals from sudden evil attack, characterized by rapid breathing, coma, unawareness, no sweating, spasms, and unilateral body pain. Ingredients include Rou Gui, Ma Huang, Gan Cao, Xing Ren.
[Note] "Closed syndrome of meridians/collaterals" refers to closed syndrome from wind pathogens invading meridians and collaterals. "Rapid breathing" refers to coarse breathing. No sweating, limb spasms, and unilateral body pain indicate exterior pathogenic closure. Use Cinnamomi Cortex, Ephedrae Herba, Glycyrrhizae Radix et Rhizoma, and Armeniacae Semen Amarum (Huanhun Tang) to open the exterior.

Duoming Tang
14. Duoming Tang treats Closed Syndrome of Zang/Fu organs, characterized by abdominal fullness, constipation, coma, trismus, and phlegm knotting in the throat. When urgent and oral medicines cannot be swallowed, use Duoming Tang (Ba Dou, Bai Zhi, Ban Xia, Ting Li, Sheng Nan Xing).
[Note] "Closed syndrome of Zang/Fu organs" refers to closed syndrome from wind pathogens invading Zang and Fu organs. "Abdominal fullness and closure" refers to abdominal distension and obstruction of bowels and bladder. Accompanied by coma, locked jaw, and phlegm stuck in the throat preventing swallowing, use emetic/purgative methods. Ingredients: Crotonis Fructus, Angelicae Dahuricae Radix, Pinelliae Rhizoma, Lepidii Semen, and Arisaema Rhizoma Recens.

Sansheng Yin
15. Sansheng Yin treats Wind-Cold Stroke, characterized by reversal cold, deep/faint pulse, and Qi-Phlegm. Sheng Nan Xing, Sheng Chuan Wu, Sheng Fu Zi, and Mu Xiang are used raw. Add Ren Shen for Qi deficiency; double Ren Shen for extreme deficiency approaching collapse.
[Note] "Wind-Cold stroke" refers to wind pathogens invading the Zang organs causing cold, regardless of meridians or collaterals. "Reversal cold" refers to cold limbs. "Deep and faint" refers to deep and hidden pulses throughout the six positions. This formula uses raw Arisaema Rhizoma Recens, raw Aconitum Carmichaelii Radix, raw Aconiti Lateralis Radix Preparata, and Aquilariae Lignum Resinatum. It is suitable only for severe cold with robust Qi. Add Ginseng Radix for Qi deficiency; double the dose for extreme deficiency approaching collapse to avoid adverse reactions.

Qufeng Zhibao Tang
16. Qufeng Zhibao Tang treats Wind-Heat Stroke, characterized by floating/rapid pulse, red face, heat, and irritability. Modify Fangfeng Tongsheng San by adding Quan Xie, Tian Ma, Xi Xin, Bai Fu Zi, Qiang Huo, Du Huo, Huang Lian, Huang Bai, and Jiang Can.
[Note] "Wind-Heat stroke" refers to wind pathogens invading the Fu organs causing heat, regardless of meridians or collaterals. "Floating and rapid" refers to floating and rapid pulses. "Heat and irritability" refers to fever and mental restlessness. "Tongsheng" refers to Fangfeng Tongsheng San. Added ingredients: Scorpio, Gastrodiae Rhizoma, Asari Radix et Rhizoma, Typhonii Rhizoma, Notopterygii Rhizoma et Radix, Lepidii Semen, Coptidis Rhizoma, Phellodendri Cortex, and Bombyx Batryticatus. Fangfeng Tongsheng San is detailed in the Cold Damage chapter.

Qingzhou Baiwanzi
17. Qingzhou Baiwanzi treats Wind-Phlegm Stroke, characterized by facial deviation, paralysis, and excessive phlegm-saliva. It is also excellent for pediatric convulsive phlegm. Ingredients include Bai Fu Zi, Chuan Wu, Nan Xing, Ban Xia.
[Note] "Wind-Phlegm stroke" refers to wind pathogens invading the exterior with phlegm-fluid retention, regardless of meridians or collaterals. "Excessive phlegm-saliva" refers to surging phlegm-saliva. This formula consists of processed Typhonii Rhizoma, processed Aconitum Carmichaelii Radix, processed Arisaema Rhizoma, and processed Pinelliae Rhizoma, made into pills.

Qianghuo Yufeng Tang
18. Qianghuo Yufeng Tang treats external wind invasion, characterized by limb weakness, difficulty speaking, muscle twitching, and insensitivity. Modify Da Qin Jiao Tang by adding Ren Shen, Guan Gui, Huang Qi, Du Zhong, Fang Ji, Zhi Mu, Zhi Ke, Chai Hu, Bo He, Man Jing Zi, Ju Hua, Qian Hu, Cang Zhu, Ma Huang, Ban Xia, Hou Po, Gou Qi, and Gu Pi.
[Note] "Treating external invasion" refers to diseases where wind enters from the exterior. There are always prodromal signs, such as limb weakness, slurred speech, occasional muscle twitching, and numbness/immobility of the thumb and index finger. This formula is appropriate. "Modifying Da Qin Jiao Tang" means adding Ginseng Radix, Cinnamomi Ramulus, Astragali Membranacei Radix, Eucommiae Cortex, Stephaniae Tetrandrae Radix, Anemarrhenae Rhizoma, Aurantii Fructus Immaturus, Bupleuri Radix, Mentha Haplocalyx, Viticis Fructus, Chrysanthemi Flos, Peucedani Radix, Atractylodis Rhizoma, Ephedrae Herba, Pinelliae Rhizoma, Magnoliae Officinalis Cortex, Lycii Cortex, and Lycii Bark to Da Qin Jiao Tang. "Conditioning various wind syndromes ensures peace" means that when internal pathogens are nearly eliminated and external pathogens fading, taking this medicine conditions the meridians, eventually expelling major wind, separating clear and turbid, and restoring Ying and Wei balance.

Qingre Huatan Tang
19. Qingre Huatan Tang treats internally generated conditions, characterized by short attention, erratic speech, dizziness, and weak legs. It modifies Liu Jun Zi Tang with Mai Dong, Huang Qin, Huang Lian, Shi Chang Pu, Zhi Shi, Zhu Ru, Nan Xing, and Mu Xiang.
[Note] "Internally generated" refers to diseases of internal Phlegm-Fire. Prodromal signs include short attention, erratic speech, upper excess/lower deficiency, dizziness, and weak legs. This formula consists of Ginseng Radix, Atractylodis Macrocephalae Rhizoma, Poria, Glycyrrhizae Radix et Rhizoma, Tangerine Peel, Pinelliae Rhizoma, Ophiopogonis Radix, Scutellariae Radix, Coptidis Rhizoma, Typhonii Rhizoma, Aurantii Fructus Immaturus, Bambusae Mesocarp, Arisaema Rhizoma, and Aquilariae Lignum Resinatum.

Dihuang Yinzi
20. Limb immobility without pain is Fei; hemiplegia with pain is Pian Gu. If speech and will remain unchanged, the pathogen is shallow in the subcutaneous layer; Huangqi Wuwu Tang can treat it. Severe inability to speak is Yin-Fei, indicating organ invasion and poor prognosis. Dihuang Yinzi contains Shu Di Huang, Rou Gui, Fu Zi, Rou Cong Rong, Ba Ji Tian, Yuan Zhi, Shan Zhu Yu, Shi Hu, Mai Dong, Wu Wei Zi, Bo He, Shi Chang Pu, and Fu Ling.
[Note] Fei, Pian Gu, and Yin-Fei are all caused by external wind invasion but vary in severity and depth. Fei refers to limb immobility without pain. Pian Gu refers to hemiplegia with pain. If speech and will remain unchanged, the pathogen is shallow, located between the subcutaneous layer, Ying, and Wei; Huangqi Wuwu Tang nourishes Ying and Wei and dispels wind. Severe cases with inability to speak, confusion, and coma are Yin-Fei, caused by Kidney deficiency and internal depletion, with Shaoyin failing to reach and causing reversal; the pathogen has entered the Zang organs, hence poor prognosis. Dihuang Yinzi treats Kidney deficiency and internal depletion. Ingredients: Prepared Rehmanniae Radix, Cinnamon Twig, Processed Aconite Root, Cistanche Stem, Morinda Root, Polygala Tuber, Cornus Fruit, Dendrobium Stem, Ophiopogon Tuber, Schisandra Fruit, Mint, Acorus Tuber, and Poria.

Ditan Tang
21. Ditan Tang treats internally generated conditions confusing the Heart orifice, characterized by stiff tongue and difficulty speaking. Combine with Wendan Tang; add Huang Qin and Huang Lian for heat excess; use Mengshi Tun Tan Wan for coma and constipation.
[Note] "Internally generated" refers to internal Phlegm-Fire confusing the Heart orifice, causing mental恍惚 and stiff tongue. Ditan Tang combines Ginseng Radix, Acorus Tuber, and Arisaema Rhizoma with Wendan Tang. Wendan Tang consists of Tangerine Peel, Pinelliae Rhizoma, Poria, Glycyrrhizae Radix et Rhizoma, Bambusae Mesocarp, and Aurantii Fructus Immaturus. Add Scutellariae Radix and Coptidis Rhizoma for heat excess. For obstruction of both bowels and bladder, use Mengshi Tun Tan Wan to purge.