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The Mai Jue (Pulse Classic) states: In stroke, a slow and floating pulse is auspicious; an urgent, solid, large, or rapid pulse indicates a dire prognosis, suggesting the dispersion of the soul. It also states: In stroke, the Yang position (Cun) is floating and slippery, while the Yin position (Chi) is soggy and weak; alternatively, it may be floating and slippery, deep and slippery, faint and deficient, or faint and rapid; Cun Kou pulse that is floating and tight, or Cun Kou pulse that is slow and delayed, are all strokes. Generally, a floating and slow pulse is auspicious, while an urgent and rapid pulse is inauspicious.

Sudden collapse with loss of consciousness, mental confusion, rigid body falling to the ground, and locked jaw: First, use Chubi Tongtian San (Nose-Insufflating Powder for Unblocking the Orifices) insufflated into the nose. Wait for the jaw to loosen, then administer Xixian San (Thin Saliva Powder), fresh ginger juice, or shrimp juice to induce vomiting of phlegm. Once the patient regains consciousness, carefully examine the pulse and symptoms. Only after confirming stroke should treatment with formulas from this school be administered.

For stroke with a floating pulse, aversion to wind and cold, limb stiffness and numbness, or limb paralysis and inability to move: Treatment requires inducing sweating. Use Xiao Xuming Tang (Minor Continuation of Life Decoction) with modifications.

In stroke, do not immediately use wind-dispelling herbs; first regulate Qi. Using wind-dispelling herbs too early may draw wind pathogens into the marrow, making treatment difficult. Use Bawei Shunqi San (Eight-Ingredient Qi-Regulating Powder), Wuyao Shunqi San (Tsaoko Cardamom Qi-Regulating Powder), or Suhexiang Wan (Styrax Pill).

When pathogenic factors affect the Fu organs, presenting exterior manifestations of the Six Channels: Use Qianghuo Yufeng Tang (Notopterygium Wind-Dispelling Decoction) with modifications, or Xiao Xuming Tang with modifications.

When pathogenic factors affect the Zang organs, presenting internal obstruction of bowel and bladder movements: Use Sanhua Tang (Three Transformations Decoction) or Shufeng Shunqi Wan (Wind-Regulating Qi-Flowing Pill).

When there are no exterior manifestations of the Six Channels and no internal obstruction of bowel and bladder movements, this is due to blood failing to nourish the sinews, resulting in inability to use the limbs and tongue stiffness causing speech difficulties. Nourish the blood, and the sinews will naturally become prosperous. As the saying goes, "To treat wind, first treat the blood; when blood flows, wind diminishes." Use Da Qinjiao Tang (Major Gentian Decoction) or Qinjiao Banxia Tang (Gentian and Pinellia Decoction).

For excessive phlegm-saliva, facial paralysis (mouth and eye deviation), and inability to speak: Use emesis therapy with Guiti San (Melon Seed Powder) or Sansheng San (Three Saints Powder).

Left hemiplegia and right flaccidity result from Qi and Blood deficiency with phlegm-fire flowing into the collaterals. If Blood is deficient, phlegm flows to the left causing left hemiplegia; if Qi is deficient, phlegm flows to the right causing right flaccidity. Treating the left side requires nourishing Blood combined with resolving phlegm and descending fire. Treating the right side requires tonifying Qi combined with clearing phlegm and resolving stagnation. For nourishing Blood, Siwu Tang (Four Substances Decoction) is primary. For tonifying Qi, [Formula missing in source text]...

Aphasia in stroke occurs because phlegm-pathogens block the Heart and Lung channels, ascending to obstruct the orifices. Use Zishou Jieyu Tang (Life-Prolonging Speech-Unblocking Decoction), or Zhuli Tang (Bamboo Sap Decoction) added with Shichangpu (Acorus Rhizome).

For tongue stiffness preventing flexible movement, unclear speech, rigid or numb tongue root: Use Jieyu Huotan Tang (Speech-Unblocking Phlegm-Resolving Decoction), Zhuanshe Gao (Tongue-Straightening Paste), or Zhengshe San (Tongue-Correcting Powder).

If a person initially feels unexplained numbness or insensitivity in the fingers, or weakness in limbs and muscle twitching, severe wind disease will likely occur within three years. The Classics state: "Muscle twitching is called mild wind." Medication must be taken in advance to prevent wind disasters. Use Yufeng Tang (Wind-Dispelling Decoction), Tianma Wan (Gastrodia Pill), Qinjiao Banxia Tang (Gentian and Pinellia Decoction), or Bafeng San (Eight Winds Powder).

Facial paralysis often results from anger, worry, thought, and depression injuring the Liver, occurring suddenly. Do not immediately treat as stroke. First, soothe the Liver and regulate Qi using Qianzheng San (Straightening Face Powder) combined with Erchen Tang (Two Aged Substances Decoction), or Huoma Wan (Hemp Seed Pill) or Xiong San (Ligusticum Powder).

Wind-phlegm diseases are mostly caused by excessive heat. Wind belongs to Yang; when heat is excessive, wind moves. Avoid using too many hot and drying herbs.

In stroke with phlegm-jue, where sounds like sawing are heard in the throat: Quickly use a goose feather dipped in tung oil to stimulate the throat and induce vomiting. If phlegm can be expelled, the condition is treatable; if phlegm is stuck in the throat and cannot be vomited, it is difficult to treat. Alternatively, administer shrimp juice to induce vomiting.

In stroke with six pulses being deep and hidden, in patients with inherent weakness or the elderly who experience spontaneous diarrhea: Use Sansheng Yin (Three Raw Infusion) or Xingxiang Yin (Aucklandia and Amber Infusion).

In stroke with fever, delirious speech, restlessness, coma,恍惚 (mental confusion), amnesia, and loss of willpower: Use Niuhuang Qingxin Wan (Calculus Bovis Clearing Heart Pill), or Anshen Wan (Spirit-Calming Pill) or Chensha San (Cinnabar Powder).

In stroke with severe heat, dry mouth and tongue, throwing hands and feet about, disordered speech, mental confusion, and inability to recognize people: Use Qingxin Tang (Clear Heart Decoction), Liangge San (Cooling Diaphragm Powder), or Renshen Baidu San (Ginseng Detoxification Powder) with modifications.

In stroke with excessive phlegm, limb paralysis, dysarthria, and joint pain: Use Ditang Tang (Phlegm-Scouring Decoction).

For constipation due to deficiency and dryness of the Stomach and Intestines: Use Siwu Tang (Four Substances Decoction) combined with Sanhua Tang (Three Transformations Decoction).

For stroke with dizziness and vertigo, feeling as if falling: Use Tianma Tang (Gastrodia Decoction) or Xiong Tang (Ligusticum Decoction).

For stroke with limb paralysis: Caoling Dan (Grass Spirit Elixir) pills.

For heavy head and eyes, tinnitus, nasal congestion, and throat discomfort: Use Xiaofeng San (Wind-Dispersing Powder).

For stroke with whole-body numbness and limb pain: Use Paifeng Tang (Wind-Expelling Decoction) added with Qinjiao (Gentian).

Obese individuals suffering from right-sided limb paralysis have damp-phlegm and Qi deficiency. Use Erchen Tang (Two Aged Substances Decoction) combined with Sijunzi Tang (Four Gentlemen Decoction) added with Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice). Take frequently for good effect.

Lean, dark-skinned individuals suffering from left-sided limb paralysis, as well as women, mostly have Blood deficiency with fire. Use Erchen Tang (Two Aged Substances Decoction) combined with Siwu Tang (Four Substances Decoction) added with Jiuhuangqin (Wine-Processed Scutellaria Root), Taoren (Peach Kernel), Qinjiao (Gentian), and Jiangzhi (Ginger Juice).

Stroke with excessive phlegm and urinary incontinence belongs to Qi deficiency failing to control the Bladder. Tonify Qi using Renshen (Ginseng) combined with herbs that clear phlegm and regulate Qi.

Joint swelling and pain in stroke is named Lijie Feng (Sequential Joint Wind). Use Qianghuo San (Notopterygium Powder), Paifeng Tang (Wind-Expelling Decoction), Hugu Jiu (Tiger Bone Wine), or Qinjiao Tang (Gentian Decoction).

For various wind-induced urticaria with whole-body itching like insects crawling: Use Huma San (Sesame Powder) or Qingfeng San (Clear Wind Powder).

For tetanus (broken wound wind) with opisthotonos and coma: Use Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) or Yuzhen San (Jade Truth Powder).

Pain in sinews during movement is due to lack of Blood nourishing the sinews, named Jin Ku (Sinew Withering). This is untreatable.