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Contracted by walking in the rain or lying on damp ground, and steamed by mountain miasma, external dampness is invaded. (Internal dampness refers to Phlegm generated from Damp-Heat as described by Zhu Danxi, which has already been discussed in the Stroke chapter.) After accumulation over a long period, symptoms include heavy and painful joints, edema, wheezing, chest fullness, abdominal distension, irritability, and sudden fainting. The pulse must be deep and slow, or deep and fine. It is suitable to use Chushi Tang (Dampness-Removing Decoction) and Baizhu Jiu (Atractylodes Macrocephala Wine). (This condition necessarily occurs after long-term accumulation; however, such cases are rarely seen clinically.) If there is a wound, and bathing causes dampness to enter through the wound, the person becomes comatose and heavy, resembling Zhongshi (Stroke-like Dampness), named Posuangshi (Traumatic Dampness), treated with Baizhu Jiu. (Question: The amount of dampness received in this condition is small, why does it lead to such severity? Answer: The flow of Qi and Blood cannot tolerate even slight obstruction. Regardless of the amount of dampness entering, if it obstructs Healthy Qi, stagnation occurs. Consequently, it rebels and attacks the Heart, leading to coma and heaviness.) I have detailed this in the Traumatic Dampness chapter.

(This is Qi rebellion, distinct from the sudden collapse due to Qi deficiency discussed by Li Dongyuan in the Stroke chapter.)
The syndrome presents as sudden collapse, loss of consciousness, locked jaw, cold body and limbs, (in Stroke, the body and limbs are warm, which differs from this,) and no phlegm-saliva. (Even if present, it is not as abundant as in Stroke. Qi stagnates internally and fails to reach the exterior, hence the cold body; Qi knots in the middle, hence phlegm does not rise to be expectorated.) Caused by Seven Emotions disturbing Qi, (especially those caused by anger,) Qi knots and blocks the middle, preventing communication between upper and lower, leading to sudden death. The pulse is deep and corresponds to the Qikou position. (In Stroke, the pulse is floating and corresponds to the Renying position, which differs from this.) Zhongqi (Qi Strike) closely resembles Stroke. Treating Wind with Qi-regulating herbs is acceptable, but treating Qi with Wind-dispelling herbs is not. (Wind herbs refer to formulas like Xuming Tang, which are dispersing agents, feared for scattering Qi. If referring to cold agents like Qingxin Wan or Xiexin Tang, Zhongqi is originally not a Fire syndrome, so cold-cooling agents should not be used either. All three formulas appear in the Stroke records.) Administer Suhexiang Wan (see various Strikes) via gavage. Upon regaining consciousness, for deficient persons, continue with Bawei Shunqi San plus Cyperi Rhizoma (Xiangfu) 3–5 qian; for robust persons, continue with Muxiang Tiaoqi San. If Phlegm remains internally, (the previous statement "no phlegm" did not mean absolute absence, but specifically that it does not obstruct the throat and mouth,) use Siqui Tang (see Qi disorders) and Xingxiang San (see Stroke). If the person is inherently deficient, with Phlegm-Qi knotting and blockage, preventing ascending and descending, or with defecation difficulty due to deficiency, use Sanhe Dan. There are cases where Qi recovers spontaneously without treatment. The Classic states: "Sudden aphonia with absent pulse, though untreated, will heal itself," because it is due to sudden Qi rebellion; once Qi recovers, health returns.