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The *Classic of Difficult Issues* (Jing) states: Wind is the beginning of all diseases. It moves swiftly and changes frequently. "Movement" implies motion. The nature of wind is heat; when heat prevails, wind arises (heat extreme generates wind). One should use stillness to overcome restlessness; this is nourishing blood. Treatment requires avoiding excessive sweating and also appropriating mild purgation. Excessive sweating empties Wei Qi (Defensive Qi); excessive purgation damages Ying Blood (Nutritive Blood). Sweating and purging must each be applied appropriately, after which one may treat the disease in the meridians. Although there are warnings against sweating and purging, there is a distinction between involvement of the Zang organs and Fu organs. Involvement of the Fu organs is suitable for sweating methods; involvement of the Zang organs is suitable for purging methods. Although this conforms to sweating and purging, it must not be excessive. Zhang Zhongjing said: Excessive sweating leads to loss of Yang; excessive purging leads to loss of Yin. Loss of Yang damages Qi; loss of Yin damages Form. Therefore, the Classics state: Blood and Qi are the spirit of humans; they must not fail to be carefully nourished.

Initially, if exterior and interior are disharmonious, sweating and purging are required. Once exterior and interior are harmonized, treatment should focus on the meridians. Symptoms of Fu organ involvement include: facial complexion showing five colors abnormally, exterior syndrome with floating pulse, aversion to wind and cold, stiffness and numbness. Whether the pathogen strikes the posterior, anterior, or lateral aspects of the body, it is called Fu organ involvement. Such diseases are generally easier to treat. Symptoms of Zang organ involvement include: flaccid lips and mouth, inability to move the tongue leading to aphasia, loss of smell, deafness, blurred vision, constipation of both stool and urine. This is called Zang organ involvement. Such diseases are difficult to treat.

The *Classic* states: Disharmony of the six Fu organs leads to stagnation and accumulation forming abscesses; disharmony of the five Zang organs leads to obstruction of the nine orifices. If there is no external stagnation forming abscesses and no internal obstruction of the nine orifices, the disease must be in the meridians. Once the initial symptoms are confirmed, it is appropriate to nourish with major herbs. One must adjust Yin and Yang according to the seasons, settle the Zang and Fu organs, and harmonize Ying and Wei Qi. There are few cases that do not heal. For wind striking the Fu organs, first use Modified Xuming Decoction to release the exterior according to the syndrome. If suddenly Zang organs are involved, feces are often constipated; Sanhua Decoction is appropriate to unblock stagnation. Once exterior and interior syndromes are stabilized without other complications, major herbs are used to harmonize and treat. Generally, Fu organ involvement affects the four limbs, while Zang organ involvement obstructs the nine orifices. Although Fu organ involvement often includes Zang organ symptoms, for tongue stiffness and aphasia, long-term use of major herbs can lead to self-healing.

For those with wind-dampness, common in summer, symptoms include heaviness like stone, inability to turn over. It is appropriate to take formulas that dispel wind, overcome dampness, and clear heat. If ineffective, acupuncture and moxibustion should be used. Now, the treatment methods for the Six Meridian Xuming Decoctions are explained.

[Xiao Xuming Tang / Minor Xuming Decoction] Universally treats disorders of Eight Winds, Five Bi, Wei Jue (flaccidity and cold limbs), etc. It takes the whole year as the general principle and the six meridians as distinctions. Add Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix) in spring and summer; add Guigui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Praeparata), Shaoyao (Paeoniae Radix Alba) in autumn and winter. Further subdivide and modify within the specific herbs for each meridian. Ancient famous physicians could not transcend this method.

Mahuang (Ephedrae Herba, removed nodes), Renshen (Ginseng Radix, removed rhizome), Huangqin (Scutellariae Radix, removed rot), Shaoyao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Chuanxiong (Chuanxiong Rhizoma), Xingren (Armeniacae Semen Amarum, peeled and tip removed, stir-fried), Fangji (Stephaniae Tetrandrae Radix), Guigui (Cinnamomi Cortex, 1 liang each), Fangfeng (Saposhnikoviae Radix, 1.5 liang), Fuzi (Aconiti Lateralis Radix Praeparata, processed, peeled, navel removed, 0.5 liang). These eleven ingredients, except Fuzi and Xingren, are crushed into coarse powder. Then add these two and mix evenly. Take 5 qian per dose, with 1.5 zhan of water and 5 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct to 1 zhan, remove dregs, drink slightly warm before meals.

In treating stroke, if one does not examine the manifestations of the six meridians for modifications, treatment is no different from no treatment. The *Neijing* says: When couli (pores) open, one feels chilly; when closed, one feels hot and stifled. Knowing sudden wind-stroke, one should first treat with Modified Xuming Decoction according to the syndrome. If stroke presents with no sweat and aversion to cold, Mahuang Xuming Tang governs. Add double the amount of Mahuang, Fangfeng, and Xingren to the base formula. Acupuncture at Zhiyin (BL67) of the Bladder Meridian for bleeding, Kunlun (BL60), and Juqiao is indicated. If stroke presents with sweat and aversion to wind, Guizhi Xuming Tang governs. Add double the amount of Guizhi (Cinnamomi Ramulus), Shaoyao, and Xingren to the base formula. Acupuncture at Fengfu (GV16) is indicated. Both above syndromes are Wind-Stroke of the Taiyang Meridian. If stroke presents with no sweat, fever but no aversion to cold, Baihu Xuming Tang governs. Add Shigao (2 liang), Zhimu (2 liang), Gancao (1 liang) to the base formula. If stroke presents with sweat, fever but no aversion to wind, Gegen Xuming Tang governs. Add Gegen (Puerariae Lobatae Radix, 2 liang) to the base formula, and double Guizhi and Huangqin. Acupuncture at Xiangu (ST41) and piercing LiDui (ST45) is indicated. Puncturing Xiangu removes the thief-pathogen of the Yangming Meridian; piercing LiDui drains excess heat of the Yangming Meridian. Both above syndromes are Wind-Stroke of the Yangming Meridian. If stroke presents with no sweat and cool body, Fuzi Xuming Tang governs. Double Fuzi in the base formula, add Ganjiang (Zingiberis Rhizoma) 2 liang, Gancao 3 liang. Acupuncture at Yinbai (SP1) is indicated to remove the thief-pathogen of the Taiyin Meridian. This is Wind-Stroke of the Taiyin Meridian. If stroke presents with sweat and no heat, Guizhi Fuzi Xuming Tang governs. Double Guizhi, Fuzi, and Gancao in the base formula. Acupuncture at Taixi (KI3) is indicated. This is Wind-Stroke of the Shaoyin Meridian.

If stroke does not confuse these four meridians and six syndromes, but belongs to Shaoyin and Jueyin meridians, with joint spasms or numbness, Qianghuo Lianqiao Xuming Tang governs. Add Qianghuo (Notopterygii Rhizoma et Radix, 4 liang), Lianqiao (Forsythiae Fructus, 6 liang) to the base formula. Ancient Xuming Decoctions were confused and undifferentiated; now we establish meridian-specific treatment and corresponding acupuncture points, ensuring cure. For Jueyin Meridian, puncture the Jing-Well point Dacun (LR1) to unblock the meridian. For Shaoyang Meridian, moxa Jiegu (GB39) to guide out heat. This is using acupuncture and moxibustion together to unblock meridians and guide heat, the general principle of treatment.

[Da Qin Jiao Tang / Major Qinjiao Decoction] Treats stroke where there are no exterior six-meridian syndromes and no interior obstruction of urination/defecation. This indicates blood deficiency failing to nourish sinews, causing immobility of limbs and tongue stiffness with aphasia. This formula nourishes blood so sinews naturally become prosperous.

Qinjiao (Gentianae Macrophyllae Radix), Shigao (Gypsum Fibrosum, 2 liang each), Gancao (Glycyrrhizae Radix et Rhizoma), Chuanxiong (Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Fuling (Poria), Shengdihuang (Rehmanniae Radix), Shudihuang (Rehmanniae Radix Praeparata, 1 liang each), Xixin (Asari Radix et Rhizoma, 0.5 liang). These sixteen ingredients are chopped. Take 1 liang per dose, with 2 zhan of water, decoct to 1 zhan, remove dregs, take warm at any time. If cloudy weather, add 7 slices of Shengjiang. If epigastric fullness, add Zhishi (Aurantii Fructus Immaturus, 1 qian) per dose. This is an autumn/winter formula; for spring/summer, add Zhimu (1 liang). For stroke with exterior six-meridian syndromes, first use Modified Xuming Decoction according to syndrome. For interior obstruction of urination/defecation, use Sanhua Decoction to guide downward.

[Sanhua Tang / Three Transformations Decoction]
Houpo (Magnoliae Officinalis Cortex, ginger-processed), Dahuang (Rhei Radix et Rhizoma), Zhishi (Aurantii Fructus Immaturus), Qianghuo (Notopterygii Rhizoma et Radix) (equal parts). These four ingredients are chopped. Take 3 liang per dose, with 3 sheng of water, decoct to 1.5 sheng, take throughout the day, stop when slight diarrhea occurs. If internal pathogens are cleared and external pathogens exhausted, take Yufeng Tang to maintain the middle way. Long-term use expels major wind. Even minor pathogens can be treated by modifying Yufeng Tang. However, treatment methods must not neglect unblocking and draining. Sometimes induce slight sweating for one qi period; sometimes promote bowel movement for ten days. This is the constant method. Over time, clear and turbid separate, Ying and Wei harmonize.

[Qianghuo Yufeng Tang / Qianghuo Wind-Dispelling Decoction] Treats Kidney and Liver deficiency, weak sinews and bones, difficulty speaking, mental confusion. This is internal weakness due to wind-damp-heat, manifesting as heavy body due to wind-heat. Or thin person with hemiplegia of arm/leg; or fat person with hemiplegia; or fearful and forgetful, prone to overthinking. The path of forgetting stems from insufficient essence. Thus, chaotic heart generates hundred diseases; quiet heart stops ten thousand diseases. This formula calms the heart and nourishes spirit, regulates Yin and Yang without excess.

Qianghuo (Notopterygii Rhizoma et Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Fangfeng (Saposhnikoviae Radix), Fangji (Stephaniae Tetrandrae Radix), Huangqi (Astragali Membranacei Radix), Manjingzi (Viticis Fructus), Chuanxiong (Chuanxiong Rhizoma), Duhuo (Angelicae Pubescentis Radix), Xixin (Asari Radix et Rhizoma), Zhike (Aurantii Fructus), Mahuang (Ephedrae Herba, removed roots), Digupi (Lycii Cortex), Renshen (Ginseng Radix), Zhimu (Anemarrhenae Rhizoma), Ganju (Chrysanthemi Flos), Bohe (Menthae Haplocalycis Herba, removed branches), Baizhi (Angelicae Dahuricae Radix), Gouqizi (Lycii Fructus), Danggui (Angelicae Sinensis Radix), Duzhong (Eucommiae Cortex, stir-fried), Qinjiao (Gentianae Macrophyllae Radix), Chaihu (Bupleuri Radix), Banxia (Pinelliae Rhizoma, soaked), Houpo (Magnoliae Officinalis Cortex, ginger-processed), Qianhu (Peucedani Radix), Shudihuang (Rehmanniae Radix Praeparata) [26 ingredients, 2 liang each], Baifuling (Poria), Huangqin (Scutellariae Radix) [3 liang each], Shengdihuang (Rehmanniae Radix), Cangzhu (Atractylodis Rhizoma), Shigao (Gypsum Fibrosum), Shaoyao (Paeoniae Radix Alba) [4 liang each], Guizhi (Cinnamomi Ramulus, 1 liang). These 33 ingredients weigh 75 liang total. Chop them. Take 1 liang per dose, with 2 zhan of water, decoct to 1 zhan, remove dregs, take warm. If cloudy weather, add 3 slices of Shengjiang. Take one dose empty stomach, decoct dregs again before sleep. Take well after meals. Empty stomach, swallow Er Dan Wan (Two Cinnabar Pills) as heavy dose; before sleep, swallow Si Bai Wan (Four White Pills) as light dose. The principle is: Movement calms the spirit; Stillness clears the Lung. Assuming slight sweating for one qi period: Use 3 liang of Yufeng Tang, add 1 liang Mahuang, divide into 4 doses. Add 5-7 slices Shengjiang per dose, take empty stomach, follow with congee. Slight sweating is good. Assuming bowel movement for ten days: Use 3 liang Yufeng Tang, add 1 liang Dahuang, divide into 4 doses. Add 5-7 slices Shengjiang per dose, take before sleep, stop when loose stools occur. This medicine taken regularly must not miss seasonal assistance. E.g., after severe cold in spring, add Banxia, Renshen, Chaihu (2 liang each), Mutong (Akebiae Caulis, 4 liang) to welcome and drain Shaoyang Qi. E.g., after Grain Rain in summer, add Shigao, Huangqin, Zhimu (2 liang each) to welcome and drain Yangming Qi. E.g., in late summer, add Fangji, Baizhu, Fuling (2 liang each) to overcome Spleen Earth dampness. E.g., after great heat in early autumn, add Houpo, Huoxiang (Agastaches Herba), Guizhi (1 liang each) to welcome and drain Taiyin Qi. E.g., after frost in winter, add Fuzi, Guigui (1 liang each), Danggui (2 liang) to overcome Shaoyin Qi. E.g., in spring climate, reduce winter additions; seasonal modifications are similar. Although these seasonal modifications are established, one must judge deficiency/excess, local suitability, and pathogen quantity at the time of illness. This formula addresses Seven Emotions and Six Desires, Four Qi, preventing Zang excess and disturbing Ying/Wei. For wind-type constipation, it prevents dryness; for chronic diarrhea, it regulates. At first sign of wind, take this and Tianma Wan (Gastrodiae Rhizoma Pill) together as interior-exterior pair; these are holy medicines for preventing disease. If already ill, take regularly regardless of gender/age. Pediatric wind-seizures, acute/chronic convulsions can take it with divine effect. For resolving four-season colds, follow seasonal modifications; truly effective.

[Si Bai Dan / Four White Pellet] Clears Lung Qi, nourishes Po (Corporeal Soul). Stroke patients often suffer stupor due to unclear Qi.

Baizhu (Atractylodis Macrocephalae Rhizoma), Sharen (Amomi Fructus Rotundus), Baifuling (Poria), Xiangfu (Cyperi Rhizoma), Fangfeng (Saposhnikoviae Radix), Chuanxiong (Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix) [0.5 liang each], Baizhi (Angelicae Dahuricae Radix, 1 liang), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Bohe (Menthae Haplocalycis Herba) [2.5 qian each], Huoxiang (Agastaches Herba), Baitanxiang (Santalum Album Lignum) [1.5 qian each), Zhimu (Anemarrhenae Rhizoma), Xixin (Asari Radix et Rhizoma) [2 qian each), Tianzhuyeq (Phragmitis Folium, 2 liang), Shexiang (Moschus, 1 qian, separately ground), Longnao (Borneolum Syntheticum, separately ground), Niuhuang (Bovis Calculus, 0.5 qian each, separately ground). Twenty ingredients powdered, honey pills, 10 pills per liang. Chew one pill before sleep, chew finely in 5-7 portions, swallow with decocted Yufeng Tang. Clears Lung Qi above, strengthens marrow below.

[Er Dan Wan / Two Cinnabar Pills] Treats forgetfulness, nourishes spirit, stabilizes will, harmonizes blood. Internally calms spirit, externally beautifies skin/couli.

Danshen (Salviae Miltiorrhizae Radix), Tianmendong (Asparagi Radix), Shudihuang (Rehmanniae Radix Praeparata) [1.5 liang each], Gancao (Glycyrrhizae Radix et Rhizoma), Maidong (Ophiopogonis Radix, removed heart), Baifuling (Poria) [1 liang each], Renshen (Ginseng Radix), Yuanzhi (Polygalae Radix, removed heart), Zhusha (Cinnabaris, 0.5 liang powdered for coating, see *Qi Yi Bao Ming Ji*), Changpu (Acori Tatarinowii Rhizoma, 1 liang). Ten ingredients powdered, honey pills sized like paulownia seeds, coated with Zhusha. Take 50-100 pills, empty stomach before meal, swallow with decocted Yufeng Tang. Regular use calms spirit and stabilizes will. This treatment uses one pill to calm spirit, one to clear Lung. Clear within clear goes to Lung to assist True Nature; Clear within turbid strengthens marrow; Turbid within clear nourishes Spirit; Turbid within turbid beautifies Couli.