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Yu Jiezhai treated a young man who suddenly fell ill with symptoms resembling stroke: inability to speak, failure to recognize people, and paralysis of the four limbs. Suhe Xiang Wan (Styrax Pills) was administered urgently but without effect. Wang Jiezhai happened to hear of this and inquired about the cause. The patient replied that he had just been entertaining guests and consuming food and drink when the condition suddenly arose. Wang then instructed him to decoct fresh ginger and light salt water, drink it in large quantities, and induce vomiting by stimulating the throat. After vomiting several bowls of undigested food, he recovered.

Zheng Xianfu, over sixty years old, fainted and became paralyzed after a fit of extreme anger. Zhu Danxi said: Anger causes fire to rise from the Liver. The Qi of the Hand-Jueyin (Pericardium) and Foot-Jueyin (Liver) meridians becomes blocked and fails to circulate, resulting in loss of consciousness. Severe anger damages the sinews, causing them to become lax and useless, hence the paralysis of the hands and feet. He prescribed Coptis and Phellodendron to clear the rebellious fire upward, and Cyperi Rhizoma to descend Liver Qi. Within one or two days, his consciousness gradually returned. Subsequently, his Qi and Blood were regulated, leading to full recovery.

A woman first experienced distending pain in her chest and hypochondrium, followed by flaccidity of the four limbs, profuse spontaneous sweating like rain, urinary incontinence, loose stools, tight mouth, and squinting eyes. Some believed it was Stroke involving the Zang organs and were deeply worried. They invited Xue Lizhai to examine her. Xue said: It is not so. If Wind had penetrated the Zang organs and the True Qi had collapsed, with malignant signs appearing, death would occur in an instant; how could it last ten days? Observing her complexion, her face and eyes were red or bluish. Palpating her pulse, the three positions on the left were surging and rapid, especially at the Guan position. Thus, he knew that the chest and breast distension was due to Liver Blood deficiency and stagnation of Liver Qi; the flaccidity of the limbs was due to Liver Blood deficiency failing to nourish the sinews; the continuous sweating was due to Heat in the Liver meridian causing leakage of body fluids; the urinary incontinence was due to severe Heat in the Liver meridian causing dysfunction of the Yin; and the loose stools were due to excessive Liver Wood suppressing Spleen Earth. He prescribed Xijiao San (Rhinoceros Horn Decoction) for four doses, after which all symptoms markedly decreased. Then, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) was used for regulation, leading to stability.

The wife of Taishi Yang Fanghu suddenly fainted. Physicians treated her with medicines for Stroke without effect. Li Shicai was summoned. The Guan position on the left was wiry and urgent; the Guan position on the right was slippery, large, and choppy. Her constitution was originally deficient in Yuan Qi, and she had food stagnation following anger-induced Qi rebellion. He administered Qi-regulating and food-resolving herbs, resulting in the passage of several black stools. He urgently switched to Liujunzi Tang (Six Gentlemen Decoction) with ginger juice. After four doses, the fainting ceased. Further treatment involved Ginseng Radix (5 qian), Atractylodis Macrocephalae Rhizoma and Pinelliae Tuber (3 qian each), Poria (2 qian), and Angelicae Sinensis Radix (2 qian), adjusted as needed. She recovered in two months. This is called Xu Zhong (Deficiency Stroke), also combined with Shi Zhong (Food Stroke).

The wife of Jianyan Yan Huaiquan first suffered chest and abdominal pain, then suddenly fainted the next day with cold extremities. A physician prepared Niuhuang Wan (Calculus Bovis Pills) for administration. Li Shicai palpated the pulse: all six pulses were hidden (Fu), only the Qikou (Radial) pulse showed slight movement. This indicated food filling the chest, blocking Yin and Yang, obstructing ascending and descending movements, hence the hidden pulses with visibility only at Qikou. He took Chenpi (Citri Reticulatae Pericarpium) and Amomi Fructus (1 liang each), Ginger (8 qian), and Salt (3 qian), decocted them, administered the liquid, and induced vomiting with a finger. Five or six bowls of retained food were vomited, and all six pulses became visible. The left Guan pulse was wiry and large, with severe chest and abdominal pain, indicating injury from extreme anger. He prescribed Mugwort Fruit, Tangerine Peel, Citri Reticulatae Pericarpium, Cyperi Rhizoma, and Atractylodis Macrocephalae Rhizoma decocted and taken orally. Pain ceased after two doses. Then, Si Junzi Tang (Four Gentlemen Decoction) with Mugwort Fruit and Lindera Root was used for regulation for over ten days until recovery. This is Shi Zhong (Food Stroke) combined with Qi Zhong (Qi Stroke).

Commentary: These two cases are similar yet distinct from those treated by Jiezhai and Danxi, demonstrating skillful learning from ancients. Hence, they are recorded together.

Zhang Zhongyu’s daughter fainted and lost consciousness while in her boudoir. After being revived with Suhe Xiang Wan (Styrax Pills), she spoke wildly and incessantly. Li Shicai palpated: the left pulse beat seven times per respiration, large and unregulated; the right pulse beat three times per respiration, minute and difficult to see. This is precisely what is meant by "two hands' pulses like two different people," a sign of demonic possession. Two thumbs were tied with thread, and moxa cones were applied to the Jing-Well points near the fingernails for seven moxibustions each. The spirit pleaded to leave. She took Tiaoqi Pingwei San (Regulate Qi and Harmonize Stomach Powder) plus Prunus Persica Nucleus (Tao Nu). After several days, the possession ceased. This is E Zhong (Evil Stroke).

Yi Silan treated Yi Zhai, grandson of the Prince of Ruichang, aged fifty-two. He habitually indulged in alcohol and sex. In early September, upon rising at night to urinate, he suddenly fell, unconscious, with closed eyes, coarse breathing, cold extremities, rigid body, and locked jaw. Physicians differed on diagnosis: some said Stroke, others Qi obstruction or Phlegm obstruction. Wuyao Shunqi San (Mayapple Smooth Qi Powder) and other formulas failed. Fuzi Lizhong Tang (Aconite Regulate Middle Decoction) worsened the rattling phlegm. Five days later, Yi examined him: the six pulses were deep, fine, tight, and slippery, becoming stronger with pressure. He said: This is Cold-Dampness clashing, causing Spasm (Jing Zheng). It belongs to the Bladder meridian. One should use Qianghuo Shengshi Tang (Notopterygium Overcoming Dampness Decoction). His brother Hongdao asked: There is no dizziness or vertigo, so we know it is not Stroke. However, it resembles Qi obstruction, Phlegm obstruction, or Yin-collapsing. Why do you specifically call it Spasm? Our royal clan lives in overly warm environments; how can Cold-Dampness cause Spasm? Yi replied: This is determined by the Six Qi transformations. Those with weak constitutions contract it. In the year Guiyou, Fire Qi was insufficient, allowing Cold Water to insult it. In late summer, Earth Qi was prosperous; Earth is the child of Fire and thus controls Water. In July and August, the dominant Qi is Dampness, and the guest Qi is Water. Cold Water gains command and is not controlled by Earth, so Cold and Damp clash. Taiyang Qi stagnates and fails to circulate. Symptoms mainly include rigidity of the neck and back, sudden difficulty turning the head, waist feeling like breaking, and neck feeling like pulling. This is Spasm of the Bladder meridian. The pulse deep, fine, tight, and slippery indicates Deep (illness in interior), Fine (Dampness), Tight (Cold), and Slippery/Strong (excess Cold-Damp clashing). A deficiency pulse would be only tight and fine, not slippery. A Wind pulse should be Floating; now it is Deep, without dizziness, so why Stroke? A Phlegm-Qi pulse is not Tight; now it is Tight with rigidity, so why Qi or Phlegm obstruction? The Spasm Poem says: Rigidity like a bow, unconsciousness like Stroke. Phlegm flows at lips and mouth, twitching same as epilepsy. First, Xixian San (Saliva Clearing Powder) was used to vomit one or two bowls of phlegm; consciousness immediately cleared. Then, Shengshi Tang was administered. After six doses, full recovery. Bawei Wan (Eight-Ingredient Pill) was used for regulation for a month, restoring essence and Qi.

Commentary: Lei Zhong (Stroke-like conditions) includes ten types: Qi Zhong, Shi Zhong, Han Zhong, Shu Zhong, Shi Zhong, E Zhong, Sha Zhong, Zhang Zhong, Tan Zhong, and Xu Zhong. These are scattered in various books and should be collected and distinguished in detail. Unlike true Stroke, although there is sudden collapse and unconsciousness, there is no hemiplegia or facial deviation. Unlike the treatment of Stroke, only Xu Zhong requires tonification; the rest do not. It depends on judging severity and depth during clinical practice. Regarding "Xu Feng" in *Mingyi Leian* and "Gan Feng" in *Linzheng Zhinan*, both fall under Miao Xiyong's concept of "Nei Xu An Feng" (Internal Deficiency Hidden Wind). *Leian* states that for Yin deficiency, cool the Liver and tonify Kidney; for Yang deficiency, warm Lung and strengthen Spleen. This is indeed crucial. However, these methods are already covered in the Stroke section, so establishing separate categories seems unnecessary. The profound principles in *Zhinan* such as draining Wood to calm Stomach, anchoring Yang to extinguish Wind, using heavy substances lightly, and transforming Wind with Acrid-Sweet combinations surpass ancient methods and refine Miao's theories. Yet, these discussions still belong to Zhang Jingyue's "Fei Feng" (Non-Wind) treatment principles. Compiling authors dividing one category into two doors commits the error of "adding a head to a head."