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Zhang Huan and others' medical formulas contain discussions on treating stroke (Zhong Feng). However, I have observed that children rarely suffer from this disease. The medications used often violate the principle of avoiding aromatic and drying substances. It is feared that blood heat generating wind (Xue Re Sheng Feng) or stroke-like syndromes (Lei Zhong Feng) may occur; misusing these drugs would cause significant harm. Therefore, all such content has been omitted and not recorded. Xue Ji stated: Stroke syndromes exist in the northwest regions. In the southeast, where the climate is warmer, pores are open and sweat is easily discharged. Those who suffer from it generally have stroke-like syndromes rather than true stroke. Moreover, children's primordial qi (Yuan Qi) is not yet fully developed, their skin and hair follicles are not solid, and they are prone to both deficiency and excess conditions. When external pathogens take advantage of this, it results in high fever, convulsions, coarse breathing, and excessive salivation. In severe cases, it leads to coma, locked jaw, resembling stroke. Misusing decoctions like Xu Ming Tang (Minor Life-Sustaining Decoction) can often lead to death. Even adults rarely suffer from true stroke (Zhen Zhong), let alone children. For any of the aforementioned symptoms, one must differentiate the cause. If there is qi deficiency in the Yangming channel, with wind pathogen invading and causing tendon vessel spasm, it is an external cause. If liver fire in the Foot Jueyin Liver channel is blazing, causing unilateral tendon vessel tension, it is an internal cause. If Spleen and Lung are weak, pores are not tight, and external pathogens invade, or if convulsive diseases are over-treated with mineral medicines, depleting Liver Blood, or if vomiting and diarrhea lead to internal loss of body fluids, failing to nourish the Liver, resulting in deviation of the mouth and eyes, these are all stroke-like syndromes caused by insufficient Liver Blood and Liver Fire generating wind.

[Qian Yi] When the Liver has wind, it may severely manifest as opisthotonos (Jiao Gong Fan Zhang) and rigidity without tremors. If the Heart does not receive heat, one should tonify the Kidney and treat the Liver. To tonify the Kidney, use Dihuang Wan (Rehmannia Pill); to treat the Liver, use Xie Qing Wan (Drain the Green Pill). Danxi stated: Spasms (Jing) are more deficient than epilepsy (Xian) and should be treated with tonification. They are mostly due to qi deficiency with fire and phlegm. Treat with Ren Shen Zhu Li (Ginseng and Bamboo Juice), avoiding wind-dispelling herbs. This theory truly reveals what predecessors had not expressed. Although Tang Shi claimed that ten out of ten spasmodic cases die, this method was never applied to people. [Xue Ji] Qian Zhongyang stated that opisthotonos is caused by wind pathogen lodging in the Taiyang channel. The classics say: Wind enters from above. The Foot Taiyang governs the qi of the whole body; its meridian starts at the inner canthus and runs along the back. Since the Liver belongs to Wood and governs wind, wind pathogen easily invades. Children's skin and flesh are not dense, making them susceptible to external pathogens. The Liver acts as ministerial fire, and its anger is easily aroused. If there is opisthotonos and rigidity with fever but no tremors, it is wind injuring the Taiyang channel. Use Renshen Qiang Huo San (Ginseng and Notopterygium Powder) or Xiao Xu Ming Tang (Minor Life-Sustaining Decoction). If triggered by sudden rage stirring up Liver Fire, use Xie Qing Wan (Drain the Green Pill). If drinking the previous prescriptions worsens the condition, this indicates the pathogen has left but Spleen qi is deficient. Use Yigong San (Benefit the Work Powder) plus Chuanxiong and Danggui to tonify. If due to deficiency-heat in the Liver channel, or if attacking treatments damage true qi leading to deficiency-heat generating wind, use Yigong San (Benefit the Work Powder) and Dihuang Wan (Rehmannia Pill) to tonify. If due to purgation causing Spleen qi exhaustion and abdominal distension, this is damage to central qi. Use Baizhu San (Atractylodes Powder) to tonify. If blood and qi are inherently weak, or after taking attacking/depleting agents, if the child seeks the collar with hands, grinds teeth, and yawns, the Liver channel is extremely deficient. Urgently use Dihuang Wan (Rehmannia Pill) to tonify, and refer to the Liver chapter for reference. A child suddenly presented with opisthotonos, upward staring eyes, and a cyan-red face. Cyan corresponds to the Liver governing wind; red corresponds to the Heart governing fire. This is wind and fire clashing. Use Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder) with doubled Gou Teng Gou (Uncaria Hook) for immediate calmness. Phlegm remained unchanged, so Bao Long Wan (Embracing Dragon Pill) was used, leading to recovery. Another child suddenly presented with opisthotonos. After taking anti-convulsant medicines, it recurred intermittently. The face was yellow-white, limbs very fatigued. I used Wu Wei Yi Gong San (Five-Ingredient Benefit the Work Powder) for over ten doses, leading to recovery. Later, due to fright combined with irregular diet, it recurred intermittently. Using the previous medicine cured it immediately. Thus, daily administration of Ginseng and Atractylodes powder, five to seven fen per dose, mixed with decocted Pao Jiang (Roasted Ginger) and Da Zao (Jujube), taken until two liang were consumed, prevented recurrence. The above two cases showed deficient primordial qi and excess pathogenic qi. Using pathogen-attacking medicines would be erroneous. A child suffering from the aforementioned condition with abundant phlegm, pale white face with cyan tinge. I stated that Lung qi cannot level the Liver, Liver qi attacks the Spleen, and Spleen qi deficiency generates phlegm. First, use two doses of Bao Long Wan (Embracing Dragon Pill) to level the Liver, followed by Liu Jun Zi Tang (Six Gentlemen Decoction) to tonify Spleen and Lung, recovering after a month and a half. Half a year later, it recurred. I stated that only by expelling phlegm could full recovery be achieved. Thus, using a purgative agent resulted in much phlegm-saliva, and sawing sounds in the throat. I said this is because the Spleen cannot control saliva, and the sound in the throat indicates extreme Lung qi deficiency. Thus, use five qian of Ren Shen (Ginseng) and three fen of Pao Jiang (Roasted Ginger), decocted in water and administered, leading to awakening. After the fourth dose, add two jujubes. Consuming several liang of Ginseng led to recovery. Later, upon each recurrence, Du Shen Tang (Single Ginseng Decoction) was required; sticking to standard formulas rarely avoids error.
Renshen Qiang Huo San (Formula seen in Convulsions) Xiao Xu Ming Tang (Formula seen in Miscellaneous Diseases - Stroke) Xie Qing Wan (Formula seen in Liver Chapter) Yigong San (Formula seen in Vomiting and Diarrhea) Chai Hu Zhi Zi San (Formula seen in Accumulated Heat) Bao Long Wan (Formula seen in Convulsions) Liu Jun Zi Tang (Formula seen in Vomiting and Diarrhea)