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In cases such as sudden collapse due to non-stroke conditions, the root cause is invariably Qi depletion (Qi exhaustion). Why? Because human life and death depend entirely on Qi; when Qi gathers, there is life, and when Qi scatters, there is death.
Those suffering from this condition often fail to exercise caution in daily life, or suffer internal injury from the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright), or indulge excessively in alcohol and sexual activity, thereby first damaging the True Yin of the Five Zang Organs; this constitutes the fundamental cause of the disease.
Furthermore, if there are additional injuries from internal or external overexertion, coupled with external triggers that damage the Yuan Qi (Original Qi) temporarily, or if physical strength declines with age leading to the separation of Qi and Blood, accumulated damage leads to collapse; this constitutes the precipitating factor for the onset of the disease.
Generally, Yin deficiency occurs prior, followed by Yang injury; Yin sinks to the lower Jiao, while Yang becomes deficient in the upper Jiao, resulting in a loss of interaction between Yin and Yang and a failure of Essence and Qi to communicate. Consequently, sudden confusion and abrupt collapse occur—is this not a sign of sudden Yang Qi collapse?
Therefore, if the patient suddenly sweats profusely, it indicates the depletion of Ying and Wei Qi (Nutritive and Defensive Qi).
If enuresis occurs, it indicates the depletion of Mingmen Qi (Gate of Life Qi).
If the mouth remains open and cannot close, it indicates the depletion of Yangming Meridian Qi.
If saliva flows from the corners of the mouth, it indicates the depletion of Taiyin Organ Qi (Spleen and Lung Qi).
If the limbs are flaccid and paralyzed, it indicates the failure of Liver and Spleen Qi.
If the patient is comatose, exhausted, unaware, and unable to speak, it indicates the failure of Shen (Spirit) in the Heart and Jing (Essence) in the Kidney.
All these conditions result from the depletion of Chong and Ren Mai (Penetrating and Conception Vessels) and the simultaneous failure of form and spirit; thus, such syndromes typically manifest only after middle age.
Why do contemporary practitioners invariably attribute this to Wind-Phlegm and treat it with methods to dissipate phlegm? They fail to realize that Wind attacking from the exterior and Phlegm stagnating in the interior are both Excess pathogens.
How can an Excess pathogen cause such sudden and severe collapse? Moreover, given such critical severity, how much more "dissipating" treatment can the body withstand? It is truly lamentable that people fail to comprehend this.
Li Dongyuan observed: "Those with Qi deficiency often suffer from this ailment," which is indeed a statement of profound insight.
However, later generations failed to understand his theory, merely regarding Li Dongyuan as the authority on Qi. How could they truly grasp the meaning of Qi?
Therefore, in treating sudden collapse and deep coma, provided there is no obstruction by Phlegm-Qi, one must use large doses of Shen Fu Tang (Ginseng and Aconite Decoction) to vigorously tonify Yuan Qi to address the emergency first. Subsequently, employ Rehmanniae Radix (Shu Di Huang), Angelicae Sinensis Radix (Dang Gui), and Lycii Fructus (Gou Qi Zi) to fill and tonify True Yin, thereby cultivating the root.
For Essence is the root of Qi; Qi arises from the lower part, representing ascending vital energy. The Classic states: "Essence transforms into Qi," referring precisely to this mechanism.
Apart from this approach, there are no other genuinely effective medical strategies.
Although, since the disease has progressed to this state due to improper health preservation, the extent of bodily deterioration is evident; hoping for full recovery is indeed difficult.
Nevertheless, if treated correctly, recovery can still be expected; but if misdiagnosed and mistreated, how can the patient endure further errors?