Library

Liu Hejian stated in *Yuan Bing Shi* (Treatise on the Origin of Diseases): Generally, wind diseases are mostly caused by extreme heat. The so-called "wind-dryness" is merely a secondary transformation combined with heat, with heat as the primary factor. The common parlance regarding "wind" focuses on the superficial aspect while forgetting the root cause. Therefore, stroke resulting in paralysis is not due to an excess of Liver Wood wind striking suddenly, nor is it caused by external wind invasion. It arises from improper lifestyle management leading to a sudden surge of Heart Fire, coupled with deficiency and decline of Kidney Water, which fails to control the fire. This results in Yin deficiency and Yang excess, with hot qi becoming stagnant and depressed. The spirit becomes confused and obscured, tendons and bones lose their function, leading to sudden collapse and loss of consciousness. Most cases of sudden stroke are caused by the excessive extremes of the five emotions—joy, anger, worry, sorrow, and fear—all due to extreme heat. If the condition is mild, there may only be a sudden fall, but Qi and Blood flow smoothly, and tendons and vessels do not spasm. In milder or slower-progressing cases, the patient returns to normal after the episode. However, if the heat is too severe, causing stagnation and obstruction where Qi and Blood cannot circulate freely, Yin Qi may suddenly cease, followed by the exhaustion of Yang Qi, leading to death.

Based on Hejian's discussion, his assertion that these conditions are neither Liver Wind nor external wind, but rather result from improper lifestyle management, is a unique insight and indeed commendable. However, attributing everything to extreme heat is incorrect. Improper lifestyle management and excessive emotional extremes essentially belong to patterns of consumptive injury (Lao Shang). Are all cases of Qi and Blood depletion due to consumption fire? Is there no such thing as Yang deficiency disease? The Classics state: Joy and anger injure Qi; cold and heat injure the form; violent anger injures Yin; violent joy injures Yang. Injury to Yin implies a deficiency of Water. Injury to Yang implies a deficiency of Fire. Treating deficiency as fire will rarely fail to lead to danger.

Furthermore, Hejian stated: When the pathogen enters the Fu organs, the face shows five colors, there are exterior symptoms, the pulse is floating with aversion to cold, and there is stiffness and numbness; this is called "Stroke of the Fu organs." Treatment is generally easier. When the pathogen enters the Zang organs, there is flaccidity of the lips and mouth, inability to move the tongue resulting in aphonia, anosmia, deafness, blurred vision, and constipation of both bowels and bladder; this is called "Stroke of the Zang organs." Treatment is generally difficult. Generally, stroke of the Fu organs manifests more in the four limbs, while stroke of the Zang organs causes stagnation in the nine orifices. If wind strikes the Fu organs, one should first use Jia Jian Xu Ming Tang (Modified Life-Sustaining Decoction) to release the exterior according to the syndrome. If suddenly struck in the Zang organs, bowel movements are often constipated and dry, so San Hua Tang (Three Transformations Decoction) should be used to unblock the stagnation. Once the interior and exterior syndromes are clarified and no other complications exist, major herbs are used for harmonious treatment.

According to these descriptions, symptoms such as a floating pulse, aversion to cold, stiffness, and numbness originally belong to the category of Cold Damage (Shang Han). Why are they named Stroke of the Fu organs? Symptoms such as flaccid lips, immobile tongue, aphonia, and deafness originally belong to the category of Jue (Cold Extremities/Reversal) and collapse. Why are they named Stroke of the Zang organs? Since the concepts of Stroke of the Zang and Fu organs were presented together, the distinction between internal injury and external contraction became blurred and chaotic. Moreover, formulas such as Xu Ming Tang and San Hua Tang can only disperse wind-cold and attack excess heat. How can diseases caused by improper lifestyle management endure treatment with these methods?