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According to the *Pathogenesis* (Bingji): The inability of the four limbs to move is commonly known as paralysis. The *Classic of Internal Medicine* (Jing) states: "Excess of Earth causes the person to be unable to move their four limbs." This is indeed a disease caused by excessive consumption of rich and sweet foods, not a deficiency of the Liver and Kidney meridians. The treatment should involve purging to weaken the Qi; when Yang Qi becomes weak and the Spleen-Earth returns to balance, health is restored. One may select Sanhua Tang (Three Transformations Decoction) or Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Atractant Decoction) for use. If it is due to Spleen deficiency, it also causes the inability to move the four limbs; the treatment can involve modifying Shiquan San (Ten Complete Powder). Siwu Tang (Four Substances Decoction) removes pathogenic factors while preserving healthy Qi.

Commentary: The general public considers the inability to move the four limbs to be Zhongfeng (Wind Stroke). Here it is stated that both excess and deficiency of Spleen-Earth can cause this condition. How can one apply medication indiscriminately?

Elucidation: The *Classic* states: "The movement of Yang Qi is likened to the swift wind in heaven and earth." Therefore, Zhongfeng (Wind Stroke) is not caused by exogenous Wind Evil, but is a disease originating from the body's own Qi. Generally, individuals over forty years old, during periods of declining Qi, or those whose Qi has been damaged by emotions such as worry, joy, anger, or resentment, often suffer from this ailment. It is absent in young adults. Even among those who are obese, it occasionally occurs, which is also a case of robust physique but deficient Qi. The treatment method for such conditions should focus on harmonizing the Zang-Fu organs and unblocking the collaterals; this constitutes the treatment of Wind. However, there are also cases where "thief wind" (exogenous pathogenic wind) attacks areas of deficiency. There are three degrees of severity in treatment, as detailed previously regarding the differentiation of disease location in the meridians, fu organs, and zang organs.

Commentary: The concept here of "self-originating disease of the proper Qi" aligns with Liu Hejian’s discussion on the generation of internal heat. While he emphasizes "heat," this text emphasizes "deficiency." Deficiency and heat coexist without contradiction.

Hejian stated: Wind diseases are mostly caused by extreme heat. The common term "wind" refers only to the superficial manifestation while forgetting the root. Thus, paralysis resulting from Zhongfeng (Wind Stroke) is not because the Wind of Liver Wood is excessively strong and suddenly strikes the body, nor is it an external contraction of wind. It is truly due to improper lifestyle management leading to a sudden surge of Heart Fire, while Kidney Water is deficient and fails to control it. This results in Yin deficiency and Yang excess, with hot qi stagnating and obstructing, causing the heart-mind to become confused and obscured, and the sinews and bones to lose function, leading to sudden collapse and loss of consciousness. This is mostly caused by the extreme excess of the five emotions (anger, joy, sorrow, worry, fear), all attributed to extreme heat. If mild, it merely involves temporary collapse; if Qi and Blood flow smoothly and sinews do not spasm, the person returns to normal after the episode. If the heat is too severe, causing stagnation and blockage, Yin Qi may suddenly cease, followed by the exhaustion of Yang Qi, leading to death. Phlegm-saliva arises because extreme heat restricts Water, which then generates phlegm to control Fire. Hemiplegia (Pianku) results from whether one side of the meridians is patent or blocked; Bi syndrome (Bihe) and paralysis are similar. Lockjaw and tendon stiffness occur because Wind-Heat is too severe, overcoming Dampness-Water, causing fluids to stagnate in the chest and diaphragm, transforming into phlegm-saliva, making the sinews overly dry. Since Dryness-Metal governs contraction and sharpness, this occurs. Alternatively, if the sinews become flaccid, it is due to extreme dryness and depletion of blood. Sinew spasms are easy to cure, whereas sinew atrophy is difficult to recover from, demonstrating the difference between mild and severe dryness-heat.