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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Wind pathogen is good at moving and changing rapidly, and is the leader of a hundred diseases. It also shifts according to the decline or prosperity of the body's vital qi. For example, in the northwest, where the land and climate are biting cold, the human body is robust and strong. When external wind suddenly enters, it causes sudden collapse, unconsciousness, deviation of the mouth and eye, frequent spitting of saliva, which can be distinguished as "True Stroke" (Zhen Zhong Feng) or "Resembling Stroke" (Lei Zhong Feng). There are distinct syndromes involving the Zang organs, Fu organs, meridians, and vessels, as well as differences between Obstruction syndrome (Bi Zheng) and Collapse syndrome (Tuo Zheng). Medicinal treatment employs methods of opening and securing, such as using Xiaoxuming Tang (Minor Continuation Decoction) to open the Wei Qi (Defensive Qi), and using Shenfu Tang (Ginseng and Aconite Decoction) or Sini Tang (Frigid Extremities Decoction) to secure the Ying Qi (Nutritive Qi). Others, such as Houji Heisan (Houji Black Powder) and Fengyin Tang (Wind-Driving Decoction), are treatments that fill the orifices to extinguish wind. Later, Li Dongyuan argued that when Yuan Qi (Primal Qi) is weak, sudden collapse and loss of consciousness occur; Liu Wansu believed that wind takes advantage of fire, and fire borrows wind's power, causing people to suddenly fall and faint; Zhu Danxi stated that in the southeast, where warmth and humidity prevail, dampness generates phlegm, phlegm generates heat, and heat generates wind, suddenly appearing with symptoms like coma, convulsions, and facial paralysis. From this, we see that the words of these three masters regarding stroke refer to its etiology, naming it "Resembling Stroke"; Zhang Zhongjing and the *Waitai Miyao* (Secrets of the Outer Cabinet) refer to its pathology/origin, i.e., "True Stroke." In recent times, Resembling Stroke is common, while True Stroke is rare. City physicians do not understand this; upon seeing signs of tremor or movement, without distinguishing between deficiency of upright qi and phlegm-fire, they indiscriminately use formulas for dispersing wind and expelling pathogens. This leads to the disintegration of the body's pivot (Yin-Yang and Qi-Blood), and life follows suit into ruin.

Regarding the symptom of swelling and distension, it arises from the failure of Yang Qi. Treatment should greatly cultivate Yuan Yang, warm the middle and support Qi, so that water metabolism proceeds naturally and swelling subsides. The body's Wei Qi (Defensive Qi) circulates and protects the exterior of the whole body, akin to the heaven enveloping the earth. The tenderness and firmness of the skin and muscles are rooted in this. If Wei Qi is invaded by pathogens and lies latent within, Yin resides on the outside instead. Water transforms under Yin influence, resulting in edema of the skin; if Middle Yang Qi is obstructed, distension occurs. Treatment should warm and release Yang Qi to drive out Yin pathogens, which is a treatment that probes the root. I often see incompetent doctors using diuretic and damp-draining agents, such as Wuling San (Five-Ingredient Powder with Poria) or Zhouche Wan (Boat Cart Pill). Initially achieving minor effects, over time the disease worsens, swelling becomes severe, and distension increases, even to the point of a flat back and protruding umbilicus, inversion of Yin and Yang positions, leading to wheezing and obstruction, and finally death. I have witnessed cases where the condition was critical, desiring to save them, but the situation was beyond recovery. I specifically elucidate the source of the disease and its principles, not shunning the trouble, to serve as a profound warning for future generations.

Commentary by Lan: Ancients discussed stroke focusing on its origin; later generations discussed stroke focusing on its cause. Treatments include methods of expelling pathogens and consolidating righteousness, and formulas for extinguishing wind, eliminating phlegm, and supporting the root. These are precise, prudent, clearly differentiated, and the major principles are complete. Regarding swelling, there are differences between deficiency and excess syndromes, elaborated in detail in the *Neijing* and clearly classified in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet). Why do city physicians fail to understand, blindly adhering to symptomatic treatment with diuretics and thereby harming patients? The Master, witnessing the harm, did not shy away from clarifying and correcting it. His heartfelt intention to benefit the world and aid people is self-evident.