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Article 1 When wind pathogen causes disease, it typically presents with hemiplegia (paralysis of one side of the body). If only the arm is unable to move, this belongs to Bi syndrome (obstruction syndrome). The pulse is faint and rapid; this is caused by Wind-stroke (Zhongfeng).

The "Wind-stroke" in *Jingui Yaolue* differs from that in *Shanghan Lun* in two aspects. What *Shanghan Lun* calls Wind-stroke refers specifically to cold wind in winter; thus, it excludes summerheat, dampness, dryness, and fire, invading only the Cold category. Cold wind attacks the meridians and contends between Ying (Nutritive) and Wei (Defensive) Qi, so symptoms such as fever appear immediately as exterior signs. In contrast, the wind mentioned in this treatise (*Jingui Yaolue*) occurs in spring, summer, and autumn. Since it does not combine with cold, one only feels slight vexation in Ying blood and lack of security in Wei Qi. It lingers over time without immediate onset; this is the first difference. Furthermore, the wind-cold discussed in *Shanghan Lun* is merely an external pathogen; once dispersed, there are no residual issues. However, the wind in this treatise enters during normal times. Wind Qi connects with the Liver; thus, the external pathogen combines with Liver deficiency. When Upper Jiao Yang Qi becomes deficient, regardless of whether it is in meridians or zang-fu organs, following the site of deficiency, the Liver (a Yin organ) generates internal wind through its Qi changes, carrying the external pathogen to suddenly strike the body, as seen in Articles 2 and 3. This adds a factor of Liver deficiency and pathogenicity compared to the wind in *Shanghan Lun*; this is the second difference. Understanding these two points allows one to thoroughly comprehend why "Wind-stroke" has different names but varied symptoms, as well as the mechanisms of speed and severity in *Shanghan Lun* and *Jingui Yaolue*. This describes a mild case of Wind-stroke where a person with deficient Yang suffers external wind invading the meridians, causing Ying and Wei dysfunction, without yet combining with internal organ pathogens. Generally, the limbs rely on Wei Yang securing the exterior and Ying Yin managing the interior to achieve the functions of Qian (Heaven/Strength) and Kun (Earth/Yielding), resulting in agility. If Yang Qi is originally deficient and external wind invades, the wind pathogen supports Yang while consuming Yin. Supported by wind, Yang loses its robust function and becomes flaccid; as Yin fluids are consumed, they lose their yielding nature and become stiff. This leads to paralysis. Wind is a Yang pathogen that moves swiftly; whether on the left or right, once struck, the entire half of the body from head to extremities becomes paralyzed due to momentum. If only one arm is paralyzed, it is a Bi obstruction disease, detailed elsewhere under Bi syndromes, and should not be mistaken for the swift-moving Yang pathogen wind. The following text uses the pulse of paralysis to verify this. Wind nature is porous and prone to sweating; being a Yang-Heat pathogen, it causes sweating, which further depletes Wei Yang, hence the faint pulse. Heat damages fluids and shortens Ying Yin, hence the faint and rapid pulse. Diagnosing a faint and rapid pulse in a patient with hemiplegia confirms it is Wind-stroke, not Bi syndrome. "Faint and rapid" refers to Ying Yin and Wei Yang; thus, the pulse refers to the Cun Kou (radial artery at the wrist), consistent with the diagnostic method in Articles 2 and 3. Therefore, treating with Guizhi Tang (Cinnamon Twig Decoction) to disperse wind, adding Renshen (Ginseng Root) and Fuzi (Prepared Aconite Root) to tonify the faint Yang, and adding Danggui (Angelica Sinensis Root) and Ejiao (Donkey-hide Gelatin) to nourish the deficient Yin, would likely align with Zhang Zhongjing's intent.

Article 2 The Cun Kou pulse is floating and tight. Tight indicates Cold; floating indicates Deficiency. Cold and Deficiency contend, placing the pathogen in the skin. Floating indicates Blood deficiency and empty collaterals; the thief pathogen cannot be expelled. The pathogen affects either the left or right side. The affected side becomes relaxed/slow, while the healthy side becomes tense. The healthy Qi pulls the pathogen, causing deviation and paralysis. If the pathogen is in the collaterals, the skin and muscles feel numb. If in the meridians, the limbs feel heavy and difficult to lift. If entering the Fu organs, the person loses consciousness/recognition. If entering the Zang organs, speech becomes difficult, and saliva dribbles from the mouth.

This occurs when external wind enters normally and combines with Liver deficiency pathogen. Consequently, the skin, meridians, Fu, and Zang organs each follow their respective sites of deficiency, bulging outward and upward to strike suddenly. The previous article described wind that had not combined with internal organ pathogens, stating directly "wind causes disease" and "caused by Wind-stroke." Here, since it has internally connected with Liver Qi and moved out, it is simply called "pathogen."

The Cun Kou pulse is superficial, corresponding to skin and meridians; superiorly, it corresponds to head, eyes, mouth, and nose; internally, Fu corresponds to Danzhong (Pericardium area), and Zang corresponds to Heart and Lung. Currently, the pulse is floating upon lifting and tight upon pressing. Tightness is the image of Cold condensing; floating is the image of Yin Blood emptiness. Cold and Deficiency contend at Cun Kou. Judging by the superficial aspect of Cun Kou, initially, the large blood in the skin was empty, showing floating; the Yin pathogen of Liver Wood bulged outward, showing tightness. Thus, we know the pathogen is in the skin. At this time, if treated primarily with Guizhi Tang (Cinnamon Twig Decoction) to reach the skin, plus Danggui (Angelica Sinensis Root) to tonify Blood and calm the floating, plus Fuzi (Prepared Aconite Root) and Mahuang (Ephedra Herb) to dispel Cold and ease the tightness, the thief pathogen could still be expelled. "Floating" refers to deficiency of large blood in the muscle intervals. Once this blood is deficient, the collaterals supporting the skin must also have deficient Ying Blood. The sudden violent pathogen in the skin is like a bandit; if not expelled for a long time, it penetrates the collaterals due to deficiency. From the collaterals, it goes left or right, ascending to the head and eyes depending on where it settles. When the pathogen wins, Zheng Qi cannot restrain it, so the affected side feels loose. When Zheng Qi is insufficient, the pathogen attacks it, so the unaffected side feels tense. Pathogen fullness and Zheng Qi deficiency constantly invade each other, as if Zheng Qi is pulling the pathogen toward itself. Thus, the mouth and nose deviate toward the unaffected side, becoming paralyzed and uncontrollable. The four sentences "Pathogen in collaterals..." supplement the section on "floating indicates Blood deficiency" to clarify the meaning of hemiplegia in Article 1. It means that those with Blood and collateral deficiency suffer more than just deviation. If left is diseased, the whole left is diseased; if right, the whole right. Small collaterals have little Blood and connect Qi to muscles; when attacked, obstruction prevents Qi flow, causing numbness. Large meridians have little Qi and nourish sinews and bones with Blood; when attacked, sluggishness prevents Blood circulation, causing heaviness and inability to lift. Wind pathogen, good at moving and changing, inevitably leads to hemiplegia. The sections on entering Fu and Zang below expand on severe symptoms derived from the floating-tight pulse.

Diagnosing internally via Cun Kou: The left hand's Fu belongs to Danzhong. Danzhong is like a government center, the spiritual pathway for the Heart Monarch. Floating indicates Heart Qi deficiency above; tight indicates Cold constriction closing the Spirit inward. Thus, pathogen entering the Fu causes loss of recognition. The right hand's Zang belongs to Lung. Metal governs voice and is the bellows of spiritual mechanism. Floating indicates Lung Qi deficiency inside; tight indicates Cold cutting making the tube/tongue stiff. Thus, pathogen entering the Zang causes difficulty speaking. This Zang also controls the free flow of essence fluids. Floating indicates ascent without descent; floating and tight indicate upward flooding of cold fluids, hence drooling saliva. The left Cun does not mention Heart but mentions its Fu because entering the Heart leads to death, leaving no symptoms to describe. A student asked: Wind-stroke is a Zang pathogen, striking via deficiency sites. I understand this. But symptoms of entering Zang/Fu appear alongside skin/meridian signs. Does this mean rising from Lower Jiao to enter Fu/Zang, then overflowing from chest division to skin/meridian surface? This logic can be appreciated spiritually. Often, seeing skin/meridian symptoms where the patient recognizes people and speaks proves Fu/Zang are not diseased. If saying it exits from Taiyang's chest division, then Danzhong and Lung, one Zang one Fu, both attach to the chest. If pathogen passes here, how can Fu/Zang not be diseased, leaving only skin/meridian? If not exiting from chest division, how does it strike the exterior, unrelated to Fu/Zang? Answer: Taiyang governs skin and meridians, indeed. But Qi of Yangming and the other five meridians open separate doors to exit their meridians, attaching to Taiyang's exterior. This likely originates from the meridian of the original Zang, emerging through Taiyang.

Article 3 The Cun Kou pulse is slow and moderate. Slow indicates Cold; moderate indicates Deficiency. Moderate Ying indicates loss of Blood; moderate Wei indicates Wind-strike. Pathogen strikes the Meridian, causing body itching and urticaria (net-like rash). Heart Qi deficiency, pathogen enters the center, causing chest fullness and shortness of breath.

"Slow" refers to frequency less than 4-5 beats per breath. "Moderate" refers to texture of relaxation and looseness. Yang Qi is weak, and the driving mechanism cannot flow continuously like pearls, hence slow; thus, slow indicates Cold. Jing-Essence is declining, unable to fill the pulse vessel, hence moderate; thus, moderate indicates Deficiency. The external correspondence of Cun Kou governs Ying, Wei, and meridians. Now the position shows moderation. If middle pressure reveals Ying level, Jing-Blood is declining and cannot fill the vessel, appearing loose and unsaturated, indicating moderate pulse is caused by Blood loss. This is the secondary aspect. If light pressure reveals Wei level, Hao Qi (Pivotal Qi) is declining and cannot command outside the vessel, appearing slack and unupright, indicating moderate pulse is caused by Wind-strike. This is the primary aspect, as the following text discusses Qi alone, not Blood. Ying and Wei belong to the exterior of meridians; the pathogen has already struck the Meridian. Due to self-deficiency of Meridian Qi, the great Qi is small, moving like insects crawling under the skin, causing itching. Wind-strike cause: Wind is Yang pathogen, good at transforming into Heat, damaging Luo Blood, causing urticaria that rises and falls suddenly, half-hidden.

Superiorly, Cun Kou corresponds to Heart, Lung, and Chest/Diaphragm. Now the position shows moderation, indicating insufficiency of empty Qi in Heart and Lung, allowing Wind pathogen to enter. The chest is the seat of swirling True Qi; pathogen intrudes, conflicting and intolerable, causing fullness. The chest is also the region where breath flows freely; pathogen enters, stagnating the mechanism and making breathing difficult, causing shortness of breath.

This continues the first section, discussing Yang-deficient persons suffering external wind in meridians without combining with Zang pathogens. Carefully reviewing this chapter, there are nine articles total, counting two formulas. Excluding the next six articles which all discuss Li-Jie (Lichow/Joint Pain), only three discuss Wind-stroke. Excluding Article 1 and 3 which mention only external wind, only Article 2 mentions combining with Zang pathogens. Moreover, the two formulas later are clearly for Li-Jie treatment, while the Wind-stroke category lacks any formula, undoubtedly incomplete. Alas! The mirror that exposes demons is cracked; the tripod handed down to generations has a broken leg. Truly makes one regret endlessly. Those in the world possessing ancient editions of Zhang Zhongjing's complete works, where original text exists or discussions/articles/formulas were lost in commercial editions, if you could inform me to broaden my ignorance, I look forward to learned gentlemen.

Article 4 The Cun Kou pulse is deep and weak. Deep governs bone; weak governs sinew. Deep indicates Kidney; weak indicates Liver. Sweating and entering water, water hurting the Heart, Li-Jie pain, yellow sweat, hence called Li-Jie.

"Cun Kou" here refers to Left Heart and Right Lung. Right Cun pulse belongs to Lung. Lung governs Qi and matches Heaven. Heaven implies height and distance; thus, its pulse is usually floating. Now it is instead deep, indicating depression of Lung Qi descending. Lung and Kidney are mother and son. Kidney stores Essence and governs bone. Lung pulse sinking deep indicates Lung Metal Mother Qi sinking into Kidney Son's bones. Hence, deep governs bone and indicates Kidney. Left Cun pulse belongs to Heart. Heart governs Blood and matches Summer. Summer implies opening and expansion; thus, its pulse usually comes strong and departs weak. Now strength becomes weakness, indicating stagnation of Heart Blood inside. Heart and Liver are mother and son. Heart pulse internally weak indicates Heart Fire Son Fluid knotting internally into Wood Mother's sinews. Hence, weak governs sinews and indicates Liver.

All sinews attach to joints. Joints are places where Shen-Qi travels in and out. Yang Qi softens and nourishes sinews. Now Shen-Qi is depressed and sunk internally, unable to travel and nourish sinews. Why? Only in summer or after exertion when sweating, Heart and Lung Qi and Blood are flourishing. If entering water then, cold water Qi binds Lung and suppresses Heart, knotting downward and sinking internally into the gaps of sinews and bones, causing Li-Jie pain. Yellow sweat results from stagnant cold water forming Dampness, and stagnant Qi/Blood generating Heat. Damp-Heat combines externally at Li-Jie. This explains Li-Jie caused by Cold-Dampness.

Article 5 The Fu Yang pulse is floating and slippery. Slippery indicates substantial Grain Qi; floating indicates spontaneous sweating.

This is the pulse of spontaneous sweating, generally discussing the cause of disease, not mentioning Li-Jie, because those with spontaneous sweating may develop Wind-stroke (like Articles 1 & 3), Rheumatism (like Wetness Chapter Articles 5 & 8), or Li-Jie. Thus, only stating pulse/symptoms as the site of disease. Sweating and entering water causes Li-Jie as stated before. But for pulses with much sweat, one must guard against it oneself, not only avoiding water but also wind. If Fu Yang (Stomach) pulse is floating and slippery: Slippery indicates gathered fluids; seen in Stomach, Qi transformed from grain/water in Stomach is substantial. Floating indicates exterior; slipperiness judged from floating, indicating fluids do not distribute to other organs but steam upward and leak outward as surface sweat. Stomach fluids are substantial but not distributed to Zang-Fu, so sinews/bones lose nourishment internally. Plus sweating, Wei Qi declines, making Wind attack easy. This shares the same disease-prone site as labor-sweat exposed to wind or sweat-water entry. Whether Wind-stroke, Rheumatism, or Li-Jie forms, one must prevent subtle beginnings. According to Mr. Li's old commentary: Previous section sweating opens pores inviting Wind; entering water lets Cold overcome and penetrate bone, so Damp flows to joints causing Li-Jie pain—this is External Cause. This section Fu Yang floating-slippery pulse, Stomach Grain Damp-Heat evaporates outward causing sweat/Wind exposure leading to Li-Jie pain—this is Internal Cause. Sweat is Damp; sweat-Wind exposure is Wind-Damp contending. Such discussions in the whole commentary are rare. But according to Chapter 1 of this classic, Zhongjing considers internal-to-external as External Cause, and external-to-internal as Internal Cause. Mr. Li reversed this, following custom and losing the classic's intent. They should be viewed separately.

Article 6 Shao Yin pulse is floating and weak. Weak indicates Blood insufficiency; floating indicates Wind. Wind and Blood contend, causing pain like pulling/tugging.

"Shao Yin" refers to Chi position, Foot Shao Yin Kidney Meridian. Floating pulse here means fleeting like fat on soup, not vast like a chariot canopy. If Shao Yin floating was forceful, it would float to exterior, inconsistent with bone/joint Li-Jie pain. Weak is like weak water unable to carry a feather. Tugging pain means pain holding back flexion/extension. Foot Shao Yin Kidney governs bone. Its meridian exits spine, descends behind inner ankle, ends at Yongquan. Meridian Qi is often insufficient, Blood often abundant. Normal pulse sinks slowly like stone in water. Now pulse floats fleetingly like oil on soup; slight pressure shows weakness like weak water. Pulse is not weak because Qi carries Pulse, and Blood carries Qi. Qi insufficient to carry pulse causes weakness; isn't this due to Blood insufficient to carry Qi? Weakness seen with floating indicates deficiency is not Zang Essence but Blood in the Zang meridian. Wind is Yang pathogen, wanting to exit outward, hence floating. Floating judged from weakness, meaning meridian Blood is short, Wind pathogen enters void, causing Zheng Qi to float up with pathogen. Hence, floating indicates Wind. Yang-Heat Wind and deficient Blood contend in meridians, overflowing from Shao Yin meridian to bone joints, causing wind-heat painful distension and Blood-deficiency dry pain. This is Li-Jie caused by Shao Yin Blood deficiency and Wind strike.

Article 7 Robust person's pulse is choppy and small. Shortness of breath, spontaneous sweating, Li-Jie pain, inability to flex/extend. All caused by sweating from alcohol and exposing to wind.

"Robust person" implies tall stature and thick muscles. Robust people should have sufficient Yin and Yang, yet pulse is choppy and small. Choppy indicates Blood deficiency; small indicates Qi weakness. Pulse does not match form. External symptoms: panting breathing and shortness of breath correspond to small pulse/Qi weakness. Spontaneous sweating and fluid injury correspond to choppy pulse/Blood deficiency. Combined with Li-Jie pain and immobility, doubt leads to realization. A robust person should not have weak pulse/symptoms. Present weakness means the person is not truly robust. Thus, knowing this is acute illness caused by alcohol-sweat-wind exposure. Robust people are originally hot; adding floating heat of wine, two heats scorch, steaming fluids from Spleen/Stomach/Heart/Lung into sweat. Sweating injures Blood, hence choppy pulse. Sweating leaks Qi, hence small pulse. With Qi/Blood deficiency, wind attacks, causing Li-Jie. Acute illness in robust person causes little damage; how else could a robust person get acute illness except drinking? How meticulous is Zhongjing's diagnosis!

Article 8 Pain in all limb joints, emaciated body, swollen feet feeling detached, dizziness, shortness of breath, nausea. Gui Zhi Shao Yao Zhi Mu Tang (Cinnamon Twig, Peony, and Anemarrhena Decoction) governs.

Formula:
Gui Zhi (Cinnamon Twig) 4 liang, Shao Yao (Peony Root) 3 liang, Zhi Mu (Anemarrhena Rhizome) 4 liang, Fang Feng (Saposhnikovia Root) 4 liang, Mahuang (Ephedra Herb) 2 liang, Fuzi (Prepared Aconite Root) 2 liang (processed), Bai Zhu (Atractylodes Macrocephala Rhizome) 5 liang, Gan Cao (Licorice Root) 2 liang, Sheng Jiang (Fresh Ginger) 5 liang.

Nine ingredients. Boil in 7 sheng water, reduce to 2 sheng. Warm drink 7 ge, three times daily.

This summarizes Articles 4-7, discussing symptoms and treatment. Not calling it Li-Jie but "pain in all limb joints" covers Cold-Damp, Wind-Damp, and Wind-stroke joint pains. Emaciation means muscle wasting. Six Meridians' function: meridians go outward, joints connect inward, allowing Water Ren to ascend and Fire Ding to descend. Joint disease Wind-Damp stops Yang fluid ascent (causing emaciation) and Yang Qi descent (causing swollen feet). Wind harassing top causes dizziness. Damp harassing Qi stagnation causes shortness of breath. Nausea indicates Wind-Damp contention, with Yangming Earth having mist-upward tendency. Treating with Gui Zhi Shao Yao Zhi Mu Tang utilizes profound power and universal exterior regulation. Article 4 sweat-water entry: cold water suppresses sweat forming Damp entering joints. Article 5 stomach excess spontaneous sweat: though not mentioning Damp, implies wind attacking sweat will stagnate it forming various symptoms. Article 7 wine-sweat-wind: wind blocks sweat forming Damp entering joints. Except Article 6 Blood-deficiency Wind-strike, others are Damp causes. Kidney is Water Zang governing bone, attracting Damp, entering bone joints directly. Treatment must focus on Kidney. If Kidney Yin/Yang sufficient, even if struck by Wind-Damp, it pushes out via sweat or urine, eliminating pathogen. How could it stay in joints? Kidney Qi weakness is evident. Tonify mother when deficient. Without Gui Zhi Shao Yao Zhi Mu Tang, who else can handle it? Zhi Mu is white, pale taste, thin Qi. White corresponds to West Metal; thin/pale Qi corresponds to Heaven's light/clear image. Thus, it is the premier medicine for Lung. This Bai Hu Tang (White Tiger Decoction) for saving Lung uses Zhi...