《内经》论中风，症因不一，有风入腠理，开则洒然寒，闭则 然闷，名曰寒热，
此言风寒在表发寒热也。有风气入胃不得外泄，则为热中，此言风邪入里发热也。有人瘦则
外泄而寒，为寒中泣出，此言人弱汗多，热气外泄，而为虚寒也。有风气与太阳俱入，散于
分肉之间，肌肉愤 而有疡，此言风毒逆于肉里而发疮疡也。有卫气有所凝而不行，其
肉有不仁，此言恶疠之风，伤人卫气，闭塞血脉而为麻风癞风也。以上，《内经》总叙风邪
之症也。又云∶风中五脏六腑之俞，各入其户，所中则为偏风。此言风邪中于各经之俞，或
左或右，则为卒中偏风，半身不遂之症也。又云∶风气循风府而上，则为脑风目风。此言头
风之症，能害人目也。又云∶饮酒中风，多汗不可单衣，喘息恶风，口干善渴，则为漏风。
此言因酒热得风，故多汗恶风，口干善渴，表里皆病之症也。又云∶入房汗出中风，则为内
风。言入房汗出，风中于内，必病遗尿便涩之症也。又云∶新浴中风，头多汗恶风。苦先一
日则病甚头痛，名首风。此言因浴见风而成头风头痛之症也。又云∶久风入中，则为肠风飧
泄。此言外伤于风之飧泄症也。又云∶外在腠理，汗出汗泄衣，身体尽痛，名泄风。此言因
自汗，成痛风之症也。以上，《内经》论外感风中也。又云∶春甲乙伤于风，嗌干善怒，憎
女子，名肝风；夏丙丁伤于风，善吓色赤，言不快，名心风；季夏戊己伤于风，四肢不欲动
，微黄不嗜食，名脾风；秋庚辛伤于风，多汗恶风，时咳短气，名肺风；冬壬癸伤于风，面
庞然浮肿，有病不能正立，名肾风。又云∶食饮不下，隔塞不通，失衣则胀，食寒则泄，形
瘦腹大，名胃风。以上，《内经》论内伤风邪也。至《千金方》，则以《内经》风论发卒中
条，立名中风，而以半身不遂，为偏枯；身无痛，四肢不收，为风痱；奄忽不知人，为风
懿；痹而不仁，为风痹，类中风，即为当今中风之祖。至仲景《金匮》，其第一条则曰∶风
之为病，当半身不遂，或但臂不遂，此为痹，脉微而数，中风使然。此发《内经》所中为偏
风之条，而以脉之微数，以明不同中寒中湿也。第二条言∶寸口脉浮而紧，紧则为寒，浮则
为虚；虚寒相搏，邪在皮肤；浮者血虚，络脉空虚；贼邪不泻，或左或右；邪气纵缓，正
气即急，正气引邪， 僻不遂；邪在于络，肌肤不仁；邪在于经，即重不胜；邪入于腑，即
不识人；邪入于脏，舌即难言，口吐涎。此发《内经》偏枯中风之症。若脉微数，则为风热
；若脉不数，而见浮紧，则为风寒；风寒国中皮肤，失治，则或左或右， 僻不遂；故邪在
于络，肌肤不仁；邪在于经，即重不胜；邪入于腑，即不识人；邪入于脏，舌即难言。此申
明风邪之中人经络脏腑，次序轻重之不同也。第三条言∶寸口脉迟而缓，迟则为寒，缓则为
虚；营缓则为亡血，卫缓则为中风。邪气中经，则身痒而隐疹；心气不足，邪气入中，则胸
满而短气。按∶前条以寸口之脉浮紧，明风寒从外而渐入于里；此条以寸口之脉迟缓，明
亦是风寒从外而渐入于里。第四条言∶寸口脉沉而弱，沉则主骨，弱则主筋，沉即为肾，弱
即为肝。汗出入水中，如水伤心，历节痛黄汗出，故曰历节。此言脉沉主骨，脉弱主筋，乃
是汗出入水中风，而成历节痛黄汗出之症。又云∶少阴脉浮而弱，弱则血不足，浮则为风，
风血相搏，即疼痛如掣。此言脉弱血虚中风而成痛风之症。又云∶盛人脉涩小，短气，自汗
出，历节疼，不可屈伸。此言不虚之盛人，脉多实大，今见涩小，且见短气、自汗出、历节
疼不可屈伸之症，例如《内经》饮酒中风多汗喘息等条，又兼见历节痛，不可屈伸之症也。
又云∶诸支节疼痛，身体 羸，脚肿如脱，头眩短气，温温欲吐，桂枝芍药知母汤主之。此
重申上文支节疼痛之痛风症，是外感，宜桂枝芍药知母汤，和营卫以散表邪也。又云∶味酸
则伤筋，筋伤则缓，名曰泄。咸则伤骨，骨伤则痿，名曰枯。枯泄相搏，名断泄。营气不通
，卫不独行，营卫俱微，三焦无所御，四属断绝，身体羸瘦，独足肿大，黄汗出，胫冷。假
令发热，便为历节。此言筋伤骨痿，内伤枯细之症，似历节痛风，然历节痛风，系外感症，
必发热；假令黄汗胫冷，且见发热，方可为历节痛风症，方可散表。故下文复申曰∶病历节
，不可屈伸疼痛，乌头汤散邪。以上，《金匮》之论中风也。由此观之，《内经》之论中风
，总叙风邪致病，非专言卒中暴仆之症。《千金方》则发卒中之偏枯、风痱、风懿、风痹四
症，而补立治法。仲景《金匮》论风，即以《千金方》所发之半身不遂，四肢不收，奄忽不
知人，风痹之历节疼痛，而发明《千金》。侯氏黑散治寒，风引汤治热，扩充而为卒中风之
准绳。然止论外感风寒，未曾详言内伤诸中。于是，河间发火性急速，暴中卒倒，皆属于火
；东垣发气郁壅滞，气虚受邪；丹溪发因痰而生热，因热而生痰。是则《千金》、仲景发
卒中病，单主风寒，但言外感，故刘、李、朱先生，发主火、主气、主痰，兼内伤卒中亦全
之矣。喻嘉言先生妙论丛生，独着中风以《内经》邪害空窍之下，补出补虚堵塞治法，此亦
一偏之见。恐留而不去，反成其害矣。夫中风寒之症，有虚有实，有气血不足，空腹见风，
风邪乘虚而入者；有气血壅滞，饮酒中风，风邪乘实而入者；有先中风寒，因而生痰生热者
；有先有痰热，后召风寒者。夫饥寒迫切，因虚而邪得以外入，人人知之也。醉饱当风，因
实而邪得外入，人所不知也。是以外有六经表症，则比例加减续命汤等散表；内见便溺阻塞
，比例于三化汤等清里。邪散正虚，当用补虚堵塞，古人分闭脱二条，以验虚实，良有以
也。至治风先治血，此言厉风伤血，血痹不行，当行血祛邪；非言补血即可治风，非言厉风
伤气，亦以血治。又云∶中风之症，理气为先。此言气道壅闭，故当先理其气，非言凡治中
风该用理气也。故当细详外感寒邪属表者，比例《千金》之候氏黑散、加减续命汤等散表；
若积热壅闭属里者，比例风引汤、三化汤等清里。若内伤之阴火上炎积热上冲者，则遵河间
治法；痰凝中脘，攻注成疾者，则丹溪、节斋之法当矣。故凡治病，切不可执一家论例。如
四肢不举，与半身不遂，似同实异。四肢不举，有虚有实；半身不遂，病邪为患。故四肢不
举，以土不及为虚，土太过为实；土不及者，脾胃二经气血不足，则浑身无力，四肢难以举
动，无麻木痛苦者也；土太过则气血壅实，而四肢作楚，不能举动，或痛或麻木，或极冷如
冰者也。至半身不遂，则壅滞者多，虚者少，岂以一人之身，有半边不虚，半边独虚之理。
即有偏中风寒者，亦止得外感寒邪，宜用辛散表邪，实非虚寒而宜温补。《准绳》书注半身
不遂，立胃脉沉涩为虚，胃脉鼓大为实是矣；后于心脉小坚急，止注元阳不足一条，不知
凡病有虚实，有心脉小坚急，元阳不足，即有心脉大搏指，心火太旺，书不尽言，学人宜细
详补解。不玩《内经》云∶心气热则阳气内动，发为肌痹，传为脉痿；又云∶阳有余，阴不
足。为偏枯。又云∶热多则大筋软短而拘，小筋弛张而痿。如是则半身不遂，未可指为元阳
不足一条立论。今之用热药，误治偏枯筋痿，以至大害，祸本于此。
《黄帝内经》论述中风，症状和病因各不相同。有的因风邪侵入腠理（皮肤纹理），腠理开泄则感到寒冷，腠理闭塞则感到烦闷，称为寒热证，这是说风寒在体表引起的恶寒发热。有的因风邪进入胃腑不能向外宣泄，从而形成热中证，这是说风邪入里导致发热。有的人身体瘦弱，热气外泄而怕冷，流泪不止，称为寒中证，这是说人体虚弱、汗出过多，热气随汗外泄，从而形成虚寒证。有的风邪与太阳经之气一同侵入，散行于分肉之间，肌肉肿胀并发生疮疡，这是说风毒逆乱于肌肉之中而引发疮疡。有的卫气凝滞不行，导致肌肉麻木不仁，这是说恶疠之风伤害人体卫气，闭塞血脉而形成麻风病。以上，《黄帝内经》总括叙述了风邪致病的各种症状。
又说：风邪中伤五脏六腑的腧穴，各自进入其门户，所中的部位就会形成偏风。这是说风邪中伤各条经络的腧穴，或左侧或右侧，就会形成卒中偏风、半身不遂的症状。又说：风邪顺着风府穴向上侵袭，就会形成脑风和目风。这是说头风病症，会损害人的眼睛。又说：饮酒后感受风邪，多汗且不敢穿单衣，喘息且怕风，口干容易口渴，称为漏风。这是说因酒热之体感受风邪，所以多汗、怕风、口干易渴，是表里同病的症状。又说：房事后汗出感受风邪，称为内风。是说房事汗出时，风邪乘虚入内，必然会出现遗尿、小便涩痛等症状。又说：刚洗完澡感受风邪，头部多汗且怕风。如果前一天已经患病，第二天病情加重出现头痛，称为首风。这是说因沐浴后受风而形成的头风头痛症状。又说：风邪久留体内深入脏腑，就会形成肠风和飧泄（完谷不化的腹泻）。这是说外伤于风导致的飧泄症状。又说：风邪停留在腠理，出汗且排泄物泄漏，身体全身疼痛，称为泄风。这是说因自汗不止，形成痛风症状。以上，《黄帝内经》论述的是外感风邪的情况。
又说：春季甲乙日伤于风邪，咽喉干燥、易怒、厌恶女性，称为肝风；夏季丙丁日伤于风邪，易受惊吓、面色发红、言语不畅，称为心风；长夏戊己日伤于风邪，四肢不想活动、面色微黄、食欲不振，称为脾风；秋季庚辛日伤于风邪，多汗怕风、时常咳嗽、气短，称为肺风；冬季壬癸日伤于风邪，面部浮肿、有病不能直立，称为肾风。又说：饮食不下，胸膈阻塞不通，脱衣受凉则腹胀，吃冷的食物则腹泻，形体消瘦但腹部胀大，称为胃风。以上，《黄帝内经》论述的是内伤风邪的情况。
到了《千金方》，则以《内经》风论中关于卒中的条文为依据，确立名为“中风”，并将半身不遂命名为偏枯；身体无痛、四肢无法收持运动，命名为风痱；突然昏倒不知人事，命名为风懿；肢体痹阻且麻木不仁，命名为风痹。这些类别成为当今所谓中风的源头。
至张仲景《金匮要略》，其第一条说：风邪致病，应当表现为半身不遂，或者仅手臂不能活动，这属于痹证，脉象微而数，这是中风所致。这是阐发《内经》中所说的中于偏风的条文，并通过脉象的微数，来阐明其与中寒、中湿的不同。第二条说：寸口脉浮而紧，紧脉主寒，浮脉主虚；虚与寒相互搏结，邪气在皮肤；浮脉表示血虚，络脉空虚；贼邪不得宣泄，或左或右地侵害；邪气使经脉弛缓，正气因而紧急，正气牵引邪气，导致口眼歪斜、肢体不能随意运动；邪气在于络脉，肌肤麻木不仁；邪气在于经脉，即感沉重难以抬举；邪气进入腑，即神志不清不识人；邪气进入脏，舌强难言，口吐涎沫。这是阐发《内经》中偏枯中风的症状。若脉象微数，则为风热；若脉不数而见浮紧，则为风寒。风寒困于皮肤，失治则或左或右，口眼歪斜、肢体不能随意运动；故邪气在于络脉，肌肤麻木不仁；邪气在于经脉，即感沉重难以抬举；邪气进入腑，即神志不清不识人；邪气进入脏，舌强难言。这是进一步阐明风邪中人，在经络脏腑间次序轻重各不相同。第三条说：寸口脉迟而缓，迟脉主寒，缓脉主虚；营气缓则亡血，卫气缓则中风。邪气中伤经脉，则身痒且起隐疹；心气不足，邪气入中，则胸满而短气。按语：前一条以寸口脉浮紧，阐明风寒从外逐渐入里；此条以寸口脉迟缓，阐明也是风寒从外逐渐入里。第四条说：寸口脉沉而弱，沉脉主骨，弱脉主筋，沉即为肾，弱即为肝。汗出时入水中，如水伤心，历节疼痛、黄汗出，所以称为历节。这是说脉沉主骨，脉弱主筋，乃是汗出时入水感受风邪，而成历节疼痛、黄汗出的症状。又说：少阴脉浮而弱，弱则血不足，浮则为风，风与血相搏，即疼痛如牵掣。这是说脉弱血虚中风而成痛风的症状。又说：肥胖之人脉涩小，短气，自汗出，历节疼痛，不可屈伸。这是说不虚的壮实之人，脉多实大，如今却见涩小，且见短气、自汗出、历节疼不可屈伸的症状，例如《内经》中饮酒中风多汗喘息等条文，又兼见历节痛、不可屈伸的症状。又说：诸肢节疼痛，身体羸瘦，脚肿如脱落之感，头晕短气，心中温温欲吐，用桂枝芍药知母汤主治。这是重申上文支节疼痛的痛风症，属于外感，宜用桂枝芍药知母汤，调和营卫以疏散表邪。又说：味酸则伤筋，筋伤则弛缓，称为泄；咸味则伤骨，骨伤则痿废，称为枯。枯与泄相互搏结，称为断泄。营气不通，卫气不能独行，营卫俱微弱，三焦无所统御，四肢失去营养而断绝联系，身体羸瘦，唯独足部肿大，黄汗出，小腿发冷。假如发热，便为历节。这是说筋伤骨痿，内伤枯细的症状，类似历节痛风，然而历节痛风，系外感症，必发热；假如黄汗、小腿冷，且见发热，方可诊断为历节痛风症，方可发散表邪。所以下文再次申明说：病历节，不可屈伸疼痛，用乌头汤散邪。以上，是《金匮要略》关于中风的论述。
由此看来，《内经》论中风，总括叙述风邪致病，并非专指卒中暴仆的症状。《千金方》则阐发了卒中中的偏枯、风痱、风懿、风痹四种症状，并补充确立了治法。仲景《金匮要略》论风，即以《千金方》所阐发的半身不遂、四肢不收、突然昏倒不知人事、风痹之历节疼痛，来发明《千金方》的内容。侯氏黑散治疗寒证，风引汤治疗热证，扩充而为卒中风的标准准则。然而只论述外感风寒，未曾详细言及内伤诸种中法。于是，刘河间发挥火性急速，暴中卒倒皆属于火；李东垣发挥气郁壅滞，气虚受邪；朱丹溪发挥因痰而生热，因热而生痰。这是因为《千金方》、仲景阐发卒中病，单主风寒，只言外感，所以刘、李、朱三位先生，发挥主火、主气、主痰的理论，兼补内伤卒中亦完全了。喻嘉言先生妙论丛生，独着中风以《内经》“邪害空窍”之下，补充出补虚堵塞的治法，这也是一个片面的见解。恐怕保留这种观点而不去除，反而会成为危害。夫中风寒之症，有虚有实，有气血不足，空腹见风，风邪乘虚而入者；有气血壅滞，饮酒中风，风邪乘实而入者；有先中风寒，因而生痰生热者；有先有痰热，后招致风寒者。夫饥寒迫切，因虚而邪得以从外侵入，人人皆知。醉饱当风，因实而邪得从外侵入，人们却不知道。因此，外有六经表症，则比例加减续命汤等方剂疏散表邪；内见便溺阻塞，则比例三化汤等方剂清泻里实。邪气散去正气虚弱，当用补虚堵塞之法，古人分为闭、脱两条，以验证虚实，确实是有道理的。至于治风先治血，这是说厉风伤血，血痹不行，当行血祛邪；并非说补血即可治风，也并非说厉风伤气，也仅以血论治。又说：中风之症，理气为先。这是说气道壅闭，故当先理其气，并非说凡是治疗中风该用理气法。故应当仔细详辨外感寒邪属表者，比例《千金方》之候氏黑散、加减续命汤等疏散表邪；若积热壅闭属里者，比例风引汤、三化汤等清泻里热。若内伤的阴火上炎、积热上冲者，则遵循河间治法；痰凝中脘，攻注成疾者，则丹溪、节斋的方法恰当。所以凡治病，切不可固执一家的理论例子。如四肢不举，与半身不遂，看似相同实则不同。四肢不举，有虚有实；半身不遂，多为病邪为患。故四肢不举，以土不及为虚，土太过为实；土不及者，脾胃二经气血不足，则浑身无力，四肢难以举动，无麻木痛苦之感；土太过则气血壅实，而四肢酸痛，不能举动，或痛或麻木，或极冷如冰。至于半身不遂，则壅滞者多，虚者少，岂有一个人身体半边不虚、半边独虚的道理。即使有偏中风寒者，也只是得了外感寒邪，宜用辛散之法疏散表邪，实在不是虚寒而宜用温补。《准绳》书注释半身不遂，立胃脉沉涩为虚，胃脉鼓大为实是正确的；后来于心脉小坚急，只注元阳不足一条，不知道凡病有虚实，有心脉小坚急、元阳不足的，也有心脉大搏指、心火太旺的，书中未能详尽言明，学人应当仔细详辨补解。不玩味《内经》说：心气热则阳气内动，发为肌痹，传为脉痿；又说：阳有余，阴不足，为偏枯。又说：热多则大筋软短而拘挛，小筋弛张而痿废。像这样，则半身不遂，不可单指为元阳不足一条来立论。今人使用热药，误治偏枯筋痿，以至造成大害，祸根就在这里。
Huangdi Neijing (Yellow Emperor's Inner Canon) discusses stroke, noting that symptoms and etiologies vary. In some cases, wind pathogen invades the couli (skin texture and interstices); when couli open, there is a sensation of cold; when they close, there is stuffiness and oppression, termed Cold-Heat syndrome. This refers to chills and fever caused by Wind-Cold at the exterior. In other cases, wind pathogen enters the Stomach and cannot diffuse outward, resulting in Heat-in-the-Middle syndrome. This refers to fever caused by wind pathogen entering the interior. In thin individuals, heat diffuses outward causing coldness and tearing, termed Cold-in-the-Middle syndrome. This refers to deficiency-cold arising from excessive sweating due to weakness, allowing heat to escape with sweat. When wind pathogen enters along with the Taiyang meridian energy and scatters between the muscle layers, muscles become swollen and develop sores; this refers to wind-toxin counterflowing within the muscles causing ulcers. When Wei Qi (Defensive Qi) stagnates and fails to circulate, muscles become insensate; this refers to malignant wind damaging Wei Qi, blocking blood vessels, leading to leprosy or numbness. Above, Huangdi Neijing summarizes the various symptoms caused by wind pathogen.
It further states: When wind pathogen strikes the Shu points (Back-Shu acupoints) of the Zang-Fu organs, entering their respective gates, it causes Pi Feng (Partial Wind). This means wind pathogen striking the Shu points of various meridians, affecting either the left or right side, results in sudden onset partial wind and hemiplegia. It also states: When wind pathogen ascends along the Fengfu point (GV16), it causes Brain Wind and Eye Wind. This refers to headache disorders that can impair vision. If one contracts wind after drinking alcohol, presenting with profuse sweating, aversion to wearing single garments, panting, aversion to wind, dry mouth, and frequent thirst, it is called Lou Feng (Leaking Wind). This refers to symptoms involving both exterior and interior, where wine-heat combined with wind causes sweating, aversion to wind, and thirst. If wind is contracted during sweating after sexual intercourse, it is called Internal Wind. This implies that wind entering internally during post-coital sweating will cause symptoms such as urinary incontinence and dysuria. If wind is contracted immediately after bathing, with head sweating and aversion to wind, and if headache worsens the next day, it is called Shou Feng (Head Wind). This refers to headache caused by wind exposure after bathing. If wind remains long-term and enters inward, it causes Chang Feng (Intestinal Wind) and Sun Xie (undigested food diarrhea). This refers to diarrhea caused by external wind injury. If wind stays in the couli, accompanied by sweating, leakage of fluids, and generalized body pain, it is called Xie Feng (Draining Wind). This refers to gout-like pain caused by spontaneous sweating. Above, Huangdi Neijing discusses externally contracted wind.
It further states: Injury by wind on Jia/Yi days in Spring causes dry throat, irritability, and aversion to women, termed Liver Wind. Injury by wind on Bing/Ding days in Summer causes fright, red complexion, and speech difficulty, termed Heart Wind. Injury by wind on Wu/Ji days in Late Summer causes desire to keep limbs still, slight yellowish complexion, and poor appetite, termed Spleen Wind. Injury by wind on Geng/Xin days in Autumn causes sweating, aversion to wind, cough, and shortness of breath, termed Lung Wind. Injury by wind on Ren/Gui days in Winter causes facial edema and inability to stand upright, termed Kidney Wind. It also states: Inability to eat or drink, chest obstruction, abdominal distension upon removing clothes, diarrhea after eating cold food, emaciation with abdominal distension, is termed Stomach Wind. Above, Huangdi Neijing discusses internally injured wind.
The Qianjin Fang (Essential Prescriptions Worth a Thousand Gold) takes the stroke-related sections from Neijing’s wind discussion to establish the name "Zhong Feng" (Stroke). It names hemiplegia as Pian Ku (Half-Body Withering); body without pain but inability to control limbs as Feng Fei (Wind Paraplegia); sudden unconsciousness as Feng Yi (Wind Obscurity); and bi-syndrome with insensibility as Feng Bi (Wind Bi). These categories became the ancestors of modern stroke concepts.
In Zhang Zhongjing’s Jingui Yaolue (Essential Prescriptions from the Golden Cabinet), Article 1 states: Wind disease should present with hemiplegia, or only arm paralysis, which is a Bi syndrome. The pulse is subtle and rapid; this is caused by wind strike. This elaborates on Neijing’s description of partial wind, using the subtle-rapid pulse to distinguish it from Cold or Damp strike. Article 2 states: The Cun Kou (Radial) pulse is floating and tight. Tight indicates Cold; Floating indicates Deficiency. Deficiency and Cold contend, placing the pathogen in the skin. Floating indicates Blood deficiency and empty collaterals. The thief pathogen cannot be expelled, attacking either left or right. The pathogen causes flaccidity, while healthy Qi becomes tense; Healthy Qi pulls the pathogen, causing deviation of the mouth and eye and limb immobility. If the pathogen is in the Collaterals, the skin and muscles are insensate. If in the Meridians, heaviness and inability to lift occur. If entering the Fu organs, consciousness is lost. If entering the Zang organs, speech is difficult, and saliva dribbles. This elaborates on Pian Ku and Stroke symptoms. A subtle-rapid pulse indicates Wind-Heat; a floating-tight pulse without rapidity indicates Wind-Cold. If Wind-Cold lingers in the skin and is untreated, it leads to deviation and immobility. Thus, pathogen in Collaterals causes insensibility; in Meridians, heaviness; in Fu organs, unconsciousness; in Zang organs, speech difficulty. This clarifies the sequence and severity of wind pathogen invading meridians and organs. Article 3 states: The Cun Kou pulse is slow and relaxed. Slow indicates Cold; Relaxed indicates Deficiency. Relaxed Ying Qi indicates Blood loss; Relaxed Wei Qi indicates Wind strike. Pathogen striking meridians causes itching and hidden rashes. Insufficient Heart Qi allows pathogen to enter centrally, causing chest fullness and shortness of breath. Note: The previous article used floating-tight pulse to show Wind-Cold moving from exterior to interior; this article uses slow-relaxed pulse to show the same progression. Article 4 states: The Cun Kou pulse is deep and weak. Deep governs bones; Weak governs sinews. Deep relates to Kidney; Weak relates to Liver. Sweating and entering water damages the Heart, causing Li Jie (Joint) pain and Yellow Sweat, hence named Li Jie. This explains that deep pulse governs bones and weak pulse governs sinews; sweating into water with wind invasion causes joint pain and yellow sweat. It also states: The Shao Yin pulse is floating and weak. Weak indicates Blood insufficiency; Floating indicates Wind. Wind and Blood contend, causing pain like pulling. This describes gout caused by wind strike in Blood deficiency. It also states: Robust persons with choppy-small pulses, shortness of breath, spontaneous sweating, Li Jie pain, and inability to flex/extend joints. This describes robust persons who usually have large-full pulses but now show choppy-small pulses with shortness of breath, sweating, and severe joint pain, similar to Neijing’s description of wind after drinking. It also states: Pain in all joints, emaciated body, swollen feet feeling detached, dizziness, shortness of breath, and nausea are treated with Guizhi Shaoyao Zhimu Tang (Cinnamon Twig, Peony, and Anemarrhena Decoction). This reiterates that joint pain gout is an external contraction, suitable for Guizhi Shaoyao Zhimu Tang to harmonize Ying and Wei and disperse exterior pathogens. It also states: Sour taste injures sinews, leading to flaccidity, termed Xie. Salty taste injures bones, leading to atrophy, termed Ku. Ku and Xie contend, termed Duan Xie. Ying Qi does not flow, Wei Qi does not move alone; both Ying and Wei are deficient. San Jiao (Triple Burner) loses control, Four Belongings (limbs) are severed. Body is emaciated, feet are swollen, yellow sweat occurs, calves are cold. If fever occurs, it is Li Jie. This describes internal injury to sinews and bones, resembling Li Jie/Gout, but true Li Jie/Gout is external and must involve fever. If yellow sweat and cold calves are present with fever, it is Li Jie/Gout, treatable by dispersing exterior. Subsequently, it states: For Li Jie with inability to flex/extend and pain, use Wutou Tang (Aconite Decoction) to disperse pathogen. Above is Jingui Yaolue’s discussion on stroke.
Thus, Neijing discusses wind broadly, not just sudden collapse. Qianjin Fang elaborated on four stroke types (Pian Ku, Feng Fei, Feng Yi, Feng Bi) and added treatments. Zhongjing’s Jingui elaborated on these using Qianjin’s framework. Hou Shi Hei San treats Cold; Feng Yin Tang treats Heat, becoming standards for stroke. However, they only discussed external Wind-Cold, neglecting internal injuries. Later, Liu Hejian emphasized Fire causing sudden collapse; Li Dongyuan emphasized Qi stagnation and deficiency; Zhu Danxi emphasized Phlegm generating Heat and vice versa. Since Qianjin and Zhongjing focused on external Wind-Cold, Liu, Li, and Zhu supplemented internal stroke theories. Yu Jiayan proposed treating stroke via “pathogen harming empty orifices” with tonification and blockage methods, which is a partial view that may cause harm if retained. Stroke has deficiency/excess patterns: Qi/Blood deficiency allowing wind entry; Qi/Blood stagnation (e.g., after drinking) allowing wind entry; pre-existing wind/cold generating phlegm/heat; or pre-existing phlegm/heat attracting wind/cold. Everyone knows deficiency allows external invasion; few know excess (drinking/eating) allows external invasion. Therefore, exterior Six Channels symptoms require dispersing formulas like Jiajian Xuming Tang; interior constipation requires purging formulas like San Hua Tang. After pathogen dispersal, tonify deficiency. Ancients distinguished Bi (Closed) and Tuo (Collapse) to verify deficiency/excess. “Treating wind by treating blood” refers to severe wind damaging blood stasis, requiring blood-invigorating methods, not merely tonifying blood. “Regulating Qi first in stroke” refers to Qi blockage requiring Qi regulation, not universal application. One must distinguish exterior Cold (treat with dispersing formulas like Hou Shi Hei San or Jiajian Xuming Tang) from interior Heat (treat with clearing formulas like Feng Yin Tang or San Hua Tang). Internal Yin Fire rising follows Hejian’s methods; Phlegm stagnating in Middle Jiao follows Danxi/Jiezai’s methods. Do not adhere to one school. Limb paralysis differs from hemiplegia. Limb paralysis can be deficiency or excess; hemiplegia is mostly pathogenic obstruction. Limb paralysis due to Earth (Spleen/Stomach) deficiency involves Qi/Blood lack causing weakness without pain/numbness; Earth excess involves Qi/Blood stagnation causing pain/numbness/cold. Hemiplegia is mostly stagnation, rarely deficiency; it is illogical for half the body to be deficient while the other is not. Even if hemiplegia is due to external wind/cold, it requires acrid-dispersing methods, not warming-tonifying. Zhunsheng correctly identified Spleen pulse deep-choppy as deficiency and drum-large as excess. However, noting small-firm-tight Heart pulse only as Yuan Yang deficiency ignores cases of large-pulsating Heart pulse indicating Heart Fire. Neijing states: Heart heat moves Yang internally, causing Muscle Bi and Pulse Wei (Flaccidity); Yang excess, Yin deficiency causes Pian Ku; Heat causes large sinews to shorten/tether and small sinews to relax/flaccid. Thus, hemiplegia cannot be solely attributed to Yuan Yang deficiency. Using hot medicines mistakenly treating Pian Ku/Wei leads to disaster; the root of this error lies here.