13. Stroke (Zhong Feng)
• Definition
--- A disorder manifested by sudden loss of consciousness with unilateral weakness, numbness, paralysis and dysphasia, or to a disorder manifested by sudden onset of unilateral paralysis and facial paralysis without experiencing unconsciousness.
• Relevant diseases of western medicine
1. Cerebrovascular disease
2. Bell’s palsy
• Etiology & pathogenesis
1. Unconsolidated channels with the invasion of exterior wind
2. Improper diet
3. Emotional stress
4. Prolonged exhaustion
• Differential diagnosis
A. Identification of channel and organ involvement:
1. Channel involvement
2. Organ involvement
B. Identification of closed disorder and abandon disorder
1. Closed disorder
2. Abandon disorder
• Classification & treatment
Channel involvement:
1. Exterior wind invading into the unconsolidated channels
Da Qin Jiao Tang
Qin Jiao, Fang Feng, Bai Zhi, Xi Xin, Qiang Huo and Du Huo---
Shu Di Huang, Dang Gui, Shao Yao and Chuan Xiong---
Bai zhu and Fu Ling---
2. Wind-Yang disturbing upwards with liver and kidney Yin deficiency
Zhen Gan Xi Feng Tang
Gui Ban, Bai Shao, Xuan Shen and Tian Men Dong---
Long Gu, Mu Li and Dai Zhe Shi---
Niu Xi---
Organ involvement:
1. Heat-type of closed disorder
Zhi Bao Dan or An Gong Niu Huang Wan and Ling Jiao Gou Teng Tang (tube feeding)
Ling Yang Jiao and Gou Teng---
Sang Ye and Ju Hua---
Sheng Di Huang and Bai Shao---
Bei Mu and Zhu Ru---
2. Cold-type of closed disorder
Su He Xiang Wan and Di Tan Tang (tube feeding)
Ban Xia, Ju Hong, and Fu Ling---
Zhu Ru---
Shi Chang Pu and Dan Nan Xing---
Zhi Shi---
3. Abandon disorder
Shen Fu Tang and Sheng Mai San
Ren Shen---.
Fu Zi---
Mai Men Dong---
Wu Wei Zi---
Sequelae:
1. Hemiplegia associated with qi deficiency and blood stasis
Bu Yang Huan Wu Tang
Huang Qi---
Tao Ren, Hong Hua, Dang Gui Wei, Chuan Xiong and Chi Shao---
Di Long---
2. Hemiplegia associated with yin deficiency and yang rising
Tian Ma Gou Teng Yin
Tian Ma, Gou Teng and Shi Jue Ming---
Zhi Zi and Huang Qin---
Yi Mu Cao---
Niu Xi---
Du Zhong and Sang Ji Sheng---
3. Dysphasia associated with wind-phlegm obstructing the channels
Jie Yu Dan
Tian Ma, Quan Xie, Dan Nan Xing and Fu Zi---
Yuan Zhi and Shi Chang Pu---
Qiang Huo---
4. Dysphasia associated with kidney essence deficiency
Di Huang Yin Zi
Shu Di Huang and Shan Zhu Yu---
Rou Cong Rong and Ba .li Tian---
Mai Men Dong, Shi Hu and Wu Wei Zi---
Shi Chang Pu, Yuan Zhi and Fu Ling---
5. Facial paralysis
Qian Zheng San
Bai Fu Zi---
Jiang Can and Quan Xie---
• Acupuncture treatment
Channel involvement
GV20 Baihui, BL7 Tongtian, GV16 Fengfu
Supplementary points:
- Paralysis of the upper limbs. + LI l5 Jianyu; LI ll Quchi; TE 5 Waiguan;
LI 4 Hegu
- Paralysis of the lower limbs. + GB 30 Huantiao; ST 36 Zusanli; ST 41 Jiexi;
GB34 Yanglingquan
- Facial paralysis. + ST 4 Dicang; ST 6 Jiache; LI 4 Hegu; ST 44 Neiting
Organ involvement
Closed disorder:
GV20 Baihui, GV26 Renzhong, ST40 Fenglong, LR3 Taichong, KI l Yongquan, 12 Jing-well points
Supplementary points:
- Locked jaws. + ST7 Xiaguan; ST6 Jiache; LI4 Hegu
- Rigid tongue and aphasia. + GV15 Yarnen; CV23 Lianquan; HT5 Tongli
Abandon disorder: Moxibustion
CV8 Shenque, CV6 Qihai, CV 4 Guanyuan
• Personal clinical experience
--- A disorder manifested by sudden loss of consciousness with unilateral weakness, numbness, paralysis and dysphasia, or to a disorder manifested by sudden onset of unilateral paralysis and facial paralysis without experiencing unconsciousness.
• Relevant diseases of western medicine
1. Cerebrovascular disease
2. Bell’s palsy
• Etiology & pathogenesis
1. Unconsolidated channels with the invasion of exterior wind
2. Improper diet
3. Emotional stress
4. Prolonged exhaustion
• Differential diagnosis
A. Identification of channel and organ involvement:
1. Channel involvement
2. Organ involvement
B. Identification of closed disorder and abandon disorder
1. Closed disorder
2. Abandon disorder
• Classification & treatment
Channel involvement:
1. Exterior wind invading into the unconsolidated channels
Da Qin Jiao Tang
Qin Jiao, Fang Feng, Bai Zhi, Xi Xin, Qiang Huo and Du Huo---
Shu Di Huang, Dang Gui, Shao Yao and Chuan Xiong---
Bai zhu and Fu Ling---
2. Wind-Yang disturbing upwards with liver and kidney Yin deficiency
Zhen Gan Xi Feng Tang
Gui Ban, Bai Shao, Xuan Shen and Tian Men Dong---
Long Gu, Mu Li and Dai Zhe Shi---
Niu Xi---
Organ involvement:
1. Heat-type of closed disorder
Zhi Bao Dan or An Gong Niu Huang Wan and Ling Jiao Gou Teng Tang (tube feeding)
Ling Yang Jiao and Gou Teng---
Sang Ye and Ju Hua---
Sheng Di Huang and Bai Shao---
Bei Mu and Zhu Ru---
2. Cold-type of closed disorder
Su He Xiang Wan and Di Tan Tang (tube feeding)
Ban Xia, Ju Hong, and Fu Ling---
Zhu Ru---
Shi Chang Pu and Dan Nan Xing---
Zhi Shi---
3. Abandon disorder
Shen Fu Tang and Sheng Mai San
Ren Shen---.
Fu Zi---
Mai Men Dong---
Wu Wei Zi---
Sequelae:
1. Hemiplegia associated with qi deficiency and blood stasis
Bu Yang Huan Wu Tang
Huang Qi---
Tao Ren, Hong Hua, Dang Gui Wei, Chuan Xiong and Chi Shao---
Di Long---
2. Hemiplegia associated with yin deficiency and yang rising
Tian Ma Gou Teng Yin
Tian Ma, Gou Teng and Shi Jue Ming---
Zhi Zi and Huang Qin---
Yi Mu Cao---
Niu Xi---
Du Zhong and Sang Ji Sheng---
3. Dysphasia associated with wind-phlegm obstructing the channels
Jie Yu Dan
Tian Ma, Quan Xie, Dan Nan Xing and Fu Zi---
Yuan Zhi and Shi Chang Pu---
Qiang Huo---
4. Dysphasia associated with kidney essence deficiency
Di Huang Yin Zi
Shu Di Huang and Shan Zhu Yu---
Rou Cong Rong and Ba .li Tian---
Mai Men Dong, Shi Hu and Wu Wei Zi---
Shi Chang Pu, Yuan Zhi and Fu Ling---
5. Facial paralysis
Qian Zheng San
Bai Fu Zi---
Jiang Can and Quan Xie---
• Acupuncture treatment
Channel involvement
GV20 Baihui, BL7 Tongtian, GV16 Fengfu
Supplementary points:
- Paralysis of the upper limbs. + LI l5 Jianyu; LI ll Quchi; TE 5 Waiguan;
LI 4 Hegu
- Paralysis of the lower limbs. + GB 30 Huantiao; ST 36 Zusanli; ST 41 Jiexi;
GB34 Yanglingquan
- Facial paralysis. + ST 4 Dicang; ST 6 Jiache; LI 4 Hegu; ST 44 Neiting
Organ involvement
Closed disorder:
GV20 Baihui, GV26 Renzhong, ST40 Fenglong, LR3 Taichong, KI l Yongquan, 12 Jing-well points
Supplementary points:
- Locked jaws. + ST7 Xiaguan; ST6 Jiache; LI4 Hegu
- Rigid tongue and aphasia. + GV15 Yarnen; CV23 Lianquan; HT5 Tongli
Abandon disorder: Moxibustion
CV8 Shenque, CV6 Qihai, CV 4 Guanyuan
• Personal clinical experience
