Wind stroke

is an emergency case manifested by falling down in a fit with loss of consciousness , or hemiplegia , slurred speech and deviated mouth . It is characterized by abrupt onset with pathological changes varying quickly like the wind , from which the term wind stroke comes .

Etiology and Pathogenesis . Wind stroke often occurs in the aged who are in poor health , with deficiency of qi and blood , or deficiency in the lower part of the body and excess in the upper part . It may be caused by deficiency of the kidney yin due to sexual indulgence , or by irregular food intake , which impedes the transportation and transformation function of the spleen , leading to production of phlegm from accumulated dampness and transformation into heat . Then there appears imbalance of yin and yang in the zang - fu organs . Other causative factors are exasperation , agitation , alcohol indulgence or overeating , overstrain and stress , or invasion ol exogenous pathogenic wind , all leading to upsurge of liver yang and heart fire , which makes qi and blood go upward together with turbid phlegm , disturbing the mind and resulting in this disease . In mild cases there are only symptoms showing dysfunction of the meridians and collaterals , while in severe cases both dysfunction of zang - fu organs and that of the meridians and collaterals are manifested . The syndrome indicating the attack on the zang - fu organs may be subdivided into tense ( excess ) type and flaccid ( deficiency ) type .

Tense ( excess ) syndrome results from disturbance of the mind by the phlegm heat , or collection of excessive fire in the heart and liver , while flaccid ( deficiency ) syndrome results from deficiency of the primary qi or collapse of the kidney yang . In untreated or improperly treated cases , the tense syndrome tends to become flaccid and the prognosis is often poor .

Differentiation

Attack on the zang - fu organs

• Tense syndrome :

Main manifestations : Falling down in a fit with loss of consciousness , tightly closed hands and clenched jaws , flushed face . coarse breathing , rattling in the throat , retention of urine , constipation , red tongue with thick yellow or dark gray coating , string - taut , rolling and forceful pulse .

Analysis : Wind stirred up by upsurge of liver yang sends qi and blood upwards , which together with the accumulated phlegm Fire disturb the mind , leading to sudden loss of consciousness with tightly closed hands and clenched jaws , flushed face , coarse breathing , retention of urine and constipation . Excessive wind phlegm brings about rattling in the throat . Red tongue with thick yellow coating or dark gray coating , string - taut , rolling and forceful pulse are the signs of wind combined with phlegm Fire .

• Flaccid syndrome :

  Main manifestations : Falling down in a Fit and sudden loss of consciousness with mouth agape and eyes closed , snoring but feeble breathing , flaccid paralysis of limbs , incontinence of urine , flaccid tongue , thready , weak pulse , and in severe cases cold limbs , or flushing of face as rouged , fading or big floating pulse .

  Analysis : Severe weakness of primary qi , separation of yin and yang and exhaustion of qi in the zang organs are indicated in mouth agape , eyes closed , snoring but feeble breathing , flaccid paralysis , and incontinence of urine . Flaccid tongue and thready weak pulse suggest the deficiency of blood and prostration of the kidney yang . If complicated with cold limbs , flushed face , fading or big floating pulse , it is a critical case , indicating exhaustion of yin in the lower portion of the body and upward going of the isolated yang .

Attack on the meridians and collaterals There are two categories . One is that only the meridians and collaterals are attacked without the zang - fu organs being involved . The other is that after wind stroke the functions of the affected zang - fu organs have been restored , yet there exists stagnation of qi and blood in the meridians and collaterals .

Main manifestations : Hemiplegia , numbness of the limbs , deviated mouth , slurring of speech , accompanied by headache , dizziness , vertigo , twitching of muscles , red eyes and flushed face , thirst , dryness of the throat , irritability , string taut and rolling pulse .

Analysis : Wind phlegm enters the meridians and collaterals due to imbalance of yin and yang , or after treatment the functions of the affected zang - fu organs have been restored , but wind phlegm still blocks the meridians and collaterals , causing retarded circulation ofqi and blood . Hence appears hemiplegia , numbness of the limbs , deviated mouth and slurring of speech . 'If complicated with upsurging of liver yang , and upward disturbance of wind yang , the symptoms are headache , dizziness , vertigo and twitching of muscles . If there is excessive fire in the heart and liver , there may be red eyes and flushed face , thirst , dryness of the throat and irritability . Stagnation of wind phlegm in the meridians and collaterals leads to a string - taut and rolling pulse .

Treatment

Attack on the zang - fu organs :

Tense syndrome Method : Points of the Du Meridian , the Liver Meridian of Foot - Jueyin and the twelve Jing - ( Well ) points are selected as the main points to promote resuscitation , reduce wind and Fire and resolve phlegm . Either reducing method or pricking , to cause little bleeding , is applied .

Prescription : Baihui ( Du 20 ) , Shuigou ( Du 26 ) , Fenglong ( S 40 ) , Taichong ( Liv 3 ) , Yongquan ( K1 ) , twelve Jing - ( Well ) points on both hands ( L11 , H9 , P9 , Li1 , Sj1 )

Supplementary Points :

• Clenched Jaws : Xiaguan ( S7 ) , Jiache ( S6 ) , Hegu ( Li4 )
• Aphasia and stiffness of tongue : Yamen ( Dul5 ) , Lianquan ( Ren23 ) , and Tongli ( H5 ) .

Explanation : As the condition is due to disturbance of the heart by phlegm associated with up surging of liver yang and upward flowing ofqi and blood , Baihui ( Du 20 ) and Shuigou ( Du 26 ) are selected to regulate qi of the Du Meridian , effecting resuscitation , Yongquan ( K 1 ) is selected to conduct the heat downward , and Taichong ( Liv 3 ) to subdue the upsurging of qi in the Liver Meridian and pacify the liver yang . Pricking the twelve Jing - ( Well ) points on both hands , where qi of the three yin and three yang meridians meet , may dispel heat and regain consciousness . The spleen and stomach are the source of phlegm production . Fenglong ( S 40 ) , the Luo - ( Connecting ) point of the Stomach Meridian can invigorate the functions of the spleen and stomach and help to resolve the turbid phlegm . Since the Yangming Meridians of Hand and Foot supply the cheeks , Xiaguan ( S 7 ) , Jiache ( S 6 ) and Hegu ( LI 4 ) are chosen to promote the circulation of qi and blood for relieving the clenched jaws . Yamen ( Du 15 ) and Lianquan ( Ren 23 ) , being local and adjacent points of the tongue , and Tongli ( H 5 ) , the Luo - ( Connecting ) point of the Heart Meridian , may relieve stiffness of tongue

Flaccid syndrome Method : Moxibustion is applied to points of the Ren Meridian to restore yang from collapse .

Prescription : Shenque ( Ren 8 ) , Qihai ( Ren 6 ) ( indirect moxibustion with salt ) , Guanyuan ( Ren 4 ) .

Explanation : Shenque ( Ren 8 ) , Qihai ( Ren 6 ) and Guanyuan ( Ren 4 ) are located on the lower abdomen along the Ren Meridian and are the main points effective for collapse . Heavy moxibustion applied on Guanyuan ( Ren 4 ) , a meeting point of the Ren Meridian and three yin meridians , can strengthen the primary qi , and restore yang from collapse .

Attack on the meridians and collaterals : Method : Points along the Du Meridian and the yang meridians of the affected side are mainly used to regulate qi and blood , remove obstruction from the meridians and collaterals and reduce the wind . Needle with even movement first from the healthy side and then the affected side .

Prescription : Baihui ( Du20 ) , Tongtian ( B7 ) , Fengfu ( Du16 ) .

Upper limbs ; Jianyu ( Li15 ) , Quchi ( Li11 ) , Waiguan ( Sj5 ) , Hegu ( Li4 ) .

Lower limbs : Huantiao ( G30 ) , Yangling - quan ( G 34 ) , Zusanii ( S36 ) , Jiexi ( S41 ) . Supplementary points : Upward disturbance of wind yang : Reducing is applied to Fenchi ( G20 ) and Taichong ( Liv3 ) , and reinforcing to Taixi ( K3 ) and Sanyinjiao ( Sp 6 ) . Excessive fire in the heart and liver : Reducing is applied to Daling ( P 7 ) and Xingjian ( Liv 2 ) , and reinforcing to Taixi ( K 3 ) .

Deviated mouth : Dicang ( S 4 ) , Jiache ( S 6 ) .

Explanation : Du Meridian is the sea of all yang meridians . Baihui ( Du 20 ) , Fengfu ( Du 16 ) combined with Tongtian ( B 7 ) can eliminate wind and remove obstruction from the meridians and collaterals . Since the yang meridians dominate the exterior of the body and qi , points of the yang meridians are selected to regulate qi and blood of the body and promote smooth circulation in the upper and lower portions of the body . For the upper disturbance of wind yang , Fengchi ( G20 ) and Taichong ( Liv3 ) are selected to reduce the wind and pacify the liver . Reinforcing applied to Taixi ( K3 ) promotes the production of the kidney yin to nourish the liver . Reinforcing applied to Sanyinjiao ( Sp6 ) nourishes yin and paciFies yang .

For excessive fire in the heart and liver , reducing Daling ( P7 ) and Xingjian ( Liv2 ) can eliminate the fire , while reinforcing to Taixi ( K 3 ) nourishes yin to reduce the fire . Dicang ( S4 ) and Jiache ( S6 ) are selected for the purpose of promoting a free circulation ofqi in the meridians and collaterals around the facial region .

Remarks

Wind stroke is referred to cerebral hemorrhage , thrombosis , embolism , subarachnoid hemorrhage , etc . When the acute stage is over , there may be sequelae , such as hemiplegia , monoplegia , aphasia , etc .

Prophylactic measures for wind stroke : The old aged with . deficiency of qi and excessive phlegm , or with manifestations of up surging of liver yang marked by dizziness and palpitations , may have premonitory symptoms such as stiff tongue , slurred speech and numbness of the Finger tips . Attention should be paid to diet and life style and avoid overstraining . Frequent moxibustion on Zusanii ( S36 ) and Xuanzhong ( G39 ) may prevent an attack of wind stroke .