Wind+Stroke

Wind stroke refers to a disorder manifested by sudden loss of consciousness w/ unilateral weakness, numbness, paralysis & dysphasia, or to a disorder manifested by sudden onset of unilateral paralysis and facial paralysis w/out experiencing unconsciousness.

Because of it's sudden & acute onset, multiple symptoms & rapid alterations in manifestations, and the onset of sudden fall & contractions are similar to the natural characteristics of wind, which is moving, migrating, and changing rapidly.

Stroke, with the above characteristics, is therefore given the name wind-stroke in Chinese medicine

Relevant Western Diseases
Bell's Palsy, Facial Paralysis, Hemorrhagic CVA, Ischemic Infarction CVA, Transient Ischemic Attack, Subarachnoid Hemorrhage, Brain Tumor, Cranial Arteritis

Etiology and Pathogenesis
could impare the Spleen's ability to transform & transport; such impairment causes generation of phlegm, which can cover the Heart orifice or obstruct the flow of the channels. Corresponding manifestations include loss of consciousness or hemiplegia & aphasia Excessive emotional stimulations affect both the Heart & the Liver. When disturbed by intense emotional stresses, Heart fire explosively flares upward whereas hyperactive Liver Yang would generate Liver wind. Mutually aggravating each other, Heart fire & Liver wind will further cause Qi & Blood to ascend & rush upwards to the brain. Sudden loss of consciousness would result. Due to aging, chronic illness, excessive exertion & weak constitution can cause Liver & Jidney Yin deficiency below w/ Liver Yang rising. This is a complicated condition of deficiency below w/ excess above. In this condition the Qi and the Blood rebel upward following Liver Yang rising. Moreover, phlegm may follow & ascend upwards to obstruct the flow in the channels or cover the clear orifices.
 * Invasion of exterior wind:**
 * Improper Diet:**
 * Emotional Stress:**
 * Prolonged Exhaustion:**

Exterior Wind Invading into the Unsolicited Channels
Sudden weakness & numbness of the extremities, facial paralysis, slurred speech, drooling or hemiplegia Obstruction of phlegm dampness or blood-stasis w/ unresolved numbness of the extremities & facial paralysis: + Dan Shen, Ji Xue Teng, Bai Jie Ze, Bai Fu Zi Accompanied w/ exterior wind-heat: + Sang Ye, Ju Hua, Bo He
 * Symptoms:** Aversion to wind, fever, soreness & pain in the joints
 * Tongue:** Thin, white coat
 * Pulse:** Floating & rapid
 * Treatment Strategy:** Dispel wind, nourish the Blood & unblock the channels
 * Formula:** Da Qin Jiao Tang
 * Modifications:**

Wind Yang Disturbing Upwards w/ Liver & Kidney Yin Deficiency
Sudden occurrence of facial paralysis, slurred speech or aphasia, numbness & heavy sensation of the extremities & hemiplegia Reinforce pacifying the Liver & extinguishing wind: + Tian Ma, Gou Teng, Ju Hua Accompanied by Phlegm-heat: + Dan Nan Xing, Zhu Li, Chuan Bei Mu Severe Headache: + Ling Yang Jiao, Shi Jue Ming, Xia Ku Cao
 * Symptoms:** Dizziness, headache, vertigo & tinnitus, dream-disturbed sleep, soreness & weakness of the lower back & knees, dry throat, constipation & scanty dark urine
 * Tongue:** Red tongue w/ scanty or greasy coat
 * Pulse:** Wiry, thready & rapid, or wiry & slippery
 * Treatment Strategy:** Nourish the Yin, subdue the Yang, extinguish wind & unblock the channels
 * Formula:** Zhen Gan Xi Feng Tang
 * Modifications:**

Heat Type of Closed Disorder
Sudden loss of consciousness w/ locked jaws, clenched fists, rigid limbs, and fecal & urinary retention as well as red face & fever Strengthen nourishing the Yin & subduing Yang: + Gui Ban, Shi Jue Ming Excessive Phlegm: + Zhu Li, Dan Nan Xing Contractions of the extremities: + Quan Xie, Wu Gong, Jiang Can Bad Breath & Constipation: + Da Huang, Zhi Shi, Mang Xiao
 * Symptoms:** Tachypnea, bad breath, excessive sputum or rattling sound in the throat, restlessness or agitation. Possible contractions & hiccoughs
 * Tongue:** Red tongue w/ yellow greasy coat
 * Pulse:** Wiry, slippery & forceful
 * Treatment Strategy:** Clear heat from the Liver, extinguish wind & open the orifices
 * Formula:** Zhi Bao Dan or An Gong Niu Huang Wan and Ling Jiao Gou Teng Tang (tube-feeding)
 * Modifications:**

Cold Type of Closed Disorder
Sudden loss of consciousness w/ locked jaws, clenched fists, rigid limbs, and fecal & urinary retention as well as pale complexion & dark lips Strengthen effects of pacifying the Liver & extinguishing winds: + Tian Ma, Gou Teng
 * Symptoms:** Quiet & still, cold extremities, distention & fullness in the abdomen, and excessive sputum
 * Tongue:** White, greasy coat
 * Pulse:** Deep, slippery & decelerating
 * Treatment Strategy:** Resolve phlegm, extinguish wind & open the orifices
 * Formula:** Su He Xiang Wang & Di Tan Tang (tube feeding)
 * Modifications:**

Abandon Disorder
Sudden loss of consciousness w/ flaccid extremities, closed eyes, opened mouth, fecal & urinary incontinence Unremitting profuse sweating: + Huang Qi, Long Gu, Mu Li, Shan Zhu Yu
 * Symptoms:** Shallow respirations, profuse sweating & clammy skin
 * Tongue:** Flaccid Tongue
 * Pulse:** Thready, weak or minute
 * Treatment Strategy:** Augment the Qi, revive the Yang & consolidate the collapse
 * Formula:** Shen Fu Tang & Sheng Mai San
 * Modifications:**

Hemiplegia Associated with Qi Deficiency & Blood Stasis
Unilateral weakness, loss of sensory & motor coordination, fatigue & lassitude, numbness or edema of the extremities & facial paralysis Reinforce effects of invigorating the collaterals: + Quan Xie, Chuan Niu Xi, Wu Shao She, Sang Zhi Significant weakness of the lower extremities: + Du Zhong, Sang Ji Sheng Significant weakness of the upper extremities: + Gui Zhi Swelling of the affected extremities: + Fu Ling, Ze Xie
 * Symptoms:** Sallow complexion, poor appetite, loose stool & slurred speech
 * Tongue:** Dark purple tongue w/ petechiae & white coat
 * Pulse:** Thready, choppy & weak
 * Treatment Strategy:** Augment the Qi, invigorate the Blood & unblock the channels
 * Formula:** Bu Yang Huan Wu Tang
 * Modifications:**

Hemiplegia Associated with Yin Deficiency & Yang Rising
Unilateral contracture of the affected extremities, headache, & red flush on the face Reinforce effects of clearing heat & nourishing Yin: + Sheng Di Huang, Bai Shao, Mai Men Dong Relax the sinews & unblock the collaterals: + Mu Gua, Shen Jin Cao
 * Symptoms:** Agitation, dizziness, tinnitus, dysphasia & numbness of the extremities
 * Tongue:** Red tongue w/ thin yellow coat
 * Pulse:** Wiry & forceful
 * Treatment Strategy:** Nourish the Yin, subdue the Yang & unblock the collaterals
 * Formula:** Tian Ma Gou Teng Yin
 * Modifications:**

Dysphasia associated with Wind-Phlegm Obstructing the Channels
Rigid tongue & slurred speech, dysphagia, excessive sticky sputum that is difficult to expectorate
 * Symptoms:** Dizziness, headache & loss of motor coordination or numbness of the extremities
 * Tongue:** Dark tongue w/ greasy white or yellow greasy coat
 * Pulse:** Wiry & Slippery
 * Treatment Strategy:** Dispel Wind-Phlegm, disclose the orifices & unblock the channels
 * Formula:** Jie Yu Dan

Weak & flaccid tongue w/ slurred speech, & soreness & weakness of the lower back & knees Preponderance of Yin Deficiency: remove Fu Zi, Rou Gui To improve Speech & open the orifice: + Xing Ren, Jie Geng
 * Symptoms:** Palpitations, dizziness & blurred vision, or fecal & urinary incontinence
 * Tongue:** Thinsmall tongue w/ scanty coat
 * Pulse:** Deep & Thready
 * Treatment Strategy:** Nourish the Yin, Tonify the Kidney & open the orifices
 * Formula:** Di Huang Yin Zi
 * Modifications:**

Facial Paralysis
Includes the loss of motor & sensory coordination of facial muscles, inability to properly open & close the affected eye, inability to control the movement of the affected side of the mouth, and drooling (See also Bell's Palsy) Strengthen the effect of extinguishing wind: + Tian Ma, Gou Teng, Shi Jue Ming Strengthen the effect of relaxing the sinews & unblocking the channels: + Bai Shao,Mu Gua
 * Treatment Strategy:** Dispel wind, resolve phlegm & unblock the channels
 * Formula:** Qian Zheng San
 * Modifications:**

Channel Involvement
GV-20, BL-7, GV-16 Paralysis of the Upper Limbs: + LI-15, LI-11, TW-5, LI-4 Paralysis of the Lower Limbs: + GB-30, ST-36, ST-41, GB-34 Facial Paralysis: + ST-4, ST-6, LI-4, St-44
 * Manipulation:** Even method on healthy side first, then affected side
 * Prescription:**
 * Supplementary Points:**

Organ Involvement
GV-20, GV-26, ST-40, LR-3, KI-1, 12 Jing-Well Points Locked Jaws: + ST-7, St-6, LI-4 Rigid Tongue & Aphasia: + GV-15, CV-23, HT-5
 * Manipulation:** Reducing Method
 * Prescription:**
 * Supplementary Points:**

Abandon Disorder
CV-8, CV-6, CV-4
 * Manipulation:** Moxa
 * Prescription:**

Modifications
Difficulty in Frowning & raising the eyebrow: BL-2, TW-23 Incomplete closing of the eye: + BL-2, BL-1, GB-1, Yu Yao, TW-23\ Difficulty in sniffing: + LI-20 Deviation of the philtrum: + GV-26 Inability to show the teeth: + ST-3 Tinnitus & deafness: + GB-2 Tenderness in the mastoid region: + GB-12, TW-5 Long standing cases: + Tai yang, St-6, ST-4, ST-3, ST-7 (use warm-needle or moxa on all)

Practical Hints
Referral to an acute healthcare facility at the onset of wind-stroke cupping may be used as an adjunctive therapy to acupuncture (once every 3-5 days)