all be present but there must usually be at least three of them to cause Wind-stroke. Also, they
may be present in different degrees of intensity giving rise to many different types of
Wind-stroke.

Of course, these are only the pathogenic factors appearing in Wind-stroke. Besides these, there
will also be some deficiency of Qi, Blood, or Yin, especially Kidney- and/or Liver-Yin.

The tongue appearance is an important indicator especially in the prevention of Wind-stroke.
The four pathological factors and the way they are reflected on the tongue are summarized in
Table 27.1Table 27.1.

The real value of tongue diagnosis in Wind-stroke lies in its preventive role. If an old person's
tongue presents an appearance as in the above table, it strongly indicates at least the possibility
of Wind-stroke. For example, the tongue may be Reddish-Purple, Stiff and Swollen, indicating
Fire, Stasis, Wind and Phlegm, the four pathogenic factors of Wind-stroke.

Differentiation

The most important differentiation in Wind-stroke is between that which attacks the internal
organs and channels and that which attacks only the channels. According to this distinction there
are two types of Wind-stroke:

• Severe type which attacks the internal organs and the channels


• Mild type which attacks only the channels.

Wind-stroke from attack of the internal organs and channels is characterized by apoplexy, loss of
consciousness, possibly coma, aphasia, paralysis and numbness. The distinguishing signs of
attack of the internal organs by Wind are loss of consciusness, coma and aphasia.

Wind-stroke from attack of the channels alone is characterized by unilateral paralysis, numbness
and slurred speech. There is no loss of consciousness or coma.

Following a severe type attack of Wind to the internal organs, a person who survives will enter
the sequelae stage when the clinical manifestations are the same as in a mild type (attack of
channels only), i.e. unilateral paralysis (hemiplegia), numbness and slurred speech. Thus, these
manifestations may either arise independently from an attack of the channels alone, or they may
be the sequelae of an attack of the internal organs.

The severe type (attack of internal organs and channels) is further divided into the Tense (or