Apoplexy is divided into the two types of "apoplexy involving meridians and collaterals" and "apoplexy involving viscera" in TCM. The former generally refers to freedom from changes of mentality and the latter often to the more serious state of illness with unconsciousness. The main clinical manifestation is hemiplegia, namely paralysis of unilateral limbs. Therefore, the disease is also called "ban shen bu sui" (hemiplegia), "plan ku" (hemilateral withering) and "plan fei" (unilateral disuse) in TCM. The patients are often accompanied by facial distortion. If the disease lasts long, the affected limbs are skinny and numb.

Syndrome differentiation and treatment

Blood stasis due to qi deficiency

It manifests hemiplegia of limbs, pale and lusterless complexion, emaciation, spontaneous sweating, numbness of skin, or swelling of hands and feet, spasm of muscle or with stabbing pain of unilateral body, squamous and dry skin, enlarged tongue with dental marks or dim and sluggish tongue with ecchymosis and petechiae, taut and thready or unsmooth and intermittent pulse. It is advisable to benefit qi and activate blood circulation, and dredge meridians and collaterls. The prescription used is the modified Buyang Huanwu Decoction (Yang-Strengthening Decoction for Recuperation). In the case of severe numb limbs and body, add Sangjisheng (Ramulus Loranthi ), Wugong (Scolopendra) and Jixueteng (Caulis Spatholobi); in the case of paralysis of upper limbs, add Sangzhi ( Ramulus Mori ) , Guizhi ( Ramulus Cinnamomi ) and Weilingxian (Radix Clematidis); in the case of paralysis of lower limbs, add Chuanniuxi (Radix Cyathulae).

Asthenia of the liver and kidney

It manifests hemiplegia, numbness and trembling of limbs and body, aching pain and flaccidity of the waist and legs, or odontoseisis and baldness, tinnitus, amnesia, light-headedness, stiff tongue with non-fluent speech, dull expression, red tongue with a little fur, taut and thready pulse. It is advisable to strengthen the liver and kidney. The prescription used is the modified Qiju Dihuang Decoction (Decoction of Six Drugs, Rehmannia with Wolberry and Chrysanthemum). In the case of palpitation and insomnia, add parched Zaoren (Semen Ziziphi Jujubae), Baiziren ( Semen Biotae ), Fuling (Poria) and Yejiaoteng (Caulis Polygoni Multiflori ); in the case of dry mouth and red tongue, add Tainmendong (Radix Asparagi) and Ejiao (Colla Corii Asini ). As for the Chinese patent drug, it is suitable to use Qiju Dihuang Bolus(Bolus of Six Drugs, Rehmannia with Wolfberry and Chrysanthemum).

Phlegm and dampness due to asthenia of the spleen

It manifests paralysis and numbness of the limbs and body, cold limbs, facial edema, chest tightness with abdominal distension, poor appetite, lassitude without physical strength, loose stool, fat body, yellowish complexion with pale lips, or cough with short breath, profuse sputum, pale tongue with white and greasy fur, taut and slippery pulse. It is advisable to strengthen the spleen, resolve phlegm and remove dampness. The prescriptions used are the Xiangsha Liujunzi Decoction Decoction of Cyperus and Amomum with Six Noble Ingredients) in combination with Erchen Decoction (Two Old Drugs Decoction) with the additional ingredients of Shichangpu ( Rhizoma Acori Graminei ), Yuanzhi ( Radix Polygalae), Yujin (Radix Curcumae) and Baijiangcan (Bombyx Batryticatus ).
Rehabilitation methods

Functional training

When the patients gradually restore their functions of limbs and the body, they may be supported to practice some simple free activities in bed such as getting up, raising arms, lifting legs and lifting feet. The patients should leave the bed as early as possible to practice standing and slow walking. At the beginning, the patients should be supported by the medical and nursing staff to practice these activities. Then gradually increase the amount of exercise from the moment the patients use the walking stick to the moment the patients stop using it. Or the patients may do some knitting by hand to have functional training. The patients with stiff tongue and non-fluent speech may say simple words during the training. Then practice saying longer sentences gradually.

As for the keep-fit patting method, please refer to the relevant content in Chapter 5.8.4.

As for functional training of fingers and upper limbs, it is advisable to adopt the method of playing games. As for the relevant detailed content, please refer to Chapter 5.3.4.