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Half-body paralysis, also known as "hemiplegia," refers to the symptom of paralysis in the upper and lower limbs on either the left or right side, resulting in the inability to move voluntarily. It is often accompanied by facial asymmetry on the paralyzed side, and over time, the affected limb may become emaciated and numb. This condition is mostly attributed to wind paralysis.

The term "half-body paralysis" first appeared in Neijing, referred to as "hemiplegia." Jingui Yaolue．apoplexy multiple arthralgia abnormal pulse syndrome and treatment records: "When wind causes illness, it results in half-body paralysis." Zhubing Yuanhou Lun describes "wind half-body immobility syndrome," "wind hemiplegia syndrome," and "hemiplegia syndrome," all of which exhibit symptoms of half-body paralysis. Later generations' literature often discusses this condition under the category of "apoplexy."

"Atrophy-flaccidity disease" refers to the flaccidity and weakness of the muscles and sinews in the limbs, leading to immobility, often symmetrically affecting the limbs or both lower limbs, thus differing from half-body paralysis. "Paralysis" is a general term for the inability to move limbs, and half-body paralysis is included within this category, specifically referring to paralysis of one side's upper and lower limbs. Bi disease may occasionally cause pain on one side of the body, leading to immobility that resembles half-body paralysis. However, its clinical manifestation is the reluctance to move due to pain, which distinguishes it from half-body paralysis.

bubble_chart Pattern Analysis

1. Wind Invading the Channels︰Sudden collapse, hemiplegia, numbness of the skin, accompanied by deviation of the mouth and eyes, slurred speech, or fever and chills, headache, joint pain, limb stiffness, white and greasy tongue coating, floating and slippery pulse manifestation. Due to insufficient healthy qi, emptiness of the collaterals, loose striae and interstice, wind evil takes advantage to invade, wind evil stirs phlegm-dampness, which flows and spreads through the collaterals, causing stagnation of qi and blood and thus the onset of disease. The treatment method is expelling wind and dredging collaterals, nourishing blood and harmonizing the nutrient qi, using Major Gentian Decoction with modifications.
2. Internal Stirring of Liver Wind︰headache vertigo, tinnitus, blurred vision, irritability, flushed face, red eyes, sudden onset of hemiplegia triggered by anger, stiff tongue with slurred speech, facial deviation, even vomiting, unconsciousness, etc., red tongue texture, wiry and rapid pulse. Mostly caused by liver-kidney yin deficiency, liver yang hyperactivity, yin deficiency with yang hyperactivity, water failing to nourish wood leading to internal stirring of wind-yang, disturbing the clear orifices, and wind-yang carrying phlegm to block the meridians. Treatment involves pacifying the liver and subduing yang, clearing phlegm and unblocking collaterals, using Gastrodia and Uncaria Drink with modifications.
3. Internal Blockage by Phlegm-Fire︰Sudden collapse, unconsciousness, hemiplegia, deviation of the mouth and eyes, clenched fists, locked jaw, flushed face, red eyes, phlegm rales in the throat, panting and restlessness, red tongue texture, yellow and greasy coating, wiry, slippery, and rapid pulse. Caused by sudden hyperactivity of liver yang, excessive yang stirring wind, upward reversal of qi and blood, and upward reversal of liver fire with phlegm-heat; classified as yang closure. Treatment should focus on pungent-cool resuscitation with aromatics, using Supreme Treasured Pill, along with formulas for clearing phlegm, calming the liver, clearing heat, and dispelling wind, such as Antelope Horn and Uncaria Decoction.
4. Damp Phlegm︰Sudden collapse, hemiplegia, somnolence or lethargy, unconsciousness, clenched fists, profuse phlegm and saliva, puffy face, locked jaw, quiet without restlessness, pale face with purple lips, cold limbs, white and greasy tongue coating, deep and slippery or slow pulse. It is caused by improper diet, dysfunction of the spleen in transportation, accumulation of dampness and phlegm, leading to obstruction by phlegm and saliva, and failure of yang qi to circulate. It belongs to yin closure and should be treated with pungent-warm resuscitation with aromatics, using Styrax Pill, as well as removing phlegm and stopping wind herbs, such as Phlegm-Guiding Decoction with Gastrodia Tuber, Stiff Silkworm, Acorus, and other medications.
5. Yang Qi Deficiency Collapse︰Sudden fainting, hemiplegia, unconsciousness, eyes closed and mouth open, hands slack, enuresis, snoring with faint breath, reversal cold of limbs, pale complexion, cold sweating on the forehead, a flaccid and pale tongue, and deep, thin, and faint pulse. Hemiplegia may also be observed upon regaining consciousness. This is a critical condition. Due to the unconscious state, determining which side is affected by hemiplegia is often difficult. However, careful observation of accompanying symptoms such as a deviated mouth angle and obvious flaccidity on the hemiplegic side when moving the limbs can help confirm the diagnosis. It is mostly caused by the exhaustion of original qi leading to the separation of yin and yang. Treatment should focus on tonifying qi and restoring yang, using the formula Ginseng and Aconite Decoction.
6. Yin-Yang Collapse and Floating︰Sudden hemiplegia, unconsciousness, deviation of the mouth and eyes, or symptoms such as closed eyes, open mouth, hand relaxation, enuresis, and faint snoring may occur. The hands and feet are cold, while the cheeks appear red. The tongue is flaccid and red, with a deep, thin pulse on the verge of disappearing. Hemiplegia may also become apparent only after regaining consciousness. This is a critical condition. Due to the unclear state of consciousness, determining the side of hemiplegia is often difficult. However, careful observation of accompanying symptoms, such as a crooked mouth or obvious flaccidity in the affected limb when moved, can help identify it. This condition arises from the exhaustion of yin below and the solitary yang surging upward, manifesting as a flushed face like makeup, a red tongue, and a floating, rootless pulse or a deep, thin pulse on the verge of disappearing. The treatment requires the method of strengthening water to control fire, using Rehmannia Decoction with modifications.
7. Qi Deficiency and Blood Stasis︰Hemiplegia, pale complexion, emaciation, spontaneous sweating, unilateral withering and thinness, numbness of the skin, or swelling of the hands and feet, spasm of the tendons, flexion of the upper limbs, extension of the lower limbs, pain upon forced flexion or extension of the limbs, or unilateral stabbing pain. Scaly skin, pale or dull tongue with static blood spots, wiry and thin or choppy and knotted pulse. Mostly caused by deficiency of qi and blood, leading to static blood obstructing the collaterals, commonly seen in elderly patients; or due to birth injuries in infants, or head trauma. Prolonged stagnation of static blood; or long-term apoplexy resulting in deficiency of qi and blood. Accompanied by qi deficiency and blood stasis, such as scaly skin, pale complexion, shortness of qi with reluctance to speak, spontaneous sweating, mental fatigue, pale lips and nails, tongue with static blood spots, thin and choppy pulse, etc. The method of replenishing qi and invigorating blood to resolve stasis can be used, with Yang-Tonifying Five-Returning Decoction modified as needed.
8. Liver and Kidney Deficiency︰The patient has been weak and frail for many years, with a pale complexion, sore waist and weak legs, loose teeth and hair loss, tinnitus, forgetfulness, dizziness, blurred vision, slurred speech, dull expression, low intelligence, appearing demented or foolish, and gradually developing hemiplegia. The tongue is pale white, and the pulse is deep, thin, and weak. This condition is mostly caused by deficiency and damage or congenital insufficiency, leading to inadequate kidney essence and liver blood, resulting in the loss of nourishment to the tendons and vessels. It is also accompanied by manifestations of liver and kidney deficiency, such as tendon and vessel stiffness, sore waist and weak legs, tinnitus, blurred vision, muscular twitching, and a demented or foolish appearance. The treatment method is to nourish water to moisten wood, using modified Rehmannia Decoction.

The condition of half-body paralysis is often one of the symptoms of "apoplexy." Mild cases can be classified into syndromes such as wind phlegm obstructing the collaterals and liver yang transforming into wind. Severe cases manifest as the pattern of obstruction and the pattern of collapse. Within the pattern of obstruction and the pattern of collapse, further distinctions must be made between yang obstruction, yin obstruction, yang collapse, and prolapse of the uterus.

bubble_chart Documentation

1. "Zheng Yin Mai Zhi" Volume 1: "External contraction half-body paralysis; the symptoms of half-body paralysis include chills and fever, sudden collapse, and after waking, either the left or right side becomes paralyzed, either painful or numb, either hot or cold, with red and astringent urine and stool. This is the symptom of external contraction half-body paralysis. The cause of half-body paralysis is improper daily habits, weak defense qi, wind pathogens entering the meridians, pathogens lingering and not dispersing, leading to blockage of qi and blood, resulting in paralysis of half the body. The pulse of half-body paralysis: if the disease is on the left, the left hand has no pulse. If the disease is on the right, the right hand has no pulse. Or if the disease is on the left, the left pulse is unusually large. If the disease is on the right, the right pulse is unusually large." "Internal damage half-body paralysis: the symptoms of half-body paralysis may start with numbness in one hand or finger, gradually becoming unable to move over a year or half a year, this is a slow onset. Or internal phlegm-fire may cause sudden stiffness and collapse, recovering shortly but unable to move half the body, this is a disease caused by fire and is acute. Both have no external pathogen symptoms, hence internal damage half-body paralysis. The cause of half-body paralysis may be qi stagnation and blood stasis, vessel impediment, or stomach heat producing phlegm, flowing into the meridians, blocking the pathways, preventing the circulation of qi and blood, or excessive drinking leading to alcohol dampness causing paralysis, thus the symptoms of half-body paralysis occur. The pulse of half-body paralysis: deep and astringent indicates blood impediment, deep and slippery indicates phlegm accumulation, deep and rapid indicates alcohol dampness; weak pulse indicates qi deficiency, thin pulse indicates blood deficiency."