1. The TCM Approach to CVA Rehabilitation
Brian W.W. Jackson, L.Ac.
University of Maryland School of Medicine
Department of Family and Community Medicine
Center for Integrative Medicine

2. A Historical Prospective中风
The Yellow Emperor’s Internal Cannon ( BC)
Pu Ji Sudden Falls
Da Jue Sudden Loss of Consciousness
Pian Ku Hemiparalysis with flaccidity
Chinese physicians were the first to characterize the clinical symptoms and define the causes of stroke:

3. Characteristics Medical History and Precursors to a stroke
Majority of patients have a history of:
Dizziness, Headaches, Vertigo, Hemidiaphoresis, Palpitations, Numbness and Tingling in the extremities (typically over one half of the body).
Precursory Signs and Symptoms:
Sudden fall, loss of consciousness, excessive phlegm leading to raspy breathing, hemiplegia, and spasticity of the tendons.

4. Early “Causal” Description
Wind 風:
Heat Wind 热风
Cold Wind 寒风
Heat Wind 热风: Those with hypertension, heart disease, diabetes, obesity, and a history of cardiovascular disease with major arterial occlusion.
Cold Wind 寒风: Those with weak constitutions who are generally cold, thin, and PAD.

5. Differential Diagnosis
闭症 Closed Syndrome:
脱症 Emptying Syndrome：
闭症 Closed Syndrome: Spasticity of the tendons, constipation, urine retention, difficulty speaking, difficulty swallowing, unable to stretch or open the hands or the extremities. Mostly in those with Heat Wind.
脱症 Emptying Syndrome：Atrophy of the muscles, slackness of the lips, incontinence, unable to move the extremities. Mostly in those with Cold Wind.

6. A Change in Understanding
Jin Yuan Dynasty ( )
刘河间: Hemorrhagic Stroke
李东垣: Embolic Stroke
朱丹溪: Ischemic Stroke (Atherosclerosis)
STROKE-LIKE CONDITIONS
刘河间, Liu He Jian: Anger, Irritability, and an over expression of emotions – Fire. Hemorrhagic Stroke
李东垣, Li Dong Yuan : Insufficiency of nutrients and weak constitution – Qi Xu. Embolic Stroke
朱丹溪, Zhu Dan Xi: Dampness causes phlegm, phlegm causes heat, heat causes internal wind – Dampness. Ischemic Stroke (Atherosclerosis)

7. Traditional Acute Herbal Medicine Treatment
闭症 Closed Syndrome:
Xu Ming Tang: Ephedra, Ligusticum, dried Ginger, Gypsum, Ginseng, Angelica Root, Cinnamon branch, Licorice, Almonds.
续命汤：麻黄，川芎，干姜，石膏，人参，当归，桂心，甘草，杏仁。
闭症 Closed Syndrome: Remove blockages and restore circulation first.

8. Traditional Acute Herbal Medicine Treatment
脱症:
Shen Fu Tang: Ginseng, Monkshood Branched Root.
参附汤: 人参，附子。
San Sheng Yin Jia Ren Shen: Bile-prepared Arisaema, Camphorwood, Aconite Root, Ginseng, Monkshood Branched Root.
三生饮加人参：南星，木香，川乌，附子，人参
脱症: Immediately warm and supplement the body. Recover the qi then remove the wind.

9. Rehabilitation
Herbal Medicine: Sheng Mai San (ginseng, ophiopogon tuber, schisandra fruit).
Tui Na
(Chinese massage and manual manipulations)
Acupuncture

10. Acupuncture
Yang Ming Jing (Stomach and Spleen)

11. Acupuncture
Shao Yin Jing (Kidney and Heart)

12. Scalp-Acupuncture
Somatomotor Cortex
Somatosensory Cortex