Wu Jitao, Department of Encephalopathy, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine (Zhengzhou 450000, Henan Province, China) Abstract: This paper presents a complete analysis of Zhang Xicun’s academic thinking in the treatment of stroke disease: the evidence is divided into two categories: cerebral congestion and cerebral anemia; the pathogenesis of cerebral congestion is characterized by “blood and qi, and go up”, while the pathogenesis of cerebral anemia is characterized by “deficiency of upper qi”. The pathogenesis of cerebral anemia is characterized by “insufficient upper qi”; in the treatment, the application of pacifying the liver and quenching the wind and inducing blood to move downward is emphasized, and famous prescriptions such as Calming the Liver and Quenching the Wind Tang and Jian Tiling Tang are invented; prevention and early treatment are emphasized, and specific methods are proposed. Key words: Zhang Xichuan; stroke disease; academic thought; cerebral congestion; cerebral anemia; Liver quenching and wind-quenching soup; Jian tiling soup Zhang Xichuan, a native of Yanshan County, Hebei Province. He advocated the convergence of Chinese and Western medicine, and spent his life tirelessly exploring the art of Manifestation, and was known as a “Manifestation of Merit”. Many of his academic ideas are still guiding clinical treatment, and his academic ideas on the treatment of stroke are summarized as follows: 1. Zhang Shichun attached great importance to empirical evidence, and researched a lot on the disease of “Zhong-like”. He has followed the anatomical experimental theory of Western medicine, using the cone to injure the hindbrain before the two rabbits, and confirmed that the perceptual movement of living creatures is “exclusively due to the brain”, thus concluding that “the disease is caused by the internal movement of water and fire, the liver and wind rising upward, blood and qi going upward, impacting the front and back of the brain and qi tendons, and fainting without knowing the person He concluded that “this syndrome is caused by the internal movement of water and fire, the liver and wind, and the blood and qi going upwards, impacting on the front and back of the brain and qi tendons, causing fainting without knowing the person. He believed that all the winds contained in the Nei Jing referred to the external evil, and that the so-called stroke and violent fall, which is the phlegm and fire congestion, is the “syncope” of the Nei Jing, or the “great syncope” mentioned in the Su Wen – Theory of Adjusting the Classic. In terms of the pathogenesis, he advocated the theory that He’s rest is inappropriate, the heart fire is very strong, and the kidney water is deficient. Since water deficiency cannot contain wood to control fire, liver wind moves within the body, thus blood merges on top and impacts the brain, which is in line with the Western medical theory. The treatment advocates not to use wind medicine again to ascend and disperse, the more disperse the more the wind moves, will certainly lead to the death of gas does not return. The medicine should be used to nourish yin and quench the wind and subdue yang, and the medicine should be chosen from turtle plate, magnetic stone, aconite, chamomile, wudou yi, lady’s mantle, raw and ripe ground, and cicada shed. Zhang’s understanding of the etiology and pathogenesis of stroke, treatment and prescriptions had a great influence on Zhang Xichun and modern treatment of stroke. Zhang Shanlei, a famous doctor in Lanxi, is not only a TCM clinician, but also a TCM theorist. Based on Zhang Tuchun’s views, he further developed and wrote the book “Stroke Yilong Yilong (中风亿埂罚衔蟹绮) Case wall miscellaneous support net parrot wit fear onyx salivary clan disaster wisp (relevant advice) Jianxi Calvary ang yu Yunrui can recover from the shockingУ pedigree of the recipient of scandium! The first is that the patient’s brain is not only congested, but also anemic. On the basis of Erzhang’s research, he clearly pointed out that there is a difference between cerebral congestion and cerebral anemia in the class. “It is because the Westerners for the evidence of impotence are blamed on the brain, but there is really a difference between cerebral congestion and cerebral anemia”, “is the main fire in the river, for cerebral congestion; Dong Yuan’s main gas, for cerebral anemia, a real and a deficiency is very different.” (2) and pointed out that the theory of both cerebral congestion and cerebral anemia originated from the Nei Jing. The Su Wen – regulation of the Classic “blood and qi, and go with the upper, it is a great syncope, syncope is a violent death, qi back to life, qi is not back to death” and “Su Wen – angry Tong Tian Lun” “Yang qi, great anger is the form of qi, and blood Wan on the upper, so that people thin syncope”, that “Blood and Qi go together on the top” is the root cause of cerebral congestion. “The pulse must be hard and long, which is caused by liver qi, stomach qi, rushing qi upward, and qi-blood rebellion, and is also seen in pain in the brain, stool obstruction, and other evidence of qi rebellion and internal qi obstruction. And cerebral anemia is derived from the “Ling Shu – mouth question” “the upper qi is not enough, the brain is not satisfied, the ears for the bitter sound, the head for the pour, the eyes for the dazzling.” According to Zhang Xichen, “Insufficient upper qi makes the brain dissatisfied” is the cause of cerebral anemia. The upper qi is the atmosphere in the chest, that is, the zong qi, which can dominate the whole body, mediating the brain and penetrating the heart. The brain is not satisfied with the blood is less, because the atmosphere in the chest is deficient, can not help the blood to rise, so the brain is not satisfied. Brain dissatisfaction and anemia, so it can be seen tinnitus, dizziness of the head and eyes, and even limb paralysis. The pulse must be “extremely fine and weak” or “sunken and weak”. The treatment of cerebral congestion and cerebral anemia is basically equivalent to the modern medical term of hemorrhagic stroke and ischemic stroke, and it is really valuable to be able to clearly classify stroke in the absence of modern examination technology. 3. The underlying pathogenesis of cerebral congestion is internal movement of liver and wind, hyperactivity of liver and yang with qi and blood upward to offend the brain, causing the blood vessels in the brain to congestion and even rupture due to their excitation. The herbs are used to induce the downward movement of blood, invigorate blood circulation and remove blood stasis; the herbs Yin Chen and Mai Mai Ma are used to relax the liver and regulate Qi. In Zhang’s Jian Tiling Tang and Liver Quenching Wind Soup, both of them are heavily used with Cow Knee and Dai Ochre, with some dosage up to 45g. Zhang believes that Cow Knee is “good at drawing blood and Qi downward, so those who want it to go downward, always use it as a guide. …… is the best product to treat cerebral congestion.” Ocimum sanctum is heavy and good at suppressing rebellious Qi, lowering phlegm and saliva, and promoting dry knots, lowering rebellious Qi without harming the positive, and promoting dry knots without opening them. Because “the liver fire is violent and the qi and blood merge and fill the brain, the only medicine is to subdue the liver fire and quench the internal wind, so that the qi and blood that rushes upward can be returned and the evidence can be recovered”, ochre is chosen for its “rapid downward force, so that the qi and blood with phlegm and fire can go down with it”. The upwelling of Qi and blood with phlegm and fire can be rapidly reduced (3). The basic pathogenesis of cerebral anemia is deficiency of qi and blood, which is unable to help qi and blood to reach the brain, resulting in impotence of limbs due to stagnation of qi and blood, and qi deficiency, yin deficiency, blood deficiency and blood stasis are the important causative factors of cerebral anemia, so the treatment is to promote qi and blood with raw astragalus, angelica and atractylodes, and to invigorate blood and remove blood stasis with frankincense and myrrh, and to dispel wind and exopathogens with wind and cinnamon. In particular, his innovative method of drawing blood downward to treat cerebral congestion brought much inspiration to future treatments. 4. emphasis on prevention and early treatment Zhang Xicun attaches great importance to the prevention of stroke disease, that stroke disease have signs: “one, the pulse must be string hard and long, or inch Sheng ruler deficiency, or greater than the normal pulse several times, and there is no intention of slowing down. Second, his head and eyes often dizzy, or feel dizzy in the brain, more forgetful, or often feel pain, or deaf and swollen eyes. 3. The stomach feels that there is qi rushing upward, blocking the food and drink, and cannot go downward, or there is qi moving upward from the lower jiao for erratic rebellion. 4. Feeling restless in the heart, or having heat in the heart, or having a wandering spirit in sleep. Fifth, the tongue is distended, speech is unfavorable, or the mouth and eyes are distorted, or there seems to be numbness in the body, or the movement is unstable, and there is a desire for dizziness, or one feels that the head is heavy and the feet are light, and the soles of the feet are like cotton wool” (4). It is also emphasized that “the symptoms listed, with one or two occasional findings, can be concluded as signs of cerebral congestion by referring to the presentation of the pulse”. The etiology of the disease is a deficiency of Yin in the liver and kidneys, water does not contain wood, the liver loses its control, liver qi carries the qi of the rushing stomach upwards, and the qi and blood fill the brain. Treatment is to nourish yin and submerge yang, calm the liver and subdue the rebellion, lead blood downward. This formula is based on Jian Tiling Tang (Sheng Di, Sheng Shan Yao, Sheng Bai Shao, Sheng Ochre, Huai Niu Knee, Sheng Long Mu and Bai Zi Ren). In this formula, ochre, white hyssop to calm the liver and lower the rebellion, lead blood downstream, supplemented by dragon peony to calm the liver and submerge the yang, raw earth, yam, peony nourish the yin of the liver and kidney, cypress seeds to nourish the heart and calm the mind, the combination of all the drugs to nourish the yin and submerge the yang, calm the liver and lower the rebellion, lead blood downstream, straight in the disease, so Zhang’s cloud after taking this formula “can make the blood in the brain like the water under the tiling, brain congestion of the evidence of self-healing. ” And after treatment must be “the pulse is calm, no string hard meaning” as the standard of cure. For the “cerebral anemia evidence” prone to ischemic stroke. Zhang Xicun proposed that its pulse is characterized by “extremely fine and weak.” For this reason, he created two formulas: First, “Dry Decay Soup”, for the treatment of impotent limbs, or withered, with extremely fine and weak pulse, prescription: five taels of raw Astragalus, one tael of Angelica, one tael of Fructus Lycii, one tael of Cornu Cervi Pantotrichum, one tael of raw Boswellia, three taels of raw Myrrh, three taels of real deer horn gum, six taels (pounded).” Second, “tonic brain impotence soup”, the main treatment for impotence of limbs, the pulse is very fine and weak, taking medicine for a long time does not heal. Prescription: raw astragalus two taels angelica eight money longan meat eight money dogwood meat five money walnut meat five money stinging insects (large) three, ground dragon (to remove the clean earth) three money raw frankincense three money raw myrrh three money deer horn gum six money made horse Qianzi three points. A total of eleven flavors of medicine, the first nine decoction of two and a half cups of soup to remove the dregs, the deer horn gum into the soup melted, in two times to deliver the powdered strychnine a minute and a half.” Zhang Xicun in the “Medical Keizhong Ginseng Xilu” not only described in detail the clinical manifestations of the aura of stroke, but also proposed effective preventive treatment methods, fully reflecting the ideology of Chinese medicine in treating the disease before it occurs. It provides a useful reference for the prevention and treatment of stroke in modern clinical practice. Zhang Xichuan’s academic thought on the treatment of stroke has long guided the practice of diagnosis and treatment of stroke disease, and it is worthwhile to further understand and master it, and develop and improve it on this basis. References: 1 Zhao Dexi. Zhang Shanlei’s Academic Thought on Stroke Disease from the “Zhongfeng Pouring Hermeneutics” [J]. Chinese Journal of Traditional Chinese Medicine, 2008 (6) 2: 17222 Zhang Xicun. Medical Science and Technology Press [M]. Shijiazhuang: Hebei Science and Technology Press, 1985: 335