
Kit Li
I remembered one Friday morning during my clinical placement at the A&E department of the Integrated Hospital of Traditional Chinese and Western Medicine, Southern Medical University (1), the waiting area was crowded and busy. Approximately two-fifths of the patients presented with Neck Pain, Dizziness, or Minor Stroke (2). This surge in cases followed an overnight temperature drop in Guangzhou, from 29c to 20c.
Many of these patients had a history of Hypertension or previous Stroke, and some also suffered from underlying chronic health conditions. They exhibited symptoms such as Bell's Palsy (3), deviation of the mouth and eyes, numbness, stiff neck, dizziness, and tinnitus (4) . According to TCM theory, these manifestations arise from Internal Wind , which develops due to disharmony within the body.
Pathogenesis in TCM
In TCM, there are six types of external pathogenic factors, which knowns as the Six Evils: Wind, Cold, Summer Heat, Dampness, Dryness, and Fire. Among these, Wind is considered the primary and leading pathogenic factor.
When external Wind invades the body, it obstructs the meridians, leading to neck stiffness. As the obstruction deepens, Qi and Blood circulation become impaired, resulting in dizziness. Prolonged stagnation may generate Internal Wind, and if left untreated, this can culminate in Wind-Stroke.
Characteristics of Wind Evil
Wind is Yang in nature, mobile, changeable, and rising upward. It is also known as 'The Leader of a Hundred Diseases'.
Typical characteristics include:
- Sudden onset and rapid change
- Migrating symptoms (pain or numbness that moves from place to place)
- Tendency to affect the upper part of the body and the superficial layer of the skin.
Common disorders associated with Wind:
- Common cold, allergies, dizziness, tremors, Wind-Stroke (Internal Wind)
- Skin conditions such as itching or hives
Wind's tendency: It easily combines with other pathogenic factors, forming patterns like Wind-Cold or Wind-Heat.
Internal Wind Mechanism
Internal Wind tends to attack the upper body, especially the head and neck, obstructing the meridians and disturbing the clear orifices (the brain, eyes and ears). In severe cases, when Yin and Yang collapse, symptoms such as loss of consciousness and paralysis occur, typical of Wind-Stroke.
Common internal causes include:
- Liver Yang Rising or Liver Wind stirring due to Yin-deficiency
- Phlegm-Fire obstructing the channels
- Qi and Blood-deficiency, allowing Wind to invade the meridians
Neck Pain
In TCM, neck pain arises from Qi and Blood stagnation in the meridians, especially those of the Taiyang channels (Bladder and Small Intestine), and sometimes the Shaoyang channels (Gallbladder and Sanjiao).
Possible causes include:
- External invasion of Wind-Cold or Wind-Damp, which blocks the flow of Qi, leading to stiffness and restricted movement.
- Internal causes, such as Liver Qi-stagnation, Blood Stasis, or Kidney-deficiency (often seen in chronic cases with weak bones or tendons).
- Emotional tension or stress, which constrains Liver Qi and affects the Gallbladder and Shaoyang channels running along the sides of the neck.
Dizziness
In TCM, dizziness isn't viewed as just a symptom of the inner ear or blood pressure, but rather as a manifestation of internal imbalance, particularly involving the Liver, Spleen, Kidney and the movement of Qi, Blood and Body Fluids. It occurs when “Clear Yang not ascending, Turbid Yin not descending”. The main underlying causes include:
- Liver Yang-Rising or Liver-Wind stirring (most common)
- Phlegm-Damp obstructing the clear orifices of the head
- Qi and Blood Deficiency, failing to nourish the brain
- Kidney Essence-Deficiency, leaving the marrow and brain undernourished
Interconnection between Wind-Stroke, Neck Pain and Dizziness
These three conditions are closely interconnected. Neck pain and dizziness can be viewed as early warning signs of Internal Wind formation. When similar pathological patterns, such as Liver Yang Rising, Phlegm Obstruction, or Qi Stagnation, intensify or suddenly flare up, they may progress to Wind-Stroke.
Shared mechanisms include:
- Liver involvement: The Liver governs Wind and regulates of Qi flow. When Liver Qi stagnates or Liver Yang rises, internal Wind develops, manifesting as neck stiffness, dizziness, tremors, or stroke-like symptoms.
- Wind pathogen progression: External Wind first invades the Taiyang or Shaoyang channels of the head and neck. If not expelled, it can transform into Internal Wind, initially causing neck pain, then dizziness, and in severe cases, Wind-Stroke.
- Qi, Blood, and Phlegm obstruction: When channels in the head and neck are blocked, Qi movement becomes impaired, leading to dizziness, headache, stiffness, and sometimes facial deviation or paralysis.
- Yang Rising and Yin-deficiency: With again, stress, or chronic imbalance, Yin fails to anchor Yang, resulting in Liver Yang Rising and Wind stirring. This may manifest as dizziness, hypertension, and an increased risk of Wind-Stroke.
Summary
- Neck pain often indicates meridian blockage, particularly in the Taiyang or Shaoyang channels.
- Dizziness reflects an imbalance between clear Yang and turbid Yin, often related to Liver or Phlegm disturbances.
- Wind-Stroke represents the acute and severe stage of these pathological developments, when Internal Wind suddenly rises to disturb the brain and channels.
Treatment Approach
- Scalp acupuncture combined with electro-acupuncture (5) , applied to key functional areas such as the Sensory Area, Head Area and Chorea-Tremor Area..etc, along with selected points on the Du or Ren meridians, using the Dao-qi technique.
- During the first two sessions, body acupoints on the Hand and Foot Yangming meridians are applied to the stronger side of the body to enhance Qi and Blood circulation, promoting recovery of the affected side. Needles are retained for 30 minutes, followed by stimulation of Shu-points on specific Yin meridians, following Professor Zhou's Twelve Meridian Method (6).
- Moxibustion is applied on the affected side to warm the meridians and promote the flow of Qi and Blood.
- Chinese herbal prescriptions should be tailored to the patient's individual constitution and pattern differentiation. Professional consultation with a qualified TCM practitioner is essential for accurate diagnosis and safe, effective treatment.
This clinical experience deepened my understanding of how sudden climatic changes can provoke Internal Wind and related disorders. It also reinforced the importance of early intervention and the integrative power of TCM in restoring balance and preventing more serious outcomes like Wind-Stroke.
References:
1) Integrated Hospital of Traditional Chinese and Western Medicine of Southern Medical University: https://www.nfzxy.com/
2) Minor Stroke
https://pmc.ncbi.nlm.nih.gov/articles/PMC9616153/
3) Bell's Palsy
https://www.mdpi.com/2813-7914/1/3/24
4) Tinnitus
https://pubmed.ncbi.nlm.nih.gov/39331935/
5) Early intervention with electrical stimulation reduces neural damage after stroke in non-human primates: https://www.nature.com/articles/s41467-025-61948-y
6) Professor Zhou Guoping, Chief Physician, Professor, Medical Doctor, Doctoral Supervisor, serves as the Director of the Acupuncture, Moxibustion, and Rehabilitation Department at the Integrated Traditional Chinese and Western Medicine Hospital of Southern Medical University. He is recognized as a "Lingnan Acupuncture Master" and a "Renowned Doctor of Yangcheng."