The Chinese medicine explanation for strokes

An article by Fletcher Kovich

Western medicine believes that most strokes are caused by a blood clot travelling to the brain and blocking the blood supply to a part of the brain. But in Traditional Chinese Medicine (TCM) it is understood that many strokes are not caused in this way. There is no blocking agent involved at all.

The damage to the brain during many “strokes” is caused by excessive “Liver energy” surging up into the patient’s head. This is the same mechanism that causes migraines, but the effects are much more serious because the brain has become weakened due to greatly depleted “Kidney energy” (depleted Kidney1 function). One of the functions of the Kidneys is to nourish the brain. Kidney energy naturally diminishes as we go through life and in old age the Kidney energy has become greatly depleted. All the symptoms of old age are due to Kidney Deficiency (poor short term memory, failing hearing, frequent urination, problems with knees or hips or ankles, brittle bones, low libido, hair turning grey and thinning and falling out).

Because the Kidneys have not been nourishing the brain properly for many years, the “substance” of the brain has become weakened (the Yin of the brain). The most noticeable symptoms of this “decay” are the poor short term memory and the failing hearing. This decay makes the brain much more prone to damage. It is weakened and it cannot protect itself against the violent up-surging of Liver energy—when this happens.

In these patients, they may experience an attack of “Liver Yang Rising” (which is the Chinese medicine term for excess Liver energy surging upwards), and because the structures in their brain have become weak, this powerful energy surging upwards into their head causes brain damage. (If they were younger and their Kidney function were stronger, so that the substance of their brain were stronger, then they would only experience a migraine attack, or something similar—with no brain damage.)

The weak Kidney function in older people not only weakens the “substance” of he brain, but also makes it more likely that they will experience one of these Liver Yang Rising attacks. This is because strong Kidney energy plays a part in restraining this excess Liver energy. But not all old people are prone to building up this excess Liver energy, which explains why not all old people are prone to suffering strokes.

The most likely time of day for attacks

The Liver energy (or: Liver function, particularly its function of storing the blood) is at its most powerful between 1-3am. And the Kidney function is at its weakest between 5-7am. These two factors make it most likely that strokes of this type will occur in the early hours of the morning, and particularly around 5am. This is because the Liver energy is at a high level and the weak Kidney energy is less able to restrain the Liver, so attacks become more likely2.

Another factor that makes such strokes more likely

The Lungs ordinarily also play a part in helping to restrain the Liver. In patients where the Lung energy (Lung function) is weak, this makes them even more prone to this type of stroke.

It is not easy to translate Chinese medicine concepts into language that can be understand by people who are only familiar with Western medicine beliefs, but this concept may be understood as follows.

The functioning of each of the twelve main organs varies in strength throughout the day. Each organ is most active at a certain time of day, and its functioning then diminishes until, twelve hours later, it is at its weakest. The Liver is at its most active between 1-3am and the Lungs are at their most active between 3-5am. When the Lungs are weak, they are less able to take their proper turn in the cycle of organs, and since the Liver reaches the peak of its activity immediately before the Lungs should reach their peak, this means that the Liver is left to go into excess, since the Lungs are not strong enough to take charge of the body’s energy resources as they should, and the resources are left in the hands of the Liver for longer than is normal.

How does this excess energy build up in the Liver?

Certain patients will be prone to this syndrome. Throughout their life, their Liver energy will tend to get blocked, and this energy will build up within the Liver until it reaches a point when the body must release it. In most cases, this excess energy then surges upwards into the head (along he Liver and Gallbladder “channels”). This is the mechanism behind most migraines. Many migraines in women occur at a certain part of their menstrual cycle. This is because most period pains and pms symptoms are caused by this same blocked Liver energy. All these symptoms can be extremely strong, which reflects the power of this excess Liver energy. In men who experience migraines, they usually present a combination of weak Kidney energy and the tendency for their Liver energy to become blocked.

The Liver energy tends to become blocked in people who are too inflexible. They have an overdeveloped sense of right and wrong, and they will insist on rules of every sort being strictly obeyed. A “rule” might be something as simple as the way a particular household task should be performed, or it may be a convention in society, such as politeness or obeying social etiquette. The person’s insistence on these “rules” being strictly obeyed is the outward expression of the fact that their own Liver energy does not flow smoothly.

Another “blocking” factor for the Liver is when emotions are not released but are held inside, when people do not express grievances and prefer to “suffer in silence”. The Liver feels the offence, feels that the person is wronged, but this emotion is not released.

People with blocked Liver energy are also often angry people. This anger is another way that this energy can be expressed, or released.

Physical stagnation is another factor that tends to lead to blocked Liver energy. Physical exercise enables the Liver energy to circulate. Indeed, when people are inactive for a long time, most people will become aware of an irritation developing around the level of their Liver, a feeling as though their blood were beginning to boil.

The Liver energy also becomes blocked due to “stress”. The person is trying to perform some task but something is preventing this from happening and the emotion they feel (the frustration) causes the Liver energy to stop flowing. They experience this same agitated feeling, as though their blood were starting to boil. This sensation is due to the Liver energy building up and creating “heat” within them. People often sigh in this situation, which is one of the ways that the body uses to attempt to move the blocked Liver energy (the diaphragm is beside the Liver, and deeply sighing, using the diaphragm, gives some momentary relief).

Case history

A woman, aged 80, had a minor stroke in the early hours of the morning. Her speech was slurred and slow and there was a visible droop to the left side of her face. A CT scan of her head was carried out about two hours later and this showed no signs of a blood clot, nor of any damage to her brain.

Throughout her life, she had been prone to outbursts of anger, was a very “fiery” person, and always spoke with a loud voice, as if shouting. She meticulously ordered her home and would often closely instruct all other people on how to perform tasks in “the right way”. In relationships, she would not usually express grievances, would “suffer in silence” just to “keep the peace”. In her earlier life, she suffered from painful period cramps and pms.

 All these symptoms were due to her Liver energy not flowing smoothly. This means that the functioning of her Liver was not smooth, and this caused excess Liver energy to build up within her.

In recent years, she also showed signs of Kidney deficiency: weak and painful knees, swollen ankles, declining hearing, thinning, white hair, shortness of breath (difficult to breath in).

About two and a half months before her stroke, she experienced a traumatic incident with her daughter. Her daughter had previously fallen out with her and then turned up unannounced and instigated a violent confrontation, involving a physical struggle (the patient attempted to evict her, but her daughter fought back and refused to leave the house). The patient said that her daughter was continuously “screaming and shouting” at her. Her daughter then called in the police, which the patient found abusive and shameful. The patient said that she never felt the same again after this incident. She was left feeling prone to fear, and was a damaged person. She was then also noticeably more unsteady on her feet.

 A few weeks later, the patient said that she had accepted that she would never again see her grandchildren. She felt that her daughter had deliberately kept them away from her and intended to continue doing this.

A further few weeks later, the patient’s Lung function declined markedly and she began regularly losing her voice.

After about one further month in this condition, she suffered the stroke.

Though the patient’s Kidney function had already become weak (which is a natural part of the aging process), it was clear that this first incident with her daughter greatly weakened her Kidneys further. And on top of this, when she felt the loss of her grandchildren, this greatly weakened her Lung function. The Lungs are the organ that feel loss or grief.

She had always been prone to developing excess Liver energy. But now that her Kidneys and Lungs had been greatly weakened, it became inevitable that she would suffer an attack of Liver Yang Rising (the surging up into her head of this powerful Liver energy), and since her Kidney function had been low for a long time, and had been greatly weakened even further in recent months, this had weakened the substance of her brain (the Yin), and her brain was not able to withstand this surge of energy and was damaged. This was the mechanism that produced the brain damage in her stroke.

The CT scan of her head showed there was no evidence of brain damage, nor evidence of a blood clot. This also supported the theory that the stroke was not caused by a blood clot travelling to her brain, but by some other "unknown" mechanism, which may or may not be related to "debris" in the blood supply.

Western medicine intervention

With this type of stroke, there were no western medicine options available that could in any way cure or heal the symptoms she was suffering from, only theoretical preventive measures based on some statistical data from a recent study. This involved prescribing a remedy (Clopidogrel) to block the blood's natural tendency to clot under certain circumstances and also to offer a risky operation on her left carotid artery.

Unfortunately the specialist stroke unit at the hospital she attended, for some bizarre reason, managed to misdiagnose the stroke as being left-sided when it was clearly right-sided (since her only muscular symptoms had appeared on her left, which is controlled by the right side of the brian), and this confusion, combined with the risks of the operation, caused the patient to decline their offer. Further, she quickly suffered bad reactions to the Clopidogrel, and also to another drug she was offered, Simverstatin (which she had tried on four separate occasions in the preceding years and had reacted badly to each time), and these reactions only caused her health to quickly deteriorate.

All her life, she had suffered bad reactions to most of the chemical remedies in common use; indeed, she was prescribed Clopidogrel ten years previously, when the drug had only just come into use, and suffered an immediate severe reaction to it.

Over the first week following her stroke, she was treated solely with acupuncture (and related techniques)3. She showed remarkable progress and was discharged from hospital four days after her stroke, being almost back to her normal self and only feeling a little weak and unsteady.

However, considerable pressure was placed on her to continue with the prescribed drugs, and despite her own preference to not take them (due to her life-long bad reactions to almost every drug she had tried), she submitted to the pressure despite the effects on her. Her health rapidly deteriorated and over the following months she suffered a gradual, creeping, "extension" of the original brain damage.

There was little doubt in my mind that this had been actively caused by the drugs, or by her reaction to them, particularly the Clopidogrel, which had ironically been prescribed to attempt to prevent this very situation. As a TCM practitioner, I could see that there was good evidence for this. The Clopidogrel had an immediate repressive effect on her Kidney function. It caused her to feel chilled, which was only alleviated by me stimulating the acupoint Kidney-1. And the more she took it, it also destroyed the quality of her blood, adding to the blood a "pathogenic factor" in the form of "Blood Heat", which produced intense itching of her skin and a severe rash, together with signs of disturbances in her Liver. Hence the effect the drug had was to prevent her brain from being properly "nourished" on a fundamental level. In a patient who was in the delicate state she was in and who had already suffered some transient brain damage (in her first mild stroke), these factors were enough to extend the damage. And four months after her first mild stroke, she eventually died.

This patient I knew intimately and had treated for years; I was familiar with her unusual sensitivity to all treatments, including natural therapies. I had this privileged access to her and deep knowledge of her because she was my mother.