Exploration of Traditional Chinese Medicine Syndrome Differentiation and Treatment of Stroke Based on the Theory of "Turbid Pathogen Damaging the Clear"

Corresponding author: guoyongsheng, 13020687669@163.com

DOI: 10.12201/bmr.202609.00024

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  Abstract: The theory of "turbid pathogen damaging the clear" originated from the physiological concept of clear and turbid in *Huangdi Neijing* (Yellow Emperor''s Inner Canon) and was established in Ye Tianshi''s *Wenre Lun* (Treatise on Warm Diseases), originally formulated for warm diseases characterized by damp-heat obstructing the orifices. Grounded in classical traditional Chinese medicine (TCM) theories, this paper extends its application to the syndrome differentiation and treatment of stroke. By analyzing the internal relationship between "turbid pathogen" and traditional pathogenesis elements including wind, fire, phlegm, blood stasis, and deficiency, it proposes that "turbid pathogen" serves as a unified generalization of the local accumulation, cohesion, and transformation of phlegm, stasis, and turbid toxin in the cerebral orifices. The theoretical connotation of "restoring the clear state" is delineated from three dimensions: clear yang, clear orifices, and clear collaterals. The pathogenesis evolution of stroke is organized into a three-stage progression—"turbid pathogen clouding clear yang — phlegm-stasis-turbid-toxin obstructing the orifices — deficiency with lingering turbid pathogen"—based on which a staged treatment regimen is constructed: aromatic turbid-resolving and orifice-opening for the prodromal stage, phlegm-resolving, stasis-dispelling, and orifice-opening for the acute stage, and clear-yang-raising, turbid-resolving, and collateral-dredging for the recovery stage. Supported by classical theories, this paper systematically establishes a "turbid pathogen damaging the clear" framework for the syndrome differentiation and treatment of stroke, offering a novel theoretical perspective for TCM-based stroke management.

  Key words: Stroke; Turbid pathogen damaging the clear; Ye Tianshi; Clear yang; Syndrome differentiation and treatment approach

  Submit time: 15 September 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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