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Every day, 1200 Americans suffer a stroke, and four hundred of them become permanently disabled. Stroke is the leading cause of disability and the third leading cause of death in the United States. It is no wonder that being disabled by a stroke is the chief fear of so many elderly Americans. According to a report from the National Institutes of Health in 1992, more than two million Americans suffer long-term disabilities from stroke, at a cost to our society of $25 billion each year.

In China, there is less incidence of stroke than in Western countries, and greater recovery of function after a stroke. This is not because Chinese people are physically different from Americans, but because of differences in diet, lifestyle, and post-stroke treatment.

Chinese medicine theory recognizes four main pathological factors (agents) of stroke: Wind, Fire, Phlegm, and Stasis. There are also considered to be four leading contributing factors to stroke, related to lifestyle: emotional stress, overwork, poor diet, and excessive sexual activity.

Because there are a number of contributing factors to stroke, because these contributing factors tend to play out over a long period of time, and because the stroke itself can manifest in a number of ways, it can be difficult to assess the exact cause of a stroke. But remember that strokes don't "just happen" for "no reason." Any of the following lifestyle factors, experienced over a period of years, could eventually result in a stroke: working long hours under stressful conditions without adequate rest; physical overwork, including excessive, strenuous sports activities; emotional strain; irregular eating habits; excessive consumption of fats, dairy products, greasy or fried foods, sugar, or alcohol; excessive sexual activity (what constitutes "excessive" sexual activity depends on the age and general physical condition of the individual).

The internal organs most likely to be weakened by these factors are the Kidney and the Spleen, causing deficiencies of Chi, Blood, and Yin. Deficiencies of Chi, Blood, or Yin permit the body to be overwhelmed by the pathological factors of Wind, Phlegm, Fire, and Stasis, resulting in such stroke-related patterns as Liver Yang Rising, Stasis of Chi or Blood, Phlegm combining with Fire, Liver Wind, or Wind in the Meridians.

Preventing Strokes

Obviously, the most effective way to prevent a stroke from occurring is to modify the lifestyle factors that lead to stroke. Physical work and exercise should be appropriate to a person's age and physical condition, and should be accompanied by adequate rest. The same advice goes for sexual activity. It is important for everyone to learn to manage stress, especially people with a history of cardio-vascular problems. Relaxation, meditation, and gentle exercise like yoga or Tai Chi are proven ways of lowering blood pressure and stress-related chemicals in the body. Perhaps the most important factor is diet. The traditional Chinese diet is high in fiber and low in fat, sugar, and dairy products. It is seen over and over again around the world that populations who eat this type of diet have dramatically lower incidence of heart attack, stroke, and diabetes than populations who eat the typical modern Western diet.

A useful Chinese herb that can help to prevent stroke is ginkgo biloba (bai guo ye). This herb has become phenomenally popular in Europe, with twenty million people taking it regularly. Harvard University's Dr. Elias Corey published his research on ginkgo in 1988 which shows that ginkgo stimulates cerebral circulation (blood flow in the brain). This can not only improve mental functioning, but can prevent blood cells from forming blood clots in the brain. Research indicates that ginkgo improves blood circulation, strengthens mental capacity, lowers plasma cholesterol concentrations, benefits Alzheimer's patients, and can prevent stroke and heart attack. In order to achieve maximum effect, ginkgo should be taken in a therapeutic dose. Because there are no universal pharmacological standards applied to herbal preparations, concentrations of ginkgo may vary from company to company, so it is hard to say what a therapeutic dose is, but 1500 mgm a day would be reasonable for most individuals.

Treating Strokes

Chinese medicine distinguishes two general types of stroke: the most severe type attacks the internal organs as well as the energy pathways (meridians); the milder type attacks only the meridians. In treating the severe type, acupuncture and Chinese herbal formulas are combined with Western drugs to relax spasm, subdue Wind, open the orifices, resolve Phlegm, and lower blood pressure. Patients with the milder type of stroke are treated primarily with acupuncture to open the meridians and promote Chi and Blood flow.

Acupuncture is the most popular treatment modality for stroke patients in China, used effectively on 85% of the stroke patients there. When Margaret Naeser, a neurology professor at Boston University School of Medicine, went to China in the 1980s, she was surprised to see that acupuncture treatments were considered to be the most important part of stroke rehabilitation at Chinese hospitals. She was even more impressed when she saw how effective such treatment was, and began to study acupuncture scientifically when she returned home. Since then, scientific evidence has been accumulating in the West. A controlled study conducted at the Lund University Hospital in Sweden provided several interesting findings. It found that a group of 38 patients who received acupuncture treatments twice a week for ten weeks reported significant improvements in the areas of walking, balance, emotions, quality of life, ease of daily activity, and mobility in comparison with a control group of 40 patients who did not receive acupuncture treatments. The Acupuncture Group spent fewer days in nursing homes and rehabilitation facilities than the Non-Acupuncture Group, with an average savings of $26,000 per patient. In the follow-up period, it was found that one year after suffering their stroke and receiving treatment, 89% of the patients in the Acupuncture Group were living at home vs. 66% of the patients in the Non-Acupuncture Group.

Scientific studies indicate that acupuncture can: facilitate nerve regeneration; decrease blood viscosity; prevent the aggregation of blood cells, dilate blood vessels by triggering the release of hormones; and help surviving nerve cells find new pathways, effectively by-passing damaged parts of the brain. Acupuncture has also been found to be helpful in the treatment of headache, dizziness and hypertension in stroke patients.

Treating stroke patients with acupuncture is one of my specialties. I have treated many stroke patients in both China and the United States, and they typically improve not only in their mobility and strength, but also in their emotional response. As they notice the improvement in their condition, they feel less depressed and are motivated to do their exercises. I can't express how wonderful it is to see people improve and feel hopeful again.

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