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We find here the original text which has influenced how Chinese Medicine delineates sub-categories of stroke. There are two parts:

Part One:

“寸口脉浮而紧，紧则为寒，浮则为虚，寒虚相搏，邪在皮肤；”

This line tells us that the cun pulse is floating and tight, and that tightness means “cold” while floating implies “deficiency;” when cold and deficiency interact, the pathogen is on the skin. This part is still kind of cryptic and its explanations sound contrived. Most people immediately associate floating with exterior and floating-tight with exterior cold. To say that floating is deficiency is still intuitable but yeah, kind of forcing a point, that the person is deficient. The least we can do is take note of this forced point.

“浮者血虚，络脉空虚，贼邪不泻，…”

Here we’re still on the topic of “floating” which we have been told is about deficiency. He adds, however, a new piece of information: It’s the blood that’s deficient! And goes on to explain that deficiency blood entails vacuous luo collaterals and the pathogen cannot be cleared… Hmmm, another long-winded explanation. Cutting to the chase, I think the author wants to stress that deficient blood is hampering the process of detox, and that this deficiency is somehow expressed as a floating pulse. Don’t ask me how, it’s just the unerring logic of the ancients. That said, we need to get his point, which is that:

• we’re gonna see a floating-tight pulse, and that it means cold-deficiency on the skin;
• the deficiency is blood deficiency which causes the pathogen to be lodge within.

“或左或右，邪气反缓，正气即急，正气引邪，喎僻不遂 。”

The third line basically describes one side pulling on the other side, as with  facial paralysis. The side being pulled is limp, and this is because of the pathogen（邪气）residing within. The side which is pulling is the healthy side（正气）. When the healthy side pulls on the limp side, we have that slantedness and that inability to move voluntarily.

Part Two:

“邪在于络，肌肤不仁；”

“邪在于经，即重不胜；”

“邪入于腑，既不是人；”

“邪入于脏，舌即难言，口吐涎。”

This outlines how the pathogen moves from the exterior inward. One will understand from this part of the text how the pathogen moves inward in the following order: 络 - 经 - 腑 - 脏. In the luo phase, there is numbness in the skin; when in the jing phase, the limbs start to feel heavy, when in the fu phase, the guy can’t recognize people; by the time the zang phase is arrived at, the tongue can’t be used to speak and the mouth starts to spit saliva.

Now, where’s the problem here?

Nothing really, if we accept that the ancients had fuzzy logic and liked to build frameworks that sound like they make sense. Brain surgeons, please correct me if I’m wrong here, but it’s the anatomy of the brain that counts and whatever part is hit will produce the corresponding symptoms. Perhaps the middle artery which runs from the bottom of the brain up to the frontal lobe is damaged, then memory, recognition and the like with be compromised - will the ancient then stand up and say “hear ye, hear ye, we’re in the 3rd phase and the pathogen is in the fu”? What if the back part of the temporal lobe is hit and he starts having problems talking (aphasia aka 失语)? Do we then aver with TCM-conviction that this guy is a goner because he’s already in the fourth phase - the zang phase?

We should appreciate that the ancient had begun building up a theoretical framework based on ideas like depth of pathogenic attack, phase of disease et al. That said, we should also embrace the anatomical understanding of the body, which hopefully helps us - though not always - explain things better.The first and second phase, on the other hand, bring to mind TIA (Transient Ischemic Attack). Below is a ‘cut and paste’ from this website, to help us glean a better understanding of the symptoms:

• One side of your body may feel numb, tingly, or heavy.
• You may not be able to move your arm, your leg, or your face on one side of your body.
• Things may look blurry or dim. You may have double vision or not be able to see.
• It may be hard to speak. You may slur or mix up your words.
• It may be hard to understand words.
• You may feel unsteady, dizzy, or clumsy. You may have trouble walking.

Already, we see how TIA immediately translates into numbness and heaviness, whether it’s of the skin or of the limbs. TIA is the precursor to a real stroke, and it happens really quickly, i.e. a few seconds before you recover from it. That said, having a TIA increases the statistical probability of you getting a stroke soon.We also note that TIA involves aphasia (inability to produce or comprehend language) as well as the inability to see well. If that’s the case, then it’s still within reasonable grounds to say that a modern interpretation of the passage could reasonably include TIA.