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Chapter 11 of 29
伤寒杂病论
Holistic Interpretation
Wind pathogen is the foremost pathogenic factor among numerous diseases, which is why it is said that "Wind is the chief of all maladies" 💨. When wind pathogen attacks the face, it tends to descend and transmit into the Yangming Channel, and in severe cases, penetrate internally into the Spleen; when it attacks the nape and neck, it descends into the Taiyang Channel, and in severe cases, penetrates internally into the Kidney; when it attacks the flanks of the body, it descends into the Shaoyang Channel, and in severe cases, penetrates internally into the Liver. Since the pathologies caused by wind pathogen vary considerably, careful pattern differentiation is required—no errors can be afforded.
I. Wind Pathogen Assailing the Liver
Wind disease manifests as headache, excessive sweating, aversion to wind, pain beneath the armpits, and inability to turn the body. The pulse is floating, wiry, and rapid—this indicates wind pathogen invading the Liver. The original text advocates Xiao Chaihu Tang (Minor Bupleurum Decoction) as the primary formula. If the wind pathogen flows into the yang organ (Gallbladder), one sees heaviness and pain of the body, retching and vomiting, abdominal distension, and frequent sighing. The original text advocates Chaihu Zhishi Shaoyao Gancao Tang (Bupleurum, Immature Bitter Orange, Peony, and Licorice Decoction).
Xiao Chaihu Tang Formula: Bupleuri Radix (Chaihu) 8 liang, Scutellariae Radix (Huangqin) 3 liang, Ginseng Radix (Renshen) 3 liang, Pinelliae Rhizoma (Banxia) 1 sheng (washed), Glycyrrhizae Radix Praeparata (Zhi Gancao) 3 liang, Zingiberis Rhizoma Recens (Shengjiang) 3 liang (sliced), Jujubae Fructus (Dazao) 12 pieces (split). Combine the above seven ingredients with 1 dou and 2 sheng of water, decoct until 6 sheng remain, strain out the dregs, then further reduce by simmering to 3 sheng. Take 1 sheng warm per dose, three times daily.
Chaihu Zhishi Shaoyao Gancao Tang Formula: Bupleuri Radix (Chaihu) 8 liang, Paeoniae Radix Alba (Shaoyao) 3 liang, Aurantii Fructus Immaturus (Zhishi) 4 pieces (roasted), Glycyrrhizae Radix Praeparata (Zhi Gancao) 3 liang. Combine the above four ingredients with 1 dou of water, decoct until 6 sheng remain, strain out the dregs, then further reduce by simmering to 3 sheng. Take 1 sheng warm per dose, three times daily.
II. Wind Pathogen Riding the Heart
Wind disease manifests as pain in the chest, distending fullness in both hypochondria, pain in the chest and back between the scapulae, dry throat, frequent belching, throat swelling, and throat obstruction (laryngeal edema with occlusion). The pulse is floating, surging, and rapid—this indicates wind pathogen invading the Heart. The original text advocates Huanglian Huangqin Maidong Jiegeng Gancao Tang (Coptis, Scutellaria, Ophiopogon, Platycodon, and Licorice Decoction).
Huanglian Huangqin Maidong Jiegeng Gancao Tang Formula: Coptidis Rhizoma (Huanglian) 1.5 liang, Scutellariae Radix (Huangqin) 3 liang, Ophiopogonis Radix (Maidong) 2 liang, Platycodonis Radix (Jiegeng) 3 liang, Glycyrrhizae Radix Praeparata (Zhi Gancao) 2 liang. Combine the above five ingredients with 6 sheng of water, decoct until 3 sheng remain, strain out the dregs. Take 1 sheng warm per dose, three times daily.
III. Wind Pathogen Riding the Spleen
Wind disease manifests as limp weakness of the four limbs, a heavy body that feels as though it cannot even bear the weight of clothing (unable to support the garments), and hypochondriac pain pulling toward the shoulders and back. The pulse is floating with wiry and rough qualities—this indicates wind pathogen invading the Spleen. The original text advocates Guizhi Tang Minus Guizhi Plus Fuling and Baizhu (Cinnamon Twig Decoction without Cinnamomi Ramulus, with Poria and Atractylodes macrocephala). If the wind pathogen flows into the yang organ (Stomach), one sees abdominal distension and loss of appetite. The original text advocates Zhishi Houpo Baizhu Gancao Tang (Immature Bitter Orange, Magnolia Bark, Atractylodes, and Licorice Decoction).
Guizhi Tang Minus Guizhi Plus Fuling and Baizhu Formula: Paeoniae Radix Alba (Shaoyao) 3 liang, Glycyrrhizae Radix Praeparata (Zhi Gancao) 2 liang, Poria (Fuling) 3 liang, Atractylodis macrocephalae Rhizoma (Baizhu) 3 liang, Zingiberis Rhizoma Recens (Shengjiang) 3 liang (sliced), Jujubae Fructus (Dazao) 12 pieces (split). Combine the above six ingredients with 8 sheng of water, decoct until 3 sheng remain, strain out the dregs. Take 1 sheng warm per dose, three times daily.
Zhishi Houpo Baizhu Gancao Tang Formula: Aurantii Fructus Immaturus (Zhishi) 4 pieces (roasted), Magnoliae Officinalis Cortex (Houpo) 2 liang (roasted, skin removed), Atractylodis macrocephalae Rhizoma (Baizhu) 3 liang, Glycyrrhizae Radix Praeparata (Zhi Gancao) 1 liang. Combine the above four ingredients with 6 sheng of water, decoct until 3 sheng remain, strain out the dregs. Take 1 sheng warm per dose, three times daily.
IV. Wind Pathogen Riding the Lung
Wind disease manifests as coughing, wheezing accompanied by phlegm rumbling sounds in the throat, and in severe cases, hemoptysis (spitting blood), dry throat, and pain in the shoulders and back. The pulse is floating, wiry, and rapid—this indicates wind pathogen invading the Lung. The original text advocates Jiegeng Gancao Zhishi Shaoyao Tang (Platycodon, Licorice, Immature Bitter Orange, and Peony Decoction). If the wind pathogen flows into the Large Intestine, one sees dry, hard, bound stools or blood in the stool. The original text advocates Jiegeng Gancao Zhishi Shaoyao Jia Dihuang Mudan Tang (Platycodon, Licorice, Immature Bitter Orange, Peony, plus Rehmannia and Moutan Decoction).
Jiegeng Gancao Zhishi Shaoyao Tang Formula: Platycodonis Radix (Jiegeng) 3 liang, Glycyrrhizae Radix (Gancao) 2 liang, Aurantii Fructus Immaturus (Zhishi) 4 pieces, Paeoniae Radix Alba (Shaoyao) 3 liang. Combine the above four ingredients with 6 sheng of water, decoct until 3 sheng remain, strain out the dregs. Take 1 sheng warm per dose, three times daily.
Jiegeng Gancao Zhishi Shaoyao Jia Dihuang Mudan Tang Formula: Platycodonis Radix (Jiegeng) 3 liang, Glycyrrhizae Radix (Gancao) 2 liang, Aurantii Fructus Immaturus (Zhishi) 4 pieces, Paeoniae Radix Alba (Shaoyao) 3 liang, Rehmanniae Radix (Dihuang) 3 liang, Moutan Cortex (Mudanpi) 2 liang. Combine the above six ingredients with 6 sheng of water, decoct until 3 sheng remain, strain out the dregs. Take 1 sheng warm per dose, three times daily.
V. Wind Pathogen Riding the Kidney
Wind disease manifests as facial and eyelid edema, back pain with inability to stand erect, difficulty with hidden and flexed activities (difficulty and discomfort with concealed, flexed actions such as urination and defecation), and in severe cases, atrophy and weakness of the bones. The pulse is deep and wiry—this indicates wind pathogen invading the Kidney. The original text advocates Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction).
Chaihu Guizhi Tang Formula: Cinnamomi Ramulus (Guizhi) 1.5 liang, Paeoniae Radix Alba (Shaoyao) 1.5 liang, Glycyrrhizae Radix Praeparata (Zhi Gancao) 1 liang, Bupleuri Radix (Chaihu) 4 liang, Pinelliae Rhizoma (Banxia) 2.5 he, Ginseng Radix (Renshen) 1.5 liang, Scutellariae Radix (Huangqin) 1.5 liang, Zingiberis Rhizoma Recens (Shengjiang) 1.5 liang, Jujubae Fructus (Dazao) 6 pieces (split). Combine the above nine ingredients with 7 sheng of water, decoct until 3 sheng remain, strain out the dregs. Take 1 sheng warm per dose, three times daily.
The above formulas, dosages, and decoction methods are recorded precisely from the classical original text and are provided solely for academic study—they do not constitute any medical guidance for medication use.
The central thesis of this chapter is: Wind is the chief of all maladies—after invading from different body regions, it can transmit through the channels to the corresponding zang-fu organs. The opening passage establishes a "channel–organ" transmission model: "invading the face—descending to Yangming—entering the Spleen"; "invading the nape—descending to Taiyang—entering the Kidney"; "invading the flanks—descending to Shaoyang—entering the Liver."
Subsequently, the manifestations of wind-damage disease are categorized and described according to the five zang organs: wind pathogen assailing the Liver manifests as headache, subaxillary pain, and inability to turn; riding the Heart manifests as chest pain, throat swelling, and throat obstruction; riding the Spleen manifests as limp four limbs and a heavy body; riding the Lung manifests as cough, wheezing, and spitting blood; riding the Kidney manifests as facial edema, back pain, and bone atrophy. This reflects the principles of pattern-based treatment (bianzheng lunzhi) and same disease, different treatments (tongbing yizhi) in Chinese medicine: although all are "wind diseases," therapies and formulas differ according to the disease location.
In terms of treatment strategy, this chapter places significant emphasis on the Chaihu (Bupleurum) category of formulas, such as Xiao Chaihu Tang, Chaihu Zhishi Shaoyao Gancao Tang, and Chaihu Guizhi Tang, suggesting that the ancients viewed wind pathogen-induced diseases as often involving the Shaoyang pivot and the region between interior and exterior, requiring harmonization and outward transpiration; meanwhile, depending on the concomitant pathogenic factors, methods such as clearing the Heart, fortifying the Spleen, diffusing the Lung, and nourishing the Kidney were also employed in combination.
"Wind pathogen" cannot be simplistically equated with a specific bacterium or virus; it more closely resembles a summary of a class of pathological states characterized by external contraction, rapid changes, and erratic wandering involvement—potentially encompassing infection, allergy, immune dysregulation, neurovascular responses, and various other factors.
Certain symptoms described in this chapter, such as sweating with aversion to wind, throat swelling and obstruction, coughing with hemoptysis, facial edema, and heavy limbs, bear partial resemblance to certain manifestations of modern respiratory infections, pharyngeal disorders, and immune-related diseases—but one-to-one correspondence cannot be established. While modern research hints that formulas such as Xiao Chaihu Tang may possess anti-inflammatory, antipyretic, or immunomodulatory effects, there remains a lack of high-level modern evidence supporting the specific efficacy, dosage, and safety of these treatments for "wind pathogen riding the five zang organs" as described in this chapter. Some medicinal ingredients carry potential toxicity and side effects, and dosage differences between ancient and modern practice are substantial—these formulas must not be self-prescribed.
🚑 Bu Gua's Note: This content is based on classical Chinese medical texts and is provided solely for traditional cultural study and research. It does not constitute any medical diagnosis, medication guidance, or therapeutic recommendation. If you experience any discomfort, please seek medical attention promptly.