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Chapter 42 of 78
黄帝内经·素问
The Yellow Emperor asked: When wind-pathogen 💨 attacks the human body, it may manifest as alternating chills and fever (intermittent cold and heat), may become heat in the middle (internal heat), may become cold in the middle (internal cold), may become li wind (leprosy-type illness), may become hemilateral withering (hemiplegia), or may simply be referred to as "wind illness." These conditions present differently, have varying names, and some even invade deeply into the five viscera and six bowels. I do not understand the principle behind this and wish to hear your explanation.
Qi Bo replied: Wind-pathogen qi hides and lingers between the skin and interstices. Inwardly, it cannot penetrate deeply and reach through; outwardly, it cannot disperse and drain smoothly. The nature of wind-pathogen is skilled at roaming and highly changeable 💨. When the cou li (interstices and textures of skin and muscle) open, one feels cold as if sprinkled with water; when the cou li close, one experiences feverish heat and vexation. Cold causes loss of appetite; heat consumes the muscles. Thus, one may shiver and tremble, unable to eat—this condition is called alternating chills and fever.
When wind-pathogen enters the stomach via the yang brightness channel, ascends along the channel pathways to the inner canthus (inner corner of the eye). If the person is corpulent, wind-pathogen cannot disperse outward and becomes pent-up heat, resulting in heat in the middle, manifesting as yellow eyes; if the person is thin, wind-pathogen easily leaks outward and causes cold, resulting in cold in the middle, manifesting as involuntary tearing.
When wind-pathogen enters together with the greater yang channel, it travels through the various shu points of the channels (acupuncture points), spreads among the fleshy interstices (spaces between muscles), and interferes with defensive qi (the body's surface defense qi). When the pathways of defensive qi are obstructed, the flesh swells and ulcerates; when defensive qi congeals and cannot circulate normally, the flesh becomes numb and insensate.
The formation of li wind (leprosy-type illness) occurs because nutritive qi (also called ying qi, the nutrient qi circulating within the blood vessels) has heat that causes decay and putrefaction, and the qi and blood become unclear. Thus, the nasal bridge is damaged, the complexion deteriorates, and the skin ulcerates. When cold wind-pathogen lingers in the channels and does not depart, it is called li wind, also known as alternating chills and fever.
When injured by wind-pathogen on jia or yi days in spring, it is called liver wind; when injured by wind on bing or ding days in summer, it is called heart wind; when injured by pathogenic qi on wu or ji days in late summer (long summer), it is called spleen wind; when struck by pathogenic qi on geng or xin days in autumn, it is called lung wind; when struck by pathogenic qi on ren or gui days in winter, it is called kidney wind.
When wind-pathogen invades the shu points of the five viscera and six bowels, it also becomes wind illness of the corresponding viscera or bowel. Wind-pathogen enters through the gates (shu points) of its corresponding viscera or bowel. If it afflicts only one side, it is called hemilateral wind (hemiplegia). When wind-pathogen ascends along the feng fu point, it becomes brain wind; when wind-pathogen invades the head channels connecting to the eyes, it becomes eye wind, manifesting as cold eyes; when wind-pathogen is contracted after drinking alcohol, it is called leakage wind; when wind-pathogen is contracted with sweating after sexual intercourse, it is called internal wind; when wind-pathogen is contracted right after washing the hair, it is called head wind; when wind-pathogen lingers and penetrates deeply into the body, it becomes intestine wind, manifesting as diarrhea with undigested food; when wind-pathogen lodges in the cou li on the body surface, it is called effusion wind. Therefore, wind-pathogen is the chief of all diseases, and when it reaches its stage of transformation and development, it evolves into various other illnesses without fixed patterns, yet the root cause is always wind-pathogen.
The Yellow Emperor asked: The manifestations of the five viscera wind illnesses differ from each other—how so? I wish to hear the diagnostic methods and pathological presentations.
Qi Bo said:
Lung wind manifests as: excessive sweating, aversion to wind, pale complexion, frequent coughing and shortness of breath, relatively better during the day and aggravated toward evening. The diagnostic site is above the eyebrows, where a white coloration appears.
Heart wind manifests as: excessive sweating, aversion to wind, parched lips and tongue, easily angered or startled, red complexion. In severe cases, speech becomes incoherent. The diagnostic site is the mouth, where a red coloration appears.
Liver wind manifests as: excessive sweating, aversion to wind, tendency toward sorrow, slightly green complexion, dry throat, easily angered, sometimes aversion to women. The diagnostic site is below the eyes, where a green coloration appears.
Spleen wind manifests as: excessive sweating, aversion to wind, bodily fatigue, limbs unwilling to move, pale and slightly yellow complexion, no desire to eat. The diagnostic site is the nose, where a yellow coloration appears.
Kidney wind manifests as: excessive sweating, aversion to wind, facial edema, spinal pain making it difficult to stand upright, black complexion, difficulty with hidden flexion (impaired urination/defecation or sexual function). The diagnostic site is the flesh of the cheekbones, where a black coloration appears.
Stomach wind manifests as: excessive sweating of the neck, aversion to wind, inability to eat or drink, obstruction of the chest and diaphragm, tendency toward abdominal distension. Wearing fewer clothes aggravates abdominal distension; eating cold food causes diarrhea. The diagnostic characteristic is emaciation of the body with abdominal protrusion.
Head wind manifests as: excessive sweating of the head and face, aversion to wind. On the day before the wind arises, the condition worsens, with headache so severe one dares not go outside; on the day of the wind itself, the condition tends to improve slightly.
Leakage wind manifests as: sometimes excessive sweating, often unable to wear thin clothing, sweating upon eating, in severe cases whole-body sweating, panting, aversion to wind, clothing constantly soaked through, dry mouth with thirst, unable to endure physical labor.
Effusion wind manifests as: excessive sweating, sweat soaking through clothing, dry mouth, upper body sweating as if soaked in water, unable to endure physical labor, generalized pain with chills.
The Yellow Emperor said: Well explained.
The core academic thought of this chapter is concentrated on two points:
First, the pathogenic characteristics of wind—"skilled at movement and highly changeable" and "chief of the hundred diseases." This is the classic summary in Chinese medicine of the essential nature of wind-pathogen. Wind is the first among the six excesses (wind, cold, summer-heat, dampness, dryness, fire—the six exogenous pathogenic factors). Its pathogenic characteristics are: wandering and unsettled, rapid in change, and penetrating through every opening. The same wind-pathogen invading the body, depending on differences in constitution (fat vs. thin), different routes of invasion (yang brightness vs. greater yang), and different sites affected (cou li, viscera, head), produces entirely distinct conditions such as chills and fever, heat in the middle, cold in the middle, li wind, or hemilateral withering. This embodies the Chinese medical dialectical thinking that the same pathogenic factor varies according to the "person" and the "location" —it is not a linear "which pathogen causes which disease" equation, but rather the interactive result of the pathogenic qi and the human body's state.
Second, the diagnosis of the five viscera wind illnesses—application of the "color diagnosis" system. The chapter enumerates the five winds of the lung, heart, liver, spleen, and kidney. Each viscus's wind illness corresponds to a specific complexion (white, red, green, yellow, black) and specific diagnostic sites (above the brows, mouth, below the eyes, nose, cheekbones). This is the application of the five-colors corresponding to five-viscera inspection diagnostic system in wind illnesses: changes in complexion and diagnostic sites reflect which layer of viscera the wind-pathogen has invaded. This diagnostic method requires no instruments—it relies on the physician's meticulous observation of the patient's overall state.
What can be corroborated: The description of wind as "skilled at movement and changeable" resonates with how modern medicine understands certain conditions that are induced or aggravated by environmental factors (such as cold or wind stimulation). For example, the migratory symptoms of certain allergic conditions, the phenomenon of arthritis worsening with wind exposure, and the "head wind" description of headaches worsening before the wind arises—all find interesting echoes in modern observations of barometric pressure changes triggering migraines. Furthermore, the records of "wind after washing hair," "wind after drinking alcohol," and "wind with sweating after sexual intercourse" suggest that the ancients observed that the body's state (e.g., open pores, vasodilation, transient immune fluctuations) affects its sensitivity to external environmental changes—a concept that has correspondence in modern discussions about the relationship between sudden temperature changes and susceptibility to respiratory infections.
Historical limitations: The conceptual framework of "wind" as a disease cause was established by the ancients through analogical reasoning rather than experimental verification. Modern medicine has definitively established that the true causes of many so-called "wind diseases" are viruses, bacteria, immune abnormalities, and the like—not an abstract "wind pathogen." For instance, "li wind" corresponds to modern leprosy, whose cause is infection by Mycobacterium leprae, not "cold wind lodged in the vessels." Derivations such as "wind injuring on spring jia/yi days becomes liver wind," which use heavenly stems for day-keeping to correspond to viscera, belong to categories better defined as extensions of ancient numerological thinking, akin to theoretical constructs rather than modern clinical observation, should thus be understood with reasonable caution.
Related Concepts:
Further Reading:
This content is based on classic texts of traditional Chinese medicine and is provided solely for the study of traditional culture and textual research. It does not constitute any medical diagnosis, medication, or treatment advice. Should you feel unwell, please consult a healthcare professional promptly.
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