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(1. Also known as Wind-Strike)

The syndrome of wind-strike presents with headache, stiffness of the neck and nape, severe pain in the thighs and joints, or eye pain, muscle heat, dry retching, nasal congestion (rhonchus), warmth of the hands and feet, spontaneous sweating, and aversion to wind and cold. The pulse is floating and slow at the Yang position (anterior to the cun-guan-chi junction) and floating and weak at the Yin position (posterior to the cun-guan-chi junction). This indicates pathogenic heat located on the exterior, representing a syndrome suitable for Guizhi Tang (Cinnamon Twig Decoction) to resolve the muscle layer and release the exterior. If there is sweating, aversion to wind, accompanied by stiffness and pain in the nape and back, Guizhi Tang plus Puerariae Radix Decoction (Guizhi Jia Gegen Tang) is appropriate. Conversely, if there is no sweating, Puerariae Decoction (Gegen Tang) is appropriate. Although Guizhi Tang has been administered, if vexation persists without interior signs, first puncture Fengchi (GB20) and Fengfu (GV16), then administer Guizhi Tang again. Or, after taking Guizhi Tang, if there is profuse sweating and a floating, surging-large pulse, it is appropriate to administer Guizhi Tang again. About half a day after sweating, if fever and vexation recur with a floating and rapid pulse, Guizhi Tang is appropriate again. If purgation is used instead of diaphoresis, resulting in diarrhea with undigested food but without chest binding (Jie Xiong), while exterior signs remain, this is exterior heat and interior cold, caused by the mistaken use of cold purgatives like Chengqi Decoctions. If mistakenly treated with hot purgatives like Crotonis Fructus (Badou), leading to persistent diarrhea with heat, or if both exterior and interior are hot with spontaneous diarrhea or vomiting, Triauretum (Wuling San) is appropriate to stop diarrhea and release the exterior simultaneously. Urgently use Sini Decoction (Sini Tang) to warm the interior; once diarrhea stops and the interior harmonizes, urgently use Guizhi Tang to release the exterior.

If the exterior is hot but the interior is harmonized, the treatment for diarrhea is the same.

In Yangming Disease (Yangming Bing), with a floating and slow pulse, sweating, and slight aversion to cold, or in Taiyin Disease (Taiyin Bing), with abdominal fullness and a floating pulse, Guizhi Tang is appropriate.

If the pulse is unexpectedly deep and solid, Major Order the Yellow Decoction (Dachengqi Tang) should be used to purge.

If purgation is performed too early, resulting in epigastric stuffiness, sweating, aversion to cold, and a floating pulse, the exterior has not yet resolved. First, use Guizhi Tang to release the exterior; subsequently, if blood appears in the stool, Tao Ren Chengqi Decoction (Taoren Chengqi Tang) or Didang Pill (Didang Wan) should be used to attack and remove blood stasis.

Head and neck pain, limb pain, and warmth of the hands and feet indicate Wind-Strike. Conversely, no sweating, aversion to cold, and a floating-tight pulse indicate Cold Damage (Shanghan). Head and neck pain, stiffness of the waist and spine, body rigidity, slight coldness of the fingertips, and absence of sweating also indicate Cold Damage. Conversely, irritability with a slow pulse indicates Wind-Strike. Wind injures the Defensive Qi (Wei Qi), while Cold injures the Nutritive Blood (Ying Blood). All things seek Yin for Yang and Yang for Yin; when Yin and Yang correspond, there is peace. Thus, Ying Blood is Yin; when Cold attacks, it injures it. Hence, Cold injures Blood, which is also Yin. Wei Qi is Yang; Wind is also Yang, so when Wind attacks, it injures it. Hence, Heat injures Qi, which is Yang. The classics state that Yin Cold governs closure and storage, while Yang Heat governs opening and dispersal. Therefore, when Cold injures Ying, the interstices become closed and dense,郁热 (stagnant heat) arises internally, causing dryness, heat, and anhidrosis, resulting in a rapid, floating, and tight pulse. When Wind injures Wei, the interstices open and disperse, causing spontaneous sweating, resulting in a floating and slow pulse. Because pathogenic heat dissipates, the pulse cannot be solid. Yangming governs the muscles, so profuse sweating leads to a surprisingly slow pulse. Heat is the utmost Yang within Yang; thus, injury by heat causes profuse spontaneous sweating. Although the disease is heat, the pulse is not solid but weak. However, stagnant heat with obstruction and anhidrosis is indeed a disease; even sweating freely can be pathological, as extreme ease turns to adversity. When human Qi is harmonious, sweat is produced, just as when Heaven and Earth Qi are harmonious, rain falls. Too much causes flooding, lack of rain causes drought; existence and non-existence, abundance and scarcity must be timely. Deviation from normality brings disaster. This applies to all matters.

When both Ying and Wei are injured, exterior and interior heat becomes severe, suitable for Da Qinglong Decoction (Da Qinglong Tang).

Xiao Qinglong Decoction (Xiao Qinglong Tang) treats Cold Damage where the exterior has not resolved, and there is fluid retention in the heart region.

Although the exterior has not resolved, heat has entered the interior, stagnating in the Stomach, preventing the transformation and dissemination of food and fluids, leading to accumulation and this condition. It is not due to excessive interior heat excess, thirst, and drinking, nor fluid retention causing pathology.

Dry retching, fever, and cough, or thirst, or diarrhea, or dysphagia, or difficulty urinating, lower abdominal fullness, or wheezing.

Fluids cannot moisten and disseminate, failing to nourish the intestines and organs, causing heat and thirst, dysphagia, wheezing, difficulty urinating, lower abdominal fullness, and wheezing; fluids cannot circulate, causing damp-heat to flourish in the intestines, leading to diarrhea.

Xiao Chaihu Decoction (Xiao Chaihu Tang) treats Cold Damage or Wind-Strike where the disease is half-exterior and half-interior (pulse located in the muscle layer, neither deep nor floating), with tendon and vessel rigidity.

Body pain, alternating chills and fever (aversion to cold indicates exterior heat, fever indicates interior heat). Alternating chills and fever indicate pathogenic heat half-exterior and half-interior, advancing and retreating incessantly, changing unpredictably.

Vomiting or coughing, epigastric and hypochondriac stuffiness, hardness, and pain, regardless of timing before or after onset, number of days, or residual heat after sweating, whether Cold Damage, miscellaneous diseases, steaming heat eruptions, or simultaneous contraction of two meridians, if reconciliation is possible, Xiao Chaihu Tang is appropriate.

Liangge San (Liangge San, also known as Lianqiao Yinzi) treats Cold Damage where the exterior has not resolved, half-entering the interior, with incomplete purgative indications, or recurrence without cure; or dry heat stagnating internally causing mental restlessness and insomnia; and regardless of Cold Damage, miscellaneous diseases, adults, children, internal organ heat accumulation, irritability, excessive thirst, facial heat, dizziness, dry lips, throat dryness, swollen tongue, pharyngeal obstruction, red eyes, epistaxis, hard nodules in the jaw and cheeks, mouth and tongue ulcers, phlegm obstruction, thick sticky sputum, restless sleep, delirium, mania, intestinal and stomach damp-dryness, difficult urination and defecation, all wind-heat congestion, wind vertigo, skin sores and tinea, Yangming Stomach heat rash in Cold Damage with incomplete purgative indications; or excessive intake of warming medicines causing various heat syndromes, alcohol toxicity, pediatric measles and smallpox eruption failure, convulsive fever with heat accumulation, indistinguishable Cold Damage; or severe heat with erupted but unsmooth smallpox; or extreme heat with black sinking indicating impending death.

Pediatric measles and smallpox not yet erupted, mistakenly treated with hot diaphoretics, intensifying Yang heat, causing dense, unsmooth eruption, often leading to black sinking and death. Consequently, laypeople often avoid medication for rashes, delaying treatment for many pediatric illnesses. They fail to realize that ancient cooling purgatives treat wind, convulsion, heat accumulation, and febrile diseases generally; even if mistakenly used for sores, they reduce heat slightly, allowing sparse but smooth eruption and early recovery. Using this formula is most excellent.

Yan Xiaozhong’s compilation *Xiao'er Fanglun* fails to understand Qian Yi’s original intent and the principles of creation, wrongly claiming black sinking in rashes is cold, and stating that cooling purgatives should never be used for rashes. Later generations followed this, leading to countless deaths from intensified heat and black sinking. Did Yan not note that Qian Yi’s formulas for black sinking, such as Niuli Gao and Baixiang Wan, involve cold purgatives that often result in recovery, whereas non-treatment leads to certain death? Thus, the heat nature of smallpox/rashes is clear. Moreover, the classics state: "All pain, itching, sores, and ulcers belong to the Heart." Regarding black sores, abdominal fullness, wheezing (hoarse breathing), and dark, scanty, obstructed urination invariably occur, indicating extreme heat. Since rashes originate from heat and worsen, how can they be cold?

For simultaneous contraction of two meridians (simultaneous transmission of three Yin and three Yang meridians), Liangge San is appropriate. In extreme heat Death-like states of Cold Damage, if Yin Qi is depleted, purgation is contraindicated; purging would cause sudden Yin collapse and subsequent Yang exhaustion and death. Instead, nourish Yin and retreat Yang until the pulse returns strong, then mildly purge with Sanyi Chengqi Decoction (Sanyi Chengqi Tang). If unresolved after purging, regulate with Liangge San. Even after recovery, take small amounts to prevent heat recurrence.

Baitu Tang (Baitu Tang) treats Wind-Strike with spontaneous sweating, where Guizhi Tang signs persist, half-entering the interior, suitable for reconciliation.

Pulse located in the muscle layer, unsuitable for purgation.

Or summerheat stroke with spontaneous sweating and a weak pulse.

Heat injuring Qi causes profuse spontaneous sweating, making the pulse weak rather than solid.

Or Cold Damage with spontaneous sweating, slippery-rapid-solid pulse, indicating both exterior and interior heat.

Pulse is forceful and rapid in both deep and floating positions; symptoms include fever, headache, irritability/thirst, abdominal fullness, and dark yellow urine. Or Three-Yang Combined Disease (simultaneous involvement of Taiyang, Shaoyang, and Yangming), abdominal fullness, heaviness, difficulty turning, dry mouth, dirty complexion, delirium, and urinary incontinence. Mistaken diaphoresis worsens delirium; purgation causes sweating on the forehead and later jaundice.

Or cold extremities with spontaneous sweating, termed Heat Dissipation (sweat dispersing heat). If interior heat with cold extremities (pulse reversal); or incomplete purgative indications; or reconciling simultaneous contraction of two meridians in Cold Damage. This formula best relieves headache and stops spontaneous sweating, applicable to summerheat, Cold Damage, wind-heat miscellaneous diseases, infectious epidemics, non-exterior wind-cold cases with non-floating pulses, spontaneous sweating, headache, and impending sweat eruptions.

Use according to syndrome regardless of season. Other formulas follow this principle.

Triauretum (Wuling San) treats summerheat stroke, and post-profuse sweating in Cold Damage causing gastric dryness, irritability, insomnia, floating pulse, difficulty urinating, subsequent heat/vexation/thirst, and both exterior/interior heat with water regurgitation (Shui Ni); or unresolved epigastric stuffiness; or dry mouth/vexation/thirst with difficulty urinating; or persistent stuffiness with diarrhea; or mistaken purgation after needing diaphoresis, causing persistent diarrhea, floating pulse, unresolved exterior, spontaneous diarrhea, or difficulty urinating.

When using Wuling San, apply regardless of pulse depth or superficiality.

For all retained fluid accumulations, use this powder to disperse water, stop thirst, and reconcile simultaneous contraction, involving Taiyang and Shaoyin diseases.

This refers to the six-meridian disease patterns mentioned in the classics.

For all vomiting/diarrhea cholera (regardless of cold/heat), and pediatric diarrhea with convulsions (regardless of acute/chronic), it is appropriate.

Guiling Ganlu San (Guiling Ganlu San, also Guiling Baizhu San) treats Cold Damage/Wind-Strike, summerheat exposure, dietary injury, and all internal/external injuries transmitting severe damp-heat; or headache, dry mouth; or vomiting/diarrhea, irritability/thirst; or dark/scanty urination, urgent bowel pain; or intermittent diarrhea; and all damp-heat, cholera vomiting/diarrhea, tetanic cramps, abdominal fullness/pain/distension, or mixed pathogenic injuries causing vomiting/diarrhea. Especially suitable during damp-heat seasons.

Also treats pediatric convulsions.

Baizhu San (Baizhu San) treats Cold Damage and miscellaneous diseases, all vomiting/diarrhea, irritability/thirst, cholera, deficiency, chronic Qi weakness, preservation of aging, and alcoholic epigastric obstruction with retching.

Sini Decoction (Sini Tang) treats Cold Damage where exterior heat has not entered the interior, but premature cold purgation caused interior cold, persistent diarrhea, or exterior heat/interior cold with persistent diarrhea. Urgently use Sini Tang to warm the interior.

Floating pulse without thirst, clear/cold urine, undigested food in stool. Observe stool/urine color, considering dietary influences.

If post-purgation diarrhea with heat persists, with dry throat and irritability, cautiously avoid warming; use Wuling San to dissipate damp-heat. Only interior cold warrants warming to stop cold diarrhea.

Once diarrhea stops and interior harmonizes, if exterior signs remain, urgently use Guizhi Tang to release the exterior. For miscellaneous disease cold-fluid vomiting or cold-damp diarrhea.

However, for miscellaneous disease damp-heat vomiting/diarrhea, this formula is inappropriate. Mild damp-heat obstruction might respond to acrid-warm dispersal, but severe cases forced open will worsen stagnant heat. Only interior cold universally suits Sini Tang.

Fuling Banxia Tang (Fuling Banxia Tang) treats Cold Damage/miscellaneous diseases, all vomiting, wheezing/cough, headache.

Banxia Jupi Tang (Banxia Jupi Tang) treats Cold Damage/miscellaneous diseases, vomiting/retching, wind vertigo, phlegm-reversal wheezing/cough, headache, wind-heat reverse flow vomiting.

Huanglian Jiedu Tang (Huanglian Jiedu Tang) treats Cold Damage/miscellaneous diseases, alcohol dryness-heat toxicity, irritability, dry retching, dry mouth, groaning, confused speech, insomnia, all severe heat/maniacal restlessness/wheezing/fullness, extreme Yin cold extremities, deep internal heat accumulation (mistakenly called Yin Toxin by laypeople); severe exterior heat with unbearable head/neck/limb pain, surging-restless pulse, slight interior heat unsuitable for diaphoresis; or severe internal damp-heat, or impending dysentery.

Loose frequent stools with lower abdominal urgency/pain, dark or obstructed urination indicate impending dysentery.

If already diarrheic with severe heat (take this formula); or pre/post-purgation where cold medicines fail to reduce severe heat. Simultaneous contraction cases follow this method.

Simultaneous Contraction: Day 1, Taiyang and Shaoyin both diseased, causing headache, dry mouth, irritability/fullness; Day 2, Yangming and Taiyin both diseased, causing deafness, scrotal retraction, cold extremities. Universally use this formula to reduce exterior/interior heat. Zhu Shi misunderstood these as heat syndromes, wrongly claiming the first three days were true cold, urging Sini Tang to warm the interior and Guizhi Tang to release the exterior, a major error.

Neither of these two formulas should be used blindly; rather, adjust based on exterior/interior and heat severity to reduce heat and prevent death from extreme heat. If severe and requiring purgation, add Dachengqi Tang. The classic mention of three-day transmission is a general rule. Treatment should follow the syndrome, not rigid adherence.

If severe and requiring purgation, fearing heat persistence, add Dachengqi Tang. If heat knot is extremely deep, multiple purgations fail, leading to inevitable death, use this method adding one qian of Kansui Root powder (Gansui) to purge (effective for vomiting/diarrhea). If heat knots only in the chest, chest elevation, abdominal fullness absent but with wheezing, oppression, delirium, coma, and deep-rapid-tight Guan pulse, this method urgently purging is especially indicated.