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Differentiating the pathogenic factors of Eight Winds from external contraction, or severe injuries caused by improper diet and overexertion, may present similarities to external injuries (external contraction diseases) within two or three days. However, other symptoms possess distinctive characteristics. If these two types of syndromes are not carefully distinguished and analyzed, there is a risk of misdiagnosing an internal injury characterized by deficiency as an excess syndrome of external wind pathogen. Although the discourse contains some repetition, it aims to facilitate easier identification for patients and more effective treatment for physicians.

The Eight Winds from external contraction constitute an excess syndrome; whereas internal injuries due to irregular diet and physical overexertion are all deficiency syndromes. Internal injuries may also manifest with aversion to wind and spontaneous sweating. However, in a warm place without drafts, aversion to wind ceases. This resembles the clear nasal discharge, headache, and spontaneous sweating seen in external contractions, but careful differentiation reveals distinct differences. In cases of external wind pathogen, symptoms such as aversion to wind, spontaneous sweating, headache, and clear nasal discharge are persistent. They intensify progressively throughout the day until the pathogen penetrates inward, forming lower jiao excess syndromes. The voice is heavy and turbid, high-pitched and forceful; nasal breathing is obstructed and blocked; appetite is preserved, the abdomen is harmonious, taste sensation in the mouth is normal, and urination and defecation are regular. There is pain in the sinews and bones, inability to move, requiring one to lie on beds or pillows, unable to rise without assistance.

Internal injuries resulting from irregular diet and overexertion may also involve aversion to wind. However, if residing in open areas and exposed to strong winds, there is no aversion. Only slight drafts entering through window or door cracks cause significant aversion, which differs markedly from Wind Strike (Shang Feng) or Cold Damage (Shang Han). Moreover, clear nasal discharge, headache, and spontaneous sweating occur only intermittently. Patients experience shortness of breath at the nose, insufficient qi for respiration, and when speaking, their qi becomes short and weak. Appetite is impaired; they may find eating difficult, be unable to eat, or have no desire to eat; these three conditions alternate. The abdomen is disharmonious, or feels tight and unable to stretch; taste for grain foods is lost; urination is frequent but without thirst. Initially, following illness from overexertion, food intake decreases, urine is dark yellow, and defecation is often difficult—either constipated or formed into hard masses—or there is straining with empty bowels yielding only small amounts of white pus. Sometimes there is passage of gas, or diarrhea with yellow, porridge-like stools, or loose white stools, or constipation with obstruction.

If there is epigastric fullness and blockage, or chest oppression with pain like knife cutting, these two conditions also alternate and do not occur simultaneously. Sometimes there is pain in the stomach region below the heart, radiating upward to both hypochondria. This pain inevitably arises from the ministerial fire below the umbilicus, surging like a great river, unstoppable and ascending, causing the Stomach Meridian of Yangming to reverse its flow and chaos in the chest. This pathological qi does not cease; severely, it leads to rapid panting. Heat damages the primordial qi, causing the four limbs to become flaccid and unresponsive, lacking the energy to move, resulting in lethargy and a desire to sleep. Since external contraction of wind and cold do not present these symptoms, differentiation is relatively easy!