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Huangdi asked: When wind pathogen invades the human body, it may cause cold-heat syndrome (Han Re Bing), heat-in-the-middle syndrome (Re Zhong), cold-in-the-middle syndrome (Han Zhong), leprosy-like wind (Li Feng), hemiplegia (Pian Ku), or wind disease (Feng Bing). These diseases are different from each other and have different names. Some pathogens reach the five zang organs and six fu organs internally. I do not understand the explanation; I wish to hear your theory. Qibo replied: Wind pathogen hides between the skin and hair follicles. It cannot circulate internally nor be excreted externally. Wind is characterized by its ability to move rapidly and change frequently. When the interstices (Cou Li) open, one feels chilly and shivering; when they close, one experiences fever and chest stuffiness. In the case of cold predominance, appetite declines; in the case of heat predominance, muscles emaciate. Thus, the person becomes fearful and trembling, unable to eat, which is named cold-heat disease.

Wind is transformed from yang qi and changes according to cold, heat, warmth, and coolness. The injury caused by cold and heat must occur through wind; therefore, wind is considered the "chief of a hundred diseases," capable of moving rapidly and changing frequently. If wind hides between the skin, Ying (nutritive) and Wei (defensive) qi cannot circulate harmoniously. The opening and closing of the interstices become irregular, leading to a struggle between yin and yang. When yin prevails, there is cold and reduced food intake; when yang prevails, there is heat and muscle wasting. Both qi and blood are injured, causing fearfulness and trembling with an inability to eat, known as cold-heat disease. "Tan Han" refers to the state of fearfulness and trembling.

When wind pathogen enters the stomach along with the Qi of the Yangming channel, traveling up the meridians to the inner canthus of the eye: if the person is obese, the wind pathogen cannot be excreted externally, resulting in heat-in-the-middle syndrome with yellowing of the eyes; if the person is thin, the wind pathogen escapes externally with sweat, causing cold, resulting in cold-in-the-middle syndrome with tearing.

Although affected by the same wind pathogen, the diseases manifest differently due to variations in body constitution (obesity vs. thinness). Therefore, whenever pathogenic factors injure the body, they transform into diseases according to the changes in the body's qi. If wind enters the stomach via the Yangming channel, and the person has a robust physique with thick muscles, the wind cannot escape externally. It stagnates and steams together with the qi of food and drink, forming damp-heat that travels upward along the meridians to cause yellowing of the eyes. Conversely, thin individuals have thin skin and loose interstices; their middle jiao yang qi escapes externally with the wind pathogen, leading to cold in the middle. As wind qi ascends to the eyes, it causes tearing.

When wind pathogen enters together with the Taiyang channel, circulating through the shu points of various meridians and scattering between the muscle intervals, it interferes with Wei (defensive) qi. This obstruction makes the meridian pathways unfavorable, causing the muscles to swell and develop sores. Because Wei qi is hindered and cannot flow, the muscles become insensible (Bu Ren).

The Taiyang channel governs the exterior of the whole body and controls Ying and Wei qi. When wind enters the Taiyang channel, circulates through the shu points, and scatters between the muscle intervals, it interferes with Wei qi. This obstructs the meridian pathways, causing Ying qi to fail to follow smoothly and reverse into the muscle tissue, generating carbuncles and swelling. When Wei qi is blocked and cannot circulate, the muscles lose sensation of pain and itch, a condition called insensibility (Bu Ren).

Leprosy-like wind (Li Feng) occurs when Ying qi becomes hot and turbid, causing the nasal bridge to collapse, complexion to deteriorate, and skin to ulcerate. When wind-cold lodges in the vessels and does not depart, it is named leprosy-like wind, also sometimes called cold-heat.

"Leprosy" refers to the toxic heat pathogen corrupting the Ying vessels, creating turbid and foul qi that steams upward to the nose, causing the nasal bridge to collapse, complexion to deteriorate, and skin to ulcerate. Initially, wind-cold lodges in the vessels and remains, combining with miasmic and evil qi to form this condition. Hence it is named leprosy-like wind, commonly known as Hansen's disease (leprosy), and anciently called "Lei." It is the most severe malignant disease. Its pathogen penetrates the bones and can be transmitted to descendants, although medical texts do contain treatment methods for it.