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The Kan trigram in the due north represents the middle son, and its disease is named Water Wind (Shuifeng). It is also called Facial Wind (Mianfeng), Tile Wind (Wafeng), or Ao Wind. When this wind pathogen occasionally invades the muscle layer, sores may appear in spring and autumn; the skin feels as if insects are crawling, wandering without a fixed location, and after ten years, hair falls out. The Kun trigram in the southwest represents the old mother, and its disease is named Cave Wind (Xuefeng). It is also called Yin Wind (Yinfeng), Lu Wind (Lufeng), or Brain Wind (Naofeng). Initially contracting this wind causes no pain or itching, nor does it produce sores; gradually, white leprosy (Bailai) forms, and after ten years, eyebrows fall out. The Xun trigram in the southeast represents the eldest daughter, and its disease is named Horn Wind (Jiaofeng). It is also called Cause Wind (Yinfeng), Li Jie Wind (Lijiefeng), or Bladder Wind (Pangguangfeng). This wind involves parasites with three colors: red head, white abdomen, and black tail; after three years, eyebrows and eyelashes fall out, and if the parasites are expelled, it can be cured. The Li trigram in the south represents the middle daughter, and its disease is named Red Wind (Chifeng). It is also called Great Wind (Dafeng), Yao Wind (Yaofeng), or Shake Wind (Doufeng). If struck by this wind, the body feels restless and unsettled, skin color changes, and after ten years, eyebrows and eyelashes fall out. The Dui trigram in the west represents the young child, and its disease is named Indulgent Wind (Yinfeng). It is also called Deficient Wind (Quefeng), Bright Wind (Mingfeng), or Clear Wind (Qingfeng). One hundred days after onset of this wind, internal steaming heat occurs, and eyebrows and hair fall out. All these conditions arise from internal injury to the Seven Emotions (Qiqing), depletion of True Yuan (Zhenyuan), and weakened Qi and Blood; if one maintains careful regulation and consolidation, how could such diseases occur?

The pathogen first strikes the Hand Taiyang (Small Intestine) Meridian and Foot Yangming (Stomach) Meridian, then extends to the Hand Taiyin (Lung) and Foot Taiyin (Spleen) meridians. Why does it not manifest immediately? Because the Lung governs the skin and hair, encountering Wind-Cold; the Foot Taiyin Spleen governs muscles, encountering Damp-Heat, leading to flow and injection throughout the bones. As the Six Meridians transmit the pathogen, it is due to the Ministerial Fire (Xianghuo) of the Sanjiao being excessive, suppressing Metal (Lung), failing to control Wood (Liver), causing Liver Qi to dominate and generate Wind. This leads to mutual overacting and insulting, resulting in deficiency of both Lung Metal and Spleen Earth. Wind-Heat, Cold-Damp, and various toxins transform into Nine Worms (Jiu Chong), burrowing into and gnawing at the Zang-Fu organs. The collateral of the Hand Yangming Large Intestine circles the mouth, flanks the nostrils, emerges at Yingxiang (LI 20), penetrates the teeth gaps, and descends to connect with the Lung diaphragm. The collateral of the Foot Yangming Stomach also runs through the nose and forehead, among the teeth, flanking the umbilicus and Qichong (ST 30); Wind pathogens enter and exit here, hence they are affected first. The Hand Taiyin Lung has its orifice in the nose and governs the skin and hair of the whole body. The Foot Taiyin Spleen has its orifice in the lips and governs the muscles of the whole body; it is also the gateway for Wind pathogens. Therefore, Wind diseases often present with rotting and destruction of the lips and nose. Thus, Metal is dry and dislikes Cold; Earth is lowly and fears Dampness; hence, alternating cold and fever occur. Internal invasion of Wind-Damp stirs all Fires; with deficient Metal, Wood is uncontrolled, Wood dominates and insults Earth, injuring the Spleen, while the Lung lacks nourishment. With both mother and child weak, Wind-Wood dominates alone. Heart Fire blazes, burning blood causing reckless bleeding; accumulated filth and evil toxins, fanned by Wind-Damp and Fire, transform into Nine Worms that eat away the Zang-Fu, resulting in Leprosy Wind (Laifeng). Eating the Liver causes hair loss; eating the Lung causes nasal collapse; eating the Spleen alters voice; eating the Kidney causes tinnitus; eating tendons causes joint separation; eating flesh causes pain and itching; eating skin causes stubborn cracking; eating fat causes rashes; eating the Heart leads to death. *Neijing* states that the intestines and stomach are like a market, receiving and containing everything. Imprudent diet causes morning injury and evening damage; accumulation over time generates Heat. Damp-Heat accumulates, and various strange worms transform according to the Qi of the Five Elements, just as rotten meat breeds maggots and rotten grass transforms into fireflies. *Waitai Miyao* records Nine Worms that eat human Zang-Fu: 1. Fu Chong (Hidden Worm), about four cun long, leader of all worms. 2. Hui Chong (Roundworm), about one chi long, commonly found in humans; if numerous, it pierces the heart and kills. 3. Bai Chong (White Worm), four to five chi long, reproducing parent-to-child, growing larger, also capable of killing. 4. Rou Chong (Flesh Worm), eats human flesh, causing irritability. 5. Fei Chong (Lung Worm), shaped like a silkworm, causing cough. 6. Si Chong (Toad Worm - note: text says "Hui Chong" but describes toad shape, likely a typo in original for another worm type, translated as described), shaped like a toad, causing vomiting and hiccups. 7. Ruo Chong (Weak Worm), also called Chang Chong (Intestinal Worm), shaped like melon seeds, causing frequent vomiting. 8. Chi Chong (Red Worm), shaped like raw meat, causing borborygmus. 9. Tuo Chong (Pinworm), shaped like vegetable worms, extremely minute, residing in the large intestine (Tongchang); numerous cases lead to hemorrhoids, severe cases to fistulas, extreme cases to Wind Leprosy. Due to existing sores, carbuncles, tinea, scabies, and dental caries, if Yuan Qi is strong, it is not a major harm; slight deficiency leads to erosion following. Worm movement generates many diseases, such as dysphagia, consumption, Leprosy Wind, and Gu Distension. Strange types like Rat Worms and Echoing Worms are too numerous to list; the harm of worms is indeed great.

Striking the Hand Shaoyin Heart Meridian causes redness of face, eyes, and tongue,翕翕 (shixi) fever, aphonia inability to speak; long-term generation of worms, eating the Heart causes perforation of the soles, knee swelling, whole-body ulceration, and foul-smelling purulent saliva, indicating Ying Blood has died first.
The tongue is the sprout of the Heart; reckless movement of Sovereign Fire causes the tongue to wither without fluids. Fire dries Metal, causing hoarseness and fever. Deficient Fire flows downward, Heat-Toxin injects into the Kidney, exiting directly at Yongquan (KI 1), causing swelling and pain, spreading along the knee joints to perforate the sole, incurable. The Heart governs Blood; blazing Fire floods internally, causing whole-body swelling and putrefaction, skin and flesh damaged, unable to gather. Toxin entering the Heart, unrestrained blood flooding, if untreated for seven years, leads to death.

Striking the Foot Jueyin Liver Meridian causes blue-green complexion, aversion to wind and spontaneous sweating, pain on the left hypochondrium; long-term generation of worms, eating the Liver causes scorched eyebrows and hair, and black spots all over the body. If fingers swell, contract, shrink, drop, or break, the sinews have died.
Wood manifests colors externally; Liver Qi is already ruined, Damp Earth is uncontrolled, causing aversion to cold and spontaneous sweating. Its collaterals circulate around the genitalia, spread along the hypochondrium, and ascend to the pharynx. The Liver pulse appears at the Left Guan position, hence left hypochondriac pain. Scorched and fallen eyebrows/hair indicate Blood fails to nourish and Qi fails to moisten, like wood without water irrigation causing branches to wither and leaves to fall. Black spots arise from Kidney Water flooding upward. Bent fingers and rotten toes are like rotten wood and dead roots/branches. Shrunken and contracted limbs signify Liver Wood drying up. Liver diseases often involve itching and pain due to the shaking nature of Wind-Wood. After three years, major illness develops; sinew death without nourishment means the disease is severe.

Striking the Foot Taiyin Spleen Meridian causes lethargy of the four limbs, twitching of skin and flesh, sallow yellow complexion; long-term generation of worms, eating the Spleen causes hoarseness and shriveled skin. If numb and insensible, the skin has died.
Spleen collaterals inject into the Heart and follow the arms, hence limb fatigue. Ruined Earth cannot settle, hence muscle twitching and jumping. Weak Qi cannot digest grain and food, hence lethargy and lack of desire for taste; upon eating or breathing, limbs fail to move. Blood vessels obstruct and dry up, unable to circulate, hence hoarseness and shrinking. Spleen belongs to Earth, dislikes Dampness; when its Qi is ruined, it cannot move, hence numbness. Numbness differs from normal skin/flesh; pressing feels like隔着 a paper. Tingling (Mu) is a buzzing sensation within the flesh, unaware of pain or itching but extremely sore. Numbness (Ma) is caused by Qi deficiency; tingling (Mu) is caused by Damp-Phlegm and Dead Blood. Both Ma and Mu together indicate Qi deficiency with Dampness accumulation, dried-up blood collaterals, non-circulation day and night, absolutely lacking nourishment to the skin. Classics state Dampness generates Phlegm, Phlegm generates Heat, Heat generates Wind. Danxi said: Damp-Heat must generate Wind, excessive Wind generates Worms. Just as rotten grass transforms into fireflies, Damp-Heat Qi rides the Wind. Patients with Spleen disease have swelling and excess water, not because Damp-Heat generates Wind, but because internal Damp-Heat allows Wind to enter through gaps. Disease forms in six years, untreatable after fifteen years.

Striking the Hand Taiyin Lung Meridian causes pale white cheeks, dry mouth and rapid panting; long-term generation of worms, eating the Lung causes nasal bridge collapse. If eyes are severed, lips everted, or aphonia occurs, it is untreatable, indicating Bone death.
Metal nature is dry, hence dry mouth. Heat/Fire burns it, hence loud voice and rapid panting. Its orifice is in the nose; worms eating the Lung cause collapse of the Shan Gen (root of nose); severely, the nasal pillar rots and falls. Ruined Metal cannot generate Water, Kidney Qi must be deficient, hence dark/dry eyes, tight skin, and vomiting. Phlegm-Qi floods the Spleen, hence thick and everted lips. Heat-Qi gathers at the epiglottis, hence loss of voice. Like a broken metal vessel losing tone, Bones belong to Metal, hence marrow withers and bone dies. Disease entering Lung Meridian causes withered, insensible skin. Difficult to treat after three years.

Striking the Foot Shaoyin Kidney Meridian causes darkened face and ears, pulling pain in waist and spine, vague discomfort in lower abdomen; long-term generation of worms eating the Kidney, causing buzzing tinnitus, sores along [meridian/locality], either itching or painful. If cutting causes no pain, the flesh has died.
Kidney Water floods upward, changing color to gray or black. Ears are the orifice of the Kidney; dried Water and scarce Essence cause hot ears and sores. Pulling pain in waist/spine indicates extreme deficiency. Once fluids are exhausted, disease becomes sour, numb, unaware of pain or itching. Kidney pathogen is fastest, becoming a major illness within one year.

Striking the Foot Yangming Stomach Meridian causes excessive sweating on the forehead, chest obstruction and blockage, choking when eating cold food; long-term generation of worms eating the Stomach, dispersing decay throughout the body, causing floating itching of the skin. If sighing/moaning, reduced appetite, and exhaustion occur, the Qi has died.
Stomach collaterals circulate above and below the eyes, hence excessive forehead sweating. Weak Spleen-Stomach Qi fails to digest grains, chest fills, reversing upwards to vomiting. Blocked Qi and Blood cause spontaneous skin itching. Dispersed Soul and Spirit, full chest causes sighing/unsmoothness, ruined intestinal Qi causes fatigue and aversion to food. Classics say intestines/stomach are a market, containing all; Heat accumulates internally, manifesting externally. Stomach organ receives toxin, trend follows worm-miasma, body swells and floats vacuously, untreatable after twenty years.

The harm of Leprosy Wind originates from the Six Excesses (Liuyin), manifesting as Six Evils (Liuxie) in the Six Departments (Liubu), each department having six types, totaling thirty-six symptom names.
Six Excesses are Wind, Cold, Summer-Heat, Dampness, Dryness, Fire—improper Qi of Heaven and Earth. Six Departments are Heart, Liver, Spleen, Lung, Kidney, Stomach. Six Evils are Pain, Itching, Numbness, Ulceration, Distension, Exhaustion. Stomach sits below Spleen, responsible for reception, storing five flavors, thus often receiving toxins like the Five Zang. Wind and Leprosy are different names; six departments each have six types, hence thirty-six items, corresponding to sixty-four hexagrams of Eight-Eight.
Heavenly toxic vapors confuse Zang-Fu, mutually injuring and transmitting, changing symptoms to their source. However, Lung disease causes pain, Stomach disease causes itching, Kidney disease causes numbness, Heart disease causes ulceration, Liver disease causes contraction, Spleen disease causes pus.
Metal Qi is dry, thus causing pain. Earth Qi is damp; meeting Yang multiplication makes it like sand/dust, thus itching. Meeting Yin multiplication makes it like mud/sludge. Water Qi is cold; Yang agitation causes numbness, Yin condensation causes tingling (Mu), both unaware of pain/itching. Sovereign and Ministerial Fires can rot all things causing ulceration. Wind-Wood nature shakes and pulls, contracting and extending to cause contraction. Five Zang and Six Fu, Ying-Wei, Lung collaterals fill and penetrate the body, connecting continuously. When淫邪 (excess pathogens) strike humans, the whole body corrodes; how could it stop at one Zang without injuring other meridians? The difference between initially struck and later struck meridians lies only in severity. Once one Zang is diseased, others inevitably suffer. For example, numbness relates to Kidney disease; however, Ma (numbness) is caused by Wind Qi attacking, Mu (tingling) by Damp combining with Cold. Though external skin knows no pain/itch, internal bone/flesh still feels it, indicating heavy Kidney disease and light Lung disease. Numbness with soft/flaccid weakness distinguishes Spleen and Kidney. Numbness with unequal leg length and hand contraction indicates Water failing to nourish Wood, Liver disease. Numbness with ulceration indicates Water and Fire not interacting, attacking the Heart. Pain is Lung disease; if pain lasts and leads to paralysis, Mother cannot protect Child, harming Spleen Qi. Pain with numbness indicates weak Mother unable to support Child, Kidney Qi deficient and receiving toxin. Pain with itching, where scratching causes unbearable pain, indicates Stomach Qi deficient and deep penetration of toxic vapors. Pain with ulceration indicates Lung failing to generate Water to control Fire, Metal and Fire punishing each other. Others can be deduced by this example.
Caught by the unpredictable, stored in the baseless, named Leprosy or Wind, different kinds gather.
Heart governs Blood; Liver toxin injuring Blood aspect causes Heart-Liver disease. Lung governs Qi; all Wind Leprosy arises from Qi stagnation. Kidney stores Essence; sexual desire and labor are harmful. Spleen and Stomach connect and store Grain Qi; injury from drunkenness, fullness, and five flavors occurs here. Thus, Wind disease affects only the Six Meridians of Heart, Liver, Spleen, Lung, Kidney, Stomach; the other six meridians cannot accept it, are not injured, nor interfered with, hence Wind Leprosy does not originate from them. Hand Shaoyang Sanjiao is a formless Fu organ; Jueyin Pericardium is an attached meridian; Yangming Large Intestine and Taiyang Small Intestine are gates of entry/exit; Foot Taiyang Bladder dwells remotely in the Lower Origin; Shaoyang Gallbladder is the office of purity and tranquility; toxic Qi does not injure or accumulate in them. Moreover, Lung orifice is in the nose, Qi enters thereby; Spleen orifice is in the lips, Flavor enters thereby. Initial causes are mostly sensations of Qi and Flavor, hence first appearing in skin and hair. *Bingyuan* states: Six departments each have six Wind diseases, totaling thirty-six, all transmitted by Six Desires, Seven Emotions, Cold-Damp, Wind-Heat, and toxic Qi to the skin/body, circulating through hundred joints, silk-like collaterals interlacing.
Those struck do not suffer in one meridian or develop one symptom; thus treatment methods and prescriptions are vast and varied. Only Lingbao Great Medicine, named Pingfen Jiachan Fang (Equal Division of Family Property Formula), is the most kingly way, achieving complete success for all thirty-six Winds. Next are Donghua Yushui prepared Huangxiang Wan (Yellow Resin Pill), also named Huanglong Wan (Yellow Dragon Pill), Xiaohuan Dan (Small Return Pill), etc., a few formulas. They can also treat various Winds. Other single formulas treat only one symptom; using others is like pouring water on stone, rarely effective. Besides Great Wind, there are fourteen types of Leprosy Sores; later generations created clever names based on varying disease trends and colors to confuse people. Ancient times only spoke of Wind Leprosy, without strange complex names. All talk of Zang-Fu like this is merely the initial cause of confusion. Once the disease erupts, like wind and water, it fills everywhere, flowing through hundred bones, transmitting through each meridian, reaching nowhere untouched.