bubble_chart Concept

The pattern of dual exuberance of wind and heat refers to the symptoms and signs caused by the stagnation of wind pathogenic heat in the skin.

The main clinical manifestations include: fever, thirst with a preference for cold drinks, redness, swelling, and pain in the face or throat, red skin eruptions, or red, swollen, hot, itchy, and painful boils and sores, constipation, yellow urine, red tongue with yellow coating, etc.

The pattern of dual exuberance of wind and heat is commonly seen in conditions such as "muscle impediment," "vertigo," "ulcerative gingivitis," "wind-heat sore (pityriasis rosea)," "rash," "carbuncle," "boil and sore," "wind red sore (eyelid dermatitis)," and "wind-fire eye."

The pattern of dual exuberance of wind and heat should be differentiated from the "pattern of wind and heat invading the upper" and the "pattern of congestion and exuberance of fire and heat and pathogenic toxin."

bubble_chart Differentiation and Treatment

Muscle impediment is one of the five body constituents of bi. The Zhubing Yuanhou Lun details the disease mechanism: "When a person's striae and interstice are deficient, they are harmed by wind-dampness qi; when it clashes with blood and qi, the blood and qi do not circulate, leading to obstruction. Genuine and pathogenic factors clash within the muscles, causing pain throughout the skin. However, the yang meridians circulate yang qi throughout the body. When wind-dampness qi lodges in the skin, it initially causes bi. If the yang meridians are injured, yang qi slows down, leading to laxity of the joints and failure of the sinews to contract, resulting in wind-dampness bi and subsequent paralysis of the body and limbs." This symptom and sign are caused by pre-existing internal heat, external contraction of wind-heat toxin, and stagnation of pathogenic qi in the skin, leading to a clash of qi and blood. Symptoms include muscle pain, tenderness, swelling, weakness, and scattered red patches on the skin, especially around the eyelids and on the chest and back, with a purplish-red color. Accompanied by aversion to cold with fever, joint pain, high fever, thirst, dark urine, dry stool, red tongue with yellow coating, and a surging or floating pulse. Treatment should focus on clearing heat and cooling blood, dispersing wind, and removing toxins. The formula used is Clearing Heat and Removing Toxin Decoction

(from "Gujin Yijian"). Vertigo is caused by pathogenic qi and was first recorded in the Lingshu-Dahuo Lun: "When pathogenic qi attacks the neck, it encounters the body's deficiency... entering the brain causes dizziness. Dizziness leads to tension in the eye connectors, which in turn causes blurred vision and dizziness." The pattern of dual exuberance of wind and heat in vertigo is seen in individuals with a strong liver constitution and external contraction of wind-heat. The two yang factors combine, causing blurred vision, dizziness, a distended head, and even a sensation of falling, accompanied by chest discomfort, vomiting, a red tongue, and a floating pulse. Treatment should focus on dispelling wind and clearing heat. The formula used is Notopterygium Decoction (from Lanshi Micang) or

Saposhnikovia Sage-Inspired Powder (from "Xuanming Lun"). The pattern of dual exuberance of wind and heat is seen in wind-heat sores (pityriasis rosea), caused by wind-heat pathogens stagnating in the lungs and manifesting on the skin. Clinical manifestations include papules on the limbs and chest, cutaneous pruritus, and sores from prolonged scratching, sometimes with bleeding. Treatment should focus on clearing heat, dispersing wind, and stopping itching. The formula used is Wind-Dispersing Powder (from

Waike Zhengzong). The pattern of dual exuberance of wind and heat is seen in rashes, often caused by wind-heat pathogens stagnating in the lungs and closing the nutrient aspect, emerging from the blood vessels. Symptoms include small red spots on the skin resembling foxtail millet, palpable to the touch, with bright red or purplish-red color indicating intense heat, and purple-black indicating severe toxicity. Accompanied by fever, thirst, dysphoria, chest tightness, a red tongue with a thin yellow coating, and a thin, rapid pulse. Treatment should focus on ventilating the lungs, clearing the nutrient aspect, and promoting eruption. The formula used is Lonicera and Forsythia Powder (from

Wenbing Tiaobian) with added clearing nutrient aspect ingredients. The pattern of dual exuberance of wind and heat is seen in abscesses, caused by wind-heat pathogens clashing and manifesting on the skin. Symptoms include localized redness, swelling, heat, and pain with clear boundaries, easy resolution, easy closure, easy ulceration, and easy pus formation. Accompanied by fever, thirst, a yellow tongue coating, and a floating pulse, often occurring in the upper body. Treatment should focus on dispersing wind, clearing heat, invigorating blood, and resolving stasis. The formula used is Burdock Muscle-Relieving Decoction (from Yangke Xinde Ji). For those with exterior pattern, Schizonepeta and Saposhnikovia Toxin-Vanquishing Powder (from

Waike Lili) can be used. The pattern of dual exuberance of wind and heat is seen in boils and sores, often caused by improper diet and external contraction of wind-heat toxin. Symptoms initially resemble foxtail millet, with a hard and deep root, followed by intense redness, fever, severe pain, and increasing swelling. Pus discharge and root expulsion lead to healing. Treatment should focus on clearing heat and removing toxins. The formula used is Five-Ingredient Toxin-Eliminating Decoction (from

Yizong Jinjian). The pattern of dual exuberance of wind and heat is seen in ulcerative gingivitis, often occurring in individuals with pre-existing yangming heat. Yangming heat clashes with wind-heat pathogens, lodging in the gums. Initial symptoms include red, swollen, and painful gums, fever or alternating chills and fever, followed by gum erosion with bleeding, constipation, nausea, vomiting, a red tongue with a thin yellow coating. Treatment should focus on dispersing wind, clearing heat, and removing toxins. The formula used is Stomach-Clearing Powder (from {|141|}Lanshi Micang{|142|}) with added dispersing wind ingredients.

Wind-fire eye is caused by the upward attack of wind-heat congestion to the eyes, with symptoms including: red and painful eyes, photophobia, tearing, hot and astringent eyelids, and increased secretions. The treatment should focus on dispelling wind and clearing heat, using the formula Qu Feng San Re Yin Zi (Shenshi Yaohan).

Wind red sore (eyelid dermatitis) as described in "Shen's Book of Life Preservation": "Caused by the accumulation of wind-heat in the spleen, the two eyelids appear as if painted with vermilion and develop sores." The main manifestations are: redness, ulceration, and pain on the eyelids and eyelid margins, cutaneous pruritus, red tongue texture, and floating rapid pulse. Treatment should focus on dispelling wind and clearing heat, along with removing toxins. The formula used is Five-Exuviae Powder (Shiyi Dexiao Fang) or Modified Four Ingredients Decoction (Yizong Jinjian).

Pattern of dual exuberance of wind and heat is seen in children with palpitation due to fright, as recorded in Taiping Shenghui Fang: "Children with palpitation due to fright are caused by heart congestion and heat, which is invaded by wind evil, leading to frequent fright. If the fright does not cease, the palpitations will not stop." Treatment should focus on clearing heat and calming fright. The formula used is Cow-Bezoar Pill ("Hundred Questions on Infants and Children") with modifications or Redness-Removing Powder (Xiao'er Yaozheng Zhijue) with modifications.

Pattern of dual exuberance of wind and heat often occurs in individuals with a strong constitution and internal heat accumulation. It is common in young adults and children, as well as in those who smoke or drink alcohol. Its progression includes: first, heat predominance leading to blood movement; second, wind-heat easily causing convulsions, especially in children; third, heat damaging fluids, easily transforming into the pattern of yin deficiency and internal heat, commonly seen in ophthalmic diseases; and fourth, potentially transforming into the pattern of qi and yin deficiency, seen in patients with sores, ulcers, boils, and other surgical conditions.

bubble_chart Differentiation of Similar Patterns

1. Pattern of dual exuberance of wind and heat and pattern of wind and heat invading the upper: Both are caused by pathogenic wind-heat and may present with fever, thirst, a red tongue, and a floating and rapid pulse. However, due to the different locations affected by wind-heat, the main clinical symptoms differ. In the former, wind-heat is congested in the face and skin, leading to symptoms such as facial redness or the development of boils, sores, and skin eruptions. In the latter, wind-heat disturbs the upper regions, resulting in symptoms like headache and deafness. The former has a more severe heat-blocking tendency, while the latter primarily affects the upper body with milder symptoms, making them easy to differentiate.
2. Pattern of dual exuberance of wind and heat and pattern of congestion and exuberance of fire-heat and pathogenic toxin: Both involve pathogenic heat and may present with local skin redness, swelling, and eruptions, as well as signs of bleeding. However, the former involves wind pathogens, causing symptoms such as facial redness, skin boils, sores, cutaneous pruritus, or vertigo due to wind movement. The latter involves heat combined with toxins, with intense internal heat that easily leads to bleeding, resulting in prominent macules and papules. Internal heat symptoms are more severe, often including high fever, dysphoria, a deep red or wax-like tongue texture, and purplish-red rashes, making differentiation straightforward.

bubble_chart Documentation

Zhubing Yuanhou Lun‧Wind Disease Various Symptoms: "When a person's yang qi is deficient externally, there is profuse sweating. If sweating occurs in the wind, wind qi will strike the muscles, and when combined with heat qi, it will produce boils. These resemble hemp seeds or beans, and in severe cases, they swell and can be scratched into sores."