Chinese medicine believes that wind-dampness heat belongs to the categories of "Bi disease" and "heart impediment." Due to the weakness of the body's healthy qi and the emptiness of the striae and interstice, the defensive yang is not firm. Additionally, factors such as overstrain from hunger and fullness, exposure to rain, or prolonged residence in damp places allow the pathogenic factors of wind-cold and dampness-heat to take advantage of the deficiency and invade. From the exterior to the interior, from qi to blood, over time the pathogenic factors move from the meridians to the zang-fu organs, causing the qi and blood to become blocked and stagnant. When the disease is in the muscles and sinews, subcutaneous nodules may appear; when it invades the joints and meridians, joint swelling and pain may be seen; when heat enters the nutrient-blood, skin erythema may occur; and when it affects the heart, it can lead to "heart impediment."

bubble_chart Modern Research

Wind-dampness heat is an acute or chronic systemic connective tissue inflammation caused by infection-induced allergic reactions. Clinically, it is characterized by manifestations such as carditis, arthritis, and skin damage. Depending on the condition, it can generally be divided into acute and chronic stages.

Modern medicine believes that this disease is related to allergic reactions caused by group A beta-hemolytic streptococcus or Coxsackie virus infection. The pathological changes of wind-dampness heat are connective tissue inflammation, mainly affecting the heart valve membrane, myocardial interstitial small stirred pulse, and serous membrane cavity. The pathological process includes the exudative deformation stage, proliferative stage, and scar stage. In the serous membrane cavity, exudation is predominant, and the exudate can often be completely absorbed. Repeated episodes of wind-dampness heat can lead to an increase in heart valve membrane scars, resulting in chronic heart valve disease.

Medical history: A history of acute tonsillitis or pharyngitis 1 to 4 weeks before the onset of the disease.

Symptoms: Sudden onset, fever, profuse sweating, fatigue, and anorexia. Children may experience epistaxis and abdominal pain. Severe cases may present with myocarditis, endocarditis, pericarditis, arthritis, and various types of skin damage.

Laboratory and other examinations:

1. Blood tests: Anti-streptolysin O titer greater than 500 units; increased erythrocyte sedimentation rate; serum mucoprotein greater than 4 mg/dl.
2. Electrocardiogram: Shows tachycardia; prolonged P-R interval.

bubble_chart Pattern Analysis

1. Cold-dampness Obstructing Collaterals︰Joint soreness without redness or swelling, aggravated by cold and alleviated by warmth, absence of fever, aversion to cold, or mild fever, shortness of breath, lack of strength, palpitation, severe palpitation. Pale red tongue with thin white coating, deep and thready pulse or wiry, thready, and tight pulse. Dissipating cold and eliminating dampness, dredging collaterals and relieving pain, modified Juanbi Decoction: Notopterygium 12g, Pubescent Angelica 12g, Saposhnikovia Root 10g, Chinese Angelica 12g, Cinnamon Twig 10g, Mulberry Twig 30g, Sichuan Lovage Rhizome 10g, Gentian 15g, Kadsura Pepper Stem 12g. For severe cold and intense pain, add prepared Aconite Mother Root 10g (to be decocted first) and prepared Kusnezoff Monkshood Root 10g (to be decocted first). For pronounced palpitation and severe palpitation, add Salvia 12g, Poria with Pine 15g, Milkwort Root 12g, and Magnetite 30g (to be decocted first).
2. Dampness-heat︰Swollen and painful joints, heavy headache, chest tightness, gastric stuffiness, poor appetite, thirst and dysphoria, fever with profuse sweating. The tongue is red with yellow greasy coating, and the pulse is soggy and rapid. Treatment involves clearing heat and draining dampness, dredging collaterals and relieving pain. Modified Atractylodes Rhizome and Gypsum Decoction: Raw Gypsum 30-50g (to be decocted first), Anemarrhena 15g, Coix Seed 30g, Atractylodes Rhizome 20g, Fourstamen Stephania Root 10g, Phellodendron Bark 12g, Hypoglaucous Yam 15g, Gentian 15g, Poria 15g, Honeysuckle Stem 12g, Gardenia 10g. For significant swelling and pain in upper limb joints, add Turmeric 12g and Chinese Clematis Root 15g; for significant swelling and pain in lower limb joints, add Cyathula Root 15g and Earthworm 12g; if dampness is more severe than heat, add Akebia Stem 12g, Alisma 10g, and Patchouli 12g.
3. Exuberance of Heat Toxin︰Joint pain with localized burning sensation, swelling, and pain that is unbearable to touch, limited mobility, may affect one or multiple joints, accompanied by fever, profuse sweating, thirst with a preference for cold drinks, dysphoria, restlessness, and dark urine. The tongue is red with a yellow and rough coating, and the pulse is surging and rapid. Treatment involves clearing heat and removing toxins, dredging collaterals, and relieving pain. Modified White Tiger Decoction is used: Gypsum Fibrosum 30–60g (to be decocted first), Anemarrhena Rhizoma 15g, Phellodendron Bark 10g, Scutellaria Baicalensis 10g, Gardenia Fruit 10g, Lonicera Stem 30g, Mulberry Twig 30g, Heteropanax Fragrans 30g, Moutan Bark 10g, Red Peony Root 10g, Liquorice Root 5g. If there is heat accumulation in the large intestine with constipation for several days, consider adding Raw Rhubarb Rhizome 15–30g (steeped in tea and taken separately), Magnolia Bark 15g, and Bitter Orange 10g. If heat toxins are congested, causing red, swollen, and painful joints, add Tokyo Violet Herb 12g and Hedyotis Diffusa 15g.
4. Deficiency of Both Qi and Yin︰Late-stage fever [third stage], lingering low-grade fever, subsiding joint redness and swelling, reduced or relieved pain, mental fatigue, spontaneous sweating and night sweats, shortness of qi and reluctance to speak, dry mouth and throat. The tongue appears red with thin or no coating, and the pulse is thin, rapid, and weak. Treatment involves tonifying qi, nourishing yin, and harmonizing the collaterals to relieve obstruction. Modified Pulse-Reinforcing Powder combined with Tao Hong Yin: American ginseng 10g (simmered separately and taken together), heterophylly falsestarwort root 12g, coastal glehnia root 15g, ophiopogon tuber 15g, schisandra fruit 10g, carthamus 15g, Chinese angelica 12g, Sichuan lovage rhizome 10g, suberect spatholobus stem 12g, black-tail snake 10g, earthworm 10g. If accompanied by palpitations, severe palpitations, weakness, and shortness of breath that worsens with activity, add astragalus root 20g, tangshen 15g, roasted milkwort root 10g, and sour jujube 15g. If there is soreness and weakness in the waist and knees, vexing heat in the chest, palms, and soles, night sweats, and a completely peeled tongue with no coating, add prepared rehmannia root 20g, anemarrhena 15g, and Asiatic cornelian cherry fruit 20g.
5. Liver and Kidney Deficiency︰Persistent joint pain, weakness in the hands and feet, limited mobility, soreness in the lower back and legs, stiffness in joint flexion and extension, especially severe in the morning. Pale tongue with thin coating, deep, thin, and weak pulse or intermittent pulse. Tonify the liver and kidneys, strengthening sinews and invigorating bones. Modified Sanbi Decoction. Astragalus Root 20g, Tangshen 15g, Chinese Angelica 15g, Sichuan Lovage Rhizome 10g, Eucommia Bark 20g, Dipsacus Root 20g, Notopterygium 10g, Pubescent Angelica 10g, Prepared Rehmannia Root 15g, Achyranthes Root 20g, Gentian 15g, Barbary Wolfberry Fruit 10g, Liquorice Root 5g. For obvious signs of deficiency-cold, add Deer Horn 10g, Desertliving Cistanche 10g, Epimedium Herb 15g, Prepared Aconite Lateral Root 10g (to be decocted first). If joint swelling, deformity, stubborn pain, or limited mobility is present, or if phlegm signs appear, add Black-Tail Snake 15g, Scorpion 10g, Little Multibanded Krait 15g, Earthworm 12g.