Zhong Feng/Shang Han
Wind Heat/Wind Cold
Shang Han Lun is based on the progression of disease. The Etiology is primary
focused on Wind Heat (Zhong Feng) and Wind Cold (Shang Han).
In this progression the body makes adjustments between Wei Qi & Ying Qi;
creating Dampness, Heat, & Dryness.
Damp Heat that has not been resolved is the underlying cause of Wind Heat
(WH) and Wind Cold (WC).
In order to properly diagnose WH & WC you must look at the body’s response
(symptoms) and determine which symptoms are perverse vs. upright.
Diagnosing and treating the origin of the pathology in its’ 1st stage will help
deter progression of the pathological factor (PF).
In an attempt to eradicate the PF the body will utilize the mobilization of Yang
Qi (DU 16 good pt. to access this) via Wei Qi which emerges at the Jing Well
pts.
If the PF is untreated or treated improperly it will move into Yin (beginning at
the Yang Ming stage) where it becomes stagnant and trapped, causing difficult
eradication. At the Yang Ming stage there is the same amount of Yang,
however, the Yang is not moving which causes stagnation.
<sidenote> At the Jue Yin level there is an abundance of saturated Yin
causing it to explode out resulting in Leakage
Tai Yang level of disease (Pulse: Exterior & Floating)
Wind = Change in one’s life
Air + Pressure
Qi + Pressure
Skin
Whenever the Air Pressure is higher than Qi Pressure inside the body the
barometric presser is changed. We attempt to use the mechanism of sweating
to correct exterior/interior AND Qi/Pressure imbalances. Sweat originates
from Yang Ming and is considered to be Turbid. If the body has an adequate
amount of Yang (Yuan Qi), the body will respond by the process of Tai
Yang/Yang Ming to reach homeostasis.
Wei Qi (LU/LV)  comes from spine & chest
Ying Qi (SP/ST/HT)
Yang Qi (KD)  Can be accessed via Yang organs, Du Mai, & Back Shu pts.
-1-
Wind
Stiffness at the region of the neck will prevent Wei Qi from moving to the
exterior for protection. This will also cause stiffness of the joints. A major pt.
for the articulation of Yang Qi in releasing this stiffness is Du 14. The neck is
a sensory portal. When the neck becomes stiff this indicates that some type of
sensory perception is activated telling the body that something is changing
either physically, emotionally, psychologically, or environmentally.
Wind can also cause headache (HA), neck pain, stiff limbs, Wu (aversion), Al
(severeness), muscle spasms, tremors, itch and chills. The body will generate a
response like fever (upright response) in addition to Heat or Cold symptoms.
Fever in turn will provoke body pressure to equalize via sweat.
Wei Qi is responsible for warming & controlling pores. It also goes to the
sinews. The body’s natural response to a PF could be inflammation (heat) in
the sinews causing swelling. This would be considered an upright response.
To make a proper diagnosis between Wind Heat and Wind Cold the following
signs & symptoms should be considered.
Wind Heat (Zhong/Feng)
Wind
Aversion to wind
** Fever (subjective not
necessarily temperature related)
* Chills
Pulse: Slow, Floating
Vs. Wind Cold (Shang/Han)
Cold constricts Qi
Aversion to cold
* Fever or no fever
** Severe chills
Physique (tired, heavy, pain, listless,
constriction)
Zong Qi (chest) will have to be utilized
to push Wei Qi out because the body
cannot access Wei Qi from Yang Qi
due to the cold
Vomit, retching, rebellious Qi
Pulse: Tight (can be felt at either
superficial or moderate level)
Zhong Feng Wind Heat
Wind
1)
2)
3)
4)
5)
Heat Tai Yang Treatment Plan:
Emit and scatter Wei Qi
Adjust Wei & Ying Qi
Adjust balance between Wei & Yang Qi
Address clumping factor in chest & abdomen
Add to protocol when you see complications
-2-
Complications
 Stiff Neck
 Pain in the 4 limbs
 Headache or heavy sensation in the head
 Dysurea
Zhong Feng (Wind Heat) Formula:
Gui Zhi Tang
Gui Zhi (Cinnamon Twigs) 3g.  Adjust balance b/ween Wei/Ying/Yuan
Bai Shao (White Peoni) 3g.  Adjust balance b/ween Wei/Ying/Yuan and
converts body fluids to Wei level
Gan Cao (Licurice) 3g.  Protects Shao Yang, relaxes chest, & drains HT Fire
Sheng Jiang (Fresh Ginger) 3g.  Harmonizes MJ & opens throat
Da Zao (Jujube) 12 pcs.  Hydrates body because you are losing BF via sweat
Decoction
- For every 30g. use 2 cups of H2O for every 90g. use 6 cups of H20
Dosage
7 cups
(1 cup 3 x day)
Instructions
 patient blankets themselves and sweats
 if patient does not sweat after they drink the 1st cup, drink another cup
after 2 hours rather than 8 hours
 2-3 days should be resolved
 no meat, noodles, alcohol, spices, fatty foods
 eat vegetable in soup and a minimal amount of fruit
 Rice Conji soup good to eat as it hydrates
 after drinking the 1st cup patient will most likely feel irritable & agitated
because qi is coming from a shaoyang level (zhong Qi). If this happens
you could use an even technique on GB 20 & DU 16
 after acupuncture treatment give the formula again
You want to release the neck, head, spine (Yang Du 14), harmonize chest &
abdomen.
<side note> the termination of the root energy of PF wind heat can
stagnate/clump Qi
Lingering of a PF is due to the clumping of qi (patient may feel much better but
continue to feel residual mild symptoms)
-3-
Pattern of Gui Zhi Tang:
 Aversion to wind (add Huang Qi, Bai Zhu, or Fang Feng (9g.)
 Can have aversion to cold (add Huang Qi, Bai Zhu, or Fang Feng (9g.)
 Can have fever
 Floating slow pulse
 Floating week pulse
 Can have dry retching
 Can have some type of nasal discharge
 Can be used for HA by adding Ma Huang (9g.) (decoct first with 7 cups
take out white foam, boil down to 5 cups). This indicates that cold is
now beginning to constrict and go inward in area of the head
 Can have tension in neck or upper back (add Ge Gen (24-28g.) reduce
Gan Cao to (14g.) decoct first with 9 cups of water, boil down to 7 cups,
take out white foam and add the other ingredients, cook down until get 3
cups
 Four limbs can be affected (add Fu Zi (9g.)
 Ascension of SP use Jie Gen to clear suspended phlegm
When you should STOP taking Gui Zhi Tang:
1) Pulse becomes week
2) Fever last longer than chills
3) Wheezing (exuberant yang qi has exceeded its limit & creates
leakage of KD qi)
4) Develops into Shanghan
At this point you need to adjust the balance between Wei & Ying Qi by adding
SJ 5 to the treatment plan and adjust the formula:
Gui Zhi Er Zhu Tang (Fever longer than chills + weekness)
Gui Zhi (9-12g.)
Bai Shao (9-12g.)
Gan Cao (9-12g.)
Jujube (4 pcs.)
Ma Haung (15g.) – Opens chest
Shi Gao (15g.) - Anchors
Ren Shen (15g.)
Decoct Ma Huang 1st in 5 cups of water, scrape foam, boil down to 3 cups, boil
down to 2 cups, take 1 cup 2 x day
Wheezing with little or no fever (interior heat causing wheezing)
Ma Huang (12 g.) – Stop wheezing
Xing Ren (50 pcs.)
Gan Cao (9-15g.)
Shi Gao (18g.)
-4-
7 cups boil down to 5 cups boil down to 2 cups, 1 cup 2 x day
<side note> Soft Pulse may indication leakage of KD Qi
** If still have symptoms after treatment this can indicate stagnation in the
Upper, Middle, or Lower Jiao  You need to support post-natal qi
(digestion) by adding to Gui Zhi Tang:
Bai Zhu (3g.) - replaces Gui Zhi
Fu Ling (3g.)
8 cups boil down to 3 cups, 1 cup 3 x day, patient should begin to urinate and
feel relief.
Tang Dynasty (added acupuncture prescriptions and standardized
protocol)
Yang can be reached via:
Jing Well pts. + Shu Stream (exterior)
Or Ying Spring pts. + He Sea (bowels & digestion)
Determine the propensity: Does patient have an adequate amount of Ying Qi
and Yuan Qi (Yang Qi)?
Determine the pulse: slow, tight, rapid, slippery
When PF is at the Tai Yang level you have to add something to protect Wei Qi &
Yin. Treat Tai Yang + protect Yang Ming. Treat Wei Qi + protect Shao Yang.
Add points that will protect Shao Yang & Yang Ming via Yuan Source pts.
Tai Yang
Mild – UB 67, UB 65
Severe – SI 1, SI 3 (lethargy, heaviness)
 Add SJ 4, GB 40 (protects Yang Qi)
 Add ST 42, LI 4 (protects Ying Qi)
 If clumping qi resulting in HA add UB 5
 Neck stiffness add UB 58
 Four Limbs affected add UB 57
 Aversion to Wind add UB 2, UB 9
 Aversion to Cold add UB 2, UB 9
 Sweat with no aversion add UB 66
 Lethargy add SI 8, SI 16
 Absence of Sweat add UB 67
 Irritability add SI 7, GB 30, DU 16
 Regulate LU Qi add LU 7
-5-
Four Limbs
When the 4 limbs are affected the Urinary Bladder and Bowels will often times
be affected as well causing urinary difficulty. This is because the 3 leg yang
sinew meridian leads to SI 18 and the 3 leg yin sinew meridian leads to Ren 3
(benefits the UB, intestines, and hemorrhoids). The 4 limbs also have to go
through the neck to get to the head resulting in stiff neck. The 3 arm yin sinew
meridian has to go through the chest causing irritability.
Pathological Factor
When the PF moves into Zong Qi the patient will have rebellious qi indicating
that the condition is becoming more severe (dry retching, vomiting, counter
flow)
During treatment there will be an increase in Yang Qi:
 Pulse will feel floating, full, strong, rapid
 More sweating will occur (can cause thirst, floating/thready pulse or
floating/week pulse). Once the patient begins to feel thirsty this will affect the
Shen due to body fluid deficiency; causing irritability. You then need to control
sweating and can use KD 7 (if you feel a pulse change), HT 6 (dehydration)
 Mild irritability
KD Qi will go up to support LU QI (via chest & diaphragm) (KD grasping LU Qi)
Relationship: Water (KD) supports  LV/GB  Commands LU
LV/GB + LU = responsible for Wei Qi
Wei Qi can be separated into two parts; (1) Ying Qi SP/ST (2) Yang Qi KD/LV
<side note> Jin Ye fluids affect blood
<side note> Add herbs (Rou Gui, Zhi Gan Cao) to nourish fluids, strengthen
KD, Calm Shen if the pulse is week, thready, choppy.
If the symptoms do not improve by the 3rd day either have wrong
diagnosis/treatment plan OR the patient has malaria (which can show the
same signs and symptoms)
Malaria
 Alternating chills & fever
 Little sweat
 No vomiting
 Little constipation
-6-

Still experience a lot of wind in the form of itching, hives, dermatologic
issues, spasms
Gui Zhi Ma Huang Ge Ban Tang (use heat to move heat)
Ma Huang 9g. (induces sweat)
Gui Zhi 9-12g.
Bai Shao 9-12g.
Gan Cao 9-12g.
Da Zao 4 pcs.
Sheng Jiang 9-12g.
Xing Ren 24 pcs. (opens chest, promote bowel movement, and induce sweat)
Pulse = floating, wiry (could be misconstrued as tight)
Determining Pulse
What is the status of exteriorization? Which direction is the floating pulse
moving toward? Is it directed toward the front/thenar eminence OR is it
moving toward the back/elbow
If the pulse is moving toward the elbow patient will experience low back pain,
stiffness, and the pulse will appear tight. Su Wen (cold) will get trapped in the
region of the sacrum at the baliao pts. UB 31,32,33,34 (disinhibits the Lower
Jiao). As the cold constricts itself into the sacrum it will have an impact on the
UB Shu pts. and Dampness will accumulate. The pathological fluids will affect
the body’s ability to stand upright (zhi yin), edema (yi yin), or phlegm fluids (tan
yin) will ensue. The patients ability to defecate & urinate my also be
diminished.
If the pulse is moving toward the thenar eminence dizziness, vertigo, tinnitus,
and convulsions may ensue.
<side note> If patient is experiencing Bi Syndrome STILL use Gui Zhi Tang
Slippery Pulse – As the body is trying to bring fluid from the ST up & out the
fluid will get stuck somewhere along the way causing a feeling of fullness &
oppression of the chest & epigastria. Slippery pulse is NOT always related to
phlegm or damp. In this instance a good formula to use would be Xiao Xian
Xion Tang (heavily opens the chest).
Tai Yin
When the Yang Qi is lacking (digestion poor & movement slow) Tai Yin disease
will commence. The patient needs to rest due to fatigue. They will display heat
signs & symptoms. Because Yang has been exhausted heat will go to the head
and will burn everything up, then the patient will feel cold again (UB Shu
stream pt. good for this).
-7-
Yin Treatment
Ying Qi - Irritability & thirst. Have to give White Tiger & Ginseng decoction
Bai Fu (18g.)
Ren Shen (18g.)
Shi Gao (30g.)
Zhi Ma (21g.)
With Amenorrhea add Geng Mi (6 cups), Gan Cao (12g.)
Complication
Pulse = Tight
PF will move deeper causing irritability, restlessness, insomnia, and body
aches. Their will be little sweating.
Fan Zao – Irritability & Restlessness key factors in differentiating diagnosis. If
patient feels these 2 symptoms give formula:
Major Blue Dragon (Da Qing Long Tang)
Gui Zhi (12g.)
Ma Huang (30g.)
Xing Ren (40 pcs.)
Shi Gao (30g.)
Shen Jiang (12g.)
Jujube (10 pcs.)
Boil Ma Huang first 7 cups of water, scrape foam, add other herbs, boil down to
3 cups. Patient will feel achy & sore because PF is attempting to eradicate from
body and the pulse should no longer feel tight.
Window of the Sky Points
Directly have an affect on sensory orifices. If the patient is having a problems
relating to eyes, ears, nose, mouth, this may be due to their unwillingness to
accept changes going on internally or externally.
Musculoskeletal alignment
1) Mastoid Process (atlas of skull)
2) Diaphragm
3) Abdominal rectus
4) Iliopsoas
5) Perivetebral muscles
You have to change muscles in order to change skeletal alignment. As you
move differently you begin to view the world differently (sensory motor track).
This will have an affect on the spine, hence, affecting the 4 limbs and head.
Releasing flesh is a way of releasing old bad habits/conditions.
-8-
Shang Han (Wind Cold)












Achy joints
Achy physique
Aversion to cold
Aversion to wind
Sever chills
Mild fever
Little or no sweat
Headache
Low back pain (some aspect of Yang Qi is constricted in Lumbar)
Potential Wheezing
Heaviness
Floating & tight pulse
Patient may have spontaneous sweating with mild chills. As Wei Qi is
surfacing to fight PF patient will feel less cold. Wind is Yang  yang moves wei
qi  wei qi induces sweating
Pulse may feel floating, tight, and slow
Because Yang Qi is going up & out there is not much Yang Qi left in the Lower
Jiao. This can cause Bi Syndrome, enuresis, poluyuria. As Yang Qi ascends it
will go through the chest affecting Zhong Qi, which creates irritability &
restlessness. The 4 limbs may spasm due to coldness (lack of Yang Qi) causing
constriction of the muscles.
If you use Gui Zhi Tang the patient will get constipated & develop dryness in
the throat, chest, Lower Jiao constipation, & rebellious Qi.
A better formula to use would be:
Gan Cao Gan Jiang Tang (Licorice & dried Ginger)
Gan Cao (15-21g.) – Tonify Qi, warm & strengthen ST
Gan Jiang (10g.) - Warms LU, disperses cold, warms & strengthen ST
3 cups boil down to 1 ½ cups, drink ¾ cup 2 x day. Stop taking the formula
once feet feel warm.
Use hot needles on Jing Well pts.
Improper Diagnosis
If you made an improper diagnosis and prescribed Gui Zhi Tang, patient can
also develop Shen disturbances, mania, delirium, etc. because Ying Qi & Yang
Qi are ascending.
-9-
To Resolve you can give the formula Tiao Wei Cheng Qi Tang:
Mang Xiao (6-9g.) – add last 10 minutes
Gan Cao (6-9g.)
Sheng Jiang (6-9g.)
This formula will harmonize the ST by purging. Boil 3 cups down to 1 cup.
If sweating becomes copious (I prefer the term drencherous myself) use
Si Ni Tang:
Fu Zi (9g.)
Gan Cao (9-12g.)
Shen Jiang (6-9g.)
How do you treat a Shang Han Tai Yang Condition (Wind Cold)?
Ma Huang Tang (3:2)
Ma Huang (15-18g.)
Gui Zhi (9-12g.)
Xing Ren (70 pcs.)
Gan Cao (9g.)
9 cups boil down to 7 cups, boil down to 2 ¼ cup, take ¾ cup 3 x day. Blanket
yourself to promote sweating
Ge Gen Tang (good for constricted neck & upper back due to cold)
Gui Zhi (9g.)
Shen Jiang (12g.)
Jujube (12 pcs.)
Ge Gen (18g.)
Ma Huang (12g.)
Decoct Ma Huang 1st by boiling 10 cups, boil down to 8 cups, boil down to 3
cups, take 1 cup 3 x day. Blanket to promote sweat
Shang Han constricts chest & prevents Qi from coming out which stagnates
fluids. A good formula for this would be:
Xiao Qing Long Tang (good for opening the chest when there is cold phlegm)
Gui Zhi
Bai Shao
Sheng Jiang
Gan Cao
Ma Huang
Ban Xia (if there is sticky phlegm)
Gan Jiang (if there is watery phlegm)
Xi Xin (if there is thin phlegm)
Wu Wei Zi
- 10 -
Da Qing Long Tang (good for Zong Qi where there is heat, irritability &
restlessness due to clumping of Qi)
Minor Xiao Xian Xiong Tang
Gua Lou – hot phlegm
Ban Xia – think phlegm
Huang Lian – damp heat
For abdomen fullness, borborygmus, bloating, distention add:
Xiao Cheng Qi Tang
Zhi Shi (15g.) – heat signs
Hou Po (9-15g.) – cold signs
Da Huang (6-9g.) – damp heat signs
Wrong Treatment!
If Pulse is floating & rapid
Patient is thirsty & sweaty
<side note>
Shang Han (hot, damp, cold)
Hot needle technique / Moxa can inadvertently cause palpitation & abdominal
distention
If there is sweating with no thirst due to the fact that the PF is trapped in the
LJ use Gui Zhi, Fu Ling, Zhu Ling, Ze Xie, Bai Zhu
Etiology


Stage


Progression

Zhong Feng
Tai Yang
Shang Han
Yang Ming
Pestilent
Shao Yang
Malaria  Creates pathology of heat & damp
Status of Ying Qi & Yang Qi
1. Tai Yang - Cold (Su Wen Zang), Yin Organs, Essences, Viral infection,
Goes to Organs
2. Yang Ming - Heat moves to bowels & sensory orifices (Jing Ye),
Fluids/Yin, Bacterial infection, curious organs
3. Shao Yang - Chest, neck, limbs, damp, Fungal infection
Progression of Pathological Factor
 skin  sinews  exocrine  pure  thin  thick  pure  Zang Fu 
turbid  curious organs  endocrine
- 11 -
When viral condition is kept under control the body has no energy to fight the
bacteria (Ying Qi xu) & fungus (Yang Qi xu), hence progression of the disease
(pleomorphism)
Tai Yang Condition have to SWEAT!
Sweating generated from the ST fluids goes up in the form of turbid aspect of
fluids and becomes sweat. CI – NOT allowed to sweat if pulse is frail, minute,
or soft. The transformation of fluid/blood becomes sweat which is why classics
say HT controls sweat via blood.
If patient partakes in fumization (i.e. sweat lodges, hot baths, hot showers,
steam rooms, sauna, Jacuzzi) in an attempt to sweat out the PF this may cause
more harm than good. Symptoms such as irritability, restlessness,
amenorrhea, and pain in the Lower Jiao can ensue because the body cannot
control the amount of sweat lost. In this instance you can prescribe Da Huang
& Tao Ren to clear the blood.
An alternative to sweating would be to release the exterior by stimulating Wei
Qi.
After the patient sweats they should experience slight thirst and the
appearance of a red face should go away when sweating subsides. Pulse will
then become slightly slow. After sweat add Ren Shen to Gui Zhi Tang to help
build the body back up.
Moving from Tai Yang to Shao Yin Disease
Patient with Tai Yang condition can quickly move into Shao Yang disease. As
ST releases fluids into the skin/sinews/blood vessels the flesh (controlled by
SP) is affected. When there is tightness & stiffness in the neck, the body has a
hard time generating fluids. As the body loses fluids, dry heat is created in the
ST resulting in nausea, dry retching, & vomiting. You need to harmonize the
SP & ST and nourish fluids by adding Ban Xia to Ge Gen Tang. If sweating
does not resolve the disease, Tai Yang can turn into Shao Yang which goes
internal, primarily affecting the chest first.
- 12 -
Combination Treatment
Disinhibit done by purging via sweat or urination
A rapid, irregular, hasty, pulse with chest fullness can occur if you improperly
treat Tai Yang disease. If this happens deduct Bai Shao from Gui Zhi Tang or
get Qi to descend back to chest by adding Ban Xia & Gua Lou minus Bai Shao
to Gui Zhi Tang.
When person purges improperly they will feel chest oppression & their Qi will
become blocked causing hasty fluids. The fluids will descend and will be felt
under the Zyphoid Process. If this happens add Magnolia bark (9-12g.) and 4
pcs of Zi Shi or Zhi Ke. 3 cups boil down to 1 ½ cups. As soon as the patient
vomits stop the treatment.
The digestive Qi can also be damaged resulting in undigested food. If this
happens prescribe
Si Ni Tang
Fu Zi (9g.)
Gan Cao (12g.)
Sheng Jiang (6-9g.)
Needle insertion can invite cold to come through the needle if the practitioner is
not in constant contact with the needle. If you take the needle out and the
patient has a welt, use a moxa cone & give Gui Zhi Tang. If you do not do this,
the patient will experience running piglet qi.
- 13 -
Summary
Tai Yang
 Floating Pulse
 Dampness and Heat
 Observe level of progression and adjust treatment plan as necessary
Wind
Or Wind Heat
Upper Chest
Cold
Or Wind Cold
Lower Chest
Abdomen
Gui Zhi Tang
Ma Huang Tang
Basic Formula but modified for both – Gui Zhi Tang
How to Differentiate between the two:
 Is pulse going toward the Thenar Eminence or toward the elbow?
 Is pulse becoming tight, slippery, rapid, or slow?
Where does
Pathological Factor
Terminate?




Head
Neck
Limbs
Chest
Does wind predominate over cold?
Xuan Yin (Suspended Fluid)
Tan Yin (Phlegm Fluid)
 Lumbar
Urinary Bladder
Disinhibit
Warm
 If patient’s symptoms increase in severity you have given an improper
treatment plan
 If patient’s symptoms affect HT blood use SI points
 When symptoms affect the HT this causes blood occlusion in the Lower Jiao,
if this occurs use PC points
- 14 -