Greater Yang Attack of Wind

Understanding Greater Yang Attack of Wind

The Shang Han Lun describes the early stage of a cold in two forms: attack of Cold, which closes the pores, and attack of Wind, which leaves them open. This page is the second: the surface is invaded but not locked.

The person sweats spontaneously rather than being unable to sweat, and is unusually sensitive to wind and draughts. There is fever, and often a mild headache and a stiff neck.

The tongue is normal in colour with a thin white coat and a slightly moist surface. The pulse is floating and moderate, also described as relaxed.

It comes from a Wind-Cold invasion with Wind predominance, weak defensive Qi, or incorrect treatment of an earlier condition.

Treatment is to harmonise the Ying and Wei rather than to force sweating. Because the pores are already open, strong sweating would worsen the picture.

Signs and symptoms

Key signs

• Spontaneous sweating
• Sensitivity to wind and draughts
• Fever
• Floating and moderate pulse

Also seen

• Mild headache
• Stiff neck and shoulders
• A stuffy nose
• Aversion to cold
• A mild sore throat
• Tiredness

Variations

• Sweating that is worse after drinking warm fluids
• A dry heave
• A mild cough

Timing

• It comes on within a day of exposure and resolves in a few days.
• The sweating and wind sensitivity are the defining features.

Practitioner notes

• The tongue is normal in colour with a thin white coat, slightly moist.
• The pulse is floating and moderate or relaxed, not tight. The absence of tightness is what distinguishes it from attack of Cold.
• The decisive contrast is sweating: spontaneous sweating here, absence of sweating in attack of Cold.
• Because the pores are open, strong diaphoretics are inappropriate; the treatment harmonises.

Causes

Common causes

• Wind-Cold invasion through the body's surface
• Constitutional weakness of defensive Qi
• Seasonal and environmental factors
• Wrong treatment of a prior condition

How it develops

• It is acute and usually self-limiting.
• If it is incorrectly treated with strong sweating, the surface weakens further.

Diagnosis

Diagnosis rests on spontaneous sweating with wind sensitivity and a floating relaxed pulse.

Tongue

• Body: Normal colour, slightly moist.
• Coating: Thin white.
• Note: A red dry tongue would suggest Wind-Heat.

Pulse

Floating, Moderate, Relaxed

Floating without tightness, which is the key difference from attack of Cold.

Observation

• Light sweating
• Warm clothing even in mild weather
• A slightly flushed face

Listening

• A slightly congested voice

Palpation

• Abdomen: Unremarkable.
• Channels: The skin is warm and damp; GB-20 and BL-13 may feel sensitive.

Questions that separate it from look-alikes

• Is there sweating without exertion?
• Does wind bother you more than usual?
• Is there fever, and are there chills?
• Did this start after cold or wind exposure?

Treatment

Principles

• Harmonise Ying and Wei
• Release the exterior without forcing sweating
• Warm the middle gently
• Avoid strong diaphoretics

Herbs

Formulas

• Gui Zhi Tang - The reference formula for this exact pattern: warming release balanced by astringing nourishment.
• Ge Gen Tang - For the same pattern with pronounced neck and shoulder stiffness.
• Gui Zhi Jia Hou Po Xing Zi Tang - For the same underlying pattern with cough and chest congestion.
• Fu Zi Tang - For the pattern with deeper coldness and cold limbs; requires professional prescribing.

Acupoints

• GB-20 (Fengchi) - The Wind point, used for wind sensitivity and headache.
• DU-16 (Fengfu) - The Wind mansion, used for Wind patterns at the surface.
• LU-7 (Lieque) - Releases the exterior and regulates the surface.
• LI-4 (Hegu) - Used with LU-7 to release the exterior.
• BL-13 (Feishu) - The Lung back-shu point, used for surface patterns affecting the Lungs.

Personalising the plan

• If sweating is marked, the astringing component is increased.
• If neck stiffness dominates, Ge Gen is increased.
• If cough is present, Lung herbs are added.
• If coldness is deep, warming is increased under supervision.

Self-care

Diet

• Warm fluids: congee, ginger tea, light broth
• Avoid cold and raw food
• Light meals

Lifestyle

• Wrap up warmly and avoid draughts
• Rest in a warm room
• Avoid strenuous exertion and strong sweating
• Dry off promptly after any sweating

Qigong and movement

• Not during the acute phase; rest is the treatment.

How it differs from look-alikes

Patterns that can be mistaken for greater yang attack of wind, and the contrast that separates them.

Where it appears

Skin conditions in which this pattern is commonly seen.

Safety and when to get help

For anything severe, sudden or spreading quickly, read when a skin problem needs urgent care.

This page describes a TCM pattern, not a diagnosis, and a pattern can accompany more than one skin condition. Get urgent medical help for a rash with fever, confusion or feeling very unwell; skin that is blistering, peeling or spreading quickly; swelling of the face, lips or throat, or difficulty breathing; or a lesion with increasing pain, warmth, red streaks or pus. For anything persistent, severe or changing, have it assessed by a clinician before treating it yourself.

Read the skin condition pages for the red flags that belong to a specific presentation.

Urgent-sign guidance is based on standard sources: NHS anaphylaxis, NHS cellulitis, NHS Stevens-Johnson syndrome, NHS melanoma.

Evidence note

No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.

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