Afraid of Wind and Cold, Sweating Profusely, and Joint Pain?

Let’s set the scene: an ancient imperial examination hall. Candidates who have studied for ten years are about to stake their futures on one single exam. And at this critical moment, one of them falls ill — in a way that makes everyone sweat with worry: fever, headache, vomiting, and worst of all, sweating profusely, sweat pouring off him as if he had just stepped out of a bath — soaked through, for days on end.

💬 Note from Doctor Luo: In this lecture we continue the stories of Doctor Xu Shuwei (许叔微), the great Northern–Southern Song formula master who treated patients with the classical prescriptions of the Shang Han Lun (Treatise on Cold Damage). Our hero here was so sick, with the exam only days away — what could be done? Today’s story starts with a condition called loufeng (漏风, “wind-leakage”). Don’t underestimate it — many people’s everyday complaints are hidden inside these few words.

Who was the patient? Peng Zijing of Jianyang, desperate for “Brother Xu” to save him

The patient was Peng Zijing, from Jianyang — a man from the Fujian region. He and Doctor Xu Shuwei were fellow candidates at the same examination. It was the autumn of the guimao year, the ninth month, and both were sitting the exam in Huainan.

With the exam only days away, Peng Zijing was frantic. He went to Doctor Xu Shuwei and said: “Brother Xu, the exam is right in front of me, but my illness is so severe — what am I to do? This year I’m probably going to fail again…” Doctor Xu Shuwei looked him over and said: “Xing wu you — have no worries. There is nothing to be anxious about. You have taken the wrong medicine! In this pattern, we must first stop the sweating.”

💬 Note from Doctor Luo: Doctor Xu Shuwei basically spent his whole life taking examinations — studying medicine and sitting the imperial exams at the same time. Legend has it that he dreamed a deity told him: “Your merit is insufficient, so you cannot pass. Give out free medicine and treat people free of charge; once your merit is full, fortune will follow.” Doctor Xu Shuwei truly did treat patients for free along the way, and when his merit was full he finally passed, becoming known as “Scholar Xu” — and he even had several sons. Of course, these are legends; I think he simply had a noble character.

Three doses later: the sweating stopped, the body cooled, and in five days he was well

What formula did Doctor Xu Shuwei give? Baizhu Fuzi Tang (白术附子汤, Atractylodes and Aconite Decoction) — the Shang Han Lun formula Guizhi Fuzi Tang Qu Gui Jia Baizhu Tang (Cinnamon Twig and Aconite Decoction minus Cinnamon Twig plus Atractylodes). Peng Zijing took it: after three doses the sweating stopped. The next day he sweated much less, his body cooled down, and his temperature returned to normal; within five days, the illness was completely cured.

💬 Note from Doctor Luo: You might think Doctor Xu Shuwei’s cases all seem too simple — not dramatic like later medical records. That’s because before him, there were almost no case records of treating patients with the Shang Han Lun. Doctor Xu Shuwei was the founder of classical-formula (jingfang) case records. His school’s hallmark was pattern-formula correspondence (fang zheng dui ying): match the symptoms Zhang Zhongjing described with the symptoms in front of you, prescribe directly, and if the diagnosis is accurate, it works quickly. So don’t let the simplicity fool you — this case is enormously significant.

What is loufeng (wind-leakage sweating)? And why does the sweat pour out?

The disease is called loufeng (漏风, “wind-leakage”), and in ancient times it was also called jiu feng (酒风, “wine wind”). How does it arise? The ancients said: after drinking wine, the pores open wide and qi and blood move differently than usual. If a person with insufficient upright qi is then blown by wind, the wind enters, and the nutritive and defensive qi (ying-wei) lose their orderly circulation — illness follows.

What are the symptoms of loufeng? Fear of wind, fear of cold, and heavy sweating — with one distinctive trait: sweat pours down like water when eating, as if leaking. Such people are usually very weak: tired at the slightest exertion, with scanty urine, sometimes body aches and joint pain. Many rheumatism patients today share exactly the same mechanism.

💬 Note from Doctor Luo: The root cause of loufeng is insufficient upright qi and spleen-kidney yang deficiency! The external invasion is only the trigger; the root lies inside the body. Inside, the body is in a deficient, cold state, with dampness present; yang qi is weak and cannot govern water-dampness, so water runs off in every direction — some leaves as sweat, pouring out in streams; some causes urinary problems. That’s why it’s called “leakage” — the fluids leak away.

Breaking down Baizhu Fuzi Tang: an extremely simple formula from Zhang Zhongjing

Where does Baizhu Fuzi Tang come from? It’s quite interesting: take Guizhi Tang (Cinnamon Twig Decoction) — gui zhi (cinnamon twig), shao yao (peony), gan cao (licorice), sheng jiang (fresh ginger), da zao (jujube) — remove the cinnamon twig and the peony, and add bai zhu (atractylodes) and fu zi (aconite). What did Zhang Zhongjing use it for? Wind-damp disease of the cold-damp type. The Shang Han Lun says: “Nine days after cold damage, wind and dampness clash with each other; the body aches with vexation, and one cannot turn over” — painful and restless, unable to turn in bed, as if cold-dampness had occupied the joints. If the stool is hard and urination is free, use the Guizhi Fuzi Tang minus Gui plus Baizhu formula.

How does the formula work?

💬 Note from Doctor Luo: Fu zi (aconite) warms yang and warms kidney yang, rallying the body’s yang energy; bai zhu (atractylodes) strengthens the spleen and resolves dampness, opening the channels; honey-fried licorice, fresh ginger, and jujube harmonize the spleen and stomach, tonifying the middle burner so that qi and blood begin to circulate again. Just these few herbs — simple, isn’t it? Although this formula is simple, it is the ancestor of all formulas for joint pain and obstructed qi-blood circulation caused by cold-dampness. Many modern approaches to rheumatism and rheumatoid arthritis trace straight back to it: one path is warming yang, one path is resolving dampness — just those two roads!

How to use it today: warm yang and resolve dampness — same strategy, more herbs

Where do modern treatments for rheumatism and rheumatoid arthritis come from? From right here. Doctor Luo Dalun explains the additions:

• Warm yang: fu zi (aconite) as the base, paired with gan jiang (dried ginger), xi xin (asarum), gui zhi (cinnamon twig) and similar;
• Resolve dampness: bai zhu (atractylodes) strengthens the spleen and dries dampness; add fu ling (poria), zhu ling (polyporus), dong gua pi (winter melon peel) to drain dampness downward;
• Dispel wind: add qiang huo (notopterygium), du huo (angelica pubescens), bai zhi (angelica dahurica), hai feng teng (kadsura stem), qing feng teng (sinomenium) to disperse wind and dry dampness;
• Invigorate blood and open channels: add ji xue teng (caulis spatholobi);
• Tonify qi: add huang qi (astragalus), dang shen (codonopsis).

💬 Note from Doctor Luo: Look at the whole formula — it never leaves the road map Zhang Zhongjing gave us: warm yang, strengthen the spleen, resolve dampness, plus a little wind-dispersing, blood-invigorating, qi-tonifying. Zhang Zhongjing opened the path; today, when treating cold-type arthritis and wind-damp bi syndromes, we still walk it. That’s what makes classical formulas so remarkable! One reminder: rheumatism and rheumatoid arthritis are two different diseases — in a hospital you’d check rheumatoid factor and so on. But from the TCM viewpoint, if the condition was caused by cold and the pain flares up with cold, this is the strategy.

Companion case 1: Doctor Liu Duzhou treats wei syndrome — sudden weakness in the left foot

Doctor Liu Duzhou was a great Shang Han scholar at Beijing University of Chinese Medicine. A patient, Mr. Cao, male, 37, from Beijing, came for treatment on June 24, 1989. Because of his work he was constantly in contact with cold water — fishing and similar work, always having to go into the water. As a result, his left foot became extremely weak — he couldn’t bend it, his toes had no strength, and walking was difficult, for a week already. There was no pain, no numbness, no visible muscle atrophy — just cold lower limbs, clear copious urine, and a limp, weak left foot.

Doctor Liu Duzhou looked: the tongue coating was thick and white and greasy — indicating heavy dampness in the body; the pulse was deep (chen) — deep pulse means cold. This was cold-dampness attacking, injuring the sinews and vessels, with yang qi losing its warming function. The treatment was to warm yang and eliminate dampness, using Guizhi Baizhu Fuzi Tang (keeping the cinnamon twig — Doctor Luo says keeping the cinnamon twig works even better), taken internally, while a decoction of chuan shan jia (pangolin scales), ai ye (mugwort), qian nian jian (homalomena), su mu (sappan wood), gui zhi (cinnamon twig), chuan xiong (ligusticum) was used to steam and soak the injured foot.

💬 Note from Doctor Luo: At the second visit, the patient felt pain in the left ankle and could lift the foot higher — this meant yang qi was returning; the warming had worked! So they strengthened sinews and bones and guided the medicine downward, adding mu gua (papaya) and niu xi (achyranthes). At the third visit, the foot was stronger, could flex and extend freely, and the toes could curl upward — only walking still felt weak. They switched to adding dang gui (angelica), du zhong (eucommia), xu duan (dipsacus), and after thirty-odd doses the illness was completely cured. Notice: this wasn’t arthritis — it was wei syndrome (atrophy-flaccidity) — a disease of limb weakness. Its cause was the same: cold invasion, insufficient yang qi, cold-dampness clinging to the channels and muscles. The same formula cured it!

Companion case 2: Doctor Liu Duzhou treats dizziness — spleen-kidney yang deficiency with turbid yin rising upward

Doctor Liu Duzhou also left a dizziness case: Ms. Zhao, female, 44, a factory worker, who came on November 5, 2001. She had been dizzy for a year — so severely that she couldn’t go to work. Multiple hospitals ran EEGs and all kinds of CT scans and found no organic lesion; Western drugs did nothing. Her complexion was dull yellow-white, appetite was very poor, stools were loose, she was exhausted, with sore weak lower back and knees, and fear of cold — pale tongue, thin white coating, deep weak pulse.

💬 Note from Doctor Luo: What was this? Yang qi insufficiency — spleen-kidney yang deficiency! The spleen loses its transport; water-dampness can’t be moved and transformed; as a result turbid yin rises upward and clear yang fails to ascend. Clear qi should rise and turbid qi descend; here it was all reversed — turbid qi on top — hence dizziness. The treatment was to warm spleen yang and warm the kidneys, using again Baizhu Fuzi Tang with modifications: bai zhu 12 g, fu zi 10 g, fu ling 15 g, hou po 10 g, jiao shan zha (charred hawthorn) 15 g, bu gu zhi (psoralea) 15 g, plus honey-fried licorice, fresh ginger, and jujube. After 10 doses the dizziness lessened, the appetite improved, the stools formed, and the fear of cold resolved; after another 10 doses, all symptoms disappeared.

Bonus story 1: Doctor Ye Tianshi treats “especially cold lower body”

The great Qing dynasty physician Doctor Ye Tianshi also used this formula. Someone’s lower body — especially the legs — was extraordinarily afraid of cold. Doctor Ye Tianshi diagnosed yang qi (defensive yang) too weak and used Baizhu Fuzi Tang plus huang qi (astragalus): huang qi, fu zi, bai zhu, honey-fried licorice, fresh ginger, jujube — and it worked.

Bonus story 2: a strange case that startled even the physicians — “shrinking yang” (suo yang)

While reading medical books, Doctor Luo Dalun came across a bizarre case from the records of Mr. Sun Fuquan: one deep night in the winter of 1972, a family came knocking urgently — the director of a factory, Director Liu, was ill and needed help. Mr. Sun threw on his coat and hurried over to find Director Liu in unbearable abdominal pain, crying out without stop — and the problem was a little embarrassing: his penis and scrotum were drawing inward, contracting.

💬 Note from Doctor Luo: This truly is a strange condition! Mr. Sun Fuquan reasoned it was probably cold contracted after intercourse. He hurried home, fetched two moxa rolls, lit them, and fumigated the patient’s lower abdomen with both at once. After an hour, the abdominal pain eased and the shouting stopped, but the penis and scrotum had not yet fully returned to normal. Questioning in detail at dawn revealed: the patient had previously suffered abdominal distension and diarrhea every morning (wugeng xie — “fifth-watch diarrhea” with loose stools); recently, after taking Western anti-diarrheal medicine, he had become constipated. See — that’s yang deficiency! So following the Shang Han Lun’s principle — “body aches with vexation, cannot turn over, hard stools with free urination: use the Guizhi Fuzi Tang minus Gui plus Baizhu formula” — he prescribed: fu zi 6 g, bai zhu 9 g, sheng jiang 9 g, honey-fried licorice 6 g, da zao 10 pieces, three doses, as a decoction. He also had the patient get moxa rolls from the health clinic and fumigate the lower abdomen three times a day, half an hour each time. After three doses, the abdominal pain was gone, the penis and scrotum returned to normal, and function was normal too, with one bowel movement per day; only the fifth-watch diarrhea remained, so he finished with Si Shen Wan (Four Spirits Pill) for the aftercare.

This “shrinking yang” is a disease name unique to ancient China: after cold exposure, the lower abdominal muscles cramp and draw inward. It occurs in both men and women; the root cause is cold. It may look bizarre, but grasp yin and yang, grasp cold and heat — for a cold pattern, give it warmth — and it can be corrected.

Closing words: profuse sweating — when must you be especially careful?

Finally, Doctor Luo Dalun offers a special reminder: many people sweat in streams while eating, or sweat weakly during the day. This is a sign of spleen deficiency and spleen-kidney yang deficiency. Warm yang, strengthen the spleen, and tonify qi slowly; hold the sweat in, and let the fluids return to their normal track. For example, many diabetes patients — the disease sits in the spleen — may well have spleen-kidney yang deficiency at the root.

But there is one situation that demands extreme caution: in the late stage of illness, when yang qi is very weak — the person breaks out in cold sweat, with a pale face and a very weak body, sweating profusely. At this point the sweating also drains the qi away; it can be a dangerous sign, and you must warm yang and secure the exterior immediately — this can even be a life-saving measure!

💬 Note from Doctor Luo: When we study the Shang Han Lun, we study its thinking. Zhang Zhongjing’s formulas are like lighthouse beacons, like a compass — symptoms are countless, but as long as your direction is right — grasp yin and yang, grasp cold and heat; tonify qi when it’s deficient, nourish blood when it’s depleted — the body will always move back toward normal. That is why classical formulas, circulating for a thousand years, remain extraordinary.

What to take away: profuse sweating with fear of wind and cold, sweating that pours down even while eating, easy fatigue, and joint pain often point to spleen-kidney yang deficiency with dampness inside — the loufeng (wind-leakage) pattern. Doctor Xu Shuwei’s simple Baizhu Fuzi Tang — atractylodes and aconite with licorice, ginger and jujube — is the ancestor of the warming-yang-plus-resolving-dampness approach that still underlies modern treatment of cold-type arthritis. And remember the warning: when a very weak person sweats cold profusely with a pale face, that is not the time to relax — it calls for immediate warming of yang and securing of the exterior.

Compiled from Doctor Luo Dalun’s commentary on Doctor Xu Shuwei’s case; the case comes from the Shang Han Jiu Shi Lun (《伤寒九十论》).