Warm evils are contracted from above: they first invade the Lung, and in adverse progression they sink into the Pericardium. The Lung governs qi and belongs to the protective (wei) layer; the Heart governs blood and belongs to the nutritive (ying) layer. Although differentiating ying, wei, qi, and xue parallels the layered approach of Cold Damage, the method of treatment stands in sharp contrast to that of Shang Han.
A patient presents with wind-warmth fever, cough and sore throat, malaise of the limbs, distending headache, and a floating-rapid pulse at the right cun position. This is wind-warmth striking from above, with the Lung failing to diffuse — the evil lodged in the Wei layer. Treatment calls for a light, cool-acrid formula: Sang Xing Tang with modifications, to gently disperse and vent the evil from the Lung-Wei.
脾胃案 · 中气不运
Spleen-Stomach Case: Failure of the Middle Qi to Transport
A patient with a slow, forceless pulse, no appetite, abdominal distension after eating, loose stools, a sallow-yellow complexion, and weariness of the limbs. This is Spleen vacuity: the middle qi fails to transport and the clear yang cannot rise. The method is sweet-warm tonification of qi; Bu Zhong Yi Qi Tang is the master formula.
肝风案 · 肝阳化风
Liver-Wind Case: Liver Yang Transforming into Wind
A patient suffers dizziness and blurred vision, numbness of the limbs, intermittent twitching, a crimson tongue with scanty fluids, and a wiry-thin rapid pulse. This is Water depleted and Wood flourishing: Liver yang has transformed into internal wind — not wind from without. The method is to soften the Liver and extinguish wind, nourish yin and subdue the floating yang. Dispersing wind-medicinals must never be casually prescribed.
A patient in autumn, dryness injuring the Lung: dry cough without phlegm, discomfort of the throat, dry nose and parched lips, a thin-rapid pulse at the right cun. This is dryness transforming into fire, scorching the Lung fluids. The method is cool-acrid and sweet-moistening — Sang Xing Tang supplemented with Sha Shen and Mai Dong.
✓Editor-reviewed· 2026-04-17
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Cite this entry
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@misc{bencaodian-lin-zheng-zhi-nan-yi-an,
author = {{Bencaodian Editorial}},
title = {Lín Zhèng Zhǐ Nán Yī Àn 临证指南医案 (Case Records as a Guide to Clinical Practice) — 叶天士},
year = {2026},
howpublished = {Bencao Dian: A Bilingual Knowledge Graph of Traditional Chinese Medicine},
url = {https://bencaodian.org/en/texts/lin-zheng-zhi-nan-yi-an},
urldate = {2026-04-17},
note = {CC BY-SA 4.0}
}