this is wind-heat or wind-dampness that invades the body and contends with preexisting damp-heat. it then becomes trapped between the flesh, skin, interstices and pores, and settles in the blood vessels. unable to drain internally or vent externally, it transforms into wind toxin. the presence of wind, the primary pathogenic influence, is reflected in the itchiness and the floating pulse.

bleeding that occurs after excoriation is called ‘seepage of blood pearls’ and is an indication of heat in the blood. this type of seepage is caused by damp-heat trapped between the flesh and the interstices and pores. the combination of heat in the blood and damp-heat gives rise to toxin.

the tongue coating varies according to the level of penetration of the heat: when the heat is superficial, the tongue coating will remain white; a slightly deeper level of penetration produces a yellow coating. the forceful, rapid pulse indicates internal heat and toxin. disorders of this nature, where the pathogenic influence is trapped between layers of the body, are often difficult to treat.