Introduction

The study of Tai Yang patterns is the gateway to understanding externally contracted disease in the classical tradition. It is here, at the surface of the body, that the first encounter between the human organism and the Six Climatic Influences takes place. Tai Yang governs the exterior, yet it is not merely a superficial layer, it represents the opening and mobilization of all Yang in the body, linking the Bladder and Small Intestine channels with the deeper currents of Shao Yin.

In The Yellow Emperor’s Classic we are told that over Tai Yang, coldness qi rules. In the Shang Han Lun we are shown how this principle manifests clinically as wind strike, wind cold, warm disease, and their many transformations. What appears at first to be a simple fever and chill contains within it the dynamic interplay of opening and closing, deficiency and excess, root and manifestation.

This text explores Tai Yang not as a rigid category, but as a living conformation. From floating pulse and aversion to wind, to combined and transmuted patterns, to the subtle interplay between Tai Yang and Shao Yin, we trace how the surface reflects the condition of the interior. The formulas and herbs presented here are not merely prescriptions, but expressions of Conformational strategy, ways of restoring the pivot, supporting Yang, nourishing Yin, and harmonizing the movement between inside and out.

To understand Tai Yang is to understand beginnings - the beginning of disease, the beginning of treatment, and the beginning of transformation.

Tai yang signs

Of the Six Climatic Influences, wind and cold have caused a drying and congestion of the Small Intestine and Bladder channels. Remember that Tai yang represents all the Yang of the body, on the exterior and interior.

Floating pulse

A floating pulse is felt with slight pressure. It indicates the pattern is on the surface and that Yang qi has become weak. Remember, Weak yang floats, and the pulse goes where the disease is.

Stiffness and pain in the head and neck

The Tai yang Bladder and Small Intestine, and the Shao yang Gall Bladder channel run over the head and neck and down to the feet or hands. In a Tai yang pattern these channels become congested due to the accumulation of cold and dampness, giving rise to stiffness and pain in the head and neck.

Aversion to cold or wind

When Yang qi fails to warm the body there arises a feeling of cold or chills. The sick person wants to avoid drafts and cold places. Both aversion to wind and cold can be present in both Tai yang wind cold and Tai yang wind strike patterns.

In the following line from the Shang Han Lun we see that aversion to wind is present in a Tai yang wind cold pattern.

Line 35 When in tai yang disease there is headache, heat effusion, generalized pain, lumbar pain, joint pain, aversion to wind, absence of sweating, and panting, ma huang tang governs.

Heat effusion

Heat effusion can be a feeling of heat or a real rise in body temperature. In Tai yang wind cold patterns heat can arise because the surface is closed and heat cannot escape. In Tai yang wind strike heat can arise because the loss of fluids causes Yang qi to float up and out.

Sweating

In Tai yang wind cold pattern the surface is closed due to the accumulation of cold. This accumulation closes the surface so there is no sweating. In Tai yang wind strike there is alternating sweating and chills. The loss of Yang gives rise to a loss of function of the pores of the skin. The lungs lose the control over the pores and sweating follows. There is also a combination pattern of Tai yang wind cold and wind strike, which is a half open and half closed surface pattern. Parts of the surface are closed, with no sweating, and parts of the surface are open, with sweating.

Basic Patterns

Wind strike

Heat effusion, aversion to wind and cold, spontaneous sweating, pulse is floating and moderate.

Wind cold

Heat effusion, aversion to cold and wind, absence of sweating, pulse is floating and tight.

Warm disease

Heat effusion, thirst and absence of aversion to cold, pulse is floating and rapid. This is a transmuted disease. The disease started out on the surface and dries fluids which in turn causes a loss of function and excessive sweating. This loss of fluids gives rise to heat which starts to progress to the Yang ming and Tai yin levels.

Primary Formulas

Wind strike use gui zhi tang

Wind cold use ma huang tang

Warm disease use chai hu gui zhi tang, ma huang sheng ma tang

Combined Patterns of Wind Strike and Wind Cold

Ge gen tang, gui zhi ma huang ge ban tang, gui zhi jia yue bi tang

Transmuted Patterns

Heat Patterns

Heat in the chest and upper abdomen causing vexation

With inability to sleep, zhi zi chi tang

With qi deficiency, zhi zi gan cao tang

With retching and vomiting, zhi zi sheng jiang chi tang

With abdominal fullness, zhi zi hou po tang

With loss of appetite, zhi zi gan jiang tang

Heat congesting the lungs with counter flow qi, ma huang xing ren gan cao shi gao tang

Entering Yang ming with heat effusion, diarrhea, sweating and panting, ge gen huang qin huang lian tang

Entering Yang ming with damage to Qi and Yin, heat effusion, excessive sweating, bai hu jia ren shen tang

Entering Shao yang and Yang ming with diarrhea, huang qin tang

Entering Shao yang and Yang ming with vomiting, huang qin jia ban xia sheng jiang tang

Cold Patterns

Heart Yang

Heart Yang deficiency with palpitations, gui zhi gan cao tang

Heart Yang and Yin deficiency with vexation, gui zhi gan cao long gu muli tang

Heart Yang and Yin deficiency with fear and fright, gui zhi qu shao yao jia shu qi muli long gu jiu ni tang

Heart Yang deficiency with counter flow of Yang qi and water, gui zhi jia gui tang

Yang deficiency with Water Qi

Heart Yang deficiency with water accumulation in the lower burner, fu ling gui zhi gan cao da zao tang

Yang deficiency with Tai yin failure to transform water, fu ling gu zhi bai zhu gan cao tang

Yang deficiency with water accumulation, gui zhi qu gui jia fu ling bai zhu tang 

Tai yin Spleen deficiency

Spleen deficiency with qi stagnation, hou po sheng jiang ban xia gan cao ren shen tang

Cold center with Qi and Blood deficiency, xiao jian zhong tang

Tai yang and Tai yin deficiency, gui zhi ren shen tang 

Shao yin deficiency

Internal cold and Yang floating with vexation during the day, gan jiang fu zi tang

Internal cold and Yang deficiency, fu ling si ni tang

Internal cold with water accumulation, zhen wu tang

Dual deficiency Yang and Yin

Yang qi deficiency and Yang ming Stomach accumulation and counter flow Qi, gan cao gan jiang tang

Deficiency of Yin and Blood, shao yao gan cao tang

Dual exterior and interior deficiency, shao yao gan cao fu zi tang

Dual Heart Yang and Yin deficiency, zhi gan cao tang 

Water and Blood accumulation

Water accumulation, wu ling san

Blood accumulation with heat in the lower abdomen, tao he cheng qi tang

Blood and heat dryness in the lower abdomen, di dang tang

Chest Bind Patterns

Major chest bind, da xian xiong tang

Minor chest bind, xiao xian xiong tang

Glomus Patterns

Heat glomus

Heat congestion in the Yang ming Stomach, da huang huang lian xie xin tang

Heat congestion and Yang deficiency, fu zi xie xin tang

Patterns of Yang ming and Tai yin

Phlegm accumulation in Yang ming and cold in Tai yin, ban xia xie xin tang

Damp accumulation in Yang ming and cold in Tai yin, sheng jiang xie xin tang

Heat accumulation in Yang ming and cold in Tai yin, gan cao xie xin tang

Water accumulation, wu ling san

Phlegm accumulation with hard glomus, xuan fu dai zhe tang

Upper body heat and lower body cold

Desire to vomit and pain in the abdomen, huang lain tang

Tai Yang Patterns

Tai Yang Conformation of the Cold Water of the North

In the flowing text the way that each of the Conformations manifests as disease is described. Each of the Conformations has a different way of manifesting. I used two different text from The Yellow Emperor’s Classic to illustrate this manifesting.

 Chapter 66

These are what is called Root; these are the so-called six principal qi.

What is above in jue yin, the wind rules it.

What is above in shao yin, the heat rules it.

What is above in tai yin, dampness rules it.

What is above in shao yang, the ministerial fire rules it.

What is above in yang ming, the dryness rules it.

What is above in tai yang, cold rules it. 

Wang Bing

The three yin and yang constitute the Tip.

Cold, dryness, fire, dampness, heat, wind constitute the  Root. 

Chapter 74

Qi Bo,

The shao yang and the tai yin conform to the root.

The shao yin and the tai yang conform to the tip and root.

The yang ming and the jue yin conform to neither the tip nor the root, they conform to the center. 

The shao yang and the tai yin conform to the root.

Wang Bing, The root of shao yang is fire, the root of tai yin is dampness. Root and tip agree, hence the text states, they confirm to their root. 

The shao yin and the tai yang conform to the tip and root.

Wang Bing, The root of shao yin is heat, its tip is yin. The root of the tai yang is cold, its tip is yang. 

The yang ming and the jue yin conform to neither the tip nor the root, they conform to the center.

Wang Bing, Within the yang ming is tai yin and within the jue yin is shao yang. Root and tip differ from what is in the center. 

Tai yang

The root of the tai yang is cold, its tip is yang.

1 In disease of the Tai Yang, the pulse is floating, the head and nape are stiff and painful, and there is aversion to cold.

Aversion to cold is the root.

2 When in Tai Yang disease there is heat effusion, sweating, aversion to wind, and a pulse that is moderate, it is called wind strike.

The heat effusion is the tip.

3 Tai Yang diseases, whether heat has effused or not, as long as there is aversion to cold, with generalized pain, retching counter flow, and yin and yang pulses both tight, is called cold damage.

Aversion to cold is the root.

Main Tai Yang Herbs 

All herbs are described according to how they interact with one or more of the Six Conformations. It is my intent to keep the description short, and mainly address the best qualities of each herb, not all its characteristics.

Gui zhi, Cinnamomi cassiae ramulus

Gui zhi Tai yang warms the surface, warms tai yang bladder

Gui zhi Shao yin warms imperial fire to warm ministerial fire

Ma huang, Ephedrae herba

Ma huang Tai yang warms the surface

Ma huang Tai yin disperses and descends the lung

Ma huang Shao yin strongly increases heart yang

Ge gen, Puerariae radix

Ge gen Tai yang disperses and nourishes tai yang channel

Ge gen Yang ming disperses the yang ming channel

Ge gen Tai yin tonifies spleen and nourishes yin fluids

Supporting Herbs

Bai shao, Paeoniae radix lactiflora

Bai shao Jue yin nourishes and moves blood

Xing ren, Armeniacae semen

Xing ren Tai yin disperses and descends lung

Sheng jiang, Zingiberis rhizoma recens

Sheng jiang Tai yang warms the surface

Sheng jiang Yang ming tonifies and disperses excess fluids in stomach

Sheng jiang Tai yin tonifies and warms spleen and lung and sends clear qi upwards

Da zao, Jujubae fructus

Da zao Tai yin tonifies spleen while moistening

Da zao Jue yin nourishes blood

Shi gao, Gypsum

Shi gao Yang ming disperses and cools yang ming channel and cools stomach heat

Shi gao Tai yin cools lung heat

Fu zi, Aconiti radix lateralis praeparata also known as zhi fu zi

Fu zi Tai yang warms the surface and disperses dampness

Fu zi Shao yin warms imperial fire

Lian qiao, Forsythiae fructus

Lian qiao Tai yang clears the surface of heat and dampness

Chai hu, Bupleuri radix

Chai hu Tai yang clears heat congestion on the surface

Chai hu Shao yang clears damp and heat in the san jiao

Sheng ma, Cimicifugae rhizome

Sheng ma Tai yang clears surface of heat congestion

Sheng ma Shao yang clears damp and heat in gall bladder and san jiao

Sheng ma Jue yin liver blood cooling

Huang qin, Scutellariae radix

Huang qin Yang ming clears damp and heat in stomach domain

Huang qin Shao yang clears damp and heat from san jiao and gall bladder

Huang qin Jue yin clears heat to cool liver blood

Ban xia, Pinelliae rhizoma

Ban xia Yang ming dries dampness and moves qi in stomach

Ban xia Tai yin tonifes and warms and dries spleen and lung

Hou po, Magnoliae cortex

Hou po Yang ming tonifies and transforms dampness while descending qi

Ren shen, Ginseng radix

Ren shen Tai yin tonifies spleen and lung while moistening and raising clear qi

Ren shen Shao yin tonifies original qi

Da huang, Rhei rhizoma

Da huang Yang ming clears accumulations of stool and heat

Long gu, Mastodi fossilium ossis

Long gu Shao yin anchors and nourishes true water

Long gu Jue yin calms wind

Mu li, Ostrea concha

Muli Shao yin reconnects the kidneys with the heart to warm the surface, softens hardness and anchor yang

Bai zhu, Atractylodis macrocephalae rhizome

Bai zhu Tai yang drains dampness on surface

Bai zhu Yang ming dries dampness in stomach

Bai zhu Tai yin warms and tonifies spleen while drying dampness

Gan jiang, Zingiberis rhizome praep, dried sheng jiang

Gan jiang Yang ming dries dampness in yang ming

Gan jiang Tai yin warms and dries dampness in lung and spleen

Yi tang, Maltose 

Yi tang Jue yin liver blood nourishing 

Wu wei zi, Schisandrae fructus

Wu wei zi Tai yin collects lung qi

Xi xin, Asari herba

Xi xin Tai yang warms the surface

Xi xin Tai yin warms and dries lung

Xi xin Shao yin warms imperial fire

Chi xiao dou, Phaseoli semen

Chi xiao dou Tai yang drains dampness

Chi xiao dou Yang ming drains damp heat in stomach domain

Formulas According to Conformations

The following formulas are listed and described for reference. I only describe the Conformations influenced by the herbs in the formulas to express the normal physiology of the body.

Gu zhi tang

gui zhi 9 bai shao 9 sheng jiang 9 da zao 9 zhi gan cao 6

Basic tai yang wind strike, tai yang, tai yin, shao yin, jue yin conformations

Gui zhi jia ge gen tang

gui zhi 6 bai shao 6 sheng jiang 9 da zao 9 zhi gan cao 6 ge gen 12

Modified gui zhi tang, ge gen yang ming and tai yin conformations

Gui zhi jia hou po xing zi tang also known as gui zhi jia hou po xing ren tang

gui zhi 9 bai shao 9 sheng jiang 9 da zao 6 zhi gan cao 6 hou po 6 xing ren 9

Modified gui zhi tang, hou po xing ren tai yin conformation

Gui zhi jia fu zi tang

gui zhi 9 bai shao 9 sheng jiang 9 da zao 9 zhi gan cao 9 fu zi 9

Modified gui zhi tang, fu zi shao yin conformation

Gui zhi qu shao yao tang

gui zhi 9 sheng jiang 9 da zao 9 zhi gan cao 6

Modified gui zhi tang, removing bai shao jue yin for more shao yin conformation

Gui zhi qu shao yao jia fu zi tang

gui zhi 12 sheng jiang 9 da zao 9 zhi gan cao 6 fu zi 9

Modified gui zhi tang, removing bai shao jue yin for more shao yin, fu zi shao yin conformation

gui zhi jia shao yao sheng jiang ge yi liang ren shen san liang xin jia tang

gui zhi 9 bai shao 12 sheng jiang 12 da zao 6 zhi gan cao 6 ren shen 9

Modified gui zhi tang, more bai shao jue yin, more sheng jiang tai yin, ren shen shao yin and tai yin conformations

Gui zhi jia gui tang

gui zhi 15 bai shao 9 sheng jiang 9 da zao 9 zhi gan cao 6

Mod gui zhi tang, more gui zhi shao yin conformation

Gui zhi jia shao yao tang

gui zhi 9 bai shao 18 sheng jiang 9 da zao 9 gan cao 6

Modified gui zhi tang, tai yang, tai yin, more jue yin

Gui zhi jia da huang tang

gui zhi 9 bai shao 18 sheng jiang 9 zhi gan cao 6 da zao 9 da huang 6

Modified gui zhi tang, more bai shao jue yin, da huang yang ming conformations

Gui zhi gan cao tang

gui zhi 12 zhi gan cao 6

Tai yang, shao yin conformations

Gui zhi long gu muli tang

gui zhi 12 zhi gan cao 6 long gu 15 muli 9

Modified gui zhi gan cao, tai yang, shao yin, long gu and mu li shai yin anchoring and astringing

gui zhi qu shao yao jia shu qi muli long gu jiu ni tang

gui zhi 9 sheng jiang 9 da zao 6 zhi gan cao 6 fu zi 15 long gu 15 mu li 9

Modified gui zhi tang, removing bai shao jue yin for more shao yin, fu zi shao yin, long gu muli shao yin anchoring and astringing

Xiao jian zhong tang

gui zhi 9 bai shao 18 sheng jiang 9 da zao 9 zhi gan cao 6 yi tang 30

Modified gui zhi tang, more bai shao jue yin, yi tang jue yin conformation.

Gui zhi ren shen tang

gui zhi 12 ren shen 9 bai zhu 9 gan jiang 9 zhi gan cao 12

Modified li zhong wan tai yin, shao yin, gui zhi tai yang

Ma huang tang

Ma huang 9 xing ren 12 gui zhi 6 zhi gan cao 6

Basic tai yang wind cold, tai yang, tai yin, shao yin

Ma huang xing ren gan cao shi gao tang

ma huang 12 xing ren 9 zhi gan cao 6 shi gao 24

Modified ma huang tang, tai yang, shi gao clears tai yin lung heat

Ma Huang sheng ma tang

ma huang 18 sheng ma 9 dang gui 9 zhi mu 6 huang qin 6 wei rui  6 bai shao 3

tian men dong 3 gui zhi 3 fu ling 3 zhi gan cao 3 shi gao 3 bai zhu 3 gan jiang 3

Combination wind strike and cold, tai yang, yang ming, shao yang, tai yin, shao yin, jue yin conformations

Ma huang lian qiao chi xiao dou tang 

ma huang 6 lian qiao 6 chi xiao dou 24 xing ren 6 sheng jiang 6 da zao 6

zhi gan cao 6 

Combination wind strike and cold, tai yang, tai yin, jue yin conformations

Ge geng tang

ma huang 9 ge gen 12 gui zhi 6 bai shao 6 sheng jiang 9 da zao 9 zhi gan cao 6

Combination wind strike and wind cold, tai yang, tai yin, shao yin, jue yin conformations

Ge gen jia ban xia tang

ge gen 12 ma huang 9 ban xia 12 gui zhi 6  bai shao 6 sheng jiang 6 da zao 9

zhi gan cao 6

Combination tai yang wind strike and cold, ban xia for tai yin phlegm

Da qing long tang

ma huang 18 shi gao 45 xing ren 6 gui zhi 6 sheng jiang 9 da zao 6 zhi gan cao 6

Modified ma huang tang and Modified gui zhi tang, tai yang wind cold, tai yin conformations

Xiao qing long tang

ma huang 9 gui zhi 9 bai shao 9 gan jiang 9 zhi gan cao 9 wu wei zi 12 xi xin 9

ban xia 12

Tai yang combination wind strike and wind cold, tai yang, tai yin, shao yin, jue yin conformations

Gui zhi ma huang ge ban tang

gui zhi 9 bai shao 9 sheng jiang 9 da zao 9 zhi gan cao 6 ma huang 9 xing ren 12

Combined tai yang wind strike and cold, more cold than deficiency, tai yang, tai yin, shao yin, jue yin conformations

Gui zhi er ma huang yi tang

gui zhi 18 bai shao 18 sheng jiang 18 da zao 18 zhi gan cao 12 ma huang 9 xing ren 12

Combined tai yang wind strike and cold, more deficiency than cold, tai yang, tai yin, shao yin, jue yin conformations

Gui zhi er yue bi yi tang

gui zhi 18 bai shao 18 sheng jiang 18 da zao 18 zhi gan cao 12 shi gao 12

ma huang 9

Combination wind strike and wind cold, tai yang, tai yin, shao yin, more deficiency and heat in tai yin conformation

Chai hu gui zhi tang

chai hu 24 huang qin 9 ban xia 12 ren shen 9 gui zhi 9 bai shao 9 sheng jiang 9

da zao 9 zhi gan cao 9

Combined gui zhi tang and xiao chai hu tang, combined wind strike and shao yang, tai yang, yang ming, shao yang, tai yin, jue yin conformations

Conclusion

Tai Yang represents the opening of the system and the first regulatory interface between the organism and the external environment. As described in the Huangdi Neijing, coldness qi rules over Tai Yang, yet its clinical expression is not limited to simple cold. In the Shang Han Lun, Tai Yang disease unfolds through distinct structural patterns, as wind strike, wind cold, warm disease, and through numerous combined and transmuted presentations. These patterns are governed by the functional state of opening and closing, the integrity of Yang qi at the surface, and the dynamic relationship between Tai Yang and Shao Yin.

The differentiation of Tai Yang patterns depends upon precise evaluation of pulse, sweating, aversion to wind or cold, heat effusion, and the condition of fluids. From these core signs, progression into Yang Ming, Shao Yang, Tai Yin, or Shao Yin can be understood as predictable transformations based on constitutional predisposition and the state of qi, blood, and fluids.

The formulas presented are not isolated prescriptions but conformational strategies. Each herb is selected according to its relationship with one or more of the Six Conformations, restoring physiological communication between exterior and interior. Whether warming and releasing, harmonizing and supporting, clearing and draining, or anchoring and astringing, treatment at the Tai Yang level always reflects an understanding of systemic regulation rather than symptomatic suppression.

Thus, mastery of Tai Yang patterns establishes the foundation for clinical reasoning within the conformation system. By accurately discerning the state of the surface and its relationship to the interior, one preserves the pivot of transformation and prevents deeper transmission of disease.