Exogenous disease syndromes are caused by external pathogens attacking the body, entering the interior, and lingering within, leading to dysfunction of the organs. Due to the different natures of the pathogens, the damage to the organs and the characteristics of the syndromes also vary. As stated in the “Treatise on the Spleen and Stomach”: “Internal injury to the spleen and stomach harms its qi; exogenous invasion of wind and cold harms its form. When the exterior is harmed, it is excess, and excess should be purged; when the interior is harmed, it is deficiency, and deficiency should be tonified.” Master TCM physician Li Zhenhua focuses on the spleen and stomach as the axis for treating exogenous diseases. This article summarizes his treatment experiences for exogenous diseases as follows.
01Wind-Cold Common Cold
Symptoms: chills and fever, headache without sweating, nasal congestion with a heavy voice, sneezing, body aches, no thirst, clear and frequent urination, cough with white phlegm, pale red tongue, floating and tight pulse. Treatment method: release the exterior with warm acrid herbs, clear heat, and harmonize the stomach. Formula: Gui Zhi (Cinnamon Twig) 8g, Bai Shao (White Peony) 15g, Ge Gen (Kudzu Root) 15g, Chuan Xiong (Szechuan Lovage) 10g, Qian Hu (Hogfennel) 10g, Xing Ren (Apricot Kernel) 10g, Chen Pi (Aged Tangerine Peel) 10g, Sheng Jiang (Fresh Ginger) 10g, Jing Jie (Schizonepeta) 10g, Gan Cao (Licorice) 3g.
02Wind-Cold Cough (Throat Itch)
Symptoms: mild fever, cough with white phlegm, throat itch, body aches, worsens with cold, no thirst, clear and frequent urination, pale red tongue, floating and rapid pulse. Treatment method: expel wind and scatter cold, diffuse the lungs and stop cough. Formula: Qian Hu, Huang Qin (Scutellaria), Bei Mu (Fritillaria), Zhi Mu (Anemarrhena), Su Zi (Perilla Seed), Jing Jie, Zhi Sang Pi (Fried Mulberry Bark), Zhi Dong Hua (Fried Winter Flower), Ju Hong (Tangerine Peel), Ban Xia (Pinellia), Jie Geng (Platycodon), Su Geng (Perilla Stem), Zhi Qiao (Bitter Orange) each 10g, Xing Ren 6g, Gan Cao 3g, Sheng Jiang 5 slices as a guide.
03Internal Injury with Exogenous Attack
Symptoms: fever and chills, alternating cold and heat, mild in the morning and severe in the evening, sweating without relief, headache, poor appetite, abdominal distension, white greasy tongue coating, pale red tongue, wiry and rapid pulse. Treatment method: resolve both exterior and interior, harmonize Ying and Wei. Formula: Chai Hu (Bupleurum), Xiang Fu (Cyperus), Chen Pi 10g, Shan Zha (Hawthorn) 10g, Qing Pi (Green Tangerine Peel) 10g, Sheng Jiang 10g, Chuan Xiong 12g, Bai Shao 15g, Gui Zhi 8g, Sha Ren (Amomum) 8g, Wu Zhu Yu (Evodia) 4g, Gan Cao 3g, Hong Tang (Brown Sugar) 30g as a guide.
04Wind-Heat Common Cold
Symptoms: slight fever with aversion to wind and cold, dry and painful throat, possible redness and swelling, headache, spontaneous sweating, thirst, cough with yellow phlegm, flushed complexion, yellow urine, thin yellow or thin white tongue coating, red tongue, floating and rapid pulse. Treatment method: release the exterior with cool acrid herbs, diffuse the lungs and clear heat. Formula: Jin Yin Hua (Honeysuckle), Dan Dou Chi (Fermented Soybean) each 12g, Lian Qiao (Forsythia), Ge Gen each 15g, Ju Hua (Chrysanthemum), Gong Jing (Dandelion), Jing Jie, Jie Geng each 10g, Bo He (Mint) 7g, Gan Cao 3g. Modification: if heat is severe, add Sheng Shi Gao (Gypsum) 15-30g, Zhi Mu 12g, Ban Lan Gen (Isatis) 20g; for cough with heavy yellow phlegm, add Xing Ren, Chuan Bei Mu (Fritillaria) each 10g, Sheng Sang Pi 15g, Di Gu Pi (Lycium) 12g.
05Influenza
Symptoms: fever without aversion to cold, or slight aversion to cold, slight sweating or no sweating, headache, itchy and painful throat, dry mouth, cough, possibly wheezing, phlegm production or difficulty expectorating, poor appetite, yellow urine, thin white tongue coating, slightly red tongue, floating and rapid pulse. Treatment method: clear heat and detoxify, cool and release the exterior. Formula: Lian Qiao, Jie Geng, Qian Niu Zi (Cowherb Seed), Sheng Sang Pi, Xing Ren each 10g, Ge Gen, Jin Yin Hua, Gong Jing, Yu Xing Cao (Houttuynia) each 15g, Zhi Mu 12g, Sheng Shi Gao 20g, Gan Cao 3g. Modification: for chest tightness and wheezing, even asthma, add Ma Huang (Ephedra) 8g.
06Wind-Heat Cough
Symptoms: mild fever, sweating, cough with difficulty expectorating, phlegm yellow and sticky, dry throat and mouth, possibly severe throat pain. Treatment method: clear heat and diffuse the lungs, cool and release the exterior. Formula: Bei Sha Shen (North American Ginseng), Sheng Sang Pi, Di Gu Pi each 15g, Qian Hu, Huang Qin, Xing Ren, Gua Lou Ren (Trichosanthes), Zhi Mu, Lu Gen (Reed), Bei Mu, Jie Geng, Bo He, Sang Ye (Mulberry Leaf) each 10g, Zhi Qiao 12g, Gan Cao 3g.
07Gastrointestinal Type Common Cold
Symptoms: fever and chills, headache, body aches, alternating cold and heat, poor appetite, severe abdominal distension and diarrhea, nausea, possibly vomiting, white greasy tongue coating, slightly enlarged tongue, pale red tongue, slippery and rapid pulse. Treatment method: strengthen the spleen and harmonize the stomach, warm and release the exterior. Formula: Bai Zhu (White Atractylodes), Zhu Ling (Polyporus), Cang Zhu (Atractylodes), Hou Po (Magnolia Bark), Chen Pi, Chai Hu, Huang Qin, Sha Ren, Jiao San Xian (Fried Three Immortals) each 10g, Fu Ling (Poria) 15g, Ze Xie (Alisma) 12g, Gui Zhi 6g, Ge Gen, Wu Zhu Yu each 5g, Gan Cao 3g, Sheng Jiang 5 slices, Da Zao (Jujube) 5 pieces as a guide.
08Qi Deficiency Common Cold
Common in the elderly or those with recurrent colds, presenting with weakness, low fever, slight aversion to cold, headache, body aches, fatigue, no thirst, no throat pain, clear and frequent urination, prolonged illness, possibly recurrent colds, pale tongue, white coating, deep and thin pulse. Treatment method: tonify qi and strengthen the spleen, harmonize Ying and Wei. Formula: Huang Qi (Astragalus) 20g, Dang Shen (Codonopsis), Fang Feng (Siler) 5g, Bai Zhu, Bai Zhi (Angelica Dahurica), Chai Hu, Sha Ren, Chen Pi each 10g, Gui Zhi 6g, Bai Shao 12g, Gan Cao 3g, Sheng Jiang 5 slices, Da Zao 5 pieces. Modification: after recovery, remove Bai Zhi, Chai Hu, and change Gan Cao to Zhi Gan Cao (Honey-fried Licorice) 6g to strengthen the spleen and prevent colds.
09Yin Deficiency Common Cold
Common in those with underlying yin deficiency and lung dryness or suffering from tuberculosis. Symptoms: mild fever, light in the morning and heavy in the evening, sweating with aversion to wind, fatigue, dizziness, headache, dry throat, thirst, five hearts heat, thin yellow tongue coating, red tongue, thin and rapid pulse. Treatment method: nourish yin and clear heat, cool and release the exterior. Formula: Bei Sha Shen 20g, Mai Dong (Ophiopogon) 15g, Sang Ye, Ju Hua, Ge Gen, Bo He, Dan Dou Chi, Jie Geng, Yin Chai Hu (Silver Chai Hu), Huang Qin each 10g, Gan Cao 3g. Modification: for severe cough, add Zhi Mu, Chuan Bei, Xing Ren, Su Zi each 10g; if no sweating, add Jing Jie 10g, Sheng Jiang 5 slices as a guide.
010Wind-Cold with Dampness Common Cold
Symptoms: mild fever, aversion to wind and cold, joint pain, overall body aches, headache, heavy head, poor appetite, thick white greasy tongue coating, pale tongue, soft and rapid pulse. Treatment method: expel wind, scatter cold, eliminate dampness, and release the exterior. Formula: Qiang Huo (Notopterygium), Du Huo (Angelica), Bai Zhi, Huo Xiang (Agastache), Sha Ren, Hou Po, Chuan Xiong, Fang Feng each 10g, Chai Hu, Ge Gen each 12g, Gui Zhi 5g, Xi Xin (Asarum), Gan Cao each 3g. All dosages are for adults; for children, adjust accordingly. Each type of common cold can be modified based on symptoms, tailored to the individual. Based on Master Li’s clinical experience, the treatment of exogenous diseases is summarized into these ten types, reflecting the TCM principle of differentiation and treatment. In treating exogenous diseases, attention is paid to protecting the spleen and stomach, as these formulas often contain herbs that tonify qi and strengthen the spleen. As Dong Yuan said: “Internal injury to the spleen and stomach leads to the emergence of a hundred diseases.” The spleen and stomach are the foundation of postnatal health, the officials of storage, residing in the center, nourishing the surroundings. Zhang Zhongjing also emphasized the spleen and stomach in treating exogenous cold damage. For example, Bai Hu Tang (White Tiger Decoction) is cold and can harm stomach qi, hence the addition of glutinous rice to protect stomach qi. Gui Zhi Tang (Cinnamon Twig Decoction) contains ginger and jujube to harmonize the middle burner, strengthen the spleen and stomach, and promote sweating to expel pathogens while protecting stomach qi. The “Huang Di Nei Jing: Su Wen” states: “When the righteous qi is stored within, evil cannot invade; where evil gathers, its qi must be deficient.” The spleen and stomach transform food and essence, ensuring sufficient qi and blood, which allows the righteous qi to flourish, preventing the body from being invaded by external pathogens and enabling quick recovery after illness. Li Zhenhua often treats diseases with a focus on the spleen and stomach, proposing the academic viewpoint of “spleen deficiency without excess, stomach often with excess” and the treatment philosophy of “the spleen should be strengthened, the liver should be soothed, and the stomach should be harmonized.” In clinical practice, the treatment of spleen and stomach diseases is effective, and it can also play a role in treating difficult and miscellaneous diseases. In summary, TCM treatment of exogenous disease syndromes should follow the principle of differentiation and treatment, with the above ten methods for reference, while also considering the middle burner spleen and stomach to aid in early recovery from illness.
I Statement Information:This article is selected from:“China Traditional Chinese Medicine News” 2021, Guizhou University of Traditional Chinese Medicine, Li Mengqi.The articles shared by this public account are for reference and learning purposes only. If there are any improper uses of the published content, please feel free to contact us. Please retain copyright information when reprinting.All formulas and treatment methods mentioned in the text are for learning reference only; non-professionals should not attempt to use them!