Editor’s Note: In Traditional Chinese Medicine (TCM), common colds are classified into three categories: Wind-Cold, Wind-Heat, and Dampness. Today, we will discuss Wind-Heat Cold. The nature of Wind-Heat Cold is distinctly different from that of Wind-Cold, and in the early stages, many symptoms are similar to Wind-Cold, making accurate differentiation challenging, even for skilled TCM practitioners.
Thanks to Teacher Zou Shizhen for sharing exclusive insights that allow even TCM novices to effectively manage the tricky Wind-Heat Cold.
What is Heat Evil?
Heat Evil refers to factors that can cause a sensation of heat in the body. Warmth, heat, summer heat, and fire all belong to the category of fire; they are similar in nature but differ in name. Warmth, heat, and summer heat are generally associated with systemic diseases caused by fire evil, differing only in the degree of heat, with warmth being the mildest and summer heat the most intense. Fire is typically associated with localized pathological changes caused by fire evil.
Fire is a Yang evil, characterized by heat, which scorches the body’s Yin fluids and depletes vital energy. Any factor that can cause such harm to the body is considered fire evil in TCM, whether physical, chemical, or biological.
What is Wind-Heat Cold?
When a person is exposed to heat, symptoms such as vasodilation, increased blood flow, sweating, thirst, and fever may occur.Cold evil damages Yang Qi, while heat evil damages Yin fluids.
Wind-Heat Cold is a cold caused by exposure to heat evil. However, if the patient exhibits purely heat evil symptoms, it is generally not referred to as a cold but rather as heat stroke. In hot summer weather, prolonged exposure to the sun can lead to profuse sweating and fainting, which is true heat stroke. Nowadays, people often refer to nausea, vomiting, chest tightness, and dizziness in summer as heat stroke, but this is not true heat stroke; rather, it is the dampness-cold evil obscuring Yang Qi, which can be resolved with Huo Xiang Zheng Qi (Agastache Decoction). True heat stroke cannot be treated with Huo Xiang Zheng Qi.
In the early stages of Wind-Heat Cold, patients typically exhibit signs of heat evil while also having cold evil present. In other words,Wind-Heat Cold in its early stages must necessarily have cold evil present.
Therefore, the commonly used formula for treating Wind-Heat Cold, Yin Qiao San (Yin Qiao Powder), includes not only heat-clearing herbs but also warming and dispersing herbs like Fang Feng (Siler) and Jing Jie (Schizonepeta) to help resolve wind-cold.
If Wind-Heat Cold is treated solely with heat-clearing herbs like Jin Hua (Honeysuckle) and Lian Qiao (Forsythia), while it may eliminate the heat evil, the condition is not completely cured, as the changes in the body caused by cold evil remain unresolved.
During my third year in university, I went on an outing with classmates, and one of them caught a cold. I recognized it as Wind-Heat Cold, but at the time, we had no medicine for treating Wind-Heat Cold, only for Wind-Cold, which left everyone worried. I noticed another classmate had throat lozenges, which are heat-clearing and throat-soothing medicines. I suggested they continuously suck on the lozenges and take some Wind-Cold medicine. My classmates were skeptical of my theory and only agreed to take the lozenges. After sucking on about seven lozenges throughout the day, they felt the fever had completely subsided, the headache was gone, but they still felt dizzy and were sensitive to the wind. I then suggested they take the Wind-Cold medicine, and indeed, all symptoms resolved. Thus, in the early stages of Wind-Heat Cold, cold evil is always present, though sometimes it may be mild and other times severe. This is also why Ban Lan Gen (Isatis Root) cannot only treat Wind-Cold and should not be used alone to treat Wind-Heat Cold..
How to Diagnose Wind-Heat Cold?
To diagnose Wind-Heat Cold, one must focus on the characteristics of heat evil. The characteristics of heat evil include causing the body to swell, fever, sweating, and damaging bodily fluids. However, in the early stages of Wind-Heat Cold, cold evil is also present, so sweating may not always occur, but there are generally signs of heat damaging bodily fluids, such as thirst, dry throat, rapid and forceful pulse, flushed face, red tongue, and nasal congestion with snoring sounds due to the dilation of blood vessels in the nasal cavity affected by heat evil.
In the early stages of Wind-Heat Cold, patients typically exhibit signs of heat evil while also having cold evil present. In other words, Wind-Heat Cold in its early stages must necessarily have cold evil present. Symptoms of cold evil include sensitivity to cold and nasal discharge.
Correct Treatment of Wind-Heat Cold
In the early stages of Wind-Heat Cold, the commonly used formula isYin Qiao San.
Wind-Heat Cold in its early stages must necessarily have cold evil present. Therefore, the commonly used formula Yin Qiao San includes not only heat-clearing herbs but also warming and dispersing herbs like Fang Feng and Jing Jie to help resolve wind-cold. If Wind-Heat Cold is treated solely with heat-clearing herbs like Jin Hua and Lian Qiao, while it may eliminate the heat evil, the condition is not completely cured, as the changes in the body caused by cold evil remain unresolved.
In the early stages of Wind-Heat Cold, use Yin Qiao San, butbe sure to assess the ratio of cold evil to heat evil in the patient. The commercial preparation of Yin Qiao San contains fewer cold-dispersing herbs; if cold evil is not severe, the commercial preparation of Yin Qiao Jie Du Wan (Yin Qiao Detoxifying Pill) may suffice. If the patient has significant cold evil, additional cold-dispersing herbs, such as cold-dispersing tea, should be added. Both Yin Qiao San and the pills should be boiled in water for better efficacy. After taking the medicine, observe the response; if the assessment is correct and the patient still has fever two hours after taking the medicine, they can continue to take it. Do not take it just twice a day in a slow manner..
Wind-Heat Cold should be treated promptly for early recovery; if delayed, it can lead to a chain reaction in the body, complicating the condition.
Do not purchase Yin Qiao San that contains Western medicine components! Some manufacturers, influenced by Western medicine, add acetaminophen to enhance fever-reducing effects, which is actually counterproductive and weakens the efficacy of Yin Qiao San. Yin Qiao San Ingredients: Jin Hua (Honeysuckle), Lian Qiao (Forsythia), Zhu Ye (Bamboo Leaf), Niu Bang Zi (Burdock Seed, roasted), Lu Gen (Reed Root), Jie Geng (Platycodon), Bo He (Mint), Dan Dou Chi (Fermented Soybean), Jing Jie (Schizonepeta), Gan Cao (Licorice). When purchasing medicine, be sure to check and avoid those containing acetaminophen, as it affects the efficacy! Starch and magnesium stearate additives in the manufacturing process do not affect efficacy.
Secrets to Treating Wind-Heat Cold
It is worth noting that sometimes, due to excessive cold evil, heat evil can be suppressed deep within the body, and the patient may not initially exhibit signs of heat evil. If the patient has significant dampness, with a white and swollen tongue, even if heat evil is present, it may be difficult to observe a red tongue. In such cases, even skilled TCM practitioners may not immediately recognize the presence of heat evil, but it is not a problem if it is not identified at first; as long as the cold evil or dampness is removed, the heat evil will naturally reveal itself.
Secrets of Wind-Heat Cold
1. First take dispersing herbs, such as cold-dispersing tea or Wind-Cold granules to eliminate cold evil;
2. After drinking the herbal decoction for 2-3 hours, observe if any heat evil appears. If the tongue color changes to red, the throat becomes red and painful, the pulse accelerates, or sweating occurs without the fever subsiding;
3. Confirm the presence of heat evil, diagnose as Wind-Heat Cold, and take Yin Qiao San immediately. Continue taking until recovery.
Thus, Zou Shizhen repeatedly emphasizes in class that when treating colds with fever, one cannot simply prescribe several doses of medicine and then neglect the patient; it is essential to follow up promptly. If the patient sweats after taking the medicine but the fever does not subside, or if the fever drops slightly and then rises again, it may indicate hidden heat evil that was not observed initially, necessitating timely adjustment of the formula.
Common Misunderstandings about Wind-Heat Cold
Entering the Interior and Transforming into Heat: Many people, including many TCM practitioners, say that Wind-Cold Cold with clear nasal discharge and white phlegm can transform into Wind-Heat Cold after a prolonged period. This statement is incorrect.
Yellow nasal discharge and yellow phlegm occur because cold evil constricts the body’s surface, preventing the smooth flow of Qi, blood, and bodily fluids. After prolonged stagnation, heat is generated, which steams the fluids, turning them yellow. This heat is entirely different in nature from the heat evil of Wind-Heat Cold. Generally, removing the cold evil from the body’s surface does not require heat-clearing; this heat will naturally dissipate. Even if the heat is significant, adding a small amount of Huang Qin (Scutellaria) to the dispersing wind-cold herbs is sufficient.
Gypsum: Some individuals who do not understand TCM say that when the body temperature reaches a certain degree, one must use Bai Hu Tang (White Tiger Decoction), which contains gypsum and other herbs. This is a significant misunderstanding. Even if Wind-Heat Cold requires heat-clearing, gypsum should not be used indiscriminately. Bai Hu Tang (Gypsum) clears specific types of heat, while Yin Qiao San clears different types of heat, as explained clearly in Zou Shizhen’s practical TCM training course. It is not appropriate to use gypsum simply because of high fever.
Conclusion: From the analysis above, it is evident that although both Wind-Cold and Wind-Heat Cold present with fever, the nature of the fever is entirely different. The fever in Wind-Cold Cold is due to cold evil constricting the body’s surface, preventing the body’s own heat from dissipating, leading to elevated body temperature. The fever in Wind-Heat Cold is due to external heat evil entering the body. Therefore, treating Wind-Cold Cold only requires dispersing the cold evil from the surface to restore the body’s heat-dissipating function, normalizing body temperature; treating Wind-Heat Cold requires using heat-clearing herbs to eliminate the heat evil that has entered the body..
END
Previous Articles: Correct Treatment of Wind-Cold, Proper Health Maintenance in Winter Solstice, Cerebral Hemorrhage and An Gong Niu Huang Wan (An Gong Niu Huang Pill)
Great Article! Must Read