In Traditional Chinese Medicine (TCM), when discussing the two types of colds, wind-cold and wind-heat, it is often said: “Wind-cold invades from the surface of the body; wind-heat invades from the mouth and nose.” This understanding is based on a typical clinical manifestation: after being affected by cold evil, one experiences chills; after being affected by heat evil, one experiences a sore throat. Chills are a typical manifestation of the loss of defensive qi (wei qi) at the surface of the body, as mentioned above; the throat, being the first barrier near the mouth and nose, intercepts the evil qi, leading to a local battle. This reasoning seems quite clear. However, upon closer examination, a question arises: How can the evils of cold and heat invade through different pathways?Consider that both cold and heat evils are, in essence, forms of “qi” from nature. Humans live in nature (and we cannot exclude the influence of artificial environments such as air conditioning), regardless of cold or heat, this remains true. So, why would the pathways of evil invasion differ?Some explanations suggest: cold is a yin evil, while heat is a yang evil; yang evils are above, and yin evils attack from below. This explanation seems inadequate; when discussing yin and yang, the skin is yang, while the organs are yin; although the throat is considered an orifice, it is also an internal organ, and compared to the hair on the body, it is more yin.Investigating the theory of “yang evils attacking from above” comes from the Ming and Qing dynasties’ school of warm diseases. The most influential statement is from Ye Tianshi: “When warm evils attack from above, they first invade the lungs and then reverse to affect the pericardium.” (From the “Warm Heat from External Pathogens” chapter) This statement appears as a theorem at the beginning of the text, and the entire chapter does not explain this viewpoint.We can say that Ye’s viewpoint is based on clinical observations, combined with the discussions of previous physicians (such as Wu Youke), proposing a new theory. This theory helps clinical practitioners open their diagnostic and treatment thinking and significantly enriches TCM theory. However, such practical value is a result rather than a cause and cannot answer the question of “why do the evils of cold and heat have different pathways of invasion?” Yun Tieqiao questioned this: “If it is established that warm diseases enter through the mouth and nose, and warm evils reach the surface from within, why then does the first prescription use Zhang Zhongjing’s Gui Zhi Decoction? Is this not a severe contradiction?” (From “Clarifying the Principles of Warm Diseases”) However, Yun’s basis is largely “there is no evidence in the Inner Canon,” which may not be entirely valid.Here, I will attempt to provide my explanation:First, why do we feel chills when affected by cold, but not when affected by heat, or only experience mild chills? The previous analysis discussed the mechanism of experiencing chills after being affected by cold evil. So, what differences arise when the invading evil qi is heat rather than cold?Cold evil has a constricting nature, while heat evil does not possess this characteristic. In cold weather, dogs curl up in a ball, hiding in corners to keep warm; in hot weather, dogs stretch out their limbs, exposing as much of their bodies as possible, even sticking out their tongues to dissipate heat. While it is said that wind has a dispersing nature, heat evil may not lack a dispersing nature either. If heat evil does not lead to constriction, but rather to dispersion, then the pathways of defensive qi entering and exiting would not be obstructed; defensive qi could reach the surface to warm it, thus there would be no manifestation of chills.So, what about the occasional occurrence of chills? When heat evil invades, defensive qi gathers to resist the evil, and for a time, the qi at the surface may become congested; for example, when a movie theater empties, a crowd gathers at the exit, causing congestion. (This idea comes from a discussion with Brother Tan years ago, and I do not dare to claim it as my own). This is the essence of the situation.Secondly, why is sore throat particularly pronounced after being affected by heat evil? Once the evil qi enters the body through the skin and hair, the next target, or the next layer to be threatened, is the meridians. If we carefully study the pathways of the meridians and their associated symptoms, we will find that nine of the twelve meridians are related to the throat, including the Foot Yangming, Foot Shaoyang, Foot Three Yin, Hand Three Yang, and Hand Shaoyin. Yang meridians are external, while yin meridians are internal, densely arranged around the throat. When heat evil invades these meridians, due to the nature of heat evil, which is fiery and inflammatory, it will naturally ascend along the meridians to reach this densely populated area.At the same time, the position of the throat in the human body is very special; in ancient times, it was often referred to as the “throat,” which is a critical barrier. Once encountering a “barrier,” it often means that passage will be restricted. On the battlefield, a flat area has no defenses; well-known battles often occur at “barriers,” such as Pingxingguan, Hangu Pass, and Juyong Pass. When the heat evil surges along the nine (actually eighteen if counting both sides) meridians and converges at the throat, the body’s defense battle officially begins; this manifests as redness, swelling, heat, and pain in the throat.Clinically, some children frequently suffer from external pathogens, leading to enlarged tonsils, resembling two sugar balls hanging in the throat; this is essentially when war becomes the norm, the body must raise its walls and dig deeper moats. One might ask: with the walls and moats fortified, how can one still suffer from repeated external pathogens? Continuing the metaphor.Tongzhou is the gateway to Beijing. If enemy troops are stationed outside Tongzhou, the defending army fortifies the walls and fights hard against the enemy, repeatedly repelling their attacks. What would the situation in Beijing be like at this time? What would the situation in the entire country be like? Quite severe! When a country is rich and strong, with well-trained troops and ample supplies, would the enemy dare to station troops in Tongzhou? No, they would not. Similarly, the body’s defense responsibilities cannot always rely on the geographical advantage of this barrier. More importantly, it is to strengthen the nation and its military, to subdue the enemy without fighting, which means to strengthen the body and enrich the vital essence.Having digressed too far, let’s continue discussing the struggle between righteousness and evil occurring in the throat. After the outbreak of war, three possible outcomes can be referenced from the previous text “A Comprehensive Explanation of Coughing from Cold”. Here, we also focus on the part where righteousness and evil are evenly matched, observing what happens when heat evil is rampant and righteous qi is abundant.First, in the early stages of the war, the systemic symptoms caused by heat evil are often not very severe, unlike when cold evil invades, where one can easily develop a fever above 38 or 39 degrees Celsius. After all, what occurs in the throat is a local battle, which is different from the mobilization of defensive qi launching a nationwide resistance. However, one should not underestimate this stage; because heat evil has a characteristic that cold evil does not possess, which is rapid transmission.When affected by cold evil, it takes several days to progress from chills to fever to lung abnormalities and coughing. However, with heat evil, this process can develop very quickly; it is common for patients to have a sore throat one day and start coughing up yellow phlegm the next. Let’s continue with a metaphor to illustrate this process.If I am walking down the street and suddenly a fierce-looking, muscular man blocks my way, glaring at me with a knife in hand, what should I do? First, I would be on high alert, ready to spring into action. Next, I would engage in a fierce battle with the enemy, fighting for my life. In the end, I might either win and drive the enemy away, or I could be defeated and at their mercy; or both could be injured, leading to mutual destruction. One might ask: but I could escape? However, when my mission is to protect this country, even if I die, I cannot flee, just like the defensive qi within the body. Cold evil appears fierce and strong; the defensive qi will recognize the enemy immediately and organize a counterattack, doing everything possible to prevent the enemy from advancing. Therefore, the invasion of cold evil is often arduous.Now, let’s change the scenario: instead of a muscular man, it’s a beautiful woman (or for female friends, a handsome man); instead of a fierce look, it’s a smiling face, charming and seductive, with sweet words. Will I still be on high alert? It would be quite difficult. And while my heart flutters, a knife can easily pierce through. Moreover, the sentries along the way are virtually useless, allowing the beautiful assassin to advance unimpeded.
Cold belongs to water, associated with fear; heat belongs to fire, associated with joy. When encountering cold evil, due to fear, I will double my defenses; when encountering heat evil, there is no fear but joy, making it easier to open my heart. Therefore, heat evil can pass through barriers much more easily than the fierce siege of cold evil, so when experiencing heat evil, sore throat must be treated promptly to prevent the heat evil from penetrating further.The metaphor can be further elaborated. With the decline of colonialism worldwide, countries that were once colonized are gaining independence. However, the political independence does not truly change the essence of their subjugation. Former powers no longer use brute force to establish control but have evolved into a seemingly harmonious form, actually conducting “soft domination” through manipulation of economic lifelines.This new form of domination has lulled the people of the subjugated countries; the wealth of the populace is continuously funneled to the ruling country through this hidden form. The evolution of this form of domination is essentially a transformation from a muscular man to a beautiful woman.A similar phenomenon occurs in the spectrum of human diseases. In the era of Zhang Zhongjing, the rampant disease was typhoid, a cold evil; by the Ming and Qing dynasties, more and more epidemics had transformed into warm diseases, which are heat evils. Nature, society, and the human body, seemingly unrelated, are actually interconnected upon careful observation.
This article is selected from the “Growth Community for TCM Enthusiasts” organized by the Wujizhe Society. Long press to identify the QR code below for details. Wujizhe Society, 2022 Learning Theme: Advanced Acupuncture.
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