The cold-heat mixed pattern of the gastrointestinal tract is a common pathological change in clinical spleen and stomach diseases. The discussion on gastrointestinal cold-heat mixed patterns first appears in the “Lingshu: Shizhuan”, which states: “If there is heat in the stomach, it will digest grains, causing a feeling of hunger and restlessness; if there is heat in the intestines, the stool will be yellow and mushy, while the skin below the navel is cold. If there is cold in the stomach, there will be abdominal distension; if there is cold in the intestines, there will be rumbling and diarrhea. If the stomach is cold and the intestines are hot, there will be distension and diarrhea; if the stomach is hot and the intestines are cold, there will be extreme hunger and abdominal pain and distension.” The original text suggests two types and six conditions of gastrointestinal cold-heat changes. If we combine the cold and heat of the gastrointestinal tract, we can derive three types and eight conditions, including both cold and heat in the gastrointestinal tract.
① Pure cold or heat patterns of the stomach or intestines and their main symptoms. Stomach heat presents with symptoms of hunger and restlessness; intestinal heat presents with diarrhea that is yellow and foul; stomach cold presents with abdominal distension; intestinal cold presents with rumbling and diarrhea that is clear and watery or abdominal pain and distension.
② Cold or heat patterns in both the stomach and intestines. Both stomach and intestines cold present with abdominal distension, rumbling, and diarrhea that is clear and watery or abdominal pain and distension; both stomach and intestines hot present with hunger and diarrhea that is yellow and foul.
③ Cold-heat mixed patterns in the gastrointestinal tract and their main symptoms. Stomach cold and intestinal heat present with abdominal distension and diarrhea that is yellow and foul; stomach heat and intestinal cold present with hunger, abdominal pain, and distension (with rumbling, diarrhea, and clear watery stools). Among the symptoms of “stomach heat and intestinal cold,” the typical symptom of intestinal cold is abdominal pain and distension. According to the “Neijing”‘s usage of “mutual textual meaning,” it can be understood that the typical symptoms of intestinal cold include both abdominal pain and distension and rumbling, diarrhea, and clear watery stools.
In the “Lingshu: Dawoh Lun”, another type of gastrointestinal cold-heat mixed pattern is mentioned: “Huangdi said: What causes a person to be hungry but not crave food? Qibo said: The essence and qi are combined in the spleen, and the heat qi remains in the stomach. If the stomach is hot, it will digest grains, leading to hunger. If the stomach qi is reversed upwards, it will be cold in the stomach, hence the lack of appetite.” Hunger and lack of appetite are both present; hunger indicates heat in the stomach leading to grain digestion, while lack of appetite indicates cold in the stomach affecting intake and transformation, showing a simultaneous presence of cold and heat in the stomach. The absence of descriptions of diarrhea also suggests that the focus of the disease is in the stomach, not the intestines. Combining this with the discussion in the “Lingshu: Shizhuan”, considering the same pathological mechanism of stomach cold, we can supplement the main symptoms of abdominal distension and lack of appetite as the primary symptoms of stomach cold. Thus, the cold-heat changes in the gastrointestinal tract in the “Neijing” can be categorized into four types and nine conditions, with the seventh, eighth, and ninth conditions being the cold-heat mixed patterns of the gastrointestinal tract, which are combinations of the first six types of gastrointestinal cold-heat symptoms, indicating the basic methods for differentiating gastrointestinal cold-heat patterns. For ease of understanding, the following table is provided.
Overview of Symptoms and Pathological Mechanisms of Gastrointestinal Cold-Heat Patterns in the “Neijing”
|
Index |
Pathological Mechanism/Typical Symptoms |
Hunger and restlessness |
Diarrhea that is yellow and foul |
Abdominal distension/Lack of appetite |
Rumbling, diarrhea that is clear and watery, and/or abdominal pain and distension |
|
1 |
Stomach Heat |
✔ |
|||
|
2 |
Intestinal Heat |
✔ |
|||
|
3 |
Stomach Cold |
✔ |
|||
|
4 |
Intestinal Cold |
✔ |
|||
|
5 |
Both Stomach and Intestines Hot |
✔ |
✔ |
||
|
6 |
Both Stomach and Intestines Cold |
✔ |
✔ |
||
|
7 |
Stomach Cold and Intestinal Heat |
✔ |
✔ |
||
|
8 |
Stomach Heat and Intestinal Cold |
✔ |
✔ |
||
|
9 |
Stomach Heat and Stomach Cold |
✔ |
✔ |
The “Lingshu: Shizhuan” proposes a treatment principle for the first six relatively simple pathological changes of gastrointestinal cold and heat: “If there is heat in the middle, it will lead to cold stools; if there is cold in the middle, it will lead to hot stools.” “Middle” refers to the stomach and intestines (“Taisu: Shengsheng”). “Stools” refers to the appropriate treatment (“Leijing: Lunzhil”). This means that if there is heat in the stomach and intestines, treat with appropriate cold methods; if there is cold in the stomach and intestines, treat with appropriate warm methods, such as using Gegen Qinlian Decoction for gastrointestinal heat and Lizhong Decoction for gastrointestinal cold in later treatments. However, the “Lingshu: Shizhuan” and “Lingshu: Dawoh Lun” do not propose corresponding treatment principles and methods for the cold-heat mixed patterns of the gastrointestinal tract. The “Lingshu: Shizhuan” raises the question, “If the stomach desires cold drinks and the intestines desire hot drinks, how can they be reconciled?” but does not provide a direct answer, instead responding with the principle of adjusting food and clothing to suit cold and warm conditions.
Another discussion on the treatment of gastrointestinal cold-heat mixed patterns comes from the “Lingshu: Wuxie”, which states: “If the evil is in the spleen and stomach, it will cause muscle pain. If yang qi is excessive and yin qi is insufficient, there will be heat in the middle leading to hunger; if yang qi is insufficient and yin qi is excessive, there will be cold leading to intestinal rumbling and abdominal pain; if both yin and yang are excessive or insufficient, there will be both cold and heat. All should be adjusted at the Sanli point.” The symptoms of hunger and intestinal rumbling and abdominal pain are very similar to the description of stomach heat and intestinal cold in the “Lingshu: Shizhuan”. The text explains the mechanism of gastrointestinal cold-heat mixed patterns through the excess or deficiency of yin and yang qi, proposing the treatment principle of “adjusting at Sanli.” “Sanli” refers to the “Zusanli” point of the Stomach Meridian and the “Shousanli” point of the Large Intestine Meridian, meaning that by regulating the qi of the stomach and intestines through acupuncture points, one can achieve the goal of balancing yin and yang, cold and heat, and deficiency and excess, thus treating the gastrointestinal cold-heat mixed patterns.
Whether it is the dietary adjustments suggested in the “Lingshu: Shizhuan” or the adjustment at Sanli in the “Lingshu: Wuxie”, both recognize the complexity of the pathological mechanism of gastrointestinal cold-heat mixed patterns. Treatment should not simply follow the principle of “treating cold with heat and heat with cold” but should be based on the sequence of symptoms, severity, and urgency of the cold-heat mixed patterns. Due to the limitations of the times, facing the treatment of gastrointestinal cold-heat mixed patterns, it is indeed as Ma Shi said, “It is very difficult to reconcile the two opposites” (“Lingshu: Zhu Zheng Fa Wei”). The “Neijing” does not propose specific treatment measures, which is a shortcoming. However, the discussions in the “Neijing” regarding gastrointestinal cold-heat patterns and treatment principles have had a significant impact on later generations in differentiating and treating gastrointestinal cold-heat mixed patterns.
Based on the above, the “Neijing” provides detailed differentiation for gastrointestinal cold-heat mixed patterns but is less comprehensive in treatment discussions. It clearly defines the location of gastrointestinal diseases and the main symptoms of simultaneous cold and heat, establishing basic norms for differentiating gastrointestinal cold-heat mixed patterns. Although there are principles for “adjusting treatment,” there are no specific therapies. Now, combining records from later medical texts, the following discussions are presented.
1. Differentiation and Treatment of Stomach Cold and Intestinal Heat Patterns
The main symptoms of stomach cold and intestinal heat patterns are abdominal distension, lack of appetite, and diarrhea that is yellow and foul. If there is cold evil in the stomach, qi movement is obstructed, leading to abdominal distension and lack of appetite; if heat evil remains in the intestines, water and grains do not gather, resulting in diarrhea, and heat causes “water and liquid to be turbid” (“Suwen: Zhizhen Yao Dalu”). Therefore, the treatment should warm the stomach and clear the intestines, adjusting cold and warm. Representative formulas may include the “He Li Le Decoction” from the “Sheng Ji Zong Lu” or the “Lian Li Decoction” from the “Secret Transmission of Diagnosis and Treatment”.
The “Sheng Ji Zong Lu: Stomach Gate” states: “To treat stomach cold and intestinal heat, with abdominal distension and discomfort, and persistent diarrhea, use the He Li Le Decoction.” This formula consists of He Li Le, Da Huang (Rhubarb), Qing Pi (Green Tangerine Peel), Gan Jiang (Dried Ginger), Hou Po (Magnolia Bark), Chen Pi (Dried Tangerine Peel), Gao Liang Jiang (Galangal), Gan Cao (Licorice), Fang Feng (Siler), and Zhi Ke (Bitter Orange). He Li Le is known to “relieve cold and abdominal distension, and eliminate retained food” (“Newly Revised Materia Medica”) and can also “warm the stomach and consolidate the intestines” (“Materia Medica Tong Xuan”). Paired with the bitter cold Da Huang, it utilizes both cold and warm properties, taking advantage of Da Huang’s ability to clear the intestines while suppressing its purgative force. Gao Liang Jiang and Gan Jiang warm the stomach and dispel cold, while Hou Po, Chen Pi, Qing Pi, Zhi Ke, and Fang Feng promote qi movement, eliminate stagnation, and relieve distension. The entire formula primarily warms the stomach while also clearing the intestines.
The Lizhong Decoction is modified with Fu Ling and Huang Lian, named the Lian Li Decoction. The “Secret Transmission of Diagnosis and Treatment” uses this formula for summer internal injury from cold, excessive diarrhea leading to anal heat, red and painful urination, and thirst in the heart, indicating stomach cold and intestinal heat. Yang Fuguo believes that the stomach cold and intestinal heat pattern presents with spleen and stomach deficiency and cold, along with accumulated heat in the intestines. However, it is often primarily a stomach cold condition. For some chronic diarrhea patients, the complexion is pale, they prefer warmth and fear cold, have a reduced appetite, and cold limbs, indicating spleen and stomach deficiency and cold. However, during diarrhea episodes, they may often experience urgency and heaviness, or even pus and blood, with a bitter mouth and yellow tongue coating, clearly indicating the presence of heat evil. In this case, the Lian Li Decoction can be used, primarily warming the middle and dispelling cold, combined with Huang Lian to clear heat and thicken the intestines, achieving better therapeutic effects.
2. Discussion on Treatment of Stomach Heat and Intestinal Cold Patterns
The main symptoms of stomach heat and intestinal cold patterns are restlessness, hunger, abdominal pain, or diarrhea that is clear and watery. If there is heat in the stomach, it will lead to hunger; regarding the term “restlessness,” Zhang Jiebin states: “Restlessness refers to the upward inflammation of stomach fire, causing the heart blood to be scorched and leading to unease” (“Leijing: Lunzhil”). This actually describes the symptoms of discomfort in the stomach. For the intestinal cold mechanism and symptoms, as stated in the “Suwen: Ju Tong Lun”: “Cold qi resides in the small intestine, preventing it from forming a mass, hence leading to abdominal pain and diarrhea.” This type of diarrhea is mostly cold-type diarrhea, where cold causes stagnation, and qi and blood do not flow, resulting in abdominal pain. The condition belongs to the cold-heat mixed pattern of the gastrointestinal tract, with heat above and cold below, and treatment should clear the stomach and warm the intestines, adjusting cold and warm. Representative formulas can be selected based on the severity of cold and heat and the presentation of symptoms. For cases with more cold than heat and significant abdominal pain, the Qing Ju Pi Wan may be chosen; for cases with more heat than cold and predominant hunger, the Gan Di Huang Tang may be selected; for long-term cases with persistent diarrhea, the Wu Mei Wan from the “Shang Han Lun” may be appropriate.
(1) For cases with more cold than heat and significant abdominal pain, this condition primarily presents with abdominal pain, hunger, and mild discomfort in the stomach, or accompanied by difficult bowel movements, indicating a type of stomach heat and intestinal cold. The treatment should use Qing Ju Pi Wan.
The Qing Ju Pi Wan is from the “Huangdi Suwen: Xuanming Lun Fang”, which states: “Qing Ju Pi Wan treats stomach heat and intestinal cold, with hunger and thirst, infrequent urination, and abdominal pain, with possible difficult bowel movements. Ingredients include Qing Pi, Jing San Ling, Huang Lian, Peng E Zhu (fried), Ba Dou Shuang (one part), ground into powder, and made into pills the size of green beans, taken three to nine pills with tea or wine after meals.” This formula uses Qing Pi to move downward and break qi stagnation, while Chen Pi treats the upper and Qing Pi treats the lower (“Tang Ye Ben Cao”). It employs San Ling and E Zhu to invigorate blood and move qi to relieve pain, with a small amount of Ba Dou to dispel cold accumulation in the intestines, and Huang Lian to clear stomach heat, utilizing both cold and warm properties, with warmth as the primary focus.
(2) For cases with more heat than cold and predominant hunger, this condition primarily presents with hunger and discomfort in the stomach, with mild abdominal pain, indicating a type of stomach heat and intestinal cold. The treatment should use Gan Di Huang Tang.
Gan Di Huang Tang is from the “Sheng Ji Zong Lu”, which states: “To treat stomach heat and intestinal cold, with frequent hunger, abdominal pain and distension, use Gan Di Huang Tang.” The ingredients include cooked Rehmannia, Ren Shen (Ginseng), Bai Fu Ling (white Poria, peeled), Mai Men Dong (Ophiopogon, heart removed and roasted), Pi Pa Ye (Loquat Leaf, washed), Di Gu Pi, Gan Cao (roasted and crushed), Shi Hu (Dendrobium, roots removed), and Huang Qi (finely crushed). All nine ingredients are of equal parts, coarsely crushed and sifted. Each dose is one qian (3 grams) with one and a half cups of water, decocted to seven parts, and taken without time restrictions. This formula primarily uses cooked Rehmannia, supplemented with Mai Men Dong and Shi Hu to nourish yin and clear heat, Di Gu Pi to eliminate heat and digest grains, Pi Pa Ye to harmonize the stomach and lower fire, and Ren Shen, Huang Qi, Fu Ling, and Gan Cao to tonify qi and harmonize the middle. This formula does not include herbs to dispel cold and move qi; it focuses on nourishing yin and clearing heat while adding tonifying and harmonizing herbs, aiming to restore the stomach and intestines’ self-regulating ability, correcting the imbalance of cold and heat in the gastrointestinal tract, which aligns with the “Lingshu: Wuxie” principle of “adjusting at Sanli.” Of course, this formula can also be adjusted with herbs to dispel cold and move qi, such as Wu Yao and Chen Xiang, to enhance the treatment of intestinal cold.
(3) For cases of stomach heat and intestinal cold with predominant long-term diarrhea, this condition primarily presents with persistent diarrhea, accompanied by hunger and discomfort, indicating a type of stomach heat and intestinal cold. The treatment should use Wu Mei Wan.
Wu Mei Wan is from the “Shang Han Lun” in the chapter on Jueyin disease, which states: “For Wu Mei syndrome, use Wu Mei Wan. It also treats persistent diarrhea.” This formula heavily utilizes Wu Mei for its sour astringent properties, combined with Shu Jiao, Gui Zhi, Gan Jiang, Fu Zi, and Xi Xin to warm and disperse, along with Huang Lian and Huang Bai to clear heat, supplemented with Ren Shen and Dang Gui to tonify qi and nourish blood. Wu Mei Wan is a representative formula for treating Wu Mei syndrome and can also treat persistent diarrhea. Regarding the mechanism of Wu Mei syndrome, many scholars have explained it from the perspective of stomach heat and intestinal cold, such as Yan Shilin, who believes, “The symptoms are due to the mixed cold and heat in different parts, with heat above and cold below, stomach heat and intestinal cold, essentially a disorder of gastrointestinal function. The treatment should clear the upper and warm the lower, calming the Wu Mei and relieving pain.” Modern literature indicates that “historically, Wu Mei Wan was often used for Wu Mei syndrome, but now it is more commonly used for diarrhea and dysentery.” Combining the cold and heat properties of the formula, with Wu Mei’s sour astringent as the main ingredient, and emphasizing warm and heat properties, it is suitable for treating gastrointestinal cold-heat mixed patterns with predominant long-term diarrhea.
For the conditions treated by Wu Mei Wan, many new expansions have emerged in modern times, indicating that the location of cold and heat mixed patterns is not limited to the gastrointestinal tract, proposing mechanisms such as spleen cold, kidney cold, liver heat, and stomach heat, enriching the understanding of clinical cold-heat mixed patterns. However, the “Neijing”‘s proposal of gastrointestinal cold-heat mixed patterns and the discussions of cold-heat mixed formulas in the “Shang Han Lun” hold original significance and deserve our attention.
(4) Discussion on Treatment of Stomach Heat and Stomach Cold Patterns
According to the discussion in the “Lingshu: Dawoh Lun”, stomach heat and stomach cold patterns exhibit both symptoms of hunger and restlessness from stomach heat and symptoms of abdominal distension and lack of appetite from stomach cold. Since it does not involve symptoms such as abdominal pain and diarrhea, this condition belongs to the type of cold-heat mixed patterns in the stomach, and the treatment should use Ban Xia Xie Xin Tang.
Ban Xia Xie Xin Tang appears in the “Shang Han Lun” at section 149: “If there is a fever after five or six days of cold damage, with vomiting, it indicates a Chai Hu Tang syndrome, but if other medicines are used and there is fullness without pain, this is a case of Pi…” The formula includes Ban Xia and Gan Jiang to warm the stomach and dispel cold, Huang Lian and Huang Qin to clear heat from the stomach, Ren Shen, Gan Cao, and Da Zao to tonify the middle qi, characterized by the combination of acrid and bitter herbs, cold and warm properties, and both tonifying and purging effects. From the perspective of formula and syndrome correlation, the main treatment of Ban Xia Xie Xin Tang aligns with the gastrointestinal cold-heat mixed patterns in the “Neijing”. Qing Dynasty physician Ke Qin referred to this type of cold-heat mixed pattern in the stomach as “the mutual binding of cold and heat under the heart”, and thereafter, “the mutual binding of cold and heat in the stomach” became a widely recognized pathological mechanism for this condition.
It can be seen that from the original understanding of gastrointestinal cold-heat mixed patterns in the “Neijing” to Zhang Zhongjing’s Ban Xia Xie Xin Tang, and then to Ke Qin’s understanding of “mutual binding of cold and heat”, there is an inherent connection in the academic lineage. Recognizing this connection helps deepen the interpretation of the “Neijing”‘s principles and aids in the clinical differentiation and treatment of cold-heat mixed patterns.
From the “Neijing”‘s understanding of gastrointestinal cold and heat, we find that ancient physicians, in the face of complex clinical manifestations of diseases, continuously sought methods to understand the essence of diseases, thereby grasping general treatment principles. How to differentiate between stomach cold and intestinal cold, stomach heat and intestinal heat? How to recognize gastrointestinal cold-heat mixed patterns and their priority and urgency? What principles and methods should be used for treatment? The answers to these questions reveal the most fundamental content of TCM clinical thinking: first, one must recognize symptoms through basic symptom analysis to understand the nature and location of the disease; second, one must comprehend the complexity of clinical manifestations and learn to grasp the essence of the disease through differentiating mixed and opposing symptoms; third, in practical application, attention must be paid to the priority and urgency of symptoms, allowing for flexible treatment.
The above discussion on the differentiation and treatment of gastrointestinal cold-heat mixed patterns focuses more on general principles and methods, serving as a demonstration for clinical differentiation and treatment for future scholars to comprehend during their learning and practice, but it cannot represent the entirety of clinical variations. The “Suwen: Qi Jue Lun” specifically discusses the issue of “the transfer of cold and heat between the five organs and six bowels”, informing us of the complex clinical changes in the transfer of cold and heat between the organs and the gastrointestinal tract. Therefore, while knowing the “norms”, it is even more necessary to apply them flexibly in clinical practice to achieve “knowing the norms and adapting to changes”.
For instance, some scholars have proposed that Ban Xia Xie Xin Tang, based on its composition, can also be used for both “stomach cold and intestinal heat” and “stomach heat and intestinal cold” types of gastrointestinal cold-heat mixed patterns. The Ban Xia Xie Xin Tang syndrome belongs to a constitution of middle jiao deficiency and cold, combined with the real evil of damp-heat accumulation in the middle, residing in the middle palace, leading to obstruction and forming Pi. If the damp-heat is more significant than the deficiency and cold constitution, it will present with predominant damp-heat diarrhea, combined with symptoms of spleen and stomach deficiency and cold, which is referred to as “stomach cold and intestinal heat”; or if the spleen yang deficiency is heavier than the Pi, leading to the emergence of hidden yang, the clinical presentation will be predominantly cold diarrhea, combined with a tendency towards heat, which is referred to as “stomach heat and intestinal cold”. This perspective connects the stomach cold and intestinal heat, stomach heat and intestinal cold with the mutual binding of cold and heat in the stomach, proposing the viewpoint of using Ban Xia Xie Xin Tang for treatment, which has theoretical and clinical basis and is worth referencing.
Additionally, in the Qing Dynasty, the “De Xin Ji Yi An” recorded a case of treating “stomach cold and intestinal heat”: “Huang Pingfu, thin and pale, during the hot season, developed vomiting and diarrhea. The physician noted thirst and red urination, treated with gypsum and bamboo leaf decoction, but the vomiting and diarrhea did not stop, and instead, there was increased fullness in the chest and abdomen, with a state of confusion and agitation, indicating a critical condition. Upon diagnosis, the pulse was floating and rapid, the skin was hot to the touch, the tongue edges were red with prickles, and the entire tongue was covered with a white coating, with a yellow-black center… Initially treated with Lian Li Decoction, followed by Ban Xia Xie Xin Tang, which successfully stopped the vomiting and diarrhea, reduced the heat, and restored appetite and comfort… This person and this condition align with cold in the stomach and heat in the intestines, hence the distension and diarrhea. However, the cold in the stomach was initially due to the external heat pressing in, with coldness lurking within, and the physician used cold medicines to clear the stomach, which further chilled the stomach. Therefore, even with cold-heat mixed patterns, it was necessary to first use Lian Li to adjust the stomach qi and differentiate yin and yang. However, with the yang evil having already penetrated, forming a Pi, it is necessary to use bitter herbs to purge and acrid herbs to open up; otherwise, how can one resolve the cold-heat mixed evil? Modern physicians treat diseases by simply treating cold with heat and heat with cold. If faced with cold-heat mixed patterns, without understanding the principles of “Neijing” regarding stomach heat and intestinal cold, stomach cold and intestinal heat, and Zhang Zhongjing’s purging and warming methods, how can they shoulder this responsibility?” This case initially used Lian Li Decoction, followed by Ban Xia Xie Xin Tang to treat the symptoms of stomach cold and intestinal heat, respecting the principles of the “Neijing”, yet the differentiation and treatment were not rigidly bound to the mechanical correspondence of gastrointestinal cold-heat mixed patterns, but rather flexibly applied both formulas based on the priority and urgency of symptoms, leading to recovery. This flexible approach is worth learning.
Combining modern gastroenterology, diseases presenting as gastrointestinal cold-heat mixed patterns are quite common, such as “stomach cold and intestinal heat” patterns often having objective indicators of both gastritis and colitis. Reports have indicated the use of warming and tonifying formulas like Xiao Jian Zhong Tang combined with detoxifying formulas like Bai Tou Weng Tang for cold and heat treatment, achieving therapeutic effects. The above examples fully demonstrate that understanding the theories of the “Neijing”, mastering the clinical differentiation and treatment thinking and methods, and applying them flexibly still hold significant guiding value for today’s clinical practice.
To differentiate gastrointestinal cold-heat mixed patterns, one must first identify whether there is evidence of simultaneous cold and heat, clarify the locations of cold and heat, distinguish between upper and lower cold and heat, and different types of simultaneous cold and heat, employing different treatment methods and formulas. As Tang Rongchuan said: “I believe that in cases of combined cold and heat, there must be evidence of simultaneous cold and heat; one cannot generalize and mix cold and heat formulas” (“Xue Zheng Lun”).
The treatment principle for gastrointestinal cold-heat mixed patterns is to adjust the stomach and intestines (adjusting at Sanli), indicating that the disharmony of the stomach and intestines is the fundamental pathological mechanism of cold-heat mixed patterns. This can be corrected through the simultaneous use of warming and clearing methods, or through the combined use of cold and heat, or by tonifying qi to adjust the middle, enhancing the self-regulating function of the stomach and intestines, achieving the goal of treating cold-heat mixed patterns.
Combining the developments and applications of cold-heat mixed patterns in later generations, one can better appreciate the original principles of the “Neijing”. Only by actively applying the classics can we maximize their clinical guiding role.
