Wind-Cold Cold Wind-Heat Cold
1. Key Points for Clinical Treatment of Wind-Cold and Wind-Heat Colds
(1) Clinical Characteristics of Wind-Cold Cold: ① Tongue coating is pale white and thin, pulse is tight and floating. ② Cough with thin phlegm, or with bubbles. ③ No sweating, headache, and joint pain all over the body. ④ Aversion to cold, fear of cold is severe, fever is mild, mostly below 38.5°C.
Prescriptions: ① Ma Huang Gui Zhi Tang from Shang Han Lun for warming and releasing the exterior. ② Jing Fang Bai Du San from Sheng Sheng Zhong Miao Fang (Jing Jie, Fang Feng, Chai Hu, Qian Hu, Qiang Huo, Du Huo, Chuan Xiong, Jie Geng, Zhi Ke, Fu Ling, Gan Cao). Mnemonic: Jing Fang Er Hu Er Huo Xiong Geng Zhi Ke Ling Gan Cao.
(2) Clinical Characteristics of Wind-Heat Cold: ① Tongue coating is yellow and thin, pulse is floating and rapid. ② Cough with thick yellow phlegm or thick white phlegm. ③ Sweating, sore throat. ④ Aversion to cold is mild, fear of wind. Fever is severe, mostly above 39°C.
Prescriptions: ① Yin Qiao San from Wen Bing Tiao Bian for cooling and releasing the exterior. ② Song Ju Yin.
(3) Adjustments for Wind-Cold and Wind-Heat Colds: ① Add Chuan Xiong to the formula to dispel Wind-Cold; add Che Qian Cao for diuresis; add Gua Lou and Hu Zhang for constipation, providing a route for the pathogen to exit. ② For cases with bacterial infection, add Pu Gong Ying and Jin Yin Hua to the formula. For viral infections, add Da Qing Ye and Ban Lan Gen. ③ For cases with fatigue and weakness, add Yin Yang Huo, Xian He Cao, and Sheng Huang Qi. ④ For those with obvious dampness (thick white tongue coating), combine with San Ren Tang for treatment. ⑤ For summer colds with nausea, add Huo Xiang to clear summer heat. ⑥ For external pathogens causing digestive issues, add Jiao San Xian and fried Lai Fu Zi to aid digestion.
2. Treatment Strategies Using Classic Formulas
For severe colds with body and joint pain, use Ma Huang Tang. Ma Huang is segmented, similar to the joints of the human body, and can help expel cold. Shang Han Lun primarily focuses on syndrome differentiation, with the key being to identify the main symptoms and their characteristics.
The pulse standard for Ma Huang Tang is: floating and tight.The pulse standard for Gui Zhi Tang is: floating and weak. Floating but not weak is the minimum standard for Ma Huang Tang. If it does not meet this standard, it is treated with Gui Zhi Tang.
●For external Wind-Cold with excess symptoms, headache, nasal congestion, no sweating, slight aversion to cold and wind, Ma Huang Tang plus Bai Zhi is effective for quick recovery. Exterior syndrome with fever and simultaneous aversion to cold indicates the condition is at the surface.
●For treating external Wind-Cold with aversion to cold and fever, body pain, and no sweating, it is advisable to take Ma Huang Tang.
●Ma Huang Fu Zi Xi Xin Tang is particularly effective for treating the initial stage of colds with sore throat. 60% of patients taking it early can control the progression to bronchitis.
In fact, regardless of the type of cold, as long as the pulse is deep as the main manifestation, taking Ma Huang Fu Zi Xi Xin Tang for 3 doses can cure over 80% of cases. In this formula, Fu Zi can invigorate Kidney Yang, expel cold pathogens, Xi Xin can search the marrow and expel internal evil from the skin, and Ma Huang releases the exterior to disperse evil, leading to recovery. TCM treatment of colds should focus on the theory of true Yang and vital energy, rather than blindly following Western viral theories.
● Some people never have a fever when they catch a cold, indicating a low inflammatory response, which is due to insufficient Shaoyin heat, leading to Yang deficiency. Use Ma Huang Fu Zi Gan Cao Tang for treatment, and if there is a cough, add Xing Ren and Kuan Dong Hua for cough relief.
●For Wind-Cold colds with fatigue and drowsiness, use Ge Gen Tang for treatment.
●For Wind-Cold colds with abdominal pain and diarrhea, use Gan Cao Ma Huang Tang (Ma Huang 10g, Gan Cao 15g) for treatment.
●Li Ke said, “External pathogens can also harm the internal, do not simply use Ma Huang Tang to release the exterior. Use Ma Huang Fu Zi Xi Xin Tang, to stabilize the root Qi and open the closed exterior. If the person is very deficient, add a small amount of Ren Shen.”
●Shang Han Lun Zhi Zi Dou Chi Tang (Zhi Zi 10g, Dou Chi 15g) efficacy: clears heat and relieves irritability. Indicated for external heat diseases, with evil in the Qi level. Symptoms include fever, chest tightness, irritability, and insomnia. Zhang Jing Ren used Zhi Zi Dou Chi Tang as the main treatment for new colds, with no exceptions, and emphasized the importance of “exterior and penetrating” in the classic formulas.
●Shen Su Yin. Rebuilding Pill. Song Ju Yin can all be adjusted for treatment.
●Yin Qiao San efficacy: disperses the exterior with acrid coolness, clears heat and detoxifies. Treats Wind-Heat colds. It can also be adjusted to treat acne and urticaria.
●Song Ju Yin and Yin Qiao San are the essence formulas of the time. Clinical practitioners should be familiar with their application.
●Yin Qiao San clinical medication rules: for constipation add Da Huang, for full Gua Lou. When experiencing external Wind-Cold with fever, add Shi Gao. For insomnia, add Suan Zao Ren. For stiff neck and back, add Ge Gen. For dry mouth and thirst, add Tian Hua Fen. For respiratory difficulties, add Suan Zao Ren. For frequent sweating, add Bai Shao. For nausea and vomiting, add Ban Xia. For cough, add Wu Wei Zi. For chest tightness, add Huang Lian. For palpitations, add Fu Ling. For stomach distension, add Gua Lou. For abdominal bloating, add Hou Po. For mental confusion, add Bai He. For reduced urination, add Hua Shi. For irritability, add Zhi Zi. For anxiety and panic, add Long Gu and Mu Li. For alternating cold and heat, add Chai Hu and Huang Qin. For sore throat and excessive phlegm, add Jie Geng.
●For summer colds with fever and clear nasal discharge, with aversion to cold and weakness, use Xiao Chai Hu Tang with diuretic bamboo leaves to provide a route for the evil to exit, and the fever will subside and the illness will be cured.
3. Clinical Treatment Strategies for Xiao Chai Hu Tang
1. Xiao Chai Hu Tang with 10g of Jing Jie and 10g of Fang Feng, used for external pathogens with half exterior and half interior symptoms, with significant aversion to wind, nasal congestion, and clear nasal discharge.
2. Xiao Chai Hu Tang with 12g of Qiang Huo and 12g of Du Huo, used for external pathogens with half exterior and half interior symptoms, with significant pain in the waist, knees, and joints.
3. Xiao Chai Hu Tang with 12g of Xing Ren and 12g of Su Ye, used for external pathogens with half exterior and half interior symptoms, with mild cough.
4. Xiao Chai Hu Tang with 12g of Huo Xiang and 10g of Su Ye, used for summer colds with cold symptoms and half exterior and half interior symptoms.
5. Xiao Chai Hu Tang combined with Zhi Sou San, used for external pathogens with half exterior and half interior symptoms and significant cough with phlegm that is difficult to expel.
4. Empirical Formula: For early Wind-Cold, use 2-3 slices of fresh ginger, boil for a while, add about 6g of mint, and 1 section of scallion with roots, cover and keep warm for about ten minutes, then take it hot to disperse the Wind evil effectively. Mint disperses the lungs, releases the exterior, soothes the liver, and clears heat.
Influenza
1. Key Points for Clinical Treatment of Influenza
Although a cold is not a serious illness, achieving effective treatment is challenging for practitioners. Therefore, the famous Qing Dynasty physician Xu Ling Tai said, “Although a cold is a minor illness, it should not be taken lightly.” Wei Yu Heng also said, “The common people often say that a cold is not serious, but it can lead to exhaustion if not treated properly.”
For strong individuals with a cold, use Ma Huang Tang, for those with Qi deficiency, use Gui Zhi Tang, and for those with Yang deficiency, use Ma Huang Fu Zi Gan Cao Tang.
2. Treatment Strategies Using Classic Formulas
●For colds, influenza, bronchitis, pharyngitis, and those with clear nasal discharge and aversion to cold and weakness, Ma Huang Fu Zi Xi Xin Tang for 3 doses can cure.
●Ma Xing Shi Gan Tang is effective for preventing and treating influenza. If using Western medicine to treat cold and fever, or using TCM “Yin Huang” to reduce fever, the fever may subside, but the cold evil remains in the patient’s body, leading to severe subsequent cough. The famous Qing physician You Zai Jing explained: “The evil in the lungs cannot be expelled without Ma Huang and Xing Ren; the cold-accumulated heat cannot be removed without Shi Gao; Gan Cao not only rescues the lung Qi but also moderates the harshness of Shi Gao.” Therefore, this formula is ideal for treating influenza A. After using Ma Xing Shi Gan Tang, the cough improves. If one tries to explain TCM with Western medical theories, it is like trying to explain Hua Tuo’s Five Animal Frolics with Western boxing, the more one explains, the more confused it becomes. In fact, the changes in diseases and viruses will always exceed technological development.
●Yin Qiao San for treating influenza should include Qiang Huo and Du Huo. Qiang Huo is a key herb for treating influenza, based on empirical evidence (Lai Chun Mao).
●In cases of epidemic diseases, which are easily transmitted, observe the tongue coating as thick and white, with thirst and no desire to drink, use Yin Qiao San plus one ingredient of Cang Zhu to help the patient resolve the exterior and eliminate dampness, leading to a quick recovery (Anqing Zhao Ping Ai’s experience).
Song Ju Yin (Wei Gen 20g, Mint 4g, Xing Ren 12g, Gan Cao, Jie Geng, Ju Hua each 6g, Lian Qiao 12g, Sang Ye 9g). Currently used for upper respiratory infections, influenza, acute bronchitis, acute tonsillitis, and acute pharyngitis.
Song Ju Yin adjustments: ① For lung heat, add Huang Qin. ② For thirst, add Tian Hua Fen. ③ For excessive phlegm, add Gua Lou Pi and Zhe Bei Mu.
3. Empirical Treatment Strategies
●Ren Shen Bai Du San is a remedy for strengthening the righteous Qi and expelling evil. It is currently widely used for treating influenza and habitual furuncles.
The late famous Yunnan TCM physician Lai Chun Mao said: Ren Shen Bai Du San without Qiang Huo makes it difficult to expel evil toxins, reducing its efficacy. In clinical application, Qiang Huo should not be omitted. Yue Mei Zhong said: “If an external pathogen formula requires Ren Shen, it is better to use Tai Zi Shen.” Zhang Lu said: “In the formula, Chai Hu and Qian Hu are both wind herbs, but Chai Hu promotes upward movement while Qian Hu promotes downward movement, which is different.”
Rebuilding Pill (Gui Zhi 6g, Bai Shao 6g, Da Zao 10g, Gan Cao 6g, Huang Qi 12g, Zhi Fu Zi 4g, Chuan Xiong 5g, Ren Shen 6g, Qiang Huo 9g, Xi Xin 4g, Fang Feng 5g). This formula treats Yang deficiency individuals with external Wind-Cold, where Yang deficiency cannot produce sweat, and the exterior syndrome does not resolve. Symptoms include fever, aversion to cold, no sweating, headache, and stiff neck.
For influenza, which belongs to Wind-Cold damp evil at the surface with interior heat, Jiu Wei Qiang Huo Tang is used for treatment.
●Influenza empirical formula: Chai Hu, Huang Qin, Qing Hao each 15g, Da Huang 3g. Decoction, take 2 times a day for 3 days. Effective for fever, clear nasal discharge, and cough (Zhang Zhi Yuan).
Body Weakness and Susceptibility to Colds
1. Key Points for Clinical Treatment of Body Weakness and Susceptibility to Colds
1. Huang Di Nei Jing: “When the evil wind of deficiency attacks, avoid it at times, remain calm and empty, true Qi will follow, and the spirit will be internally guarded, where does the illness come from?” These twenty-four characters summarize the principles of health preservation. Clinically, it is recommended for such individuals to strengthen nutrition and engage in appropriate exercise, while adapting to climate changes, keeping the neck (Tian Tu point), back, and forehead warm to prevent cold-induced cough and throat irritation.
2. For Wind-Cold, use: Fang Feng, Jing Jie. For Wind-Heat, use: Su Ye, Scallion.
3. Where evil gathers, its Qi must be deficient; if it lingers and does not leave, the illness will be real. Deficiency means lacking and insufficient. Excess means full and abundant.
4. In cases of Wind-Cold, if there is no desire to eat, do not take warming spleen medicines. It is common for those with Wind-Cold to have no appetite; there is no reason to starve to death. For example, Li Zhong Wan and similar formulas should not be taken lightly. If taken by Yang-deficient individuals, it can increase heat Qi, or lead to no rescue. It is also said: In the early stages of Wind-Cold, do not overeat or labor, or eat lamb and engage in sexual activity, or consume bone broth and drink alcohol. If the illness improves, overeating can lead to digestive issues, and the illness will return. Laboring too early can also cause a relapse. Eating lamb, engaging in sexual activity, and consuming broth can lead to a return of the illness. Lei Zheng Huo Ren Shu. This clinical observation is a reminder for those who do not pay attention; after recovery, they may worsen and require hospitalization.
5. For chest and flank pain and abdominal distension in Wind-Cold, do not recklessly use moxibustion. Moxibustion can cause toxic gas to rise with fire, leading to swelling and breathlessness, which can be fatal. It is not known that chest and flank pain belong to Shaoyang, while abdominal distension belongs to Taiyin. Additionally, only Yin syndromes can be moxibustioned. Lei Zheng Huo Ren Shu.
6. For Taiyang disease, whether there is fever or not, there must be aversion to cold, body pain, and vomiting, with both Yin and Yang pulses being tight, it is called Wind-Cold. Shang Han Lun.
7. For Taiyin disease, the pulse is neither relaxed nor tight but moves rapidly, or the two inches are particularly large, with skin heat, headache, slight aversion to wind and cold, body heat with spontaneous sweating, thirst, or no thirst, and cough, with increased heat in the afternoon, it is called Warm Disease. Wen Bing Tiao Bian.
2. Treatment Strategies Using Classic Formulas
●To enhance physical strength and prevent susceptibility to colds, Gui Zhi Tang plus Huang Qi is effective. It is also effective for autonomic dysfunction and neurasthenia.
Looking at Shang Han Lun with 113 formulas, 91 types of herbs, most are tonics that can restore righteous Qi, and the formulas are all for expelling evil and supporting the righteous. The more evil Qi is removed, the more righteous Qi can be restored. From the perspective of integrating TCM and Western medicine, Gui Zhi Tang is not a sweating agent, but a strengthening agent. Additionally, for young women with menstrual colds, Gui Zhi Tang is used for treatment.
●Gui Zhi Tang treatment characteristics: If nausea and vomiting occur, increase the amount of ginger; if there is external Wind-Cold but little sweating, the amount of Gui Zhi should be greater than Bai Shao; if there is much sweating, the amounts of Gui Zhi and Bai Shao should be equal; if there is weakness, the amount of Da Zao can be increased by 20-40 pieces (Zhang Zhi Yuan).
●Chai Hu Gui Zhi Tang is the main formula for Shaoyang with Taiyang, and is a good formula for treating external pathogens in those with physical weakness, clinically effective for dispersing the heat of the three Yangs. For fever, Chai Hu generally needs to be used at 20-60g or even 120g for significant effects.
●“For weak individuals with Wind-Cold, Zhang Zhong Jing never uses exterior-releasing herbs; first, warm the middle and tonify deficiency with Li Zhong Tang, and if the exterior evil is still unresolved, then use Gui Zhi Tang to resolve it.
●For anemia, spontaneous sweating, and susceptibility to colds, with middle Jiao deficiency and cold abdominal pain, use Huang Qi Jian Zhong Tang for treatment.
●Huang Qi Jian Zhong Tang treats all deficiency-related illnesses, such as weakness, poor digestion, recurrent colds, and physical weakness with spontaneous sweating. Symptoms include a yellow complexion, loose muscles, and a swollen appearance. The syrup in Huang Qi Jian Zhong Tang (maltose, sweet taste). If the patient does not like sweet foods or has abdominal distension, malt can be substituted. If the patient is constipated, honey can be used instead, as honey can tonify the middle and also moisten the intestines.
●Zhi Gan Cao Tang is considered a strengthening formula for patients with deficiency, serving as a nourishing tonic.
●Ling Gui Zhu Gan Tang has a strong Qi tonifying effect, and regular consumption can enhance immunity and prevent colds.
●For weak individuals with colds, or postpartum colds, use Xiao Chai Hu Tang for effective treatment.
3. Treatment Strategies for Seasonal Formulas
●For recurrent colds, if You Gui Yin is ineffective, increase Huang Qi by 30-40g for ideal results. For those with fatigue and poor physical condition, add Xian Ling Pi 30g.You Gui Yin composition: Shu Di 18g, Shan Yao 12g, Gou Qi Zi 12g, Du Zhong 12g, Shan Yu Rou 6g, Rou Gui 2g, Zhi Fu Zi 12g, Zhi Gan Cao 6g. Decoction for oral administration.
●For weak children and elderly individuals who are prone to colds, with nasal congestion and clear nasal discharge due to Wind-Cold, combine You Gui Yin with Gui Zhi Tang for treatment. Therefore, for recurrent colds that linger and do not resolve, clinical treatment should focus on warming the kidneys.
●For Yang-deficient colds, an effective formula is Yu Ping Feng San combined with Gui Fu Ren Qiang Hua Cao.Yu Ping Feng San composition: Huang Qi 12g, Bai Zhu 9g, Fang Feng 10g, Gui Zhi 9g, Zhi Fu Zi 6g, Ren Shen 6g, Qiang Huo 10g, Jin Yin Hua 6g, Zhi Gan Cao 6g. This formula treats individuals with poor physical condition, susceptibility to colds, and recurrent external pathogens that are difficult to resolve.
●For individuals with colds, Yu Ping Feng San combined with Buzhong Yiqi Tang for treatment. For those prone to colds, the formula can be adjusted to include Song Jie 30g for better results.
●For individuals with colds and spontaneous sweating, use Gui Zhi Tang, Yu Ping Feng San, and Buzhong Yiqi Tang. The combination of these three formulas is more effective than using a single formula.
●For those who are prone to colds, cough, sneezing, and sweating, use Huang Qi Gui Zhi Wu Wu Tang combined with Yu Ping Feng San for treatment.
●For individuals with physical weakness and frequent colds, especially the elderly, combine Chai Hu Gui Zhi Tang with Yu Ping Feng San. This combination can treat existing illnesses and prevent new ones, effectively managing high fever and low fever, especially in the elderly and weak individuals, making it a good health-preserving formula without the need for tonics.
The above selections are from the book One Disease, Multiple Formulas.
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