Differentiation of Cold and Heat Syndromes (All Organs)

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Location	Clinical Manifestations
Heat	Cold
Organ function activity is hyperactive	Organ function activity is impaired or reduced
Complexion	Full face redness mostly indicates true heat; two cheeks flushed mostly indicate false heat	Pale complexion indicates false cold
Posture	Likes to lie outward, tossing and turning, uncovering blankets	Likes to lie inward, curled up and motionless, prefers more blankets
Infant Fontanel	Fontanel is high and bulging	Fontanel is sunken
Head	Dizziness and headache with irritability mostly indicate liver fire; dizziness and headache with tinnitus mostly indicate liver yang rising; headache with nasal discharge and cough with phlegm mostly indicate wind-heat attacking	Cold headache, top of the head pain, or dizziness indicates false cold
Eyes	Red and swollen eyes mostly indicate true heat; styes mostly indicate wind-heat toxin; red corners of the eyes mostly indicate heart fire; swollen and wet eyelids, entropion, and opacity mostly indicate liver-gallbladder damp-heat; bulging eyes with neck swelling, irritability mostly indicate liver qi stagnation	Swollen eyelids, painful and tearing with headache, nasal congestion indicates cold invading the eyes
Ears	Wet and rotten ear auricle mostly indicates liver-spleen damp-heat; purulent discharge from the ear mostly indicates liver-gallbladder damp-heat; tinnitus followed by deafness, itching in the ear, irritability mostly indicates wind-heat obstructing; persistent tinnitus or deafness with irritability mostly indicates phlegm-fire rising; tinnitus with insomnia and dry mouth mostly indicates liver-kidney yin deficiency with excess fire	Closed and swollen ears, enhanced self-sound, tinnitus, deafness worsened by exertion indicates spleen-stomach qi deficiency
Nose	Red tip of the nose mostly indicates lung-spleen damp-heat; flaring nostrils, yellow phlegm, coarse breath mostly indicates lung heat; dry nose with blood-streaked mucus mostly indicates lung dryness; nosebleeds mostly indicate lung heat disturbing; red tip of the nose, papules, and sores mostly indicate lung-stomach heat excess; nasal ulcers with dry mouth and dry tongue mostly indicate blood heat not dispersing	Blue-tinged tip of the nose indicates cold congealing. Cold tip of the nose, nasal congestion with clear discharge indicates external wind-cold
Oral Cavity	Dry mouth, bitter taste, thirst indicates heat; oral and tongue ulcers mostly indicate heart-spleen accumulated heat; sweet and sticky mouth mostly indicates spleen-stomach damp-heat; sour regurgitation mostly indicates liver channel heat accumulation.	Pale mouth, no desire to drink, sour saliva indicates cold
Lips	Deep red lips mostly indicate excess heat; red, swollen, and dry lips mostly indicate extreme heat; ulcerated lips mostly indicate spleen-stomach damp-heat rising	Pale or bluish-black lips indicate cold
Teeth	Yellow and dry teeth mostly indicate heat injuring fluids; teeth dry and hard as stone mostly indicate yangming heat excess, fluids severely injured; grinding teeth at night mostly indicate stomach heat or accumulation of parasites; loose teeth mostly indicate false fire rising; teeth with tartar mostly indicate stomach-kidney heat excess	Teeth tightly clenched indicate cold congealing
Gums	Red and swollen gums mostly indicate stomach fire rising; swollen, painful, and bleeding gums mostly indicate stomach heat injuring collaterals	Pale white gums indicate blood deficiency with cold
Tongue	Red tongue with yellow coating mostly indicates true heat; red tongue with cracks and no coating mostly indicates yin deficiency with fluid injury; ulcers on the tongue tip indicate excess heart fire; ulcers on the tongue edges mostly indicate liver-gallbladder damp-heat; prickly growths on the tongue body mostly indicate stomach heat excess	Pale tongue with white coating indicates cold
Throat	Red and swollen throat mostly indicates lung-stomach heat; red, swollen, and purulent ulcers indicate heat toxin accumulation; tender red color, mild swelling or dry pain mostly indicates yin deficiency with excess fire; white membrane on the throat that cannot be scraped off mostly indicates lung-stomach heat	Itchy throat, cough indicates cold. Hoarseness with chills, no sweat mostly indicates cold evil externally binding
Neck	Neck and back pain, pulling and limited movement with bitter mouth mostly indicates damp-heat	Cold pain in the neck and back indicates cold
Chest	Chest pain, accompanied by strong heat and red face indicates heat	Chest pain, tightness, prefers pressure and warmth indicates cold
Flanks	Burning pain in the flanks, red face, bitter mouth mostly indicates liver fire; distended pain in the flanks, yellowing of the body and eyes mostly indicates liver-gallbladder damp-heat. Distended pain in the flanks, belching relieves, irritability mostly indicates liver qi stagnation transforming into fire	Flank pain relieved by pressure, vomiting clear saliva mostly indicates liver-stomach false cold
Abdomen	Abdominal pain with aversion to heat, refuses pressure	Abdominal pain prefers warmth, enjoys pressure
Heart	Palpitations, insomnia with vivid dreams mostly indicate heat; if accompanied by tidal fever and night sweats, five hearts heat indicates heart yin deficiency; if accompanied by oral and tongue ulcers indicates heart fire rising; if accompanied by painful urination indicates heart fire descending to the small intestine; if accompanied by agitation and delirium mostly indicates phlegm-fire disturbing the heart	Palpitations, chest tightness, shortness of breath, spontaneous sweating, worsens with movement, pale complexion indicates cold
Lungs	Cough with yellow phlegm indicates lung heat; if accompanied by yellow nasal discharge mostly indicates wind-heat invading the lungs; if accompanied by wheezing, coarse breath, flaring nostrils, or coughing up purulent blood-stained phlegm mostly indicates evil heat obstructing the lungs; dry cough or phlegm with blood streaks, flushed cheeks, tidal fever, night sweats mostly indicates lung yin deficiency	Cough with white phlegm indicates cold evil in the lungs
Liver	Distended pain in the flanks, bitter mouth, poor appetite, nausea mostly indicates liver-gallbladder damp-heat; burning pain in the flanks, accompanied by headache, dizziness, tinnitus, red face, irritability, vivid dreams mostly indicates liver fire rising; dull pain in the flanks, accompanied by dizziness, tinnitus, dry eyes mostly indicates liver yin deficiency	Lower abdominal pulling pain radiating to the testicles, or scrotal contraction pain mostly indicates cold stagnation in the liver channel
Spleen	Abdominal fullness, nausea, aversion to food, heaviness in limbs, loose stools with urgency, fluctuating body heat, itchy skin	Abdominal distension, poor appetite, loose stools with foul gas, pale complexion, heaviness in limbs, edema, clear and thin leukorrhea
Kidney	Soreness and weakness in the lower back and knees, dizziness, tinnitus, insomnia with vivid dreams, men with strong yang, yellow and thick nocturnal emissions, women with scanty menstruation, amenorrhea or excessive bleeding, thin body, tidal fever, night sweats mostly indicates kidney yin deficiency	Cold pain in the lower back and knees, aversion to cold limbs, or edema below the waist, men with impotence and nocturnal emissions, women with cold womb infertility mostly indicates cold in the kidneys
Stomach	Burning pain in the stomach, sour regurgitation, good appetite, thirst for cold drinks, swollen and ulcerated gums, bleeding teeth, bad breath	Cold pain in the stomach, pale mouth, no thirst, clear saliva, nausea after eating, rumbling intestines
Gallbladder	Palpitations, insomnia, irritability, bitter mouth, nausea, chest tightness, dizziness	Dry heaving, chest tightness relieved by pressure
Small Intestine	Agitation, oral ulcers, throat pain, deafness, short and red urination, painful urination or blood in urine, pain in the penis	Dull pain in the lower abdomen, rumbling intestines, persistent diarrhea, frequent and unsatisfactory urination, scrotal hernia pain
Large Intestine	Abdominal pain with bloody diarrhea, urgency with a heavy feeling in the rectum or explosive diarrhea, yellow and foul-smelling stools, blood in stools indicates intestinal wind bleeding	Frequent diarrhea, incontinence, or prolapse of the rectum
Bladder	Frequent urination, urgency, scanty and painful urination, or yellow, turbid urine, or blood in urine, or urine with sand and stones	Frequent, clear, and long urination
Triple Burner	Chills with little sweating, body heat not rising, heavy head, heavy body and limbs, chest tightness, abdominal fullness, pale mouth with no thirst indicates upper burner warm heat; body heat not rising, sweating but heat not resolving, thirst but no desire to drink, abdominal fullness with nausea, heavy limbs, loose stools indicates middle burner damp heat; difficulty urinating, thirst but no desire to drink, hardness and fullness in the lower abdomen, dull complexion indicates lower burner damp heat	Includes cold syndromes of the heart, lungs, liver, spleen, kidneys, stomach, gallbladder, large intestine, small intestine, bladder, etc.
Lower Back	Heavy and painful lower back, heat in the lower back, red urine, thirst indicates damp-heat stagnation	Lower back pain radiating to the back, cold in the lower back
External Genitalia	Red, swollen, hot, painful vulva or scrotum, or red rash, itchy, rotten skin indicates damp-heat descending	Cold pain in the vulva or scrotum, retraction
Anus	Burning anus, unsatisfactory defecation, red and swollen perianal area or ulceration with purulent discharge indicates damp-heat descending, anal fissures mostly indicate blood heat with dry intestines	Incontinence, diarrhea, or prolapse of the anus
Hands and Feet	Both hands and feet are hot. Hotness in the front of hands and feet indicates external heat; hotness in the palms and soles indicates internal injury heat	Both hands and feet are cold
Skin	All skin is hot. Initially hot to the touch, but less hot with prolonged pressure indicates heat on the surface; increasingly hot with prolonged pressure indicates heat inside	All skin is cold
Voice	Voice is loud and strong, talking a lot indicates heat. Laughing and scolding, incoherent speech indicates phlegm-fire disturbing the heart; slurred speech indicates heat entering the pericardium	Weak, low voice indicates cold
Breathing Sound	Breathing is coarse and strong, breath is hot	Weak and powerless breathing
Hiccup Sound	Hiccups are loud and short, continuous and strong indicate true heat	Hiccups are low and long, weak and powerless indicate false cold
Cough Sound	Cough sound is not loud indicates lung heat; cough sound is crisp indicates dry heat	Cough sound is low, weak, and heavy
Vomiting Sound	Forceful vomiting, loud sound	Weak vomiting or dry heaving
Vomitus	Foul, turbid, sour smell indicates heat; yellow-green bitter water indicates liver-gallbladder damp-heat; vomiting fresh blood indicates liver fire invading the stomach	Clear and thin, fishy smell indicates cold
Phlegm	Yellow and thick phlegm indicates lung heat; purulent, blood-stained, foul-smelling phlegm indicates lung abscess; sticky phlegm difficult to expectorate like beads or threads or phlegm with blood streaks indicates dry phlegm	White and clear phlegm
Saliva	Sticky saliva in the mouth indicates spleen-stomach damp-heat; drooling during sleep indicates stomach heat	Excessive, clear saliva
Sweat	Profuse sweating with red face, thirst indicates true heat; sweat with fishy smell indicates wind-damp-heat accumulating in the skin; dry skin with no sweat, accompanied by dry mouth, constipation mostly indicates dry heat injuring yin; spontaneous sweating or night sweats with five hearts heat indicates yin deficiency not contained; sticky or yellow-stained sweat indicates damp-heat obstructing	No sweat with aversion to cold indicates cold evil externally binding; spontaneous sweating or night sweats, cold sweat indicates yang deficiency not solid
Urine	Yellow, short, and scanty urine indicates heat. Blood in urine indicates heat injuring blood vessels; cloudy urine like paste indicates damp-heat descending, urine with sand and stones indicates damp-heat internally accumulating	Large volume, clear, frequent urination
Stool	Deep yellow and foul, sticky and thick indicates damp-heat; dry stool like sheep droppings indicates heat excess injuring fluids; stool mixed with blood indicates heat scorching the intestinal collaterals	Clear and thin stool like water indicates cold-damp
Menstruation	Menstrual flow is obstructed or early with fatigue, itching, red and painful urination indicates damp-heat descending; irregular menstruation or obstructed flow with breast distension, flank pain, irritability, bitter mouth indicates liver qi stagnation transforming into fire; dark red menstrual blood, thick and abundant indicates heat pattern	Late menstrual flow with scanty amount and pain relieved by pressure indicates cold; pale menstrual blood, thin and scanty also indicates cold congealing
Leukorrhea	Yellow, thick, foul-smelling leukorrhea indicates damp-heat; red or mixed red and white leukorrhea indicates liver qi stagnation transforming into fire	White, clear, thin, and abundant leukorrhea
Semen	Yellow and thick semen indicates heat; blood in semen indicates heat disturbing the essence	Clear and cold semen indicates cold
Infant Fingerprints	Purple-red fingerprints, thickened, with visible branches	Pale fingerprints, thinned, with invisible branches
Nails	Deep red nails indicate internal heat	Pale nails indicate cold congealing
Thenar Patterns	Red color indicates stomach heat	Blue color indicates stomach cold
Pulse	Floating and rapid indicates exterior heat; surging and rapid indicates interior heat; slippery and rapid indicates damp-heat; thin and rapid indicates yin deficiency with excess fire	Floating and tight indicates exterior cold; deep and slow indicates interior cold
Application of Cooling Tea	Suitable to use cooling tea	Use cooling tea with caution or avoid

Source: Yipin Pavilion

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