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At the end of 2022, the outbreak of COVID-19 made many people pay attention to the types of colds, and they compared their various symptoms with the official prevention and treatment guidelines and the descriptions of many traditional Chinese medicines regarding “Wind-Cold Cold” and “Wind-Heat Cold” to determine whether they belong to Wind-Heat or Wind-Cold. Most people found themselves confused: they discovered that they exhibited characteristics of both “Wind-Cold” and “Wind-Heat”. So what kind of cold do they actually have?
Today, Teacher Mu Mu will provide a basic introduction to TCM regarding external pathogens (colds), but it may differ significantly from what most people find on Baidu about colds, so Teacher Mu Mu can only say that this article represents one perspective and is for readers’ reference only.
Why do I say this? Because Teacher Mu Mu has repeatedly mentioned that the term “Wind-Heat Cold” is a term that emerged in recent years after Western medical thinking dominated the TCM medical system, created under a so-called “standardized” framework, along with terms like “gastrointestinal cold”.
In traditional Chinese medicine, external pathogens are a series of pathological changes caused by the invasion of the six external evils (wind, fire, heat, dryness, cold) into the human body, which can lead to misdiagnosis and mistreatment. Therefore, traditional Chinese medicine classifies diseases with exterior symptoms using Shao Yin and Wen Bing (and miscellaneous diseases).
Shao Yin, in a narrow sense, refers to the invasion of cold evil into the human body, while in a broad sense, it refers to the invasion of external evils such as fire, dryness, and epidemic qi. Why is “cold” used as a general term? Because cold evil is the most widespread and common (partly due to the classic work of the medical sage Zhang Zhongjing, “Shang Han Za Bing Lun”). The so-called “Wind-Heat Cold” symptoms (such as sore throat and thick nasal discharge) are actually primarily caused by wind evil and cold evil binding the exterior, leading to the emergence of internal heat, which also falls under the category of Shao Yin.
Therefore, Teacher Mu Mu dares to say, “Where does Wind-Heat Cold come from?” The vast majority of colds in today’s society are caused by wind evil leading the way, either from Wind-Cold or Wind-Cold-Damp, while pure dryness, fire, and heat evils are rarely seen. The common external evils throughout the year are as follows:
Wind evil in all four seasons represented by Gui Zhi Tang; Wind-Cold-Damp in spring represented by Jiu Wei Qiang Huo Tang; the alternating cold and heat in summer (cold evil from air conditioning and dampness from excessive drinking) represented by the “heat restraining cold” formulas like Xiang Ru Yin and Huo Xiang Zheng Qi San; autumn coolness represented by Shen Su Yin, autumn dryness represented by Xing Su San, and autumn cold-damp represented by Ren Shen Bai Du San; winter cold evil represented by Ma Huang Tang, and external cold with internal heat represented by Da Qing Long Tang, and external cold with internal cold-damp represented by Xiao Qing Long Tang. These are typical representatives, and not just these few formulas can completely resolve issues throughout the year. Specific treatment requires differentiation based on the three causes, such as the Gui Zhi Jiang Fu Tang for winter Wind-Cold-Damp, and many series of transformations caused by misdiagnosis and mistreatment of external pathogens (such as Ge Qian Lian Tang, Wu Ling San, etc.)—this is why it is said that “colds are the root of a hundred diseases” and “cancer also comes from colds”. Therefore, a truly skilled TCM practitioner must be proficient in the dialectical understanding of the transformations of evil qi. Conversely, if a TCM practitioner can treat external pathogens with pure herbal medicine and can “know the second dose after the first”, they must be a master.
Mr. Ni Hai Xia has had an extremely significant influence on the dissemination of TCM culture. Many TCM practitioners and enthusiasts know this person and have been greatly influenced by him, but his controversies are also significant. One of the main reasons is Mr. Ni Hai Xia’s sharp criticism of the Wen Bing school, stating that there is only Shao Yin and no Wen Bing (which translates to there being no Wind-Heat Cold). To be precise, Mr. Ni believes that Wen Bing also belongs to Shao Yin, meaning there is only one path: “Winter injury from cold must lead to spring illness from heat”.
Teacher Mu Mu does not fully agree with Mr. Ni’s view of “only Shao Yin, where does Wen Bing come from?” but speculates that one important reason for his attack on the Wen Bing school is related to external pathogens. Currently, the public’s understanding of TCM often begins with the division of “Wind-Cold” and “Wind-Heat”, which leads them into a pit from the start. Nowadays, whether in folk TCM, private TCM clinics, or public hospitals, the treatment of external pathogens using the mindset of “Wind-Heat Cold” can usually alleviate and relieve the symptoms caused by external pathogens, but not only is the treatment effect slow, strictly speaking, it is akin to using Western medicine to eliminate the sequelae of external pathogens, which is “fifty steps versus a hundred steps” (there are still many TCM practitioners who prescribe cold medicine for seven days, which is truly laughable and sad).
At this point, many people will ask Teacher Mu Mu, with so many symptoms of Wind-Heat Cold, how can we explain that?
The so-called symptoms of “Wind-Heat” cold are characterized by “heat”, which manifests as signs of heat, such as a red tongue, flushed face, inflamed throat, and thick nasal discharge.
The normal body temperature is always higher than the ambient temperature. For example, we usually say it is 36-37 degrees, while the ambient temperature is usually below 36°C (if the external temperature is higher than the body temperature, how many people can withstand it?). Therefore, the human body continuously dissipates heat through the skin, but the rate of heat dissipation is very slow, which is protected by the bladder meridian. The so-called external pathogens are exterior symptoms, meaning the evil qi is on the surface. Where exactly is it? It must be in the meridians on the surface. If there is evil qi in the meridians, it means it is bound on the surface (this evil qi can be wind, fire, heat, dryness, cold, or any combination of these). Thus, the mechanism for the body to release heat energy outward becomes disordered, leading to the accumulation of heat within—this is the internal heat caused by external pathogens.Therefore, external pathogens will always lead to internal heat, with cold evil binding the surface being the most common. When fire and heat evils invade the surface of the body, the surface pores are open, and heat will be released with sweat. Additionally, the characteristic of fire evil is “rapid nature”, which will not stay on the surface for long—it will either enter the interior or exit.
The heat mentioned above is the internal heat caused by external pathogens, and many symptoms manifested by this internal heat are what are referred to as the symptoms of “Wind-Heat Cold”—in fact, the vast majority of the reasons still fall under the category of Wind-Cold external pathogens, rather than creating a term “Wind-Heat Cold” that corresponds to cold.
When this heat accumulates to a certain extent, and the external pathogen has disappeared, what remains is heat, which then enters the category of “Wen Bing”.
On the other hand, due to various reasons, if the external pathogen has not yet occurred, but internal heat has already formed and become dominant—this is a typical Wen Bing. Wen Bing is relatively fierce and transforms particularly quickly, which is why the general public rarely has the opportunity to use TCM Wen Bing formulas such as Xi Jiao Di Huang Tang, Qing Ying Tang, and An Gong Niu Huang Wan—because once Wen Bing forms, the transformation is too fast, and it easily becomes an acute condition. At this point, most people have already gone to the hospital for modern medical treatment. The commonly used formulas are for the initial onset of Wen Bing, such as Yin Qiao San and Sang Ju Yin, which Teacher Mu Mu will discuss below.
What are the typical representative formulas for the so-called “Wind-Heat Cold”? Teacher Mu Mu prefers to use the accurate term “initial onset of Wen Bing” to replace “Wind-Heat Cold”.
When external evil qi invades the human body, it first follows two paths: the surface and the mouth and nose. Many TCM practitioners now say that Shao Yin enters from the surface, while Wen Bing enters from the mouth and nose. In fact, whether it is Wen Bing or Shao Yin, both can enter from the surface and the mouth and nose. For instance, Shao Yin can directly enter the spleen and stomach (Li Zhong Tang, Ge Gen Qin Lian Tang, Si Ni Tang) from the mouth and nose, and the symptoms of Yin Qiao San can enter from the mouth and nose or from the surface. Heat stroke can also enter from both the surface and the mouth and nose.
Fire evil (heat evil) entering through the mouth and nose, or internal heat caused by Shao Yin leading to internal heat, will remain in the lung system (lung and lung meridian), resulting in the symptoms of “initial onset of Wen Bing”.
When heat evil is in the Tai Yin lung meridian, the person will have a fever, feel hot and cold (or the fear of cold is not obvious), sweat is not obvious but also not completely absent, and there may be a slight cough, dry throat—this is the symptom of Yin Qiao San.
When heat evil enters the lung but is not in the lung meridian, there will be no fever (because the evil qi is not on the surface, there are no exterior symptoms), and there will be no fear of cold or heat, but there will be a cough, either dry or with very little phlegm, and dry mouth and throat, with or without throat pain—this is the symptom of Sang Ju Yin.
The transformation of Wen Bing will be gradually introduced in future articles by Teacher Mu Mu. Wen Bing is more about internal injury rather than external pathogens, so this article focuses on external pathogens and will not elaborate on Wen Bing.
Why does Teacher Mu Mu emphasize not using the term “Wind-Heat Cold”? Because historically, there have indeed been many cases of initial onset of Wen Bing that are significantly different from Shao Yin, but in today’s society, due to the great abundance of material life and the advent of air conditioning, the situation of external evil being fire evil invading is rare. The vast majority of colds today are cases of wind-cold evil binding the surface, and the information available online often leads people to first distinguish between Wind-Heat and Wind-Cold, which is truly misleading—if external cold is not resolved, and only heat-clearing herbs are used to clear internal heat, it leads to the internal invasion of external evil, causing a series of pathological changes—resulting in TCM being blamed!
Finally, let’s discuss how to practically use external pathogen formulas:
1. The formulas mentioned in this article have specific compositions in Teacher Mu Mu’s previous articles on this public account, you can search for the corresponding formula names.
2. For the specific application of external pathogen transformations, you can search for keywords “external pathogens” or “cold” to view a series of articles on external pathogens.
Note from the author:
Core article series by Teacher Mu Mu:
1. Seasonal Diseases (External Pathogens)
2. Treatment of the Five Organs (Fu)
3. Transformation of the Six External Evils (Wind, Fire, Heat, Dampness, Dryness, Cold)
4. Miscellaneous Diseases (classified by disease name)
5. Collection of Folk Remedies
6. Interpretation of Classic Formulas: Shao Yin, Jin Kui, Wen Bing
7. Meridians and Acupoints: Acupuncture, Moxibustion, Massage
8. Others: Five Movements and Six Qi, Zi Wei Dou Shu
Target audience for Teacher Mu Mu’s community:
1. TCM enthusiasts
2. Those needing COVID-19 protection and post-COVID-19 recovery
3. Cancer patients
4. Patients with difficult and miscellaneous diseases
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The formulas shared by Mu Mu are for communication purposes only; professional formulas and prescription medications should be used under the guidance of a physician. Do not take them casually; the consequences are at your own risk.