Cold and Heat Differentiation: Cold and heat are a pair of principles used to differentiate the nature of diseases, reflecting the imbalance of Yin and Yang during the disease process.1. Cold Syndrome refers to the invasion of cold pathogens, or Yang deficiency with excessive Yin, leading to a decline in the body’s functional activities, manifesting symptoms characterized by coldness. This is often due to external invasion of Yin-cold pathogens, excessive consumption of cold foods, or internal accumulation of cold due to prolonged illness resulting in Yang deficiency. Clinical manifestations: Symptoms of cold syndromes can vary, commonly including aversion to cold, fear of cold, cold pain, preference for warmth, pale and dry mouth with little thirst, cold limbs curled up, clear and thin phlegm, clear and long urine, loose stools, pale complexion, and a pale tongue with white and slippery coating. The pulse may be slow or tight. Key points for differentiation: The main mechanism is insufficient Yang Qi or excessive Yin harming Yang; Yang Qi is restrained and insufficient to perform its warming function, which can be assessed based on the main symptoms of aversion to cold, cold limbs, curled posture, preference for warmth, pale complexion, pale tongue, and white slippery coating.2. Heat Syndrome refers to the invasion of heat pathogens, or Yin deficiency with excessive Yang, or excessive Yang Qi in the organs, or emotional disturbances leading to fire, resulting in hyperactivity of the body’s functional activities, manifesting symptoms characterized by warmth and heat. Heat syndromes are often due to external invasion of fire-heat pathogens, transformation of cold pathogens into heat internally, excessive emotional stress leading to fire, dietary irregularities, accumulation transforming into heat, sexual exhaustion, and Yin deficiency with Yang excess. Clinical manifestations: Symptoms of heat syndromes can vary, commonly including fever, aversion to heat with preference for coolness, thirst with a preference for cold drinks, flushed face and red eyes, irritability, yellow and thick phlegm, short and red urine, dry and hard stools, red tongue with yellow and dry coating, and rapid pulse. Key points for differentiation: The main pathological mechanisms are Yang excess or internal heat due to Yin deficiency; main symptoms include fever, aversion to heat with preference for coolness, flushed face and red eyes, and rapid pulse; manifestations of heat damaging body fluids, such as thirst, constipation, red urine, and yellow dry coating; manifestations of fire burning blood vessels, leading to abnormal bleeding, such as hemoptysis.End
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Understanding Disease Differentiation in TCM: Eight Principles – Exterior and Interior
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