(Source: Rational Drug Use in China)
Common cold, or “shangfeng” (伤风), is an external pathogenic disease caused by the invasion of wind evil into the body, clinically characterized by symptoms such as headache, nasal congestion, runny nose, sneezing, cough, chills, fever, and general malaise. The typical duration of the illness is 3 to 7 days. The wind evil often invades according to seasonal changes: in spring, it is mostly wind-heat; in summer, it is often accompanied by heat and dampness; in autumn, it is commonly associated with dryness; and in winter, it is frequently wind-cold. Individuals with a weak constitution are more susceptible to wind-cold. This illness can occur in all seasons, particularly more frequently in winter and spring.
Based on clinical manifestations, the common cold can be classified into four types: wind-cold attacking the exterior (风寒束表证), wind-heat invading the exterior (风热犯表证), summer-heat and dampness injuring the exterior (暑湿伤表证), and qi deficiency with external invasion (气虚外感证). Today, we will mainly discuss wind-cold and wind-heat colds.
How to Distinguish Between Wind-Cold and Wind-Heat Colds?
01 Ask about Chills and Fever to Differentiate Pathogenic Factors
Clinically, asking patients about chills and fever helps to distinguish between wind-cold and wind-heat. If chills are severe, requiring thick clothing and heavy blankets, with mild fever, or if chills are predominant with relatively high fever, it generally indicates wind-cold;
Whereas if fever is severe and chills are mild, with high fever of 39°C or above, and the patient does not fear cold but only fears wind (aversion to wind), it generally indicates wind-heat.
02 Ask about Headache to Differentiate Cold and Heat
Headaches that are concentrated in the forehead and temples, often accompanied by body aches and neck stiffness, which worsen with cold, are mostly due to wind-cold.
A heavy sensation in the head is often due to wind-cold with dampness.
Headaches that feel swollen, with a flushed face, mild chills, and high fever are mostly due to wind-heat.
03 Observe Secretions and Excretions to Differentiate Cold and Heat
Secretions include nasal mucus and phlegm; excretions include urine and stool.
Nasal congestion with clear discharge indicates wind-cold; nasal congestion with turbid or yellow discharge indicates wind-heat.
Coughing with white, thin, or foamy phlegm indicates wind-cold; coughing with white, sticky, or yellow phlegm indicates wind-heat.
Clear urine indicates wind-cold; dark, yellow urine indicates wind-heat.
Loose stools are mostly due to wind-cold; dry stools or constipation are mostly due to wind-heat.
04 Examine the Throat to Differentiate Cold and Heat
Generally, a scratchy throat indicates wind-cold.
Generally, a swollen and painful throat indicates wind-heat.
05 Examine the Tongue and Pulse to Differentiate Cold and Heat
A pale red tongue with thin white coating and a floating or tight pulse generally indicates wind-cold.
A pale red or red tongue with thin yellow coating and a floating, rapid pulse generally indicates wind-heat.
06 Consider the Season to Differentiate Pathogenic Factors
Wind is the chief of the six evils, often accompanied by cold, heat, dampness, dryness, and summer heat to invade the body and cause disease.
The seasonal weather changes are closely related to the six evils. Generally, wind-cold colds are common in winter; wind-heat colds are common in spring; summer-heat colds are common in summer; and wind-dry colds are common in autumn. This is a general rule, but clinically, the situation can be quite complex, and one may contract this illness outside of its typical season. Therefore, careful examination and accurate differentiation are essential for treatment.
Differentiation and Treatment01Wind-Cold Cold
Differentiation
Symptoms: Severe chills, mild fever, no sweating, headache, body aches, nasal congestion, clear runny nose, cough with thin or white phlegm, thin white tongue coating, floating or tight pulse.
Treatment should focus on warming and releasing the exterior, and dispersing cold from the lungs, using modified Ma Huang Tang (麻黄汤) (Ephedra Decoction) (Ma Huang, Gui Zhi, Su Ye, Ju Hong, Chai Hu, Jie Geng, Xing Ren, Gan Cao); or modified Jing Fang Bai Du San (荆防败毒散) (Schizonepeta and Saposhnikovia Powder).
For mild wind-cold cold (severe chills without sweating, slight headache, cough with thin phlegm, nasal congestion, dry throat, thin white tongue coating, floating pulse), use modified Xing Su San (杏苏散) (Apricot and Perilla Powder);
If wind-cold is accompanied by dampness (body heat not prominent, heavy head, aching limbs, white or greasy tongue coating, floating or soft pulse), use modified Jiu Wei Qiang Huo Tang (九味羌活汤) (Nine Flavor Qiang Huo Decoction);
If wind-cold has not resolved, leading to heat transformation or if there is pre-existing internal heat, and then re-exposure to wind-cold (symptoms include mild chills, heavier fever, no sweating, headache, body aches, nasal congestion, sore or swollen throat, dry mouth or thirst, thin yellow tongue coating, floating slippery rapid pulse), use modified Chai Ge Jie Ji Tang (柴葛解肌汤) (Bupleurum and Kudzu Decoction).
Selected Patent Medicines
① Wind-Cold Cold Granules
② Jing Fang Granules
③ Cold Relief Granules
④ Cold Soft Capsules
⑤ Zheng Chai Hu Drink Granules
⑥ Cold Stopping Capsules
⑦ Cold Wind Dispelling Capsules
Examples of Patent Medicine Combinations
1. For severe symptoms of wind-cold cold, use Wind-Cold Cold Granules and Cold Relief Granules. Both medicines can be taken together as a “medicated tea” (方2) prepared by extracting the juice, taken once in the morning and evening, and Wind-Cold Cold Granules once at noon.
2. For wind-cold cold with heavy head, body aches, or chest discomfort, nausea, vomiting, poor appetite, and diarrhea, use Jing Fang Granules and Wushi Tea Granules. Both medicines can be taken together as a “medicated tea” (方2) prepared by extracting the juice, taken once in the morning and evening, and Jing Fang Granules once at noon.
3. For wind-cold cold with cough and phlegm, especially with white, thin phlegm, use Tong Xuan Li Fei Granules combined with Zhi Sou Wan. Tong Xuan Li Fei Granules can be taken as a “medicated tea” (方5) prepared by extracting the juice, taken with Zhi Sou Wan, once in the morning and afternoon.
4. For wind-cold cold with severe headache, use Jing Fang Granules combined with Du Liang Wan. Jing Fang Granules can be taken as a “medicated tea” (方4) prepared by extracting the juice, taken with Du Liang Wan, once in the morning, noon, and evening.
Medicated Tea Preparation
方1: Jing Jie 10g, Zi Su Ye 10g, Sheng Jiang 10g (crushed), Hong Tang 20g;
方2: Dan Dou Chi 15g, Lian Xu Cong Bai 5 stalks (crushed), Sheng Jiang 3 slices (crushed);
方3: Zi Su Ye 10g, Fang Feng 10g;
方4: Jing Jie 10g, Fang Feng 10g;
方5: Zi Su Ye 6g, Sheng Jiang 3 slices (crushed).
02Wind-Heat Cold
Differentiation
Symptoms: Severe fever, aversion to wind or slight aversion to cold, headache, nasal congestion with sneezing, thick nasal discharge, no sweating or sweating, sore throat, cough with thick phlegm, dry mouth and thirst, red tongue, thin yellow coating, floating rapid pulse.
Treatment should focus on cooling and releasing the exterior, clearing heat and detoxifying, using modified Sang Ju Yin (桑菊饮) (Mulberry Leaf and Chrysanthemum Decoction);
For severe fever and sore throat, use modified Yin Qiao San (银翘散) (Silver Willow Powder), and for very high fever, add Shi Gao and Zhi Mu;
If there is severe throat swelling and pain, add Xuan Shen, Ban Lan Gen, and Ma Bo;
If there is yellow phlegm, add Xing Ren, Gua Lou Pi, Huang Qin, Zhe Bei, and Yu Xing Cao;
If there is severe thirst, increase Lu Gen and add Hua Fen.
Selected Patent Medicines
① Yin Qiao Detoxification Tablets
② Wind-Heat Cold Granules
③ Sang Ju Cold Granules
④ Sang Ju Yin Qiao San
⑤ Qing Kai Ling Oral Liquid
⑥ Ling Qiao Detoxification Tablets
⑦ Lian Hua Qing Wen Capsules
⑧ Shuang Huang Lian Oral Liquid
⑨ Chai Hu Oral Liquid
⑩ Chuan Xin Lian Tablets; Jin Lian Qing Re Granules; Compound Da Qing Ye Mixture; Jin Qing Cold Granules; Ling Yang Cold Tablets.
Examples of Patent Medicine Combinations
1. For severe symptoms of wind-heat cold, use Sang Ju Yin Qiao San combined with Ling Qiao Detoxification Granules. Ling Qiao Detoxification Granules can be taken as a “medicated tea” (方1) prepared by extracting the juice, taken with Sang Ju Yin Qiao San, once in the morning, noon, and evening.
2. For wind-heat cold with throat swelling and pain, use Wind-Heat Cold Granules combined with Chuan Xin Lian Tablets. Wind-Heat Cold Granules can be taken as a “medicated tea” (方3) prepared by extracting the juice, taken with Chuan Xin Lian Tablets, once in the morning, noon, and evening.
3. For wind-heat cold with severe cough, use Sang Ju Cold Granules combined with Wind-Heat Cough Capsules. Sang Ju Cold Granules can be taken as a “medicated tea” (方1) prepared by extracting the juice, taken with Wind-Heat Cough Capsules, once in the morning, noon, and evening; or use Shuang Qing Oral Liquid combined with Ji Zhi Syrup. Both medicines can be taken together, once in the morning, noon, and evening.
4. For wind-heat cold with severe thirst, use Sang Ju Cold Granules combined with Qing Liang Fang Shu Granules. Both medicines can be taken together as a “medicated tea” (方1) prepared by extracting the juice, taken once in the morning, noon, and evening.
5. For wind-heat cold with severe fever, symptoms of high fever, thirst, dry throat, sore throat, and cough with thick phlegm, use Qing Kai Ling Oral Liquid combined with Shuang Huang Lian Oral Liquid. Both medicines can be taken together, once in the morning and evening; and Shuang Huang Lian Oral Liquid once at noon. Alternatively, use Jin Lian Qing Re Granules combined with Chai Hu Oral Liquid. Jin Lian Qing Re Granules can be taken as a “medicated tea” (方3) prepared by extracting the juice, taken with Chai Hu Oral Liquid, once in the morning, noon, and evening; if there is high fever, take four times a day.
6. For wind-heat cold with severe headache, use Sang Ju Cold Granules combined with Qiong Ju Shang Qing Wan. Sang Ju Cold Granules can be taken as a “medicated tea” (方4) prepared by extracting the juice, taken with Qiong Ju Shang Qing Wan, once in the morning and afternoon.
Medicated Tea Preparation
方1: Sang Ye 5g, Ju Hua 5g, Lu Gen 15g;方2: Ye Ju Hua 15g, Sang Ye 10g;方3: Bo He 6g, Jin Yin Hua 10g, Lian Qiao 10g;方4: Da Qing Ye 30g, Yu Xing Cao 10g;方5: Bo He 6g, Jin Yin Hua 10g.Dietary Considerations During a Cold
During a cold, the digestive enzyme activity in the patient’s stomach is affected, leading to poor appetite, accompanied by vomiting, diarrhea, and constipation. The body’s vitamin consumption increases, and the levels decrease, making it difficult to balance consumption and supplementation. Therefore, in addition to medication, cold patients should also adjust their diet appropriately to promote health.
So, what dietary adjustments should be made during a cold? What dietary therapies are available?
Dietary Dos and Don’ts
During a cold, it is advisable to eat small, frequent meals, favoring light, low-fat foods that are easy to digest and rich in vitamins, which can meet nutritional needs and enhance appetite. It is also important to drink plenty of water, primarily plain boiled water.
Avoid eating raw and cold foods, as they can easily damage the spleen and stomach, worsening symptoms and prolonging recovery.
Avoid salty foods, as they can cause the mucous membranes in the affected areas to constrict, worsening nasal congestion and throat discomfort, and overly salty foods can easily produce phlegm, aggravating cough.
Avoid sweet and greasy foods, as sweets can generate dampness and heat, while greasy foods are hard to digest, so cold patients should avoid all types of candies, beverages, and fatty meats.
Avoid spicy foods, as they can injure qi and consume body fluids, generating phlegm that is difficult to expel, so cold patients should not consume them.
Avoid barbecued and fried foods, as these can irritate the respiratory and digestive tracts, leading to mucosal constriction and worsening the condition, and they are also hard to digest. Smoking and drinking should also be avoided.
Consultation Phone for Jilin Provincial Drug Administration
Drug Registration Management: 0431–81763183 Drug Production Supervision: 0431–81763056 Drug Distribution Supervision: 0431– 81763159 Medical Device Registration: 0431–81763152 Medical Device Supervision: 0431–81763051 Cosmetic Supervision: 0431–81763095 Administrative Approval: 0431– 82752811 82752009
Address: 657 Zhanjiang Road, Economic and Technological Development Zone, Changchun City, Jilin Province