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Editor’s Introduction
The warming method (温法) is a therapeutic approach that utilizes warming techniques, cold removal, or Yang revival to dispel cold and restore Yang, primarily used for treating cold syndromes. This method is based on the principles of “treating cold with heat” and “heating the cold”. Are you familiar with the classifications of warming methods, applicable formulas, and clinical considerations? If you want to learn this knowledge, let’s take a look at Professor Shi Zhichao’s summary.
01
Classification of Warming Methods
The causes of internal cold syndromes can be due to external cold invading the interior, damage to Yang Qi from improper use of herbs, or insufficient original Yang leading to internal cold generation. Due to the differences in the organs and meridians affected by internal cold syndromes, the warming methods can be classified into Warming the Interior to Expel Cold (温中祛寒), Yang Revival to Rescue from Reversal (回阳救逆), and Warming the Meridians to Disperse Cold (温经散寒). Deficiency and cold often coexist, thus warming methods are frequently combined with tonifying methods.
1.Warming the Interior to Expel Cold
Used for treating Spleen and Stomach deficiency cold syndromes.The Spleen and Stomach are located in the middle burner and are responsible for transformation and transportation. If there is deficiency cold in the Spleen and Stomach, symptoms such as fatigue, poor appetite, abdominal pain, vomiting, diarrhea, and cold extremities may occur.Commonly used formulas combine warming herbs with Spleen tonifying herbs, such as using dried ginger (干姜), Wu Yao (吴萸), and Sichuan pepper (蜀椒) with ginseng (人参) and licorice (甘草). The representative formula is Li Zhong Wan (理中丸).
2.Yang Revival to Rescue from Reversal
Used for treating conditions of excessive Yin and deficient Yang, where Yang Qi is about to collapse.When the disease progresses to a state of weak Yang Qi and excessive Yin cold, symptoms such as cold extremities, aversion to cold, lethargy, vomiting, and diarrhea with a submerged and weak pulse may occur. In such cases, large doses of warming and hot herbs are necessary to revive Yang and rescue from reversal.The Yang revival formulas mainly consist of acrid, warming, and drying herbs, such as Aconite (附子), dried ginger (干姜), and cinnamon (肉桂). The representative formula is Si Ni Tang (四逆汤).
3.Warming the Meridians to Disperse Cold
Applicable for conditions of cold evil stagnating in the meridians causing pain, cold abdominal pain, and Yin abscesses.Insufficient Yang Qi leads to cold in the meridians, causing poor blood circulation, resulting in cold extremities, limb pain, or the development of Yin abscesses. Such diseases are often due to Yang Qi deficiency, weak Yin blood, and cold stagnation in the meridians. Therefore, the characteristic of this category of formulas is the combination of acrid warming dispersing herbs with blood nourishing and meridian opening herbs, with main herbs including Ephedra (麻黄), cinnamon twig (桂枝), Asarum (细辛), ginger (生姜), Angelica (当归), and Duhuo (独活). Representative formulas include Dang Gui Si Ni Tang (当归四逆汤) and Yang He Tang (阳和汤).
02
Commonly Used Warming Formulas
1.Warming the Interior to Expel Cold
Li Zhong Wan (Fu Zi Li Zhong Wan (附子理中丸), Gui Fu Li Zhong Tang (桂附理中汤), Lian Li Tang (连理汤), Gui Zhi Ren Shen Tang (桂枝人参汤), Li Zhong Hua Tan Wan (理中化痰丸), Zhi Shi Li Zhong Wan (枳实理中丸), Ding Yu Li Zhong Tang (丁萸理中汤), Fu Zi Jiang Mi Tang (附子粳米汤), Fu Zi Ba Wu Tang (附子八物汤),Wu Zhu Yu Tang (Gao Liang Jiang Tang (高良姜汤)),Xiao Jian Zhong Tang (Dang Gui Jian Zhong Tang (当归建中汤), Huang Qi Jian Zhong Tang (黄芪建中汤)),Da Jian Zhong Tang (Wu Tou Gui Zhi Tang (乌头桂枝汤), Wu Tou Chi Shi Zhi Wan (乌头赤石脂丸)),Hou Po Warming the Interior Decoction.
2.Yang Revival to Rescue from Reversal
Si Ni Tang (Si Ni Jia Ren Shen Tang (四逆加人参汤), Tong Mai Si Ni Tang (通脉四逆汤), Bai Tong Tang (白通汤), Bai Tong Jia Zhu Dan Zhi Tang (白通加猪胆汁汤)),Shen Fu Tang (Du Shen Tang (独参汤), Qi Fu Tang (芪附汤), Shu Fu Tang (术附汤), Ji Jiu Hui Yang Tang (急救回阳汤), Hui Yang Jiu Ji Tang (回阳救急汤), Shen Fu Long Mu Jiu Ni Tang (参附龙牡救逆汤), Er Jia Long Gu Tang (二加龙骨汤), Shen Fu Long Mu Tang (参附龙牡汤), Si Wei Hui Yang Yin (四味回阳饮),Zhen Wu Tang (Fu Zi Tang (附子汤)),Hei Xi Dan.
3.Warming the Meridians to Disperse Cold
Dang Gui Si Ni Tang (Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang (当归四逆加吴茱萸生姜汤), Huang Qi Gui Zhi Wu Wu Tang (黄芪桂枝五物汤),Yang He Tang (Xiao Jin Dan (小金丹)).
03
Clinical Application Considerations for Warming Methods
1.Heat Does Not Offend Heat
This treatment method and the formulas often contain acrid, hot, and dry properties, which can easily consume Yin and generate fire. Therefore, during hot weather or for individuals with a constitution prone to heat, the dosage should be reduced, which is referred to as “heat does not offend heat” (《内经》).
2.Distinguish True from False
When using warming methods and formulas, it is essential to distinguish between true and false cold and heat, and not to be misled by false appearances. Clinically, it is common to find heat hidden in the interior, deep heat with deep cold, treating false cold as true heat can lead to errors.
3.Rejection of Treatment
When Yin cold is too excessive, taking hot herbs can lead to immediate vomiting, which is termed rejection of treatment. In such cases, it is advisable to add some cooling items or take hot herbs cold, which is a method of counteracting cold with cold. As stated in the “Medical Heart Understanding”: “When Yin is excessive and obstructs Yang externally, if warming herbs are ineffective, then Bai Tong Tang should be added with human urine and pig bile to counteract it, as the classics say, ‘heat is used to treat cold’.”
4.Emphasize Deficiency Syndromes
The warming method is primarily designed for treating solid cold syndromes; if Yang deficiency leads to cold, it is not advisable to rely solely on warming methods and formulas for treatment. As stated in the “True Essentials of the Great Treatise”: “For all cold that generates heat, take from Yin; for heat that generates cold, take from Yang, which is the principle of seeking its nature.”
Famous Doctors’ Medical Discussions
The above text is derived from Professor Shi Zhichao’s experience summary. In addition, Professor Shi has many unique academic thoughts and clinical experiences—
“Shi Zhichao’s Medical Discussions”
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This book is a collection of medical discussions by Professor Shi Zhichao, a chief physician at Dalian Traditional Chinese Medicine Hospital and a guiding teacher for the sixth batch of national old TCM experts’ academic experience inheritance work. The book selects over 40 medical discussions and nearly 50 medical dialogues, gathering nearly 50 years of clinical experience and insights from Professor Shi Zhichao, reflecting his rich and unique academic thoughts.
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