Interior-warming agents

Interior-warming medicinals warm the interior and dispel cold. They are used for interior cold patterns.

Cold patterns are generally characterized by cold signs such as cold abdominal pain, cold limbs, or fear of cold. But they vary according to location. For example, in spleen and stomach patterns, there may be retching and vomiting or diarrhea with cold abdominal pain. In lung cold, there are cold signs with cough, panting, and phlegm rale.

Interior-warming medicinals are warm or hot in nature. Most of the medicinals labeled as hot are found in this category. Most of them are acrid in nature, and this acridity is related to their cold-dispersing action. Most enter the spleen and stomach channels.

Interior-warming medicinals differ from yáng-supplementing medicinals. Being generally hotter than yáng-supplementing medicinals, they tend to address cold rather than the underlying yáng vacuity, hence treating the tip of a condition rather than the root. For example, they provide a speedy rescue for yáng collapse. Many enter the spleen and stomach channels, and several primarily focus on the center burner. Others address cold in the channels.

Properties

Nature:Warm or hot.

Flavor: Acrid.

Channel entry: Most enter the spleen and stomach channels, but some also enter the kidney, liver, heart, and lung channels.

Actions

Warming and freeing:Because interior-warming medicinals are warm or hot in nature and acrid in flavor, they have a warming and freeing action.

Relieving pain: Cold is congealing and stagnating by nature, and is associated with pain. Hence interior-warming medicinals relieve pain by warming and dispersing congealing cold and freeing the channels.

Other actions: Some interior-warming medicinals also have liver-warming, yáng-assisting, and yáng-returning actions.

Indications

Interior cold may result from external cold directly striking the bowels and viscera or the channels, or from insufficiency of yáng qì due to constitutional vacuity, dietary irregularities, or enduring illness. Cold is a yīn evil and easily damages yáng qì, so interior cold is often associated with yáng vacuity patterns. Interior cold patterns include:

Contraction of cold evil in the spleen and stomach or spleen-stomach vacuity cold, with impaired movement and transformation

Pathomechanism: External cold evil can strike the spleen and stomach directly. Alternatively, spleen-stomach vacuity cold arises from constitutional insufficiency, dietary irregularities, or enduring illness.

Signs: Cold pain (i.e., pain that is relieved by warmth) in the stomach duct and abdomen, vomiting, diarrhea, and a pale tongue with white fur.

Treatment method: Warm the center and disperse cold. Interior-warming medicinals that perform this function enter the spleen and stomach channels to warm the center, disperse cold, and relieve pain. Examples of such agents are gān jiāng (Zingiberis Rhizoma), hú jiāo (Piperis Fructus), dīng xiāng (Caryophylli Flos), bì bō (Piperis Longi Fructus), and huā jiāo (Zanthoxyli Pericarpium).

Liver Channel Contracting Cold (Cold Congealing in the Liver Vessel)

Pathomechanism: Externally contracted cold evil entering the liver channel and causing stagnation there.

Signs: Lesser abdominal pain, painful cold mounting, and reverting yīn (jué yīn) headache.

Treatment method: Warm the liver and disperse cold with medicinals such as wú zhū yú (Evodiae Fructus) and xiǎo huí xiāng (Foeniculi Fructus).

Lung Cold Phlegm-Rheum

Pathomechanism: Rheum evil ascending to invade the lung and thereby preventing normal downbearing of lung qì. It usually lies latent and is exacerbated by, or occurs in episodes brought on by, exposure to cold.

Signs: Cough and panting with phlegm rale, expectoration of clear thin white phlegm, and a pale tongue with glossy fur.

Treatment method: Warm the lung and transform rheum. Interior-warming medicinals that perform this function include gān jiāng (Zingiberis Rhizoma) and xì xīn (Asari Herba).

Kidney Yáng Vacuity or Kidney Cold

Pathomechanism: Kidney yáng vacuity is due to numerous factors, including constitutional insufficiency, enduring illness, and the natural decline of health in advancing years. Cold in the kidney is due to contraction of external cold evil.

Signs: Impotence or uterine cold, cold pain in the lumbus and knees, frequent profuse urination at night, enuresis, and seminal efflux.

Treatment method: Warm the kidney and assist yáng. Interior-warming medicinals that perform this function enter the kidney channel. Examples include ròu guì (Cinnamomi Cortex) and fù zǐ (Aconiti Radix Lateralis Praeparata).

Heart-Kidney Yáng Vacuity

Pathomechanism: Numerous factors including constitutional insufficiency, enduring illness, mental taxation, and the natural decline of health in advancing years.

Signs: Heart palpitation or fearful throbbing, oppression in the chest, fear of cold and cold limbs, inhibited urination, and puffy swelling of the limbs.

Treatment method: Warm and supplement the heart and kidney; stabilize palpitations; disinhibit water. Suitable interior-warming medicinals enter the heart and kidney channels to warm yáng and free the vessels. Examples of medicinals to consider are fù zǐ (Aconiti Radix Lateralis Praeparata) and ròu guì (Cinnamomi Cortex).

Yáng Collapse

Pathomechanism:Sudden desertion of yáng qì, arising either from yáng vacuity in enduring illness or from great sweating or loss of blood.

Signs: Reversal cold of the limbs, fear of cold and lying in curled-up posture, sweating, lassitude of spirit, and a faint pulse verging on expiration.

Treatment method: Return yáng and stem counterflow, using gān jiāng (Zingiberis Rhizoma) and fù zǐ (Aconiti Radix Lateralis Praeparata).

Combinations With Other Categories

Interior-warming medicinals can be combined with medicinals from other categories for the treatment of various patterns.

Warm acrid exterior-resolving medicinals: For external cold invading the interior, when exterior cold has not yet resolved, combine interior-warming agents with warm acrid exterior-resolving medicinals to achieve dual resolution of the exterior and interior.

Qì-moving medicinals: Because cold is associated with contracture and tautness, it can cause qì stagnation. Hence, qì-moving medicinals are often added to warm and free the qì dynamic.

Blood-quickening stasis-dispelling medicinals. For cold stagnating in the channels with concurrent blood stasis, use interior-warming medicinals together with blood-quickening stasis-dispelling medicinals, to warm and free the channels.

Aromatic dampness-transforming medicinals: For cold binding dampness to cause internal obstruction, combine with aromatic dampness-transforming medicinals to warm and disperse cold-damp.

Yáng-supplementing medicinals: Cold is a yīn evil that easily damages yáng qì. When there are signs of vacuity cold, yáng-supplementing medicinals can be used to warm yáng and disperse cold.

Yáng-returning desertion-stemming medicinals: For yáng vacuity with qì desertion, use medicinals that greatly supplement original qì in order to return yáng and stem desertion.

Warnings

Contraindications: The medicinals of this category are generally contraindicated in heat patterns, in yīn vacuity with effulgent fire, and in depletion of liquid and blood.

Use with care for pregnancy in hot weather: Fù zǐ (Aconiti Radix Lateralis Praeparata), cǎo wū (Aconiti Kusnezoffii Radix) and chuān wū (Aconiti Radix) are contraindicated in pregnancy; ròu guì (Cinnamomi Cortex) and huā jiāo (Zanthoxyli Pericarpium) are best avoided in pregnancy.

Toxicity: Some interior-warming agents, such as fù zǐ and cǎo wū, are toxic. Care must be taken to process and prepare them correctly and use them in appropriate doses.