Reversal cold of the extremities

Also counterflow cold of the extremities; counterflow cold of the limbs; reversal cold of the limbs; limb reversal. Pronounced cold in the extremities up to the knees and elbows or beyond, as occurs in yáng collapse or internal heat evil block. Reversal cold of the extremities is similar to lack of warmth in the extremities. However, the latter differs in that it is less pronounced, does not reach as far as the knees and elbowsand is observed in general yáng vacuity patterns. Reversal cold of the extremities is called reversal because yáng qì recedes away from the extremities. Distinction is made between cold and heat.

Patterns

Cold (寒 hán) patterns are attributed to debilitation of yáng qì and exuberant internal yīn coldand are associated with fear of cold, clear-grain diarrhea, and a faint sunken pulse.

Medicinal therapy: Return yáng and stem counterflow with Counterflow Cold Decoction (四逆汤 sì nì tāng) or Aconite Main Tuber Brew (乌头煎 wū tóu jiān).

Heat (热 rè) patterns are attributed to depressed heat evil preventing yáng qì from reaching the four limbsand are associated with heat vexation in the chest and abdomen and with thirst.

Medicinal therapy: Diffuse depressed heat with Counterflow Cold Powder (四逆散 sì nì sǎn), White Tiger Decoction (白虎汤 bái hǔ tāng), or one of the Qì-Coordinating Decoctions (承气汤 chéng qì tāng). Reversal cold of the extremities is observed in cold damage, reversal patterns, and in mounting (shàn).

See reversal.