Cold pattern

Any disease pattern characterized by cold signs such as aversion to cold, a somber-white or green-blue facial complexion, slow or tight pulse, no thirst or desire for warm fluid, long voidings of clear urine. The complexion and the pulse are explained in terms of the principle that cold causes contraction and tension and tightens the blood vessels. Long voidings of clear urine and moist white tongue fur exemplify the general observation that all disease with watery humors that are clear, pure, and cold is ascribed to cold. Cold patterns may result from the influence of yīn evils or insufficiency of yáng qì, this distinction being apparent in signs.

1. Prevalence of yīn due to an exuberant yīn evil accounts for pronounced cold signs such as abdominal pain, fulminant (i.e., sudden and violent) vomiting or diarrhea, green-blue facial complexion, and a tight pulse.
2. Yáng vacuity accounts for signs more commonly encountered in clinical practice, such as liking for quiet, curled-up lying posture, long voidings of clear urine, clear-grain diarrhea, counterflow cold of the limbs, and a slow pulse. Since cold evil may damage yáng, and yáng vacuity may engender cold, these two forms of cold are interrelated. Cold limbs and somber-white facial complexion, which are commonly observed cold signs, are attributed to the debilitation of yáng qì and the presence of an exuberant cold evil.

Medicinal therapy: Since cold is treated with heat, warming is the chief method of treating cold patterns. Patterns mainly involving invasion by an external evil are treated by dispersing cold evil with warm medicinals. Those patterns primarily characterized by debilitation of yáng qì are treated by warming yáng and boosting qì. Commonly used medicinals that disperse cold evil include aconite (Aconiti Radix Lateralis Praeparata, 附子 fù zǐ), cinnamon bark (Cinnamomi Cortex, 肉桂 ròu guì), fresh ginger (Zingiberis Rhizoma Recens, 生姜 shēng jiāng), dried ginger (Zingiberis Rhizoma, 干姜 gān jiāng), evodia (Evodiae Fructus, 吴茱萸 wú zhū yú), and lesser galangal (Alpiniae Officinarum Rhizoma, 高良姜 gāo liáng jiāng). In addition, aconite (Aconiti Radix Lateralis Praeparata, 附子 fù zǐ) and cinnamon bark (Cinnamomi Cortex, 肉桂 ròu guì) possess a yáng-warming effect. Ginseng (Ginseng Radix, 人参 rén shēn), or its more economical substitute codonopsis (Codonopsis Radix, 党参 dǎng shēn), licorice (Glycyrrhizae Radix, 甘草 gān cǎo), white atractylodes (Atractylodis Macrocephalae Rhizoma, 白朮 bái zhú), and other qì-supplementing medicinals can be added to boost qì. Cold-Dispersing formulas include Lesser Galangal and Cyperus Pill (良附丸 liáng fù wán), which is commonly used where there is pain. Ginseng and Aconite Decoction (参附汤 shēn fù tāng), Counterflow Cold Decoction Plus Ginseng (四逆加人参汤 sì nì jiā rén shēn tāng), and Center-Rectifying Pill (理中丸 lǐ zhōng wán) are commonly used to warm yáng and boost qì.

Acumoxatherapy: The use of moxibustion is important in treating cold patterns and conditions characterized by yáng debilitation. Commonly used points include the following: CV-6 (Sea of Qì, 气海 qì hǎi)^mx, CV-4 (Pass Head, 关元 guān yuán)^mx, ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ)^mx, SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo)^mx, BL-20 (Spleen Transport, 脾俞 pí shù)^mx, and GV-4 (Life Gate, 命门 mìng mén)^mx.