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Cold gān (also called lean cold gān) and heat gān (also called fat heat gān.) New gān disease (i.e., recent onset) tends to manifest in external and heat signs, whereas old gān disease tends to manifest in internal and cold signs. Hence, new gān tends to be heat gan, whereas old gān tends to be cold gān.

The Level-Line of Pediatrics (幼科准绳 yòu kē zhǔn shéng) states, Heat gān is mostly external; there is erosion under the nose, head sores and damp itch, vexing heat in the five hearts, rejection of clothing, rough breathing, thirst with intake of cold water, vexation and agitation, tendency to lie on the ground, hot belly and cold feet, and tidal heat. These signs all indicate heat gan. Cold gān is mostly internal. Signs include diarrhea of abnormal color with whitish green-blue foam, limp weak limbs, swollen eyes, and soot-black facial complexion. Another pattern is agitation and thirst with a tendency to lie on the ground like the heat pattern, but with inability to eat and continuous efflux diarrhea. This is also cold gān. The heat pattern is one of heat in vacuity; the cold pattern is one of cold in vacuity. In treating the heat pattern, one should not wildly apply cool medicinals for the exterior; in treating the cold pattern, one should not suddenly apply drastic supplementing medicinals. For heat gān, The Level-Line of Pediatrics (幼科准绳 yòu kē zhǔn shéng) prescribes a formula for Coptis Pill (黄连丸 huáng lián wán), which comprises coptis (Coptidis Rhizoma, 黄连 huáng lián), trichosanthes root (Trichosanthis Radix, 天花粉 tiān huā fěn), mume (Mume Fructus, 乌梅 wū méi), apricot kernel (Armeniacae Semen, 杏仁 xìng rén), and lotus fruit (Nelumbinis Fructus, 石莲子 shí lián zǐ) blended with ox’s gallbladder (Bovis Vesica Fellea, 牛胆 niú dǎn) and formed into pills.

See gān.

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