Cats TCM Notes

a resource for students of chinese medicine

Common Cold

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies

Biomedical Discussion and Definition:
A common cold is a viral infection characterized by inflammation of the mucous membranes lining the upper respiratory passages and usually accompanied by malaise, fever, chills, coughing, and sneezing. Biomedically, the common cold is an upper respiratory infection (URI). Other types of URI's include influenzas, but are still classified as a common cold or Gan Mao in Chinese medicine.

Western medicine identifies several viral groups as causes: rhinovirus, adenovirus, parainfluenza virus, and respiratory syncytial virus in kids. Secondary bacterial infections may take advantage of the initial viral attack, often adding signs of heat or toxicity. Biomedical treatments for viral URI's are limited to symptomatic relief: antipyretics for fevers, antihistamines and decongestants to free breathing. Antibiotics may be used for secondary bacterial infections.

Left untreated URI's can lead to lower respiratory tract infections (i.e., pneumonia) with or without secondary infection. Pre-existing conditions like chronic bronchitis or diabetes can lead to further complications.

TCM Etiology and Pathology
The etiology from a TCM perspective is the invasion of pathogens, possibly even epidemic pathogens. When they invade a large segment of population it indicates these pathogens are strong even against strong defensive qi. Wind is a primary invader, often carrying other pathogens with it. It invades the upper portions of the body, primarily affecting the Lungs.

Wind combines with cold most often in the winter; with heat most often in the spring; with damp most often in the summer. Body constitution and the strength of anti-pathogenic Qi determines the severity and possibility of invasion. Young adults and yin deficient people are more prone to wind-heat, for example, and when invaded with wind-cold these same people are more likely to have it transform to wind-heat. Yang deficient people and the elderly, on the other hand are more likely to catch wind-cold invasions.

The Lungs govern skin and are closely associated with Wei/Defensive Qi.

Distinguishing common colds, allergic rhinitis, and influenza
Airborne allergy symptoms often look a lot like a common cold because the reaction of the immune system is much the same. Both have nasal congestion, sneezing and drainage. To figure out which you are dealing with, look at other signs and symptoms. Allergies have a history. Most people know the timing of the year that they tend to get allergies and most know what they are allergic to. Allergen counts give you a good clue about this. Also, allergy symptoms do not progress through the typical stages of a cold.

Common colds require recent exposure to wind and cold, a tendency to get wind invasions, or contact with someone suffering from a cold. The onset is often acute, indicative of a wind invasion. Compared to allergic reactions, the common cold is more likely to have aversion to wind and cold, mild fever, a scratchy throat, body aches and/or headaches and other symptoms. Regardless, the treatment of allergies and colds are similar in TCM.

Influenza is similar to a common cold, but presents with stronger reactions, more fever, stronger body aches, and often comes with malaise and a loss of appetite. Many herbal treatments for common cold can be used with influenza, but you have to modify the formula to fit the patient's differentiation and symptoms.

General treatment strategy is to expel pathogens, support defensive/Wei Qi, support Lung Qi and alleviate symptoms. Additional strategies are based on the syndrome differentiation (i.e., clear heat, resolve damp, detoxify, prevent secondary pathogens, etc.). Your herbal treatment strategy will depend on proper differentiation as well as the season and the patient's constitution.

General care:
If not treated and there are no complications a common cold should run it's course and resolve within 2 weeks. Treatment can significantly shorten this. Herbal treatment and intervention can also prevent progression of cold to more serious ailments like a lingering cough (which can damage and scatter the Qi) or pneumonia.

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies

Wind Cold Invasion

Signs and Symptoms:
Acute onset. Strong aversion to wind and cold. Slight concurrent fever. No sweating = excess. Mild sweating = deficiency. Headache in Taiyang region. Aching joints and limbs. Stiff neck. Sneezing. Congested nose and sinuses. Clear or white runny nasal discharge. Scratchy throat. Cough with thin white or clear sputum. No sensation of excessive thirst.
T:
Body is not dry or red. Coat is thin, moist white (not yellow)
P: Floating/superficial, tight. Wind cold deficiency may have a floating soft pulse. If you catch it in the early stage, pulse may not yet be superficial.
Treatment Principle:
For wind-cold excess - release the exterior, dispel cold, disperse obstructed Lung qi.
For wind-cold deficiency - release the exterior, dispel cold, harmonize Ying and Wei.

Acupuncture Treatment:

Basic Points
Function
LI 4 + LU 7 This combination is a host/guest combination. Expels wind and exterior.

GB 20

Expels exterior wind, good for all kinds of headaches
UB 12 + UB 13 UB 12 is called "the wind gate" and helps wind exit. UB 13 is Back shu of Lung and treats all kinds of Lung disorders and conditions affecting the Lung

SJ 17

Eliminates wind
Taiyang

Eliminates wind

See general care above. Other techniques or treatments you might consider:

Herbal Treatment:
Base raw or powdered formula is Jing Fang Bai Du San with modifications as needed. See general care above. Some modifications to consider:

Patent formulas:
Consider some of the following. Always evaluate the herbs in the patents and be sure they are right for your patient's condition and differentiation. Not all patents contain the same herbs even though the names may be the same. See general care above.

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies

Wind Heat Invasion

Signs and Symptoms:
Acute onset (Wei level). High or prominent fever. Slight aversion to cold. Sweating. Headache (can be whole head). Cough with thick yellow phlegm. Dry or sore throat - throat may be red. Obvious thirst (may be slight). Nasal congestion with turbid yellow or greenish mucous. Possible skin rash. Redness of eyes.
Note:
Might be wind cold transforming to wind heat. Symptoms and signs can be mixed.
T:
Dry body with a red tip. Coat is thin and yellow.
P: Floating/superficial and rapid.
Treatment Principle: Dispel wind, clear heat, resolve the exterior. Harmonize Ying and Wei.

Acupuncture Treatment:

Basic Points
Function
LI 4 + LU 7

This combination is a host/guest combination. Expels wind and exterior.
GB 20

Expels exterior wind, good for all kinds of headaches
UB 12 + UB 13 UB 12 is called "the wind gate" and helps wind exit. UB 13 is Back shu of Lung and treats all kinds of Lung disorders and conditions affecting the Lung

SJ 17

Eliminates wind
Taiyang

Eliminates wind
Specific Points
Function

SJ 5, LI 11, DU 14

Removes heat

LU 11, LI 1 Prick to bleed for high fevers

LU 10 Needle or bleed for severe sore throat

Herbal Treatment:
Base formula for raw or powdered formula is Yin Qiao San with modifications as needed. See general care above. Some modifications to consider:

Patent formulas:
If your patient would prefer patents or tinctures, consider some of the following. Always evaluate the herbs in the patents and be sure they are right for your patient's condition and differentiation. Not all patents contain the same herbs even though the names may be the same. See general care above.

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies

Wind Damp (Summer Wind Damp)

Signs and Symptoms:
Acute onset. Chills with aversion to cold. Slight fever or unsurfaced fever. No sweating. Heaviness of the whole body. Joint pain. Heaviness of the head and a foggy sensation, dizziness. Chest tightness or oppression with sensation of not enough oxygen. Possible cough with sticky phlegm. Lowered appetite, tastelessness and/or greasy feeling in the mouth, nausea, vomiting, feeling of fullness or distention in the abdomen/epigastrium. No thirst or preference for warm drinks. Loose stools or diarrhea. Cloudy, dark or scanty urine.
Note:
Most often occurs in the summer or late summer.
T:
Body can be swollen. Thick, slimy, greasy coating - white or yellow.
P: Soft/soggy, slippery. Big but without strength. Can also be superficial.
Treatment Principle: Release exterior, resolve damp, dispel wind. Harmonize the middle jiao.
Key of treatment is to prevent infection.

Acupuncture Treatment:

Basic Points
Function
LI 4 + LU 7

This combination is a host/guest combination. Expels wind and exterior.
GB 20

Expels exterior wind, good for all kinds of headaches
UB 12 + UB 13 UB 12 is called "the wind gate" and helps wind exit. UB 13 is Back shu of Lung and treats all kinds of Lung disorders and conditions affecting the Lung

SJ 17

Eliminates wind
Taiyang

Eliminates wind

Normally you don't use lower body or yin points with an external pathogen release, but case it's ok because damp originates in the Spleen. . . and the diarrhea/loose stool indicates that the pathogen is already at the interior. In other words, won't drive the pathogen deeper.

Specific Points
Function
PC 6, Ren 12 Harmonize middle jiao, calm queasy stomach. PC 6 also opens the chest. Ren 12 will also help resolve phlegm/damp

ST 25, ST 37

Firm the bowels or stop diarrhea

ST 36 Harmonize the middle jiao

ST 40, SP 9 Resolve phlegm/damp

SP 6 Tonifies St/Sp and helps resolve damp. Also harmonizes the lower jiao.

UB 12 Expels wind and releases the exterior

UB 20 and 21 Spleen and Stomach back shu points to help harmonize middle jiao

Yintang and ST 8 For damp headaches

Herbal Treatment:
Base formula for raw or powdered formula is Xin Jia Xiang Ru Yin with modifications as needed. See general care above. Some modifications to consider:

Patent formulas to consider include the following. Always evaluate the herbs in the patents and be sure they are right for your patient's condition and differentiation. Not all patents contain the same herbs even though the names may be the same. See general care above.

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies

Summer Heat Invasion

Signs and Symptoms:
Fever or high fever. Slight chills. Aversion to cold. Great/profuse sweating. Rough breathing. Chest distention. Nausea and vomiting, worse in the mornings. Decreased appetite. Great thirst. May have a desire for cold drinks. Restlessness, irritability, tossing and turning. Urine is scanty and yellow. BM can be normal, constipated, or loose.
T:
Red or scarlet body. Thick greasy yellow coat.
P: Forceful or slippery, rapid. Overflowing in heart position.
Note: Summer heat attacks the heart and pericardium directly, so comes with more shen disturbance.
Treatment Principle: Expel summer heat. Harmonize middle jiao. Calm shen.

Acupuncture Treatment:

Basic Points
Function
LI 4 + LU 7

This combination is a host/guest combination. Expels wind and exterior.
GB 20

Expels exterior wind, good for all kinds of headaches
UB 12 + UB 13 UB 12 is called "the wind gate" and helps wind exit. UB 13 is Back shu of Lung and treats all kinds of Lung disorders and conditions affecting the Lung

SJ 17

Eliminates wind
Taiyang

Eliminates wind
Specific Points
Function
Du 20

Calm shen
Du 14, HT 8, UB 40,
Prick shi xuan, LI 11, SJ 5

Clear heat
HT 1, PC 6, PC 3,
UB 12, UB 14,
UB 15, Ren 17

Benefit heart and upper jiao
UB 20, UB 21,
Ren 12, SP 6, S 9

Benefit middle jiao

Herbal Treatment:
There are several formulas to consider - modify as needed. See general care above.

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies

Exterior Cold with Interior Heat

Signs and Symptoms:
Strong fever and chills. No sweating. Thirst. Nasal congestion. Sore throat. Cough w/sticky yellow phlegm. Dyspnea. Dark yellow urine. Constipation.
T:
Red body. White or yellowish coating.
P: Floating/superficial, rapid.
Treatment Principle: Release exterior. Clear heat and relieve toxicity. Disperse Lung Qi

Acupuncture Treatment:

Basic Points
Function
LI 4 + LU 7 This combination is a host/guest combination. Expels wind and exterior.

GB 20 Expels exterior wind, good for all kinds of headaches

UB 12 + UB 13 UB 12 is called "the wind gate" and helps wind exit. UB 13 is Back shu of Lung and treats all kinds of Lung disorders and conditions affecting the Lung

SJ 17 Eliminates wind

Taiyang Eliminates wind

Specific Points
Function
LI 11, SJ 5/6,
DU14, BL 40
Removes heat from the body. SJ 5 clears heat in the lower body while SJ 6 assists to clear constipation.

PC 6, Ren 17 Relieve chest tightness and open breathing

Ren 22 Benefits the throat

LU11, LI 1, LU 10 Prick to bleed to release heat, benefit the throat

Herbal Treatment:
Base formula for raw or powdered formula is Shuang Jie San with modifications as needed. See general care above. Some modifications to consider:

Patent formulas to consider include the following. Always evaluate the herbs in the patents and be sure they are right for your patient's condition and differentiation. Not all patents contain the same herbs even though the names may be the same. See general care above.

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies

Exterior Wind Invasion with Yin/Blood Deficiency

Signs and Symptoms:
Slight aversion to cold. Prominent fever, hotter at night. Headache. Slight or no sweating. Dry mouth and throat with thirst. Dry could with scanty yellowish phlegm. Dry, burning or sore throat. Nasal passages congested, but possibly dry. Dizziness.
Note: Yin xu patients will deficient heat signs (night sweats, 5 palm heat, etc.) while Blood xu patients will have pale face, poor memory/concentration, dream disturbed sleep, scanty menses, pale nails, floaters in vision, anemia, etc.
T:
Red body with little coat. Could be pale body if more blood deficient.
P: Floating, thin, rapid.
Treatment Principle: Dispel wind, clear heat, nourish yin, resolve exterior.

Acupuncture Treatment:

Basic Points
Function
LI 4 + LU 7 This combination is a host/guest combination. Expels wind and exterior.

GB 20 Expels exterior wind, good for all kinds of headaches

UB 12 + UB 13 UB 12 is called "the wind gate" and helps wind exit. UB 13 is Back shu of Lung and treats all kinds of Lung disorders and conditions affecting the Lung

SJ 17 Eliminates wind

Taiyang Eliminates wind

Specific Points
Function

LI 11, DU 14,
SJ 5, UB 40

Clear heat

LU 9, UB 43, KI 3, KI 7, SP 6, UB52.

Tonify yin
LV 8, ST 36, UB 17
SP 10, SP 6, UB 20
UB 23

Tonify blood
LU 11, LI 1, LU10

Prick to bleed. Clears LU and LI heat, clears heat from severe sore throat.
LU 20 --> Bi Tong,
Yin Tang. BL 7
Thread from LU 20 to Bitong. This combination opens the nasal passages. BL 7 also opens the nasal passages and has a longer lasting effect.

Herbal Treatment:
Base formula for raw or powdered formula for more Yin deficient patients is Jia Jian Wei Rui Tang with modifications as needed. If patient is more Blood deficient, consider Si Wu Tang or Zhai Zao San. See general care above. Some modifications to consider:

Patent formulas to consider include the following. Always evaluate the herbs in the patents and be sure they are right for your patient's condition and differentiation. Not all patents contain the same herbs even though the names may be the same. See general care above.

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies

Exterior Wind Invasion with Yang/Qi Deficiency

Signs and Symptoms:
Strong aversion to cold. Slight fever. May have slight sweating that doesn't help improve sickness. Headache, Nasal congestion. Cough with white discharge/phlegm. Shortness of breath. Weak cough. No desire to speak. Tiredness/fatigue.
T:
Pale body with a white coat
P: Floating, no root, forceless.
Note: symptoms won't appear as strong because patient is qi deficient. (Applies to yang xu too as this is an advanced form of qi xu.) Overall constitution is that of qi or yang xu. Yang deficient patients will have all pertinent yang xu symptoms.
Treatment Principle: Dispel wind, dissipate cold, supplement qi, resolve exterior.

Acupuncture Treatment:

Basic Points
Function
LI 4 + LU 7 This combination is a host/guest combination. Expels wind and exterior.

GB 20 Expels exterior wind, good for all kinds of headaches

UB 12 + UB 13 UB 12 is called "the wind gate" and helps wind exit. UB 13 is Back shu of Lung and treats all kinds of Lung disorders and conditions affecting the Lung. Consider using moxa here in this case.

SJ 17 Eliminates wind

Taiyang Eliminates wind

Specific Points
Function

Du 4, UB 23, UB 52

Tonify Yang. Use moxa on these points, especially Du 4.

Ren 17, Ren 12,
Ren 4 and 6
Tonifies Qi. Consider moxa at Ren 4 and 6 to warm also.
ST 36 Tonify Qi

Herbal Treatment:
Base formula for raw or powdered formula is Shen Su Yin with modifications as needed. See general care above. Some modifications to consider:

Patent formulas to consider include the following. Always evaluate the herbs in the patents and be sure they are right for your patient's condition and differentiation. Not all patents contain the same herbs even though the names may be the same. See general care above.

Wind cold - Wind heat - Wind damp (Summer heat/damp) - Summer Heat Invasion
Exterior Cold + Interior Heat
External Wind with Yin/Blood Deficiencies - Exterior Wind with Yang/Qi Deficiencies