Cold Symptoms: Differentiating Between Wind-Heat and Lung-Heat in TCM

How to classify a cold?

I currently have a cold and have seen two doctors.
One said it is caused by "wind-heat," while the other said it is due to "lung-heat" causing the cough.
They prescribed me Yin Qiao San (8g), Sha Shen (1.5g), Huang Qin (1.5g), Qing Dai (1.5g), Xing Ren (1.5g), and Ge Gen (1.5g).
Are the two doctors describing the same type of condition? How is a cold classified, and what are its symptoms? Are there any dietary restrictions? I have been experiencing a full-body heat sensation, especially in my cheeks and mouth.
Should I drink hot tea or just regular water? I feel more comfortable when I can expel phlegm.
A friend suggested that drinking hot white sugarcane juice can help soothe the cough; is that effective? Thank you.

Pipi Hou, 40~49 year old female. Ask Date: 2010/07/23

Dr. Yan Sumei reply Traditional Chinese Medicine

Dear Pi Pi Monkey,
I am pleased to receive your letter.
Regarding the classification of the common cold, Traditional Chinese Medicine (TCM) has various schools of thought, each with different classifications and terminology, so the opinions of the two doctors are fundamentally similar.
Here is one classification for your reference:
1.
Wind-Cold Type
(1) Wind-Cold Excess Syndrome: Characterized by severe chills and mild fever, no sweating, headache and neck stiffness, nasal congestion with a heavy voice, occasional clear nasal discharge, or itchy throat with cough, white phlegm, no thirst, body aches, thin white tongue coating, and a floating tight pulse.
(2) Wind-Cold Deficiency Syndrome: Characterized by aversion to wind with fever, sweating, headache or neck stiffness, cough with wheezing, white thin phlegm, thin white tongue coating, and a floating relaxed pulse.
2.
Wind-Heat Type
(1) Wind-Heat Excess Syndrome: Characterized by high fever, slight aversion to wind and cold, nasal congestion with yellow thick discharge, fever without sweating, headache, sore throat, thirst, or cough with yellow phlegm, thin yellow tongue coating, and a floating rapid pulse.
(2) Wind-Heat Deficiency Syndrome: Characterized by mild fever with slight aversion to wind and cold, sweating, headache, cough with irritability, dry throat and thirst, red tongue edges, thin yellow tongue coating, and a floating rapid pulse.
3.
Summer External Pathogen with Dampness: Characterized by chills, body heat not rising, little sweating or sweating without relief from heat, heavy and aching limbs, a feeling of heaviness in the head, slight white phlegm, chest tightness, nausea, no thirst, poor appetite, abdominal bloating with loose stools, white greasy tongue coating, and a slippery relaxed pulse.
4.
Summer External Pathogen with Heat: Characterized by fever with chills, body heat with little sweating or sweating without relief from heat, headache and body aches, irritability, short and red urine, or fatigue in the limbs, nausea, thirst, chest tightness, poor appetite, yellow greasy tongue coating, and a slippery rapid pulse.
Taking the prescribed medicine will gradually improve the symptoms of the cold.
It is advisable to avoid cold drinks and prefer warm water.
As for drinking hot white sugarcane juice to relieve cough, I have not heard of it, but you may try it without harm.
Besides taking medicine, resting is very important; avoid going out at night and try to sleep early.
In crowded places, hospitals, and clinics, there are many viruses, so wearing a mask is recommended.
Wash your hands frequently after returning home.
This is a small reminder.
This is my response to you; I hope it meets your satisfaction.
Wishing you health, happiness, and may all your wishes come true!
Sincerely,
Yen Su-Mei
Department of Traditional Chinese Medicine
Nantou Hospital

Reply Date: 2010/07/23

More Info

In Traditional Chinese Medicine (TCM), differentiating between "Wind-Heat" and "Lung-Heat" is crucial for understanding the nature of a cold or flu-like illness. Both conditions can present with similar symptoms, but they arise from different pathogenic factors and require distinct treatment approaches.

Wind-Heat is characterized by symptoms that often include a sudden onset of fever, chills, a sore throat, headache, and a dry cough. The tongue may appear red with a thin yellow coating, and the pulse is typically rapid. This condition is often associated with exposure to external pathogens, particularly during seasonal changes when the weather is windy and warm. The body’s response to these pathogens results in an increase in heat, leading to the symptoms mentioned.

On the other hand, Lung-Heat is more specifically related to the lungs and is characterized by a persistent cough that may produce yellow or green phlegm, a feeling of fullness in the chest, and possibly a fever. The tongue may also appear red but is more likely to have a thicker yellow coating, and the pulse may be rapid and slippery. This condition can arise from internal factors, such as excessive heat in the body due to poor diet, emotional stress, or chronic illness.

In your case, the two doctors you consulted have provided you with different diagnoses based on their observations. The first doctor diagnosing "Wind-Heat" and the second "Lung-Heat" suggests that they are recognizing different aspects of your condition. The herbal prescriptions you received, including ingredients like Yin Qiao San (for Wind-Heat) and Sha Shen (for Lung-Heat), indicate that they are treating the symptoms from their respective perspectives.

When it comes to dietary considerations during a cold, TCM suggests avoiding foods that generate internal heat, such as spicy, fried, or overly sweet foods. Instead, focus on consuming cooling foods and drinks. Drinking warm water is generally recommended, as it helps to soothe the throat and promote digestion. Hot teas, especially those with cooling properties like chrysanthemum tea or peppermint tea, can also be beneficial.
Regarding your question about drinking hot tea versus regular water, it is often advised to consume warm liquids during a cold, as they can help to alleviate symptoms and promote comfort. Hot drinks can help to thin mucus and soothe the throat, while cold drinks might exacerbate symptoms in some individuals.

As for your friend’s suggestion of drinking hot sugarcane juice, it is considered a natural remedy in some cultures for soothing coughs and providing hydration. However, it is essential to ensure that it is not overly sweet, as excessive sugar can contribute to internal heat.

In summary, while both "Wind-Heat" and "Lung-Heat" can present with overlapping symptoms, they stem from different causes and may require different treatments. It is essential to listen to your body and consult with healthcare professionals who can provide personalized advice based on your specific symptoms and overall health. If symptoms persist or worsen, seeking further medical evaluation is advisable.

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