THE COMMON COLD

The common cold is an exogenous disease caused by pathogenic wind. Its main
clinical symptoms include stuffy and running nose, sneezing, cough, headache,
chilliness, fever, and general discomfort.
It may happen throughout the whole year, but more common in winter or spring, in
which it has more climatic changes than the other two. Spring is the wind season and
wind is the head of the six climatic evils. Wind has more chance to attack the human
body due to its moving and changeable property. Winter is the cold season, in which
wind and cold will be easier to attack the human body. In terms of the severity of the
pathogenic factors, "attack by cold", "attack by wind”, “cold" and "severe cold" are
distinguished. Attack by wind or cold is a mild case caused by seasonal pathogenic
factors.
Influenza is a contagious disease which may wide-spread in a certain period and the
patients have similar symptoms.
The following diseases in Western medicine can be differentiated and treated
according to corresponding descriptions given below:
Infection of the upper respiratory tract,
Common cold,
Infectious cold,
Acute inflammation of the upper respiratory tract by the viral and bacterial infections.
ETIOLOGY AND PATHOGENESIS
When the resistance is weak, or pathogens' attack is severe, six pathogenic factors and
pestilential factors can attack the body from the skin, hair, mouth and nose, resulting
in disharmony of defensive Qi and dysfunction of the lungs' dispersing and
descending. Thus, the common cold ensues. Wind is the head of the six pathogenic
factors so wind is the predominant etiological factor.
1. External pathogenic factors
The seasonal pathogenic factors, non-seasonal pathogenic factors and pestilential
factors may exceed the human body’s resistance, and succeed in invasion, thus
resulting in common cold or influenza.
2. Internal causes
An irregular life style.
Ignorance for the changes in temperature and overfatigue will loosen the skin and
interspace of the muscles, impairing their functions of preventing external pathogenic
factors. The common cold thus ensues.
Old age, congenital deficiency and prolonged diseases may weaken the defensive
Qi, thus allowing the pathogenic factors to attack the human body easily. The
common cold then occurs.
The body’s constitution plays a role in the attack. A person with a Yang deficiency is
susceptible to wind-cold, and one with a Yin deficiency is susceptible to wind-heat
and dryness-heat. In a case of excess dampness and phlegm, he is likely to be attacked
by external dampness.
The attack of the body surface by external pathogenic factors hinders the smooth
circulation of defensive Qi, resulting in chilliness, fever, headache, and aching all
over the body. Dysfunction of the lungs' dispersing and descending explains nasal
stuffiness with discharge, cough and sore throat.
Different pathogenic factors and different constitution determine the symptoms,
which include wind-cold, wind-heat and combination of summer-heat and dampness.
Transformation and complication of cold and heat can also be seen. Wind, cold and
dampness block the skin and hair, mainly leading to the pulmonary dysfunction of
dispersing while wind-heat, summer-heat and dryness hinder the soothing and
purging( 疏 泄 ) function of the skin and hair, mainly leading to the pulmonary
dysfunction of descending. The conditions caused by infectious pathogens are severe
and easy to transform into other diseases.
DIAGNOSIS
1.Symptoms: at early stage, it is usually marked by nasal and defensive symptoms
including itching and discomfort in the nose and throat, nasal stuffiness with
discharge (first clear, then sticky), sneezing, hoarse voice, headache, aversion to cold
and wind. Then the patients have fever, cough, and sore throat, sore and heavy limbs.
Some patients will have chest fullness, nausea, vomiting, a poor appetite, and loose
stools.
Influenza is an epidemic disease marked by simultaneous onset and rapid wide-
spread. Initial symptoms usually include aversion to cold, fever (39 ℃-40 ℃), general
soreness and pain, tiredness. 1-3 days later, severe pulmonary system’s symptoms
occur including nasal stuffiness with discharge, sneezing, cough, sore throat, etc. It is
more severe than the common cold and its recovery is slow.
2. Short course of disease (3-7 days). No transmission in terms of the common cold.
3. More common in winter and spring though it may occur throughout the whole year.
DIFFERENTIAL DIAGNOSIS
Cold should be differentiated with initial pulmonary febrile disease. The latter has a
high fever, which cannot be relieved by sweating and may own transmission
syndrome such as cough, chest pain, coma, and convulsions. But the former does not
have these characteristics.
KEYPOINT OF DIFFERENTIATION
1. Distinguishing between the common cold and influenza
The former is marked by nasal stuffiness with discharge, sneezing, cough, itching or
pain in the throat, aversion to cold or wind, fever, headache, aching all over the body,
with mild general symptoms and less transmission. The disease lasts for 5-10days.
Influenza is an epidemic disease marked by the abrupt and simultaneous onset of
aversion to cold, chilliness, fever, general aching, lassitude, cough, sore throat. Its
general symptoms are severe and can be transmitted into the interior causing other
diseases.
2. Distinguishing between exterior cold and exterior heat
The former has severe chilliness, mild fever, no sweating, no sore throat and a white
tongue fur and a floating and tense pulse while the latter has mild chilliness, high
fever, sweating, sore throat, a yellow tongue fur and a floating rapid pulse. In
addition, we should know the combination of summer-heat, dampness and dryness.
3. Distinguishing between cold due to Qi deficiency and cold due to Yin deficiency
On the basis of the common symptoms, the former is complicated with more severe
aversion to cold, tiredness, shortness of breath, dislike of speech, pain in the limbs, no
sweating, weak expectoration, and a floating pulse while the latter is combined with
mild fever, a hot sensation in the palms, soles and chest, dry mouth, slight sweating,
non - productive cough and a thready and rapid pulse.
PRINCIPLES OF TREATMENT
The principles of treatment are to relieve the exterior syndrome, eliminate pathogenic
factors, disperse the lungs' Qi and take care of complications.
In the case of wind-cold, perspiration with pungent and warm herbs in nature is used
to relieve the exterior cold.
In the case of wind-heat, sweating with pungent and cool herbs in nature is used to
disperse heat.
The methods should be modified in treating the cases with complication of dampness
and summer - heat. Those are to clear summer - heat, resolve dampness to relieve
exterior signs plus harmonizing the stomach and regulating Qi.
Reinforcing Qi and blood and relieving the exterior signs should be carried out
simultaneously in the treatment of the common cold due to weak resistance since
exclusive application of diaphoretics may cause severe damage to the lungs' Qi.
As for influenza, clearing heat and detoxication are very important treatment
principles due to its easiness to transmit into heart.
TREATMENT ACCORDING SYNDROMES
The common cold due to wind -cold
SYMPTOMS
Severe chills, mild fever, no sweating, headache, soreness of the limbs, sneezing,
nasal stuffiness with watery discharge, hoarse voice, cough with thin and white
sputum, itching of the throat, no thirst or thirst for hot drink, a thin, white and moist
tongue coating, and a floating and tense pulse.
METHODS
Relieving exterior syndrome with acrid and warm herbs.
PRESCRIPTIONS
Jingfang Baidu San ( Antiphlogistic Powder of Schizonepeta and Ledebouriella).
The common cold due to wind heat
SYMPTOMS
More remarkable fever, slight aversion to wind-cold, unsmoothness in sweating,
distending headache, nasal stuffiness with turbid discharge, dryness of the throat,
congested and sore throat and tonsillitis, coughing with yellow and thick sputum,
thirst with the desire for drink, a thin and yellow tongue coating and a floating and
rapid pulse.
METHODS
Relieving exterior syndrome with acrid and cool herbs.
PRESCRIPTIONS
Yinqiao San ( Powder of Lonicera and Forsythia).

The common cold due to summer - heat and dampness

SYMPTOMS
Fever, slight aversion to wind, scanty sweating, a heavy sensation in the limbs and the
head, soreness or pain in the limbs, distending headache, cough with sticky sputum,
nasal turbid discharge, vexation, scanty, deep and yellow urine, chest fullness, nausea,
a sticky feeling in the mouth, thirst with no desire for drink, a yellow and sticky
tongue and a soft and rapid pulse.
METHODS
Clearing away summer-heat and eliminating dampness to relieve the exterior signs.
PRESCRIPTIONS
Xinjia Xiangru Yin (Decoction of Elsholtzia with Supplement). Liuyi San (Six to One
Powder) and Fuling (Poria) can be added to clear away heat and drain off dampness
as for scanty deep yellow urine.

The common cold due to Qi deficiency

SYMPTOMS
Fever, chilliness, nasal stuffiness or clear nasal discharge, coughing with white and
thin sputum, headache, lassitude, no sweating, soreness in the limbs, a thin and white
tongue coating, and a superficial and weak pulse.
METHODS
Benefiting Qi to relieving exterior signs.
PRESCRIPTIONS
Shensu Yin( Ginseng and Perilla Drink ). In the case of the combination of
spontaneous sweating and being apt to the attack of wind resulting from deficiency of
the exterior, Yupingfeng San (Jade-Screen Powder) is used to reinforce Qi,
consolidate the body surface and avoid the occurrence of cold.

The common cold due to Yin deficiency

SYMPTOMS
Headache, fever, mild chilliness, absence of sweating or slight sweating, dizziness,
restlessness, dryness of the throat, a hot sensation in the palms and soles, non-
productive cough, a red tongue with exfoliated coating or none at all, and a thready
and rapid pulse.
METHODS
Nourishing Yin and relieving exterior sign.
PRESCRIPTIONS
Jiajian Weirui Tang( Modified Decoction of Fragrant Solomonseal)

Exterior cold and interior heat (cold wraps fire)

SYMPTOMS
Fever, aversion to cold, no sweating, thirst, stuffy nose, hoarse voice, sore throat,
cough, rapid breath, yellow and sticky sputum, dark urine constipation, a yellow and
white coating and a floating and rapid pulse.
METHODS
Relieving the exterior sign, clearing the interior, dispersing the lungs and dispelling
wind.
PRESCRIPTIONS
Shuangjie Tang (Shuangjie Decoction or Decoction for Both Relieving the Exterior
and Interior Signs)
 COUGH
The Chinese word for cough is "Kesou". Ke means the production of coughing sound
with no sputum expectorated and Sou is the presence of sputum in the throat that can
be spat out without coughing sound. Ke and Sou are clinically difficult to be separated
so we combine them together and call them "Kesou". A general distinction is made
between productive and non-productive cough. The KE is caused by dryness and fire
and the SOU results from the retention of phlegm and dampness.
Cough is caused by the attack of six external pathogens damaging the lung or
functional disorders of Zangfu organs affecting the lung. The pathogenesis is the
dysfunction of the lungs in descending and dispersing. Its main clinical manifestations
include cough and expectoration of sputum.
The following diseases can be treated and differentiated according to cough when
they have the main symptom of cough: acute and chronic bronchitis, bronchiectasis,
pulmonary tuberculosis, and the infection of upper respiratory tracts.
ETIOLOGY AND PATHOGENESIS
Only when external pathogenic factors or internal damage cause the lungs'
dysfunction of dispersing and descending and counterflow ascent of the lung Qi, does
cough occur.
1. Cough due to external pathogenic factors
Wind together with cold, heat and dryness attacks the lungs from the mouth and nose,
and the skin and hair when the defensive Qi is weak, resulting in the lungs'
dysfunction of dispersing and descending and counterflow ascent of the lung Qi.
Cough, therefore, occurs.
2. Cough due to internal damage
This type of cough is caused by the affection of the lung due to the dysfunction of the
other Zangfu organs and dysfunction of the lung itself.
•Emotional stimulation
Mental depression and anger results in stagnation of the liver Qi. The stagnated liver
Qi then turns to fire, which attacks the lung, giving rise to the lung dysfunction of
dispersing and descending and counterflow ascent of the lung Qi. As a result, cough
occurs.
•Improper diet
Oversmoking and overdrinking alcohol may burn the fluid in the lungs and stomach
into phlegm. Overeating acrid and greasy food may result in dysfunction of the spleen
in transportation and transformation, then producing turbid phlegm. The turbid
phlegm is then stored in the lungs, impairing the lungs' function of dispersing and
descending. Consequently, cough occurs.
•Lung deficiency
Many protracted pulmonary diseases result in deficiencies of the lung Yin or Qi.
Deficiency of lung Yin means dryness in the lungs, which then impairs its dispersive
and descending function. Deficiency of lung Qi also impairs the function of the lung
and hence causes cough.
In conclusion, the main pathological changes of cough lie in the lung but cough is
also related to the spleen, the liver and the kidney.
According to the theory of the five elements, the lung is the son of the spleen and
mother of the kidney. The spleen digests food and transports the nutrient essence to
the lung, where it is distributed to various parts of the body. Disorders of the son
consume Qi of the mother, while disorders of the mother affect the son. The splenic
dysfunction results in the production of phlegm which, then, is stored in the lung.
Inability of the kidney to receive Qi leads to the shortness of breath shortly after
movement. Metal acts on wood and wood counteract metal when metal is in a state of
deficiency.
The liver channel passes through the hypochondrium on both sides, and then enters
the lung. Hyperactivity of the liver may attack the weak lungs, resulting in cough.
The pathological characteristics of cough are the pulmonary dysfunction of
dispersing and descending and counterflow ascent of the lung Qi, caused by the
attack of the lung by the pathogenic factors.
MUTUAL TRANSFORMATION
Cough due to the attack of external pathogenic factors belongs to excess. Cough due
to wind-cold may turn into wind-heat cough because of improper treatment. Wind-
heat may turn into dryness and consumes Yin and hence cough due to pulmonary Yin
deficiency occurs. The heat in the lung burns the fluid into phlegm-heat.
Cough due to internal damage belongs to the combination of excess and deficiency,
whose pathogens are phlegm and fire. Cough due to the invasion of the lung by the
other Zangfu organs usually develop from excess to deficiency while cough due to the
diseased lung itself usually develop from deficiency to excess.
For example, when hyperactivity of the liver fire attacks the lung, the fire may burn
the fluid into phlegm.
The splenic dysfunction leads to the production of phlegm which is stored in the lung,
then resulting in cough due to phlegm-dampness.
A protracted case of cough due to phlegm-dampness may lead to Qi deficiency of the
lung and the spleen and even the kidneys.
Deficient pulmonary Yin, on the other hand, may lead to phlegm caused by deficient
fire.
Internal damage cough caused by phlegm-fire usually belongs to the combination of
excess and deficiency. Stagnated phlegm may turn into fire while fire may burn the
fluid into phlegm. In addition, phlegm includes heat phlegm and cold phlegm and fire
has excessive fire and deficient fire.
External contraction cough and internal damage cough may mutually transform. A
protracted case of external contraction cough damages the lung Qi, resulting in the
frequent attack of the external pathogenic factors. Internal damage cough, therefore,
gradually develops. Internal damage cough is apt to be worsened by the attack of
external pathogenic factors due the weak defensive Qi.
DIAGNOSIS
1. Main symptoms: cough, which may be accompanied by itching throat and
expectoration of phlegm.
2. External contraction cough is marked by acute onset and exterior syndrome of
chills and fever; internal damage cough usually results from recurrent attack of the
external pathogenic factors, has a long course of disease and is combined with
dyspnea.
3. During the acute period, leucocyte count and neutrophil count are high.
4. In auscultation, exaggerated breath sound or scattered dry or wet rales can be heard.
5. Chest X - ray can be normal or with strong lung markings.
DIFFERENTIAL DIAGNOSIS
1. Asthma and dyspnea.
Both can have cough but they are mainly marked by wheezing and dyspnea
respectively. Asthma is mainly marked by a wheezing sound rattling in the throat,
difficulty in breath, even inability to lie down, a rapid onset and a rapid remission.
Dyspnea is manifested as difficulty in breath, even breathing with opened mouth,
raised shoulders and flapping of ala nasi. It is a symptom in various acute and chronic
diseases.
2. Lung distension. (Emphysema or Pulmonary heart disease)
It has a long history of chronic cough, dyspnea, asthma, etc. In addition to cough, it
also includes distension and fullness in the chest, dyspnea, vexation, palpitation,
cyanosis, and edema.
3. Pulmonary tuberculosis.
Cough is one of its symptoms. It is marked by non-productive cough, hemoptysis, low
fever, night sweating and emaciation. Chest X-ray will help determine the affected
location.
4. Lung cancer.
Cough or hemoptysis is its main symptom. Male smokers who are over 40 years are
susceptible to have this disease. Cough is usually a stimulant and non-productive one.
General condition is manifested as cachexia. Chest X-ray and cell examination of
phlegm will be helpful to its diagnosis.
KEYPOINT OF DIFFERENTIATION
1. Distinguishing between external contraction cough and internal damage cough
External contraction cough is a new disease as usual, which has an acute onset and a
short course of disease, and is often accompanied by exterior syndrome. Internal
damage cough, however, is a protracted disease, which has a long course of disease
and the signs of the other Zangfu organs and occurs recurrently.
2. Distinguishing between deficiency and excess
External contraction cough due to wind-cold, wind-heat and wind-dryness belongs to
excess.
Internal damage cough due to phlegm-dampness, phlegm-heat and liver fire belongs
to the combination of excess and deficiency.
Cough due to Yin deficiency belongs to deficiency or deficiency combined with
excess.
PRINCIPLES OF TREATMENT
External contraction cough is treated with the methods of expelling pathogenic factors
and releasing the flow of the lung Qi. Lay emphasis on resolving phlegm and
normalizing Qi. The herbs should be clear and light.
In the case of internal damage cough, the methods of dispelling pathogenic factors to
check cough and supporting the anti-pathogenic Qi and supplementing vacuity should
be adopted. Treat both manifestation and root cause of disease.
TREATMENT ACCORDING SYNDROMES
• COUGH DUE TO THE INVASION OF EXTERNAL PATHOGENIC FACTORS
Cough due to wind-cold
SYMPTOMS
Cough, heavy and turbid voice, rapid breath, itching throat, thin and white sputum, all
of which are often accompanied by exterior wind-cold syndrome such as nasal
stuffiness with clear discharge, headache, soreness in the limbs, chilliness, fever, no
sweating. The tongue coating is thin and white. The pulse is superficial or superficial
and tense.
METHODS
Dispersing Wind-cold and ventilating the flow of the lung Qi to relieve cough.
PRESCRIPTIONS
Sanniu Tang (Decoction of Three Crude Herbs) and Zhisou San (Powder for Stopping
Cough).

Cough due to wind-heat

SYMPTOMS
Severe and frequent cough, rough breathing, hoarse voice, dry and sore throat, thick
or yellow sputum which is difficult to expectorate. All of them are often accompanied
by other exterior wind-heat symptoms such as sweating when coughing, thirst, yellow
and turbid nasal discharge, headache, soreness of limbs, aversion to wind, fever, a thin
and yellow tongue coating and a superficial and rapid pulse.
METHODS
Eliminating wind, dispersing heat, promoting the lungs' dispersive function to stop
cough.
PRESCRIPTIONS
Sangju Yin (Drink of Mulberry Leaf and Chrysanthemum).

Cough due to wind-dryness

SYMPTOMS
Uninterrupted and non-productive cough, dry and itching throat, dry lip, nose and
mouth, no sputum or little sticky sputum even with blood which is difficult to
expectorate. All of them are accompanied by nasal stuffiness, headache, slight
chilliness, fever, a thin and white or yellow tongue coating, a dry and reddened
tongue, and a superficial and rapid pulse.
METHODS
Dispelling wind, clearing the lung, moistening the dryness to check cough.
PRESCRIPTIONS
Sangxing Tang (Decoction of Mulberry Leaf and Apricot Kernel).
In the case of the combination of dryness and wind-cold marked by non-productive
cough with no sputum or little sputum, dry throat and nose, chilliness, fever,
headache, no sweating, a thin, dry and white tongue coating, Xingsu San (Bitter
Apricot Kernel and Perilla Powder) can be used to moisten and warm the lungs to
check cough.

• COUGH DUE TO INTERNAL DAMAGE

Phlegm-dampness gathering in the lung
SYMPTOMS
Intermittent and recurrent cough, heavy turbid voice, profuse, white and sticky
sputum, cough which is relieved after expectoration, cough and the amount of sputum
getting worse after getting up in the morning or after eating sweat and greasy food,
distention in the chest and epigastrium, listlessness, poor appetite, abdominal
distension, loose stools, a white and sticky tongue coating, and a soft and smooth
pulse.
METHODS
Invigorating the spleen, drying out dampness to resolve phlegm, regulating Qi to stop
cough.
PRESCRIPTIONS
Erchen Tang (Two Old Herbs Decoction) and Sanzi Yangqin Tang (Decoction of
Three Kinds of Seeds for the Aged).

Phlegm-heat gathering in the lung

SYMPTOMS
Cough, rough and rapid breath, or rales in the throat, profuse thick and yellowish
sputum which is difficult to expectorate, or expectorating bloody sputum with foul
smell, distending pain in the chest and hypochondrium, flushed face, fever, thirst, dry
mouth with the desire for water, a reddened tongue with a yellowish and thick
coating, and a slippery and rapid pulse.
METHODS
Clearing the heat in the lung to descend the lung Qi, resolving phlegm to stop cough.
PRESCRIPTIONS
Qingjin Huatan Tang (Decoction for Clearing Away the Lungs and Resolving
Phlegm).

Invasion of the lung by the liver fire

SYMPTOMS
Intermittent cough, phlegm congested in the throat which is difficult to expectorate,
little and sticky sputum, hypochondriac pain on both sides when coughing, flushed
face, dry throat, bitterness of mouth. All of them are relieved or worsened by emotion,
a thin and yellow tongue coating with little moisture and a taut and rapid pulse.
METHODS
Clearing the liver, purging the lung and resolving phlegm to stop cough.
PRESCRIPTIONS
Xiebai San (Powder for Dispersing the Lungs)and Daige San( Powder of Natural
Indigo and Clam Shell).

Cough due to deficiency of the lung Yin

SYMPTOMS
Non-productive cough, short and rapid coughing voice, little sputum or blood-tinged
sputum, gradually hoarse voice, dry mouth and throat, afternoon fever, malar flush, a
hot sensation in the palms and soles, night sweating, emaciation, a slow onset, a red
tongue with exfoliated coating and a thready and rapid pulse.
METHODS
Nourishing Yin, moistening the lung, resolving phlegm to check cough.
Prescriptions
Shashen Maidong Tang(Decoction of Glehnia Ophiopogon)