Chills in Traditional Chinese Medicine

Understanding different chills patterns according to TCM theory

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14
TCM Patterns
88
Formulas
Overview
What causes it 14 TCM patterns documented
How to recognize Symptoms specific to each chills pattern
Classical remedies 88 herbal formulas documented

In Traditional Chinese Medicine (TCM), chills are seen as an indication of internal disharmony. TCM practitioners believe that chills can result from various imbalances within the body, such as Deficiencies or Stagnation in the flow of Qi and Blood. Unlike Western medicine, which might focus on infections or physiological causes, TCM emphasizes diagnosing the specific pattern of disharmony to create an effective treatment plan tailored to the individual's needs.

TCM Patterns for Chills

Cold

Congeals body fluids, damages Yang Qi, and causes pain with fixed location

Causes: Chills, Feeling of cold, Chills with skin that is warm to the touch, Severe chills, Strong chills, Chills without sweating

21 variations documented
Onset Sudden
Location Can be local or systemic
Features Aversion to cold • Prefers warmth • Pain relieved by heat • Tight/contracted feeling

Cold is the predominant pathogenic factor of winter in Traditional Chinese Medicine. Cold represents an environmental pathogen that, when excessive, causes disease characterized by its cold, congealing, and contracting nature. While Cold is the main pathogen of winter, it can cause illness in any season through exposure to cold temperatures, getting caught in rain, sweating followed by wind exposure, or excessive air conditioning.

Early Stage Summerheat with Exterior Wind-Cold
How it presents with chills

Chills

Along with: Fever, Lack of sweating, Headaches, Thirst, Flushed face, Stifling sensation in the chest,

Traditional Herbal Formulas
Exterior-Cold
How it presents with chills

Chills

Along with: Aversion to cold, Fever, Body pain, Stiff neck, Lack of sweating, Absence of thirst,

Traditional Herbal Formulas
Lesser Yin Cold Transformation
How it presents with chills

Feeling of cold, Chills

Along with: Diarrhea, Absence of thirst, Desire to lie down curled up, Apathy, Hypersomnia, Cold extremities,

Traditional Herbal Formulas
Wind-Cold
How it presents with chills

Chills

Along with: Aversion to cold, Fever, Sneezing, Coughing, Nasal discharge, Occipital headache,

Wind-Cold invading the Lungs
How it presents with chills

Chills

Along with: Aversion to cold, Fever, Itchy throat, Shortness of breath, Congested nose, Nasal discharge,

Bladder Deficient and Cold
How it presents with chills

Feeling of cold

Along with: Frequent urination, Pale and abudant urination, Urinary or fecal incontinence, Enuresis, Lower back pain, Dizziness,

Traditional Herbal Formulas
Cold in the Uterus
How it presents with chills

Feeling of cold

Along with: Diarrhea, Loss of appetite, Generalized fatigue, General weakness, Thin vaginal discharge

Cold invading the Large Intestine
How it presents with chills

Feeling of cold

Along with: Abdominal pain, Diarrhea, Chills, Abdominal cold sensation

Traditional Herbal Formulas
Cold invading the Stomach
How it presents with chills

Feeling of cold

Along with: Severe upper abdominal pain, Chills, Cold extremities, Desire for hot beverages and foods, Vomiting clear liquid, Nausea,

Cold-Phlegm in the Lungs
How it presents with chills

Feeling of cold

Along with: Coughing, White and watery sputum, Chills, Cold hands, Sputum, Dizziness,

Damp-Cold
How it presents with chills

Feeling of cold

Along with: Mouth ulcers, White and watery sputum, Nasal discharge, Sneezing, Chills, Abdominal pain,

Traditional Herbal Formulas
Empty-Cold
How it presents with chills

Feeling of cold

Along with: Chills, Cold extremities, Pale face, Absence of thirst, Apathy, Excessive sweating,

Greater Yin stage
How it presents with chills

Feeling of cold

Along with: Loss of appetite, Vomit, Abdominal fullness, Chills, Diarrhea, Absence of thirst,

Traditional Herbal Formulas
Stagnation of Cold in the Liver Channel
How it presents with chills

Feeling of cold

Along with: Hypochondrial fullness and distention with pain alleviated by warmth, Testicular pain, Scrotal contraction, Vertical headaches, Chills, Cold extremities,

Traditional Herbal Formulas
Exterior Cold with Interior Dampness in Summer
How it presents with chills

Chills with skin that is warm to the touch

Along with: Chills with warm skin, Lack of sweating, Heavy sensation in the head, Headaches, Abdominal pain, Vomit,

Traditional Herbal Formulas
Wind-Cold invading with Yang Deficiency
How it presents with chills

Severe chills

Along with: Low grade fever, Exhaustion, Hypersomnia, Cold extremities, Lumbar pain, Lower back pain,

Wind Cold with Internal Heat
How it presents with chills

Strong chills

Along with: High fever, Severe chills, Lack of sweating, Headaches, Feeling of heaviness, General sensation of tightness,

Traditional Herbal Formulas
Exterior Cold invading the Interior
How it presents with chills

Chills

Along with: Abdominal pain, Constipation, Hypochondriac pain, Low grade fever, Cold extremities, Sweating that doesn't reduce fever,

Traditional Herbal Formulas
Stomach Deficiency
How it presents with chills

Feeling of cold

Along with: Nausea or vomiting, Generalized fatigue, Chills, Loss of appetite, Depression, Dry mouth,

Painful Obstruction with Wind-Cold-Damp
How it presents with chills

Chills without sweating

Along with: Swollen and painful joints worsening at night, Joint stiffness, Weight loss, Headaches, Dizziness, Shortness of breath,

Traditional Herbal Formulas
Exterior Dry Cold invading the Lungs
How it presents with chills

Chills without sweating

Along with: Headaches, Congested nose, Dry throat, Sputum, Dry cough, Common cold,

Traditional Herbal Formulas

Yang Deficiency

Insufficient yang qi causing coldness, fatigue, and diminished physiological functions throughout the body

Causes: Feeling of cold, Chills, Severe chills

11 variations documented
Onset Gradual
Location Systemic
Features Always cold • Fatigue • Pale face • Prefers warmth • Cold limbs

Yang Deficiency represents a fundamental weakness of the body's yang qi in Traditional Chinese Medicine. It manifests as an inability to warm the body, transform substances, and maintain normal physiological activities, resulting in various cold-type symptoms and functional decline.

Lesser Yin Cold Transformation
How it presents with chills

Feeling of cold, Chills

Along with: Diarrhea, Absence of thirst, Desire to lie down curled up, Apathy, Hypersomnia, Cold extremities,

Traditional Herbal Formulas
Kidney Yang Deficiency
How it presents with chills

Chills, Feeling of cold

Along with: Lower back pain, Dizziness, Tinnitus, Weak and cold knees, Lower back coldness, Weak legs,

Spleen Yang Deficiency
How it presents with chills

Feeling of cold, Chills

Along with: Slight abdominal distension after eating, General weakness, Desire to lie down curled up, Pale face, Cold extremities, Undigested food in stools,

Greater Yin stage
How it presents with chills

Feeling of cold

Along with: Loss of appetite, Vomit, Abdominal fullness, Chills, Diarrhea, Absence of thirst,

Traditional Herbal Formulas
Heart Yang Deficiency
How it presents with chills

Feeling of cold

Along with: Palpitations, Exertional dyspnea, Generalized fatigue, Spontaneous sweat, Slight feeling of stuffiness in the heart, Chills,

Traditional Herbal Formulas
Kidney and Spleen Yang Deficiency
How it presents with chills

Feeling of cold

Along with: Lower back pain, Weak and cold knees, Back cold sensation, Chills, Weak legs, Bright pale face,

Traditional Herbal Formulas
Kidney Yang Deficiency with Water overflowing
How it presents with chills

Feeling of cold

Along with: Edema of the lower extremities, Cold sensation in legs and back, Abdominal distention, Lumbar pain, Chills, Scanty clear urination,

Traditional Herbal Formulas
Yang Deficiency or Empty Yang
How it presents with chills

Feeling of cold

Along with: Chills, General cold feeling, Pale urine, Undigested food in stools, General weakness, Abdominal pain relieved by pressure and warmth,

Wind-Cold invading with Yang Deficiency
How it presents with chills

Severe chills

Along with: Low grade fever, Exhaustion, Hypersomnia, Cold extremities, Lumbar pain, Lower back pain,

Deficiency of both the Kidney Yin and Yang
How it presents with chills

Chills

Along with: Menopausal symptoms, Hypertension, Irregular periods, Menopausal hot flashes, Excessive sweating, Irritability,

Traditional Herbal Formulas
Spleen or Kidney Yang Deficiency
How it presents with chills

Feeling of cold

Along with: Abdominal pain that worsens with cold, Urinary dysfunction, Deep pain and heaviness in limbs, Dizziness, Heavy sensation in the head, Edema,

Traditional Herbal Formulas

Wind

Causes sudden symptoms, movement disorders, and serves as the vehicle for other pathogens

Causes: Chills, Slight chills, Severe chills, Strong chills, Chills without sweating

8 variations documented
Onset Sudden
Location Often upper body/exterior
Features Rapid onset • Moving/migrating symptoms • Itching • Symptoms change location

Wind is the predominant pathogenic factor of spring in Traditional Chinese Medicine and is considered the leader of the six external pathogens. Wind is described as "the leader of the hundred diseases" (百病之长), serving as the primary factor in external pathogenic invasions. Wind represents a pathogen characterized by constant movement, changeability, and a tendency to affect the upper and outer portions of the body.

Early Stage Summerheat with Exterior Wind-Cold
How it presents with chills

Chills

Along with: Fever, Lack of sweating, Headaches, Thirst, Flushed face, Stifling sensation in the chest,

Traditional Herbal Formulas
Wind-Cold
How it presents with chills

Chills

Along with: Aversion to cold, Fever, Sneezing, Coughing, Nasal discharge, Occipital headache,

Wind-Cold invading the Lungs
How it presents with chills

Chills

Along with: Aversion to cold, Fever, Itchy throat, Shortness of breath, Congested nose, Nasal discharge,

Wind-Heat
How it presents with chills

Chills

Along with: Aversion to cold, Fever, Sneezing, Coughing, Nasal discharge, Occipital stiffness,

Wind-Heat invading the Lungs
How it presents with chills

Slight chills

Along with: Aversion to cold, Fever, Coughing, Sore throat, Congested nose, Nasal discharge,

Traditional Herbal Formulas
Wind-Cold invading with Yang Deficiency
How it presents with chills

Severe chills

Along with: Low grade fever, Exhaustion, Hypersomnia, Cold extremities, Lumbar pain, Lower back pain,

Wind Cold with Internal Heat
How it presents with chills

Strong chills

Along with: High fever, Severe chills, Lack of sweating, Headaches, Feeling of heaviness, General sensation of tightness,

Traditional Herbal Formulas
Painful Obstruction with Wind-Cold-Damp
How it presents with chills

Chills without sweating

Along with: Swollen and painful joints worsening at night, Joint stiffness, Weight loss, Headaches, Dizziness, Shortness of breath,

Traditional Herbal Formulas

Heat

Intense, ascending pathogenic force that consumes body fluids, disturbs the mind, and accelerates all physiological processes

Causes: Chills, Slight chills, Strong chills, Shaking chills, Feeling of cold, Mild chills alternating with pronounced fever

7 variations documented
Onset Can be sudden
Location Can be local or systemic
Features Red face/eyes • Thirst for cold drinks • Restlessness • Yellow/dark secretions

Heat is a major pathogenic factor in Traditional Chinese Medicine that can arise from external invasion or internal generation. Heat has the characteristics of burning intensity, rising upward, consuming qi and fluids, and generating wind and disturbing blood. In TCM philosophy, normal physiological warmth is called "minor fire" (少火) which maintains life functions, while pathological heat is "major fire" (壮火) which damages the body.

Early Stage Summerheat with Exterior Wind-Cold
How it presents with chills

Chills

Along with: Fever, Lack of sweating, Headaches, Thirst, Flushed face, Stifling sensation in the chest,

Traditional Herbal Formulas
Wind-Heat
How it presents with chills

Chills

Along with: Aversion to cold, Fever, Sneezing, Coughing, Nasal discharge, Occipital stiffness,

Wind-Heat invading the Lungs
How it presents with chills

Slight chills

Along with: Aversion to cold, Fever, Coughing, Sore throat, Congested nose, Nasal discharge,

Traditional Herbal Formulas
Wind Cold with Internal Heat
How it presents with chills

Strong chills

Along with: High fever, Severe chills, Lack of sweating, Headaches, Feeling of heaviness, General sensation of tightness,

Traditional Herbal Formulas
Painful Obstruction due to Damp Heat in Channels
How it presents with chills

Shaking chills

Along with: Heat and pain in the joints, Difficulty in moving, Fever, Chills, Scanty and dark urine, Dull yellow complexion,

Traditional Herbal Formulas
Stomach Deficiency
How it presents with chills

Feeling of cold

Along with: Nausea or vomiting, Generalized fatigue, Chills, Loss of appetite, Depression, Dry mouth,

Heat in Gall Bladder
How it presents with chills

Mild chills alternating with pronounced fever

Along with: Mild chills with high fever, Bitter taste in the mouth, Stifling sensation in the chest, Vomiting of sour fluids, Thirst, Hypochondriac pain and discomfort,

Traditional Herbal Formulas

Dampness

Heavy, sticky moisture that obstructs body functions and creates sluggishness

Causes: Chills, Feeling of cold, Chills with skin that is warm to the touch, Shaking chills, Chills without sweating

6 variations documented
Onset Gradual
Location Systemic, especially digestive
Features Heavy/foggy feeling • Sticky/turbid discharges • Poor appetite • Bloating

Dampness manifests as swelling, bloating, a feeling of heaviness in the head and limbs, and digestive issues. It's like having waterlogged tissues that make everything feel heavy and slow. Common signs include a thick, greasy tongue coating, sticky mouth sensation, and stools that are difficult to flush.

Early Stage Summerheat with Exterior Wind-Cold
How it presents with chills

Chills

Along with: Fever, Lack of sweating, Headaches, Thirst, Flushed face, Stifling sensation in the chest,

Traditional Herbal Formulas
Damp-Cold
How it presents with chills

Feeling of cold

Along with: Mouth ulcers, White and watery sputum, Nasal discharge, Sneezing, Chills, Abdominal pain,

Traditional Herbal Formulas
Kidney Yang Deficiency with Water overflowing
How it presents with chills

Feeling of cold

Along with: Edema of the lower extremities, Cold sensation in legs and back, Abdominal distention, Lumbar pain, Chills, Scanty clear urination,

Traditional Herbal Formulas
Exterior Cold with Interior Dampness in Summer
How it presents with chills

Chills with skin that is warm to the touch

Along with: Chills with warm skin, Lack of sweating, Heavy sensation in the head, Headaches, Abdominal pain, Vomit,

Traditional Herbal Formulas
Painful Obstruction due to Damp Heat in Channels
How it presents with chills

Shaking chills

Along with: Heat and pain in the joints, Difficulty in moving, Fever, Chills, Scanty and dark urine, Dull yellow complexion,

Traditional Herbal Formulas
Painful Obstruction with Wind-Cold-Damp
How it presents with chills

Chills without sweating

Along with: Swollen and painful joints worsening at night, Joint stiffness, Weight loss, Headaches, Dizziness, Shortness of breath,

Traditional Herbal Formulas

Qi Deficiency

Insufficient vital energy causing fatigue, weakness, poor digestion, and reduced function of organs and protective systems

Causes: Feeling of cold

4 variations documented
Onset Gradual
Location Systemic
Features Fatigue • Weak voice • Shortness of breath • Spontaneous sweating • Poor appetite

Qi Deficiency is a fundamental pattern in Traditional Chinese Medicine where the body's vital energy is insufficient to maintain normal physiological functions, leading to weakness, fatigue, and various organ dysfunctions.

Bladder Deficient and Cold
How it presents with chills

Feeling of cold

Along with: Frequent urination, Pale and abudant urination, Urinary or fecal incontinence, Enuresis, Lower back pain, Dizziness,

Traditional Herbal Formulas
Kidney Qi not Firm
How it presents with chills

Feeling of cold

Along with: Lower back pain, Lower back weakness, Polyuria, Weak urine stream, Enuresis, Nocturnal emission,

Spleen or Kidney Qi Deficiency
How it presents with chills

Feeling of cold

Along with: Early menstruation, Pale menstrual flow, Lower back pain, Dizziness, Chills, Nocturia,

Stomach Deficiency
How it presents with chills

Feeling of cold

Along with: Nausea or vomiting, Generalized fatigue, Chills, Loss of appetite, Depression, Dry mouth,

Yin Deficiency

Depletion of cooling, moistening fluids causing dryness, false heat rising, and restless agitation throughout the body

Causes: Chills, Feeling of cold

3 variations documented
Onset Gradual
Location Systemic
Features Night sweats • Dry mouth/throat • Heat in afternoon/evening • Malar flush

Yin Deficiency represents a fundamental pattern in Traditional Chinese Medicine where the body's yin fluids - blood, essence, and body fluids - become depleted, losing their ability to cool, moisten, and anchor the yang energy, resulting in relative hyperactivity of yang and internal heat manifestations.

Deficiency of both the Kidney Yin and Yang
How it presents with chills

Chills

Along with: Menopausal symptoms, Hypertension, Irregular periods, Menopausal hot flashes, Excessive sweating, Irritability,

Traditional Herbal Formulas
Kidney-Deficiency
How it presents with chills

Feeling of cold

Along with: Scanty menstruation, Pale menstrual flow, Back pain, Knee pain, Dizziness, Tinnitus,

Stomach Deficiency
How it presents with chills

Feeling of cold

Along with: Nausea or vomiting, Generalized fatigue, Chills, Loss of appetite, Depression, Dry mouth,

Phlegm

Thick, sticky pathological fluid that obstructs body functions and can manifest anywhere in the body

Causes: Feeling of cold

2 variations documented
Onset Gradual
Location Local or systemic
Features Nodules/lumps • Heavy sensation • Mucus/expectoration • Mental confusion (if affecting mind)

Phlegm is both a pathological product and a pathogenic factor in Traditional Chinese Medicine. It results from impaired fluid metabolism when the body's transformative functions fail, particularly affecting the Spleen, Lungs, and Kidneys. Classical texts emphasize that "the Spleen is the source of phlegm production, while the Lungs are the storage vessel for phlegm."

Cold-Phlegm in the Lungs
How it presents with chills

Feeling of cold

Along with: Coughing, White and watery sputum, Chills, Cold hands, Sputum, Dizziness,

Phlegm-Fluids in the Lungs
How it presents with chills

Feeling of cold

Along with: Coughing, White and watery sputum, Shortness of breath, Gurgling noise in the chest, Stifling sensation in the chest, Feeling of heaviness,

Blood Deficiency

Insufficient blood to nourish the body, causing paleness, dizziness, and dryness throughout the system

Causes: Feeling of cold

1 variation documented
Onset Gradual
Location Systemic
Features Pale face/lips/nails • Blurred vision • Dizziness • Scanty menses • Numbness

Blood Deficiency represents a fundamental lack of blood volume or quality in the body, resulting in organs, tissues, and the mind being undernourished. In Traditional Chinese Medicine, blood not only refers to the red fluid in our vessels but encompasses the body's entire nourishing and moistening functions.

Liver Blood and Kidney Essence Deficiency
How it presents with chills

Feeling of cold

Along with: Primary amenorrhea, Lower back pain, Generalized fatigue, Knee pain, Dizziness, Depression,

Essence Deficiency

Depletion of the fundamental substance governing growth, development, reproduction, and aging

Causes: Feeling of cold

1 variation documented
Onset Very gradual
Location Systemic, especially Kidney
Features Developmental issues • Premature aging • Weak bones/teeth • Poor growth/fertility

Essence Deficiency is a fundamental pattern category in Traditional Chinese Medicine involving insufficient Jing (精), the vital substance that governs human growth, development, reproduction, and the aging process. Jing forms the material foundation of life itself, stored primarily in the Kidneys, and manifests throughout the body as the source of constitutional strength and vitality.

Liver Blood and Kidney Essence Deficiency
How it presents with chills

Feeling of cold

Along with: Primary amenorrhea, Lower back pain, Generalized fatigue, Knee pain, Dizziness, Depression,

Yang Collapse

Sudden, catastrophic loss of yang energy causing systemic shutdown with cold sweating, frozen extremities, and consciousness fading

Causes: Feeling of cold

1 variation documented
Onset Sudden
Location Systemic/Critical
Features Life-threatening • Cold extremities • Profuse cold sweat • Loss of consciousness

Yang Collapse represents the most critical yang deficiency pattern in Traditional Chinese Medicine - a life-threatening condition where the body's yang energy suddenly and massively depletes, leading to systemic functional failure.

Collapse of Yang
How it presents with chills

Feeling of cold

Along with: Apathy, Chills, Cold extremities, Bright pale face, Sweating on forehead, Absence of thirst,

Traditional Herbal Formulas

Yin Excess

Pathological accumulation of cold, heavy substances causing stagnation, obstruction, and suppression of yang energy with internal cold manifestations

Causes: Feeling of cold

1 variation documented
Onset Gradual
Location Systemic
Features Pathological cold from internal Yin • Accumulation of cold fluids • Slow metabolism

Yin Excess represents patterns in Traditional Chinese Medicine where yin-natured pathological substances - cold, phlegm, dampness, and fluids - accumulate excessively in the body, overwhelming yang energy and causing obstruction, stagnation, and cold manifestations throughout the system.

Yin Excess
How it presents with chills

Feeling of cold

Along with: Absence of thirst, Slow and forceful movement, Epigastric pain worsen by pressure, Polyuria, Feeling of chest oppression, Nausea,

Traditional Herbal Formulas

Summer Heat

Intense summer heat that rapidly depletes both energy and fluids

Causes: Chills

1 variation documented
Onset Sudden
Location Systemic
Features Mostly summer season • Profuse sweating • Intense thirst • Possible fever

Summer-Heat (暑 Shǔ) is a unique pathogenic factor in Traditional Chinese Medicine that only occurs during summer. Unlike other disease-causing factors in TCM that can arise internally or externally, Summer-Heat always comes from the environment - specifically from exposure to intense summer heat and humidity.

Early Stage Summerheat with Exterior Wind-Cold
How it presents with chills

Chills

Along with: Fever, Lack of sweating, Headaches, Thirst, Flushed face, Stifling sensation in the chest,

Traditional Herbal Formulas

Dryness

Depletes body fluids and primarily damages the lungs

Causes: Chills without sweating

1 variation documented
Onset Gradual
Location Systemic, especially Lung/skin
Features Dry skin/lips/throat • Dry cough • Autumn association • Cracked/rough texture

Dryness is the predominant pathogenic factor of autumn in Traditional Chinese Medicine. It represents environmental dryness that damages the body's fluids and particularly affects the respiratory system.

Exterior Dry Cold invading the Lungs
How it presents with chills

Chills without sweating

Along with: Headaches, Congested nose, Dry throat, Sputum, Dry cough, Common cold,

Traditional Herbal Formulas

Herbal Formulas for Chills

Traditional Chinese Medicine formulas used to address chills

You Gui Wan

Addresses these chills patterns:

Yang Deficiency Yin Deficiency Qi Deficiency

Ma Huang Tang

Addresses these chills patterns:

Cold Wind

Ba Wei Di Huang Wan

Addresses these chills patterns:

Yang Deficiency

Ban Liu Wan

Addresses these chills patterns:

Cold Yang Deficiency

Bu Zhong Yi Qi Tang

Addresses these chills patterns:

Yang Deficiency Qi Deficiency

Cong Chi Tang

Addresses these chills patterns:

Cold Wind Heat

Er Xian Tang

Addresses these chills patterns:

Yang Deficiency Yin Deficiency

Er Zhi Wan

Addresses these chills patterns:

Yang Deficiency Yin Deficiency

He Che Da Zao Wan

Addresses these chills patterns:

Blood Deficiency Essence Deficiency Qi Deficiency