Exterior-Cold

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Pattern factsheet

Chinese name: 表寒

Pinyin name: Biǎo Hán

Associated TCM concepts: Exterior Cold evil

Diagnosis

Common symptoms: Fever Chills No sweat No thirst Stiff neck and five other symptoms

Pulse type(s): Tight (Jin), Floating (Fu)

Tongue description: Pale tongue with thin white coating

This pattern is classified as ‘Exterior’ not because it derived from an external pathogenic factor but because its manifestations are located in the ‘Exterior’ of the body (the skin, muscles and channels). 

'Cold' here is an exterior pathogenic factor. Spontaneous 'Fever' and aversion to cold are the typical manifestations. The Cold constrains the skin pores and thus there is no sweat. 

Aversion to cold refers to the sudden chilliness and dislike coldness when patients get sick with a cold or other acute diseases. ‘Fever’ (发热 /Fa Re) does not necessarily indicate an actual fever, but rather the patients' objective feeling of the heat. 

Wind is a pathology that commonly accompanies Cold Evil. External Wind can also refer to the proliferation of various bacteria and viruses in additional to actual windy environment. The fact that the Chinese character for Wind is a small insect might perhaps suggest that they suspected the existence of external pathogens such as germs and viruses. 

The combined Wind-Cold invasion is an Exterior-Excess pattern and Ma Huang Tang is commonly used. 

If the pattern is rather Exterior-Empty, which means the Cold exists due to lack of Yang element, Gui Zhi Tang is more recommended. 

Diagnosing Exterior-Cold

The Exterior in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Exterior in Chinese Medicine

Pulse type(s): Tight (Jin) or floating (Fu)

Tongue description: Pale tongue with thin white coating

Possible symptoms: Fever Chills No sweat No thirst Stiff neck Loose stools Clear urination Feeling of heat Aversion to cold Generalized body pain

Diagnosing a pattern in Chinese Medicine is no easy feat and should be left to professional practitioners.

In particular one has to know how to differentiate between different types of pulses and tongue coatings, shapes and colors. Here patients with Exterior-Cold will tend to exhibit tight (Jin) or floating (Fu) pulses.

Practitioners also learn to read from a long list of seemingly unrelated symptoms. Here patients with Exterior-Cold might experience symptoms like loose stools, clear urination, aversion to cold and fever (full list here above).

Herbal formulas used to treat Exterior-Cold

Ma Huang Tang

Source date: 220 AD

Number of ingredients: 4 herbs

Key actions: Releases exterior cold. Treats wheezing.

Formula summary

Ma Huang Tang is a 4-ingredient Chinese Medicine formula with Ephedra (Ma Huang) as a principal ingredient. Invented in 220 AD, it belongs to the category of formulas that clear Wind-Cold.

Besides Exterior-Cold, Ma Huang Tang is also used to treat Wind-Cold invading the Lungs or Greater Yang Attack of Cold.

Read more about Ma Huang Tang

Gui Zhi Tang

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Releases pathogens from the muscle layer. Regulates the Nutritive and Protective Qi.

Formula summary

Gui Zhi Tang is a 5-ingredient Chinese Medicine formula with Cinnamon Twigs (Gui Zhi) as a principal ingredient. Invented in 220 AD, it belongs to the category of formulas that clear Wind-Cold.

Besides Exterior-Cold, Gui Zhi Tang is also used to treat Greater Yang Attack of Wind or Exterior-Empty.

Read more about Gui Zhi Tang

Most important herbs used to treat Exterior-Cold