Alternating fever and chills according to Chinese Medicine

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Alternating fever and chills can be the consequence of several so-called “patterns of disharmony” in Chinese Medicine.

Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted, leading to symptoms or signs that something is wrong (like alternating fever and chills here). It is similar to the concept of disease in Western Medicine but not quite: a Western disease can often be explained by several Chinese patterns and vice-versa.

A pattern often manifests itself in a combination of symptoms that, at first glance, do not seem necessarily related to each others. For instance here alternating fever and chills is often associated with irritability, flank pain and stifling sensation in the chest causing one to have deep sighs in the pattern “Liver Qi Stagnation”. As you will see below, we have in record two patterns that can cause alternating fever and chills.

Once identified, patterns are treated using medicinal herbs, acupuncture, and other therapies. In the case of alternating fever and chills we’ve identified three herbal formulas that may help treat patterns behind the symptom.

We’ve also selected below the five medicinal herbs that we think are most likely to help treat alternating fever and chills.

The two "patterns of disharmony" that can cause alternating fever and chills

In Chinese Medicine alternating fever and chills is a symptom for 2 patterns that we have on record. Below is a small explanation for each of them with links for more details.

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Qi Stagnation

Pulse type(s): Wiry (Xian)

Tongue color: Normal (light red)

When Liver Qi does not flow smoothly or regularly, it becomes Stagnant and in Excess. This leads to Heat accumulating in the Liver. The feeling of ‘Distension’ (zhang 胀) is the main symptom of Liver Qi Stagnation.

In addition to alternating fever and chills, other symptoms associated with Liver Qi Stagnation include irritability, flank pain and stifling sensation in the chest causing one to have deep sighs.

From a Western Medicine standpoint Liver Qi Stagnation is associated with health issues such as Low Breast Milk Supply, Mastitis or Breast Engorgement.

Liver Qi Stagnation is often treated with Xiao Yao San, a herbal formula made of 6 herbs (including Bupleurum Roots - Chai Hu - as a key herb). Xiao Yao San belongs to the category of "formulas that harmonize liver-spleen", which might be why it is often recommended for this pattern. Its main action as a formula is: "Harmonizes the function of Liver and Spleen".

Read more about Liver Qi Stagnation here

Bupleurum Roots (Chai Hu) is the king ingredient for Xiao Chai Hu Tang, a formula used for Lesser Yang stage

Lesser Yang stage

Pulse type(s): Wiry (Xian), Fine (Xi)

In addition to alternating fever and chills, other symptoms associated with Lesser Yang stage include irritability, dry throat and bitter taste in the mouth.

Lesser Yang stage is often treated with Xiao Chai Hu Tang, a herbal formula made of 7 herbs (including Bupleurum Roots - Chai Hu - as a key herb). Xiao Chai Hu Tang belongs to the category of "formulas that harmonize lesser yang-warp disorders", which might be why it is often recommended for this pattern. Its main action as a formula is: "Treats the Lesser Yang Channels (Gallbladder and Triple Warmer)".

Read more about Lesser Yang stage here

Three herbal formulas that might help with alternating fever and chills

Xiao Yao San

Source date: 1107 AD

Number of ingredients: 6 herbs

Key actions: Harmonizes the function of Liver and Spleen. Relieves Liver Qi stagnation. Nourishes the Blood.

Why might Xiao Yao San help with alternating fever and chills?

Because it is a formula often recommended to treat the pattern 'Liver Qi Stagnation' of which alternating fever and chills is a symptom.

Other symptoms characteristic of Liver Qi Stagnation include irritability, flank pain and stifling sensation in the chest causing one to have deep sighs.

Read more about Xiao Yao San here

Xiao Chai Hu Tang

Source date: 220 AD

Number of ingredients: 7 herbs

Key actions: Treats the Lesser Yang Channels (Gallbladder and Triple Warmer). Regulates the Liver and Spleen functions. Addresses combined Yin-Yang symptoms of External and Internal, Excess and Deficiency, and Hot and Cold.

Why might Xiao Chai Hu Tang help with alternating fever and chills?

Because it is a formula often recommended to treat the pattern 'Lesser Yang stage' of which alternating fever and chills is a symptom.

Other symptoms characteristic of Lesser Yang Stage include irritability, dry throat and bitter taste in the mouth.

Read more about Xiao Chai Hu Tang here

Jia Wei Xiao Yao San

Source date: Ming dynasty

Number of ingredients: 10 herbs

Key actions: Clears Liver and Spleen Qi Stagnation. Tonifies Spleen. Clears Deficient Heat. Nourishes the blood.

Why might Jia Wei Xiao Yao San help with alternating fever and chills?

Because it is a formula often recommended to treat the pattern 'Liver Qi Stagnation' of which alternating fever and chills is a symptom.

Other symptoms characteristic of Liver Qi Stagnation include irritability, flank pain and stifling sensation in the chest causing one to have deep sighs.

Read more about Jia Wei Xiao Yao San here

The five Chinese Medicinal herbs most likely to help treat alternating fever and chills

Why might Liquorice (Gan Cao) help with alternating fever and chills?

Because Liquorice is an ingredient in several formulas indicated to treat alternating fever and chills as a symptom, like Xiao Yao San or Jia Wei Xiao Yao San for instance.

Liquorice is a Neutral herb that tastes Sweet. It targets the Spleen, the Stomach, the Heart and the Lung.

Its main actions are: Tonifies the Basal Qi and nourishes the Spleen Qi. Clears Heat and dispels toxicity. Moistens the Lungsexpel phlegm and stop coughing. Relieves spasms and alleviates pain. Harmonizes and moderates the effects of other herbs.

Read more about Liquorice here

Why might White Peony Root (Bai Shao) help with alternating fever and chills?

Because White Peony Root is an ingredient in several formulas indicated to treat alternating fever and chills as a symptom, like Xiao Yao San or Jia Wei Xiao Yao San for instance.

White Peony Roots is a Neutral herb that tastes Bitter and Sour. It targets the Spleen and the Liver.

Its main actions are: Tonifies the Blood and preserves the Yin. Nourishes the Liver and assists in the smooth flow of Qi. Regulates the meridians and eases the pain.

Read more about White Peony Roots here

Why might Bupleurum Root (Chai Hu) help with alternating fever and chills?

Because Bupleurum Root is an ingredient in several formulas indicated to treat alternating fever and chills as a symptom, like Xiao Chai Hu Tang or Xiao Yao San for instance.

Bupleurum Roots is a Cool herb that tastes Bitter. It targets the Gallbladder and the Liver.

Its main actions are: Harmonizes exterior and interior. Smoothes the Liver and upraises the Yang.

Read more about Bupleurum Roots here

Why might Poria-Cocos Mushroom (Fu Ling) help with alternating fever and chills?

Because Poria-Cocos Mushroom is an ingredient in several formulas indicated to treat alternating fever and chills as a symptom, like Xiao Yao San or Jia Wei Xiao Yao San for instance.

Poria-Cocos Mushrooms is a Neutral herb that tastes Sweet. It targets the Spleen, the Heart, the Kidney and the Lung.

Its main actions are: Encourages urination and drains Dampness. Tonic to the Spleen/Stomach. Assists the Heart and calms the Spirit.

Read more about Poria-Cocos Mushrooms here

Why might Atractylodes Rhizome (Bai Zhu) help with alternating fever and chills?

Because Atractylodes Rhizome is an ingredient in several formulas indicated to treat alternating fever and chills as a symptom, like Jia Wei Xiao Yao San or Yue Ju Wan for instance.

Atractylodes Rhizomes is a Warm herb that tastes Bitter and Sweet. It targets the Spleen and the Stomach.

Its main actions are: Tonifies the Spleen Qi. Fortifies the Spleen Yang and dispels Damp through urination. Tonifies Qi and stops sweating. Calms restless fetus when due to Deficiency of Spleen Qi.

Read more about Atractylodes Rhizomes here