Cold: An External Problem that Internalises

cold mountains - bad for large intestine luo channel symptoms
Mountains - cold and beautiful

First, Cold can be Beautiful!

But … Cold can also be an External Cause of Disease

After WindCold  is the second most common of what are called the ‘external’ causes of disease – common in climates far from the equator.

In Chinese medicine it is called an ‘external pathogenic factor‘. This means that it invades you from outside, and that your body tries to keep it at a distance from its essential inner Energy Organs, your ‘zang-fu‘ organs like your Heart, Liver, Kidneys, Stomach, Pancreas, Lungs and so on.

Nearly 2000 years ago an observant Chinese doctor produced a theory called the Invasion of Cold in Six Stages., still as useful today as it was then! His theory explains what your body does as Cold invades, both in terms of symptoms and how serious they are – and what to do.

The rest of this page is a gentle introduction to the first of those six stages.

Your body defends itself as far as possible by putting or containing the symptoms in the acupuncture channels – usually the limbs and joints – away from the vital organs in the torso.

Cold can, however, penetrate those vital inner organs when the body’s defence system is damaged, perhaps by

  • accident
  • ill-advised treatment
  • medication (most OTT medications help to clear the symptoms of Heat, so may be cooling and not necessarily helpful here!) or
  • ignorance.
  • OR when your body is too weak to contain the pathogenic factor in a ‘safe’ place – ie on the outside, or as far from the centre as possible.


If your body cannot defend itself, at the start Cold may attack its surface areas, its muscles and sinews, frequently starting with your head, shoulders and neck. These are your more yang areas, where your body mounts its first defence.

Depending on where you have weakness, it may then invade, for example, your

  • Stomach (causing stomach pain and vomiting as in some forms of Stomach-Cold);
  • your womb, (causing acutely painful periods.  Many women can trace onset of dysmenorrhoea – painful periods – to cold exposure in their teens near onset of periods); or
  • your Intestines (diarrhoea and abdominal pain).


Of course, once it’s reached inside like this, it has become Internal Cold, about which read more below.

crystal gemstones
Photo by Scott Rodgerson

What are Typical ‘Full-Cold’ Symptoms?

If you think about what it is like to get suddenly intensely cold, you’ll recognise some of the symptoms in the list.

Often you don’t want to move much – except to shiver – and you like or crave warmth.

Mentally, it often makes you fearful and tense.

If you also have Qi stagnation, the Cold and Qi stagnation will reinforce one another.

Depending on other factors you could also have sneezing or shivering, for instance if Wind invades at the same time. (And yes, what is called Wind-Chill can certainly cause it. Read more about Wind Chill here.)

People with strong constitutions can become intensely restless and some feel terrified that they are about to die.


Acute Cold can make you fear you are dying
Photo by Aron Visuals on Unsplash

Cold symptoms

  • Your body tightens up
  • Tension
  • Lack of thirst
  • Dislike of cold
  • Preference for warmth
  • Shivering
  • Pain, often in one place and dull or stabbing
  • Watery discharges eg from the nose; pale urine; runny faeces; clear or white vaginal discharges
  • Cold arms and legs, particularly hands/feet
  • Preference for warm coverings and drinks
  • Tongue: thick white coating over a pale tongue body. The thick white coating appears gradually.
  • Pulse: slow (in extreme cases, can be very slow)


Unexpected sources of Cold

Both Wind and Cold can invade quickly where your defensive-qi (this is roughly the equivalent of your immune system from the Western medical perspective) cannot prevent it.

Their penetration into your body can be stopped if caught early on.

Do not overlook or disregard this as a cause of disease! it can arrive unexpectedly, such as

  • when a woman in labour, sweating and heaving, asks for cool air to be fanned on her
  • on a warm evening when you’re hot and let yourself get cooled too fast by a breeze or by air-conditioning, and then get a chill
  • as cramps or spasms when you get up in the night to go to the lavatory or
  • when, hot in bed, to cool down you stick a leg out into cool air.
  • … and, of course, if you go out in a cold wind without enough clothes!
Warm clothes combat Cold
Photo by Victoria Strukovskaya on Unsplash

If appropriate action is taken immediately, such as covering up, or wrapping up well or taking a hot bath, the body may expel or overcome it.

If it lingers, however, it can lead to a long-term invasion and increasing bouts of severe pain for many years, culminating in the diagnosis perhaps of arthritis and the prescription of anti-inflammatory medications, steroids and painkillers. By then, it will certainly have become internal cold.

It might even turn to Heat! …

By then the body may have even changed it into ‘Heat‘ symptoms, (masking the original cause) in a desperate attempt to contain or combat it. You might recognize this in the ‘burning’ skin around an arthritic joint.

With the correct treatment, if that Heat can be expelled, it is possible that the patient will then experience a period of coldness again, at which time appropriate treatment would be needed, possibly the opposite of the treatment for symptoms of Heat. (In other words, having successfully treated to clear Heat, you then need to treat to clear Cold – often with Heat!)


Treatment for Cold

Self-treatment for the early stages?

Depends on what you have available. If you are otherwise in good health, what to do? (Apart from getting out of the Cold, of course! And out of damp or wet conditions, too.)

Read Carefully!

  • More warm, dry, clothes, for a start.
  • Something to warm you up – could be a warm wheat-bag or hot water bottle which you’ll probably want on your abdomen or back
  • Warm food or warm drink. See our recipe for a hot toddy on our page on ‘Wind-Cold‘.


  • Hot Toddy Ingredients
    Hot Toddy Ingredients – Copyright
  • Although too much alcohol will cool you down, a very little added to the toddy can help the ‘toddy’ work faster.
  • A warm bath or hot shower. Stay in until not only does your shivering end but you start to feel uncomfortably hot, even slightly sweaty. But don’t stay in for more than 20 minutes. When clearing an attack of external Cold by taking a warm shower, do not finish with a Cold shower: cold showers have their place, but not here. Instead, once you’ve developed a very slight sweat, eg on your brow, and are feeling nicely warm, even slightly uncomfortably warm, get out of the bath or shower, dry off rapidly, and cover up with warm clothes. Ideally, that slight perspiration will continue for a few minutes, even once you are dressed. Then, obviously (I hope) stay dry, keep warm and rest.
  • A warm fire to sit by, or a warm bed to get into. Ideally, get warm in bed and go to sleep to recover.
  • For very fit and healthy individuals, theoretically a vigorous game of squash or similar (indoors, away from cold) may heat you up so quickly that you burn off the Cold.
  • If caught by Cold and you think you have the symptoms of Cold invasion and can’t access the above suggestions, I suggest you try to walk faster, even run, to force your body to warm up. But there’s only a short time period for this between realising you have Cold Invasion and benefiting from this extra effort. Better is to get inside and warm up as suggested.
  • If frost-bitten, do not apply direct heat to the frozen areas. Apply gentle warmth to your centre and let that warm up gradully. Put your frozen fingers or toes in cold (not freezing) water and allow them slowly to thaw out. Gradually add warm water only as the pain goes and you get circulation going again.


Treatment for Cold from a professional?

Various kinds of treatment for Cold once you have been invaded?

  • Personally I would first try a homoeopathic remedy called Aconite – if I have it handy, of course! It’s easy to take and often works fast if homoeopathic to your situation. In effect, it’s a very small (safe) amount of a powerful toxin that stimulates your body to produce a strong yang-like reaction. How well and quickly it works depends on the strength of your constitution.
  • An acupuncturist would use moxibustion as well as needles, and other forms of warmth to help you recover. See our warning below, however.
  • Herbs: there are Chinese herbal formulae to encourage your metabolism to warm up and sweat out the invader. Traditionally these often included a small quantity of fu zi (which is, guess what? ! – aconite!) as well as other herbs to balance the formula.
  • Hot stone treatment may help some, but actually a warm bath is better.


Warning: Any form of external warmth, including moxibustion, may take a while to register with your nerves if you are feeling frozen. Until you get a return of some feeling in your skin, you could easily burn. Take Great Care! And this is even more important if you or the patient is old. An older body’s nerves work less efficiently: be sure to warm them up before applying external warmth.


Please realise that no matter how good the treatment you receive, it won’t work for long if you go out and get cold again, especially if you eat Cold Foods

You MUST make sure what you eat is warming. So… no cold salad, no cold fruit, no chilled food, no raw food, no ice, no ice-cream, no gin and no chilled lemonade etc.


Nourishing warm soup - good for Lung Dryness and Yin deficiency
Nourishing warm soup for Cold, Yin deficiency and dryness – Photo by Dipesh Gurav on Unsplash

Just eat food that has been cooked and is warm when eaten. But don’t overeat! Your energy is depleted by cold, and this includes your Stomach energy. Small amounts of warm food, over a period of time, are digested better. (Check our page on Stomach Cold and Deficient for more on this!)

Avoid Cold Food and Eat/Drink Warm Food.


Read about the other external causes of disease:


Further reading? If this has whetted your appetite, there are many more pages on this site to consider, or why not consult our acupuncture study reading list?

Jonathan Brand colours

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