Hot and Cold? You’d think telling the difference would be easy!
This distinction often IS easy, but then again, often it’s not. The problem is that Yang and Yin take many forms.
You can have
Yet, for the sake of improving health and ameliorating disease, the distinction is vital.
By the way … For more about this important topic, you could look up the nature of Cold, and similarly of Heat. In Chinese medical theory Heat takes several forms, for instance Summer Heat, Heatwave and Sunstroke, which are serious causes of ill-health. Also, you assess the progress of a disease from where it’s got to in the Four Levels (for Hot diseases), or Six Stages (for Cold). As an example, Covid 19 is treated as a hot disease.
So we can have, by combining Hot or Cold with ‘internal/external’ and ‘full/empty’:
This kind of Hot and Cold is the subject of THIS page.
Look at the tables further on down below to read about the usual symptoms and causes.
‘Internal’ means the disease process has penetrated to the inside and the body is trying to keep it from invading further. Your acupuncturist’s job is to help your body push this disease process outwards, away from the centre. Click here to read about the difference between Internal and External syndromes.
However, there are several other important categories, see 2/ and 3/ below.
‘External’ means the disease is on the outside of the body, trying to get in, and the body is trying to keep it out. Click here to read about External Hot and Cold syndromes.
This is a different kind of distinction between hot and cold. Whereas ‘Full’ means that the body has the energy to battle with an invasive energy such as a bug, ‘Empty’ means that symptoms arise not from ‘Fullness’ but from ‘Deficiency’ – a kind of Weakness.
Put another way, Emptiness (ie arising from Deficiency) means that your body is under-functioning. It has been weakened by age or disease, and is producing symptoms not caused mainly by a bug or an external pathogenic factor. Click to read more about the difference between Full and Empty conditions.
(An example of emptiness? For instance when you sweat copiously without cause, when not exerting yourself and not because of high ambient temperature or fear.)
When you feel unwell, you’ll find you nearly always feel warmer or colder than normal, whatever the cause may be.
The Chinese analysed these different ways of feeling ill, and established the causes.
Disease can come from outside (as from a bug; an accident; or exposure to inclement conditions like a heatwave or cold). Your body reacts to this with either heat or cold symptoms. The Chinese described these as being External Heat or Cold syndromes.
Alternatively, the disease can be generated from internal factors. Sometimes this comes about because an external factor has overcome your body’s best attempts at dealing with it (via External Heat or External Cold syndromes) and the disease process has penetrated to the interior.
Sometimes internal disease comes about because you’ve been eating unwisely, or because of emotional factors. (Don’t underestimate the power of emotional factors in causing disease!) These internal hot and cold syndromes are the subject of this page.
So that covers ‘Full EXTERNAL Heat and Cold‘, and ‘Full INTERNAL Heat and Cold’, which you can read about below, on this page.
There’s another set of conditions, called EMPTY Heat or Empty Cold syndromes. Sometimes, from exhaustion or dissipation of its energy, your body is deficient in Yin or Yang energy. It lacks the power to mount a proper attack on the invading force, and in fact there needn’t even be an invading force. That’s when you get Empty Heat or Empty Cold syndromes, arising from a deficiency in either Yin or Yang factors.
In the table below you’ll see the distinction between full Hot and full Cold syndromes. What this means is that if your symptoms are like those on the left side, you will be diagnosed as suffering from a Full Internal Heat condition.
If your symptoms are like those in the right hand column, then the diagnosis would be Full Internal Cold.
The tongue, in particular, is often a strong pointer to whether a condition is hot or cold.
In the picture, the tongue is a bit pale and moist, suggesting a Cold condition.
However, the tongue coating isn’t thick enough to confirm Full Internal Cold so this is more likely a condition of Heart and Spleen Blood deficiency and possibly Yang deficiency. The front of the tongue is also a little darker than the rest, suggesting a tendency towards Heart Qi deficiency.
So this a rather deficient tongue, indicating a deficiency of Heat.
|Full-Heat: common symptoms||Full-Cold: common symptoms|
|Feeling hot, possibly fever, averse heat||Sensation||Feels cold, limbs cold and pale or bluish|
|Thirsty||Thirst level||No thirst, but if drinks, wants warm fluids|
|Red face||Complexion||Bright White, or pallid or even bluish face|
|Stools dry||Bowel movements||Stools loose|
|After bowel action||Feels better|
|Dark, scanty, may burn||Urine||Urine copious, clear|
|Raised, red eruptions||Skin||No skin eruptions from Full-Cold|
|Burning||Pain||Sharp, piercing, worse if pressed|
|Mania, restlessness||Mind||Anxiety, low spirits, may prefer company nearby|
|Red||Tongue Body||Pale or blue-purple|
|Yellow||Tongue Coating||Thick, white|
|Rapid and full, may be flooding||Pulse quality||Deep, tight, full|
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How do you acquire these Hot and Cold syndromes?
In the table you’ll see the reasons, on left for Hot and on right for Cold syndromes.
|Usual Causes of Internal Heat||Normal Causes of Internal Heat and Cold||Usual Causes of Internal Cold|
|Eating too much hot-energy food (eg spicy, alcoholic or red meat)||Food||Too much cold-type foods, ie foods that cause the body to cool down or run ‘cold’|
|Emotional stress causing Qi stagnation that turns to Interior Heat||Emotions||(Your emotions are not a cause of Full-Cold)|
|From an external pathogenic factor that penetrates (often via mouth or nose, but there are other factors) to the interior where it is turned into Heat||Invasion by an external pathogenic factor||External cold invasion (invades the channels first through the skin, then subsequently enters the zang-fu organs – causing interior cold)|
Full Internal Hot conditions can be helped by what you do, depending on how severe they are, and what caused them.
If they arise from eating foods that are too ‘heat’ producing, then over time you may improve your health by avoiding many such foods. Eating just COLD-type foods would probably be a bad idea, however, as it’s hard to judge how much is enough:
If caused by emotional stress, especially continuing emotional stress, you cannot really expect that even good treatment purely to clear Internal Heat syndromes will work for long.
This is because if you live on top of a volcano and huge chunks of flaming rock keep sailing through your windows, just sitting in a cool bath isn’t really going to cure your problem.
You will need some kind of help to resolve your emotional stress. This could be a shoulder to cry on, but more likely some kind of therapy, counselling, and/or a change in your life situation or direction.
Do not underestimate the power of Chinese medicine to help. Some parts of its huge body of theory and practice are very appropriate for treating emotional stress. You can read more about it under Qi Stagnation, but it’s such a big subject that eventually I wrote a book about it, see below.
Chinese medicine has plenty of experience of treating this, using a range of therapies including acupuncture and herbs. Probably you will need professional help. However, avoiding emotional stress and avoiding hot foods will help a bit, but on their own they won’t cure it.
So have you been eating too much ‘cold’-type food? You can probably make a huge difference quite fast by avoiding cold-type foods and changing your diet to eat more ‘warming’-type foods. I’ve seen many patients who cured themselves without doing anything else than this!
Even if changing your diet does not cure your condition completely, you’ll almost certainly start to feel better. What’s more, you’ll find that treatment by your acupuncturist, perhaps using moxibustion (picture below), will speed things up.
Of course, you should also keep warm and wear plenty of clothes etc.
You will WANT to keep warm. Although warm baths will help you feel a bit better and might have helped your body get rid of the problem when it was still at the ‘exterior’ level, it is now too late to expect a warm bath to solve the problem.
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