Hot and Cold Syndromes: are you empty or full?

Hot and Cold? You’d think telling the difference would be easy!

‘Hot is Yang and Cold is Yin’ so where’s the problem?

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

• excess Yang and 
• excess Yin;
• deficient Yang and 
• deficient Yin,
• and various combinations of them.

In addition, when combined with four of the other 8 principles (internal/external and full/empty), you can end up with confusion.

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’:

1/ ‘Full Internal’ Hot and Cold syndromes

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.

2/ ‘Full External’ Hot and Cold syndromes

‘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.

3/ ‘Empty’ 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.

Click here to read about Empty Heat and Cold.

This ‘deficiency’ may arise from weakness in one or more of the Organ-energies (zang-fu), or weakness in either or both Yin or Yang.

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.)

More about Hot and Cold: yet another attempt to explain them!

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.

Signs of Full Internal Heat and Full Internal Cold syndromes

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.

If there are confused signals, the final decision might come down to diagnosis from inspection of pulse and tongue.

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.