Hot and Cold Syndromes

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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 they represent Yang and Yin, but Yang and Yin take many forms.

You can have

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.

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’.

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? An example might be 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 in reacting to this produces either heat or cold symptoms. The Chinese described these as being External Heat or Cold syndromes.

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 often isn't 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 would probably come down to the pulse and tongue.

The tongue, in particular, is often a strong pointer to whether a condition is hot or cold. (The tongue in the picture, right, is 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.)

Full-Heat: common symptoms
Full-Cold: common symptoms
Feels hot, possibly fever, averse heat
Feels cold, limbs cold and pale or bluish
Thirst level
No thirst, but if drinks, wants warm fluids
Red face
Bright White, or pallid or even bluish face
Stools dry
Stools loose
After bowel action
Feels better
Dark, scanty, may burn
Urine copious, clear
Raised, red eruptions
No skin eruptions from Full-Cold
Sharp, piercing, worse if pressed
Mania, restlessness
Anxiety, low spirits, may prefer company nearby
Tongue Body
Pale or blue-purple
Tongue Coating
Thick, white
Rapid and full, may be flooding
Pulse quality
Deep, tight, full

Usual Causes of Full Internal Heat and Full Internal Cold Syndromes

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
Usual Causes of Internal Heat and Cold
Usual Causes of Internal Cold
Eating too much hot-energy food (eg spicy, alcoholic or red meat)
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 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)

What to do about 'Full Internal' Hot syndromes?

Full Internal Hot conditions can be helped by what you do, depending on how severe they are, and what caused them.

Diet too Heating

If they arise from  eating foods that are too 'heat' producing, then over time, you may improve this by avoiding such foods. Eating lots of very COLD-type foods would be a bad idea, however, as it's hard to judge how much is enough:

  • Would you use a single bucket of cold water to put out a forest fire?
  • Would you use an iceberg to quench a cigarette? 

Emotional Stress

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.

A pathogenic factor invades you causing Internal Full Heat

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 won't cure it.

What to do about 'Full Internal' Cold syndromes?

Diet too Cooling

If the cause is identified as eating too much 'cold'-type food, then you can probably make a huge difference quite fast by changing your diet and starting to eat 'warming'-type foods.

Although changing your diet may not cure the condition completely, you'll almost certainly start to feel better. Treatment by your acupuncturist using moxibustion will speed things up. There are many herbal recipes in Chinese medicine to assist - but see someone experienced who can assess your condition properly, including taking your pulse and assessing your tongue.

Of course, you should also keep warm, wear plenty of clothes etc.

Invasion by an External Pathogenic Factor, causing Full Internal Cold

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.

You need

  • moxibustion,
  • acupuncture to help clear and smoothe the channels and
  • herbs to warm and chase out the invader.
  • See someone experienced.

Return from Hot and Cold to 8 Principles.

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