Cold Conditions: Treating a Traditional Chinese Medicine Principle
Perhaps the most interesting thing about humans is our differences. Like me, you may have wished for a clone to take up the slack in your life. But really, wouldn’t you have serious doubts about wanting to have yourself in your face all day long? Sounds scary, and boring. I enjoy knowing people with so many different perspectives and ways of being.
According to TCM, “coldness” is a disease-causing agent.
These differences (called our constitutional nature in herbal medicine) help make being an herbal practitioner exciting and fresh. An intimate knowledge of these differences has been acknowledged as an essential part of herbal medicine for thousands of years. Two basic types of constitutional makeups are “cold” and “hot” types. In the May/June 2000 column we talked of hot types, and in this article we’ll discuss individuals with a fundamentally cold constitution.
A common term for someone who often appears unemotional or who can perform certain tasks that most people would find emotionally challenging, with no outward sign of emotion, is “cold-blooded.” I remember a patient who fit this description perfectly. In fact, her case was another major step in convincing my Western mind that the diagnostic system of Traditional Chinese Medicine (TCM) really does work.
A Textbook Case of Cold Condition
I met Gretchen through a friend of hers at a big herbal conference. Her friend introduced us because she thought I might be able to help Gretchen with a difficult digestive problem she was dealing with—she couldn’t digest anything without experiencing pain and diarrhea.
My first clue to Gretchen’s nature was her previous job—she’d been an ambulance driver for ten years before taking over her family farm after her dad died.
Gretchen had been to several doctors and had gotten absolutely no relief. They had ordered all kinds of tests and had recommended over-the-counter digestive aids such as Maalox, Tums, and Pepto Bismol—all to no avail. They even had threaded a scope down her esophagus and looked around her stomach, then put one up her rectum and checked out her intestines. They saw nothing because the disease-causing agent, coldness, creates few obvious physiological changes. Finally, her doctor recommended a psychiatrist who prescribed Prozac.
This is a case I’m fond of describing to my students because it’s a textbook example of constitutional coldness—someone who is just naturally cold but has created a cold condition on top of that with diet and daily habits.
According to TCM, “coldness” is a pathogen, or disease-causing agent. We can create cold by eating cold foods for a long time, or we can be “invaded” by cold, for instance, when we hang out on a street corner in Bangor, Maine, in January without a jacket. The coldness can penetrate the body’s defenses, right to the core, creating a bad situation. Besides these kinds of cold pathogens, most of us cool down as we get older. When hormone levels start to decline, and a lot of vital energy is used up in the process of living, we start to cool off. This condition is called “yang deficiency.”
Always Cold: Examining a Common Case of Coldness
Gretchen was a cold type to begin with—she told me she had always been on the cold side. When her friends were wearing shorts, she’d have on long pants and usually kept a jacket on hand.
We sat down on the grass, and I looked at Gretchen’s tongue. It had a thick snow-white coat over the entire surface, especially toward the back. A normal tongue should have a thin white coating with a good rough surface, but Gretchen’s tongue looked like it had cream cheese spread all over it. Her pulse was hard and labored, especially over the digestive position, showing tremendous stagnation from the cold.
I was particularly curious about Gretchen’s diet, which turned out to be a major contributing factor to her condition. Gretchen’s family owned a huge apple farm. She told me that she ate apples all day to check the quality, along with other fruit at the family roadside stand, and drank a lot of apple juice. According to TCM, all this fruit is essentially cold, and excess consumption of fruit and fruit juice could lead to a cold pathogen invading the body and accumulating in the digestive area. Gretchen’s symptoms were classic, too—a feeling of pressure and pain in the abdomen, intermittent diarrhea, loss of appetite, and some nausea. Low energy was also a major problem.
Because Gretchen had an accumulation of excess cold, according to theory at least, the pathogen could be quickly drained or dispelled from the body, and the symptoms would rapidly disappear. It’s much easier to remove an excess pathogen than to try and tonify or make up a deficiency such as weak adrenals. In Gretchen’s case, however, she not only had a cold pathogen invading her body, but she was also constitutionally cold, which made dispelling the coldness more difficult.
A Tried-and-True Combination: Warming Herbs
When I returned to the clinic, I had my pharmacy make up a powdered extract of ginger (Zingiber officinale) and red ginseng (Panax ginseng). This combination never fails, and was probably used by herbalists 2,000 years ago. I also sent a package of dried herbs to make a tea with two-thirds dried ginger, coarsely chopped, and one-third red ginseng slices. Ginseng is often thought of as an energy herb, but in China it’s primarily a warming digestive herb.
Gretchen called two weeks later to say that most of her symptoms had gone away—after a year of suffering! Of course, I also put her on a strict diet—no fruit or juice for at least a month, and even then, no more than one piece a day with no concentrated juice for the next six months or so. I had her eat more steamed or stir-fried dishes, and urged her to avoid ice, cold drinks, and cold foods.
Christopher Hobbs’s case studies are gleaned from his thirty years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is an Herbs for Health editorial adviser and licensed acupuncturist. He is the coauthor of Vitamins for Dummies (IDG, 1999) and many other books.
“Cold Conditions: Treating a Traditional Chinese Medicine Principle” is not intended to replace the advice of your health-care provider.
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