The common cold, also called “Wind Injury” in TCM, is one of the frequently encountered external contracted diseases caused by the invasion of wind. Its clinical manifestations are characterized by nasal obstruction, cough, aversion to cold, fever and general malaise. It may occur year-round, especially in the spring. It is known as upper respiratory infection in western medicine, but it can be classified into the category of a common cold in TCM, and influenza can be put into the category of “epidemic cold”.
Causes and Pathogenesis of the Disease
The most important reason of a common cold is a weak constitution and the body’s decreased resistance to diseases. During this time, the immune function cannot adjust to the violent climatic variation, giving the evil qi a chance to invade the body through the skin, mouth and nose. As a result, symptoms in the lungs and defensive fen appear as nasal obstruction, cough, headache, chills and fever, and general malaise. A wind-cold evil restricts the body surface, resulting in the obstruction of lung-qi and occlusion of the skin pores. Meanwhile, a wind-heat evil scorches the lung, resulting in impairment of the general functions of the lung. The common cold is usually caused by the wind evil, but it can also mix with dampness and summer-heat.
Chief symptoms: Chills and fever, headache, nasal obstruction, nasal discharge, and a floating pulse.
The pattern of wind-cold manifests as severe chills, slight fever or no fever, absence of sweating, nasal obstruction, sneezing, watery nasal discharge, cough, a thin white tongue coating and a floating, tight pulse. The pattern of wind-heat manifests as slight chills, severe fever, sweating, nasal obstruction, swollen, painful throat, thirst, a thin yellow tongue coating and a floating, rapid pulse. The pattern summer-heat and dampness manifests as unsurfaced fever, difficulty sweating, headache as if the head was wrapped up, oppression in the chest , anorexia, thirst but without preference to drink water, a white greasy tongue coating and a soggy pulse.
(1) Primary treatment
Principal points: Lieque (LU 7), Hegu (LI 4), Dazhui (GV 14), and Fengchi (GB 20).
Supplementary points: In the pattern of wind-cold, add Fengmen (BL 12) and Feishu (BL 13); in the pattern wind-heat, add Quchi (LI 11) and Chize (LU 5); if accompanied by dampness, add Yinlingquan (SP 9); if accompanied by summer-heat, add Weizhong (BL 40); and in the pattern of a weak constitution, add Zusanli (ST 36). In case of nasal obstruction and watery nasal discharge, add Yingxiang (LI 20); in case of persistent headache, add Taiyang (EX-HN5); in case of swollen, painful throat, add Shaoshang (LU 11); and in case of general malaise, add Shenzhu (GV 12).
Explanation: The common cold is caused by invasion of external evils into the lung and defensive fen. Taiyin and yangming channels relate to each other interiorly- exteriorly, so Lieque (LU 7) of the hand-taiyin channel and Hegu (LI 4) of the hand- yangming channel are selected to expel the evils from the body surface. The Governor Vessel dominates yang–qi of the entire body, so moxibustion or bloodletting on Dazhui (GV 14) can activate yang to disperse the cold or remove heat respectively. As the disorders of the Yang Link Vessel manifest as chills and fever, Fengchi (GB 20), a Crossing Point of the foot-shaoyang channel and the Yang Link Vessel, is selected to dispel the cold and brighten and clear the head and eyes.
(2) Alternate methods of treatment
Cupping: Select Dazhui (GV 14), Shenzhu (GV 12) and Feishu (BL 13), do cupping on them and retain them for 15 minutes; flash-cupping can be done as well. This therapy is suitable for the wind-cold pattern.
Bloodletting and cupping: Select Dazhui (GV 14), Fengmen (BL 12), Shenzhu (GV 12) and Feishu (BL 13). Disinfect the local area first, then prick the points with a three edged needle for bloodletting. When the color of the blood turns into fresh, bright red, apply cups them and retain them for 10 minutes. After the removal of the cups, clean and disinfect the bloodletting areas. This therapy is suitable for the wind-heat pattern.
Acupuncture is effective for the common cold. The common cold is similar to the early symptoms of some infectious diseases, so they must be clearly differentiated in the clinic especially in children.
During the epidemic seasons for the common cold, it is advisable to keep the room well-ventilated, or fumigate it with vinegar. In addition, other preventative measures include doing acupuncture on Zusanli (ST 36) once daily, or massaging Yingxiang (LI 20) and Hegu (LI 4) for 3 to 5 minutes respectively.
During treatment, patients should have adequate rest, eat light food, and drink more water. Cold-resistance exercises and suitable sports are recommended.
1. Wind-cold Type
Prescription: Modified Jing Fang Baidu San (Antiphlogistic Powder with Schizonepetae and Saposhnikoviae), composed of Jinjie (Herba Schizonepeta）10g, Fangfeng (Radix Saposhnikoviae）10g, Qianhu(Radix Peucedani)10g, Xingren(Semen Armeniacae Amarum)10g, Zhike（Fructus Aurantii)10g, Chuanxiong (Rhizoma Chuangxiong)10g, Zisuye (Folium Perillae)10g, Guizhi (Ramulus Cinnamomi) 6g, Gancao (Radix Glycyrrhizae) 5g, and Shengjiang（Rhizoma Zingiberis Recens）5g.
Modification: For severe chills and no sweating, add Mahuang (Herba Ephedrae) 6g and Jiegeng (Redix Platycodi) 6g; for severe headache and general aching resulting from wind-cold combined with dampness, add Baizhi (Radix Angelicae Dahuricae)10g and Qianghuo (Rhizoma et Radix Notoperygii) 6g, for stuffy and running nose, add Cang’erzi（Fructus Xanthii) 10g and Xinyi (Flos Magnoliae) 6g, for general discomfort and lassitude，forceless cough, pale tongue coating and superficial and weak pulse, add Danshen (Radix Codonopsis）10 g, Fuling (Poria) 10g and Gegen (Radix Puemratiae) 10g.
2. Wind-heat Type
Prescrlption: Modified Yin Qiao San (Lonicerae and Forsythiae Powder) and Cong Chi Jiegeng Tang（Decoction old Shallot, Sojae Preparatum and Platycodi), composed of Jinyinhua 15g, Lianqiao 15g, Dandouchi 12g，Bohe (to be decocted later) 5g, Niubangzi 10g, Xingren 10g,Jiegeng 6g and Gancao 5g.
Modifications:For severe distending pain in head, add Manjingzi 10, Sangye 10g and Juhua 10g; for abundant sputum, add Zhebeimu 10g and Gualoupi 15g; for sore swelling and red throat, add Xuanshen 10g, Tniuxi 15g; for severe fever and thirst, add Zhimu10g and Tianhuafen 15g; for pronounced manifestations due to toxic heat, add Daqingye 30g,and Caoheche 30g; for patients attacked by autumnal dry throat, nose and lips, dry and thin tougue coating, add Nabshashen 12g, Tianhuafen 15g and Lipi 10g; for patients complicated with dizziness, restlessness, cough with little sputurn, red tongue with little coating and thready and rapid pulse add Yuzhu 10g and Baiweu 10g.
3．Exterrior Cold and Interior Heat Type
Prescription: Modified Ma Xing Shi Gan Tang (Decotion of Ephedrae, Armeniacae Amarum, Gypsum Fibrosum and Glycyrrhizae)，composed of Mahuang 6g, Xingren 10g,Fangfeng 10g, Jimgjie 10g，Huangqin 10g, Zhizi 10g, Lianqiao 10g, Shengshigao (to be decocted first) 30g, Jiegeng 5g, Bohe (to be ted later) 5g and Shenggancao 5g.
Modifications: For aversion to cold and pain in the bone and joints due to severe external pathogenic cold, add Zisuye 10g and Jiegeng 8g; for red, swelling sore throat due to severe endogenous heat, add Banlangen 30g and Tuniuxi15g; for constipation, add Zhidahuang 5-10g; for persistent high fever, restlessness, thirst, or even coma or delirium, crimson tongue with yellow and dry coating and rapid pulse due to transformation wind and cold into the interior，add Shuiniujiao (to be decocted first) 30g, Shengdihuang 15g, Zhuye 10g, Lianqiao 12g, Jinyinhua 15g, Xuanshen 12g, Huanglian 6g，Huangqin 10g, Shichangpu 3g.
4. Summer-heat and Dampness
Prescription: Modified Xinjia Xiangru Yin (Newly Modified Mosla Decoction)，composed of Xiangru 6g, Jinyinhua 10g，Biandouhua 10g， Lianqiao 10g, Heye 10g, Houpo 8g, Lugen 15g and Shenggancao 5g.
Modifications: For Predominant summer-heat, add Huanglian 5g and Qinghao 6g; for dampness attacking weifen and the exterior, add Doujuan 10g and Peilan 10g; predominant endogenous dampness，add Cangzhu 10g, Baikouren (to be decocted later) 5g; for scanty and dark urine, add Liuyi San (Sic to one Powder, wrapped)10g and Fuling 15g.