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Discussion on Cold-Induced Disorders [傷寒論]

Shāng to injure; hurt; wound; pain; suffering; mental/emotional disorder
Hán cold; freezing
Lùn debate; discuss; discourse; criticize; criticism; classic

• Oldest surviving Chinese medical text devoted to externally-contracted diseases (wài gǎn bìng [外感病])
• Written by the Eastern Han physician Zhāng Jī [張机], Zhòng Jǐng [仲景], 150-219 AD, as a means to explain the origins of illness
• Theory of text rooted in the philosophy of the Huáng Dì Nèi Jīng [黃帝内經], Nán Jīng [難經], and Shén Nóng Běn Cǎo Jīng [神農本草經]
• Most, if not all, of this ancient text has been lost, especially its original form as the Shāng Hán Zá Bìng Lùn [傷寒雜病論]

The Six Stages – Liù Jīng [六經]

Yin Stages Yang Stages

Lung Large Intestine
GREAT YIN Hand (3-5AM)
太陰 ¶ 陽明
Spleen Stomach
tài yīn Foot (9-11 AM)
Foot yáng míng

Heart Small Intestine
LESSER YIN Hand (11-1PM)
少陰 ¶ 太陽
Kidney Urinary Bladder
shǎo yīn Foot (5-7PM)
Foot tài yáng

Pericardium Triple Burner
厥陰 ¶ 少陽
Liver Gall Bladder
jué yīn Foot (1-3AM)
Foot shǎo yáng

Nán Jīng [難經] - Difficult Issue Number Seven

Chinese Pin Yin Pulses Solar Phases

太陽 tài yáng Full, big, long 121st-180th day

陽明 yáng míng Superficial, big, short 61st-120th day

少陽 shǎo yáng Alternating big/small or short/long Winter Solstice to the 60th day

太陰 tài yīn Tight, big, long 181st – 240th day

少陰 shǎo yīn Tight, thin/fine, minute 241st – 300th day

厥陰 jué yīn Deep, short, thick 301st-360th day

David C. Mainenti, L.Ac., C.A., Dipl. OM © Eco-Med LLC 1999-2009


Nèi Jīng Sù Wèn [内經素問] – Analysis of the Six Stages

Ch. 79 Ch. 24 Ch. 6 Ch. 31 Ch. 24 Ch. 16 Ch. 68 Ch. 49

Chinese Pin Yin Images Contents Differentiation Exterior Disorders Needling Collapse Influences Time/Space
Rigidity and
primordial, Day One: Can bleed to 寅
On the stiffness of the
dynamic headache; stiff disperse evil
tài More blood; surface; open back; spasms; yín
太陽 yáng
less qi and expansive;
neck and pain in energy, but protect
(1st month)
spreads along lumbar region of the qi from
the outside spontaneous
back, trunk, the back and spine escaping
and limbs
Day Two: hot Facial paralysis;
More qi;
Internal; stores sensations in the Can bleed or delirium; yellow 午
yáng traverses the and holds the body; eye and sedate the qi to face; swelling, wǔ
陽明 míng front of the
abundance of
outside cheek pain; dry disperse evil numbness,
(5th month)
trunk and limbs together nose; inability to lie energy stiffness; muscular
down; fever spasms; immobility /
Day Three: rib/flank
pain; eye pain; Deafness; joints 戌
interior and Hinge/switch
headache; pain Can disperse evil and bones will
shǎo exterior, where Less blood; that connects xū
少陽 yáng the qi makes more qi the exterior
along the gall qi, but protect the become loose and Fire
(9th month)
bladder channel; blood disjointed; eyes will
its way into the with the interior
deeper layers
earache; deafness; malfunction 
of the body
Day Four: Abdominal 子
Mother; the Most
abdominal fullness, Can disperse evil distension; fullness;
tài great nurturer; More qi; less superficial of zǐ
太陰 yīn outermost yin blood the yin
swelling, and qi, but protect the stagnation; difficulty Dampness
(11th month)
distension; dry blood breathing; sighing;
channel channels
throat burping; vomiting 
Gatherer; Face turns black; 申
moves qi into Day Five: dry Can disperse evil gums recede; teeth
shǎo More qi; less that connects shēn
少陰 yīn
the deep
blood tai yin and jue
mouth and tongue; qi, but protect the rot; abdomen Heat
(7th month)
reservoirs of thirst blood distends and
the body stagnates 
Transition Feverish in chest;
between yin Deepest area Can bleed to dry throat; frequent 辰
Day Six: irritability;
and yang; of the yin; disperse evil urination;
jué More blood; agitation; genital chén
厥陰 yīn
maintains the
less qi
stores and
contraction; qi
energy, but protect restlessness; Wind
(3rd month)
delicate holds the the qi from irritability; stiff
balance inside inside together escaping tongue; genital .
the body contraction

Nèi Jīng Líng Shū [内經靈樞] – Analysis of the Six Stages

Ch. 5 Ch. 5 Ch. 9 Ch. 65 Ch. 78 Ch. 78

Chinese Pin Yin Images Pathologies Terminal State Axioms Needling Paired Stage
Eyes roll up, spinal rigidity,
tài Superficial Eyebrows; much Needle to let out
太陽 yáng
spasms, convulsions, white
blood, little qi blood and protect qi
Shao Yin
Twitching of lips/eyelids,
yáng Weakness, nervousness and fear, Facial hair: much Needle to let out
陽明 míng
Inner door
due to excess confused speech, yellow blood and much qi blood and evil qi
Tai Yin
skin, fullness
Weak bones Whiskers and
shǎo Deafness, loose joints, eye Needle to let out qi
少陽 yáng
Pivot and joints, loss
weakness, green skin
sideburns: much qi,
and protect blood
Jue Yin
of balance little blood
tài Swollen abdomen, shortness Needs to let out
太陰 yīn
Gates Qi deficiency
of breath, vomiting
Much blood, little qi
blood and protect qi
Yang Ming

shǎo Heart/kidney Black face; rotten teeth, Needle to let out qi

少陰 yīn
disharmony swollen abdomen, stagnation
Much qi, little blood
and protect blood
Tai Yang

Chest pain and heat, dry

jué Mental Needle to let out
厥陰 yīn
Inner door
throat, frequent urination, stiff Much blood, little qi
blood and protect qi
Shao Yang
tongue, contracted genitals

David C. Mainenti, L.Ac., C.A., Dipl. OM © Eco-Med LLC 1999-2009


Shāng Hán Lùn [傷寒論] Disease and Formula Overview

Disease Etiology Symptoms Major Diseases Specific Symptoms Major Herbal Prescription Variations

Guì Zhī Tāng [桂枝湯]

Fever, sweating, aversion
Exterior Wind Invasion Cinnamon Twig Decoction
Evil Qi to wind, moderate pulse
and Feng Chi / Feng Fu
invading the
Floating pulse; Aversion to cold; Constrained heat;
exterior layers Má Huáng Tāng [麻黃湯]
太陽病 of the body
stiff neck and Exterior Cold Invasion generalized body pains;
Ephedra Decoction
tài yáng shoulders; nausea; tight pulse yang deficiency;
from the outer
bìng headache; Fever, thirst, no aversion yin/yang deficiency;
aversion to cold to cold, floating pulse, water accumulation
disrupting the Exterior Wind-Heat Zhī Zǐ Chǐ Tāng [梔子豉湯]
channels spontaneous sweating,
Invasion Gardenia and Fermented Soybean Decoction
heaviness; tiredness,
snoring, difficulty speaking

Floating/tight pulse, dry

throat, bitter taste in Zhī Zǐ Chǐ Tāng [梔子豉湯]
Exterior Wind Invasion
mouth, abdominal fullness, Gardenia and Fermented Soybean Decoction
generalized heaviness
Large/big/full pulse, thirst
Bái Hǔ Tāng [白虎湯]
Evil Qi Excess Heat with desire to drink,
White Tiger Decoction
progressing irritability
into the Mild constipation, Tiào Wèi Chéng Qì Tāng [調胃承氣湯]
陽明病 interior of the
irritability; dry yellow Regulate the Stomach and Order the Qi Damp-heat; heat in
yáng spontaneous
exterior layers tongue moss Decoction the blood;
míng sweating,
of the body, Constipation, abdominal deficiency-cold
bìng aversion to heat
invading the distension and fullness, Xiǎo Chéng Qì Tāng [小承氣湯]
Stomach and tidal fever, delirious Minor Order the Qi Decoction
Excess Dryness
turning to heat speech
Extreme constipation,
abdominal distension and
Dà Chéng Qì Tāng [大承氣湯]
fullness, hardness and
Major Order the Qi Decoction
pain, tidal fever, delirious

Bitter taste in the Loss of hearing in either

Evil Qi moving mouth, dry Exterior Wind Invasion ear, red eyes, chest/rib
Concurrent interior
少陽病 between the throat, dizziness, pain, irritability
excess, dampness,
shǎo interior (Yang vertigo, Xiǎo Chái Hú Tāng [小柴胡湯]
or mania;
yáng Ming) and alternating chills Minor Bupleurum Decoction
Wiry/fine pulse, headache, unresolved exterior
bìng exterior (Tai and fever; no Exterior Cold Invasion
fever pattern
Yang) desire to eat or

Evil Qi Exterior Wind Guì Zhī Tāng [桂枝湯]

Abdominal Floating pulse
disrupting a Invasion Cinnamon Twig Decoction
太陰病 weakened
fullness and Concurrent exterior
tài yīn pain, vomiting, Spontaneous diarrhea, no pattern; abdominal
interior, Formulas that Warm the Interior and Dispel
bìng no desire to eat, Interior Cold thirst, moderate/weak pain
depleting the Cold
diarrhea pulse

Deep/slow pulse, cold

Evil Qi Sì Nì Tāng [四逆湯]
limbs, diarrhea, nausea
少陰病 disrupting the Fine/minute Deficiency Cold Frigid Extremities Decoction
and vomiting, aversion to Concurrent exterior
shǎo yīn integration of pulse, desire or moxibustion
cold pattern; sore throat
bìng water and fire, only to sleep
Irritability; palpitations, Huáng Lián Ē Jiāo Tāng [黃連阿膠湯]
depleting both Deficiency Heat
insomnia Coptis and Ass-Hide Glue Decoction

Weak pulse, cold skin,

Voracious thirst, Heat Above/Cold agitated mood but also Wū Méi Wán [烏梅丸]
chest pain, Below quiet at times, vomiting of Mume Pill
Evil Qi roundworms, diarrhea
厥陰病 invading the
palpitations, Phlegm obstruction;
jué yīn hunger with no Yin/yang imbalance, fever, stomach deficiency;
extreme Bái Hǔ Tāng [白虎湯]
bìng desire to eat, Extreme Heat cold extremities, slippery diarrhea; hiccups
interior White Tiger Decoction
nausea/vomiting pulse
of roundworms Yin/yang imbalance, cold Dāng Guī Sì Nì Tāng [當歸四逆湯]
Extreme Cold
fingers, diarrhea, fine pulse Angelica Decoction for Frigid Extremities

David C. Mainenti, L.Ac., C.A., Dipl. OM © Eco-Med LLC 1999-2009