Chinese Medicine’s Approach to Colds and Flu

Acupuncture and Chinese Medicine for Colds and FluAlthough many people don’t think of it first, Chinese Medicine has a specific  approach to colds and flu (upper respiratory infections).


Catching a cold or the flu is an event that Chinese medicine has commented on for at least a couple thousand years. Chinese medicine views these events as invasions of pathogens they called “wind”.  The idea is that these pathogens invade the surface of the body. Wind is said to be the primary pathogen, and it can have cold properties or hot properties. The most vulnerable of the internal organs are the lungs, and when these pathogens invade the first signs are “tightening of the surface level” which creates body ache or stiff neck, and then an interruption of the lung’s job of distributing fluids….thus the fluids collect inappropriately in the nose and we get that first sneeze and runny nose.


The Chinese concept of “wind” being the invader and instigator of illness makes sense when you consider that these ideas were developed over 2000 years ago. No one had seen the microscopic world of viruses and bacteria. Now we know that viruses create most colds and flus, but the concept that “wind” invades our surface and lungs can help us think about how to shorten the course of these events. These wind pathogens are also known as a type of “evil qi”.


Distinguishing between a wind-cold invasion and a wind-heat invasion is important if you are treating with herbs. The symptom picture of a wind-cold upper respiratory infection (URI) is more chills than fever (but a low-grade fever is possible), clear runny nose, maybe a cough, malaise, some body ache. A wind-heat URI often starts with a sore throat, fever predominates over chills, and body ache, malaise or cough may also be present. If your nose runs it will be with yellow-tinged mucous rather than clear. Wind-heat corresponds to a more severe flu event.  So the main distinction is the subjective feeling of being chilled vs. developing a higher fever. If you have wind-cold you take herbs that have a warm energy. If you have a wind-heat invasion you take cold natured herbs.


If you make a mistake in distinguishing wind-cold vs. wind-heat and take the wrong herbs, you can worsen the situation. Thus if you have wind-cold, and mistakenly take a cooling formula like Yin Chiao, you can aggravate the problem, driving it deeper into the body. I will make a few suggestions to guide you in treating the early stage when its not quite clear if it’s wind-cold or wind-heat.


I love the descriptions in Chinese medicine of how these diseases progress and make us miserable! Once the wind pathogen invades the surface, the body wisely will do everything it can to prevent the pathogen from getting deeper. Our body will mobilize all its resources to help us. Our “righteous qi” is the sum total of our immunity, constitutional strength, and vitality. The righteous qi will battle the invading evil qi, and many of our symptoms are the displays of this showdown.  As righteous qi and evil qi collide, heat and stagnation are generated, giving you the lovely experience of fever and body pain. Notice when you have a fever how sometimes your skin hurts?  The stronger your righteous qi the more severe these discomforts are. You are putting up a good fight!! Weaker people may have less drama in their URI experiences, but in fact the pathogen may be getting deeper and will be able to linger.


Chinese medicine treats a URI differently at each stage of its life-span. The initial treatment is called “releasing the exterior”….i.e. you are sweeping outward and away the evil qi. Acupuncture can do this. Gua sha (scraping the upper back with a round-edged tool) can be helpful. Also, creating a slight sweat is a way to release the exterior. You can do this by making fresh ginger tea, fairly strong. Drink that, then wrap up in blankets and rest for an hour. You’ll start to sweat. Good, let it happen. Take a nap if you can. The sweat is said to move the pathogen out. Don’t sweat too much, just a little. Too much sweating (i.e. in a sauna) would be too draining.


The best time to release the exterior is within 24 hours of that first tiny clue that something is wrong: the stiff neck, the first sniffle, the punk feeling of malaise. Try the ginger tea and sweat, or gua sha or acupuncture at that time. Then REST. Your righteous qi will require all your resources to have a chance to nip the cold in the bud. Sadly most of our lives don’t allow this sort of self-care, but try. Rest is fundamental.


Herbal formulas to be used during this initial phase must be distinguished between wind-cold and wind-heat. These are available at a Chinese herb shop or an acupuncturist’s office.


For wind-cold:


Fresh ginger tea is great if it is clearly a wind-cold

Xin Yi Wan – Magnolia Flower Pills

Xiao Qing Long Tang – Minor Blue Dragon formula – be careful with this one: you must clearly feel chilled for this to work for you.


For Wind-heat:


Yin Chiao Jie Du Wan – famous formula. Fever and sore throat should be present to use this.

Sang Ju Yin Wan – some fever and sore throat should be present, but with more cough.


If the wind-heat is severe, i.e. high fever and misery, consider Gan Mao Ling, which is for more severe “toxic heat” which corresponds to a true influenza.


Interestingly, many of the herbs used in these formulas have anti-viral properties, when studied with modern scientific methods.


Once a URI has really settled in, releasing the exterior will be of little benefit. At that point you need to a) keep resting to allow your body to finish the battle and recover, and b) use other Chinese formulas for other symptoms.


For sinus congestion, and even sinus infection:


Bi Min Gan Wan, also spelled “Pe Min Kan Wan” or

Bi Tong Wan


Both of these treat nasal congestion from either a URI or allergies, but the mucous should be yellow or green, not clear, to use these appropriately



Another insight from Chinese medicine is what to do when a URI settles in to become a lingering, exhausting cough or cold you just can’t get rid of. We believe that if your body isn’t strong enough to fully expel the pathogen, or if the pathogen happens to be a super strong variety, that the body will shunt the pathogen off to a level of the body that is “half-exterior and half-interior”. I.e. Not deeply interior such that the pathogen could end your life, but you can’t get rid of it, so it goes to this half-exterior/half-interior level called the Shaoyang.


I see people who have gotten a URI and can’t get completely well 3 or 4 weeks later. They may have taken antibiotics, and they may have really needed them, but they are still sick, tired, and coughing. We use herbs and acupuncture to move the pathogen out of their hiding place in the Shaoyang level. An herbal formula that is designed for this event is called Xiao Chai Hu Tang, or Minor Bupluerum. This scenario usually requires an expert in Chinese medicine to tailor the formula to the person’s symptoms and provide acupuncture to assist.  In treating these sorts of lingering upper respiratory events Chinese medicine really excels and offers something that western medicine cannot provide.


I also have been noticing in recent years that adequate Vitamin D is a great immune booster. Supplementing with D when 25(OH)D is less than 30 ng/ml has helped several clients who used to get colds several times a year. We would consider that a dose of yang from the sun to boost the righteous qi.  You can ask your doctor to check your vitamin D level, or visit where you can purchase a home test kit for a 25(OH)D level. (It just requires a finger stick and a few drops of blood.) This website also has lots of great information about recent research on vitamin D.


One more bit of Chinese wisdom: the neck is considered the wind gate. We are vulnerable to wind invasion through the neck area. Wear a scarf on cold days. Your grandmother was right!


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