Last time we have talked about the fever without aversion to cold. Now we come to the opposite situation----aversion to cold without accompaniment of fever.

 

Ⅲ. Aversion to cold without the accompaniment of fever

Aversion to cold is a subjective sensation, including chill and aversion to cold. If the patients feel cold and such sensation cannot be relieved after putting on more clothes and getting close to fire, it is called chill; if the patients feel cold and such sensation can be relieved after putting on more clothes and getting close to fire, it is called aversion to cold.

 

Aversion to cold without the accompaniment of fever means that the patients only feel cold but there is no fever. It is usually caused by direct invasion of pathogenic cold into the interior so that the yang qi is stagnated and cannot move outwards; or deficiency of yang qi fails to warm up the body. According to the onset, duration, cause and pathogenesis, aversion to cold without the accompaniment of fever can be further divided into chill in new disease and aversion to cold in chronic disease.

 

⑴Chill in new disease: It is caused by serious invasion of cold directly into the viscera so that the yang qi is stagnated and the body is lack of the warmth from it. Sudden chill with cold limbs and abdominal pain with cold feelings or with dyspnea and asthma with sputum pertains to interior cold syndrome of excess type.

 

⑵Aversion to cold in chronic disease: Aversion to cold in chronic disease is usually caused by deficiency of yang qi and lack of warmth of the body. The patients frequently fear cold and the limbs are not warm. These symptoms are usually relieved with warmth. The tongue body is often pale and tender and the pulse is deep, slow and weak. So we call such pathological conditions the interior cold syndrome of deficiency type.

 

Ⅳ. Alternation between cold and fever

Alternation between cold and fever means that aversion to cold and fever occurs alternately due to struggle between vital qi and pathogenic factors. The alternation between cold and fever manifests in two ways: irregular alternate cold and fever and regular cold and fever.

 

⑴ Irregular alternation of cold and fever: It pertains to semi-interior and semi-exterior syndrome due to struggle between vital qi and pathogenic factors. It is seen in shaoyang disease. The evil stays in the middle part between the interior and exterior, in other words, it is further than the interior portion and less than the exterior portion. It is going to attack the interior when it becomes strong enough. The conflict of the vital qi and pathogenic factors often brings about such consequence: predomination of pathogenic factors leads to aversion to cold, while the predomination of the vital qi leads to fever.

 

⑵ Regular cold and fever: It usually occurs once per day or once every two or three days. The accompanying symptoms include severe headache, thirst and profuse sweating. This kind of alternation of cold and fever is often seen in malaria. When the pathogenic factors invade the body, they stay in the semi-interior and semi-exterior region and may disturb the body both interiorly and exteriorly. When they move deep into the body, they struggle with yin; and when they move outwards, they struggle with yang. That is why chills and high fever appear alternately and continually.

                                            (to be continued…)

 

 

1. Lufen Wang, Zhaoguo Li, Bai Bao, Dianostics of Traditional Chinese Medicine, Publishing House of Shanghai University of traditional Chinese medicine.

 

2. Wenfeng Zhu, Diagnostics of Traditional Chinese Medicine, Shanghai Science and Technology Publishing House

 

3.Yanfu Zuo, The New Century Chinese-English Dictionary of Traditional Chinese Medicine, People’s Military Medical Press.

 

 (Yanting Guan, Translation Section)