Korean Herbal Formulation [Part 4] Is My Body “Cold” or “Hot”?

  CALee Acupuncture

Korean Herbal Formulation [Part 4]

Is My Body “Cold” or “Hot”? — Understanding the Nature of Cold (寒) and Heat (熱)

Part 1: Eight Guiding Principles — Your Inner Compass

Lesson 2: The Secret Behind Cold and Heat Patterns

In the previous lesson, we explored how the Eight Principles (八綱) begin with identifying the location of illness — whether it is at the exterior (表) or in the interior (裏).
In this lesson, we move to the second major axis of diagnosis: determining whether the condition is fundamentally Cold (寒) or Heat (熱).

Distinguishing Cold from Heat is not about subjective sensation alone.
It is the key step that guides whether the body needs warming and supporting,
or clearing and cooling — the foundation of treatment in Traditional Asian Medicine.

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1️⃣ Cold and Heat Patterns Are Rooted in Yin–Yang

The Eight Principles consist of four paired categories:
Yin–Yang (陰陽), Exterior–Interior (表裏), Cold–Heat (寒熱), Deficiency–Excess (虛實).

Among these, Cold and Heat each belong to their respective Yin–Yang qualities.

🌙 Cold (寒): A Manifestation of Yin

Cold may arise from internal Cold (內寒) or from the invasion of external Cold (外寒).
A fundamental principle applies:

“Cold patterns tend to be deficient.” (寒者多虛)
Meaning: when the body’s vital energy is weakened, Cold easily takes hold.

☀️ Heat (熱): A Manifestation of Yang

Heat may be due to internal Heat (內熱) or from external Heat (外熱).
Likewise:

“Heat patterns tend to be excessive.” (熱者多實)
Meaning: Heat usually arises from stagnation, buildup, or inflammatory reactivity.

From the perspective of pathogenic influences (邪氣):

• Yin pathogens → transform into Cold, damaging the body’s form and structure

• Yang pathogens → transform into Heat, damaging the body’s energy and function

Thus, identifying Cold vs. Heat is essential for determining the therapeutic direction.

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2️⃣ Key Differences Between Cold and Heat Patterns

The following table summarizes the most clinically relevant signs.

Diagnostic Category	Cold Pattern (寒證)	Heat Pattern (熱證)
Temperature Sensation	Feels cold, dislikes cold (惡寒)	Feels hot, dislikes heat (惡熱)
Preferences	Prefers warm drinks/heat	Prefers cold drinks, drinks often (多飮)
Extremities	Cold hands and feet	Hot and restless hands/feet
Thirst	Little/no thirst, or drinks small amounts (假渴)	Strong thirst, irritability (煩燥)
Stool/Urine	Loose stools, clear long urination	Hard stools, short dark urination
Tongue	Pale tongue, white moist coating	Red tongue, yellow/black coating
Pulse	Slow (遲脈)	Rapid (數脈)

✔️ In essence:
Cold → Warm and support the system
Heat → Clear, cool, and relieve the buildup

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3️⃣ A Deeper Look: Excess Heat (實火) vs. Deficiency Heat (虛火)

Not all Heat is the same.
The body may experience exuberant Heat due to excess,
or restless false Heat due to deficiency.
This distinction completely changes the treatment approach.

According to Donguibogam (東醫寶鑑):

🔥 Excess Heat (實火): “True Heat” From Excess

• Normal appetite

• Strong thirst, dry mouth

• Hard stools

• Restlessness

• Treatment: Purge and drain Heat using strong cold and bitter herbs

• Examples: Bai Hu Tang (白虎湯), Cheng Qi Tang (承氣湯)

🔥 Deficiency Heat (虛火): “False Heat” From Yin Deficiency

• Poor appetite

• Spontaneous sweating

• Shortness of breath, fatigue

• Treatment: Clear Heat while nourishing Yin (瀉熱補陰)

• Examples: Zi Yin Jiang Huo Tang (滋陰降火湯), Liu Wei Di Huang Wan (六味地黃元)

Among all Heat patterns,
the most crucial diagnostic task is distinguishing true Heat from false Heat.

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4️⃣ Diagnostic Order: Exterior–Interior → Cold–Heat → Deficiency–Excess

Traditional Asian Medicine always examines Cold and Heat after determining where the illness is located.

1. Exterior / Interior (表裏) — Where is the illness?

2. Cold / Heat (寒熱) — What is its nature?

3. Deficiency / Excess (虛實) — What is the body’s internal state?

Only by following this order can treatment be precise and effective.

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5️⃣ Treatment Principles — Warm Cold, Clear Heat

❄️ Treating Cold Patterns

• Warm the body

• Support Yang, dispel Cold

• Common therapeutic actions: warming the center (溫中), restoring Yang (回陽)

🔥 Treating Heat Patterns

• Clear Heat and detoxify

• Drain excessive Heat

• Cool and nourish in deficiency Heat

The essence is simple:
Cold is treated with warmth; Heat is treated with cooling.

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📘 Conclusion

Cold and Heat patterns reveal the direction of imbalance within the body —
whether internal functions are stagnated and overheated,
or whether warmth and vitality have weakened.

Understanding this distinction makes it possible to determine
whether the body needs warming and supporting,
or cooling and purifying.

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📖 Preview of Part 5

In the next part of this series, we turn to the final axis of the Eight Principles:
Does the body have excess (實), or is it lacking (虛)?

Korean Herbal Formulation [Part 5]
Is the Body Overflowing or Exhausted? — Understanding Deficiency and Excess (虛實)

 

📌 [Previous Episode]: Korean Herbal Formulation [Part 3] Where Does the Illness Reside? — The World of Exterior (表) and Interior (裏)
👉 Next Post: Korean Herbal Formulation [Part 5] Is Your Energy “Excessive” or “Insufficient”? — The Logic of Deficiency (虛) and Excess (實)

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