Chinese Medicine : Pharmacology : Common Cold

Common Cold

The common cold is a disorder with nasal obstruction and discharge, sneezing, headache, cough, fever, chilliness and malaise as its chief manifestations. It usually occurs in winter and spring, but may also be seen throughout the year. Influenza is also grouped under this category in traditional Chinese medicine and treated according to the principles mentioned below.

Etiology and Pathogenesis

This disease is mainly due to the invasion of exogenous wind and usually occurs during a sudden change of weather with unexpected cold or warmth. Inappropriate clothing, being drenched by rain and fatigue may decrease one's body resistance and predispose one to catch a cold. The pathogenic factors usually are different in the four seasons. For example, wind-cold is the factor in winter, wind-heat in spring, association with summer-heat and dampness in summer, with dryness in autumn and with dampness in the rainy season. Hence, according to the variations of the climate, the pathogenic factor and the patient's constitution, the disease may be manifested as a wind-heat syndrome or a disorder associated with summer-heat or a dampness syndrome, which may change or complicate each other during the course of this disease. However, no matter what kinds of pathogenic factors are involved, they impair the descending and dispersing functions of the lungs, leading to the blockage of the sweat pores. In the case of a malady caused by seasonal pestilence, such as influenza, the general symptoms are remarkable and severe and may be complicated by other diseases.

Syndrome Differentiation and Therapeutic Principles

A. Syndrome differentiation
(a) When the pathogenic factor is located in the lungs and body superficies, the disorder is usually attributed to superficies-sthenia syndrome.
(b) To identify the nature of pathogenic factors, so as to distinguish the wind-cold syndrome, wind-heat syndrome, and complication of summer-heat syndrome and dampness syndrome.

B. Therapeutic principles
Eliminating wind, releasing stagnated lung-qi and expelling superficial evils are the main therapeutic principles.

Classification and Treatment

A. Wind-cold syndrome
Manifestations: Severe chilliness with mild fever, anhidrosis, headache, soreness and pain of the limbs, nasal obstruction or discharge, itching of the throat, cough with thin sputum, no thirst or thirst with desire for hot drink, thin-white and moist tongue coating and superficial or superficial-tense pulse.

Therapeutic principles: Expel superficial evil with drugs of acrid taste and warm nature, release the stagnated lung-qi, and dispel cold.

Prescription:
(1) The Modified Decoction of Allii Fistulosi and Sojae Praeparatum for mild cases
Bulbus Allii Fistulosi 5 pcs
Semen Sojae Praeparatum 10 g
Herba Schizonepetae 10 g
Radix Ledebouriellae 9 g
Folium Perillae 10 g
Semen Armeniacae Amarum 10 g

(2) The Modified Antiphlogistic Powder of Schizonepetae and Ledebouriellae for serious cases
Herba Schizonepetae 10 g
Radix Ledebouriellae 10 g
Rhizoma Zingiberis Recens 3 pcs
Herba Menthae (decocted later) 6-10 g
Rhizoma Chuanxiong 9 g
Radix Platycodi 9 g
Radix Bupleuri 10 g
Radix Peucedani 10 g
Rhizoma seu Radix Notopterygii 10 g

Remarks: For cases with severe cold in superficies, add Herba Ephedrae and Ramulus Cinnamomi. For cases of wind-cold syndrome complicated by dampness syndrome add Cortex Magnoliae Officinalis, Pericarpium Citri Reticulatae, Rhizoma Pinelliae and Rhizoma Atractylodis.

B. Wind-Heat syndrome
Manifestations: High fever with mild chilliness, nasal obstruction, sweating, distending pain over the head, congestion of the throat, sore throat, cough with thick or yellow sputum, thirst, thin-yellow tongue coating and superficial and rapid pulse.
Therapeutic principles: Expel superficial evil with drugs of acrid taste and cool nature, release the stagnated lung-qi, and clear away heat.
Prescription: The Modified Powder of Forsythiae and Lonicerae

Flos Lonicerae 12 g
Fructus Forsythiae 12 g
Radix Platycodi 10 g
Fructus Arctii 10 g
Herba Schizonepetae 6-10 g
Herba Menthae (decocted later) 6-10 g
Radix Glycyrrhizae 6 g
Rhizoma Phragmitis 10-30 g
Herba Lophatheri 9 g
Radix Peucedani 10 g

Remarks: For cases with severe headache, add Folium Mori, Flos Chrysanthemi and Fructus Viticis. For cases with cough and profuse yellow expectoration, add Bulbus Fritillariae Thunbergii, Semen Armeniacae Amarum and Pericarpium Trichosanthis. For cases with sore throat and congestion of the throat, add Radix Scrophulariae, Radix Isatidis and Periostracum Cicadae. For cases of influenza with marked heat-toxic symptoms, add Folium Isatidis, Radix Isatidis and Rhizoma Paridis. For serious cases of wind-heat syndrome manifested as high fever, flushed cheeks, restlessness and thirst, add Gypsum Fibrosum. For cases with superficies-cold and interior-heat syndrome manifested as fever, chilliness, anhidrosis, pain of limbs, thirst, sore throat, shortness of breath and cough with thick yellow sputum, add gypsum Fibrosum and Herba Ephedrae.

C. Summer-heat-dampness syndrome
Manifestations: Fever, anhidrosis, mild chilliness, heavy and painful sensation over the limbs, headache, dizziness, thirst and desire for a little drink, oppressive feeling over the chest, vomiting, nausea, yellow and greasy tongue coating and rapid and soft-floating pulse. Therapeutic principles: Dispel summer-heat evil from the superficies and eliminate dampness with drugs of fragrant flavor.
Prescription: The Modification of Elsholtziae seu Moslae Decoction

Herba Elsholtziae seu Moslae 10 g
Herba Agastachis 10 g
Herba Eupatorii 10 g
Flos Lonicerae 10 g
Fructus Forsythiae 12 g
Rhizoma Coptidis 6 g
Flos Dolichoris 6-10 g
Cortex Magnoliae Officinalis 6 g

D. Common cold in debilitated persons
A weak person is subject to colds which are liable to recur and to resist being cured. In these cases, therapy for merely dispelling evil and potent diaphoretic agents are not advisable so as to avoid further damage of healthy energy. Tonics, varied according to the different kinds of deficiencies, should be added to the prescriptions which disperse superficial evil and sweating.

(a) Qi-deficiency type
Manifestations: Chilliness, fever, headache, stuffy nose, cough with whitish sputum, shortness of breath, pale tongue with thin, white coating and floating and weak pulse. Therapeutic principles: Benefit qi and dispel the superficial evil.
Prescription: The Modified Decoction of Codonopsis Pilosulae and Perillae

Radix Codonopsis Pilosulae 10 g
Poria 10 g
Folim Perillae 6-10 g
Radix Puerariae 12 g
Radix Glycyrrhizae Praeparata 6 g
Radix Peucedani 10 g
Rhizoma Pinelliae 6 g
Radix Platycodi 9 g
Folium Eriobotryae 10 g

(b) Yang-deficiency type
Manifestations: Mild fever with predominant chilliness, headache, general aching, anhidrosis or spontaneous perspiration, pale complexion, cold limbs, weak voice, corpulent-pale tongue with thing and white coating and floating and weak pulse. Therapeutic principles: Restore yang and expel the superficial evil.
Prescription: The Modification of Codonopsis Pilosulae and Aconiti Lateralis Bolus

Radix Codonopsis Pilosulae 10 g
Radix Astragali 12 g
Ramulus Cinnamomi 10 g
Radix Aconiti Lateralis Praeparata 3-9 g
Radix Ledebouriellae 10 g
Rhizoma seu Radix Notopterygii 10 g
Rhizoma Zingiberis Recens 3 pcs
Radix Glycyrrhizae Praeparata 6 g

(c) Blood-deficiency type
Manifestations: Headache, fever, mild chilliness, anhidrosis, pale complexion, lips and nails, dizziness, palpitations, pale tongue with thin, white coating and small or floating-weak pulse.
Therapeutic principles: Nourish blood and expel superficial evil.
Prescription: The Modified Decoction of Allii Fistulosi with Sever Other Drugs

Radix Rehmanniae 10 g
Radix Angelicae Sinensis 10 g
Rhizoma Chuanxiong 10 g
Radix Paeoniae Alba 10 g
Herba Schizonepetae 6-10 g
Radix Ledebouriellae 10 g
Radix Puerariae 12 g
Bulbus Allii Fistulosi 3-5 g
Rhizoma Zangiberis Recens 3 pcs

(d) Yin-deficiency type
Manifestations: Headache, fever, mild chilliness, anhidrosis or slight perspiration, dryness of throat, thirst, feverish sensation over the palms, soles and the chest, dry cough, dizziness, uneasy feeling in the eyes, red tongue with little coating and rapid and small pulse.
Therapeutic principles: Nourish yin and expel the superficial evil.
Prescription: The modified Decoction of Polygonati Odorati

Radix Scrophulariae 20-30 g
Herba Menthae (decocted later) 6-9 g
Phizoma Polygonati Odorati 10 g
Radix Cynanchi Atrati 10 g
Herba Schizonepetae 3-6 g
Radix Platycodi 9 g
Radix Glycyrrhizae 6 g
Rhizoma Phragmitis 15 g
Fructus Arctii 10 g

Experiential Prescription

A. Bulbus Allii Fistulosi (3-7 pcs) and Rhizoma Zingiberis Recnes (3-5 pcs) prepared as decoction and mixed with a certain amount of red sugar; drink when still hot to induce perspiration; applicable to the onset of common cold of wind-cold type or after being drenched.
B. Folim Perillae (9 g), Rhizoma Zingiberis Recens (6 g) and a handful of Herba Coriandri Sativi; prepared as decoction; applicable to common cold of wind-cold type.
C. Radix Isatidis (15 g), Folium Isatidis (15 g) and Herba Schizonepetae (9 g); prepared as decoction; applicable to common cold of wind-heat type.
D. Radix Isatidis (15-30 g), Folium Isatidis (15-30 g) and Fructus Forsythiae (12 g); prepared as decoction; applicable to common cold of wind-heat type.
E. Bulbus Allii Fistulosi (60 g); crushed and fried; apply half of the total amount on the umbilicus; apply the other half later.
F. Prescriptions for preventive purposes:
(a) Rhizoma Dryopteris Crassirhizomae (10 g), Folium Perillae (10 g), Herba Schizonepetae (10 g) and Radix Glycyrrhizae (3 g); prepared as decoction; taken once daily for 3 days; suitable for prevention of common cold in winter and spring.
(b) Herba Agastachis (5 g), Herba Eupatorii (5 g) and Herba Menthae (3 g); prepared as decoction for drinking; suitable for prevention of common cold in summer.
(c) Radix Isatidis or Folium Isatidis (15 g), Rhizoma Dryopteris and Radix Glycyrrhizae (3 g); prepared as decoction; taken once daily for 3 days; suitable for prevention of influenza.