I hope everyone is enjoying their Spring so far! I want to introduce another concept in Chinese medicine that we are all affected by. The six external pathogenic factors refer to environmental or climatic factors that may cause internal disease in our bodies. We are especially susceptible to these climatic changes if they are stronger than usual or if our body’s qi or immune system, is weak compared to the climatic change.
What are the six external pathogenic factors?
The six external causes of disease are:
Usually, weather should not have a pathological effect on the body, as our bodies are designed to withstand these changes in weather and protect against them. The exterior of the body, which includes the skin, muscles, nose, and mouth, function to defend the body from these pathogenic factors. The weather causes disease only when our bodies and Defensive Qi are relatively weak compared to the climatic factor. I say “relatively” weak since you don’t have to be extremely weak for the pathogenic factor to invade your body. These exterior factors can invade a relatively strong and healthy person if it is stronger than that person’s body energy at that point in time. Make sense?
A person’s basic constitutional make-up, which is different in everyone, will also determine which exterior pathogenic factor will affect them the most. Someone who is born with a hotter constitution (heat intolerant) will tend to be more affected by heat and dryness, while someone who is more cold intolerant will be more affected by wind and cold.
Each pathogenic factor is also associated with a season during which it is more prevalent. However, pathogenic factors can occur during any season.
- Wind – Spring
- Heat – Summer
- Dryness – Autumn
- Cold – Winter
- Dampness – Late Summer
- Fire – Summer
While these pathogenic factors invade the exterior first, the internal organs may also be affected if there is already weakness and disharmony in that organ system. Once it invades the body, they can easily change their nature. Wind-Cold can easily turn into Heat. Dampness can also generate Heat. Extreme Heat can turn into Wind.
The climatic factors will trigger certain clinical symptoms indicative of that climate. That is, the symptoms your body experiences mimics the pattern and behavior of the pathogenic factor. So not only is the pathogenic factor a “cause” of the disease, but the behavior of it becomes clinically relevant as “patterns of disharmony” in the body that need to be treated. I will give examples to make this easier to understand.
Spring External Wind
Since we are in the heart of spring, I will focus on Wind and its clinical manifestations of the body. Wind is yang in nature and tends to injure the blood and yin of our bodies. Wind can carry other pathogenic factors into the body (i.e., cold can enter the body as Wind-Cold and heat can enter the body as Wind-Heat). Like wind, the symptoms happen quickly and can change rapidly.
The behavior of wind include:
- rapid onset
- causes rapid changes in signs and symptoms
- causes signs and symptoms to move from one area to another area of the body
- can cause tremors, convulsions, as well as stiffness and paralysis (extreme cases: Parkinson’s and stroke)
- affects the top part of the body (especially the head and neck)
- attacks the lungs first
- affects the skin
- can cause itching
Wind-Cold Signs and Symptoms – aversion to cold or wind, shivering, sneezing and cough, runny nose with white-watery mucus, no fever or slight fever (seen more with Wind-Heat), severe occipital stiffness and aching, itchy throat, possible sweating (Wind-Cold with a stronger cold component will have no sweating as cold contracts pores, while Wind-Cold with a stronger wind component will have slight sweating, since the pores are open), no thirst. Tongue body color – no change with thin-white coating. Floating-tight pulse.
Wind-Heat Signs and Symptoms – aversion to cold, shivering, sneezing, cough, runny nose with yellow mucus, fever, occipital stiffness and aching, slight sweating, sore throat, swollen tonsils, thirst. Tongue body color – red on the tips or sides, thin-white coating. Floating-rapid pulse.
(Note: Chinese Medicine uses the tongue and pulse to diagnose diseases. Tongue diagnosis is based on the color, shape, coating, and moisture of the tongue while pulse diagnosis is more complex. These subjects will require their own posts!)
Do the signs and symptoms of Wind-Cold and Wind-Heat sound familiar? Yes, it’s the common cold or flu. When these symptoms are not promptly addressed or your body’s constitution and defenses are too weak to fight them, the symptoms can invade deeper into the body and cause more severe respiratory problems such as bronchitis, upper respiratory infections, and pneumonia. From a Western medicine perspective, the common cold is caused by viruses, not bacteria, which is why antibiotics don’t work on a cold. We have viruses and bacteria in our bodies all the time. It is not until our defenses (“Defensive Qi” or immune system) are compromised that our bodies cannot handle them and we get sick.
Finally, the internal organ that is most affected by Wind in the body is your liver. According to the Five Element Theory, Wind is associated with the season of Spring, the Wood element, and the Liver (more about this later). Exterior Wind can aggravate an already weakened Liver disharmony in the body which can cause stiff neck and headaches. It can also “stir” Blood (since wind moves) stored in the Liver manifesting symptoms of skin rashes that will start suddenly and move all over the body (e.g. urticaria and hives).
Note: I have been talking about “external” wind, from climatic changes. Internal wind, can also cause disease. Some of the clinical manifestations may be similar to external wind, but it is mainly caused by Liver weakness and disharmony (i.e., Liver issues will cause internal wind in your body).
What are practical ways to prevent and treat the common cold?
Wind usually enters the back of the neck under the occiput, while cold enters the bottoms of the feet or the base of the neck. If you are already cold intolerant, it’s important to keep your feet warm on colder days and wear a scarf to protect your neck on windier days. We are most vulnerable to catching colds during season changes, especially winter into spring, or summer into fall. Poor nutrition, lack of sleep, too much alcohol, overwork, and increased stress will also make us more susceptible to getting sick.
When we get sick, supportive care is usually the best way to get through a cold. Increase your fluid intake (water is best) and get plenty of rest and sleep. Adding lemon, ginger, and honey to warm or room temp water can also help wind-cold symptoms, as lemon strengthens your liver, ginger can clear wind and is slightly warming, while honey is soothing to your throat. Try to stay away from cold or iced drinks which can increase phlegm and mucus in your body, aggravating symptoms. It is important to spit out any phlegm (whether you have cold or heat symptoms) since swallowing it back into your system will keep the pathogen in your body longer.
If you are more internally hot, a cold can quickly turn into Wind-Heat in your body. Feeling warm or flushed, fever, sore throat, and yellow mucus are early signs of Wind-Heat in your body. Focus on drinking fluids only (water, dilute juices, and herbal teas such as green or peppermint tea, which can clear heat symptoms – green tea and peppermint have a cooling thermal nature). Eat only if you are truly hungry as fasting for a day can clear heat from your body quickly.
If you are not sweating, it may be helpful to induce sweating to release the pathogen (in both wind-cold and wind-heat). In this case, drink a strong cup of ginger tea followed by a hot bath until your entire body is sweating. Once this happens, stay in for another 5 minutes, dry off completely, cloth yourself completely to avoid exposure to cold, and then take a long nap.
Food, herbs, and supplements for the common cold
Anti-wind herbs – ginger, fennel, basil, anise, and valerian – can also use cinnamon, garlic, and onions (which all have detoxifying properties)
Wind-cold reducers: oats, pine nuts, shrimp
Anti-wind herbs – peppermint and peony root
Wind-heat reducers: celery, mulberry, strawberry
For both Wind-Cold and Wind-Heat:
Wind reducers with a neutral thermal nature – black soybeans, back sesame seed, fresh flax oil, herbs – sage and chamomile
Pears, especially Asian pears, are good for cough and help to moisten the lungs.
Foods to avoid:
Wind aggravators : eggs, crabmeat, and buckwheat
Phlegm producing foods: all dairy products, bananas, sugar, cold drinks, alcohol, rich and heavy foods (phlegm and mucus are perfect breeding grounds for virus and bacteria)
Supplements and Herbs
Vitamin C – A meta-analysis of 29 trials in a total of 11,306 participants found that supplementing with 200mg Vitamin C daily did not reduce the frequency of colds, but did reduce the severity and duration of colds.
Echinacea – Lab and animal studies suggest that echinacea contains substances that enhance our immune systems, relieve pain, reduce inflammation and may have anti-viral and anti-oxidant effects. One study found that of 95 people with early symptoms of cold and flu, those who drank several cups of echinacea tea every day for 5 days felt better sooner than those who drank tea without echinacea. Echinacea has been found to work well with Vitamin C.
Tinctures are the best way to take echinacea since they are better absorbed and easier on the stomach than taking capsules. Drink 1-3ml or (20-90 drops) of a 1:5 tincture, added to warm water or tea, 3-4 times a day.
Goldenseal – This is also used in conjunction with echinacea to treat colds, but because it is cooling, it should only be used with symptoms of wind-heat. The National Center for Complementary and Integrative Health (NCCIH) is currently funding studies on possible anti-bacterial mechanisms and cholesterol lowering effects of goldenseal.
Reishi – This medicinal mushroom has long been known for its immune boosting properties. It should be used more for long-term immune building and prevention rather than treatment of acute colds. (More on this soon.)
Your cold should generally resolve in 7-10 days and you shouldn’t need to take supplements and herbs for longer than this. If your symptoms don’t improve, go see your doctor!
What do you do when you catch a cold?
In health and wellness,
The Foundations of Chinese Medicine by Giovanni Maciocia
Healing with Whole Foods by Paul Pitchford
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