The Energetic Difference Between a Cold and the Flu

Day 13

by Gene Chuah

This is a late entry for the class I attended a week ago (July 29). The final exam was on July 31st. I think I did okay!

Have you ever wondered what the difference is between a cold and the flu? Well, on a general level, most people know that when they have the chills and a runny nose, it’s a cold; on the other hand, if there’s a lot of fever and congestion, it’s the flu. This is correct! From the Traditional Chinese Medicine perspective, a cold is considered invasion by Wind-Cold, and the flu is invasion by Wind-Heat. The key thing is that usually a cold progresses into the flu, as the body bolsters its defenses to fight the pathogen, generating Heat as its main weapon.

Below: Differences in Symptoms Between a Cold and the Flu
Symptom Wind-Cold Wind-Heat
Aversion to wind & cold wind & heat
Fever slight high
Sweating none/slight lots
Thirst none big
Nose runny congested
Nasal discharge thin, watery thick, yellow
Throat itchy bad sore throat
Cough slight strong
Tongue no change red (heat, fever)
Pulse slow (cold) rapid (heat)
Headaches usually occipital (Tai-Yang), and not severe can be throbbing, temporal, frontal, more severe
Aching/Stiffness upper shoulder muscle aches and stiff neck body aches especially in upper shoulders and neck
Sneezing yes -
Chills yes -
Below: Typical Progression of Cold into Flu

Normally, a cold turns into the flu, but one can also succumb to Wind-Heat directly, as in the case of sunstroke and some infectious diseases. Most of the time Heat is generated by the Wei (Defensive) Qi in order to kill the pathogen.

Fevers are a good thing, and in fact by using fever-lowering medications too much or too soon, we are hampering the body’s normal immune response. It’s a known fact that heat prevents virus telomeres from binding, in effect stopping their spread. When there is too much, however, it becomes a problem and is known as Pathogenic Heat. This Heat could be generated either internally or from external sources. Pathogenic Heat needs to be removed from the body, and this is what TCM doctors and acupuncturists are good for!

Patient Case Studies

In the next section we covered case studies of patients. This is the exciting part and where everything in this course comes together in real-world-usage. Normally in patients the symptoms of their illness will fit a pattern that tells us what the disharmony is, and we can form a conclusion along the 8 Principles (4 Dimensions, really) :
Yin vs Yang  |  Cold vs Heat  |  Interior vs Exterior  |  Deficiency vs Excess.

Due to limited time, I’ll only cover one case study.

We’re going to refer to The 4 Energetic Imbalance Conditions so here’s a handy diagram:
Also a good refresher of the 8 Principles from Day 12 is also in order.

Case Study: 50-year-old woman, menopausal.

Symptom Explanation Principle
Insomnia — falls asleep pretty easily but wakes several times in the AM This is a known flag for Yin Deficiency. We can liken the Yin to a “blanket of sleep” that is too short, and the person wakes up too early because the Yin isn’t enough to cover them for the full night. Yin is the nutritive aspect necessary for rejuvenating sleep (see Day 4). Deficiency vs Excess? Deficiency.
Yin vs. Yang? Yang (weak Yin means stronger Yang, relatively).
Slight irritability. This is known flag for Liver Qi Stagnation. Heat is one of the things that can trigger it. Cold vs Heat? Heat.
Heart palpations when startled. “When startled” here is key, it points to a Deficiency (a type of straining due to tiredness); heart palpitations of this type are a known flag for Blood Deficiency. Blood is needed to ground the Shen (clear, sound mind/consciousness). Organs such as Heart and Kidneys are also implicated in this type of Deficiency. Deficiency vs Excess? Deficiency.
Malar (partial) flush. Anytime it’s partial vs full, we know it’s Deficiency vs Excess. A flushed face means there’s Heat. Of the 4 Imbalance Conditions (see chart above), only 2 are of the Heat type: Yang Excess or Yin Deficiency. Since partial = Deficiency, We know this is a Yin Deficiency (malar flush is a known flag for this). Deficiency vs Excess? Deficiency.
Yin vs. Yang? Yang.
Feeling of heat in the evening. This is a known flag for Yin Deficiency. On the other hand, feeling hot throughout the day is a sign for Yang Excess. After sunset, it is a “time of Yin” and if one is lacking in Yin, this is when they feel Heat most. Deficiency vs Excess? Deficiency.
Yin vs. Yang? Yang.
Night sweats. This is a known flag for Yin Deficiency. On the other hand, excessive sweating throughout the day is a sign for Yang Excess. Deficiency vs Excess? Deficiency.
Yin vs. Yang? Yang.
Dry mouth and throat. This is a known flag for Yin Deficiency and Body Fluids Deficiency (related, since Body Fluids are considered Yin). Deficiency vs Excess? Deficiency.
Yin vs. Yang? Yang.
Thirst for small sips to moisten throat. This is a known flag for Yin Deficiency. On the other hand, big thirst is a sign for Yang Excess. Deficiency vs Excess? Deficiency.
Yin vs. Yang? Yang.
Sore and weak lower back, relieved by cold. Known flag for Kidney Yin Deficiency. “Relieved by cold” points to a Heat condition. Deficiency vs Excess? Deficiency.
Interior vs. Exterior? Interior (Kidneys).
Cold vs Heat? Heat.
Yin vs Yang? Yang.
Dry stools, tendency to constipate, feels weak after evacuation. “Dry” and “tendency to constipate” point to Heat. “Feels weak” points to a Deficiency (takes precious energy to defecate). This is either Yin Deficiency or Blood Deficiency. Cold vs Heat? Heat.
Deficiency vs Excess? Deficiency.
Dark scanty urine. This is a known flag for Heat. Heat burns up liquid and makes it more concentrated (thicker, darker). Cold vs Heat? Heat.
Tongue: red, peeled coat. This is a known flag for Yin Deficiency. Deficiency vs Excess? Deficiency.
Yin vs. Yang? Yang.
Pulse: weak, rapid. Weakness points to Deficiency. Rapid pulse is a known flag for Heat, whereas slow pulse is a known flag for Cold (think of the reptiles). Deficiency vs Excess? Deficiency.
Cold vs Heat? Heat.


We already know that menopause = Yin Deficiency (from Day 6), and each of the symptoms here confirms this, on their own anyways.

In making a TCM diagnosis, we piece together parts of the puzzle. In this case for instance, we saw Heat as symptom on its own. It helped us narrow down from the 4 Energetic Imbalance Conditions to 2 (the Heat-related ones, top 2 in the diagram). Since in this case we’re seeing Deficiency and not Excess, we relate the Heat to Yin Deficiency and not Yang Excess. In fact the other symptoms also pointed in that direction, helping us connect the dots.

Now looking at the 8 Principles (4 Dimensions), we conclude this patient as having the following:

Yin vs Yang? Yang
Cold vs Heat? Heat
Interior vs Exterior? Interior (Kidneys)
Deficiency vs Excess? Deficiency

… with the overall diagnosis of Kidney Yin Deficiency
… which opens up the path for our treatment approach. To treat Deficiency, we tonify, and it’s Kidney Yin in this case. Some ideas from the Interwebs here.

One renowned option : Liu Wei Di Huang Wan, also known as Liuwei Dihuang teapills (simplified Chinese: 六味地黄丸; traditional Chinese: 六味地黃丸; pinyin: liùwèi dìhuáng wán) or Six Flavor Rehmanni.


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