The Third Stagnation: Cold Stagnation, Part 2

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In Part I we learned about the many signs and symptoms of Cold Stagnation and its effects on physical and mental health. In this segment we’ll cover how to treat and prevent Cold Stagnation. You may be most interested in herbs and formulas that treat this condition, but first I’ll cover other therapies integral to preventing and treating this issue.

Therapies for Cold Stagnation

Diet Therapy:

Foods to Eat: All cooked foods, warm drinks; spices added to food; animal protein (except crabmeat and shellfish); cooked and spiced vegetables and fruits 

Foods to Avoid: Refrigerated foods and drinks; raw foods (including salads); iced drinks; frozen yogurt, ice cream, popsicles, etc.; most fruit and vegetable juices; melons, bananas; crabmeat and shellfish (except shrimp); soy milk and tofu

Emotional Therapy: Appropriate expression and release of emotions

 

Lifestyle Therapies: Dress warmly and adequately for the weather; cover neck with a high collar or scarf; cover lower back, waist and midriff

 

Other Therapies: As with Blood Stagnation, moxibustion is the main therapy for Cold Stagnation, although other heat applications may be used such as hot stones, hot packs, warming herbal patches, ginger fomentations, and so forth.

 

Herbal Therapy: Herbs for Cold Stagnation tend to come from the "Herbs That Warm the Interior" or "Herbs that Tonify Yang" categories. In Western herbalism this can include stimulants along with certain adaptogens. These herbs have a warm to hot energy and generally pungent and/or sweet flavor. If there is also Wind or Dampness involved, then herbs that resolve Wind-Cold or disperse Cold Damp are also used. Take these herbs with cooked, warm food or as warm teas. Examples of herbs used for Cold Stagnation follow:

  • cayenne pepper
  • pippali long pepper
  • anise seed
  • horseradish root
  • cloves
  • prickly ash
  • bayberry bark
  • ginger, especially dried
  • cinnamon
  • garlic
  • black pepper
  • fenugreek
  • damiana
  • dipsacus
  • cuscuta

 

Kitchen medicine: Many kitchen spices are warming in energy, which disperse Cold Stagnation, such as ginger, cinnamon, cloves, black pepper and garlic.

Formulas for Cold Stagnation

Stagnation of Cold in the Upper Warmer

Aconite Combination (Si Ni Tang)

  • *Prepared aconite (fu zi, Aconitum carmichaeli) 9-12 g 
  • Dry ginger  (gan jiang, Zingiberis officinalis) 6-9 g 
  • Baked Licorice (zhi gan cao, Glycyrrhiza uralensis) 9-12 g 
  • *Substitute for aconite: cinnamon bark, rou gui

Properties and Actions:

a) For Yang exhaustion of the Lesser Yin (Xiao Yin) stage.

b) For Yang Deficiency caused by excessive perspiration.

 

Indications: This formula can be used for collapse of vital functions and cardiac failure. Symptoms include: cold extremities, fear of cold, fatigue and exhaustion, diarrhea with undigested food in the stool, nausea and vomiting, abdominal pain and lack of thirst. This formula was originally indicated for individuals who were inappropriately prescribed diaphoretics.

 

Pulse: Deep and weak

 

Tongue: Pale or dark purplish-blue

Contraindications: Avoid if there is Excess Heat or Yin Deficiency.

 

Stagnation of Cold in the Middle Warmer

Ginseng and Ginger Combination or Regulate the Middle Pill (Li Zhong Wan)

  • Dry ginger (gan jiang, Zingiber officinalis) 9 g 
  • Ginseng (ren shen, Panax ginseng) 9 g 
  • White atractylodes (bai zhu, Atractylodes alba) 9 g 
  • Baked licorice (zhi gan cao, Glycyrrhiza uralensis) 9 g 

Preparation: Grind the ingredients into a powder. Warm honey until it is liquid. Stir the herb powder into the honey until it is a thick doughy consistency. Roll into balls about half the size of a lime. Take two or three daily before meals. A single dose of pills should equal to about 6-9 grams of the powdered herb. It can also be taken as a decoction. The pill is often taken with rice congee. Unless it is an acute case, codonopsis (dang shen) can be doubled in amount and substituted for ginseng (ren shen).

Properties and Actions:

a) Tonic, warms and tonifies Spleen and Stomach Yang

b) Strengthens digestion and raises digestive metabolism

Indications: It may be considered for symptoms of deficiency such as diarrhea with watery stool, nausea and vomiting, no particular thirst, loss of appetite, abdominal pain.

Pulse: Deep and thin

Tongue: Pale tongue with white coat

Note: This formula is often combined with either or both 6 g of cinnamon bark (rou gui) and 6 g of prepared aconite (fu zi) to make it stronger and warmer; this is Aconite, Ginger and Ginseng Combination (Fu Zi Li Zhong Wan). It is particularly useful for vegetarians, who through eating too much cold, raw food, have injured the Spleen Yang and seriously weakened their digestive metabolism.

Contraindications: Avoid if there is Excess Heat or Yin Deficiency.

 

Stagnation of Cold in the Lower Warmer

Rehmannia Eight Combination (Jin Gui Shen Qi Wan or Ba Wei Di Huang Wan)

  • Prepared aconite (fu zi, Aconitum praeparata) 10-15 g 
  • Cinnamon twigs (gui zhi, Cinnamomum cassia) 6-9 g 
  • Prepared Rehmannia (shu di huang, Rehmannia glutinosa) 20-30 g 
  • Cornus (shan zhu yu, Cornus officinalis) 10-15 g 
  • Dioscorea (shan yao, Dioscorea opposita) 10-15 g 
  • Water Plantain (ze xie, Alisma plantago-aquatica) 9-12 g 
  • Moutan Peony (mu dan pi, Paeonia suffruticosa) 6-9 g 
  • Poria (fu ling, Poria cocos) 9-12 g 

Properties and Actions:

a) Tonifies Yang

b) Warms the Kidneys and lower extremities

Indications: For symptoms of Kidney Yang Deficiency with lower backache, coldness in the lower extremities, impotence, spermatorrhea, prostatic hypertrophy, frequent urination, nocturia, cough, asthma, persistent diarrhea, dysuria, spasms of the lower abdomen. It can be considered for diabetes mellitus and insipidus, hyperaldosteronism, Addison’s disease, hypothyroidism, arteriosclerosis, hypertension, edema, cystitis, chronic nephritis, kidney stones, albuminaria, chronic bronchitis, edema, chronic diarrhea, rectal prolapse, chronic gonorrhea, arthritis, menopausal problems, eczema, senile pruritis, vaginal itching, urticaria, neurasthenia, cataracts, glaucoma, keratitis.

 

Pulse: Sunken, slow and weak

Tongue: White

Contraindications: Avoid if there is Excess Heat, Yin Deficiency or gastrointestinal weakness.

 

Stagnation of Cold in Liver Channel

Warm the Liver Decoction (Nuan Gan Jian)

  • Angelica sinensis (dang gui) 6-9 g
  • Lycii berries (gou ji zi, Fructus lycii) 9 g 
  • Fennel seeds (xiao hui xiang, Foeniculi vulgaris) 6 g 
  • Cinnamon bark (rou gui, Cinnamomi cassiae) 3-6 g 
  • Lindera root (wu yao, Linderae strychnifoliae) 6 g 
  • Aquilaria wood (chen xiang, Lignum aguilariae) 6 g 
  • Poria (fu ling, Poria cocos) 6 g 
  • Fresh ginger (sheng jiang, Zingiberis officinalis) 3-5 slices 

Preparation: Take warm. Saussurea (mu xiang) is often substituted for the harder to obtain aquilaria, which is also known as Lignum vitae. This formula is particularly indicated for hernial disorders for which fennel seed is a near specific.

Contraindications: Avoid if there is Excess Heat, Yin Deficiency or gastrointestinal weakness.

 

Cold Invading the Large/Small Intestine

Magnolia and Hoelen Combination (Wei Ling Tang)

  • Alisma (ze xie, Alisma plantago-aquatica) 2.5 g 
  • Poria (fu ling, Poria cocos) 2.5 g
  • Polyporus (zhu ling, Polyporus umbellatus) 2.5 g 
  • Cinnamon twig (gui zhi, Cinnamomum cassia) 2 g 
  • White Atractylodes (bai zhu, Atractylodes alba) 2.5 g 
  • Black Atractylodes (cang zhu, Atractylodes lancea) 2.5 g 
  • Magnolia bark (hou po, Magnolia officinalis) 2.5 g 
  • Citrus peel (chen pi, Citrus reticulata) 2.5 g 
  • Licorice (gan cao, Glycyrrhizae uralensis) 1 g 
  • Fresh ginger (sheng jiang, Zingiberis officinale) 1.5 g 
  • Jujube dates (da zao, Zizyphus jujuba) 3-5 pcs

Properties and Actions:

a) Eliminates Dampness of the Spleen (relieves bloating)

b) Carminative, restores the function of the Stomach and assists digestion.

Indications: Abdominal bloating and fullness, loss of appetite, dull heavy feeling in the head and body, watery diarrhea, decreased urination.

Pulse: Slippery and thready

Tongue: White with a greasy coat

Contraindications: Avoid if there is Excess Heat, or Yin Deficiency.

 

Cold Obstruction of the Channels

Frigid Extremities Decoction (Si Ni Tang)

  • *Prepared Aconite (fu zi, Aconitum carmichaeli) 6-9 g
  • Dry ginger (gan jiang, Zingiber officinale) 4.5 g 
  • Honey baked licorice (zhi gan cao, Glycyrrhiza uralensis) 6 g 
  • *Substitute cinnamon twig for the aconite

Properties and Actions:

a) Metabolic Stimulant, stimulates Yang

b) Warms and counteracts internal Cold

Indications: Aversion to cold, coldness in the hands and feet, coldness in the Stomach and Spleen, vomiting, diarrhea, lethargy, abdominal pain, lack of thirst.

Pulse: Thin, deep and faint

Tongue: White, moist coat

Variation: By adding 6-9 g of ginseng (ren shen), the formula has wider tonic properties, tonifying Yin, Blood and Qi. Both these formulas are appropriate for both the Xiao Yin and Jue Stages as well.

Note: This is the basic metabolic stimulant formula.

Contraindications: Avoid if there is Excess Heat or Deficient Yin.

 

Ayurvedic Compounds for Cold Stagnation

Trikatu is used for Internal Cold Stagnation and to dry mucus. It consists of equal parts powdered black pepper, pippali long pepper and ginger mixed with honey. A teaspoon is taken 2 or 3 times daily to lessen mucus and treat upper respiratory allergies.

Sito Paladi Churna is a traditional household formula used to treat the symptoms of the common cold. It consists of equal parts sugar, bamboo manna, pippali long pepper, cardamom seeds, cinnamon bark and ginger. It is warming, anti-mucus and clears Dampness.

 

Western Thompsonian Herbal Formula for Cold Stagnation

Composition Powder

  • 4 parts bayberry bark powder
  • 2 parts white pine bark powder
  • 2 parts powdered ginger root (dried)
  • 1/2 part cayenne pepper
  • 1/2 part cloves powder

A teaspoon of this can be taken in hot or warm water three or four times daily. While this helps induce perspiration in someone with the first sign of a cold or flu (followed a half hour later with a bowl of thin porridge such as rice cream or oatmeal if the patient is weak), this formula may also be taken in smaller doses to move Cold Stagnation. As well, it may be modified with cinnamon bark and licorice.

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