The common cold and flu in Traditional Chinese Medicine (TCM) was one of the first ailments to be discussed in the classical text books of TCM. According to TCM theory, a cold or flu is grouped into different categories based on the signs and symptoms present in a patient at the time of treatment. This diversity is a foundational aspect to TCM and is an imperative part of diagnosing symptoms for the right pattern to treat for a patient’s complaint. How does this work?


Syndrome Differentiation in TCM

In TCM, we view a cold or flu as an invasion into the superficial layers of the body by a pathogenic wind. There are several theories in western medicine about how colds or flu viruses are transmitted to the human body which do not apply to the view of a TCM “pathogenic wind invading the body”. This is specific to TCM and is a thought process that greatly helps direct the treatment. The pathogenic wind can be accompanied by cold, heat, dampness, or dryness which is reflective of the current climate. The patient’s own physical constitution can also change the way the pathogenic wind interacts with the body. For example, a strong constitution can cause more heat related symptoms. Let’s take a look at an example of two patients who have contracted a cold at the same time but with different symptoms.

     Patient 1 Symptoms

  • Acute fever and chills at the same time with stronger chills than fever
  • No sweating
  • Sore neck and headache to back of head
  • Nasal obstruction or sneezing with clear or white discharge

Tongue coating is white and pulse is floating and tight

    Patient 2 Symptoms

  • Acute to moderate high fever with mild chills
  • Sore throat or scratchy throat
  • Mild sweating
  • Frontal headache
  • Dry mouth or throat with thirst
  • Cough with yellow phlegm that is hard to move
  • Nasal discharge that is thick and yellow in color

Tongue is red with a yellow coating and pulse is floating and rapid

The importance of syndrome differentiation  

The proper treatment in clinic relies on the correct differentiation. By treatment we mean the modalities used in clinical practice such as Acupuncture and Chinese Herbal Medicine. Both modalities use different combinations of acupuncture points and herbs to comprise a treatment course that reflects the symptoms being treated. Looking at the above examples we can apply the right treatment as follows.  


Patient 1 is showing symptoms of a cold or flu that is cool in nature. The appropriate treatment for this is to apply herbs that (1) dispel wind-cold and are acrid and warm in nature, (2) promote diffusion and descent of lung qi. Acupuncture points used (1) to clear wind from the superficial levels of the body, (2) promote diffusion of the lungs. A common herbal formula for this treatment would be called Jing Fang Bai Du SanSchizonepeta and Saposhnikovia powder to overcome pathogenic influences. This treatment would not work well for patient 2. The principles of treatment do not support bringing the body back to balance in patient 2.  

Patient 2 has symptoms of heat that are dominant in the cold or flu process currently affecting the body. Using herbs and acupuncture points to clear heat are the best course of action in this case. Herbs that are (1) acrid and cool that dispel wind-heat. Acupuncture points that (1) clear heat and dispel wind. A common herbal formula for this treatment is called Yin Qiao SanHoneysuckle and Forsythia powder. It is comprised mainly of herbs that clear heat and dispel wind.  

The two cases above are a good example how a complaint of acute cough or nasal congestion can be categorized into different treatment options that promote the best results. This is a good illustration of several aspects of TCM in clinical practice and is also only a brief explanation into understanding the theory of TCM. This article is to show that when it comes to the common cold or flu that not one size fits all.  

When is it a good time to get treatment for a cold or flu?   

At any time and at any stage of a cold or flu a person can have treatment. The pattern will change showing different symptoms which means adjusting the treatment as needed. Most people will benefit from getting treatment at the first sign of symptoms. This will be of great benefit to reducing symptoms of a cold. Another good option is when symptoms are not getting better or there are further complications.          

Both patients have a cold and they may come to a TCM clinic with a complaint of a “cough” or nasal congestion looking for relief, but on further investigation we can see that there are several differences with their symptoms. This is an important part of the treatment process to ensure that the appropriate method is used. Improper treatment can lead to cold and flu symptoms progressing deeper into the body