True Cold - False Heat

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The following is taken from The Foundations of by

Giovanni Maciocia:

 

" Red cheeks, but red colour is like powder, rest of face white;

irritability but also lislessness, desire to lie with body curled

up; Pale and wet tongue.

 

" Breathing quiet; low voice.

 

" Thirst but no desire to drink, or desire to drink warm fluids, body

feels hot but he or she likes to be covered: sore throat but without

redness or swelling; pale urine.

 

" Pulse Rapid, Floating and Big but Empty. " (p. 196.)

 

For those new to TCM: In general, red means Heat. Reddish complexion

and too red tongue mean Heat. But here's a scenario even though

there is red in the complexion, it's a case of Cold. This Heat sign

is false. So how to tell when it's a false sign of Heat?

 

The key is in the description. The red is like someone wearing rouge

lightly dabbed on without blending. In cases of (real) Excess Heat,

the face will be uniformly red. (Excess Heat can be caused by too

much Heat in the environment invading, Liver Yang Rising, too many

foods and herbs with warming thermal energy, etc. Excess problems

are caused by there being too much of something.)

 

On the other hand, the redness of Yin Deficiency is a mottled red.

It's not uniform. Maciocia refers to this as a " malar flush " . It

looks sort of like someone partially stirred light cake batter and

dark together. Some areas are very dark and some are very light with

a lot of different shades inbetween. Yin Deficiency Heat, aka

Deficiency Heat is due to there not being enough Yin to properly

cool the body. Deficiency problems are caused by there not being

enough of something the body needs.

 

The redness of True Cold - False Heat is different from the uniform

reddness of Excess Heat and the malar flush of Yin Deficiency. Even

with the different shades of the malar flush, the shadings go deep

into the complexion. Think of the way a healing bruise looks (only

the shades are red and white instead of purple and yellow). When one

looks at a healing bruise, it's obvious that the damage goes deep

into the skin. The red of True Cold - False Heat is different. It's

very surface. Like someone dabbed rouge on without blending it out.

The red of True Cold - False Heat also can look like someone

sprinkled red powder over white. Again, it's surface.

 

BTW, I have known CFIDS (Chronic Fatigue Immune Dysfunction

Syndrome) patients who had the rouge-like dusting of True Cold -

False Heat. This doesn't mean that all PWCs (People With CFIDS) have

it and are suffering from True Cold - False Heat, or that PWCs are

the only people to get it. It means that PWCs are one client group

that the healer is likely to see cases of True Cold - False Heat in

from time to time.

 

A rapid pulse (or rapid movements or rapid speech) usually point to

Heat. Heat causes things to speed up. In the case of True Cold -

False Heat, the rapid pulse is a false sign. (People who are

overweight may also have a rapid pulse without there being Heat.

Sometimes there will be Heat but sometimes not in people who are

overweight and have rapid pulses.

 

" Thirst but no desire to drink " can also be a symptom of Yin

Deficiency so by itself, this is not a determining factor of True

Cold - False Heat. When a person prefers hot liquids when s/he does

drink, this is a classic symptom of Yang Deficiency. So is pale

urine. Maciocia is mentioning this to let students know that this

also is what they commonly will see in cases of True Cold - False

Heat. In other words, within the mixture of symptoms and signs

pointing to Cold and Heat, these two that point to Cold are pointing

to what's really happening. The red (rouge-like) complexion and the

rapid pulse give a false indication. The desire to lie with body

curled up (fetal position) also is a classic symptom of Yang

Deficiency.

 

The " body feels hot but he or she likes to be covered " points very

strongly to the possibility of True Cold - False Heat. Usually when

a person is too hot, s/he will kick covers off. In cases of True

Cold - False Heat the person may feel hot to the touch but insist on

being covered up. May even call for more blankets. Usually when a

person really is too hot, the person will not curl up into a fetal

position. The person will stretch out so as to expose as much skin

surface as possible to the cooling air so heat can be disipated.

People who are too Cold will tend to bunch up in order to conserve

as much of their Heat as possible. Even when they feel hot to the

touch.

 

Irritability usually points to Heat; lethargy to Cold. In True Cold -

False Heat one often sees a mixture of the two. The person manages

to be both listless and snappish.

 

For the TCM students: Always keep in mind that whenever Excess Cold

invades from the environment or Excess Cold arises from the person

consuming too much food or herbs with Cold thermal energy, that the

Cold is going to attack Yang and attack the Kidneys (and Spleen).

The Kidneys are the most vulnerable to Cold of all the Organs. If

the Excess Cold goes on long enough and/or is strong enough,

eventually the person will develop Yang Deficiency because of the

Cold attacking the Yang and attacking the Kidneys. (The Kidneys are

responsible for supplying Yang to the rest of the body.) This is why

so many of the " true " symptoms of True Cold - False Heat are

symptoms of Kidney Yang Deficiency.

 

I also want to point out the True Cold - False Heat is not something

that develops overnight in a healthy person. It develops after

problems have gone untreated for some time, and there are multiple

imbalances. Maciocia says, " This only happens in extreme conditions

and is quite rare. " (p. 185.) Maciocia also cautions against

confuing False Heat and False Cold with cases of combined Heat and

Cold where both Heat and Cold really are present though in different

parts of the body. " In False Heat and False Cold, the appearence is

false, i.e. there is no Heat or Cold respectively. " (p. 185.) That

last sentence is very important. Unlike cases where there is both

Cold and Heat, there is no real Cold or real Heat in these cases.