The Wisdom of the Yellow Emperor: A Lesson in Treating Heat-Induced Illnesses

The Yellow Emperor once inquired: “The illnesses we refer to as external fever disorders all seem to fall under the category of ‘cold damage,’ with some patients recovering and others perishing. Those who die often succumb between the sixth and seventh day, while those who recover usually do so after the tenth day. Why is this the case? I’m perplexed, and I’d like to understand the reasoning behind it.”

Qi Bo replied: “The Sun Meridian is the ruler of all the Six Meridians, controlling the yang aspect of the body. All yang energies belong to the Sun. This meridian connects with the Wind Palace and links with the Governor Vessel and the Yang Wei, running along the back of the head and neck. Therefore, the Sun Meridian is the master of all yang energies, governing the body’s surface. When a person is attacked by cold, fever will arise, but while the fever might be intense, death is not inevitable. However, if both the exterior and interior of the body suffer from cold, the outcome becomes much graver.”

The Yellow Emperor asked, “What are the symptoms of cold damage?”

Qi Bo answered: “On the first day, the Sun Meridian suffers from cold damage. The Sun’s energy, from head to neck and down along the back to the waist, causes head and neck pain and stiffness in the spine.

On the second day, the Yangming Meridian is affected. Yangming governs the muscles. The energy of this meridian runs along the nose, around the eyes, and down into the abdomen, resulting in body heat, eye pain, and a dry nose, making it hard to sleep.

On the third day, the Shaoyang Meridian is affected. This meridian governs the bones. Its energy flows along the ribs and connects to the ears, leading to chest pain and ear deafness. If all three yang meridians are affected but the internal organs are still intact, sweating will help the patient recover.

By the fourth day, the Taiyin Meridian is affected. This energy spreads to the stomach and connects to the throat, causing abdominal bloating and dryness in the throat.

On the fifth day, the Shaoyin Meridian is affected. Its energy runs through the kidneys and links to the lungs, ultimately connecting to the base of the tongue. This leads to dry mouth, a dry tongue, and thirst.

On the sixth day, the Jueyin Meridian is affected. This meridian encircles the genital area and connects to the liver, resulting in irritability and the contraction of the scrotum. If the energy of all three yin and yang meridians, as well as the five organs and six bowels, is blocked, and the flow of qi is hindered, the patient will likely die.

If the illness is not a simultaneous interior and exterior cold invasion, recovery is more gradual: On the seventh day, the Sun Meridian’s symptoms subside and the headache improves; by the eighth day, the Yangming Meridian’s symptoms begin to ease, body heat diminishes; on the ninth day, the Shaoyang symptoms improve, hearing starts to return; on the tenth day, the Taiyin symptoms recede, abdominal bloating reduces, and the appetite returns; by the eleventh day, Shaoyin symptoms ease, thirst fades, and sneezing begins; on the twelfth day, Jueyin symptoms subside, the scrotum relaxes, and the body starts to recover. By then, the great evil energy has left, and the illness gradually recedes.

The Yellow Emperor asked, “How should one treat this illness?”

Qi Bo answered: “The treatment should be tailored to the specific organ and meridian affected. The illness will gradually fade with the right approach. For illnesses not yet three days old with the external cold still present, sweating will help recovery. However, if the illness has progressed for more than three days and the cold has entered the interior, purging will be necessary.”

The Yellow Emperor asked, “Why do some patients continue to harbor residual heat even after the fever has subsided?”

Qi Bo explained: “Residual heat is often the result of overeating during the more intense fever phases, which traps heat within the body. Even though the disease appears to have abated, this latent heat can cause a relapse if the patient is forced to eat when the digestion is not yet ready, leading to further heating. It’s like adding fuel to an already smoldering fire.”

The Yellow Emperor inquired, “How do we treat this lingering heat?”

Qi Bo advised: “We must carefully examine the patient’s condition, adjusting treatments to either tonify or purge, depending on their needs. This targeted treatment can help the patient recover fully.”

The Yellow Emperor asked: “Are there any restrictions when caring for patients with heat-related illnesses?”

Qi Bo cautioned: “Once the fever starts to subside, consuming meat can cause the illness to return. Overeating can lead to persistent residual heat, which is a dangerous condition for someone suffering from a heat illness.”

The Yellow Emperor asked: “What about cases where both the exterior and interior are simultaneously attacked by cold?”

Qi Bo responded: “When both the Sun and Shaoyin meridians are affected on the first day, the symptoms include Sun’s headache and Shaoyin’s dry mouth and irritability. On the second day, the Yangming and Taiyin meridians are affected, leading to Yangming’s fever, delirium, and Taiyin’s bloating and lack of appetite. By the third day, the Shaoyang and Jueyin meridians are also involved, resulting in Shaoyang’s deafness and Jueyin’s cold limbs and contracted scrotum. If the condition develops to the point of water not entering the body, and the patient becomes unconscious, death is imminent by the sixth day.”

The Yellow Emperor asked, “Why do some patients, after their illness has progressed to damage the five organs and disrupt the flow of qi, die after three days?”

Qi Bo replied: “The Yangming Meridian is the ‘chief’ of the twelve meridians. Its energy and blood are the most abundant, so when it is depleted after three days, the patient will inevitably succumb.”

Lastly, Qi Bo shared: “Any illness caused by cold invasion that turns into heat disease before the Summer Solstice is considered a ‘warm disease.’ After the solstice, it is classified as a ‘summer disease.’ Summer diseases often involve sweating, which helps expel the heat through perspiration, and should not be suppressed.”