Deficient Cold Patterns, Key Symptoms, and Clinical Applications
By Dianiel Cho, L.Ac. (email: c0454445@gmail.com)
* Ling Gui Wei Gan Tang: Fu Ling 8g, Gui Zhi 8g, Wu Wei Zi 6g, Gan Cao 6g ×2 (Frequency of clinical use: Low-Middle, 2++)
Ling Gui Wei Gan Tang consists of Ling Gui Gan Tang plus Wu Wei Zhi.
Ling Gui Gan Tang: Deficient Cold patients typically exhibit weak stamina, pale complexion, Yin-natured personality, aversion to cold, cold limbs, and difficulty falling asleep. (Wu Wei Zhi: Dry cough, heavy-headedness, headache, and dizziness.)
Patients may catch colds easily or develop chronic rhinitis due to weak respiratory function. Since Wu Wei Zhi has a low indicator score, its characteristic symptoms may be subtle or absent. Thus, Ling Gui Wei Gan Tang can be selected by eliminating other Ling Gui Gan formulas.
Prescription Criteria and CAPE Signs
The prescription criteria are based on Ling Gui Gan Tang. In the formula table, black letters indicate shared symptoms, while red and blue identify differences.
CAPE signs resemble those of Ling Gui Gan Tang and Gui Zhi Tang. Patients generally have an underweight-to-normal build, weak stamina, pale complexion, and Yin-natured personality, although intermediate or Yang-natured traits may occur. Emotional characteristics include worry, sensitivity, tension, and anxiety.
Main symptoms: Aversion to cold, cold limbs, difficulty falling asleep, and Wu Wei Zhi’s dry cough.
Mild cough, sore throat without respiratory discharge, recurrent colds, and persistent rhinitis are common.
Clinical Case: Chronic Dry Cough
A 41-year-old woman with a short, chubby build presented with persistent dry cough, throat irritation, and a foreign-body sensation.
For several years, she had experienced throat dryness and a persistent sensation of phlegm, frequently clearing her throat. Occasionally, the pain made swallowing saliva difficult. She also reported rhinitis, dizziness upon standing, and palpitations.
Her Deficient Cold constitution, Yin-natured personality, insomnia, Upper Rush, dizziness, and palpitations suggested Ling Gui Gan Tang. Persistent throat dryness, irritation, and mild cough indicated Wu Wei Zhi.
After 42 days of treatment, throat irritation and residual cough resolved, while rhinitis, dizziness, and palpitations improved.
Additional Symptoms and Tendencies
Possible symptoms include Upper Rush, headache, chest discomfort associated with palpitations, and heavy-headedness.
Patients may describe: “My head feels heavy, as though a millstone is pressing down.”, “My head feels foggy and dizzy.”
The author associates these sensations with reduced respiratory function.
Low lung capacity is another reported tendency. Some Wu Wei Zhi patients cannot hold their breath beyond 30 seconds after maximum inhalation. The author associates this with reduced alveolar gas exchange, although breath-holding time alone cannot establish such impairment.
Cautionary signs: Obesity, strong stamina, dark complexion, Yang-natured personality, emotional stability, aversion to heat, and sound sleep.
Clinical Applications
The author reports using Ling Gui Wei Gan Tang for psychiatric, respiratory, gynecological, musculoskeletal, and skin disorders, including panic disorder, anxiety, unexplained chronic cough with sore throat, bronchiolitis obliterans organizing pneumonia (BOOP), back pain, menopause, and interpersonal facial flushing.
Other presentations include headache, dizziness, and tinnitus. These clinical observations do not establish treatment efficacy.
Classical Reference: Jin Gui Yao Lue 「手足厥逆 氣從少腹上衝胸咽」 Cold extremities with Qi rising from the lower abdomen toward the chest and throat.
「時復冒 可與茯苓桂枝五味子甘草湯 治其氣衝」 Intermittent dizziness or mental cloudiness may indicate Ling Gui Wei Gan Tang for upward-rushing Qi.
Mao (冒) describes dizziness, distant-feeling eyes, and mental cloudiness, as though the head were covered. – The Dictionary of Shang Han Lun Terminology
