Library

Zhonghan Syndrome (Cold Strike), commonly referred to by the laypeople as Yin-pattern Shanghan (Exogenous Cold Damage), is entirely attributed by them to cold injury sustained during sexual intercourse, and blamed upon the patient. However, if the patient has indeed not engaged in sexual activity, they firmly refuse to admit it.

They naturally refuse to take medicines for treating Yin-pattern Zhonghan, yet if left to manage other syndromes as they are, they willingly comply. Alas! The number of people mistakenly dying from this is countless.

It is unknown that Zhonghan syndrome first arises from deficiency of the Five Zang organs and extreme depletion of Yuan Qi (Original Qi). Cold pathogen invades directly, entering the Yin meridians to form Zhonghan syndrome, which is precisely what is called Yin pattern. To be rigidly confined to whether it stems from sexual activity is surely a mistake!

*Yuji Wei Yi* states: Zhonghan involves sudden onset of disease, where pathogenic factors directly enter the Three Yin meridians (Taiyin, Shaoyin, Jueyin), presenting with acute pain and spasms, shivering and rigidity, coma and cold limbs, locked jaw and loss of voice; this is Zhonghan. Treatment should primarily focus on warming the middle and dispersing cold. In cases of Shanghan, because there is pre-existing stagnant heat within, and external wind-cold causes the muscle pores and interstices to become tight, the heat becomes trapped and stagnates. When cold pathogen lodges in the collaterals, it initially presents with headache, body heat, and aversion to cold; this is Shanghan, and it should be treated according to the principles of Zhang Zhongjing.

Zhonghan syndrome occurs when cold pathogen takes advantage of loose skin pores and interstices, directly invading the Kidney meridian without following the regular meridian pathways. There is no fever to erupt, so it suddenly presents with cold limbs, locked jaw, abdominal pain, blue lips, and critical coma resembling stroke. If treatment is delayed even slightly, death is inevitable.

*Mai Jing* says: Slow and tight pulse indicates cold; slow, choppy, deep, and thin pulses also indicate cold. Firm and wiry or deep and thin pulses all indicate Zhonghan. A scattered pulse in Zhonghan indicates death. A slow and sluggish pulse at the Chi position indicates cold in the Lower Jiao.

When cold invades the Three Yin meridians, sudden collapse occurs, with loss of consciousness, locked jaw and loss of voice, rigidity of the four limbs, spasms, and pain; this also resembles stroke. If treated with wind-dispelling herbs, death will result. One must urgently use Fuzi Lizhong Tang (Aconite Decoction to Regulate the Middle). If there is cold extremities, blue lips, retracted scrotum, and absent pulse, apply Congyi method (moxibustion/warming with green onion) and moxa the Qihai (CV-6) and Guanyuan (CV-4) acupoints for 20-30 moxa cones. If the pulse gradually returns and hands and feet gradually warm up, survival is possible.

If cold invades the Taiyin meridian, pain occurs at the Zhongwan (CV-12) area; treatment suits Lizhong Tang (Regulate the Middle Decoction). If cold invades the Shaoyin meridian, pain occurs around the umbilicus and abdomen; treatment suits Wuji San (Five Accumulations Powder) added with Evodiae Fructus (Zhu Yu). If cold invades the Jueyin meridian, pain occurs in the lower abdomen; treatment suits Sini Tang (Frigid Extremities Decoction) added with Evodiae Fructus (Zhu Yu), doubling the dosage of Aconiti Lateralis Radix Praeparata (Fuzi).