Characteristics of Cold Body and Classification of Deficiency Syndromes: The Diagnostic Basis for Tonifying Deficiency and Dispelling Cold in the Elderly

**Article 16**

**Characteristics of Cold Body Constitution: What Symptoms Indicate Cold Body Constitution?**

From the perspective of Traditional Chinese Medicine, most cases of "cold constitution" are actually "deficiency-cold," meaning the body is both weak and cold. People with a cold constitution are already sensitive to cold, and if they are also weak, they will be even more sensitive to cold. What are the symptoms of deficiency-cold?

Symptoms of deficiency-cold can be classified as mild, moderate, and severe, and their respective symptoms are as follows.

**1. Mild symptoms of deficiency and cold**

(1) Fear of cold and cold, and cold limbs.

(2) They are prone to catching colds, and it takes a long time to recover from a cold.

(3) The complexion is dull, pale, and bloodless.

(4) Easily fatigued, and joints are prone to soreness.

(5) Poor sleep quality, shallow sleep.

Having the above three symptoms can be considered a mild case of deficiency and cold.

**2. Moderate symptoms of deficiency and cold**

(1) The mouth is prone to inflammation and canker sores.

(2) Prone to constipation and often feel abdominal bloating and pain.

(3) Dry skin is prone to cracking.

(4) The heels are prone to dryness and cracking, and the blood circulation in the feet is not smooth.

(5) Dislikes eating cold foods such as fruits.

Having the above three symptoms can be considered as moderate deficiency and cold.

**3. Severe Symptoms of Deficiency and Cold**

(1) Frequent urination and difficulty urinating.

(2) Severe edema in the lower body.

(3) My hands and feet are still cold when I wake up.

(4) Numbness and soreness in the limbs when waking up.

(5) Frequently experience bloating.

Having the above three symptoms can be considered as severe deficiency and cold.

**Analysis of syndrome differentiation to determine the type of deficiency syndrome**

There are four types of deficiency syndromes in the human body: Yang deficiency, Yin deficiency, Qi deficiency, and Blood deficiency. Elderly people need to understand which type of deficiency they have in order to receive targeted and effective treatment. So, what are the definitions, pathological causes, and symptoms associated with each type, affecting the affected organs?

**1. Yang Deficiency**

Definition: Yang deficiency refers to a pathological condition characterized by a decline in Yang energy, resulting in reduced warming function. Its main symptoms include aversion to cold, cold hands and feet, and general coldness. Symptoms of Yang deficiency are milder in summer and more severe in winter. Generally, Yang deficiency develops from Qi deficiency.

Etiology: Multiple factors include deficiency of Yang Qi in the body; or invasion of external Yin-cold pathogens, which damages Yang Qi; or aging and decline of Yang Qi, which damages kidney Yang.

Yang deficiency syndrome can occur in various organs, and its symptoms vary:

Heart Yang Deficiency Syndrome: Palpitation, chest tightness, shortness of breath, emptiness in the heart, and easy to be startled.

Liver Yang Deficiency Syndrome: Dizziness, discomfort in the hypochondriac region, breast distension and pain, and depression.

Spleen Yang Deficiency Syndrome: decreased appetite, stomach prefers warmth, stomach feels comfortable after pressure, tasteless mouth, prefers hot drinks, loose stools or stools containing undigested food, accompanied by edema, pale complexion, etc.

Lung Yang Deficiency Syndrome: Cough, shortness of breath, weak breathing, low voice, and reluctance to speak, with white frothy sputum.

Kidney Yang Deficiency Syndrome: Soreness and coldness in the lower back and knees, aversion to cold limbs, frequent and clear urination or bedwetting, edema in the lower back, pain around the navel, borborygmus and diarrhea, with pain disappearing after defecation.

**2. Yin Deficiency**

Definition: This refers to a pathological condition characterized by deficiency of essence, blood, or body fluids. Due to the inability of Yin to control fire, nourish, or restrain Yang, the main symptoms include low-grade fever, afternoon fever, hot palms and soles, night sweats, dry mouth and throat, dizziness and tinnitus, irritability and insomnia, red tongue with little coating, and a thready and rapid pulse.

Etiology: Yin deficiency is mostly caused by the depletion of yin fluids after febrile diseases or prolonged illnesses, or by excessive emotional stress, immoderate sexual activity, or excessive consumption of warming and drying substances, which leads to the gradual depletion of yin fluids and the loss of nourishing substances in the body.

Yin deficiency syndrome can occur in various organs, and its symptoms vary:

Heart Yin Deficiency Syndrome: Palpitation, insomnia, forgetfulness, dreaminess, night sweats, restlessness, hot palms and soles, dry mouth and throat, red tongue tip, little coating, thready and rapid pulse, etc.; or symptoms such as flushed cheeks, dizziness and vertigo.

Liver Yin Deficiency Syndrome: Dizziness, headache, dry eyes, photophobia, blurred vision or night blindness, insomnia and excessive dreaming, poor nail luster.

Spleen Yin Deficiency Syndrome: Loss of appetite, indigestion after eating, nausea, dry mouth, thirst, constipation, and weight loss.

Lung Yin Deficiency Syndrome: Dry cough, scanty and sticky sputum, or sputum with blood, hoarseness, sweating during sleep, night sweats.

Kidney Yin Deficiency Syndrome: Lower back pain and weakness in the legs, heel pain, hot palms and soles or accompanied by irritability and heat, insomnia, night sweats, seminal emission, hair loss, and loose teeth.

**3. Qi Deficiency**

Definition: Generally refers to the pathological changes caused by insufficient Qi or deficiency of vital energy, mainly manifested as fatigue and weakness.

Etiology: Qi deficiency is often related to insufficient congenital endowment, malnutrition after birth, prolonged illness, decreased function of organs such as the lungs, spleen, and kidneys, excessive labor and depletion, and insufficient production of Qi.

Qi deficiency is classified into lung qi deficiency, heart qi deficiency, kidney qi deficiency, and spleen qi deficiency.

Lung Qi Deficiency Syndrome: Symptoms include shortness of breath, spontaneous sweating, weak voice, cough, wheezing, chest tightness, susceptibility to colds, and difficulty urinating.

Heart Qi Deficiency Syndrome: Palpitation, shortness of breath, excessive sweating, aggravated by exertion, fatigue, etc.

Kidney Qi Deficiency Syndrome: Symptoms include fatigue, dizziness, forgetfulness, weakness and soreness in the lower back and knees, and frequent urination.

Spleen Qi Deficiency Syndrome: Reduced appetite, stomach discomfort after meals, fatigue, emaciation, loose stools, sallow complexion, pale tongue with thin coating, weak pulse, etc.

**4. Blood Deficiency**

Definition: This refers to a pathological phenomenon of deficiency of Yin and Blood in the body. The main manifestation is pale complexion, often accompanied by symptoms of Qi deficiency.

Etiology: Caused by excessive blood loss, dysfunction of the spleen and stomach, or depletion of yin and blood due to prolonged illness.

Blood deficiency is divided into heart blood deficiency and liver blood deficiency:

Heart blood deficiency syndrome: palpitations, irritability, insomnia, excessive dreaming, forgetfulness, pale complexion, pale lips and tongue.

Symptoms of liver blood deficiency include blurred and dry eyes, dull, pale, brittle, and thin nails, even deformed nails, night blindness, blurred vision, tinnitus, numbness in the hands and feet, emaciation, insomnia, and excessive dreaming.