The corresponding Traditional Chinese Medicine (TCM) term for “Cold Invasion in the Liver Meridian” is “Cold Congestion in the Liver Meridian” (also known as “Cold Stagnation in the Liver Meridian” or “Cold Invading the Liver Meridian”).
This is a syndrome pattern in TCM that refers to the invasion of cold pathogens into the Liver Meridian, leading to stagnation of qi and blood and tightness in the meridians.
Common manifestations include:
Pain-related symptoms: Cold pain in the lower abdomen; a sensation of heaviness and distension in the testicles or dull, aching pain in the scrotum, which worsens with exposure to cold; some individuals may experience headaches at the crown of the head, accompanied by a desire to vomit clear fluid or frothy saliva during episodes of pain.
Limbs and General Condition: Cold hands and feet; lack of warmth in the limbs; aversion to cold and a preference for warmth.
Emotions and Sleep: Low mood and depression, possibly accompanied by insomnia and vivid dreams.
Women: May experience irregular menstruation and dysmenorrhea (which is relieved by warmth).
The Story of the Trees That Froze to Death
When I was a child, my family grew many tangerine trees, and we could enjoy sweet tangerines every year. One winter, the weather was bitterly cold. The howling north wind caused the temperature to plummet, and people could only stay indoors by the fire, afraid to go outside. When spring arrived and all things came back to life, many of our family’s tangerine trees had died. My father explained that it was because last winter had been so cold that the trees had frozen to death! Before then, I had only known that during hot weather, if tangerine trees weren’t watered, their leaves would turn yellow and, in severe cases, wither and die. I never imagined that trees could also freeze to death from the cold.
Many years later, I traveled to Inner Mongolia for a conference—it was winter again. As the train passed through Shanxi, I noticed the trees along the roadside were sparse and scattered, nowhere near as lush as those in the south. At the time, a colleague remarked, “The soil quality here isn’t good; the trees don’t grow well.” But I thought to myself: In such cold weather, it’s a miracle the trees aren’t frozen to death. If they endure such extreme cold every year, surely many will die the following year—how could they ever thrive?
After becoming a doctor and entering clinical practice, whenever I saw patients with liver disease, I naturally thought of the liver’s association with the Wood element. Drawing parallels from the pathological states of trees in nature, it was easy to make the connection to the pathological states of the liver.
When the earth is parched and trees lack the nourishment of water, they wither easily and burn when exposed to fire. In the human body, when Kidney Water is deficient and fails to nourish the Liver, Liver Fire becomes excessive, leading to a condition known as “Liver Yang Rising.” At this point, the liver resembles a withered tree. Furthermore, the heart fire in the human body requires kidney water to keep it in check, and the ascent of kidney water relies on the ascending movement of liver qi. Now that kidney water is deficient and liver fire is excessive, heart fire naturally cannot be regulated by kidney water, leading to an excess of fire in the upper burner. Consequently, patients exhibit symptoms such as thirst, excessive drinking, restlessness, and insomnia.
In nature, when temperatures drop too low, the cold’s contracting nature causes trees to wither from the cold. The human body functions similarly: when cold pathogens penetrate deeply into the Foot Jueyin Liver Meridian, they cause the meridians to contract due to the cold, eventually leading to withering.
When wood is exposed to cold, it withers! Here, “wither” does not refer to a lack of water or a loss of nourishment for the tree, but rather to the water being too cold, causing the tree’s tendons and vessels to contract so that fluids cannot nourish the trunk. Look at the trees in nature: trees that have withered and died are just like those that have died from the cold—their branches are all withered, a sign of insufficient moisture!
In the human body, when Kidney Yang is deficient and cold pathogens arise internally, preventing the proper warming and transformation of dampness and fluid, the cold pathogens will invade the Liver Meridian. As the Liver Meridian contracts due to the cold, discomfort will arise.
I. Common Symptoms and Treatment of Cold Invading the Liver Meridian
When cold pathogens invade and stagnate in the Liver Meridian, symptoms primarily characterized by cold pain will appear in the areas traversed by the meridian—such as cold pain in the lower abdomen, genital area, or the top of the head. Traditional Chinese Medicine refers to this as “Cold Stagnation in the Liver Meridian Syndrome,” also known as “Liver Cold Syndrome.”
Clinically, some patients complain to their doctors: “Doctor, “My scalp feels freezing cold, as if a bucket of cold water had been poured on it.” Other patients report, “Doctor, my penis always feels cold. Why is that?”
In fact, this is caused by cold pathogens entering the Liver Meridian; the Liver Meridian contracts due to the cold, and when the flow is obstructed, pain ensues.
In the ancient medical text *Medical Inventions*, there is a classic formula—Tiantai Wuyao Powder. Its ingredients include Tiantai Wuyao, Mu Xiang, Xiao Hui Xiang, Qing Pi, Gao Liang Jiang, Bin Lang, Chuan Lian Zi, and Ba Dou. It is specifically used to treat small intestine hernias caused by cold pathogens invading the Liver Meridian, as well as symptoms such as pain in the lower abdomen radiating to the testicles, a sensation of heaviness and distension, or lower abdominal pain.
The Tiantai Wuyao, Mu Xiang, Xiao Huixiang, Qingpi, and Gaoliangjiang in this formula all promote the flow of qi, soothe the liver, dispel cold, and relieve pain. Binlang descends qi and resolves stagnation, while Chuanlianzi promotes the flow of qi and relieves pain. When processed together with Ba Dou—and then the Ba Dou is removed and Chuanlianzi is added back in—this not only reduces the cold nature of Chuanlianzi but also enhances its ability to promote qi flow and disperse nodules.
The formula also includes one herb—Fennel Seed (Xiaohuixiang)—which may seem ordinary and is commonly used as a spice in daily life, but when applied correctly, it can actually treat many ailments. Medical texts record that fennel has a pungent aroma and a warm nature; it enters the Liver, Kidney, Spleen, and Stomach meridians, and possesses the therapeutic effects of dispelling cold, relieving pain, regulating qi, and harmonizing the stomach. Clinically, it produces rapid results for patients experiencing bloating, fullness, and pain in the stomach, intestines, or lower abdomen following exposure to cold.
A female patient surnamed Zhou experienced lower abdominal distension and discomfort, frequent urination, and an unbearable sense of urgency after her lower abdomen was exposed to cold. Treatment for acute cystitis at the hospital proved ineffective; a subsequent ultrasound revealed a small amount of fluid accumulation in the pelvic cavity. She was prescribed 30 grams of fennel seeds decocted in water for oral administration, and her condition was cured in a single course of treatment.
Another male patient, Mr. Zhang, suffered from difficulty urinating and distension and tightness in the lower abdomen. Treatment for chronic prostatitis proved ineffective; after taking fennel, his symptoms were relieved after one dose and he was completely cured after three doses.
There are countless similar cases. In fact, as long as there is distension in the lower abdomen without other obvious signs of heat syndrome, this method will be effective.
Not only do I prefer to use this method, but there are also historical records documenting its use.
Toward the end of the Qing Dynasty, a wealthy Russian merchant named Mikhailov was touring West Lake in Hangzhou by boat. Just as he was fully enjoying the beautiful scenery, he suddenly suffered a hernia attack and cried out in pain. The Russian doctor traveling with him was at a loss, but fortunately, the boatman recommended an elderly TCM practitioner. The elderly TCM practitioner ground one liang of the Chinese herb fennel into a coarse powder and instructed Mikhailov to take it with two liang of Shaoxing rice wine from Zhejiang. After about 20 minutes, Mikhailov’s hernia pain miraculously subsided and soon disappeared entirely. Upon learning that his pain had been cured by fennel, he exclaimed that it was truly miraculous. This story quickly became a celebrated anecdote.
II. Treatment for Severe Cold Invasion of the Liver Meridian
When cold pathogens invade the Liver Meridian, mild cases may present with cold pain in the lower abdomen, genital area, or crown of the head, while severe cases may progress to Jueyin syndrome. How, then, should Jueyin syndrome be treated? Wu Mei Wan is the treatment of choice.
The *Treatise on Cold Damage* records: “300 black plums, 6 liang of Asarum, 10 liang of dried ginger, 16 liang of Coptis, 4 liang of Angelica sinensis, 6 liang of Aconite (peeled and processed), 4 liang of Sichuan pepper, 6 liang each of Cinnamomum cassia (peeled), Ginseng, and Phellodendron. Grind each of the above herbs into a fine powder and mix them together. Soak the black plums in vinegar overnight, remove the pits, and steam them with five dou of rice. Once the rice is cooked, mash it into a paste and mix it with the herbs until well combined. Place the mixture in a white porcelain bowl, add refined honey, and roll into pills the size of a paulownia seed. Take ten pills each time before meals, washed down with a drink, three times a day, gradually increasing the dose to twenty-nine.”
Its main indications are: 1. Cold in the viscera, with roundworms ascending into the diaphragm, causing restlessness and agitation, cold extremities, vomiting after eating, abdominal pain, and intermittent expulsion of roundworms. 2. Typhoid fever, dysentery with abdominal pain, and chronic dysentery that has not responded to other treatments. 3. Chronic conditions characterized by alternating chills and fever that have persisted for years without resolution, accompanied by emaciation.
As can be seen from the above, the indications for Wu Mei Wan are actually quite broad. It can be used for any condition that fits the pathogenesis of “heat above and cold below” (i.e., hyperactive heart fire, spleen and kidney yang deficiency, and cold in the liver meridian). It is effective for digestive system disorders, respiratory system disorders, and nervous system disorders. Clinically, many intractable and complex conditions have shown remarkably effective results when treated with Wu Mei Wan with appropriate modifications.
Some might ask: Since the Five Elements’ cycle of mutual generation is like a loop that always moves in one direction, is it possible for this cycle to become excessive? Just like the wheels of a car, there must be brakes; without them, it would be far too unsafe.
In addition to the cycle of generation, the Five Elements also involve a cycle of restraint. The cycle of generation ensures the distribution of qi, blood, and energy among the five zang organs, while the cycle of restraint ensures mutual checks and balances among them. A cycle of generation without restraint is prone to problems.
How should we understand the cycle of restraint? Let’s look at the following story: the story of raising a cat.
