Colds, Hot and Cold: Herbal Approaches to a Common Condition

Marcey Shapiro, MD.

NEW YORK—Choosing the right herbs to treat a common cold depends on what kind of cold someone has, said Marcey Shapiro, MD, at Columbia University’s annual Botanical Medicine in Modern Clinical Practice course.

Dr. Shapiro, a private practice family physician and herbalist in Berkeley, Calif., said the common cold tends to come in three “varieties” or symptom patterns: “Cold,” “Hot,” and “Part Cold, Part Hot.”

“Cold” colds are characterized by chills, constant drippy rhinitis with thin, clear or white mucus, frequent sneezing and coughing. Other than feeling chilly and sneezy, these patients generally do not feel terribly ill. But the symptoms can linger for several weeks if left unchecked.

In contrast, “Hot” colds are characterized by fever, heavy painful sinus congestion, thick and sticky yellow-green mucus, aches and inflammation, and general malaise. The overall pattern is flu-like and the patient feels pretty lousy.

“Part Hot, Part Cold” colds are a three-ring circus of symptoms, characterized by alternation between fever and chills, congestion and drainage.

The basic principle for herbal treatment of colds is to balance the symptom pattern with herbs that have the opposite “temperature,” she explained. In other words, treat a “Cold” cold with warming herbs, and a “Hot” cold with cooling herbs.

With cold and flu season in full-effect across much of the nation, your patients will need all the help they can get. Dr. Shapiro, who trained at Montefiore Hospital, Bronx, NY, and established a 50-herb formulary for the Montefiore Family Health Center, recommended the following herbal approaches:

Warming the “Cold” Cold

Dr. Shapiro’s warming formula of choice is inexpensive and very easy for patients to make: simply take one clove of garlic, minced finely, and mix it with 1/4–1/2 teaspoon of cayenne pepper in the juice of one freshly squeezed lemon.

“You just chug it back, and chase it with a glass of water. It is very warming, and I believe there are antiviral compounds in there. It is simply magic,” she said.

Fresh ginger is another good warming herb and circulatory stimulant. Simply chop up a thumb-sized chunk of fresh root and boil it in a teapot full of water for several minutes, then drink the decoction. Some patients like to add a bit of ground cinnamon bark, which is also a good warming herb. And speaking of warm liquids, you can never go wrong with chicken soup or vegetable broth.

Patients with “Cold” colds often feel a need to get warm, and there is no better way to do that than with a hot herbal bath. “My patients love being prescribed herbal baths,” said Dr. Shapiro.

She recommended a combination of chamomile flowers, lemon verbena, calendula flowers, and spearmint or lemon balm leaves.

One way to use loose dried herbs in a bath is to put a small handful of each plant into an old sock, tie the open end, and simply float the sock in the tub. The other way is to boil a cup of the mixed herbs in a large pot of water for 10 minutes, let it cool, and then add the “tea” to the bathwater. Essential oils of eucalyptus or lavender can also be added to an herbal bath—10 drops directly in the water is usually enough.

Cooling the “Hot” Cold

In this situation, stay away from ginger, garlic, cayenne the other warming herbs. These patients will really benefit from echinacea, said Dr. Shapiro. “I use a lot of echinacea tincture, 1 teaspoon, four times daily.” She recommended echinacea products made by Gaia Herbs or Herb Farm. She has also found that decoctions of dried marhsmallow root or hollyhock, which patients can prepare themselves, are effective in opening plugged sinuses.

Extracts of berberine-containing plants such as goldenseal, Oregon grape, barberry, or coptis are all good cooling herbs, especially if there is very heavy congestion with dark yellow or green mucus. Dr. Shapiro said she steers patients away from goldenseal, since it is difficult to cultivate and wild stocks are being over-harvested to the point where high-quality products are becoming rare and very costly.

A traditional Chinese multi-herb formula called Yin Quao, available in tablet or tincture form, is very effective in staving off full-blown “hot” colds if used for a day or two early on in the symptom progression. Generally, she directs patients toward Chinese formulations made by US companies like McZand or K’an Herbs. These are more expensive than patent formulas imported from the Far East. but the latter carry a greater risk of contamination or adulteration.

Some patients with “hot” colds may enjoy a bath with cooling herbs such as elder flowers, peppermint and linden flowers.

Taming the “Part Hot, Part Cold” Cold

For colds with an alternating pattern, Dr. Shapiro has found another traditional Chinese liquid preparation called Gan Mao Ling” or “Minor Blue-Green Dragon” helps many patients feel better. It contains ephedra, cinnamon, and ginger, and other herbs, some of which have warming effects, while others are cooling. Taken two to three times daily, this formula seems to balance out the swings between feverishness and chills. As with Yin Quao, the Minor Blue Green Dragon formula is also available from US-based manufacturers like K’an Herb Company.

Dr. Shapiro said many of her patients find eucalyptus steams—a few drops of eucalyptus oil in a bowl of boiling water—to be a good way of breaking up the congestion associated with “part hot, part cold” colds.

THE REDUX: Different types of colds need different herbal treatments. “Cold” colds (chills, drippy rhinitis with thin, clear or white mucus, frequent sneezing and coughing) are remedied with “warming” herbs like cayenne, garlic, ginger, and chamomile. Treat “Hot” colds (fever, sinus pain, thick mucus, aches and general malaise) with “cooling” herbs like echinacea, and berberine-rich plants like Oregon grape, goldenseal, barberry or coptis. “Part Hot, Part Cold” colds often respond to a classical Chinese formula called “Minor Blue-Green Dragon.”

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