Child Sneezing and Dripping Clear Snot After the Cold Snap? Doctor Luo Dalun: Recognize Wind-Cold Early and Snuff It Out — Er Gan Qing Oral Liquid Treats Both Exterior and Interior

Patient search terms: children’s cold / wind-cold cold / sneezing with clear runny nose / cold wrapping fire (exterior cold with interior heat) / Er Gan Qing Oral Liquid / children’s cough with phlegm / children’s sore throat

Corresponding medical names: acute upper respiratory infection · wind-cold exterior pattern with lung-stomach heat

Opening: once Beginning of Autumn passes, children start catching colds

After the Beginning of Autumn, the season has turned. In the north the weather cools day by day, and in the northeast the lowest temperatures have already dropped to the teens. As the weather turns cold you will notice far more people catching colds — Doctor Luo says the number of sick people around him has suddenly multiplied.

💬 Note from Doctor Luo: All summer everyone wore masks, which reduced the chances of external pathogens entering through the mouth and nose, so summer external contraction was rare. I thought the trend would hold into autumn, but I was wrong — in the last two days many friends have asked me about colds; a lot of people have come down with them. So we still need to talk about external contraction, and everyone should take precautions. Today I will talk about children’s external contraction — parents, listen closely.

Why must parents know a little Chinese medicine childcare?

Many parents today know nothing about Chinese medicine. When a child falls ill, the very beginning is actually easy to control — but if it is not controlled, the pathogen invades deeper, high fever develops, pneumonia sets in, and then whether you go to a Chinese or Western hospital, treatment takes a great deal of effort.

💬 Note from Doctor Luo: Parents must understand this kind of external contraction. If you know how to prevent it, you can put out the fire while it is still a small spark. I have always advocated that parents should learn a little Chinese medicine. The pressure on the entire Western pediatric system is enormous — every winter the pediatric departments of hospitals are packed, the IV drip stations overflow, and often there simply are not enough doctors; nationally the number of Western pediatricians is insufficient. If everyone could learn a bit of Chinese-medicine childcare to prevent external contraction, it would be enormously helpful.

What are the six excesses? — Why cold is the chief culprit

Chinese medicine speaks of six excesses (liu yin) among external pathogens: wind, cold, summer heat, dampness, dryness, and fire — these are the six abnormal changes of weather between heaven and earth, and when they go beyond the normal they are called “excessive” (yin — the character means “going too far”).

💬 Note from Doctor Luo: The colds we catch are basically all caused by them. Which one causes the most? Cold — wind-cold, wind and cold joining together to attack the body, is the cause of most external contraction. Of course there are also wind-heat, summerheat-dampness, dryness-fire and other combinations, but cold is definitely the most important. Why? Because our classic text, the Shang Han Za Bing Lun (Treatise on Cold Damage and Miscellaneous Diseases), singles out “cold” precisely because most of the time the problem starts with exposure to cold.

How do you catch a wind-cold cold in autumn? — Two most common scenes

Autumn colds are mostly about cold: early in the morning the air is chill — in the north it is now in the teens — and if you step out in a T-shirt, the cool wind blows, the temperature drops, and that is cold.

💬 Note from Doctor Luo: Another example: by day the sun is fierce, the air is clear, the autumn sun burns like fire, and you sweat and sweat — if your body fluids are insufficient, and the sun bakes you and you sweat too much, you can get a warm disease. But some people are different: they sweat heavily without catching cold, then step into tree shade and a cool breeze hits them — at that moment the pores are open and the sweat is out, and the cool wind blows: a shiver runs through you, you shudder once, and you catch cold! That is a wind-cold cold, caused by the drop in temperature. There is also the person who dresses too lightly in the hot afternoon, and at night the autumn wind brings waves of coolness — the wind blows, and at night you start sneezing with clear nasal discharge. That too is wind-cold.

So autumn does carry dryness and dampness, and sometimes genuinely warm-disease factors, but most colds in this season are tied to wind-cold. Even more so in winter — in the months ahead, wind-cold formulas will be the mainstay of every pharmacy.

How to recognize a wind-cold cold? — Remember these six features

Is Chinese medicine complicated? What exactly is wind-cold? Doctor Luo gives a very clear recognition method: if you are injured by the cold pathogen, it is because the temperature dropped, the body’s surface defense system failed, and the cold pathogen invaded — these symptoms appear.

💬 Note from Doctor Luo: First, sneezing, with clear nasal discharge — the mucus running out is clear, watery, like water; not yellow mucus — yellow mucus means heat; clear mucus mostly means you have been chilled. Then if you cough, the phlegm is also clear, not yellow. Your whole body fears cold, you get goose bumps, and a gust of wind makes you feel cold. Sometimes there is headache, pain in the back of the neck, and a slightly stiff feeling in the neck. The tongue body is pale white, not bright red, and the coating is thin and white — it may be thin or thick, but it must be white. The pulse is not racing. Put these together and you have a wind-cold cold — a cold pattern.

First response: warm the body up and put out the small flame

When you feel the wind-cold, the most important thing in that first moment is to remember: use every means to warm the body up. Once the body is warm, qi and blood start moving, the cold pathogen is released, and you recover.

💬 Note from Doctor Luo: There are many methods. For example, take about 30 g of huai shan yao (Chinese yam) powder and brew it into a paste with boiling water — shan yao tonifies the lungs, spleen and kidneys, especially the spleen and lungs; it tops up your upright qi, and because the paste is warm, drinking it produces a light sweat: upright qi sufficient, qi and blood unobstructed, and the cold pathogen is released. Then there is zi su ye (perilla leaf), which releases the exterior and disperses cold — buy some zi su ye, soak the child’s feet in a decoction of it, or boil it into a tea to drink; the body warms up and sweats. There are plenty of other methods: use a hair dryer — spread a towel over the back of the child’s neck and blow warm air on Dazhui GV14, the highest protruding vertebra of the spine when you bow your head; ginger-sugar water works too.

But unfortunately this first window is very short, and many parents miss it.

💬 Note from Doctor Luo: If you do catch it, there is nothing left for the doctor to do — you have solved the problem yourself. You put out the small flame, and the fire brigade never has to come save the house from a roaring blaze; a small spark you can swat out with one hand, but a roaring fire, no.

Missed the window? Stage two arrives: exterior cold with interior heat (“cold wrapping fire”)

If stage one is not controlled, the wind-cold cold enters stage two — the exterior-cold-with-interior-heat stage. What happens in this stage?

💬 Note from Doctor Luo: The exterior cold symptoms remain — the body surface is still locked in a standoff with the pathogen: sneezing, clear nasal discharge, coughing and choking, chills all over, headache, stiff neck — all of these persist. But at the same time interior heat appears: the pathogen pushes deeper, the body fights it inside, the battlefield is full of smoke, and the resistance produces heat signs — the phlegm turns yellow, the nasal discharge turns yellow, the throat becomes sore and swollen, and fever appears. The edges of the tongue may redden and the pulse starts to speed up. Exterior cold and interior heat appearing together is called exterior cold with interior heat — in folk terms, “cold wrapping fire.”

Most wind-cold colds, if stage one is missed, basically all enter stage two, and this stage lasts relatively longer. It is the state doctors see most in children, and the state pharmacy clerks see most in kids — because by stage one everyone has already missed the window; if you had caught it, you would never have shown up at the pharmacy or hospital.

Which children are most prone to “cold wrapping fire”? — Meat-lovers, beware

What kind of child is more likely to enter the exterior-cold-interior-heat stage? A child whose body already carries heat inside.

💬 Note from Doctor Luo: A child who usually loves meat — after eating meat, the spleen and stomach in the middle jiao accumulate food stagnation, which easily clogs up; once clogged, the lungs and stomach harbor heat, with a constant simmering-fire feeling. When an external pathogen arrives, it starts as cold on the body surface, but the moment it tries to penetrate deeper, the interior is already hot — heat on top of heat, and the heat becomes very obvious. With such a child, as soon as the pathogen arrives, there is a little cold at first, and then quickly the throat swells and the tonsils puff up. Most are meat-lovers whose lungs and stomach already carry heat, with food stagnation inside that produces heat — lung qi fails to descend, stomach heat and lung heat combine, and this is how it happens.

So parents really must learn, because with most children you will not catch the pure exterior-cold stage — what you discover is usually the second stage of exterior cold with interior heat. This stage you must know how to handle.

What to do in stage two? — Two armies marching, treating both exterior and interior

How do you treat it? Usually a Chinese herbal formula, for example a patent medicine. What is the characteristic of a patent medicine? The herbs it sends out must march in two armies.

💬 Note from Doctor Luo: One army is warm herbs to disperse the exterior cold — you must use warm herbs for that. The other army is cool herbs — cold, heat-clearing, toxin-resolving medicines to clear the interior heat. Both sides strike together — one disperses the exterior cold, the other clears the interior heat. This is called treating both exterior and interior (biao li shuang jie), and it is how the disease is cured. The idea goes back to the Shang Han Za Bing Lun — Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction) is exactly this approach — and in the Jin-Yuan era Fang Feng Tong Sheng San (Ledebouriella Powder That Unblocks the Sages) continued the tradition.

Many such patent medicines exist today. For example, Er Gan Qing Oral Liquid made by Tong Ren Tang is precisely biao li shuang jie — dispersing the exterior cold outside while clearing the interior heat inside. What is in the formula? Let me explain.

Formula breakdown 1: jing jie sui paired with zi su ye — leading the attack on exterior cold

First look at the exterior-dispersing army. The formula uses jing jie sui — note, not jing jie (schizonepeta), but jing jie sui, the flower spike.

💬 Note from Doctor Luo: Jing jie disperses exterior cold, dispels wind and disperses cold, with a releasing-the-exterior action; jing jie sui is the flower spike of the jing jie plant, and its wind-dispelling, exterior-releasing action is stronger. Normally we would use jing jie itself; this formula uses jing jie sui, which is a distinctive choice — for external contraction it releases the exterior more powerfully. Jing jie sui is a warm herb and can disperse the exterior cold.

Then it pairs with zi su ye (perilla leaf). You all know zi su ye — it is the perilla leaf we eat, a common food in the northeast.

💬 Note from Doctor Luo: Zi su ye is also warm in nature, with the actions of releasing the exterior, dispersing cold and inducing sweat. If you catch a wind-cold cold, buy some zi su ye at the pharmacy, boil it in water and drink it — it works. In the exterior-cold-interior-heat state, this herb comes in to disperse the exterior cold, to lead the attack and release the exterior. Jing jie sui paired with zi su ye — two pungent-warm exterior-releasing herbs to disperse the exterior cold.

Formula breakdown 2: hua ju hong and fa ban xia — opening the lungs, transforming phlegm, letting qi move both up and down

Next comes hua ju hong. What is hua ju hong? It is the ju hong produced in Huazhou, Guangdong.

💬 Note from Doctor Luo: Hua ju hong is a kind of citrus product with a tangerine fragrance, but it is different from the tangerines we eat — its taste is bitter, its nature is warm, and it disperses cold, releases the exterior, transforms phlegm and opens the lungs. Why is it needed? When an external pathogen arrives it first attacks the lungs; the lungs govern the skin and body hair, and surface chilling is also tied to the lungs, so the cold pathogen usually invades the lungs — at that point the child develops a choking cough (ke sou), a shallow, dry hack. If the choking cough is not controlled and the pathogen pushes deeper, the whole lung begins to cough with heavy phlegm sounds, and that is when real trouble starts. So at this stage you must definitely disperse cold and open the lungs — hua ju hong opens the lungs, stops cough, disperses cold and releases the exterior.

There is also fa ban xia (processed pinellia), also warm in nature, which transforms phlegm and sends qi downward.

💬 Note from Doctor Luo: Such children usually eat a lot of meat, so their lungs and stomach harbor heat, lung and stomach qi fail to descend, the qi mechanism is blocked, and problems easily arise. The formula uses fa ban xia to send qi down and transform phlegm — phlegm, it dissolves for you; qi, it lets move downward — there is both rising and falling: herbs that release outward and upward, and herbs that send things down, letting the accumulated heat descend. If such a child is also given a little hawthorn, radish or other qi-descending foods to clear the food stagnation, the illness resolves even faster.

Pediatrics’ biggest feature: external contraction is usually tied to food stagnation

This is a hallmark of pediatrics, and parents must clearly understand it.

💬 Note from Doctor Luo: In pediatric patients, external contraction is usually connected to food stagnation from eating too well. Once food stagnates, the qi mechanism is blocked, qi and blood circulation is impaired, the stagnation clogs the middle jiao, the function of the entire lung-stomach axis drops, and external pathogens invade more easily. So while you treat the external contraction, if you can add something that resolves food stagnation and guides the stagnant matter out, the child recovers faster.

Formula breakdown 3: huang qin paired with bo he — the cool army that clears interior heat

Everything so far has been about dispersing exterior cold. The formula has another part — the heat-clearing herbs.

💬 Note from Doctor Luo: Take huang qin (baical skullcap root) — a very important herb for clearing lung heat. You disperse the cold on the outside, but the heat inside must also be cleared, because this is exterior cold with interior heat — we use huang qin to clear the interior heat. Pair it with bo he (mint) — bo he is pungent and cool, releasing the exterior; since there is heat inside, I use the cool method to release the exterior as well, pushing the interior heat outward. It belongs to the aromatic orifice-opening herbs that drive pathogens out. So bo he assists huang qin in clearing heat.

Then jie geng (platycodon root). Jie geng soothes the throat, opens lung qi, and clears the throat — because heat causes the throat pain, it is effective. Jie geng is paired with sheng gan cao (raw licorice root), which also soothes the throat, resolves toxins, and harmonizes all the herbs in the formula.

💬 Note from Doctor Luo: Do you see it? This formula is a classic: on one side warm herbs to disperse the exterior cold, on the other side cool herbs to clear the interior heat, and in between herbs that regulate the qi mechanism — jie geng, ban xia and the rest — treating both exterior and interior, unlocking the whole exterior-cold-interior-heat pattern.

How to read the package insert? — Resolves the exterior and clears heat, opens the lungs and transforms phlegm

What does this formula treat? Look at the insert: resolves the exterior and clears heat, opens the lungs and transforms phlegm (jie biao qing re, xuan fei hua tan). “Resolves the exterior” means dispersing the exterior cold; “clears heat” means clearing the interior heat; “opens the lungs and transforms phlegm” means that when lung qi is constrained and phlegm sits inside, the formula opens the lung qi and dissolves the phlegm.

💬 Note from Doctor Luo: It treats children’s external contraction of wind-cold — the wind-cold pathogen has injured the child — combined with the pattern of heat accumulating in the lungs and stomach (fei wei yun re) — inside, the lungs and stomach still carry heat. So this is the exterior-cold-interior-heat pattern. Sometimes warm diseases also present as exterior cold with interior heat. As long as the exterior-cold-interior-heat pattern is present, whether you label it wind-cold or wind-heat, you can use it — one part disperses the exterior cold, one part clears the interior heat; this battle formation works. So the formula is a classic expression of the exterior-cold-interior-heat, treat-both-sides approach.

What symptoms call for this formula? — Fever with chills, yellow-and-white mixed discharge, sore throat

What symptoms actually use it? Remember this description.

💬 Note from Doctor Luo: Fever with chills — fever, because there is interior heat and the battle has begun inside with smoke everywhere; chills, because the body surface carries cold — so “fever with chills” is often the description of exterior cold with interior heat. Then nasal congestion with discharge — the nose is blocked and mucus runs; the mucus is often yellow and white mixed: some clear mucus, some yellow mucus. Clear mucus represents the exterior cold; because interior heat is also present, there is yellow mucus too. Coughing brings phlegm — sometimes clear, with yellow mixed in — this is the classic sign of cold and heat coexisting. Then sore, swollen throat — there is heat inside, the lungs and stomach harbor heat, the heat attacks upward, arrives at the throat, and heat toxin accumulates, producing a sore swollen throat. That is why the formula includes bo he, jie geng and gan cao — all aimed at detoxifying the throat.

Here is a particularly important idea: you may be agonizing — is this a wind-cold cold or a wind-heat cold?

💬 Note from Doctor Luo: Yellow mucus and yellow phlegm mean wind-heat, so why is there also some clear phlegm and clear mucus? Is it wind-cold then? Actually these are different stages of the same cold — the exterior-cold-interior-heat stage is precisely the stage where cold and heat coexist. So the manifestation of cold-heat coexistence is: part of the nasal discharge is clear, part is yellow; part of the phlegm is clear, part is yellow. If you mechanically insist this is wind-cold and that is wind-heat, you often cannot decide which formula to use. That is not the way — clinically we have long treated cold and heat together; a great many formulas put one part dispersing exterior cold and one part clearing interior heat into a single prescription. That is the Chinese medicine way of thinking.

Recovery: light diet plus digestion-helping foods for faster healing

Use this formula, and gradually the exterior cold resolves and the interior heat clears; the body slowly recovers. This kind of patent medicine is an excellent helper that removes obstacles for the child and lets the body restore itself. Diet must keep pace.

💬 Note from Doctor Luo: At this point give the child light food — absolutely no meat. Add some digestion-helping ingredients — especially if the tongue coating is very thick: radish, hawthorn, malt, charred hawthorn, boiled into water and drunk — the effect is better. Once you grasp the principles, when you look at those classic formulas you will understand why they are built the way they are; and once you understand, you will know when to use them and which one fits your child’s state — your aim becomes precise, and the child recovers faster.

Ending: be your child’s guardian

Dear friends, that is all for today on protecting children from external contraction.

💬 Note from Doctor Luo: The autumn and winter ahead are a real challenge. I hope everyone learns more Chinese medicine, masters more methods like these, and we can protect our children better in the challenges to come. Parents, keep going — this is not addressed to the children, it is addressed to you parents. I hope you press on and become a guardian who protects your child!

Compiled from Doctor Luo Dalun’s formula lecture series.