bubble_chart Concept

Abdominal coldness refers to the subjective sensation of coldness inside and outside the abdomen.

This symptom is referred to as "cold in the middle" and "cold skin below the navel" in the Lingshu chapter on teacher transmission. In the Jingui Yaolue{|105|} section on abdominal distension and fullness, cold abdominal colic, retained food, and abnormal pulse, it is also called "cold in the middle of the belly." The {|106|}Chinese Medicine Clinical Essentials{|107|} names it "cold abdominal skin."

bubble_chart Pattern Analysis

1. Spleen and Stomach Yang Deficiency︰The abdomen often feels cold, or is accompanied by abdominal pain, acid reflux, or vomiting of clear fluid, fear of cold and preference for warmth, or loose stools and diarrhea, limb fatigue and mental fatigue, a pale tongue with white coating, and a deep, thin pulse. This is due to congenital yang qi deficiency, or excessive consumption of raw and cold foods, or overuse of bitter and cold purgative medicinals, or lack of proper recuperation after illness, which injures the spleen and stomach, leading to deficiency of middle yang; or due to excessive sexual activity, or improper recovery from a severe or prolonged illness, resulting in depletion of lower origin and causing abdominal cold from spleen and stomach yang deficiency. Because spleen yang fails to warm, the abdomen often feels cold and prefers warmth with fear of cold; yang deficiency leads to dysfunction of the spleen in transportation, and the stomach fails to descend normally, manifesting as vomiting of clear fluid above and loose stools or diarrhea below; spleen deficiency results in insufficient production of qi and blood, hence limb fatigue and mental fatigue; a pale tongue with white coating and a deep, thin pulse are signs of spleen yang deficiency. The treatment should focus on warming and tonifying the spleen and stomach, and the recommended formula is Minor Center-Fortifying Decoction.
2. Kidney Yang Deficiency︰Cold sensation in the abdomen, diarrhea before dawn, soreness and weakness of the waist and knees, frequent nocturia or dribbling of urine, pale tongue with thin white coating, deep and thready pulse, and weak chi pulse. This condition may arise from excessive sexual activity or improper recovery after a severe or prolonged illness, leading to depletion of the lower origin and resulting in cold abdomen due to kidney yang deficiency. When kidney yang qi fails to ascend and warm the body, a cold sensation in the abdomen occurs. Kidney yang deficiency causes the large intestine to lose its restraining function and impairs bladder qi transformation, leading to diarrhea before dawn, frequent nocturia, or dribbling of urine. The waist is the residence of the kidneys, and the area below the waist is governed by the kidneys. Kidney deficiency results in inadequate nourishment, hence soreness and weakness of the waist and knees. A pale tongue with thin white coating, deep and thready pulse, and weak chi pulse are signs of kidney yang deficiency. The treatment should focus on warming and tonifying kidney yang, using a combined prescription of Kidney Qi Pill and Four Miracle Pill.
3. Chong and Ren Meridians Deficiency-Cold︰Cold sensation in the abdomen, especially in the lower abdomen, delayed menstruation, scanty menstrual flow with pale color or accompanied by blood clots, or clear and thin leukorrhea, or difficulty in conceiving, or dark circles under the eyes, a swollen and pale tongue with tooth marks on the edges, thin white coating, and a fine and slow pulse. This is caused by congenital deficiency, poor postnatal development, excessive sexual activity, multiple pregnancies and deliveries, or exposure to rain and wading in water during menstruation, leading to damage to the Chong and Ren meridians and cold congealing in the uterus with appendages. Due to cold invasion in the uterus with appendages and disharmony of the Chong and Ren meridians, there is abdominal coldness and delayed menstruation, with scanty and pale menstrual flow. The Chong meridian governs the Sea of Blood, and the Ren meridian governs the fetus, hence difficulty in conceiving. If the Dai meridian fails to restrain, there is clear and thin leukorrhea. Cold pathogens congeal and stagnate, causing poor blood circulation, resulting in dark circles under the eyes. A swollen and pale tongue with tooth marks, thin white coating, and a fine and slow pulse are all signs of deficiency-cold in the Chong and Ren meridians. Deficiency-cold in the Chong and Ren meridians commonly occurs in women, manifesting as abdominal coldness, delayed menstruation, scanty and pale menstrual flow or with blood clots, clear and thin leukorrhea, infertility, etc. Treatment should focus on regulating and tonifying the Chong and Ren meridians, warming the meridians and dissipating cold. The recommended formula is Meridian-Warming Decoction.
4. Cold Stagnation in the Liver Meridian︰Cold sensation in the abdomen, particularly severe in the lower abdomen, accompanied by dragging pain and distension in the testicles, or scrotal contraction, worsened by exposure to cold and relieved by warmth, or cold limbs, white and slippery tongue coating, deep and wiry or slow pulse. This is caused by external cold pathogen leading to stagnation of qi and blood in the liver channel. Since the liver channel reaches the lower abdomen and encircles the external genitalia, cold congealing in the liver channel obstructs liver qi and stagnates liver blood, resulting in cold sensation in the lower abdomen or dragging pain and distension in the testicles, cold limbs, and scrotal contraction. A slippery tongue coating and deep, slow, wiry pulse are all signs of cold stagnation in the liver channel. Cold stagnation in the liver channel is more common in males. In addition to abdominal coldness, it is often accompanied by dragging pain and distension in the testicles, scrotal contraction, and systemic manifestations such as fear of cold and cold limbs. The treatment should focus on warming the liver to dispel cold and promoting qi and blood circulation, using Liver-Warming Decoction.

The symptom of abdominal coldness is often associated with deficiency-cold conditions. The disease is typically located in the middle and lower burners. When it affects the middle burner, it involves the spleen and stomach; when it affects the lower burner, it involves the liver, kidneys, uterus, and its appendages. Differentiation is generally not difficult.

bubble_chart Documentation

1. "Symptom Differentiation and Treatment: Cold Abdomen": "A cold sensation in the lower abdomen (the area below the navel) is often associated with kidney and bladder as well as uterus with appendages disorders; a cold sensation around the navel area is mostly related to spleen and large and small intestine disorders; a cold sensation in the upper abdomen (the area above the navel) is mostly related to spleen and stomach disorders."