Bell's Palsy - Wind-Cold Attacking the Collaterals Pattern
TCM differentiation and treatment for Bell's palsy with
Bell's Palsy · Wind-Cold Attacking the Collaterals Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Head
Pattern Overview
Wind-Cold Attacking the Collaterals is the core pattern in acute Bell's
palsy, characterized by **facial nerve edema compressing the facial
nerve, sudden facial paralysis, facial cold pain, ear pain, chills, and
neck stiffness. The core pathogenesis is invasion of Wind-Cold
pathogens into the facial Yangming collaterals**, causing nerve edema,
ischemia, and facial muscle paralysis.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|
| Primary Symptoms |
|---|
pain, inability to close the eye |
| Associated Symptoms |
|---|
drooling, tearing |
| Tongue and Pulse |
|---|
floating and tense pulse |
| Pathogenesis |
|---|
collaterals |
| Etiology |
|---|
conditioning drafts |
Acupuncture Point Prescription
| Point | Location | Function |
|---|
| Fengchi (GB20) |
|---|
sternocleidomastoid and trapezius | Disperses Wind-Cold and clears the
head |
| Hegu (LI4) |
|---|
metacarpals | Disperses Wind and unblocks collaterals |
| Dicang (ST4) | About 0.4 cun lateral to the corner of the mouth |
|---|
Treats deviation of the mouth |
| Jiache (ST6) |
|---|
zygomatic arch, about 1 cun anterior to the angle of the mandible |
Treats facial paralysis |
| Yangbai (GB14) |
|---|
eyebrow | Treats inability to close the eye |
| Yifeng (TE17) |
|---|
mastoid process and the mandible | Treats ear pain and facial paralysis
|
Clinical Recommendation: Filament needle, even method; during the
acute phase (first 7 days), use gentle technique. Electro-acupuncture
may be added during the recovery phase.
Herbal Formula
Base Formula: Qian Zheng San (牵正散) + Ma Huang Fu Zi Xi Xin Tang
(麻黄附子细辛汤)
Composition:
White Aconite (Bai Fu Zi), Bombyx Batryticatus (Jiang Can), Scorpion
(Quan Xie), Ephedra (Ma Huang), Asarum (Xi Xin), Saposhnikovia (Fang
Feng), Angelica Dahurica (Bai Zhi), Licorice (Gan Cao)
Action: Disperses Wind-Cold, unblocks collaterals, and corrects
facial deviation.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|
| Severe facial cold pain | Add Gui Zhi, Sheng Jiang to warm meridians |
|---|
| Ear pain | Add Chuan Xiong, Chai Hu to disperse Wind and stop pain |
|---|
| Tearing | Add Ju Hua, Sang Ye to disperse Wind and clear Heat |
|---|
| Neck stiffness | Add Ge Gen to relax sinews and unblock collaterals |
|---|
| Qi deficiency |
|---|
collaterals |
Western Mechanism Reference
Facial nerve edema compressing the facial nerve, with increased
intraneural pressure and nerve ischemia. Wind-Cold Attacking the
Collaterals corresponds to acute Bell's palsy, where viral reactivation
(HSV-1) and nerve inflammation cause facial nerve edema, increased
intraneural pressure, and nerve ischemia.
References
1. Internal Medicine of TCM - Facial Paralysis with Wind-Cold Attacking
Collaterals.
2. Zang-Fu Pattern Differentiation: Wind-Cold → Clearing Pathway.
3. WHO. (2023). Neurological health. World Health Organization.
Explore More
- Find your solution at MendGod.com –
Personalized herbal protocols and acupressure tools for facial nerve
health.
- Deepen your knowledge at TcmCIO.com – Full
research papers and clinical case studies on TCM neurology.
Related TCM Patterns for Bells Palsy
- Wind-Heat Attacking the Collaterals
- Qi-Blood Deficiency
- Phlegm-Blood Stasis Obstructing the Collaterals
Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly
Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.