TRADITIONAL CHINESE MEDICINE - H1N1

INFLUENZA A [H1N1] AND TRADITIONAL CHINESE MEDICINE

In April 2009, in a little boy in a village in Mexico contacted Influenza A [H1N1]. Since then, it has spread far and wide across the five Continents of the world. As of 4th August 2009, the World Health Organisation has reported that 1,154 people have died of H1N1 and as per report in the Malaysian newspaper on 16th August 2009, an estimated 80,000 Malaysians might have been infected with Influenza A [H1N1], which is a viral pneumonia since it the outbreak began in May 2009. Until 16th August 2009, 59 people have died in Malaysia.

The newspaper reported that the Ministry of Health has reported that it noted that H1N1 related deaths in Malaysia were caused by virus attacking the respiratory system [breathing system]. Most of the death victims suffered from acute respiratory distress syndrome as a result of severe fulminant [disease or symptom of severe and sudden in onset] pneumonia.

The H1N1 virus, like seasonal flu, is spread from person to person through coughing or sneezing by the infected people. It can also be spread by persons who touch on the surface of an object, which are contaminated by droplets from a cough or sneeze of an infected person.

The signs and symptoms of H1N1 as reported include: -
[1] fever of >38 degrees
[2] dry cough
[3] body aches
[4] running nose
[5] sore throat
[6] nausea
[7] vomiting and/or
[8] diarrhoea
[9] headache
[10] difficulty in breathing

The Lungs, according to the Chinese Medical Philosophy, are “Lid of the of the Yin Organ. It is the cap on top of the thoracic cavity. The Lungs are the most easily affected by External Pernicious Influences.

The Chinese Medical Philosophy describes that the function of the Lungs is very closely associated with the Qi of the Chest. The Qi of the Chest is associated with the movement of all Qi and Blood in the body. A disharmony of the Lungs can lead to Deficient Qi or Stagnant Qi anyway in the human body..

According to the Chinese Medical Philosophy, “Lungs are the upper origin of water”. That is, the Lungs move water in the body in the same two directions as it moves the Qi. The Lungs liquefy water vapour and move it downwards to the Kidneys. At the same time, the Lungs have the disseminating function of circulating and scattering water vapour throughout the human body through the skin and pores. In another words, the Lungs cause the water vapour to ascend or circulate while the water in liquid form to descend. Disharmonies of the Lung Qi may lead to weakening of the Protective Qi in the human body that may result in fever, urination problems or edema and other complications, etc.

Ancient Traditional Chinese Medical experts have classified that diseases are caused mainly by either of the following factors: -
[1] Pestilential Factors
[2] improper diet
[3] fatigue and lack of proper physical exercise
[4] the seven emotions, namely: joy, anger, meditation (thinking frequently about a happening
etc.), fear, grief, melancholy and anxiety
[5] the six excesses, that is: wind, cold, summer-heat, dampness, dryness and fire (heat)
[6] traumatic wound
[7] insect or animal bites
and so on.
These causes are classified further into Yin and Yang categories. Zhang Zhongjing of Han Dynasty [206-220 B.C.], in his Synopsis of the Golden Bookcase, had described that there were several ways a person can contact or acquire a disease, that is, when a pathogenic factor invades the meridian and the viscera [organs], infects the skin, and injuries from excessive sexual activity, wounds, insect or animal bites.

Disease caused by Pestilential Factors
Pestilential factors are highly infectious and contagious pathogens. They are characterised by rapid onset a critical disease with severe infection of a highly contagious type. The Pathogens may attack a local area as well as over a number of areas of the human body.

The prevalence of the Pestilential Factors is usually related to: -
[1] Abnormal change of climate such as the recent Tsunami that hit Indonesia and Sri
Lanka, the Cyclone that hit Myanmar, the Earthquake that hit Szechuan in China and
the Marokat Typhoon that hit Taiwan
[2] The Environment
[3] Delayed prevention and isolation action, e.g. the current spread of the H1N1
[4] Diet,
[5] Pollution of the air
[6] Influence through social activities.
[7] Poor public health programmes o control of the spread of the deadly contagious
disease.

Traditional Chinese Medicine holds that in a situation where the body constitution of Yin and Yang is in balance, the viscera [organs] will function normally and well. The Qi, the Blood and the body fluid will be enriched and hence the anti-pathogenic factor in the human body will be strong. When there is a Yin-Yang imbalance, the anti-pathogenic factor will be weak leading to invasion of pathogenic factors into the human body. The anti-pathogenic factor includes the human body condition that is not conducive for the pathogenic factor to live in.

According to Traditional Chinese Medicine [TCM], an invasion by the pathogenic factors into the human body is an indication that there is Yin-Yang imbalance in the human body. The TCM treatment is to restore the Yin-Yang balance in the human body so that the body condition will become non-conducive for the pathogenic factors to live in. Hence the invaders will die naturally as the result of restoration of the Yin-Yang balance and hence strengthen the anti-pathogenic factor in the human body.

The signs and symptoms of the H1N1 as described above indicate that there is Yang excess as the result of the invasion that cause Yin Qi to decrease or Yang Qi to increase into a condition of Yin Qi deficiency in the body. Vomiting and diarrhoea indicate that there is Yin-Yang imbalance in the lungs, spleen and the stomach as the result of the pathogenic attack. The dry cough, headache and sore throat indicate that there is Yang excess [pathogenic wind-heat] in the Lungs and the Liver. Running nose and difficulty in breathing are signs of the pathogenic attack on the Respiratory System.

Analysis of the signs and symptoms indicates that the affection of exogenous (i.e. relating to external factors) pathogenic heat has invaded the Lungs. Hence the Lungs cannot carry on its clearing functions leading to occurrence of cough, difficulty in breathing (hasty and rough breathing). The body fluid has been consumed by the burning heat causing thirst. The blockage of the Lungs by the pathogenic heat caused the sore throat. Delay in clearing stagnation of pathogenic heat from the Lungs will cause the body fluid to be concentrated into phlegm, which will block the Lungs and the nutritional blood will be impaired and pus may form in the Lungs leading to gangrene of the Lungs with foul expectoration. The exogenous pathogenic dryness by invading the Lungs has severely consumed the body fluid and caused occurrence of asthmatic breath with no or little mucoid sputum. The Lung Qi will be weaken and becomes unable to carry out its dispersing functions resulting to fever and aversion to cold. When the pathogenic damp-heat invades the Stomach and the Intestines, the stagnant pathogenic damp-heat accumulates in the Large Intestine as the result of improper diet. The accumulated and stagnated pathogenic damp-heat in the Large Intestine will force the Qi to stagnate causing failure of the Large Intestine to perform its transportation function and hence, diarrhoea occurs and burning sensation of the anus and thirst results.

The Yang Excess condition is conducive for the H1N1 virus [pathogens] to survive in the human body. The TCM method of curing such disease or to prevent the human body from such attack is to restore and maintain the Yin-Yang balance in the human body. Below are some of the herbs that reduce the Yang Excess to restore the Yin-Yang balance in the body and thus overcome the pathogenic attack. However, administrations of the various types of herbs rest with the body condition of the individual and the combination of herbs.

Folium Mori and Semen Sojae Praeparatum in combination can ventilate the Lungs to dispel the pathogenic factors therefrom. Semen Pruni Armeniacae will ventilate the Lungs and promote the flow of Qi while the Radix Adenophorae, Bulbus Fritillariae Thunbergii together with Exocarpium Pyrus will moisten the Lungs to arrest cough. Fructus Gardeniae will clear the pathogenic heat in the chest. Folium Mori and Flos Chrysanthemi can expel pathogenic heat from the Lungs and the Wei System while the Herba Menthae, which has the effect of dispelling wind-heat with Semen Armeniacae Amarum and Radix Platycodi will assist to promote the dispersing function of the Lungs. Fructus Forsythiae together with Rhizoma Phragmitis can be adjuvant herbs to dispel and clear wind-heat from the exterior and promote the production of body fluid to quench thirst. Radix Glycyrrhizae is the mediator for co-ordinating the various effects of the herbs in the recipe.
Gypsum Fibrosum can clear away the heat from the Lungs and from the Stomach and the Pericarpium Trichosanthis will promote the circulation of the vital Qi to clear the heat and phlegm. Semen Armeniacae Amarum will calm the Lung Qi to increase the purgative effect of Radix et Rhizoma Rhei to expel stagnated heat in the Large Intestine in order to keep the Lung Qi pure and descending. Rhizoma Anemarrhenae which will enhance the effect of Gypsum Fibrosum. Radix Glycyrrhizae and Semen Oryzae Sativae will benefit the Stomach and promote production of body fluids to prevent the extreme cold agents from damaging the Stomach.

Herba Menthae is cool in property and it acts on the Lungs and Liver Channels. It is effective in dispelling wind-heat and relieving sore throat while Flos Lonicerae is cold in property. Flos Lonicerae acts on the Lungs, Stomach and Large Intestine Channels. Fructus Forsythiae is cold in property and it acts on the Lungs, Heart and Gallbladder Channels. It clears away heat and toxins. Radix Platycodi is neutral in property and it acts on the Lung Channel. It ventilates the Lungs while Semen Armeniacae Amaran, which is slightly warm in property, acts on the Lungs and the Large Intestine Channels. It relieves cough and moistens the Intestines to relax the bowels. Rhazoma Amenarrhenae is cold in property and it acts on the Lung, Stomach and Kidney Channels. It clears away heat, purge out fire and promotes the production of body fluid. Rhizoma Coptidis is cold in property and acts on the Heart, Stomach, Liver and Large Intestine Channels. It clears away heat, dry up dampness and purge away fire and clears away toxins. Cortex Phellodendri is cold in property, acting on the Kidneys, Urinary Bladder and Large Intestine Channels. It clears away heat, purging fire & toxins. Herba Artenisiae is cold in property and acts on the Liver, Gallbladder and the Kidney Channels. It can effectively remove the heat from the blood and brings down hectic fever. It also clears away heat from the Gall bladder. Radix Palsatilla, which is cold in property acts on the Large Intestine Channels. It detoxifies and clears and removes the heat from the blood. Cortex Lycii Radicis is cold in property and it acts on the Lungs and Kidney Channels. It removes and clear away heat from the Blood and the Lungs and brings down hectic fever. Semen Arecae is warm in property and acts on the Stomach and the Large Intestine. It has anthelmintic functions (destory parasites in the human body) as well as descend of flow of Qi function. Radix Spepheniae Tetrandrae is cold in property and acts on the Urinary Bladder, Kidney and Spleen Channels. It expel wind to relieve pain. Semen Plantaginis is cold in property and acts on the Kidney, Liver and the Lung Channels. It induces diuresis to arrest diarrhoea, Caulis Artistolochiae Manshuriensis is cold in property and it acts on the Heart, Small Intestine and Urinary Bladder Channels, It expels heat and induces duiresis. Pericarpium Citri Reticulatae is warm in property and it acts on the Lung and Spleen Channels. It regulates Qi and normalises the functions the Spleen and the Stomach. Magnoliae Officinalis is warm in property and it acts on the Lung, Spleen, Stomach, and the Large Intestine Channels. Bulbus Macrostemi is warm in property and it acts on the Lung, Stomach and the Large Intestine Channels. It can disperse the accumulation of pathogens and promote circulation of Qi. Herba Leonuri is slightly cold in property and it acts on the Heart, Liver, and the Urinary Bladder Channels. It invigorates the Blood Circulation to remove blood stasis. Rhizoma Corydalis is warm in property and acts on the Heart, Liver and Spleen Channels. It promotes Blood Circulation and the flow of Qi to relieve pain. Radix Polygalae is slightly warm in property and it acts on the Lung and the Heart Channels. It tranquillises the mind and induce resuscitation. Fructus Mume is neutral in property and it acts on the Lung, Liver, Spleen and Large Intestine Channels. It acts on the Lungs and the bowels to relieve cough and stop diarrhea. Fructus Tritici Lovis is cold in property and acts on the Heart Channel. It replenishes Qi and clear away heat. Herba Dendrobii is cold in property and acts on the Stomach and Kidney Channels. It nourishes Yin and clear away heat. Radix Ophiopogonis is slightly cold in property and it acts on the Lung, Heart and the Stomach Channels. It moist the Lungs and nourishes Yin and clear away Heart-fire. 424, Radix Glehniae is slightly cold in property and acts on the Lung and Stomach Channels. It nourishes the Yin and clear away heat from the Lungs. It also reinforces the Stomach as well as promoting production of body fluid. Radix Salviae Miltiorrhizae is slightly cold in property and acting on the Heart, Pericardium and the Liver Channels. It invigorates the Blood Circulation to cool the blood and tranquillises the disturbed mind.

Most of the herbs prescribed above are cold or cool in property and act on the Lung, Heart, Liver, Stomach, Gallbladder and Spleen, e.g., Folium Mori is cold in property and is good for clearing away wind-heat or dry-heat from the Lungs, but it is not strong enough, hence it has to be assisted by Semen Sojae Praeparata and Fructus Gardeniae, which is cold in property and acts on the Heart, Lungs, Stomach and the Sanjiao Channels. Fructus Gardeniae is capable of purging fire-heat, relieving dysphoria, removing heat from the Blood and promoting diuresis. However, some of the herbs are warm in property such as the Rhizoma Corydalis and Radix Polygalae.

Application of herbs is related to the body condition as diagnosis has determined by the TCM Physicians. However, to strengthen the body resistance and relieve exterior syndromes, the first decoction to start with can be as follow:
[1] RhizomaPolygonati Odorati [H40] 9g 90
[2] Bulbus Allii Fistulosis [H41] 6g 90
[3] Radix Platycodi [H10] 5g
[4] Radix Cynanchi Atrati [H43] 3g 90
[5] Semen Sojae Praeparata [H44] 9g
[6] Radix Glycyrrhizae Praeparata [H45] 2g 90
[7] Herba Menthae [H 8] 5g
[8] Fructus Ziziphi Jujubae [H47] 2pcs 90



The second prescription that follows after taking 4 to 6 packets more of the aforesaid prescribtion can be as follow [take about 4 packets]:

[1] Semen Armeniacae Amarum [H 9] 6g
[2] Fructus Forsythiae [H 11] 5g
[3] Herba Menthae [H 8] 2.5g
[4] FOLIUM Mori [H 1] 7.5g
[5] Flos Chrysantemi [H 7] 3g
[6] Radix Platycodi [H 10] 6g
[7] Radix Gyyrrhizae [H 13] 2.3g
[8] Rhizoma Phragmitis [H 12] 6g

The subsequent prescriptions eill be determined by the body’s response to the two above decoctions. As a general preventive measure, a person can drink the following decoction once or twice a week [ prescription for adult. For children, reduce the weight age of the herbs so prescribe below by half]:

[1] Flos Lonicerae [H 19] 12g
[2] Flos Chrysantemi [H 7] 8g
[3] Herba Menthae [H 8] 3g
[4] FOLIUM mori [H 1] 12g
[5] Semen Arecae [H 25] 4g
[6] Semen Plantaginis [H 42] 10g

The following herbs can also be added to the above 6 herbs:

[7] Fructus Gardeniae [H 6] 8g
[8] Magnoliae Officinalis [H 29] 8g
[9] Radix Polygaiae [H 33] 8g
[10] Semen Armeniacae Amarum [H 9] 8g


W Y Ho, ACIS
[Dragon Ho]
8th September 2009-09-15

W Y Ho [Ho Wah Ying] is the former Advisor to the Kuala Lumpur Traditional Chinese Physicians Association. Currently, he is the President of the Kiwanis Club of Pandan Jaya [2007 – 2008 & 2008 – 2009] and the Lt. Governor-Elect for Division 3 of Kiwanis Malaysia [2009 – 2010]. For his contributions to societies, China has awarded W Y Ho with:



WARNING: The author is not asking or advising readers to follow this article of his and he therefore disclaims and shall not be liable for any eventualities as the dispensing of the herbs must be prescribed by TCM physicians.



[Please see the names of herbs in Chinese below: