An Ancient Wen Bing Strategy of Ye Tian Shi in Dealing with the Recent Outbreak of Coronavirus Epidemic
By Dr. Greta Young Jie De
TCM and Western medicine have different theoretical systems for interpreting infectious diseases. Western medicine is based on pathogenic microorganisms, such as bacteria, viruses, spirochaete, chlamydia, mycoplasma, protozoa, etc. Coronavirus belongs to the category of virus. On the contrary, Chinese Medicine theory differs from the conventional western concept. TCM’s understanding of infectious diseases is interpreted on the basis of the abnormal climatic changes and how people can adapt to these changes. The normal climatic changes include the seasonally prevailing six factors (or six qi) in nature, namely, wind, cold, summer heat, humidity, dryness and fire. Generally, people should be able to adapt to these normal seasonal changes. However, when these factors become excessive or occurring out-of-season or when an individual is constitutionally deficient, these factors may become pestilential qi, also known as Li Qi. Unlike the normal, seasonal six qi (wind, cold summer-heat, damp, dryness and fire) the prevailing pestilential qi can lead to a massive outbreak of epidemic diseases. The characteristic of pestilential qi is that it is highly contagious and can affect a large number of people resulting in similar clinical features.
The one common denominator of all epidemic diseases is that they are very contagious characterized by fever and other related symptoms. Historically, China has been through many episodes of epidemic over thousands of years. Over the years, TCM practitioners accumulated a plethora of road-tested experience in dealing with all aspects of epidemic outbreaks in the past. The first major breakthrough was during the Ming Dynasty by a renowned practitioner by the name of Wu You Ke. In his book entitled “Wen Yi Lun”, he featured a detailed discussion of the pathogenesis and treatment of epidemic caused by pestilential qi. In addition, he created a formula known as Da Yuan Yin to address the epidemic disorder during his time. Da Yuan Yin consists of three key herbs, namely, Cao Guo, Bing Lang and Hou Po to target severe dampness with thick and powdery tongue coating.
Two core theories which form the basis of Wen Bing diagnosis are pattern differentiation according to wei, qi, ying and xue, better known as the Four Aspects and pattern differentiation according to the triple jiao. The theory of wei, qi, ying and xue was formulated by the Qing dynasty physician Dr. Ye Tian Shi (1667-1746) and is integral to Wen Bing diagnosis. In analysing the development of miscellaneous diseases, this same theory can be applied to determine the depth or level of disease: whether it is at the relatively superficial levels of wei or qi aspect, or at the deeper levels of ying or xue aspect indicating that the disease is deep-seated and therefore more serious. Accordingly, the diagnosis and treatment of epidemic diseases can be classified as Wei, Qi, Ying and Xue with treatment based on the different developmental stages of the disease.
On the other hand, the triple jiao (also known as the san jiao or triple energizer) comprises the upper, middle and lower jiao, and according to the Nei Jing, this entity concept incorporates all the zang fu organs in the body, each belonging to the upper or middle or lower jiao depending on their location in the body. The system of diagnosis associated with this concept was created by the Qing dynasty practitioner Wu Ju Tong who regarded that disease course and its development from the superficiallevel to the deeper and more serious level starts in the upper jiao in the initial stage, and becomes more serious as it moves to the middle and finally the lower jiao. The ramification of this theory is that the Triple Jiao System not only identifies the location / zang fu organ of disease, but also is relevant in diagnosing the severity of disease. By correlating the Triple Jiao System with Ye Tian Shi’s Theory of the Four Aspects, this diagnostic approach provides pratitioners better appreciation of the location as well as the severity (ie., developmental stage) of the disease.
One overarching importance in pestilent qi outbreak is the strength of our zheng qi. Huang Di Nei Jing said: “If the zheng qi is intact, the body can ward off pathogenic attack.” Conversely, if zheng qi is weakened, then the body is susceptible to attack by pathogenic qi. Therefore, an effort to boost our zheng qi is vital in times of prevailing pestilent qi such as the current Coronavirus epidermic, and one such simple formula to help prevent the contraction of external pathogen is Yu Ping Feng San (consisting of Huang Qi, Bai Zhu and Fang Feng). This formula is generally recognised to have the function of consolidating the exterior. In other words, the objective is to enhance our body immunity against any external pathogenic attack. During the Qing Dynasty, a practitioner called Yu Jia Yan strongly advocated the use of aromatic herbs such as Huo Xiang, Yin Hua, Su Ye, Bai Zhi to ward off turbidity and relieve toxicity.
From the herbal treatment perspective, our ancient sage had many road-tested preventative and treatment prescriptions. The followings are some such examples:
Treatment Strategy according to the different stages of the disease:
Early stage: Cold, damp constraining the lung
Aversion to cold or fever, dry hacking cough, parched throat, fatigue, chest oppression, nausea, sloppy stool, pale tongue, white and greasy tongue coating and soggy pulse.
Prescription: Cang Zhu 15g; Chen Pi 10g; Hou Po 10g; Hua Xiang 10g; Cao Guo 6g, Jing Jie 6g; Dou Chi 6g; Qiang Huo 10g; Bing Lang 10g.
Mid-stage: Lung heat congestion by epidemic toxin
Unresolved fever or alternating fever and chill; cough with no or scant phlegm or yellow phlegm; abdominal fullness, constipation, chest oppression, rapid breathing; wheezing or panting on exertion; red tongue, yellow, greasy or yellow and parched tongue coating and slippery and rapid pulse.
Gua Lou 30g; Shi Gao 30g; Xing Ren 10g, Sheng Da Huang 6g (Xuan Bai Cheng Qi Tang); Sheng Zhi Zi 10g; Ma Huang 6g; Ting LI Zi 10g; Tao Ren 10g; Cao Guo 6g; Bing Lang 10g; Can Zhu 10g.
Peak and Severe Stage: Interior obstruction and exterior desertion
Difficulty in breathing; wheezing on exertion, delirious speech; vexation, sweating with cold limbs; purple and dull tongue with thick, greasy or parched tongue coating; big and rootless pulse.
Ren Shen 15g; Hei Shun Pian 10g (decoct first); Shan Zhu Yu 15g. If the patient is unconscious , then An Gong Niu Huang Wan can be used to revive consciousness. Intravenous drip of Sheng Mai Yin.
Convalescent Stage: Lung and spleen qi deficiency
Shortness of breath; fatigue; lethargy; epigastric fullness ,sloppy stool with difficulty to defecate; pale and swollen tongue with white, greasy tongue coating.
Ban Xia Qu 9g; Chen Pi 10g; Dang Shen 15g; Zhi Huang Qi 30g; fu Ling 15g; Huo Xiang 10g; Sha Ren 6g.
It is hoped with the integrated Western and Chinese medicines, we can overcome this current epidemic and halt the rapid transmission of disease.
About An Ancient Wen Bing Strategy of Ye Tian Shi in Dealing with the Recent Outbreak of Coronavirus Epidemic By Dr. Greta Young Jie De