中藥單方複方的八卦，PTT和Yahoo名人娛樂都在討論

看到醫勞盟轉了下面這篇圖文，注意到中醫健保各項給付一樣過低，影響病人安全的狀況。 連結我放在文末。

這是2015年的照片和情況，而現在，更。低 。唷(笑)

健保給付的科學中藥藥粉，各大GMP藥廠各種單方複方價錢就是那樣，人家做藥也是要成本的。

繼續追求低價，就是頂新黑心油的故事重演。


中醫在健保體制下，開藥這件事情，並不會賺錢。
所以每次聽到病人在那邊歡說「醫生你們開藥是為了多賺錢」

狗屁。

這也是有時候中醫診所診所除了部分負擔外，一個禮拜的藥粉會多個幾十塊的原因。

不是為了多賺多少，而只是為了「不要賠錢」wwww

當廚師出餐，不給你食材成本，
做修車師傅，拿不到零件料錢，
開書商印書，紙張材料費叫你自己吞......

這種事情看爽度看交情，偶一為之還可以。
但是每天，每一個case都被政府要求要這樣，幹不幹。

---------------------------

喔對了，一包藥不到NTD 9元，你覺得醫生能施展的療效空間有多大。
有沒聽過「一分錢一分貨」這句話。

啊，有沒有更好療效的中醫藥?
有的！

丸散膏丹，保存良好繁複加工程序的道地藥材，各家門派高深的針法，複雜的傷科手法，中醫招數一堆。


但，不到9塊錢？逗我笑哩wwwww

---------------------------

回過頭來聊聊自己的日常見聞。

小鎮上，各色病人大概家裡什麼樣的狀況，幾年下來，看久了都有個底。

碰到真的家裡狀況辛苦的病人，在範圍內盡量多給多做，
是的，有時我會呢。

但這是我自己的選擇。簡單來說，「我爽」。

這種可能會被說成仁心仁術之類的行為，是個人選擇。
但，這不該是理所當然要求每一個醫師每一個case的

「政策性道德勒索」。

健保使太多人變得太貪婪。
太多明明平常吃喝行走很ok的人。

拿個iphone穿著乾淨時尚，嘻皮笑臉還在問說健保能不能拿自費療效好的丸劑或藥材。

然後，連幾十塊百來塊部分負擔或自費都在那邊靠盃的時候。

啊，診間空氣中瀰漫著貪婪和愚蠢的氣息，
讓我實在懶的多說什麼呢。


喔對了，通常這種病人還會拿幾千幾萬的保健食品來問你，

然後臨走的時候再繼續跟櫃台抱怨為什麼拿藥還要多付

幾
十
塊
錢
。

https://www.facebook.com/MK1977TW/posts/10154464199206376

老同學寄來的讀書感想

今天稍早接到老同學寄給我的「讀書感想」，在這裡和大家分享。韓宜博士很多年前和我一起經由教育部特殊資優輔導計劃保送上台大物理系，後來轉向財經及企業管理，當上教授，現在還和電視劇「三十而已」中的顧佳一樣，經營高品質有機茶葉的事業，她的簡介列在文章後面，讓讀者認識她。大學畢業後，大家都忙於進修、工作、家庭等，二十多年過去了，一直沒有機會好好聚在一起聊聊。這次新書一出版，老同學不但馬上閲讀完整本書，心中感觸很深，立即寫了「讀書感想」，還多買了八九本新書來分贈親友。非常感謝韓博士的支持及鼓勵！

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李宗恩醫師新書《當張仲景遇上史丹佛》讀後感

韓宜博士

前幾個星期才和我在英國幫我調整骨骼的大師Barry Pluke和他傳承的兒子Benjamin Raphael Pluke談到人體和重力的問題，討論到西方醫學不承認重力對人體的影響，我當時提到了在美國矽谷及華人圈以中醫赫赫有名的台大物理系同學李宗恩，於是我們開始討論中醫及許多東方傳統醫學與物理的關係，難怪一位懂物理的優秀同學可以把中醫融會貫通到極致！幾小時後，在物理系群組得知了李醫師新書要上市的消息，我馬上跟大師和所有在現場的朋友分享這個好消息。可惜他們都看不懂中文，而這也凸顯了即使西方有很多想要在中醫上面精進的有心人，若無相當的中文基礎，難以深入探討，更不用說在西方主流醫學上能夠有辦法取得任何的發言權。

然而，從小在台灣長大的李宗恩醫師，大學後即赴美深造並長年居住矽谷，這本中文新書『當張仲景遇上史丹佛』至少是一個充滿希望的開始，是一位在西方土地上發揚與實踐中醫的世界級大醫師，以多年的各種案例及最近的新冠肺炎治癒成果，讓全世界各地的中文讀者可以最科學邏輯的思維進入中醫的大門。

我從小在台北長大，從小到大看病都是去西醫，前公公也是知名的台大醫學院名譽教授及前連戰副總統的家庭醫生，為什麼這十年來我選擇完全拒絕西醫的醫療？

當年我三歲大的女兒突然跟我說他背痛，我不想要他從小穿著矯正鐵衣，於是有位朋友介紹我去給中醫看，當時我也如同李醫師書中寫的很多人對中醫的刻版印象，認為中醫不科學、不可靠、江湖術士…..但我沒辦法之下，開始到處問人。

『中醫是五千年人體試驗的結果，人類知識有限，如何能對不知道的東西說他不科學？』第一次在波士頓與一位在知名西藥廠當研發主管的朋友討論西藥和中藥的事情，他接著說『中藥是複方、西藥是單方，中藥一次可以打多個機轉、西藥一次只能打一個機轉。我們想要從中藥裡面得到有效成分去研發西藥，就算投入了巨額經費，也只知其中一兩種成分，你怎麼可以說中醫和中藥不科學？我們人類的知識太淺薄了』。這位高中老朋友給了我很多觀念的糾正。

在我父親去世前一週，我和母親被台北榮總的主治醫師請到房間，他打開電腦給我們看一些難懂的數值，說『因為你父親的肺積水造成感染，我們給他用抗生素，但是他又不能喝很多水以免產生更多積水，所以腎臟的指數一直上來，預計下週就會出現紅字……』。我母親一直哭，我很生氣的問醫生說『你們早就知道會這樣的，不是今天才知道，為什麼先前一直跟我母親說你們可以治？現在擺明了就是你們沒辦法治！為什麼不早一點承認，好讓我母親可以接受我建議的中醫及第三類醫學的治療？』

如同波士頓的朋友所強調，多重問題根本不可能透過西醫和單一的西藥去處理，就算不同科別的西醫會診、聯合用藥，所有的西藥研發過程與上市許可都是嚴格控制在單一機轉上，無法對交叉效果去作預測。

父親的喪禮上，我沒哭，因為我還在生氣。到現在，我也很少哭，因為我還沒生完氣！一直等到看到李醫師的這本書，我才大哭，中醫和中藥一直被包括華人在內的台灣人所不信任，這本書至少得到了一次平反的契機。

但誠如李醫師書中提到許多人的困惑，甚至有些有名的中醫也是故弄玄虛以賺錢為目的，以致中醫背負了許多罪名。『中醫有沒有效？你看了以後自己身體會有感覺。感覺變好，就是有效，如果兩三天都沒感覺，你就再換一個中醫』我在洛杉磯UCLA醫藥管理畢業的表妹建議我。

就這樣，我與朋友介紹的一位台中的中醫師結緣，到最近這十年來，我感冒也看中醫，如果症狀很輕，一帖藥下去就好。後來我每天忙事業和學校，有一天下課後我突然暈眩，學校叫救護車來，我在救護車上要求把我送去中醫，醫護人員說一定要把我送到西醫的急診室，結果檢查搞半天弄不出所以然（我本來就知道會是這樣），給我打了一瓶點滴後，放我離開，我就直接去找中醫，他幫我緩解幾個穴道，躺了一小時後就恢復了。這也凸顯了在現代醫藥制度下，甚至在台灣這麼多優秀中醫的環境裡，我們沒有辦法完全選擇自己的醫療方式。回應到李醫師開頭寫的新冠肺炎可以100%用中藥醫治重症甚至預防的成功經驗，世界各國甚至包括台灣防疫模範生是否可以讓患者選擇使用100%中醫的治療？這真的不是是非題，寧可花大錢用昂貴的西醫西藥，讓醫護人員疲於奔命，讓重症無助地離開，我相信是中西方醫界的發言權位階問題，更是各國政治角力的問題。

借用洛杉磯表妹說的，如果西醫和西藥無法改善，為什麼還要繼續去？

我不能理解的是，我們總是覺得西方先進國家一切都科學，從小被洗腦，但有腦子思考的人，為什麼不問上面這麼簡單的問題，還要一直在西醫拗下去？這就是我在台北榮總生氣的原因，台中的中醫幫我爸爸治好中風，可以下床自己走動，當時也是因為在台北榮總請我中風的爸爸出院時，醫生跟我說『你父親就是要這樣躺一輩子了….』在我母親絕望下，他們願意『試看看』我說的中醫。中醫總是在西醫沒辦法下，成為那最後『試看看』的選擇，好，我也認了，但是已經幫我爸爸治好中風的醫師，為什麼我的母親和妹妹卻在最後還是要選擇那個從來就無法治好爸爸的台北榮總？

後續，我也因此接觸到第三類醫學，每週固定去給一位老先生治療，這位老先生精通易經八卦和氣功，其實身體有很多西方醫學檢查不出來的問題（像是我的暈眩案例），是『氣』不通暢造成。我一直和這位老先生討論各式各樣的這些課題，讓我領悟到許多事情，其實中醫就如李醫師說的『宏觀』，人體是一整個系統，無法用西醫的『微觀』去『頭痛醫頭、腳痛醫腳』，因為頭痛可能是其他的原因造成，就像我長期開車跑農場，坐骨下半身很容易痛，但是那是因為我本來就有脊椎側彎曲問題，導致長時間坐著開車時更加壓迫，不是坐骨本身的問題。李醫師在書中寫到的許多案例，看似表象是什麼問題，但其實另有其因，都是同樣的原理。這就是西醫『治標不治本』，大家從小都聽過，但你有沒有認真想過？尤其人過中年有很多是西醫儀器測不出來的病，相信不少朋友都有經驗。

長期跑農場，我深信健全的生態平衡是最好的永續。人體本身就是一個生態系，西醫的微觀出現最大的問題，就是會失掉生態系的平衡！就像我父親最後腎衰竭離世，絕對不是他的腎臟有問題，而是他的身體生態平衡嚴重失衡造成的。

同樣的，新冠肺炎致死？新冠肺炎就算是世紀瘟疫，也只是身體失衡的一個促動點，和其他流感致死沒有兩樣。至於為什麼要獨厚『新冠肺炎』？為它封國封城、為它隔離、為它在家工作、為它放棄人類文明的基本尊嚴……明明中醫有有效的治療甚至防範方式，卻仍然蒙閉眼睛，告訴大家什麼西藥、什麼趕鴨子上架的疫苗？

這就是我母親和妹妹當年眼看著我父親在西醫的治療下，愈來愈糟，卻仍然不承認他們選擇的錯誤，直到今天，他們還是相信西醫和西藥的『科學』。

以李宗恩醫師深厚的『科學』訓練背景：台大物理系、史丹佛電機博士、矽谷科技新貴…..。他這樣有多重紮實背景的中外知名中醫寫出來的書，希望能取信更多曾經不願意面對中醫科學和有效五千年人體試驗的事實。我在英國有許多朋友也是寧死不打COVID-19疫苗、更不會去NHS（UK National Healthcare System）的。我一直相信，中醫會在海外發揚光大，因為華人自己很難相信自己五千年的智慧累積會比西方更科學，因為我們的知識太有限了。所以，從李醫師的這本書開始，讓我看到了『中醫史丹佛』的未來！加油！

作者簡介

韓宜博士，Dr. I Han，畢業於台大財金系與經濟系、英國University of Reading國際管理碩士、台大國際企業研究所碩士、博士，目前任職於逢甲大學國際經營與貿易學系副教授，並為亞格農時尚社會企業創辦人（Agra Boutique 亞格農時尚），協助台灣小農手作精品，以Taiwan Tea & Co.品牌進軍美國和Formosan Farms品牌進軍英國與歐洲市場（www.taiwanteaco.com， www.formosanfarms.com.tw）。代表著作Social Innovation and Business in Taiwan為紐約Palgrave Macmillan邀請出版，十多年來專注於台灣農業、農村偏鄉社區、弱勢農民的研究、教學、輔導，近年研究與實踐皆以農村永續環境與商業模式，和女性社會創業為主軸。
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（http://andylee.pro/wp/?p=9270）
#當張仲景遇上史丹佛
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從非典到新冠肺炎

From SARS to Novel Coronavirus (COVID-19) - English version is in the second half

新冠肺炎，Novel coronavirus (2019-nCoV) 新型冠状病毒肺炎，疫情越來越嚴重，被證實可以人傳人，也在武漢以外的許多地方發現病例，造成世界各國及世界衛生組織（WHO）高度關切，當然也讓很多住在中國大陸及附近區域的華人非常緊張，就好像當年的非典肺炎疫情即將再一次大爆發一樣。

目前，現代醫學還沒有找到治療新冠肺炎的方法，只能針對某些症狀來處理，疫苗的研發更是遙遙無期。怎麼辦？每次遇到這種情況，中醫就會被搬出來，這次也不例外。新冠肺炎爆發後，網上馬上有許多中醫對付新冠肺炎的文章。當然，除非哪位中醫師看過、治好過大量的新冠肺炎病例，所有的討論都是猜想、假設。然而，有些猜想及假設值得參考，有些猜想及假設卻明顯在誤導大眾。

我還沒有治療過新冠肺炎，不能大肆評論。不過，我治好過很多禽流感、豬流感、及每年流感導致的嚴重肺炎及其它病變的病人。其中許多病人是被美國大型西醫院證實為嚴重肺炎，被要求醫院或居家隔離，偷偷溜出來找中醫看診的。也因此許多病人及討論中醫的網站，希望我能針對新冠肺炎發表一些意見。

我們以前就討論過，這些彪悍的流感病毒，經過那麼多年、那麼多次的變種（mutation），每年都不一樣，東漢時期傳下來的經典中醫，根本沒有遇到過現在的病毒，怎麼可能治療如此嚴重的肺炎呢？

中醫從來就不認識病毒，也不從病毒種類的角度來思考。中醫是探討人體受到外界因素破壞，失去平衡後，身體會有哪些現象、哪些反應，根據那些現象、那些反應來調整身體狀況，期待身體能恢復到平衡狀態，把外界因素帶來的破壞減到最小。我打個半開玩笑的比方，警匪槍戰時，我們注意到壞人哪個方向來的火力強大，造成我們部署在哪個位置的警員傷亡，這時我們會趕緊重新部署人員，或者想辦法增派警力，我們大概無暇去管壞人是用哪個牌子的槍、哪個工廠做的子彈！

雖然幾百年幾千年下來，病毒變種等等的外界因素改變了非常多，人體演化的改變卻非常有限。人體的功能，無論是怎麼被破壞的，某項功能被破壞而導致的症狀、反應、後續演變，卻依然有明顯的脈絡可循。也因為如此，在很多情況下，中醫以專注人體本身平衡狀態的治療方式，反而比西醫專注在外來敵人的治療方式來得有效許多。

依據多年累積大量的臨床病例觀察，無論是禽流感、豬流感、還是每年的流感，人體敗壞的進程依然如同傷寒雜病論探討的一樣，非常簡化的說，從一般桂枝湯證、葛根湯證等的表寒，轉變到小青龍湯證等的裡寒，津液不足、水道運化失調而化熱，變成比較嚴重的大青龍湯證，或者更嚴重肺臟的寒熱夾雜，金匮要略肺痿肺癰咳嗽上氣病脈證治第七篇中的射干麻黃證、葶藶大棗瀉肺湯證、澤漆湯證、小青龍加石膏湯證等等混雜出現，搞得亂七八糟，也不再是什麼簡單方劑可以對應的。

然而，雖然進程很像，不同於一般外感的是，這些嚴重流感肺炎病情加重的改變速度快非常多，也來得猛烈頑強很多。一般的外感從桂枝湯證、葛根湯證等轉變到大青龍湯證或更複雜的病情，通常需要一兩週的時間。同時，還得病人自己非常不注意，或者醫生治療錯誤，一般感冒才會沒辦法自己好，反而變成嚴重的病症。這幾年的流感，從一開始覺得不太對勁，到嚴重複雜的病情，只需要三四天，而且有越來越快的趨勢。這大幅提高中醫師治療流感時，判斷功力及敏感度的要求，中醫師必須在許多症狀還沒有出現時，就得抓緊時間，趕緊行動，卻又不能預防過度，反而讓病情加重。換句話說，時機、劑量、藥材比例變得非常重要，稍有不慎，就無法反轉病情。

舉個例子，有些病人得了流感，咳嗽非常嚴重，痰非常多，呼吸困難。依照中醫的辨證，假如一致都是寒，舌苔白、小便清、怕冷等等，本來依照辨證論治，我們可能會開射干麻黃湯加減給病人。然而，因為流感的進程非常快速，中醫師得非常敏感，譬如看到舌苔白卻帶有一絲絲乾的感覺，就很可能得加上大寒的石膏來避免肺喪失津液，卻又不能加太多石膏，以免肺寒加重。又譬如聽到咳嗽聲音非常深沈，從肺的底部發出，又帶有膿痰的濁音，就很可能得加上瀉肺的葶藶來避免肺中水飲、痰飲大幅增加，卻又不能加太多葶藶，以免肺變得太虛弱。

我們回頭來看這次的新冠肺炎。根據有限的資訊，我們知道感染後有大約兩週的潛伏期，這段時間沒有什麼症狀，病人可能只會感到有些疲憊。剛開始發病時，很像一般的感冒，病人會發熱、乏力，並不嚴重，沒有什麼流鼻涕等上呼吸道的症狀，有的甚至沒有發熱。約一半的病人一週多後恢復，另一半的病人卻在一週後出現呼吸困難，有些病人會快速進展為急性呼吸窘迫綜合征、膿毒症休克、代謝性酸中毒、凝血功能障礙等等嚴重的問題，可能導致死亡。

從上面的敘述，我們不難發現，一開始很像一般中醫外感的桂枝湯證、葛根湯證，一半的病人也就自己恢復了，另一半的病人卻出現快速的入裡化熱現象，肺津液迅速流失，非常濃稠的痰飲沈積在肺部下方。同時，中醫認為肺為人體調節津液的源頭，肺金生水，好比天空下雨一般，而當肺的功能及津液調節出現嚴重障礙，很快就會拖累三焦水道、腎臟等的功能，導致上面提到的幾種嚴重病情。換句話說，新冠肺炎可以讓輕微的太陽證外感，迅速發展成嚴重的肺痿肺癰，再進一步瓦解人體其它功能的運作。

怎麼治療？在沒有直接治療武漢肺炎病人的情況下，我們也只能根據有限的資訊來推論，不過，以前大量的流感肺炎治療病例，可以讓我們比較有信心的面對新冠肺炎。當病人已經出現明顯新冠肺炎症狀時，大多已經入裡化熱，嚴重的肺痿肺癰。這個時候，得用大劑量的石膏清肺熱、加強肺津液運作。也得靠葶藶、大戟等把肺下方濃稠的痰飲及胸腔可能的積液去掉，痰飲積液不去，是無法修復肺家津液運作的。同時，肺氣不宣，就好像吸管上頭堵住了，吸管內的水無法上下，我們還得使用麻黃等宣肺、發陽的中藥來配合。另外，肺已經受損了，除了大動作急救外，比較穩定後，還得靠一些潤肺的藥來收尾，讓肺完全恢復。如果我們列一個可能加入的中藥單，大致有石膏、葶藶子、大戟、生半夏、麻黃、射干、紫菀 、款冬花、 生薑、炙甘草、紅棗、麥門冬、杏仁等等。當然，如前面所言，用藥的時機、劑量、藥材比例非常重要，每一個病人的差異也很大，嚴格考驗中醫師的功力與膽識，一旦判斷錯誤，不但沒有效果，反而可能會加重病情。

網上有些中醫師，說新冠肺炎或其它流感肺炎可以用板藍根清熱解毒來治好。也有些中醫師說可以用麥門冬湯等等的輕劑治好嚴重的肺炎。甚至還有些中醫師說多喝綠豆湯可以預防新冠肺炎！其實，真的遇過、治好過禽流感、豬流感等嚴重流感肺炎的中醫師，一看這些文章，就幾乎可以確定這些人根本沒有治療過嚴重肺炎的經驗，充其量只是在西醫治療下，在旁邊幫幫病人一些小忙而已。這樣的情況下，難怪中國政府平時大力推展中醫，真的有如同新冠肺炎這樣重大疫情爆發時，卻看不到中國政府大量使用中醫方法來治療病人、控制疫情。醫學是實戰的學問，沒有大量臨床病例，講得再好聽都是沒有用的，如果希望中醫真的在主流醫學裡站立起來，希望中醫真的能面對大規模的疫情，回歸最基本的臨床療效，才是最重要的，其它都只像是武術表演，而非實際作戰。

From SARS to Novel Coronavirus (COVID-19)

Written in Chinese by Dr. Andy Lee, January 21, 2020
Translated to English by Dr. James Yeh and Dr. Andy Lee, March 28, 2020

The epidemic from Novel Coronavirus is becoming much more serious. Transmissivity among people has been proven. (Note: It's now named COVID–19. The term “Coronavirus” will be used here.) Cases were found in areas beyond Wuhan. It has caused serious attentions from the WHO (World Health Organization) and many countries around the world. The residents in China and the surrounding regions are quite worried and wonder whether it will break out like SARS (2003). (Note: The article was written on January 21, 2020, before Coronavirus became a global pandemic.)

So far, the modern medical field has not found a cure for Coronavirus, but resorts to treating patients’ symptoms only. Any vaccine to treat Coronavirus is still no way in the sight. What do we do? Every time such a situation happens, the topic of using Traditional Chinese Medicine (TCM) is raised (at least among the Chinese communities). There is no exception this time. Many articles related to using TCM on Coronavirus have been popping up on the web. However, unless some TCM doctors who have actually treated many Coronavirus cases, all the discussion would be hypotheses or assumptions. Some hypotheses are worth considering while many others could be quite misleading.

Personally I have not treated patients cases related to Coronavirus. (Note: Shortly after this writing, the author has directly and indirectly participated in treating patients of Coronavirus successfully, and has published other later blogs which included his involvement in treating those patients. Please refer to his medical blog http://www.DrLee.us.) However, I did treat and cure patients inflicted by other viruses in the past, such as the Bird Flu, Swine Flu, and other influenza. A good amount of those patients were diagnosed as severe pneumonia by large hospitals and were required for isolation or self-quarantine. Hence many of patients and online medical forums online are asking for my opinions about Coronavirus.

As we discussed before, all these viruses from the outbreaks are either newly found or mutated from previous strands. The strand can be different every year. Therefore, people always ask how one can say that the TCM knowledge developed in East Han Dynasty (25-220 AD) would be any useful for treating the modern diseases, let alone the severe ones.

It turns out that TCM does not recognize any virus and does not deal with the concept of which type of virus is microscopically at work. TCM looks at how human bodies would become out-of-balance and react to external stimuli. Once the body is out of balance, what symptoms will exhibit and what reactions will be to adjust the body conditions to regain the balance, hence to reduce the damage to the body to the minimum. Let me take an example to illustrate: when there is a gunfight between the police and bandits, we want to see which direction the shots are coming from, causing casualties of the police force, so that we are able to adjust or reinforce the police power. We have no time to think about which brand of the guns or bullets the bandits use.

Over thousands of years, the external viruses have changed and evolved quite a bit, but the evolution of human beings was quite limited. The human body function, no matter how it was damaged, the symptoms due to the damage of the function, the reactions, and the following progression of the disease still follow certain paths. For this very reason, TCM’s focus on the balance of the human body often surpasses the effectiveness of Western medicine, which focuses more on external treats and the microscopic aspect of how human body’s cells are impacted by the external treats.

From the accumulation of many years of clinical treatment and observations, no matter it is Bird Flu, Swine Flu or other influenza, the bodily ‘damage’ and its progression by the viral attack still follow the description of the classic TCM literature “Treatise on Cold Damage on Miscellaneous Disease” (傷寒雜病論). In short summary, the disease usually starts with “Exterior Deficiency or Weakness” (表虛) or “External Coldness” (表寒), for which is matched to one of the several syndromes named with the corresponding herbal remedies such as “Gui Zhi Tang” (桂枝湯) and “Ge Geng Tang” (葛根湯). Then, the disease moves onto the next stage “Interior Coldness” (裡寒) or “Lung Coldness” (肺寒), which shows the syndromes named as “Xiao Qing Long Tang” (小青龍湯), etc. When the respiratory system is “affected by the coldness”, the body fluid function of the respiratory system gets affected. The circulation function of the lung becomes “Dry and Overheated” (燥热). This would lead to a more serious stage “Heated Interior” (入裡化熱) and would often be matched to its herbal remedy “Da Qing Long Tang” (大青龍湯). Or, even worse, it becomes so-called “mixed coldness and heat” (寒熱夾雜) in the lung. Such a complex situation was extensively discussed in Chapter 7 of the classic literature “Synopsis of Prescriptions of the Golden Chamber” (金匮要略肺痿肺癰咳嗽上氣病脈證治第七篇). At this complex stage, the illness development varies significantly among patients of different preconditions and other variants. It is no longer the situation that a simple herbal remedy can be applied to all the situations. The TCM theory illustrates various treatments by those herbal remedies such as “She Gan Ma Hung Tang” (射干麻黃湯), “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), ”Ze Qi Tang” (澤漆湯), “Xiao Qing Long Jia Shi Gao Tang” (小青龍加石膏湯), and others.

However, even the disease progressions are similar, the more serious viral attacks like Coronavirus can and often do progress much faster with more severe consequences than the common flu. As described in the previous paragraph, normally the disease progression of the “External Coldness” stage to the more serious “Heated Interior” stage usually takes one to two weeks. It is also often due to the ignorance of the patient or misdiagnosis and treatment of the doctor, which prevents the patient from recovering from this “catching a cold”. In the recent several years though, the time period between the time that the patient did not feel well and the time that the patient is in a serious and complex situation can be as short as 3 to 4 days. We also see the trend that this period gets shorter and shorter. In other words, the disease progression is getting much faster. This phenomenon poses a much higher demand on TCM doctors’ ability to make a quick and proper judgment and sensitivity to the subject matter. TCM doctors must intercept the disease progression before it reaches to a more serious stage, even without obvious symptoms of the next stage. TCM doctors have to timely prescribe the proper herbal remedy in terms of the type of herbs and relative dosages of herbs. Too weak a dosage could not stop the progression while too strong a dosage could worsen the condition also. A misjudgment would not be able the turn the conditions around, but hurt the patient more.

The above can be illustrated by a simple example. A patient caught flu and has symptoms such as heavy coughing, lots of sputum, and difficulty in breathing. From the TCM dialectics, with observations of white tongue coating, clear urine, and feeling chilly, etc., it is clearly caused by “Coldness”. Such a patient typically should be prescribed with “She Gan Ma Hung Tang” (射干麻黃湯) or its variations. However, due to the fast progression of the modern flu, the TCM doctor would need to pay attention to much subtle details such as the dryness of the tongue although it still shows the white coating. In this case, Sheng Shi Gao (Gypsum, 生石膏) might need to be added to the herbal remedy to make sure that the lung would not suffer dryness. Given that Sheng Shi Gao (Gypsum, 生石膏) itself is an ingredicient that is “very cold” in nature, the dosage could not be too strong to make the lung too chilly. At the opposite end of the spectrum, if the sound of the coughing is very ‘deep’, like dense sputum coming from the bottom of the lung, the herbal remedy might need to add Ting Li (Sisymbrium indicum, 葶藶) to clear up the lung to avoid too much mucus in the lung. And again, the dosage of葶藶 could not be too much to weaken the lung. (Note: Handling the proper timing and proper remedy can be a real test to the ability and experience of the TCM doctor.)

Let’s go back to the discussion on Coronavirus. From the limited information available so far, we know that there are about two weeks of incubation period after the infection. There are little symptoms during this period and the patient may just feel more tired than usual. More obvious symptoms will start like those of common flu with fever, fatigue but not too serious. Upper respiratory symptoms like running nose are less common. Some patients may not even exhibit fever. About half of the patients infected will recover over a week or so. The other half of the patients will experience difficulty in breathing, or rapid progression to acute respiratory distress syndrome, septic shock, metabolic acidosis, coagulopathy, etc. Some patients had died due to these severe conditions.

From the above description, this Coronavirus, in the beginning, is very much like the common flu and will stay in stages of “Exterior Deficiency or Weakness” (表虛) or “External Coldness” (表寒). Half of the patients infected will recover by themselves as in common cold. The other half of the patients may exhibit situations of rapid penetration into inner organs and excess ‘heat’, which causes loss of fluidity of respiratory system and accumulation of dense sputum at the lower part of the lung. In the TCM theory, the lung serves as the initial “gating factor” of body fluids. When the lung fails to serve the proper function, other organs like the kidney will be adversely affected also. In other words, Coronavirus can turn a light “External Coldness” to extremely severe “Lung Atrophy” (肺痿) and “Lung Abscess” (肺癰), which in turn will impair the function of other organs.

How to treat? Without direct experience of treating Coronavirus patients, we can only postulate from our limited information available in hand. (Note: Shortly after this writing, the author has directly and indirectly participated in treating patients of Coronavirus successfully. The treatments were exactly as outlined in this article.) From the ample experience of dealing pneumonia cases caused by flu, we are confident that we can also treat Coronavirus successfully. When patients are showing the obvious Coronavirus symptoms, most of them would have entered the stage of “Heated Interior” (入裡化熱) with “Lung Atrophy” (肺痿) or “Lung Abscess” (肺癰) to a certain degree. At this stage, we will need large dosages of Sheng Shi Gao (Gypsum, 生石膏) to clear the heat to ensure the proper fluidity function of the lung. Also, we will rely on Ting Li (Sisymbrium indicum, 葶藶), Da Ji (Euphorbia pekinensis Rupr., 大戟), etc. to clear up the dense mucus at the lower part of the lung and to remove the edema of the chest chamber. Without getting rid of the excess mucus and fluid, the lung cannot properly function. We need to use Ma Huang (Ephedra sinica Stapf., 麻黃), etc. to enhance the lung function (宣肺、發陽) and restore proper breathing. When the lung is damaged as in fibrosis, after the conditions stabilize, we need to “moisturize” the lung (润肺) to help the lung to recover fully. In other words, we will most likely use the herbal ingredients such as Sheng Shi Gao (Gypsum, 生石膏), Ting Li (Sisymbrium indicum, 葶藶), Da Ji (Euphorbia pekinensis Rupr., 大戟), Sheng Ban Xia (Pinellia ternate, 生半夏), Ma Huang (Ephedra sinica Stapf., 麻黃), She Gan (Belamcanda chinensis, 射干), Zi Wan (Aster tataricus, 紫菀), Kuan Dong Hua (Tussilago farfara flower, 款冬花), Sheng Jiang (Ginger, 生薑), Zhi Gan Cao (processed Glycyrrhiza uralensis Fisch., 炙甘草), Hong Zao (Ziziphus jujube, 紅棗), Mai Men Dong (Ophiopogon japonicas, 麥門冬), Xing Ren (Prunus armeniaca, 杏仁), and others. As we discussed in previous paragraphs, the timing, dosage, the relative ratios of different herbal ingredients are very critical. Given that there are quite some variations in patient conditions, the challenges on TCM doctors’ comprehensive knowledge, judgment and courage are unprecedented.

In those articles online, some TCM doctors claimed that Coronavirus can be cured by Ban Lan Gen (Isatis tinctoria root, 板藍根), which is believed to have natural antibiotic chemicals to “clear up the heat and toxics”. Some TCM doctors suggested using a simple mild herbal remedy “Mai Men Dong Tang” (麥門冬湯), which mainly relies on the ingredient Mai Men Dong (Ophiopogon japonicas, 麥門冬). Some people even suggested that having the green bean soup could prevent Coronavirus. In fact, those TCM doctors who have good experience of treating Bird Flu, Swine Flu, and pneumonia caused by other influenza would know that the people making those claims never had the real experience of treating severe pneumonia. They at most helped in a minor way the patients under Western medicine treatments. Under such conditions, it is not a surprise that the China government has not used TCM as the primary method of treating Coronavirus, despite its big promotion of TCM in the recent years. (Note: After this writing, Coronavirus epidemic became so severe in China that the China government changed its strategy and started to use TCM extensively in treating many mild Coronaviurs cases.)

Medicine is the science based on real treatment results. Without a good amount of successful cases in clinical treatments, it is useless to promote any fancy idea of treating patients. If we would like TCM to be respected in the mainstream medicine and to be meaningfully used in a severe epidemic like Coronavirus, it is critical to focus on the most fundamental. That’s the clinical results. Like the martial arts, unless you can fight off the bad guys, it’s just a show of fancy movements.

（http://andylee.pro/wp/?p=7169）
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