In this article I attempt to demystify a few of the most common patent Chinese herbal formulas for prevention & treatment of early stage colds & flu so that you, the layperson, can take advantage of these useful medicinals to protect yourself & your family from icky wintertime bugs.
First, a word about how Chinese herbs are adminstered:
Herbalists who work with Chinese herbs typically administer herbal treatments to patients in three basic ways: raw herbs, powder concentrates and patent formulas. Raw herbs need to be boiled for a period of time (20-40 minutes) with water in a teapot and drunken as a decoction. Powder concentrates are mixed with warm water and drunken as a tea. Patent formulas come in the form of "tea pills" or tablets and are the most easy and convenient to take.
Raw herbs and powder concentrates are superior in that they offer the clinical herbalist much more flexibility. TCM herbalists recognize that each patient has a unique constitution and a unique set of presenting symptoms. Working with raw herbs or powders, we mix and match individual herbs to specifically address the underlying imbalance giving rise to illness symptoms.
Patent herb formulas (tea pills or tablets) offer somewhat less flexibility because they are a pre-formulated blend of herbs. Nevertheless, there are a great variety of patent formulas, so it's usually possible to find something to address a patient's condition.
Usually patents based on age-old traditional formulas developed by expert physicians of previous centuries. Often the precise blends of herbs in the formula have been updated with the addition of one or two herbs (or minerals or other medicinals) to meet modern conditions, or in line with modern discoveries about certain medicinals.
The point is, in prescribing patent formulas, you have to match a whole formula to a patient, and sometimes the fit isn't as perfect as if you were designing a formula from individual herbs. But, patent formulas often serve the purpose in acute situations.
It can be useful for the layperson to be familiar with a few patent formulas---such as for traumatic injury or for cold and flu prevention. In terms of cold and flu remedies, for busy, on-the-go folks, I highly recommend carrying a small bottle bottle of one of these formulas with you in your purse or in the car, especially during the winter months.
These formulas are easy to find in the Bay Area, and probably in most other U.S. cities, as well.
When taken at first sign of a cold or flu, they have a remarkable ability to stop, moderate or shorten the duration of an upper respiratory tract infection (URI).
Your TCM herbalist can recommend patent formulas for you to have on hand in your home or in your purse. In this article, I introduce a few easy common cold/flu formulas and home remedies.
Theoretical Framework for Patent Cold Formulas:
Traditional Chinese herbalist treating patients for upper-respiratory tract infections, might have an arsenal of 300 herbs to choose from, and would combine these herbs into a specific blend precisely addressing each patient's constitution and unique presentation of symptoms.
In self-treatment with patent formulas, the lay person does not have the range of options, or the diagnostic skills, that were/are available to the traditional herbalist. However, patent formulas can still be used with excellent effect to ward off infections, moderate symptoms, and shorten the duration of illness.
To understand how Chinese herbs work in treating colds, it is useful to be familiar with Chinese medical theories on upper respiratory tract infections. For more details on these, please see my article, "Cold & Flu: Traditional Chinese Perspectives Summarized."
Suffice it to say that initial onset of a new cold or flu infection is regarded, in TCM, as an invasion of exterior pathogenic “wind” into the surface levels of the body. Clinically, it is treated with spicy herbs which induce a mild sweat in order to expel the invading pathogen from the body via the skin and flesh. The herbs used may be “warm” or “cold,” energetically, depending on the presentation of symptoms in a particular patient—i.e. whether the invading pathogen is “wind-heat” or “wind-cold.”
In the U.S., most URIs manifest as either “wind-heat” or a combination of “wind-heat-wind-cold,” very rarely as pure “wind-cold.” Also, most URIs also have an element of “toxic-heat,” the traditional Chinese medicine phrase used for heat symptoms caused by an infectious pathogen. Concretely, most URIs, within a day or two of onset at least, produce symptoms of heat (sore throat, mild fever, dark-colored mucous secretions, thirst, etc.) We also know that the viruses which cause these hot infections enter the body through the patient's nose and mouth, putting the resulting illness into the traditional category of “warm-febrile” disease.
So, the categories of herbs from the Chinese pharmacopeia which are generally useful in treating early stage URIs are the aforereferenced “cool, spicy exterior-releasing,” as well as a category of herbs useful in treating “warm-febrile” diseases. Herbs from this latter category are cold, bitter and eliminate heat toxins through the urine. In biomedical terms, these herbs are strongly anti-viral.
Here, then, are three patent formulas to choose from :
1. YIN QIAO SAN
(marketed with variable titles, depending on the translation from Chinese: Yin Chao, Yin Qiao Jie Du Pian, or Yin Chiao Chieh Tu Pien)
named for the two main herbs in the formula, a famous pair for releasing exterior heat & clearing heat toxins:
jin yin hua (honeysuckle flower, pictured left below)
lian qiao (forsythia fuit, pictured in dried form, right below)
Yin Qiao San, or “yin qiao” as it's familiarly referred to in US health food stores, might be the most widely-known Chinese patent formula among the general US population. “Yin Qiao” is most effective when taken at the very first signs of a new cold or flu, i.e. when you first feel that slight dryness or tickle in your throat. It looses its effectiveness if the infection lasts longer than a day or two , at which point, you'd want to begin using another herbal formula.
Yin Qiao functions to dispel wind-heat invasion in its early stages and to clear toxic heat. Symptoms might include low-grade fever; mild or no chills; scratchy or sore throat; sudden fatigue; swollen lymph nodes; headache; thirst; nasal congestion; slight dry cough or cough with a small amount of yellow phlegm; sneezing; red irritated eyes. (To more effectively treat acute sore throat, you can combine with other appropriate patent herb formulas.)
Incidentally, yin qiao san is also useful in treating itchy red skin rashes (especially those which appear suddenly & move around quickly, especially in the upper body) and acute inflammation of the eye (conjunctivitis), because these conditions are also often manifestations of surface-level wind-heat invasion and heat-toxin.
The individual herbs in yin qiao san function to release pathogens from the exterior level of the body through mild sweating, clear toxic heat through the urine, restore proper function to the lungs and sinuses, and cool sore throat. A few herbs in the formula also help the body to generate fluids in order to alleviate thirst & dryness of tissues which was conducive to contraction of a viral infection in the first place.
2. SANG JU YIN
named for the two chief herbs in the formula, a famous combination for releasing exterior heat:
sang ye (white mulberry leaf, left below)
ju hua (chrysanthemum flower, right below)
This formula is closely related to the above-mentioned yin qiao san formula and, in fact, contains many of the same ingredients. What distinguishes sang ju yin is that it is more effective for treating cough and moistening the lungs in the early stages of a URI. Take this formula if you have a cold or flu that starts out with coughing, accompanied by mild fever or thirst, or if dry hacking cough characterizes the early stages of your illness. Other symptoms might include slight fever; sore throat; or red, burning, itchy or weepy eyes. Like yin qiao san, this formula also treats the initial stages of colds and flus, and is less effective for later stages of these viruses.
San ju yin would also be my first choice in treating acute conjunctivitis if the eye is red & inflamed. Chrysanthemum flower, one of the formula's chief ingredients, is famous for its ability to cool and clear the eyes.
The herbs in sang ju yin function to release exterior wind-heat and also to disperse & descend congested Lung Qi to stop cough.
3. GAN MAO LING
Translated as “Miraculous Cold Pills,” these are great to have on hand at home or when you're out. While yin qiao san or sang ju yin work great when taken at the first sign of a cold characterized by heat signs (sore throat or coughing, respectively), gan mao ling has a bit more flexibility. First, it is a good general formula for all external wind patterns (either wind-heat, mild wind-cold or mixed). Second, compared to the first two formulas, you can take gan mao ling with good effect beyond the initial stages of the infection. It is more effective for an entrenched cold or flu with achy body, mucus congestion, etc.
Compared to the first two formulas, gan mao ling contains more herbs that clear toxic heat and are strongly anti-viral (English Holly, wild chrysanthemum, isatis root, honeysuckle flower, etc.).
Isatis plant, below, with dried root parts pictured at right:
Indications for gan mao ling include fever, mild chills; scratchy or sore throat; sudden fatigue; swollen lymph glands; thirst; sore neck and shoulders; generalized body aches; headache; nasal congestion; cough with white or yellow mucus.
Early-stage Home Remedy for Wind-Cold Invasion:
Finally, what to do if you're coming down with a cold and you don't have any heat signs? Perhaps you're getting sick & you simply feel chilled. No fever, no sore throat, no thirst. Perhaps you've been out in cold wind or rain. In this case, I would recommend a famous home remedy: tea fresh scallions & ginger.
1-2 scallions, coarsely chopped
(Be sure the include the white hair-like roots of the scallion. They are the most medicinally important part in this case.)
3-5 1/4-inch slices of fresh ginger, peeled (as pictured at right)
2-3 cups water
Simmer 10 minutes to ½ hour. Strain & drink the liquid, then bundle up warmly and go to bed. The tea and the bedcovers will induce a mild sweat, helping to push the cold/flu pathogen out of your body. It is important, then, to rest and sleep, to help your body fight off infection.
I try to always have fresh ginger & scallions in the fridge, especially in fall and winter.
What Brand of Patent Formulas Should I Buy?
If you shop for patent formulas in Chinatown, you'll find many different brands from different manufacturers. There are also several different reputable companies marketing Chinese patent formulas to western health food store consumers.
One company I highly recommend for patent formulas is Mayway Corporation. Mayway is a multi-generation, family-owned Bay Area Green Business based in Oakland, CA . Mayway has a liaison office in Beijing and an herb processing facility in Anguo, China. Mayway's products are rigorously tested for quality and purity. For more information, see Mayway's website, www.mayway.com.
For at home or on-the-go use, I recommend Yin Qiao San (marketed as Yin Chiao Chieh Tu Pien), Sang Ju Yin (marketed as Clear Wind-Heat Teapills) and Gan Mao Ling from Mayway's Plum Flower line of products. (Photos above are all Mayway products).
Another excellent Oakland-based herb company is Health Concerns. Health Concerns sells a tincture called Yin Chao Jr., which is a pediatric formulation of Yin Qian San, often available in Bay Area health food stores. They sell cold/flu prevention & treatment formulas, including Chinese & western herbs, under a variety of product names. See www.healthconcerns.com.
There are a lot of great products out there, with many subtle variations among them. I am happy to help you find patent herb formulas that are right for you. (And, for the record, I have no official relationship with either Mayway Corp or Health Concerns.)
What Sorts of Herb Formulas Can I Give to My Child?
It is generally safe to administer all of the patent formulas discussed in this article to children, especially if the formulas come from reputable manufacturers like the ones mentioned above. Generally, one would use a smaller dose. Getting your kid to take formulas in pill form can be a challenge of course.
A few U.S. companies manufacture pediatric Chinese herbal formulas in tincture form, such as Health Concerns' Yin Qiao Jr., mentioned above (pictured at left).
In my practice, I stock a full line of palatable pediatric Chinese herbal tinctures from Kan Herb Co. called "Gentle Warriors." This line includes formulas for cold/flu treatment & prevention, as well as for secondary syndrome including asthma, bronchitis, ear infections, sinus congestions, eczema, diarrhea, digestive weakness, etc.
I keep several of these Gentle Warriors on hand. Fortunately, my daughter loves taking them.
Simple herbal infusions, drunken a luke-warm teas, are also nice for children with colds. Use common herbs like peppermint, chamomile, thyme, sage, chrysanthemum, elder berries, elder flowers, etc.
I am happy to consult further about Chinese herbal treatment for babies and children.
What About Western Herbal Formulations like Echinacea & Goldenseal for Cold and Flu Prevention?
Western herbs like echinacea, goldenseal, elder berries, etc. have comparable properties to the herbs used in the patent formulas described above. Formulations of these herbs can be equally useful in warding off or shortening the duration of upper respiratory tract infections. Supplements like Vitamin C, Vitamin D and Zinc have also been shown to be helpful in preventing & shortening duration of viral URIs.
It can be useful periodically to change the herbs you are using. For instance, if you've used echinacea to treat your last three colds, the herb might begin to lose its effectiveness for your body. It could be useful to switch to using one of the Chinese formulations for a time. And, vice versa, if you've been using yin qiao san at the first sign of a cold for the last several months, you might want to pick up a bottle of echinacea next time you're in the health food store.
Long-Term Use of Patent Cold Formulas?
The herbs contained in the Chinese patent formulas discussed in this article are mostly cold and bitter, as are echinacea and goldenseal. Cold, bitter herbs, when used over a prolonged period of time, according to TCM, damage the organs of body (especially the Spleen). They can easily weaken digestion and impair the body's energy. In western naturopathic terms, cold bitter herbs will impair and eliminate the body's beneficial microorganisms, just as antibiotic drugs do, but in a milder manner. The first sign of the negative effects of cold, bitter herbs is usually loose stools.
These formulas should only be taken short-term—at the first sign of a cold or flu, or during the first days of a URI. It can also be useful to take a dose of yin qiao san once per week, prophylactically, during the cold and flu season, especially if you are frequently exposed to colds and flus (i.e. teachers, daycare workers, preschool moms, etc.)
These formula are designed to quickly rid pathogens from the body by making the body tissues less hospitable to microbes. They do not, however, build the immune system.
A TCM practitioner can help you build your immune system to prevent cold and flu infections with acupuncture and/or herbal formulas which tonify and balance your physiology. Getting adequate rest and eating warm, cooked foods also helps build your immunity to colds and flus.
For more ideas see my article, "Winter Cold & Flu Prevention: Eight Simple Lifestyle Adjustments."
Treatment of Secondary Symptoms of URIs
Cold and flu patients usually develop a variety of unpleasant secondary symptoms depending on the nature of the virus they've contracted, as well as their individual constitutional strengths and weaknesses. Symptoms include nasal congestion or runny nose, sneezing, cough, sinus infections, ear infections, etc.
Excellent patent formulas are available to alleviate secondary symptoms, as well as to fight cold viruses as they penetrate more deeply into the body. These formulas are outside the scope of this article.
An acupuncturist or herbalist will be happy to help you in alleviating URI symptoms.
What if my Cold Prevention Strategy Doesn't Work?
Sometimes we still get knocked out by a cold or flu despite our efforts to head it off with herbs, rest and other therapies. Colds are miserable, and they suck a lot of time from our schedule. In patients with compromised immune systems, or with tendencies to develop bronchitis, catching a cold can be a significant health risk.
In general, however, suffering a cold or flu can have therapeutic value. We often catch colds when we are over-scheduled, not resting enough, or eating too much unhealthy food. Being sick tends to re-calibrate our systems, forcing us to drop activities, get rest and clean out our diets in order to restore our health. Research suggests that our immune systems are strengthened when as they fight and kick out cold or flu viruses. On a spiritual level, illness forces us to reevaluate our priorities. For these reasons, though they may feel miserable in the moment, being struck down by an occasional cold and flu may not be such a bad thing.
Along this line, one of the bloggers I follow just published a fun article entitled "Do Healthy Kids Get Sick?" She likens illness to housecleaning for the body, and suggests that we may not always want to suppress cold and flu symptoms. Something to consider....
It is also advisable to use herbs to rebuild your body after a cold or flu infection, since these viruses often weaken the body's qi and yin making the body slightly more vulnerable to future infections of long-term chronic illness. Once again, keep in mind that each individual has a unique constitution and a unique set of symptoms. It is best to consult your acupuncturist who can formulate a treatment that will be most effective for you, in the short term and in the long term.