Monday, April 13, 2020

Roots of Chinese Medicine Strategies for the Treatment of Infectious Disease

Physician Zhang Zhong-Jing
Photo CreditWikipedia
Chinese medicine is a valuable resource in context of the COVID-19 pandemic. Herbal strategies for addressing infectious disease have been refined over the course of 2000 years, and have been particularly influenced by historical epidemics.

The first significant textbook of herbal formulas was written by the famous doctor Zhang Zhong-Jing (150-219 CE.) Zhang lived during the final years of the Eastern Han Dynasty, when continual war and strife led to the outbreak of many epidemics. Zhang lost two-thirds of his family members, the majority of them to infectious diseases. He dedicated his life to distilling a formulary for every stage of infectious disease. These formulas are detailed in the classic Chinese medicine text Discussion of Cold-Induced Disorders, or Shang Han Lun.

Later, in the Ming Dynasty (14th-19th centuries,) the introduction of western diseases such as mumps and measles was a catalyst to revising Zhang’s formulas to effectively treat these new epidemics. The foremost physicians credited with these revisions were early 18th century physician Ye Tian-Shi, and late 18th century physician Wu Ju-Tong, whose work culminated in the medical text Systemic Differentiation of Warm Diseases, or Wen Bing Tiao Bian.

Ming Dynasty Physician Ye Tian-Shi
Photo Credit http://www.itmonline.org/
Modern-day practitioners of Chinese herbal medicine draw heavily on theories laid out in both the Shang Han Lun and the Wen Bing when treating colds, flus and epidemics, including the earlier coronaviruses SARS and MERS.

One notable feature of these texts is that they both outline a specific progression of stages by which infectious disease enters and overtakes the human body. In the case of the earlier Shang Han, or cold-induced disorders, infection was considered to progress through six stages: three external (or yang) stages and three internal (or yin) stages. Specific formulas (or formula variations) are employed at each level, with the goal of keeping the infection on the outside (yang, energetic, defensive or muscular) of the body and preventing it from becoming more serious and penetrating to the interior (yin organs). Similarly, later in history, the Wen Bing, or warm disease school, built on earlier ideas and outlined a four-stage progression whereby infectious disease progresses from exterior to deeper layers of the body. The Wen Bing school, in the 18th century, was also the first in China to clarify an understanding that infectious disease pathogens spread from person to person.

In the United States, obviously, patients in advanced, severe stages of COVID-19 infection are treated in the hospital for pneumonia, put on ventilators, etc. These patients are generally not receiving herbal treatment. However, Chinese herbalists in the United States can draw on the rich formulary developed over 2,000 years to effectively prevent viral infection and mitigate symptoms during earlier stages of infection.

Sources:
Bensky, Dan & Barolet, Randall. Chinese Herbal Medicine: Formulas & Strategies.

Mitchell, Craig; Ye, Feng & Wiseman, Nigel, ed. Shang Han Lun: On Cold Damage, Translation & Commentaries.