Front-line Formulas for Acute Upper Respiratory Illness

One of the ways that Traditional Chinese Medicine shows its brilliance is through its understanding and treatment of acute Upper Respiratory Illnesses. While Wind invasion may seem an absurd concept to the uninitiated, this explanation of the progression of acute viral and bacterial infections generates effective protocols for treating the early stage of a variety of upper respiratory illnesses.

The body's defensive shield is known as the Wei or Protective Qi which circulates between the skin and the muscles, regulating the opening and closing of the pores. Wind is the primary pathogen, and it is with Wind as their vehicle that other adverse influences enter the body, penetrating its weakened defenses.

To "nip it in the bud," our primary objective is to quickly expel the pathogens from the surface of the body, so these noxious influences will not penetrate deeper. Treatment to relieve the surface should be given within 72 hours.

Most of the Wind induced illnesses seen in clinics today are classified variously as Wind Cold, Wind Heat or a combination of the two. How each of these syndromes is likely to manifest and how it can be treated may be appreciated by reviewing a few of the front-line prescriptions from Kan's formulary. The appropriate and timely application of these outstanding remedies can provide great assurance of success.

Purge External Wind

External Wind Invasion is characterized by suddenness of onset. What this also reveals is the body's inability to adapt to changes in the weather and environment. Ailments such as nasal allergies, skin rashes, stiff neck and rheumatism are also manifestations of this syndrome.

Chinese Modular Solutions' Purge External Wind is a broad spectrum formula that addresses a range of wind patterns: body aches with chills, mild fever, occipital headaches, and nasal stuffiness, as well as the sneezing, itchy and watery eyes, and sinus congestion associated with nasal allergies. It is effective when used alone or combined with other formulas such as Purge Cold or Purge Heat to address variants of this type of illness, and enables the organism to mobilize its defensive resources at the body's surface.

Dispel Invasion

In addition to sudden onset, a Wind Cold condition is characterized by the sensation of cold. The pathogen is said to enter through the skin. Symptoms include chills, headache, body ache, stuffy and runny nose with clear mucus and, occasionally, a mild fever.

Dispel Invasion is the classic Chinese formula, Jing Feng Bai Du San (Schizonepeta and Ledebouriella Powder to Overcome Pathogenic Influences). This formula relieves the surface by inducing perspiration and is also indicated for Wind Cold Damp patterns. In this situation, mild perspiration will be sufficient to expel the pathogen. It is common to see chills and fever, stuffiness in the chest and head, headaches, and body aches that may be mild, strong or more pronounced in areas that tend toward weakness. Dispel Invasion also addresses joint and muscle discomfort that occurs in damp weather.

Yin Qiao & Initial Defense

The Wind Heat pathogen enters through the nose and the mouth and then descends to attack the Lungs. Often the first sign is a raspy, dry, and somewhat itchy throat - a harbinger of the soreness and swelling to come. Intervention at this early stage can net brilliant results, though most people are not yet aware that a Wind Heat invasion is "in the wings." Recognizable symptoms include sore throat, slight fever, no chills (occasionally mild chills), thirst, headache, cough, itchy and red eyes.

Yin Qiao (Honeysuckle and Forsythia Powder) is the most widely used formula for Wind Heat invasion. It enables the body to expel toxins through the skin before they can penetrate to a deeper level. The toxin relieving herbs in the formula have antiviral and antibacterial properties and can bring great relief from fever, sore throat, headaches, rashes and various allergic responses such as burning in the eyes and nose, yellowish or yellow-green nasal discharge, and irritability.

Initial Defense is a combination of Yin Qiao and another classic formula, Sang Ju Yin (Mulberry Leaf and Chrysanthemum Decoction). Though quite similar in their actions, the addition of Sang Ju Yin makes Initial Defense more effective for Wind Heat coughs with yellow or yellow-green phlegm and eye disorders. This formula can also be used prophylactically in small doses, over a longer period to enhance resistance.

Gan Mao Ling

Pathogenic Wind is most associated with the Spring though it can appear in any season. Wind Invasions occur most frequently during early Spring, late Fall, and Winter when the body tends to be more vulnerable as it tries to adapt to constant temperature fluctuations. Also, the relative coldness and darkness of the Winter months weaken the body's resistance because the body's greater need for warmth and energy increases the demand on Qi supplied by the lungs and other organs. This weakens the Wei (Protective Qi), making colds and flus more prevalent at this time.

The classic texts often refer to Wind Cold turning into Wind Heat in the body as the Wei or Protective Qi comes to the fore. Gan Mao Ling is derived from the extremely popular Chinese patent medicine of the same name. It addresses the concurrence of these two patterns. While the majority of the herbs are cold and toxin-relieving, the formula contains over 20% Wu Zhu Yu (evodia fruit) which is an acrid, hot herb that relieves nausea and headache and moderates the colder herbs in the formula, making it effective for this mixed pattern. Like Yin Qiao and Initial Defense, it can also be used preventively.

Zhong Gan Ling

During the Flu season practitioners take pride in being able to keep someone from becoming ill. Sometimes an external invasion is so virulent that we don't recognize the warning signs early enough to get our artillery in place. When we see high fevers, sore throats and swollen glands appearing suddenly, Zhong Gan Ling is the formula of choice. With its ability to dispel intense Wind Heat and Heat Toxins, the duration of the illness can be shortened immensely. The other symptoms that are relieved by this formula are intense headache and aching of the limbs and joints, high fever, restlessness, and sweating - signs of a severe flu. An extremely potent formula, Zhong Gan Ling should not be taken for an extended period. For patients with a weak constitution, using this formula for more than 7 days could further undermine the Spleen, Stomach and Intestines. This "side effect", however, can be countered by beginning to administer a tonic formula along with Zhong Gan Ling such as Prosperous Farmer once the acuity and severity of the symptoms begin to abate.

Case Study #1

Miranda, an energetic 16 year old left in the morning with a plan for a full day of school, soccer practice, and dinner at a friend's. By lunch time she had returned home with a fever of 102° F and a horrible sore throat. She ached all over and was extremely irritable. She was advised to take Zhong Gan Ling, 4 tablets every 2 to 3 hours until her symptoms began to subside. After the first day there was a 50% reduction in her symptoms. By day 3, her sore throat was nearly gone and her temperature was only slightly elevated, but her body continued to ache and she felt exhausted. Zhong Gan Ling was continued at a dosage of 3 tablets, 3 times a day. By the 5th day her symptoms were almost completely gone with only some lingering tiredness remaining. She decided to go back to school because she was too bored to stay home another day.

Commentary

Zhong Gan Ling was chosen because of its effectiveness in dispelling Wind Heat that enters the body with strength and rapidity. It contains cold, toxin clearing herbs and a large proportion of Ge Gen (Puerariae) making it effective for relieving inflamed throats, fever, and the notorious body aches of a bad flu. Because Miranda was previously in good health with a strong constitution, she managed to get through this illness quickly.

Case Study #2

A man in his mid forties, Steve, is a night shift custodian in a hospital. While priding himself in rarely getting sick, he now complains of a stuffy nose, sniffles, and occasional tightness in the back of his neck. His symptoms are absent in the morning (after a good night's sleep) but gradually appear and worsen as the day progresses. To his knowledge, he has no allergies. His tongue is somewhat pale and his Lung pulse is weak.

Steve was given a formula containing equal parts of Purge External Wind and Tonify Qi, 2 dropperfuls to be taken 2 times a day. After two weeks of taking this formula he reported that he had more energy at work and, except for occasional sniffles at night, his symptoms were almost gone. He continued the formula with a lesser proportion of Purge External Wind (Purge External Wind, one part; Tonify Qi, two parts). After two more weeks he reported that he felt very good and no longer needed to take the herbs.

Commentary:

It was clear that Steve was showing signs of Qi deficiency (symptoms that worsen as the day progresses and difficulty overcoming them) and some mild but definite signs of External Wind invasion (sniffles, stuffy nose, and muscle tightness). He was hardy enough to avoid a full blown cold, and Tonify Qi helped to strengthen his resistance while Purge External Wind relieved the symptoms.