From the point of view of luck, the epidemic virus invades by time and gas, and it is overpowering and suffocating. For the treatment of critical illness, it is necessary to emphasize the principle of supporting yang and protecting body fluid from the angles of cold and dryness.
The recent outbreak of H7N9 avian influenza. This is the first new disease in the world, which is different from the general flu with high mortality. If we stick to the past empirical prescriptions for preventing and treating other flu, it will be difficult to achieve satisfactory results. We should dig deep into the valuable experience of predecessors in treating epidemics, explore new ideas and explore better methods in multiple ways.
Xue Shengbai, a famous febrile disease scientist in Qing Dynasty, said: "In the year of severe epidemic, there are many diseases that are difficult to recognize, and doctors are never sure. There are many prescriptions and medicines mixed, and many deaths are wasted, so we should get the general formula. Let's just say that in the past three years, where is the person who is good at pushing the climate, and then we should seek it in the spring in accordance with this year's season, so as to use this medicine, although it is not miss, it is not far away.
although human infection with H7N9 virus is not a major epidemic, it is also the first "difficult disease" that is different from ordinary influenza. The theory of luck emphasizes that the epidemic is caused by heaven, man and evil, and "you must be old first" is an important principle put forward in Huangdi Neijing. "I don't know the increase of years, the rise and fall of qi, and the role of excess and deficiency, so I can't work for it!" Therefore, for new epidemics, we can first explore the pathogenesis and treatment from the perspective of luck.
Analysis of the Luck Causes of the H7N9 Avian Influenza Epidemic
From the perspective of the five movements and six qi of Chinese medicine, it is found that the fourth year of Guisi is not as good as the fire, but it is also the year of the same age meeting, and the "meeting with the same age is not as good as it is", which can generally be treated as an equal spirit. However, "Gui", as an inferior fire, is still vulnerable to the attack of cold water and gas, and "Si" is the year of "antithesis" in the theory of luck. Theoretically, "it is too strong to be true to the transformation, but it is successful to recover", which means that this balance is not stable enough, and it is easy to win and regain the gas, and it is also easy to have cold in the spring. If there is too much cold or rain, it is a sign of bad luck. The so-called "cold and rain are better than the same, and evil spirits are also worse."
According to the actual climate observation this year, both the Jue Yin wind wood of Si Tian Qi and the polite Yangming dry gold of Yi Qi moved to the right place at the beginning of the year, and there was no obvious fluctuation. However, there were many strong sandstorms later, and the temperature rose earlier and higher in early March, which was theoretically caused by the "excessive" qi of Jue Yin and Feng Mu, and "the wind is dry and hot, and it is better to recover"; From the second half of March, there was a severe cold in late spring, with frequent cold waves and large fluctuations in temperature. For example, on April 14th, China News Service pointed out: "Liaoning Province is experiencing the coldest spring in 45 years. The reporter learned from the Liaoning Meteorological Bureau on the 14th that the average temperature in Liaoning in the first ten days of April was 3.2℃ lower than normal, which was the lowest in the same period since 1969, and it was snowed in April three times.
The Yellow Emperor's Canon of Internal Medicine, On the Truth and Truth, says, "Jue Yin governs the heaven. If you win, you will get tinnitus and dizziness, and even cough. The so-called "guest wins" is a "polite victory". Lu Maoxiu's "Interpretation of Neijing Luck Diseases" said: "This statement is that the guest's initial gas is dry and golden, the guest's second gas is cold and water wins, and the guest's third gas is wind and wood wins. ..... Both dryness and cold can cause cough. "Now, the three politeness are all manifested as a strong victory that can" cause cough ",and it is not surprising that there is an epidemic of H7N9 avian influenza.
Analysis on the scale and development trend of the epidemic
Because the overall luck condition in the past four years was not very bad, and there were no major epidemic-causing factors such as "three-year epidemic" and "abnormal rise and fall", the current abnormal luck was caused by too much "qi at that time" and did not belong to "untimely qi" which easily caused a major epidemic. From our previous analysis of historical epidemics, most of the epidemics caused by such bad luck are minor epidemics. Therefore, from the theory of luck, this influenza will not develop into a big epidemic like SARS.
May 5th is long summer Festival. After long summer, the luck will change, and we can expect a turning point in the decline of the epidemic. The third qi period is the main order of Jue Yin Feng Mu of Si Tian Qi, and the main qi is less Yang and fire. Although "fire can kill gold", lung gold is still vulnerable to evil, but by this time the cold has gone, and the occurrence of wind-hot climate is "normalization" in theory, which should not be a big problem; If it is cold and wet, it will be bad for the epidemic. The luck of "Four Qi" has turned to damp heat, which no longer supports the continuation of H7N9 avian influenza epidemic, but we should be alert to the occurrence of other diseases such as damp heat jaundice.
Analysis of the pathogenesis and treatment of current epidemic diseases
Before the Spring Festival, there were some flu epidemics in northern provinces of China. At that time, luck was wet in the spring and the climate was characterized by severe smog. After entering the fourth year, luck and climate have changed obviously. In February 213, the total number of influenza cases in China decreased from 16,12 cases in January to 9,86 cases, indicating that the original influenza has subsided. The current H7N9 avian influenza epidemic is obviously different from last winter in terms of luck and climatic conditions, and it happened after the original flu subsided, and the pathogenic virus is also different. Therefore, this flu is not a continuation of last winter's flu, and its luck pathogenesis and TCM treatment should also be different from last winter's flu.
Luck factors that caused the current epidemic: First, the "wind" gas in the dark days was too strong and the temperature rose too quickly, and the "fire" gas appeared in the wind from cremation; The second is the "dry" gas under the mild climate. Third, the politeness of the second gas, the "cold" gas caused by the strong cold water of the sun, and the "cold" factor of the low temperature in the early winter of last year; Fourth, it is said in Neijing that "the cold of the second qi can't go away, and the disease of the people is hot in the middle", that is, the "hot" qi transformed from cold into the interior. Therefore, the luck pathogenesis of this avian influenza is more complicated, sometimes evil, but also hidden evil; It is related to wind, fire, dryness and cold.
here, we will focus on three key factors: wind, cold and dryness. Because the pathogenesis of fiery heat is an outstanding theory in the popular theory of febrile diseases, it will not be ignored, so it will be omitted here.
1. "Wind"-This year is a windy day, and the actual climate is also windy. Since the wind was cremated, the temperature rose earlier and higher in early March. The meteorological department said: "Since March, the national average temperature has been 3.5℃, which is 2.3℃ higher than the normal period, and …… the spring is obviously earlier"; "As of March 7th, compared with normal years, most areas in the southwest and east, most areas in the south of the Yangtze River and northern Fujian entered spring 1 to 2 days earlier". According to the theory of traditional Chinese medicine, Jue Yin Feng Mu and Shao Yang are in fire, "in fact, Shao Yang, deficiency is Jue Yin". This year, the syncope of Yin qi came earlier and stronger, and the temperature rose earlier and higher, which is the performance of syncope of Yin qi. However, this kind of "wind" and "fire" is a temporary evil rather than a hidden evil, and it is superficial to invade the human body. Therefore, patients with mild initial clinical symptoms can be treated according to shaoyang disease. Zhang Luzhi, one of the three famous doctors in the early Qing Dynasty, treated spring fever mainly by shaoyang, and used Xiaochaihu to add and subtract. We have recently used Xiaochaihu decoction to treat common influenza in clinic, and the effect is very good.
Peng Ziyi used ebony soup (ebony, peppermint, white sugar or rock sugar) to treat febrile diseases in Ancient Chinese Medicine of Circular Movement. Generally speaking, it is considered that the astringency of dark plum acid is not suitable for the initial symptoms of exogenous diseases, but Peng's book lists 15 medical records, all of which have outstanding effects. Peng believes that "ebony is an important medicine for anemone, which can produce body fluid without astringency, especially for febrile diseases". Zhang Zhicong's "Materia Medica Worship the Original" explains Wumei: "Mei Shi was born in spring, ... and mainly applied yang to the reason"; "Taste sour, get the oriental wood taste, ... and get the spring above. This medicinal characteristic of ebony is suitable for diseases of liver and lung dysfunction caused by Jue Yin Feng Mu, especially for patients with red tongue and little coating. This is also in line with the principle of "weathering in heaven, treating with acid and temperature" in Huangdi Neijing. Peng's recipe is cut from Lu Fu Ban Fang and Mei Su Wan, and the beauty lies in adding mint to the recipe to open the closed bundle of defensive qi, which can avoid the evil.
2. "Cold" —— As mentioned earlier, the cold in late spring is more serious this year, and it is known that there are more people suffering from aversion to cold and body aches in patients infected with H7N9 avian influenza, which accords with the syndrome characteristics of cold. According to the theory of typhoid fever, Daqinglong decoction can be used for those who have obvious high fever, no sweat, headache and body pain due to cold; Radix Aconiti Lateralis can also be added for patients with obvious aversion to cold and deep and thin pulse. Small Qinglong decoction can also be used for individuals with thin and white sputum. The image of the Dragon in the East should be named "Dragon" because of the wind, wood and spring, which has a special meaning.
However, cold in spring is the evil of the time. According to the theory of epidemic diseases in traditional Chinese medicine, all serious diseases have the factor of "latent evil". Xue Fuchen, a famous doctor in Wuxi in the late Qing Dynasty, said: If there is no latent qi in the disease, the disease will not be serious; Serious illness is a new evil, which leads to latent evil.
It was noted that the majority of patients with H7N9 avian influenza were elderly people (as of 17: on April 16th, 71 cases were diagnosed by * * *, of which 56 cases were over 5 years old, accounting for 78.87%; There are only 2 cases of teenagers under the age of 2, and a child patient in Shanghai has been cured and discharged, and a child patient in Beijing has also been cured and discharged. Another 4-year-old child is a virus carrier and has no disease); Most of the elderly are men (among 56 cases over 5 years old, 43 cases are men, accounting for 76.79%, while among 15 cases under 5 years old, there is no obvious difference). How to explain this phenomenon? According to the theory of traditional Chinese medicine, the characteristics of male middle-aged and elderly people are the gradual decline of vital energy. If "essence is not stored in winter", it is easy to cause febrile diseases in spring. Liu Baozhi, a representative physician of the Longsha medical school, said in "Warming the Source": "Kidney-qi is the first deficiency, so the evil lies in the lack of yin. When the yang moves in spring, the cold evil turns into heat." "However, if you don't hide essence in winter, you will get cold, and all the cold you suffer will lie in the lack of yin. "Fu evil originates from shaoyin, so you can see severe internal heat from the beginning. Liu Bao-zhi thinks that "Ye Xiangyan's pungent, cool and clear solution is superficial." Foolish, if you don't use Huangqin decoction plus lobster sauce and Scrophularia, it will be a very difficult method. "
In the treatment of this critical syndrome, we should pay special attention to the factors of latent cold. Liu Bao-yi said, "Cold evil lurks with little yin, and cold will hurt Yang. Since kidney yang is weak, it can't be steamed and encouraged. Whenever there is an initial onset of warm evil, kidney yang is timid first, so the evil machine is frozen, and it can't be achieved. Between the exhibition and the turn, the evil will sink in and cannot be saved. This is the most difficult proof to start. Taking into account the severe cold in the previous stage, I personally think that in the treatment of severe patients, we should re-use the prescription of nourishing yang (Liu Baoyu commented that Yu Jiayan used the method of warming yang with the theory that "if it is not this powerful medicine, then less yin will sink into the cold, and it will encourage you"), and use the bitter cold with relative caution.
Liu also believes that "the stagnation of qi will be released at any time, and it will also be accompanied by seasonal evil." ""It is caused by the evil of the time ... The light one can treat both, and the heavy one is to deliberately withdraw the new evil at the beginning; Once the new evil is solved first, then the latent evil is cured. Therefore, the above methods of Qinglong and Chaihu can be randomly combined.
3. "Dryness" —— The politeness of this year's qi is Yangming's dryness and gold, and the precipitation shown by meteorological data is obviously less, which corresponds to the lucky feature of "weathering in the sky, clearing up and overcoming it" in Huangdi Neijing. It is noted that most severe patients with H7N9 avian influenza have obvious fatigue except dry cough and little sputum, and they quickly develop respiratory distress symptoms, expectoration with blood, which is similar to SARS in 23. It is necessary to consider the problem of "stagnation". SARS was caused by dryness and heat in Geng Chen's year, which turned into a "three-year epidemic". Although there was no dry factor three years ago this year, the climate in the late winter of last year was already dry, and the dry gas that appeared early could form a dry factor for the current epidemic. Although this kind of dryness is not deep, it is also a factor to be considered. Stagnant dryness hurts the lungs, and it is most likely to burn the vaginal fluid. When the vaginal fluid is injured, it becomes a syndrome of bee rising. "If you save one point of body fluid, you will have one point of vitality. Therefore, it is especially important to take care of its vaginal fluid step by step during treatment.
From the point of view of luck, the epidemic virus invades by time and gas, and it is overpowering and suffocating. The treatment of critical illness of this disease needs to emphasize the principle of supporting yang and protecting body fluid from the angles of cold and dryness.
"Fu Qi" is an important concept in the theory of epidemic diseases in traditional Chinese medicine, which is especially important for the treatment of severe febrile diseases. He Lianchen warned in "Re-defining the Theory of Wide Warming and Warm": "Doctors must know how to fu Qi, so that they can not see the disease and treat it, and they can grasp the machine before the symptoms. However, the problem of latent qi is often ignored in modern Chinese medicine textbooks, which seriously affects the overall level of Chinese medicine in treating diseases.
At present, the pathogenesis of avian influenza is complicated and varied, so all kinds of situations cannot be described. According to the theory in Huangdi Neijing that the evil between man and nature "causes epidemic disease due to three deficiency", only by combining the three aspects, can we fully reflect the overall thought of the correspondence between man and nature and the flexible thinking of adapting to the three factors, so as to achieve better clinical efficacy.