FW: SARS:Summing-Up

[Guest guest]



 

What would I do?

 

If not miss

information.

 

As a source

of practice.

 

Had Rey and others not learn Chinese?

 

Yet,

Words and wordings

barrier.

 

Till one too

tries to read:

 

As good as Rey and Others...

 

 

Thanks for a very interesting article...

 

Marco

 

[Guest guest]

May 11,2003

 

Dear List members,

 

Below is an article that I translated from Chinese into English . The

article was published in the on-line issue of the Takung Pao (May 9,2003)

which coincides with a conference that is now happening in Beijing that is

assessing the role of TCM in the current SARS epidemic. But the article

itself seems to have reviewed the experience of the Guangdong Provincial

TCM Hospital's use of TCM in treating SARS patients in February .

 

In response to some listmembers request , I have included the Chinese script

of some critical words translated into English.

 

Regards,

 

Rey Tiquia

Phd Candidate

Dept. of History and Philosophy of Science

University of Melbourne

Victoria

Australia

 

 

May 9,2003

 

Mainland Chinese TCM Experts Sum-up Anti- SARS (Atypical pneumonia)

Experience

Constructing An Integrated -Western Medicine Treatment

Plan

 

- Guangzhou City TCM Prof. Lin Lin who is coming to Hongkong upon invitation

to participate in the CM-WM joint consultation and treatment of Atypical

pneumonia , since the outbreak of the epidemic yi zheng for a month now,

has continued with her unselfish work yi zhi wang wo gong zuo and has

'endured the hardships of a long journey' feng chen pu pu . A few days

before coming to Hongkong, she went to Beijing to participate in the 'Fift

Strategic Positioning of TCM ' di wu jie zhong yi yao zhan lue di wei yan

tao hui. The main theme of the conference is " TCM Prevention and Treatment

of Atypical Pneumonia " zhong yi yao fang zhi fei dian xing fei yan . In

this meeting, Lin Lin and other experts introduced and exchanged their

experience on the the prevention and treatment of atypical pneumonia . This

newspaper has collated and recorded the various reports of Mainland Chinese

media on this conference . In this way, the readers can understand the role

played by TCM in the encounter with this SARS natural disaster as well as

the importance of 'coordinating CM and WM ' treatments zhong xi yi pei he

zhi liao

 

Takung Pao May 9,2003 - Based upon reports from the China TCM Journal zhong

guo zhong yi yao bao and Hsinhua Gang , the day before last, the 'Fifth

Study Discussion Conference on the Strategic Positioning of TCM ' was

convened in Beijing. Professors Lin Lin, Zou Xu, Peng Sheng Quan, Zhu Min

etc. from the No. 1 and Number 2 Hospitals Attached to the Guangzhou TCM

University which are in the front line in the treatment of atypical

pneumonia in Guangdong Province, introduced jie shao their experience in

the prevention and treatment of SARS. At the same time, they exchanged

experience on the etiology bing yin , pathomechanism bing ji methods of

prevention and treatment of the disease with experts from the China TCM

Research Institute, Beijing City TCM Hospital and Beijing City Tibetan

Medical Hospital .

 

From January up the the present time, the No.2 Hospital Attached to the

Guangzhou TCM University treated 112 patients suffering from SARS. After

integrated CM-WM treatment, aside from 7 cases who died , all the 105

patients have all been cured and discharged from the hospital. Under the

concrete supervision of national famous veteran TCM experts like Deng Tie

Tao, Ren Ji Xue, Jiao Shu De, Chao En Xiang, Lu Zhi Zheng, Lu Huang Xin ,

Yan De Xin, Zhou Zhong Ying, this hospital has ‘fumbled into’ mo suo chu 摸

索出 a SARS clinical pattern zheng hou gui lu è­‰å€™è¦ which in the process

lead to the creation of a set of treatment plan in dealing with SARS.

 

The Disease Progression is Divided into Four Phases and Their Corresponding Treatment

 

According to a report made by the director of the hospital casualty

department Lin Lin , the disease can be categorized in TCM terms as

‘Epidemic Spring febrile Damp-Heat ’ Chun Wen shi re yi bing 春瘟濕熱疫

ç—….This classification is made on the basis of the seasonal onset of the

disease as well as the clinical symptoms lin chuang zheng zhuang 臨床症狀.

The pathomechanism bing ji 病機 is ‘Damp-heat embedded with toxins’

‘hindering’ the Two upper and middle energizers ‘shi re yun du zu e zhong

shang er jiao 濕熱蘊毒阻é中上二焦. At the same time, this situation easily

leads to the exhaustion of Qi accompanied with ‘stasis’ yi hao qi jia yu

易耗氣夾瘀. In severe cases, it has the features ‘closure of the openings

within ‘ nei bi 內閉, ‘dyspnea’ chuan 喘’exhaustion’ tuo 脫. In accordance

with the the patient’s clinical manifestation lin chuang biao xian 臨床

表ç¾, this hospital classified SARS into four phases:

 

Initial Phase: This manifests from the first up to around five days of the

disease. If at this phase the progression of SARS is stopped, then the

patient can get into the recuperation stage hui fu qi æ¢å¾©æœŸ which will

greatly shorten the course of the illness. The pathomechanism in this phase

is characterized by the ‘damp and heat hindering , with both the Wei and Qi

‘layers’ being pathologically affected’ shi re e zu wei Qi tong bing 是熱é

阻衛氣åŒç—…. In treating this disease at this phase, stress must be places in

‘dispersing and dispelling (the heteropathy ;Trans.) and clearing and

transforming xuan tou qing hua 宣é€æ¸…化. The formula to use are combined San

Ren Tang 三ä»æ¹¯ and Sheng Jiang San å‡é™æ•£; combined Ma Xing Shi Gan Tang

ç—³æ石甘湯 and Sheng Jiang San å‡é™æ•£.

 

Middle Phase: This occurs generally on the third to the tenth day from the

onset of the disease. The pathomechanism is characterized by the ‘damp and

heat embedded with toxin’ with the heteropathy laying in wait in the

pleurodiaphragmatic interspaces , and the heteropathy hindering the Shao

Yang “ shi wen yong du, xie fu mo yuan 濕熱蘊毒，邪ä¼è†œåŽŸï¼Œé‚ªé˜»å°‘陽. The

treatment mainly involves clearing and transforming the heat and dampness,

ventilate and promote the free circulation of the Qi qing hua shi re,

xuanchang Qi ji 清化濕熱，宣暢氣機. After sorting out the clinical pattern

fen zheng 分証 use either the adjusted jia jian 加減 formulae gan lu xiao du

dan 甘露消毒丹 Da Yuan yin é”原飲’, Hao Qin Qing Dan Tang 蒿苓清膽湯. In

this phase, majority duo shu 多數 patients after going through a course of

TCM treatments can directly move towards the recuperation stage. However,

there are also cases who being affected by strong toxins du li 毒力 continue

to deteriorate and thus enter the ‘Climactic Phase’ ji qi 極期.

 

Climactic Phase At this phase, aside from manifesting a preponderance of

damp heat and toxin shi re du sheng 濕熱毒盛, slight symptoms of Qi

exhaustion, damage to the Yin , blood stasis and internal blockage hao Qi,

shang yin, yu xue,nei zu 耗氣傷隱，瘀血內阻. Hence, in the treatment

deployed in this phase, aside from dispelling the heteropathy qu xie 祛邪,

support for the Zheng Qi fu zheng 扶正 must simultaneously be stressed. In

this phase, the formulae bai hu jia ren shen tang 白虎加人åƒæ¹¯; Qing Ying

Tang 清營湯; 犀角湯, and add some materia medica which can enliven blood

flow and transform the stasis huo xue hua yu 活血化瘀. At the same time

,administer intravenously the injection formulae shen fu zhen åƒé™„é‡, shen

mai zhen åƒéº¥é‡; Dan Shen zhen 丹åƒé‡ etc. When the clinical pattern of

‘closure of the openings’ bi zheng 閉症 and ’exhaustion’ tuo zheng 脫癥

appears, either of the formulae an gong niu huang wan 安宮牛黃丸

or Zi Xue Dan 紫雪丹 may be added.

 

Recuperation Phase hui fu qi æ¢å¾©æœŸ

At this phase, the patient’s Zheng Qi is vacuous or deficient while

the heteropathy is “reluctant to leave its post†Zheng Xu Xie lian 正虛邪戀

while at the same time the patient is also ‘harboring’ dampness and stasis

xie shi xie xu 挾濕挾瘀. The treatment at this phase must support the Zheng

Qi(medicatrix naturae) and dispel the heteropathies. fu zheng tou xie 扶正

é€é‚ª. At the same time, attention must also be given towards transforming

the dampness and enlivening blood flow hua shi huo xue 化濕活血. Based upon

the degree of vacuity of the Zheng Qi and the different heteropathy harbored

xie xie 挾邪, one can tailor a treatment hua cai åŒ–è£ from the formulae Shen

Mai San åƒéº¥æ•£, Sha Shen Mai Dong Tang æ²™åƒéº¥å†¬æ¹¯, Li shi Qing Shu Yi Qi

Tang æŽæ°æ¸…暑益氣湯 Shen Ling Bai Shu San åƒä»¤ç™½è¡“æ•£, Xue Fu Zhu Yu Tang è¡€

府é€ç˜€æ¹¯ etc. During the recuperation phase, due to the’harboring’ of

Dampness heteropathy Xie you shi xie 挾有濕邪, while there is damage to the

yin yin shang 陰傷, there are no manifestations of red tongue she hong 舌紅

and little amount of tongue coat shao tai å°‘è‹”.. Hence, when the patient

exhibits symptoms and signs such as dryness in the mouth, incoherent talk

yi yu å½èªž, the pulse is thready and rapid mai xi shuo 脈細數, fatigue fa li

ä¹åŠ› , this clinical condition can be diagnosed as damage to the Yin. We

should not be a stickler for the configuration of the tongue bu bi ju ni yu

she xiang ä¸å¿…拘泥於舌象.

 

Professor Lin said, SARS is a a human calamity. It came very

ferociously, and the trajectory of the illness was very severe. Treating the

disease went through a very tortuous and difficult course. However, on the

main, we have to integrate CM with WM, use the strong point of one to make

up for the shortcoming of the other. In this way, the disease condition can

be better put under control.

 

Among Thousands of Medical and Health Personell-Not A Single One Got

Infected

 

Professors Zhu Min and Peng Sheng Quan from the No.1 Hospital Attached

to the Guangzhou TCM University in the course of using TCM’s tailoring of

treatment in accordance with the diagnosed clinical pattern bian zheng lun

zhi 辨證論治 have achieved excellent clinical results. At the casualty ward

where Prof. Zhu Min was , from February to April 17th, all in all 37 SARS

patients. were admitted Through integrated CM and WM treatments, all these

patients disease conditions were all placed under control. At present mu

qian ç›®å‰, aside from four patients who are still in the hospital, all of

the other 33 patients have been

 

cured and discharged from the hospital. On the average , within 2.97 days

the fever went down. On the average, the time for hospitalization of the

SARS patient was about 9 days. In addition , among the more than one

thousand medical and health personnel of the hospital, not one got infected

wu yi gan ran 無一感染. In summing-up the experience of the hospital with

SARS, Prof. Zhu mentioned two things: first, ventilation tong feng 通風. As

much as possible, reduce the possibility of air flow. Secondly, ‘tailoring

treatments in accordance with the diagnosed clinical pattern’ bian zheng shi

zhi 辨證施治, put into full play the superiority of ‘CM-WM comprehensive

treatments ‘ zhong xi yi zong he zhi liao 中西醫綜åˆæ²»ç™‚, regulate the patient’s auto-immune system , and enhance hiscapacity to resist disease.

 

In summing-up Guangzhou City’s experience in using the integrated CM-WM

method of preventing and treating SARS,a number of proposals from TCM

experts is worthy of our attention:

 

I. In the course of treating SARS the early and timely intervention and use

of TCM materia medica is very important. According to Director Lin, at the

No.2 Hospital Attached to the Guangzhou City TCM University, there were 15

medical and health personnel who got infected in the course of treating SARS

patients. At that time they exhibit early symptoms of the disease like

fever. After the use of TCM’s tailoring of treatment to the diagnosed

clinical pattern bian zheng shi zhi and without the use of any Western

medicines, the progression of the disease was stopped and good clinical

results were achieved. And among the 38 SARS patients treated by Prof. Pang

Sheng Quan, everyone were discharged from the hospital except one who

received late TCM intervention and did not respond to emergency treatment.

 

 

II. At the early stages of SARS, slight clearing , dispersing and dispelling

qing qing xuan tou æ¸…è¼•å®£é€ therapeutic methods may be used. However , no

cold and cooling han liang 寒涼 (materia medica) must be used. This will

prevent ‘the closing of the door and allow the heteropathy to be harbored

inside.’yi fang guan men liu xie 以防關門留邪. Prof. Deng Tie Tao from the

Guangzhou TCM University thinks that although SARS patients have been

afflicted by ‘Damp, Heat Toxic heteropathies’ shi re du xie 濕熱毒邪,

however, internally their ZhengQi (medicatrix naturae) must be vacuous zheng xu 正虛 i.e. in winter theymust have been damaged by cold dong shang yu han 冬傷於寒, and thus inspring they will suffer from ‘warm febrile’ disease chun bi bing wen 春必病

溫. Hence, at the initial stages of the disease, the treatment must be aimed

at ‘ascending and dispersing ventilating and dispersing’ sheng san xuan tou

å‡æ•£å®£é€. Excessively cold materia medica must not be used. We must give the

‘damp heteropathy’ a way out. This is a matter that needs to be looked at in

the entire course of the treatment of SARS. Prof. Deng also thinks that it

is not suitable to use antibiotics kang sheng su 抗生素 in the treatment

of SARS. On the one hand, antibiotics can damage the Zheng Qi of the patient

thereby aggravating its vacuity (deficiency) On the other hand, TCM thinks

that antibiotics has a cold and cooling inclination xing pian han liang 性å

寒涼 which can stagnate the dampness heteropathy thereby giving no way out

to the heteropathy.

 

III. Because of the complicated nature of SARS , in the course of its

pathological transformation, dampness, stasis ,toxins and vacuity all were

‘harbored’simultaneously . Hence at the initial stages of the disease, one

must simultaneously support the Zheng Qi, enliven blood flow, soften any

hardening(of feces) , and disperse any accumulation of masses. American

Ginseng administered orally can support the Zheng Qi and nurture the root

and dispel the heteropathy. The formula Xian Fang Huo Ming Yin can transform

the stasis, soften any hardening, connect the Yang Qim and transform the

dampness; prevent fibrosis of the lungs as well as the focal spread, while

promoting the early absorption of the focal disease. At the same time, in

the course of the treatment, administer the formula An gong Niu Huang Wan as

early as possible in order to prevent the toxic heteropathy sink into the

pericardium, thereby preventing the transmission of the illness.

 

IV. In the course of the treatment, the bowels must be kept open in order to

promote the expulsion of the toxins.

 

The TCM experts stressed the point that their therapeutic experience

was clinically patterned out bianzheng dechu 辨證得出 of the actual local

condition of Guangdong Province. When other regions draw lessons from this

experience and perform a tailoring of treatment in accordance with the

diagnosed clinical pattern of SARS patients, it must be done in accordance

with their local requirements . The above experience clearly indicates that

in the prevention and treatment of SARS, TCM has a great potentials. Lin thinks that in the

 

course of dealing with SARS, TCM ‘s role is manifested in five aspects. :

early intervention, prevent the progression of the disease; clearly

alleviates the symptoms; shorten the duration of fever and period of

hospitalization of the patient; enhance the absorption of the inflammatory

effusion, and reduce any sequelae; reduce complications and side-effects

from Western drugs.

 

TCM Was not Given Its Due Worth

 

The World Health Organization expert Dr. James McGuire when inspecting

the Guangdong Provincial TCM Hospital then gave a very high regard to

results of TCM treatment of SARS. He then said that the experience of TCM “

has great help in finding a conventional treatment (for the disease)†.

However, some experts thought that at present, due to various reasons, TCM

was not given its due worth in the overall strategy of preventing and

treating SARS. Hence, they are making a strong call that at the present

situation when there are no specific effective medicine against SARS, TCM

must be allowed to get into the treatment of the disease and give full play

to the the superiority of the system of integrated CM and WM. Take the good

sides from each system to achieve a victorious battle ag ainst SARS.

 

Zhu Guo Ben , the chairman of the China National Medical Association

thinks that the integration of CM with WM can rationalize medical resources,

reduce mortality and complications and reduce medical cost.

[Guest guest]

Rey,

This last paragraph of the paper you translated appears to indicate a lifting of the worth of Chinese medicine in the eyes of the powers that be. Clearly Western medicine at this time has no treatment for cold or flu viruses, and Chinese medicine clearly has value in treating such conditions. Do you sense at least a slight rise in the stock of CM in China? "Scientism" as you put it is no doubt a difficult religion to go up against.

Emmanuel Segmen

 

TCM Was not Given Its Due Worth The World Health Organization expert Dr. James McGuire when inspecting the Guangdong Provincial TCM Hospital then gave a very high regard to results of TCM treatment of SARS. He then said that the experience of TCM “has great help in finding a conventional treatment (for the disease)†. However, some experts thought that at present, due to various reasons, TCM was not given its due worth in the overall strategy of preventing and treating SARS. Hence, they are making a strong call that at the present situation when there are no specific effective medicine against SARS, TCM must be allowed to get into the treatment of the disease and give full play to the the superiority of the system of integrated CM and WM. Take the good sides from each system to achieve a victorious battle ag ainst SARS. Zhu Guo Ben , the chairman of the China National Medical Associationthinks that the integration of CM with WM can rationalize medical resources,reduce mortality and complications and reduce medical cost.

[Guest guest]

May 13,2003

 

Dear Emmanuel,

 

I think there was a very slight rise in the stock of TCM in the

course of this SARS epidemic. However, it is still a very hard

slog considering the hold of the scientiistic and modernistic

religion in China at the moment.. There are bright spots on the

horizon however, especially the trend of TCM development in

Hongkong. I can see the core of the TCM practitoners and

academics in HK as leading the move towards an independent

TCM indentity in China. But the job will not be that easy.

 

For us TCM practitioners in the West, the SARS epidemic was a

great foreplay as to how this sort of epidemic might fan out in

the future. We now have some clear idea who the powers might

be who will certainly re-play their respective roles in the future

and we are now conceptually prepared on how to deploy our

strategic resources.

 

Regards,

 

Rey Tiquia

 

, " Emmanuel

Segmen " <susegmen@i...> wrote:

> FW: SARS:Summing-UpRey,

> This last paragraph of the paper you translated appears to

indicate a lifting of the worth of Chinese medicine in the eyes of

the powers that be. Clearly Western medicine at this time has

no treatment for cold or flu viruses, and Chinese medicine

clearly has value in treating such conditions. Do you sense at

least a slight rise in the stock of CM in China? " Scientism " as

you put it is no doubt a difficult religion to go up against.

> Emmanuel Segmen

>

> TCM Was not Given Its Due Worth

>

> The World Health Organization expert Dr. James McGuire

when inspecting the Guangdong Provincial TCM Hospital then

gave a very high regard to results of TCM treatment of SARS. He

then said that the experience of TCM “has great help in

finding a conventional treatment (for the disease)� . However,

some experts thought that at present, due to various reasons,

TCM was not given its due worth in the overall strategy of

preventing and treating SARS. Hence, they are making a strong

call that at the present situation when there are no specific

effective medicine against SARS, TCM must be allowed to get

into the treatment of the disease and give full play to the the

superiority of the system of integrated CM and WM. Take the

good sides from each system to achieve a victorious battle ag

ainst SARS.

>

> Zhu Guo Ben , the chairman of the China National Medical

Association

> thinks that the integration of CM with WM can rationalize

medical resources,

> reduce mortality and complications and reduce medical cost.

[Guest guest]

Rey, Emmanuel, and all

 

I'm currently in the pre-production process

of a special probably one-hour program on

the TCM understanding and approach to SARS

for China Central Television. The program

will be in English and will be broadcast

internationally. I will appreciate any help,

suggestions, comments, warnings, threats,

and cat calls that anyone has to offer.

 

Thanks,

 

Ken

 

PS. Please either post to the list or send your

feedback to me at my hotmail address.

[Guest guest]

, " dragon90405 " wrote:

> I'm currently in the pre-production process

> of a special probably one-hour program on

> the TCM understanding and approach to SARS

> for China Central Television. The program

> will be in English and will be broadcast

> internationally. I will appreciate any help,

> suggestions, comments, warnings, threats,

> and cat calls that anyone has to offer. >>>

 

 

Ken:

 

Sounds exciting. Have you been able to verify that a SARS patient

was treated by TCM and improved?

 

 

Jim Ramholz

[Guest guest]



Clearly Western medicine at this time has no treatment for cold or flu viruses,

>>>Not true, there are several drugs for type a flu

alon

[Guest guest]



 

Electrical Acupuncture Beneficial in Older Patients With Chronic Low Back Pain

NEW YORK (Reuters Health) May 13 - Percutaneous nerve stimulation (PENS) via acupuncture needles reduces pain and disability in older patients with chronic low back pain, based on results of a study published in the May issue of the Journal of the American Geriatrics Society.

In addition, mood, life control and physical performance are improved in these patients.

Dr. Debra K. Weiner, of the University of Pittsburgh, Pennsylvania, and colleagues randomly assigned 34 patients at least 65 years of age with chronic low back pain to receive PENS twice a week plus physical therapy or sham PENS plus physical therapy for 6 weeks.

PENS involved the placement of acupuncture needles "at the appropriate dermatomal, myotomal and sclerotomal levels," with electrical stimulation at frequencies ranging from 2 to 200 Hz. Sham PENS used needle placement without electrical stimulation.

The researchers assessed pain intensity and pain-related disability at baseline, immediately following the 6-week intervention period, and again 3 months later. They also examined secondary outcome measures, including physical performance, psychosocial factors, and cognitive function.

"The PENS plus physical therapy group displayed significant reductions in pain-related disability from pre- to post-treatment (p = 0.002), but the sham PENS plus physical therapy group did not," Dr. Weiner and colleagues report. "The effect was maintained at the 3 month follow-up."]

The PENS plus physical therapy group, but not the control group, also showed significant improvements in psychosocial function, timed chair rise, and lifting endurance.

The investigators say these preliminary findings indicate that PENS is promising in this setting, but validation is needed before it could be adopted in clinical practice.

J Am Geriatr Soc 2003;51:599-608.