by Harriet Beinfield and Efrem Korngold

Kan Herbal Crossroads: February 2005

Now that autumn leaves have fallen, winter rains have arrived, signifying Nature's official warning to prepare for the season of colds and flus-the time of sicknesses due to Invasion by Cold, Wind, and Damp. The ancient texts describe autumn as the "killing season" corresponding to the phase of Metal and the organ network of the Lung. The phrase killing season suggests that autumn is a time when the luxuriant, warm, munificent efflorescence of summer has vanished, leaving plants, animals, the ground, and our own bodies exposed and vulnerable to harsh changes in the environment.

The Lung Network-which includes the lungs, bronchi, trachea, nose, sinuses, the large intestine and the skin-governs all of the protective boundaries of the body and the movement of the Wei (defense Qi): those surfaces and functions that act as the interface between our insides and the external world. In a psychological sense, the Lung Network also acts to protect us from psychic and emotional negativity and to facilitate the outward expression of our authentic feelings and thoughts. So it's no surprise that becoming mentally strained or emotionally drained can diminish our resistance to illness. The Chinese Modular Solutions repertoire offers a number of formulas and strategies for coping effectively with the challenges of the fall and winter seasons.

Winter Seasons

How can we adjust our psychic and body rhythm to suit the season? During the frostiness of winter, plants submerge their lifeblood into their roots, animals thicken their hides, and ponds harden into ice. This is a time of apparent quiescence and stasis, yet beneath the surface is the hidden activity of gestation and germination that will bring forth renewal in spring. Before seeds and bulbs germinate, they demand a spell of chilly slumber.

Winter is a time to scrutinize things, until their meaning and significance coalesce into the germ of understanding. During this period of hibernation, the essence of life persists in its most primitive state. The Kidney abides within us like the bear in its cave, harboring the germ of being, our Essence (Jing), feeding and renewing our life. Whereas Kidney Yin controls the juicy essences, Kidney Yang is like an ember concealing its intense heat within a dark husk of charred wood, ready to ignite new fuel, re-kindling the metabolic process. All the other organs depend upon the Kidney for moistening and regeneration (Yin), and for animation and warmth (Yang). The Kidney is like the pilot light burning beneath the cauldron of the Stomach, so good digestion also depends upon the Kidney.

The Kidney is vulnerable to damage by exposure to cold-cold weather or air conditioning-and by the ingestion of iced or refrigerated foods and beverages. Kidney Yin is subject to damage by chemical agents, such as antibiotics, analgesics, tranquilizers, food additives, air pollutants, and recreational drugs. It may also be harmed by inadequate intake of water and too much bitter, salty, or hot, spicy food. The Kidney Qi or Essence is often drained as a result of inadequate sleep, excessive exercise or sexual activity, and overworking.

Winter is the time to slow down, rest, accumulate reserves, and take stock, reflecting upon how our lives match what we envision for ourselves. During the dark nights of winter, we harvest our memories and dreams. We hope that our wisdom is married with compassion as we attempt to close the gap between what we imagine can be, compared to what we see.

Colds and Flus: Early Intervention

The Chinese medicine view explains that colds and flus are disorders caused by the attack and invasion of external pathogenic influences (Cold, Heat, Humidity, Dryness, Wind). These attacks manifest along yang yin continua: the parameters of congestion-depletion (shi xu), hot-cold (re han), external-internal (biao li) or superficial-deep (fu shen). The prime objective in treating the syndromes of colds and flus is to intervene before they become entrenched (internal and/or deep), undermining the patient's resistance and exhausting her adaptive reserves (depletion and attrition of qi, blood, essence).

Useful prescriptions for colds and flus using Chinese Modular Solutions

Symptoms & Signs

Solutions

Purge External Wind
For chills, headache, muscle soreness, skin sensitivity, sneezing and runny nose

Congestion Solution
For the above symptoms minus chills, but with the addition of sinus pain, earache, toothache, and eye pain

Windbreaker
For sneezing, stuffy or runny nose, scratchy throat, stuffy or painful ears, hoarseness, irritated eyes, fullness in the sinuses, slight cough due to post-nasal drainage

Phlogisticlean
For swollen or painful sore throat, swollen and/or tender glands in the neck or under the jaw, with or without fever, with or without soreness of muscles and joints

After the Fall (second stage of acute illness)

Symptoms and signs of the early stage of colds and flus may persist or transform into those of the second stage, at which time the illness becomes deeper and/or more virulent. The following formulas may be administered individually or combined with any of the preceding ones.

Symptoms & Signs

Solutions

Chest Relief
For simple bronchial cough, thickened or lightly colored phlegm, pain or tightness in the chest, cough with wheezing, or difficult expectoration

Purge Heat
For low to moderate fever without chills; sores in the mouth, on the lips or on the tongue; burning sensation in the chest, throat, nose, eyes, or skin

Purge Phlegm
For cough and/or nasal discharge with thick, sticky phlegm

Consolidate Moisture
For excessive perspiration while coughing, eating, or with exertion

Strengthen Lung
For a feeling of weakness in the chest, shortness of breath, fatigue, cough triggered by cold air, physical exertion, or mental effort

Secondary Patterns

Even though a person has been exposed to a viral infection, he may not develop an illness without a triggering event such as exposure to sudden changes in the weather, a few nights with inadequate sleep, an evening of overindulgence in food and alcohol, or overdoing a workout at the gym. Psychological stressors may also have an adverse impact on resistance. Colds and flus are often accompanied by mental and emotional features like irritability, irascibility, melancholy, confusion, fright, even depression. While the respiratory system may appear to be the primary target, these secondary symptoms reveal a more complex pattern of dysfunction. Sometimes it is necessary to combine the remedies for the primary pattern-the physiological manifestations of the cold or flu-with one or two for secondary patterns that result from the impact of a Lung Network disharmony on other organ networks. And these other organ networks will not necessarily display discreet physical symptoms, but rather a mix of minor somatic and psychic complaints.

The following formulas may be added to any protocol or mixed with any of the above formulations.

Symptoms & Signs

Solutions

Harmonize Lung-Liver
For tense or depressive mood, irritability or irascibility, discomfort in the ribs, upper abdomen, or waist (especially when coughing or sighing), difficulty taking a deep breath, muscle twitches or cramps, neuralgias, vertex, occipital, or lateral headache

Harmonize Heart-Lung
For melancholy, sensitive or tearful mood, fright or anxiety, uncomfortable sensations in the region of the heart, palpitations or tachycardia, insomnia, fearful dreams, itching, rashes, or pimples

Comfort Shen
For extreme mental or emotional anxiety and concern about illness that interferes with treatment and/or recovery

Recovery and Redemption

Appropriate treatment during the recovery stage is no less important than effective treatment at the onset or during the progression of a viral illness. Though most people will feel fine completing the process of recovery without assistance, it is during the final resolution of an acute illness that there is an opportunity for restoring and invigorating the patient's overall resilience and resistance, thus helping to prevent relapses and reduce the incidence of future sickness.

A prolonged cold or flu, especially one that develops into bronchitis, can leave the patient fatigued, dehydrated, debilitated by excessive coughing and loss of appetite, and worried about being able to recover her strength and enthusiasm for everyday living. This is the time to supplement the qi, moisture, and blood and revive the function of the organ networks, particularly that of the Spleen, the Lung and the Kidneys-the Three Sources of Qi.

The following formulas or combinations of formulas are useful during the recovery stage.

Symptoms & Signs

Solutions

Move Mountains
For general fatigue, weakness and lack of enthusiasm

Strengthen Lung + Consolidate Moisture
For lingering tendency to cough after effort or from exposure to cold air or airborne irritants, and thirst

Strengthen Spleen + Purge Phlegm (in the throat) or Congestion Solution (in the head) or Chest Relief (in the bronchi)
For loss of appetite, lethargy, and lingering congestion of mucus

Strengthen Lung + Tonify Blood
For weakness and fatigue, generalized dryness of skin and hair, with lingering cough due to dryness of the throat but without thirst

Strenghten Lung + Tonify Qi + Tonify Blood + Purge External Wind
For generalized weakness, fatigue, a feeling of vulnerability and concern about relapsing

Strengthen Lung + Strengthen Kidney
For generalized fatigue, a feeling of weakness or vulnerability in the chest and soreness or tiredness of the low back and legs

Prevention and Early Intervention

We have come full circle from the earliest stage, through progression of a cold or flu, to recovery and restitution. Now the matter of prevention comes to the fore. Ultimately, the prevention of both minor and serious illnesses depends largely on the strength of a person's constitution, their adaptability to challenges and change, and their general level of nutrition, work, recreation, rest, sleep, and gratification, plus a large dose of good luck. However, there are strategies for augmenting someone's resistance when there is an expectation of exposure to viral infection: on an airplane, in the company of others who are already sick, in a hospital or outpatient medical clinic, starting school after summer vacation, returning to work after a holiday.

In this context, prevention and early intervention are essentially the same. The objective is to avoid getting sick at all or to greatly minimize the severity and duration of any complaints that might arise. According to Chinese medicine theory, to prevent illness it is necessary to augment the Ying and the Wei, the Blood and the Qi, and to strengthen the Root. The Ying and Wei, Blood and Qi correspond to the Spleen and Lung respectively; and the Root corresponds to the Kidneys. Thus we return to the Three Sources of Qi.

There are numerous approaches and methods for strengthening the body and fortifying its resistance to disease. This is best accomplished when a person is already in a reasonably good state of health. The traditional way to achieve this is to employ so-called tonic herbs similar to the manner in which people take a daily multi-vitamin. Chinese Modular Solutions formulas and combinations of formulas that meet these criteria include: Move Mountains, Tonify Qi + Tonify Blood, and Replenish Essence. And, if you look closely at the ingredients in these formulas, you will see that Move Mountains is a remedy that very adroitly incorporates ingredients that replenish and harmonize Qi, Blood and Essence. Choosing just the right formula(s) of course depends upon a determination of the locale of an individual patient's weaknesses, whether constitutional (from birth) or acquired. But, for general purposes, these three formulas will be beneficial for almost every case in which the person needs to be re-invigorated after recovering from an illness, from surgery, or any other challenge or strain that has sapped his resources.

For a healthy person who wants to remain so, in spite of the fact that he will come into contact with people who might be infected or already sick, there are also a few effective combination remedies. These include: Windbreaker + Chest Relief, Strengthen Lung + Purge External Wind or Congestion Solution + Phlogisticlean.

The Excellent Record of Two Pediatric Formulas

Although Windbreaker and Chest Relief were originally formulated specifically for children-for whom they have produced consistently good and sometimes miraculous results-they turn out to be effective for adults as well. Several pediatricians have used these two formulas in their large practices to successfully treat chronic, recalcitrant otitis media (Windbreaker) as well as acute and chronic bronchial asthma (Chest Relief). Since many colds eventually progress from a superficial upper respiratory illness to a bronchial cough, a sinusitis, or both, the combination of these two formulas is especially effective for preventing a cold or flu from developing or, once it has appeared, shortening its course and mitigating its severity. Many adult patients can benefit from this combination, especially as a protection while traveling or when under other conditions of stress and exposure.

Some Illustrative Cases

Case Illustration #1

A forty-four-year-old woman called to say that both she and her three-year-old son had come down with a cold. The boy was sneezing, had a runny nose with a clear discharge, but without any signs of cough, fever, headache or other discomfort. The mother reported a very sore throat, felt better after drinking warm liquids, the glands under her jaw were tender but not swollen, and she had a non-productive but painful cough, with a feeling of weakness in her chest. She was not experiencing fever or chills, but she was feeling unusually weary.

This patient also had a six-year-old boy who did not appear to be ill; but the boys had just started pre-school and first grade. My recommendation for the younger boy was 60 drops of Windbreaker every four hours. I also suggested that his older brother be given 60 drops of Windbreaker twice a day, hopefully to prevent his coming down with a cold. For the mom I prescribed the following combination: Chest Relief + Phlogisticlean + Strengthen Lung, 90 drops in hot water every two hours.

The younger brother's symptoms cleared up within 48 hours. The older brother developed sniffles with a slight fever and fatigue for about a day and then was fine. Because the mother had to take extra care of both boys for a few days, she became even more tired. Her sore throat persisted and her cough became more severe and painful, although her lymph nodes were no longer tender. She began to feel quite weak and vulnerable, fearing that she could develop walking pneumonia that she had suffered a few years earlier. She had progressed to the second stage of her illness.

Since one of the primary features she had at this stage of her illness was pain, a feeling of weakness, and vulnerability in her chest, her prescription was modified as follows: Strengthen Lung + Chest Relief + Harmonize Heart-Lung + Tonify Blood. For pain in the chest due to bronchial inflammation-as opposed to tension in the ribs, in which case Harmonize Lung-Liver would be indicated-Harmonize Heart-Lung is almost always helpful in conditions where there is inflammation with pain or itching in either the skin or the respiratory organs. The addition of Tonify Blood helps to moisten and soothe the sensitive membranes of the bronchi, trachea, and throat, especially when thirst is not a prominent feature.

Taking 120 drops every four hours began to resolve the symptoms within a couple of days; and within one week she was well on the way to recovery. A post-recovery tonic for this patient was: Harmonize Heart-Lung + Strengthen Lung + Tonify Blood.

Case Illustration #2

A 56-year-old man had been receiving treatment for about two months for chronic hives, nasal congestion due to respiratory allergies, and recurring sinus infections. Typically, if he caught a cold it would immediately worsen into a sinus infection with a great deal of sinus congestion, purulent discharge, and severe headache. In the past he would ultimately require antibiotics to resolve the infection.

All of his symptoms had been gradually improving when he came down with a cold. He had been taking the following combination for his chronic condition: Congestion Solution + Purge Heat + Tonify Blood + Harmonize Heart-Lung, 60 drops in warm water taken three to four times per day depending on the frequency and severity of his complaints. I modified this prescription to address the acute cold symptoms of sneezing, runny nose, and a slight frontal headache, prescribing: Purge Heat + Purge External Wind + Harmonize Heart-Lung + Tonify Blood, 90 drops in hot water to be taken every two hours until the symptoms began to improve, and every four hours thereafter. For this patient, the combination of Harmonize Heart-Lung and Tonify Blood helps to quell the inflammation in the skin that is due to "Wind penetrating the Blood". Harmonize Heart-Lung is good for rashes characterized by Heat (erythema), swelling and itching--urticaria (hives) is the most common example of this. And the combination of Tonify Blood with Purge External Wind is almost a generic remedy for any kind of itching in conditions where Blood deficiency is a prevalent pattern.

When he returned for his next appointment a week later, he had not developed a sinus infection, as he had feared-the acute congestion had cleared within four days and his hives continued to recede. After the cold was resolved, he experienced a bout of acute hay fever, but that resolved within a day and his sinuses were feeling clearer than they had in many years.

Case Illustration #3

A 13-year-old autistic boy with a history of chronic allergic rhinitis and recurring sinusitis had been receiving treatment for several months that included weekly acupuncture, dietary changes (exclusion of wheat and milk products), and herbal formulas. His formula for the past several weeks combined were: Congestion Solution + Digestion Solution + Harmonize Liver-Spleen + Harmonize Lung-Liver. Gradually his sinus congestion had been clearing-up, he was less reactive to seasonal pollens, was becoming slimmer and more muscular, and doing much better in school. Six months after beginning treatment he developed cold symptoms: a somewhat irritating, blood-tinged, nasal discharge, slight headache, and a very stuffy nose. He began taking the following combination: Purge External Wind + Purge Heat + Windbreaker. One week later his cold symptoms had mostly cleared, but he had developed a slight cough, probably due to post-nasal drainage, and he was irritable and inattentive at school. His new prescription included: Windbreaker + Purge Heat + Chest Relief. The next week his father reported that all of his symptoms had cleared within a few days and, as a result, he was sleeping better and performing better in school.

Case Illustration #4

A fifty-two-year-old man with Hepatitis C, who had been treated for six months with Interferon and Ribivarin two years before, began treatment with acupuncture and Chinese herbal medicine in hopes of improving his general health and controlling his Hepatitis without needing to resort to antiviral therapy in the future. He also had a history of allergic sinusitis and indigestion. He was given the following daily constitutional prescription: Harmonize Liver-Spleen + Harmonize Lung-Liver + Digestion Solution + Purge Heat. After several weeks on this regimen, all of his symptoms were markedly improved and he was feeling better than he had in many months.

He was planning a cross-country trip and was worried that he might catch a cold and develop sinusitis, so he was given the following prescription as a preventive remedy in addition to his regular formula: Congestion Solution + Phlogisticlean, 60 drops to be taken every two hours while traveling and two times per day after arriving at his destination. He was also advised to increase the dose and/or the frequency if he developed any signs of a cold. He returned after two weeks and reported complete success in avoiding illness.

A Note About Combining Formulas

In preparing CMS prescriptions, measure the ingredients according to the bottle size that you select: a one-ounce holds approximately 30cc, a two-ounce bottle 60cc, and a four-ounce bottle 120cc. For example, in case illustration #2 the patient's prescription for his chronic condition was: Congestion Solution (30cc) + Purge Heat (30cc) + Tonify Blood (30cc) + Harmonize Heart-Lung (30cc). The constituent formulas are in equal proportions because each one addresses an equally prominent aspect of the patient's condition. On the other hand, in case illustration #3, the patient's prescription is: Congestion Solution (40cc) + Digestion Solution (40cc) + Harmonize Liver-Spleen (20cc) + Harmonize Lung-Liver (20cc), with unequal proportions of constituent formulas so that the primary features of his condition (chronic nasal & sinus congestion along with poor digestion) receive greater emphasis than the underlying constitutional patterns (the disharmony between the Liver, the Spleen, and the Lung).

For an acute condition that may be rapidly changing, choose a one ounce or two ounce bottle. For example, in illustration #3, a two ounce bottle of the final prescription was given: Windbreaker (30cc) + Purge Heat (15cc) + Chest Relief (15cc). In this case, Purge Heat and Chest Relief serve to complement and enhance the action of Windbreaker. And for the young patient described in illustration #1, a one ounce bottle (30cc) of Windbreaker was given with the expectation that his cold would either resolve quickly or rapidly develop into another stage.