Tuesday, April 28, 2009

Swine Flu, Concerned Parents, Western Medicine and Chinese Medicine

Yesterday I got an email from my dad. I've been sick for the past few weeks, but what with finals and the end of school, I only got serious about treating it last Friday, when I went to see Dr. Yuhong Chen at the Yosan clinic (scroll down to read her bio). I had two acupuncture treatments and she wrote a kick-ass herbal formula, and five days later I'm back to 100%.

My main symptom was sore throat, persisting for three weeks, plus fatigue, and at various points during that four weeks I had body aches, slight fever, night sweats, thick sticky green phlegm streaked with blood, thin white phlegm, and probably something else too. It sounds bad when I write it all out, but it didn't bother me too much. All those symptoms didn't occur at the same time, and when they did occur they only lasted a day or so. The only thing that persisted was the sore throat.

In a phone conversation last weekend, my dad suggested that I go get a throat culture and, if it turned out to be strep throat, take antibiotics. I told him that I was fairly sure it wasn't strep, and even if it was, I'd rather take Chinese medicine. Like many Americans, I don't have health insurance, and my last trip to the ER cost me nearly $1000.

Then the swine flu media panic got out of control over the weekend, and I had the email exchange reproduced below with my dad. I guess I was a little defensive about Chinese medicine - after all, I just spent four years studying this completely different, completely effective system of medicine, and now my dad wants me to take antibiotics and Tamiflu? Sheesh.

But I think it's instructive about the way a lot of people feel about Chinese medicine - that's it's good for mild symptoms, but if it's "something serious," then you absolutely have to "go see a doctor," which means an M.D. The fact is, Chinese medicine can treat everything. Let me say that again: Chinese medicine can treat everything.

And now, without further ado...

11:54 AM (22 hours ago)
(My Dad)
to me

Hey Jonah,

Not sure if your symptoms fit this profile, but if they’re in the ballpark I would urge you to go to a clinic or even a hospital ER somewhere to get a test. This has public health implications – the only way the CDC can track what’s happening is by monitoring test results – but more important the health networks are well stocked with anti-virals (tamiflu and another one whose name I forget) that so far have been effective if the result turns out positive. So no need to panic, but also no reason not to be proactive. From the news reports it looks as if this could get serious down the line. As you have probably been reading, the group most at risk from this outbreak are healthy young adults in the 20-40 age range.



From: Lisa
Sent: Sunday, April 26, 2009 7:29 PM
Subject: IMPORTANT UPDATE! Swine Influenza Outbreak.
Importance: High

Fellow Employees:

The World Health Organization (WHO) and Center for Disease Control (CDC) have confirmed an outbreak of the Swine Influenza A/H1N1 (swine flu) in Mexico with now twenty (20) confirmed cases in the United States. Swine Influenza is a respiratory disease found in pigs caused by type A influenza that regularly causes outbreaks of influenza among pigs. CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people.

The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Your health and the health of your family is greatly important. Please take some general precautions during this time.

Since influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people, there are many things you can to do preventing getting and spreading influenza:

Everyday actions:

· Cover coughs and sneezes with tissues or by coughing into the inside of the elbow. Throw the tissue in the trash after you use it.

· Wash your hands often with soap and water for 20 seconds, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.

· Avoid touching your eyes, nose or mouth. Germs spread that way.

Try to avoid close contact with sick people.

· Limit close contact (within 6 feet) with others when possible.

· Stay away from places where there are large groups of people.

· If you get sick, CDC recommends that you stay home from work and limit contact with others to keep from infecting them.

All offices remain open at this time. However, we would like to recommend that business travel to/from Mexico be delayed/re-scheduled. In lieu of travel, please consider conducting conference calls and/or video conferences.

The following link is the CDC’s Q&A which provides the detail regarding when to contact your health care provider, especially for children or someone with pre-existing health issues. http://www.cdc.gov/swineflu/swineflu_you.htm

We will continue to send you updates on any important information as it becomes available. Please contact your HRBP or the Benefits Team if you have any other questions or concerns.


Vice President, Human Resources

1:23 PM (21 hours ago)
Jonah Ewell
to (My Dad)

Hey Dad,

I appreciate your concern! But I'm getting much better. Chinese medicine is much much more effective for any kind of influenza than drugs. When SARS broke out in China, they used herbal medicine. If Chinese medicine were in wider use in the Americas, swine flu would be much easier to contain. Obviously, to treat the root of the problem you need to stop having factory farming and crowding huge amounts of pigs together, which concentrates effluvia (aka pigshit!) and breeds disease. Until that happens, Chinese medicine, handwashing, and rest are the best way to recover from a flu.

I'm currently taking a Chinese herbal prescription which consists of 15 herbs. Some of the key herbs, such as 茵陳蒿 Yin Chen Hao (a type of artemisiae) and 山豆根 Shan Dou Gen (a type of sophora root) have been proven in laboratory testing to have broad-spectrum antiviral and antibacterial actions. No need to worry, Chinese medicine is on the case!


1:53 PM (20 hours ago)
(My Dad)
to me

OK, sounds good. But do you know whether you have the particular virus that’s in the news?




2:35 PM (19 hours ago)
Jonah Ewell
to (My Dad)

In the framework of Chinese medicine, it's unimportant what exact microbe or virus is causing you problems. Western science and medicine is reductionist, always looking for that ONE THING that they can point to and say is the cause of illness. When you find the exact bacteria or virus, all you have to do is kill it, or remove it, or block it, or any of the other things Western medicine does. This is a relatively recent development, hinging on the invention of advanced microscopes. Thanks to these instruments, we have made incredible advances in being able to look at and detect these small microbes and viruses, which has helped the world deal with serious health problems. However, as we are seeing, looking for the one microbe and trying to eliminate it is a textbook case of missing the forest for the trees.

What causes disease? Why do some people get sick and others don't? If the swine flu was really so contagious, why haven't more people become sick and died? According to what I've heard on the radio and read in the newspapers, less than 10% of people with swine flu have died. Over 90% recover. Think of fruit in a basket. If you leave it for awhile, you might find that one piece of fruit has mold on it. Another piece of fruit, sitting right next to it and even touching it, cheek-by-jowl, is unaffected. Why is that?

Louis Pasteur, the father of modern bacteria studies (the process of pasteurization was named for him) was said to have renounced bacteria-based medicine on his deathbed, saying "Terrain is everything." Terrain means our bodies, our immune system, our environment. If you have a strong immune system (what the Chinese call 卫气 wei qi, or defensive qi) without underlying deficiencies, and live in harmony with your environment, you will not become sick.

Chinese medicine has, over the course of 2000-3000 years of recorded history, developed a number of powerful diagnostic systems that, properly applied, can cure nearly everything. Modern medicine has a place, and it adds to the world's knowledge. But it doesn't replace Chinese medicine.

Chinese medicine looks at the totality of a person and treats the person, not the disease. The herbal formula I'm taking was written exactly for me, taking into account all my body systems, my constitution and my presenting symptoms. This is what good medicine is. Simply telling millions of people, young, old, tall, short, skinny, fat, to go dose themselves with Tamiflu is ridiculous.

If you have an epidemic situation, in Chinese medicine it falls under the general classification of 温病 wen bing, or warm disease. There are many subcategories within it, but one of note is called 杂气 za qi, or miscellaneous qi. This is a type of qi that arises under special circumstances and is outside the realm of the ordinary system of Chinese medicine, which holds that there are six types of exogenous pathogens. This seventh type of qi was discussed by 吴有性 Dr. Wu Youxing in his work the 温疫论 Wen Yi Lun in 1642 A.D., many centuries after the main classics of Chinese medicine were written but two centuries before Dr. Pasteur made his discoveries in the area of germ theory.

In other words... don't worry!



6:05 PM (16 hours ago)
(My Dad)
to me

In principle I can see your point, but the 1918 flu pandemic killed millions of people in a single year before it ran its course, and the treatments that have been developed since then to combat viruses of this type are pretty specific and pretty effective once the agent has been identified. Not sure of the details, but I think that anti-virals are different from antibiotics, which are less specific and also ineffective against viruses. Also, according to the NYT article on it yesterday, what makes this particular virus so deadly is not so much what it does directly as the immune reaction that it triggers, literally drowning the patient as the body tries to activate its natural defenses to meet a perceived but not well understood threat. Viruses (which are basically small free-floating pieces of genetic code) are tricky, and developing an effective anti-viral agent on the molecular level seems mostly to be a matter of strategy. So maybe the most appropriate medical text for this kind of threat would be the Sunzi…

Anyway, my 2 cents for what it’s worth.




10:03 PM (12 hours ago)
Jonah Ewell
to (My Dad)

Sunzi is used as a medical text, but antiviral medications are a far cry from the wisdom of Sunzi. One of Sunzi's basic tenets is to follow the laws of Heaven and Earth. In medical terms, that means the exterior and the interior, the environment and the body. Viruses are highly adaptable, which is why getting a flu shot is such a crap shoot. They have to guess which flu strain is going to go around, and a lot of times they get it wrong, so all these old folks are immunized against something which poses no threat, and they have no defense against the flu strain that actually does come around.

They would be far, far better off to do the basics: light exercise daily, eat foods in accordance with the seasons, and have a stable emotional life. Add handwashing, proper clothing for the weather, and there's your natural flu vaccine. It's easy to tune out because it's so basic. The basics are hard! Huaching Ni says that having a normal life is actually quite difficult, and that few people ever achieve it. Instead of focusing on the basics, everyone's looking for the magic pill or injection which is going to allow them to continue with their bad habits.

The CDC is doing their job by telling people to wash their hands (http://www.cdc.gov/swineflu/), but that doesn't get picked up by the media. Everyone's looking for a vaccine or treatment. As the Neijing says, treating an illness after it has started is like digging a well when you get thirsty, or forging weapons after the battle has begun.

There is an "attacking school" or "detoxification school" of Chinese medicine that concentrates on using harsh, bitter, cold herbs to drive pathogens from the body (攻邪学派 Gong Xie Xue Pai). It's one of the four famous schools of medical thought from the Jin-Yuan period. Most modern western medicine can be thought of as an extreme example of the attacking school. Antibiotics, antivirals, chemotherapy, radiation, are all very effective if used correctly (big if) but they absolutely destroy your body and leave it open to further attack. This mode of thought is just one of many overlapping theories that are used concurrently in Chinese medicine, and certainly not a dominant one.


10:34 PM (11 hours ago)
Jonah Ewell
to (My Dad)

You're correct in that strategy is important, but if the only time you apply strategy is in a quest to find the best anti-viral medication, that's a misapplication of strategy. Everyone is looking through the microscope, which is fine, but if the virus is underneath a microscope that means it's not in a human body. At the same time as you bend over the microscope, you also have to step back and look at what's going on in a real live sick person, and then step back again to look at where that person lives, the state of the environment in which he or she lives, and all the people around them, sick or not. The strength of Chinese medicine is that we deal with living systems in their natural environments.

Modern machinery is great - who wouldn't want an MRI machine to peer inside the body? - but it doesn't replace the basics of the four examinations - palpation, listening/smelling, observation, and questioning. When you add blood tests, X-rays and scopes to that, you have a some very powerful diagnostic tools. If you rely too much on the machines and lab reports, as many modern doctors tend to do, you can very easily be misled. Western medicine, until very recently, made good use of palpation, physical exam, and the verbal investigation to form a complete diagnosis. Nowadays, it's just testing. Some of my patients in the clinic get sent for test after test after test. Some of these tests are very invasive, and at the end of it the doctors say, "we can't find anything wrong. It must be psychological." Well, they're looking in the wrong place, with the wrong tools, and the wrong mindset.


Karen said...

Fabulous writing, Jonah! You make great points about the root cause being food animal containment and the root prevention being "terrain"...good stuff!!


Jonah Ewell said...


Anonymous said...

Haha I have had this arugment with family over many years. I can remember getting a sore throat daignosed as strep throat with a culture and told I couldn't treat it with TCM. However I still went to the TCM doctor and with 2 days on Yin Qiao San and drinking sipping some Ban lan gen I was feeling great. This year I felt the flu coming on with the sore throat and fever coming fast and again I treated it right away with TCM while other co-workers remained out of work on antibiotics. The trick is jsut to catch it early, don't wait until it become a disaster, Thanks for your post Jonah! It's a shame true TCM just gets lumped in with all 'holistic' care.

Brandi Buzzard said...

H1:N1 is the proper name for what you refer to as 'swine flu'. H1:N1 is not spread to humans from pigs. Humans actually give it to pigs, so avoiding contact with pigs or pork products is an ineffective way to prevent contracting the virus. I will agree that handwashing and avoiding fellow humans with the flu is the best preventative action.

I'd like to point out that you use the term 'factory farms' - can you define a factory farm to me? My definition is a farm that efficiently produces large amounts of food for a growing WORLD at an extremely cheap cost to the consumer.
I hope you weren't sick too long with H1:N1.

Best regards

Jonah Ewell said...

Hi Brandi -

I just saw this, thanks for leaving a comment. My definition of factory farm is a production facility owned by a huge company that views profit as the number one motivation, discarding traditional husbandry practices such as care for the land and concern for the health of the animals.