SARS AND CHINESE MEDICINE
 
This article is found on the The Institute for Traditional Medicine website:
http://www.itmonline.org/arts/sars.htm
Dr. Dharmananda was a mentor of our Shane Hoffman in Portland. Shane had been part of the clinic team at The Institute for Traditional Medicine (ITM). The Institute is well known for it's innovative work in developing protocols to apply Traditional Chinese Medicine to modern health issues such as HIV and CFS, MS, breast cancer, hepatitis, chronic pain and menopause.
 
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
 
SARS (Severe Acute Respiratory Syndrome) appeared suddenly in the news during March 2003, but it is thought that cases of the syndrome had been observed as much as six months earlier as an unusual type of pneumonia. The first official case, with the disease being named SARS, was in Vietnam. On February 26th, a man was admitted to hospital in Hanoi with high fever, dry cough, myalgia (muscle soreness), and mild sore throat. Over the next four days, he developed increasing breathing difficulties, severe thrombocytopenia (low platelet count) and signs of adult respiratory distress syndrome requiring ventilator support.
 
By March 18, over 200 cases and 4 deaths had been reported. During a period of just three weeks, the number of SARS cases then soared to over 2,000, with a death rate hovering around 3.5% of cases. At the time of this writing (early April 2003), it appears that the spread of the disease has been successfully slowed. The main effective preventive measures include quarantine efforts to isolate those already infected, coupled with numerous actions to reduce the spread of the disease that could occur with crowding (including cancellation of school classes in Hong Kong; reduced air travel between the main disease areas and the rest of the world, etc.). Nonetheless, there are still several hundred new cases reported each week. Depending on where infected people now are, the disease may remain controlled or may again spread rapidly.
 
It is understood that SARS is likely due to a coronavirus. Coronaviruses are a common cause of mild to moderate upper-respiratory illness in humans; they are associated with respiratory diseases in animals; animals may also experience gastrointestinal, liver and neurologic diseases from coronaviruses. These viruses can survive in the environment for as long as three hours. Based on current data, it is likely that a virus in an animal in Guangzhou Province of China was transmitted to a human, who then spread it to other people. Such animal to human transmissions may occur when there are slight mutations of the virus that makes it better able to survive in humans than the original virus. Guangzhou is a crowded province with much intermingling of human and animal populations, especially with chickens and pigs.
 
There are no established treatments for the SARS virus at present. Since the main center of the infection cases has been in Southern China, where herbal medicine is still a vital part of the health care system, Chinese herbs have been administered to some of the patients with SARS and taken by others who fear getting SARS. The results of these herbal therapies are unknown.
 
Recently, a newspaper article relayed some of these efforts.
 
Many Asians Turn to Traditional Medicine
 
By YEOH EN-LAI
The Associated Press
 
April 5, 2003
SINGAPORE (AP)-Ginseng, chrysanthemum, white fungus [tremella] and all manner of herbal remedies are selling fast across Asia as people seek ways to ward off severe acute respiratory syndrome, the deadly flu-like disease with no proven cure.
 
In Singapore, where four people have died and 100 are sickened with SARS, customer Tan Ai Bee is confident she has the stuff to ward it off-five large packets of Chinese herbs and roots meant to boost immunity. "These are for fever and flu. They can help prevent the SARS virus," said Tan. "I have been taking Chinese medicines for a long time; there is no reason to lose faith in them now."
 
SARS has killed at least 85 people in Asia and Canada and sickened 2,300 in more than a dozen nations as infected travelers carry the virus between continents.
 
On Friday, a woman died of SARS in Singapore, the country's sixth death. Singapore's government and others across Asia have appealed to people with sudden high fever or difficulty breathing to see a doctor. But many are self-medicating with herbal remedies, traditional medicines regarded in Asia as a reliable way to get well and stay well. Frankie Lew, a consultant physician at the Meiseido Chinese Medical Treatment Center in Singapore, said some might find comfort in the medicines, fearing that they will be quarantined if they go to a hospital.
 
"Some may not want to be isolated, so they come to us for cures," said Lew, consultant physician at the upscale Meiseido Chinese Medical Treatment center. Lew said many patients came to the center last week seeking herbal medicine for flu and pneumonia. No one said they had SARS, he said. Some people asked for a simple herbal soup mix of ginseng, roots and leaves to treat pneumonia, Lew said. The herbal cocktail costs $1.13.
 
Items like ginseng, chrysanthemum and white fungus are selling fast, said Chiang Pin Pin, a marketing executive with Yue Hwa Chinese Products. Another hot seller is Pientzehuang-green chiretta [Pientzehuang is the brand name; andrographis is the green chiretta, called chuanxinlian in Chinese]-tablets from China that are believed to reduce the chance of infections. They're almost sold out with no sign of being restocked, Chiang said. "Our suppliers in China are running out of stocks because people are rushing for the same items," said Chiang.
 
Ginseng is mentioned here because it is relied upon to protect a person from disease; it is also considered important in treating serious lung diseases. White fungus is a tonic that is considered beneficial to take as a food to prevent illness and is also commonly used to resolve lung ailments. Chrysanthemum is used to treat "wind-heat" syndromes, such as influenza, with symptoms of fever, sore throat, and cough, somewhat like what is experienced with early stage of SARS. Andrographis is a bitter herb that is used to treat infections; it has become a popular herb for treatment of common cold and flu. Andrographis is classified in the Chinese system as an anti-toxin herb, where a toxin can refer to an infectious organism that has taken hold in the body.
 
Suppliers of Chinese herbs are running low not because there are so many cases of SARS-only a few hundred in China at the time the above report was issued-but because so many people are worried about SARS and rushing to get preventive health care products and just-in-case remedies to have at home.
 
From the TCM perspective, prevention of illness is usually a matter of nourishing the body to enhance its resistance to the invasion of foreign influences. Hence, tonic herbs are used. At the first stage of an air-borne infectious disease, like SARS, herbs for dispelling wind-heat are given, in an effort to repel the invading pathogen and halt the disease before it takes up residence in the body. If the disease takes hold, antitoxin herbs are then employed. Once a person becomes quite ill, it may be time to bring in the tonics again, this time to help preserve the life of a patient who is suffering from the damaging effects of a prolonged and serious infection.
 
A typical remedy for early stage of infectious disease is Yin Qiao Jie Du Pian, a patent medicine that has over 150 years of history as a popular remedy in China. This can be used along with andrographis. Tonic formulas with ginseng or food preparations with tremella (white fungus) are common in Chinese medicine.
 
While it seems reasonable for people already interested in Chinese medicine to make use of these herbs, there is a lack of evidence for their efficacy; it would not be appropriate to recommend them to others. Those involved with Chinese herbs generally like to take them both for preventive health care and treatment of various ailments; for them, the main question is not whether to use the herbs, but rather which herbs one should choose out of the many available. The above-mentioned news article relays examples of herbs that are being selected; the principles of therapy guiding those selections have been roughly outlined here.
Tremella (Tremella fuciformis)
(white fungus; silver ear).
It is used to nourish the yin, tonify the lung, eliminate sputum, relieve cough, and calm the mind.
 
Ginseng (Panax ginseng)
It is used to tonify the qi, improve digestion, strengthen the lungs, alleviate coughing, and calm the mind.
 
Andrographis (Andrographis peniculata) (green chiretta).
It is used to treat toxic heat syndromes, alleviating fever, cough, and sore throat.
 
Chrysanthemum (Chrysanthemum morifolium). It is used to dispel wind-heat, applied in early stage of febrile diseases.
 
In another story about Chinese herbs for SARS, isatis root (banlangen), another antitoxin herb, used like andrographis, is featured:
 
Hong Kongers Throng Herb Stores as Virus Spreads
 
Carrie Lee, April 04, 2003
 
HONG KONG - Panic-stricken Hong Kong residents are crowding into Chinese medicine shops to buy herbs they hope will ward off or even cure a deadly pneumonia epidemic that is believed to have killed more than 80 people worldwide.
 
"Many more people are buying Chinese herbs for pneumonia these days than before. All Chinese medicine stores are very busy," said Chinese medicine practitioner Michael Pang. "There has been talk that certain prescriptions can cure atypical pneumonia and many people are buying herbs listed on those prescriptions," he added.
 
Doctors in hospitals have had some success treating patients using anti-viral drugs and steroids, but scientists have yet to find a specific cure for the highly infectious disease, called Severe Acute Respiratory Syndrome. It has killed more than 80 people and infected some 2,400 others worldwide, including more than 700 in Hong Kong.
 
Though the virus is believed to be a new one, many Chinese are turning to traditional remedies, based more on centuries of experience than scientific foundation. "I'm buying this Banlangen for the first time. People say it can treat atypical pneumonia," said an elderly woman, picking a pack of herbs from a shelf.
 
Rumors have been swirling that tea made with Banlangen, a kind of dried plant root which is often used to treat problems like flu and sore throat, can cure the new disease.
 
But some Chinese herbalists have misgivings. "You cannot rule out its function altogether, it has worked on flu and pneumonia, but we can't say it's a specific cure for this atypical pneumonia because we don't even know what virus is causing the disease," Pang said.
 
Wu King-shing, another Chinese medicine practitioner, was prescribing another plant root believed to be able to fight a wide range of viruses. "I'd treat the disease with Huzhang [Polygonum cuspidatum]. It can suppress many kinds of viruses, including flu virus and coronavirus and has showed very satisfactory results," Wu said. "And there is no side effect." Some Hong Kong scientists believe a new strain of coronavirus, which causes the common cold, is the primary cause for the disease. "I drink the tea every other day myself," Wu said, eagerly writing a prescription for a prospective client.... Isatis root Isatis root (Isatis tinctoria; banlangen) Polygonum cuspidatum Polygonum cuspidatum (huzhang)
 
Both herbs are commonly used as broad spectrum antiviral agents
 
April 2003
 
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