Epidemic Spreading—How Do We Protect Ourselves? Doctor Luo Dalun’s Master Plan: First Tell Cold from Heat, Then Talk About Formulas

💬 Note from Doctor Luo: Dear friends, good morning. The pneumonia situation in Wuhan has touched all our hearts. We pay tribute to the medical workers fighting on the front line, and at the same time, everyone needs to do a good job protecting themselves. So how do we protect ourselves? Today I want to give you a complete walkthrough of the various prevention measures and the Chinese medicine thinking behind them.

Opening: This is destined to be an unusual Spring Festival

The Spring Festival of 2020 coincided with the Spring Festival travel rush and the epidemic — massive population movement, plus all the customary visiting, movie-going, and shopping of the holiday season, gave people countless chances to gather in crowds.

💬 Note from Doctor Luo: So a disease breaking out at this time of year, during the Spring Festival, is a serious test for us. This is destined to be a special Spring Festival. Many years ago I actually called for attention to this — I have always been worried about the massive population movement of the Spring Festival travel rush. Why? Because transport capacity is stretched to the absolute limit, and when every bit of capacity is strained to the breaking point, problems are especially likely. Some people call the travel rush the largest human migration on earth.

First thing: If you can avoid going home, don’t go — celebrating where you are is fine too

Doctor Luo’s call sounds especially plain today: there is no need to rush home at the peak of the travel rush; staggering your trip or celebrating the New Year where you work are both real options.

💬 Note from Doctor Luo: When I previously suggested celebrating the New Year away from home, many people were very resistant — they scolded me: ‘If we don’t go home now, when will we?’ Going home for the New Year is a Chinese tradition, and I understand that feeling — I myself worked far from home for many years. But now that our living conditions have improved, we are celebrating the New Year all the time — every day is a festival. You’ll find that going home for the New Year is really just the same few things: a family get-together, red envelopes for the kids, some gifts, a few extra drinks. The festive flavor has actually faded — why? Because our daily lives already feel like a festival every day, so by the time the New Year arrives you can’t think of anything particularly special to eat; you no longer need to save the meat until New Year’s like in the old days. So the fading of festive flavor is actually a good thing.

So this year, he especially advises friends around Wuhan: celebrate the New Year where you work, don’t insist on rushing back to Wuhan and then back out again.

💬 Note from Doctor Luo: Who does this benefit? It benefits you yourself, and it helps relieve the epidemic pressure on the whole country. So far I haven’t seen any media proposing this. I think this comes from a humanitarian standpoint — if there’s an epidemic there and you insist on going, you’re being unfair to your family; and if you take your children back, are you being responsible to them? So please take this suggestion into consideration.

Second thing: If you have a fever or a cold, skip the gatherings

Chinese people have a trait: when friends arrange a get-together, once the time is set, even if someone has a fever or a cold, they feel they “can’t lose face” and go anyway.

💬 Note from Doctor Luo: Everyone, I think we absolutely must change this attitude — if anyone has a fever or a cold, go see a doctor right away, or rest at home; don’t attend public events. This Spring Festival, we really do need to reduce moving around. Don’t say ‘I simply must see this movie’ — hundreds of people packed into one theater, is there any risk in that? So this holiday, try as much as possible to avoid crowded, enclosed spaces. Cut back on gatherings — if someone has a fever, don’t go, that’s absolute. This is not about face. What is it about? It’s about personal safety.

Third thing: Watch your mouth, and turn the Spring Festival into a health-preserving holiday

In a special period, your spleen and stomach can’t afford to be wrecked. Tables piled with braised pork, pig trotters, even rare game — people who usually eat lightly are most likely to overeat at times like this.

💬 Note from Doctor Luo: This is exactly when people ruin their spleen and stomach. Overeating causes spleen and stomach problems, so I think during the Spring Festival especially we should strictly control our diet and turn the holiday into a fitness and wellness holiday instead: eat moderately, exercise, read at home — this reduces the burden on the whole defense system and benefits you. As I said a couple of days ago: wash hands often, wear a mask outdoors, bathe regularly, and sleep well and rest — this is absolutely critical.

Don’t take medicine randomly! — Most “prevention formulas” are armchair strategies

Many “pneumonia prevention formulas” from famous doctors have already appeared online. Doctor Luo’s reminder is very direct:

💬 Note from Doctor Luo: These are mostly armchair strategies — they haven’t even seen a single patient; the authorities haven’t even released information about what the patients are like, and they’re already handing out formulas. And healthy people are told to take these formulas — if your qi and blood are circulating fine, why would you take a formula? Maybe you’re someone with yang deficiency; you insist on taking formulas with honeysuckle and isatis root, and your body gets colder and colder — is that boosting immunity or lowering it? Or you’re someone with yin deficiency and internal heat, usually with liver fire, and now you add astragalus tonics — isn’t that pouring oil on the fire? So I strongly advise everyone not to casually take formulas when nothing is wrong. Food-based remedies that strengthen the spleen and stomach — those are fine to eat. The formulas — I suggest skipping them.

What can you do if you have extra energy? Doctor Luo mentioned several everyday practices: aromatherapy, foot baths, moxibustion, massage — but there’s one premise you must remember:

💬 Note from Doctor Luo: When doing moxibustion, don’t strip your shoulders bare — goodness, if the room is cold and you catch a chill, that defeats the purpose. Same with massage: if you wear too little and catch cold, that’s no good either. Do all of it while staying warm.

The fundamental Chinese medicine approach: tell cold from heat

What if you start feeling a little off? China has an enormous number of epidemic-prevention formulas from ancient times, and many different approaches. But the fundamental approach — whether it’s a common cold, an influenza, or a plague — is the same:

💬 Note from Doctor Luo: You must tell cold from heat. These external-contraction illnesses manifest in the body as heat signs or cold signs, and we absolutely have to get this right. If you get it backwards, the illness cannot be properly nursed back to health. And how do heat signs and cold signs behave? They can be mixed together, or they can appear at different stages of the illness, one after another. So some people are quite certain this epidemic is heat evil, is a warm disease — I’m not so sure, because it can change. So we must uphold the Chinese medicine principle of pattern differentiation and treatment — distinguishing cold from heat. This is extremely important.

What does cold look like? — Clear runny nose, white phlegm, chills, listlessness

How do you recognize someone with cold signs? Doctor Luo gave a very concrete picture:

💬 Note from Doctor Luo: A person with cold signs has a clear runny nose, and phlegm that is white — either white foam or white sticky stuff, in any case not yellow. The whole body feels cold, there’s shivering, and coughing. Such people are often listless and lacking energy — meaning their yang qi is insufficient. Once someone is listless and lacking energy, it shows their upright qi is insufficient. Do such people get fevers? Yes, they can — even in the cold stage they can run a fever. But such people feel cold all over, and their hands and feet are ice-cold to the touch.

In the cold stage, you should use warming methods. Doctor Luo’s principle: any way of warming the body works.

💬 Note from Doctor Luo: When external evil has just arrived, warm up quickly — moxibustion, a hot bath, some ginger soup, all of these are fine. And remember this: at this time you must have something in your stomach — drink some hot congee. Never induce sweating on an empty stomach — sweating cannot be induced on an empty stomach. So at this stage we use all kinds of warming methods to make the body warm.

What formulas for cold? — The Shang Han Lun toolkit

Among Chinese formulas, the entire Shang Han Lun (Treatise on Cold Damage) addresses external-contraction illness: Gui Zhi Tang (Cinnamon Twig Decoction), Ma Huang Tang (Ephedra Decoction), Xiao Qing Long Tang (Minor Green Dragon Decoction), Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction), and the Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite and Asarum Decoction) that Doctor Luo talked about earlier — the formula he used most this winter and the one he most highly recommends.

💬 Note from Doctor Luo: I wrote an article about Ma Huang Fu Zi Xi Xin Tang on my WeChat public account ‘Luo Dalun Channel,’ and the readership was very low. But let me tell you, this is an especially important formula in Chinese medicine for fighting cold evil — it’s one of the most powerful formulas in the Shang Han Lun. Who is it for? It’s for people with insufficient upright qi — especially people with shaoyin deficiency (kidney essence deficiency) who catch external cold and have that characteristic reaction. This winter I treated several such patients — this kind of case was rare in winters past. So is this epidemic definitely warm evil? Many people say warm evil, but I’m not so sure — I haven’t seen the patients either, but based on my experience treating external-contraction illness this winter, there are plenty of opportunities to encounter cold evil. So Ma Huang Fu Zi Xi Xin Tang is very important.

Ma Huang Fu Zi Xi Xin Tang: just three herbs, effective in one dose

How simple is this formula? Three herbs: ma huang (ephedra), fu zi (aconite), and xi xin (asarum).

💬 Note from Doctor Luo: When doctors prescribe these three herbs, we might use six grams or so, but for self-use, three grams is enough: ma huang 3 g, xi xin 3 g, and for fu zi you can use 9 g — the prepared kind, zhi fu zi. The prepared fu zi should be simmered first; to be cautious, everyone can simmer the prepared fu zi for half an hour first — actually, modern prepared fu zi has almost no toxicity left, and generally if you boil fu zi for an hour its toxicity is completely destroyed. The prepared fu zi has already had most of its toxicity processed out; to be safe we simmer it for half an hour first, then simmer it together with the other herbs for another half hour, and that’s basically done.

Who does this formula suit? The profile is very distinctive:

💬 Note from Doctor Luo: For this kind of external-contraction illness — shaoyin insufficiency, shaoyin deficiency, kidney-essence deficiency, then catching external cold — what is the biggest characteristic of such patients? Listlessness, a feeling of always wanting to sleep. This formula is extremely powerful for lifting upright qi and expelling external cold — so much so that I’ve even had patients simmer the formula and soak their feet in the decoction. One dose basically resolves most of the problem. This winter, every time I used it, one dose solved the problem, and the remaining two doses were for consolidation. This is Zhang Zhongjing’s formula for scattering external cold, and I highly recommend it.

Why does he recommend it so strongly? Because very many modern people have insufficient kidney qi. There is an old saying that hits the mark:

💬 Note from Doctor Luo: The ancients said, ‘shang han pian si xia xu ren’ — in cold-damage epidemics, the ones who die are the lower-deficient people. What does that mean? It means when an external-contraction illness sweeps through, who ends up dying? Ordinary healthy people are fine and recover in a few days; the ones who die are the kidney-deficient people. This saying makes sense: people with sufficient upright qi have strong resistance to evil, so they don’t suddenly collapse when infected. What kind of people develop severe illness after catching external evil? For example, the elderly; people who are dissipated, consuming their kidney qi until it is insufficient; people who are chronically overworked. So when we find that an external-contraction infection has occurred and it’s the cold pattern, we can choose these Shang Han Lun formulas — the effect is excellent.

What does heat look like? — High fever, yellow phlegm, sore throat, red tongue with yellow coating

What if what you catch is heat evil, or you’re in the heat stage? What does that look like?

💬 Note from Doctor Luo: What are the symptoms of heat evil? High fever, phlegm that is all yellow, a sore swollen throat, and the whole body showing heat signs — for example, the tongue body is red and the tongue coating is yellow. When it’s cold, the tongue body is pale and the coating is white; when the phlegm is all yellow — that’s the heat pattern. At this point we use Chinese medicine’s heat-clearing formulas.

What heat-clearing formulas are there? Doctor Luo listed a string of them:

💬 Note from Doctor Luo: Chinese medicine has an enormous number of heat-clearing and toxin-resolving formulas. The Pu Ji Xiao Du Yin (Universal Salvation Toxin-Dispelling Beverage) I’ve discussed is a famous one — it’s specifically for heat evil attacking the head and face, that is, when the sore throat is especially severe and heat evil is concentrated in the head and face, its effect is excellent. For clearing lung heat there are many formulas, for example Qian Jin Wei Jing Tang (Thousand Gold Pieces Reed Rhizome Decoction); and there’s Bai Hu Tang (White Tiger Decoction), a formula from the Shang Han Lun. What is the core of Bai Hu Tang? The core is sheng shi gao (raw gypsum). So when there is a heat pattern, if we can grasp this one herb — raw gypsum — and use it well, then ordinary heat evil can generally be cleared.

Raw gypsum has a real story in epidemic history, which Doctor Luo recounted:

💬 Note from Doctor Luo: Back when Japanese encephalitis was epidemic in Beijing, the famous Chinese physician Pu Fuzhou also used Bai Hu Tang, with raw gypsum in it. The larger the dose, the stronger the heat-clearing effect. I’ve mentioned before that Zhang Xichun was exceptionally skilled with raw gypsum — in fact, in the Ming and Qing dynasties, raw gypsum was used extremely widely in treating epidemics; many famous Ming-Qing masters were especially good at it. So in this situation, having some understanding of this is beneficial.

Epidemic-specific formula one: Sheng Jiang San — raising and lowering the qi dynamic, opening up stagnation

Besides the formulas for ordinary external-contraction illness, the ancients also created formulas specifically for epidemics. The most famous one is called Sheng Jiang San (Rise-Fall Powder).

💬 Note from Doctor Luo: There are also famous formulas — Sheng Jiang San, for example, was used especially often in treating epidemics. This formula was indeed created in the Qing dynasty specifically to treat epidemics. Its creator was Yang Lishan, who wrote a book called Shang Han Wen Yi Tiao Bian (Differentiation of Epidemics within Cold Damage). In the book he listed more than a dozen formulas, all for treating epidemics. Strictly speaking, the formulas we discussed earlier — except for Pu Ji Xiao Du Yin — were all for treating ordinary external-contraction illness: colds, upper respiratory infections, and so on. Pu Ji Xiao Du Yin, you could say, was truly for treating an epidemic: when Li Dongyuan created it, the epidemic raging at the time was called ‘da tou wen’ (big-head epidemic) — it was a plague. By Yang Lishan’s time, people’s understanding of epidemics had broadened — they discovered that treating epidemics with the ordinary methods for cold damage didn’t work well, and the disease spread extremely fast; once infected, people fell ill rapidly, progressed very quickly, and could reach a critical state fast. So people began to think of new methods specifically for treating epidemics, and Sheng Jiang San was one of the formulas devised then.

How many herbs in this formula? Very simple — four:

💬 Note from Doctor Luo: Bai jiang can (white stiff silkworm), then chan tui (cicada slough), plus jiang huang (turmeric), and then da huang (rhubarb) — just these four herbs. These four herbs can raise and lower the qi dynamic, open up stagnation, and have the function of expelling evil and resolving toxins. They really do work well for epidemics. Even in ordinary practice, when we treat warm-toxin disease, if we add these four herbs to the formula, in my experience the effect immediately improves — because they open up the qi dynamic. So when I treat ordinary colds where the heat toxin is deep, I often add these herbs to the formula as well. This is a very famous formula for treating epidemics.

Epidemic-specific formula two: Da Yuan Yin and Wu Youke’s doctrine of “li qi” (pestilential qi)

There is also the formula of the late-Ming physician Wu Youke. Wu Youke wrote a book called Wen Yi Lun (Treatise on Pestilence) — note that the ‘wen’ in the name is the character meaning ‘warm’, not the one with the illness radical that means ‘plague’.

💬 Note from Doctor Luo: The Wen Yi Lun is the founding work of the later warm-disease school. It especially guided the development of tongue diagnosis — he placed great importance on tongue signs and discussed pestilence in great detail. He said that between heaven and earth there is a kind of li qi (pestilential qi) — not the ordinary cold or heat we normally speak of, but a kind of pestilential qi. When this li qi arrives and attacks the body, people fall ill extremely fast; once a person is struck by it, that is pestilence. In the book he discussed in detail how this li qi enters the body, how it transmits and transforms, how it produces symptoms, where it lurks, and what methods to use to treat it.

Wu Youke’s contribution to tongue diagnosis is written into epidemic history:

💬 Note from Doctor Luo: He especially emphasized tongue diagnosis — for example, the coating he described, called the ‘ji fen tai’ (powdered-coating tongue). This tongue coating was later regarded as a classic tongue sign of pestilence. What is a ji fen tai? It means the coating on the tongue looks like a lot of powder has piled up on it — very thick and greasy, like piled powder. This condition is caused by evil qi condensing and the qi dynamic not moving smoothly. What formula does he use for this? He gave several formulas, for example Da Yuan Yin (Reaching-the-Origin Beverage) — this is also an important formula for treating epidemics.

What’s in Da Yuan Yin?

💬 Note from Doctor Luo: Bing lang (betel nut), hou po (magnolia bark), cao guo (tsao-ko), plus zhi mu (anemarrhena), shao yao (peony), huang qin (skullcap), and gan cao (licorice), among others. What are the betel nut and tsao-ko for? They are also aromatic — using their fragrance to drive out the turbid, filthy qi. Because Wu Youke believed that after li qi enters the body, the evil lurks in the mo yuan — mo as in the membrane, yuan as in the plain. Where is the mo yuan? Wu Youke said: it’s not in the interior, not in the channels, not in the organs — there is a special place called the mo yuan, a half-interior, half-exterior region. When the evil lurks in the mo yuan, he uses Da Yuan Yin to drive out the turbid, filthy qi. This is a famous formula for treating epidemics. Later in Wu Youke’s Wen Yi Lun, he also used many Shang Han Lun formulas — Bai Hu Tang, for example, and later Cheng Qi Tang (Qi-Coordinating Decoction) and so on.

Closing: In fighting epidemics, the Chinese people’s experience and lessons are both treasures

Doctor Luo wrapped the whole lecture into one basic framework:

💬 Note from Doctor Luo: In the course of fighting epidemics, the Chinese people have accumulated rich experience, and they have also had many lessons — all of these are what we should learn today. What I’m sharing is really to give everyone a sense of what approaches Chinese medicine has. Just having this understanding is enough — for actually prescribing formulas, that must be left to the doctors. That’s all I’ll say about this pneumonia situation. Because the New Year is almost here, I want to wish everyone in advance: a happy new year, good health for the whole family, and happiness and good fortune. In the new year, we will continue to use voice to share Chinese medicine knowledge with everyone. See you in the new year.

Compiled from Doctor Luo Dalun’s health lecture series (master plan for epidemic prevention — Chinese medicine prevention and treatment thinking). Formulas referenced from the Shang Han Lun, Li Dongyuan’s Pu Ji Xiao Du Yin, Yang Lishan’s Shang Han Wen Yi Tiao Bian (Sheng Jiang San), and Wu Youke’s Wen Yi Lun (Da Yuan Yin).