Flu (H1N1 Influenza) Is Spreading — What Should I Do? Doctor Luo Dalun: Differentiation of Syndromes Is All You Need

Patient search terms: flu (influenza A/H1N1) what to do / flu symptoms in children school outbreak / flu with high fever no sweating / flu with chills and sweating / flu with sore throat and dry mouth / cold wrapping fire (exterior cold interior heat) / flu with nausea vomiting diarrhea / how to bring down flu fever fast

Corresponding medical names: influenza A (H1N1) · seasonal influenza · common cold · exterior cold pattern · ying-wei disharmony (nutritive-defensive disharmony) · exterior cold with interior heat · cold-dampness affliction · damp-heat affliction · warm disease (wen bing) pattern

Opening: one wave after another — nature is changing violently, and external pathogens seize their chance

💬 Note from Doctor Luo: Dear friends, good morning, everyone. Today let’s talk about preventing and controlling H1N1 flu. Why? Because right now it is spreading again across the north — and it has even reached Shanghai, Zhejiang and other places. Many children go to school and come down with a fever, and whole classes have been suspended. People are quite worried and keep asking me “what do we do about the flu?” — even in my daily livestreams, everyone is asking about the flu. So today let’s discuss it properly. Look at this pattern: one wave not yet settled, another rising — what does it tell us? It tells us the external pathogen is always with us.

These past two years, the changes in the natural world have been violent. Doctor Luo says that yesterday he watched the news — the water in Venice, the Italian water city, has dried up. That’s seawater — somehow it receded, exposing the mud underneath, and the little boats (gondolas, or whatever they’re called) were stranded in the silt. When nature changes this much and extreme weather keeps appearing, it creates an environment for external pathogens to attack humans.

💬 Note from Doctor Luo: Because nature keeps changing, the human body’s tolerance drops. If your body is strong, you’re fine; but some people tolerate change poorly, their defense system begins to weaken, and then external pathogens easily invade. In fact, over the long course of evolution humans long ago adapted to the natural environment — as long as nature follows its normal rhythm, our bodies are adapted; even if there’s some external pathogen, we can resist it. But when it’s dry one moment and flooded the next, cold one moment and hot the next, many people can’t take it. So you see, wave after wave of external pathogens begin to arrive.

After COVID’s great battle, first restore zheng qi (upright qi)

So when facing external pathogens, what comes first? First, protect and restore zheng qi (upright qi). Doctor Luo has always emphasized: now that the COVID pandemic is behind us, restoring upright qi is the most urgent task.

💬 Note from Doctor Luo: After fighting a great war, you are like a country — what happens after Ukraine and Russia finish fighting? Ukraine is riddled with holes. At that point, what must be done? You must rebuild, you must repair. Some friends ask: is it because we caught COVID that our immunity dropped, so when the flu arrived our symptoms were severe? That’s possible. After a great battle in the body, zheng qi is insufficient, and external pathogens invade more easily.

How to restore zheng qi? Doctor Luo gives concrete advice:

Diet to nourish the spleen and stomach: eat whole grains regularly, plus shan yao (Chinese yam) and lian zi (lotus seed) — protect the spleen and stomach and build up upright qi;
Qi-tonifying herbs: take a little huang qi (astragalus) regularly to fill up upright qi;
Don’t squander it: now that we’re finally free after COVID, don’t stay up playing until deep into the night, don’t stuff yourself and wreck your spleen and stomach again — this is the time to let the body recover carefully. Protecting zheng qi comes first.

There is no “flu miracle formula”: the soul of Chinese medicine is bian zheng lun zhi (syndrome differentiation)

Everyone always asks: what method treats the flu? Is there a single formula that cures flu? Doctor Luo says that every external-cold-caused treatment method discussed before applies to the flu as well — because Chinese medicine treats external afflictions with these same approaches, differentiating and treating according to the symptoms you present.

💬 Note from Doctor Luo: If you’ve studied Chinese medicine courses, do you think there exists a formula such that when the flu arrives, you use that one formula to kill the virus? Everyone, is this the Chinese medicine way of thinking? No. Because the weather differs, each region’s conditions differ, dryness and dampness differ, and people differ too — some have yin deficiency with heat and easily develop fire, others are yang deficient by nature. The same external pathogen produces different responses in different people. Chinese medicine looks at the local climate characteristics — for example, some places suddenly drop in temperature, suddenly turn cold — and combines that with your physical constitution, observes what reactions you develop, judges what state you’re in, and then determines the treatment.

Got chilled: the Ma Huang Tang (Ephedra Decoction) approach — warm the body up

For example, some places suddenly turn cold. A person with yang deficiency, or with weak wei qi (defensive qi) that fails to protect the exterior, catches the flu and shows a “cold” state.

💬 Note from Doctor Luo: This kind of person feels freezing cold all over — icy cold — and yet has a fever, high body temperature, and absolutely no sweat — that fierce, blazing heat. What to do? In Chinese medicine we say: warm the body up — because you’ve been invaded by cold, the cold pathogen lodges on the exterior, so we use the Ma Huang Tang (Ephedra Decoction) type of approach: pungent-warm herbs that release the exterior and induce sweating (nowadays we sometimes don’t use ma huang [ephedra] itself; su ye [perilla leaf] and similar herbs replace it), to dissolve the cold pathogen. That’s one approach.

Aversion to wind, sweating at the slightest movement: Gui Zhi Tang (Cinnamon Twig Decoction) for ying-wei disharmony

Another type: a person with insufficient zheng qi catches cold — afraid of wind and cold, and most importantly sweating, sweating at the slightest movement. What is this? Ying-wei disharmony (disharmony between the nutritive and defensive qi).

💬 Note from Doctor Luo: The wei qi can no longer control the pores, and the ying qi has also diminished, so body fluids leak out. In this case use Gui Zhi Tang (Cinnamon Twig Decoction) — it unblocks the channels, warms and disperses cold, harmonizes ying and wei, and holds the sweat in. That’s exactly what Gui Zhi Tang does.

Exterior cold with interior heat — “cold wrapping fire”: Ma Xing Shi Gan Tang and Da Qing Long Tang thinking

Another very common situation: the exterior is cold — the body surface feels cold, you fear wind and cold — but inside there is heat: irritability, thirst, red tongue, yellow tongue coating. This is called exterior cold with interior heat.

💬 Note from Doctor Luo: What does Chinese medicine use? Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction) — ma huang disperses the exterior cold (today su ye can substitute), plus fang feng (siler root), jing jie (schizonepeta) and similar herbs to scatter exterior cold; for the interior heat, sheng shi gao (raw gypsum) clears the interior heat, and today you can add lian qiao (forsythia), pu gong ying (dandelion) and other heat-clearing, toxin-removing herbs. Da Qing Long Tang (Great Blue Dragon Decoction) follows the same logic: ma huang and gui zhi (cinnamon twig) scatter cold, paired with sheng shi gao to clear interior heat, plus xing ren (apricot kernel), gan cao (licorice), sheng jiang (fresh ginger) and da zao (jujube). This approach left later generations with a great deal of guiding wisdom.

Doctor Luo points out in particular: many patent Chinese medicines on the market today treat this “exterior cold with interior heat” situation (what ordinary people call “cold wrapping fire”) — often an exterior cold at the very start wasn’t controlled, the pathogen moved inward, and the condition entered the exterior-cold-interior-heat state. This state is extremely common.

💬 Note from Doctor Luo: That’s why so many patent medicines combine two approaches: one part scatters exterior cold — su ye, fang feng, jing jie, bai zhi, du huo and so on, pungent-warm herbs that course wind and disperse cold; another part clears interior heat — sheng shi gao as the representative, plus lian qiao, pu gong ying, huang qin (baical skullcap root) and other heat-clearing, toxin-removing herbs, and jin yin hua (honeysuckle) on top — dispersing the external pathogen while clearing interior heat at the same time, which works wonderfully. If there’s some dampness mixed in, add a little huo xiang (agastache) and pei lan (eupatorium). For example, the Kang Bing Du Kou Fu Ye (Antiviral Oral Liquid) I recommended before contains exactly this kind of combination.

Heavy dampness: cold-dampness uses Huo Xiang Zheng Qi, damp-heat uses San Ren Tang

Apart from cold invasion, there are also people with heavy dampness. Dampness too divides into cold and heat.

Cold-dampness: the tongue is plump, pale and moist; a white coating spreads over it; saliva is copious. When a dampness-heavy person catches an external affliction, spleen and stomach function is affected — vomiting and diarrhea, nausea, and a head that feels wrapped up and muzzy.

💬 Note from Doctor Luo: For cold-dampness, what do we use? Huo Xiang Zheng Qi. The herbs in Huo Xiang Zheng Qi are all warm — they dispel dampness and scatter cold. Use it, the cold-dampness drains away, and the person recovers at once. If you have exterior cold and at the same time some dampness inside — the air outside is very humid and foggy, your stomach feels uncomfortable, you have a bit of diarrhea, your whole body fears cold, and your head feels muzzy — you can combine the Ma Xing Shi Gan Tang or Da Qing Long Tang approach with Huo Xiang Zheng Qi. The effect is excellent.

Damp-heat: the tongue body is red, wrapped by the coating which is slightly yellow; the person runs a bit of heat, urine is yellow, there’s some irritability, the heart races, and during fever the body feels sticky and uncomfortable.

💬 Note from Doctor Luo: For damp-heat, what do we use? San Ren Tang (Three Kernels Decoction) — xing ren (apricot kernel), bai kou ren (white cardamom kernel) and yi yi ren (coix seed) as the core, paired with hou po (magnolia bark) and ban xia (pinellia), plus tong cao (rice-paper plant pith), zhu ye (bamboo leaf) and hua shi (talc powder), to drain the damp-heat away — immediate results, and the body recovers. In the dampness-dispelling playbook: cold-dampness is Huo Xiang Zheng Qi, damp-heat is San Ren Tang.

Warm-heat patterns: people deficient in jin ye (body fluids) are the most vulnerable

In spring (which is the season right now), what we see more often is warm-heat — that is, wen bing (warm disease). What’s going on here? Doctor Luo says these people usually have relatively vigorous xiang huo (ministerial fire) internally, a tendency toward yin deficiency, and often insufficient jin ye (body fluids).

💬 Note from Doctor Luo: When do these people get sick? When the weather turns hot — it should have stayed cool, but suddenly it warms up; you heat up and start sweating profusely, and your body fluids become even more depleted. It’s like moving troops along a river channel — when the channel has no water, the soldiers can’t be transported. When jin ye is insufficient, the channels’ movement goes wrong, ying and wei qi circulate abnormally, and external pathogens easily invade.

When this kind of person gets sick, there are several characteristic signs, which Doctor Luo emphasizes everyone should note carefully:

💬 Note from Doctor Luo: First, the weather suddenly and abnormally turns hot — temperature rising — that’s the first condition. Second, urine volume decreases — notice it yourself: you normally go a certain number of times a day, now the number drops and each voiding is smaller, and it’s a bit yellow. This is the most important signal. Third, dry mouth and tongue — the edges of the tongue are red, the mouth is dry, and you keep wanting to drink something. At this point people easily develop a sore throat — the slightest problem and the throat hurts. When jin ye is insufficient, external pathogens invade, there’s heat inside, the heat quickly accumulates in the throat region and causes swelling and pain. The pulse beats faster — it’s a heat pattern; there’s some vexation and irritability; fever and sore throat appear. At this point, we call it a warm disease.

The Three Beans, Wu Mei (smoked plum) and Sugar Decoction: drink it, and the fever drops right away

So what to do for a warm disease? Doctor Luo says the simplest method is the Three Beans, Wu Mei and Sugar Decoction he has introduced before.

💬 Note from Doctor Luo: One handful of black soybeans, one handful of yellow soybeans, one handful of mung beans, five wu mei (smoked plums, bought at the pharmacy), and two tablespoons of white sugar (rock sugar works too). Boil for two hours until it becomes a drink — it’s basically sour plum soup, and it’s delicious. Brew it the day you drink it; don’t keep it for the next day — make a fresh batch the next day. Drink it this way and the effect is excellent.

Why does it work? Doctor Luo breaks down the reasoning behind these three beans and one plum:

Black soybeans: tonify the kidneys while draining fire — they can bring fire down;
Mung beans: drain the ministerial fire of the liver and gallbladder;
Yellow soybeans: tonify the spleen and stomach. During COVID many ordinary people boiled yellow soybeans and drank the water — yellow soybeans really do contain many active ingredients and are beneficial;
Wu mei + sugar: sour-sweet combination that generates yin (suan gan hua yin) — it converts the water you drink into body fluids. That’s the body’s conversion mechanism. Once jin ye is replenished, the body recovers.

💬 Note from Doctor Luo: Many people drink this soup and their fever breaks right away. But most ordinary people don’t know it — right now many students in schools have fevers, and there’s no easy way, so they buy Western medicine; I’ve heard the search volume for certain Western drugs has multiplied over a thousandfold. But are people really so unfamiliar with Chinese medicine? Drink this soup and the child recovers quickly. I once gave it to an older sister in Beijing who had had a high fever for days without it breaking. She said: “Can this thing really work?” She drank it — and the fever broke. She said: “How is this so interesting? Put these few kinds of beans together and it actually brought my high fever down. What’s the principle? It’s simply unbelievable — the wisdom of the ancient Chinese is truly unbelievable.” It genuinely works. This kind of food therapy, drunk as a beverage, has no downside — everyone can use it.

Beyond food therapy, what about medication? Doctor Luo says you can use Yin Qiao Jie Du (Honeysuckle and Forsythia Detoxification) and Ling Qiao Jie Du Wan pills — that class of heat-clearing, toxin-removing remedies that also clears and vents outward.

💬 Note from Doctor Luo: If there’s a doctor nearby, having the doctor prescribe this kind of clearing-and-venting formula is even better — the effect is stronger. Basically, for spring flu, most of these situations are warm diseases — warm-heat predominates. In the few cases in the north caused by temperature drops, you use cold-damage (shang han) thinking — approaches like Ma Huang Tang and Gui Zhi Tang — and those are also immediately effective.

Why does Chinese medicine always fail to “get on the field” in every flu season? — classifying the external pathogen, and Doctor Zhu Weiju’s teaching

At this point, Doctor Luo turns to a deeper question: why is it that in every flu season, Chinese medicine “can’t get on the field”?

💬 Note from Doctor Luo: Every flu season, when Chinese medicine steps up, we hit the same question — is this flu cold or hot? What nature does this flu actually have? Everyone, this absolutely must be clarified. If the understanding isn’t clear, Chinese medicine will fail to rise to the occasion in every epidemic. I remember when I was a master’s student, I discussed this with my Shanghai teacher, Mr. Guan Qingzeng: every year the flu appears in the northeastern cities, every year so many people crowd into hospitals, so why can’t we Chinese medicine practitioners get on the field? Why can’t Chinese medicine be promoted? At the time the teacher just smiled without answering. Later I gradually understood — after getting into practice I understood: there are some problems Chinese medicine hasn’t solved. What problem? When it comes to infectious diseases, the problem of “classifying” the external pathogen.

Doctor Luo says people argued about this during COVID too: is COVID a cold-dampness epidemic? A warm-heat epidemic? Or a cold epidemic? In the end, the debate was never settled.

💬 Note from Doctor Luo: You produce a formula based on one line of thinking — it works in one place, fails in another; works one season, fails the next. Why? I’ve always emphasized: an external pathogen is an external pathogen. A pathogen may have a tendency to cause cold or to cause heat, but that tendency only takes effect under specific environmental and bodily conditions. So the same flu reacts completely differently in different places — in the northeast, where cold weather is the cause, many people get cold patterns; you use the cold-damage approach, because cold weather made yang-deficient people develop a cold pattern — you solve that problem by warming them up. In other places (like the south), though temperatures also fluctuate, warm-heat patterns predominate, and you use the warm-disease approach. It all depends on changes in the external environment and your own bodily state.

Finally, Doctor Luo invokes the view of Republic-era famous doctor Zhu Weiju to make the point clear:

💬 Note from Doctor Luo: The Republic-era master Doctor Zhu Weiju put it clearly: an external pathogen is just an external pathogen — it divides into the organic pathogen and the inorganic pathogen. The organic pathogen is the living kind — bacteria, viruses and so on. Its properties are not so obvious; it can survive anywhere and reproduce whenever conditions suit it. In cold places, when yang-deficient people have weakened bodily conditions and the environment suits it, it reproduces vigorously; in hot places, when yin-deficient people meet hot weather, the pathogen also reproduces easily. What are you adjusting? You’re adjusting the environment and the resulting state of the person — you cannot say this virus is cold or hot. If you go looking for whether the virus is cold or hot, you’ll never figure it out. You’ll find: in Guangdong and in the northeast, the very same flu virus behaves completely differently and is treated with different formulas — so is the virus cold or hot?

Doctor Luo also uses the common cold as an example: many people don’t know how to treat a cold — this person has clear nasal mucus, that person has yellow mucus; and the same person starts with clear mucus that later turns yellow. So is that cold a cold pathogen or a heat pathogen?

💬 Note from Doctor Luo: Why does clear mucus turn yellow later? Because different stages bring different bodily responses. You can’t say the external pathogen is cold or hot — it’s that in a cold environment, the invading pathogen manifests as cold; later, when the environment of the body’s struggle changes, it manifests as heat, and we call it a heat pathogen. That’s your state; it’s not that the pathogen keeps flipping back and forth. When a person inside their body is cold one moment and hot the next, that’s your body manifesting differently — different constitutions, different states, different times, different external environments, combining to produce different results. Do you all understand what I mean?

So, back to the original question: how do we treat the flu?

💬 Note from Doctor Luo: Chinese medicine speaks of bian zheng lun zhi (differentiation of syndromes to determine treatment) — this is the core soul. Different regions, different constitutions, different climates, different times — we respond according to the situation: if you manifest cold, I warm; if you manifest heat, I clear; if you have dampness, I dispel dampness. That is the soul of Chinese medicine. Once this question is clear, I think you’ve entered the hall. Every listener who understands will know: analyze for yourself whether your reaction is cold or heat, and you’ll know how to medicate; or if cold and heat coexist — exterior cold with interior heat — you can handle it yourself too.

Doctor Luo closes by reassuring everyone: the flu didn’t appear yesterday — it comes every year, and every year we fight it. It’s just that after COVID, everyone has been frightened.

💬 Note from Doctor Luo: Some friends say the flu is scarier than COVID — “with COVID I never had such a severe fever, but the flu fever is really intense.” What is that? It may indeed be that the body’s zheng qi is insufficient, so take good care of yourself. Once you catch it, adjust treatment according to your situation and you’ll be fine. This disease is not frightening; it’s not a particularly dangerous illness — just somewhat more uncomfortable. Once you understand the principles, you basically know how to handle it yourself. Today I’ve woven together all the external-affliction treatment material from the past and reviewed it for you — savor it slowly, go back and reread what I’ve taught before; that’s beneficial too. Thank you all for listening. I wish everyone peace and safety, and that we all overcome this external affliction!

Compiled from Doctor Luo Dalun’s health lecture (external affliction treatment series: the flu special).