Click blue textQinghe Zhi
2023
01/05
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Recently, the first wave of the pandemic has gradually eased after the restrictions were lifted. The peak period of collective suffering from the virus in the middle to late last month is slowly passing. However, just like a flood, after the peak passes, what remains is a mess. The subsequent recovery is as important as the initial fever reduction, yet many people often overlook the post-fever recovery.
Based on recent clinical observations, many people experience lingering symptoms after a high fever, such as fatigue, cough, excessive phlegm, and diminished or lost sense of smell and taste. How can we better recover during this stage?
In today’s article, I will mainly discuss some personal insights and experiences regarding diet. Many experts are currently providing education online, but some of their statements seem logically consistent on their own, yet when compared with other experts’ advice, they become confusing and even contradictory. For example, a recently discussed “expert” repeatedly emphasizes that during the fever stage, one should eat more eggs and drink more milk to supplement high-quality protein to boost immunity!
So, the logic of this viewpoint is:
Eggs and milk = high-quality protein = immunity = eat more eggs and milk after infection
This seems quite reasonable, doesn’t it?
However, the People’s Daily also published a nutrition expert’s education stating that during the fever stage, high-protein foods are not recommended because high protein generates heat during digestion, which is not conducive to lowering body temperature during fever. Instead, one should have a light diet primarily consisting of grains.
The statements of these two experts are contradictory and even have serious conflicts, leaving the general public confused about whom to listen to!
Over the past half month, I have observed in clinical practice that many people have fallen into two extremes. One group is the staunch supporters of “high protein,” who eat whatever is deemed “nutritious” without restraint (provided they still have an appetite), resulting in prolonged fever duration. Although the high fever subsides, they continue to have low-grade fevers or severe cough with excessive phlegm, which cannot be alleviated by any medication. The other group strictly adheres to a “light diet,” consuming only plain porridge and vegetables for a long time after the fever, even when they are starving, unsure if they should or can eat meat. Some breastfeeding women have only consumed plain porridge for several days, nearly losing their milk supply. These are all excessive practices; after illness, the body’s functions are constantly changing, and our dietary structure should also change accordingly. It is not beneficial to maintain a single dietary structure, as this hinders the body’s ability to expel pathogens and recover.
My experience and the approach I convey to patients are:
1. During the Fever Stage
If still in the fever period, with a clear floating pulse, strictly follow the instructions after decocting Guizhi Decoction (Gui Zhi Tang) to avoid “raw, cold, greasy, meat, five pungent spices, alcohol, foul-smelling, etc.” The primary issue to resolve is to reduce the fever; consuming meat and eggs at this time will hinder the process of reducing fever. In fact, I previously noted that “some people eat whatever is deemed ‘nutritious’ without restraint, but only if they still have an appetite.” During this pandemic, many people’s appetites have actually decreased after infection. When experiencing fever, body aches, and throat pain, there is almost no appetite, and they may not even want to eat anything for an entire day, let alone high-protein foods like meat, eggs, and milk. Only a bowl of hot, thin porridge seems appealing and manageable.
Thus, the reduced appetite during the fever stage is actually a self-protective mechanism of the body, as the primary task at this time is to concentrate efforts to eliminate the virus (external pathogens). If one forcibly consumes a lot of high-protein foods, which are difficult to digest, the body will divert some of its energy to process these high-nutrition foods instead of focusing on eliminating the virus, leading to two outcomes: first, the efficiency of virus elimination decreases, making the “counter-invasion war” more passive (historically, Empress Dowager Cixi did this during the First Sino-Japanese War, extravagantly celebrating her sixtieth birthday while the war was ongoing, and the results were evident); second, high-protein foods, which are already hard to digest, become even more difficult to digest in this state, and undigested food becomes waste in the body. This is why some people experience severe vomiting when eating during high fever; their bodies can no longer accept these foods and expel them to lighten the burden.
However, completely abstaining from food is also not advisable. The best method is to drink hot, thin porridge, which can nourish the stomach qi and preserve body fluids; it can also assist the righteous qi in expelling external pathogens. In the decoction method of Guizhi Decoction, Zhang Zhongjing elaborated extensively on how to decoct the medicine, how to take it, and how to care for oneself and avoid certain foods, setting a standard for prescriptions. He emphasized that after drinking Guizhi Decoction, one should “sip one liter of hot, thin porridge to assist the medicinal effect.” The methods and dietary structure during the fever stage of COVID-19 can similarly refer to the content of Guizhi Decoction.
2. After Fever Reduction
Next, observe the changes in the patient’s condition after taking the medicine. If the fever subsides and the floating pulse gradually decreases, assess the patient’s appetite and tongue appearance. If there is no obvious dampness and the stomach qi is acceptable, then small amounts of minced meat can be cooked in porridge (with ginger), or some meat broth can be prepared to gradually reintroduce meat into the diet. If the body can accept it without symptoms such as abdominal distension, diarrhea, recurrent fever, worsening cough, or thickening and increasing phlegm, then after 2-3 days, the diet can slightly increase the amount of meat. If the cough is not significant and phlegm is not excessive, some light fish soup can be consumed. For vegetarians, yam can be mashed or made into soup. Overall, ensure the basic amount of staple food, and meat should be reintroduced gradually. As for milk, in my personal experience, it is best for adults not to consume it.
Therefore, for patients who usually consume meat, during the recovery phase after fever reduction, it is necessary to eat some meat in appropriate amounts and at the right time. Otherwise, many people who only eat rice porridge for a period of time become increasingly fatigued and weak, feeling uncomfortable. This is actually due to insufficient nutrition. In the early stages of illness, the body needs to mobilize a large amount of yang qi to combat external pathogens, and the entire process consumes a lot of energy. Appropriate nutritional supplementation in the later stages is beneficial for recovery.
3. TCM Nutritional Perspective
Traditional Chinese Medicine (TCM) has its unique understanding of nutrition that must not be overlooked. The viewpoint is:
“Poisonous drugs attack pathogens, grains provide nourishment, fruits assist, livestock benefit, vegetables supplement, and flavors combine for consumption.”
Poisonous drugs are weapons used only when there is pathogenic qi; they should not be used lightly in normal times. Recently, news has reported many people using medications indiscriminately, with incorrect dosages and symptoms, leading to severe liver damage. This illustrates the misunderstanding of the meaning of “poisonous drugs attacking pathogens”; the true nourishment for the body, or the most effective nourishment, comes from grains, which are the staple foods. In the south, rice is predominant, while in the north, wheat is the mainstay. Therefore, even during the fever stage, when one may not have an appetite for other foods, the staple food must not be neglected. Many people’s experience is that “during the one or two days of high fever, lying in bed and unable to move, they rely entirely on that bowl of hot porridge to survive,” which is correct. Fruits play a supportive role, adding a finishing touch but are not essential. However, many people have it reversed, not eating grains but consuming large amounts of fruit, which is not just misplaced priorities but fundamentally incorrect. Livestock refers to various meats, which serve a beneficial role. What does beneficial mean? It means providing more on the basis of ensuring the essentials. The premise is that there are no “leaks” in the body; if the body is experiencing various “leaks,” then this “benefit” is meaningless. During the fever stage, the body is experiencing significant “leaks”; the primary issue is how to “plug the leaks” rather than “supplement benefits”. Vegetables also play a role in supplementing and perfecting on the basis of ensuring essentials, similar to the function of livestock. Understanding which category of food is fundamental in the dietary structure allows one to remain clear-headed at all times, without being confused by individual “experts'” statements.
Recently, I have seen some breastfeeding mothers who, during the recovery phase, only drink plain porridge, gradually leading to a decrease in milk supply. This is actually an excessive taboo. The fatigue from insufficient nutrition should be distinguished from the fatigue after infection: the fatigue after infection is characterized by body weariness, heaviness in limbs, and easy sweating during activity, but there is not a strong appetite; whereas the fatigue from insufficient nutrition is characterized by lightness and weakness in the body, a feeling of hunger in the abdomen, and a strong craving for certain foods, even a sense of discomfort. Some patients have continued to feel fatigued while only drinking plain porridge, but once they opened their diet and began to drink some meat broth, they quickly regained energy, and their recovery process accelerated significantly.
Overall, the dietary approach for exogenous diseases (such as COVID-19) follows the principle stated in the Huangdi Neijing (Yellow Emperor’s Inner Canon) – Discussion on Heat: “When the disease is hot and not yet resolved, eating meat will cause a relapse; excessive consumption will lead to loss; this is the prohibition.” However, under this principle, it is also necessary to flexibly adjust the dietary structure based on clinical realities and the patient’s recovery status, which is the embodiment of TCM’s spirit of “differentiation and treatment”.
The above viewpoints are merely my personal understanding and experience.
Pinghe
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