As winter arrives and temperatures drop, the likelihood of contracting exogenous diseases increases. The main reason is that the temperature difference between the external environment and body temperature becomes significant. If a person’s Zheng Qi (正气, vital energy) is relatively weak and cannot maintain body temperature, immunity will decline, making it easier to be attacked by bacteria or viruses, leading to the onset of exogenous diseases. Therefore, it is essential to prevent exogenous diseases. Here are several effective methods.
First: Wear a mask. Avoid crowded places to reduce the chances of exposure to bacteria or viruses.
Second: Dress warmly. Do not allow yourself to feel cold. When you feel cold, the body’s immunity begins to decline, making it easier to become ill.
Third: Strengthen your physical constitution. Through exercise and dietary improvements, enhance your physical fitness and boost your immunity, which will help you feel less cold and maintain a higher level of immunity when you do feel cold. If these three points are not adhered to and one accidentally catches a cold or develops similar illnesses, there are several commonly used TCM formulas that I will briefly outline for reference.
1. Ma Xing Shi Gan Tang (麻杏石甘汤).
Main indication: Exogenous disease with external cold and internal heat. Common symptoms include: fever, cough with wheezing, nasal congestion, thirst, sore throat, sweating or no sweating, and a thin white or yellow tongue coating.
Ingredients: Ma Huang (Ephedra, 去节) 5g, Xing Ren (Apricot Kernel, 去皮尖) 5g, Gan Cao (Licorice, 炙) 3g, Shi Gao (Gypsum) 10g.
2. Ma Huang Tang (麻黄汤).
Main indication: Exogenous disease with external cold. Common symptoms include: chills and fever, body aches, pain in the joints, no sweating but wheezing, thin white tongue coating, and a floating tight pulse.
Ingredients: Ma Huang (Ephedra) 5g, Gui Zhi (Cinnamon Twig) 3g, Ku Xing Ren (Bitter Apricot Kernel) 3g, Gan Cao (Licorice) 2g.
3. Gui Zhi Tang (桂枝汤).
Main indication: Exogenous disease due to wind. Common symptoms include: low fever, aversion to wind, and excessive sweating.
Ingredients: Gui Zhi (Cinnamon Twig) 5g, Bai Shao (White Peony) 5g, Sheng Jiang (Fresh Ginger) 5g, Da Zao (Jujube, 切) 5g, Gan Cao (Licorice, 炙) 3g.
4. Bai Hu Tang (白虎汤).
Main indication: Exogenous febrile disease. Common symptoms include: heat in the Qi level, high fever with a red face, thirst with a desire to drink, sweating with aversion to heat, and a strong, large pulse.
Ingredients: Shi Gao (Gypsum) 10g, Zhi Mu (Anemarrhena) 10g, Gan Cao (Licorice) 5g, Jing Mi (Polished Rice) 10g.
5. Xiao Qing Long Tang (小青龙汤).
Main indication: Exogenous disease with internal phlegm due to external cold. Common symptoms include: chills and fever, body aches, no sweating, cough with phlegm, clear and copious sputum, or dry heaving, or cough with phlegm, difficulty lying flat, or heavy body aches, white slippery tongue coating, and floating pulse.
Ingredients: Ma Huang (Ephedra) 5g, Shao Yao (Peony) 5g, Xi Xin (Asarum) 2g, Gan Jiang (Dried Ginger) 5g, Gan Cao (Licorice, 炙) 5g, Gui Zhi (Cinnamon Twig) 5g, Wu Wei Zi (Schisandra) 3g, Ban Xia (Pinellia) 5g.
6. Da Qing Long Tang (大青龙汤).
Main indication: Exogenous disease with internal heat. Symptoms: chills and fever, cough, body aches, no sweating, and irritability, with a floating tight pulse.
Ingredients: Ma Huang (Ephedra) 5g, Gui Zhi (Cinnamon Twig) 3g, Gan Cao (Licorice, 炙) 5g, Ku Xing Ren (Bitter Apricot Kernel) 10g, Sheng Jiang (Fresh Ginger, 切) 5g, Da Zao (Jujube, 切) 5 pieces, Shi Gao (Gypsum) 10g.
7. Zhu Ye Shi Gao Tang (竹叶石膏汤). This formula is primarily used for treating residual heat from febrile diseases, such as typhoid, warm diseases, and summer heat. Symptoms include: body heat with excessive sweating, irritability in the chest, nausea, dry mouth with a preference for drinking, shortness of breath, fatigue, or restlessness with insomnia, red tongue with little coating, and a weak rapid pulse.
Ingredients: Zhu Ye (Bamboo Leaves) 6g, Shi Gao (Gypsum) 10g, Dang Shen (Codonopsis) 6g, Mai Dong (Ophiopogon) 10g, Ban Xia (Pinellia) 9g, Gan Cao (Licorice) 6g, Jing Mi (Polished Rice) 10g.
8. Zhi Zi Dou Chi Tang (栀子豆豉汤). This formula has the effect of clearing heat and relieving irritability, treating symptoms such as: restlessness and insomnia, and feelings of discomfort in the heart.
Ingredients: Zhi Zi (Gardenia) 10g, Dou Chi (Fermented Soybean) 5g.
The above are some commonly used formulas for exogenous diseases. These formulas are intended for treatment and should not be used for prevention. This is because these formulas have significant biases; some are cold herbs, while others are hot herbs. If a person takes these formulas while in a state of Yin-Yang balance, it can alter their Yin-Yang state, leading to imbalance. Therefore, one should not think of using medicinal formulas for treatment as a means of health maintenance.
For exogenous diseases with severe sore throat, one should not hastily use warming Yang and dispelling cold herbs. For example, the currently prevalent Omicron virus symptoms resemble a condition of external cold and internal heat. Generally, Ma Xing Shi Gan Tang would have a good effect. In fact, we can see that the popular Lianhua Qingwen capsules on the market are a combination of Ma Xing Shi Gan Tang and other formulas. Therefore, theoretically, it is effective. Previous studies have shown that Lianhua Qingwen capsules can treat mild cases of COVID-19 and also speed up the recovery of asymptomatic carriers. However, I do not recommend taking Lianhua Qingwen capsules solely based on a positive nucleic acid test without any symptoms, including sore throat or fever. As mentioned earlier, Lianhua Qingwen capsules are relatively cold herbs, and if taken by asymptomatic individuals, it may lead to the accumulation of cold in the body, thereby reducing immunity.
In addition to Ma Xing Shi Gan Tang, I have also introduced other commonly used formulas because each person’s physical condition is different, and the symptoms exhibited by exogenous diseases vary, as do the internal cold-heat conditions. Therefore, ancient medical texts provide numerous formulas for treating exogenous diseases. These formulas are tailored to each individual’s unique Yin-Yang condition. Thus, I have prepared several commonly used formulas for exogenous diseases to accommodate different symptoms. However, it is generally difficult for individuals to determine which formula they should take; it is best to seek guidance from a professional, such as a doctor. If that is not possible, one must first distinguish between cold and heat. If the cold-heat distinction is correct, even if the effect is not significant, there will not be much adverse reaction. It is important to note that fever in TCM terminology is referred to as ‘fa re’ (发热), but not all fevers are heat syndromes; many cold syndromes can also present with fever, so symptoms should be comprehensively assessed.
It is also important to remind that these formulas for exogenous diseases are often aimed at common exogenous symptoms. If someone is severely ill, especially bedridden with other serious conditions, extreme caution is required, and these formulas may not be suitable. This is because in severe cases, the body’s Yin-Yang cold-heat state is very complex, and one cannot only consider exogenous diseases; the overall condition of the body must be taken into account. This is not something that can be explained in a few sentences, and when a person is in a severe state, contracting an exogenous disease can often exacerbate the situation, significantly increasing the risk of danger. Therefore, many critically ill patients who catch a cold are at a higher risk of mortality.
Finally, the last two formulas, Zhu Ye Shi Gao Tang and Zhi Zi Dou Chi Tang, are generally used for recovery when exogenous diseases are improving. For example, sometimes after taking medication, symptoms improve, but there is some irritability and insomnia. If a comprehensive assessment indicates that there is deficiency heat, Zhu Ye Shi Gao Tang can be considered to help accelerate recovery. Of course, for some long COVID symptoms abroad, these two formulas may not completely cure them. These long COVID symptoms are often due to Qi deficiency and require appropriate tonification. Since there is no TCM in many foreign countries, there may be more individuals experiencing these symptoms, and interventions based on Western medicine often yield little effect. Of course, these symptoms generally do not affect normal daily life, but individuals often feel more fatigued than before they fell ill. In fact, many people experience lingering fatigue symptoms after a severe cold, which can be difficult to resolve. However, because China has TCM, many people choose TCM for adjustment, and some even use some tonifying Chinese herbs themselves, so this situation is relatively rare.
In conclusion, I still advise everyone not to take Lianhua Qingwen capsules without reason; they really cannot prevent illness. For prevention, it is still essential to wear masks and exercise more.