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2020年06月22日
APPLICATION OF TRADITIONAL CHINESE MEDICINE IN THE PREVENTION OF AIRBORNE INFECTION (中藥醫在防控空氣傳播傳染病應用)

  

Lee Chun-hsin, PhD,

General Secretary, Taiwan Association of Intergrated Health Promotion

Li Ting-an, Master, Department of Neurology, The Third Hospital attached to Beijing University

 

Abstract

In the 1990s, a global investigation sponsored by WHO revealed that, for factors influencing one’s health and life span, the lifestyle and behaviors occupy the leading position, representing 60%; environmental factor comes next, representing 17%; heredity represents 15%; whereas medical services represent 8%.  The above figures show that the role played by lifestyle and behaviors in the maintenance of one’s health is crucial, an idea goes against one’s common sense.   Reasonable and healthy daily lifestyle and behaviors for keeping fit are significant in the prevention of major and serious diseases in one’s future life.  All these fall under the category of modern preventive medicine, and is called “ a superb practitioner treats prior to onset of disease ” in traditional Chinese medicine ( TCM), while medical treatment belongs to the work of “ a charlatan treats after the occurrence of disease” in TCM, obviously reflecting the principle of prevention is superior to treatment.  In Huang di nei jing (The Inner Canon of Yellow Emepror) ( 99 BC~26 BC), it writes that “ a superb physician treats prior to the onset of disease instead of after its occurrence ”, fully reflecting that, in TCM, the way of life nurturing and prevention rather than treatment are stressed. An airborne infectious disease causing an overwhelming global epidemic is basically the influenza.  The SARS outbreak in Guangdong province in 2002 was only prevented for its transmission by the contemporary common approaches, including sterilization, aromatic fumigation, and wearing mask.       

The theory of TCM maintains that odor is omnipotent to penetrate all orifices.  Aromatic smell is capable of entering the body through the superficial orifices, including the mouth, nostrils, and the sweat pores, and thus affects the functions of the internal organs, balances Qi and blood circulation in the body, harmonizes the hollow and solid viscera, prevents disease, strengthens body resistance, and dispels the pathogenic filths.  These have been proved by modern biomedicine with the same idea, claiming that the odor particles can promote the formation of immune globulin, elevate the body immunity, regulate metabolism, and balance the function of autonomous nervous system.

The traditional aromatic fumigation method for preventing airborne infection includes: (1) burning of Radix Atractylodis, sterilizing by burning strips made of Folium Artemisiae Argyi so as to dispel the pathogens in the room; (2) Carrying aromatic sustances, a method derived from the “dressing method ” of TCM in which medicines are carried within the clothes, shoes, socks, or decorations.  By the absorption of the aroma odor through the respiratory tract or superficial skin orifices into the body to develop its action of prevention or treatment.

During the epidemic of H7N9 bird flu, the Commission of Health and Family Planning of mainland China and its Provincial Departments od Public Health promulgated a Project for TCM Prevention and Treatment of H7N9 Bird flu in Human being, pointing out specifically the method of preventing its infection by wearing traditional Chinese aromatic bag.  Meantime, the Public Health Bureau of Hsinpei City, Taiwan also recommended the use of Folium Artemisiae Argyi and Rhizoma Acori Graminei for dispelling pathogenic filths, expelling harmful insects, and detoxification,  Inside the bag, aromatic volatile aromatic herbs are placed.  The bag is carried over the chest, smelt through the nostrils several times a day, and placed beside the pillow when sleeping.  Prolonged use of such method can yield an excellent healthcare action.  As a result, this approach for preventing epidemics became a vogue across the strait.

This article, based on the principle of “ Inheritance without stereotyped acceptance, creation following ancestors’  steps”, follows the past method and traditional experiences on prevention of airborne infections, together with modern technique to modify and prepare an epidemic prevention warm moxa mask with a patented open-layer in which a pouch containing an epidemic preventing bag with Chinese medicines (aromatic bag) is contained.  In addition to the effective prevention of spread of pathogenic microbes floating in the air, this also possesses the actions of balancing Qi-blood circulation, harmonizing the internal viscera, expelling disease and increasing body resistance, with the effect of aroma dispelling pathogens, which is based on traditional TCM and modern biomedical theory and is a kind of aromatic therapy.  This is the first point of preventing spread of infections.  The warm-moxa bag can raise its temperature to 40˚C~45˚C, resulting in thermotherapy in which warm air is inhaled, the mucous secretion of the respiratory tract can be increased with the virus attached there expelled out of the body in time.  Thus, body resistance and epidemic prevention mechanism are elevated.  This is the second point of preventing spread of infection.  Since the optimal temperature for the growth of flu virus is 10˚C~20˚C, a temperature over 33˚C can prevent and ameliorate the spread of flu virus.  This is the third point of preventing spread of infection.  As the Chinese medicinal bag is placed directly over the mouth and nose and is convenient to use, this is a creation of external aromatic therapy combined with thermotherapy, and is naturally a new approach for medicinal adminitration.

Sun Simiao, the Chinese ancient medical king, said: “Lying on one’s lateral side with flexed knees is beneficial to your health, and is better than supine sleeping position. ”  He advocated this lateral lying posture with bending knees because it strengthens body Qi circulation (i.e., increase the blood oxygen value), and is, of course, better than the supine lying position.  Since the latter position has the nose and mouth facing upward and is vulnerable to the invasion of infectious virus which, through the carrying by the sputum, could flow onto the lower parts of the lungs where it grows and proliferates.  This is one of the main reasons of infection of flu virus.  Therefore, avoiding a supine sleeping posture is one of the main points in TCM to prevent the spread of airborne infections, and is naturally not to be ignored.  

Key words 

 Health care; Mask for preventing disease;

Warm moxa mask;Supine sleeping posture     

 

A.  Prevention is superior to treatment  

In the 1990s, a global investigation sponsored by WHO revealed that, for factors influencing one’s health and life span, the lifestyle and behaviors occupy the leading position, representing 60%; the environmental factor comes next, representing 17%; heredity represents 15%; whereas medical services represent 8%.  The above figures show that the role played by lifestyle and behaviors in the maintenance of one’s health is crucial, an idea goes against one’s common sense.   Reasonable and healthy  daily lifestyle and behaviors for keeping fit are significant in the prevention of major and serious diseases in one’s future life.  All these fall under the category of modern preventive medicine, and is called “ a superb practitioner treats prior to the onset of a disease ” in traditional Chinese medicine ( TCM), while medical treatment belongs to the work of “ a charlatan treats after the occurrence of a disease” in TCM, obviously reflecting the principle of prevention is superior to treatment.  In Huang di nei jing (The Inner Canon of Yellow Emepror) ( 99 BC~26 BC), it writes that “ a superb physician treats prior to the onset of disease instead of after its occurrence ”, fully reflecting that, in TCM, the way of life nurturing and prevention rather than treatment are stressed. An airborne infectious disease causing an overwhelming global epidemic is basically the influenza.  The SARS outbreak in Guangdong province in 2002 was only prevented for its transmission by the contemporary common approaches, including sterilization, aromatic fumigation, and wearing mask.

B. Serious disasters to human being through airborne infections

1. In 1978, H1N1 influenza was an epidemic which eventually resulted in the global overwhelming outbreak of Spanish influenza with 1 billion victims ( by then the global population being 1.7 billion ) with a death toll of 25 million to 40-million, the total mortality rate was 2.5%~5%.

2. The H2N2 influenza in China in 1957 involved the whole world (including the U.S.) until 1985. with a death toll of at least 1 million.

3. In 1968~1969, H3N2 influenza occurred in Hong Kong with a death toll of 750 000.  By then, experts of WHO warned that global massive epidemic of influenza might occur once evry 30 years.  

4. In 2002, SARS outbreak occurred in Guangdong province, with the bat as vector of transmission among human being, the death toll being 776.  Living under the threatening of SARS, Hong Kong people revealed an increasing consciousness of self protection, evidenced by the increase in the rate of wearing mask in Hong Kong community.  During the climax of the epidemic, 65% of passengers in subway wore mask, more female than male.  Facial mask is effective for preventing the airborne infection of SARS which can be transmitted through droplets within a distance of 1 meter .  For SARS patients, wearing a mask can also prevent the spreading of the infectious virus.  Meanwhile, all sorts of aromatic fumigation can also kill effectively the coronavirus.

Obviously, virus causing global massive epidemic is basically influenza virus, the current prophylactic measures of which only include, in addition to sterilization, wearing mask and aromatic fumigation.  The latter half of this paper would deal mainly with the prevention of airborne infections influenza.   

C.           The mode of transmission of the airborne infections

There are three key factors in the mode of spread and epidemic of infectious diseases: (1) Origin of infection: Man or animal that can excrete pathogenic agents; (2) Routes of infection: the ways of the pathogenic agents capable of spreading to other persons; (3) Susceptible person: including those without immunity. The pathogens, or the origin of infections might spread through the breathing of the host to cause disease through the respiratory tract, and live in the host’s mucus of the mucous membrane of respiratory tract or in the fragments of its ciliated cells, and then stimulate the nervous reflex to spray the  pathogens, which are minute enough, contained in the mucus or exudates, into the air when the patient exhales, speaks loudly, cries, snores, coughs, and sneezes, waiting to enter the body of other hosts.   This is the so-called droplet infection. 

Based on the size of the particles, the mode of spreading of airborne infection can be divided into three types: droplet, droplet nucleus, and dust:

The epidemic of flu is basically through droplet infection.  Through sneezing and coughing, the droplets and saliva contain large amount of virus,  The droplets sprayed out could reach a distance as long as 1~2 meters.  One might be infected when inhales virus within this distance.  Hence, facial mask constitutes the first juncture for its defense.  Investigation show that the close contact between the mask and the mouth-nose is crucial to its defensive mechanism.  Since the auricles for hanging the mask can’t stand too much weight, and the facial surface is not a smooth plane, the regular mask sold in the market can’t be so closely contact with the mouth-nose.  It is estimated that about 50% of the droplets in the air escape the blocking action of the mask, and the preventive action is not satisfactory.  Only those masks fixed over the crown of the head can have a closer contact with the face and get a better preventive action with about only 10% air droplets escape the blocking action of the mask.  The N95 mask is made of material with minute texture and could filter very minute particles.  Based on the efficacy of filtration, the preventive effect of N95 seems to be better.  However, virus and dust particles are but two different things.  N95 can block particles of 0.3μ, yet the size of H1N1 virus is 0.1μ.  So, strictly speaking, it can’t filter the virus.  Moreover, prolonged wearing of N95 would cause short breath and can’t stand for long.  The filter material would become saturated after 8 hours.  Such mask is not suitable for common people, but for medical professionals only, and can’t be repeatedly used.

D.           The application of TCM in the prevention of spread of  airborne infection  

Theoretically, TCM claims that odor is omnipotent to penetrate all sorts of pores.  Odor can enter human body through the mouth, nostrils, and sweating pores to affect the visceral functions, balance the Qi-blood circulation, harmonize the internal organs, get rid of diseases, and strengthen the body.  This is the basic principle of dispelling pathogenic filths with aroma.  The theory has been proved by biomedicine, claiming that the aromatic particles can promote the production of immuno-globulin to enhance body resistance, regulate metabolism, and adjust the functions of the autonomous nervous system.  TCM holds that medicines of pungent-warm and aromatic dryness property are capable of dispelling pathogenic filths. The most commonly applied medicines of such kind include Rhizoma Atractylodis, Folium Artemisiae Argyi, Radix Auklandiae, Radix Angelica Dahurica, Herba Pogostemonis, Flos Chrysanthemunu Indici, Rhizoma Zingiberis Recens, and Fructus Amomi.

There are two common measures of aromatic dispelling pathogenic filths (aromatic epidemic prevention ):

1, Fumigation sterilization by burning Chinese materia medica with aromatic dispelling pathogenic filths for indoor use

  (a) Burning Rhizoma Atractylodis for dispelling pathogenic filths     

 Ben cao gang mu ( Compendium of Materia Medica) writesZhang Zhongjing dispels all sorts of malignant-Qi by burning with the smoke of Rhizoma Atractylodis and claws of pork trotters; Tao Yinju also said this medicine expels all malignant-Qi , suppress all disasters,  That’s why people used to burn Rhizoma  Atractylodis in New Year and during epidemic period to dispel pathogenic filths

Zhang Shanlei, a famous modern Chinese physician said: “Rhizoma Atractylodis has a heavy and strong smell, even stronger than Rhizoma Atractylodis Macrocephalae, and is capable of drying up dampness, restoring the normal Qi movement of the lungs to expel phlegm, overcoming seasonal pathogens.  It is mostly applied in seasonal pestilence, extensively used for sterilizing the air in hospitals.  The procedures include:  First immerse the Rhizoma Atractylodis in 95% ethyl alcohol for 10 hours.  Then take it out and put it in a room to be sterilized.  Burn it until it becomes ash.  Since the volatile oil it contains is nontoxic, non irritating, the odor it produced is non corrosive, and can be tolerated by everyone, it can be sustainably used for air sterilization and is better than other similar methods like ultraviolet ray, ozone, and other chemical agents. ” .

(b) Burning moxa strip

There is a proverb popular in Qizhou, Hubei province where excellent moxa is produced, saying that “with 3-year old moxa .ever ready at home, there is practically no need to invite a doctor. ”  The smoke it produces when burnt prevents disorders, prevents pestilence.  This is because the moxa smoke yields inhibitory action on many bacteria, fungi, and virus that cause different kinds of infections and epidemics.

2, Commonly used methods of carring aroma

(a) This method is originated from the “dressing therapy” in TCM

In the relic objects unearthed in the Han tomb of Mawangdui, Changsha, aromatic bag was found which, based on the historical documents, is used to collect Chinese medicines for expelling insects and dispelling pathogenic filths.   

 (b) In the classic of Shan hai jing ( Classic of Mountains and Seas), there are paragraphs mentioning that wearing certain medicines can prevent pestilence and cure diseases.

Ancient people used to place chrysanthemum, camphor, and mint in the hat to prevent summer heat, clearing the heart.  They also put medicines with properties of removing wind, dispersing cold, and arresting pain like Herba Asari, Radix Aconiti in the shoes so as to avoid fatigue when travelling afar.

Chouxiang (a kind of animal aromatic substance similar to musk) placed in one’s hat can strengthen one’s brain function; chrysanthemum plus old moxa prepared as knee pad can treat knee arthritis; wearing a bag containing vanilla can get rid of filths.  Since aromatic bag yields specific therapeutic effect, it is popularly welcome by people, and becomes a vogue in the folk as a common custom even today.

Being a kind of folk custom, wearing of aromatic bag could prevent common cold is due to the heavy aromatic odor scattered from the medicines in the bag.  The odor forms a aromatic mini-environment around the body.  The aromatic medicines can promote the amount of mucous membrane secretion of immune globulin, and increase the self immunity.  Regularly, medicines with stronger volatile aromatic ingredients capable of promoting the orifice functions, resolving turbid substances, and dispersing pestilence are selected.  The medicinal ingredients are smashed as powder and placed in the bag for wearing .  Such bag is carried over the chest and close to the mouth and nostrils as near as possible, which can be smelt several times a day and placed beside the pillow when sleeping.  Prolonged application of such habit can produce excellent health care effect.

(b) Origin of aromatic bag

In remote ancient time, Chinese ancestors knew how to wear aromatic bag for preventing pathogens.  During the reign of Yellow Emperor tribe, there was an overwhelming epidemic.  It was told that Guangcheng zi (Master Guangcheng) was conversant with medical know-how who was visited by a messeger dispatched by the emperor, requesting for the measures to tackle the epidemic problem.  The Master gave him a package containing realgar and let them wear it.  Eventually the epidemic was brought under control.

During the Southern-Northern dynasties, the package developed into an aromatic pocket.

During the Tang dynasty, the pocket developed as an exquisite aromatic bag.   

In the Song dynasty, the exquisite bag was no longer the fashion for the ladies and beauties only, male officials also began to wear such bags.  Some officials even wore the bag with the official attire when going to the royal court.  Since aromatic substances were expensive and inaccessible at that time, somebody used aromatic medicines as substitutes.  It was then found that such aromatic medicinal bags were not only fragrant, but also with the effect of dispelling the filths and preventing diseases.  Thus, people flocked to wear such bags and became a fashion.  People used to carry it around the waist as a decoration, while some even used it as a souvenir or mascot for engagement.

Modern people place it in clothes closet to prevent insects or termites, refresh the air in the room, and keep it ventilated with fragrance.

(c) Prevention of influenza by aromatic bag

The famous physician Hua Tuo made aromatic bag with clove and Radix Stemonae and suspended it indoor to prevent lung disease.

In Qian jin yao fang ( Essential Prescriptions Worth a Thousand gold ) written by Sun Simiao of the Tang dynasty, it is claimed that wearing  “ Silk bag” “ can escape pestilent Qi, and protect people from infections .”

During the Qing dynasty, wearing aromatic bag became one of the measures to prevent disease in the royal palace.  The Qianlong Emperor delivered an imperial order : “ Beginning from the first of May, (all household should ) suspend the pouch for the ‘ five poisons '.”  Even the Emperor himself carried the “ Five poisons pouch”, “ Dragon boat pouch”.  Early May is at the turn of Spring and Summer when all insects and pest grow, and epidemics spread, therefore, the prevention of diseases and sterilization are of utmost importance.  People carries medicinal aromatic bags can both expel insects, removing bad odor, and dispersing turbidity, dispelling sweating smell, and express the wishes for peace and health for their children.  This exquisite gadget might also serve as a toy.  When wearing it at the waist, over the chest, or around the navel, the medicines it contains could diffuse through the acupoints, channels and collaterals to reach the site(s) of disorders.  This could not only refresh the brain to yield a clear mind, but also yield the capacity of preventing and treating many kinds of diseases.  It is capable of activating blood circulation, resolving blood stasis, combating cold, arresting pain, , drying dampness, draining channels, dispersing wind, expelling cold, strengthening the spleen, harmonizing the stomach, regulating Qi to stop pain, opening orifices.  Most of these medicines contain volatile oil,, with persistent fragrant odor, its effective ingredients are capable of inhibiting or killing, to different degrees, bacteria, fungi, and virus, and dispelling pathogens and preventing pestilence.  Based on the above descriptions, it is obvious that different human groups should select different kinds of aromatic orifice-opening medicines, so as to achieve and utilize its health protection actions.

Current studies show that the dispersion of heavy aromatic odor from the medicines contained in the aroma bag could enter the body through the respiratory tract to stimulate the nervous system and the immune system, promote the formation of antibodies, inhibit the growth of harmful bacteria, increase the body resistance.  In the meantime, aromatic particles could promote digestion after absorption, stimulate secretion to enhance the activities of digestive glands, activate digestive enzymes, with ensuing good appetite.

In children, since their nasal mucosa secreted immune globulin is less, therefore, they are vulnerable to upper respiratory infection.  Indeed, they are most appropriate to wearing aromatic bag.  Constant carrying of such bags over the chest, inside the pocket and besides the pillow could prevent flu, diphtheria, epidemic meningitis, measles, and chickenpox, and is also helpful to its treatment, more or less,

It should be noted that not all people are appropriate to wear aromatic bags.  People with idiosyncrasy, pregnant women, weak people or physique with predominant damp-heat factors, thick greasy yellow fur on the tongue, and sticky stool, should be cautious to carry such bags.  

During the epidemic of H7N9 bird flu, a “ Project of for Treatment and Prevention by TCM for H7N9 Bird flu in Human Being ” announced by the Commission of Health and Family Planning pointed out specifically recommended the method of aromatic bags with Chinese medicines for the prevention of H7N9 bird flu; while the Health Bureau of  Hsinpei City, Taiwan also recommended the use of Folium Artemisiae Argyi and Rhizoma Acori Graminei for dispelling pestilence, expelling harmful  insects, and detoxication.  When these aromatic materia medica were placed in aroma bags, the aromatic fragrant odor diffused could prevent epidemic.  Thus, the traditional method of prevention and treatment for pestilence became rejuvenated.

The H7N9 bird flu infection falls under the category of “ pestilence” in TCM.  Based on the past clinical experience

on the prevention and treatment of flu, civilians are encouraged to massage their Yingxiang point and carrying aroma bags with Chinese materia medica to prevent the disease.  Being a kind of folk custom, wearing aroma bags is a method for preventing pestilence, recognized as a decoration and a measure to dispel pathogenic filths, keep fit and prevent disorders.

1, Zhejiang version of wearing aromatic bags with Chinese medicines: Take equal amount of  Herba Agastachi, Folium Artemisiae Argyi, Cortex Cinnamomi, Rhizoma Kaemferiae, Rhizoma Atractylodis, and clean all the ingredients to remove  the impurities and dry them in a dryer under 60°C.  Smash them as powder to over 100 sieve or micronized to 1000 sieve, if possible ( with a micronizer).  Pack the powder in bags 3.5~5 g each, and then prepare it as aromatic bags, one for each person.  Wear the bag over the chest, and smell it twice each day, 3 minutes each time.  Place it beside the pillow when sleeping, and change the bag once weekly.

2, Wuhan version of Chinese aroma bags wore by the Wuhan Hospital of TCM: Take equal amount of Herba Agastachis, Herba Eupatori, Folium Artemisiae Argyi, Rhizoma Atractylodis, and prepare them as powder and then placed in bags.  Wear a bag over the chest, and smell it twice daily, three minutes each time.  Place it beside the pillow when sleeping.  Change the bag weekly.

3, Shanghai version of aroma bag: Aromatic medicines include Herba Agastachis, Rhizoma Atractylodis, Semen Amomi Cadamomi, , Folium Perilla Fructescence(L) Britt. prepared as powder and then place it in a bag.  Wear it for preventing flu.

4,The “ Center for Treatment prior to Onset of Disease ” attached to the Hospital of TCM, Luzhou Medical College is going to set up a Medicinal Bag for Supporting the Body to Prevent Cold, which reinforces body resistance and prevents cold that benefits your health.

5, The “ Center for Treatment prior to the Onset of Diseases” attached to the Hospital of TCM, Leshan, Sichuan province has announced a successful product of aromatic bag for combating cold and an aromatic bag for calming down coronary heart disease.  The former is for strengthening body resistance and preventing cold, and the latter, for warming the channels, draining the collaterals, regulating Qi, and easing the chest, activating blood circulation, and resolving blood stasis.

6, On 22nd, May, 2014, Lin Kuanqin, Director of the FDA, Deparment of Public Health, Hsinpei City, Taiean claimed that, since ancient medicine was still not well developed, and infections were apt to developed, people tried to use Herba Artemisiae Argyi and Rhizoma Acori Graminei to dispel pathogens, expel harmful insects, detoxi11fication, which, after prolonged use, developed into aromatic bags in which the Chinese medicines evaporate fragrant smell, diffuse into the channel-collaterals.  The shape of the bags could be prepared in various forms for convenience of indoor and outdoor use.

This custom was especially popular during the 5th, May ( lunar calendar) festival and universally welcome.  A small silk pocket was filled with cotton together with Chinese medicines, and then connected with a red thread at the sealed opening for easy carrying.

The Chinese Society of Physicians of New Taipei City claim that, carrying aromatic bag clears the air, expels pathogens, and harmful insects.  The Herba Agastachican resolves the dampness, arrests vomiting; Rhizoma Acori Graminei opens the orifices, harmonizes the interior and strengthens the stomach;  Folium Artemisiae Argyi facilitates the channel-collaterals; Herba Minthae removes wind and disperses heat; Radix Glycyrrhiza nurtures the spleen-stomach, moistens the lung, clears heat, and harmonizes all other ingredients; Fructus Anisi Stellari expels cold, stimulates appetite, and regulates Qi flowing.

This method for prevention and treatment of “ pestilence” becomes a vogue across the Strait.

The method of use of the aromatic bag: place the medicinal cluster of aromatic medicines in the bag, and carry the bag during daytime over the Tanzhong point of the chest, and smell it several times a day, 3 minutes each time.  Place it beside the pillow when sleeping.  Change the medicines in the bag once every 15~30 days. 

Effects: aroma expels pathogenic filths, and detoxifies. It should be prevented from water, and dampness. Pregnant women should be cautions to use it.  If skin rashes and itch appear after direct contact, the bag should be taken off and place it in a ventilated room, while the affected area washed by saline water.  As science develops, dressing method also advances recently.  Unfortunately, this approach overlooks the use of applying the epidemic preventive mask with a closer contact with the face, which is, indeed, a real defect.


E.            Application of warm moxa mask with Chinese medicines for the prevention of airborne infections

The authors, based on the principle of “ inheritance without stereotyped acceptance, creation following ancestors’ steps ”, and following the traditional epidemic preventing aroma bag and moxibustion methods, devise a multiple approaches Qihuang mask with the actions of warming, protection, keeping warm, preventing cold, which is devised on the basis of the degree of close contact with the face, body functions, characteristics of flu virus.  This device creates by combining regular facial mask, and the hot compress, warm moxa bag and aromatic bag into a whole, which is not only a new approach of medication, but also for keeping fit and health care as well.  It is convenient for carrying, and readily available all the time.  It has been patented in Taiwan and mainland China, and the application for its patented right in the US and other countries is also underway.    

For this new device, there are 5 additional actions for epidemic prevention as compared with the ordinary mask:

1, The crown hanging style yields closer contact with the mouth and nostrils, preventing the entering of pathogens.  This is the first point of epidemic prevention.

2, It contains an filtered unknitted cloth immersed in 5 kinds of traditional epidemic prevention, folk aromatic Chinese medicines ( absent in disposable type), which, in addition to filtering bacteria, virus, dust, has a reinforced preventive action.  This is the second point of epidemic prevention.

3, A patented open layer.  During an epidemic of flu, the aromatic bag with 5 kinds of Chinese traditional folk medicines for epidemic prevention can be placed into the open layer of the mask in order to prevent the growth of virus.  This is the third point of epidemic prevention.

4, The flu virus is prevalent during the epidemic and dry and cold weather days.  The patented open layer can accept the 5 kinds of epidemic prevention traditional folk aromatic Chinese medicines and a warm moxa bag which can elevate the temperature to 40°C~45°C .  This warmth  keeps the inhaled air warm, and stimulates the secretion of the respiratory mucous membrane.  It removes the virus in time, increases the body resistance, and stimulates the preventive mechanism of the body.  This is the fourth point of epidemic prevention.

5, The warm moxa bag, after being rubbed, can have a temperature as high as 40°C~45°C.  While the optimal temperature for viral growth is 10°C~20°C, a temperature exceeding 33°C can mitigate the spread of the epidemic.  This is the fifth point of epidemic prevention.     

A brief introduction to the 5 kinds of traditional folk aromatic Chinese medicines;

Fructus Anisi Stellali

Shikinic acid is mainly extracted from the plant Illicium Verum Hook.f or Illicium Anisatum, its structure being 4,5 trihydroxycyclo hex-1-enelcarboxylic acid.  It is a white crystalline soluble in water , and is the antecedent of osettamivir, an ingredient of Tamiflu produced by the Roche Pharmaceuticals of Switzerland.  

Folium Artemistae Argyi

This is an herbal plant with special fragrant smell which is capable of expelling mosquitoes.  Ancient people used to suspend this herb at the front door for avoiding pathogenic filths, and expelling mosquitoes as well.  Modern laboratory exams reveal that this herb is capable of inhibiting bacteria and virus.  In vitro tests show that the herb yields inhibiting action to 10 kinds of gram positive aerobic bacteria, including Bacillus anthracis, α-Streptococcus hemolyticus, β-Streptococcus hemolyticus, Bacillus diphtheriae, Diplococcus pneumoniae, Staphylococcus aureus, Staphylococcus albus, Staphylococcus citreus, and Bacillus subtilis.  Moxa oil in 40x3(-3) concentration (test tube method) also inhibits, to different extent, the growth of Diplococcus pneumoniae, Staphylococcus aureus, Staphylococcus albus, α-Streptococcus, Escherichia coli, Salmonella typhii, Salmonella paratyphii, and Flexneri bacillus. 

Fumigation of moxa leaves also inhibits many kinds of pathogenic fungi.  Water extract and decoction of moxa also reveals inhibitory actions, to different extent, many kinds of pathogenic fungi and many kinds of bacteria, including Staphylococcus aureus, α-Streptococcus hemolyticus, Diplococcus pneumoniae, Bacillus diphtheriae, Sonne bacillus, Salmonella typhii, Salmonella paratyphii, and Vibrio cholera.

Fructus Amomi

The seeds of Fructus Amomi contains 1.7~3 % volatile oil, with δ-camphor, a kind of terpene, acetic boryl ester, linalool, nerolidol, limonene, .  The content of volatile oil in its leaves is similar to that in its seeds.  It contains Dipterocarpacea, camphor, acetic bornyl ester. bornyl, and limonene.  It also contains 0.69%  saponin.

Action and indication Activating Qi-circulation, arresting vomiting and regurgitation, cold diarrhea, dysentery.

Yao xing lun( On Drug Property):  its indications include abdominal pain due to cold, consumptive disease, arresting recurrent Qi-dysentery, and warming the stomach.

Ben cao shi yi ( Supplements to Materia Medica ) : its indications include shortness of breath, asthma, abdominal upset, pathogenic Qi causing convulsion and epilepsy.

Rihuazi ben cao ( Master Rihuazi’s Materia Medica ): its indications include all sorts of pathogenic diseases, cramping, vomiting and diarrhea, precordial and abdominal pain,

Ben cao gang mu ( Compendium of Materia Medica): it is capable of replenishing the lung and spleen, nurturing the stomach, benefitting the kidney, regulating the primordial Qi , activating the stagnant Qi, , dispersing cold and lumps, arresting vomiting and regurgitation.

Han Kou’s yi tong( Medical Comprehension ) says: the kidney is averse of dryness and should be moistened by medicines with pungent drugs such as Fructus Amomi.  It also holds that Fructus Amomi regulates the spleen and stomach, and ushes other drugs to the Dantian (alchemic field).

Rhizoma Zingiberis

In TCM, ginger is believed to be capable of dispersing action, arresting vomiting, warming the lung to stop coughing, and preventing cold.  Li Shizhen did praise ginger to be “ pungent yet without stinking smell. It is capable of expelling pathogenic filths.  When travelling in mountainous areas in early morning, a piece of ginger should be kept in mouth so as to avoid dampness and miasmic Qi. ”

Its effect and indications:

Ben cao gang mu: “when applied fresh, it is capable of dispersing action; when applied warm, it regulates the digestive functions.  It is used in common cold, wind-cold, superficial excessive syndrome.  Mild cold can be readily cured by this herb after sweating. ”

Yao pin hua yi (Augmented Explanation  of Materia Medica) maintains that fresh ginger “ ventilates the orifices and facilitates lung-Qi, arrests coughing.  Fresh ginger is warm, pungent and its channel affinity is the lung channel, hence, it warms up the lung for ventilation, arresting cough.  Its pungent taste activates Qi circulation, resolves sputum, and is used in coughing due to mild cold wind, sputum and coughing due to lung cold. ”

Folium Isatidis

This is the leaves of the biennial plant Isatidis Tinctoria L. of Cruciferae or that of the perennial grass Baphicacanthus Casia ( Nees) Bremek.. of Acanthaceae.  Its taste, property and channel affinity: bitter, salty, very cold, with affinity to the lung, heart, and stomach channels.  Effect: clearing heat, detoxication, cooling blood, resolving petechiae, clearing excessive fire of the heart and stomach, channels, resolving pestilence and seasonal poisons, with actions of detoxication and facilitating the throat.

Ben cao zheng ( Corrections for Materia Medica ) :  “ It treats epidemic, heat-poisons causing petechiae, wind heat and typhus, sores and carbuncles, eliminating fidgety and thirst, arresting epistaxis, hemoptysis.  All fever with poisoning should be treated by the juice of this herb. ”  

 

F. Avoiding supine sleeping position, the key points of preventing airborne infections

Sun Simiao, the medical king of TCM, said:” lying on one’s side with bending knees is beneficial to one’s body strength and is better than a supine position”.  The reasons why lying on lateral side with flexed knees can increase one’s body strength ( i.e., elevation of blood oxygen value) rather than a supine position are:

(a)             In a supine posture, one’s mouth and nostrils are facing upward and is vulnerable to the invasion of airborne infectious virus through the mouth and nose

(b)            As a person contacts the flu virus and infected, some of the virus could be dispelled outside the body with the sputum.  For the first few days, it is an incubation period, the number of virus are not enough to cause symptoms like high fever, fatigue,  muscular sour pain, and upper respiratory symptoms and is, of course, uneasy to be diagnosed.  However, those virus not coughed out of the body are retained in the throat, and after several nights of adopting supine sleeping position, might move downward due to gravitational force or choking to the lower parts of the lung and multiply and grow there.  Also due to the failure of the bronchial mucosal cilia to move the virus upward and dispel them out of the body, the virus proliferate steadily until it causes the onset of flu disease.  Eventually, the blood oxygen is lowered and the patient need to accept tracheostomy.  Some patients might even be fatal.  Therefore, a supine sleeping posture becomes the cause of those sputum with flu virus moving downward along the respiratory tract to the lower parts of the lungs and grow, reproduce there with ensuing respiratory disease and its aggravation.  Hence, supine sleeping position is one of the main causes increasing the pathogenic flu virus, and this is an important point of preventing the spread of airborne infection in TCM, which is not to be ignored.

(c)Shigeaki Hinohara,, the 101-year-old   most authoritative Japanese pioneer of preventive medicine who received the most honorable cultural medal from Japanese Mikado in 2005, the only physician received such honor in a century, published in 2009,9 his The method of healthy prone sleeping posture that creates the miracle of 100 years of age.

After twenty years of his advocacy prone sleeping posture benefits to the human body, although its shortcomings, the Department of six pillows to support the head and body, its main drawback.

(d)            The 2013/6/2 editorial of the New England Medical Journal announces: For severe acute respiratory distress syndrome, the time of selecting a prone sleeping position for ventilation is coming, with its safety being proved and identified. Doubtlessly, it’s appropriate to adopt a prone position, and is indeed an approach to stop harmful therapy.  This means that it is essential to spread the idea of the advantages of prone position in order to save hundreds of thousands of lives and avoid the misery, mind and body, of the eventual tracheostomy in a supine position and save the expensive costs as well.  Presently, this is the only safe and effective therapy to increase the blood oxygen value by the ventilated prone position.

(e) But their disadvantage is observed when the clinical research subjects, still line with six pillows to support, and the need to train a group of skilled nurses how to make patient prone sleeping position, which can only be used when the short-term clinical observational study.

The large study in 2013 supported by the French Ministry of Health 12 has 237 patients were assigned to the prone position group, 229 cases were assigned supine group. Prone group of 28-day mortality was 16.0%; supine group was 32.8%. 28 days and 90 days mortality was significantly decreased.

Since the infections pathogens and the vulnerable persons are difficult to control, the current top measure is to sever the infectious routes to stop the transmission.

(1)            The warm moxa mask for preventing epidemics

  1, Effectively prevent the spread of droplets floating in the air with airborne pathogenic origin ;

2, Apply aromatic Chinese medicinal bag for epidemic prevention and dispelling pathogenic filths, placed directly in front of the nose for smelling.  This is very convenient to use.

3, The warm moxa bag could elevate the temperature to 40°C~45°C.  This warm temperature, in addition to the inhalation of warm air to keep warm, could promote the secretion of the respiratory mucous membrane so as to expel the virus in time and elevate the body resistance for preventing pestilence.

4, Since the optimal temperature for virus growth is 10°C~20°C,  a temperature over 33°C  would diminish the spread of flu.

(2) Avoiding supine sleeping posture

Sun Simiao, the king of TCM once said: “ a lateral lying position with flexed knees reinforces one’s strength, and is better than a supine position.”  Advocacy of lateral lying position with bent knees is beneficial to one’s strength (increase of blood oxygen value), is preferred to spine posture.

The above-mentioned four points for preventing virus infections are ignored by modern medicine.  The devices of the “ pillow and frame for prone sleeping position ” and the “ Qihuang mask for preventing pestilence ” based on the above idea fill the gap and has achieved international patents.  It could save millions of lives each year, and avoid the therapy of tracheostomy, and save the waste of hundreds of billions of dollars.  This holy mission needs the common efforts of global advanced medical professionals.  Let’s strive together for the health of all mankind!        

References

1 Yang sze piao, Li Chun hsin, Li Ting an, sleeping revolution, Asian medicine Press, Hong Kong, 2013.09: 1-4.

2Lin Zhi hui, Qiu Shu jun, Lai Shu wide, Chen hao yong, global influenza epidemiology, outbreak reports, Taiwan's Department of Health, Centers for Disease Control 2005: 477-498.

3Zhu yuk zheng, Shi fu yuan, Xu yiao ring, Wu tsung-tree, Hu Fu Qiang, Jin zhuan chun, SARS 2003 review Transnational epidemic, outbreak reports, Taiwan's Department of Health, Centers for Disease Control, 2004: 130-132.

4Yang sze piao, Li Chun hsin, Li Ting an, Keep away Tracheostomy of the flu epidemic, Taiwan health care magazine, 2014.05, Chapter 5: 1-13.

5Chen Gui ting, Rhizoma Atractylodis, Compendium of Ben cao gang mu through release, Academy Press, Beijing, 1992: 505.

6Yuan dan hua, 2009, Huaxia Jingwei Website, Chinese culture, medicine Holy net.

7Wang Jin, Dong bright, Chen Gu Miao, Mawangdui unearthed Sachet inquiry, silk, Vol 48, 2011.

8Chou Yi, Shanghai people infected with H7N9 avian flu to develop Chinese medicine prevention programs, Xinhua News Agency, 2013.

9Yang sze piao, Li Chun hsin, Li Ting anIntegration of Chinese and Western medicine lay sleeping position of health care, the integration of Chinese and Western Medicine in Taiwan, Taichung, June.2013; 15 (2): 17-31.

10Hino original weight Ming Chuan pill Seishiro: to create a hundred miracles Pashui Health Act, Wen DESA, Taipei, 2009; 3-4,10-16.

11Gattinoni LCarlesso ETaccone PPolli FGuérin CMancebo J.Prone positioning decreases mortality in severe ARDS (PROSEVA Trial) 2 Minute Medicine | August 14, 2013

12 Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, Mercier E, Badet M, Mercat A, Baudin O, Clavel M, Chatellier D, Jaber S, Rosselli S, Mancebo J, Sirodot M, Hilbert G, Bengler C, Richecoeur J, Gainnier M, Bayle F, Bourdin G, Leray V, Girard R, Baboi L, Ayzac L; PROSEVA Study Group.Prone positioning in severe acute respiratory distress syndrome.N Engl J Med. 2013 Jun 6;368(23):2159-68.

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