Most of my patients that have come in the office this week have expressed their concern over the Coronavirus Covid-19, and have wanted to know my thoughts about it as an Acupuncturist and practitioner of Traditional Chinese Medicine. I spent the last few days diving deep into the current understanding of the virus and looking into Chinese Medicine as a possible resource for aiding in the treatment of viral illness.

Chinese Medicine (CM) has a rich history and robust understanding of herbs that have been used effectively for centuries to treat the common cold and a wide range of viral infections. Current research is being conducted in China on the treatment of Covid-19 with Traditional Chinese Medicine (TCM) and most of the treatments in hospitals in China combine Chinese Medicine along with Conventional medicine. We will have a greater understanding in the weeks and months to come as far as the use of Chinese herbs and its possible inhibitory function on Covid-19, and its use as a complementary treatment for symptoms of coronavirus infections[1]. I hope we see an increase in the use of these centuries old treatments as a resource for the treatment of viral disease in the future.

There are many herbal formulas used in TCM to treat flu symptoms such as fever, sore throat, and chest congestion. These formulas contain a variety of complex herbal substances and are prescribed regularly in my practice. Fritillaria (Chuan Bai Mu) and Pinellia (Ban Xia) are TCM herbs that are particularly useful for all types of coughs. They are traditionally used as antiviral and antibacterial herbs that moisten dry mucus membranes, resolve phlegm and control coughing. Research conducted in China has shown that compounds in Fritillaria help inhibit the contraction of bronchial smooth muscle and decrease mucus secretion. Fritillaria and Pinellia are used as decongestants, and to reduce swelling [2]. Yin Qiao Jin, Clear Heat, Lonicera granules and Pinellia XPT granules are some of the formulas I use in my practice for viral and bacterial infections and coughs. Granule form is slightly more concentrated and taken dissolved in liquid. I have stocked a variety of formulas like Yin Qiao, Lonicera and Pinellia in granule form to have on hand at the office.

In TCM we divide colds and the flu into two categories - Wind Heat or Wind Cold. Depending on the presentation of your symptoms, herbalists choose appropriate formulas. Chills, aversion to cold, stiffness (especially of the neck), headache, and white or clear-colored phlegm are signs of wind-cold. Sore throat, feeling warm and/or agitated (whether or not there is a fever), yellow or green-colored phlegm, and aversion to heat are some indications of wind-heat. There can also be combined symptoms, along with deficiencies and dryness, or underlying conditions that need to be taken into account when diagnosing or prescribing herbs. For instance, the strength of the digestive system is important to identify because some patients can not tolerate very hot or very cold herbs. For Wind Heat conditions Fritillaria is used to clear congestion from the lungs. With Wind Cold congestion in the lungs and cough Pinellia is used. It is important to have a good diagnosis to ensure the efficacy of herbal treatment.

Immune responses resulting from viral infection play a vital role in clearing infection and can differ from person to person. Activating or restoring the immune system is critical for the initiation of our immune responses, and is important in order to prevent virus replication [3]. This could possibly explain why some patients are symptomatic while others are asymptomatic. The amount of virus we are exposed to also plays a part in how sick we get- in other words, how flooded our immune system might get from a virus, and our body's inherent strength and ability to fight off infection. Boosting your immune system may be helpful along with reducing the potential contact with a virus. In addition to frequent hand washing and limiting exposure to areas where there are many people, increasing your intake of antioxidants, increasing anti inflammatory herbs like Curcumin, taking immune boosting substances like Vitamin C, Vitamin D, Zinc, Probiotics, Cordyceps, and using essential oils like Ravinsara, Thieves or Breathe Great, could be potentially helpful.

In TCM, White Peony Root (Bai Shao), is a herb that may be involved in restoring the immune system and is present in many herbal formulas. Astragalus (Huang Qi) is another TCM immune boosting herb that has been prescribed traditionally to help increase resistance to pathogens. In recent studies on Traditional Chinese Herbal formulas and individual herbs, in addition to direct antiviral potencies, some TCMs exert anti-inflammatory effects that work to suppress the excessive inflammatory response caused by influenza infection or regulate the immune system to resist viral infection. For example, the TCM herbs found in formulas that treat colds and flu such as Forsythia (Lian Qiao), Rehmannia (She Di Huang), and Gardenia (Zhi Zi), possess anti-inflammatory properties. Again, may of these anti inflammatory and cold/flu herbs are present in combination in TCM formulas like Yin Chao Jin, Cold away, Astra Istatis, and Clear Heat.

There are studies showing the efficacy of some TCM herbs against other corona viruses, including SARS-CoV and H1N1. Though these studies are relatively small, they show promising results. The most frequently used herbs included Radix astragali (Huang Qi), Radix glycyrrhizae (Gan Cao), Radix saposhnikoviae (Fang Feng), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Lonicerae Japonicae Flos (Jin Yin Hua), and Fructus forsythia (Lian Qiao) [4]. If I have ever prescribed you herbs for your immune system, a cough or cold/flu, you most likely have taken these herbs or have them in your medicine cabinet.

While I do not believe we can rely on TCM and Complementary medicine as a treatment for Covid-19, I do believe we can employ some of the known benefits and use TCM in cold and flu symptom reduction and for the benefit of immune enhancement.

Please feel free to send me an email or reach out with any questions or concerns. This email is not intended to present any cure, rather to share how colds and viral infections are currently treated by TCM. Please do not come in to the office for treatment if you are showing any signs or symptoms of an active cold or flu. I am happy to prescribe herbal therapies over the phone. it is important to be in touch with your primary care MD if you present with any symptoms relating to the flu.

-Arcadia Farber, L.Ac., MTOM arcadiafarber.com (arcadia@arcadiafarber.com)

[1] Chinese Proprietary Herbal Medicine Listed in ‘China National Essential Drug List’ for Common Cold: A Systematic Literature Review, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4203808/.

[2] Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica, revised edition. Seattle: Eastland Press, 1993.

[3] Antiviral Activities of Several Oral Traditional Chinese Medicines against Influenza Viruses. https://www.hindawi.com/journals/ecam/2015/367250/. Evidence Based

Complementary and Alternative Medicine Journal.

[4] Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs. https://www.ncbi.nlm.nih.gov/pubmed/32065348