Dr. Zhang II

I’m finishing up a week-and-a-half seminar with Dr. Zhang Zhiwen, an expert in what’s referred to in Chinese medicine as Warm Disease (Wen 1 Bing 4). It’s sponsored by the Chengdu University of Traditional Chinese Medicine, and is part of a program for Czech, French, and German students, plus three from Singapore. Myself and one other American, a woman from Brooklyn, NY, managed to squeeze in as well.

Dr. Zhang speaks in Chinese, which is then translated into English, then into German. The delay is helpful, allowing copious note taking. The whole thing takes place in a TCM Hotel. It’s a hotel, which also houses a first floor treatment area, where massage, acupuncture, and things like cupping, are available, as well as a travel agency and restaurant. On the eight floors above is a strange combination of conference rooms, lecture rooms, and hotel rooms.

The temperature recently has dropped dramatically to the upper 50s, lower 60s. There’s no heat in China, so the classroom is cold. Ironically, on the second day of lectures, many students were sneezing, and blowing their noses, leading to a good amount of suppressed laughter.

In the classroom each chair is accompanied by a white cup with a lid, filled with loose jasmine tea. Just before class begins, a women comes in with a large thermos of hot water, filling our tea cups. She reappears throughout the afternoon, helping keep everyone both a little warmer and more awake.

The German group leader and translator, who has been coming to Chengdu for twenty years, has a good sense of humor. He had a hard time keeping a straight face when Dr. Zhang was using the metaphor of irrigating a swamp in his advise to use herbs that promote urination to address a condition known as internal dampness, or when he went into great detail describing the nature of a hypothetical patient’s hypothetical stool (chocolate color, and as though mixed up with green beans).

The lectures go for three hours a day. It’s all fairly basic Traditional Chinese Medicine (TCM) theory, with a considerable amount of attention put on treatment strategies and the specifics of various herbal formulas and their various modifications. It’s a good review for me, and a chance to learn directly from a master in the field.

Traditional Chinese Medicine has an elaborate system of metaphors for making sense of our relationship with the physical world. Viruses are one way of thinking about the common cold, and this approach is not in any way discarded by TCM practitioners. But the conceptual landscape of TCM is quite different from Western models.

At the same time, TCM developed through application of the scientific method. Ideas were developed, then tested in the real world. Those that proved to work were kept in the corpus, and those that did not were discarded.

Traditional Chinese Medicine posits things such as External Pathogenic Influences (EPI). Phenomenon such as Wind, Heat, Cold, and Damp are all environmental factors which greatly influence human health and therefore play prominent roles in TCM thinking. Parallels with Western thinking here include the notion of “catching a draft,” and not going outside if it’s cold and windy without a hat and scarf. In TCM Colds are caused by either Wind-Cold or Wind-Heat. Two ways to distinguish between these two causes are the existence of a sore throat and the condition of the coating on the tongue. The presence of a sore throat indicates a Wind-Heat Invasion (looking at the effect to find the cause). Once the person has been ill for a while, or in a chronic condition, Heat will manifest as a yellow tongue coating.

According to the school of thought around Warm Diseases, if a Heat Invasion is not caught at an early stage, it will continue to penetrate to deeper levels. Also included are epidemic diseases and conditions which do not originate as the common cold.

There are four levels to Warm Disease, starting at the surface level (Wei) moving to the Qi level, then to the Nutritive Level (Ying) and finally to the Blood Level (Xue). Heat in the Blood level, features such symptoms as hemorrhaging, bleeding from orifices, convulsions, mania, and delirium. Thus the theory of Warm Disease covers everything from the common cold to conditions resembling those suffered in 28 Days Later.

Dr. Zhang discussed the whole Odyssey of the Wind-Heat Invasion, following it from sore throats through high fevers, to heat in the intestines, thick yellow greasy tongue coating, tongues with no coat, deep red or purple in color, convulsions, mania, and delirium and a whole variety of herbal formulas to cover almost every contingency.

The body is protected by something called Wei Qi. This is our first line of defense against Evil Wind. One of the early signs of a Wind Invasion is aversion to wind, which represents the weakening of the Wei Qi. Without that external defense, we feel vulnerable. When the External Pathogenic Influence gets tangled up with the Wei Qi, a battle ensues. This back and forth is what causes chills.

A classic Chinese formula for the common cold fairly well known and widely available in the West is Yin 2 Qiao 2. Be careful though. Only take Yin Qiao if you have a sore throat. If you’re suffering from a Wind-Cold Invasion and take it, it could become worse. For the early stages of a Wind-Heat Invasion, Yin Qiao is very effective.