In my last article, I discussed some basic concepts for winter immune health in order to prevent standard cold and flu presentations in the clinic.This article will review the actual treatment of acute cold/flu presentations and present ways to integrate Western herbs with TCM formulas to more effectively treat and resolve symptoms.
One of the most common mistakes a clinician can make when presented with standard cold/flu symptoms is to simply rely on one herb to treat the pattern. It is not uncommon for me to see a patient referred by another practitioner who was prescribed a single medicinal to treat a wind-cold or wind-heat pattern. A single medicinal such as echinacea or oregano oil will not resolve a gan mao pattern in most cases and if prescribed alone, can allow the pathogen to penetrate deeper into the system resulting in a concomitant respiratory issue as well. Not only is prescribing a single medicinal not effective in most cases, it is also not professional TCM methodology.
One of the most common symptoms of cold/flu presentations is chills, fever and body aches. I will not discuss standard TCM formulas to address gan mao patterns, as I will assume that readers are familiar with or have professional sources to consult for appropriate wind-cold or wind-heat patterns. However, I would like to discuss three herbs that can be highly effective when combined with appropriate TCM formulas vis a vis pattern differentiation. These herbs are boneset (Eupatorium perfoliatum), lomatium (Lomatium dissectum) and osha (Ligusticum porteri).
Boneset is a highly effective and vastly underutilized herb for wind-heat presentations. Used extensively in Western eclectic medicine, boneset was typically used when the patient presented with influenza symptoms with deep aching pains, high fever, a large full pulse and hot damp skin. It was dosed as a warm tea or tincture with frequent low doses until symptoms resolved. Boneset is an excellent addition to standard TCM wind-heat formulas to hasten resolution of symptoms. Dosing is typically 10-30 drops of tincture TID and/or 2-4 ounces of warm tea TID. This can be added to TCM teas or taken with TCM patent medicines with minimal trouble. Large doses can cause nausea, therefore it is imperative for the clinician to explain that the "more is better" approach does not apply with boneset. When combined with TCM formulas, the dose can be kept low enough to avoid this issue easily.
Another herb that was historically used for influenza symptoms is lomatium. This is a highly effective anti-viral and can be combined with TCM wind-heat formulas to more effectively resolve symptoms. As with boneset, doses for lomatium are very low, typically 10-20 drops of a tincture TID, used only until symptoms resolve. Some individuals seem to develop a rash when using lomatium, so discontinue use if this occurs. However when used with appropriate dose and combined with TCM formulas, this can typically be avoided. In the history of Western eclectic herbal medicine, lomatium was concerned a first-line medicinal in all cases of influenza. Eclectic physicians would often build a formula around this medicinal reflecting its effectiveness in treating and resolving influenza symptoms.
The final herb I wish to present is osha. This is a prime herb for acute cold and flu symptoms and was used extensively by Native Americans and eclectic physicians alike for standard wind-cold presentations. Osha has a very warm and drying nature and is excellent for use with cold, damp and stagnant respiratory conditions or initial wind-cold presentations. It is typically dosed as a tea or tincture at 10-40 drops TID or 2-4 ounces of tea TID. Osha, much like lomatium, has an anti-viral activity. When combined with TCM formulas, the practitioner can harmonize the warm drying nature of osha with other medicinals in order to avoid potential constitutional aggravations. One of the main concerns when using osha is the pattern of yin vacuity or liver yang rising. If either of these patterns are in the background of a wind-cold or wind-heat pattern, osha should either not be used or it must be combined with appropriate TCM medicinals. I typically always combine osha with the TCM medicinal mai men dong in order to avoid such issues. Osha has a particular tropism or affinity to the lungs (much like jie geng) and is excellent for preventing secondary respiratory complications of cold/flu presentations. However please keep in mind the patient's underlying constitution or background patterns when treating any acute presentation.
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