Exterior and Interior Disease – Understanding COVID-19 From A Traditional Chinese Medicine Perspective
Writing a blog is wonderful way to stay connected to my patients, and anybody else who is reading this, whilst in self-isolation due to the Covid-19 virus mandates.
I would like to introduce to you in a very simple way, cold and flu from a Traditional Chinese Medicine (TCM) concept. And provide simple daily tips to increase your immunity to prevent a cold or flu and how to treat MILD signs and symptoms of a cold and flu.
The Language of Traditional Chinese Medicine
Before I begin explaining TCM concepts of bacteria and viruses I am already going to go off topic here!
First, I want to acknowledge how much the early physicians of China knew about infectious diseases (and most other areas of health), which they characterized as a pestilence, 1000’s of years ago without any of the technology we have today.
Equally important is to not undermine the unique language and terminology TCM utilizes, which is very difficult for other cultures and physicians rooted in modern science. The words Qi, Yin and Yang bring to mind ideas of an esoteric and almost spiritual connotation to most of the Western World. Simplistic definitions for these words are frequently repeated, such as Qi meaning energy. But there is no single simplistic meaning to these words, rather an array of potential meanings that must be applied in context.
Such words were created in the Chinese language to express complex, yet concrete, ideas and concepts, within the context of TCM that you will read below.
These words objectively express fundamental ideas of complex physiology in the body. And I have found, integrate well with modern terminology and disease description.
To better understand these terms outside of Asian culture, one must understand the context of the language itself. The Chinese language is perhaps the oldest original language left on our planet, and is composed of pictorial characters rather than letters. This use of written characters allows the Chinese culture to express concrete ideas that are very complicated and dependent on the context of the surrounding characters.
While these concepts and terms may be hard to grasp, they are very important and unique to modern Western medicine, as they reflect a medical philosophy that is:
- Holistic (body, mind and spirit)
- Acknowledges and integrates the laws of nature and the universe
- Is based on an individualized diagnostic system that contrasts to a one-size fits all allopathic model of medicine.
Interior and Exterior Diseases
Establishing the depth of a disease in the body is important to the diagnosis and treatment of the disease. A cold or flu often starts in the exterior and if not eliminated will progress to the interior of the body where it can become a chronic disease.
The Covid-19 virus is known as a Pulmonary Pestilence in TCM. It starts in the exterior and progresses to the interior of the lungs.
Exterior disease are like your common cold and flu, Bell’s Palsy and many skin conditions. They are acute and do not last very long. Pathogens (germs, virus, bacteria etc) that surround us enter the body via wind into the exterior, the surface of the body. As the pathogen lodges itself in the exterior, the exterior parts of the body are affected, which are the skin, muscles, tendons, joints and orifices (including the mucous membranes).
Typical Signs and Symptoms of an exterior condition:
- Acute and short duration
- Simultaneous chills and fevers
- Runny nose
- Muscle and joint ache
- Recent headache
- Intolerance to wind or cold
Signs and symptoms are further influenced by the type of pathogen that invaded the exterior, such as wind, heat, cold, dryness and dampness. For example, an invasion of dampness, a type of pathogenic excess fluid, is characterized as sticky, dirty and heavy. Dampness will give rise to a feeling of a heavy body, foggy/muzzy head, strong body and joint ache and copious phlegm – runny nose and congested sinuses. An invasion of dryness will produce a dry cough, dry mouth, dry throat, dry nose and dry tongue.
Pathogens in the exterior tissues are best eliminated by sweating. People with a strong immune system can fight this pathogen at the exterior level preventing it from penetrating deeper into the body where it can become chronic. A fever accompanied by sweating is good sign that your immune system is fighting the pathogen.
Contagious diseases that affect the sinuses, bronchials and throat often have exterior signs in their initial stages. Therefore, as soon as one recognizes and treats the onset of an exterior disease, the more likely you can reverse their progression to an interior disease.
If the pathogen is not purged by sweating it will move deeper into the body in stages. If a person has extremely weak Wei Qi (weak immunity) the pathogen can penetrate directly into the interior. The interior areas of the body include bones, internal organs, deeper nerves and blood vessels.
Signs and Symptoms of an interior condition are vast depending on which areas are affected. Using the above the example an exterior damp type of cold that penetrates the interior, such as the lungs, will manifest as a chronic cough with profuse sputum (pneumonia, bronchitis) or chronic sinusitis.
The treatment of an interior disease will often require an in person visit with your TCM practitioner and/or Western physician.
The Covid-19 virus is known as a Pulmonary Pestilence in TCM. It starts in the exterior manifesting mostly as fever and dry cough. If the patient has a compromised immune system and/or is not treated early it progresses to the interior, the lungs, where it can cause increased difficulty breathing, pneumonia. In TCM the treatment is to cleanse and detoxify the lungs and all other symptoms are treated to avoid complications.
TCM Doctors specializing in Chinese herbs have developed Chinese formulas to treat early to middle stages of Covid-19. This video demonstrates the power of TCM and how successfully it can easily adapt to modern diseases and integrate with modern Western medicine.
Food for Health
Food for health, just like Chinese herbs, is a full branch of Traditional Chinese Medicine and so easy to incorporate into your day. Food and Chinese herbs have unique TCM therapeutic functions. For example for Dampness we would use drying herbs or foods. There are even specific herbs and foods that will dry particular areas or organs.
- Disperse (expand, spread)
- Astringe (hold, bind)
- Tonify (nourish, boost)
- Eliminate toxins
- Move (exterior, interior, ascend, descend)
Treating an Exterior Disease
At the first sign of a possible infection of a cold or flu we want to expel the pathogen to the exterior and purge it via sweating. Profuse sweating is not recommended and promoting sweating is NOT recommended for the very weak, very old and very young.
Beneficial Herbs and Spices
At home in our kitchen we may have a plethora of ingredients for home made remedies. This is very convenient for those now on a tight budget or in self-isolation. When you start to feel sick (cold or flu) we want to choose herbs and spices that have the action of dispersing to the exterior and opening (expanding) the sweat glands to sweat out the exterior disease lodged near the surface.
Common Diaphoretic (sweating) and Dispersing Herbs:
- Fresh ginger *(NOT dry)
- Scallions and Chives (NOT onions)
- Mint or peppermint
- Szechuan pepper corns
- Cayenne red pepper*
- Drink a cup or more of hot diaphoretic herbal tea (see below)
- Take a hot bath or shower
- Drink more hot tea
- Cover yourself in blanket and sweat
Do not sweat to the point of exhaustion. After sweating change your bedding and rest. This procedure can be repeated twice daily until exterior signs lift.
If a hot bath or shower is inconvenient, drink 1/2 cup of tea every half hour in bed until perspiring freely. When diaphoresis does not work this indicates a deeper/interior condition likely exists.
Sweating therapy can also be beneficial for infectious diseases marked by rashes. It helps bring the toxins in the rash out of the body.
Diaphoretic Herbal Teas:
3 slices of fresh ginger, 1/4 lemon juice and peel with rind, whites of 3 scallions, stick of cinnamon (or ground), some raw honey for flavor
Fresh mint leaves, 1/4 orange peel with rind, whites of 3 scallions, 3 cloves, some raw honey for flavor
For predominating chills add Cayenne red pepper to your tea.
Garlic can stop a cold or flu if taken at the onset of symptoms. Hold half a peeled garlic clove against your cheek for 20-30 minutes every 3 hours during the day. Move the garlic clove in your mouth occasionally to avoid a “burning” sensation.
It is best to eat much less and eat a simple, liquid-based diet. If chills predominate eat vegetable and/or grain soups and if fever is more predominate consume fresh fruit and vegetable or fruit juices.
- Green peppers
- Parsley and cilantro
- Turnips and parsnips
- Chives and scallions*
- Bok choy
- Collard greens
For predominating chills use more warming herbs and foods marked with “*”.
Convalescing From An Interior Or Exterior Disease
An important part of recovering from a flu like Covid-19 is hydration. Consuming soup is more effective than simply drinking water. Soups provide a slow release of fluids, allowing it to assimilate in the body, whereas water moves through the body quickly and has a more cleansing affect.
For people convalescing from the flu soups should be nourishing, easy to digest and aid in digestion to ensure the assimilation of nutrients. These soups are also wonderful for anybody recovering from any chronic illness and for the elderly.
Porridge and congee can be eaten for breakfast. It is recommended to use: oat meal, millet, rice, cream of wheat or polenta.
Soups For Recovering From The Flu:
- Chicken and rice
- Beef and barley
- Corn chowder
- Mushroom soup
- Lentil soup
- Butternut/Squash/Sweet potato soup
Rice Congee Recipe:
This recipe is from Andrew Sterman and has more congee recipes here.
To make good congee, use good quality medium-grain or long-grain white rice, preferably grown in the style suited to the Asian market in Canada. Also avoid short-grain, arborio or risotto rices, they are too sticky.
1 cup dry rice makes enough congee for 4-6 people. Eventually the amount of water for 1 cup white rice is 8-10 cups.
Begin by bringing 8-12 cups water to a boil. Use a stock pot on the stove burner behind the congee pot. Simple stocks can be used, but avoid complex chicken or bone stocks for congee.
- Put 1 cup uncooked long-grain white rice in large pot. Turn heat to high, add a tablespoon of good oil (grapeseed, organic peanut, safflower, etc). Stir so each grain is coated lightly with oil. Add two generous pinches salt.
- Then, add just enough boiling water to float the grains, perhaps 1 cup (no need to measure carefully). Stir constantly as the grains absorb the water. When almost dry, add more boiling water, keep stirring. After 3 or 4 gradual additions of water while you are nearly constantly stirring (about 10 minutes), the grains will have given up starch to the water.
- Once the grains have released starch into the cooking water, you can add a lot more water and turn the heat down to a gentle low simmer for about 30-45 minutes, now stirring occasionally. Do not allow the grains to settle and stick to the bottom of the pot. Add water (stock) as needed to get the special congee consistency, in other words, milky water between discernible rice grains, very soft cooked.
- Once done, congee is always served with other things—start with a few simple ingredients.
- Eat with simple condiments (with scallion, soy sauce, ginger and toasted sesame oil) or improvise more substantial additions: sliced fish, seafood, nuts, pumpkin/squash, corn niblets, soft-boiled eggs, gently cooked bean sprouts, dried scallops, sliced pork, duck, chicken, cilantro, etc., often utilizing leftovers from the refrigerator or contributions from the freezer. Always consider your intention when selecting ingredients, based on your growing knowledge of food energetics and current health needs.
Avoid Dehydrating Foods and Drink:
- Onions and garlic
- Hot spices
- Tea and coffee
- Soda water
Treating An Interior Disease
When an Exterior disease moves deeper into the body creating an Interior disease the treatment protocol to eliminate the pathogen differs. The pathogen’s only exit is via the the intestines and bladder therefore it is very important to main good bowel movements to eliminate the pathogen. We also need to add bitter foods to our diet as they are descending in nature and will help eliminate the disease.
As previously mentioned the treatment of an interior disease will often require an in person visit with your TCM practitioner (for Chinese herbs and acupuncture) and/or Western physician.
Beneficial Foods for Good Bowel Movement:
- Oats, rye, barley, oat meal, millet, brown rice, corn (polenta, grits), spelt, amaranth
- Fruit with peel, especially apples and asian pears
- Nuts and seeds, especially almonds, pine nuts, pumpkin seeds, flax, chia
- Green vegetables
- Carrots, beets, parsnips, daikon, mushrooms
Foods That Are Descending:
- Endive, radicchio
- Water cress
- Broccoli, raw
- Dandelion greens
- Bean sprouts
Steps to Prevent Catching A Cold or Flu
- Moderate regular exercise is recommended.
- Lack of physical activity, excess sexual activity and overwork impair immunity.
- Maintain an orderly, pleasant living and working environment.
- Stay hydrated.
- Quality sleep is important for your body to restore itself.
- It is essential for those with very weak immunity to associate with completely supportive people.
- Sunlight, clean, fresh air and pure water strengthen the immunity.
- Avoid overexposure to dampness and protect against other climatic extremes.
Healing your mindset is the foundation for immunity; gratitude and forgiveness are the preliminary steps.
We want to avoid sugar, gluten and dairy (especially cheese) as they are damp forming foods. Dampness can easily affect the lungs creating excess phlegm and mucous in the upper and lower air ways.
In winter when it is the cold and flu season, we want to avoid icy foods and fluids as they are hard on the lungs. These can weaken the lungs making them more susceptible to disease such as pneumonia and bronchitis
- Eat whole foods, choosing a variety from a grain and vegetable-based diet.
- Moderate under eating and simpler food combinations can strengthen immunity.
- Do not eat late at night.
- Avoid intoxicants, refined or chemically contaminated foods, rancid nuts and seeds.
- Limit oils and fats.
- If candida overgrowth symptoms are present, further dietary discipline is necessary. Candida exists in high levels in individuals with a weak immune system. Candida inhibits proper assimilation of essential amino acids and other nutrients further weakening immunity.
- Supplements include; zinc, selenium, Vitamins; A, B, C, E and B complex.
- Whole food supplements are often immeasurably more effective than the synthetic variety. Vitamins in whole foods include: whole or barley grass concentrates, sea vegetables, chlorella and spirulina are all beneficial for long term use.
Chinese herbal formulas to strengthen the immunity are readily available. They are best taken 1-2 months before the cold and flu season.