From the initial wave of Mycoplasma-induced coughing to the daily parade of patients presenting with all manner of fevers, the final two months of 2023 have been utterly exhausting. One dormitory after another on campus has come down with fevers; some students have even been hospitalized with secondary complications. I’ve been working far beyond capacity every single day. What has become abundantly clear is that these ailments respond remarkably well to traditional Chinese medicine — and far less so to Western approaches. Masks are undeniably an excellent preventive measure, but prolonged shielding from external pathogens inevitably breeds complacency in the body’s own righteous qi (zheng qi).
We have now entered the terminal qi (zhong qi) phase of the year. The overarching pattern is the Sovereign Fire of Shaoyin overlaying the Cold Water of Taiyang. In northern China, most colds and coughs at present are fundamentally cold in nature, with some heat-like manifestations being perfectly normal. Treatment must therefore be anchored by sweet and warming herbs, and the ephedra-based strategy of dispersing wind-cold is indispensable. This kind of heat presentation is absolutely not something that acrid-cooling remedies can resolve. I still see practitioners prescribing Yin Qiao–based formulas, and the results consistently disappoint — most patients end up bouncing from one treatment to another without real improvement.
Recent coughs differ markedly from those seen last month. Mycoplasma is genuinely difficult to manage; its pathogenic mechanisms are complex, often requiring two or three formula modifications over roughly ten days before resolution. The coughs of the past few weeks, by contrast, have been straightforward — most presenting as wind-cold binding the lungs. For mild cases or convalescence, Zhisou Powder works well. When fever is present, Ma Xing Decoction or Minor Blue Dragon Decoction is appropriate. Marked heat signs call for Mahuang Shengma Decoction. Copious sputum responds to Qianhu Zhisou Decoction. For persistent cough, a modification of Ling Gan Wuwei Jiang Xin Xia Xing Decoction usually stops the coughing within two days.
After that, three to five days of supporting the righteous qi are essential — otherwise relapse is highly likely. This is, in large part, a consequence of three years of masking: exposure to pathogens was so minimal that immunity declined across the population. After this year’s upheaval, however, next year should be considerably better.
Some observers have noted that people who previously tested positive for COVID but did not receive Chinese medical treatment are generally more susceptible to the current round of respiratory illness and tend to develop more severe symptoms. This may be related to the damage the virus inflicted on the body — but how serious that damage truly is, and whether it can fully recover, remain open questions. I have never treated patients who don’t believe in Chinese medicine, so I have no direct examples to draw upon.
I have also noticed that colds over the past two weeks are frequently accompanied by fatigue and loss of appetite. This is closely related to the resurgence of Taiyin (spleen-earth) energy. In severe cases, diarrhea develops. Such conditions are generally treated with bitter, warm, sour, and acrid herbs. I typically reach for a modified Minor Bupleurum Decoction, with excellent results.
This current wave of respiratory illness is not the type that Western medicine handles best — it is characterized by prolonged treatment courses, slow symptom relief, and a heavy reliance on self-recovery. I recommend seeking Chinese medical treatment as early as possible. Even if the condition deteriorates to the point of hospitalization, Chinese medicine still has an important role to play. The facts, as always, tell us: early treatment means early recovery, and early happiness.
中文原文 / Chinese Original
从刚开始支原体咳嗽到现在天天都有各种各样发热的病人，学校里一个宿舍接着一个宿舍发烧，还有同学伴发其他问题住院，我每天都是超超负荷工作，发现这些毛病中医很好解决，西医并不好解决，可以说戴口罩确实是一个非常好的预防手段，但是总不接触外界的邪气也确实会造成正气的懒惰。
最近已经进入了终之气，整体形势为少阴君火加临太阳寒水，可以说现在北方大多数感冒咳嗽都是以寒为基础，有点热像很正常，治疗一定是以甘热药物为主，麻黄类的发散风寒思路必不可少，这种热象绝不是辛凉之品能够解决的，我看到仍然有以银翘为主的方剂在使用，事实证明效果均不太好，大都出现辗转救治的情况。
近期的咳嗽与上个月的咳嗽发生了显著变化，支原体确实不太好搞，对人体造成的病机较为复杂，往往需要变化两至三次耗至十天左右方可治愈。最近这段时间的咳嗽很简单，大都表现为风寒束肺，轻症或善后可用止嗽散，发热可用麻杏或小青龙剂，热象明显可用麻黄升麻汤，痰多可用前胡止嗽汤，持续咳嗽可用苓甘五味姜辛夏杏汤化裁，大多两日止咳。
后面还需要扶正三至五日，否则极易复发，这都是口罩三年接触病原体太少免疫力下降带来的后果，经过今年这么一折腾，明年估计会好很多。
但也有一部分人发现前期阳过未经中医治疗的人群本轮呼吸道疾病普遍易感且症状较重，可能与病毒对人体的损伤有关，这种损伤到底有多严重，究竟能不能恢复，现在都是未解之谜。我从来不给不信中医的人看病，周围接触不到这种例子，无法判断。
另外我还发现，这两周的感冒大都伴有乏力和食欲不振的情况，这与太阴之复关系甚大，严重的会出现腹泻的情况，这种情况一般要用苦热酸辛药治疗，我一般选小柴胡汤加减，效用甚佳。
本轮呼吸道疾病并不是西医所擅长的类型，存在治疗周期长，症状缓解慢，主要靠自愈的问题，建议尽早求治中医，如果发展严重了不得不住院中医仍然有用武之地，事实仍然告诉我们：早用早好早幸福。
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