© 2010 JulieSenko.org
Thinking Through Lurking Pathogens: A Pragmatic Approach to Clinical
By Charles Chace, Lic. Ac.
from ChineseMedicineTools.com, May 2007
One of the most evocative concepts in the modern clinical practice of Chinese medicine
is that of lurking pathogens (伏邪fú xié).[1] Today Chinese medical practitioners most
often evoke the notion of a lurking pathogen as a means of understanding the course
of intractable modern diseases characterized by pathogens, often viruses, which lay
dormant prior to their active such as Epstein-
The classical notion of a lurking pathogen is rooted in Chapter Three of the Basic Questions which states: "if the body is attacked by cold in the winter, the person will suffer from a warm disease in the spring."[3] This has been extrapolated to include any pathogenic factor that is contracted at sometime in the past, with or without presenting symptoms, and that lies dormant for an indeterminate period of time
prior to its active expression.
One of the reasons that the Chinese medical idea of lurking pathogens is so compelling is that, at least superficially, it resembles our current biomedical understanding of the pathology of the deadly and intractable diseases mentioned above. From there, it is a short leap to modeling the consequences of antibiotic suppression and immunization in the context of lurking pathogens in the hopes that Chinese medicine has something to offer these very modern medical challenges. An inherent pitfall of this project, however, is that the biomedical model exerts its own influence on our understanding of lurking pathogens. In our efforts to forge an integrative understanding of disease, our biomedical thinking often clouds our Chinese medical thinking. In the end we are left with a number of unspoken, and typically unexamined assumptions regarding lurking pathogens that may or may not be clinically applicable in a Chinese medical context. By linking the Chinese medical notion of a lurking pathogen to a dormant spirochete, a virus, its attenuated vaccine, or an antibiotic, we fix our attention on one of the least promising aspects of the lurking pathogen paradigm. When we focus on the bug and not the process we limit the scope of our application of this paradigm considerably.
What then makes a lurking pathogen a lurking pathogen from the perspective of clinical
practice? We can, of course, invoke the above-
The first is that despite allusions to dormancy in theoretical discussion of lurking
pathogens, even a cursory review of the warm disease case history literature reveals
that the term fú xié is most often used to refer not to pathogens that have actually
disappeared from the clinical landscape for some period of time but rather those
that simply persist or become intractable. We see this even in the case histories
ofsome of the most influential pre-
The second problem is that even when modern case histories evoke a lurking pathogen
diagnosis, it is not uncommon for the actual prescriptions to look a great deal like
standard wenbing or even TCM Thinking Through Lurking Pathogens Page 1 of 9 http://www.siom.com/resources/texts/articles/c-
One thing we can say regarding lurking pathogens is that: "Lurking warm disease progresses
by moving from the interior to the exterior."[5] Above and beyond the etiology or
nature of the pathogen, a propensity toward exteriorization is a defining characteristic
of lurking pathogens. Unfortunately, not all lurking pathogens exteriorize spontaneously,
and in fact, the most intractable ones do not. According to Liu Bao-
In terms of how it is actually treated, the defining characteristic of a lurking
pathogen is that it is evicted through multiple layers in a sequential manner. Discussions
of the treatment of lurking pathogens in the pre-
If one hopes to get to the root of disease one must carefully attend to the details. Lurking warm pathogens such as this have many layers. After resolution and a cessation [of symptoms over the course of] one to two days, one may proceed to evict through the next layer. Moreover, the pathogen of subsequent layers will invariably be worse than the first.
[7]
Here, Liu is talking about moving inward, peeling the layers of a pathological onion,
although other physicians clearly think in terms of moving from the inside outward.
The common thread is the sequencing of the treatment. For myself, the notion of a
lurking pathogen is best understood as a therapeutic process rather than a specific
pathogen. I do not approach the concept of lurking pathogens as referring to a thing
to be eliminated, but more as an approach to treatment that indicates a methodology
that is clinically effective and in the case that follows it proved helpful. In practical
terms, what makes a pathogen a lurking pathogen has less to do with the nature of
the pathogen or even how it got there, than it does with the strategy adopted for
treating it. A lurking pathogen paradigm helps us to more skillfully plan and guide
the course of therapy. This raises another issue pertaining to our understanding
of lurking pathogens. As simple as its pathodynamics may appear, the etiology of
this case is still relatively messy and as such, it is representative of the cases
most of us see in clinic every day. My patient had also done a number of other therapies
along the way that most likely contributed substantially to the situation. In truth,
it is difficult to say exactly where the lurking heat came from. This is in fact
one of the central points of the case. I believe that etiological ambiguity such
as this is such a common scenario in clinical practice that I am of the opinion that
efforts to identify and treat the biomedical pathogen caused by a specific pharmacological
or biomedical entity are largely a waste of time. It is unproductive to agonize over
whether the situation one is trying to treat is he result of antibiotic treatment,
homeopathic treatment, or a vaccination received during childhood when all one really
needs to identify is whether the presenting symptom complex is one of wind, heat,
damp etc. Despite these ambiguities, once we have framed the presenting symptoms
and signs within a Chinese Thinking Through Lurking Pathogens Page 2 of 9 http://www.siom.com/resources/texts/articles/c-
Naturally, it would have been preferable if had my patient simply recovered after the first sip of the first cup of her first packet of herbs. Nevertheless, she did manage to recover in what I perceived as an orderly manner, and the progression of events was both instructive and conceptually satisfying. While the case could have been approached in a variety of very different and possibly more skillful ways, the manner in which I did manage it resulted in the pathogen moving from the inside outward in an unambiguous progression. We saw a pathogen that had penetrated deep into a patient, wend its way backoutward, triggering old symptoms along the way.
The Case
A close colleague of mine had been going through a period of great emotional upheaval that culminated
in symptoms of palpitations, chest tightness, and poor sleep. She had taken a homeopathic preparation
called "CoroCalm" that relieved all of her symptoms almost instantly. Unfortunately, within a few days
of taking this preparation she developed a severe urinary tract infection with obvious hematuria. It was
her impression that there had been heat in her heart that had been vented to her small intestine and on to
her urinary bladder. She then took Ba Zheng San and a homeopathic vaginal suppository that initially
seemed to hold the symptoms at bay. However, the hematuria persisted. She finally resorted to a sulfa
drug when she felt the pain moving further into her pelvis and then up into her back. My colleague
initially responded so violently to the antibiotic that she was convinced she was going to die but by the
fifth day of this regimen her urinary symptoms had largely abated. Nevertheless, she still felt terrible,
and she was profoundly exhausted and nauseated. At this point she asked me to write a prescription for
her.
First Visit:
Her tongue was dry and red, with slightly raised red papillae and her pulse was wiry and strong. She had
extremely cold hands and feet and had a bad taste in her mouth. She complained of being "very
mucousy," was averse to drinking water, and she still had some slight urinary burning.
My diagnosis was damp heat in the shaoyang complicated by phlegm and I gave her the following
formula.
Herba Artemesiae Annuae (Qing Hao) 9g., added in the last 10 minutes.
Radix Scutellaria Baicalensis (Huang Qin) 6g.,
Radix Codonopsis Pilosulae (Dang Shen) 6g.,
Radix Glycyrrhizae Uralensis (Gan Cao ) 6g.,
Rhizoma Zingeberis Officianalis (Sheng Jiang) 3g.,
Rhizoma Alismatis Officianalis (Ze Xie) 6g.,
Herba Lopatheri Gracilis (Dan Zhu Ye) 9g,.
Caulis Bambusae in taeniis (Zhu Ru) 9., and
Herba Eupatorii Fortunei (Pei Lan) 9g.
Given my diagnosis, Xiao Chai Hu Tang was an obvious possibility as a base prescription. However,
although Xiao Chai Hu Tang could easily have been modified to address the component of dampness in
my patient's presentation, my patient had a long history of sensitivity to medications of all sorts and
Radix Bupleuri (Chai Hu) in particular. In light of this I felt that administering Chai Hu as a sovereign
medicinal was much too harsh and upbearing for her. I needed something that would vent the pathogen
from the shaoyang/qi aspect with a softer touch. Hao Qing Wen Dan Tang was another possibility that
actually addressed the damp-
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Qing Hao struck me as a much more appropriate sovereign medicinal for my patient. According to
Wang Tian Ru (王天如), Qing Hao is bitter, slightly acrid, and cold in nature. Its qi is light and it is
aromatic. Qing Hao is typically used to abate bone-
summerheat dampness and repletion heat. It enters the spleen, stomach, liver, heart and kidneys. Qing
Hao is bitter but does not damage the yin; it is cold but does not create dampness. It is acrid and
transforms turbidity. It is light and clearing and evicts pathogens Its three major functions are in draining
heat, rectifying taxation and resolving summerheat. It can be used for warm disease pathogens in any
aspect: defense, qi, construction or blood. It can be used as a sovereign or assistant medicinal depending
on how it is combined with other medicinals. [8] Given the weakened condition of my patient, and the
presence both heat and dampness, Qing Hao was a good call. In my experience, it is only effective in
evicting pathogens when decocted for 10 minutes or less..
Then there was the question of how much dampness was actually present. My colleague complained of
being very "mucousy," reflecting phlegm with form. She also reported a frank aversion to fluids,
although her tongue was quite dry. These symptoms I interpreted as dampness constraining the
waterways. Thus, I took this as an opportunity to drain some more heat along with dampness while still
protecting her fluids using Zhu Ye, Zhu Ru and Pei Lan. Since this was predominantly a qi aspect
problem, and my colleague still had some heat in her urinary tract, I mildly vented heat through diuresis
with Ze Xie rather than hitting it harder with the Green Jade Powder (碧玉散Bì Yù Sàn)
She decocted 1 packet of herbs in 6 cups of water, simmered down to 3 cups, and took 1 cup 3 T.I.D.
Next Visit.
My colleague felt remarkably better after the taking her first cup of the medication. The following
morning she reported that her cold extremities had disappeared, as had her urinary burning, and the bad
taste in her mouth. Her thirst was now normal. However, she nevertheless woke feeling exhausted and
asthmatic, an old symptom for her. Based on pure intuition, she took a dose Sheng Mai San, which
provided significant, if short-
She reported that her face felt as if it was vibrating and she had a slight nasal drip. Her tongue was
slightly less red with red papillae, and the moisture had returned. Her pulse was rapid and replete. She
didn't feel great, but she was certainly better than the day before.
My sense was that we had vented the heat from the shaoyang to the qi aspect of the lung and that it was
already moving on to the exterior. I considered giving her
Ma Xing Shi Gan Tang to clear the constrained heat from her lungs, however, we knew that the patient
tended toward hypersensitive responses to Herba Ephedrae (Ma Huang) and without a vigorous venting
influence like (Ma Huang) to balance it out, I was concerned that the Gypsum (Shi Gao) would just
constrain the heat further.[9] Instead, I took a milder approach that better reflected my patient's
constitution.
Cortex Mori Albae Radicis (Sang Bai Pi)15g.,
Cortex Lycii Chinensis (Di Gu Pi) 15g.,
Rhizoma Anemarrhenae (Zhi Mu) 12.,
Radix Panacis Ginseng (Ren Shen) 9g.,
Semen Pruni Armeniacae (Xing Ren) 12g.,
Semen Soja Preparatum (Dan Dou Chi) 6g. added in the last seven minutes Herba seu Flos
Schizonepetae Teniufoliae (Jing Jie) 9g.,
1 packet of herbs was decocted in 6cups of water, simmered down to 3 cups with a cup taken 3 times per
day.
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Since a tight chest and shortness of breath are reliable indicators of some sort of constraint it is
reasonable to wonder why I didn't employ more qi movers in this prescription. As I alluded to above,
many strong, cold heat-
Lian) do nothing to actually move the qi and if not paired with qi-
constrain the heat further, leaving one to wonder why their double digit doses aren't working. In this
case, however, there was already a propensity for movement. There were signs of constraint, of course,
but the qi was already pushing toward the exterior. My inclination was to simply make sure the door was
open with a gentle, slightly warm, acrid, and outthrusting pairing of Dan Dou Chi, and Jing Jie 9g.
In my first prescription I utilized two vectors for draining heat, venting outward while transforming
dampness with aromatic herbs like Qing Hao and Pei Lan, and draining downward through the urination
with Ze Xie.
By now the waterways had normalized and things were moving so I decided to leave well enough alone
and to continue to vent heat exclusively through the exterior.
By and large, wenbing theory takes a dim view of supplementation too early in the course of treatment,
before a pathogen has been fully expelled. I too, believe that using supplementation to push out a heat
pathogen often doesn't work very well. How then could I justify my use of Ren Shen? My colleague's
spontaneous experiment with Sheng Mai San that morning encouraged me to break the rule, otherwise I
probably not have included a supplementing component in the in the prescription at that time. It
occurred to me that Sheng Mai San had probably been helpful for her because it not only boosted the qi
but because is also engendered fluids. I rationalized my use of Renshen by remembering its use in On
Cold Damage (傷寒論Shäng Hán Lùn) for engendering fluids, as well as for boosting the qi.
THIRD VISIT
Again, she immediately improved after the first dose and the following morning she reported that she
felt had nearly recovered. She was feeling cold again, and her nose was runny, although she still had
some sense of dryness and tightness. Her tongue was definitely still on the red side, but her pulse was
floating and relaxed, suggesting that the pathogen could finally be expelled through the exterior.
The use of Gui Zhi Tang to treat early stage warm disease is hotly debated in the wenbing literature but
the general consensus is that this is a bad idea. Taking all of this under advisement, I still used Gui ZhiJia Hou Po Xing Zi Tang
as my base formula for the following reasons. First, with the exception of her
tongue, my colleague's symptoms fit the Gui Zhi presentation. Then too, she had often taken Gui ZhiTang
in the past with great success in treating wind cold conditions. Finally, I am of the opinion that
even if a wind cold pathogen transforms to heat early in a disease process, it may be useful to address
that pathogen as wind cold at some point in the course of treatment. Such an opportunity had presented
itself.
Ramulus Cinnamomi (Gui Zhi) 9.,Herba seu Flos Schizonepetae Teniufoliae (Jing Jie) 9g.,
Radix Paeoniae Albae (Bai Shao) 4g.,
Fructus Zizyphi Jujubae (Da Zao) 6g.,Radix Glycyrrhizae Uralensis (
Gan Cao) 9g.,
Cortex Magnoliae Officianalis (Hou Po) 12g.,Semen Pruni Armeniacae (
Xing Ren) 12g.,
and Radix Panacis Ginseng (Ren Shen) 6g.,My misgivings about the
Ren Shen notwithstanding, it seemed to be facilitating the ultimate resolution
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of the problem so I left it in the prescription. Hou Po is an obvious modification of Gui Zhi Tang for
opening the chest, and it may be that if I had moved the qi in the chest just a bit more in the previous
formula I wouldn't have needed it now.
In retrospect, my inclusion of Jing Jie in this prescription may have been less than an optimal choice.
My thought at the time was that her situation required slightly more extrerior resolution than that
provided by the base prescription. Yi Fan-
unnecessary, and I probably should have left well enough alone. Nevertheless, by the next day, she felt
fine. On her own initiative, my colleague resumed taking Sheng Mai San, which appears to have been a
fruitful decision in so far as her health continued to improve.
An alternative Ending?
A good rule of thumb to follow when reading case histories is not to ask yourself why the physician
failed to treat their patient they way you would have, but instead to try to understand why he or she did
what they did. One is much more likely to learn something this way and there's always time for secondguessing
later. Nevertheless, those of us who remain at all thoughtful in our clinical practice probably
spend a considerable amount of time second-
therapeutic endeavor is largely reserved for 'failed cases' and is rarely discussed when the case is
actually deemed a success. Sometimes though what a physician didn't do, can be as informative as what
she did do. This clinical soul-
decisions that are frequently almost unconscious. Finally, it is all too easy to say 'look how clever I was
in solving this conundrum' and more challenging to ask oneself, 'how could I have done it any better"
What would have happened if I had taken a more vigorous approach in my first prescription, including a
stronger diuretic and downbearing component inherent in the original version of Qing Hao Wen Dan
Tang? Might I then have vented the lurking heat in a single stroke? Perhaps. Some
of Ye Tian-
histories seem to indicate that he achieved resolution of a lurking pathogen with the administration of a
single treatment strategy.[11] Might a more aggressive treatment strategy have further debilitated an
already weakened patient? I think that this is equally likely. My only justification for this is my previous
experience in treating this patient.
In deconstructing this case, it may be worth asking why we should bother with this wenbing business at
all? The first two interviews in this case are easily interpreted within the context of established TCM
zangfu theory. Strictly speaking, by the time I became involved in the case, it is hard to say that the
overall situation demanded an external pathogen perspective at all. One can imagine a different
treatment strategy focusing on liver heat due to emotional constraint, which subsequently invaded the
lungs. Tomato, Tomatoe? Perhaps. It is difficult to imagine how one might rationalize the final
symptoms as anything other than an exterior condition. On the other hand, it is conceivable that they
represented a secondary attack, occurring in an individual whose correct qi had already become
compromised. One could argue that the final exterior symptoms represented a separate, albeit related
condition.
While this case could have been approached in a variety of different ways, a lurking pathogen
perspective provided me with the overall sense of the propensity or flow (勢 shi) of the case that was
central to its resolution It is the capacity to respond proactively to this propensity as opposed to simply
reacting to it that makes the difference between simply grabbing the tigers tail and being prepared to
whack it on the head when it turns around to bite you.
A Question of Orthodox Methodology.
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The treatment of lurking pathogens is often the most satisfying in situations like the case above where
we get to see a pathogen pop back out through the exterior like a boil coming to a head. This is as close
as most of us are going to get to the experience of those Pilipino faith healers who reach into your
stomach and pull out neoplasm, chicken entrails or both. In my clinical practice, at least, this is not the
norm. Lurking pathogen or not, things are usually more messy than this.
It is clear that even lurking pathogens that have become lodged in the construction aspect may be vented
through the exterior. For instance, Qing Ying Tang contains Flos Lonicera Japonicae (Jin Yin Hua) and Fructus Forsythia Suspensae (Lian Qiao) not only because they clear heat and resolve toxin, but because
they guide the pathogen to the exterior. Of course, this begs the question of whether we should actually
see exterior symptoms in the course of outwardly evicting a lurking pathogen. The venting of a pathogen
to the exterior is not necessarily the same thing as inducing an exterior symptom complex wenbing
specialist Guohui Liu is of the opinion that the appearance of defense level symptoms at the end stage of
treating a lurking pathogen is an unambiguously positive development.[12] The Shäng Hán Lùn
provides us with some further justification for interpreting exterior symptoms in a positive light. Line
149 informs us that subsequent to the administration of Xiao Chai Hu Tang, the patient may experience
"steaming and quivering, then heat effusion and sweating" [by which the disease] resolves.[13]
In a wenbing framework we know that we've successfully vented a pathogen from the construction to
the qi aspect when we cease seeing construction level symptoms and begin seeing qi level symptoms.
Once a pathogen is established back in the qi aspect, we have a variety of options for finally expelling it,
one of which is through the exterior. However, even when medicinals are included to vent a pathogen
through the exterior, the case history source literature typically reflects a resolution of the pathogen from
the qi aspect without the development of overt exterior symptoms.
One might point to the eruption of a rash as an obvious indicator of heat venting through the exterior.
Rashes, however, are rather ambiguous signs Although rashes may represent an opportunity to more
fully vent heat to the exterior they -
constructive/blood levels. The development of a rash can actually be quite onerous. Moreover, in the
majority of case histories that I am aware of, although the eruption of a rash in the course of treating a
deep-
development. Most wenbing clinicians aren't actively trying to induce a rash as a means of venting a
pathogen to the exterior, but they will do so should the opportunity arise.
All of this leaves us wondering whether the most skillful expression of having drained a lurking
pathogen from the qi aspect might be characterized by the absence of overt exterior symptoms. Either
way, the absence of exterior symptoms at the end stage of treatment is another reason why many case
histories that invoke a lurking pathogen diagnosis often bear a remarkable similarity to ordinary gardenvariety
wenbing cases.
A final question that comes to mind concerns the question of whether we ever really eliminate lurking
pathogens at all. The source literature speaks of some constitutional weakness, most often in the kidneys
that allows for a pathogen to become lodged. While this is a neat model, real patients are messy. Over
the course of a lifetime people tend to develop many predisposing imbalances and as we have already
discussed, they sustain multiple pathological assaults that are often incompletely resolved. If we are
going to apply the notion of lurking pathogens to a real person with a continually evolving constitutional
pattern then we have to recognize that pathogens may lurk on multiple interrelated layers. In most cases
it is probably more accurate to speak of a "lurking pathogen complex" than a single pathogen. In this
case, it is likely that what was eliminated was only the most superficial stratum of a lurking pathogen
complex. The conventional wisdom on lurking pathogens is that the course of treatment tends to be quite
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protracted. Wang Meng-
lurking pathogen complexes is often an ongoing process and it is quite difficult to say when it is
finished. A patient may exhibit remarkable signs of both objective and subjective improvement, but
some evidence of the pathogen usually remains. It typically becomes a part of their background
constitutional pattern.
Conclusions.
Identifying biomedical disease entities characterized by periods of dormancy as lurking pathogens (伏邪fú xié) does not mean that a lurking pathogen methodology is necessarily the treatment strategy of
choice for these conditions. Conversely, clinical scenarios that are not obviously lurking pathogen cases
may be treated effectively with this methodology. However fruitful an integrated Chinese
medical/biomedical understanding may prove to be, it is equally important to understand the concept of
lurking pathogens or any Chinese medical idea in its richest context, which is within the framework of
Chinese medicine. In light of this, the most effective approach to lurking pathogens I have found frames
this idea primarily as a treatment methodology, as opposed to an etiology.
The thumbnail sketches of ideas like lurking pathogens presented in modern Chinese medical texts are at
best only referents to a much broader scope of sometimes contradictory understandings. The historical
literature on lurking pathogens is particularly unsystematic in its vision of how to go about treating
them. Textbook presentations inevitably filter Chinese medical ideas such as these in a manner that
renders them static and divorces them from the flow of treatment. The case history literature is much
more facile in illuminating this aspect of clinical practice. After all, most clinicians advance their
theories based on how they've actually treated people. A case history cuts closer to the bone than a
theoretical exegesis. Finally, above and beyond simply presenting what did or did not work for a given
clinician in a given situation, case histories provide a forum for the critical analysis of our thinking at
every step of the therapeutic encounter.
End.
[1] When the term lurking pathogen is used in this essay, it refers only to the Chinese medical concept
and not to any potential biomedical medical corollary.
[2] Whether it is actually clinically helpful to model such diseases in the context of the historical
concept of lurking pathogens is very much an open question for me. It may well be that the most
effective Chinese medical methodologies that are eventually developed to treat diseases such as
Hepatitis C and AIDS bear little resemblance to the historical Chinese medical notion of fú xié.
[3] 黃帝內經素問文校釋 (Huang Di Nei Jing Su Wen Jiao Shi-
Questions), People's Health & Hygiene Press, Beijing, 1980:pg 46
[4] See for instance, the case histories of two of the most important thinkers on lurking pathogens, Ye
Tian Shi's (葉天士) Clinical Guide to Patterns Based on Case Studies (臨証指南醫案 Lin zheng zhi
nan yi an), and Liu Bao Yi's (柳寶冶) Liu's Select Case Histories From Four Currents. (柳選四家医案
Liu xuan si jia yi an).
[5] Liu, Guo Hui, 2000:66
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[6]Liu Bao Yi, Journey to the Origin of Warm-
Encyclopedia of Chinese [Medical] Classics 中華醫典Zhong Hua Yi Dian-
Hongyu@public.cs.hn.cn.
[7] Liu's Select Case Histories From Four Currents. 柳選四家医案-
Zhong Yi Yao Chu Ben Shu, Beijing:1997 . This is an anthology of four case collections written by You
Zai Jing (尤在涇), Bo Ren (伯仁) Wang Xu Gao(王旭高), and Zhang Zhong Hua (張仲華). Liu is the
anthologist and comments on each of the cases. The passage cited here appears in the context of a case
in Wangs's Case Histories of the Grass Court of the Encircling River 環溪草堂醫案Xuan Huan Xi Cao
Tang Yi An
[8] Wang Tian Ru (王天如) in An Anthology of Wen Bing 溫病專輯Wen Bing Zhuan Ji, Beijing,
Zhong Yi Gu Zhu Chu Ban Shu:1988; 146-
[9] Most textbooks attribute pathogen-
upon its combination with Mahuang.
[10] Yan, Yi-
2002:29
[11] This, of course, calls into question the entire premise of this paper. On the other hand, Ye has many
cases where a sequenced strategy was required.
[12] Personal correspondence, Seattle, March 3003.
[13] Mitchell, Ye and Wiseman, Shang Han Lun, On Cold Damage, Brookline Mass. Paradigm
Publications, 2000,: p 235 (line 149)
[14] Wang Meng Ying, Warp and Woof of Warm Febrile Diseases (溫熱經微Wen Re Jing Wei) in 中華
醫典
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