4 Traditional Chinese Medicine Resources on Diphtheria Differentiation and Treatment

6. Toxicity Spreading Through the Meridians: The primary symptoms include speech impairment, throat obstruction, choking cough, or facial asymmetry, limb paralysis, pale red tongue with white coating, and a fine pulse. Treatment focuses on nourishing blood, replenishing qi, relaxing muscles, and activating the meridians—using modified Yang Zheng Tang: 20g of Sheng Di, 15g of Shou Wu, 12g of Yu Zhu, 12g of Mai Dong, 30g of Shan Yao, 12g of Bai Shao, 10g of Rong Zhi, 12g of Mu Gua, 15g of Jie Teng Teng, 20g of Dan Shen. Brew the herbs in water and take one dose per day.

In the above classification-based treatments, although there have been historical views stating that “diphtheria should avoid external exposure,” when external symptoms are prominent, treatment should focus on releasing exterior patterns, often adding Mulberry Leaves and Kudzu Root; for high fever, add Stone Nettle and Motherwort; for those with rapidly spreading pseudomembranes and neck swelling, add Ban Lan Gen, Tuo Niu Xi, and Shan Dou Gen; for those with a strong need to clear heat, add Motherwort and Chrysanthemum; for those with constipation, add Rhubarb, Magnesium Sulfate, or Hemp Seeds; for those with difficulty breathing, add Eupatorium and fresh Bamboo Juice; for those who are weak, add Ginseng and Astragalus; for severe dryness of the mouth, add Shashan and Mai Dong; for severe cough, add Beimu; for those with severe pain, add Chicken Blood and Shen Qu.

(4) Traditional Chinese Medicine Resources on Diphtheria Differentiation and Treatment Different regions have developed various classifications of diphtheria based on different criteria. Summarizing these classifications, we find three main types: ① Classifying according to the internal organs and meridians into five types:

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Practical Internal Medicine Combined with Western Medicine | Such as | Zhu Hu Hua Du Tang: For the type of lung qi obstruction, treatment focuses on clearing heat, resolving stagnation, and harmonizing qi—this is the main formula. Heat-clearing and detoxification methods, with the main formula being Blue… | > 18g of Le, 30g each of Dajing and Huang Lian, 12g of Ba Dou Shuang; Yin-deficiency lung hardening—two types | > (Kidney Meridian Syndrome) Treatment (Realgar, Zhe Bei Mu, Ban Dian… | > Treats by strengthening the spleen and eliminating phlegm, using modified Si Jun and Er Chen Tang as the main formulas; for the spleen, | > Focuses on nourishing yin and clearing the lungs with for the spleen, and tonifying the kidneys with Tian Fu Mei Tang; For the heart and kidney deficiency type (heart meridian syndrome), treat with wind-clearing and heat-clearing methods, focusing on resolving heat and detoxifying, and using Tian Fu Mei Tang, or Ma Xing Shi Gan Tang, with modifications; for the heart and kidney deficiency type (heart meridian syndrome), use Tian Fu Mei Tang, combined with the use of “Chu Yao San” for treating the condition; for the heart and kidney deficiency type (heart meridian syndrome), use modified Tian Fu Mei Tang, combining with “Chu Yao San.” Qin Bo Wei and others believed that cases leaning toward wind-heat often present with both cold and heat, accompanied by headache and a floating, rapid pulse. Treatment begins with dispersing the exterior and clearing heat and detoxifying, using Sang Ge Tang in combination with “Chu Yao San”; after the exterior symptoms subside, continue with Yang Yin Clear Lung Decoction, combined with Tuo Niu Xi for treatment. For cases leaning toward yin deficiency, initial treatment does not involve exterior symptoms, but rather a rapid, weak pulse—these cases should focus on nourishing yin and clearing heat, using Yang Yin Clear Lung Decoction combined with Tuo Niu Xi, along with “Chu Yao San.” Both formulas are used to cool and clear the throat. There are also formulas that focus on clearing heat, detoxifying, nourishing yin, and resolving phlegm—such as Ma Xing Shi Gan Tang. Sang Ge Tang, Yin Qiao San, Yang Yin Clear Lung Decoction (also used in conjunction with Bing Xiong San to cool the throat). ② Classifying according to the relationship between defensive qi and pathogenic qi: For example, in cases of defensive qi (wind-heat), add Sheng Xi; in cases of qi-deficiency, reduce the amount of Dafu Chi, add Niu Xi, Chan Yi, Xuan Shen, Shan Dou Gen; for cases of wind-heat, use Sang Ju Yin; for cases of yin deficiency, treat with clearing heat and detoxifying, using Xian Fang Huo Ming Tang, or Ma Xing Shi Gan Tang, with modifications; for cases of yin deficiency (dry heat), treat with nourishing yin, clearing the lungs, and detoxifying—using Yang Yin Clear Lung Decoction combined with Niu Xi. Qin Bo Wei and others believed that cases leaning toward wind-heat often present with both cold and heat, accompanied by headache and a floating, rapid pulse. Treatment begins with dispersing the exterior and clearing heat and detoxifying, using Sang Ge Tang in combination with “Chu Yao San”; after the exterior symptoms subside, continue with Yang Yin Clear Lung Decoction combined with Tuo Niu Xi for treatment. For cases leaning toward yin deficiency, initial treatment does not involve exterior symptoms, but rather a rapid, weak pulse—these cases should focus on nourishing yin and clearing heat, using Yang Yin Clear Lung Decoction combined with Tuo Niu Xi, along with “Chu Yao San.” Both formulas are used to cool and clear the throat. There are also formulas that focus on clearing heat, detoxifying, nourishing yin, and resolving phlegm—such as Ma Xing Shi Gan Tang. Sang Ge Tang, Yin Qiao San, Yang Yin Clear Lung Decoction (also used in conjunction with Bing Xiong San to cool the throat). ③ Classifying according to the relationship between pathogenic qi and righteous qi: For example, classifying into three types: pathogenic qi dominant, righteous qi dominant, and righteous qi dominant with pathogenic qi. Nantong Medical College classified this disease into two types: “Pathogenic Qi Dominant” and “Deficiency of Righteous Qi.” Pathogenic qi dominant is further divided into dry heat type, wind-heat type, wind-cold type, and wind-toxin type; “Deficiency of Righteous Qi” primarily refers to complications and secondary conditions of diphtheria, such as myocarditis and nerve paralysis. Myocarditis is classified into heart-yin deficiency type and heart-yang deficiency type. Changzhou Traditional Chinese Medicine Hospital classified this disease into types such as “Epidemic Diphtheria,” “Hidden Evil Diphtheria,” “Diphtheria Transforming into Fire,” “Diphtheria with Heat,” “Yangming,” and “Diphtheria with Heat Disrupting the Pericardium.” Other classifications include those based on “etiology,” “San Jiao,” and “disease stage,” though their meanings and treatment approaches are similar. Some scholars have offered differing perspectives on earlier discussions, pointing out that “Diphtheria should avoid external exposure; improper sweating can be dangerous” (the principle of treating diphtheria avoiding external exposure and supporting the vital energy), which refers to cases where no hidden evils or secondary conditions exist in diphtheria; “When diphtheria presents with symptoms of wind-heat, it’s best to treat with external exposure—sweating will help” (from “The Correct Way to Treat Diphtheria”), which suggests that during the early stages of diphtheria, when the rash has not yet broken through, it is crucial to grasp the stage of the disease and the underlying pathogenesis, and to treat externally appropriately to achieve effective results. It is recommended that those with initial symptoms of diphtheria, especially those with external symptoms, use modified Dajing Tang, Zhu Hu Hua Du Tang, or Shen Dong Bi Xie San for treatment; for cases leaning toward wind-heat, use modified Yin Qiao San; for cases of lung heat and yin burning, use Yang Yin Clear Lung Decoction; for cases of heat and yin accumulation in the lungs and stomach, use Xian Fang Huo Ming Tang combined with Clear Throat and Diaphragm Decoction; if there is no high fever but residual toxins have not yet been cleared, use Qing Xin Ti Tan Tang, Yang Zheng Tang, or modified Four Gentlemen Decoctions with Jin Yin Hua. Ouyang Qi pointed out that the key issues in treating diphtheria are: ① controlling and managing respiratory distress caused by diphtheria; it is advisable to use products like Leizhi Zi, Xing Ren, Bai Jie Zi, and Zhu Li to descend qi and clear phlegm, while avoiding medicines like Shengma, Gegen, and Dajing that promote upward movement; it is also advisable to employ methods of vomiting (if necessary, perform tracheostomy). ② Regarding the prevention and treatment of myocarditis, see below for details—treat myocarditis by controlling it while simultaneously detoxifying and reinforcing righteous qi. For cases with concurrent complications, such as myocarditis, the condition often involves heat-toxin invading the heart and kidneys, exhaustion of the heart, liver, and kidneys, yin deficiency, yang weakness, and blood loss. Treatment focuses on nourishing yin, replenishing blood, benefiting qi, strengthening yang, and restoring pulse and consolidating depletion—common formulas include Eight Flavor Rehmannia Decoction, modified Repulse Decoction, Three-Element Repulse Decoction, Fuzi Lizhong Decoction, Shenfu Decoction, Gui Pi Decoction, Sheng Mai San, and Zhi Gan Cao Tang, Du Can Tang, among others. For cases of laryngeal obstruction or laryngeal paralysis, treatment for laryngeal obstruction focuses on clearing phlegm, opening the airway, and detoxifying—use products like “Xiong Huang Jie Du Wan” (30g of Xiong Huang, 3g of Yu Jin, 14 peeled Ba Dou seeds, all ground into a fine powder and made into vinegar paste pills, 1.5g per dose, halved for children, taken with hot water), “Jie Bai San” (7 red Ba Dou seeds, flying Xiong Huang, Zhe Bei Mu, Dajing, each 15g, ground into a fine powder, 1–8 years old, 1–2g per dose), Di Hou San, Xi Yan San, Saogao Ku Jiu, and Dajing Bai San. In recent years, there have been reports of late-stage diphtheria cases developing nerve paralysis—recently, Xia Yue Wen reported a specialized formula for treating soft palate paralysis in diphtheria: 6–12g of Chan Yi, 6–15g of Jiang Can, 10–20g of Ren Dong, 10–15g of Sheng Di, 6–18g of Si Gua Luo and Dan Pi, 3–6g of Quan Xie and Dajing, 6–10g of Gan Cao, taken in water once daily, with 22 cases recovering, and 3 cases discontinuing treatment (Shanghai Journal of Traditional Chinese Medicine, 1987.1). Additionally, during the recovery phase, 30g of Sheng Di, 15g of Mai Dong, 15g of Xuan Shen, 15g of Fresh Dendrobium, 15g of Huang Ling, 15g of Jin Yin Hua, plus 9g of Tian Ma, 15g of Xun Duan, 15g of Sang Ji Sheng, 6g of Tian Nan Xing—some used the post-recovery Yang Zheng Tang to treat soft palate paralysis, using Yu Zhu, Shan Yao, Sheng Di, Sheng Di, and Sheng Di, paired with Tian (Tu) Zhu, Da Chui, Ying Xiang, Yin Tang, Zu San Li, Zhao Hai. They also paired Feng Fu, Feng Chi, Feng Long, Tang Zhong, and Jian Jing. Some used Yin Tang and Tai Chong as primary acupoints, paired with He Gu and Shao Shang as auxiliary points. Others used the primary acupoint Lian Quan, Tian Tu, Shao Shang, paired with Xiao Tu, Fu Tu, Tian Rong, Tian Chuang, Tian Ding, Fei Yu, Fei Xu, Tian Tong, Tian Ding, Fei Yu, Fei Xu, Tian Ding, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu, Tian Yu......

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2001.3)

3 Treatment of infantile whooping cough (spasmodic phase) with Jian Tang, achieving satisfactory therapeutic results in 62 cases. The formula for Jian Tang is as follows: Feng Wu, Zhang Wu Bing Yun, using the formula “Jie Jing Zhen Xi Chu Kou Jie.”

Cui Dong, 4g; Jiang Can, 4g; Bai Ri Bu 11 Before, 10g; Zi Wan, 10g; Gan Cao, 6g. One dose per day, plus Bai Xiao Mao Zhao Gen Li 1, for treatment purposes:

And Su Qian, 6g; Ke Chou, 6g; Xie Yi, 6g; B Children aged 1 year, taking 1 dose daily.

5** Tablets: For children aged 1 year, take 2 tablets daily, once a day, at a dosage of 0.7% of the total daily dose. Progress was observed in 122 cases after 3 doses; after 4–7 doses, the treatment was effective in 2002.5).

Gui Yu Yan et al. achieved good therapeutic results when treating infantile whooping cough syndrome with compound antitussive therapy. Each component of the compound antitussive formulation...

T 寸 应 用 发 刀 咳 火 和 小 H⁷ 个B Children aged 1 year, taking 1 dose daily. 5** Tablets: For children aged 1 year, take 2 tablets daily, once a day, at a dosage of 0.7% of the total daily dose. Progress was observed in 16 cases. For children aged 6–2 months, each 1 tablet; 1 tablet; 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old, 1 tablet each, 1–3 years old,......2001.3)

3 Treatment of infantile whooping cough (spasmodic phase) with Jian Tang, achieving satisfactory therapeutic results in 62 cases. The formula for the Spasm-Relieving and Cough-Relieving Decoction consists of: Feng Wu, Zhang Wu Bing Yun’s formula for treating whooping cough, which includes: Centipede, Silkworm Cocoon, 4g each; Earthworm, 6g; Dianthus, 10g; Aster, 11g. Before use, take 10g of each ingredient, combined with 10g of purple aster root and 10g of white peony root. Take one dose daily, adding 10g of purple aster root and 10g of white peony root to the decoction. Additionally, take 10g of purple aster root and 10g of white peony root as a supplement to the treatment regimen.

The formula also includes: 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white peony root, 10g of purple aster root, 10g of white......

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