Input:

Input: Fang Yong Ganlu Duan Jia Jian: Huoxiang 10g, Yiyiren 10g, Changpu 10g, Huangqin 12g, Lianqiao 15g, Huaishi 15g, Qinqiao 12g, Luoshi Teng 12g. Decocted in water and taken as a decoction, 1 dose per day. 3. Damp-Heat Obstructing the Collateral Channels and Blood-Stagnation In mild cases, symptoms may include paralysis of the limbs; in severe cases, qi is depleted, leading to loss of yang. This stage is characterized by paralysis, with spinal cord-type manifestations presenting as limb paralysis, while brainstem-type cases can result in respiratory and circulatory failure. Treatment should focus on clearing heat and transforming dampness while activating blood circulation and unblocking the collaterals. The formula uses Sanmiao Wan with modifications: Cangzhu 10g, Huangbai 12g, Niu Xi 10g, Dang Gui 6g, Luoshi Teng 12g, Sangjisheng 15g, Ji Xue Teng 15g. For those with phlegm obstruction, add Changpu 10g, Yu Jin 10g, Chuan Bei Mu 10g; for those with facial asymmetry, add Jiang Can 6g; for those with qi depletion, administer 15g of ginseng immediately. Decocted in water and taken as a decoction, 1 dose per day. 4. When Pathogen Is Eliminated, Qi Is Deficient Symptoms include limb weakness and deformities. This is the post-remission stage; treatment should focus on tonifying qi and blood, nourishing liver and kidney. The formula uses Qibao Meiran Dan with modifications: Huangqi 15g, Dang Gui 10g, Shu Di 15g, Niu Xi 10g, Roucong Rong 15g, Gouqi Zi 15g, Buguozhi 10g. Decocted in water and taken as a decoction, 1 dose per day. Simultaneously, acupuncture should be employed to enhance therapeutic efficacy. (4) Traditional Chinese Medicine Resources on the Diagnosis and Treatment of This Disease In “Acupoint Injection and Acupuncture Therapy for 56 Cases of Polio Paralysis,” scopolamine 0.01–0.05 mg/kg was administered via acupoint injection once daily, along with acupuncture at Jianyu, Shou Sanli, Neiguan, Fuxu, Zusanli, Sanyinjiao, Tian Zhu, Dachui, Shen Yu, and other points, treating 56 cases. Four cases were cured, 10 showed marked improvement, and 41 experienced notable improvement. (Chinese Journal of Traditional Chinese Medicine, 1988, No. 2) “Clinical Observation on the Diagnosis and Treatment of 50 Cases of Polio Based on Syndrome Differentiation” introduced two treatment types: the damp-heat obstructing the collaterals type (pre-paralysis to paralytic stage). Treatment focused on clearing heat and eliminating dampness, and opening the meridians; commonly used ingredients included Cangzhu, Huangbai, Niu Xi, Yiyiren, Siguoluo, Shan Yao, Kuansheng Teng, Nindong Teng, Muguagou, Baishao, Gancao, Ge Gen, Ban Lan Gen, etc. The qi-deficiency and blood-stasis type (recovery period to post-remission period) treated with replenishing qi, activating blood, and opening the collaterals; commonly used ingredients included Huangqi, Chishao, Baishao, Chuanxiong, Guiwai, Dilong, Taoren, Honghua, Taizishen, Danshen, Ji Xue Teng, Niu Xi, etc. All treatments were combined with electroacupuncture. Eleven cases were cured, 24 showed marked improvement, 11 were effective, and 4 were ineffective, with an average hospital stay ranging from 3 to 81 days. (Guangxi Traditional Chinese Medicine, 1988, No. 4) “Comprehensive Summary of the Efficacy of Traditional Chinese Medicine in Treating 53 Cases of Polio in Children” divided treatment into three types: ① Kidney Deficiency Type: Tian Dong and Dang Gui each 15g, Shu Di, Chuan Muguagou, Sangjisheng, Wusao She, Chuan Niu Xi each 20g, Fangfeng 10g, Bai Zhu 8g, Lu Rong 3g, Sheng Mahuang 5g—ground into powder and sifted, for one-year-old children, the dosage was adjusted according to age, dividing the total into 40 packets. Other ages were adjusted accordingly. ② Spleen and Kidney Deficiency Type: Chao Bai Zhu, Dang Gui, Fu Ling, Ji Neijin, Chuan Muguagou each 15g, Shu Di, Wuchegu, Gouqi Zi, Wusao She, Sheng Maiya each 20g, Lu Rong 3g, Sheng Mahuang 8g—ground into powder and sifted, for children aged 1–1.5 years, the dosage was divided into 25 packets. ③ Lung and Kidney Deficiency Type: Shu Di, Tian Dong, Wuchegu, Ji Xue Teng each 20g, Chuan Bei Mu, Xingren each 20g, Bei Sha Shen, Dang Gui, Gouqi Zi, Dili Long each 15g, Lu Rong 3g—ground into powder and sifted, for children aged 2 years, the dosage was divided into 30 packets. Results: 12 cases showed marked improvement (with basic correction of foot inversion and basic ability to walk), 32 cases showed effective improvement (able to stand and walk with support, though with weak legs), and 9 cases were ineffective. (Henan Traditional Chinese Medicine, 1989, No. 1) “Efficacy Observation on 268 Cases of Polio Based on Syndrome Differentiation and Treatment” treated cases in two types: the damp-heat obstructing the collaterals type (paralytic stage) used Polio No. I: Cangzhu, Nindong Teng, Du Huo, Muguagou, Chuanxiong, Danshen, Chuan Niu Xi each 10g, Yiyiren 15g, Huangbai 6g—decocted in water and taken in 3 doses daily until body temperature returned to normal. The qi-deficiency and blood-stasis type (recovery period) was treated with Polio No. II: Huangqi 15g, Chishao, Danshen, Ji Xue Teng, Sangjisheng, Dang Gui, Huai Niu Xi each 10g, Dili Long 5g. One dose per day, decocted in water and taken as a decoction, with a course lasting 30 days. Simultaneously, electroacupuncture was applied at Jixi, Jianyu, Jianzhong, Quchi, Wai Guan, Hegu, Huan Tian, Feng Shi, Zusanli, Fuxu, Yanglingquan, Kunlun, among other acupoints, employing a tonifying approach with needles retained for 30 minutes, once daily, for a total of 20 sessions per course, with intervals of 5 days between courses. Additionally, daily massage and pinching of the affected limb’s muscles and tendons were performed for 20–30 minutes, 2–3 times per day. Treatment lasted for 3–12 courses. Results: 65 cases were cured, 97 showed marked improvement, 94 were effective, and 12 were ineffective. The overall effective rate reached 95.5%. The longer the acupuncture course, the higher the cure rate and the more pronounced the improvement. (Gansu Traditional Chinese Medicine, 1992, No. 2) IV. Western Medical Treatment There is no specific cure for this disease. During the prodromal and pre-paralytic stages, patients should rest in bed and avoid excessive activity. A light diet with adequate nutrition is recommended. For patients with high fever or severe limb pain, antipyretic analgesics and corticosteroids may be administered as appropriate for 2–5 days. During the paralytic stage, pay attention to the functional positioning of the affected limbs and avoid injury. For central paralysis, ensure proper suctioning of secretions, oxygen administration, and close monitoring of vital signs, along with emergency care. Medications that promote nerve cell metabolism and neuromuscular conduction, such as vitamin B₁, B₁₂, and diazepam, may also be used. The dosage for children is 0.1–0.2 mg/kg, while adults receive 5–10 mg, taken once daily for 10 days. During the recovery and post-remission periods, massage, functional exercises, physiotherapy, and corrective surgeries for deformities may be employed. In addition, single herbal formulas can be used as follows: during the initial fever phase, use 30 g of wild chrysanthemum, Nindong Teng, and fresh green bean flowers, decocted in water and taken as a decoction; during the post-remission phase, use 10 g of Niu Xi, 7 pieces of Dilibei, horse… Part Two: Infectious Diseases

Qian Zi 0.5 g (fried in oil), ground into a fine powder, divided into 7 packets, and each packet was dissolved in yellow wine and taken before bedtime. Since 1958, China has been using self-made attenuated live vaccines, which have shown excellent immunization effects. The ideal age group for oral vaccination is 2 months to 7 years, administered in winter and spring, following the I, II, and III types, with intervals of 4–6 weeks between doses. Avoid administering the vaccine with hot water, as it may kill the vaccine virus. Repeat the vaccination once annually for consecutive years. Before the age of 7, administer another mixed vaccine. During regular times and during outbreaks, pay attention to patient isolation, as well as hygiene measures regarding diet and environment. Close contacts of young children should receive a subcutaneous injection of 10% human gamma globulin, 0.3–0.5 ml/kg, with a second injection possible the next day. (Huang Hui, Qiao Fu, Qiu Wu) Chapter 19: Viral Hepatitis – Overview

Viral hepatitis encompasses six types: A, B, C, D, E, and G. In recent years, viral hepatitis caused by TTV has also been discovered. Viral hepatitis is classified as a Category B statutory infectious disease, highly contagious, with complex transmission routes and a relatively high incidence. Types B, C, and D can progress to chronic forms, posing significant risks to public health. To prevent and treat hepatitis, comprehensive prevention and control measures focusing on cutting off transmission routes are essential.

Since 1854, acute jaundice-related hepatitis was often mistakenly referred to as acute catarrhal jaundice. It wasn’t until 1940 that scientists realized the disease was caused by viruses, and it was later observed that hepatitis could be transmitted both through contact and via the bloodstream. In 1963, Blumbtrg discovered the “Australian antigen,” followed by Feinstone’s discovery of 27-nm viral-like particles in 1973. With successful virus isolation, it became clear that the previously known infectious hepatitis was actually Hepatitis A, while serum-based hepatitis was Hepatitis B. Since then, clinical and epidemiological observations revealed that in addition to Hepatitis A and Hepatitis B, there may be several other types of hepatitis, collectively known as non-A, non-B hepatitis. Among these, one group primarily spread through bloodborne infection was proven by Houghton in 1989 to be Hepatitis C; another group, transmitted via fecal-oral route, was identified as Hepatitis E, first discovered in 1983 by Balayan, who identified 25–32 nm viral-like particles—though cell culture efforts have yet to succeed. As for Hepatitis D, Rizzetto’s research on Hepatitis B in 1977 led to the discovery of the delta factor, which was named Hepatitis D virus in 1984. This virus requires the presence of Hepatitis B virus to replicate; therefore, Hepatitis B and Hepatitis D often co-infect or occur simultaneously. The Hepatitis G virus was discovered in 1995. In December 1997, Japanese researchers successfully isolated a new hepatotropic virus from the serum of a patient who had developed hepatitis after a blood transfusion, naming it TTV. To date, seven different hepatotropic viruses have been identified as capable of causing hepatitis. (1) Etiology