Input:

Input: Fang Yong Ganlu Duan Dan with additions and subtractions: Ho Xiang 10g, Yi Yi Ren 10g, Chang Pu 10g, Huang Qin 12g, Lian Qiao 15g, Hua Shi 15g, Qin Tiao 12g, Luo Shi Teng 12g. Decocted in water and taken as a decoction, 1 dose per day. 3. Damp-Heat Obstructing the Collateral Channels, Blood and Qi Stagnation In mild cases, symptoms may include paralysis of the limbs; in severe cases, qi is depleted, leading to loss of yang energy. 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 drying dampness while activating blood circulation and unblocking the collaterals. The formula uses San Miao Wan with modifications: Cang Zhu 10g, Huang Bai 12g, Niu Xi 10g, Dang Gui 6g, Luo Shi Teng 12g, Sang Ji Sheng 15g, Ji Xue Teng 15g. For those with phlegm obstruction, add Chang Pu 10g, Yu Jin 10g, Chuan Bei Mu 10g; for those with facial asymmetry due to windstroke, 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. Pathogen Eliminated, Vitality 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 Qi Bao Mei Ran Dan with modifications: Huang Qi 15g, Dang Gui 10g, Shu Di 15g, Niu Xi 10g, Rou Cong Rong 15g, Ku Zi Zi 15g, Bu Gu Zhi 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 Differentiation 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 Jian Qu, Shou San Li, Nei Guan, Fu Tu, Zu San Li, San Yin Jiao, Tian Zhu, Da Zhu, Shen Yu, to treat 56 cases; 4 cases were cured, 10 cases showed marked improvement, and 41 cases improved. (Chinese Medical Journal, 1988, No. 2) “Clinical Observation on Differentiation and Treatment of 50 Cases of Polio” introduced two treatment approaches: the damp-heat obstructing the collaterals type (pre-paralysis to paralytic stage). Treatment focused on clearing heat and drying dampness, and unblocking the meridians, commonly using Cang Zhu, Huang Bai, Niu Xi, Yi Yi Ren, Si Gua Lu, Shan Yao, Kuan Jin Teng, Ren Dong Teng, Mu Gua, Bai Shao, Gan Cao, Ge Gen, Ban Lan Gen, among others. The qi-deficiency and blood-stasis type (recovery period to post-remission period) treated with replenishing qi, activating blood, and unblocking the collaterals, often employing Huang Qi, Chi Shao, Bai Shao, Chuan Xiong, Gui Wei, Di Long, Tao Ren, Hong Hua, Tai Zi Shen, Dan Shen, Ji Xue Teng, Niu Xi, among others. All treatments were combined with electro-acupuncture. 11 cases were cured, 24 cases showed marked improvement, 11 cases were effective, and 4 cases were ineffective, with an average hospital stay of 3–81 days. (Guangxi Traditional Chinese Medicine, 1988, No. 4) “Comprehensive Summary of the Efficacy of Traditional Chinese Medicine in Treating 53 Cases of Polio” divided treatment into three types: ① Kidney Deficiency Type: Tian Dong and Dang Shen each 15g, Shu Di, Chuan Mu Gua, Sang Ji Sheng, Wu Shao She, Chuan Niu Xi each 20g, Fang Feng 10g, Bai Zhu 8g, Lu Rong 3g, Sheng Ma Huang 5g, ground into powder and sifted, for one-year-old children, divided into 40 packets; dosages for other ages were adjusted accordingly. ② Spleen and Kidney Deficiency Type: Chao Bai Zhu, Dang Shen, Fu Ling, Ji Nei Jin, Chuan Mu Gua each 15g, Shu Di, Wu Chei Gu, Ku Zi Zi, Wu Shao She, Sheng Mai Ya each 20g, Lu Rong 3g, Sheng Ma Huang 8g, ground into powder and sifted; children aged 1–1.5 years were divided into 25 packets. ③ Lung and Kidney Deficiency Type: Shu Di, Tian Dong, Wu Chei Gu, Ji Xue Teng each 20g, Chuan Bei Mu and Xing Ren each 20g, Bei Sha Shen, Dang Shen, Ku Zi Zi, Wu Shao She, Di Long each 15g, Lu Rong 3g, ground into powder and sifted; children aged 2 years were divided into 30 packets. Results: 12 cases showed marked improvement (with basic correction of foot inversion and basic walking ability), 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 of 268 Cases of Polio through Differentiation and Treatment” treated cases in two types: the damp-heat obstructing the collaterals type (paralytic stage) used Polio No. I: Cang Zhu, Ren Dong Teng, Du Huo, Mu Gua, Chuan Xiong, Dan Shen, Chuan Niu Xi each 10g, Yi Yi Ren 15g, Huang Bai 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: Huang Qi 15g, Chi Shao, Dan Shen, Ji Xue Teng, Sang Ji Sheng, Dang Gui, Huai Niu Xi each 10g, Di Long 5g. One dose per day, decocted in water and taken as a decoction, with a course of 30 days. Simultaneously, electro-acupuncture was applied at Jie Ji, Jian Yu, Jian Zhong, Qu Chi, Wai Guan, He Gu, Huan Tiao, Feng Shi, Zu San Li, Fu Tu, Yang Ling Quan, Kun Lun, etc., employing tonifying techniques, leaving needles in place for 30 minutes, once daily, with 20 sessions constituting one course, with a 5-day interval between courses. Additionally, daily massage and pinching of the affected limb’s muscles and tendons were performed 2–3 times, for 20–30 minutes each time. Treatment lasted for 3–12 courses. Results: 65 cases were cured, 97 cases showed marked improvement, 94 cases were effective, and 12 cases were ineffective. The overall effective rate was 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, 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 per dose, 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 are also available: during the initial fever phase, use 30 g of wild chrysanthemum, Ren Dong Teng, and fresh broad bean flowers, decocted in water and taken as a decoction; during the post-remission period, use 10 g of Niu Xi, 7 pieces of Dibei Chong, horse… Part Two: Infectious Diseases

Qian Zi 0.5 g (fried in oil), ground into a fine powder, divided into 7 packets; each packet was dissolved in yellow wine and taken before bedtime. Since 1958, China has been administering homemade 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 sequence of Types I, II, and III, with intervals of 4–6 weeks. Avoid administering the vaccine with hot water, as it may kill the vaccine virus. Repeat the vaccination annually for 2 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 0.3–0.5 ml/kg intramuscular injection of 10% human gamma globulin, with a second injection possible the next day. (Huang Hui, Zhao Qiu, Fu Qu, Wu Bin) 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 identified. 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 health risks to the population. To prevent and control 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, Blumburg discovered the “Australian antigen,” followed by Feinstone’s identification 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. Subsequently, through clinical and epidemiological observations, in addition to Hepatitis A and Hepatitis B, several other types of hepatitis were identified—collectively referred to 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 simultaneously or occur in overlapping patterns. 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, which they named TTV. To date, there are over seven known hepatotropic viruses capable of causing hepatitis.

(1) Etiology