II. Diagnosis

II. Diagnosis (1) Diagnosis Based on the disease’s strict seasonal pattern—July, August, September—and the fact that patients in epidemic areas who develop sudden high fever, headache, vomiting, with a significant increase in total white blood cell count and neutrophil classification, and slight elevation in cerebrospinal fluid white blood cell counts, can be initially diagnosed. Subsequently, specific IgM antibody testing can confirm early diagnosis. Complement binding tests aid in retrospective diagnosis. (2) Differential Diagnosis

1. Brain-Typhoid Fever Patients with brain-typhoid fever often have a history of unclean food consumption; onset is more abrupt, and smear examination of anal swabs may reveal pus, red blood cells, and white blood cells. Cerebrospinal fluid is normal, and antibiotic treatment is effective.
2. Purulent meningitis—meningitis often occurs in winter and spring, with skin lesions such as ecchymoses, bruises, and lip herpes; antibiotic treatment is effective. Other forms of meningitis frequently accompany pneumonia, otitis media, mastoiditis, sinusitis, and other purulent lesions, where antibiotic treatment is effective. Cerebrospinal fluid becomes cloudy, with thousands of cells present, and pathogens may be detected.
3. Other Conditions Viral meningitis, poliomyelitis, non-specific encephalitis, brain-type malaria, and heatstroke also require differential diagnosis. III. Traditional Chinese Medicine’s Understanding and Treatment of Epidemic Encephalitis B (1) Historical Medical Views on Similar Conditions The Inner Canon already contained general discussions on heat-related illnesses. Song Dynasty · The “Taiping Huimin Heji Bureau Formula” mentioned “summer swelling and heat toxicity,” which shares similarities with the onset of this disease. The “Jusheng Fang” also introduced the concept of “heat wind.” Ming Dynasty physicians provided more detailed discussions on this disease, such as “Shou Shi Bao Yuan” stating: “Heat wind causes loss of consciousness, body stiffness, resembling stroke-like convulsions—this is a very severe condition.” Qing Dynasty · “Shi Bing Tiao Bian” further noted: “For children with heat-wind, sudden high fever and convulsions.” These records indicate that children were often affected by this disease. Contemporary renowned old Chinese medicine practitioner Jiang Yuren proposed the theory of “heat, phlegm, and wind” as the underlying causes of the disease.

(2) Traditional Chinese Medicine’s Understanding of the Pathogenesis of Epidemic Encephalitis B

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