從非典到新冠肺炎

From SARS to Novel Coronavirus (COVID-19) - English version is in the second half

新冠肺炎，Novel coronavirus (2019-nCoV) 新型冠状病毒肺炎，疫情越來越嚴重，被證實可以人傳人，也在武漢以外的許多地方發現病例，造成世界各國及世界衛生組織（WHO）高度關切，當然也讓很多住在中國大陸及附近區域的華人非常緊張，就好像當年的非典肺炎疫情即將再一次大爆發一樣。

目前，現代醫學還沒有找到治療新冠肺炎的方法，只能針對某些症狀來處理，疫苗的研發更是遙遙無期。怎麼辦？每次遇到這種情況，中醫就會被搬出來，這次也不例外。新冠肺炎爆發後，網上馬上有許多中醫對付新冠肺炎的文章。當然，除非哪位中醫師看過、治好過大量的新冠肺炎病例，所有的討論都是猜想、假設。然而，有些猜想及假設值得參考，有些猜想及假設卻明顯在誤導大眾。

我還沒有治療過新冠肺炎，不能大肆評論。不過，我治好過很多禽流感、豬流感、及每年流感導致的嚴重肺炎及其它病變的病人。其中許多病人是被美國大型西醫院證實為嚴重肺炎，被要求醫院或居家隔離，偷偷溜出來找中醫看診的。也因此許多病人及討論中醫的網站，希望我能針對新冠肺炎發表一些意見。

我們以前就討論過，這些彪悍的流感病毒，經過那麼多年、那麼多次的變種（mutation），每年都不一樣，東漢時期傳下來的經典中醫，根本沒有遇到過現在的病毒，怎麼可能治療如此嚴重的肺炎呢？

中醫從來就不認識病毒，也不從病毒種類的角度來思考。中醫是探討人體受到外界因素破壞，失去平衡後，身體會有哪些現象、哪些反應，根據那些現象、那些反應來調整身體狀況，期待身體能恢復到平衡狀態，把外界因素帶來的破壞減到最小。我打個半開玩笑的比方，警匪槍戰時，我們注意到壞人哪個方向來的火力強大，造成我們部署在哪個位置的警員傷亡，這時我們會趕緊重新部署人員，或者想辦法增派警力，我們大概無暇去管壞人是用哪個牌子的槍、哪個工廠做的子彈！

雖然幾百年幾千年下來，病毒變種等等的外界因素改變了非常多，人體演化的改變卻非常有限。人體的功能，無論是怎麼被破壞的，某項功能被破壞而導致的症狀、反應、後續演變，卻依然有明顯的脈絡可循。也因為如此，在很多情況下，中醫以專注人體本身平衡狀態的治療方式，反而比西醫專注在外來敵人的治療方式來得有效許多。

依據多年累積大量的臨床病例觀察，無論是禽流感、豬流感、還是每年的流感，人體敗壞的進程依然如同傷寒雜病論探討的一樣，非常簡化的說，從一般桂枝湯證、葛根湯證等的表寒，轉變到小青龍湯證等的裡寒，津液不足、水道運化失調而化熱，變成比較嚴重的大青龍湯證，或者更嚴重肺臟的寒熱夾雜，金匮要略肺痿肺癰咳嗽上氣病脈證治第七篇中的射干麻黃證、葶藶大棗瀉肺湯證、澤漆湯證、小青龍加石膏湯證等等混雜出現，搞得亂七八糟，也不再是什麼簡單方劑可以對應的。

然而，雖然進程很像，不同於一般外感的是，這些嚴重流感肺炎病情加重的改變速度快非常多，也來得猛烈頑強很多。一般的外感從桂枝湯證、葛根湯證等轉變到大青龍湯證或更複雜的病情，通常需要一兩週的時間。同時，還得病人自己非常不注意，或者醫生治療錯誤，一般感冒才會沒辦法自己好，反而變成嚴重的病症。這幾年的流感，從一開始覺得不太對勁，到嚴重複雜的病情，只需要三四天，而且有越來越快的趨勢。這大幅提高中醫師治療流感時，判斷功力及敏感度的要求，中醫師必須在許多症狀還沒有出現時，就得抓緊時間，趕緊行動，卻又不能預防過度，反而讓病情加重。換句話說，時機、劑量、藥材比例變得非常重要，稍有不慎，就無法反轉病情。

舉個例子，有些病人得了流感，咳嗽非常嚴重，痰非常多，呼吸困難。依照中醫的辨證，假如一致都是寒，舌苔白、小便清、怕冷等等，本來依照辨證論治，我們可能會開射干麻黃湯加減給病人。然而，因為流感的進程非常快速，中醫師得非常敏感，譬如看到舌苔白卻帶有一絲絲乾的感覺，就很可能得加上大寒的石膏來避免肺喪失津液，卻又不能加太多石膏，以免肺寒加重。又譬如聽到咳嗽聲音非常深沈，從肺的底部發出，又帶有膿痰的濁音，就很可能得加上瀉肺的葶藶來避免肺中水飲、痰飲大幅增加，卻又不能加太多葶藶，以免肺變得太虛弱。

我們回頭來看這次的新冠肺炎。根據有限的資訊，我們知道感染後有大約兩週的潛伏期，這段時間沒有什麼症狀，病人可能只會感到有些疲憊。剛開始發病時，很像一般的感冒，病人會發熱、乏力，並不嚴重，沒有什麼流鼻涕等上呼吸道的症狀，有的甚至沒有發熱。約一半的病人一週多後恢復，另一半的病人卻在一週後出現呼吸困難，有些病人會快速進展為急性呼吸窘迫綜合征、膿毒症休克、代謝性酸中毒、凝血功能障礙等等嚴重的問題，可能導致死亡。

從上面的敘述，我們不難發現，一開始很像一般中醫外感的桂枝湯證、葛根湯證，一半的病人也就自己恢復了，另一半的病人卻出現快速的入裡化熱現象，肺津液迅速流失，非常濃稠的痰飲沈積在肺部下方。同時，中醫認為肺為人體調節津液的源頭，肺金生水，好比天空下雨一般，而當肺的功能及津液調節出現嚴重障礙，很快就會拖累三焦水道、腎臟等的功能，導致上面提到的幾種嚴重病情。換句話說，新冠肺炎可以讓輕微的太陽證外感，迅速發展成嚴重的肺痿肺癰，再進一步瓦解人體其它功能的運作。

怎麼治療？在沒有直接治療武漢肺炎病人的情況下，我們也只能根據有限的資訊來推論，不過，以前大量的流感肺炎治療病例，可以讓我們比較有信心的面對新冠肺炎。當病人已經出現明顯新冠肺炎症狀時，大多已經入裡化熱，嚴重的肺痿肺癰。這個時候，得用大劑量的石膏清肺熱、加強肺津液運作。也得靠葶藶、大戟等把肺下方濃稠的痰飲及胸腔可能的積液去掉，痰飲積液不去，是無法修復肺家津液運作的。同時，肺氣不宣，就好像吸管上頭堵住了，吸管內的水無法上下，我們還得使用麻黃等宣肺、發陽的中藥來配合。另外，肺已經受損了，除了大動作急救外，比較穩定後，還得靠一些潤肺的藥來收尾，讓肺完全恢復。如果我們列一個可能加入的中藥單，大致有石膏、葶藶子、大戟、生半夏、麻黃、射干、紫菀 、款冬花、 生薑、炙甘草、紅棗、麥門冬、杏仁等等。當然，如前面所言，用藥的時機、劑量、藥材比例非常重要，每一個病人的差異也很大，嚴格考驗中醫師的功力與膽識，一旦判斷錯誤，不但沒有效果，反而可能會加重病情。

網上有些中醫師，說新冠肺炎或其它流感肺炎可以用板藍根清熱解毒來治好。也有些中醫師說可以用麥門冬湯等等的輕劑治好嚴重的肺炎。甚至還有些中醫師說多喝綠豆湯可以預防新冠肺炎！其實，真的遇過、治好過禽流感、豬流感等嚴重流感肺炎的中醫師，一看這些文章，就幾乎可以確定這些人根本沒有治療過嚴重肺炎的經驗，充其量只是在西醫治療下，在旁邊幫幫病人一些小忙而已。這樣的情況下，難怪中國政府平時大力推展中醫，真的有如同新冠肺炎這樣重大疫情爆發時，卻看不到中國政府大量使用中醫方法來治療病人、控制疫情。醫學是實戰的學問，沒有大量臨床病例，講得再好聽都是沒有用的，如果希望中醫真的在主流醫學裡站立起來，希望中醫真的能面對大規模的疫情，回歸最基本的臨床療效，才是最重要的，其它都只像是武術表演，而非實際作戰。

From SARS to Novel Coronavirus (COVID-19)

Written in Chinese by Dr. Andy Lee, January 21, 2020
Translated to English by Dr. James Yeh and Dr. Andy Lee, March 28, 2020

The epidemic from Novel Coronavirus is becoming much more serious. Transmissivity among people has been proven. (Note: It's now named COVID–19. The term “Coronavirus” will be used here.) Cases were found in areas beyond Wuhan. It has caused serious attentions from the WHO (World Health Organization) and many countries around the world. The residents in China and the surrounding regions are quite worried and wonder whether it will break out like SARS (2003). (Note: The article was written on January 21, 2020, before Coronavirus became a global pandemic.)

So far, the modern medical field has not found a cure for Coronavirus, but resorts to treating patients’ symptoms only. Any vaccine to treat Coronavirus is still no way in the sight. What do we do? Every time such a situation happens, the topic of using Traditional Chinese Medicine (TCM) is raised (at least among the Chinese communities). There is no exception this time. Many articles related to using TCM on Coronavirus have been popping up on the web. However, unless some TCM doctors who have actually treated many Coronavirus cases, all the discussion would be hypotheses or assumptions. Some hypotheses are worth considering while many others could be quite misleading.

Personally I have not treated patients cases related to Coronavirus. (Note: Shortly after this writing, the author has directly and indirectly participated in treating patients of Coronavirus successfully, and has published other later blogs which included his involvement in treating those patients. Please refer to his medical blog http://www.DrLee.us.) However, I did treat and cure patients inflicted by other viruses in the past, such as the Bird Flu, Swine Flu, and other influenza. A good amount of those patients were diagnosed as severe pneumonia by large hospitals and were required for isolation or self-quarantine. Hence many of patients and online medical forums online are asking for my opinions about Coronavirus.

As we discussed before, all these viruses from the outbreaks are either newly found or mutated from previous strands. The strand can be different every year. Therefore, people always ask how one can say that the TCM knowledge developed in East Han Dynasty (25-220 AD) would be any useful for treating the modern diseases, let alone the severe ones.

It turns out that TCM does not recognize any virus and does not deal with the concept of which type of virus is microscopically at work. TCM looks at how human bodies would become out-of-balance and react to external stimuli. Once the body is out of balance, what symptoms will exhibit and what reactions will be to adjust the body conditions to regain the balance, hence to reduce the damage to the body to the minimum. Let me take an example to illustrate: when there is a gunfight between the police and bandits, we want to see which direction the shots are coming from, causing casualties of the police force, so that we are able to adjust or reinforce the police power. We have no time to think about which brand of the guns or bullets the bandits use.

Over thousands of years, the external viruses have changed and evolved quite a bit, but the evolution of human beings was quite limited. The human body function, no matter how it was damaged, the symptoms due to the damage of the function, the reactions, and the following progression of the disease still follow certain paths. For this very reason, TCM’s focus on the balance of the human body often surpasses the effectiveness of Western medicine, which focuses more on external treats and the microscopic aspect of how human body’s cells are impacted by the external treats.

From the accumulation of many years of clinical treatment and observations, no matter it is Bird Flu, Swine Flu or other influenza, the bodily ‘damage’ and its progression by the viral attack still follow the description of the classic TCM literature “Treatise on Cold Damage on Miscellaneous Disease” (傷寒雜病論). In short summary, the disease usually starts with “Exterior Deficiency or Weakness” (表虛) or “External Coldness” (表寒), for which is matched to one of the several syndromes named with the corresponding herbal remedies such as “Gui Zhi Tang” (桂枝湯) and “Ge Geng Tang” (葛根湯). Then, the disease moves onto the next stage “Interior Coldness” (裡寒) or “Lung Coldness” (肺寒), which shows the syndromes named as “Xiao Qing Long Tang” (小青龍湯), etc. When the respiratory system is “affected by the coldness”, the body fluid function of the respiratory system gets affected. The circulation function of the lung becomes “Dry and Overheated” (燥热). This would lead to a more serious stage “Heated Interior” (入裡化熱) and would often be matched to its herbal remedy “Da Qing Long Tang” (大青龍湯). Or, even worse, it becomes so-called “mixed coldness and heat” (寒熱夾雜) in the lung. Such a complex situation was extensively discussed in Chapter 7 of the classic literature “Synopsis of Prescriptions of the Golden Chamber” (金匮要略肺痿肺癰咳嗽上氣病脈證治第七篇). At this complex stage, the illness development varies significantly among patients of different preconditions and other variants. It is no longer the situation that a simple herbal remedy can be applied to all the situations. The TCM theory illustrates various treatments by those herbal remedies such as “She Gan Ma Hung Tang” (射干麻黃湯), “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), ”Ze Qi Tang” (澤漆湯), “Xiao Qing Long Jia Shi Gao Tang” (小青龍加石膏湯), and others.

However, even the disease progressions are similar, the more serious viral attacks like Coronavirus can and often do progress much faster with more severe consequences than the common flu. As described in the previous paragraph, normally the disease progression of the “External Coldness” stage to the more serious “Heated Interior” stage usually takes one to two weeks. It is also often due to the ignorance of the patient or misdiagnosis and treatment of the doctor, which prevents the patient from recovering from this “catching a cold”. In the recent several years though, the time period between the time that the patient did not feel well and the time that the patient is in a serious and complex situation can be as short as 3 to 4 days. We also see the trend that this period gets shorter and shorter. In other words, the disease progression is getting much faster. This phenomenon poses a much higher demand on TCM doctors’ ability to make a quick and proper judgment and sensitivity to the subject matter. TCM doctors must intercept the disease progression before it reaches to a more serious stage, even without obvious symptoms of the next stage. TCM doctors have to timely prescribe the proper herbal remedy in terms of the type of herbs and relative dosages of herbs. Too weak a dosage could not stop the progression while too strong a dosage could worsen the condition also. A misjudgment would not be able the turn the conditions around, but hurt the patient more.

The above can be illustrated by a simple example. A patient caught flu and has symptoms such as heavy coughing, lots of sputum, and difficulty in breathing. From the TCM dialectics, with observations of white tongue coating, clear urine, and feeling chilly, etc., it is clearly caused by “Coldness”. Such a patient typically should be prescribed with “She Gan Ma Hung Tang” (射干麻黃湯) or its variations. However, due to the fast progression of the modern flu, the TCM doctor would need to pay attention to much subtle details such as the dryness of the tongue although it still shows the white coating. In this case, Sheng Shi Gao (Gypsum, 生石膏) might need to be added to the herbal remedy to make sure that the lung would not suffer dryness. Given that Sheng Shi Gao (Gypsum, 生石膏) itself is an ingredicient that is “very cold” in nature, the dosage could not be too strong to make the lung too chilly. At the opposite end of the spectrum, if the sound of the coughing is very ‘deep’, like dense sputum coming from the bottom of the lung, the herbal remedy might need to add Ting Li (Sisymbrium indicum, 葶藶) to clear up the lung to avoid too much mucus in the lung. And again, the dosage of葶藶 could not be too much to weaken the lung. (Note: Handling the proper timing and proper remedy can be a real test to the ability and experience of the TCM doctor.)

Let’s go back to the discussion on Coronavirus. From the limited information available so far, we know that there are about two weeks of incubation period after the infection. There are little symptoms during this period and the patient may just feel more tired than usual. More obvious symptoms will start like those of common flu with fever, fatigue but not too serious. Upper respiratory symptoms like running nose are less common. Some patients may not even exhibit fever. About half of the patients infected will recover over a week or so. The other half of the patients will experience difficulty in breathing, or rapid progression to acute respiratory distress syndrome, septic shock, metabolic acidosis, coagulopathy, etc. Some patients had died due to these severe conditions.

From the above description, this Coronavirus, in the beginning, is very much like the common flu and will stay in stages of “Exterior Deficiency or Weakness” (表虛) or “External Coldness” (表寒). Half of the patients infected will recover by themselves as in common cold. The other half of the patients may exhibit situations of rapid penetration into inner organs and excess ‘heat’, which causes loss of fluidity of respiratory system and accumulation of dense sputum at the lower part of the lung. In the TCM theory, the lung serves as the initial “gating factor” of body fluids. When the lung fails to serve the proper function, other organs like the kidney will be adversely affected also. In other words, Coronavirus can turn a light “External Coldness” to extremely severe “Lung Atrophy” (肺痿) and “Lung Abscess” (肺癰), which in turn will impair the function of other organs.

How to treat? Without direct experience of treating Coronavirus patients, we can only postulate from our limited information available in hand. (Note: Shortly after this writing, the author has directly and indirectly participated in treating patients of Coronavirus successfully. The treatments were exactly as outlined in this article.) From the ample experience of dealing pneumonia cases caused by flu, we are confident that we can also treat Coronavirus successfully. When patients are showing the obvious Coronavirus symptoms, most of them would have entered the stage of “Heated Interior” (入裡化熱) with “Lung Atrophy” (肺痿) or “Lung Abscess” (肺癰) to a certain degree. At this stage, we will need large dosages of Sheng Shi Gao (Gypsum, 生石膏) to clear the heat to ensure the proper fluidity function of the lung. Also, we will rely on Ting Li (Sisymbrium indicum, 葶藶), Da Ji (Euphorbia pekinensis Rupr., 大戟), etc. to clear up the dense mucus at the lower part of the lung and to remove the edema of the chest chamber. Without getting rid of the excess mucus and fluid, the lung cannot properly function. We need to use Ma Huang (Ephedra sinica Stapf., 麻黃), etc. to enhance the lung function (宣肺、發陽) and restore proper breathing. When the lung is damaged as in fibrosis, after the conditions stabilize, we need to “moisturize” the lung (润肺) to help the lung to recover fully. In other words, we will most likely use the herbal ingredients such as Sheng Shi Gao (Gypsum, 生石膏), Ting Li (Sisymbrium indicum, 葶藶), Da Ji (Euphorbia pekinensis Rupr., 大戟), Sheng Ban Xia (Pinellia ternate, 生半夏), Ma Huang (Ephedra sinica Stapf., 麻黃), She Gan (Belamcanda chinensis, 射干), Zi Wan (Aster tataricus, 紫菀), Kuan Dong Hua (Tussilago farfara flower, 款冬花), Sheng Jiang (Ginger, 生薑), Zhi Gan Cao (processed Glycyrrhiza uralensis Fisch., 炙甘草), Hong Zao (Ziziphus jujube, 紅棗), Mai Men Dong (Ophiopogon japonicas, 麥門冬), Xing Ren (Prunus armeniaca, 杏仁), and others. As we discussed in previous paragraphs, the timing, dosage, the relative ratios of different herbal ingredients are very critical. Given that there are quite some variations in patient conditions, the challenges on TCM doctors’ comprehensive knowledge, judgment and courage are unprecedented.

In those articles online, some TCM doctors claimed that Coronavirus can be cured by Ban Lan Gen (Isatis tinctoria root, 板藍根), which is believed to have natural antibiotic chemicals to “clear up the heat and toxics”. Some TCM doctors suggested using a simple mild herbal remedy “Mai Men Dong Tang” (麥門冬湯), which mainly relies on the ingredient Mai Men Dong (Ophiopogon japonicas, 麥門冬). Some people even suggested that having the green bean soup could prevent Coronavirus. In fact, those TCM doctors who have good experience of treating Bird Flu, Swine Flu, and pneumonia caused by other influenza would know that the people making those claims never had the real experience of treating severe pneumonia. They at most helped in a minor way the patients under Western medicine treatments. Under such conditions, it is not a surprise that the China government has not used TCM as the primary method of treating Coronavirus, despite its big promotion of TCM in the recent years. (Note: After this writing, Coronavirus epidemic became so severe in China that the China government changed its strategy and started to use TCM extensively in treating many mild Coronaviurs cases.)

Medicine is the science based on real treatment results. Without a good amount of successful cases in clinical treatments, it is useless to promote any fancy idea of treating patients. If we would like TCM to be respected in the mainstream medicine and to be meaningfully used in a severe epidemic like Coronavirus, it is critical to focus on the most fundamental. That’s the clinical results. Like the martial arts, unless you can fight off the bad guys, it’s just a show of fancy movements.

（http://andylee.pro/wp/?p=7169）
#當張仲景遇上史丹佛

冰冷飲食 – 養兒育女必須知道的21件中醫知識（9）

好久沒有寫這個系列的文章了，一方面事情忙，另一方面一直有其它想先討論的題材蹦出來，雖然那些題材也多多少少和養兒育女有些關係，但總好像把這個系列給忘掉了似的，實在不好意思。

每隔一陣子，網路上就會掀起筆戰，西醫為主的一派會説冰冷飲食對身體沒有壞處，中醫為主的另一派會説冰冷飲食對身體有深遠的影響。主張冰冷飲食沒有壞處的一方，會強調「沒有科學證據」，主張冰冷飲食有壞處的一方，會強調「中醫所謂的寒」。我本來不想參與這樣的討論，畢竟我自己是中醫，而會來看我文章的讀者，也大多偏向中醫，那我的結論是什麼，不用想都猜得到。不過，既然這個問題對養兒育女有很大的影響，也有不少讀者來問我，我們就來討論吧。

首先，我們先探討一下所謂的「沒有科學證據」。這樣的說詞常常被拿來做為辯論的邏輯，把「沒有科學證據」當成「就是錯的」一樣，真的嗎？所謂科學證據，那得先要有人想到這個問題，願意去花時間、花精力、花錢去研究，如果在西方醫學發展的過程中沒有強調「寒熱」的觀念，那麼又怎麼會有大量相關的臨床研究？然而，真的沒有西醫方面對這個問題的研究嗎？其實，早在1970年代就已經有些粗淺的研究，譬如1978年有一篇「Effects of drinking hot water, cold water, and chicken soup on nasal mucus velocity and nasal airflow resistance（飲用熱水、冷水、和雞湯對鼻粘液速度及鼻氣流阻力的影響）」的論文，在美國國家醫學中心資料庫中可以找到：https://www.ncbi.nlm.nih.gov/pubmed/359266。這個研究指出，飲用冷水會使鼻粘膜變厚，讓空氣更難通過呼吸道，而相比之下，喝熱水或雞湯可以讓鼻粘膜變薄，幫助人們輕鬆地呼吸，因此建議在感冒期間不要喝冷水，免得讓鼻塞更嚴重。很有意思吧，竟然有人做這樣的研究，而這其實和中醫所謂的「寒濕」不約而同，濕在鼻腔，當然就鼻塞嚴重了，而還有其它許多可以引用的醫學研究，我們就不一一討論。所以，不是「沒有科學證據」，而是這方面的研究和其它如基因工程等熱門題材相比，確實少了很多，但是，真的認真去找，還是可以找到許多「科學證據」。當然，這並不是説我們可以用有沒有科學證據來完全斷定一件事情的正確與否，很多時候那只能代表研究的熱門方向，以及贊助方是不是有利可圖。

那「冰冷飲食」到底對人體有什麼影響？「冰冷飲食」分為兩類，一類是「溫度冷」，另一類是「性質冷」。「溫度冷」比較容易了解，譬如冰水，水對人體很重要，也沒什麼特別的偏性，所以水本身不是問題，而是冰水的溫度太低的問題。這樣冰冷的東西進入了腸胃道，需要損耗掉人體許多的能量來把腸胃道溫度調整回來，以中醫的說法是短暫地損耗胃氣、損耗心臟移轉到小腸的熱。如果你身體強健、胃氣十足，這樣的損耗或許沒什麼大不了，休息休息就可以恢復，但是，如果你不是那麼的身強體壯，或者如果你長時期如此損耗你的身體，那麼你的胃氣就會大幅下降，小腸的溫度不足，由小腸負責加溫的中下焦器官也就開始功能下降，導致許多可能的健康問題，譬如子宮寒冷而有肌瘤，或者攝護腺寒冷而肥大等等。

有人會問，這樣對冰水負面評價的說法，似乎只在華人的文化裡，許多外國人，尤其是美國人，特別喜歡喝冰水，為什麼他們沒有那麼多的健康問題？其實，這是一個誤解。一般的美國人，確實每天喝許多冷飲，三餐還配上加滿冰塊的水，然而，一般的美國人普遍嚴重肥胖，同時衰老的很快，許多美國人你以為七老八十了，其實可能還比你年輕。另一方面，真正重視體能的美國人，是很小心飲食的。我是國際潛水協會PADI認證的Divemaster，熱衷於攀岩，也有許多奧林匹克運動員等級的朋友及病人，在這些積極運動的圈子裡，很少人吃垃圾食物，很少人沒事在外面吹冷風，也越來越多人開始避免喝冰水，因為他們自己的身體可以體會到，少損耗一分體能，就多一分體能表現在運動上。如果這樣解釋你還是不能理解，那麼我們來做一個簡單的實驗，你去泡一個很熱很熱的熱水澡，在泡澡的同時，喝很冰很冰的冰水，看看你有什麼感受。不管你多麼身強體壯，我保證你馬上能感受到胃不舒服、整個人不對勁。這不是很奇怪嗎？明明身體泡得熱呼呼的，喝冰水來降溫，應該很舒服才對，為什麼反而會不舒服呢？因為不管你多麼身強體壯、胃氣多麼強，當身體泡在很熱很熱的熱水澡裡，大量的陽氣會往體表走，發散出去，這個時候護守胃及其它內臟的陽氣會大幅減少，在這樣的情況下喝下很冰很冰的冰水，你自然就很能體會到寒涼傷胃的感覺。這也是為什麼老一輩的人會説「夏天吃薑」，因為夏天熱，陽氣發散在外，護守中下焦的陽氣少，適當吃一些薑，可以避免夏天冷飲冷食對胃的影響。

另一類的「冰冷飲食」是「性質冷」，西方醫學在這方面的研究偏向特定化學成分對身體的影響，對食物或草藥的「寒熱」研究就更少了，因為除非是如附子、石膏等大熱大寒的中藥材，一般食物的寒熱對身體的影響，不是短時間能反應出來的。而也因為「性質冷」對身體的影響，不像「溫度冷」那麼快能表現出來，一般而言，如果吃不多，加上平時注意其它飲食的配合，問題可能不大。然而，如果長時間吃「性質冷」的食物，並不能像「溫度冷」那樣，單單依靠身強體壯、胃氣強來化解，它的影響反而是比較長久深遠的，特別是寒濕的長年累積，非常不容易改善。譬如感冒了，許多人買感冒糖漿來服用，或者中國大陸流行喝板藍根沖劑，説板藍根可以清熱、解毒、消炎，結果咽喉不適好像好了一些，身體卻變得更寒了，下一次感冒季節，這些人一定不缺席。

回到養兒育女中醫知識的主題，現在的生活裡，有太多太多「冰冷飲食」的誘惑，冰水、珍珠奶茶、冰淇淋、汽水等等，再加上許多連大人都誤以為對人體好處多多的生鮮蔬果汁、生菜沙拉等等，小孩子很容易被誤導到不健康的飲食習慣，做父母的得趁早多花時間及精力來灌輸他們正確的觀念，在他們飲食習慣還沒有完全形成前，把他們導入正確的方向。當然，即使是垃圾食物等級的冰冷飲食，在日常生活中也不可能完全避免，畢竟連大人都會嘴饞，何況小孩子？所以，適當的「放水」，偶爾放寬、享受一下嘴饞的快感，並無傷大雅，只要小孩子知道「冰冷飲食」的壞處，知道適可而止，那麼做父母的也不需要每次都和小孩子吵到不行，破壞了親子關係。

（http://andylee.pro/wp/?p=5063）

【直線抽擊偽科學系列《七》】— 被餵狂犬病藥丸的小孩
————————————————————
文科生沒有勇氣和能力去改變香港社會，但仍然會盡我所有的知識和力量去為大家去除偽科學。今個星期連續追擊順勢療法，星期日會有彩蛋講文科生當年受害於另類療法的故事。記住留意啊！
————————————————————

在加拿大有位母親帶有行為問題的小孩去順勢療法。順勢療法的practitioner見小孩有睡眠困擾、相對暴力的傾向，便根據之前小孩被狗咬過的病歷去推測小孩是患上狂犬病（瘋狗症, rabies）。

“The child presented a perfect picture of rabies state” （小孩完美地呈現了狂犬病的狀況）

順勢療法的推廣人或practitioner又一次完美表演他們缺乏醫學知識和對病理學的認識。

———————背景資料———————

狂犬病(rabies)是一種透過傷口傳播Lyssavirus 病毒的病。雖然所有捕乳類都可以感染並傳染給人類，但環球大部分的感染都是由狗狗造成。

雖然最常見的傳播媒介是狗咬，但感染的狗狗的口水如果接觸到充滿mucus的地方例如眼、鼻和口一樣有感染的可能性。

Rabies是一種很有趣的病毒，他們會用axonal retrograde transmission從周邊神經傳送到大腦再引起感染。rabies最大的問題是只有當徵狀出現時才能確診，但當徵狀出現便是生活倒數之時。所以一般有病人懷疑被有狂犬病的狗咬的話，為安全起見都會立即打狂犬病抗體。
—————————————————————

狂犬病雖然會引起暴力傾向，aggressiveness, delirium，但只要徵狀出現後，生命是以日去倒數，大多會於2-10日內死亡。如果小孩真的患有狂犬病，你覺得他還有命去試順勢療法嗎？

更加荒謬的是，順勢療法的概念是以「能引起類似徵狀的化學物去治療該疾病」。順勢療法practitioner不單止靠想像力、連檢查都不做便去推斷小孩患上狂犬病，更以狂犬病狗隻的口水製成的藥丸去治療小孩。

順勢療法的另一個核心價值是把化學物的濃度無限稀釋、愈稀釋便愈有治療的效果。

常識告訴我們，化學物的效果是和濃度成正比。愈高濃度便能對人體的生理系統(physiological system)造成愈大的效果。

順勢療法的極度稀釋療劑其實同普通水係無分別。雖然無效，但興幸的是因爲極度稀釋的關係，狂犬病口水藥丸並沒有對小孩引起感染。

我們常常會聽到順勢療法的推廣者會把陰謀論掛在口中，說什麼是藥廠為了自身利益打壓㾾價的順勢療法，說什麼其實早在幾百年前已有文獻記載療法的效益，近年亦有大量文獻顯示其實際效果。

但當你叫他們拿證據出來時，往往只有以下情境

1. 瘋狂吹噓順勢療法有歷史支持，但到最後仍然係繼續吹緊，一篇論文都見唔到
2. 隨便google 幾篇有順勢療法在標題的論文，但其實無真係睇過篇文。否則會發現原來論文的結論是順勢療法效果等同安慰劑效果
3. 引用幾篇在順勢療法協會自己創立的刊物裡面登載的論文。而這刊物早被醫學界批評低水準，咁同強國自己整個獎牌和認證比自己有咩分別？

當你認真去睇所謂的協會創辦人，某某教授（自己幫自己整個教授title）的論文，你會發現成個methodology都出奇地怪異。完全比唔上一般經得起peer reviewed的文獻。

在資訊發達的今日，偽科學、假資訊隨處可見，科學普及教育更顯得異常重要。

當今日狂犬病狗隻口水被順勢療法用來治病時，明天會是齊來服食肺結核、HIV、甚至天花藥丸嗎？

追擊順勢療法真係好疲累，希望各讀者可以幫忙share，讓大家知道順勢療法的偽科學之處

#大學生FYP都寫得好過順勢療法論文
#某某「教授」你唔覺得好樣衰咩
#自己幫自己整個title
#強國式造假技術

Reference
https://globalnews.ca/…/rabid-dog-saliva-growling-boy-natu…/

Photo reference
http://dogsaholic.com/care/rabies-in-dogs.html
————————————————————————-
如果喜歡文科生的文章的話請慷慨給個讚和分享給身邊的朋友，讓文科生更有動力寫文啊啊啊

記住把文科生set做see first就可以時常睇到文科生的小故事啊