Exploring Novel Corona virus Pneumonia- A Wen Bing Epidemic Disease

By: Keren Zelicha

Coronavirus is an infectious disease related to warm epidemic disease (温疫) category in Chinese medicine and specifically to Damp plaque.

Beside the six excesses pathogens in TCM theory, (the Liu yin 六淫: Wind, Cold, Summer heat, Damp, Dryness and Fire), the Wen Bing theory also mentions toxic heat (温毒) and epidemic 疫疠 pathogens. These toxic pathogens can be spread around us quickly regardless which climate or season.

In Chinese medicine theory, Corona virus may be an epidemic evil pathogen that can be categorized as:

Li qi 戾气 (Perverse qi).

Yi li 疫疠 (Epidemic pestilence).

Li qi 疠气 (Pestilential qi).

Za qi 杂气 (Miscellaneous qi).

Du qi 毒气 (Toxic qi).

All are descriptions of highly contagious epidemic pathogens that can be transmitted through the mouth and nose or by direct contact.

The Yellow emperor (Su wen chapter 72) writes about epidemic disease [1]:

Yellow emperor said: I have heard that when the five types of epidemic disease attack, they are very contagious with similar symptoms observed on adults and children alike.

From this we can start to understand the nature of an epidemic evil qi, it spread out quickly and it attacks all ages. 

Along the history, China had to deal with many pandemic diseases. The classics of Chinese medicine reported different approaches to treat these kinds of epidemics.

In the Ming dynasty, Wu You Xing (1582- 1652) in his book “on warm epidemics” (温疫论), proposed a new etiology for epidemic febrile disease.

Wu You Xing wrote: 夫温疫之为病，非风非寒，非暑非湿，乃天地间别有一种异气所感

Meaning that warm epidemic diseases are not caused directly by climatic factors (not Wind/ Cold/ Summer heat/ Damp) acting out of their proper time or an excess condition. They are instead caused by Li qi 疠气 (harmful evil qi) or Za qi 杂气 (miscellaneous qi) which reside between “heaven and Earth”.

The nature of an epidemic disease will vary according to the nature of the specific miscellaneous evil qi.

The Li qi evils are invisible and shapeless. They are only noticeable by their effect within the body. They may attack at any season and they have a warm or hot nature. They can be received from “Heaven” or via a direct contagious contact. The harmful evils enter the body through the nose and mouth, and not through the skin or body hair as was assumed before Wu You Xing’s theory.

The evil qi, once it enters the body, it lodges at the “Mo yuan” 膜原 “membrane source” which is located between the inner and outer parts of the body.

The “Li qi” evil manifest in the body with the same signs and symptoms of the six excesses 六淫 (Liu Yin: Wind/ Cold/ Summer heat/ Damp/ Dryness/ Fire). They differ from the six excesses by their great violence and contagious power. They pass quickly and diffuse widely between people. They invade the body regardless of constitution, age or physical strength, all people can be infected. [2]

What are the characteristic of epidemic evils in Chinese medicine?

Li qi or miscellaneous evil qi are:

1. Unpredictable, invisible, contagious types of miscellaneous qi that passes quickly through nose and mouth and can even attack healthy people.
2. They are not brought by abnormal season or climatic excess (Liu yin excessive pathogens).
3. They can hide and attack the “source membranes” Mo Yuan which are located between the inner and outer parts of the body.
4. In the body they manifest and cause symptoms exactly the same as the six excesses (the Liu Yin) depending on their nature but with harsh acute expression.

Where is the Mo yuan “The Source Membrane”?

The concept of membrane system in the body was consisted of an: [3]

1. External system: Muscles and ligaments (经筋).
2. Internal system: The source membrane “Mo yuan” (膜原).

Both systems today belongs to the fascia- connective tissue.

In the book “on Warm epidemic disease” it was mention that:

“The evil qi enters the body through the nose and mouth, it lodges interior but not inside at the Zang Fu organs, nor outside at the Jing Lou meridians.

It is hidden interior to the spine, not far from the exterior, near the stomach; it is between the boundaries of the exterior and interior, half exterior half interior, where the Mo yuan is”.

We can understand that the Mo yuan- source membrane is located between organs, half exterior half interior, and in modern thinking we might relate it to the connective tissue or Fascia.

The triple warmer relationship with the “Mo Yuan” (Source membrane):

The Wen Bing theory, relates the San jiao triple warmer to the source membrane “Mo yuan”.

Triple warmer is half exterior half interior, including upper- lower, interior- exterior body parts. The Triple warmer covers various membrane layers and functions within the internal organs, inside and outside of the lumen (the inside space of a tubular structure) and between muscles and bones. It ensures free communication above and below, left and right, internally and externally. It offer a medium for communication the same as the connective tissue or Fascia.

Today, in modern thinking, the triple warmer functions can specifically refer to membrane of the large omentum, pleura, pleural cavity, diaphragm, including respiratory membrane, pericardium, gastrointestinal mucosa, glomerular filtration membrane and related peritoneum and even capillary tube wall membranes. [4]

The original function of the triple warmer on the Mo yuan is to regulate water passages and qi flow. This way the communication between upper and lower, interior and exterior parts of the body can be preserve. The Li qi pathogen after entering the body can attack the Mo Yuan- “Source membranes” that surround the body depending on their strength or weakness.

The novel Corona virus causing pneumonia is related in Chinese medicine to 疫病 – epidemic disease. It is transmitted out fast, spreads through droplets of saliva or nose discharges, attack the respiratory tracts and in sever cases might cause pneumonia and even death. The specific nature of the pathogen is damp plague, lodging into the Mo yuan membranes. According to the Wen Bing theory, the mo yuan is related to triple burner (San Jiao) functions. We can see the damage to the San jiao by observing the disease:  it includes damage to water- fluids passages and damage to the qi circulation. Both can lead to other pathological signs. The organs that are involve in  COVID-19 disease are: the upper Jiao- lungs- heart, middle Jiao – digestive system and in sever cases the lower Jiao kidney functions can be damaged.

What are the symptoms of Corona virus?

What is its Traditional Chinese Medicine pathophysiology?

Click here to read more about Chinese medicine understanding of novel corona virus

Related article:

Chinese Herbal Medicine Treatment Plan For Novel Coronavirus Pneumonia

Bibliography:

[1] A complete translation of Nei jing- Henry C. Lu

[2] Socio-Ecological Dimensions of Infectious Diseases in Southeast Asia – Serge Morand, Jean-Pierre Dujardin, Régine Lefait-Robin, Chamnarn Apiwathnasorn

[3] 基于“肺—三焦膜原—肾”理论对新型冠状病毒肺炎肺肾同损的认识与思考-董斐,柳红良，谷晓红

[4] ibid