Hi, I’m Virginia Doran, your host this week for To The Point, a show very generously produced by the American Acupuncture Council. We had another show scheduled for today, but considering the time that we’re living in right now with COVID-19, we decided to have another guest, and that is someone that many of you will be familiar with, Jake Fratkin. He’s going to talk about Chinese herbal treatment in different stages of the virus and various practical tips of products that are available from various sources. And he’s been an educator, an author in the field for decades, and practices out in Boulder, Colorado.
Many accomplishments, too many to list here, maybe he will enlighten us, or you can see on his website. And because there’s so much information to cover, I want to turn it right over to him. So, Jake, please inform us practitioners of your ideas for Chinese herbal treatment for this virus.
Okay, I’m ready to talk. Am I on? I’m on. You can hear me. Okay, so hi, everybody. I want to thank the American Acupuncture Council for inviting me. It was kind of short notice, but I’m happy to share the information that I’ve been pursuing about how to address the various stages of the virus with Chinese herbal formulas or herbal products. Now some of you out there do raw herb customizing or work with powders and do raw herb customizing, and so about the half the information or more is going to be directed to you, because you have the ability to customize formulas to patients at the various stages.
If you don’t customize formulas, you have two choices, one of them is to get herbal products that are already made and we’re going to talk about, or to ask one of the companies that does make formulas like Crane, and Lotus, and Mayway, that they’ll make the formulas up for you to give to your patients, so that’s one caveat there. We have a lot of groundwork to cover. I am certainly not going to go into detail, but the whole PowerPoint lecture that you’re going to see can be downloaded off my website. You’ll see it. If you go to my website you’ll see it in the lower right-hand corner, the way to download the lecture notes from this lecture. So that’s what we’re going to do.
And that’s called fratkin.com?
No, it’s at the end of the lecture, but it’s drjakefratkin.com.
D-R, no period. Okay, let’s get started.
And you know, we want to just remind our viewers if you don’t have Chinese herbal training then you shouldn’t be doing this. You will want to do everything in accordance with your license in the states where you live or licensed in. And we’re not curing, and we want to be very careful not to state or misinform our patients that we are curing.
Yeah. The COVID-19 virus is very patent-protected by the FDA. You can’t advertise that you’re treating COVID-19. You can’t mention the words, because they will go after you, so I’m just calling it toxic heat invasion and working at it from there. I don’t know if my PowerPoint’s up because on my screen I can’t see what’s exactly up. I don’t see my face yet.
They’re not up yet.
They’re not up yet. And is my face up on the screen, or no?
Allen says they are up, but I don’t see them yet.
Yeah, you have the yellow box around you, but I don’t. So I don’t know if my face-
He says we’re up.
So I want to get my face up. I want to get the PowerPoint up. So let me know when you see the PowerPoint, Virginia.
Do you see it? No.
No. Okay, let’s just start it now.
Allen, you see it, but we don’t.
Okay. In general, the worst is going to come starting in about two weeks. Some of you may be seeing corona patients right now. I am over the phone. Everything I’m doing is by phone, webinar, phone consultation, and then I’m working from the material to send people herbal products. Now the way I work is I combine herbal extract powders. I use extract powders, and when I make a formula I make 100 grams. So I never like to make a formula that has more than 10 or 12 ingredients in it, 12 would be my max just because in 100 gram mix, you just can’t get the strength of enough herbs if you go more than 10 or 12 herbs. In a decoction you can put in 20 or 30 herbs, they don’t care, you just add it to the pot.
Virginia, do you see my face or no?
You do? [inaudible 00:06:30].
He’s saying that the audience can see things that we can’t.
Okay. All right. So I’m working with 100 gram powders and the formulas that I’m going to show are very large, they’re huge formulas, 15, 20 herb formulas, so I really recommend that if you have training in Chinese herbs, don’t give the whole formula unless you’re going to do raw soup decoction, which most of you don’t do. If you’re going to do powder extractions, then you have to whittle down the suggested 15 herbs or so into 10 or 11 herbs or so. So that’s up to you. I would not go the full formulas that they’re recommending unless you’re doing raw herb. If you don’t do powders or custom, then you default to the products.
Now, we’re going to have some products to offer, they’re not going to be as strong as these other formulas. Virginia, do you see my PowerPoint up?
Okay, good. So these things come from two sources from China, one is Guidance for Coronavirus Disease. This is a wonderful, 140-page manual. It’s actually available on eLotus down here. I think they have a download so you can see the whole thing. Which if you’re a raw herb prescriber, there’s a lot of notes in there I’m not including, so you might want to get that document. The other document is what John Chen and Lori Hsu did, which is called, How COVID-19 is Currently Treated in China. So there’s two Chinese sources we’re working with here.
The first group is called Medical Observation Period. There’s been no lab confirmation of COVID. This is where people suspect, they have a couple symptoms, they’re not sure. So we divided those into two groups, not we, the Chinese. One is fatigue with GI upset, so there’ll be some diarrhea, there’ll be some abdominal cramping. There may or may not be fever. There’s fatigue. The formula of choice is Huo Xiang Zheng Qi Pian. These are, if you go to my book, this book which we’ll talk about, it has all the manufacturers of any formula, so it says Huo Xiang, it’ll name every manufacturer that makes it. Another phase will be-
Including American brands?
Yeah. It’s mostly, in this book there’s only GMP formulas.
It’s only products made, pretty much put together in America, or they’re GMP otherwise. So the other one is fatigue with fever. We can’t get any of these recommendations that they’re talking about, but they’re very similar to one of these three, Gan Mao Ling, Zhong Gan Ling, or Yin Qiao. If you are not familiar with those, my book will talk about them in detail. Now for what they call confirmed or highly suspected cases, they throughout, they have this foundation formula so I can’t see… yeah, it’s hard to see the ingredients there, hard to see the ingredients. Can we move the pictures over a little so-
No, we can see.
Oh, okay, okay. So the lung-clearing detox soup is kind of like a foundation formula that they will use in all cases, mild to severe, but this is too many herbs. You have to reduce them according to how much heat you see and how much dampness you see. So this is really going to be an interplay between heat, between dampness, and between toxic heat. So toxic heat are herbs that go after viruses, and regular heat is heat in the qi, so for example Shi Gao is used a lot to bring down fever. So in this stage there’ll be coughs, there’ll be maybe some dampness. And then, of course, kind of a foundation there, Xiao Chai Hu Tang. If you’re going to work with products, probably the best combo here is Xiao Chai Hu Tang, mixing it with something called San Ren Tang, and not a lot of people have San Ren Tang, so I think you can mix it with Huo Xiang Zheng Qi Pian, Xiao Chai Hu Tang and Huo Xiang.
But as you’ll see when I go back to my other references, you always want to give toxic heat herbs, so you can always use these Gan Mao Ling, Zhong Gan Lings as part of it. Yin Qiao’s not strong enough, but it’s helpful in other ways.
I just want to ask a question here. Some people are getting it or at least starting with more of a wind cold damp scenario.
Yeah. Yeah, yeah. We go into that.
Okay. So now in the early stage where it’s mild, there’s two presentations that I’ll show, cold dampness into the lungs, and the second one is damp heat into the lungs. So for cold damp they’re using this formula. Again, if you’re making it, really reduce it. You can’t put all these into a 100 gram bottle, there’s no way. They recommend Ephedra in all these cases, Ma Huang, which we cannot get in this country, so I’m substituting Cinnamomum, Gui Zhi, instead. This will reduce heat, it’ll dispel wind, and it will clear damp, so it’s a good general formula, cold dampness affecting the lungs. There’s maybe slight fever, it’s not real bad. There’s some cough, the chest is tight. The key symptom is nausea, nausea. So if there’s nausea, we think that there’s a damp accumulation and the stomach qi is not descending, so this formula addresses that.
If you’re going to do it with product, you use Huo Xiang Zheng Qi with something called Jing Fang Bai Du, which is in my book. For the heat stage, still the difference isn’t the fever, but now their body’s very achy. You have headache, you’re achy. There’s a dry cough, maybe a sore throat. The mouth is dry, the chest is tight, again, nausea. The stools could be loose or constipated. So this one is more cooling with herbs like Huang Qin and Lian Qiao, Qing Hao, Ban Lan Gen. So now we’re really starting to address the heat toxins, the viral toxins, Isatis, Ban Lan Gen, Forsythia, Lian Qiao, plus you also have a Xiao Chai Hu Tang basis in there with Chai Hu Huang Qin. For products, can use Xiao Chai Hu Tang with either Gan Mao Ling or Zhong Gan Ling for that stage. This is early, still considered an early stage.
In the general stage, now this is the bigger stage, it’s not hospital-level, but this is where people are sick. So this stage is called damp toxin, stagnating the lung. The fever is now starting to go up. The cough is getting more. There’s difficulty breathing. The abdomen is uncomfortable. The tongue will probably start to be more red with a slight yellow coat, but not always. Tongue doesn’t always, tongue confirms, but it doesn’t rule out. If the tongue is not red or not greasy it doesn’t mean they don’t have this, it just means it hasn’t shown on the tongue yet, so don’t require the tongue to confirm. But if it does confirm, then more power to you. The pulse is more rapid and slippery due to heat. Again, they’re using Ma Huang, again I’m substituting.
Now we’re addressing cough with Xing Ren and getting heat out of the lungs, Shi Gao, so there’s still an attention to dampness. If you have to go with products, you want to use Huo Xiang Zheng Qi, but now we’re going to use Qing Zao Jiu Fei, or things like that. I’ll talk about this stage a little bit in a minute. Cold dampness, no fever or very low fever, but again you have this cough and chest tightness and nausea. But the tongue is not red, the pulse is not rapid. And we give this, which is much more addressing cold and dampness, and again here we can use Ban Xia Hou Po Tang with Ge Gen Tang or Gui Zhi Tang. Ge Gen Tang and Gui Zhi Tang will push out the wind cold, Ban Xia Hou Po will neutralize the phlegm and dampness.
All these are on these notes which you can download from my website. Now when it gets really severe, this is the stage people want to go to the hospital. In two or three or four weeks, the hospitals are not going to take everybody. There’s going to be someone at the door saying, “Okay, you, not you.” It’s because they don’t have the beds. They don’t have the beds. Here the fever is high. This is the lung blocked by epidemic toxin. This is where the viral toxin really cranks, and this is usually seven days after their first symptom, after their first symptom of feeling fatigue and achy. After about seven days it’ll crank, and you’ll get a high fever with redness, a harsh cough because the heat now is going into the lung.
There may be some sticky phlegm, there may not. Very hard to breathe, painful to breathe. Dry mouth, there may be damp symptoms such as nausea. Now a lot of these Chinese formulas come out of Wuhan and Hubei, very damp place. Now if you live in the East Coast, that’s going to relate to you. I live in a very dry area in Colorado. We don’t see that much, we just don’t see that much dampness, but here they’re very sick. Now we have high fever, harsh cough. This is the recommended formula. They’re still trying to get rid of wind cold with Ma Huang and Xing Ren, but they’re moving again to Shi Gao. It’s a very similar formula. If there’s constipation, you work with the Da Huang, and here we can use Chai Ge Jie Ji Tang combined with Bai Hu Tang and Liang Ge San.
I talk about who has these products later. Flaring heat in the qi and yin is beyond just the lungs, this is very high fever. People will be trying to get into the hospital, but there are going to be people turned away from the hospital, and this kind of has a Bai Hu Tang foundation, Shi Gao, Zhi Mu. They’re using Shui Niu Jiao, which you’ll only get if you’re a raw herb herbalist. I think you can get this by powder form. Okay. They have cooling herbs, Xuan Shen, Lian Qiao, and Huang Lian, Lophatherum and Zhu Ye will bring down systemic heat. So if you have fever, this Zhu Ye is an important herb and Shi Gao is an important herb. You’ll see on the raw herbs that they’ll be going 30 to 60 grams in a decoction. That’s a lot. That’s a lot.
We’ll never approximate that in a extract powder, you’ll never get that much. But I would, on an extract powder, do at least 12 grams of Shi Gao. Here we would use Bai Hu Tang with either Gan Mao Ling or Zhong Gan Ling or one of the other anti-viral formulas that I’m going to talk about.
Critical stage, you’re not going to see this. This is where they’ve collapsed, they’ve collapsed. They’re not going to survive without a ventilator. The TCM people are recommending the combination of Ren Shen and Fu Zi for collapsed yang and qi, Shan Zhu Yu to bring it into the body. You won’t be seeing these patients. They’ll be in the hospital or dead.
Now my recommendations for illness with fever, you want to use heat toxin herbs. You want to use Wu Wei Xiao Du, and here’s the availability. This is everybody that carries that product. This is how my yellow book is organized. I’ll take a formula, I’ll say, who’s got it? So an asterisk means it’s based on, it’s a variation on a theme. Chuan Xin Lian is very good anti-viral, it’s a three-herb combo of Isatis, Ban Lan Gen, and Andrographis, Chuan Xin Lian and Tara Xacum, Pu Gong Ying. These are all the people that have it. Gan Mao Ling, here’s who has it. Zhong Gan Ling, here’s who has it. But there are a lot of products that are in my book that people don’t know about. All of these are anti-viral, all of these products.
I put asterisks in the ones that I think are stronger and more appropriate. Okay, Seven Forest has a lot of these products. They have Patrinia 7, Paris 7, so on. But all these companies, and then Golden Flower has Viola Clear Fire, it’s a great, great product. But all these are good, and they’re just heat toxin herbs, so you add this into what you’re doing. Let’s say you’re on a Huo Xiang stage, but you want to get the heat toxins, the virus, you really have to default to one of those or one of these. Those are very important to combine heat toxin herbs with the more classical formulas.
Lung fire, this is a painful, barking, dry, harsh cough. Qing Zao Jiu Fei is helpful, Huang Lian Shang Qing is helpful, and Qing Fei Yi Huo is very helpful. American-made products, Seven Forest has two products, Bellamcanda 15 and Stemona, they’re very good for heat. I have a product called SVP Lung. It’s good, it sort of like medium. And then here’s the codes, if I said GC it means Guang Ci Tang, if I said GF, it means Golden Flower, so on. These products can be found at Crane, Golden Needle will have them, other distributors will have all of them. But-
And what are you hearing about availability with the demand?
Don’t know. It’s not yet running out, but it will be. That’s why if you have a raw herb pharmacy or extract granule pharmacy, you can work with that. I had trouble getting some extract granules from my supplier so I went to another supplier and was able to get what I wanted. You can either stock up, or you’re going to reach a point where you’re just out of herbs. eLotus, that’s John Chen’s and Tina Chen’s group, Evergreen, they translated numerous articles from China for treating COVID-19. This is that link, or you just go to their website, eLotus.
And they have a wonderful hour and a half free presentation about it, when-
Oh, yeah. Yeah, yeah. So this sums up their information. So they took a document called How COVID-19 is Currently Treated in China, they translated it. They divided that into four phases, prevention, influenza, pneumonia, and recovery. So I’m just summing up their stuff here because they give a lot more detail, but pneumonia prevention number one, they had this formula. Influenza phase, they said patent medicine you can combine Ge Gen Tang or Chai Ge Jie Ji Tang. I would combine it with one of the anti-viral formulas based around Gan Mao Ling. Flu formula number one with headache, with dry throat. These are not strong enough in my mind. They’re good, but I would combine them with a strong heat toxin formula that we just talked about.
Then toxic heat attacks the lungs, they give a recommended formula. This is a good formula, I like this formula. Damp cold in the lung, it’s not going to be acute. I mean, it might be. It’s a difficult differentiation here, because when they’re feverish, you think everything is heat, but here there’s more of the damp side, the distension, nausea, diarrhea. Remember in China, they have a lot more damp presentations than they have in most places in America, but that’s their recommended formula. With this again, you could default to Huo Xiang Zheng Qi or Ban Xia Hou Po Tang.
I understand that the testing of people’s lungs who had severe cases of it, they found like thick, rubbery, congealed phlegm blocking the airways. So yeah, phlegm is really important to treat.
Pneumonia phase, this is a special phase. It’s kind of a Shaoyang stage with accumulation of damp. Herbal formulas you can use are Xiao Chai Hu Tang, San Ren Tang, or Gan Lu Xiao Du. Pneumonia phase, again it’s Xiao Chai Hu Tang with some, it’s sort of like what you see up here but in a customized formula. Finally, damp heat, another pneumonia formula. You download this, print it out, keep this as your reference. Now these are smaller formulas, so you can just make this just like it is, changing these doses here for soup. You have to adjust that for 100 gram bottle if that’s what you’re doing.
Toxic stagnation, this is where there’s a lot of fever, here’s the formula. You’ll have to look at it and look at it closely. This is the end-stage abandonment. You won’t see this, this is definitely in the hospital or dying. These patent medicines you cannot get anymore in the United States. I had them in my original patent medicine book, An Gong Niu Huang and Zi Xue San for fever that’s killing you. And you can get them in Chinatown, but you’re not going to get them from any of the GMP-type distributors.
This last phase is just collapse. It’s ginseng Ren Shen and Aconiti Fu Zi. There is a recovery phase, and they’re basically recommending Sha Shen Mai Dong Tang as a recovery formula. That’s available. A lot of people have it. Here is if you customize it, that’s how you would do it. All right. So all those products that I mentioned, they’re in my book. You can see who’s got it, you can see what’s the applications, what are the contraindications, what’s the historical origins, and so on. I guess that’s about it.
The handout notes are available from that link, which is drjakefratkin.com/toxic-heat-invasion/. But if you go to my site, it’ll be on there. All right. Virginia, any questions?
I really want to thank you for putting this together on such short notice and bringing your expertise. Your original patent book was the first book I read on Chinese herbs in the early ’90s before I studied it in-depth and it was really invaluable, and now I’m glad to see that you have another, more in-depth version. You really contributed a lot to the field, so I want to thank you for that, as well as what you’ve done for the show and what you’re doing right now.
Only one thing I want to say about this book. I made the mistake of not calling it essential Chinese patent medicines because it’s just about products that are available in our country, so there’s 133 classical formulas, and 83 modern formulas. These modern formulas, people who just study the classics have missed out on what China’s been doing since 1950, which is developing a lot of new products. The best ones have come out as patent medicines, so there’s 83 of them in this book that are GMP. Everything in this book is GMP. They’re GMP in China, but then usually a lot of them are tested when they come to this country. I can guarantee you they’re clean. There’s no heavy metals, there’s no pharmaceuticals, and so on.
And a lot of companies sell these, and so you want to look at this document and stock up on what you think you’re going to need, okay? All right. Thanks for your time. I hope this was helpful, and I want to really thank American Acupuncture Council for sponsoring these shows and for giving me an opportunity to talk and share my information. And it’s not mine, I just compiled it, I just compiled what’s out there.
And for people who do have an hour and a half to watch John Chen’s webinar, it’s really useful, and he gives some research studies behind things. And he talks about how, for practitioners, it’s really early-stage and recovery that we are probably best apt to treat and most likely to be treating. But it’s good to know this, because as you say, if the hospitals are full, people will be desperate for something. So I’m grateful, and thank you again to the American Acupuncture Council, and we will see you again soon.
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