Fighting Fire with Fire
By Adam Tate, 2013The concept of Traditional Medicine generally relies on treating an imbalance with its opposite. So a condition with Heat or excess Bile would be treated with a cooling medicine to correct the imbalance.
But what about the use of hot medicines to treat Heat diseases?
The Ayurvedic system regularly uses hot medicines to treat Heat diseases. This same approach can be seen in some cases in the Tibetan and Western Traditions.
In general, in modern TCM practice, this is not commonly seen. However, the Sichuan Fire School (Huo Shen Pai) also believes in the use of Heating medicines to treat most diseases. In fact, in an interview and teaching with one of the main professors of this school of thought at the Sichuan TCM University, I was told that in all her years of clinical practice she had only used cold formulas a couple of times.
The Great Compounds of the West
In the Western Tradition, the 2 great cornerstones of western treatment for epidemic and infectious diseases were Theriac and Mithridate, both of which were in use for almost 2 millennia. And both these medicines were very heating, containing a larger number of medicines, both hot and cold.
It was the Arab physicians who introduced cooling compounds based on Camphor and Tabasheer for Heat diseases into the Western tradition from around 900–1000AD. But before this time and well after, these great heating compounds remained staples in the treatment of not only epidemic and infectious diseases, but a myriad of other conditions too.
A personal Experience
I also had the personal experience in India in the 1990’s. In a remote part of Rajasthan I got severe food poisoning (stupidly, from eating chicken which I was assured by fellow travellers was both safe and delicious). At 4am the next morning, I woke with crippling abdominal cramps, a high fever, and then violent diarrhea. I had some medicine with me, but nothing sufficient to treat this. I began to worry as I was very remote and had friends who had nearly died in similar situations in India.
Once I had emptied the entire contents of my digestive system, I wanted to leave the place I was staying to try to find some Ayurvedic medicine. To my amazement, opposite the doorway where I was staying was a nomadic peasant women sitting with a small cloth upon which sat a dozen or so wild purple garlic bulbs. You must realise this was before 7am in the morning and well away from any other stalls or market space.
I immediately took this as a positive sign and spent about 10 cents buying 2 whole bulbs. I began swallowing 2 peeled cloves at a time, every half-hour or so, until I had taken an entire bulb. I drank only water for the rest of the day, and although hungry, felt quite well by the mid afternoon. I felt so well, in fact, that I had a light vegetarian meal with rice for dinner which stayed down. The next day, I was back to normal. And no, in that trip and subsequent trips to India, I did not eat any meat again!
So how can this work in the face of the primary concept of traditional medicine: that of using opposites to restore balance?
The use of heating medicines works by stimulating and supporting the natural body function. And in some cases, such as with Garlic, there are potent heat-clearing and poison-relieving effects, despite the fact that it is hot in itself. Garlic is so effective as an anti-biotic in fact, it has been referred to as ‘Russian Penicillin’.
Of course, chemically, many warming, aromatic and pungent medicines contain a number of constituents which are anti-bacterial, anti-viral, anti-fungal, anti-inflammatory and immuno-stimulating. But aside from this, these medicines promote circulation, quicken metabolism, stimulate fever when necessary and induce perspiration. They aid the bodies circulation, digestion and latent immune response.
It is also important to note, that despite the fact my constitution is warm, and the temperature was extremely hot, the short-term use of such a heating medicine was acceptable.
Supporting the Natural Heat
Ancient Physicians regarded the Natural or Innate Heat (Yang) as being associated with Life, and when lost, death is the result. Therefore, cherishing the Natural Heat was long regarded as being of prime importance. By increasing the Natural Heat of the body, we support the natural body functions, and in this way rely on the efforts of the body to heal itself. Thus, this is truly supporting nature, not fighting it.
Heat conditions in the Young vs Heat conditions in the Elderly.
Young bodies tend to abound with Heat and Moisture, because they are growing rapidly and usually the Yang Qi is very active. Elderly bodies are slowly becoming Cold and Dry (opposite to the state of Health, Warm and Moist) eventually leading to death. Therefore, supporting the body warmth (Yang) is imperative. If there are signs of Yin deficiency and dryness, this is married with Yin tonics. The most suitable medicines are the Warm and Moist, such as Ginseng, or Shen Qi Wan in TCM.
Acute Heat vs Chronic Heat
Acute heat conditions can arise quickly and progress rapidly. In these cases, especially if urgent, strong, Heat-clearing medicines which will tend to be cold are used to counter the Heat to avert damage to the Yin and body systems. The Camphor and Tabasheer formulas are especially useful for acute, severe Heat conditions.
Chronic cases of Heat, such as chronic Hepatitis, require strengthening, which will normally use warming medicines, perhaps along with addition of some cold remedies. But in chronic cases, the focus is on supporting the body, not clearing heat.
An exception to this was a tactic regularly used in western practice where supportive medicines are used daily, and perhaps once weekly a cold, draining medicine is used to clear the excess. This tactic was employed in various chronic conditions such as Leprosy, the Plague, Tumors and Cancer.
The Detriment of Cold Medicines
Cold medicines can have various detrimental effects due to their opposite nature to human life, which is warm. They slow metabolism, hinder digestion and circulation, constrict blood vessels and the pores, and tend to allay Fever. All of these attributes are detrimental except in cases with marked High Fever in a strong and excess body-type.
By suppressing the bodies reaction to a pathogen, it may be contained within the body to cause further problems at a later date. It may cause obstruction in the body due to the fact that Fever and perspiration are induced by the body to throw off toxic debris caused by infection and inflammation, and by inhibiting these processes, much debris remains in the body to cause obstruction of Qi and Blood, which breeds many obstinate and difficult diseases when unattended.
Practical application in a modern clinic.
1. Acute conditions, such as the beginning of Colds, Influenza and early stages of infection can often be relieved by giving heating medicines to encourage the body to throw off the offending pathogen.
2. Heat diseases can be treated with complex formulas involving both Hot and Cold medicines.
3. Cold formulas can have heating medicines added to both increase the effect of the Cold medicines while counteracting any negative effects from using Cold medicines. Contrary to some Traditional Philosophical reasoning, this does not make the formula less Cold and therefore less effective at clearing Heat, but rather, increases efficacy of the Cold medicines to enhance the effect without causing any deleterious effect.
4. Cold medicines can be followed with a course of Warming medicines to counteract any negative effects.
5. Cases with Heat that is associated with weakness, and in a body that was generally cold, deficient or sluggish before the Heat condition may be treated with warming formulas.
6. Fever and Heat diseases can be treated with pills that are cold, while simultaneously taking a decoction that strengthens and harmonises, as for example Xiao Chai Hu Tang of TCM.
7. Heat conditions in the elderly can often be treated with warming, stimulating medicines in combination with Yin tonics.