關於 primary one english writing ，我們在網路上蒐集到這些相關的討論、資訊與評價

翻轉視界 18 Changing Perspective

There's not just one road to the destination, but many roads. You just need to take the little step that’s right in front of you, and then the next one, and a few years down the track, they will seem like massive achievements.

通往目的地的路不止一條，有很多路可走。你只需要邁出眼前這一小步，然後再邁出下一步，幾年下來，將會成為巨大成就。

文章來自於New Humans of Australia (有取得授權)

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I didn’t meet my father until I was 6 years old. My parents had a comfortable, middle-class life in Shanghai, or as close as you could get under communism. But they always wanted to live overseas, and just before I was born, my dad came to Sydney to set things up. I don’t know why, but in the end, my mother and I didn’t join him until I was 6.

•a middle-class life 中產階級生活
•set things up 打點一切
•live overseas 往海外生活
•in the end 最後 (表達在經過一段時間或一連串事件之後的結果)

直到六歲前我都未曾見過父親。我的雙親在上海過著舒適的中產階級生活，或著說，在共產階級下所能得到的最接近的生活。他們一直響往海外生活，就在我出生前，我父親來到雪梨打點一切。但不知何故，直到六歲那年我與母親才終於與父親團聚。

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Unfortunately, half a year after we arrived, he left us. That was a huge shock. Our transition had already been quite difficult, as we both didn't speak English. Also, as Shanghai was such a big bustling city, Sydney felt a bit like the countryside, especially on the weekends, as no shops were open back then!

•shock 令人震驚的事件（或經歷）；驚愕，震驚 (come as a great shock 讓人倍感震驚)
•transition 轉變；過渡
•a bustling city 繁華都會

不幸的是，就在我跟母親抵達半年後，父親離開了我們。這是個巨大的打擊，因爲我們不會說英文，在適應過渡期本就已過得相當艱辛。此外，不同於上海的繁華都會，雪梨更像鄉下，尤其在週末，那時連商店都不開門。

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We were very much reliant on my dad, not only financially, but also as a conduit into the wider community. So to have that broken was quite distressing. I remember Mum crying a lot. As we had become socially isolated, we didn’t find out anything about Centrelink, so we survived on her savings for a while, and then got some help from her family back in China.

•be reliant on… 依賴...
•a conduit into 進入...的渠道
•distressing (adj.) 令人苦惱的,令人擔憂的
•become socially isolated 變得孤立於社會
•survive on her savings 僅靠的她積蓄過日子

我們相當依賴我父親，不僅是經濟，他也是我們進入更廣泛社區的渠道。因此，當局面被打破時令人相當痛苦，我還記得母親時常哭泣。由於我們孤立於社會，所以我們並不知道澳洲社會福利聯絡中心 （Centrelink）的任何資訊，僅靠母親的積蓄支撐了一段時間，然後從母親在中國的娘家得到一些幫助。

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Eventually, Mum moved us down to Melbourne, where we were able to make some new networks and family friendships. But I was bullied a bit at school about things like my food and clothing! Whenever someone bullied me, I would defend myself, but because I didn’t have the language skills to explain to the teacher why, I got in trouble quite a bit. I ended up having to move school 3 times before I came to Balwyn Primary School, which was relatively multicultural.

•be able to 能夠
•make new networks 建立新的人脈，關係網
•be bullied 被霸凌
•language skills 語言能力
•get in trouble 惹上麻煩
•end up 最後處於；最後成爲；以…告終
•relatively 相對地
•multicultural 多元文化的

最後，母親帶著我搬遷到墨爾本，在那我們能夠建立起新的網絡與家庭情誼。然而。我在學校飽受霸凌，例如我的食物及衣物。每當有人霸凌我，我會自我防衛，但我的語言技巧不足以向老師解釋事發原因，因此常常陷入麻煩。後來我不得不再三轉學，直到就讀相對多元文化的博文小學（Balwyn Primary School）。

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After that, I did alright. Music featured very prominently in my life. I had started learning the violin from the age of 2.5 years old and even with all the troubles that were going on in my life, had somehow still kept up with it. As a result, I got a music scholarship to Trinity Grammar School. But even there I used to get into quite a lot of mischief, and would often skip school to go to the movies.

•do alight 過得不錯，做的不錯
•feature (v.) 以…為特色；給…以顯著的地位
•prominently 重要地；著名地；突出地，顯眼地

之後，我便過得不錯。音樂在我生活中佔有重要的一席之地，我從兩歲半開始學習小提琴，儘管生活中事事不如意，我依然堅持不輟。因此，我獲得三一文法學校（ Trinity Grammar School）的音樂獎學金。但即使在那，我也常惡作劇、逃學看電影。

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By the end of year 11, I was told I would have to either repeat the year, or consider going to another school, which was quite humiliating for my mum. I decided to move school and surprisingly, I ended up doing quite well in year 12! As a result, I ended up getting into a double degree in Law and Music at Monash.

•repeat the year 留級 ; 重唸一年
•humiliating 令人感到恥辱的，丟臉的

11年級結束時，我被告知要麽被留級，要麼考慮轉學，這對我母親來說相當丟人。我決定轉學，而令人驚訝的是，我在12年級的時候表現優異，最後錄取蒙納士大學法律與音樂雙學位。

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When I started, my first thought was that I didn’t belong because I had done so badly in school up to year 11 and everyone else seemed so smart. But I put my head down, got through it, and ended up getting a job in the legal department of a major manufacturing company, which was a different approach to what most law students do.

•do not belong 不屬於這
•put my head down 埋頭苦幹
•the legal department of ...的法律部門
•a different approach 不同途徑
•approach （思考問題的）方式，方法，態度

當我開始進入大學，最初的想法是我不屬於這，因為我在11年級前都表現不佳，而這裡的人似乎都聰明絕頂。但我埋頭苦幹，咬牙撐過，最後在一家大型製造公司的法律部門找到工作，這與多數法律系學生的途徑不同。

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I really enjoyed it. It was hard work, but I learned a lot of foundational business, legal and corporate communication skills. After that I worked in corporate governance in RMIT, then started to moonlight as a lecturer in the Law Faculty. Eventually, they asked me if I wanted to do a PhD and I blindly said yes! I next worked at Swinburne University, and then was head-hunted to lead the corporate legal team at the Commercial Passenger Vehicles Commission.

•foundational 基礎的
•communication skills 溝通技巧
•corporate governance
•moonlight (v.) （尤指瞞著僱主）從事第二職業，兼職
•headhunt (v.) 物色（人才）； 挖角
•legal team 法律團隊

我非常喜歡這份工作，這是份辛苦的工作，但我學習了很多基礎商業、法律以及公司溝通技巧。之後我在皇家墨爾本理工大學（ RMIT）從事公司治理工作，並開始兼職擔任法律系講師。後來他們問我是否想要讀博士，我便盲目地答應了。接下來，我在斯威本大學（Swinburne University）工作，再被挖角到商用小客車委員會領導法律團隊。

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I had a good life, but after a while, I realised I wanted a different kind of job. I could see my seniors were making a lot of money but that their family life was not that good. And looking at my own upbringing, I wanted to be the kind of father who could be present in my own kids’ lives. So I decided on dentistry. It would not only allow me to use the hand skills that I had developed from playing the violin, but also the analytical and reasoning skills that I'd developed in law. Plus it would be flexible, and offer me a stable income and the chance to meet different people every day!

•upbringing 教養
•decide on sth 決定某事或東西
•analytical and reasoning skills 分析和推理能力
•offer a stable income 提供穩定收入

我的生活很不錯，但一段時間後，我意識到自己想要一份不同的工作。我知道前輩們賺了很多錢，但他們的家庭生活並不美滿。看著自己的成長經歷，我想要成為可以在孩子生活中出席的父親，所以我決定改行當牙醫。這項職業能讓我使用從拉小提琴中發展出的手部技巧，也能運用我在法律中發展出的分析與推理技能。此外，這個職業相當靈活，能為我提供穩定收入，並有機會每天與不同的人見面。

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My now fiancée, who was my girlfriend at the time, was also applying for further study, and coincidentally we both got into university in South Australia, so we moved to Adelaide together a few years ago.

•fiancée 未婚妻
•at the time 當時
•apply for 申請
•further study 繼續教育，進修；進一步研究；深造
•coincidentally 碰巧地；巧合地

我的未婚妻，當時的女友，也申請繼續深造，巧的是我們都考上南澳大學（University of South Australia)，所以幾年前一起搬到阿得雷德（ Adelaide）。

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I was lucky to get a university job at Flinders University. Initially, I started out as a casual lecturer in the law school, but I’ve since transitioned into teaching health law and research, and I’m currently writing a few books on the intersection between law and medicine. And also, obviously, trying to finish my dentistry degree!

•start out as… 起初擔任...
•transition into… 轉變到...

我很幸運的在福林德斯大學（Flinders University）找到工作，起初我在法學院擔任臨時講師，但我後來轉換到醫事法教學及研究。目前我正撰寫幾本關於法律與醫學相接的書籍，並努力完成我的牙醫學位。

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Mum eventually retrained as a Chinese high school teacher, and she’s still teaching to this day. Like most first generation migrants, she struggled quite a lot, and invested heavily in my success. After we’re married, my fiancée and I are planning to have children, and I’m sure they will have it much easier than I did.

•retrain 重新培養；再培訓；再訓練
•to this day 至今
•first generation migrants 第一代移民
•struggle a lot 掙扎奮鬥許久
•have it much easier 過的比較輕鬆

我的母親最終重新接受培訓，成為一名中文高中老師並執教至今。如同大多數第一代移民，她掙扎奮鬥許久，並為我的成功投資甚多。我與未婚妻打算婚後生孩子，我確信孩子會過的比我輕鬆得多。

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Still, a lot of the failures that I’ve had in my life have really informed a lot of my successes. Looking back, I wouldn't really want to change that to have a smoother life.

•inform [正式] 影響某人的態度或意見
https://www.ldoceonline.com/dictionary/inform

•have a smoother life 有一個更順遂的人生

我的生活中的種種失敗確實為我的成功提供借鑑。回首過去，我不會想要改變那些坎坷經歷去擁有一個更順遂的人生。

★★★★★★★★★★★★

Over the years, I've learned that perseverance is very important. I hope that through telling my story, I can be an example to others who might be in a similar position as I was: to show that there's not just one road to the destination, but many roads. You just need to take the little step that’s right in front of you, and then the next one, and a few years down the track, they will seem like massive achievements.

•over the years 多年來
•perseverance 不屈不撓，堅持不懈
•be an example 成為榜樣
•be in a similar position 處於相似的處境
•down the road/line/track 將來(的路)

多年來，我學到堅持不懈是至關重要的。我希望透過講述自己的故事，能成為其他可能與我有相似處境的人的榜樣：向他們展示通往目的地的路不止一條，有很多路可走。你只需要邁出眼前這一小步，然後再邁出下一步，幾年下來，將會成為巨大成就。

有興趣的同學可以支持New Humans of Australia

www.patreon.com/newhumansofaustralia

Photographer: Paul Heinrich instagram.com/paulfheinrich

文章與圖片出處: https://bit.ly/2XJsciq

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翻轉視界: http://bit.ly/3fPvKUs

批判性思考問題大全: http://bit.ly/34rdtJ7

TỪ VỰNG IELTS CHỦ ĐỀ EDUCATION (Kèm bài mẫu)
🔆PHẦN TỪ VỰNG
▪️separate schools = single-sex schools/education = single-gender schools/education: trường 1 giới
▪️mixed schools = mixed-sex schools/education = mixed-gender schools/education = integrated schools/education = co-ed schools/education: trường 2 giới
▪️send sb to….: đưa ai đó tới đâu
▪️study at ….school = e..school = enter…education =choose…school: học tại đâu
▪️there is little chance for: hầu như không có cơ hội cho…
▪️early relationships: việc nảy sinh tình cảm sớm
▪️concentrate on = focus on: tập trung vào…
▪️get higher academic results: đạt được kết quả học tập cao
▪️have the opportunity to: có cơ hội làm gì
interact and take part in group work activities: tương tác và tham gia vào các hoạt động nhóm
▪️opposite-sex classmates: bạn khác giới
▪️learn a wide range of skills: học được các kỹ năng khác nhau
▪️communication or teamwork skils: kỹ năng giao tiếp hay làm việc nhóm
▪️co-existence and gender equality: sự cùng tồn tại và sự bình đẳng giới
▪️explore each other’s perspectives, their ▪️similarities and differences: khám phá sự khác nhau/giống nhau và quan điểm của người khác
▪️brings more benefits for: mang lại nhiều lợi ích hơn cho…
▪️pass/fail the exam: đậu/ rớt kỳ thi
▪️gain in-depth knowledge: có được kiến thức sâu sắc
▪️core subjects such as science, English and maths: những môn học nòng cốt như khoa học, tiếng Anh và toán
▪️study abroad = study in a different country: du học
▪️drop out of school: bỏ học
▪️gain international qualifications: có được bằng cấp quốc tế
▪️improve educational outcomes: nâng cao đầu ra của giáo dục
▪️top international educational league tables: xếp đầu bảng giáo dục quốc tế
▪️encourage independent learning: thúc đẩy việc tự học

🔆PHẦN BÀI MẪU

Đề bài: Some people think that it is better to educate boys and girls in separate schools. Others, however, believe that boys and girls benefit more from attending mixed schools. Discuss both these views and give your own opinion.

Dịch đề: Một số người nói rằng tốt hơn nên đưa trẻ nam và trẻ nữ tới các trường học riêng biệt (chỉ dành cho 1 giới). Tuy nhiên, một số người khác lại tin rằng nam và nữ có lợi hơn khi tham gia trường 2 giới. Thảo luận cả hai quan điểm và đưa ra ý kiến của bạn.

It is argued by some that students would benefit more when they attend single-sex schools. In my opinion, however, it would be better for them to enter mixed-gender education.

On the one hand, the primary reason why some people support single-gender education would be students’ better academic results. When boys and girls are taught separately, there is little chance for early relationships. This is considered as one of the most distracting problems for teenage and adolescent students. Without worrying about these distractions, students might be able to concentrate more on their study, and therefore, might get higher grades than those at co-ed schools. Despite this being true to some extent, having no interaction with the opposite sex will cause these students a lot of troubles later in life, especially in their careers.

On the other hand, I would argue that mixed-sex education is a better option because students are better prepared for their future jobs. Nowadays, it is almost impossible to find a company where there is only male or female staff. Therefore, those who graduate from single- sex schools, despite their higher academic results, might find it hard to work collaboratively with their colleagues of the opposite sex. By contrast, people from mixed schools might easily cooperate with their opposite-gender partners since they have learned how to communicate and interact effectively with opposite-sex classmates during their time at school.

In conclusion, although some people think that it is more beneficial to send students to single- sex schools, I personally believe that mixed-gender education brings more benefits for students.
(257 words, written by Nguyen Huyen)
#ieltsnguyenhuyen
https://ielts-nguyenhuyen.com/tu-vung-ielts-writing-chu-de-education/

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）
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