The energetics of antibiotics Abstract: This article discusses the CM energetic properties of antibiotics, how to deal with them from a completely CM point of view, including acupuncture point selections and herbal prescriptions and modifications. Keywords: Antibiotics, penicillin, acidophillus, probiotics, energetic description
How to deal with antibiotics from an entirely Chinese Medical point of view? What points, herbs,foods and rationale to use when dealing with patients on antibiotics? How to support thesepatients before, during and after antibiotics treatment.
How to deal with these modern medicines? There is already a lot of writing that elaboratelycritiques the prescription of these drugs. However, the aim of this article is to provide practicalinsights into the energetics of antibiotics to actively support the patient's health with thatknowledge.
As one of the very few therapeutical systems, Chinese Medicine has its own conceptual language. Using this language any practitioner can succinctly describe a patient's current situation. Applyingthe si zhen (i.e. any form of macroscopic diagnosis) one can determine the patient's status at thatmoment. Chinese Medicine developed into a primarily descriptive method, therefore as long as 1. a rudimentary description of 'health' is available, and 2. the energetic effects of the therapy areknown. Chinese Medicine can be applied to any situation. It is entirely irrelevant if the patient,deals with a well-known or 'new' disease, if the patient is human or animal or what herbs, pills,tools, surgical operations or therapies are applied. As long as the effects of these modalities arecoded in the same conceptual language as the situation of the patient.
Imagine the following, given that Penicillin had been discovered in the China of yore. How likelywould it be that it would NOT have been used? Obviously, a medicinal as effective as Penicillinwould have been annexed into the existing Materia Medica's immediately. In fact, I think it highlylikely that its medicinal properties would have been described and the substance used withoutdelay. After noticing the clear side effects associated with use, other substances would have beenused to harmonize the unwanted effects. Additionally, new herbal formulas would develop tofurther enhance its therapeutical properties. I find it very important for the professionaldevelopment of Chinese Medicine to describe these energetic properties. In this article I present aformalized description for peer review.
Please note that this article focusses on a GENERAL energetic description of antibiotics (coveringmost Beta-lactam, Tetracyclin and Macrolide class antibiotics. It does NOT describe Interferons orsteroidal anti-inflammatory drugs. These are sometimes cal ed antibiotics, but adhere tocompletely different modes of action.
Antibiotics, since the 1940s the drug-class of choice for the smothering of bacterial infections. Ithas saved mil ions of lives and has reduced suffering for many patients. Was the originalpenicil ium a naturally growing fungus, nowadays new types are neatly synthesized in sanitizedlaboratories .
A lot has changed since the discovery of Penicil ium's medical significance in 1928. Research hasgiven new insights into the workings of antibiotics. Despite this biomedical research, the propertiesof antibiotics have roughly remained the same, with all their positive and negative effects .
Although there are many different types of antibiotics, here a general description is presentedwhich helps understand both the effects and side-effects.
Antibiotics - a general description Title: Antibiotics Also known as: Penicil in, Amoxycillin, Doxycyclin, Clarythromycin, etc. Western Materia Medica Category: Systemic anti-inflammatory agents
Type: Natural or synthetic compoundChinese Materia Medica Category: Downward draining substancesZang fu orientation: Stomach, Spleen Lung, Large IntestineProperties: Cold, bitter, toxicActions:- Drains fire and du (Toxicity) downward, clears heat from the organs and promotes defecation- Drains phlegm, promotes breathing and alleviates pain- Calms the shenCautions & Contraindications: Due to its toxicity and depleting nature, use only for short periods oftime. Toxicity: Antibiotics are toxic. LD50 indications are different per antibiotic and per route ofadministration, usually between 8 and 30 mg/kg (oral). Use wit great caution in pregnancy. Contraindications: Wei qi xu, spleen yang xu or kidney yang xu due to the extreme cold. Kidney yin xu or liver xue xu due to toxins building internally. Modus operandi: Antibiotics are very substantial, cold and bitter in nature. Their heat-draining and phlegm drying properties close the exterior and drain fire and du (toxicity) downward. Antibiotics are very substantial and cloying which greatly taxes the Spleen in its yun hua function. Used to purge heat and drain downward, used for longer periods of time it depletes Spleen qi resulting in fatigue, abdominal distention and chronic diarrhea. Its toxic nature causes the Stomach qi to rebel upward, resulting in vomiting, nausea and sometimes diarrhea. Their use depletes the qi of the Lung and and Spleen. Long-term use builds up toxins internally, drying the Kidney yin and Liver xue eventually resulting in inflammation of organ tissue. Comparisons: Antibiotics are similar to Da Huang (Radix et Rhizoma Rhei) in terms of their cold and bitterness and the ability to purge Fire and du (Toxicity) downward. Most notably however is the similarity in closing the surface, which traps an exterior pathogen on the inside. Left untreated, this pathogen can 'smolder' on the inside and consume zheng qi, often with sub-clinical symptoms .
Antibiotics are similar to several of the cold herbs in calming the shen when it is irritated due toheat or fire. Examples are Zhi Mu (Rhizoma AnemarrhenaeAsphodeloidis) and Huang Lian (Rhizoma Coptidis).
Antibiotics are similar to Sheng Di Huang (Radix Rehmanniae Glutinosae), not in their nourishingabilities, but in their cloying nature. This cloying effect in part hinders the downward flow of Stomach qi and it taxes the yun huafunction of the Spleen, thus giving rise to symptoms of middle jiao deficiency, comparable toexcessive consumption of Di Huang. Most evident of these is a hua mai, slippery pulse, that mayremain evident up to several weeks after treatment with antibiotics. Treatment effects: Antibiotics are highly effective in acute conditions. Long-term use however shows many unwanted effects.
In terms of the nei jing tu, the internal landscape, antibiotics use is like flooding the empire in acold mist. The mist hinders both xie qi, the foreign soldiers, and the zheng qi, native forces, thusstopping the battle and alleviating the symptoms. The antibiotic mist extinguishes small fires but inits stead, leaves a layer of thick moisture. After treatment is stopped, the mist settles and thefarmers work to remove the moist layer that covers the lands.
This analogy describes how antibiotics influence the ENTIRE organism, not only xie qi. Furthermore it shows that the mist also causes a strain on the system that lasts longer than theperiod of the inflammation itself.
It is easy to understand that this moist layer that covers the land hinders the creation andtransportation of new farmers and especially soldiers. Additionally, if the xie qi is not completely
destroyed but 'covered' by the mist, it may remain undetected while slowly growing and consumingthe produce of the empire.
Chronic overuse of antibiotics results in an increasingly thick layer of moisture on the lands, thatpoisons the produce and eventually kills the inhabitants. In this state of disarray, a reneweduprising of the foreign army can occur with detrimental results.
Antibiotics-use, as is true with most cold substances, is contra-indicated in Stomach and Spleendeficient patterns, overuse quickly creates diarrhea and tiredness and inhibits the Spleen in itsfunctions of transforming gu qi. Secondarily, since the Spleen stores dampness in the Lung, thisprevents the Lung in its generative, purgative and defensive tasks. Long term and repeatedtreatment depletes the yang of the entire system and eventually toxins build up internally.
Toxins both in and of themselves are damaging to the system. Secondarily, toxins and other formsof excessive heat can trigger a hidden or 'antibiotically smothered' pathogen. A current example isan old tuberculosis, reemerging during corticosteroid treatment. Commentary: Many physicians prescribe antibiotics liberally when a bacterium is (presumed to be) the cause of an inflammation. Antibiotics often close the exterior too quickly, thus preventing the wei qi from dealing correctly with the evil hot or cold pathogen. A trapped pathogen often 'smolders' on the inside and is the cause of many post-inflammation symptoms, in some leading to serious il ness. With regard to 'smoldering', It is important to state that anyone treated with antibiotics for a strong pathogen, may have a 'hidden evil' in their system without clear symptoms.
Ofcourse, antibiotics may be the only and best choice to treat an inflammation in some instances. CM has a unique role in supporting the treatment, preventing side-effects and supporting thepatient's well-being. This is remarkably easy when sticking to the conceptual methodologyunderlying CM. The energetics of antibiotics
This part deals with several practical issues surrounding the treatment of patients on antibiotics.
Treatment options: Before, during and after
Supporting the antibiotic treatment of an active inflammation. Note: formulas and point-selectionprovided here are suggestions, it may be very relevant to change these according to your patient'ssituation.
Although this article focusses on combining treatment modalities with regard to active bacterialinflammation, the ultimate goal and last point of this article is to support the patient's individualconstitution and prevent recurrence and support.health.
However, this article ultimately shows that within the logical equation of Chinese Medicine we caneffectively support antibiotics treatments and circumvent unwanted effects as long as we stick tothe energetic description of the patient and the medicinals he uses. Before antibiotic treatment Considering the energetic properties of antibiotics, the treatment principle is simple: Tonify the the center qi - supports the zheng qi for the coming battle and subsequent cleanup- actions It is understood here that this period lasts no longer than a few days or even hours. The suggestions provided here however are highly practical. The patient can use the belowmentioned substances during the entire treatment period.
Probiotics: Lactobacillus Acidophil usAs soon as your patient contacts you, advise them to start probiotic treatment (unless there arecircumstances which make this unwise, such as bacterial overgrowth in the stomach, etc). Probiotics are readily available and generally cheap. Acidophillus cultures, somewhat sweet, saltyand warm in nature are excellent in protecting Stomach qi and the Spleen's yun hua function.
Fresh gingerWidely available and cheap, Sheng Jiang (Rhizoma Zingiberis Officinalis) is advised. Simply makea tea from several slices. Drink during the day for the entire period that antibioitics have beenprescribed. Discontinue if redness or itching in the flanks present and be cautious if the patienthas a primary yin vacuity condition. Acrid and warming, Sheng Jiang (Rhizoma ZingiberisOfficinalis) is ideal for protecting the Stomach and Spleen against the extreme cold of antibiotics,harmonizing the middle jiao and preventing nausea and stomach upset. Additional y, Sheng Jiang(Rhizoma Zingiberis Officinalis) gently harmonizes the effects of drugs and has good detoxifyingproperties to support phlegm-drying herbs (such as Ban Xia (Rhizoma Pinelliae Ternatae)).
Acupuncture point combinations should follow the same principle. Tonify the center qi - Zhongwan REN-12, Guanyuan REN-4, Zusanli ST-36, Sanyinjiao SP-6
If the patient easily experiences diarrhea or other gastrointestinal complaints, also use ShangjuxuST-37. If the patient has concurrent dampness, also use Fenglong ST-40. During antibiotic treatment One of the most interesting points about antibiotics is their ability to close the surface. Although this al eviates symptoms spectacularly it not always solves the problem. As stated above, this same problem occurs with Huang Qin (Radix Scutellariae Baicalensis). To counter this, a surface releasing effect mus be established to prevent 'smoldering of evil heat on the inside'.
Having established this, the principles of treatment are clear:Clear heat or fire - the inflammationRelease the exterior - prevent 'smoldering'Protect the Stomach and support the Spleen
Xiao Chai Hu Tang (Minor Bupleurum Decoction) and its associated modifications are highlysuitable for these tasks. Herbalists wil recognize the ever-present combination of Chai Hu (RadixBupleuri) and Huang Qin (Radix Scutellariae Baicalensis) in all of the 'Chai Hu'-formulas. Thiscombination exists for the exact reasons described above. Chai Hu's imperial presence is requiredhere to release the exterior and push out evil heat. Without Chai Hu (Radix Bupleuri), thisformula's ability to clear heat would be vastly different. It would then have the ability to dry phlegm,drain heat from the upper jiao, stop sweating and promote the downward direction of Stomach qi. However, it would trap the evil heat on the inside, similar to antibiotics, defeating the purpose ofthis formula. Without minister Huang Qin (Radix Scutellariae Baicalensis), this formula's ability toclear Heat would be reduced, as wel as its ability to drain downward. Also, Huang Qin (RadixScutellariae Baicalensis) protects the yin, which is necessary because of Ban Xia's (RhizomaPinelliae Ternatae) drying and Chai Hu's (Radix Bupleuri) yang raising -thus yin depleting- natures. Although it is essentially possible to remove Huang Qin (Radix Scutellariae Baicalensis) from theformula, and let antibiotics perform its tasks of draining heat, It is advisable to keep it in becauseof its yin-protecting effects. On the other hand, the amount of Chai Hu (Radix Bupleuri) can bedoubled to support clearing the surface 'through' the presence of both Huang Qin (RadixScutellariae Baicalensis) and antibiotics. Xiao Chai Hu Tang (Minor Bupleurum Decoction) Radix Bupleuri (Chai Hu) 24gRadix Scutellariae (Huang Qin) 9gRhizoma Pinelliae Ternatae (Ban Xia) 24gRhizoma Zingiberis Officinalis Recens (Sheng Jiang) 9gRadix Ginseng (Ren Shen) 9g
Honey-fried Radix Glycyrrhizae Uralensis (Zhi Gan Cao) 9gFructus Zizyphi Jujubae (Da Zao) 12 pcs
Alternatively, if there is a situation of severe deficiency, it is advisable to use a formula that isstronger in tonifying the qi. Ren Shen Bai Du San is then applicable. Even though it iscontraindicated for use in situations with heat, as long as the inflammatory heat is countered byantibiotics, this formula can be used. Interestingly, classical y too it was modified with a doubling ofChai Hu (Radix Bupleuri) and the addition of Huang Qin (Radix Scutel ariae Baicalensis), which isalso highly relevant in this case, since this supports the treatment of a condition with heat.
Ren Shen Bai Du San (Ginseng Powder to Overcome Pathogenic Influences) Radix et Rhizoma Notopterygii (Qiang Huo) 30gRadix Angelicae Pubescentis (Du Huo) 30gRadix Ligustici Chuanxiong (Chuan Xiong) 30gRadix Bupleuri (Chai Hu) 30gRadix Platycodi Grandiflori (Jie Geng) 30gFructus Citri seu Ponciri (Zhi Ke) 30gRadix Peucedani (Qian Hu) 30gRadix Ginseng (Ren Shen) 30gSclerotium Poriae Cocos (Fu Ling) 30gRadix Glycyrrhizae Uralensis (Gan Cao) 15g
Acupuncture following the same treatment principlesClear heat - Chuchi LI-11, Dazhui DU-14, Lingtai DU-10Release the exterior - Zhongfu LU-1, Lieque LU-7, Hegu LI-4Protect the stomach and support the Spleen - Zhongwan REN-12, Zusanli ST-36, Sanyinjiao SP-6Add points as required by the situation. After antibiotics treatment If the inflammatory symptoms have been countered and the 'mist has settled', it is relevant to clean up and harmonize the patient. This ends, by definition, in treatment of the ben and should support the patients constitution.
Treatment principle:Transform cold phlegmMove the qi and drain dampness
If the zheng qi is sufficient, strong formulas can be used such as: Qing Qi Hua Tan Wan (Clearthe Qi and Transform Phlegm Pill), Er Chen Tang (Two-Cured Decoction) or Bai Tou Wen Tang(Pulsatilla Decoction). Al are excellent in transforming and removing phlegm and dampness out ofthe various nooks and crannies of the patient's system.
Er Chen Tang (Two-Cured Decoction) is the most relevant of these formulas. From it, most of theother formulas have been derived. This simple formula is centered around Ban Xia (RhizomaPinelliae Ternatae) and Chen Pi (Pericarpium Citri Reticulatae). These warm and moving herbsare excellently suited to deal with the cold, cloying nature of antibiotics. With the ministers Fu Ling(Sclerotium Poriae Cocos Botanical) and Zhi Gan Cao (Honey-fried Radix Glycyrrhizae Uralensis)the Spleen and Stomach are well protected, especially if the patient also drinks fresh ginger tea. Er Chen Tang (Two-Cured Decoction) thus tonifies the middle, transforms the 'antibiotic mist' anddrains dampness downward. This not only removes the antibiotic leftovers, but also removes thedampness that was created by the original battle between xie qi and zheng qi.
Er Chen Tang (Two-Cured Decoction)Rhizoma Pinelliae Ternatae (Ban Xia) 15gPericarpium Citri Erythrocarpae (Ju Hong) 15gSclerotium Poriae Cocos (Fu Ling) 9gHoney-fried Radix Glycyrrhizae Uralensis (Zhi Gan Cao) 4.5g
Ju Hong (Rubra Epicarpii Citri Erythrocarpae) is usually substituted by Chen Pi (Pericarpium CitriReticulatae). 
Er Chen Tang (Two-Cured Decoction) can be modified by adding more tonifying herbs such as BaiZhu (Rhizoma Atractylodis Macrocephalae) and Ren Shen (Radix Ginseng), Maciocia notices thatTai Zi Shen (Radix Pseudostellariae Heterophyllae) has ideal qualities to support the Stomach andSpleen during and after antibiotic treatment . Heat clearing herbs such as Huang Qin (RadixScutellariae Baicalensis), Huang Lian (Rhizoma Coptidis) or Huang Bai (Cortex Phellodendri) canbe added depending on the presentation. Please note: Er Chen Tang (Two-Cured Decoction) iswarm and drying, patients with underlying yin vacuity patterns require additional herbs such asSheng Di Huang (Radix Rehmanniae Glutinosae), Gou Qi Zi (Fructus Lycii) and Zhi Mu (RhizomaAnemarrhenae Asphodeloidis).
If the zheng qi is deficient it may be relevant to combine the above with tonifying formulas such asLiu Jun Zi Tang (Six Gentlemen Decoction) or Shen Ling Bai Zhu San (Ginseng, Poria, andAtractylodes Macrocephala Powder) in case of more qi deficiency. Use Shi Wei Wen Dan Tang(Eleven-Ingredient Decoction to Warm the Gallbladder) instead of Qing Qi Hua Tan Tang ((Clearthe Qi and Transform Phlegm Pill) to better support the qi and xue.
Acupuncture treatment following the same principle is quite short:Transform phlegm and move dampness - Sanyinjiao SP-6 (moxa), Taibai SP-3, Fenglong ST-40(moxa), Zhongfu LU-1 and Chize LU-5Add points to support constitution.
Harmonize and maintain health. Eventually, after the pulse has normalized, harmonize the patient with formulas that support theirconstitution to prevent recurrence of the pathological situation. The end advice is ofcourse:Meditation, Yoga, Taiji, Qigong, a regular lifestyle and imperially healthy foods. About the author: Edgar Vossen is a licenced Acupuncturist, Herbalist and Tui Na Massage Therapist maintaining a practice in Zwolle, The Netherlands and publishes mainly on the energetic descriptions of non-CM medicinals.
For any comments or questions, please contact the author at [email protected]Bibliography  Bensky, D. & Gamble, A., . Chinese Herbal Medicine Materia Medica. 3rd edition. Eastland Press  Bensky, D. & Barolet, R., . Chinese Herbal Medicine Formulas & Strategies, Eastland Press  Chen, J.K. & Chen, T.T., . Chinese Medical Herbology and Pharmacology, Art of Medicine Press, Inc.  Vossten, G.J., . Thesis: The East West Dialogue - Describing and using energetic descriptions of western medications  Gascoigne, S., . Prescribed Drug Guide, Jigme Press  Maciocia, G., . The Practice of Chinese Medicine, Churchill Livingstone, Ch.25  Wikipedia, . Antibiotics
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