By Heiner Fruehauf
National University of Natural Medicine
College of Classical Chinese Medicine


Originally Published March 2020. Revised September 2021 and January 2022

In recent weeks, the coronavirus outbreak has prompted many questions about how to prevent or potentially treat this epidemic if it ever arrives at our clinic doorstep. During the infamous SARS outbreak 18 years ago the late Dr. Deng Tietao demonstrated that Chinese medicine treatment proved to be more effective than standard hospital procedures by saving the lives of all patients in his care at the Affiliated Hospital of Guangzhou University of TCM. The coronavirus provides us with another opportunity to put our herbal thinking caps on.

Since we presently do not know much about the exact symptoms of coronavirus induced pneumonia (see the accompanying report by Dr. Liu Lihong for up-to-date symptom characteristics), it seems prudent to assume at least some of the characteristics of the “regular” respiratory epidemic that we have been facing during the last 2 months. At first, as predicted by the Chinese science of cosmic energetics (wuyun liuqi) for the latter part of 2019, we observed a tide of shaoyang respiratory infections, prompting the prescription of Chaihu (bupleurum) based regimens featuring Ease Pearls, or Release Pearls, or Xiao Chaihu Tang, or Chaihu Guizhi Ganjiang Tang.

At the beginning of 2020, patients with symptoms indicative of Perilla Pearls and/or Thunder Pearls started to pour in. Interestingly, even the more serious pneumonia patients did not require the primary prescription of heat clearing herbs (i.e., Dragon Pearls); rather, Fengsui Dan dominated as a secondary add-on remedy—a remedy that can simultaneously transform dampness and flare-up of deficient Kidney fire.

Several weeks ago, the following useful description of coronavirus characteristics from a Chinese medicine perspective circulated on Chinese media sites, first translated and shared on Facebook by Will Ceurvels (reproduced below in edited form):

“Coronavirus should be thought of as a damp type of epidemic. The pathogens linger and are difficult to dissipate completely. This disease is different from wind-heat accompanied by dampness, a situation where the heat will clear automatically as soon as the dampness is resolved, leading to the swift and full recovery of the patient. Damp toxicity, on the other hand, lingers and clings to the sick person like “oil mixed into flour”. When choosing a course of treatment, therefore, practitioners must be very careful not to mistake damp toxicity transforming into heat with heat toxicity accompanied by dampness. The herbs that should be used for these two situations are very different.

Coronavirus’ main etiology appears to be damp toxicity, not heat toxicity accompanied by dampness. When treating heat toxicity accompanied by dampness, the strategy is usually to clear heat, resolve toxins and dispel dampness. When encountering damp toxicity that transforms into heat or recalcitrant damp heat toxins, however, you should not use the familiar method of clearing heat and resolving toxicity—using cold herbs too early will inevitably exacerbate the dampness in this case and lead to cold enveloping heat . . . a move that will produce adverse effects in treatment outcomes. When treating this disease, therefore, the focus should be on resolving turbidity with aromatic herbs, thus outthrusting the surface and regulating the up-down dynamics of the Spleen/Stomach network. As this particular type of dampness becomes resolved, stagnant heat will be able to disperse and toxins will be not be able to form, thus leading to a gradual resolution of symptoms.”

This description resonates with the type of respiratory infections we have seen at our clinic near Portland, Oregon during the last 6 weeks. The following are examples of how a typical prevention and treatment regimen may look like (dosages are for adults):

PREVENTION (airplane travel, etc.)

3 Thunder Pearls 2x/day

EXPOSURE (to confirmed COVID-19 case)

2 Perilla Pearls + 2 Lightning Pearls 3x/day
3 Thunder Pearls + 1 Yin Qiao San 3x/day

TREATMENT (in order of likelihood)

3 Xiao Chaihu Tang or 3 Release Pearls or 3 Chaihu Guizhi Ganjiang Tang or 3 Ease Pearls
2 Yin Qiao San or 2 Lightning Pearls or 2 Thunder Pearls
1 Fengsui Dan or 1 Qianyang Dan or 1 Jingui Shenqi Wan

Revised Treatment Approaches, September 2021

Considering the dynamic circumstances of what has become a worldwide pandemic, the mutation of the coronavirus into new variants (i.e., Delta), and based on eighteen months of research and clinical presentations of COVID-19 and its related pathologies, my treatment approach with Chinese medicine has evolved. Here are some revised general recommendations:

  1. Recommendation for prevention of COVID-19 infection: take Thunder Pearls 3 capsules 2x/day.
  2. Recommendation for exposure to COVID-19 or during travel days: take Thunder Pearls 3 capsules 3x/day.
  3. Recommendation for treatment of early stage of COVID-19 infection, accompanied by clear signs of taiyang/shaoyang complexity syndrome (i.e., stiff neck, ear pain, malaise, sore throat): take Chaihu Guizhi Ganjiang Tang 3 capsules plus Yin Qiao San 3 capsules 3-4x/day; take for at least 10-14 days.
  4. Recommendation for treatment of early stage of COVID-19 infection, accompanied by clear signs of shaoyang/yangming complexity syndrome (i.e., stiff neck, pronounced headache with pain behind the eyes, obvious malaise and body pain): take Release Pearls 4 capsules plus Yin Qiao San 2 capsules 3-4x/day; take for at least 10-14 days.
  5. Recommendation for treatment of early stage of COVID-19 infection, accompanied by clear signs of shaoyang/taiyin dual affliction syndrome (i.e., stiff neck, ear fullness or lymphatic swelling, pronounced nausea or vomiting, diarrhea, dizziness, general state of malaise, mild sore throat): take Xiao Chaihu Tang OR Ease Pearls 3 capsules plus Thunder Pearls 2 capsules plus Fengsui Dan 1 capsule 3-4x/day; take for at least 10-14 days.
  6. Recommendation for prevention of side effects of COVID-19 vaccination (all types) and prevention of blood clot formation: Take Release Pearls 3 capsules 3x/day for 5 days, starting on the morning of the vaccination (both for the first and second shot); or, take for as long as soreness in the arm or other body parts persists.
  7. Recommendation for treatment of blood stasis in post-COVID-19 or post-vaccination situations: take Lightning Pearls 3 capsules plus Xuefu Zhuyu Tang 2 capsules 3x/day for 2 weeks, or for as long as problems persist.
  8. Recommendation for treatment of sudden spiking of blood pressure accompanied by symptoms of dizziness in post-COVID-19 or post-vaccination situations: take Dahuang Zhechong Wan 2 capsules plus Balance Pearls 2 capsules plus Lightning Pearls 2 capsules 3x/day for 3-4 weeks, or for as long as problems persist.
  9. Recommendation for the general treatment of long-haul COVID-19 symptoms (fatigue, low energy, body pain): 2 Thunder Pearls plus 2 Shenxian Dushi Dan plus 1 Fengsui Dan 2-3x/day for 4-12 weeks.
  10. Recommendation for the lingering effect of COVID-19 or COVID-19 vaccination on the shaoyin (Heart and Kidney) system: take 2 Counterflow Pearls plus 2 Jingui Shenqi Wan plus 1 Fengsui Dan 2-3x/day for 2-6 weeks.
Revised Treatment Approaches In Response to the Omicron Variant, January 2022

The Omicron variant appears to cause more variegated symptoms, and thus behaves more like the common cold/flu in people’s bodies. The Chaihu approach, overall speaking, appears to be less and less important, but the Triple Warmer congestion is still involved, now featuring Wendan Tang or Hao Qin Qingdan Tang (Wendan Tang plus Qinghao and Huangqin). The latest Omicron protocol we’re employing at our clinic has thus been:

For younger people

35 years of age or younger, with less likelihood of immediately developing blood stasis
3 Thunder Pearls + 2 Wendan Tang + 1 Wind Pearls 3-4x/day

For adults

older than 35 years of age
3 Thunder Pearls + 2 Wendan Tang + 1 Dahuang Zhechong Wan 3-4x/day