key: cord-0077159-0qb3mt3w
authors: Fang, Jianhe; Zhu, Weifeng; Liu, Hongning
title: Discussing the Dietary Regimen and Disease Prevention and its Application as an Anti-epidemic Measure
date: 2020-09-22
journal: nan
DOI: 10.4103/cmac.cmac_36_20
sha: 8c92fc25ab1a392c563ab1d695302cf841b31fdc
doc_id: 77159
cord_uid: 0qb3mt3w

This article discusses the role of dietary regimen in the traditional culture of Chinese medicine according to its origin. Dietary regimen is a technique that inherits the traditional culture of Chinese medicine. Through analysis of the characteristics of the dietary regimen and the discussion of the idea of disease prevention, the application of the dietary regimen in disease prevention is sought. Under the guidance of three key factors, the application of the dietary regimen in disease prevention is mainly manifested in two aspects. First, the dietary regimen can be used to guide the daily reasonable diet to maintain the human body in a balance of Yin and Yang, which could prevent the occurrence of diseases. Second, on the basis of minimizing health loss, it can be used for disease treatment, adjuvant treatment, and rehabilitation. Finally, taking preventive treatment as the guiding ideology, the application of a dietary regimen as an “anti-epidemic” was briefly discussed.

These three categories of etiologic factors are the main law which should be obeyed. The Chinese medicine method consists of specific technical measures formulated under the guidance of law, such as the use of specific traditional Chinese medicine prescriptions, the implementations of acupuncture, moxibustion, and the application of a dietary regimen.

The specifications and unique content of the dietary regimen could supplement other Chinese medicine methods, but it could also replace other methods to maintain the health of the human body under certain circumstances. The dietary regimen mainly consists of two parts: food that should be avoided and food that could be consumed.

Dietary restrictions include healthy diet restrictions, seasonal diet restrictions, food consumption restrictions, food quality (i.e., whether or not spoiled) restrictions, food collocation restrictions, and disease dietary restrictions.

Appropriate food refers to, according to the health of the individual, to determine what to eat, what kind of ingredients to choose, what kind of processing and production methods to use, and so on.

Appropriate foods are mainly obtained through the formulation of the daily general diet and prescription formulation to achieve health maintenance. The food regimen prescription is the prescription composed mainly of ingredients. Compared with the traditional prescription, the prescription of the food regimen is more interesting and acceptable, which also makes food and nourishment encompass the function of "regulating the heart and treating illness" in the form of porridge, soup, cake, and other forms of common diet or medicinal meals and other forms such as tea.

Disease prevention is not treatment. At present, we basically agree that disease prevention mainly consists of preventing disease, preventing change from illness, and recovering after illness. Specifically, the first focus of maintaining health is to grasp the initiative of health, to prevent the occurrence of disease and, to prevent the deterioration of the body from disease, and to prevent the recurrence of disease after cure, in order to minimize the loss of health caused by illness or treatment. Therefore, the so-called "disease prevention," that is, to use a corresponding method to prevent the occurrence, development, and recurrence of diseases, is in fact fundamentally put forward as the way to maintain human health, a way to actively guide the body to develop in the direction of being healthy.

Due to the neutral nature of food, it acts as the main source of nutrients needed for normal physiological activities of the human body. Food is different from drugs, which have deviated from nature and which easily cause side effects [Note 1]. As long as the method is proper, the dietary regimen can prevent disease, and it can also help the body recover from diseases on the basis of reducing the loss of health caused by the side effects of drug treatment. This feature makes it one of the most important methods to realize disease prevention in traditional Chinese medicine. As Lou Juzhong, a famous doctor in the Song Dynasty, said, "Body is treated when food is controlled," [1] "it's the method of a good doctor in disease prevention."

The dietary regimen can be used to guide the daily diet, aid recuperation, and maintain the healthy human body in a state of harmonized Yin and hidden Yang. It is one of the most important methods to prevent diseases. It is mainly suitable for generally healthy people and sub-healthy people. Some healthy or sub-healthy people in a special physiological stage, such as the old, the young, and pregnant women, should pay special attention to the rationality of the diet structure and methods.

According to the above-mentioned factors, as a part of the art of traditional Chinese medicine, food and nourishment is based on the general guiding principle of "three-factor adaptation." The guiding effect of "three-factor adaptation" on food and feeding is mainly manifested in the formulation of different dietary regimens because of individual, seasonal, and geographic differences.

Individual adaptation is the need to make different dietary plans according to the physical condition of the individual. For example, some people often have symptoms such as fatigue, lower energy, and shortness of breath, but examination shows that the physiological indicators are within the normal range. These kinds of people are most likely to belong to the sub-healthy group with qi deficiency. People with qi deficiency can be nurtured by eating more food that can benefit qi and invigorate the spleen, such as soybeans, lentils, chicken, loach, Lentinus edodes, jujube, cinnamon, and honey. At the same time, they should eat less food that cause gas, such as betel nut, cabbage, and lettuce. For the old, young, pregnant, and other special groups, we should pay more attention to the rationality of the dietary plan.

Seasonal change adaptation is the need to make different dietary plans according to the climate. Traditional Chinese medicine holds that: spring budding, summer growing, autumn harvesting, and winter storing. For example, in the spring, the Ginkgo biloba sprouts; in the summer, it produces fruit; in the autumn, it ripens and its leaves fall; and in the winter, there is only a bare trunk. The Zang-fu organs of the human body will also have different physiological reactions in different seasons, especially the five Zang organs of the liver, heart, spleen, lung, and kidney (and the correlated six Fu organs) will have the exuberant performance of qi in the corresponding spring, summer, long summer, autumn, and winter, respectively. Therefore, the dietary regimen should follow the law of nourishing the liver in spring, nourishing the heart in summer, nourishing the spleen in summer, nourishing the lung in autumn, and nourishing the kidney in winter, often with half the effort and belonging to the important part of seasonal health.

Take nourishing the liver in spring as an example. It is stated in Su Wen "Ying Yang Ying Xiang Da Lun" (《素问·阴阳 应象大论》Basic Questions Comprehensive Discourse on Phenomena Corresponding to Yin and Yang) that "Wind is originated from the east and promotes wood, wood promotes sourness, sourness promotes the liver (东方生风，风生木， 木生酸，酸生干)…." [2] Hence, spring belongs to wood, wood qi can produce a sour taste for nourishing the liver. It is not so correct that people think to replenish the liver in spring. According to Su Wen "Si Qi Tiao Shen Da Lun" (《素问·四 气调神大论》Basic Questions Comprehensive Discourse on Regulating the Spirit (in Accordance with) the Qi of the Four Seasons), spring is a new birth season; people should act according to the "budding" characteristics of spring; the so-called "sprouting gradually, giving birth instead of killing, giving instead of taking, rewarding instead of punishing (披 发缓行，以使志生，生而勿杀，予而勿夺，赏而勿罚)" in order to correspond to the spring spirit. What happens if you don't do it? "Reverse damage to the liver, getting cold in summer, less dedication for growing (逆之则伤肝，夏为寒 变，奉长者少)." [2] Therefore, the author believes that, like emotion, Qi guidance, and other health maintenance methods, the main responsibility of the dietary regimen in seasonal health is to maintain the Zang-fu organs in a healthy seasonal physiological state, such as the liver governs free flow of qi and prefers free activity. The key point of spring liver is to maintain the liver in a state of adjustment to correspond to the birth of spring, and at the same time to prepare for the arrival of the next season. This is also the embodiment of the thought of disease prevention in traditional Chinese medicine.

Seasonal feeding does not blindly replenish, but depends on the physical state of people to decide whether to replenish or purge, how to replenish, and how to purge, in order to help the Zang-fu organs adapt to the characteristics of the season. For example, traditional Chinese medicine has the method of "replenishing form," but the "synopsis of the Jin Gui Yao Lue (《金匮要略》 Synopsis of the Golden Chamber)" puts forward that "spring does not eat liver, summer does not eat heart, autumn does not eat lung, winter does not eat kidney, the four seasons do not eat spleen (春不食肝，夏不食心， 秋不食肺，冬不食肾，四季不食脾)." [3] Taking tonifying the liver as an example, Zhongjing explains that there are two main reasons why liver is not eaten in the spring: (1) Spring is the season of exuberant liver qi, if eating liver to replenish liver, it will lead to excessive exuberance of liver wood qi and the restraint of the spleen and soil. (2) The liver of the animal will lead to "dead gas into the liver and fear of hurting the soul." According to the above, attention should be paid to maintaining the physiological function of the liver in the state of catharsis and adjustment in spring; the liver of the animal may increase the burden of the human liver, which is not conducive to the regulation of the liver. Therefore, for people with a deficiency of liver and qi, spring is not the best season to replenish the liver with liver. So, how should this kind of person with a deficiency of liver and qi deal with spring? The author thinks that we should pay attention to the following two points: 1. Eat more vegetables. In spring, vegetables are full of woody gas, which can help the liver qi, and does not lead to overreplenishment like animal liver does. The method of "replenishing the liver with the liver" can depend on the situation in other seasons 2. Winter replenishment. Nan Jing "Liu Shi Jiu Nan" (《难 经·六十九难》Classic of Difficult Issues The Sixty-ninth Issue) "deficiency is to supplement its mother (虚则补其 母)," [4] kidney water is the mother of liver wood, so, if you want to replenish the liver, we must first do a good job in the maintenance of the kidney, and the best season to nourish the kidney is winter.

Adaptation according to places mainly refers to the characteristics of an individual's long-term geographical environment and selection of the correspondingly appropriate dietary regimen. The dietary customs are different in different parts of China, so is the embodiment of "adjustment measure to local conditions" where Sichuan people like to eat peppers because of the high humidity and hot weather of Sichuan. Hot peppers could dispel the spleen's dampness, resulting in people's relaxation. The unique features of the local environment always give special characteristics to its inhabitants. Our ancestors, to some extent, had the wit to adapt to the local geography and climate in life.

According to Bei Ji Qian Jin Yao Fang (《备急千金要方》 Essential Prescriptions Worth a Thousand Gold Pieces for Emergencies), [5] beriberi is caused by failure to adapt to local conditions. When the Jin Dynasty moved to the south [Note 2], those northern aristocrats who moved there usually did not work in their daily life, but indulged in sumptuous dishes with a generous amount of meat and fish while ignoring the humidity and hot climate in the south, so they suffered from beriberi.

The concept of three-factor adaptation (individual, season, and place) is an overarching concept, and all the three factors should be combined in their application in daily life.

As the saying goes, when you nourish yourself in the winter, you could get a stronger body in the spring. On the other hand, the climate turns cold after the start of winter; in solar terms, the Yang Qi is hidden inside the body, where the cold evil from the outside environment would invade the inside. At this time, especially the elderly and people who have a Yang deficiency, should consume nourishing and warm food such as mutton, beef, and longan to resist the cold pathogens and also take medicine when necessary. However, nourishing the body could cause irritability, nose bleeding, constipation, loss of appetite, and other symptoms to youngsters that have exuberant Yang. On the other hand, the kidney should be nourished in winter because the kidney qi is exuberant in winter and will accumulate essence to boost the liver blood. The kidney belongs to water, water promotes wood, the liver belongs to wood, and corresponds to spring. When the kidney is nourished in the winter, it could help the liver qi in spring and it could also reserve the body's strength for spring. At the same time, China has a vast territory, in which the climate varies greatly from place to place, where the time for nourishing the body and the proportion of supplements should be considered.

The dietary regimen can be used in the treatment or auxiliary treatment of disease, and is one of the important methods to realize the ideas of "preventing and curing disease" and "preventing and recovering from disease." The therapeutic effect of the dietary regimen is called food treatment, which is what we often call food therapy now. Food treatment was put forward by Sun Simiao, a famous medical scientist in the Tang Dynasty in Bei Ji Qian Jin Yao Fang "Shi Zhi" (《备急千金 要方·食治》Essential Prescriptions Worth a Thousand Gold Pieces for Emergencies Diet Therapy). [5] Its main intention is to convey that herbs that could be used as drugs are poisonous, their nature is often strong, and the use of medicine is like using an army to fight, where even if it wins, there would be a certain amount of injury. Moreover, if there is a lack of clear command, the consequences will be even more serious. Therefore, it is best to treat disease using neutral food. The treatment of disease should still be based on its priorities and one should decide whether to treat it with food or medicine. Generally, diet therapy is mainly suitable for chronic or mild disease, or auxiliary treatment, as well as in the recuperation or rehabilitation stage of the disease.

The effect of diet therapy is mainly realized through feeding prescriptions. After Sun Simiao put forward the theory of food and treatment, a large number of food and nourishing prescriptions appeared, especially in the Song Dynasty. There are 294 diet feeding prescriptions in Tai Ping Shen Hui Fang (《太平圣惠方》Taiping Holy Prescriptions for Universal Relief), which cover 28 diseases and draw a conclusion on the effect of the diet treatment.

1. "Good mood will clear disease." [6] As stated above, the dietary regimen should be effective enough to get the patient to a good mood, which would help in recovery 2. "Should be treated with a dietary regimen." [6] For some diseases, the dietary regimen could be considered the first choice. When the dietary regimen could not cure the disease, then medicine therapy should be considered. It can be seen in the book that mainly chronic diseases, non-severe diseases, and some special populations such as pregnant women and the old and young can be treated with dietary therapy. Taking the elderly as an example, Chen Zhi, a famous doctor in the Song Dynasty, pointed out [7] that the qi and blood of the elderly usually decline. If the elderly still use strong drugs to attack evil qi after they get sick, perspiration will easily lead to the leakage of Yang Qi. Vomiting will easily lead to the inversion of stomach qi. Purging will easily lead to the loss of vital energy. Therefore, the treatment of the elderly patients should involve some gentle and neutral herbs that could smooth qi and tonify the deficiency. The dietary regimen method could also be used as a treatment to help them restore their health 3. "To increase the power of medication." [6] For some diseases, the dietary regimen could improve the curative effect.

When some diabetic patients have symptoms such as upset stomach, reverse of stomach qi, and loss of appetite, they could have some almond cheese porridge to assist the treatment. It has almond cheese, milk, and barley as its recipe 4. "In order to help acute disease." [6] At that period of time, the dietary regimen is more convenient than drug treatments, so it can play a role in helping acute disease as a first-aid management.

It must be pointed out that the dietary regimen in Taiping Lu has ingredients that are considered herbs according to our modern classifications. The main reason is that the boundary between food and medicine in ancient China was relatively blurred, and many local ingredients often eaten by the ancients, such as common food in Henan province, are not in the category of food or herbal food in the sense of modern classifications. Some food could protect the body and slow down the stimulation of rigid herbs. The topic will be discussed in another article.

Modern medicine has proved that the outbreak is mainly due to some infectious and highly pathogenic viruses or bacteria that appear in a crowd and catch people off guard. However, under what conditions and how these strange viruses and bacteria are being produced is unknown, which leads to a slightly helpless situation that people could not predict, preventing them from dealing with it as soon as possible.

From a general point of view, the qi circulation theory of traditional Chinese medicine points out that if human beings are not well prepared to deal with climate change, they will be prone to illness, especially according to Su Wen "Qi Jiao Bian Da Lun" (《素问·气交变大论》Basic Questions Comprehensive Discourse on Changes Resulting from Qi Interaction), "over and insufficient" [2] will often cause more disease. There is also the theory that "pandemic will be formed due to 3-year accumulations (三年化疫)" [2] in Su Wen "Ci Fa Lun" (《素问·刺法论》Basic Questions Discussion on Acupuncutre Methods). In the Ming Dynasty, Wu Ke wrote Wen Yi Lun (《瘟疫论》Treatise on Pestilence) which put forward the theory that "epidemic disease" is caused by "feeling the lethargy of heaven and earth (感天地之疠气)." He further pointed out that the pestilent qi was miscellaneous qi, which was not among the normal seasonal qi, so it was difficult to prevent. Hence, what is the cause of the miscellaneous gas?

The author believes that "the healthy qi mechanism should stay in flowing equilibrium instead of steady to be healthy." Wu thinks that the emergence of miscellaneous gas is the combination of external climate change with the special natural environment and hygiene. These strange viruses and bacteria may not only be brought by wild animals from nature but may also be the result of a variation of the "safer" viruses and bacteria that originally existed in the population or animals. Therefore, to prevent epidemic disease, the primary task is to devote oneself to the management of the public health environment and the natural environment and to formulate health maintenance measurers to deal with the changes in the natural environment.

The dietary regimen still can be used as a preventive treatment that is anti-epidemic, and even more specific measures can be adopted. 1. Disease prevention. As the Basic Questions "Discussion on Acupuncutre Methods" stated, "when there is vital qi inside the body, the pathogen could not invade (正气存内,邪不可 干)." When the body's immunity is increased, it is not easy for disease to invade or even if the invasion occurs, the damage done to the body could be reduced. In addition to the first point of preventive treatment mentioned above, the application of the dietary regimen to fight an epidemic should consider the climate and the impact of the environment on people's health and take appropriate dietary regimen measures to avoid the body's being in an imperceptible sub-health state. With regard to this, the movement and qi theory in TCM culture, modern medical meteorology and public health science can be used for guidance. 2. Prevent inversion of disease and reoccurrence after recovery. Su Wen's "Wu Chang Zheng Da Lun" (《素问·五常政大论》Basic Questions Comprehensive Discourse on the Five Regular Policies) states that "a stronger poisonous drug could treat disease at a scale of 6 out of 10, a normal drug could treat disease at a scale of 7 out of 10, a milder drug could treat disease at a scale of 8 out of 10. When using non-poisonous drug, it could treat disease at a scale of 9 out of 10. Grains, vegetables, meat and fruits are considered as dietary regimen where there would be no harm to vital qi." [2] The treatment with drugs will eventually damage the health, over which one should have a certain degree of control and introduce a dietary regimen to help patients recover. This is one of the main concepts of Chinese medicine, through which you could expel pathogenic qi without harming the vital qi. Taking this coronavirus as an example, many patients have experienced a higher intensity of drug therapy where a reasonable dietary regimen could help patients in their recovery. It has high application value to the health maintenance work of prevention of disease, inversion of disease, and prevention of reoccurrence after recovery.

Dietary regimen, as part of traditional Chinese medicine, is a method of disease prevention that is safe, convenient, interesting, and feasible. The promotion of the dietary regimen is also conducive to the inheritance and promotion of Chinese medicine culture. Modern civilization is gradually changing the way of life and living environment of human beings, with the warming of the global climate, the emergence of new viruses, the use of air conditioning and electronic products, and so on, which are affecting human health and even genes. As President Xi Jinping emphasized in the important instructions for the work of Chinese medicine in October 2019 to the effect that to promote the development of Chinese medicine, we must follow the law of development of Chinese medicine, inherit the essence, and maintain integrity and innovation. In my opinion, maintaining the integrity is the expression of national cultural confidence, while innovation requires the development of the times and civilization, and the essence of traditional culture should be made use of for the people. For the dietary regimen, what needs to be solved the most is the safety of traditional food materials and how to effectively apply food culture to modern civilization.

Note 1: Food also has the same warmth, coldness, and heat characteristics as medicines, but most foods are not as strong as medicines, and long-term partial eclipse can also cause health damage.

Note 2: It refers to the historical phenomenon that a large number of the Han people from the North moved to the South in order to avoid war during the Yongjia period under the reign of the Jin and Yuan Emperors (307-311).

Nil.

There are no conflicts of interest.

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