Anti-nue Boost the Qi

by Bob Flaws, Dipl. Ac. & C.H., FNAAOM

Recently, a customer called to say that they had tried our latest formula, Anti-nue Boost the Qi, on a CFIDS patient and it had not worked as well as our other formulas. Since most American practitioners are not well versed in the concept of nue, I'd like to share some thoughts on why this formula may not have achieved the desired results in this patient.

According to Wiseman and Feng in A Practical Dictionary of Chinese Medicine, the Chinese disease category of nue or malaria refers to "a recurrent disease characterized by shivering, vigorous heat [effusion], and sweating..." Its disease cause is typically an external invasion by heat evils which then lodge in the shao yang division, i.e., half exterior and half interior. While the Chinese concept of nue describes malaria in its Western medical sense, it also describes any disease characterized by periodic outbreaks of fever, chills, and sweating. In addition, there a number of different kinds of nue: wind malaria, summerheat malaria, damp malaria, cold malaria, warm malaria, pure heat malaria, etc. One of the kinds of malaria in Chinese medicine lao nue, taxation malaria. This kind of nue is triggered by and associated with marked taxation fatigue. According to Wiseman and Feng, "Taxation malaria is characterized by mild aversion to cold and mild heat effusion [i.e., mild fever] occurring in the day or at night, with attacks being brought on by taxation." Other characteristics of taxation malaria include the fact that it is an enduring condition and that it is associated with marked debility of the correct or righteous qi.

Since many chronic fatigue immune deficiency syndrome (CFIDS) patients suffer from periodic episodes of fever (and chills) provoked and accompanied by pronounced fatigue, I believe that many CFIDS patients fall under the traditional Chinese disease category of taxation nue. When patients are diagnosed with taxation malaria and they exhibit the patterns of marked qi vacuity with damp heat evils lodged in the shao yang, Blue Poppy Herbs' anti-nue modification of Bu Zhong Yi Qi Tang (Supplement the Center & Boost the Qi Decoction) has proven itself clinically effective for several hundred years.

However, in order for this formula to work, your CFIDS patient must have taxation nue. That means that they must exhibit periodic episodes of low-grade fever, typically provoked by exacerbations in fatigue (or anything else which further damages the spleen). Not all CFIDS patients have such episodes of fever. In those cases, they do not have the traditional Chinese disease diagnosis of taxation nue, and they should not be treated with this formula. Further, these patients must also exhibit the following constellation of patterns:

1. marked spleen qi vacuity
2. damp heat lodged in the shao yang, with dampness being more pronounced than heat
3. liver depression qi stagnation
4. possible lung-stomach fluid damage or yin vacuity due to enduring heat damaging both the qi and yin fluids.

If your patient does not have either this traditional Chinese disease diagnosis or this combination of patterns, then this formula is not the right one. In other words, Blue Poppy Herbs Anti-nue Boost the Qi formula is not a CFIDS formula. Standard professional Chinese medicine is practiced based on A) the patient's traditional Chinese disease diagnosis and B), and even more importantly, the patient's personal pattern discrimination. It should not be practiced solely or even primarily based on a Western medical disease diagnosis. Our anti-nue version of Bu Zhong Yi Qi Tang is based on a formula originally created by Li Dong-yuan and then modified by Ye Tian-shi. These are two of the greatest names in the history of Chinese medicine. When this formula is correctly prescribed based on a combination of correct Chinese disease diagnosis and pattern discrimination, we feel confident of its efficacy. I have personally used this formula in my practice for a number of years with success.

However, in order to achieve success with this formula, the dose also needs to be correct. The FDA requires that all "herbal supplements" have a serving size listed on the label. The FDA does not allow for a dosage range. In order to prevent mishaps by the uninformed, Blue Poppy Herbs (like other Chinese medicinal suppliers) publishes the low end of the dosage range on our labels. Therefore, not only do you need the correct disease diagnosis and pattern discrimination, you also need the right dose. In many cases, this means prescribing more than the serving size published on the label. In other cases, it means prescribing less. Dosing guidelines, based on age, weight, and condition are explained in some detail in Blue Poppy Herbs Product Manual & Guide.

And last but not least, it goes without saying that, in order to achieve clinical success with this formula, the patient's diet and lifestyle must be adjusted first. Patients with taxation nue typically have marked spleen qi vacuity detriment. Therefore, their spleens are easily damaged even further by faulty diet, excessive thinking and worry, and both too much and too little exercise. Typically, their spleens are also further weakened by damp, hot weather. Because of their enduring disease and the frustration this entails, they also will have liver depression qi stagnation. Therefore, anything which damages the liver or causes inhibition of the qi mechanism will further deteriorate their condition and/or impede healing. While Blue Poppy Herbs are made from the highest potency Chinese medicinal concentrates on the market today, no formula can achieve its full effects without patient adherence to their total treatment plan, and that total treatment plan must include diet and lifestyle.

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