關於 big large差異 ，我們在網路上蒐集到這些相關的討論、資訊與評價

【台灣防疫成效 #國際政要 都肯定👍👍👍】

第二波移入疫情強勢回流 🌀
看到確診人數增加
相信有在追指揮中心記者會的大家
內心不免七上八下
但只要我們 #謹慎應對 持續落實 #防疫工作
相信還是有機會守住J一波‼️

雖然還是會擔心
但蒐集癖小編決定要再發一篇落落長的文
讓各位看看世界各國的政要大咖
如何讚 #台灣 目前為止的防疫模式 👏👏👏

#我們不害怕雨淋
#因為我們知道大雨之後會有彩虹 🌈
#團結一心 #正向防疫
#台灣加油 💪

As the coronavirus pandemic continues, we'll endeavour to remain prudent in our epidemic prevention measures. We believe we can stem the tide.
To reinstill some confidence, we've collected a series of quotes from politicians and ministers around the world, praising the #TaiwanModel as part of the fight against the #COVID19 #WuhanCoronavirus. Read what they had to say below!

《亞太地區》

#紐西蘭 New Zealand 🇳🇿
3/15 ─ 紐西蘭總理阿爾登：「我們將緊密遵循相當接近於台灣的模式，他們(台灣政府)針對公眾集會所建立的因應架構，是相當成功的。我們將以它為根據，來設定我們的標準。」
March 15 - Prime Minister Jacinda Ardern said, in a Q+A interview on Sunday, that officials were looking at tailored criteria for events that may need to be cancelled, such as whether people would be in close proximity to one another.
“We're going to follow, pretty closely, the Taiwanese model. They worked up a framework for mass gatherings that's been quite successful,” she said.

#日本 Japan 🇯🇵
3/12 ─ 日本台灣交流協會代表泉裕泰：「我相信台灣的真知灼見可與世界各國廣泛共享，並對苦於遭受傳染蔓延的其他國家與地區做出巨大的貢獻。」
March 12 - Japan's chief representative in Taiwan, Hiroyasu Izumi, stated that he believes Taiwan's insights can be widely shared with other countries in the world and make great contributions to other countries and regions suffering from the spread of infection.

《亞非地區》

#以色列 Israel 🇮🇱
3/14 ─ 以色列總理尼坦雅胡：「順帶一提，這個方法已經在台灣試過了，可能很成功。以色列是少數國家當中，有這個能力做的。我們將採用這個方法。」
March 14 - Prime Minister Benjamin Netanyahu said it was not an easy choice to make and described the virus as an “invisible enemy that must be located.” He said Israel would follow similar methods used by Taiwan.

3/14 ─ 以色列前總理巴拉克：「以色列可以對抗新冠病毒，但必須像台灣一樣反應快速。」
March 14 - Former prime minister Ehud Barak stated that Israel can fight against the novel coronovirus, but that it must react as swiftly as Taiwan.

《拉美地區》

#尼加拉瓜 Nicaragua🇳🇮
3/11 ─ 尼加拉瓜副總統穆麗優：「我們得知台灣政府及人民實行了成功的防疫模式，我們已向台灣駐尼大使提出請求，期盼台灣與我們分享經驗，因為台灣不僅成功防制傳染，且維持人民秩序免於慌亂，確實值得學習。」
March 11 - La vicepresidenta de Nicaragua, Rosario Murillo, declaró: "Nosotros hemos conocido el Modelo exitoso de contención que puso en práctica el Gobierno y el Pueblo de la República de China(Taiwán), y hemos pedido a su Embajador aquí, que nos presenten ese Modelo exitoso, porque han logrado no solo contener, sino también mantener a la población en un estado que no esté de pánico." (The vice president of Nicaragua, Rosario Murillo, stated, "We are aware of the successful model of prevention that the government and the people of Taiwan have put into practice, and we've asked the Taiwanese ambassador to make a presentation on this successful model, because they've not only managed to contain the virus, but they've kept their population from panicking.")

#聖文森 Saint Vincent and the Grenadines🇻🇨
3/12 ─ 聖文森衛生部長布朗：「台灣因『一個中國』原則不被承認為獨立國家，因此未被納入參與「世界衛生大會」（WHA），台灣距離中國僅為海峽之隔，然而疫情爆發至今卻僅有少數確診病例，我已正式致函何大使尋求台灣的協助以對抗聖國疫情。」
March 12 - "It’s quite remarkable that they’re just 81 miles from mainland China and whereas coronavirus in mainland China has been spiralling out of control...That’s incredible,” Health minister Luke Brown said. Taiwan is not a part of the World Health Assembly as it is not recognised as being an independent country under the One-China policy. Browne said the ambassador has mentioned some of the measures that Taiwan has taken, some of which he believes will work in the Vincentian context while others may not.

#聖露西亞 Saint Lucia🇱🇨
3/11 ─ 聖露西亞衛生部長艾瑟柯：「目前全球正共同對抗來自中國武漢的新型冠狀病毒，聖露西亞政府藉此機會讚許臺灣採取有效率且具成效的防疫措施，並提議與露國緊密合作防疫。」
March 11 - “As the world is fighting the COVID-19 Coronavirus originated from Wuhan, China, the Government of Saint Lucia wishes to take this opportunity to commend Taiwan for its efficient and efficacious measures, and its offer to work closely with Saint Lucia to contain the pandemic,” said Health Minister Mary Isaac.

#貝里斯 Belize🇧🇿
2/4 ─ 貝里斯衛生部長馬林：「貝國政府及衛生部肯定台灣關鍵的公衛措施，包括對隔離案例進行電子監控、口罩及其他物資供應，強化防疫工作。」
Feb. 4 - Minister of Health, Hon. Pablo Marin: “The Government of Belize, and by extension the Ministry of Health, applauds Taiwan’s key public health measures that include electronic monitoring of quarantined cases and the provision of masks and other items to support the prevention efforts.”

#巴拉圭 Paraguay🇵🇾
3/17 ─ 巴拉圭參議員法切提：「儘管與WHO無任何合作關係，台灣仍向前行…台灣也因此能夠成功防堵新冠病毒。」
March 17 - Fernando Silva Facetti, Paraguayan politician: "A PESAR DE LA NULA COOPERACIÓN DE LA @opsoms, #TAIWAN SIGUE ADELANTE... Así es como Taiwán logró contener el brote de #coronavirus" (Despite the lack of cooperation from the WHO, Taiwan continues to progress... This is how Taiwan managed to contain the coronavirus.)

#委內瑞拉 Venezuela🇻🇪
3/13 ─ 委內瑞拉臨時政府代表楊杰斯議員：「感謝情同手足的台灣人民贈交我們防疫所需的口罩及酒精。Taiwan Can Help！」
March 13 - Jesús M. Yánez M., Venezuelan politician: "Gracias a el hermano pueblo de Taiwan nos encontramos entregando tapa boca y kits de alcohol, denunciando la falta de prevención y de medidas acordes contra el COVIDー19 Taiwan Can Help" (Thanks to our brothers and sisters in Taiwan, we find ourselves with face masks and alcohol kits, denouncing the lack of prevention and appropriate measures against COVID-19. Taiwan Can Help.)

3/15 ─ 委內瑞拉駐西班牙大使艾卡利：「台灣及早警覺，並已阻擋了疫情擴散。」
March 15 - Antonio Ecarri B., Ambassador of Venezuela in Spain: "Taiwan se alarmó y frenó su expansión." (Taiwan was alarmed and curbed the spread.)

#阿根廷 Argentina 🇦🇷
3/11 ─ 阿根廷國會議員康帕紐利：「台灣是成功控制疫情的模範。」
March 11 - Marcela Campagnoli, National Deputy in Argentina: "Taiwan es un ejemplo de como lo han controlado." (Taiwan is an example of how to control it.)

3/16 ─ 阿根廷國際關係委員會秘書長桑提巴聶茲：「認為威權政府防疫工作做得比民主國家好，這個想法是錯的。台灣、韓國及新加坡做得非常好，他們都是民主國家。」
March 16 - Francisco de Santibañes, Secretary General of the Argentine Council for International Relations: "Sería un error pensar que los gobiernos autoritarios actuaron mejor que las democracias a la hora de controlar el coronavirus. Corea del Sur, Singapur y Taiwán lo hicieron muy bien y son democracias." (It would be a mistake to think that authoritarian governments act better than democracies in curbing the coronavirus. South Korea, Singapore and Taiwan did it very well and they're democracies.)

#哥倫比亞 Colombia🇨🇴
3/12 ─ 哥倫比亞內科醫師學會前主席希尼爾：「看看台灣，從全球確診統計圖表中漸漸消失，並對照其他亞洲國家防疫進展。他們比其他國家聰明嗎？不，是因為他們比較有組織、守紀律！」
March 12 - Juan Senior, ex-president of the Colombian Association of Internal Medicine: "Miren la evolución de Taiwán, desaparece del panorama y como evoluciona la epidemia en países asiáticos. Son más inteligentes que todos? No, son más organizados y disciplinados!!!" (Look how things have gone in Taiwan, they're out of the picture now and how the epidemic has developed in asian countries. Are they smarter than everyone else? No, they're more organized and more disciplined!!!)

#巴拿馬 Panama 🇵🇦
3/11 ─ 巴拿馬前駐台大使馬締斯：「台灣向世界展現，他們運用2003年抗煞所學到的經驗，準備好對抗新冠疫情。」
March 11 - Dr. Alfredo Martiz, former Ambassador of Panama in Taiwan: "Lo que Taiwán puede enseñar al mundo sobre la lucha contra el coronavirus Análisis: Taiwán aprovechó las lecciones aprendidas durante el brote de SARS de 2003, y esta vez su gobierno y su pueblo estaban preparados" (What Taiwan can teach the world about the fight against the coronavirus. Analysis: Taiwan took the lessons learned during the SARS outbreak of 2003 and this time its government and its people were ready.)

《歐洲》

#捷克 Czech Republic🇨🇿
3/15 ─ 捷克總理巴比斯：「政府決定改變中央危機應變中心的定位及人員調度，仿照如同媒體所報導台灣的因應做法。」 March 15 - Prime Minister Andrej Babis: “The government decided to change the status of the Central Crisis Staff, where the crisis staff will be modeled, as we read in the media and it was in Taiwan.”

#丹麥 Denmark🇩🇰
3/18 ─ 丹麥前總理拉斯穆森：「台灣利用大數據、透明、由中央指揮的防疫作為奏效，值得世界各國學習。現在是時候告訴中國，確有地方可以討論地緣政治的，但不是在世界衛生組織。」 March 18 - In his March 18 piece in Time Magazine, former prime minister of Denmark Anders Fogh Rasmussen, stated "After the first notifications at the end of 2019, Taipei swiftly deployed a combination of measures to identify and contain the virus, including the use of big data to help contain potential cases."

#法國 France🇫🇷
3/5 ─ 前法國衛生部長及外交部長杜斯特：「檢視中央集權與非中央集權國家決策模式的差異十分有意思。台灣雖緊鄰中國卻可能是受武漢肺炎死亡率最低及受影響最輕的國家，其防疫成果完全令人難以置信，是為出色的危機管理。」
March 5 - Former French health and foreign minister Philippe Douste-Blazy said, "Ce qui est très intéressant en regardant les différents pays, c’est la centralisation ou la non-centralisation des décisions. Et on s’aperçoit que par exemple Taiwan est probablement le pays où il y a le moins de létalité et le pays le moins touché alors que c’est extrêmement près de la Chine. Le résultat est absolument invraisemblable. C’est une magnifique gestion de crise." (What is quite interesting with different countries, is centralization vs non-centralization of decisions. And one realizes that, for example, Taiwan is probably the country where the mortality rate is the lowest and the least affected country despite its extreme proximity to China. The result is absolutely implausible. It’s wonderful crisis management.)

3/7 ─ 法國國民議會友臺小組主席瑟賽希尼：「臺灣是處理武漢肺炎疫情的典範。」
March 7 - The chair of the French National Assembly's France-Taiwan Parliamentary Friendship Group, Jean François Cesarini, stated "Taïwan : Exemplaire dans sa gestion de l’épidémie du Coronavirus." (Taiwan: an excellent model for the management of the coronavirus epidemic.)

3/6 ─ 法國國民議會友臺小組副主席拉赫迪耶：「臺灣堪稱處理武漢肺炎危機的典範。」
March 6 - The deputy chair of the French National Assembly's France-Taiwan Parliamentary Friendship Group, Laure de La Raudière, stated "Gestion exemplaire de Taiwan de la crise du Coronavirus." (Taiwan's exemplary management of the coronavirus crisis.)

#義大利 Italy🇮🇹
3/16 ─ 義大利前外交部長德爾其：「台灣可能是第一個向WHO報告新冠病毒人傳人的國家，而且早在中國和WHO承認之前。顯然地，台灣因為北京施壓，被排除在世衛組織之外已有兩年之久。」
March 16 - Former foreign minister, Giulio Terzi: "Taiwan potrebber esser stato primo Paese a comunicare alla OMS che coronavirus COVID19 si stava trasmettendo da uomo a uomo.Molto prima che Cina e OMS lo ammettessero. Ovviamente, per volere Pechino, Taipei subisce esclusione da OMS da due anni." (Taiwan may have been the first country to report to WHO that coronavirus COVID19 was spreading from amongst humans, long before China and WHO admitted it. Obviously, at the behest of Beijing, Taipei has been excluded from WHO for two years.)

3/19 ─ 義大利北聯黨外交事務首席法拉利，轉推蔡總統「台美簽署防疫聯合夥伴關係聲明」推文：「這是向中國，也是向世界傳達的重要訊息。」
March 19: Lega Nord head of foreign affairs in Lombardy, Max Ferrari: "Coronavirus. Importante messaggio alla Cina e al mondo da Taiwan e Usa." (Coronavirus. Important message to China and the world from Taiwan and the USA.)

#歐盟 EU🇪🇺
3/14 ─ 歐洲議會議員暨中國關係代表團團長包瑞翰：「在這次疫情危機中，台灣在拯救生命方面做得很好。為什麼不邀請他們充分參與國際呢？ 為什麼WHO不這樣做？因為北京玩弄民族主義政治，犧牲人民的利益。」
March 14 - “Taiwan is doing a great job with saving lives in this corona crisis. Why not acknowledge that and invite them to participate fully in international efforts? Why doesn't WHO do it? Because Beijing is playing nationalist politics at people's expense,” said Reinhard Bütikofer

#英國 UK 🇬🇧
3/13 ─ 英國前衛生大臣杭特表示，政府應採取更積極的行動，包括禁止探視養老院的長者。他認為，英國應該像是泰國和台灣等已控制住疫情的國家一樣，採取行動。
March 13 - Jeremy Hunt, the UK former health secretary: "Countries like Thailand and Taiwan had controlled the outbreak by taking such action. People will be concerned we are not moving sooner on social distancing."

#瑞典 Sweden🇸🇪
2/18 ─ 瑞典國會議員溫和黨主席席德斐：「從長遠來看，世衛組織不願將台灣納入扼止新冠病毒傳播及由該病毒所引起的傳播的任務，是完全站不住腳的，並且從很多面向來看是適得其反，例如從醫學和經濟角度。」
Feb. 18 - Moderate Party MP Margareta Cederfelt pointed out that “WHO’s unwillingness to include Taiwan in its work with limiting the spread of the coronavirus and stopping infections caused by the virus in the long-run, is indefensible and counterproductive seen from several perspectives, for example from a medical and economic perspective.”

#德國 Germany🇩🇪
3/13 ─ 德國自民黨主席國會議員布本多弗：「有一個國家在抗疫上脫穎而出，運用明確的策略及冷靜的態度有效對抗新冠肺炎，這個國家就是臺灣。」
March 13 - Chair of the district association Mühldorf am Inn of the FDP Bavaria Sandra Maria Bubendorfe: "Bei meiner 3. Rede im Deutschen Bundestag zum Thema Zivil und Katastrophenschutz in Deutschland vergangen Freitag, war es mir ein besonderes Bedürfnis Taiwan hervorzuheben, das gezeigt hat wie man mit klaren Strategien und kühlen Kopf auf die Gefahr des Corona Virus antworten kann und damit die Ausbreitung deutlich erschwert und verlangsamt wird." (During my third speech in the German Bundestag on civil and civil protection in Germany last Friday, I felt a need to highlight Taiwan, which showed how to respond to the dangers of the coronavirus with a clear strategy and a cool head, and thus significantly slowed its spread.)

#荷蘭 The Netherlands🇳🇱
3/18 ─ 荷蘭前中央銀行主席維林克：「臺灣防疫預警作為，是這個擁有約2400萬居民，且每年接受約300萬中國旅客往訪的國家，迄今得以有效控制疫情的關鍵作為。」
March 18 - The former head of the Dutch central bank stated that with its 24 million strong population and 3 million annual tourists from China, Taiwan has unrolled effective key measures to curb the spread of the epidemic.

3/18 ─ 荷蘭50 Plus黨眾議員兼主席克羅及民主論壇黨眾議員兼主席伯德特：「台灣是成功例子」 無黨籍眾議員哈加：「台灣大量檢測與居家隔離，成功控制疫情，為何荷蘭不學習？」
March 18 - The leaders of the 50PLUS party and the Forum for Democracy, Henk Krol and Thierry Beaudet, stated that Taiwan has provided a successful model. Independent Dutch MP Wybren van Haga stated that Taiwan has been testing on a large scale and enforcing home quarantines, successful measures in curbing the epidemic and asked why the Netherlands wasn't learning from their example.

#瑞士 Switzerland 🇨🇭
3/10 ─ 瑞士國會下議員瓦爾德：「臺灣對抗新冠病毒具特別成效。」 March 10 - Swiss National Councillor Nicolas Walder said Taiwan's response to the novel coronavirus has been particularly effective.

#葡萄牙 Portugal🇵🇹
3/15 ─ 葡萄牙前人民黨黨揆暨資深媒體評論家波塔斯：「台灣承襲2003年對抗SARS經驗，成功壓抑疫情曲線峰值，值得葡國作為借鏡。」
March 15 - Former Deputy Prime Minister of Portugal and media personality Paulo Portas stated that Taiwan's experience in fighting SARS in 2003 allowed it to be successful in flattening the curve, providing a model Portugal can learn from.

3/18 ─ 葡萄牙國會友臺小組歐利維拉：「台灣病例出現雖早，卻在努力下獲得很好的控制，台灣防疫措施值得肯定及學習。」
March 18 - Chair of the Portugal-Taiwan Parliamentary Friendship Group Paulo Rios de Oliveira stated that although cases in Taiwan started to appear quite early on, they've controlled it very well with a lot of effort. Taiwan's epidemic control measures should be praised and studied.

#西班牙 Spain🇪🇸
3/13 ─ 西班牙前國會議員瓦紐費瑞：「這些措施證明台灣公衛模式有效，包括世界上最先進的醫衛系統、自2003年抗煞以來所累積的廣泛防疫經驗等。」
March 13 - Francisco Vañó Ferre, a former member of the Spanish Parliament: "Estas y otras medidas prueban la eficacia del modelo sanitario de Taiwán, que cuenta con uno de los más avanzados sistemas de salud del mundo y con amplia experiencia en la lucha contra enfermedades contagiosas tras haber sufrido la epidemia del SARS en 2003." (These and other measures prove the efficacy of the health model of Taiwan, which has one of the most advanced health systems in the world and a wealth of experience in the fight against contagious diseases, after having suffered from the SARS epidemic in 2003.)

#匈牙利 Hungary🇭🇺
3/15 ─ 匈牙利醫師學會：「在中國其他省份和其他亞洲國家，例如台灣和新加坡等，已經能夠預防感染的傳播。」
March 15 - The Hungarian Medical Chamber stated “In other provinces of China and other Asian countries (eg Taiwan, Hong Kong and Singapore) have been able to prevent the spread of the infection.”

北美：
#美國 US🇺🇸
2/5 ─ 美國前衛生部長派司：「台灣已經證明其防疫行動極為負責且透明，特別是在醫學和科學領域。最近有幸到訪台灣，台灣協助研發疫苗或以其他方式協助拯救生命，並促進人類對抗病毒的能力及情報，此刻尤顯出色。」
Feb. 5 – US former secretary of health and human services Tom Price: "Taiwan has shown itself to be extremely responsible and transparent in its actions, especially in the area of medicine and science. Having had the privilege of visiting recently, the capacity of Taiwan to help formulate a vaccine or assist in other ways to help save lives and advance human engagement and intelligence at this time is remarkable."

#加拿大 Canada🇨🇦
3/6 ─ 加拿大前國務部長契爾格：「將台灣排除在世衛組織之外，會讓新冠病毒對其國民和世界其他地區變得更加危險。」
March 6 - Canadian former secretary of state David Kilgour: “Excluding Taiwan from contact with WHO makes COVID-19 more dangerous for its nationals and the rest of the world.”

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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