Glandular
fever is an infectious disease caused by the
Epstein-Barr virus. Some TCM practitioners who were trained in China might not be
familiar with this, but its formal name -- infectious mononucleosis, will be
more familiar.
The
diagnosis of this disease is not difficult. The main points of diagnosis are
included in the names of the disease. The clinical manifestations are fever
with swollen glands, sore throat, headache,
fatigue and muscle ache. These symptoms are
similar to flu, except that the patient will have a unique blood test result
with monocytes count
significantly increased. There may be swollen lymph nodes, enlarged liver and
spleen, widespread red skin rash without itchiness.
This
disease can occur in any age groups but young people between 10 and 25 years
are most vulnerable to this infection. The
incubation period from infection to when the symptoms first appear is between
30 and 50 days.
Western
medicine does not have any efficient treatment for infections caused by virus.
Usually patients will be prescribed medicine such as paracetamol or ibuprofen to
ease the symptoms. Antibiotics may be used if the patient developed a secondary
bacterial infection of the throat. Steroids may also be prescribed in severe
swelling of tonsils.
Chinese
medicine diagnosed this disease as Wenbing (温病,
epidemic febrile). It is due to wind-heat or
wind-cold invading the superficies. The
exogenous evils produce heat and toxin. These heat-toxin spread to the blood,
it consumes qi and body fluid, then causing qi and yin deficiency at a later
stage.
Chinese
medicine treats glandular fever with different treatment principles at
different stages. In the early stage the diagnosis is due to wind-heat invading
the lung, we can use modified Yinqiao San to clear and detoxify wind-heat. In the middle stage where the heat develops
from Wei stage to Qi stage, we need to use modified Baihu
Tang to purge the internal fire. In the later stage the heat develops to Ying stage, we select Qingying Tang to
clear heat and cool the blood. At the recovery stage, patients usually have qi
and yin deficiency symptoms, we should then select modified Zhuye Shigao Tang
to clear the remaining fever and tonify qi and yin.
Some
Chinese herbs have a good function of inhibiting virus which can be applied to
treat glandular fever. These are
Banlangen (Radix Isatidis), Daqingye (Folium Isatidis), Lianqiao (Fructus Forsythiae),
Jinyinhua (Lonicera japonica Thunb), Guanzhong
(Cyrtomium Rhizome), Huangqin (Radix Scutellariae). If the patient has red skin
rash appearing, I would like to add Chishao (Red
Peony Root), Mudanpi (Tree Peony Bark),
Zicao (Radix Lithospermi), Qiancao (Radix Rubiae), Xuanshen (Radix
Scrophulariae) to cool blood. If the patient has qi and yin deficiency,
Maimendong (Dwarf Lilyturf Tuber),
Zhuye (Folium Phyllostach Lophatheri), Zhimu (Rhizoma Anemarrhenae), Taizishen
(Radix Pseudostellariae) can be added.
In
addition to Chinese herbal medicine, acupuncture can also be used to treat
glandular fever. The commonly used points are Hegu (LI4), Quchi (LI11), Waiguan
(SJ5), Dazhui (Du14), Fengmeng (BL12), Feishu (BL13), Xuehai (SP10). A reducing manipulation can be applied. In
some severe cases with high temperature, bloodletting cupping at Dazhui (DU14)
is necessary.
Glandular
fever usually takes 2-4 weeks to resolve without complications. In about 3 per
cent of the cases, it might develop into complications such as pneumonia, anaemia,
thrombocytopenia, meningitis or encephalitis. Three percent is a very low chance, but if it
happened to an individual person that mean a hundred percent to him/her. Glandular
fever should not be ignored. If a
patient has got this disease, he should have plenty of rest, drink plenty of
water, and access to a Chinese medicine practitioner. I am sure Chinese herbal
medicine and acupuncture can give more help than chemical drugs.
