Full download test bank at ebookmeta.

com

COVID 19 from Traditional Chinese Medicine

Perspective Severe Clinical Cases in the Context
of Syndrome Differentiation 1st Edition Luqi Huang
Hao Li Wensheng Qi Zhixu Yang Qing Miao
For dowload this book click LINK or Button below

https://ebookmeta.com/product/covid-19-from-
traditional-chinese-medicine-perspective-severe-
clinical-cases-in-the-context-of-syndrome-
differentiation-1st-edition-luqi-huang-hao-li-
wensheng-qi-zhixu-yang-qing-miao/
OR CLICK BUTTON

DOWLOAD EBOOK

Download More ebooks from https://ebookmeta.com

More products digital (pdf, epub, mobi) instant
download maybe you interests ...

COVID 19 from Traditional Chinese Medicine Perspective

Severe Clinical Cases in the Context of Syndrome
Differentiation 1st Edition Luqi Huang

https://ebookmeta.com/product/covid-19-from-traditional-chinese-
medicine-perspective-severe-clinical-cases-in-the-context-of-
syndrome-differentiation-1st-edition-luqi-huang/

Use of Patented Traditional Chinese Medicine Against

COVID 19 1st Edition Huaqiang Zhai

https://ebookmeta.com/product/use-of-patented-traditional-
chinese-medicine-against-covid-19-1st-edition-huaqiang-zhai/

Folklore Studies of Traditional Chinese House-Building

1st Edition Shiwu Li

https://ebookmeta.com/product/folklore-studies-of-traditional-
chinese-house-building-1st-edition-shiwu-li/

Clinical Cases in Internal Medicine 1st Edition Samy

Azer

https://ebookmeta.com/product/clinical-cases-in-internal-
medicine-1st-edition-samy-azer/
Polymorphism in Crystals Jingxiang Yang Xin Huang

https://ebookmeta.com/product/polymorphism-in-crystals-jingxiang-
yang-xin-huang/

Cybersecurity Lessons from CoVID 19 1st Edition Slade

https://ebookmeta.com/product/cybersecurity-lessons-from-
covid-19-1st-edition-slade/

Essence of Traditional Chinese Medicine 1st Edition

Wenjun Zhu Yuan Lin Sim Kim Cheng

https://ebookmeta.com/product/essence-of-traditional-chinese-
medicine-1st-edition-wenjun-zhu-yuan-lin-sim-kim-cheng/

Best 2022 Clinical Cases in Intensive Care Medicine:

From the ESICM NEXT Committee Clinical Case Contest 1st
Edition David Pérez-Torres

https://ebookmeta.com/product/best-2022-clinical-cases-in-
intensive-care-medicine-from-the-esicm-next-committee-clinical-
case-contest-1st-edition-david-perez-torres/

The Beginnings of Chinese Civilization Chi Li Chi Li

https://ebookmeta.com/product/the-beginnings-of-chinese-
civilization-chi-li-chi-li/
Published by
World Scientific Publishing Co. Pte. Ltd.
5 Toh Tuck Link, Singapore 596224
USA office: 27 Warren Street, Suite 401-402, Hackensack, NJ 07601
UK office: 57 Shelton Street, Covent Garden, London WC2H 9HE

Library of Congress Control Number: 2020950190

British Library Cataloguing-in-Publication Data

A catalogue record for this book is available from the British Library.

〈〈重型新冠肺炎案例精选: 中医治疗策略与分析〉〉
Originally published in Chinese by Shanghai Scientific & Technical Publishers
Copyright © 2020 by Shanghai Scientific & Technical Publishers
English translation rights arranged with Shanghai Scientific & Technical Publishers

COVID-19 FROM TRADITIONAL CHINESE MEDICINE PERSPECTIVE

Severe Clinical Cases in the Context of Syndrome Differentiation
Copyright © 2021 by World Scientific Publishing Co. Pte. Ltd.
All rights reserved. This book, or parts thereof, may not be reproduced in any form
or by any means, electronic or mechanical, including photocopying, recording or
any information storage and retrieval system now known or to be invented,
without written permission from the publisher.

For photocopying of material in this volume, please pay a copying fee through the
Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, USA.
In this case permission to photocopy is not required from the publisher.
ISBN 978-981-122-874-2 (hardcover)
ISBN 978-981-122-875-9 (ebook for institutions)
ISBN 978-981-122-876-6 (ebook for individuals)

For any available supplementary material, please visit

https://www.worldscientific.com/worldscibooks/10.1142/12056#t=suppl

Typeset by Stallion Press

Email: enquiries@stallionpress.com

Printed in Singapore
 Preface

With white clothes and armor, national doctors of traditional Chinese

medicine (TCM) took the lead. In late January 2020, the outbreak of
COVID-19 in Wuhan had concerned millions of people across the
country. Under the unified leadership of the Central Committee of
the Communist Party of China (CCCPC) and the State Council, and
the State Administration of TCM’s unified deployment, China
Academy of Chinese Medical Sciences (CACMS) quickly established
the first batch of the national TCM medical teams consisting of 35
people from Xiyuan Hospital and Guang’anmen Hospital, and led by
Academician Luqi Huang, president of CACMS. On January 25th, the
first day of the Lunar New Year, the medical team rushed to Wuhan
and completely took over the No. 1 south ward of Wuhan Jinyintan
Hospital.
All of patients in the No. 1 south ward were severe or critical
cases of COVID-19. In the absence of any effective antiviral drug or
vaccine from western medicine, Academician Luqi Huang proposed
to highlight the advantages of TCM on COVID-19 treatment by
starting the treatment at an earlier stage and fully participating and
getting involved deeply during the whole treatment process, in order
to bring TCM into full play for the prevention and control of COVID-
19.
During the following 66 days, the first batch of the national TCM
medical team demonstrated in practice the responsibility that a
national team should take and, fulfilled the historical mission, “for
the country, for the people”, and showed the spirit of dedication of
“an eminent and sincere doctor”. With hard work, the prevention and
control of COVID-19 was achieved in a phased manner, which
contributed the “China Method” and “China Experience” to people
around the world for the prevention and treatment of COVID-19.

First of all, multiple methods were developed

simultaneously, where scientific and clinical research
promoted each other reciprocally. “Treating, researching and
summarizing at the same time” was the working principle that was
strictly adhered to by the national TCM medical team. The TCM
medical team always attached equal importance to clinical, nursing,
and scientific research, along with coordination and cooperation
among the frontline and back-end teams. The clinical and basic
research promoted and complemented each other, leading to a
series of new concepts, new techniques, and new methods, which
made outstanding contributions to the prevention and control of
COVID-19.

Second, the deployment was made scientifically, where the

TCM treatment plan set the benchmark. “Scientific analysis,
precise treatment” was the decision-making principle of the national
TCM medical team. According to the characteristics of the disease,
the medical team made scientific policies and conducted classified
treatments. Aiming at different stages of prevention, treatment, and
rehabilitation, the medical team formulated a set of mature and
effective treatments for COVID-19, based on four main
characteristics: treating at an earlier stage, participating in the whole
process, classifying the case as per the respective methods, and
laying equal emphasis on both TCM and western medicine.
Moreover, based on the clinical data, the treatment plan was
continually optimized according to the clinical characteristics of the
disease, which fully demonstrated the characteristics and advantages
of TCM in COVID-19 treatment.

Third, new drugs were under research and development,

where effectiveness was shown following the principle
“eliminating dampness and dispelling toxin”. “Dispel the evil
Qi and strengthen the healthy Qi, eliminate dampness and dispel
toxin” was the principle and method of treatment that the national
TCM medical team summarized from clinical practice. At the early
stage of clinical treatment, Academician Luqi Huang asked the back-
end team to prepare for new drug research and development, so
that it could be started once the effective prescription was
determined. With the gradual understanding of COVID-19, the
national TCM medical team continually optimized the treatment plan
according to the clinical characteristic of the disease, and finally
established the treatment principle, “dispelling the evil Qi and
strengthening the healthy Qi”, and the basic treatment method,
“eliminating dampness and dispelling toxin”. Under the guidance of
the principle and the basic treatment method, the core formula for
COVID-19, Huashi Baidu formula, was created and a new drug for
COVID-19, Huashi Baidu granules, was developed. Huashi Baidu
granules are a materialized carrier reflecting the clinical efficacy of
TCM against COVID-19, and also the first new TCM drugs on COVID-
19 to be completely patented nationwide.

Last but not least, both TCM and western medicine were
given equal importance, where the cooperation of two
systems made new achievements. “The integration of TCM and
the western medicine, the equal emphasis on TCM and the western
medicine, and the combining usage of TCM and the western
medicine in prescription” were the diagnosis and treatment principles
of the national TCM medical team for the severe and critical COVID-
19 cases. Academician Luqi Huang believed that TCM should be
further strengthened for severe and critical COVID-19 patients, and
strongly advocated TCM injections on the basis of oral application of
TCM. He also stressed many times that patients without indications
for antibiotics or steroids should be treated with TCM, while the
application of western medicine should not be excluded. When it
was necessary, the integration of TCM and western medicine was
done, with equal emphasis on both, and the combined usage of TCM
and western medicine in prescription was accomplished, so that both
TCM and western medicine could demonstrate their advantages,
complement each other, and cooperate with each other to form a
“China Plan” for prevention and treatment of COVID-19.
The curative effect was the vitality of TCM and the “touchstone”
for TCM. The national TCM medical team achieved outstanding
results with their work. By March 31st, the date when the national
TCM medical team returned to Beijing, 158 new patients in total with
severe and critical COVID-19 symptoms had been treated in the No.
1 south ward of Jinyintan Hospital. A hundred and forty patients
were cured and discharged, among which 88 cases were treated
purely by TCM. At the same time, 452 patients in Wuhan Fangcang
Hospital took Huashi Baidu granules and showed good results as
well. Clinical Evaluation Criteria of COVID-19 Based on Case Analysis
and Expert Experience Summary and Proposal on Treatment of
COVID-19 with TCM summarized by the national TCM medical team
were incorporated into the national diagnosis and treatment plan
(the sixth and seventh trial versions).
In view of the past, there is still a long way to go. Medical
records are the comprehensive embodiment of clinical diagnosis and
treatment experience, and TCM case records are the essence of TCM
thinking and methods. At present, although the work of COVID-19
prevention and control has achieved phased results, the epidemic
situation overseas is still very serious. The number of local clustering
cases caused by foreign entrants in some provinces has also
continually increased. Taking this reality into consideration, the
clinical experience of treating severe or critical COVID-19 cases with
TCM in Wuhan was compiled and published in this book. In
accordance with the compilation idea of case analysis, the book
presented the clinical thinking process and the experience of
diagnosis and treatment with TCM to the readers through simple
language and a combination of vivid illustrations and texts. The first
purpose of this book is to provide reference for relevant personnel
by summarizing the diagnosis and treatment experience and
methods of TCM for COVID-19. The second purpose is to explore
and summarize diagnosis and treatment regularity by analyzing the
thought process and methods of TCM for COVID-19. The third
purpose is to provide the medium by sharing the experience and
achievements of TCM treatment on COVID-19 with other countries
and regions that are fighting against the pandemic and providing
valuable reference for prevention and control of COVID-19
worldwide.

Photo 1. Group photo of the first batch of the national TCM medical team.
Photo 2. Secretary Yanhong Yu and Deputy Director Shujiang Yan of the State
Administration of TCM visited the first batch of the national TCM medical team in
Wuhan.

The selected cases in this book focus on the analysis of diagnosis

and treatment ideas and methods. It is believed that this book will
be helpful in the current work of prevention and control of COVID-
19. Due to limited time and ability and the limited level of
translation, it is inevitable that this book will have some flaws. If
there is any mistake, please inform us and we will correct it.
 Contents

Preface
List of Editors
General Introduction of COVID-19 by Luqi Huang

Part I TCM Treatment Overview

Discussion on COVID-19 by Hao Li
Discussion on COVID-19 by Wensheng Qi
Discussion on COVID-19 by Zhixu Yang
Discussion on COVID-19 by Qing Miao

Part II Case Analysis

Case 1 A COVID-19 Patient with Persistent High Fever Was Treated
with Traditional Chinese Medicine
Case 2 Removing Toxin and Clearing Away Heat for a Severe Case
of COVID-19 with Heat Transformed from Epidemic Toxin
and Blocking the Lungs
Case 3 Clearing and Invigorating Treatment for a Severe COVID-19
Case
Case 4 Clearing Heat and Draining Dampness, Separating
Elimination from Upper and Lower for Severe COVID-19
Case 5 Integrated Traditional Chinese Medicine and Western
Medicine Treatment of an Elderly Patient with Critical
 COVID-19
Case 6 A Case of COVID-19 with Acute Kidney Injury Treated by
Dispersing Lung Qi and Dampness and Activating Blood
Circulation and Detoxification
Case 7 Clearing Away Toxic Material, Resolving Dampness,
Invigorating Qi, and Nourishing Yin Treatment of a Severe
COVID-19 Case with AIDS
Case 8 Strengthening Healthy Qi to Eliminate Evil Qi, Harmonizing
the Pivot for Severe COVID-19
Case 9 Grasp the Opportunity: Integrated Treatment of Traditional
Chinese and Western Medicine for COVID-19
Case 10 Strengthening Body Resistance to Dissipate Dampness and
Remove Toxin for a Severe Case of COVID-19 Which Was
Treated by Antibiotics Unreasonably
Case 11 Strengthening Healthy Qi and Clearing Away Toxic Material
Treatment of a Severe COVID-19 Case
Case 12 Eliminating Pathogens from Both the Exterior and Interior,
and Regulating San Jiao for COVID-19
Case 13 Integrated Traditional Chinese Medicine and Western
Medicine Treatment for a Patient with Progressive COVID-19
Case 14 A Critical Case of COVID-19 Treated by Traditional Chinese
Medicine Using Dynamic Syndrome Differentiation
Case 15 Eliminating and Invigorating Treatment of a Severe COVID-
19 Case
Case 16 Ventilating Lung Qi to Dissipate Phlegm and Blood Stasis for
COVID-19 Combined with AIDS
Case 17 Treatment of a COVID-19 Patient with Persistent Nucleic
Acid Positive by Replenishing Qi, Reducing Dampness, and
Removing Toxin
Case 18 Detoxification and Clearing Heat Treatment for a Case of
COVID-19 with Complaint of Sore Throat Resulting from the
Epidemic Toxin
Case 19 Consolidating Body Resistance and Eliminating Evil Qi
Treatment of a Severe COVID-19 Case
Case 20 Tonifying and Replenishing the Liver and Kidneys for
Flaccidity and Syncope Caused by COVID-19
 List of Editors

Guoju Dong
Qing Cao
Yu Cao
Xiaodong Cong
Tiebing Fan
Yiling Fan
Xiaoyu Hao
Chen Hu
Bin Li
You Li
Nanyang Liu
Xinting Liu
Jin Sha
Jiaheng Shi
Jiahui Sun
Zhanfei Tan
Jinlin Tong
Anlu Wang
Bing Wang
Huichan Wang
Ning Wang
Yuxin Wang
Yongyue Xian
Jinliang Yang
Dan Zhang
Tingting Zhang
Haoning Zhu
General Introduction of COVID-19:
Dispel Plague by Removing
Dampness and Toxin, Merge New
Knowledge with Flourishing Ancient
Wisdom
— To expound the etiology, pathogenesis, and
treatment of “toxin and dampness plague“
with “plague Qi” theory

Luqi Huang

The development history of traditional Chinese medicine (TCM) is

also a history of fighting against the plague. According to preliminary
statistics, there have been more than 300 major plagues in Chinese
history recorded in the literature. In the battle against the plague
disease, the Chinese government unprecedentedly sent national TCM
teams to participate in the treatment of mild, moderate, severe, and
critical diseases, and to carry out all-round intervention from three
aspects: primary prevention before diseases, preventing
exacerbation during diseases, and preventing recurrence after
diseases. The efficacy on the plague proves the vitality of TCM.
1. Excellent Methods from the War Against
Plague, Obvious Superiority from the
Efficacy
In every battle against the plague in the past, the ancient sages of
all dynasties thought hard and innovated with new ideas, theories,
methods, and technologies, which provided a source of power for
the continuous enrichment and development of the theory and
methods of TCM. In the Spring and Autumn period and the Warring
States period (770–221BC), the following is recorded in the book
Suwen (the chapter of acupuncture theory in the Suwen): “During
the outbreak of the five epidemic diseases, people are easy to get
infected with each other, no matter how old or young they are, with
similar symptoms.” This expounded the clinical manifestations of the
plague in detail. In the preface of Shanghan Zabing Lun, the author
Zhang Zhongjing of the Eastern Han Dynasty said that he “grieved
for the death, felt sad for the wounded” and therefore established
the syndrome differentiation system of six meridians. Chao Yuanfang
of the Sui Dynasty (581–619AD), who wrote the book Zhubing
Yuanhou Lun, thought the plague was “all due to the improper solar
term, imbalance of temperature, and people were susceptible to
plague qi” and put forward the etiology and pathogenesis of the
plague.
During the Song, Jin, and Yuan Dynasties (960–1368AD), most
doctors inherited the viewpoint of Huangdi Neijing in their
understanding of the plague. In the Ming and Qing Dynasties (1368–
1912AD), the frequent occurrence of the plague caused TCM to gain
a further understanding of it. At the end of the Ming Dynasty, Wu
Youke, inspired by his predecessors, sighed that one who “not die
from disease, but die from medicine; not die from medicine, but die
from the loss of the classics” in his book Wenyi Lun and founded the
theory of “plague Qi”. He expounded in detail how plague Qi caused
the plague, explored the causes and transmission of the plague, and
made pioneering contributions to the development of plague theory,
which plays an important guiding role in TCM even today. In the
Qing Dynasty, Ye Tianshi wrote Wenre Lun and created the system
of Wei Qi Ying and Xue syndrome differentiation; Wu Jutong wrote
Wenbing Tiaobian, advocated the sanjiao syndrome differentiation,
and summarized a series of effective prescriptions for the treatment
of pestilence; and Wang Mengying, who took the work of the Yellow
Emperor and Zhongjing’s words as longitude and the syndrome
differentiation of Ye Tianshi and Xue Shengbai as latitude, wrote the
book Wenre Jingwei, which was interlaced by the longitude and
latitude and formed a comprehensive monograph on the plague.
Since the first day of the first month of the Gengzi year (Gengzi
year is the Chinese name for 2020 according to the lunar calendar),
I have rushed to the front line of Wuhan and led the first batch of
national medical teams of TCM to fight against COVID-19 for more
than two months. We reconstructed an independent ward in
Jinyintan Hospital of Wuhan. By March 31st, we received more than
150 patients with a cure discharge rate of 88.61%. We developed
Huashi Baidu granules successfully and achieved phased success.
Our theory and methods of diagnosis and treatment on the plague
have achieved good results in clinical practice, fully reflecting the
characteristics and advantages of TCM.

2. Distinguish Toxin and Dampness of COVID-

19 First, According to Plague Qi Theory
According to the related theories of TCM, especially “plague Qi
theory” by Wu Youke, combining the specific characteristic of
COVID-19 and summarizing our clinical practice experience, I think
COVID-19 belongs to the category of “toxin and dampness plague”.
The etiology of it is affected by plague Qi and the core pathogenesis
of it is toxin and dampness stagnation. COVID-19 is highly
infectious, mainly transmitted by mouth and nose, and with lung
(TCM lung) and spleen (TCM spleen) injury.
(1) Exogenous plague qi, toxin and dampness
obstruction, and then rampant plague
Exogenous plague Qi is the basic pathogeny of the plague. Wu
Youke put forward the theory of “plague Qi”, which broke through
the traditional view that “all diseases are born in six Qi (six Qi
includes wind, cold, summer heat, dampness, dryness, fire)”. He
thought that the plague was induced not by wind or cold, not
summer heat or dampness, but by an abnormal Qi between the
heaven and the earth. In his opinion, the “abnormal Qi” was a kind
of infectious exogenous pathogen, which is also called “plague Qi”,
“miscellaneous Qi”, “violent Qi”, and “epidemic Qi”. “Plague Qi” has
the following pathogenic characteristics: First, specificity: One kind
of plague Qi induces one kind of plague with similar symptoms, such
as “cattle disease but not sheep disease, chicken disease but not
duck disease, human disease but not animal disease, all because of
different plague Qi”, and “The same plague Qi induced the same
plague maybe with different invasion by nature or by contagion”.
Second, materiality: For example, “Qi is the substance, the
substance is the Qi. You can know substance by learning Qi, also
you recognize and control Qi by learning substance.” Third, strong
pathogenicity and infectivity: It is prone to epidemicity and sudden
onset, for example, “when plague Qi comes, regardless of the strong
or the weak, the old or the young, all will be ill by touching it.” For
COVID-19, plague Qi invasion is the external cause, and the
deficiency of the healthy Qi is the internal cause. When the healthy
Qi of the human body is deficient, one is more prone to be affected
by the plague Qi and becomes ill. Then, the disease will show strong
pathogenicity, epidemicity, and infectivity, which is in line with the
characteristics of “plague Qi”.
“Toxin and dampness stasis” constitute the core pathogenesis of
the toxin dampness plague. Wu Youke thought that “toxin” was the
fundamental of the plague, and he proposed that “the toxin Qi is the
different Qi in the nature”. He attributed the rise and fall of plague Qi
to “plague Qi preferring different thickness (thickness means
strength)”. In terms of COVID-19, on the one hand, there are the
climatic conditions: In December 2019, Wuhan experienced a warm
winter climate. First, it was humid and hot. Then, it was rainy. The
temperature dropped suddenly, and the humidity was heavy. This
abnormal climate induced “abnormal Qi at the right time”, which was
the prerequisite for the toxin and damp evil to invade people. On the
other hand, there are the characteristics of the disease: It is
characterized by rapid spread, multiple changes, dangerous
condition, etc., which accord with the characteristics of “toxin”; at
the same time, the disease is insidious and protracted. In general,
the tongue coating is greasy, and the symptoms are mostly short of
breath, poor appetite, diarrhea, fatigue, etc., which have the
characteristics of “dampness evil”, such as heavy turbidity, viscosity,
and obstruction of Qi and Yang. The above characteristics fully
reflect the core pathogenesis of “toxin and dampness stagnation”.
In addition, plague Qi can also mingle with six evils (six evils
mean wind, cold, summer, dampness, dryness, and heat, which exist
in the nature, belonging to “normal Qi”, compared with plague Qi).
As Wu Zhen of the Qing Dynasty put forward in Shanghan Zhizhang,
“the plague Qi is popular among all the infected people. However, all
the foul Qi is inhaled from the mouth and nose from the nature,
sometimes mingle with six evils, sometimes not.”

(2) Entrance of mouth and nose, damage of

lungs and spleen, involvement of viscera
The entrance of the mouth and nose is the main way of infection of
the plague. In Wenyi Lun, Wu Youke creatively put forward that “evil
enters from the mouth and nose”, which broke through the general
saying that most of the foreign evil injuries enter through the skin
and hair and had a significant impact on the doctors of later
generations. For example, Li Bing of the Qing Dynasty said in his
Bianyi Suoyan, “plague Qi enters from the mouth and nose” and
“everyone might not speak but everyone needs to breathe all the
time”. At the end of the Qing Dynasty, Zhang Xichun put forward in
his Yixue Zhongzhong Canxi Lu about “those who are infected with
epidemics because of plague Qi entering into the mouth and nose.”
In the process of fighting the epidemic, it was found that the mode
of transmission of this epidemic disease was not only like the
“natural reception” of air transmission but also like “infection”
through contact, and the most important means of transmission was
through the “mouth and nose”.
The “lungs and spleen” are the main disease locations of “toxin
and dampness plague”. The “plague Qi” enters through the mouth
and nose and mainly acts on the lungs and spleen. As it was said in
Zhuanzhi Masha Chubian, “The lung is in charge of Qi in our body,
and lung is also in charge of skin and hair on the body. Spleen is in
charge of muscle. The lung is opened to the throat and nose and the
nose Qi passes through the weather. So, when suffering evil, the evil
Qi enters the lung and spleen from the mouth and nose.” Autopsy of
COVID-19 patients showed that it has the morphological
manifestations of the lungs and spleen damage and immune system
damage, which coincided with our opinion. At the same time, it will
also influence the stomach because the spleen and the stomach
have a certain correlation with each other. With the development of
the disease, it is found that the disease is also closely related to the
heart, liver, kidney, large intestine, and other viscera, all of which
have a risk of damage.

(3) Evils incubate in the membrane source of

TCM, then change with nine kinds of
exterior or interior progress
According to the clinical observation, we divided the disease into five
stages: early stage, middle stage, severe stage, critical stage, and
recovery stage. From the syndrome differentiation point of view, the
mild and moderate patients in the early and middle stage were
mainly characterized by lung dampness and spleen dampness; the
main syndrome of severe patients in the severe stage was plague
fever closing the lungs and injuring the spleen; the critical patients
in the critical stage were characterized by deficiency of Qi, blood
stasis, and blood consumption induced by plague fever; and the
main symptoms of convalescent patients were deficiency of lung Qi
and spleen Qi. If the disease is dangerous and the treatment is not
effective, it will lead to the exhaustion of Yin and Yang, and the
patient will die of multiple organ failure.
“Evils incubating in the membrane source of TCM” is the initial
stage of toxin and dampness plague. Wu Youke put forward the
theory of “evils incubating in the membrane source of TCM” in Wenyi
Lun: “When evil enters from the mouth and nose, it locates not in
the viscera, not in the meridians, but conceal in the Jiaji points, not
far from the surface, but near the stomach, which is the boundary
between the surface and the inside. That is so-called membrane
source of TCM in Zhenjing.” This explained the process of “plague
Qi” incubating in the body from outside to inside. Wu Youke thought
that the “membrane source” was the part connecting the exterior
and interior. In the early stages of the plague, plague Qi lurked in
the membrane source and broke out because of a “trigger”, as it is
described by Wu Youke: “The plague incubates before touching cold
or wind, which induces the outbreak of disease one after another.”
The outbreak time is restricted by the balance of strength between
healthy Qi and evil Qi, so there is a difference between “immediate
onset” and “onset after incubation period”, as mentioned in the
following: “Those who are incubated because of stronger healthy Qi
and evil Qi deficiency, but begin to spread because of hunger or
exhaustion, sadness or anger, which will hurt healthy Qi.” “Those
who break out from the membrane source in two or three days, and
those who do not transmit for more than half a month or ten days.”
The onset time of COVID-19 is varied, which is consistent with the
characteristics of the uncertain onset time after the “transmission
from membrane source”. For some of the asymptomatic patients,
they should have felt the hidden evil, but it did not attack
temporarily because of their strong healthy Qi or not being touched
by the external evil. The theory of “membranous source” in TCM
provides a theoretical basis for the interpretation of the outbreak
process of the disease, and has important guiding significance for
the clinical diagnosis and treatment of the disease.
“Nine external and internal transmissions” is the transmission
way of “toxin and dampness plague”. The plague spreads rapidly and
changes frequently. Wu Youke pointed out that the fundamental
reason for the variety of the disease is that the transmission ways
are “different either outside or inside”. “As soon as the evil Qi leaves
the membrane source, there are many different ways either outside
or inside.” According to Wu’s practical experience, he summed up
nine different ways of exterior and interior transmission after the
pathogen leaves the “membrane source”: “There are those which
are only exterior not interior, those which are not outside but inside,
those which are outside and outside further, those which are inside
and inside again, those which are inside and outside respectively and
transmit again respectively, those which are outside more than
inside, those inside more than outside, those outside first and then
inside, those inside first and then outside; although all these nine
transmission ways, the disease is only one.” According to Wu Youke’s
view, “Although there are nine kinds of transmission ways, they are
just between the exterior and the interior.” From the point of view of
COVID-19, although the onset is relatively hidden, once the attack
takes place, the transmission changes rapidly and changes more.
Some are always superficial syndromes with mild disease; some are
superficial syndromes in the initial stage, then turn into exterior
syndromes gradually; some are both exterior and interior syndromes
in the initial stage and maintain it for a relatively long time; and
some are superficial syndromes for a very short time, then quickly
change to the internal syndrome, and the initial condition is more
critical. All of the abovementioned routes of disease progress can be
found in the nine transmission ways of plague theory summarized by
Wu Youke.

3. Rules for the Treatment of Plague —

Remove Pathogenic Factors, Strengthen the
 Healthy Qi, and Eliminate Dampness and
Toxin
“Removing pathogenic factors and strengthening the healthy Qi”
constitute the treatment principles of the plague. During the
treatment of the plague, we should always pay attention to the
treatment principle of “removing pathogenic factors without causing
injury of healthy Qi and strengthening the healthy Qi without
hindering the removal of pathogenic factors”. Wu Youke believed
that it is more difficult to treat weak people suffering from plague.
He proposed, “The healthy Qi is deficient, while breathing, external
evil seizes the opportunity to invade.” “When healthy Qi is deficient
first, the disease was added and evil Qi invaded gradually and it was
difficult to cure.” Therefore, we always follow the treatment principle
of “strengthening the healthy Qi and eliminating pathogenic factors”
while treating plague. The first thing is to dispel evils and eliminate
filth, and never forget to consolidate the foundation. For the patients
with excessive dampness, the main method is to eliminate dampness
and pathogenic factors. But, considering the characteristics of
“dampness injures the spleen” and “hindered Qi injures Yang”, we
need to rationally apply the dosage or proportion of attack medicine
and tonic medicine, combined with the patient’s constitution in
different stages of treatment. Especially for the weak and deficient
elderly patients with multiple diseases, the power of attacking herbs
should not be too strong, so as to prevent the injury of vitality and
to avoid inducing the evil inside. Second, we should strengthen
vitality and integrate attack and defense. Strengthening the healthy
Qi is not only to supplement the deficiency but also not to retain the
evil. For those who are healthy qi deficient with strong evil, we
should supplement the deficiency to help eliminate the evil.
Especially for those with deficiency of both the lungs and spleen in
the recovery period, considering the characteristics of dampness
stagnation and lingering, it is necessary to determine the application
proportion of the tonic and attacking medicine reasonably while
focusing on tonic deficiency, so as to prevent incomplete clearing of
dampness or closing the door early which could induce the invaders
to be retained. We need to combine attack and defense
appropriately.
“Removing dampness and eliminating toxin” is the basic
treatment for “dampness and toxin plague”. Based on the method of
“removing dampness and toxin”, we summed up an effective “Huashi
Baidu Formula” in the process of treatment, while summarizing and
researching at the same time. First, we should eliminate dampness
and toxin, and take into account the characteristics of San Jiao. Yu
Jiayan of the Qing Dynasty said in Shanglun Pian, “When evil enters,
it is urgent to clear filth as the first meaning. The upper Jiao is like
fog, it needs to ascend and chase toxin and evil; the middle Jiao is
like retting, it needs to scatter and chase the toxin and evil; the
lower Jiao just like a drainer, it needs to open and chase toxin and
evil.” Therefore, we take the medicine of Maxing Shigan Decoction
and Tingli Dazao Xiefen Decoction to disperse the lungs and clear
the heat to evacuate the upper Jiao with the purpose of “ascending
and chasing”; the medicine of Dayuan Yin and Huoxiang Zhengqi
Powder to remove the dampness and harmonize the stomach to
mediate middle jiao with the method of “scattering and chasing”;
and the medicine of Taoren Chengqi Decoction and Xuanbai Chengqi
Decoction to activate the blood and detoxify to reach the lower Jiao
with the effect of “opening and chasing”. The combination of various
drugs acts on the San Jiao with different effects to remove
dampness and dispel toxin. Second, we should pay attention to the
combination of disease and syndrome. By “removing dampness and
eliminating toxin”, we should not only aim at the core pathogenesis
of “dampness and toxin stagnation” but also aim at the changing
syndrome, the combination of disease differentiation and syndrome
differentiation, and treat the disease flexibly. Through our research,
we have found that 10 of the 14 herbs that constitute “Huashi Baidu
Formula” can bind and inhibit MPRO and spike protein of the virus,
and the combination of all herbs has an important therapeutic effect
on COVID-19, which embodies the method of a combination of
disease differentiation and syndrome differentiation. Third, we
should pay attention to the combination of attack and defense.
“Huashi Baidu Formula” not only uses herbs to remove dampness
and dispel toxin but also takes Yupingfeng Powder and Huangqi
Chifeng Decoction to protect and enhance healthy Qi. “Huashi Baidu
Formula” was incorporated into multiple editions of the national
treatment plan for COVID-19. The effects of “Huashi Baidu Formula”
were the value embodiment of Wu Youke’s “plague Qi” theory and
also the practical proof of “removing dampness and reducing toxin”.
At present, “Huashi Baidu Formula” has become the first Chinese
medicine to receive clinical approval for treating COVID-19, which
brings great international response and promotes the process of
TCM internationally to join the fight against COVID-19.
The “plague Qi” theory runs through the pathogenesis and
treatment of COVID-19, which provides theoretical support for the
diagnosis and treatment system of COVID-19, and plays an
important guiding role in the practice of plague prevention and
control, and proves its scientific nature, advanced nature, and
practicability by itself. Its ideological innovation is the inexhaustible
driving force of the continuous and vigorous development of TCM for
thousands of years. The theory of “plague Qi” also has its
shortcomings and limitations; for example, for the nature of the
disease, more attention is paid to heat dampness than cold
dampness; for the transmission ways, three yang meridians are
emphasized more and three yin meridians are ignored; and the
elaboration of some theories is more general and less precise, all of
which need further improvement and optimization. Therefore, the
development of TCM plague theory needs to not only concentrate on
inheriting the wisdom and experience of the ancient sages but also
constantly enrich and improve the original theory according to the
current practical experience of plague prevention. Only by persisting
in carrying forward the past and opening up the future, continuing
innovation, developing the ancient meaning, and integrating new
knowledge can we better inherit, develop, and utilize the precious
wealth of TCM.
 Part I

TCM Treatment Overview

 Discussion on COVID-19

Hao Li

Treatment of COVID-19 from the Perspective

of Dampness
Since the outbreak of the Coronavirus Disease 2019 (COVID-19) in
December 2019, the epidemic has swept across more than 200
countries and regions around the world, causing widespread
concern. COVID-19 is a new viral infectious disease, which is
characterized by strong infectivity, long incubation period, different
clinical manifestations, and wide susceptibility. Our clinical
experience and a large number of works of literature show the
considerable advantages of Chinese medicine in treating COVID-19.
Based on TCM theory, its onset and development are attributed to
continuous Dampness, accompanied by the Toxic Evil. Throughout
the whole course of the disease, Dampness can be mixed with Six
Excesses. Hence, the Dampness-removing approaches extracted
from Ma Xing Yi Gan Decoction and San Ren Decoction are effective
and will be discussed in detail.
Zhang Zhongjing used Ma Xing Yi Gan Decoction to treat Wind-
Dampness, which was characterized by “systemic pain, fever, and
aggravating at 3–5 p.m.”. This decoction treats Wind and Dampness
accumulated in meridians and collaterals. It removes the Gui Zhi
(Cinnamoni Ramulus) from Ma Huang Decoction and adds Yi Yi Ren
(Coicis Semen). Yi Yi Ren can help drain Dampness in meridians,
muscles, and bones. Ma Huang (Ephedrae Herba) can relieve the
exterior and induce sweat to eliminate Dampness. Xing Ren
(Armeniacae Semen Amarum) cooperates with Ma Huang (Ephedrae
Herba) to eliminate excess water in the upper part of the body thus
treating wheezing. The combination of all herbs can remove
Dampness by dispersing upward, diffusing outward, and excreting
downward. Besides, it can dredge channels, relieve the surface of
the body, dispel Wind, and eliminate Dampness. The San Ren
Decoction created by Dr. Wu Jutong was inspired by Ma Xing Yi Gan
Decoction. Dr. Wu treated Dampness-Warmth based on syndrome
differentiation according to its development and established the
theory of San Jiao pattern identification. “San Jiao is the organ in
charge of dredging and is responsible for regulating the water-
passage.” Therefore, Dr. Wu’s theory of San Jiao pattern
identification closely follows the law of the transmission of Damp
disease and concludes the rules for the treatment of Dampness-
Warmth. Xing Ren (Armeniacae Semen Amarum) is used in San Ren
Decoction to spread the Lung Qi of the Upper Jiao. The lungs ascend
well, and the function of dredging and regulating the water passage
is smooth. Furthermore, the Lung Qi is beneficial, and the Evil of
Water and Dampness flows down and cannot be hidden. Bai Kou
Ren (Amomi Fructus Rotundus) has the characteristics of acridity
and aroma, which can play a role in enlivening the spleen and
resolving Dampness in the Middle Jiao, and regulating the Qi blocked
by Dampness. Sheng Yi Ren (raw Coicis Semen) can eliminate
Dampness with bland medicine and clear Damp-Heat, and remove
the obstruction that causes the stagnation of the Lower Jiao. The
drugs in the prescription are separated from San Jiao for treatment,
but they are coordinated and integrated with each other. The
prescription that diffuses the Upper Jiao is helpful to smooth Qi of
the Middle Jiao, and it also has the therapeutic effect of diffusing the
upper and guiding the lower down, giving the Evil a way out and
relieving the problem of entanglement of Dampness and Heat. Once
San Jiao is unblocked, the Qi can run on its own, the Evil of Damp-
Heat and turbid filth can be released and resolved, and Dense Qi can
also have a way to dissipate.
 The syndromes of COVID-19 patients were different. Some
symptoms were marked by fever. Some patients had obvious
symptoms of wheezing and suffocation, some had severe cough,
and some had prominent symptoms of fatigue and drowsiness.
However, most of the patients’ clinical symptoms showed the wet
characteristics of a long course of disease from which it was difficult
to recover. The original prescription of Ma Xing Yi Gan Decoction
written by Zhang zhongjing only stated that it could treat
rheumatism with fever, body pain, and other syndromes. There is no
argument that it can treat cough and wheezing. Since this
prescription has two herbs of Ma Huang (Ephedrae Herba) and Xing
Ren (Armeniacae Semen Amarum), it is only different from Ma Xing
Shi Gan Decoction with Shi Gao (Gypsum Fibrosum). Since Ma Xing
Shi Gan Decoction can treat Heat-cough and wheezing, is there no
reason to suppose this prescription could treat Damp asthma and
cough? In the process of clinical syndrome differentiation and
treatment of COVID-19, the key is to grasp the pathogenesis. The
pathogenesis of COVID-19 is that pathogenic Qi directly reaches the
lungs. Coughing, wheezing, and suffocation are common symptoms.
The use of Ma Xing Yi Gan Decoction in the treatment of this disease
is in line with the syndrome and pathogenesis, but the intensity of
dehumidification is obviously insufficient. Therefore, according to the
symptoms, we chose Ma Xing Yi Gan Decoction combined with San
Ren Decoction to carry out the treatment. In the process of clinical
diagnosis and treatment, it was found that according to the theory
of “human correlating with nature” in traditional Chinese medicine
(TCM), due to the ever-changing climate and the richer composition
of diets, these factors make people’s constitution develop in the
direction of the “Damp-Heat type”. Therefore, whether induced by
exogenous or internal injury factors, the syndrome of the disease
with Dampness and Heat has become a common trend. In the
process of the novel coronavirus wreaking havoc, many cases had
the pathogenic characteristics of the combination of Dampness and
Heat, and were accompanied by severe manifestations of Toxic Evils.
Application of Ma Xing Yi Gan Decoction combined with San Ren
Decoction together with the addition of Chinese medicines with a
detoxification effect, such as Jin Yin Hua (Lonicerae Flos), Lian Qiao
(Forsythiae Fructus), and Bai Jiang Cao (Patriniae Herba), can often
have a good curative effect.

Treatment for Elderly Patients with COVID-19

In China, people over the age of 60 are defined as the elderly. With
the normal aging process, the physical functions of the elderly
gradually deteriorate. The constitutional characteristics and
tendencies of the elderly are different from those of the young.
Grasping the physical characteristics of the elderly is helpful for
better treatment, nursing, and rehabilitation of the elderly patients
with COVID-19. Miraculous Pivot — Natural Life Span puts forward
that “all the five internal organs are empty and the spirit is losing”
which summarizes the frail constitutional characteristics of the
elderly. With the process of aging, the genuine Qi of the five internal
organs is damaged. The dysfunction of the internal organs leads to
many pathological products. The lack of blood in the liver leads to
the inability to fill the blood vessels and stagnation of blood.
Decreased lung and spleen function can easily lead to phlegm and
dampness in the body. With the spread of the epidemic, strict
blockade measures and a closed treatment environment are more
likely to bring serious psychological crisis to elderly patients,
resulting in negative thoughts and emotions of sorrow, anxiety, fear,
and fright. Combined with the experience of fighting the epidemic
situation on the clinical front line, I want to discuss the syndrome
differentiation and treatment for this special group of elderly COVID-
19 patients.
The elderly with COVID-19 are the main group of the critical
type. They have the physical characteristics of the five internal
organs being hollow, attacking between Truth and Evil, and
fluctuating mood. In this epidemic, “Dampness”, “Toxin”, and
“Deficiency” are mixed with each other. Treatments should be
applied according to Defense-Qi-Nutrient-Blood syndrome
differentiation and San Jiao syndrome differentiation as the main
theory, besides giving consideration to Shao Yang cardinals.
Combined with the clinical treatment experience of inpatient elderly
patients, the pathogenesis of elderly COVID-19 patients can be
divided into four stages and seven syndromes. In the early stage,
the Toxin is mainly lurking in the membrane source, trapped in the
Middle Jiao, or the Dampness Toxin invades the body surface,
overflows the meridians and collaterals, or the Toxin invades Shao
Yang, and the cardinal is obstructed. In the advanced stage, there is
Heat scorching Qi aspect caused by Dampness Toxin or injuring
blood caused by entry into the nutrient aspect. In the period of
critical illness, Evil Qi is excessive, Healthy Qi is deficient, and even
internal blockage and external collapse may occur. During the
recovery period, dual deficiency Qi and Yin may appear, and
Dampness Toxin will remain. Treatment should follow these
principles: “emphasizing Dampness Toxin”, “taking Toxin Evil
throughout”, and “taking weak constitution into account”.

Early stage
(1) The syndrome of Toxin lurking in the pleurodiaphragmatic
interspace caused the Middle Jiao to become stuck. The key
points of syndrome differentiation are fatigue, low fever, the
body is heavy, anorexia, abdominal distension, white or yellow-
white coating, light and fat tongue and pulse.
At the beginning of the disease, the Healthy Qi of the elderly
patients is declining, the exorcism is reduced, and the Evil of
Dampness and Toxin is most likely to lie in the membrane. In
“Damp-Heat disease”, which is of “membranous origin, external
muscle, internal stomach”, the Evil of Dampness and Toxin traps
the spleen and stomach, and most of the clinical manifestations
are digestive tract symptoms. Treatment should not only focus
on the local areas, as appropriate, but also add light clear hair
products to help detoxify and disperse Evil and circulate Qi. For
the treatment of aromatic Dampness and penetrating into the
original membrane, doctors can choose Da Yuan Yin plus Ping
 Wei Powder, Sheng Jiang Powder (Jiang Can Bombyx
Batryticatus, Chan Tui Cicadae Periostracum, Cao Guo Tsaoko
Fructus, Bing Lang Arecae Semen, Cang Zhu Atractylodis
Rhizoma, Hou Pu Magnoliae Officinalis Cortex, Chen Pi Citri
Reticulatae Pericarpium, Zhi Mu Anemarrhenae Rhizoma, Huang
Qin Bupleuri Radix, Jiang Huang Curcumae Longae Rhizoma, Zhi
Gan Cao Glycyrrhizae Radix et Rhizoma Preparatum, etc.).
(2) The syndrome of Dampness Toxin invading the defense aspect
disturbs around meridians and collaterals. The key points of
syndrome differentiation are chills with fever, heavy and painful
body, fatigue, loss of appetite, dark red tongue with slimy white
coating, and soggy and rapid pulse.
If the elderly patient has a healthy constitution or the
Dampness Toxin has already developed, the Evil Qi is fighting
with Healthy Qi on defense surface manifesting fever or chills.
The Dampness Toxin entangling in the middle energizer causes
anorexia. The Dampness flows into the meridians causing
heaviness in the body. However, the elderly patients are weak in
Healthy Qi, due to which it is difficult to dispel Evil so that the
fever is often lingering and difficult to remove. At this time, the
treatment focused on both strengthening the Healthy Qi and
removing the pathogen. Yu Shiyu of the Qing Dynasty wrote in Yi
Zhen Yi De, “First use Toxin-Vanquishing Powder to get rid of the
violent nature of the epidemic.” Reinforcing the Healthy Qi and
eliminating the pathogenic factors, transforming Dampness, and
resolving Toxin are appropriate treatments in this stage. Doctors
can choose the modified formula of Toxin-Vanquishing Powder
(Qiang Huo Notopterygii Rhizoma et Radix, Du Huo Angelicae
Pubescentis Radix, Chai Hu Bupleuri Radix, Qian Hu Peucedani
Radix, Chuan Xiong Chuanxiong Rhizoma, Jie Geng Platycodi
Radix, Zhi Qiao Aurantii Fructus, Fu Ling Poria, Tai Zi Shen
Pseudostellariae Radix, etc.).
(3) The syndrome of Toxin invades Shao Yang and the cardinal is
obstructed. The key points of syndrome differentiation are
alternating chills and fever, bitter taste in mouth, dry throat,
 dizziness, oppression in the chest, red tongue with greasy yellow
coating, and stringy and rapid pulse.
Elderly patients have the constitutional characteristics of
attacking between Healthy Qi and Evil Qi. The complexity of the
underlying disease also determines the complexity of the
condition of COVID-19. If the Dampness Toxin defends the
defendant surface and the long-term struggle between Healthy
Qi and Evil Qi is difficult to resolve, then the Toxin will be
internalized and transformed into Shao Yang syndrome. The Evil
trapped in Shao Yang is different from the pleurodiaphragmatic
interspace. At this time, the Evil Toxin has been effused, mostly
showing heated symptoms, and the parts of the symptoms are
concentrated in the Shao Yang meridians. There is still some
Healthy Qi, and Toxin Evils are also strong. A harmonizing
method should be selected at this stage. Harmonizing Shao Yang
and resolving Dampness and Toxin are appropriate treatments.
Doctors can choose the modified formula of Bupleurum and
Porta Decoction (Chai Hu Bupleuri Radix, Huang Qin Scutellariae
Radix, Gui Zhi Cinnamomi Ramulus, Ban Xia Pinelliae Rhizoma
Preparatum, Bai Zhu Atractylodis Macrocephalae Rhizoma, Fu
Ling Poria, Zhu Ling Polyporus, Ze Xie Alisrmatis Rhizoma, etc.).

Advanced stage
(1) The syndrome of Dampness Toxin transforming into Heat
scorches the Qi aspect. The key points of syndrome
differentiation are panting, high fever, thirst with a liking for
fluids, abdominal distention or hard and full abdomen, yellow
tongue coating, red tongue, and surging and large pulse.
Treatise on Warm Heat Disease stated that “In the body of
yang exuberance, the Stomach has a lot of Dampness; in the
body of yin exuberance, the Spleen has a lot of Dampness. But
their Dampness can both transform into Heat.” At this stage,
Dampness Toxin quickly heats up, scorches the lungs upward,
and disturbs the ascending and descending of the Qi movement.
 There will be panting and thirst with a liking for fluids. Elderly
patients have more gastrointestinal stagnation with this form.
Dry feces are more likely to form due to HeatToxin burning the
stomach fluid, causing abdominal distension and a hard and full
abdomen. In addition, the lungs and large intestine stand in an
interior–exterior relationship. If the Intestinal Qi is stagnated, the
Lung Qi has difficulty in falling. If the lungs are not clear and
disinhibited, the Intestinal Qi has difficulty in flowing freely.
Thus, it forms a vicious circle that aggravates the condition. The
treatment should be based on clearing up and down movement,
and at the same time restoring the ascending and descending
movement of the Qi. Do not use pure bitter cold detoxification
drugs. Treatment should clear Heat and remove Toxin,
ventilating the lungs and relaxing the bowels. Use a modified
formula of Bai Hu Decoction and Xuan Bai Cheng Qi Decoction
(Sheng Shi Gao Gypsum Fibrosum, Zhi Mu Anemarrhenae
Rhizoma, Quan Gua Lou Trichosanthis Fructus, Xing Ren
Armeniacae Semen Amarum, Da Huang Rhei Radix et Rhizoma,
Sheng Gan Cao Glycyrrhizae Radix et Rhizoma, etc.) for the
treatment. If Lung Heat causes a person high fever, panting, and
coughing, doctors can use Ma Huang (Ephedrae Herba) and
increase the amount of Sheng Shi Gao (Gypsum Fibrosum). The
symptoms of refusal to press the abdomen and difficulty in
expelling stools are an indication that a bowel excess
pathogenesis has been formed. Doctors can add Sheng Di
(Rehmanniae Radix), Xuan Shen (Scrophulariae Radix), and Zhi
Shi (Aurantii Fructus Immaturus) to treat it.
(2) The syndrome of Dampness Toxin transforms into Heat, injuring
blood by entering the nutrient aspect. The key points of
syndrome differentiation are panting, hemoptysis, dysphoria,
intense heat at night, dull red papules on the body, red or
crimson tongue, and fine and rapid pulse.
With the continuous development of the disease, the Evil of
Dampness and Toxin is further heated. Dampness Evil gradually
slacks or becomes more obvious with heating and drying. Elderly
patients have blood in vessels that can easily stagnate and
 become hot. At the advanced stage, Toxic Evil disturbs the blood
vessels, harming the collaterals with the visible blood stasis, and
hemoptysis and papules appear. Treatise on Warm Heat Disease
stated that “When evil enters the blood, it is afraid that it will
consume and stir blood.” If the blood is not cooled and detoxified
in time, it will easily be transferred to the critical stage and the
prognosis will be poor. Treatment should follow the principles
written in the Plain Questions Discussion on the Most Important
and Abstruse Theory stating, “when heat encroaches upon what
it dominates, this is balanced by salty and cold. To assist, use
bitter and sweet. Use sour to contract it.” Doctors can choose the
drugs entering Ying-blood to cool the blood and dissipate stasis,
resolving the toxin and engendering the fluid. Doctors can
choose a modified formula of Qing Ying Decoction (Zi Cao
Arnebiae Radix, Sheng Di Rehmanniae Radix, Xuan Shen
Scrophulariae Radix, Dan Shen Salviae miltiorrhizae Radix et
Rhizoma, Lian Qiao Forsythiae Fructus, Zhu Ye Lophatheri Herba,
Chi Shao Paeoniae Radix Rubra, etc.). If the amount of
hemoptysis is large and the lung vessels are damaged, Chuan
Bei Mu (Fritillariae Cirrhosae Bulbus) and Bai Mao Gen
(Imperatae Rhizoma) can be added. If there is burning in the
extremities and the red papules are obvious, it is stagnated heat
in blood aspect, and Dan Pi (Moutan Cortex) and Qian Cao
(Rubiae Radix et Rhizoma) can be added. At the same time,
large doses of Sheng Di (Rehmanniae Radix), Xuan Shen
(Scrophulariae Radix), and Mai Dong (Ophiopogonis Radix) can
be used in advance to treat dry bound stools, which will avoid
toxin accumulation in the intestines that can aggravate the
condition.

Critical stage
Syndrome of Healthy Qi deficiency and pathogen excessiveness arise
from internal block and external collapse. The key points of
syndrome differentiation are unconsciousness and dysphoria,
increased breathlessness, lip cyanosis, dull complexion, scorching
hot or cold hands and feet, rough and dry yellow tongue fur, dark
tongue, and the pulse appearing large and rootless at the surface.
Elderly patients’ constitutional Healthy Qi cannot overcome Toxin
evils. There may be two unfavorable situations. One is that Evil Qi is
too strong, but the Healthy Qi and internal organs have been
exhausted. The second is that Evil Qi destroys the normal function of
the spirit. Meanwhile, the Healthy Qi within the body rapidly loses.
The former is incurable, while the latter can be called Healthy Qi
deficiency and pathogen excessiveness arising from internal block
and external collapse. Pathogen excessiveness arising from internal
block is the initiating factor of the objective condition of the disease,
and it is the trend state of self-reaction that Healthy Qi deficiency
arises from external collapse. Plain Questions — Liuweizhi Dalun
states that “When leaving and entering ceases, then the
transforming activity of the spirit mechanism vanishes; when rise
and descent stop, then the Qi set-up is solitary and in danger.” This
suggests that the abnormal ascending, descending, exiting, and
entering of Qi are the main reasons for the failure of the spiritual
mechanism. If the lungs are closed by pathogenic Toxin, increased
breathlessness will appear. If Pectoral Qi cannot pass blood, it will
appear as lip cyanosis and dark tongue. During the treatment, the
Stomach Qi should be taken care of first to make the gastrointestinal
medicine effective, and then drugs that make the spirit active can be
added. However, most elderly patients have a poor prognosis after
entering this stage. Regarding the treatment, drastic tonification for
the Original Qi and resuscitation for spirit should be strengthened.
Shen Fu Decoction should be used to give a modified formula of Su
He Xiang Pills (Ren Shen Ginseng Radix et Rhizoma, Fu Zi Aconm
Lateralis Radix praeparaia, Su He Xiang Pills, etc.). If the patient’s
tongue is dry and crimson, it is a sign of Toxin going into the
pericardium, and the Fu Zi (Aconm Lateralis Radix praeparaia)
should be replaced with Mai Dong (Ophiopogonis Radix), Wu Wei Zi
(Schisandrae Chinensis Fructus), and An Gong Niu Huang Pills
should be chosen for the treatment. If the patient has convulsions in
the limbs, it is a sign of internal stirring of Liver Wind, which can be
treated with Purple Snow Elixir. If the patient is obese and wheezing
due to retention of phlegm in the throat, it is a manifestation of clear
orifice confused by phlegm, and it can be treated with Jade Pivot
Elixir.

Recovery stage
For the syndrome of both Qi and Yin deficiency, Dampness remains:
the key points of syndrome differentiation are fatigue combined with
low-grade fever, thirst but not wanting to drink water, loss of
appetite, loose stools, only a positive nucleic acid test, slimy or dry
white tongue fur, dark tongue, and weak pulse.
In elderly patients, there is a lack of constitutional vacuity,
Original Qi, and Yin deficiency, coupled with Qi and liquid
consumptions. So, signs of dual deficiency of Qi and Yin are common
after the disease is cured. Signs of dual deficiency of Qi and Yin are
fatigue, low-grade fever, thirst, and so on. The Evil remained as it
had not been exhausted, hindering the functional recovery of the
spleen and stomach that manifested as anorexia and thirst but not
wanting to drink water. Treatment is with replenishing Qi and
nourishing Yin, invigorating the spleen and harmonizing the
stomach. A modified formula of seven-ingredient ovate atractylodes
powder (Ge Gen Puerariae Lobatae Radix, Huo Xiang Pogostemonis
Herba, Mu Xiang Aucklandiae Radix, Tai Zi Shen Pseudostellariae
Radix, Fu Ling Poria, Bai Zhu Atractylodis Macrocephalae Rhizoma,
Chao Yi Yi Ren Coicis Semen, Shan Yao Dioscoriae Rhizoma, Chen Pi
Citri Reticulatae Pericarpium, etc.) is used for the cure. If the
anorexia is caused by constrained Stomach Qi, Mai Ya (Hordei
Fructus Germinatus) and Su Geng (Perillae Caulis) can be added. If
the thin sloppy stools are caused by stagnant Dampness of the
intestines, Fang Feng (Saposhnikoviae Radix) and Chen Pi (Citri
Reticulatae Pericarpium) can be added.
Another random document with
no related content on Scribd:
de la terra, y la elecció d’uns ó altres, tant pot confiarse al poble
directament, com al poder executiu ab aprobació d’una part del
llegislatiu, com á las Cámaras d’aquest. Tot cap dins de la organisació
particularista sens alterarla essencialment. Filla del reconeixement
de las varietats, en res renega de son orígen.

Y encara no’s detura aqui la flexibilitat del sistema de associació

d’Estats. Aquesta pot tenir sóls dos graus, com succeheix per regla
general, dividintse las atribucions de la soberania entre’ls Estats
particulars y’l conjunt d’aquestos, ó pot tenirne més de dos.
Comparantla ab una institució de dret característica de la nostra
terra, direm que en los casos en que convingui, en la organisació
particularista, com en l’enfitéusis de Barcelona, ademes de las
senyorias directa y útil, pot havernhi de mitjanas. Si á algun dels
Estats associats li convé fer nous establiments en favor de
agrupacions més reduhidas, fa com l’enfitéuta barceloní, y las sub-
estableix. Aixis succehia, per exemple, á Suissa, ahont lo Cantó dels
Grisons era un compost de varias Lligas, y’l del Valais, de varias
decenas; aixis tendeix á ferse en cada un dels membres del imperi de
Austria-Hungria, quals respectivas regions desitjan aumentar la
relativa autonomia de que gosan. En los casos en que existeixi dins
de la associació d’Estats la que anomenarem soberanía mitjana, las
divisions interiors de cada membre han de ser oficialment
desconegudas del conjunt, de la meteixa manera que las divisions
interiors de la associació en general són diplomáticament ignoradas
per las potencias extrangeras. Cada un dels Estats associats de per si
s’organisa de la manera que millor s’acomoda ab las necessitats é
interessos de sos elements, y ab tal de que ab sa organisació no
destruheixi cap de las cláusulas de la Constitució general, ni aquesta
ni ningú té’l dret de fiscalisar sos actes. Basta que al davant de sos
co-associats se presenti lo Estat formant un tot als efectes
constitucionals, pera que pugui funcionar ab desembrás l’associació.

Inútil es que diguem que’l sistema particularista será tant més

fecundo y abundós en fruyts civilisadors, quant més aprofiti la
flexibilitat que sas condicions naturals li permeten pera acomodarse
á las formas que la ciencia política recomana. Per la nostra part, si
hagués d’establirse á la nostra terra, travallariam pera que la
organisació que’s dés al particularisme se basés en tots los avensos
polítichs socials compatibles ab las condicions históricas del nostre
poble, entenent per tals condicions, sos antecedents, son estat actual
y sas aspiracions pera’l pervenir.
Capitol VIII.
 Divisió de la soberania
La divisió de la soberanía es la base del Estat compost.– Duas missions
capitals del Estat.– Vida exterior y vida interior.– Lo referent á la primera
correspón al poder general.– Guerra y diplomacia.– Garantía de las
llibertats y de llur ordenat exercissi.– Diferents maneras de exercir lo poder
general aquesta garantia.– Serveys generals.– Diferents sistemas pera la
concentració de algunas brancas del dret privat.– Atribucions dels Estats
particulars.– Tenen totas las de que no se han després en pro del Estat
general.

Hem dit que la base del sistema de associació d’Estats es la divisió de

la soberanía, que té de destriarse en las varias atribucions que la
componen, encarregantne algunas al Estat general ó gerent del
conjunt, y quedantse’ls Estats particulars ab las restants. Anem á
veure si poden donarse algunas reglas pera fer la tria y repartició.

Un Estat, com tots los sers naturals ó jurídichs, desde lo moment que
gosa de personalitat propia, té duas missions capitals que cumplir.
La primera comprén tot lo que’s refereix á sa vida íntima; la segona
tot que’s té que veure ab sa vida exterior. Negada la possibilitat de
que tota la humanitat y tota la terra formin un sol Estat, han de
coexistirne varis, y puig que’ls Estats son conjunts d’homens,
necessaria y precisament han de relacionarse los uns ab los altres.
Aixis com no’s concebeix l’individuo sinó formant societat ab altres
individuos, tampoch se pot imaginar un Estat aislat de tots los altres.
La associació d’Estats té com un de sos objectes donar al conjunt de
molts de petits las condicions d’un de gran, sens que hagin de
renunciar á las ventatjas que’ls són propias, y perdent, per contra, las
desventatjas que de llur petitesa se originan. Los Estats associats van
á ferse forts per medi de la unió. Pera alcansar aquest resultat, al
dividirse las atribucions de la soberanía, deuhen encarregarse al
conjunt ó Estat general totas las que son indispensables pera la vida
exterior de la Confederació. Aquesta ha de presentarse unida y
compacta davant de las altras nacions, que han d’ignorar
diplomáticament la existencia de las varietats interiors.

Tan essencial es que’l poder general estigui encarregat de tot lo

referent á la vida exterior de la associació d’Estats, que d’altra
manera no’s compendria la existencia d’aquesta, com no’s comprén
una companyía entre individuos sens gerent que la representi. Lo
primer dels objectes socials es utilisar la potencia que resulta de la
concentració dels esforsos dels associats pera la consecució dels fins
comuns que’s proposan, vencent las resistencias exteriors que
lograrian deturar ó dificultar la marxa dels meteixos elements si
estessin aislats. La idea de associació no acut jamay al enteniment
del que se sent prou fort pera sortir victoriós en la lluyta per la vida:
los que tenen conciencia de llur debilitat son los que pensan en
associarse. Tota associació, donchs, naix ab lo propósit de vencer
obstacles ó de dominar resistencias, y la associació d’Estats no es pas
una excepció de aquesta regla. Los Estats petits s’uneixen pera
imposar respecte als Estats grans, evitant aixis que puguin
engolírsels ó imposársels.
La concentració de las atribucions relativas á la vida exterior
corretgeix, ademés, los més perillosos defectes dels Estats petits.
Aquestos son propensos á criar faccions interiors, que lluytant entre
ellas s’apassionan moltas vegadas fins á encegarse. Pera cada una
d’ellas l’interés suprem del món se reduheix á dominar á las
contrarias, y ab objecte de conseguirho no tindrian reparo en buscar
auxiliars en los extrangers. Aquestos, sobre tot si són poderosos,
coneixent los defectes dels Estats petits, están sempre amatents á lo
que passa en llur interior, y no perden ocasió que’ls permeti
intervenirhi. Si las faccions vensudas no pensessin en demanar ajuda
als poders vehins, aquestos trobarian medi de insinuarsels.
Aprofitant los moments en que la desesperació treu lo coneixement,
los farian cáure en lo parany, y comensant per quebrantar la forsa de
l’associació, acabarian per imposarse á tots sos membres. Totas las
Lligas ó Confederacions que no han tingut concentradas en l’Estat
general las atribucions relativas á la vida exterior; totas aquellas que
han deixat á llurs membres en disposició de tractar directament ab
los poders extrangers, han sigut víctimas d’aquestos. Aixís van
acabar las Lligas gregas; aixís van ser dominadas las unións que
s’havian format en la edat mitjana. De las que existian á Europa sóls
pogué salvarse la Confederació suissa, gracias á un conjunt
extraordinari de circunstancias favorables, no sens haver estat cent
vegadas á ran de la perdició. Avuy, per fortuna, aquesta Confederació
ha entrat ja en la via que ha de resguardarla de tals perills, y desde fa
ja anys se presenta formant un tot nacional davant de las potencias
extrangeras, tenint assegurada sa independencia per la concentració
de las atribucions relativas á la vida exterior en l’Estat federal,
representació de tots los Cantons que’l constituheixen.
La vida exterior d’un Estat presenta aspectes molt variats que
dependeixen de la classe de relacions que sosté ab los demés Estats.
Desde la situació de guerra oberta, fins á la que’s condensa en las
fórmulas de bona cortesía diplomática, poden aquellas relacions
presentarse de cent maneras distintas. Gracias al avens del dret
internacional, que sab ja respectar al element civil dels pobles que
están en guerra, ni durant aquesta arriban á rompres del tot los
llassos internacionals. En temps de pau, los Estats independents
tenen constantment necessitat de tractar y contractar entre ells, y
avuy fan convenis comercials, demá de propietat literaria ó artística,
passat demá de extradició de criminals, etc., etc.. Si las posicions
respectivas ho aconsellan, contreuhen aliansas ofensivas ó
defensivas, y pera aumentar lo benestar general, se posan d’acort
pera las comunicacions internacionals, postals y telegráficas, pera’l
curs de la moneda, pera lo respecte mútuo de llurs ciutadans, y pera
cent altres objectes, que van aumentant á mida que’l progrés avansa.

De totas aquestas relacions ha de cuidar lo poder general en una

associació d’Estats. Ell ha de ser l’únich encarregat de declarar la
guerra y de fer la pau, dirigint al efecte la diplomacia, y cuidant dels
medis que han de fer respectar sas decisions. A n’ell li toca
exclusivament la facultat de tractar y contractar, podent entrar en
convenis, aliansas y convencions, siguin de la classe que siguin.

La direcció y organisació de la forsa armada, aixís de mar com de

terra; la recepció dels enviats extrangers y la designació y direcció
dels que l’Estat tingui prop de las nacions extrangeras; la regulació
del comers exterior y de totas aquellas materias que s’hagin de cuidar
per més d’una nació, són atribucions de las que’ls Estats associats
han de despendres en favor de llur representant. Aquest es l’únich
que ha de portar la veu de tots quan aquesta veu ha de traspassar las
fronteras.

No vol aixó dir que’ls Estats associats no puguin imposar limitacions

al general en aquestas materias: vol dir, si, que aquestas limitacions
han de ser purament interiors. Poden, per exemple, restringir al
Estat general la facultat de tenir grans exércits y poderosas
esquadras, arrivant fins á prohibirli que’ls sostingui permanents,
com succeheix en la Confederació suissa, ó amidantli’ls recursos,
com fa la Unió americana. Poden fixarli las bases de la política
internacional que ha de seguir, reservantse los Estats associats la
intervenció directa en ella per medi de llurs representants, com fa la
mentada Unió, que subjecta la acció diplomática del President á la
aprobació y consentiment del Senat, format per los delegats dels
cossos llegislatius de cada un dels Estats. Poden voler que las
decisions que comprometen á tota la associació deguin pendres ab
gran solemnitat y després de maduríssim exámen. Las ditas y cent
altras garantías poden establir los Estats particulars de una
associació mentres se tracti de preparar la acció exterior del gerent
del conjunt: pero un cop aquest fa sentir la seva veu més enllá de las
fronteras, totas las altras veus del interior d’aquestas deuhen callar, á
fi de que la que parla en nom comú tingui més forsa y ressonansia.

Ademés d’aquest feix d’atribucions, las més essencials pera la

conservació de la vida, l’Estat general, en una associació d’Estats, ha
de tenirne d’altras delegadas. Las referents á la garantía de las
llibertats y conservació del ordre interior constituheixen lo segón feix
ó grupo.
La acritut de las faccions locals es un altre dels inconvenients dels
Estats petits, y á n’ell, per lo tant, ha de portar remey l’associació. Al
formarla, los Estats que s’uneixen han de confiar al poder general los
recursos necessaris pera corretgir aquell defecte. En la Constitució ó
escriptura social se fixa lo mínimum de llibertat y drets de que voleu
disfrutar tots los associats, y’l gerent s’ha de cuidar de ferlos
respectar per tothom, y de defensarlos contra qui sigui que vulgui
atacarlos. Aixís, donchs, lo poder general ha de tenir atribucions pera
sostenir als goberns dels Estats particulars en lo cas de veures
amenassats per turbulencias ilegals, promogudas per faccions
interiors, al meteix temps que ha de amparar á qualsevol ciutadá
quals drets y llibertat siguin desconeguts per qualsevol entitat ó
autoritat, encara que aquesta sigui la suprema del Estat particular.
Pera cumplir aquestas missions l’Estat general disposa de la forsa
pública dels Estats fidels y de sos tribunals especials. En cas de
revolta, la domina ab l’auxili de la primera y castiga a sos autors ab la
ajuda dels últims. En cas de desconeixement de algun dret ó llibertat
llegítima, los tribunals generals amparan al agraviat ó li otorgan la
reparació justa.

Lo grupo ó feix de atribucions de que’ns ocupem poden los Estats

particulars conferirlo al representant de llur conjunt de varias
maneras. Poden encarregarli la garantía de las lleys constitutivas,
com ho fa la Confederació suissa. Poden constituhirlo en una especie
de tribunal de apel·lació, com succeheix en la Unió americana. Poden
fer materia de la competencia del conjunt tot lo que’s refereix á la
garantía dels drets y llibertats, en qual cas se consignan
expressament en la Constitució general. Poden…, mes no volem
prosseguir, puig basta saber que l’associació d’Estats té lo
particularisme per base, pera deduhirne que’ls medis que pot
emplear son tan variats, com variadas poden ser las condicions y
necessitats dels pobles á que s’aplica. La única regla directiva
essencial es que las atribucions de la soberanía se reparteixin entre’ls
membres particulars de la associació y llur conjunt, desllindantse
clara y terminantment quinas corresponen als uns y quinas al altre.

Assegurada la independencia nacional y garantits los drets y

llibertats aixís dels individuos com de llurs agrupacions per medi
dels dos feixos d’atribucions que acabem de indicar, es encara
convenient á la associació encarregarne un tercer feix al Estat
general. Tots aquells serveys públichs que guanyan ab l’uniformitat y
logran aumentar en utilitat si’s prestan baix una direcció única, se
poden confiar al conjunt. Lo comers d’Estat á Estat y tots los
elements que l’auxilian, com vias generals de comunicació, correus,
telégrafos, regulació de pesos y mesuras, fixació de la lley de la
moneda, etc., etc., han de ser atribucions de las autoritats de
l’associació. Los Estats s’uneixen no sóls pera mantenir llur
independencia y garantir las llibertats, sinó també pera aumentar lo
benestar y la felicitat de llurs membres. Tot lo que pot contribuhir á
donar aquest resultat sens perjudicar als altres objectes socials, ha de
ser materia del contracte de associació, y sa gerencia confiada al
conjunt que la representa.

En algun dels capítols anteriors hem indicat que certas brancas del
dret privat poden ser concentradas ab benefici de tots aquells á quins
han de obligar, puig per llur naturalesa especial no afectan á una sola
comarca, ni á una sola agrupació nacional, sinó á totas las societats
civilisadas. Molts contractes mercantils se troban en aquest cas. Se
pot, donchs, confiar sens inconvenient algunas atribucions relativas
á tals materias als poders generals de l’associació d’Estats.

Pera la concessió de aquestas atribucions s’han probat diferents

sistemas. En las Confederacions germánica y suissa se tendeix á
destriar la llegislació en sas diferents brancas, algunas de las quals se
reservan los Estats particulars, confiantse las altras al Estat general.
Alguna cosa semblant estableix la Constitució dels Estats Units, al
entregar al Congrés federal la llegislació sobre quebras, piraterias y
ofensas contra’l dret de gents.

Aquest sistema es complicat y perillós. Posat l’Estat central en la

pendent, li ha de ser molt difícil resistir al afany d’absorció que es
condició de tot poder, y sos resultats dolents s’están ja tocant en
algunas de las Confederacions esmentadas. L’Estat federal suís,
després d’haver promulgat un códich complet de obligacions, fa
grans esforsos pera apoderarse de altras brancas del dret civil, y es de
temer que arribi á conseguirho. Al nostre entendre es cent vegadas
preferible un altre sistema, que está indicat en la Constitució nort-
americana.

Aquest sistema consisteix en que l’Estat general, sens entrar á

llegislar concretament en cap branca del dret privat, estableixi alguns
principis directius als que hagin de acomodarse las llegislacions
particulars dels Estats. La esmentada Constitució americana prevé
que cap dels de la Unió "podrá declarar que altra cosa que la moneda
d’or y de plata degui ser aceptada en paga de deutes; ni dictar decrets
de proscripció infamatoria (of attainder); ni fer cap lley de efectes
retroactius ó ex post facto, ni que alteri ó debiliti (impairing) las
obligacions dels contractes. Tals principis directius no perjudican la
potestat llegislativa dels Estats particulars, y són en cambi una
garantía de llibertat pera tots los membres de la Unió.
Induptablement aquest sistema está perfectament d’acort ab la
naturalesa del particularisme.

Desllindadas las atribucions de la soberanía que s’encarregan al

conjunt social, totas las restants corresponen al Estat particular.
Aquest, en ús de las que’s reserva, se organisa interiorment de la
manera que creu millor, y dins de aquesta organisació dirigeix sa
política y sa administració pública. Totas las brancas del dret de que
no s’ha després, son materia de sa llegislació especial, que basa la
familia y regula la propietat de conformitat ab los antecedents,
necessitats y aspiracions de sas comarcas. En l’exercici de las
atribucions sóberanas que conserva, sa llibertat es completa. Ni cap
altre dels Estats associats ni’l poder que representa lo conjunt tenen
cap dret de intervenir en sa vida interior. En totas las materias á que
no s’ha extés la limitació al constituhir l’Estat compost, cada un de
sos membres es soberá y autónom.

De tot lo dit resulta ben clar, que al destriar y distribuhir las

atribucions de la soberanía entre las parts y’l tot de Estat compost, la
flexibilitat propia del sistema fa que puguin ser atesas totas las
necessitats y conveniencias. Entre l’Estat general y’ls particulars han
de exercirlas totas, puig que las que no s’han encarregat al primer
quedan reservadas als últims. Aquestos son los originariament
soberans, per qual motiu, sigui la que sigui la part de soberanía de
que’s desprenguin, en la restant segueixen sentho. En aixó consisteix
la essencia del sistema particularista quan pren la forma de
associació d’Estats. Las reglas que havem indicat en aquest capítol
contribuheixen á que’ls resultats siguin los més favorables possibles,
en relació á las condicions en que’s trobin los pobles que adoptin lo
sistema.
Capitol IX.
 Ventatjas positivas del estat
compost
Marxa regular y desembrassada del Estat compost.– Los membres de
aquest disposan de tota llur iniciativa pera la millora interior.– Possibilitat de
fer probas dificils sens perill.– Resultats que per aquest camí se obtenen.–
Exemples práctichs trets del dret polítich suís.– Exemples trets del dret
civil.– Lo Homestead en los Estats americans.– La lley Torrens en las
colonias británicas.– Exemple tret de la nostra historia.– Lo Recognoverunt
Proceres.– Funcionament del Estat compost en la garantia de llibertats y
drets.– Limita á la autoritat la quantitat, no la qualitat.– Garantías fillas de la
combinació dels poders y de llur gelosía mútua.– La federal liberty.–
Possibilitat de la puresa del sistema representatiu sens barrejas de
prácticas parlamentarias.– Combinació de la representació general ab la
especial.– Possibilitat de viure agrupadas entitats que’s trobin en condicions
distintas.– Bona distribució de la població en tot lo territori.– Regeneració
dels carácters decaiguts.

Coneixent ja la naturalesa y carácters del Estat compost, y la forma y

manera de distribuhirse las atribucions de la soberanía entre’ls
membres components y llur conjunt, podem ja destinar alguns
párrafos á estudiar son funcionament, que ha d’ensenyarnos las
ventatjas positivas del sistema.

Pera aquest estudi pendrem com á model una associació d’Estats, en

la que lo poder general tingui encarregat tot lo referent á la vida
exterior, la garantía del ordenat exercici de las llibertats individuals y
corporativas en lo interior, y la alta direcció d’alguns assumptos
d’interés reconegudament comú, y quals membres components ó
Estats particulars conservin totas las demés atribucions de la
soberanía. Suposarem, ademes, que la tal associació forma un
veritable Estat federatiu ó compost, y que, per lo tant, la autoritat
representant del conjunt exerceix jurisdicció directa sobre’ls
individuos y agrupacions, en totas las atribucions de sa competencia.

Sense profundisar gaire l’estudi veurem ja que la marxa de tal

agrupació ha de ser regular y desembrassada. Las autoritats generals
se cuidan de tot lo que es vida exterior, y en quant á la interior fan
poca cosa més que servir de garantía y donar impuls á un número
reduhit d’assumptos, de lo qual se’n desprén que han d’atendre á
moltas menys cosas que’l poder de un Estat unificat. Tot lo que en
aquestos dona més que fer al poder suprem, está fora de la
competencia de las autoritats generals en un Estat compost. Lo
gobern y administració de las provincias; la llegislació en materias de
dret privat; la organisació de tribunals pera resoldre las qüestions
civils y fallar las causas criminals; las eleccions pera corporacions
provincials y municipals; lo nombrament y separació dels empleats y
funcionaris polítichs y administratius que no desempenyin serveys
generals; la organisació y direcció de la ensenyansa, de la
beneficencia, etc., etc., no han distreure llur atenció, que poden
concentrar enterament en las altíssimas atribucions que tenen
confiadas. Poden, donchs, exercirlas ab verdader coneixement de
causa y ab perfecta imparcialitat. Cap interés mesquí, cap mira
egoista ha de alterar la serenitat de la política internacional ni de la
alta direcció de una part de la interior, que condénsan los encárrechs
que’ls Estats particulars tenen fets al representant de llur conjunt.
Aquest, per regla general, está lliure de tenir que pendre midas
odiosas. Pot presentarse sempre als ulls de tots los confederats baix
l’aspecte d’un poder veritablement protector, no sentli gens ni mica
difícil mantenir la popularitat, y rodejarse de aquella atmósfera de
respecte y d’estimació, que es la sóla que dona als goberns forsa real
y prestigi.

Los goberns dels Estats particulars, en cambi, se troban

desembrassats de totas las qüestions que acostuman pendre lo
carácter de enutjosas. No han d’atendre gens á la política exterior,
que un altre cuida per llur compte. Tenen la vida perfectament
assegurada, y per lo tant, no han de pensar en res més que en
disfrutar d’ella y ferla agradable. Respecte á política interior, lo més
essencial tampoch ha de darlos cap cuidado. Tancantse dins de la
legalitat, tenen qui’ls garanteix l’exercici de llurs atribucions, y las
qüestions de ordre públich, que tant perturban als poders unitaris,
no han de preocuparlos poch ni gens. En cas de disturbis, si las
forsas del Estat particular no bastan pera corretjirlos ó reprimirlos,
allí está lo poder general que se n’encarregará, utilisant en cas
necessari las de tots los confederats.

Es incalculable la suma de beneficis que pot produhir un gobern

col·locat en tant favorables condicions. Tota sa iniciativa, tots los
recursos de que disposa, poden ser empleats en milloras interiors, y
en lo perfeccionament de las lleys. Las qüestions d’interés local s’han
d’examinar minuciosament, puig que ellas són las que ocupan quasi
exclussivament l’atenció dels gobernants. Aixís las autoritats
executivas com los cossos llegislatius han de mirarlas ab gran interés,
encara que no vulguin, puig que no sóls s’enclouhen en ellas quasi
totas llurs atribucions, sinó que’ls ulls del públich s’hi fixan y’ls
donan la importancia de grans problemas. Los Estats particulars se
trovan dins de la Confederació en la situació en que estaria un
individuo que tingués assegurada la vida y no hagués de pensar en
las necessitats de cada dia, que més amohinan al comú de la gent.
Aquest individuo, en lo ram á que’s dediqués, obtindria resultats
extraordinaris, puig no hi hauria res que’l distregués de son objecte,
ni deuria temer los perills, per molt que s’arrisqués á empresas
difícils.

La situació desembrassada en que’s troban los Estats particulars

dintre de una Confederació ben organisada, los permet travallar pel
progrés ab molta més energía que’ls Estats unificats. Poden
entregarse á probas difícils, sens temor á las conseqüencias, puig
sigui’l que sigui’l resultat que obtinguin, ni’s posará en perill llur
independencia, ni l’ordre s’alterará fins al punt de produhir
perturbacions desastrosas. En los membres d’un Estat compost
poden ferse tota classe d’ensaigs polítichs-socials, estudiantse
practicament fins reformas quinas ventatjas teóricas no s’han
subjectat encara á la pedra de toch de la experiencia, en la seguretat
de que durant lo período que l’ensaig duri, y siguin quins siguin los
resultats, los grans interessos generals no se’n resentirán, y seguirán
llur curs magestuós, impulsats per los poders federals. La facilitat de
fer probas y ensaigs en los Estats particulars es una de las més grans
ventatjas del sistema que sostenim. Si’ls resultats que s’obtenen de
una reforma no son pas los que sos autors esperavan, res los priva de
tornarla endarrera. Aixis com cap gran interés generat s’ha ressentit
al establiment de la lley, aixis tampoch se’n conmourá cap al
derogarla pera tornar al estat legal anterior. Si la reforma ensajada,
en cambi, dona bons resultats, no sóls se solida en l’Estat que ha prés
la iniciativa, sinó que’ls demés associats la imitan, fenthi las
modificacions que llurs circunstancias especials los aconsellan, y
entre tots la perfeccionan.

Tal vegada á molts los semblará que aquesta ventatja del Estat
compost es molt bona pera ser exposada en teoria, y no creurán que
pugui manifestarse en fets práctichs. Si tal los semblés ó aixó
creguessin, s’enganyarian completament. No sóls aquellas ventatjas
se manifestan en la práctica, sino que son conseqüencia precisa de la
organisació particularista.

¿Se’n volen exemples? No hem de fer més que girar la vista cap á
qualsevol de las associacions d’Estats, y’n trovarem de tota classe.
¿Se’n volen en lo terreno del dret polítich? A Suissa tenim lo Veto, lo
Referendum, la Iniciativa, etc., quinas institucions s’han anat
introduhint en la majoría dels Cantons, en vista dels bons resultats
obtinguts per lo que primer va ferne la proba. Lo dret de revisar las
lleys dictadas per la autoritat llegislativa per medi de votacions
populars ad Referendum va naixer en los Cantons del Valais y dels
Grisons, en los quals hi havia d’antich la costum de referir ó donar
compte de las lleys fetas per lo Concell á las decenas ó municipalitats,
á fi y efecte que resolguessin sobre d’ellas en definitiva. Al acomodar
los Cantons la tradició ab las aspiracions, van modernisar la
institució, y copiantla los que no la havian encara adoptada dels que
ja la tenian, van anarla perfeccionant y extenent fins al punt, de que
avuy forma ja part del dret federal, puig que las lleys que dictan las
autoritats representativas del conjunt han de ser subjectadas á la
revisió popular de tota la Confederació, sempre que
constitucionalment ho demanan trenta mil ciutadans actius ó vuit
dels Cantons confederats. Y tot passant dels uns Cantons als altres, la
institució ha anat prenent formas tan variadas, que mentres en
alguns es lo Referendum obligatori pera totas las lleys, en altres ho es
sóls pera las que importin un gasto que passi d’una quantitat fixada,
y en altres es purament facultatiu ó condicional, no tenint efecte sinó
que ho demani lo número de ciutadans actius que está fixat en las
lleys fonamentals. De la meteixa manera que’l Referendum han anat
extenentse las demés institucions que havem citat y moltas altras.

¿Se’n volen exemples en lo camp del dret civil? Girem la mirada á la

Confederació americana, y’n trobarém un dels més marcats que
pugui desitjarse. Un dels Estats va idear una lley eminentment
práctica, que responia perfectament al carácter emprenedor y
febrosencament actiu de aquells pobles. Lo Homestead, nom ab que
es coneguda la lley á que’ns referim, y que no vol dir més que “ajuda,
auxili de la llar ó de la casa, —(la paraula es composta de Home; casa,
llar, y de Stead; ajuda, auxili,”)— dona á cada individuo la facultat de
sustreure la casa que ocupa sa familia y una gleba de terreno, á tota
responsabilitat y execució per deutes. Lo qui vol utilisar aquest
benefici no ha de fer res més que declararho davant de la autoritat
competent del seu districte ó municipalitat, y aquesta autoritat ne
pren nota en lo registre oficial destinat al efecte, y ho publica en la
forma que está establerta. La declaració no té efecte retroactiu, ni
lliura, per lo tant, la propietat assegurada de responsabilitats
anteriorment contretas: pero desde’l moment de la anotació, lo qui
utilisa lo Homestead queda com si no possehís res de lo que ha
declarat voler reservarse, y’ls que tractan ab ell no poden dir jamay
que han sigut enganyats, puig saben per endavant quina es la seva
situació.