Using Streptococcal Infection as an Example, on the Important Value of Integrated Chinese-Western Medicine

Streptococcus is a large genus of common Gram-positive pyogenic cocci, widely distributed in nature, in human and animal feces, and in the nasopharynx of healthy people; most do not cause disease. Pathogenic streptococci mainly cause various purulent inflammations in humans, and can also cause pneumonia, scarlet fever, and other diseases. The genus Streptococcus contains more than a thousand species; the strongly pathogenic ones are mainly group A streptococci, and over 90% of human streptococcal infections are caused by group A—especially group A beta-hemolytic streptococci.

Diseases caused by streptococci include:

1. Various purulent diseases: when bacteria enter through a skin wound they cause purulent inflammation of the skin and subcutaneous tissue, such as furuncles, carbuncles, cellulitis, and erysipelas; spreading along lymphatic vessels they can cause lymphangitis, lymphadenitis, and sepsis; entering through the respiratory tract they commonly cause acute tonsillitis and pharyngitis, spreading to surrounding areas to cause abscesses, otitis media, mastoiditis, tracheitis, and pneumonia; and unhygienic delivery can lead to infection through the birth canal and cause puerperal fever.
2. Scarlet fever: group A streptococci acquired through the respiratory tract can cause scarlet fever, clinically characterized by fever, pharyngitis, a generalized diffuse bright-red rash, and marked desquamation after the rash fades.
3. Two hypersensitivity diseases: rheumatic fever and acute glomerulonephritis, both mainly affecting children and adolescents. If rheumatic fever recurs repeatedly without proper treatment it can lead to rheumatic arthritis and chronic rheumatic heart disease, a lingering, hard-to-cure ailment that can torment a patient for life. Acute glomerulonephritis, if not properly treated, can also progress to chronic nephritis and may cause renal hypertension, proving lifelong and hard to cure.
4. In addition, infection with group B streptococci can cause sepsis, meningitis, pneumonia, and other conditions.

Although group A streptococci are strongly pathogenic, they are not easily drug-resistant; penicillin inhibits their growth. After a group A streptococcal infection, standard Western medical treatment is with penicillin G and anti-inflammatory drugs, usually for 7–10 days.

If we did not study Western medicine, it would be hard to connect the various purulent diseases, scarlet fever, rheumatism, and glomerulonephritis. Without seeing the connection, we would find it hard to discover better ways to treat them.

Purulent diseases belong to the TCM category of "yong" (carbuncles/sores), which TCM attributes to heat toxin; treatment mainly follows the strategy of clearing heat and resolving toxin, with representative formulas such as Xianfang Huoming Yin (Immortal's Formula Life-Saving Decoction) and Wuwei Xiaodu Yin (Five-Ingredient Antidotal Drink).

But after comparing many methods, I have found that for purulent tonsillitis caused by streptococci (the TCM disease name is "ru-e," moth-like throat) and similar conditions, the most effective method is dripping the juice of Sedum lineare (佛甲草, Fojia Cao) into the nose. This method relieves a child's symptoms within half an hour and effects a cure overnight—far faster than penicillin G. Over the past decade-plus I have used this method repeatedly and never failed.

Why is Fojia Cao so effective against purulent tonsillitis caused by streptococcal infection? At one point I suspected Fojia Cao had a strong inhibitory effect on beta-hemolytic streptococci, but consulting the literature and doing experiments, I found it may have only a weak bacteriostatic action.

Yet if a weakly bacteriostatic herb has such good efficacy, there must be some other mechanism not yet fully understood. Of course, now that the true cause is known, I also suspect that Fojia Cao's action on this disease may be only symptomatic, not addressing the root; that remains to be verified in future practice.

This led me to another question: for diseases such as rheumatic arthritis, rheumatic heart disease, and glomerulonephritis, Western medicine treats the acute phase very well with penicillin G. But a regrettable reality is that many patients are easily misdiagnosed or missed, or, through the negligence of patients and their families, fail to seek timely care. They finally progress to chronic rheumatic arthritis, rheumatic heart disease, and glomerulonephritis, with far-reaching consequences.

TCM, however, cannot recognize the relationship between rheumatism and glomerulonephritis on the one hand and streptococcal infection on the other. In ancient TCM texts, rheumatic arthritis is wind-damp bi pain, and glomerulonephritis is generally classed under hematuria or edema; the treatment of these two conditions is not the same as for "yong" (sores).

This is a major disadvantage of TCM's failure to study disease at the microbial level: although we may have good Chinese herbs for certain conditions, because we do not know their true causes we cannot precisely select the most effective drugs.

If we integrate Chinese and Western medicine and recognize that these diseases share the same cause, we can use the same methods to treat conditions that appear unrelated. This will help find more effective and more economical treatments for such diseases and relieve the suffering of many patients.

Thus, integrating Chinese and Western medicine lets each learn the other's strengths and jointly advance medical technology. In this sense, integrated Chinese-Western medicine has important value.

I am currently studying the above diseases. Rheumatic arthritis, rheumatic heart disease, and chronic glomerulonephritis are all hard to treat; many patients are affected by them for life, and Fojia Cao alone can no longer suffice. But once we understand the true cause of such complex diseases, we are one step closer to better results.

I very much hope that both TCM and Western medicine will set aside sectarian prejudices and undertake meaningful exploration of treating such diseases. If we can combine the experience of both traditions in treating them, we may be able to work out highly valuable innovative treatment plans that better relieve these patients' suffering and help them recover their health.