RESIDUAL PATHOGENIC FACTOR

Chapter 107


imageRESIDUAL PATHOGENIC FACTOR




INTRODUCTION


A residual pathogenic factor is a pathogenic factor that is left over following an invasion or repeated invasions of Wind. I use ‘Wind’ here in a general sense to designate an external pathogenic factor, which may be Wind-Cold, Wind-Heat, Wind-Dryness, Heat, Dampness, Damp-Heat, Summer-Heat, or indeed any type of exterior pathogenic factor.


After an invasion of a pathogenic factor, the pathological development can have three possible outcomes:






A residual pathogenic factor can also be formed after an exterior pathogenic factor has become interior (see Figure 107.1).



Thus, a residual pathogenic factor is simply a left-over pathological product when the patient appears to recover after an acute invasion of an exterior agent.



FORMATION OF RESIDUAL PATHOGENIC FACTOR


A residual pathogenic factor is formed in two ways: first, as described above, the original exterior pathogenic factor is not cleared and residual pathogenic factor either forms directly in the Exterior or when the pathogenic factor penetrates the Interior (Fig. 107.1); secondly, an exterior pathogenic factor, whether at the exterior or interior level, always disrupts the ascending of Spleen-Qi and descending of Stomach-Qi thus leading to the formation of Dampness or Phlegm (Fig. 107.2).



Why is a residual pathogenic factor formed? Usually, the main reason is simply not taking care of oneself during an acute illness. Unfortunately, most people in the West have lost any idea of common sense or wisdom in looking after themselves. During an acute febrile illness, one should stop working and rest as much as possible: this is the best way to avoid a possible development of a residual pathogenic factor. Most people, however, simply go on working (or even overworking) as usual so that the body’s Upright Qi (or immune system, from a Western point of view) cannot fight the pathogenic factor adequately and a residual pathogenic factor develops. Such a history is extremely common in patients suffering from ME: nearly all adults suffering from this condition report that it started after a severe infection during which they went on working (or overworking) as before.


Another frequent reason for the development of a residual pathogenic factor is the use, or rather inappropriate use, of antibiotics. From a Chinese perspective, antibiotics kill bacteria but they do not clear Heat and, most importantly, do not resolve Dampness or Phlegm. On the contrary, they often upset the digestive system and therefore contribute to forming Dampness or Phlegm. The use of antibiotics is especially inappropriate for viral infections as these agents are not effective against viruses; in spite of this, they are still used frequently for infections that are clearly viral. It is estimated that in previously normal adults without underlying lung disease (i.e. not suffering from chronic bronchitis), up to 95% of acute episodes of lower-respiratory tract infections are caused by viral infection.1 A meta-analysis of randomized, double-blind, placebo-controlled trials of the efficacy of antibiotics in previously healthy adults with acute bronchitis found no differences between antibiotic- and placebo-treated groups in patient- or physician-reported symptoms, resolution of cough or fever, or return to work.2


Residual pathogenic factors are particularly common in children because their digestive system is still immature and easily upset, and invasions of Wind nearly always cause the formation of Dampness or Phlegm. In my experience it would not be an exaggeration to say that more than half of children’s problems are due to retention of residual pathogenic factors. Box 107.1 lists conditions in children that are frequently due to retention of residual pathogenic factors.



BOX 107.1   CHILDREN’S ILLNESSES OFTEN DUE TO RETENTION OF RESIDUAL PATHOGENIC FACTOR




As children grow up, the manifestations and effects of a residual pathogenic factor may become less obvious; often, this does not mean that the residual pathogenic factor has been cleared but the Qi has got stronger. In fact, Qi and the residual pathogenic factor are like two plates of a scale: when one goes down, the other goes up and vice versa (Fig. 107.3).




DIAGNOSIS AND TREATMENT OF RESIDUAL PATHOGENIC FACTOR



How is it diagnosed?


The diagnosis of a residual pathogenic factor is made on the basis of the history and symptoms. Patients report a history of an acute febrile episode from which they appeared to recover but which left them with a chronic problem such as a cough, earache, sinusitis, catarrh, etc.


As for symptomatology, the most common forms of residual pathogenic factor are Damp-Heat and Phlegm-Heat and there will therefore be some signs of Heat and Dampness or Phlegm. Symptoms of Heat will include thirst, a feeling of heat, irritability, insomnia and dark urine. The tongue will have a sticky yellow coating and the pulse will be slightly Rapid. Figure 107.4 shows different tongue signs indicating retention of residual pathogenic factor.


Related posts:

  1. OBSERVATION OF THE GENITALIA
  2. MENSTRUAL SYMPTOMS
  3. DIAGNOSIS BY HEARING
  4. MENTAL AND EMOTIONAL SYMPTOMS

Stay updated, free articles. Join our Telegram channel
Tags:
Apr 15, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on RESIDUAL PATHOGENIC FACTOR

Full access? Get Clinical Tree
Get Clinical Tree app for offline access