COVID-19, A TCM SOLUTION

        As the pandemic of COVID-19 spreads far and wide around the globe, the world helter-skelter, there is no ready vaccines cater for immediate needs. TCM may be an alternative.

TCM evolves about thousands years through many trials and errors to refine its cure. In the midst, it went through many epidemics, learning to diagnose and treatment of epidemics the hard ways. With the modernization of medical equipment impinges on our understanding at micro level the chemical components of Chinese herbs, giving TCM’s diagnosis and treatment leaps and bounds improvements.

The following is an extract from March issues of “The Economist” how COVID-19 virus functions:

A SARS-COV-2 virus particle, known technically as a virion, is about 90 nanometres (billionths of a metre) across-around a millionth the volume of the sort of cells it infects in the human lung. It contains four different proteins and a strand of RNA-a molecule which, like DNA, can store genetic information as a sequence of chemical letters called nucleotides. In this case, that information includes how to make all the other proteins that the virus needs in order to make copies of itself, but which it does not carry along from cell to cell.

The outer proteins sit athwart a membrane provided by the cell in which the virion was created. This membrane, made of lipids, breaks up when it encounters soap and water, which is why hand-washing is such a valuable barrier to infection. 


The most prominent protein, the one which gives the virions their crown- or mine-like appearance by standing proud of the membrane, is called spike. Two other proteins, envelope protein and membrane protein, sit in the membrane between these spikes, providing structural integrity. Inside the membrane a fourth protein, nucleocapsid, acts as a scaffold around which the virus wraps the 29, 900 nucleotides of RNA which make up its genome. 


Though they store their genes in DNA, living cells use RNA for a range of other activities, such as taking the instructions written in the cell's genome to the machinery which turns those instructions into proteins. Various sorts of virus, though, store their genes on RNA. Viruses like HIV, which causes AIDS, make DNA copies of their RNA genome once they get into a cell. This allows them to get into the nucleus and stay around for years. Coronaviruses take a simpler approach. Their RNA is formatted to look like the messenger RNA which tells cells what proteins to make. As soon as that RNA gets into the cell, flummoxed protein-making machinery starts reading the viral genes and making the proteins they describe. 


First contact between a virion and a cell is made by the spike protein. There is a region on this protein that fits hand-in-glove with ACE2, a protein found on the surface of some human cells, particularly those in the respiratory tract.

ACE2 has a role in controlling blood pressure, and preliminary data from a hospital in Wuhan suggest that high blood pressure increases the risks of someone who has contracted the illness dying of it (so do diabetes and heart disease). Whether this has anything to do with the fact that the virus's entry point is linked to blood pressure regulation remains to be seen.

Once a virion has attached itself to an ACE2 molecule, it bends a second protein on the exterior of the cell to its will. This is TMPRSS2, a protease. Proteases exist to cleave other proteins asunder, and the virus depends on TMPRSS2 obligingly cutting open the spike protein, exposing a stump called a fusion peptide. This lets the virion into the cell, where it is soon able to open up and release its RNA. 


Coronaviruses have genomes bigger than those seen in any other RNA viruses -about three times longer than HIV'S, twice as long as the influenza virus’s and half as long again as the Ebola virus's. At one end are the genes for the four structural proteins and eight genes for small "accessory" proteins that seem to inhibit the host's defences. Together these account for just a third of the genome. The rest is the province of a complex gene called replicase. Cells have no interest in making RNA copies of RNA molecules, and so they have no machinery for the task that the virus can hijack. This means the virus has to bring the genes with which to make its own. The replicase gene creates two big "polyproteins" that cut themselves up into 15, or just possibly 16, short "nonstructural proteins" (NSPS). These make up the machinery for copying and proofreading the genome-though some of them may have other roles, too.


Once the cell is making both structural proteins and RNA, it is time to start churning out new virions. Some of the RNA molecules get wrapped up with copies of the nucleocapsid proteins. They are then provided with bits of membrane which are rich in the three outer proteins. The envelope and membrane proteins play a large role in this assembly process, which takes place in a cellular workshop called the Golgi apparatus. A cell may make between 100 and 1,000 virions in this way, according to Stanley Perlman of the University of Iowa. Most of them are capable of taking over a new cell--either nearby or in another body--and starting the process off again.


Not all the RNA that has been created ends up packed into virions; leftovers escape into wider circulation. The coronavirus tests now in use pick up and amplify SARS-COV-2-speciflc RNA sequences found in the sputum of infected patients.

The holy grail of western medicine is to develop targeted vaccine specifically for the virus. TCM evolves through trial and error to accumulate knowledge through experiential refining practices. Not until recent decades TCM makes use of the developments of medical equipment and through laboratory examination, discovers the chemical components of the herbs to substantiate the reasoning why some ancient prescriptions prevail for thousands of years and still effective. 

Underlying the usage of Chinese herbs is the core of TCM theory which is epistemological between human and environment. Unlike their Western counterpart builds their theory based on existing science. TCM is philosophical and experiential like the ancient Greek medicine；Western Medicine leap to a bigger stride after 19^th century and coupled with the technological innovation in 20^th century carry it much further. The fundamental of its outlook is micro oriented whereas TCM sees disease and human body as a whole but lacks the nitty-gritty.

After years of research, many of the chemical components of the herbs become known to us that why certain herbs or combination of them are efficacy for some diseases, such as scorpion which TCM often uses, has the effects of relieving spasm, alleviate pain; according to Wikipedia, Short-chain scorpion toxins constitute the largest group of potassium (K+) channel-blocking peptides. An important physiological role of the KCNA3 channel, also known as KV1.3, is to help maintain large electrical gradients for the sustained transport of ions such as Ca2+ that controls T lymphocyte (T cell) proliferation. Thus KV1.3 blockers could be potential immunosuppressant for the treatment of autoimmune disorders (such as rheumatoid arthritis, inflammatory bowel disease, and multiple sclerosis).

         My prescription is based on Zhang Zhong jing (张仲景) born around AC 150, he went through numerous epidemics during his time. His book Shang han lun (伤寒论) is sacred for studying TCM theory. More than a thousand year later, his prescriptions in the book are still widely used in today’s TCM clinical practices. My prescription is based on his prescription of MA Xin Shi Gan Tang (麻杏石甘汤) ， commonly used for heated pneumonia cough and asthma. I vary the line of prescription to take into accounts of the symptoms of COVID-19, and adding herbs to strengthen the immune system fight against the virus. Hopefully someone will find it useful.

麻黄3 钱（Ephedra）  枇杷叶3钱 (loquat leaf） 南沙参 3钱（Fourleaf ladybell root） 重楼5 钱 （Paris root）五爪龙5 钱 (Ipomoea cairica (L.) Sweet) 生石膏1两（Gypsum ）， 光杏仁3 钱 (Bitter apricot seed) ，全蝎2 钱（Scorpion） 地龙3 钱(Earthworm) 杭白芍 3 钱(Debark peony root)  金蝉蜕 3 钱(Cicada slough) 太子参 3 钱 (Heterophylly falsestarwort root)僵蚕 3 钱 (Stiff silkworm)金莲花 3 钱(Trollius chinensis ) 漂白术 3钱 （Largehead atractylodes rhizome.）甘草 1 钱 (Liquorice root).

You need a pot (pottery type) specifically for brewing the herbs; pour four bowls of water to specially brewed生石膏 for thirty minutes using small flame, then add in the rest, add water just cover the top of the herbs, and use big flame till it boiled, and switch to small flame again for another twenty minutes, you should get a bowl of brewed herbs. A pack can be brewed three times just to get your money worth. 

Reference：The Economist 12 march 2012 issue

Brexit, an arduous path to make Britain great again

            BY TAN CHYE HONG

June 23, the world will be in complete stew about whether Britons will vote for Brexit. According to Bloomberg’s news, those voting for “Yes” and “No” to Brexit come close to around within few percentage point in favour to leave, and younger voters incline than older voters to remain in the Bloc.

Many older Britons are still nostalgic, beguiled by erstwhile glory when Britain built its empire. Harkening back to the bygone days, buoyant with national pride left them into believing that Britain will be great again if it goes solo. Is that true?

Well, at its worst, Brexit does not spell the end of the day. However, times have changed, the notion of what constitutes as a great nation also changed. Great nation pooh-poohs about land-grabbed globally type of empire-building. Especially, the West has not recovered from war-fatigue. Empire building is no longer an enviable task. It is a shibboleth.

A great nation will leverage its strength exerting influence in global affairs for the common good of the world. Our world needs better managed in that all nations abide the rules of law ubiquitously agreed upon and also international norms, peaceful means of resolution of conflicts, better tackle climate change, eliminate poverty etc. It is great because it wins many a heart to care of global good over those bellicose brawns that run roughshod over others, many countries are too inward focus that render paucity of global issues attenuated; such as the migrant issue. It will not go away if Britain chooses to leave, the issue will continue to pester Britain, and its intricacies are better managed by interested parties together. Coupled with the US is receding its global influence; for this, it is monumental if Britain can sagaciously play an exemplary role as a global leader to fill that vacuum. Britain finds back its lost lustre.

Being in the network will largely amplify Britain’s influence in global affairs, size does matter; you aim to have a tilt by getting your voice heard louder as a prominent leader in the EU. Consider the number of EU members in the permanent UN Security Council, in IMF, and other global institutions that play to Britain’s favour. In other words, being in the bloc provides the platform that exalts Britain to a higher level that chimes with great again ambition. It would be blinkered if you vote for Brexit, you deprive your political leader a chance using that platform to leverage on global affairs, and certainly your lone voice is overshadowed by the hubbub surrounding and marginalised by other global powers. You find discomfiting in an arduous path to project a towering figure’s image.

Security is also a major concern that you cannot ignore. The major threat is from the North. In a recent American military report, in the past one year, Russia nuclear submarine activities were frequent in North Atlantic. Although Brexit Britain will remain in NATO, the entire security structure will be chipping away. Strategically, it will be a different ballgame. Exit will only let Mr. Vladimir Putin sneer surreptitiously. A broken Europe enhances Russia military leverage in the rickety region. Now the crux of an effective defence is for the EU to establish an impregnable cohesive front with NATO. After the cold war, many EU countries rest on their laurels, run their defence budget on a shoestring. And now it is dawn on them the real threat coming from Russia. Brexit will certainly aggravate the security concern in the EU. The breakup will derail NATO’s plan, as the two are now separate entities. EU has a written law to treat every member’s security as their own that is the major concern Mr Vladimir Putin ineluctably to take deep contemplation before any military deliberation, not any Britain’s enviable military assets. How NATO works with EU in the rise of the occasion in case of military confrontation has yet been tested. Brexit makes it more tenuous.

On the economic front, there are many papers predict pessimistic outcome for ensuing economic growth after breakup. It is hard to reckon an accurate projection. But one thing is for sure, despite the uncertainty, we can expect short-term adversity at least. Especially badgering the banking sector, this is Britain’s major asset. Brexit will change the trade relationship of British banks with its European business partners. British banks have majority of their customers from EU, and there is also about 51% trade of goods with EU business partners. The breakup will not unwind everything right off the bet, but certainly Britain will be taken as outsider subject to different yardsticks. In other words, Britons will live in uncertainty for a period of time of painful adjustments.

A “nation migrant reception attitude survey” caught my attention recently, lo and behold; Britain ranks second in the world after China and ahead of Germany as the nation most welcome migrants. I am not sure how truthful and representative is the survey. It seems to me anti-immigration campaign forms a chorus for Brexiteers. I think in the broader sense, before we enmesh in immigration issue, we need to recognise there are two different characteristics of migrant issues involved, One is under EU’s Schengen agreement that offer free movement of the people within the EU that borderless is one of the four freedoms of the rules regarded as basic  to EU membership. That rule is an idealism somewhat that lately proved to have severe loopholes; such as in counter terrorism and in refugees unfettered moving around the borderless bloc.

Euro-sceptics raise concern about the loss of sovereignty due to free flow of migrants, last year alone; migrants to Britain hit second record high of 333,000. “The Economist” adopting a forbearing attitude made such a calculation: “EU migrants living in Britain at around 1.8m to 1.9m is roughly the same as that of Britons living in the rest of EU. Many of the British are retirees and impose healthcare costs on their hosts, whereas younger EU workers in Britain pay more taxes than they consume in benefits.” But those advocates for exit have legitimate reason for opposing free flow of workers too. For one, it is to blame the languishing world economy, many unemployed Britons feel threatened by an influx of EU migrants, those in the job worry about job security. Forget the law of one price; it is propitious to take advantage of exchange differences to work in Britain to receive Pounds than Euros in the Eurozone. There are impetuses for Southern and Eastern Europeans move to the rich North for jobs. However, the stark economic reality exhibits a diabolical job market growth. We are all living in macro-constraints. Increasing job seeker supply without corresponding job creation, only make competition intensity worse. There is more than what we simply ascribe as xenophobia. So, there can be a slight twist of the rule that still free flow of people, but job seeking is restricted to the host country’s needs only.

The second type of migrant is refugees; there is a grain of truth that refugee migrant issue is a tussle between humanity principle and economic reality. The major concern is assimilation to the host country’s cultures. The culture diversity between refugee migrants and host countries cannot be more real at every turn laden with political backlash; all hell broke loose, making veritable humanity look all the worse that compelled Dr Angela Merkel quick reversal of her migrant policy. The grave concern is no one can tell the scale of refugee migration. A receptive approach also sends a wrong signal for those risk-taking migrants that they are most welcome to Europe. Refugee migrants aggravate the nascent economic recovery in Europe. So there must be a realistic solution that fits into individual country’s circumstances. But the root causes are the political conflicts in the Middle East and economic poverty in Northern Africa. So, tackle problems out of pickle at the source is much efforts saving than futile receptive approach.

Another reason to vote for “in” is trade reason. EU, a close to homogeneous mature market that breeds middle class willing to spend for British luxury goods and services, both share proximately similar culture, value and belief. It is an ideal market which proximity reduces non-value added transport costs especially for transporting goods to countries farther afield. Relatively high wages and living standard in some EU countries certainly lead us to conclude that trading with EU partners can sustain high wages in Britain.

In any rate, I am a strong sceptic about the following practice: In cost cutting exercise, companies relentlessly first target at labour costs either through furlough or lay off workers in droves to maintain or raise company’s earnings in order to pander the market. I believe any business firm should have a social objective. Competitiveness is not a race to cut wages to match those of the Emerging markets. Why there are so many outcries by economists about wages stagnant, unequal distribution of wealth, wage growth disparity. It is mortified that Capitalism goes the wrong way. You just cannot reconcile conflicting objectives of on the one hand to relentlessly cut wages to lower costs and on the other expecting it also lifting living standard. A business firm should maintain healthy workforce with social obligation to take care of employees in good times and bad. Competitiveness in a sense is not to compare British wages with those of emerging markets. It embraces product attributes, quality as a whole. If that is not the case, why so many Chinese middle class rush to buy European goods? So, it is borne out by evidence that don’t forsake EU market which brings you the lifeline.

Living in a world in EU which is fastidious about rules and regulation is difficult to bear for some Britons, those self-proclaimed free market advocates dislike rule based governance and fret about circumscription compromises Britain’s sovereignty, for example, the European Court of Justice can overrule British courts. The best option is not to opt-out but participate in decision process to make change. Since Britain the second biggest contributor coughed up almost 10 billion pounds tax payer’s money in 2014 alone to EU’s coffer, it should have a say about EU’s policy, even Britain not a Eurozone member. Many institutions confer more rights to member with bigger contribution. IMF also adopts such practice. It is only participation of decision process can change the ineptitude of a Neanderthal institution.

The current institution in Brussel is centralised, garners too much power, but govern a bloc with huge historical differences and cultures that needs great tact and flexibility. Intransigency bounds to botch. The ideal structure is a political union where member states are elected to the council to lead, coordinate, trade-off in order to reach consensus among member states, decide on policies related to common interests. The structure is largely decentralised. To have a better chance to spur reform in current EU, Britain should go the whole hog by participating in the decision making process.  If Britons opt to stay out, everything in EU will still be in situ; you are still immeasurably encumbered by those rules in future dealing with EU.

EU to Britain is like centripetal; the smaller mass are ensnared to the larger mass by short distance. I am not a physicist. It is felicitous to apply the same analogy in the making for Taiwan which abutting its border to Mainland China. The new president thought it can extricate economic dependency on Mainland China by developing southward trading strategy mainly with South East Asia. The quick answer to her strategy effectiveness is: she can’t get away with the gravitational effect of the Mainland China’s centripetal force. Many Western businesses are bedevilled with hate and love about doing business in China, hate because a swaggering China wields its economics’ clout, infiltrates business rules with noxious party politics and ideology to bulldoze blustering practices by fair means or foul; a blasé attitude many foreign investors feel unpalatable. Love because of its vast market that many don’t mind being gravitated. There is no such scruple for Britain and EU. Both share common value and belief, whether you are progressive or conservative. With compromise, things certainly can be ironed out. Nothing is insuperable.

In the nick of time, if you vote “yes” on a whim, your vote will be a dicey twist. Britain will unmoor to EU, and the Scots ditch Britain. And the balance has gone the other way, the “yes” votes cast a pall over the great again hope, and scupper. Britain will be truly shrinking fast in size. It is indubitably in your interest and the interest of the world to vote for “no” on the 23 of June to Brexit to save the day. 

How to stop Zika Virus become Pandemic?

It is in vain to be in distraught, to cry over spilt milk when Vaccines are not ready till this September (according to the latest news), a slow remedy that cannot meet the Urgency. I am writing to tell you how to manage the outgrowth not until it becomes widespread Pandemic.

1.     Small scale test trial my prescription

I am pretty confident that my prescription will work the wonder, if you are not intransigent to elude TCM’s cure as an alternative preferring to leave money on the table. (Which means prefer to cling to the belief that I am a little more than a demagogue, and that TCM is not scientific, perversely believing the outmoded threadbare that vaccine is the only putative cure). That argument is probably spurious.

The stark fact is you have no other effective panacea to control the speed of the spreading of Zika at its efflorescence, and it is soon become pandemic. Offhand, there is something worth the trails.

To save lives and stop afflicted area become wide-spreading calamity, the first step to do is to test trails my prescription in small scale in stricken areas. Quickly examine and conclude whether to move to the second step below.

2.    Move forward to mass production phase

If my prescription is truly workable, you can move to mass production stage. There are manufacturers in mainland China, Hong Kong, Singapore and Malaysia; they are specialized to produce herbal mixture liquid, Granules, Tablet, and Pills, so is to uplift the production quantity immediately instead of the cumbersome brewing of the herbs, It saves time and is convenient for wide distribution and usage. 

By doing so, you will be able to bring the pandemic under control.

Zika Virus, from a Traditional Chinese Medicine perspective

Zika Virus is a mosquito-borne disease. Aedes mosquitoes are considered as main vectors.

Outbreak distribution: in tropical Africa and in some areas of Southeast Asia. Since 2007, several islands of the Pacific region have experienced outbreaks. In 2015, ZIKV disease outbreaks were reported in South America for the first time. ZIKV disease is now considered as an emerging infectious disease.

Pathology:

According to Wiki, Zika virus is enveloped and icosahedral with a non-segmented, single-stranded, positive-sense RNA genome. It is most closely related to the Spondweni virus and is one of the two viruses in the Spondweni virus. The pathogenesis of the virus is hypothesized to start with an infection of dendrite cells near the site of inoculation, followed by a spread to lymph nodes and the bloodstream. Flaviviruses generally replicate in the cytoplasm, but Zika virus antigens have been found in infected cell nuclei. : It was suggested that Zika virus can be sexually transmitted between humans.

Symptoms:

Most of the infections remain asymptomatic (between 60 to 80%). a short-lasting self-limiting febrile illness of 4–7 days duration without severe complications, with no associated fatalities and a low hospitalisation rate.

Symptoms are similar to other Flaviviruses, such as Dengue fever or Chikungunya; but are milder in form and usually last four to seven days.

Common symptoms include mild headaches, maculopapular rash. It is a red area on the skin that is covered with small confluent bumps, often starts on the face and then spreads throughout the body.); fever (low-grade), malaise, pink eye (e.g. light sensitivity), and joint pains, mainly in the smaller joints of the hands and feet). Muscle pain, vomiting. Zika fever has been a relatively mild disease with limited scope, with only one in five persons developing symptoms, with no fatalities, but its true potential as a viral agent of disease is unknown. For pregnant woman it has been suspected (but not proven) that a transplacental infection of the fetus may lead to microcephaly and brain damage.

Treatment

No vaccine or medications are available to prevent or treat Zika infections

Treatment from TCM perspective

In TCM, It is exterior pathogenic dampness heat（外感湿热） to be the cause of the disease.

由于湿热交织，则热不甚。湿浊伤清阳之气(湿甚阳微) 清阳出上窍，发腠理

，实四肢，故见头痛，湿热流注，邪伏膜原，见瘙痒，湿热入于血分，见疹斑，流注关节，则疼痛。邪客肝经，肝藏血，开窍于目，怕光，红眼，湿热蕴织中焦，胃失和降，则呕吐。

In TCM terms,

Owing to dampness and heat intertwined, patient develops mild fever, predominant turbid and moist pathogenic factors harm the “yang qi” which is characterised by lightness (轻扬) and upward mobility（上行）, the disruption of “Lucid Yang” (清阳) ascending to the upper orifices, causing the symptom of headache; The latent pathogen of dampness  heat in 膜原， (膜原 is the space outside the viscera in the neighbourhood of the stomach, and also in TCM term, usually indicating the position of pleura and the diaphragm), developing the symptom of itchiness, malaise. 

The dampness heat reaching the blood phase湿热入于血分, patient develops rashes, when reaching the joints, inflicting joints’ pain. The exterior pathogen stations in liver meridian, the function of liver is to store blood, the eye is the orifice to the liver, that evil（Dampness heat） causes pink eyes and light sensitivity. The evil (Dampness heat) in middle-warmer (中焦) ， the stomach loses the function of descending of “qi” causing vomiting.

It is all right if you can’t apprehend what a picture I was trying to depict. All the more, TCM is so much philosophical. That piece is just to determine the pathogenic factors and derive the following prescription based on the differentiation of symptoms and signs. (辩证求因).

TCM prescription:

生山栀3钱(Cape Jasmine Fruit)  片姜黄2钱(Gurcuma )  荆芥穗3钱(Schizonepeta Spike) 金蝉衣3钱( Cicada Slough) 生大黄（后下）2钱(Rhubarb)  白僵蚕2钱( Batryticated Silkworm)，飞滑石1两(Talc)，京赤芍3钱(Red Peony Root)  蕤仁肉3钱  (Prinsepia uniflora Batal)草豆蔻3钱 (Alpinia Katsumadai Hay.) 嫩青蒿3钱(Herb 0f Sweet Wormwood) 广藿香3钱(Cablin Patchouli)  北柴胡3钱(Bupleurum),  净连翘3钱(Capsule of Weeping Forsythia) 徐长卿3钱(Paniculate swallowwort root) 白花蛇舌草5钱 (Oldenlandia) 粉甘草1钱(Liquorice root)

Reference: Wikipedia 

Alopecia areata（斑秃）, why not try Chinese Medicine?

The following is a response to the local newspaper publishing a Alopecia areata patient's predicament.

I read your medical condition with sympathy.  You are too pessimistic. The disease is not without cure. According to my research, elsewhere hospitals used Chinese medicine to treat Alopecia areata’s patients. The statistical evidence showed encouraging results. The effective rate is as high as 90%. There are also wide variety of treatments available, such as Skin needle(皮肤针), Body acupuncture(体针), Point injection(穴位注射), Catgut embedding(穴位埋线), Laser acupuncture(穴位激光照射), Bloodletting(刺血).They are all passed clinical tests with flying colors.

In ancient China, there was widespread ignorance about the disease, commonly known as "receive many" alopecia (鬼剃头).And now we know that neural spirit factors are thought to be primary factors; such as anxiety, sadness, depression, endocrine disorders, stress resulting the onset of the disease. Besides, people with genetic allergy background are a cause of alopecia areata. Autoimmune disease, another cause that causes the surrounding of hair follicles and lower part of lymphoid cell infiltration; a part of it infiltrates hair follicle wall, resulting stromal cells (hair matrix cells) degeneration.  Its follicle vessel branches also vasculitis, blood vessels are damaged, that reduces vascular network, making blood supply insufficient, causing hair loss.

I suggest herbal treatment for you.  Try my prescription every day, three times a day for a month. If those herbs worked wonder for others, I don’t see why you are exceptional. You need to be patient, some of the herbs are meant for boosting immune system. It takes time to build a stronger system.

何首乌1两，炙黄芪1两，明天麻3钱，侧柏叶5钱，升麻3钱，白蒺藜3钱，杭白芍3钱，楮实子5钱，酒川芎 3 钱，西红花2钱，墨旱莲3钱，女贞子3钱，菟丝子3钱，五味子3钱，紫丹参3钱，牡丹皮3钱，生地黄3钱，熟地黄3钱，金蝉蜕2 钱，北柴胡3钱，广郁金3钱，土茯苓3钱。

Let me explain to you the meaning of the prescription and why I use those herbs. In TCM, the sudden loss of hair is due to wind (风)There is a well-quoted ethology."高巅之上，唯风可及” It  literally means "High up the peak, only the ethology factor of wind can reach the height. 内经有云：风者，善行而数变，wind has the characteristics of “mobility”, “change”, “abruptness” Wind is caused by deficiency of blood (血虚生风)( 何首乌, 明天麻, 白蒺藜, 酒川芎, 升麻,杭白芍,熟地黄, 金蝉蜕)The kidney is reflected by our hair(其华在发)(Hair loss is due to deficiency of liver and renal yin(肝肾阴虚)( 墨旱莲, 女贞子, 菟丝子, 五味子, 楮实子) Deficiency of liver and renal yin can be the result of disharmony of hepatic qi (肝郁气滞(北柴胡, 广郁金)the chain effect will be stagnant blood(血瘀，血热生风，风往上行)( 牡丹皮, 生地黄, 西红花, 侧柏叶) There are immune system strengthening herbs (炙黄芪, 土茯苓). Some of the herbs mentioned above also carry immune system boosting effect.

My prescription can be purchased from local Chinese medical hall. My best esimate is it costs within twenty dollars per pack. You need a pot specially to brew the herbs; the pot can be bought at pottery shop. You pour four rice bowls of water just cover the top of the herbs, and use big flame till it boiled, and switch to small flame for another twenty minutes, you should get a bowl of brewed herbs. A pack can be brewed three times just to get your money worth.  The residue of the herbs can be used by pouring warm water into it to hand wash the scalp.

It took me three hours to type and research; I hope you take my suggestion seriously.

注解：
经免疫学研究，这种斑秃可出现抗甲状腺球蛋白、抗肾上腺细胞、抗甲状腺细胞等抗体，而无抗毛囊抗体，故认为是一种自体免疫性血管炎性秃发。