Analysis of the application of five tone therapy in the prevention and control of COVID-19

Yu Guo*,Jie Chen2

1Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai,China.

2Shanghai Changning Tianshan Traditional Chinese Medicine Hospital,Shanghai,China.

#Yu Guo and Jie Chen contributed equally to this work and shared the first authorship.

Abstract The new coronavirus variant Omicron spread in China this time has the characteristics of strong transmission, short infection incubation period and mild symptoms. In order to effectively prevent and control the epidemic, medical staff, public security, volunteers and other staff are facing great challenges. At the same time, due to the unknown of the disease and many conditions such as home isolation, the entire society has a lot of social anxiety and sadness. Music therapy is an important supplement for the treatment of mental and behavioral disorders. This commentary takes the prevention idea of"preventing disease"as the basic principle to analyze the application of five-tone therapy to the mitigation and control of Coronavirus disease 2019. It is a method worth popularizing and applying.

Keywords:Pentatonic music therapy, Traditional Chinese medicine,COVID-19, Psychology

Background

The emergence of a new variant of the coronavirus, Omicron, has exacerbated the spread of the novel coronavirus disease 2019(COVID-19) outbreak. According to research data[1], the infection of the Omicron variant mainly involves the upper respiratory tract, and the lower respiratory tract is relatively rare.At present,the main early symptoms of patients with COVID-19 in China are nasal congestion,runny nose, sore throat, hyposmia or loss of smell, conjunctivitis [2].In addition, the Omicron variant has many mutation sites, rapid spread, and great changes in infectivity and immunological characteristics. There is a risk of immune escape and breakthrough of the immune protection of existing vaccines [3]. As of 24:00 on Apr 8,2022, the cumulative number of people diagnosed with COVID-19 in China has reached 314,707. Currently in Shanghai, grid-based nucleic acid screening, centralized isolation management and treatment are adopted for populations in key areas. This scheme is safe and orderly.The city's medical staff, public security police, volunteers and other staff are all working overnight, and community residents also actively cooperate. However, the heavy workload of the staff day and night,and the fact that people are not aware of the disease and are isolated at home, have caused the whole society to have a lot of social anxiety and sadness.

As an emerging non-drug therapy that intersects various disciplines such as music and medicine and psychology, music therapy is an important complement to the treatment of mental and behavioral disorders. China has clearly recognized the therapeutic role of music since ancient times. In Oracle bone script, the characters,“樂”(music)and “薬” (herbal), are consistent, and the medicine is derived from music. It has certain clinical value for guiding people to properly use music to coordinate the five internal organs, regulate Qi (energy) and blood,control emotions,dispel diseases and maintain health.Based on the prevention thought of "preventive treatment", this article analyses the application of Pentatonic Music Therapy to the prevention and control of the pandemic situation of COVID-19 pneumonia.

Music therapy

Long-term studies have shown [4-8] that music therapy is positively associated with quality of life,and can effectively alleviate the patient′s anxious and depressive. From a psychological point of view, music therapy can be used as an adjunct to emotional regulation and coping skills.From a physiological point of view, music participation therapy can regulate arousal, including heart rate and cortisol. Some clinical trials showed that music intervention is associated with reducing symptoms such as depression, anxiety, and posttraumatic stress disorder [9-12].Listening to music can regulate emotions and reshape cognition,such as regulating anger and anxiety,and producing a sense of well-being.

Understanding of the five tones

Music has a natural attribute. The "sound" in nature comes from the empty orifices of things. Chinese traditional pentatonic tones include palace, commerce, horn, sign and feather, representing Do, Re, Mi,Sol, La in music phoneme respectively.Guanzi·Diyuanrecorded"Everyone listening to signs is like being awake and horrified;listening to feathers is like a horse singing in the wild; those who listen to the palace are like ox singing in the middle; those who listen to the merchants are like flock of sheep; those who listen to a horn are like pheasant climbing the tree to sing." And it also has social attributes.Great musicsays: "Sound comes from harmony, harmony comes from comfort, and that is where the kings formulated music."On Musicwrote: “If there is no music in the world, it is difficult to reconcile Yin(negative) and Yang (positive) and avoid disasters. Music can make people calm in spirit and prevent depression." Therefore, the emotional interaction between"happy"and people was proposed.Five tones (Pentatonic Music) is formed by combining the ideas of Yin-Yang (the two opposing principles in nature, negative and positive), and five elements with the music theory of Taoism and Confucianism.Inner Canon of the Yellow Emperor(the most authoritative text of early medical theory and drug therapy) recorded about connection between music and medicine, and connection between five tones and five laws with people's five internal organs,the affiliation of five elements, emotions.

"Lingshu·Five tones and five flavors" recorded "The palace tone is melodious and harmonious, helping the spleen to be healthy, and the appetite to be exuberant; the commerce tone is sonorous and solemn,good at controlling anger, making people peaceful; the horn tone is smooth and peaceful,good at dispelling melancholy,helping people to fall asleep; the sign sound help reading and chanting, adjusting the blood veins, and shaking spirit; the feather tone is soft and thorough,which makes people enter the state of mindfulness meditation.

Understanding of pentatonic therapy

The style of the palace sound (Do) is melodious, quiet, harmonious and gentle. The palace sound is related to the spleen, which can regulate the nervous system, increase appetite, and promote the digestive system [13]. The commercial style sound (Re) is loud and sonorous, solemn and tragic. Commerce sound is related to the lung,which can strengthen the function of the respiratory system and improve people's irritability. The horn-tuned sound (Mi) is melodious and vibrant. The sound of horn is related to the liver, which can make people touch melancholy mood, relieve pain and calm nerves, and relieve chest pain, chest tightness and other symptoms [14]. The sign sound (Sol) is cheerful, relaxed and lively, which is related to the heart, has a promoting effect on cardiovascular function and mood regulation, and is especially suitable for diseases affected by deficiency of Qi [15]. The music style of feather tune (La) is pure and soft,desolate and mournful,flowing with clouds and running water. It belongs to water in the five elements of Yin and Yang. The sound of feather is soft and can help the kidney, which can improve the function of the kidney, supplement the deficiency of the kidney, and has therapeutic effect on the deficiency of Yin, the hyperactivity of fire, and the deficiency of kidney essence.

The mechanism of pentatonic therapy in COVID-19 pneumonia

Theory of state of viscera

The theory of state of viscera aims to explore the law of visceral activity through the external signs of the human body, and then effectively guide health preservation and disease prevention,diagnosis, treatment and rehabilitation. It is the core content of the theoretical system of traditional Chinese medicine.

"Suwen·Cite the pain theory" wrote "I've heard that many diseases occur due to Qi dysfunction. If you are angry, you will turn your Qi upside down;if you are overjoyed,you will lose your Qi;if you are too sad,you will dissipate your Qi;if you are too afraid,you will sink your Qi;if you are cold,you will gather your Qi;if you are heated,you will leak your Qi;if you are too frightened,you will be confused;if you are too tired,you will lose your Qi,and if you are too worried,you will be depressed. The changes of these nine kinds of Qi are different. What diseases can they lead to respectively?". “Excessive sorrow makes the heart tense and anxious, the lung lobes swell; the Qi is in the upper coke, and the passage is not smooth. The Qi of camp and defense cannot be dispersed, and the hot Qi stagnates inside and does not dissipate.For a long time,the Qi will be consumed.Too much fear will lead to the decline of essence and Qi. The decline of essence and Qi will lead to the occlusion of the upper coke, the obstruction of the upper coke, the return of Qi to the lower coke, the depression of Qi and the lower coke, and the fullness of Qi. Therefore, it is called the decline of Qi.”

According to the etiology and pathogenesis of respiratory tract infection, traditional Chinese medicine believes that the lung is the first to be affected when toxic pathogens invade the human body. The lung is delicate and refined, and deficiency after feeling evil.Meanwhile, Chinese medicine believes that the lungs store energy,and its emotions are manifested as worry.Suwen·The law of movement of yin and yang recordedthe lung is the most important organ;too much sorrow hurts the lung.Sadness and worry are normal emotional changes of human body, but excessive sadness and worry can damage the lungs.Lung’s deficiency will affect the generation and operation of Qi of the whole body, unable to effectively inhale the clear Qi of nature, affect the generation of Qi from the chest, and weaken the life activities of the body;The disorder of propaganda and elimination makes the Qi running outside the pulse unable to be effectively publicized, which affects its role in protecting the human body and avoiding the invasion of external pathogens.

Suwen·Declare the five Qirecorded the five internal organ stores meaning;the heart stores the spirit;the liver stores the soul;the spleen stores the mind; the kidney stores the will. The heart is the master of the five internal organs and the home of the spirit. Sorrow and fear can hurt the heart.

Mental activity is related to the five viscera, but the mind is dominant. Mood changes affect the heart. The physiological function of the heart is related to the "joy" of emotional activities. The happy emotions are beneficial to the function of the main blood vessel of the heart, can effectively transport nutrients to the whole body, maintain the normal physiological functions of the human body.

The Five Elements Theory

From the perspective of the relationship between the five elements and the changes, the lungs and the other four viscera can maintain their normal state of mutual balance by restricting and complementing each other. Insufficient energy in lung, unable to take inhaled clear energy down to the kidneys. Lungs and kidneys coexist as mother and child, and the mother's disease affects the child, and if the kidney is not nourished, the lung also cannot be nourished. The lung is the main hub of Qi, and the spleen is the source of Qi. The spleen and the lung are also the mother-child relationship. Only by coordinating with each other and influencing each other can the normal distribution and excretion of semen be ensured. "Cultivating soil and generating gold” means a mutual relationship. With healthy spleen, the water and grains are transported to the lungs, so that the lungs can be nourished and maintain normal physiological functions.The lungs govern Qi,the heart governs blood.It shows that the normal performance of the respiratory function of the lung department is affected by the function of the main blood vessels of the heart. If the emotion injured, the heart is damaged, and it is unable to normally push the blood vessels, nourishing and restricting the lungs.Suwen·Conditioning meridian theoryrecorded, “Energetic mood is always happy;mental deficiency is easy to be sad.”As weak gold,lung cannot overcome wood, it’s resulting to abnormal dredging function of the liver. If the lung storage is damaged and the lung metal is weak, the wood cannot be restrained,resulting in abnormal dredging function of the liver.Only liver is relieved,therefore energy machine is smoothed,so as to promote the coordination of the ascending and descending movement of the spleen and stomach.

Application strategy of pentatonic therapy in COVID-19 pneumonia pandemic situation

Apply music dialectically according to the stages of novel coronavirus pneumonia

The prevention and treatment characteristics of traditional Chinese medicine are prevention before illness, prevention and degeneration of existing diseases, and combination of prevention and treatment.Therefore, according to different disease periods, using five tone therapy and giving different tunes to different patients can simultaneously treat physical and psychological diseases.

In the stage of disease prevention, give the high pitched and sonorous commercial sound into the lungs, eliminate the excessive anxiety of the crowd during the pandemic, alleviate the irritable mood, enhance the confidence in disease prevention and treatment,and improve the function of the respiratory system by tonifying and dispersing the lung.At the same time,the appropriate style is cheerful,relaxed and lively, which can adjust the emotions, and make heart happy. A benign emotional response has a coordinating effect on the Yin and Yang of the heart, and the mind is clear, so it can be full of vitality. If there is a unique and charming "red song" song, the tune is beautiful,with a strong sense of rhythm,giving birth to a heroic spirit,motivating people to make progress, not only to enjoy the senses, but also to please the body and mind.

At present, during the severe pandemic prevention and control period, according to the symptoms in different groups, syndrome differentiation and treatment are carried out, and music corresponding to the viscera is given to play an auxiliary treatment role. For example, in this new coronavirus pneumonia, according to experts' recommendations, the treatment principles of traditional Chinese medicine treatment can be given in different periods [2].Following this series of treatment schemes, in the process of prevention and treatment of this disease, we should give priority to palace sound which can regulate the nervous system, promote the digestive system and commercial sound which can improve the function of respiratory system, which can have the effect of dispersing lung, strengthening spleen and supplementing energy. At the same time, the tunes of horn, sign and feather are used to assist the music,so as to make the viscera interact and biochemical restrict each other in the pathogenesis,and reconcile the relationship between the viscera from the whole. In addition, it can also alleviate the tension and anxiety of the crowd and actively cooperate with other intervention measures.

Giving music during quarantine

Adhering to the general strategy of "preventing import from outside and rebound from inside"and the general policy of"dynamic clearing"it requires medical staff to work day and night, stay awake and strive to complete the screening work in time, and it also requires the active cooperation of residents in various regions. In such an unprecedented high-intensity work and life state, people will inevitably experience emotional problems such as anxiety and sadness, as well as physical problems such as sleep disorders and tinnitus. According to the treatment principles of traditional Chinese medicine,such as"soothing the liver and relieving depression", "nourishing the heart and soothing the mind", and "restoring normal coordination between heart and kidney", the horn sounds in the five tones are selected to enter the liver, so that they can be smooth and peaceful, which can relieve people's worries and thoughts, relieve anxiety and calm the mind, and help people fall asleep. The style of feather tune is pure and soft,flowing with clouds and water.It belongs to water in the five elements of Yin and Yang,which has a magical function to help the kidney.The Yin in the kidney goes up to the heart, which can cultivate the Yin of the heart. The water and fire of the kidney rise and fall with each other, coordinate with each other and maintain balance.

Specific operation methods and effects

Relying on the internet and other information technologies, we develop intelligent medical care, and guide everyone to take the initiative to use the "Internet + health care" service. Combined with traditional Chinese medicine practitioners, psychotherapists, and teachers of music colleges, the designated music is sorted and classified according to its different tones, such as “Palace, Commerce,Horn, Sign and Feather”, and stored on the Internet medical platform.In addition, we can establish a correlation between music and therapeutic interventions, allowing different groups of people to inquire using the International Statistical Classification of Diseases and related health problem codes after consultation with doctors, and then choose the music under the corresponding syndrome classification for selected intervention.

If there is no corresponding digital diagnosis and treatment platform to provide professional music, under the current pandemic situation,people in different environments can also obtain music appreciation under various artificial intelligence apps according to their understanding of different music or their preferences. Some scholars have found[16,17]that the intervention given by music may be more attractive and fun than other interventions, which can improve the experience of participants,and listen to happy music when they are in a bad mood, which has a stronger impact on their emotions than listening to sad music when in a negative mood.

Summary

The application of pentatonic therapy to the mitigation and control of COVID-19 is different from the traditional method. "preventive treatment" is not limited to the theory of health preservation of internal and external use of medicine,but also through different forms of music, to achieve the unity of body and spirit, starting from the human body's own organism, through the coordination of the functions of various viscera organs. It provides a way for people who are experiencing different problems under the pandemic. It is a rare non-drug-assisted prevention and treatment method in traditional Chinese medicine.