The classic flu comes with the classic advice: "Go to bed and drink plenty of fluids. Take paracetamol for aches, pains and fever." It would drive you mad. Who has time to go to bed? If you're self-employed, a parent of small children or merely too ambitious to let your PC and your mobile go cold, the recommended four to five days in bed may be impossible, not to mention that post-viral slump that can have you dragging yourself around for weeks. So for an increasing number of health-conscious individuals, it's less a case of a being a patient, and more a case of one flu over to the herbalist's place, without delay.
Many acupuncturists and Chinese herbalists keep two tried and trusted Chinese formulas from the 17th century in their medicine chests: Yin Qiao pills (approx £6.50 a box in Chinese supermarkets) and King To Nin Jom Pei Pe Koa cough bottle (approx £4.50). They must be taken just as the flu is setting in to be effective.
Devotees of Chinese medicine may head to Dr W.T. Wang, at the Chinese Natural Herbal Centre in Dublin. He sees up to 100 patients a week. The philosophy of Chinese medicine is that you prevent flu and other illnesses by boosting the immune system through lifestyle and the judicious use of herbs, rather than seeking help when you are falling apart.
But that's not to say Wang won't help you if you feel yourself coming down with flu. Depending on your symptoms and the stage of illness which you are at, he will provide you from his dispensary with a bag of Chinese herbs, roots and flowers. At home, you infuse these into a tea, which you drink daily (the cost is approximately £25 a bag). Certain Chinese herbs can prevent post-viral syndrome, that tired, depressed feeling many people suffer after a bout of the flu, Wang says. "In China, these remedies are considered orthodox, not `alternative' and it is only a matter of time before they are recognised by orthodox medicine in the West," he believes. Already, Western pharmaceutical companies are working with Chinese herbalists to discover and test the chemical ingredients which prevent and treat an array of illnesses and conditions. But you don't have to wait. The smart set is already toting around little bottles of a vile-tasting, olive-coloured potion, Echinacea purpurea tincture, a remedy made from the roots and flowers of the purple coneflower, a pretty member of the daisy family.
They should call it "ech" for short. But be brave and swallow it, because it works a treat for nipping respiratory infections in the bud and it is readily available in chemists and health shops. Echinacea is also fun, since dropping the required 15 drops (two to three times a day) into your glass of mineral water makes you feel just that teensy bit witchy and New Agey. (It costs £5.99 for Nature's Way's own brand, which is selling at a rate of 2,000 packets a month, and £6.99 for the Bioforce brand in health food shops and chemists).
"Sales of echinacea have increased dramatically in the past two years," says Brendan Glennon, a pharmacist in Sandycove, Co Dublin, where he is well-placed to spot the trends. Echinacea is just one of a series of natural remedies bearing up to orthodox medical scrutiny, says Dr Desmond Corrigan, director of the School of Pharmacy at Trinity College, Dublin and member of the European Scientific Cooperative on Phytotherapy, which advises the EU in the licensing of herbal medicines. The remedy's active ingredients are phenolic acids, polysaccharides and alkamides, all three of which have been scientifically shown to boost the immune system. Properly conducted, medically monitored, double-blind, controlled trials have shown that echinacea boosts the immune system by making white cells more active and increasing their ability to scavenge for pathogens. One study showed that people prone to respiratory infections who took echinacea halved their relapse rate. Those on echinacea had on average 40 symptom-free days between bouts of respiratory symptoms, while those prescribed the placebo had only 25 days between bouts.
Taken at the onset of infection, echinacea can greatly limit the course of a cold or flu (one colleague who felt herself coming down with a fever, chills, aches and pains took echinacea and awoke the next morning feeling well). When taken during a bout of flu, it can relieve symptoms. But it may be best taken before you have any symptoms at all. The scientific evidence shows people who are prone to recurring infections of the upper respiratory tract, can benefit from taking echinacea preventively during the cold and flu season, Corrigan says.
So why hasn't your GP told you about it? In Germany and in many medical schools in the US, natural medicines are on the curriculum, as they are at the School of Pharmacy at Dublin University. Irish GPs, however, have not had access to information on natural medicines, although that may change. An important issue for doctors and consumers, Corrigan says, is the quality of natural medicines, which have not been subject to the same regulatory standards as pharmaceuticals. The EU is considering harmonising standards for medicines such as echinacea, so that consumers know they are getting an effective product manufactured under hygienic conditions.
Despite its benefits, echinacea does come with a warning: it should not be taken by anyone who is allergic to plants of the chrysanthemum or aster families, nor should it be taken without medical advice by anyone with TB, MS and HIV because of its action on the immune system. In fact, the treatments should not be experimented with, without medical advice, when you or a family member has a flattening case of flu. The influenza virus can be life-threatening in vulnerable people, particularly the elderly and people with diabetes, kidney disease, chest problems and heart disease, so natural remedies must be kept in perspective. You must see your doctor if: the infection has not cleared up within a week to 10 days; if a secondary, bacterial infection is suspected; if blood or green sputum is produced by the cough; if the cough is accompanied by chest pain; or if you are pregnant.
Antibiotics are useless with flu, which is caused by a virus, although they may help to fight a secondary, bacterial infection. Otherwise, your GP will advise you to go home to bed, although a stop at the chemist on the way home may help make you more comfortable. Paracetamol may be all you need (90p for 24 generic tablets, compared to £1.10 for 12 Panadol). The Republic's fastestselling orthodox cold and flu remedy is Benylin 4 Flu, which has cornered 16.4 per cent of the market since its launch in August. Containing paracetamol, diphenhydram and pseudo ephedrine, it combats all four flu symptoms at once: fever, nasal congestion, body aches and pains and coughing (£4.95 for liquid or tablets). The best insurance against getting flu in the first place is the flu vaccine, which contrary to myth does not give you the flu. It may make you feel slightly achy for a day, but that's better than the severe symptoms of the flu, which include a hard cough, marked fever of up to 104 and aches and pains that can land you in bed for a week.
Dr Michelle Rice, a GP in south Co Dublin, believes all adults should have the vaccine. "It's a bit arrogant to say only workers should have it, since mothers in the home looking after young children need it more than anyone," she says. It also helps to eat well, get plenty of rest and take Vitamin C, she advises. Zinc is less well-known than Vitamin C, but may be even more effective in preventing flu, according to Dr Brendan Fitzgerald, a medical doctor and homeopath in Dublin who specialises in natural approaches. Selenium and Vitamin E may also prove significant as research into the value of vitamin supplements proceeds. The role of vitamins in maintaining a strong immune system and good health is now being recognised by orthodox medicine.
Ideally, rather than taking a multi-vitamin supplement you should seek advice on which specific vitamins you may need to reach optimum health, Fitzgerald says. "It is better to prevent illness than to have top treat it," he suggests. But if you do get flu anyway, there are homeopathic remedies, such as gelsemium, which can ease flu symptoms. That flushed, feverish, toxic feeling can be eased by belladonna, also known as deadly nightshade.
Fitzgerald observes that people are working themselves into the ground, refusing to go to bed when they have the flu and attempting to "work through" repeated colds and infections. If you do this, it doesn't matter how exotic a remedy you find. "You are putting yourself at risk of recurrent post-viral infections and ultimately total exhaustion three or four months down the road," he warns. "In a perfect world, if you have the real flu, you should go to bed for the first four or five days. Most people go back to work sooner than they should."
And it is these workaholics who end up in Fitzgerald's surgery, seeking help to cope with chronic fatigue. As a medical doctor trained in the orthodox manner and a homeopath combined, Fitzgerald believes bottles and potions are all very well - but once you have the flu nothing beats total bed-rest with plenty of fluids to flush out the virus. Which leaves us back where we started.