Shang Han Case:

Yang, a two and five month-year-old girl, presented with the chief complaint of cough, that  had been going on for one month. There was sometimes white and sometimes yellow phlegm, nasal congestion, profuse sweating, fear of wind, reduced food intake, no thirst, and her bowels were not dry. She tried many Chinese and Western treatments without success. Her tongue body was normal and there was a white coat. Her pulse was deep and rapid.

Diagnosis: cough (wind pathogen invading the Lungs, which has started to slightly transform to heat).

Prescription: modified guì zhī tāng (Cinnamon Twig Decoction)

guì zhī (Cinnamomi Ramulus) 20g
chì sháo (Paeoniae Radix rubra) 15g
shēng jiāng (fresh ginger rhizome) 20g
dà zǎo (Jujubae Fructus) 15g
zhì gān cǎo (prepared licorice root) 15g
zǐ sū gěng (Perillae Caulis) 15g
qián hú (Peucedani Radix) 10g
fáng fēng (Saposhnikoviae Radix) 10
xì xīn (asarum, Chinese wild ginger) 10g
cāng ěr zǐ (Xanthii Fructus) 8g
sāng yè (Mori Folium) 15g
shén qū (medicated leaven) 20g

She was given three packets to take over three days.

Follow-up visit: the cough had greatly reduced, the sweat was lessened, and appetite was back to normal, but there was still some nasal congestion with clear runny mucus. The tongue coat was white, and the pulse was deep and not rapid. The previous formula, minus sāng yè (white mulberry leaf) and shén qū (medicated leaven), was given.

Prescription:

guì zhī (Cinnamomi Ramulus) 20g
chì sháo (Paeoniae Radix rubra) 20g
shēng jiāng (fresh ginger rhizome) 30g
dà zǎo (Jujubae Fructus) 15g
zhì gān cǎo (prepared licorice root) 15g
zǐ sū gěng (Perillae Caulis) 15g
qián hú (Peucedani Radix) 15g
fáng fēng (Saposhnikoviae Radix) 10
xì xīn (asarum, Chinese wild ginger) 10g
cāng ěr zǐ (Xanthii Fructus) 8g

She was given two packets to take over three days and she completely covered.

Commentary: guì zhï täng (Cinnamon Twig Decoction) is a formula that treats taiyang wind strike and is Zhang Zhong-Jing’s foremost harmonizing formula. It is able to dispel wind and resolve the exterior, harmonize the nutritive and protective, harmonize the yin and yang, and harmonize the exterior and interior.

This is a case of wind cough, but the pulse was deep and rapid and the cough’s mucus was yellow. The dynamic had already moved to the interior and transformed to heat. Therefore a modified guì zhï täng (Cinnamon Twig Decoction) was given. zǐ sū gěng (Perillae Caulis), qián hú (Peucedani Radix), and fáng fēng (Saposhnikoviae Radix) were added to dispel wind, resolve the exterior, diffuse the Lungs, and stop cough. Xì xīn (asarum, Chinese wild ginger) esters the interior to track down the pathogen as well as diffuse the nasal orifices providing assistance to cāng ěr zǐ (Xanthii Fructus). Sāng yè (Mori Folium) was added to clear the Lungs and release heat. Shén qū (medicated leaven) opens the stomach and increases food intake.

Source: <经方医案系列>

Translated by: Jason Blalack

Tags: Cough, Gui Zhi Tang, Shang Han Lun