In

Zhao, suffered from warm disease. The [previous] physician prescribed Cinnamon Twig Decoction (gui zhi tang), which led to a subjective sensation of heat, thirst, and labored breathing. He then prescribed [Minor] Bupleurum Decoction (xiao chai hu tang) which made the heat especially worse and For the past six or seven she had increased wheezing and cough,  repeatedly vomited up phlegm drool and had been unable to lie down. Her physician then said that her disease had become very severe and that he lacked the skill to address it. When her family learned of this they were alarmed and flustered. Younger brother Yi fang was dispatched to send for a physician.

When I arrived, I saw that the patient was experiencing hasty wheezing and shoulder breathing and spontaneous sweating from his head. This was heat in both the exterior and interior. His tongue coat was dark grey and his tongue was so contracted that he was unable to speak. I immediately took his pulse and found it floating, rapid, and strong, yet extremely empty upon stronger pressure. Because of this I thought that this was a pattern of extreme yang ming heat where the yin aspect was about to be exhausted. It actually was a worsening pattern from incorrect administration of  (gui zhi tang) and Minor Bupleurum Decoction (xiao chai hu tang).

I immediately gave her White Tiger and Ginseng Decoction (bai hu jia ren shen tang), substituting Dioscorea Radix (shan yao) for the nonglutinous rice (jing mi) [1]. In addition, I substituted Scrophulariae Radix (xuan shen) for Anemarrhenae Rhizoma (zhi mu). She took two packets of the formula in succession and her thirst was relieved, and her wheezing stopped. Her pulse was no longer floating and rapid although it was still strong. Her tongue stretched out and she was able to speak. Her phlegmatic cough was no longer intense and appeared to be milder. He then continued with a modification of Follow the Dragon Decoction (cong long tang), omitting the Perillae Fructus (su zi) and adding 4 qian of Ginseng Radix (ren shen) and 8 qian of Ophiopogonis Radix (mai men dong).

After taking 7 packets she was completely cured.

赵××,患温病。医者投以桂枝汤,觉热渴气促。又与柴胡汤,热尤甚,且增喘嗽,频吐痰涎,不得卧者六七日。医者谓病甚重,不能为矣。举家闻之,惶恐无措。伊芳弟××延为延医。急投以白虎加人参以山药代粳米汤,更以玄参代知母。连服两剂,渴愈喘止,脉不浮数,仍然有力,舌伸能言,而痰嗽不甚见轻。继投以从龙汤,去苏子,加人参四钱,天冬八钱,服七剂全愈

Follow the Dragon Decoction (cong long tang) contains:

  • Fossilia Ossis Mastodi (long gu) (not calcined, crushed)30 grams
  • Ostreae Concha (mu li) (not calcined, crushed)30 grams
  • Paeoniae Radix alba (bai shao)15 grams
  • purified Pinelliae Rhizoma (qing ban xia)12 grams
  • Dry-fried Perillae Fructus (chao su zi) (crushed)12 grams
  • Dry-fried Arctii Fructus (chao niu bang zi)9 grams

Charles Chace and I provided  commentary to the case in the article  Tracing The Dragon, published in the RCHM Journal Autumn 2011, Vol. 8, No. 2.

Please feel free to leave any comments, questions, or criticisms here.

Recent Posts
Showing 6 comments
  • Barry Levine
    Reply

    I read the commentary in RCHM, and very much appreciate the value of this kind of case history, which I think is the heart of clinical practice.
    Thinking about the formula Cong Long Tang, I see this: The mu li, long gu, and bai shao appear, in the main, to be the followup to the leftover effects from the previously prescribed xiao qing long tang – to consolidate the surface and astringe perspiration. Descend qi and expel phlegm (zhi ban xia, chao su zi). Clear heat (niu bang zi). I would not have thought niu bang zi would be sufficient – and wonder what, by the way, is the advantage of dry-frying it. Does this remove the laxative oil component?
    There’s an interesting case history in Otsuka’s 30 Years of Kanpo, where he treats someone who’s been previously over-treated with ma huang tang, who has sweated heavily, and whose yang and yin have been damaged. The outcome is not as favorable, however.

    • Jason Blalack
      Reply

      1. The Mu Li, Long Gu etc. are not there to consolidate the exterior / astringe perspiration. They are specific to descend qi and treat the wheezing. Of course it has this effect also, but he uses these routinely when there is no sweating and the discussions are fairly clear on this.
      2.Chao Niu Bang Zi is not to clear heat. Here it is diffusing the Lung qi. Actually dry-frying it (chao) makes the thermal nature neutral to warm. If you have my book, check out page 4 where Qin uses it in the method Diffuse and Transform Phlegm, which is a phlegm cold pattern. It is further discussed in that chapter as well.

      Hope that helps, and please feel free to write back if there are other questions or comments.

  • Julie Sehler
    Reply

    HELLO JASON… I JUST LEFT YOU A MESSAGE BY PHONE. I AM INTERESTED IN THIS PROTOCOL FOR MY DOG. I AM FAIRLY CERTAIN(?) THAT SHE HAS PSEUDO-DYPSNEA FROM SPLEEN DEFICIENCY, LIVER QI INVADING and LIVER QI STAGNATION WITH WIND THAT HAS CREATED CHRONIC WHEEZING DUE TO GASTRITIS. HER LUNGS WERE FULL OF PHLEGM-FLUID ON XRAY (several weeks ago), SHE HAS BEEN VERY HOT, DAMP, AND EXTREMELY THIRSTY (unquenchable). HER WHEEZING IS HARDER ON EXHALE and SHE RETCHES CLEAR FLUID (or nothing). SHE STOPS WHEEZING ON EXERTION (gently walking at the park in the A.M.) which then SHIFTS TO WHEEZING ON EXERTION FOR THE REST OF THE DAY. SHE IS COLD SEEKING WANTING TO LAY DOWN ON CEMENT FLOORS, HAS DISTENSION OF THE ABDOMEN AND PERICARDIUM WITH A SORE THROAT, GNAWING HUNGER, STIFF AND ACHING BACK, SHOULDERS, PELVIS AND LEGS (she looks rather roly-poly), HER WHEEZING SOUNDS LIKE HONKING AND IT CAN FORCE HER TO PASS WIND. SHE USED TO BELCH A LOT BUT THAT APPEARS TO HAVE DECREASED WITH TREATMENT. SHE HAS CHRONIC DIARRHEA, FLATULENCE, BELCHING, MULTIPLE LIPOMAS IN THE LOWER JIAO AND I BELIEVE SHE MAY HAVE HYPOGLYCEMIA. SHE ALSO HAS MITRAL VALVE PROLAPSE AND SIEZURES (1 year). I HAVE TREATED HER WITH SAI MEI AN, YUNNAN BAI YAO, ER CHEN TANG, BU FEI TANG, BAN XIA HO PU TANG AND HAVE TRIED MULTIPLE COMBINATIONS OF PHLEGM FIRE/GASTRITIS-WHEEZING FORMULAS COMBINED WITH YIN TONICS AND HAVE HAS SOME SUCCESS. BUT SHE IS STILL WHEEZING. SHE IS HAVING SOME GOOD HOURS HERE AND THERE. DO YOU THINK THIS PROTOCOL MIGHT HELP HER? I UNDERSTAND THAT YOU MANY NOT BE ABLE TO MAKE ANY CLAIMS OF EFFICACY BUT I WILLING TO TRY ANYTHING THAT MIGHT HELP HER. IF YOU THINK IT WOULD BE WORTH IT I WOULD BE INTERESTED IN A PHONE CONSULTATION. THANK YOU VERY MUCH, JULIE SEHLER

    • Huang Qi
      Reply

      Maybe some others will have something intelligent to say, but I just have no knowledge of how to treat dogs and feel incapable of making a call on this one. I am sorry. Good luck though…

      • J Sehler
        Reply

        Who are you Huang Qi?

        • Huang Qi
          Reply

          Oh, sorry I have not completely set up this account properly. I am Jason Blalack…

Leave a Comment

Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap.

Not readable? Change text. captcha txt
0

Start typing and press Enter to search