(Case 6) – from Understanding Case Records Pt. 2

A 10 year-old presented with a mild cough and tidal fever. This was caused by childhood yin exhaustion and qi aspect heat.

Di Gu Pi 3 qian (Lycii Cortex)
Qing Hao 1 qian (Artemisiae Annuae Herba)
Zhi Mu 1 qian (Anemarrhenae Rhizoma)
Gan Cao 3 fen (Glycyrrhizae Radix)
Nan Sha Shen 1 qian (Adenophorae Radix)
Shi Hu 3 qian (Dendrobii Herba)

Qin Bo-Wei’s Commentary:

This case is also a cough with Lung heat and yin exhaustion, but there is a tidal fever which in general shows that the yin exhaustion has progressed. There is incessant heat that is certainly resulting in more and more consumption of the qi and yin. This is important to consider. Nan Sha Shen (Adenophorae Radix), Gan Cao (Glycyrrhizae Radix) and Shi Hu (Dendrobii Herba) not only moisten the Lungs, but with Di Gu Pi (Lycii Cortex), Qing Hao (Artemisiae Annuae Herba) and Zhi Mu (Anemarrhenae Rhizoma) also clear heat and reduce steaming. The “mild” in “mild cough” illustrates that this is a chronic disease with an infrequent cough. Therefore he did not use Xing Ren (Armeniacae Semen) or Chuan Bei Mu (Fritillariae cirrhosae Bulbus).

Translated by: Jason Blalack

Original Chinese: 十岁，嗽缓，潮热，稚年阴亏，气热所致。地骨皮(三钱)、青蒿(一钱)、知母(一钱)、生甘草(三分)、南沙叁(一 钱)、川斛(三钱)。

按:此案亦咳嗽肺热阴亏，但有潮热则比一般阴亏更进一步，热不止，势必气阴愈受消耗，所以特别提出。并用沙参、甘草、石斜润肺外，加入地骨皮、青莆、知母清热退蒸。咳缓的缓字，说明病已经久，咳己不繁，故不用杏仁、川贝之属。

Source: Case from the Cough chapter of Case Records as a Guide to Clinical Practice (lín zhèng zhî nán yï àn) 《临证指南医案》. Commentary from Complete Famous Medical Works of Qin Bo-Wei.

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