Case By: Fei Sheng-Fu (费绳甫)

Mr Xu Zhongxiu from Zhenjiang [suffered] from swelling of the feet and legs as well as of the testicles, abdominal distension, coughing, facial edema, and reduced urination. He came to me for examination and treatment because treatment so far had not worked. His pulse was floating and wiry in the right cun position indicating water swelling. The Lungs were unable to afford regular passage through the water ways towards the Bladder so that water qi flowed over transversely into the spaces between the skin and flesh. I considered Yu’s treatment [strategy] for flooding, which relies on first dredging [the water pathways] so that [water qi] can flow downward. Once the water has a way to exit [the body] it will no longer have cause to flow over [into the body].

mole cricket (lóu gū) 9g
Tetrapanacis Medulla (töng câo) 9g
Kochiae Fructus (dì fü zî) 9g
Acanthopanacis Cortex (wû jiä pí) 6g
Poriae Cutis (fú líng pí) 12g
Benincasae Exocarpium (döng guä pí)  12g
Armeniacae Semen (xìng rén) 9g
Fritillariae cirrhosae Bulbus (chuän bèi mû) 9g
Citri reticulatae Exocarpium rubrum (jú hóng) 3g
Junci Medulla (dëng xïn câo) 3 chi

Commentary: Whereas in the previous two cases (#6 and #5) obstruction of Lung qi was due to Liver yang or fire, here it is due to obstruction of Lung qi by dampness. No longer moving downward it spills into the body, including the Liver channel (the testes). The treatment strategy relies of draining dampness from the Lungs via the Three Heater with a combination of Three-Seed Decoction (sän rén täng) and Five-Peel Drink (wû pí yîn).

Translated by: Volker Scheid

For more reading on Fei Bo-Xiong, please look for Volker’s upcoming book from Eastland Press. Its working title is, “Menge Medicine,  Vol. 1, Fei Boxiong’s Refined Medicine Remembered with Commentaries and Fei Family Case Histories”

The wife of minister Jin Junhui from Anhui [suffered] from severe distension of the chest and abdomen, which caused painful knotting and lumps. The legs and feet were distended and swollen, there was internal heat with dryness of the mouth, and she was mentally tired and lacked strength. The momentum of this disorder was towards the development of drum-like abdominal distension and previous treatment had been unsuccessful. I examined her pulse, which was deep, thin and slippery. Both qi and yin fluids were deficient. Liver yang ascended carrying damp-heat [with it] to obstruct the qi dynamic and scorch the yin fluids so that their irrigating [function] had been lost. The necessary treatment [strategy] is to build up and nourish qi and yin fluids, combined with clearing the Liver and transforming dampness. Such a strategy is bound to yield results.

Ginseng Radix (rén shën) 2.4g
Panacis quinquefolii Radix (xï yáng shën) 4.5g
Ophiopogonis Radix (mài mén döng) 9g
Poria (fú líng) 12g
Benincasae Semen (döng guä zî) 9g
Benincasae Exocarpium (döng guä pí) 9g
Kochiae Fructus (dì fü zî) 9g
Coptidis Rhizoma (huáng lián) 0.3g
Evodiae Fructus (wú zhü yú) 0.3g
Dendrobii Herba (shí hú) 9g
Gigeriae galli Endothelium corneum (jï nèi jïn) 9g
fresh Bambusae Caulis in taeniam (zhú rú) 3g
Citri reticulatae Exocarpium rubrum (jú hóng) 3g
fresh and prepared Setariae (Oryzae)Fructus germinatus (gû yá) 12g each
Paeoniae Radix alba (bái sháo) 4.5g
Toosendan Fructus (chuän liàn zî) 4.5g

After 12 prescriptions of the above formula the condition was cured.

Commentary: This case byFei Sheng-Fu matches the pathology of case 5 (cough & panting), with the exception that here the hyperactivity of Liver yang is due to Liver fire resultant from constraint rather than Liver yang. Hence, the strategy requires regulating Liver qi as well as clearing Liver fire. He came to me for examination and treatment because treatment so far had not worked. His pulse was floating and wiry in the right cun position indicating water swelling. The Lungs were unable to afford regular passage through the water ways towards the Bladder so that water qi flowed over transversely into the spaces between the skin and flesh.

** Translated by: Volker Scheid

Case by Fei Sheng-Fu (费绳甫）

The wife of Mr. Zhu Zhushi from Zhejiang was ill with cough and panting so that it was difficult for her to lie down at night. Her heart was irritable and vexed, she had a stifling sensation in the upper abdomen, and the mouth was greasy with little intake of either food or drink. The face was puffy and the legs swollen, and at night she could not sleep. The momentum [of this disorders] was extremely serious. When I examined her the pulse came overflowing, big, wiry and rapid.

[Diagnosis & Pathodynamic]: Both qi and yin fluids were deficient so that Liver yang ascended excessively. This combined with habitually steaming phlegm dampness blocking Lungs and Stomach so that clarifying and directing downward had no force.

[Treatment Principle]: The [appropriate] strategy was to build and nourish qi and yin fluids, clear the Liver and transform phlegm.

[Prescription]:

Ginseng Radix (rén shën) 3g
Panacis quinquefolii Radix (xï yáng shën) 4.5g
Eucommiae Cortex (dù zhòng) 9g
Poriae Sclerotium pararadicis (fú shén) 6g
Fritillariae cirrhosae Bulbus (chuän bèi mû) 9g
Aurantii Fructus (zhî ké) 3g
Trichosanthis Pericarpium (guä lóu pí) 9g
Ligustri lucidi Fructus (nu zhën zî) 9g
Armeniacae Semen (xìng rén) 9g
Paeoniae Radix alba (bái sháo) 4.5g
Ostreae Concha (mû lì) 12g
Fossilia Dentis Mastodi (lóng chî) 6g
Benincasae Semen (döng guä zî) 12g
Bambusae Caulis in taeniam (zhú rú) 3g

After two prescriptions the momentum of the excessively ascending Liver yang was gradually being pacified, the heart irritability and vexation had stopped, and she was able to sleep at night. I continued the previous formula with the addition of Dendrobii Herba (shí hú) 9g, five slices of pear, and five pieces of Eleocharitis Rhizoma (bí qì). As the bowel moved [regularly] phlegm was being drained from below so that Stomach and Lungs clarified and directed downward [once more], and wheezing and coughing were pacified, and she could lie down at night. The appetite gradually returned and the facial swelling and swelling of the legs subsided. I continued the formula with the addition of mao yan (毛燕), regulating [the condition] for half a month until she was cured.

** Translated by: Volker Scheid

Volker’s Commentary: This case by FSF does not correspond to any of his own or FBX’s manifestation patterns for swelling and edema. It thereby demonstrates that these patterns, where they are made explicit, constitute a general assessment of the terrain from which pathological processes can be deduced and not an attempt to provide prescriptive protocols. Here, the overflowing rapid pulse when related to the symptom pattern indicates the pathological process described by FSF. Hence, while facilitating the clearing and downward directing functions of Lungs and Stomach is necessary to treat the manifestations, root treatment focuses on pacifying hyperactive Liver yang. 

Jason’s Commentary: This 毛燕 (mao yan) is a type of bird’s nest (燕窝, yan wo) that is of a relatively inferior quality. It is grey colored and contains many feathers.

Case from Fei Sheng-Fu (费绳甫）

Mr. Wu from northern Jiangsu [suffered] from Liver wood encroaching the Spleen until only it’s [qi] was present in the abdomen  致成單腹. The abdomen was distended like a drum, the umbilicus protruded outward, the tendons were blue. The back was normal but the waist full. This constituted a dangerous pattern. In this situation [the appropriate strategy] is to curb wood and support earth, unblock with warming [medicinals], and leach out dampness. Prescription was:

** Translated by: Volker Scheid

Volker’s Commentary: Read together with the previous case, this record from FSF’s case histories further illustrates the importance of the middle burner at the centre of the qi dynamic and of fluid metabolism. The situation is described as dangerous because both the qi and yang of the middle burner have collapsed. Movement and transformation have come to a standstill, hence the position of earth is seized by wood. This is visibly manifest in the protruding umbilicus, representing Spleen earth, which is pushed upwards by Liver qi. The treatment therefore is aimed directly and only at the middle burner employing a combined strategy of warming in order to reignite transformative process, acrid downward moving in order to break up stasis, and leaching out of excess dampness from the middle burner. The core formula used for this purpose is modified Bolster the Spleen Drink (shí pí yîn), which in turn builds on True Warrior Decoction (zhën wû täng) and Three-Substance Decoction with Magnolia Bark (hòu pò sän wù täng). Even here, however, FSF takes account of the role and relation between Liver and Lungs, qi and blood. This explains his use of Angelicae sinensis Radix (däng guï), on the one hand, and of Benincasae Semen (döng guä zî) and Coicis Semen (yì yî rén) on the other, which together with Amomi Fructus rotundus (bái dòu kòu) and Magnoliae officinalis Cortex (hòu pò) suggest the intention of Three-Seed Decoction (sän rén täng).

Thus, like his grandfather, FSF skillfully interweaves cold damage and warm pathogen strategies to realize the principles of harmonization and moderation even in a strongly warming and draining prescription.”