Liu du zhou’s case:[Patient] Lǐ was a 53 year old female that suffered from paroxysmal heat effusion and sweating for over one year. This would occur 2-3 times every day. A previous doctor treated her for a yin deficiency fever, but after taking over 20 bags there was no result. When questioned, her diet, urination and bowel movements were normal. She had a pale tongue with a white coat, slack and soft pulse that lacked strength.
The differential diagnosis was a pattern of nutritive and defensive disharmony, where defensive is not safeguarding the nutritive. The treatment method was to harmonize the nutritive and defensive, yin and yang, and use the method of promoting a sweat in order to stop a sweat. She was given two packets of gui zhi tang: gui zhi 9, bai shao 9, sheng jiang 9, zhi gan cao 6, da zao 12p. The medicinals were sipped warm with water gruel, and then she covered up, obtaining a light sweat. After this the disease was gone.
Commentary: There was heat effusion, sweating with a tongue that was not red, but pale; the coating is not scant, but white, the pulse was not thin but moderate. This is not a pattern of yin deficiency with fever. It is a disharmony between the nutritive and protective. Nutritive and protective is the body’s yin and yang, it is more suitable for them to work together then for them to work apart. If the nutritive and protective are harmonious then yin and yang are coordinated and protective qi secures and the nutritive qi guards. If the nutritive and protective are not harmonious then yin and yang mutually will go against each other. Nutritive-yin fails the protective-yang resulting in fever, protective-yang does not secure the nutritive-yin and there is sweat. Gui zhi tang is used to “first promote a sweat which will then bring about a cure”
(Translated by: Jason Blalack)