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) . 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.
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.
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