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Townsend Letter for Doctors and Patients, May, 2004 by Bob Flaws
Additions & subtractions: If fever abates and only joint pain remains, Shi Gao and Zhi Mu should be replaced by Cortex Phellodendri (Huang Bai) and Rhizoma Atractylodis (Cang Zhu) and nine grams each of Radix Angelicae Sinensis (Dang Gui) and Radix Albus Paeoniae Lactiflorae (Bai Shao) should be added. If there is then marked fatigue, add 15 grams of Radix Astragali Membranacei (Huang Qi) and nine grams of Radix Codonopsitis Pilosulae (Dang Shen).
3. Heat damaging qi & yin pattern
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Main symptoms: Vexatious heat, spontaneous perspiration, heart palpitations, chest oppression, shortness of breath, cough, vacuity vexation insomnia. Vexation and agitation may be relatively severe and the lips may be greenish purple or the facial complexion may be somber white. There may also be counterflow chilling of the four extremities. The four extremities may lack strength and the essence spirit may be listless and fatigued. The pulse is fine and weak, bound, or regularly intermittent. The tongue is pale with thin, white fur. This pattern is mostly seen in those with accompanying cardiopulmonary damage or central nervous system damage.
Rx: Zhi Gan Cao Tang (Mix-fried Licorice Decoction) & Xie Xin Tang (Drain the Heart Decoction) with additions and subtractions.
Ingredients: Radix Panacis Ginseng (Ren Shen), 15g, Fructus Zizyphi Jujubae (Da Zao), 20 pieces, uncooked Radix Rehmanniae (Sheng Di), 50g, mix-fried Radix Glycyrrhizae (Gan Cao), 15g, Gelatinum Corii Asini (E Jiao), Tuber Ophiopogonis Japonici (Mai Dong), uncooked Rhizoma Zingiberis (Sheng Jiang), Ramulus Cinnamomi Cassiae (Gui Zhi), Semen Cannabis Sativae (Huo Ma Ren), Rhizoma Coptidis Chinensis (Huang Lian), Radix Scutellariae Baicalensis (Huang Qin), and Radix Et Rhizoma Rhei (Da Huang), 10g each.
Additions & subtractions: If qi vacuity is severe, add 30-100 grams of Radix Astragali Membranacei (Huang Qi), increasing the dosage gradually. If spleen vacuity is pronounced and resulting in loose stools and decreased eating, add nine grams each of Sclerotium Poriae Cocos (Fu Ling), Rhizoma Atractylodis Macrocephalae (Bai Zhu), and scorched Three Immortals (San Xian: Massa Medica Fermentata, Shen Qu, Fructus Crataegi, Shan Zha, and Fructus Germinatus Hordei Vulgaris, Mai Ya). If yin vacuity is marked with dry mouth, parched throat, and dry cough, add 20 grams of Radix Glehniae Littoralis (Sha Shen) and 12 grams each of Tuber Asparagi Cochinensis (Tian Dong) and Tuber Ophiopogonis Japonici (Mai Men Dong). If there is vacuity vexation with difficulty sleeping, add nine grams each of Cortex Albizziae Julibrissinis (He Huan Pi), Caulis Polygoni Multiflori (Ye Jiao Teng), and Semen Zizyphi Spinosae (Suan Zao Ren). If vexation and agitation are severe, add five grams of Folium Bambusae (Zhu Ye) and nine grams each of Fructus Forsythiae Suspensae (Lian Qiao) and Cortex Radicis Lycii Chinensis (Di Gu Pi). If there is hasty, rapid breathing, cough, and uneasy hacking out of phlegm, add nine grams each of Cortex Radicis Mori Albi (Sang Bai Pi), Herba Houttuyniae Cordatae Cum Radice (Yu Xing Cao), Radix Asteris Tatarici (Zi Wan), and Flos Tussilaginis Farfarae (Kuan Dong Hua) and 15 grams of Herba Oldenlandiae Diffusae (Bai Hua She She Cao). If the facial complexion is somber white and dread of cold and chilled extremities are pronounced, add nine grams each of Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Zi), Cortex Cinnamomi Cassiae (Rou Gui), and Herba Epimedii (Yin Yang Huo).
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