In October of 1960, a 54-year-old male Chéng Dū resident presented at the clinic.

Over the last two years, this patient had been experiencing daily fevers immediately after eating breakfast, with temperatures around 38° C. These fevers would be accompanied by relatively copious sweating, which would continue for over two hours, and would subside as soon as the fever receded. Afterwards, a strong fear of cold was felt. This was an everyday occurrence.

In addition, he experienced, dizziness, a bitter taste in the mouth, a dry throat, fullness in the chest and ribs, and irritability. His tongue was red, with a sticky, white and slightly yellow tongue coat. His pulse was wiry and rapid.

He was seen at a local hospital, where he was diagnosed with fevers of unknown origin. No positive effects were seen from any of the treatments offered.

This is a Shào Yáng fever, and treatment should involve harmonizing and resolving the Shào Yáng. A modified version of xiǎo chái hú tāng (Minor Bupleurum Decoction) is appropriate.

Formula: 

chái hú (Bupleuri Radix) 24g
huáng qín (Scutellariae Radix) 10g
bàn xià (Pinelliae Rhizoma preparatum) 15g
shā shēn (Glehniae/Adenophorae Radix) 15g
gān cǎo (Glycyrrhizae Radix) 10g
zhī mǔ (Anemarrhenae Rhizoma) 15g
shí gāo (Gypsum fibrosum) 30g
mǔ lì (Ostreae Concha) 24g
chén pí (Citri reticulatae Pericarpium) 9g
fú líng (Poria) 12g

One package was administered.

After taking the one package, his fever had reduced, and most of his symptoms improved. He was advised that there was no need to continue the herbs, and that if he took care of himself, the condition would resolve. After a long period of time, the patient reported to Dr. Fàn, that the condition had never returned.

[Commentary] The signs and symptoms of bitter taste in the mouth, dry throat, dizziness, alternating cold and heat, bitter fullness in the chest and ribs, irritability, and a wiry pulse, are all very clear signs of a Shào Yáng channel pattern. This condition had lasted for over two years, so was treated according to the original lines of the Shāng hán lùn (傷寒論 Discussion of Cold Damage) where it states;

“When chái hú signs are still present, first administer xiǎo chái hú tāng (Minor Bupleurum Decoction)”. 

The presence of fevers with sweating, thirst, and a red tongue, signify the presence of depressed heat, and therefore, shēng jiāng (Zingiberis Rhizoma recens), and dà zǎo (Jujubae Fructus) were removed, and zhī mǔ (Anemarrhenae Rhizoma), and shí gāo (Gypsum fibrosum) were added in order to clear (heat). In addition, because the fullness in the chest and ribs was quite severe, damp pathogens were clearly also present, so mǔ lì (Ostreae Concha), chén pí (Citri reticulatae Pericarpium), and fú líng (Poria) were added to percolate dampness, transform stagnation, and disperse bind.