38 year old female first seen on Feb 12 1966. Patient had suffered with a dry cough and itchy throat for over a month. She had taken a modified version of Zhi Sou San (Stop Cough Powder), and modified versions of Sang Xing Tang (Mulberry Leaf & Apricot Kernel Decoction) and Mai Men Dong Tang (Ophiopogonis Decoction). The cough not only failed to improve but actually got worse. Currently she presents with a dry cough, itchy throat, dry mouth with no desire to drink, belching, chest oppression, loose bowel movements occurring once or twice daily, a thick slimy tongue coating and a slippery thin pulse.

Prescription given was Ling Gan Wu Wei Jiang Xin Xia Tang (Poria, Licorice, Schisandra, Ginger, Asarum and Pinellia Decoction) with additions and subtractions:

Fu Ling 4qian
Xi Xin 2 qian
Wu Wei Zi 4 qian
Ban Xia 5 qian
Zhi Gan Cao 2 qian
Chen Pi 5 qian
Sheng Jiang 3 qian
Xing Ren 3 qian
Ku Jie Geng 3 qian
Zhi Pi Pa Ye 3 qian

Results: After taking one package of the above formula, the cough had decreased. After three packages the cough stopped.

The above patient suffered from a dry cough, itchy throat and dry mouth commonly seen in Lung heat, Liver fire or yin vacuity. In addition this patient also had no desire to drink, belching, chest oppression, sloppy stools, a thick slimy tongue coating and a slippery pulse. All these signify a phlegm-rheum pattern. The dry cough is from phlegm-rheum invading the lung and impaired diffusion and downbearing of the lung. The dry cough and itchy throat are a result of stagnation and obstruction to fluids which are unable to bear upwards. Therefore when treating this type of dry cough, using bitter cold, heat clearing herbs or sweet cold Yin enriching herbs will only worsen the stagnation and obstruction of fluids and cause phlegm-rheum to harass the upper (burner) and delay recovery. Because phlegm was treated by restraint and the formula was chosen on the basis of the pattern, the use of only three packages were needed for recovery.

 

Case #1 Hu Xi-Shu, Shang Han Lun Tong Su Jiang Hua （伤寒论通俗讲话）
Huang, Female, 38 years old

Initial diagnosis was on Feb 12, 1966: Patient presented with a cough combined with expectoration of white phlegm, itchy throat, chest fullness, a dry throat with no desire for fluids and bilateral rib side distension. She has already taken several packages of herbal formulas to no avail. Her tongue coating was thick and slimy, and her pulse slippery-thin.

This pattern belongs to phlegm-rheum harassing the upper (burner), and impaired depurative downbearing of the lungs. This was treated by warm transformation and downbearing counterflow with a modified version of Ban Xia Hou Po Tang.

Ban Xia 4 qian
Hou Po 3 qian
Fu Ling 4 qian
Su Zi 3 qian
Ju Pi 5 qian
Xing Ren 3 qian
Jie Geng 3 qian
Sheng Jiang 3 qian

Results: After taking only 2 packages of the above herbs, the cough had stopped.

Ban Xia Hou Po Tang is originally from the Jin Gui Yao Lue (Essentials from the golden cabinet) in the miscellaneous gynaecological diseases section. Originally used for “female patients with the sensation of fried meat in the back of the throat”
Dr. Hu believed this formula to be Xiao Ban Xia Jia Fu Ling Tang with the additions of Hou Po and Su Ye. It is used in phlegm-rheum qi bind manifesting with chest fullness, throat blockage and cough. It warms and transforms phlegm-rheum, downbears counterflow and regulates Qi. The patient above was manifesting with a phlegm-rheum cough, therefore the use of this formula offered a quick resolution.
The original formula contains (Zi) Su Ye, but Dr. Hu prefers to use (Zi) Su Zi. If there are obvious exterior signs present, then (Zi) Su Ye may be added, and you may also add either Gui Zhi Tang or Ma Huang Tang. If there are obvious heat signs then Sheng Shi Gao may be added. If there is an enduring cough due to cold rheum, without any obvious exterior signs, then combine with Ling Gan Wu Wei Jiang Xin Xia Tang (Poria, Licorice, Schisandra, Ginger, Asarum, and Pinellia Decoction).