Traditional Chinese Medicine Case Study / Clinical Reference Article for Learning TCM

In Traditional Chinese Medicine (TCM), treating common fevers is a fundamental skill, as routine as eating. It should be easy to treat, yet sometimes it is not. Today, I will share a case of a child who had a persistent fever for several days. The child’s mother, also knowledgeable in TCM, sought my help due to the prolonged fever.Many children with fever are treated with Western medicine to induce sweating, which may temporarily reduce the fever, but it often returns shortly after. Even with TCM patent medicines, the fever may subside temporarily but then return, or it may only resolve during the day and recur in the afternoon or evening.There is a key point here: when a child has a fever, they may sweat, but as the weather cools in the afternoon and evening, the fever can return. This indicates a deficiency of body fluids and the need to eliminate dampness, especially if the tongue coating is thick. In fact, eliminating dampness and replenishing body fluids can occur simultaneously. For example, the ancient formula for treating epidemics, Da Yuan Yin (达原饮), both clears heat and transforms dampness while replenishing body fluids. However, sometimes the exterior-releasing aspect is slightly lacking.In this case, I confidently predicted that the child would have a fever reduction by the next day, and indeed, it happened as expected. As a doctor, one should not make absolute statements, but with experience, one can have confidence. The details are shown in the screenshots below:The young patient had a persistent low-grade fever around 38 degrees Celsius. The parents had previously used TCM patent medicines, which induced some sweating and temporarily reduced the fever. However, the fever persisted for several days. Upon examination, the patient’s tongue coating was white with a slight yellowish tint, indicating dampness and turbidity, and the pulse was floating and wiry. This suggested that it was not a case of Taiyang (太阳) cold damage with a tight pulse.I did not inquire whether the patient was afraid of the cold, which was an oversight, but the pulse was wiry rather than tight, which basically ruled out Taiyang cold damage. The patient did not report severe headaches, indicating that the condition was not serious. That afternoon, I prescribed a TCM patent medicine: Yin Qiao San (银翘散) to clear heat, Fang Feng (防风) to release the exterior, Bao He Wan (保和丸) to transform dampness, and Mai Dong (麦冬) to replenish body fluids. After taking it a couple of times, the fever had not subsided by evening, and the parents were anxious. I then decided to prescribe a decoction for a more comprehensive approach, assuring them that the fever would resolve by the next day. The prescription was as follows:Jing Jie (荆芥) 6g, Fang Feng (防风) 4g, Lian Qiao (连翘) 4g, Bai He (百合) 9g, Chai Hu (柴胡) 4g, Huang Qin (黄芩) 4g, Xing Ren (杏仁) 6g, Cao Guo (草果) 1 piece, Bin Lang (槟榔) 4g, Hou Po (厚朴) 4g, Che Qian Zi (车前子) 6g, Bai Shao (白芍) 6g, Mai Dong (麦冬) 9g, Zhi Mu (知母) 4g, Zhi Gan Cao (炙甘草) 4g, Sheng Jiang (生姜) 2 slices, Yu Zhu (玉竹) 9g, for two doses.Indeed, by the evening, after taking the medicine a couple of times, the fever had completely subsided by the next morning, and there was no fever throughout the afternoon.Here is a brief introduction to Da Yuan Yin (达原饮) from Baidu:“Da Yuan Yin, originally named Da Yuan San, was created by the Ming Dynasty TCM physician Wu Youke (吴又可) and is recorded in the “Wen Yi Lun” (温疫论). It consists of seven ingredients: Bin Lang (槟榔), Hou Po (厚朴), Cao Guo (草果), Zhi Mu (知母), Bai Shao (白芍), Huang Qin (黄芩), and Zhi Gan Cao (甘草). It is used for epidemic diseases or malaria with hidden pathogens, characterized by aversion to cold and strong heat, with daily occurrences of fever. Wu Youke pointed out that Bin Lang eliminates the miasma of Lingnan, Hou Po breaks the stagnant qi, and Cao Guo expels hidden pathogens. These three ingredients work together to reach the nest of the pathogens, causing them to collapse and quickly leave the membranes… The other four ingredients are merely harmonizing agents.”The main medicinal ingredients of Da Yuan Yin should be Cao Guo and Zhi Mu, as Cao Guo treats the cold of the Taiyin and Zhi Mu treats the heat of the Yangming. Clinically, it is used to treat damp-heat obstruction, leading to fluctuating cold and heat, persistent fever, chest fullness, nausea, and even diarrhea during the summer and autumn gastrointestinal type colds.[Indications] Epidemic diseases or malaria with hidden pathogens. Aversion to cold and strong heat, with fever occurring one to three times a day, or at irregular times, accompanied by chest tightness, nausea, headache, irritability, wiry and rapid pulse, deep red tongue edges, and greasy tongue coating, or thick white coating like accumulated powder. (This formula is commonly used for malaria, influenza, and viral encephalitis associated with warm heat epidemic toxins hidden in the membranes.)[Modifications] For rib pain and ear deafness, add Chai Hu (柴胡) 3g; for low back and neck pain, add Qiang Huo (羌活) 3g; for eye pain and orbital pain, add Gan Cao (干葛) 3g.[Formula Song] “Da Yuan, Cao Guo, Bin Lang, Hou Po, Zhi Mu, Huang Qin, Bai Shao, Zhi Gan Cao as assistants, dispel filth and transform turbidity to reach the membranes, expelling hidden pathogens from the membranes, causing cold and heat to act together.”Da Yuan Yin combines Bin Lang, Hou Po, and Cao Guo to warm and transform dampness, while Zhi Gan Cao, Zhi Mu, and Bai Shao replenish body fluids, and Huang Qin and Zhi Mu clear heat. It simultaneously warms and transforms dampness while replenishing body fluids, addressing both cold and heat.The prescription I provided is actually a modification of Da Yuan Yin, adding Jing Jie and Fang Feng to enhance the exterior-releasing effect (though not as strong as Ma Huang (麻黄) and Gui Zhi (桂枝)), and adding Bai He, Mai Dong, and Yu Zhu to strengthen the replenishment of body fluids, along with Che Qian Zi to enhance dampness elimination, and Yin Hua (银花) and Lian Qiao to strengthen heat-clearing and detoxifying effects (which is relatively necessary for viral infections), and Sheng Jiang to warm the interior. The formula uses Zhi Mu and Huang Qin to clear excess heat from the interior. After taking the medicine, the fever quickly subsided.This formula is particularly suitable for children who have already sweated or have recurrent low-grade fevers that worsen in the afternoon and evening, with a slightly greasy tongue coating, making it relatively widely applicable.I have previously mentioned in my public account that I have a universal formula for treating various fevers, including COVID-19 and influenza, which is essentially a modified Ma Huang Sheng Ma Tang (麻黄升麻汤) combined with some detoxifying herbs, and Cao Guo and others. It is comprehensive, replenishing body fluids while eliminating dampness, releasing the exterior while warming the interior, clearing heat while warming the interior, and addressing both cold and heat.The formula used to treat this child is somewhat similar to the modified Ma Huang Sheng Ma Tang, as Jing Jie and Fang Feng are similar to Ma Huang and Gui Zhi, but not as strong in releasing the exterior. Che Qian Zi is similar to Bai Zhu (白术) and Fu Ling (茯苓). Yu Zhu and Zhi Mu are common to both formulas.In fact, Da Yuan Yin has some resemblance to the classic formula Ma Huang Sheng Ma Tang, as it uses both dampness transformation and body fluid replenishment. However, Da Yuan Yin has fewer exterior-releasing herbs and more dampness-transforming herbs like Cao Guo and Bin Lang. That’s all I want to say.Another reason for not using Ma Huang and Gui Zhi is that the patient had a recurrent fever for several days and had already sweated. The pulse was wiry, and considering the current atmospheric conditions, there was a balance of cold water and the ruling fire. Although there was cold water obstructing the exterior, there was also ruling fire warming and opening it somewhat. It was not too closed. Of course, if the patient had severe chills and fever with a tight pulse, one would naturally consider using Ma Huang and Gui Zhi. Ultimately, the treatment should be based on syndrome differentiation.“Mycoplasma pneumonia is prevalent, and three cases were recorded previously treated with a universal formula for rapid fever reduction for COVID-19 and influenza – along with an analysis of the five movements and six qi.”

Kongtong Daoist Jingzhitang

Collection of Articles on the Five Movements and Six Qi

Exploring the Theory of Qi Mechanism in TCM: Unveiling the Millennia of Mysteries

In the “Neijing”, the nearly lost theories of “Transmission” and “Transmission” (Opening and Closing Pivot) are discussed.Calculating the Five Movements and Six Qi series by the famous physician Huang Yuanyu’s cases and treatments.Using TCM’s Five Movements and Six Qi to analyze the causes of Gao Yixiang’s myocardial infarction and the recent increase in myocardial infarction cases.Calculating the Five Movements and Six Qi series behind the story of Bian Que meeting Duke Cai Huan and the numerical principles involved.Identifying the physical constitution of individuals based on their body types (Nourishing and Guarding, Internal and External Injuries).Unveiling the correspondence between the Five Elements and Five Tastes and why Yang Fire can descend.Clinical experiences of TCM patent medicines in treating pediatric fevers and otitis media.Deciphering the true meaning of the Five Tastes in the Auxiliary Method (Twenty-Five Medicinal Essence Method) for eliminating the Five Syndromes (Distress, Fullness, Dryness, Stagnation, Spasm).A case of an elderly patient with mild cerebral infarction treated with patent medicine, and the potential for severe epidemics to be treated with An Gong Zhi Bao.Analysis of the Five Movements and Six Qi in relation to the Wuhan epidemic!Which Qi governs rain and the recent increase in rainfall?Analyzing the roots of anger in medical theory and solutions.A case of diarrhea occurring twenty times a day resolved with one dose.Correcting the Five Movements and Six Qi: Why is it still relatively cold in late spring? (Guest Movement Correction)Using the Five Movements and Six Qi to deduce the birth date of a patient who passed away from lung cancer.Recent verification of many software and books misclassifying the Five Movements and Guest Movements and the theory of the Five Movements and Seven Qi.Unveiling the secrets of the Five Movements and Six Qi calculations in relation to Ericson, the timing of diseases, and the common origin of Tai Yi divine numbers.Calculating the Qi movements in the treatment of lymphadenopathy and certain skin diseases with the modified formula.Five Movements and Six Qi – Qi interactions in Zhengzhou and surrounding areas during heavy rain and drowning, and TCM treatment methods.In the year of Gengzi, Wuhan’s anti-epidemic frontline nurses used TCM patent medicines to relieve pain and fatigue without infection, and many illnesses are due to a mix of dampness and dryness.Calculating the Five Movements and Six Qi in a patient with prostate cancer who had abdominal pain for six months, resolved with two doses of herbal medicine, followed by a recurrence after eating old hen meat.Using the Five Movements and Six Qi to analyze a case of suspected intestinal obstruction.Enlightenment under the tree (A case of sudden loss of voice for a week cured).Jingzhitang: Revealing the hidden fire of the guest ruler in the early year of Ren Yin, but with cold snow, is the Qi movement inaccurate?Jingzhitang: Unveiling the connection between the Qi movements in the “Neijing” and Tai Yi, and analyzing the current situation in Russia and Ukraine using Tai Yi.Jingzhitang: Calculating the Five Movements and Six Qi in relation to shoulder and scapular muscle pain, and the practical application of the external Tai Yi formula.Jingzhitang: For colds with nasal congestion and runny nose or rhinitis, pressing this effective ear point can quickly relieve nasal congestion.Jingzhitang: Calculating the Five Movements and Six Qi in deciphering severe acne treatment methods and pure classical formula cases.Jingzhitang: Moxibustion at these three acupoints can stop night sweats and excessive sweating after just one session! Understanding the underlying reasons…Jingzhitang: A case of a thirteen-year-old boy with breast swelling cured, along with dietary precautions for children.Jingzhitang: Weight loss is actually that simple; replenishing Qi shows effects instantly! Much faster than ginseng.Jingzhitang: Sharing an effective prescription for treating uterine bleeding and a case of uterine bleeding with acne.Jingzhitang: “Transmission” and “Transmission” in manual heart rescue cases and the need to change “Heart and Kidney Not Intersecting” to “Pericardium and Kidney Not Intersecting” (as the connection between the pericardium and kidney is closer and faster).Jingzhitang: Calculating the Five Movements and Six Qi in the case of Sun Simiao’s birth date (legendary biography) and why he did not use Bai Shao (白芍) for treating strokes!Jingzhitang: Treating a case of hordeolum (stye) with a single needle, which can lead to insights into some external treatment methods for tumors.Jingzhitang: The reincarnation of Sun Simiao’s tiger riding cloud and the miraculous effects of a certain medicine for kidney stones.Jingzhitang: A woman with a dry throat and pain after taking contraceptives, verifying the meridian theory.Jingzhitang: A case of a severely malnourished autistic child cured in a month (acupuncture and dietary adjustments) – a warning against indiscriminate moxibustion on those with undifferentiated constitutions.Jingzhitang: A case of a TCM patent medicine curing a case of throat paralysis and loss of voice.Jingzhitang: After the fifth Qi of Ren Yin, external cold and heat closed, leading to chest and rib pain, stomach pain, lymphadenitis (with medical cases), cough, shortness of breath, and frequent external diseases.Jingzhitang: Conventional pulse diagnosis does not differentiate between Yin and Yang, which can lead to errors; using an external case to illustrate the practicality of Daoist pulse diagnosis.Jingzhitang: A case of duodenal pain cured in one dose.Jingzhitang: A case of a patient in a coma for over half a month after a car accident, who woke up after three doses of medicine.Jingzhitang: This fever and throat pain case proves that Qian Hu (前胡) can sometimes replace Chai Hu (柴胡), and that Qi movements can easily lead to external infections.Jingzhitang: An elderly doctor in the countryside of Guilin treated a young man with insomnia with one dose, leading to a deep sleep (another case of constipation and deafness).Jingzhitang: After using Gan Cao (甘草) and Xie Xin Tang (泻心汤) without effect for tongue ulcers, a combination of several herbs from the “Yi Xin Fang” (医心方) and “Qian Jin” (千金) led to rapid recovery.Jingzhitang: Two cases of oral ulcers during the fifth Qi of Ren Yin.Jingzhitang: A woman with insufficient milk after weaning for a month regained her milk supply after taking this formula (originally for treating tongue ulcers and nasal congestion).Jingzhitang: In the absence of medical resources, pressing these two acupoints can relieve throat pain (also effective for constipation).Jingzhitang: A case of flu with a focus on the eight principles of syndrome differentiation, which did not use detoxifying herbs, leading to a delayed recovery (and a rapid recovery case of flu due to food accumulation).Jingzhitang: A woman with retained products after a miscarriage expelled them after three doses of the classic formula (due to the high cost of Ejiao (阿胶), those eating should avoid looking).Jingzhitang: Using a method to treat facial dark spots with a specific medicine led to the expulsion of blood clots and dark sticky blood.Jingzhitang: Discussing the method of activating blood and eliminating dampness (transforming white greasy tongue) based on a case.Jingzhitang: The same person may require different treatments under different Qi movements, confirming the use of Jin Gui (金匮) for shortness of breath, with both formulas addressing this (including the new effects of Tu Si Zi (菟丝子)).Jingzhitang: A child with runny nose and cough who sweated was cured with one dose, transitioning to diarrhea with blood, verifying the changes in pulse diagnosis.Jingzhitang: A TCM patent medicine cured a patient of heart pain, leading to a change in voice and improvement in early symptoms.Jingzhitang: A patient with lung cancer and lymphatic metastasis who used my formula for shortness of breath saw significant symptom reduction, and lower limb swelling also decreased (the original formula remained unchanged).Jingzhitang: A collection of true cases of TCM patent medicines treating COVID-19, along with the potential of mustard greens as a good medicine in times of medical shortages.Jingzhitang: Three cases of COVID-19 fever treated with TCM patent medicines, and the observation that sweating in thin individuals does not necessarily require Ma Huang and Gui Zhi, as Jing Jie and Chai Hu can also be effective (deliberately avoiding decoctions).Jingzhitang: A beautiful woman with peeling palms and nighttime anxiety was cured with four doses of herbal medicine, transforming her from a reluctant herbal medicine drinker to a TCM enthusiast.Jingzhitang: The same formula treated severe diarrhea in thin individuals and also addressed fever in similar constitutions.Jingzhitang: A TCM patent medicine cured cases of urticaria and a child’s testicular rash using two specific warm disease formulas and two TCM patent medicines.Jingzhitang: Three cases of influenza, one treated with decoction and TCM patent medicine, and two cured with TCM patent medicines.Jingzhitang: A TCM patent medicine case of Yin Qiao San treating aversion to cold and fever, along with a detoxification case.Jingzhitang: A woman with a hard lump in her left breast the size of an egg was cured with one needle.Jingzhitang: Four doses of Xiao Jian Zhong Tang (小建中汤) cured a case of hand and foot eczema.Jingzhitang: TCM patent medicines cured two brothers suspected of influenza.Jingzhitang: A TCM patent medicine case during COVID-19 with two instances of cough, phlegm, and blood-streaked nasal discharge.Jingzhitang: A TCM patent medicine case of two patients with skin redness and itching, both cured with the same TCM patent medicine, one chronic and one acute!Jingzhitang: Strongly advising a severe urticaria patient against using hormones, leading to a cure with a classic formula; some people even immigrated due to this illness!Jingzhitang: Using the Five Movements and Six Qi to analyze why it is still hot in Jiangnan and Lingnan after the start of winter, with multiple typhoons and several case examples.[Read Previous Exciting Articles]#Introduction to TCM Collection #Donghai Medical Collection#Experience of Old TCM Doctors #Wonderful TCM Formulas #Proven Secret Formulas #Master of National Medicine#Famous Cases of Cold Damage #Selected Famous Cases from Jin Gui#Four Gentlemen Decoction #Etiology Assignment #Herbal Properties Assignment#Herbal Properties Song for 400 Herbs #Medical Three-Character Classic#Daily Insights from Mentorship#Daily Insights on Principles, Methods, Formulas, and Medicines#TCM Serialization CollectionWhat is the essence of applying Wen Jing Tang (温经汤)?Insights and Techniques from 60 Years of TCM Diagnosis by Zhou Zhongying (all essence)Ding Guangdi: Qiang Huo Sheng Shi Tang (羌活胜湿汤) for treating “Five Morning Diarrhea”Unexpectedly, “Qing Gu San” (清骨散) is indeed the remedy for fever after bone fractures!Dan Zha San for treating hyperlipidemia (including four high blood lipid formulas)Shanghai Shen’s 600-Year Family Secret Formula for Women’s DiseasesMagical! 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