The increasing severity of exogenous diseases has become alarming. I often feel that typical exogenous conditions can be cured with slight adjustments. However, the current exogenous diseases are increasingly complex due to heavy fog and haze, which complicate the air composition. The human body is affected by these changes, and the most impacted system is our respiratory system. Therefore, we must select effective remedies from the treasure trove of Traditional Chinese Medicine (TCM).
If current exogenous conditions are not controlled, they can worsen and even develop into lung infections, leading to pneumonia. In such cases, Western medicine resorts to antibiotics. However, excessive use of antibiotics has led to resistance, diminishing their effectiveness, and many people find that antibiotics no longer work.
For lung infections, TCM has proven to be very effective, a fact that we often overlook. We tend to believe that Western medicine is faster, while TCM is slower, not realizing that when TCM is appropriately targeted, its effects can be equally swift.
Lung infections in TCM are categorized into various syndromes, including deficiency of Yang Qi. However, in the initial stages, most cases are due to heat evil obstructing the lungs.
At this time, patients typically exhibit symptoms such as fever, and in severe cases, they may cough up foul-smelling phlegm or pus and blood, with chest pain that worsens during coughing. The patient’s tongue is red, with a yellow greasy coating, and the pulse is slippery and rapid, referred to in TCM as a rapid pulse.
Observing the tongue is crucial; a red tongue indicates more severe heat. In such cases, TCM would use herbs to clear heat and detoxify, as well as to transform phlegm and clear the lungs. I recommend adding a classic TCM formula to the heat-clearing and detoxifying herbs: Wei Jing Tang (Reed Stem Decoction).
This formula, found in Sun Simiao’s Bei Ji Qian Jin Yao Fang, is also known as Qian Jin Wei Jing Tang to distinguish it from other similarly named formulas.
The original dosage of this formula is as follows: 2 sheng of Wei Jing (Reed Stem), 0.5 sheng of Yi Yi Ren (Job’s Tears), 50 pieces of Tao Ren (Peach Kernel), and 0.5 sheng of Gua Ban (Melon Seed). Boil the reed stem in 10 dou of water until you obtain 5 sheng. Strain and add the other herbs, then boil down to 2 sheng. Take 1 sheng.
Currently, I typically use the following dosages: 60 grams of Lu Gen (Reed Root), 30 grams of Yi Yi Ren, 30-60 grams of Dong Gua Zi (Winter Melon Seed), and 9 grams of Tao Ren.
In this formula, the original ingredient used is Wei Jing, which has some debate regarding its identity. Most practitioners believe it refers to the stem of the reed, as it is above water and has a strong ability to disperse and vent evils. However, in modern practice, Lu Gen is often used instead, as it is believed to have superior heat-clearing properties. My experience shows that it is still quite effective. The original method involved boiling the reed stem first and then using that water to decoct the other herbs, but today we can boil them together.
The ingredient Gua Ban also has some controversy; texts like Zhang Shi Yi Tong suggest it refers to sweet melon seeds, while we now often use Dong Gua Zi, which works very well.
This formula is commonly used in conjunction with treatments for lung abscesses, lobar pneumonia, bronchitis, and whooping cough, particularly in cases of lung heat with phlegm and blood stasis.
Regarding this formula, Cheng Fang Bian Du states: “Abscesses are due to obstruction, similar to how land becomes blocked and impassable. Therefore, the symptoms of lung abscesses arise from phlegm, blood, and fire evils mutually obstructing the lungs, eventually leading to pus formation. Tao Ren and sweet melon seeds are both moistening agents; one promotes blood circulation, while the other transforms turbidity. Wei Jing clears heat and vents upward, and Yi Yi Ren eliminates dampness and promotes downward movement. Although the formula appears simple, its power to disperse masses, promote blood circulation, transform phlegm, and eliminate heat is truly remarkable. Since the disease is in the upper jiao, we do not want to use heavy, turbid medicines that could harm the lower jiao.”
In this formula, Lu Gen is effective in venting heat and clearing lung obstructions, used in significant quantities, providing substantial heat-clearing power. Yi Yi Ren dispels dampness and detoxifies, guiding the damp-heat evil downward. If lung Qi cannot descend, it becomes obstructed; once the damp-heat is removed, the clear and light Qi can rise, allowing the lung metal Qi to descend and regulate. Dong Gua Zi, as noted in the Qing dynasty’s Ben Cao Shu Gou Yuan, is essential for resolving internal accumulations, breaking down pus and blood, and is a key herb for gastrointestinal obstructions. It has diuretic and detoxifying effects, and while it works well here, if there is a lung abscess, sweet melon seeds are preferable.
I believe the most ingenious use of this formula is the inclusion of Tao Ren for invigorating blood and breaking stasis. It is important to note that when heat is trapped internally, there is often stasis. If this stasis is not resolved, the effects of various detoxifying herbs may be limited. Therefore, when I encounter stubborn conditions, I often add blood-invigorating herbs like San Qi, Tao Ren, Hong Hua (Safflower), and Dan Shen (Salvia), which can often yield immediate results. This is a personal insight I wish to share. The lung’s fine texture makes it more susceptible to obstruction after illness, making the use of blood-invigorating herbs even more significant.
Generally, I rarely use Wei Jing Tang alone; it is often combined with other clearing herbs during severe lung infections. In such cases, the combination with Wei Jing Tang to eliminate damp-heat obstruction often yields excellent results. I usually also incorporate some fresh Zhu Li (Bamboo Sap), which enhances the effect.
Some may wonder if Yi Yi Ren is used to dispel dampness, does this formula address severe damp-heat lung infections?
This line of thinking is reasonable; if damp-heat is the issue, this formula is indeed very effective.
However, if the lung infection is severe due to dryness evil or heat evil injuring Yin, leading to insufficient lung fluids, one can also use nourishing Yin and clearing lung formulas, which can be combined with this formula. The lung is a delicate organ, susceptible to external evils. Even if heat evils are rampant, there may still be local damp evils and stasis. In other words, insufficient fluids and damp obstruction are two separate issues that can coexist at the same time, requiring simultaneous attention.
I have a relative, an elderly person who had tuberculosis in their youth and later recovered. Recently, they developed a lung infection following a cold and were hospitalized. Western doctors diagnosed pneumonia primarily in the right lung. After two weeks of cephalosporin antibiotics, the high fever subsided to a low fever, and they were discharged. However, after stopping the medication, the high fever returned. The hospital did not admit them again, so they switched to another hospital and continued with antibiotics for another seven days, but the results were still not significant, with only a low fever. Tests for tuberculosis were negative, and the Western doctors, having used too many antibiotics, did not recommend continuing them, suggesting TCM for treatment.
I assessed that the antibiotics had some effect but did not ultimately resolve the issue, as the high fever could return at any time. The elderly person had a rapid pulse and hot palms and feet, indicating heat evil injuring Yin, but phlegm was still present, necessitating heat-clearing and phlegm-transforming treatment. Therefore, I used herbs to nourish Yin and clear the lungs, combined with Wei Jing Tang, as the condition was in the right lung, indicating a failure of lung and stomach Qi to descend. I added 9 grams each of Jiao San Xian and Chao Ji Nei Jin, along with two doses of fresh bamboo sap.
After five days, the patient was nearly normal. During the last two days, their daytime temperature was normal, and they measured their temperature five times each night, finding that it only briefly rose to 37 degrees Celsius, usually around dawn, before returning to normal. At this point, I checked the pulse, which was weak, indicating that after battling the external evil, the righteous Qi was insufficient. I used a modified Xiao Chai Hu Tang (Minor Bupleurum Decoction) with increased Ren Shen (Ginseng) to support the righteous Qi and expel the evil, and within two days, the patient recovered.
Of course, it is rare for exogenous conditions to lead to pneumonia, but when they do, especially in the elderly, it can cause significant problems. By broadening our perspectives, we may save patients from peril. Therefore, I encourage my colleagues to consider this, and patients facing such issues can use this as a reference.
Qian Jin Wei Jing Tang is a classic formula summarized by ancient practitioners. We should not overlook it simply because its ingredients seem plain. The ancient practitioners used what was readily available, often simple herbs and foods, but selected them based on profound theoretical guidance. Each herb has its unique purpose and function, and when combined, they can produce excellent results.
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