A neighbor named Guo had a daughter who remarried into a neighboring village. After returning to her parents’ home for visits, she would often stay for months. One day, she suddenly developed a cough. At first, she paid little attention to it, but the condition gradually worsened. The doctors she consulted diagnosed it as a “consumptive disease ” and prescribed treatments to tonify qi , then shifted to invigorating blood circulation and resolving stasis , and later attempted to regulate the spleen and soothe liver qi. Despite repeated changes to the prescriptions, her cough persisted.
Eventually, her mother brought her to me. I asked, “Does the cough come and go, or does it trigger flushed cheeks, shortness of breath, and nonstop coughing fits?” The mother replied, “It’s very severe and continuous.” Observing the patient’s rosy complexion, I ruled out a deficiency syndrome. Upon checking her pulse, I noticed a floating, slippery, and rapid pulse at the cun position of the right wrist, while other pulse positions were normal.
I explained, “This is phlegm-fire stagnation in the lung meridian. She likely experiences frequent chest tightness, and coughing episodes expel both phlegm and heat. This is not a consumptive disease but a severe excess-heat syndrome.” I prescribed Er Chen Wan ( a classic phlegm-resolving formula) combined with Scutellaria baicalensis ( huangqin), Coptis chinensis ( huanglian), Morus alba bark ( sangbaipi), and Akebia stem ( mutong) to clear heat and unblock stagnation. After three days, her cough significantly improved.
During the follow-up visit, her pulse rate had slowed, but the slippery quality remained. I noted, “The heat has subsided, but phlegm lingers. Without elimination, relapse is likely.” I adjusted the prescription to Ping Wei San ( a classic formula for regulating the spleen and stomach) combined with Er Chen Tang , adding Citrus aurantium ( zhishi) and Rheum palmatum ( dahuang) to purge phlegm. After two doses, she expelled several bowls of thick phlegm. Her chest discomfort vanished, and the cough ceased entirely.
(Note: Er Chen Wan and Ping Wei San are classic formulas in Traditional Chinese Medicine. Key ingredients typically include herbs for resolving phlegm, clearing heat, and regulating digestion.)
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