A neighbor named Yang Bentan’s mother-in-law, being impoverished and unable to sustain herself, relied entirely on her son-in-law for food and clothing. Yang himself had lost his job and remained at home, their daily life becoming increasingly strained. The two faced each other with worry, their anxieties growing daily. Out of concern for her daughter, the elderly woman developed worsening cough and wheezing, abdominal distension, and loss of appetite. Unable to bear watching her suffer, Yang invited me to treat her.
Upon examination, I found her sallow and emaciated, her breathing labored. She told me: “I haven’t eaten for days. It feels like something is stuck in my throat—I can’t swallow it down nor cough it up. Others say it’s seasonal illness, but I beg you to determine the truth.”
Her pulse revealed:
- All six pulses deep and weak
- Both chi pulses (kidney positions) thready, barely perceptible
I explained: “This is severe deficiency syndrome. It requires aggressive supplementation with strong tonics over dozens of doses. Combined with emotional calm and reduced stress, full recovery is possible. The throat obstruction you feel is ‘Plum Pit Qi’ (globus hystericus), not seasonal illness. This can be relieved within three doses.”
Yang interjected: “If we can just clear her throat and restore eating, that’s enough for now. As for long-term tonic (used in traditional contexts)… our circumstances make affording such medicines impossible.”
“A practical approach,” I conceded. I prescribed Four-Seven Decoction modified with Citri reticulatae pericarpium (chenpi) and Cyperi rhizoma (xiangfu) to promote Qi circulation and alleviate stagnation.
Treatment course:
- By nightfall after the first dose, she felt the throat obstruction “drop into her abdomen,” restoring normal breathing.
- After two doses, her appetite returned and vitality improved.
Yang eagerly reported: “My mother-in-law seems fully recovered!”
I cautioned: “Not so. The Four-Seven Decoction merely clears obstructions—it doesn’t address the root deficiency. The temporary relief comes from prolonged illness stagnation being moved. Without proper (used in traditional contexts), her appetite will fail again within days. Her pulse remains dire. To continue half-measures would waste silver to no purpose.”
Yang accepted this assessment.
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