Library

Treats cases where Yin deficiency has persisted for a long time, gradually leading to Lung Qi deficiency with phlegm, resulting in cough and asthenic asthma (consumptive wheezing), or accompanied by pulmonary tuberculosis (pulmonary tubercles).

Ren Shen (Ginseng Radix) (3 qian) Gan Mai Dong (Ophiopogonis Tuber, dried, retaining the heart) (4 qian) Sheng Shan Yao (Dioscoreae Rhizoma, raw) (6 qian) Qing Ban Xia (Pinelliae Rhizoma, cleaned) (2 qian) Niu Bang Zi (Arctii Fructus) (3 qian, stir-fried and crushed) Su Zi (Perillae Fructus) (2 qian, stir-fried and crushed)
Sheng Hang Shao (Paeoniae Radix Alba, Hangzhou origin, raw) (3 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (1.5 qian)

Ren Shen is the principal herb for tonifying Lung Qi, but there is a concern that its warmth may exacerbate "Lung heat injuring the Lung." With Mai Dong assisting, it can instead clear heat. Mai Dong is a key herb for moistening the Lung, but there is a saying that it should be avoided in cough due to its cloying nature; with Ban Xia assisting, it can instead stop cough. As for Shan Yao, its astringent property helps Ren Shen tonify Qi, and its sticky-moistening property helps Mai Dong nourish fluids. Although prolonged and heavy use might cause stagnation, the slippery and unblocking nature of Niu Bang Zi can compensate for this. Moreover, Niu Bang Zi descends rebellious Lung Qi, Ban Xia descends rebellious Stomach Qi and Chong Qi, and Su Zi used with Ren Shen can also descend Qi rebellion caused by deficiency. By calming these rebellious Qi movements, asthma and cough will heal spontaneously without direct treatment. Bai Shao is used because the Liver is the counterpart organ to the Lung; when Lung Metal is deficient and cannot descend clearly to suppress Liver Wood, Liver Fire often flares up and rebels upward. Therefore, Shao Yao is added to astringe and restrain the fire. Furthermore, when Shao Yao is used with Gan Cao, their combined sweet-bitter flavor resembles Ren Shen, and its efficacy is similar to Ren Shen, while also being an herb that tonifies the Lung.

Note: Ancient formulas mostly used Mai Dong to treat Lung deficiency cough, but Xu Lingtai alone stated that coughers absolutely should not use it. This is likely because Mai Dong's juice is too sticky and cloying; if even a slight pathogenic factor lingers in the Lung, it will remain stagnant. Only by assisting with the acrid-drying and opening nature of Ban Xia can it effectively treat not only cough but also asthma. Thus, Zhang Zhongjing used Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) after the resolution of Cold Damage, for cases of emaciation, shortness of breath, and rebellious Qi with nausea, where Mai Dong and Ban Xia were used together. For fire-induced rebellious Qi, he used Mai Men Dong Tang (Ophiopogon Decoction), using Mai Dong as the sovereign herb, assisted by Ban Xia. Additionally, physicians often avoid using Ban Xia for Lung deficiency consumptive cough, which shows they do not understand the nature of Ban Xia. Xu Lingtai said: "The Lung belongs to Metal, preferring astringency over dispersion." Astringency causes Lung lobes to hang down and Qi to flow smoothly, while dispersion causes Lung lobes to expand and Qi to rebel. The acridity of Ban Xia is distinctly different from that of Sheng Jiang (Zingiberis Rhizoma Recens) and Gui Zhi (Cinnamomi Ramulus). It closes the throat causing inability to speak when entering, and stops bleeding when applied to wounds; it is acrid yet astringent/stagnant, thus capable of both unblocking and astringing. Furthermore, the astringency of Acrid differs from that of Sour; Sour primarily focuses on astringency, whereas Acrid contains the intent of dispersion within astringency, which particularly suits the Lung. Yu Jiayan praised the use of Ban Xia in Mai Men Dong Tang, saying: "In large formulas that build Middle Qi and generate copious fluids, adding one acrid-warm herb of Ban Xia to benefit the throat and descend Qi—this is not merely the merit of Ban Xia, but the merit of skillfully using Ban Xia."

I have studied this condition carefully and know that the treatment method should be subdivided into several types. When Kidney disease transmits to the Lung, the main treatment should be herbs that greatly nourish True Yin, assisted by herbs that clear the Lung and resolve phlegm, such as my formulated Li Quan Yin (Spring Water Drink); when Lung disease transmits to the Kidney, the main treatment should be herbs that clear the Lung and resolve phlegm, assisted by herbs that nourish True Yin, such as this Shen Mai Tang (Ginseng and Ophiopogon Decoction); when both Lung and Kidney are diseased, affecting the Spleen and Stomach, dual tonification of Lung and Kidney should be employed while attending to the Spleen and Stomach, such as my formulated Zi Pei Tang (Nourishing and Nurturing Decoction) and Zhu Yu Er Bao Zhou (Pearl and Jade Two-Treasure Porridge). Treating along these distinct paths with careful consideration, and additionally administering Aspirin, all cases with pulse roots that can still be salvaged will recover given time. For cases with only pulmonary tubercles without involvement of other organs, appropriate methods can be selected from the lung disease formulas in this volume (the discussion on lung disease treatment methods actually details consumptive lung diseases comprehensively; those treating consumptive diseases and lung diseases should refer to this).

Aspirin is cool in nature and dispersing, good at reducing fever from external contraction. For initial external wind-heat contraction, taking it induces cool sweating and leads to recovery. It can also reduce internal injury fever; for tuberculosis patients, using it to eliminate heat indeed yields miraculous effects. It is also good at treating acute joint swelling and pain, expelling toxin from smallpox/rash, and various conditions like gastroenteritis and pleurisy, making it one of the most applicable Western medicines.
However, its sweating power is very fierce. If the crystals are hard and large, half a grain suffices to induce sweating for external contraction; if the weather is cold or in near-arctic regions, one grain or one and a half grains must be taken. If it resembles white powder with slight crystallization, the medicinal power is weak, requiring one grain to induce sweating, and can generally be taken up to one and a half or two grains. This requires the clinician to judge the quality of the drug and adapt to time, place, and individual constitution.
When using Aspirin for internal injury, the dosage must be especially low. Because people with internal injury fever have Yin deficiency with floating Yang, they sweat easily. Westerners use three grains daily for tuberculosis fever; given Europe's cold climate and their diet rich in meat since childhood, leading to strong Zang-Fu and Ying-Wei defenses, this might be acceptable. However, in China, this is certainly not feasible. Therefore, Ding Zhonghu used Aspirin for tuberculosis, taking one and a half grains total per day (three times), which is less than what Westerners use. My usage for tuberculosis is reduced further compared to Westerners. I once treated a young man with tuberculosis, cough, poor appetite, and emaciation, who had not recovered for half a year. I prescribed herbs to regulate the Lung, clear phlegm, strengthen the Stomach, and nourish Yin. At bedtime, I gave him Aspirin (one-third of a grain) dissolved in water with white sucrose. He sweated profusely throughout his body shortly after, and the sweating stopped after three hours. The next day, he felt sore and lazy all over due to excessive sweating. However, his cough was lighter, and his appetite improved slightly. After taking several doses of tonifying herbs, using only one-sixth of a grain of Aspirin once daily, sometimes inducing slight sweating or none, his spirit gradually cleared. He recovered after about a month of treatment. Since then, when using Aspirin for tuberculosis, I always start with a minimal test dose, never daring to increase it initially.
Westerners suggest combining it with antihydrotics to prevent sweating, which is a good method. However, there is still fear that the antihydrotics may fail, and Aspirin's sweating effect remains strong. In my treatment of tuberculosis, if I use one grain or slightly more per day, I divide it into ten or more doses. No antihydrotics are needed, and no sweating occurs. Even if slight sweating occurs occasionally, it is a good sign.
For all consumptive Yin deficiency syndromes with rapid and urgent pulses, regardless of whether tuberculosis is present, besides each dose of tonifying agents, Aspirin should be taken, either half a grain or up to one grain. To prevent excessive sweating, it should be divided into several doses. On the first day, take enough to induce slight sweating; subsequently, take it daily, aiming for either slight sweating or no sweating. Within ten days, the rapid pulse can gradually become harmonious and slow.

Appendix:
Letter from Bin XX in Binyang, Liuzhou, Guangxi:
Treated a woman, aged 43, who suffered from hemoptysis due to mental labor from household chores and emotional distress. Although the hemoptysis healed, severe wheezing and coughing followed, preventing her from lying down at night. Various doctors treated her with Loquat Leaf, Farfura Flower, Apricot Seed, Aster Root, and Fritillary Bulb. Later, her right cheek became pale red and swollen, but the cough and wheezing did not improve. I was then consulted. I first prescribed Wang Qingren's Shaofu Zhuyu Tang (Minor Abdominal Blood-Stasis Expelling Decoction) plus Perilla Fruit and Agarwood, administered for two doses. Then, she took Shen Mai Tang from this book for eight doses, after which both wheezing and coughing resolved.

Also: Treated a man, aged 46, suffering from heart heat and wheezing, who had been treated ineffectively for three years. Upon examination, I first prescribed Zisheng Tang (Life-Nourishing Decoction) from this book, adding Raw Rehmannia Root (Sheng Di Huang) six qian according to the notes. One dose showed improvement, and several doses reduced the illness by half. Subsequently, several doses of Shen Mai Tang cured nine-tenths to eight-tenths of the disease. However, having been ill for years, his body was emaciated, and recovery could not be achieved hastily. I hope the master will bestow a follow-up prescription, which would be greatly appreciated.