2．麻疹后期，热退、疹消，如出现视物不明，皮肤搔痒者，若属热伤肺阴，肺阴受损，宜清肺热、补肝阴为主，用黑豆、绿豆、扁豆、虫蜕、关吉力、赤芍、果杞治之。痒止后，仍用三豆加石决明、广木贼、关吉力、密蒙花、鸡肝．滋肝明目，以恢复视力。
3．麻疹靥后，若肝肺余热不尽，症见低热持续，微咳不止，治宜养阴润燥兼清肺经余热，用三豆汤合二仙汤(黑豆、绿豆、红饭豆、黄芩、杭芍)治之。如服后热退咳止．继用三豆汤加乌梅、冰糖，酸甘化阴调治为宜。
麻疹后期，变证颇多，如属有余之证，或余邪未尽，或肝肺津枯，均可采用三豆汤加减治之。
1．表邪外束，肺胃郁热，发热，咳嗽，头身疼痛，舌红，苔薄黄或薄白少津，脉浮数，证属风热袭肺，肺气不降， (如支周感染等)治宜疏散风热，降逆止咳。方用枳实三豆银翘散(枳实、黑豆、绿豆、淡豆豉、银花、连翘、薄荷、牛蒡子、桑叶、贝母、苇根)。
2．外受表邪，肺胃郁热，咽痛较剧(如急性扁桃腺炎等)，用上方枳实三豆银翘散加桔梗、甘草。
3．大头瘟，风温犯肺，三阳经郁热，致颜面漫肿发红，头痛寒热，脉数，舌红。治宜清热泻火，疏风解毒。用三豆汤加味(黑豆、绿豆、红饭豆、淡豆豉、生石膏、桑叶、银花、连翘、紫草、焦楂、僵蚕、虫蜕、淡竹叶)。
4．痄腮，一般由风温病毒所致者，症见发热，一侧或两侧腮腺肿胀疼痛，拒按，舌红，脉数。治宜疏风清热。方用三豆饮加味(黑豆、绿豆、淡豆豉、银花、荆芥、连翘、夏枯花、僵蚕、板兰根)。
5．风热所致其他疾患，如荨麻疹、急性过敏性疾病、过敏性紫斑、天泡疮、漆疮、急性蜂窝组织炎等，各病表现虽然不同，但病因均多为风热，火毒阳邪外侵，肺胃郁热，病位反映均在皮肤、肌肉。肺主皮毛，胃主肌肉，故均可用枳实三豆银翘散加减治之。
(三)用于其他方面
1．小儿高热惊风，症由高热伤津，肝失濡养，热极生风所致者，用黑豆、绿豆、淡豆豉加钩藤、僵蚕、虫蜕、竹茹。
3．妇女更年期综合征，虚烦，自汗，低热，血压波动，脉弦或沉弦，证属肝肾阴虚，津液不足者，可用黑豆、绿豆、淡豆豉加山萸肉、果杞、五味子、乌梅、桔络、竹茹、冰糖。
如属胆热痰滞，烦躁，失眠者，可用栀豉温胆汤加黑豆、绿豆、桔络、菖蒲、远志。
如属肝阴虚较重者，用三豆汤与生脉散合方服用(黑豆、绿豆、红饭豆、太子参、麦冬、淮枣皮、乌梅、冰糖)。
4．小儿遗尿，属肝旺脾虚者，用黑豆、绿豆、扁豆、淮山药、莲子、乌梅、冰糖。
5．小儿腹泻后，脾弱肝旺，饮食不为肌肤，形体消瘦，性怪喜哭，证属肝脾失调，治宜调和肝脾，用黑豆、绿豆、扁豆、桑叶、乌梅、冰糖、竹茹、灯心治之。
6．多发性疖疮，属风火湿热者，治宜清热解毒，祛风利湿，用黑豆、绿豆、红饭豆、桑叶、荆芥、银花、连翘、僵蚕、牛蒡子、蝉蜕、甘草。
7．预防流感，可用黑豆、绿豆、淡豆豉、桑叶、乌梅、银花、连翘、冰糖。
1O．药物过敏，或药物中毒，用黑豆、绿豆、红饭豆、防风、甘草治之。
三豆汤及其加减方的临床运用，范围甚广。总之，大凡急性、热性，津液亏损等疾患。均可在三豆汤的基础上加减使用。三、病案举例
例一：
张姓小儿，年二岁。发热持续七日，心烦闷，唇焦燥，咳嗽流涕，小便短赤。舌红，脉数。耳前后疹出隐约。脉症合参，显系风温束肺，阴液受损．致疹不外达。治以清热透疹佐宣肺养液。用三豆饮加味。处方：
香菌脚3克(公鸡冠血数滴为引)
上方服二剂，疹自胸背渐出达于手足，热亦减退，胸闷心烦消失。凡治疗者须知，胸闷一分不减，痧出一分未透，此．临证至关重要者。
二诊：疹出顺畅，但患几夜间少寐，易惊，思水较多。此系疹出伤津，津虚不眠。用三豆饮加减。处方；
淡豆豉10克 黑豆15克 绿豆15克 桑叶10克 乌梅15克
服一剂，能安静入睡，此时疹子渐靥。
例二：
王姓男孩，年七岁。麻疹靥后，两眼视物逐渐不明，且兼周身皮肤发痒，舌质红，微有薄白苔，脉弦兼细。尿短少，胃纳不佳。形体消瘦，急躁不安。此为疹出热邪伤阴，肝肺阴液耗损，治以润肺养肝，滋津复液。用三豆汤加味。处方：
红饭豆10克 黑豆15克
果杞15克 乌悔15克 (冰糖少量为引)
二诊：上方服三剂后，皮肤发痒已止，原方红饭豆易扁亘加石决明、广木贼、鸡肝一个。
三诊：上方服十二剂，视力逐渐恢复。
例三：
李姓男孩，年四岁。麻疹已靥。但发热持续(体温摄氏38度左右)不退，且咳嗽，自汗，喘促。脉弦数，舌红苔黄腻质干。诊为疹毒未尽，复受热邪，郁遏肺经。治以清热解毒平喘，方用三豆汤合二仙汤。处方：
杭芍15克
二诊：上方服二剂，热退喘咳止。仍用三豆汤，淡豆豉易红饭豆，减黄芩、杭芍，加乌梅15克，用冰糖少许为引，调理而愈。
例四：
杨××，女，二十一岁。发热三日，头胀痛，继之头面漫肿，颜面灼热疼痛。舌红少津，苔薄白粉刺，脉数。口臭，便秘。西医诊为颜面丹毒，转中医诊治。证系风温犯肺．三阳经郁热，肺胃气机阻滞，表里俱热。治以清热解毒，宜疏通气机为主。方用三豆合升降散。处方：
红饭豆15克 黑豆20克 绿豆30克 僵蚕15克 蝉蜕10克
二诊：上方服二剂，便通，头面肿势渐消，热减退。方用三豆汤加味。处方：
三诊：上方服二剂，颜面肿势全消，且脱皮屑。此时出现虚烦不眠，苔粉刺已退，转现舌红少津。用三豆汤合温胆汤加山萸肉15克、乌梅15克、桑叶15克，调治而愈。
例五：
张××，男，四十一岁。发热39度，已三日，左下肢膝关节以下红肿灼热疼痛，逐渐向下蔓延至足背，行走不便。西医诊断为急性蜂窝组织炎，转服中药治疗。察舌红，答黄厚腻，脉弦数。全身酸困，尿短赤。诊为风湿外束，肺胃湿热。治以清热、解毒、化湿为主。方用三豆汤加味。处方：
淡豆豉15克 黑豆20克 绿豆30克 银花15克 连翘15克
生石膏30克 枳实10克 焦楂30克 僵蚕10克 紫草10克
二诊：上方服三剂，热退，下肢红肿灼热疼痛大减．且能行走。继以三豆汤加驱风除湿剂。处方：
红饭豆15克 黑豆20克 绿豆30克 土茯苓15克 苡仁30克
三诊：上方服二剂，下肢红肿疼痛全止，病已减去七八。脉由弦数转缓。继用三仁汤合三豆汤祛湿解毒，调治而愈：
例六：
方× ×，女，四十八岁。经期前后，皮肤发痒，虚烦不眠，潮热，心烦，手足热感较重。此证已持续三年，近半年来，发作更甚。脉细数，舌红少津。诊为肝阴虚损，肺燥生风．治以三豆汤加滋肝润燥之品。处方：
淡豆豉15克 黑豆20克 绿豆30克 果杞15克 枣皮15克
三诊：上方服后，潮热及手足心灼热已止。嘱仍用原方，每周服二至三剂，继续调治以巩固疗效。
例七：
李××，女，四十一岁。潮热，失眠，动则自汗，手足心灼热，已一年余。西医诊断为植物神经功能紊乱，遂转服中药。察其脉细数，舌润无苔。诊为心阴虚损，肝阴不足。用三豆汤合生脉散加味。处方：
扁豆15克 黑豆20克 绿豆30克 太子参30克 麦冬15克
五味子10克 枣皮15克 桔络6克 乌梅15克(冰糖少许为引)
二诊：上方服十余剂后，汗止，潮热退，且能安睡。嘱患者可以守方间断服用，以巩固疗效。
结语
从三豆汤及其加减方在临床上的使用情况看，可归结为以下几个方面：
1．抗病毒。如用治麻疹、腮腺炎等。
2．抗细菌。如治疗支周感染、麻疹合并肺炎、扁桃腺炎、蜂窝组织炎等。
4．解毒。如用于药物、食物中毒等。
5．调节植物神经功能。如用于妇女更年期症候群等。
综上所述，病虽不同，但根据异病同治的原则，三豆汤及其加减方所治各症，都是由于阳邪伤津，导致机体津液耗损而出现之热症、燥证，临床表现虽各有不同，但燥热伤津是其共同的病理变化，这是制方的理论根据，亦即中医辨证施治的一条重要原则。
此外，本方还具有简便、廉、验等优点，随处可得，不需加工炮制，临床使用确能取效。
麻黄人参芍药汤亦治咳血之良方
麻黄人参芍药汤系李东垣《脾胃论》所载方剂之一。原书用治虚热吐血，余用于虚热感冒及虚热咳血，经数十年临床实践证明，效果亦佳。凡证属气阴两虚，外受寒邪，疰现畏寒发热、咳嗽、痰中带血，舌润略腻，脉紧或弦紧，经服止血、凉血之剂而咳血不止者，采用此方。轻者一至二剂，重者三剂，即可收到热退咳血并止之效。
本方因有麻黄、桂枝，易使人产生顾虑。一畏麻黄发汗，因仲景有“亡血家不可发汗”的禁忌；二畏桂枝动血，既已咳血，再用桂枝则犯“血家禁桂”之戒。为使这一有效之方不致湮没或误解，特论述如下：
咳血一证，除内伤所致者外(非本方适应症)多因六淫之邪所致。其中如风、暑、燥、火等阳邪所致咳血易辨，若气阴两虚外受寒邪所致之咳血，则每易忽视，临证若不宣散寒邪，见血止血，概以清热凉血为治，势必关门缉盗，迁延时日，变生他证。
诚然，如果咳血只用单昧麻黄、桂枝，显然也是不对的，但经过恰当配伍，功效则异。本方之所以能收止咳止血退热之功，系与《内经》“夺汗者无血，夺血者无汗”之理论有关。方中麻黄、桂枝，解表以宣散外入之寒邪，参、芪，甘草补益脾肺，固卫实表，归芍养血敛阴止血，五味、麦冬养阴生津，收敛肺阴。全方组合，外能散表寒而固卫气，内能润肺生津、养阴而清虚热以止咳血。全方具调和阴阳、气血，协调肺脾，尤妙在麻黄、桂枝之辛温宣散，入于补气血养阴液之品中，能起到散补兼施，又可使麻黄、桂枝不致宣散太过，既使寒邪有向外宣散之机，又固液敛阴而收止血之效。此方既扶正又解表，既养血又止血。不仅可治气阴两虚外感风寒，亦可治疗体质虚弱，虚热内蕴，外受寒邪的咳血。但治咳血，余每于方中加炮姜一味，与方中甘草相配为炮姜甘草汤，苦甘化阴，可增强止咳血之作用。此方原剂量过轻，特更改如下：
炙麻绒6克 苏条参30克 杭芍15克 桂枝10克 麦冬15克
上方曾治疗虚热受寒所致之咳血患者百余例(症状以发热、哆嗽、痰血等为主)。经用凉血止血之剂无效者，用此方均收到热退咳血并止之效，诚治咳血之良剂。但是，如属风热犯肺及肝火犯肺等所致之咳血，则非本方所宜。
麻疹论治
2. In the late stage of measles, when fever subsides and rashes disappear, if the patient presents with blurred vision and skin itching, and the syndrome is identified as heat damaging lung Yin (the yin fluids of the lungs), leading to lung Yin deficiency, the treatment should primarily focus on clearing lung heat and nourishing liver Yin. Treatment can be administered using Adzuki beans (Vigna angularis), Mung beans (Vigna radiata), Hyacinth beans (Dolichos lablab), Cicada slough (Periostracum Cicadae), Guan Jili (a local herbal medicine), Red Peony Root (Radix Paeoniae Rubra), and Goji berries (Fructus Lycii). After the itching subsides, San Dou Tang (Three Bean Decoction) should still be used as a base, added with Abalone Shell (Concha Haliotidis), Equisetum (Herba Equiseti Hiemalis), Guan Jili, Buddleja Flower (Flos Buddlejae Officinalis), and Chicken Liver, to nourish the liver and brighten the eyes, thereby restoring vision.
3. After the resolution of measles rashes, if residual heat in the liver and lungs persists, presenting symptoms such as persistent low-grade fever and continuous mild cough, the treatment should aim to nourish Yin, moisten dryness, and clear residual heat from the lung meridian. This can be treated with a combination of San Dou Tang (Three Bean Decoction) and Er Xian Tang (Two Immortals Decoction), composed of Adzuki beans, Mung beans, Red Rice Beans (Phaseolus vulgaris var. umbrosus), Scutellaria Root (Radix Scutellariae), and White Peony Root (Radix Paeoniae Alba). If fever subsides and cough stops after taking the prescription, subsequent treatment with San Dou Tang added with Chinese Plum (Fructus Mume) and rock sugar is appropriate, utilizing the sour-sweet method to generate Yin fluids for regulation.
In the late stage of measles, there are many variations in complications. Whether it belongs to syndromes with excess pathogens, incomplete clearance of residual pathogens, or depletion of fluids in the liver and lungs, San Dou Tang (Three Bean Decoction) can be modified and used for treatment.
(II) Application to Wind-Heat and Fire-Toxicity
1. When external pathogenic factors constrain the exterior, and heat stagnates in the lungs and stomach, presenting with fever, cough, headache, body pain, red tongue, thin yellow or thin white coating lacking moisture, and floating-rapid pulse, the syndrome belongs to wind-heat attacking the lungs, causing failure of lung Qi to descend (such as peribronchial infection, etc.). The treatment should involve dispersing wind-heat and descending rebellious Qi to stop cough. The formula used is Zhi Shi San Dou Yin Qiao San (Bitter Orange, Three Beans, Honeysuckle and Forsythia Powder), composed of Bitter Orange (Fructus Aurantii), Adzuki beans, Mung beans, Fermented Soybeans (Semen Sojae Praeparatum), Honeysuckle Flower (Flos Lonicerae Japonicae), Forsythia Fruit (Fructus Forsythiae), Mint (Herba Menthae), Burdock Fruit (Fructus Arctii), Mulberry Leaf (Folium Mori), Fritillaria Bulb (Bulbus Fritillariae Cirrhosae), and Reed Rhizome (Rhizoma Phragmitis).
2. When external pathogenic factors constrain the exterior and heat stagnates in the lungs and stomach, causing severe sore throat (such as acute tonsillitis, etc.), the above-mentioned Zhi Shi San Dou Yin Qiao San is used, added with Platycodon Root (Radix Platycodi) and Licorice Root (Radix Glycyrrhizae).
3. For Da Tou Wen (Big Head Plague, characterized by facial swelling), where wind-warmth attacks the lungs and heat stagnates in the three Yang meridians, causing diffuse facial swelling and redness, headache, alternating chills and fever, rapid pulse, and red tongue, the treatment should clear heat, purge fire, disperse wind, and resolve toxicity. San Dou Tang (Three Bean Decoction) with modifications is used, composed of Adzuki beans, Mung beans, Red Rice Beans, Fermented Soybeans, Raw Gypsum (Gypsum Fibrosum), Mulberry Leaf, Honeysuckle Flower, Forsythia Fruit, Purple Perilla Herb (Herba Perillae), Stir-fried Hawthorn Fruit (Fructus Crataegi), Stiff Silkworm (Bombyx Batryticatus), Cicada Slough, and Light Bamboo Leaves (Folium Bambusae).
4. For Ma Ying (Mumps, epidemic parotitis), generally caused by wind-warmth viruses, presenting with fever, unilateral or bilateral parotid gland swelling and pain, tenderness upon pressure, red tongue, and rapid pulse, the treatment should disperse wind and clear heat. The formula used is San Dou Yin (Three Bean Drink) with modifications, composed of Adzuki beans, Mung beans, Fermented Soybeans, Honeysuckle Flower, Schizonepeta (Herba Schizonepetae), Forsythia Fruit, Prunella Spike (Spica Prunellae), Stiff Silkworm, and Blue Indigo Root (Radix Baphicacanthi Cusiei).
5. Other diseases caused by wind-heat, such as urticaria, acute allergic diseases, allergic purpura, pemphigus, lacquer dermatitis, and acute cellulitis, although their manifestations differ, their etiology is mostly wind-heat, with fire-toxicity and yang pathogens invading externally, causing heat stagnation in the lungs and stomach. The pathological location reflects in the skin and muscles. Since the lungs govern the skin and hair, and the stomach governs the muscles, all these conditions can be treated with modified Zhi Shi San Dou Yin Qiao San.
(III) Application in Other Aspects
1. For pediatric high fever with convulsions, where symptoms are caused by high fever damaging fluids, leading to liver loss of nourishment and extreme heat generating wind, use Adzuki beans, Mung beans, Fermented Soybeans, added with Uncaria (Ramulus Uncariae cum Uncis), Stiff Silkworm, Cicada Slough, and Bamboo Shavings (Caulis Bambusae in Taenia).
2. For early-stage Rosacea (Jiu Cao Bi), mostly caused by heat stagnation in the lungs and stomach, Zhi Shi San Dou Yin Qiao San can be used.
3. For women's menopause syndrome, presenting with deficiency vexillation, spontaneous sweating, low-grade fever, blood pressure fluctuations, and wiry or deep-wiry pulse, where the syndrome belongs to liver-kidney Yin deficiency and fluid insufficiency, use Adzuki beans, Mung beans, Fermented Soybeans, added with Cornus Fruit (Fructus Corni), Goji berries, Schisandra Berry (Fructus Schisandrae Chinensis), Chinese Plum, Tangerine Pith (Cortex Citri Reticulatae), Bamboo Shavings, and rock sugar.
If belonging to gallbladder heat with phlegm stagnation, presenting with irritability and insomnia, Zhi Chi Wen Dan Tang (Gardenia and Fermented Soybean Decoction combined with Warm Gallbladder Decoction) added with Adzuki beans, Mung beans, Tangerine Pith, Acorus (Rhizoma Acori Tatarinowii), and Polygala Root (Radix Polygalae) can be used.
If liver Yin deficiency is more severe, San Dou Tang (Three Bean Decoction) combined with Sheng Mai San (Generate the Pulse Powder) can be taken together, composed of Adzuki beans, Mung beans, Red Rice Beans, Pseudoginseng Root (Radix Notoginseng), Ophiopogon Tuber (Tuber Ophiopogonis), Cornus Fruit, Chinese Plum, and rock sugar.
4. For pediatric enuresis, belonging to hyperactive liver and deficient spleen, use Adzuki beans, Mung beans, Hyacinth beans, Chinese Yam (Rhizoma Dioscoreae), Lotus Seed (Semen Nelumbinis), Chinese Plum, and rock sugar.
5. After pediatric diarrhea, where spleen weakness and liver hyperactivity lead to poor nutrition absorption, emaciation, strange behavior, and crying propensity, belonging to liver-spleen disharmony, the treatment should harmonize the liver and spleen. Use Adzuki beans, Mung beans, Hyacinth beans, Mulberry Leaf, Chinese Plum, rock sugar, Bamboo Shavings, and Centipede Grass (Herba Dictamni) for treatment.
6. For multiple furuncles, belonging to wind-fire-damp-heat, the treatment should clear heat, resolve toxicity, dispel wind, and promote diuresis to remove dampness. Use Adzuki beans, Mung beans, Red Rice Beans, Mulberry Leaf, Schizonepeta, Honeysuckle Flower, Forsythia Fruit, Stiff Silkworm, Burdock Fruit, Cicada Slough, and Licorice Root.
7. For influenza prevention, use Adzuki beans, Mung beans, Fermented Soybeans, Mulberry Leaf, Chinese Plum, Honeysuckle Flower, Forsythia Fruit, and rock sugar.
8. For measles prevention, use Adzuki beans, Mung beans, Red Rice Beans, Lithospermum Root (Radix Arnebiae seu Lithospermi), Honeysuckle Flower, and Licorice Root.
9. For food allergy presenting with whole-body itching and unbearable pruritus, use Zhi Shi San Dou Yin Qiao San.
10. For drug allergy or drug poisoning, use Adzuki beans, Mung beans, Red Rice Beans, Saposhnikovia Root (Radix Saposhnikoviae), and Licorice Root.
The clinical application of San Dou Tang (Three Bean Decoction) and its modified formulas is very broad. In general, for any acute, febrile diseases, or conditions involving fluid depletion, they can be modified and used based on San Dou Tang.
III. Case Examples
Case 1:
A two-year-old boy surnamed Zhang. Persistent fever for seven days, mental restlessness, dry and cracked lips, cough with runny nose, short and dark urine. Red tongue, rapid pulse. Rash appearing faintly around the ears. Combining pulse and symptoms, it is clearly wind-warmth constraining the lungs, damaging Yin fluids, preventing the rash from expressing outwardly. Treatment should clear heat, express the rash, assist in diffusing lung Qi, and nourish fluids. Use modified San Dou Yin (Three Bean Drink). Prescription:
Adzuki beans 10g, Mung beans 15g, Fermented Soybeans 10g, Mulberry Leaf 10g, Mint 5g, Xiang Jun Jiao 3g (with a few drops of rooster comb blood as a guide).
After taking two doses of the above prescription, the rash gradually appeared from the chest and back to the hands and feet, fever also subsided, and chest tightness and mental restlessness disappeared. Practitioners must know that if chest tightness does not decrease by one point, the rash will not express completely by one point; this is crucial in clinical practice.
Second visit: The rash expressed smoothly, but the child had little sleep at night, was easily startled, and desired water frequently. This is due to fluid damage from the rash, causing insomnia from fluid deficiency. Use modified San Dou Yin. Prescription:
Fermented Soybeans 10g, Adzuki beans 15g, Mung beans 15g, Mulberry Leaf 10g, Chinese Plum 15g, Bamboo Shavings 6g (with a little rock sugar as a guide).
After one dose, he could fall asleep quietly, and the rash began to resolve.
Third visit: Replace Fermented Soybeans in the original prescription with Hyacinth beans to strengthen spleen tonification, liver nourishment, and lung harmonization, resulting in recovery.
Case 2:
A seven-year-old boy surnamed Wang. After measles resolution, vision gradually became unclear, accompanied by whole-body skin itching. Red tongue, slight thin white coating, wiry and fine pulse. Short urine, poor appetite. Emaciated, irritable and restless. This is due to heat pathogens damaging Yin during rash expression, depleting liver and lung Yin fluids. Treatment should moisten the lungs, nourish the liver, and replenish fluids. Use modified San Dou Tang. Prescription:
Red Rice Beans 10g, Adzuki beans 15g, Mung beans 15g, Cordyceps Flower (Cordyceps militaris) 15g, Red Peony Root 10g, Goji berries 15g, Chinese Plum 15g (with a small amount of rock sugar as a guide).
Second visit: After three doses, skin itching stopped. In the original prescription, replace Red Rice Beans with Hyacinth beans, add Abalone Shell, Equisetum, and one chicken liver.
Third visit: After twelve doses, vision gradually recovered.
Case 3:
A four-year-old boy surnamed Li. Measles had resolved, but fever persisted (around 38°C) without subsiding, accompanied by cough, spontaneous sweating, and panting. Wiry-rapid pulse, red tongue with yellow greasy and dry coating. Diagnosed as residual measles toxin not fully cleared, re-infected by heat pathogens, obstructing the lung meridian. Treatment should clear heat, resolve toxicity, and calm panting. Use San Dou Tang combined with Er Xian Tang. Prescription:
Fermented Soybeans 10g, Adzuki beans 15g, Mung beans 15g, Mulberry Leaf 10g, Scutellaria Root 6g, White Peony Root 15g.
Second visit: After two doses, fever subsided, panting and cough stopped. Continue using San Dou Tang, replace Fermented Soybeans with Red Rice Beans, reduce Scutellaria Root and White Peony Root, add Chinese Plum 15g, with a little rock sugar as a guide, resulting in recovery through regulation.
Case 4:
Yang XX, female, 21 years old. Fever for three days, head distending pain, followed by diffuse head and face swelling, burning pain on the face. Red tongue, scant fluids, thin white acne-like coating, rapid pulse. Bad breath, constipation. Western medicine diagnosed as facial erysipelas, transferred to TCM treatment. Syndrome belongs to wind-warmth attacking the lungs, heat stagnating in the three Yang meridians, obstruction of lung-stomach Qi mechanism, heat in both interior and exterior. Treatment should clear heat, resolve toxicity, and prioritize unblocking Qi mechanism. Use San Dou Tang combined with Sheng Jiang San (Ascending and Descending Powder). Prescription:
Red Rice Beans 15g, Adzuki beans 20g, Mung beans 30g, Stiff Silkworm 15g, Cicada Slough 10g, Turmeric Rhizome (Rhizoma Curcumae Longae) 10g, Rhubarb (Radix et Rhizoma Rhei) 6g, Mulberry Leaf 10g, Lithospermum Root 6g.
Second visit: After two doses, bowel movement normalized, head and face swelling gradually subsided, fever reduced. Formula changed to modified San Dou Tang. Prescription:
Red Rice Beans 15g, Adzuki beans 20g, Mung beans 30g, Lithospermum Root 6g, Stir-fried Hawthorn Fruit 30g, Raw Gypsum 30g, Honeysuckle Flower 10g, Forsythia Fruit 10g, Stiff Silkworm 10g.
Third visit: After two doses, facial swelling completely subsided, and peeling occurred. At this time, deficiency vexillation and insomnia appeared, acne-like coating receded, turning into red tongue with scant fluids. Use San Dou Tang combined with Wen Dan Tang (Warm Gallbladder Decoction), added with Cornus Fruit 15g, Chinese Plum 15g, Mulberry Leaf 15g, resulting in recovery through regulation.
Case 5:
Zhang XX, male, 41 years old. Fever 39°C for three days, redness, swelling, burning pain below the left knee joint, gradually spreading to the dorsum of the foot, difficulty walking. Western medicine diagnosed as acute cellulitis, transferred to TCM treatment. Tongue red, yellow thick greasy coating, wiry-rapid pulse. Whole-body soreness and fatigue, short dark urine. Diagnosed as wind-dampness constraining the exterior, damp-heat in lungs and stomach. Treatment should prioritize clearing heat, resolving toxicity, and transforming dampness. Use modified San Dou Tang. Prescription:
Fermented Soybeans 15g, Adzuki beans 20g, Mung beans 30g, Honeysuckle Flower 15g, Forsythia Fruit 15g, Raw Gypsum 30g, Bitter Orange 10g, Stir-fried Hawthorn Fruit 30g, Stiff Silkworm 10g, Lithospermum Root 10g, Mulberry Leaf 15g, Imperata Rhizome (Rhizoma Imperatae) 10g.
Second visit: After three doses, fever subsided, lower limb redness, swelling, burning pain significantly reduced, able to walk. Continue with San Dou Tang added with wind-dispelling and dampness-draining agents. Prescription:
Red Rice Beans 15g, Adzuki beans 20g, Mung beans 30g, Smilax Glabra Rhizome (Rhizoma Smilacis Glabrae) 15g, Coix Seed (Semen Coicis) 30g, Cicada Slough 10g, Angelica Pubescens Root (Radix Angelicae Pubescentis) 6g, Red Peony Root 15g, Aurantium Peel (Pericarpium Citri Reticulatae Viride) 10g, Achyranthes Root (Radix Achyranthis Bidentatae) 10g, Schizonepeta 6g, Forsythia Fruit 15g, Ligusticum Rhizome (Rhizoma Chuanxiong) 6g, Bupleurum Root (Radix Bupleuri) 6g.
Third visit: After two doses, lower limb redness, swelling, and pain completely stopped, illness reduced by 70-80%. Pulse changed from wiry-rapid to moderate. Continue with San Ren Tang (Three Seeds Decoction) combined with San Dou Tang to drain dampness and resolve toxicity, resulting in recovery through regulation.
Case 6:
Fang XX, female, 48 years old. Skin itching before and after menstruation, deficiency vexillation, insomnia, tidal fever, irritability, significant heat sensation in hands and feet. This condition has persisted for three years, worsening in the past six months. Fine-rapid pulse, red tongue with scant fluids. Diagnosed as liver Yin damage, lung dryness generating wind. Treatment uses San Dou Tang added with liver-nourishing and dryness-moistening products. Prescription:
Fermented Soybeans 15g, Adzuki beans 20g, Mung beans 30g, Goji berries 15g, Cornus Fruit 15g, Chinese Plum 30g, Bamboo Shavings 6g (with a little rock sugar as a guide).
Third visit: After taking the above prescription, tidal fever and burning heat in palms and soles stopped. Advised to continue using the original prescription, two to three doses per week, to consolidate efficacy.
Case 7:
Li XX, female, 41 years old. Tidal fever, insomnia, spontaneous sweating upon movement, burning heat in palms and soles, persisting for over a year. Western medicine diagnosed as autonomic nervous system dysfunction, transferred to TCM treatment. Fine-rapid pulse, moist tongue without coating. Diagnosed as heart Yin damage, liver Yin insufficiency. Use San Dou Tang combined with Sheng Mai San (Generate the Pulse Powder) with modifications. Prescription:
Hyacinth beans 15g, Adzuki beans 20g, Mung beans 30g, Pseudoginseng Root 30g, Ophiopogon Tuber 15g, Schisandra Berry 10g, Cornus Fruit 15g, Tangerine Pith 6g, Chinese Plum 15g (with a little rock sugar as a guide).
Second visit: After taking more than ten doses, sweating stopped, tidal fever subsided, and peaceful sleep was achieved. Advised the patient to take the prescription intermittently according to the original formula to consolidate efficacy.
Conclusion
From the clinical usage of San Dou Tang (Three Bean Decoction) and its modified formulas, it can be summarized in the following aspects:
1. Antiviral action. Such as treating measles, mumps, etc.
2. Antibacterial action. Such as treating peribronchial infection, measles complicated with pneumonia, tonsillitis, cellulitis, etc.
3. Enhancing immune mechanisms. Such as preventing measles, preventing influenza, etc.
4. Detoxification. Such as treating drug poisoning, food poisoning, etc.
5. Regulating autonomic nerve function. Such as treating women's menopause syndrome, etc.
In summary, although the diseases differ, based on the principle of "treating different diseases with the same method," the symptoms treated by San Dou Tang and its modified formulas are all caused by yang pathogens damaging fluids, leading to fluid depletion in the body, resulting in heat syndromes and dryness syndromes. Although clinical manifestations vary, "dryness-heat damaging fluids" is their common pathological change. This is the theoretical basis for formulating the prescription, which is an important principle of TCM syndrome differentiation and treatment.
Furthermore, this formula has advantages such as simplicity, low cost, and efficacy. Ingredients are readily available and do not require complex processing. Clinical use indeed achieves therapeutic effects.
Ma Huang Ren Shen Shao Yao Tang is also an excellent formula for treating hemoptysis.
Ma Huang Ren Shen Shao Yao Tang (Ephedra, Ginseng, and Peony Decoction) is one of the formulas recorded in Li Dongyuan's "Pi Wei Lun" (Treatise on the Spleen and Stomach). The original book used it to treat vomiting of blood due to deficiency-heat. I have used it for deficiency-heat colds and deficiency-heat hemoptysis. Decades of clinical practice have proven its effectiveness. For cases belonging to dual deficiency of Qi and Yin, external contraction of cold pathogens, presenting with aversion to cold, fever, cough, blood in sputum, moist and slightly greasy tongue, tight or wiry-tight pulse, where hemoptysis persists despite taking hemostatic and cooling-blood agents, this formula is adopted. Mild cases may see results after one to two doses, and severe cases after three doses, achieving cessation of fever and hemoptysis.
This formula contains Ephedra (Herba Ephedrae) and Cinnamon Twig (Ramulus Cinnamomi), which often causes concern. First, fear that Ephedra induces sweating, due to Zhang Zhongjing's contraindication "those who have lost blood should not be sweated"; second, fear that Cinnamon Twig moves blood, meaning that since hemoptysis has occurred, using Cinnamon Twig violates the prohibition "blood disorders forbid Cinnamon." To prevent this effective formula from being obscured or misunderstood, I discuss it as follows:
Hemoptysis, except when caused by internal injury (not indicated for this formula), is mostly caused by the six exogenous pathogens. Among them, hemoptysis caused by yang pathogens like wind, summerheat, dryness, and fire is easy to identify. However, hemoptysis caused by dual deficiency of Qi and Yin with external cold contraction is often overlooked. In clinical practice, if cold pathogens are not dispersed, and bleeding is stopped merely by seeing blood, generally treating with clearing heat and cooling blood, it inevitably leads to "locking the door to catch the thief," prolonging the disease and generating other complications.
Indeed, using only single herbs Ephedra and Cinnamon Twig for hemoptysis is obviously incorrect, but with appropriate compatibility, the efficacy differs. The reason this formula can achieve the effects of stopping cough, stopping bleeding, and reducing fever is related to the theory in "Nei Jing" (Inner Canon): "Those who lose sweat have no blood; those who lose blood have no sweat." In the formula, Ephedra and Cinnamon Twig release the exterior to disperse external cold pathogens; Ginseng, Astragalus (Radix Astragali), and Licorice tonify spleen and lung, consolidating defensive Qi and strengthening the exterior; Angelica Root (Radix Angelicae Sinensis) and White Peony Root nourish blood, astringe Yin, and stop bleeding; Schisandra Berry and Ophiopogon Tuber nourish Yin, generate fluids, and astringe lung Yin. The combination of the entire formula can externally dissipate exterior cold and consolidate defensive Qi, while internally moistening the lungs, generating fluids, nourishing Yin, and clearing deficiency-heat to stop hemoptysis. The formula harmonizes Yin-Yang and Qi-Blood, coordinates lung and spleen. Its particular brilliance lies in the acrid-warm dispersing nature of Ephedra and Cinnamon Twig entering into ingredients that tonify Qi, Blood, and nourish Yin fluids. This achieves simultaneous dispersal and tonification, prevents excessive dispersal by Ephedra and Cinnamon Twig, provides a pathway for cold pathogens to disperse outward, and consolidates fluids and astringes Yin to achieve hemostasis. This formula both supports healthy Qi and releases the exterior, both nourishes blood and stops bleeding. It not only treats exterior cold contraction with dual Qi-Yin deficiency but also treats hemoptysis caused by constitutional weakness, internal accumulation of deficiency-heat, and external cold contraction. However, when treating hemoptysis, I usually add Roasted Ginger (Rhizoma Zingiberis Preparatum) to the formula, combined with Licorice to form Pao Jiang Gan Cao Tang (Roasted Ginger and Licorice Decoction). Bitter and sweet transform into Yin, enhancing the effect of stopping hemoptysis. The original dosage of this formula was too light, so I have modified it as follows:
Roasted Ephedra 6g, Su Tiao Shen (Codonopsis Pilosula) 30g, Hang Shao (White Peony Root) 15g, Cinnamon Twig 10g, Ophiopogon Tuber 15g, Schisandra Berry 10g, Angelica Root 15g, Astragalus 15g, Licorice 6g, Roasted Ginger 9g.
The above prescription has been used to treat more than a hundred patients with hemoptysis caused by deficiency-heat and cold contraction (symptoms mainly including fever, cough, blood in sputum, etc.). Those who were ineffective after using cooling-blood and hemostatic agents all achieved cessation of fever and hemoptysis with this formula, proving it to be an excellent agent for treating hemoptysis. However, for hemoptysis caused by wind-heat attacking the lungs or liver fire attacking the lungs, this formula is not suitable.
Discussion on the Treatment of Measles