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(I) Common Cold

Case 1 Patient Xue XX, male, 60 years old. Initial consultation date: March 8, 1963. Suffering from a common cold for two weeks, still experiencing fever, nasal congestion with runny nose, cough, itchy and painful throat, dry stool, normal urination. Pulse is floating and slightly rapid; tongue is pale with white-yellow greasy coating. Syndrome differentiation indicates a common cold complicated with dampness (Shi), treatment should prioritize dispersing and resolving (Shu Jie). Prescription: Perillae Folium (Suye) 4.5g, Armeniacae Semen (Xingren) 6g, Platycodonis Radix (Jiegeng) 3g, Fried Aurantii Fructus (Chao Zhike) 3g, Peucedani Radix (Qianhu) 3g, Prepared Cyperi Rhizoma (Zhi Xiangfu) 3g, Citri Reticulatae Pericarpium (Chenpi) 3g, Fried Raphani Semen (Chao Laifuzi) 4.5g, Menthae Haplocalycis Herba (Bohe, added later) 3g, Schizonepetae Spica (Jingjie) 3g, Glycyrrhizae Radix et Rhizoma (Gancao) 1.5g, Allii Fistulosi Bulbus (Congbai, added later) 3 cun.

(Second Consultation): Body temperature normalized, cough stopped, throat no longer painful or itchy, nasal congestion alleviated, discharge of yellow sticky nasal mucus, stool softened but scanty in quantity. Pulse is floating and slippery; turbid coating remains. Although the disease trend has decreased, external pathogens are not yet fully eliminated. Treatment should prioritize dispersing and resolving, combined with regulating the intestines and stomach. Prescription: Perillae Folium (Suye) 6g, Armeniacae Semen (Xingren) 6g, Platycodonis Radix (Jiegeng) 3g, Fried Aurantii Fructus (Chao Zhike) 4.5g, Peucedani Radix (Qianhu) 3g, Prepared Cyperi Rhizoma (Zhi Xiangfu) 4.5g, Citri Reticulatae Pericarpium (Chenpi) 3g, Fried Raphani Semen (Chao Laifuzi) 4.5g, Bombyx Batryticatus (Jiangcan) 4.5g, Fried Medicated Leaven (Chao Shenqu) 6g, Glycyrrhizae Radix et Rhizoma (Gancao) 1.5g, Fermented Soybean (Douchi) 9g, Allii Fistulosi Bulbus (Congbai, added later) 3 cun.

(Third Consultation): After medication, nasal congestion reduced, no more runny nose, appetite acceptable, but abdominal distension present, stool unsmooth and scanty. Pulse is deep and slippery; turbid coating not yet cleared. External pathogens resolved, but dampness and stagnation remain. Treatment should harmonize the spleen, eliminate stagnation, and clear heat and dampness. Prescription: Fried Atractylodis Rhizoma (Chao Cangzhu) 6g, Magnoliae Officinalis Cortex (Houpo) 6g, Citri Reticulatae Pericarpium (Chenpi) 4.5g, Honey-fried Glycyrrhizae Radix et Rhizoma (Zhi Gancao) 1.5g, Processed Pinelliae Tuber (Fa Banxia) 6g, Agastaches Rhizoma et Herba (Huoxiang Geng) 6g, Arecae Semen (Binglang) 4.5g, Fried Zanthoxyli Fructus (Chao Zhishi) 3g, Rheum Palmatum (Dahuang, separately packed, added later) 3g, Medicated Leaven (Chao Shenqu) 6g, Fresh Ginger (Shengjiang) 3 slices. Continue taking Xiangsha Pingwei Wan (3 bags), 6g each morning and evening, taken with plain boiled water. Recovered after regulation. (From "Medical Experience of Pu Fuzhou")

Case 2 Patient Cao X, male. Manifestations include aversion to cold and bone/joint soreness. This is due to wind-cold pathogen binding the exterior of the Taiyang channel (Taiyang Biao), preventing proper venting through the interstices (Cou Li). No bowel movement for seven days. Zhang Zhongjing had an example of Guizhi Tang (Cinnamon Twig Decoction) plus Rhubarb. Now following its intent. Prescription: Chuan Guizhi (Cinnamon Twig) 3g (added later), Raw Ephedrae Herba (Mahuang) 3g, Viticis Fructus (Manjingzi) 3g, Notopterygii Rhizoma et Radix (Qianghuo) 9g, Raw Rheum Palmatum (Sheng Jinwen) 3g (crushed into fine powder, taken in divided doses), Pruni Semen (Yuliren) 12g, Armeniacae Paste (Xingren Ni) 18g, Mulberry Silkworm Faeces (Wancansha, wrapped) 9g, Powdered Licorice Root (Fen Gancao) 3g. (From "Zhang Cigong's Medical Cases")

Case 3 Patient Zhu XX, physically frail, suffering from chronic spermatorrhea. Yesterday attended a banquet in a neighboring village, drank heavily and ate until full, returning late at night. Inevitably invaded by wind-cold. Next day felt unwell, no aversion to cold but slight fever, body distension, lower back soreness, dull headache, slight sweating. Self-decocted Congchi Shengjiang Tang (Scallion, Fermented Soybean, and Fresh Ginger Decoction), but illness persisted, spirit listless, bland taste in mouth, no desire to eat. Came for consultation. Pulse is subtle, fine, and weak. Combining with previous symptoms, this belongs to Yang Deficiency Common Cold (Yang Xu Gan Mao). Prescription: Codonopsis Radix (Dangshen) 15g, Cinnamomi Ramulus (Guizhi) 9g, Wine-processed Paeoniae Radix Rubra (Jiu Shaoyao) 9g, Glycyrrhizae Radix et Rhizoma (Gancao) 9g, Fresh Ginger (Shengjiang) 4.5g, Aconiti Lateralis Radix Praeparata (Fuzi) 9g, Jujubae Fructus (Dazao) 5 pieces. Instructed to take 3 doses then re-evaluate. On follow-up, all symptoms disappeared, appetite slightly recovered, but spirit still listless, pulse still weak/faint. Indicates severe decline of Yang Qi, still suitable for warming and tonifying. Prescribed Fuzi Tang (Aconite Decoction) plus Morindae Officinalis Radix (Bajitian), Lycii Fructus (Gouqi), Cervi Cornu Colla (Lujiao), and Pyracanthae Semen (Luba) among other kidney-tonifying items.

(Zhao Shouzhen: "Memories of My Medical Practice")

Case 4 Patient Qian X, male, 39 years old. Half a year ago suffered several episodes of common cold. After recovery, still experienced daily afternoon low-grade fever, not very high, around 38°C, with occasional sweating. ... Repeatedly used Western antibiotics like Penicillin and Streptomycin, and Chinese medicines including Huanglian Jiedu Tang (Coptis Decoction for Detoxification), Baihu Tang (White Tiger Decoction), Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), Qinghao Biejia Tang (Artemisia Annua and Turtle Shell Decoction), Longdan Xiegan Tang (Gentian Liver-Draining Decoction), Angong Niuhuang Wan (Antipyretic Pill), Zixue Dan (Purple Snow Pill), as well as Yinqiao San (Honeysuckle and Forsythia Powder), Jingfang San (Schizonepeta and Saposhnikovia Powder) etc., all without effect. ... Appetite also poor, tongue red/crimson and dry mouth, pulse deep and wiry, frequent sensation of qi rushing upward rapidly, strong resistance upon heavy pressure. Synthesizing symptoms and pulse, carefully reviewing past condition and prescriptions, it seems like recurrent common colds leaving residual pathogens inside, lingering between Qi and Blood meridians, not deeply invading organs. Thus hard to diagnose via standard checks. Observing afternoon fever, sweat traces, tongue appearance, pulse shape, and resistance, it is known that pathogens have been潜伏 (latent) deep inside, showing signs of seeking an exit. Plan to use methods to guide medicine deeper and draw illness out. Trial dose administered, will discuss clearing and aftermath prescription if effective. Moutan Cortex (Danpi), Salviae Miltiorrhizae Radix (Danshen) each 6g, Red and White Paeoniae Radix (Chi/Bai Shaoyao) each 6g, Fine and Fresh Rehmanniae Radix (Xi/Xian Shengdi) each 9g, Artemisiae Annuae Herba (Qinghao) 9g, Lycii Cortex (Digupi) 9g, Black Schizonepetae Spica (Hei Jiesui) 9g, Lemna Minoris Herba (Fuping) 6g, Sojae Semen Praeparatum (Dadoujuan) 24g, Gardeniae Fructus (Shanzhizi) 9g, Akebiae Caulis (Mutong) 4.5g, Stellariae Radix (Yinchaihu) 4.5g, Scutellariae Radix (Pian Huangqin) 9g. Additionally: Antelopis Cornu (Lingyangjiao) 1.8g, Bovis Calculus (Niuhuang) 0.6g, ground together into fine powder, taken in divided doses. Second Consultation: Previous medicine taken for 2 doses, slight sweating, dark urine, significant reduction in fever, although tidal fever occurs, no longer fixed to afternoon, irritability gone, desire to eat returned. Proceed with nourishing Yin, preserving fluids, clearing residual heat to reduce remaining pathogens and consolidate results. White Reed Rhizome (Baimaowugen), Phragmitis Rhizome (Weigen) each 12g, Raw Rehmanniae Radix (Sheng Dihuang) 15g, Testudinis et Testudinis Carapax et Plastrum (Biejia) 15g, Ophiopogonis Tuber (Cun Maidong) 9g, Aquae Calcis (Han Shuishí) 12g (mixed with滑石 Hua Shi 15g, wrapped in cloth), Anemarrhenae Rhizoma (Baiwei) 6g, Red Poria (Chi Ling), White Paeoniae Radix (Shaoyao) each 9g, Coptidis Rhizoma (Huanglian) 4.5g, Cicadae Periostracum (Chanyi) 4.5g, Prepared Scrophulariae Radix (Run Yuan Shen) 12g, Powdered Moutan Cortex (Fen Danpi) 9g, Anemarrhenae Rhizoma (Zhimu) 6g, Fried Aurantii Fructus (Chao Zhike) 6g, Polygoni Multiflori Caulis (Nan Huafen) 12g, Grass Tip (Cao Shao) 3g. Third Consultation: Taken continuously for 5 doses, fever gradually subsided completely, pulse calm, body cool, urine changed from dark to yellow to clear and abundant, no residual pathogens lingering. However, Qi and Blood deficiency needs rapid compensation. Establish pill prescription for aftermath. Raw and Fried Rehmanniae Radix (Sheng/Shu Di) each 30g, Codonopsis Radix (Dangshen) 60g, Old Donkey-hide Gelatin (Ch E'jiao) 60g, Atractylodis Macrocephalae Rhizoma (Baizhu) 60g, Angelicae Sinensis Radix (Danggui Shen) 30g, American Ginseng (Yangshen) 30g, Schisandrae Fructus (Wuweizi) 30g, Polygonati Odorati Rhizoma (Yuzhu) 60g, Wine-processed Hang Paeoniae Radix (Jiu Hang Shao) 60g, Testudinis Carapax et Plastrum (Guiban) 60g, Sweet Lycii Fructus (Gan Gouqi) 60g, Salviae Miltiorrhizae Radix (Danshen) 60g, Astragali Membranacei Radix (Mian Huangqi) 90g, Asparagi Tuber (Tiantong) 30g, Cloud Poria (Yunling Fu) and Spirit Poria (Fushen) each 30g, Honey-fried Glycyrrhizae Radix et Rhizoma (Zhi Cao) 30g. Right-side medicines ground into fine powder, refined honey made into pills, weighing 9g each, take 1 pill morning and evening, washed down with plain boiled water.

(Compiled by Shi Zhimo et al.: Shi Jinmo's Medical Cases, "Chinese Journal of Traditional Medicine" 5:328, 1958).

Case 5 Patient Cui X, male, 40 years old. Both pulses fine, weak, and powerless. Physical aversion to cold, especially on the back. Wheezing and counterflow qi for nearly one year, worsening in winter. Cough, tongue coating white and greasy, tongue body pink-red. No desire to drink water. Pain inside left hypochondrium, unable to lie on the left side. Bowel and bladder functions normal. Disease belongs to common cold transmitting inward, combining with fluid retention (Yin) staying in the hypochondrium. Tentatively using warming and moving to transform fluid retention, deeply fearing swelling of feet and severe asthma. Tender Peucedani Radix (Qianhu) 3g (boiled thoroughly in Mahuang Tang, remove Mahuang), Coarse Cinnamomi Ramulus (Guizhi) 1.5g (fried with Red Paeoniae Radix/Chi Shaoyao 6g), Home Perillae Fructus (Su Zi) 4.5g, White Mustard Seed (Bai Jiezi) 1.5g, Mulberry Root Bark (Sangbaipi) 9g, Sweet Descurainiae/Semen Lepidii (Tinglizi) 3g (roasted), Large Red Dates (Dazao) 7 pieces, Processed Pinelliae Tuber (Fa Banxia) 9g (beaten with Powdered Licorice/Fencao 3g), New Crimson Shavings (Xintiao Xie) 4.5g, Raw Haishijing (Sheng Haishi) 15g (decoct first), Bitter Apricot Kernel (Ku Xingren) 9g, Jian Xie (likely Ze Xie/Acorus mix or specific local term, here translated as Jian Xie) 9g. Additionally: White Cardamom Seed (Baikou Ren) 0.6g, True Amber (Zhen Hupo) 0.9g. Grind all flavors together, fill into capsules, divide into two doses, send down with medicinal juice. Second Consultation: Back cold reduced, unable to lie on left side, wheezing calming, cough reduced, tongue coating self-greasy and thick, body crimson. Disease prolonged, prevent increased fever, plan to modify previous method. Coarse Cinnamomi Ramulus (Guizhi) 1.5g (fried with Chi Shaoyao 4.5g), Tender Peucedani Radix (Qianhu) 3g, Mulberry Root Bark (Sangbaipi) 9g, Home Perillae Fructus (Su Zi) 4.5g, Sweet Tinglizi 3g (roasted), Xiaoyao Wan (Free and Easy Wanderer Pills) 15g (wrapped), Fresh Loquat Leaf (Xin Pipaye) 9g (wrapped), Inula Flower (Xuanfuhua) 6g (wrapped), New Crimson Shavings (Xinjiao Xie) 6g, Processed Pinelliae Tuber (Fa Banxia) 9g (beaten with Fencao 3g), Bitter Apricot Kernel (Ku Xingren) 9g, Fresh Roasted Ginger (Xian Weijiang) 2.1g, Large Red Dates (Dazao) 7 pieces, Jian Xie 9g, Scorched Coix Seed (Jiao Yimi) 9g. Third Consultation: Cough reduced, worse during Yin-Mao hours (5-7 AM), tongue coating self-greasy and thick, both pulses fine and weak, water in left hypochondrium transformed, pain stopped. Disease long-standing causing Qi stagnation, fluid retention inside, plan to use mild warming to transform fluid. Lightly processed Aconite Slice (Dan Fupian) 2.1g (roasted thoroughly in flour paste), Coarse Cinnamomi Ramulus (Guizhi) 1.5g (honey-fried), Raw Aster Tataricus Root (Sheng Ziwan) 3g, Processed Pinelliae Tuber (Fa Banxia) 9g (beaten with Fencao 3g), Processed Citri Reticulatae Pericarpium (Zhifa Chenpi) 4.5g, Bitter Apricot Kernel (Ku Xingren) 9g, Fresh Loquat Leaf (Xin Pipaye) 9g (wrapped), Xiangsha Zhiju Wan (Costus and Amomum Pill) 15g (wrapped), Fresh Roasted Ginger (Xian Weijiang) 2.1g, Large Red Dates (Dazao) 7 pieces, Raw and Fried Barley and Millet Sprouts (Sheng Shu Guyamai) each 9g, Jian Xie 9g, Winter Melon Seed (Dongguazi) 30g, Elephant Bellflower Bulb (Xiang Beimu) 12g, Poria with Skin (Lian Pi Ling) 12g. Fourth Consultation: Cough stopped, no cough at night, only shortness of breath and slight asthma upon labor, tongue coating white and greasy, both pulses fine and weak. Fluid retention transformed, Qi and Blood both deficient after disease, should follow Jingui method with modifications. Whole Angelicae Sinensis Radix (Quang Danggui) 9g (fried with Coarse Guizhi 1.5g), Processed Pinelliae Tuber (Fa Banxia) 9g (beaten with Fencao 3g), Honey-fried Citri Reticulatae Pericarpium (Zhi Chenpi) 4.5g, Sweet Apricot Kernel (Tian Xingren) 9g, Fresh Roasted Ginger (Xian Weijiang) 2.1g, Large Red Dates (Dazao) 10 pieces, Xiangsha Liujunzi Wan (Costus and Amomum Six Gentlemen Pill) 15g (wrapped), Lightly Processed Aconite Slice (Dan Fupian) 3g (roasted in flour paste), Lu Codonopsis Radix (Lu Dangshen) 9g (rice-fried), Raw and Fried Wheat and Barley Sprouts (Sheng Shu Maigu Ya) each 9g, Luffa Sponge (Sigualuo) 9g, Jian Xie 9g.

(Compiled by Feng Yangzeng, Wang Fengchun's Medical Cases, "Chinese Journal of Traditional Medicine" 8:549, 1958).

Case 6 Male, 67 years old. Frequently suffers from common colds, often consecutive every one or two months. Symptoms only show nasal congestion, cough with phlegm, excessive sweating on head and face, slight fatigue. Previously took Yupingfeng San (Jade Windscreen Powder), no effect for half a month. Used Guizhi Tang (Cinnamon Twig Decoction) plus Astragalus. After taking, felt physical strength increase, common colds subsequently reduced. Same herb Astragalus used in this case yielded different results... Guizhi Tang harmonizes Ying and Wei (Nutritive and Defensive levels), adding Astragalus consolidates the exterior, strengthening Zheng Qi (Upright Qi) to resist pathogens. Yupingfeng San treats deficient persons receiving pathogens, where pathogens linger unresolved, aiming to boost Qi to expel pathogens. Generally believed that Astragalus and Saposhnikovia root have mutual inhibition/enhancement properties; Astragalus with Saposhnikovia does not worry about trapping pathogens; Saposhnikovia with Astragalus does not worry about scattering the exterior. Actually, dispersion contains tonification, tonification contains dispersion, which is not equal to supporting upright Qi and consolidating the exterior. Precisely because of this, if there is originally no exterior pathogen, frequently taking Saposhnikovia for dispersion actually gives opportunities for external pathogens to invade.

(Qin Bowei "Qianzhai Medical Lectures")

[Commentary] Common cold is one of the common diseases. Caused by invasion of wind pathogens and viruses. Clinically divided into Wind-Cold and Wind-Heat types. Wind-Cold common cold can refer to Shanghan (Cold Damage) exterior syndrome treatment methods; early stage of Wind-Heat common cold is similar to Wei (Defensive) level syndrome treatment in Warm Diseases, not listing medical cases one by one here. The cases selected here are those with special complications or difficult to treat, for reference in clinical practice.

Case 1 Common cold for two weeks, still fever, yellow greasy coating, due to dampness being sticky and lingering. Syndrome is common cold complicated with dampness. Dr. Pu, in treatment, based on the principle from Nei Jing "When pathology originates externally and becomes severe internally, treat the exterior first then regulate the interior," initial treatment focused on dispersing and resolving, second consultation dispersing/resolving combined with regulating intestines/stomach, third consultation external pathogens resolved, dampness/stagnation not fully cleared, thus treating with harmonizing spleen, promoting dampness, eliminating stagnation method. The hierarchy and logic of prescription formulation are relatively clear.

Case 2 Wind-Cold common cold, external pathogens binding the exterior, no bowel movement for seven days, exterior and interior both excess, thus using simultaneous releasing of exterior and interior method. Because of physical cold and bone soreness, further using Ephedra and Notopterygium to strengthen exterior-releasing power; Prunus seed and Apricot kernel moisten intestines; small amount of raw Rhubarb crushed into fine powder taken in divided doses, taking advantage of its mild purgative effect, learning from ancient prescription intent without being bound by established formulas.

Case 3 Constitutionally frail, frequent spermatorrhea, root of Kidney deficiency. After receiving external pathogens, symptoms show slight fever, slight sweating, pulse subtle/fine/weak, indicating Yang Deficiency Exterior Invasion (Yang Xu Wai Gan). Initially taking Congchi Shengjiang Tang, purely dispersing, further damaging Yang Qi, symptoms worsened. Then using Codonopsis, Aconite, Ginger, Cinnamon together, warming Yang and dispelling cold, supporting upright Qi and expelling pathogens, three doses and all symptoms resolved.

Case 4 Syndrome belongs to residual pathogens lingering internally after common cold. Patient suffered common cold several times half a year ago, after recovery low-grade fever did not subside, occasional sweating, syndrome caused by deficiency of upright Qi and lingering pathogens. Dr. Shi grasped the sign that deeply latent pathogens seek an exit, treatment should guide according to momentum, using method of drawing illness out, fever significantly reduced. Subsequently nourishing Yin and preserving fluids, clearing residual heat, aiming to remove residual pathogens. Once residual pathogens removed, established pill prescription to tonify Qi and Blood to prevent future troubles.

Case 5 External pathogen invaded inward, combining with fluid retention staying in hypochondrium, hence showing physical cold, wheezing, cough, hypochondriac pain, no desire to eat, both pulses fine/weak/powerless. Due to physical cold, know exterior pathogen not cleared. Prescription within warming/moving/fluid-transforming method contains meaning of releasing exterior/expelling pathogens. After medication, cold dispersed, fluid transformed. Subsequently using warming/transforming fluid/regulating Qi-Blood method for aftermath. Although condition complex, Dr. Wang's prescription and drug selection show unique ingenuity.

Case 6 Introduces Dr. Qin's experience in prevention and treatment of frequent common colds in deficient persons, having both practical examples and theoretical analysis, concise and profound.

(II) Internal Injury Fever

(High Fever)

Case 1 Patient Wang XX, male, 11 years old. High fever continued for over a month, highest temperature reached 42°C, no effect seen after treatment with various antibiotics and antipyretics. Symptoms show heat intensity rising twice daily after noon, slightly decreasing next morning. Although temperature above 40°C, patient feels no heat. Pulse wiry and choppy, tongue color dark, face lacks heat color, right hypochondriac pain fixed/unmoving, mouth not thirsty, bowel movements self-regulated, urination smooth. Observing high temperature but feeling no heat, indicates no exterior heat; mouth not thirsty, stool not constipated, indicates no interior heat. Pulse wiry/choppy, fixed hypochondriac pain, dark tongue quality, indicates Blood Stasis Fever, evidence sufficient. Suggest using invigorating Blood and removing stasis method, formula using Xuefu Zhuyu Tang (Blood Mansion Stasis-Removing Decoction) modified. Angelicae Sinensis Radix Tail (Danggui Wei), Red Paeoniae Radix (Chi Shao), Ligusticum Chuanxiong Rhizome (Chuanxiong), Safflower (Xihonghua), Fried Aurantii Fructus (Chao Zhike), Bupleuri Radix (Chaihu), Processed Myrrha (Zhi Moyao) each 4.5g, Clean Peach Kernel (Jing Taoren), Achyranthes Bidentatae Radix (Chuan Niuxi), Dry Earthworm (Gan Dilong) each 6g, Dry Rehmanniae Radix (Gan Shengdi) 9g, Platycodonis Radix (Jiegeng), Glycyrrhizae Radix et Rhizoma (Gancao) each 3g. Take continuously for one week, occasionally adding Raw Turtle Shell (Sheng Biejia), Raw Oyster Shell (Sheng Muli), or Corydalis Rhizoma (Yanhusu), Hematites (Xuexue), afternoon fever showed slight downward trend. Again using original formula assisting with Xiaojin Dan (Little Golden Pill), one pill morning and evening. Two weeks later fever dropped, pain reduced; three weeks later afternoon fever low, hypochondriac pain disappeared, stool once saw black feces, dark tongue slightly reduced, pulse fine, changed to one dose every two days, slowing the dosage to continue harmonizing, ensuring stasis fully removed while upright Qi not injured. Twenty days later follow-up, fever gone for over two weeks, stopped medication for one week, patient weight increased from 29.5kg to 31kg, tongue color fresh red not dark, pulse gentle not wiry/choppy, spirit and physical strength restored. (From "Pu Fuzhou's Medical Cases")