Zhao, suffered from warm disease. The [previous] physician prescribed Cinnamon Twig Decoction (gui zhi tang), which led to a subjective sensation of heat, thirst, and labored breathing. He then prescribed [Minor] Bupleurum Decoction (xiao chai hu tang) which made the heat especially worse and For the past six or seven she had increased wheezing and cough, repeatedly vomited up phlegm drool and had been unable to lie down. Her physician then said that her disease had become very severe and that he lacked the skill to address it. When her family learned of this they were alarmed and flustered. Younger brother Yi fang was dispatched to send for a physician.
When I arrived, I saw that the patient was experiencing hasty wheezing and shoulder breathing and spontaneous sweating from his head. This was heat in both the exterior and interior. His tongue coat was dark grey and his tongue was so contracted that he was unable to speak. I immediately took his pulse and found it floating, rapid, and strong, yet extremely empty upon stronger pressure. Because of this I thought that this was a pattern of extreme yang ming heat where the yin aspect was about to be exhausted. It actually was a worsening pattern from incorrect administration of (gui zhi tang) and Minor Bupleurum Decoction (xiao chai hu tang).
I immediately gave her White Tiger and Ginseng Decoction (bai hu jia ren shen tang), substituting Dioscorea Radix (shan yao) for the nonglutinous rice (jing mi) [1]. In addition, I substituted Scrophulariae Radix (xuan shen) for Anemarrhenae Rhizoma (zhi mu). She took two packets of the formula in succession and her thirst was relieved, and her wheezing stopped. Her pulse was no longer floating and rapid although it was still strong. Her tongue stretched out and she was able to speak. Her phlegmatic cough was no longer intense and appeared to be milder. He then continued with a modification of Follow the Dragon Decoction (cong long tang), omitting the Perillae Fructus (su zi) and adding 4 qian of Ginseng Radix (ren shen) and 8 qian of Ophiopogonis Radix (mai men dong).
After taking 7 packets she was completely cured.
赵××，患温病。医者投以桂枝汤，觉热渴气促。又与柴胡汤，热尤甚，且增喘嗽，频吐痰涎，不得卧者六七日。医者谓病甚重，不能为矣。举家闻之，惶恐无措。伊芳弟××延为延医。急投以白虎加人参以山药代粳米汤，更以玄参代知母。连服两剂，渴愈喘止，脉不浮数，仍然有力，舌伸能言，而痰嗽不甚见轻。继投以从龙汤，去苏子，加人参四钱，天冬八钱，服七剂全愈
Follow the Dragon Decoction (cong long tang) contains:
- Fossilia Ossis Mastodi (long gu) (not calcined, crushed)30 grams
- Ostreae Concha (mu li) (not calcined, crushed)30 grams
- Paeoniae Radix alba (bai shao)15 grams
- purified Pinelliae Rhizoma (qing ban xia)12 grams
- Dry-fried Perillae Fructus (chao su zi) (crushed)12 grams
- Dry-fried Arctii Fructus (chao niu bang zi)9 grams
Charles Chace and I provided commentary to the case in the article Tracing The Dragon, published in the RCHM Journal Autumn 2011, Vol. 8, No. 2.
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