Her tongue was Red, redder on the sides and tip with a yellow coating. Her pulse was Wiry on
the left side.
Diagnosis This asthma is not allergic but of the late-onset type and it is very
clearly related to a Liver disharmony. Stagnation of Liver-Qi, over a
long period of time, has turned into Liver-Fire and this has obstructed
the descending of Lung-Qi in the chest giving rise to asthma. The
presence of Liver-Fire is obvious from the Red tongue body with redder
sides.
The thick-yellow nasal discharge is a case of rhinorrhoea (Bi Yuan)
from Liver and Gall-Bladder Fire rising to the nose.Treatment principle Move Liver-Qi, clear Liver-Fire, restore the descending of Lung-Qi,
calm the Mind and settle the Ethereal Soul.
Herbal treatment This patient was treated only with herbs. The formula chosen was a
variation of Si Ni San Four Rebellious Powder which moves Liver-Qi
and Xie Bai San Draining Whiteness Powder which clears Lung-Heat
and restores the descending of Lung-Qi. Si Ni San was chosen because
it was Liver-Qi stagnation which led to Liver-Fire. The method to be
adopted therefore is not to drain Liver-Fire with bitter and cold herbs,
but to clear Liver-Fire with pungent herbs which open Qi and bitter
herbs which drain. A further reason for choosing Si Ni San was because
the patient had cold hands when under emotional strain, one of the
symptoms of this formula.
The formula used was:
Chai Hu Radix Bupleuri 6 g
Bai Shao Radix Paeoniae albae 9 g
Gan Cao Radix Glycyrrhizae uralensis 4.5 g
Zhi Shi Fructus Citri aurantii immaturus 6 g
Hou Po Cortex Magnoliae officinalis 4.5 g
Shan Zhi Zi Fructus Gardeniae jasminoidis 4 g
Sang Bai Pi Cortex Mori albae radicis 6 g
Di Gu Pi Cortex Lycii chinensis radicis 4 g
Su Zi Fructus Perillae frutescentis 6 g
Xing Ren Semen Pruni armeniacae 6 g
Suan Zao Ren Semen Ziziphi spinosae 4 g
Yuan Zhi Radix Polygalae tenuifoliae 4 gExplanation Chai Hu, Bai Shao, Gan Cao and Zhi Shi constitute the Si Ni San
which moves Liver-Qi and calms the Mind.
Hou Po, a pungent herb, was added to help to move Qi and open the
chest. It will therefore help breathing and has also a good calming effect