Chapter 6: Warm Disease: Pulse, Signs, and Treatment
CHAPTER 6: WARM DISEASE PULSE, SYNDROME, AND TREATMENT
(Taiyang disease, with fever, thirst, and no aversion to cold, is warm disease. If after sweating the body is scorching hot, it is called wind-warmth. In wind-warmth disease, the pulse is floating in both yin and yang positions, spontaneous sweating occurs, the body is heavy, there is excessive sleepiness, the nasal breathing must be snoring, and speech is difficult. If purgation is used, urination becomes unsmooth, the eyes stare straight ahead, and there is incontinence of urine and stool; if fire therapy is used, mild cases show a yellow tinge, severe cases resemble convulsions with constant spasms; if fire fumigation is used, one mistaken treatment can still delay death, but a second mistaken treatment shortens life.) Cited from Volume 6, "Differentiation of Taiyang Disease Pulse, Syndrome, and Treatment, Part 1."
Warm disease has three types: spring warmth, autumn warmth, and winter warmth. These all arise from latent qi and manifest as disease. Summer disease is summerheat disease, not warm disease.
In winter, injury from cold pathogen, the cold qi lurks in the lesser yin, and in spring it breaks out as warm disease, called spring warmth.
In summer, injury from dampness pathogen, the damp qi lurks in the greater yin, and in autumn when dryness qi prevails, it breaks out as warm disease, called autumn warmth.
When the climate arrives when it should not, with severe cold in early winter, dryness qi contracts inward, its qi lurks in the reverting yin. After the winter solstice, when the weather should be cold but instead is warm, it breaks out as warm disease, called winter warmth.
Warm disease contracted in spring or autumn is normal; warm disease contracted in winter is abnormal. When winter should be cold but is instead very warm, this is an untimely accumulation of pathogenic qi. It does not manifest at the time but breaks out in spring, called great warmth. This is because in winter the essential qi cannot be stored, qi loses its normal state. In spring, when yang qi disperses outward, the two qi clash and cause severe disease. If physicians do not understand the disease source and treat accordingly, they mistakenly cause the corpse qi to spread, eventually forming epidemic disease.
When suffering spring warmth disease, the pathogenic qi is in the upper region. There is headache, dry throat, fever, blurred vision, and in severe cases, delirious speech. The pulse is string-like and tense. It is treated primarily with Xiao Chai Hu Jia Huang Lian Mu Dan Tang.
Xiao Chai Hu Jia Huang Lian Mu Dan Tang Formula
Bupleurum (Chai Hu) half a jin, Scutellaria (Huang Qin) 3 liang, Ginseng (Ren Shen) 3 liang, Trichosanthes root (Gua Lou Gen) 4 liang, Coptis (Huang Lian) 3 liang, Moutan bark (Mu Dan Pi) 4 liang, Licorice (Gan Cao) 3 liang (roasted), Fresh ginger (Sheng Jiang) 3 liang, Jujubes (Da Zao) 12 pieces (split).
These nine herbs, use 1 dou 2 sheng of water, decoct to obtain 3 sheng, remove the dregs, take 1 sheng warm, three times daily.
When suffering autumn warmth disease, the pathogenic qi is in the middle region. There is fever, thirst, heat pain in the abdomen, diarrhea with pus and blood in the stool. The pulse is large and short-rough. It is treated primarily with Di Huang Zhi Mu Huang Lian E Jiao Tang. If there is no pus and blood in the stool, treat with Bai Hu Tang.
Di Huang Zhi Mu Huang Lian E Jiao Tang Formula
Rehmannia (Di Huang) 8 liang, Anemarrhena (Zhi Mu) 4 liang, Coptis (Huang Lian) 3 liang, Ass-hide glue (E Jiao) 1 liang.
These four herbs, use 1 dou of water, decoct until the rice is cooked, when the decoction is done remove the dregs, take 1 sheng warm, three times daily.
When suffering winter warmth disease, the pathogenic qi is in the lower region. There is fever, abdominal pain pulling the lower abdomen, dry pain in the throat at midnight, the pulse is deep and firm, sometimes large and rapid. It is treated primarily with Shi Gao Huang Lian Huang Qin Gan Cao Tang. If there has been no bowel movement for six or seven days, treat with Da Huang Huang Qin Di Huang Mu Dan Tang.
Shi Gao Huang Lian Huang Qin Gan Cao Tang Formula
Gypsum (Shi Gao) half a jin (broken, wrapped in cotton), Coptis (Huang Lian) 3 liang, Scutellaria (Huang Qin) 4 liang, Licorice (Gan Cao) 2 liang.
These four herbs, use 1 dou of water, decoct to obtain 3 sheng, take 1 sheng warm, three times daily.
Da Huang Huang Qin Di Huang Mu Dan Tang Formula
Rhubarb (Da Huang) 4 liang, Scutellaria (Huang Qin) 3 liang, Rehmannia (Di Huang) 4 liang, Moutan bark (Mu Dan Pi) 3 liang.
These four herbs, use 1 dou 2 sheng of water, decoct to obtain 2 sheng, remove the dregs, take warm in two divided doses. After the bowels move, stop taking the medicine.
When suffering warm disease, with headache, red complexion, fever, spasms of the hands and feet, the pulse floating, string-like, and rapid, it is called wind-warmth. It is treated primarily with Huang Lian Huang Qin Zhi Zi Mu Dan Shao Yao Tang.
Huang Lian Huang Qin Zhi Zi Mu Dan Shao Yao Tang Formula
Coptis (Huang Lian) 3 liang, Scutellaria (Huang Qin) 3 liang, Gardenia fruit (Zhi Zi) 14 pieces (split), Moutan bark (Mu Dan) 3 liang, Peony (Shao Yao) 3 liang.
These five herbs, use 6 sheng of water, decoct to obtain 3 sheng, remove the dregs, take 1 sheng warm, three times daily.
When suffering warm disease, the patient usually has dampness pathogen. There is fever, dry lips, diarrhea, heat pain in the abdomen, the pulse is large and rapid. It is called damp-warmth. It is treated primarily with Zhu Ling Jia Huang Lian Mu Dan Tang.
Zhu Ling Jia Huang Lian Mu Dan Tang Formula
Polyporus (Zhu Ling) 1 liang, Poria (Fu Ling) 1 liang, Ass-hide glue (E Jiao) 1 liang, Alisma (Ze Xie) 1 liang, Talcum (Hua Shi) 1 liang, Coptis (Huang Lian) 1 liang, Moutan bark (Mu Dan) 1 liang.
These seven herbs, use 4 sheng of water, first decoct the six herbs (excluding E Jiao) to obtain 2 sheng, remove the dregs, add the ass-hide glue and melt it, take warm in two divided doses.
When suffering warm disease, with red tongue, dry throat, vexing heat in the heart, the pulse is tense and rapid, surging up to the inch opening, this is warm pathogen invading the heart. It is treated primarily with Huang Lian Huang Qin E Jiao Gan Cao Tang.
Huang Lian Huang Qin E Jiao Gan Cao Tang Formula
Coptis (Huang Lian) 1 liang, Scutellaria (Huang Qin) 1 liang, Ass-hide glue (E Jiao) 1 liang, Licorice (Gan Cao) 1 liang.
These four herbs, use 1 dou of water, first decoct the three herbs (excluding E Jiao) to obtain 4 sheng, remove the dregs, add the ass-hide glue and melt it, take warm in three divided doses.
When suffering warm disease, with thirst, cough, unceasing nosebleed, the pulse is floating, rapid, and large, this is warm pathogen invading the lung. It is treated primarily with Huang Qin Shi Gao Xing Ren Gan Cao Tang.
Huang Qin Shi Gao Xing Ren Gan Cao Tang Formula
Scutellaria (Huang Qin) 3 liang, Gypsum (Shi Gao) half a jin (broken), Apricot kernel (Xing Ren) 14 pieces (remove skin and tip), Licorice (Gan Cao) 1 liang (roasted).
These four herbs, use 5 sheng of water, decoct to obtain 3 sheng, remove the dregs, take 1 sheng warm, three times daily.
When suffering warm disease, with fever, water qi below the waist, heat pain in the lower abdomen, urine red and frequent, the pulse is tense and rapid descending to the cubit region, this is warm pathogen shifting to the kidney. It is treated primarily with Di Huang Huang Bai Qin Pi Fu Ling Ze Xie Tang.
Di Huang Huang Bai Qin Pi Fu Ling Ze Xie Tang Formula
Rehmannia (Di Huang) 6 liang, Phellodendron (Huang Bai) 3 liang, Ash bark (Qin Pi) 2 liang, Poria (Fu Ling) 3 liang, Alisma (Ze Xie) 1 liang.
These five herbs, use 8 sheng of water, decoct to obtain 3 sheng, remove the dregs, take 1 sheng warm, three times daily.
When suffering great warmth disease, with fever, dizziness, blurred vision, withered teeth, dry lips, delirious speech, unconsciousness, complexion alternating green and red, the pulse is tense, large, and rapid. It is treated primarily with Da Huang Xiang Pu Tang. If the throat is obstructed making swallowing difficult, needle the Shao Shang point to cause bleeding. If the pulse is sometimes sparse and sometimes frequent, and the eyes are sunken inward, death will occur.
Da Huang Xiang Pu Tang Formula
Rhubarb (Da Huang) 4 liang, Typha (Xiang Pu) 1 liang, Coptis (Huang Lian) 3 liang, Rehmannia (Di Huang) half a jin, Moutan bark (Mu Dan Pi) 6 liang.
These five herbs, use 1 dou of water, decoct to obtain 6 sheng, remove the dregs, take 2 sheng warm, three times daily.
In warm disease, if after using purgation the stool becomes thin, it should resolve naturally. If after using purgation the diarrhea does not stop, there will surely be abdominal distension. It is appropriate to treat with Fu Ling Bai Zhu Gan Cao Tang.
Fu Ling Bai Zhu Gan Cao Tang Formula
Poria (Fu Ling) 4 liang, Atractylodes (Bai Zhu) 3 liang, Licorice (Gan Cao) 1 liang (roasted).
These three herbs, use 8 sheng of water, decoct to obtain 3 sheng, remove the dregs, take 1 sheng warm, three times daily.
Wind-warmth disease arises because the patient usually has heat and additionally contracts wind pathogen, thus forming the disease. The pulse is floating, string-like, and rapid. If there is no headache, treat primarily with Gui Zhi Qu Gui Jia Huang Qin Mu Dan Tang. If it is latent qi disease with warmth, and sweating is mistakenly induced, then there will be great heat, vexation, dry lips, red eyes, or nosebleed, or vomiting, or deafness, and the pulse is large and rapid. It is appropriate to use Bai Hu Tang. If the interior excess is severe, it is appropriate to use Cheng Qi type formulas. If it reaches ten or more days and the pathogen enters the interior, it is appropriate to use Huang Lian E Jiao Tang. How does one know the pathogen has entered the interior? Because the pulse is deep and rapid, and the heart is vexed so that the patient cannot lie down, thus it is known.
Gui Zhi Qu Gui Jia Huang Qin Mu Dan Tang Formula
Peony (Shao Yao) 3 liang, Licorice (Gan Cao) 2 liang (roasted), Fresh ginger (Sheng Jiang) 3 liang (cut), Jujubes (Da Zao) 12 pieces (split), Scutellaria (Huang Qin) 3 liang, Moutan bark (Mu Dan Pi) 3 liang.
These six herbs, use 8 sheng of water, decoct to obtain 3 sheng, remove the dregs, take 1 sheng warm, three times daily.
Bai Hu Tang Formula (See above)
Da Cheng Qi Tang Formula
Rhubarb (Da Huang) 4 liang (washed in wine), Magnolia bark (Hou Po) half a jin (processed), Unripe bitter orange (Zhi Shi) 5 pieces (roasted), Mirabilite (Mang Xiao) 3 ge.
These four herbs, use 1 dou of water, first decoct the Magnolia bark and Unripe bitter orange, two herbs, to obtain 5 sheng, remove the dregs, add the rhubarb and decoct again to obtain 2 sheng, remove the dregs, add the mirabilite, then simmer over a low fire for one or two boils, take warm in two divided doses. After purgation is obtained, the remaining medicine should not be taken.
Xiao Cheng Qi Tang Formula
Rhubarb (Da Huang) 4 liang (washed in wine), Magnolia bark (Hou Po) 2 liang (processed), Unripe bitter orange (Zhi Shi) 3 large pieces (roasted).
These three medicinals, use four sheng of water, decoct to obtain one sheng and two ge, remove the dregs, take warm in two portions. After the first dose, there should be a bowel movement; if there is no bowel movement, finish the entire amount. If there is a bowel movement, do not take the rest.
Tiao Wei Cheng Qi Tang Formula
Da Huang four liang (washed in wine) Gan Cao two liang (roasted) Mang Xiao half a jin
These three medicinals, use three sheng of water, decoct Da Huang and Gan Cao until one sheng remains, remove the dregs, add Mang Xiao, then heat over a low flame until it boils, take warm in small amounts.
Huang Lian E Jiao Tang Formula
Huang Lian four liang Shao Yao two liang Huang Qin two liang E Jiao three liang Ji Zi Huang three pieces
These five medicinals, use six sheng of water, first decoct Huang Lian, Shao Yao, and Huang Qin to obtain two sheng, remove the dregs, add E Jiao and melt it, allow to cool slightly, then add Ji Zi Huang, stir to make uniform, take warm, seven ge per serving, three servings per day.
When suffering from warm disease, if treatment is not proper and the disease lingers and transfers to the three burners: if in the upper burner, there is stiffness of the tongue and clouded consciousness; it is appropriate to use Zhi Zi Tang. If in the middle burner, there is abdominal pain and diarrhea, pain after diarrhea, and dry lips and mouth; it is appropriate to use Bai Hu Jia Di Huang Tang. If in the three burners, there is heat below the lower back, blackening of the teeth, and dry throat; it is appropriate to use Bai He Di Huang Mu Dan Pi Ban Xia Fu Ling Tang.
Zhi Zi Tang Formula
Zhi Zi sixteen pieces (split) Huang Qin three liang Ban Xia half a sheng (washed) Gan Cao two liang
These four medicinals, use four sheng of water, first decoct Zhi Zi to obtain two and a half sheng, remove the dregs, add the other three medicinals, decoct to obtain one sheng, take warm in two portions.
Bai Hu Jia Di Huang Tang Formula
Zhi Mu six liang Shi Gao one jin (broken) Gan Cao two liang (roasted) Jing Mi six ge Di Huang six liang
These five medicinals, use one dou of water, decoct until the rice is cooked, then the decoction is finished, remove the dregs, take warm, one sheng per serving, three servings per day.
Bai He Di Huang Mu Dan Pi Ban Xia Fu Ling Tang Formula
Bai He seven pieces (split) Di Huang Zhi one sheng Mu Dan Pi six liang Ban Xia one sheng (washed) Fu Ling four liang
These five medicinals, first wash Bai He with water, soak overnight, until white foam emerges, pour off the water, then separately use two sheng of water, decoct to obtain one sheng, remove the dregs; then separately use four sheng of spring water, decoct Mu Dan Pi, Ban Xia, and Fu Ling to obtain two sheng, remove the dregs; add Di Huang Zhi and the Bai He decoction, then place over heat, bring to a boil, take warm, one sheng per serving, three servings per day.