Experience with Mahuang Tang for Summer Influenza
This summer, influenza was rampant, and my teacher's whole family caught it too. First my teacher developed symptoms of a heavy cold, then my teacher's wife, then my teacher's mother. My teacher and his mother were in fairly good shape, but my teacher's wife has the underlying disease of asthma, and every cold is treated as a major event. Other people can use some ready-made medicine such as Ganmao Keli or Ganmao Ling; but once she catches cold, treatment is quite difficult, and if mishandled it may trigger an asthma attack.
Over the years, she has basically been treated by me for external contraction illnesses or asthma attacks, so I know her situation better than others. This time, after she caught influenza back in her hometown, she first took Ganmao Ling on her own; although she sweated somewhat after taking it, the cough was uncontrollable and even worsening. She asked me to prescribe Chinese medicine for her; I first gave her a dose of Sanren Tang.
Sanren Tang was ineffective; the cough increased, she coughed white phlegm, had abdominal distension, wheezing in the throat, a blocked left ear with tinnitus, shortness of breath and wheezing—it seemed another asthma attack was brewing. This influenza first attacked my teacher; after his cold he had headache, sore throat, no sweating with aversion to cold, clear nasal discharge and sneezing. They say the family had done a few days of deep cleaning at home; the weather in Hubei right now is unbearably hot, and when they got tired they used the air conditioner.
Earlier, based on my teacher's condition, I had prescribed him Mahuang Tang: Mahuang 6g, Guizhi 10g, Xingren 6g, Zhigancao 6g. My teacher did not drink it; he does not like decocting Chinese medicine and wanted ready-made medicine, so he doubled the Ganmao Ling on his own; after taking it he sweated successfully, his symptoms gradually eased, and he never drank the Mahuang Tang.
Considering that my teacher's wife's condition before catching cold was the same as my teacher's, except that Ganmao Ling granules were ineffective for her, I finally plucked up the courage to decide to use Mahuang Tang on her in this hot summer. For safety, I first had her take the formula at half dose, and changed raw Mahuang to roasted Mahuang. Prescription: Zhimahuang (roasted ephedra) 3g, Guizhi 6g, Xingren 3g, Zhigancao 3g. That way, even if ineffective, the side effects would be smaller; after all, our ancestors repeatedly emphasized not using Mahuang and Guizhi in spring and summer, and the side effects of Mahuang Tang should not be underestimated.
After taking the medicine, the teacher's wife's cough lessened, but that dramatic immediate relief was not achieved. In TCM, treatment of cold-type diseases has always been immediate; the ideal state is a cure within half a day, so this efficacy is not ideal.
By evening, my teacher's wife even began to fever, temperature 37.7°C, and later the temperature gradually rose to 37.8, 38.4 and 38.7 degrees. The teacher's wife asked whether she could use the prescription of Mahuang 6g, Guizhi 10g, Xingren 6g, Zhigancao 6g, and take two doses a day rather than one. I told her to try it, and to keep me informed at any time; if the temperature continued to rise, to contact me to adjust the treatment plan.
In the evening the teacher's wife used the large-dose Mahuang Tang; during the night her temperature returned to normal and never rebounded. The cough was much better, and the symptoms of shortness of breath and wheezing also improved markedly. The next morning she told me the condition had eased, and I set my mind at ease. But her cough was not completely resolved, so I had her switch to Mahuang She oral liquid or use Mahuang Tang at half dose for follow-up care.
Using Mahuang Tang in summer is indeed somewhat risky, especially in a heat wave like this year's, when using it must be done with great care. Unless it is myself or my own family who are ill, I would not dare use Mahuang Tang in such a season. The reason is none other than fear of causing an accident and a medical dispute.
But, as I have mentioned in many case records, modern people use air conditioners and fans; the summer of modern society cannot be compared with the summer of the traditional farming era. Air-conditioner disease in the modern summer has much in common with the cold-damage and stroke diseases of past autumns and winters; treating such diseases should boldly use Mahuang Tang, Gegen Tang and Guizhi Tang.
TCM treatment of influenza has no unified approach; the doctor must treat based on pattern differentiation according to the patient's specific symptoms and the inducement of illness. TCM treatment of such diseases is also unlike Western medicine, which targets specific pathogens with the same regimen for different patients; rather, medication is based on the patient's clinical symptoms. Different patients triggered by the same pathogen, if their clinical symptoms differ, receive different TCM medication—in TCM this is called "same disease, different treatment." If the disease's inducement and clinical symptoms suit Mahuang Tang, then regardless of the season, Mahuang Tang can be used.