Release Stagnated Heat: Using Mahuang Decoction Again for Summer Air-Conditioner Illness

Beijing has entered the scorching summer, and my family can hardly stand it either, so we sleep with the air conditioner on. After sleeping several nights in an air-conditioned room, yesterday afternoon I developed a sore throat, with inflammation of the right tonsil and a concomitant attack of right-sided otitis media. My throat was so sore that it was hard to drink water; swallowing was painful not only in the right tonsil but also in the right ear.

In early spring this year, when the weather was briefly warm then cold, I once had a cold exactly like this one. The symptoms were identical: pain in the right tonsil radiating to the right middle ear, phlegm stuck in my throat affecting my breathing and making it impossible to sleep. Last night I woke again and again; this morning the condition worsened, and by afternoon I had a fever.

At first I wanted to use Yinqiao Powder, since acrid-cool exterior-releasing is the correct way to treat a summer cold. Several packets of Yinqiao Powder later, the symptoms were not alleviated; my whole body ached, and by three in the afternoon even my finger joints hurt, to an unbearable degree. Moreover my belly was swollen like a drum; after the cold medicine entered my stomach, the abdominal distension and pain were wrenching and hard to bear.

A fever began in the afternoon, the thermometer showing 37.3°C; I took Xiaochaihu granules with no obvious relief. By evening my lower limbs turned icy cold; although the weather was hot, I could not sweat at all, and felt extremely miserable. I thought this was exactly the indication for Mahuang Decoction. I took my own pulse; it was not floating and tight, but the symptoms completely matched the Mahuang Decoction pattern. I have always valued pattern-formula correspondence more than the pulse, so I decided to use Mahuang Decoction.

After the first packet of Mahuang Decoction, the reaction was unremarkable, but my body warmed slightly; fifteen minutes later, as the effect wore off, my limbs turned cold again. So I soaked three packets of Mahuang Decoction together and drank them. This time, after drinking it, intestinal peristalsis accelerated, I passed gas frequently, and the abdominal distension was greatly relieved; I felt relaxed all over. More than twenty minutes later, Mahuang Decoction's effect again waned and my limbs began to cool; without hesitation I soaked three more packets. Only after this third dose did I feel as if I had returned from winter to summer: I felt the heat again, began to sweat, and all the illness left me. The body aches and finger-joint pain completely disappeared, the drum-like abdominal distension vanished, the sore throat was much relieved, and my middle ear no longer sent shooting pain on swallowing. I even had the strength to get up and write this article.

TCM speaks of "releasing stagnated heat" (huo yu fa zhi): after a person catches cold, heat evil lies hidden within the body; one should follow the trend and outwardly dispatch the heat evil through the sweating method. Although there is an ancient precept not to use Ephedra/Cinnamon branch in spring and summer, the present age is very different from the past; the existence of air conditioners means the four seasons no longer affect the body as before. So one should not be bound by the old rule that Ephedra and Cinnamon branch cannot be used in spring and summer; when indicated, use them. Especially when treating air-conditioner illness, I often use Gegen Decoction, Mahuang Decoction, Guizhi Decoction, and Guizhi plus Gegen Decoction, with good results.

But after all it is summer; such medicines must not be overused. Once the symptoms are relieved, even if residual evil has not been fully cleared, stop the medicine and just drink more hot water as an aid; do not continue taking Mahuang Decoction and the like. After all, excessive use of Ephedra and Cinnamon branch also brings drawbacks. People still spend much of their time outside the air-conditioned room, and the seasonal influence has not entirely disappeared; so the proper measure must be kept, and treatment should stop when enough is enough.

I have always loved the speed of TCM. When relieving symptoms, if one masters the techniques of TCM treatment well, one can cure a self-limiting illness that might drag on for a long time within an hour or two. But when prescribing one should not be bound by the routine; as I treated myself, I did not follow the rules. I did not take the medicine three times a day before or after meals, but closely observed my body's response: as soon as the drug took effect, I pressed on to finish the job. Conversely, if one drug does not work, one should immediately switch; do not use "TCM treats slowly" as an excuse for having used the wrong formula.