A TCM Empirical Formula for Respiratory Tract Infection Caused by the Winter Common Cold
Winter colds are mostly of wind-cold nature. But if a cold drags on, or if the patient is affected by other diseases, the cold may give rise to a respiratory tract infection. At this point it can no longer be treated as wind-cold; it should be treated as lung heat. A formula that clears and releases exterior heat should be used, and formulas such as Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction) must no longer be used.
Professor Yin Huihe had an empirical formula: Sangbaipi (Mori Cortex) 9 g, Sangye (Mori Folium) 9 g, Juhua (Chrysanthemi Flos) 9 g, Huangqin (Scutellariae Radix) 12 g, Shandougen (Sophorae Tonkinensis Radix) 10 g, Yuxingcao (Houttuyniae Herba) 30 g, Pipa Ye (Eriobotryae Folium) 9 g, Lugen (Phragmitis Rhizoma) 30 g, Sheng Shigao (Gypsum Fibrosum crudum) 30 g.
Professor Yin's formula mainly addresses fever and aversion to cold, with fever predominant and aversion to cold mild, or even no aversion to cold; distending headache; thirst with a desire to drink; nasal congestion with discharge; sneezing; cough; sore throat; redness of the tongue edges and tip; white or yellow coating; and a floating, rapid pulse. It may be used in modern medicine for cases of common cold with fever and marked upper respiratory inflammation.
This formula is a combination of Sangju Yin (Mulberry Leaf and Chrysanthemum Drink) and Yinqiao San (Honeysuckle and Forsythia Powder), subsequently modified. It is mostly applied to colds in spring and summer, but it is also suitable for winter colds that have already transformed from cold to heat. For a cold that has already transformed from cold to heat, only cool-medicating, exterior-releasing herbs may be used; acrid-warm exterior-releasing herbs must not be used.
Whether to use a cool-moistening formula or an acrid-warm formula hinges on the key pattern differentiation: whether the patient is thirsty or not. If the mouth is not thirsty, the pathogenic heat is still in the exterior and has not entered the interior; at this point an acrid-warm formula such as Mahuang Tang or Guizhi Tang may be used. If the patient is thirsty, it belongs to warm disease; acrid-warm formulas may no longer be used, and only cool-moistening formulas may be used.
The representative cool-moistening exterior-releasing formulas are Sangju Yin and Yinqiao San. The genius of Professor Yin's formula lies in combining the two, then adding Sangbaipi, Sheng Shigao, and Yuxingcao, and replacing Lianqiao (Forsythiae Fructus) with Shandougen to strengthen the force of clearing and draining lung heat.
Professor Yin always considered the patient's economic means. Shandougen is cheaper than Lianqiao, so he preferred Shandougen and disliked using Lianqiao. In fact, Shandougen and Lianqiao may be used together in this formula. Moreover, if the patient's fever is difficult to abate, Baiwei (Cynanchi Atrati Radix) 9 g and Fuping (Spirodelae Herba) 9 g may be added.
If the patient has other accompanying symptoms, the physician should modify this formula further according to the corresponding symptoms. In addition, when treating febrile diseases, the physician should instruct the patient not to take the medicine once after breakfast and once after dinner as usual, but to take it every two hours; while the fever has not fully subsided, it may be taken again at night. Thus to break a fever one often needs 2–3 doses a day, each dose taken in two portions. During fever, all fish, meat, and dairy foods are to be avoided.