Case 1

Name: Li.

Sex: Female.

Age: 32 years.

Occupation: A saleswoman.

Chief Complaint: Repeated asthma for 10 years.

History of Present Illness:  Ten years ago, the patient got asthma due to catching a cold. At the beginning, it occurred paroxysmally, slowly it occurred constantly. As it occurred, she got chest oppression, short  breath and asphyxia  sensation. Usually each attack persisted for 2 hours or so. In the past 10 years, she had asked innumerable doctors for treatment, all the drugs that she had taken included "Adrenalin, Cortical Hormone, Aminophylline "and so on, in addition, she had been treated with some chinese herbs and external treatment according to the theory of the treatment in summer for the disease in winter, but all the above treatments weren't really effective against her asthma. Finally, the attack became regular, it must recur in every autumn. When it recurred, she gasped continuously all day and night, it caused she and her family could not sleep throughout night. In the past 10 years, the recurrence had never missed an autumn, all the treatments of TCM and Western medicine that she had gotten could not defeat the recurrence in every autumn. Then she came to our hospital for treatment on July 10,1997. She told me this autumn would come back soon, she was afraid of its recurrence very much. So she asked me to treat it in advance.

Physical Examination:  The patient was conscious with a normal general condition. The pulse was thready and rapid, the tongue was red with a thin layer of white fur. No wheezing sounds couldn't be heard in both lungs.  There was not other abnormal sign.

Diagnosis: Bronchial Asthma.

Differentiation: This disease, in TCM, belongs to the category of "ChuanZheng"(asthma). It was caused by deficiency of spleen and kidney. Deficiency of spleen qi could directly cause a failure of middle Jiao to conduct transporting clear fluid as normal. Then the clear fluid  accumulated together and  became pathogenic phlegm in the lungs, which prevented the lungs from taking charge of dispersing, purifying and descending function, so that the asthma was  caused. Additionally, the permanent asthma caused excessive consumption of kidney qi, which resulted in a failure of kidney to be responsible for reception of air, then it's more difficult to cure the asthma easily. As for why it must recur in every autumn, it obviously indicated the deficiency of spleen. According to the theory of five elements motion and six kinds of weather, the spleen qi ought to play a leading role in summer while the lung qi ought to play a leading role in autumn. But the patient's spleen qi had been so deficient in summer that the essential substances from food and water couldn't be transported normally and effectively, then some parts of them would became pathogenic dampness phlegm and accumulated in the lungs. When autumn came back, the lung-qi could not play a leading role because of the pathogenic dampness phlegm, which had been produced in summer and had accumulated in lungs. So that the attack of her asthma came back again and again in every autumn.

Therapeutic Principle:  It's cardinal therapy to invigorate spleen qi, it's  auxiliary  therapy  to  restrain  the  excessive consumption of kidney qi, it's expectant therapy to regulate lung-qi.

Recipe:

  DangShen,Pilose Asiabell Root 90g

  BaiZhu,Bighead Atractylodes Rhizome 50g

  FuLing, Tuckahoe 60g

  ShaRen,Amomum Fruit 30g

 QianHu,Peucedanum Root 30g

 MaHuang, Ephedra 15g

 SangBaiPi,Mulberry Bark 30g

 DiGuPi,Wolfberry Bark 25g

 YiYiRen,Coix Seed 60g

 ShanYao,Chinese Yam Rhizome 50g

 TuSiZi,Dodder Seed 60g

 FuPenZi, Raspberry 60g

 XingRen,Bitter Apricot Seed 15g

 WuWeiZi,Schisandra Fruit 30g

 SuZi,Perilla Fruit 30g

 BaiJieZi,White Mustard Seed 20g

 ChaiHu,Bupleurum Root 28g

 NiuXi,Achyranthes Root 30g

 TaoRen,Peach Seed 25g

 DanShen,Red Sage Root 30g

 HuangLian,Coptis Root 20g

 HuangQin,Scutellaria Root 25g

 YiZhiRen,Bitter Cardamon 30g

 WuYao,Lindera Root 25g

    All the above drugs were to be ground into powder and mixed with water to make pills, taking 9g of the pills each time,3 times a day. Greasy and hot food was forbidden during the treatment. She was told to take the pills 1 month earlier than the beginning of autumn.

Effect Observation: After beginning to take the pills according my advice, the patient merely gasped slightly in this autumn. After 20 days' treatment, her asthma was stopped completely. After 2 months' treatment, the patient was in good health in that autumn and winter all along. After 2 years' follow up, there wasn't recurrence of the illness. Then it's ending.

Case 2

Name: La.

Sex: Female.

Age: 30 years.

Occupation: A peasant.

Chief Complaint: Constant asthma for 20 years.

History of Present Illness: Twenty years ago, the patient got asthma and short breath without obvious cause. The asthma occurred continuously, it was not accompanied by fever, cough and profuse sputum. After asking many doctors for treatment, it was diagnosed as "Bronchial Asthma, "she was treated with many kinds of antiasthmatic  drugs  such  as  " Aminophylline"  and "Capsule of Cinnamomi and Dragon's Bone for Relieving Cough and Asthma, "but there was not obvious curative effect on her. Additionally, she was treated with some chinese herbs, but there was no curative effect on her either. Usually she couldn' t sleep horizontally. Furthermore, her persistant asthma prevented her from keeping the chest and back straight whenever she was walking, sitting or sleeping. It was often aggravated by weather changing. Only by spraying "Adrenalin, "could it be relieved for half an hour or so. But the asthma couldn't be stopped all along. Then she came here for treatment on March 29,1996.

Physical Examination: The patient was conscious with a fresh complexion. The pulse was thready and rapid, the tongue was red with a thin layer of white fur. Her respiratory sounds were harsh ,wheezing sounds could be heard clearly all over the lungs even without using echometer. There was not other abnormal sign.

Diagnosis: Bronchial Asthma.

Differentiation: This disease,in TCM, belongs to the category of "ChuanZheng"(asthma). It was caused by sthenic heat evil, which obstructed the lungs and burnt the lung-Ying. Then the clear fluid in lungs became dry and withered and couldn't be distributed in lungs as normal. So that the lungs couldn't be moistened and nourished normally. Then there was a failure of the lung to conduct dispersing and purifying, descending function as normal, the patient got the asthma.

Therapeutic  Principle:   Clearing  away  pulmonary heat, smoothing the chest and activating qi, eliminating phlegm evil to stop asthma, nourishing Yin and promoting the production of clear fluid.

Recipe:

  ShengShiGao,Gypsum 25g (to be decocted earlier)

  ShengDiHuang,Dried Rehmannia Root 20g

  ZhiMu,Windweed Rhizome 20g

  SangBaiPi, Mulberry Bark 15g

  GuaLou, Trichosanthes Fruit 15g

  ChuanBeiMu,Sichuan Fritillary Bulb 20g

  MaHuang, Ephedra 10g

  BaiJieZi,White Mustard Seed 15g

  FaBanXia,Pinellia Tuber 8g

  XingRen,Bitter Apricot Seed 10g

  SuZi,Perilla Fruit 15g

  WuWeiZi,Sehisandra Fruit 25g

  ChenPi,Tangerine Peel 15g

  ZhiKe,Fruit of Citron 15g

  GanCao,Liquoriee Root 10g

    All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. She was told to avoid eating hot and greasy food during the treatment.

Effect Observation:  After taking the decoction, her asthma was relieved greatly, she could keep her chest and back straight whenever she was doing. Because she was poor and couldn't take decoction for a long term, then I told her to take 5 doses of the above prescription once more in order to make pills, taking the pills slowly for keeping a long term of curative effect.

     After half a year's follow-up, the patient was in good health all along. There was not recurrence of asthma. Then it' s ending.