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Main Signs and Symptoms
For the past two days: runny nose, mild cough, fever 37.5 degrees.
Pulse: floating-rapid
Tongue: red with a thin coat.
Diagnosis and Treatment
TCM Diagnosis:
Wind-Cold attack on the Exterior
Treatment:
Treatment Principle: Release the Exterior and expel Wind-Cold
Treatment: Yin Qiao Wan (Lonicera & Forsythia Formula)
Outcome:
After one day symptoms improved, and after 2 days the fever was resolved but the cough, runny nose and headache were still present. Changed the formula to Xiao Chai Hu Wan (Minor Bupleurum Formula).
He initially began to improve, but on the evening of day 4 the fever returned and the cough became severe and the child could not sleep. Changed the formula to Wu Wei Xiao Du Yin (Lonicera & Wild Chrysanthemum Formula) taken every three hours until the fever has been reduced and the cough has stopped: After this return to normal dose three times daily. After 3 doses, the fever resolved and the child slept soundly for the rest of the night and into the morning. They were advised to continue Wu Wei Xiao Du Yin (Lonicera & Wild Chrysanthemum Formula) for one more day and then change to formula to Yu Ping Feng San (Jade Screen Formula) 3 times daily.
After one week, the parents reported that their son has returned to normal health.
Comments:
Paediatric patients are not able to describe their symptoms clearly, so it is very difficult for a practitioner to detect when the condition has begun to change, in order to continually prescribe a suitable medicine as the disease progresses (or improves). In addition children’s diseases change very rapidly and it is crucial to be able to diagnose accurately and prescribe appropriately in order to achieve a successful outcome. Often this requires that the practitioner anticipate the next stage in the development of the illness – either worsening or improving.
This type of illness generally progresses in the following manner: it begins on the Exterior, and then moves to half Exterior and half Interior. From here, if not resolved, the disease process may move into the Interior (generally the Lung). When at the Exterior the most suitable formula is Yin Qiao Wan (Lonicera & Forsythia Formula). When it is at the half Exterior and half Interior level, use Xiao Chai Hu Wan (Minor Bupleurum Formula). When it is on the Interior, use Wu Wei Xiao Du Yin (Lonicera & Wild Chrysanthemum Formula) to clear the Interior Heat and Toxin.
Following the resolution of this illness, it is important to tonify the Qi and strengthen the Exterior. The best formula for this is Yu Ping Feng San (Jade Screen Formula). In this case it is particularly important to do this as the illness progressed to the Interior, which shows that the child’s defences were already insufficient before contracting this illness, and that after fighting off the pathogens they would become further depleted.