Journal of TCM. Dec. 2002, Vol. 43, No. 12

Kalin Huddleston

August 21, 2001

First office call

37 years old male

The patient came in with a cough up and spit up phlegm and pus for eight years.  The last two years he has coughed up phlegm with blood at times.  The color of the blood was bright red or dark red.  Occasionally coughs up only blood into his mouth.  When he experiences fatigue the cough gets worse.  In a suburban hospital he had a CT scan that showed an enlargement in the lower left lung that appears like a bronchial cyst.  The western and Chinese medical treatments were not affective.  The pattern seen at the time of the appointment was choking and coughing occasionally, cough up phlegm in to his mouth several times a day.  The phlegm was yellow with a fishy smell.  Occasionally there may be bright red blood in the phlegm.  His mouth is dry but is still able to eat and he has dry stool.  His tongue is red with a thin, greasy yellow coat and his pulse is fine and wiry.  This pattern is phlegm heat accumulating overtime injuring the qi and yin, damaging the lung collaterals.  The treatment plan was to nourish the yin, clear heat from the lungs, stop bleeding, and harmonize the collaterals (vessels).  The herbs used in his formula were: nan sha shen 10g, xuan shen 10g, mai dong 10g, sheng di huang 15g, zhi da huang 6g, huang qin 10g, han lian cao 10g, si gua luo 10g, dai ge san 15g, bai bu 15g, bai mao gen 30g, dong gua zi 15g.  After he took twenty bags the bleeding stopped, the cough and phlegm were less, and the remaining symptoms got better.  In the above formula the following herbs were removed: da huang and sheng di huang and sang bai pi, bei mu, yi yi ren and bai shao were added to nourish yin, clear heat, and transform damp.  He continued to take these herbs and other herbs for two months and after that his pattern was stable.