www.needleplant.com

Those that are cold:

Not in all coughing and panting and even wheezing does the patient exhibit cold symptoms:

• afraid of cold（表寒）
• no perspiration（无汗）
• clear and/or bubbly phlegm（痰液清稀）
• clear or white-coated tongue with slippery surface（舌淡苔润）

For these symptoms, we can use 小青龙汤 or 麻黄汤 as a base formula. These two decoctions use the 麻、桂 combination - both of which are hot in nature - to treat the cold symptoms.

The hot ones:

For some people the following symptoms stand out more:

• fever（发热）- meaning to me a quick transit to the higher set-point temperature, quickly bypassing the stage where you’re afraid of the cold
• perspiration（出汗）- meaning the heat is driving fluids out
• thick, sticky and even yellow phlegm（痰液粘稠色黄）
• reddish tongue with yellowish coating（舌红苔黄）
• thirst（咽干口渴）

It’s no longer 痰饮 like in 小青龙汤’s pattern. It’s now 痰热.

• For 痰, just relate it to the breathing difficulties;
• For 热, it’ll be all the hot symptoms like high fever, heavy perspiration, inquenchable thirst and all things to do with heat. Because the heat is causing sweat, which in turn is taking away the heat, the skin is one thing that isn’t scorching, although deeper beneath, especially in the lungs, it is.

Treating heat symptoms:
This is when you consider adding 石膏 as the freeze agent. Instead of the 麻、桂 combination that helps you sweat, we have a 麻、膏 combination that helps to get rid of heat. This is key herb-pair in the decoction 越婢汤（麻、膏、姜、枣、草）. It’s also present in 大青龙汤 and of course in 小青龙加石膏汤.

Plain Vanilla Hot vs. Cold-Wrapping Hot:

What I call Plain Vanilla Hot is just plain hot. If you’re plain hot, then the heat will definitely drive the waters out i.e. your body will perspire with great fervor. However, there are instances where the person is very “replete” on the exterior. The skin just doesn’t release the heat out. You don’t sweat. That’s painful, and you’re just accumulating heat inside that keeps growing. That’s when you need 石膏.

More on Plain Vanilla Hot:

Here, two base formulae are suggested.

• 定喘汤: See here for breakdown.
• 越婢加半夏汤: See here for breakdown.

More on Cold Wrapping Hot:

Here, two base formulae are suggested.

• 小青龙加石膏汤
  • Over here you are trying to solve all the 小青龙汤-pattern problems, but they are all heaty in nature. So you add 石膏.
• 厚朴麻黄汤
  • See here.

More to follow…