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Formula patterns are the key to achieving clinical success with Jing Fang (Classical

Formulas). Each of the formula patterns has been identified to treat one or multiple
syndromes at once. However, these formula patterns have a very sensitive symbiosis and
balance between each of the ingredients and their ratio. Any addition or subtraction results
in a completely different formula pattern. In this sense, any changes made to the original
formula deserve serious consideration.

Let’s observe a few case studies to fully understand the application of the Jing Fang
approach to clinical practice.

Clinical Case #1: Mr. Feng, 10 years old


1st consultation: September 24th, 2009

The patient presented with fever between 39- 39.5 ℃which had lasted over 2 days and was
increasingly worse by the hour, with sweating, low consciousness, no desire to speak, dry
mouth, a desire to drink and only eat watermelon. His temperature that night at 7pm was
39.4℃with a greasy white tongue coating and a wiry and slippery pulse.

Six Syndrome Differentiation: Yang ming syndrome


Formula Pattern:Bai Hu Jia Ren Shen Cang Zhu (White Tiger Decoction plus Ginseng and
Atractylodis) Formula pattern
Ingredients:Sheng Shi Gao (Gypsum Fibrosum) 100g, Zhi Mu (Rhizoma
Anemarrhenae) 15g, Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum
Melle) 6g, Cang Zhu (Rhizoma Atractylodis) 10g, Ren Shen (Radix et Rhizoma
Ginseng)10g, a pinch of rice.
Results: The 1st dose was given at 8pm and the fever decreased to 38.8℃after one hour.
The patient had no fever the next morning. Since there was a cough with scanty
phlegm, Ban Xia Hou Po Tang (Pinellia and Officinal Magnolia Bark Decoction) Modified
was given for two days. All symptoms resolved.
Analysis: The patient was administered Bai Hu Tang (White Tiger Decoction) since he
suffered from the “4 bigs”: heat, fever, large pulse, thirst and sweating. In this case, Ren
Shen(Radix et Rhizoma Ginseng) was added to support the function of the body in creating
body fluid. After such excessive sweating, the patient had a severe fluid deficiency, which
needed to be addressed. On the other hand, Cang Zhu (Rhizoma Atractylodis) was also
added because of the greasy tongue coating and the inability to process fluids.
Note: The 10 year old patient was administered 100g of Sheng Shi Gao (Gypsum
Fibrosum), which is well beyond the recommended dosage of 15g. The temperature
of Sheng Shi Gao (Gypsum Fibrosum) is extremely cold and can affect the functions of the
stomach. However, in this case, the boy was given one dose before he had a reaction and
started sweating. One hour later the fever was already starting to decrease so the other
dose was not administered.
Clinical Case #2: Mr. Sun, 2 years old
1st consultation: November 24th, 2013

The boy caught a cold and suffered from a fever for 10 days. He had taken antibiotics with
no results. He now presented with symptoms of cough, sticky phlegm, wheezing, shortness
of breath, abdominal fullness, loose stools, hot sensation of the hands and feet, a white and
greasy tongue coating, and a wiry and rapid pulse.

Six Syndrome Differentiation: Three Yang syndrome with internal phlegm dampness
retention. (Tai Yang, Yang Ming, Shao Yang Tai Yin Concurrent pattern)
Formula Pattern: Xiao Chai Hu plus Sheng Shi Gao and Ban Xia Hou Po Tang
(Minor Bupleurum plus Gypsum, Pinellia, Officinal Magnolia Bark Decoction)

Ingredients:Chai Hu (Radix Bupleuri) 24g, Ban Xia (Rhizoma Pinelliae) 12g, Dang Shen
(Radix Codonopsis) 10g, Huang Qin (Radix Scutellariae) 10g, Sheng Jiang (Rhizoma
Zingiberis Recens) 10g, Da Zao (Fructus Jujubae) 4 pieces, Sheng Shi Gao (Gypsum
Fibrosum) 45g, Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum
Melle) 6g, Hou Po (Cortex Magnoliae Officinalis) 10g, Su Zi (Fructus Perillae) 10g, Fu Ling
(Poria Cocos) 12g.
Results: The decoction was prepared once and separated in two portions. After taking the
1st portion, the patient experienced some sweating and the fever decreased. The cough
reduced and the shortness of breath and abdominal fullness resolved. Since the patient had
a cough with scanty phlegm, Ban Xia Hou Po Tang Modified was given for two days and all
symptoms resolved.
Analysis: In this case, we notice that the amount of Chai Hu (Radix Bupleuri) is double the
traditional amount due to the high fever. Giving the lower dosage of Chai Hu would be less
effective in cases of high fever.
When it comes to treating children, the syndromes are usually acute and their symptoms
change very quickly, so it’s often appropriate to give one day of decoction taken over the
course of two days while paying close attention to the changes in the symptoms. Once the
symptoms change, we need to change the formula.

Classical medicine and Chinese medicine often have a reputation for successfully treating
chronic diseases. But as we see clearly in this case, results can be achieved in one dose
with the appropriate diagnosis and the correct formula pattern. Correctly applying the
wisdom of the classical medicine is a refined skill that is not only fascinating, but extremely
effective.
Dr. Suzanne Robidoux PhD, CM, DOM, LAc, is an international speaker and author
presently conducting a clinical trial at the Beijing University of Chinese Medicine on the
application of classical thinking from the ancient doctor Zhang Zhong Jing, according to the
six syndromes differentiation. She is also the founder of an online platform to link foreign
practitioners to masters in China.
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