bubble_chart Content

A 15-year-old male sought medical attention in January 1976. He had been suffering from persistent high fever for over a month, and despite numerous examinations, no abnormalities were found. He was diagnosed with "fever of unknown origin." The fever did not subside despite repeated use of heat-clearing remedies. Upon inquiry, it was revealed that the patient initially experienced fatigue, malaise, chills, and body aches, which were thought to be a common cold and were not taken seriously. Subsequently, the fever rose and remained above 39°C, especially in the afternoon. Since then, the fever was always accompanied by slight aversion to cold, and although there was occasional spontaneous sweating, the fever did not abate with sweating. The patient did not feel thirsty even when the fever was high. There were multiple swollen lymph nodes behind the left ear, which were not very painful upon palpation. The spleen was enlarged 1 cm below the rib, and there was a sense of discomfort and fullness in the hypochondrium. The patient often felt irritable and had no appetite. In 1974, he had a similar fever and was diagnosed with "reactive lymphocytosis," which resolved after treatment and he was discharged from the hospital.
The syndrome was attributed to cold-damage disease, with cold constraining the exterior and failure to warm and disperse, leading to unresolved exterior pattern and interior heat that was not yet substantial, thus lingering between the exterior and interior. This resulted in fullness and discomfort in the chest and hypochondrium, which could have been treated with Minor Bupleurum Decoction. However, the slight aversion to cold indicated that despite the prolonged fever, the exterior pattern was not completely resolved. Therefore, a combination of Bupleurum and Cinnamon Twig Decoctions was used.

Bupleurum 9g, Pinellia 9g, Skullcap Root 9g, Tangshen 30g, Fresh Ginger Rhizome 2 slices, Chinese Date 5 pieces, Cinnamon Twig 6g, Peony Root 9g.
After taking 6 doses, the patient experienced slight sweating, and the high fever suddenly subsided. The afternoon fever dropped to around 37.1°C, and sweating also decreased. The swollen lymph nodes behind the ear gradually diminished, and the patient's appetite improved. The exterior was resolved, and the interior was cleared, resulting in the sudden resolution of a high fever that had lasted for over 3 months.