| title | Medical Cases of Wu Peiheng |
Hai, female, 19 years old, first consultation on January 3, 1959. The patient underwent a cesarean section with excessive loss of blood. After a blood transfusion and emergency treatment, she suddenly developed a high fever above 40°C. After several days of treatment with penicillin, streptomycin, and other medications, her body temperature decreased, but she became unconscious and experienced difficulty breathing, with white blood cell counts exceeding 20,000. Due to the critical condition, she could not be moved, so no X-ray examination was performed. At that time, Western medicine did not provide a clear diagnosis, and treatment continued with large doses of broad-spectrum antibiotics, along with intravenous fluids and oxygen inhalation, all of which were ineffective. Another doctor prescribed a dose of Ma Xing Shi Gan Tang, but the condition worsened, leading to my consultation.
The patient was unconscious, with a pale, purplish-gray complexion, a bluish-black tongue texture, flaring nostrils, and irregular breathing that rose and fell like tidal waves. Her fingers and nails were bluish-black, and her pulse was wiry, tight, and weak upon palpation, feeling empty. This condition had entered the Jueyin stage, with excessive yin qi in the liver and kidneys. It was not a transmitted disease but a true organ disease, with extreme weakness of the heart and kidney yang. The true yang of the lower jiao did not rise, and the yin pathogen of the upper jiao did not descend. A faint remnant of yang was on the verge of extinction, showing signs of collapse, making the condition critical and difficult to treat. The only approach was to support yang, suppress yin, strengthen the heart, and stabilize the kidneys, striving to save the patient from the brink of death. The main treatment was a large dose of Restoring Yang Decoction (Cold-Extremities Decoction with Cassia Bark). Prescription:
Since the aconite root needed to be simmered for three to four hours to ensure it was fully cooked and non-toxic, the patient was first given the superior cassia bark soaked in water to urgently strengthen the heart. The family was warned that after taking this prescription, the patient might experience vomiting. If after vomiting, the throat no longer produced phlegmy sounds, breathing was no longer labored, and the tongue color turned red, there was still a glimmer of hope. Otherwise, the condition would be difficult to treat.
Second consultation: After taking the above prescription yesterday, as predicted, the patient vomited phlegm and showed signs of improvement. She was more conscious than before, lethargic but able to slowly respond to questions and consume liquids. The tip of her tongue showed a faint red color, with a white, slippery, and thick coating. The bluish-purple color of her lips had faded, her cheeks were purplish-red, and her nostrils no longer flared. Breathing was still difficult but no longer tidal. She began to cough, expelling large amounts of purulent phlegm. The pulse remained wiry, slippery, and tight, feeling empty upon palpation. The critical signs of collapse had significantly lessened, and the treatment continued to focus on supporting yang and warming transformation. Prescription:
Aconite Lateral Root 150g, Dried Ginger 50g, Superior Cassia Bark 10g (ground, soaked in water for oral administration), Pinellia 10g, Poria 20g, Liquorice Root 8g
Third consultation: The patient was fully conscious, speaking clearly, with slightly rosy cheeks. The bluish-purple color of her nails, lips, and tongue had faded by 80-90%. The nose and orbital areas were slightly bluish, with afternoon tidal fever, shortness of breath, and coughing up large amounts of purulent phlegm. However, there was occasional phlegm obstruction in the throat. The pulse was wiry and slippery. The condition had turned from critical to stable, and the treatment continued with modifications to the previous prescription. Prescription:
Fourth consultation: The patient's cheeks were slightly rosy, and the bluish-purple color of her lips and tongue texture had faded. Breathing gradually stabilized, and the afternoon tidal fever subsided. Coughing and expelling purulent phlegm slightly decreased. Stomach qi had improved, allowing her to eat, and her speech and mental state were nearly normal. The pulse became moderate. Large, loose stools were a sign of disease resolution. Nighttime dreamfulness was due to yang not overcoming yin, with pathogenic yin disturbing the spirit. As the major illness had just subsided, the yang of the kidneys was still weak, and cold-dampness pathogenic yin had not completely dissipated. The treatment continued to focus on supporting yang and warming transformation. Taking the medication for three to four doses was expected to lead to recovery.
At this point, the patient's condition had improved enough to allow movement. An X-ray examination revealed multiple round cavities of varying sizes in both lungs, with most of the contents already expelled. A bacterial culture of the blood reported the presence of drug-resistant Staphylococcus aureus. The final Western diagnosis was "acute severe lung abscess caused by drug-resistant Staphylococcus aureus." Prescription:
Aconite Lateral Root 150g, Dried Ginger 50g, Dried Tangerine Peel 8g, Prepared Ephedra 8g, Bitter Apricot Seed 8g (crushed)
After taking the above prescription for four doses, a follow-up consultation a week later showed the patient cheerful, speaking freely, with restored energy and appetite. The symptoms had disappeared, and she was fully recovered.
