Lung Distension

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• Lung Distension
• TCM Diagnoses and Treatments
• Lung distension results from development
  of multiple chronic pulmonary disease and is
  characterized as thoracic bulge fullness,
  cough, panting with reversed flow of qi,
  worsening while making exertion, stuff chest
  abundant sputum.
• Etiology Pathology
• Etiology
• 1) Lung def. due to chronic disease ( chronic
  pulmonary disease obstruction emphysema, cough,
  asthma, pneumonectomy, chronic pulmonary heart
  disease, senile pneumonectomy, etc)
• 2) Exogenous pathogens affection

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• Main Points for differentiation
• Lung Qi Def.
• Lung Qi Yin Def.
• Lung Spleen Def.
• Lung Kidney Def.
• Spleen Kidney Yang Def.
• Wheeze, Panting Lung distension

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• Treatment
• 1) Phlegm Accumulation
• Signs Symptoms
• Main Sym. cough with abundant sputum, white
  sticky or thin, panting, worsening on exertion.
• Concurrent sym. shortness of breath, gasp,
  aversion to wind, frequent sweating, cold limbs,
  fullness in the stomach, poor appetite, weakness
• Tongue pale body with thin greasy
  coating
• Pulse small, taunt slippery pulse
• Treatment Protocol
• Resolving the sputum
• Strengthen Sp. nourish Lu.

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• Formula
• Modifications
• fullness in the chest , abundant sputum,
  inability to lie flat
• -- Ting Li Zi
• with exterior wind-cold sym.
• -- Xiao Qing Long Tang

Su Zi Jiang Qi Tang Su Zi Jiang Qi Tang Su Zi Jiang Qi Tang Su Zi Jiang Qi Tang Su Zi Jiang Qi Tang Su Zi Jiang Qi Tang Su Zi Jiang Qi Tang
Zi Su Zi Ju Pi Ban Xia Dang Gui Qian Hu Qian Hu Hou Pu
Rou Gui Gan Cao Sheng Jiang
San Zi Yang Qing Tang San Zi Yang Qing Tang San Zi Yang Qing Tang San Zi Yang Qing Tang San Zi Yang Qing Tang San Zi Yang Qing Tang San Zi Yang Qing Tang
Su Zi Bie Jie Zi Lai Fu Zi
Liu Jun Zi Tang Liu Jun Zi Tang Liu Jun Zi Tang Liu Jun Zi Tang Liu Jun Zi Tang Liu Jun Zi Tang Liu Jun Zi Tang
Ren Sheng Fu Ling Bai Zhu Chen Pi Ban Xia Zhi Gan Cao Zhi Gan Cao
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• Treatment
• 2) Phlegm heat Accumulation
• Signs Symptoms
• Main Sym. cough with yellowish and sticky-white
  sputum being difficult to spit out, asthmatic
  breathing, coarse voice.
• Concurrent sym. irritability, fever, sweating,
  brown urine, constipation, thirsty,
• Tongue red body with yellow or yellow
  greasy coating
• Pulse rapid slippery pulse
• Treatment Protocol
• Resolving the sputum
• Clear the lung heat
• Stop asthma

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• Formula
• Modifications
• Sticky sputum and difficulty to be spit out
• -- Gua Lou, Hai Ge Ke, Yu Xing Cao
• Wheezing inability to lie flat
• -- She Gan, Ting Li Zi
• Thirsty
• -- Tian Hua Feng, Lu Geng
• Yin Def.
• -- Sha Sheng, Mai dong

Yue Bi Jia Ban Xia Tang Yue Bi Jia Ban Xia Tang Yue Bi Jia Ban Xia Tang Yue Bi Jia Ban Xia Tang Yue Bi Jia Ban Xia Tang Yue Bi Jia Ban Xia Tang Yue Bi Jia Ban Xia Tang
Ma Huang Shi Gao Sheng Jiang Da Zhao Bai Zhu Ban Xia Ban Xia
Sang Bai Pi Tang Sang Bai Pi Tang Sang Bai Pi Tang Sang Bai Pi Tang Sang Bai Pi Tang Sang Bai Pi Tang Sang Bai Pi Tang
Sang Bai pi Ban Xia Su Zi Xing Ren Bei Mu Bei Mu Huang Qin
Huang Lian Shan Zhi Zi
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• Treatment
• 3) Lung Kidney Qi Def.
• Signs Symptoms
• Main Sym. Rapid shallow respiration, dyspnea,
  panting worsening on exertion.
• Concurrent sym. Gasp for breath with open mouth
  shoulders elevated, inability to lie flat,
  lower voice, shortness of breath, cough, white
  sputum being difficult to spit out, stuffy chest,
  palpitation, cold limbs sweating.
• Tongue Pale or purplish
• Pulse deep, thready, rapid and weak or
  uneven pulse
• Treatment Protocol
• Tonify Lung Kidney
• Stop panting

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• Formula
• Modifications
• Lung def. cold
• -- Rou Gui, Gang Jiang
• Yin def. lower fever
• -- Sheng Di, Mai dong, Yu Zhu
• Blood stasis
• -- Dang gui, Dan Shen, Shu Mu
• Yin Def.
• -- Sha Shen, Mai dong

Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang Ping Chuan Gu Ben Tang
Dang Shen Wu Wei Zi Wu Wei Zi Dong Chong Xia Cao Dong Chong Xia Cao Dong Chong Xia Cao Ci shi Ci shi Su Zi Su Zi
Ban Xia Chen Xiang Chen Xiang Hu Tao rou Hu Tao rou Hu Tao rou Ju Hong Ju Hong Kuang DongHua Kuang DongHua Kuang DongHua
Bu Fei Tang Bu Fei Tang Bu Fei Tang Bu Fei Tang Bu Fei Tang Bu Fei Tang Bu Fei Tang Bu Fei Tang Bu Fei Tang Bu Fei Tang Bu Fei Tang
Ren Sheng Ren Sheng Huang Qi Huang Qi Shu Di Wu Wei zi Wu Wei zi Zi Wan Zi Wan Sang Bai Pi Sang Bai Pi
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• Treatment
• 4) Edema due to Yang Def.
• Signs Symptoms
• Main Sym. Asthma, cough, dyspnea, edema in
  face, eye-lipids lower limbs or even in the
  whole body.
• Concurrent sym. Clear thin sputum, less
  urination, fullness in the stomach, poor
  appetite, palpitation, abdominal distension and
  fullness.
• Tongue dim enlarged tongue, white
  slippery fur
• Pulse deep thready pulse
• Treatment Protocol
• Warming the kidney strengthening the spleen
• Removing water fluid retension

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• Formula
• Modifications
• Panting severe edema
• -- Ting Li Zi, Cheng Xiang
• Blood stasis sym.
• -- Dan Shen, Yi Mu Cao

Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang
Fu Zi Bai Zhu Bai Zhu Fu Ling Fu Ling Fu Ling Shao Yao Shao Yao Sheng Jiang Sheng Jiang
Wu ling Tang Wu ling Tang Wu ling Tang Wu ling Tang Wu ling Tang Wu ling Tang Wu ling Tang Wu ling Tang Wu ling Tang Wu ling Tang Wu ling Tang
Gui Zhi Gui Zhi Fu Ling Fu Ling Bai Zhu Zhu Ling Zhu Ling Zhe Xie Zhe Xie
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• Case History
• 1. Male 67 years
• Medical history Patient has suffered chronic
  pulmonary heart heart disease for years.
• First visiting
• Main complain panting coughing for
  several days
• Several days ago, patient start coughing
  panting again due to cold weather, with white
  foamy sputum but difficultly to be expectorated.
  Severe panting, inability to lie flat. Fullness
  distention in the chest and abdomen, no appetite,
  loose stools, tiredness, face four limbs edema,
  cold limbs, pale face color.
• Tongue pale body with white
  slippery coating Pulse deep thready
• TCM diagnose
• Lung Def. cold water retention in the lung
  Kid Sp Yang Def.
• Treatment protocol
• disperse lung Qi removing the water Warm
  up Sp Kid yang
• Formula
• Shen Fu Tang Xiao Qing Long Tang
• Ren Shen 9, Fu zi 15, Bai Zhu 12, Ma Huang
  4.5, Xing Ren 12, Gan Jiang 3, Wu Wei Zi 3, Ban
  Xia 9, Chen Pi 4.5, Xi Xing 3, Fu Ling 15, Zhi
  Gan Cao 3, Cheng Xiang 3
  X 2 bags

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• Case History
• 1. Male 67 years
• Medical history Patient has suffered chronic
  pulmonary heart heart disease for years.
• Second visiting
• Main complain panting coughing has
  become much better
• Fullness distention in the chest and abdomen
  are also getting better, edema on the ankle is
  reduced, appetite is little better, no
  spontaneous sweating
• other symptoms are still..
• Tongue pink body with white
  coating Pulse deep thready slippery
• TCM diagnose
• Lung Def. cold water retention in the lung
  Kid Sp Yang Def.
• Treatment protocol
• descending lung Qi Stopping panting
  strengthen sp function
• Formula
• Dang Sheng 15, Fu zi 9, Bai Zhu 12, Ma
  Huang 3, Xing Ren 9, Gan Jiang 3, Wu Wei Zi 3,
  Su Zi 9, Sha Ren 3, Jiao Qu 12, Fu Ling 12, Yin
  xing 5,
• 
  X 3 bags

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• Case History
• 1. Male 67 years
• Medical history Patient has suffered chronic
  pulmonary heart heart disease for years.
• Third visiting
• Main complain Cough is reduced and no
  panting
• No fullness distention in the chest and
  abdomen, no edema on the legs, appetite is
  better, sleeping is also better, no loose stools,
  
• Face edema, sputum not so
  difficult to spit out,
• Tongue pink body with thin
  white coating Pulse soft slippery
• TCM diagnose
• Lung Def. cold water retention in the lung
  Kid Sp Yang Def.
• Treatment protocol
• tonify Qi Warm Kid yang tonify Sp
• Formula
• Dang Sheng 15, Huang Qi 9, Fu zi 9, Fu Ling
  9, Bai Zhu 12, Gui Zhi 3, Ma Huang 3, Xing Ren 9,
  Ban Xia 9, Chen Pi 4.5, Xi Xing 2, Hong Zao 5,
  
• 
  X 3 bags

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• Sputum Retention
• TCM Diagnoses and Treatments
• Sputum retention is referred to a category
  of disease caused by abnormal stagnation of water
  fluid in a certain part of the body because of
  disorder of its distribution, transformation and
  transportation.
• Etiology Pathology
• Etiology
• 1) Dysfunction of the lung, spleen and kidney

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• Main Points for differentiation
• 1) Location
• 2) Def. Excess
• 3) Coexistence of two or more syndromes
• Cold Heat
• Exterior Interior
• Qi Stag. Blood Stasis
• Qi Def. Blood Stasis

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Difference of dampness, water, fluid retention and sputum Difference of dampness, water, fluid retention and sputum Difference of dampness, water, fluid retention and sputum Difference of dampness, water, fluid retention and sputum Difference of dampness, water, fluid retention and sputum
Dampness Water Fluid retention Sputum
Property texture Sticky No fixed shape Clear fluid Thin Thick Turbid
Focus Everywhere Spread within the muscles skin of the whole body the lower part flaccid part Appear in the topical part of the body St., intestines, chest, Hy., 4 limbs Everywhere
Property of the disease Cold Heat Exterior interior Yang-water or Yin-water Results from accumulation of body fluid Yang def. or Yin cold Cold heat type
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• Main Points for therapeutic Principles
• 1) Warming Reducing
• Exhaustion of Yang Hyperactivity of Yin
• Combined with dispelling, inducing diuresis
  diaphoresis herbs
• 2) Proper method should be taken according to
  the symptoms.
• Water retention dispelling pathogen
• Exhaustion of Yang Warming
• Exterior syn. Warming dispelling sweating
• Interior Syn. Warming dispelling
  diuresis-inducing
• Weak body resistance Reinforcing
• Excess of pathogens Purging
• Coexistence of excess of pathogens weakness
  of body resistance
• 
  -- eliminating reinforcing
• Coexistence of fluid retention heat Syn.
• -- Warming cooling

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• Treatment
• Excess type
• 1) Fluid retention in the stomach without
  heat-transformation
• Signs Symptoms
• Main Sym. Chest fullness, epigastric
  stuffiness, water-shaking sound over the abdomen,
  thirsty without desire for drinking, or being
  readily to vomit on drinking water, throwing up
  clear water or thin saliva.
• Concurrent sym. dizziness, palpitations,
  shortness of breath,
• Tongue pale body with white slippery
  coating
• Pulse deep, taunt slippery pulse
• Treatment Protocol
• Warming Yang
• promote diuresis

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• Formula
• Modifications
• Dizziness less urination
• -- Cang Zhu, Ze Xie, Zhu Ling,
• Fullness of chest or epigastric
• -- Zhi Shi, Hou Pu
• Cold sensation on the back being about a palm
  size
• -- Gan Jiang, Hu Zhu Yu, Rou Gui

Ling Gui Zhu Gan Tang Ling Gui Zhu Gan Tang Ling Gui Zhu Gan Tang Ling Gui Zhu Gan Tang Ling Gui Zhu Gan Tang Ling Gui Zhu Gan Tang
Fu Ling Gui Zhi Bai Zhu Gan Cao Sheng Jiang
Xiao Ban Xia Jia Fu Ling Tang ( stopping vomiting) Xiao Ban Xia Jia Fu Ling Tang ( stopping vomiting) Xiao Ban Xia Jia Fu Ling Tang ( stopping vomiting) Xiao Ban Xia Jia Fu Ling Tang ( stopping vomiting) Xiao Ban Xia Jia Fu Ling Tang ( stopping vomiting) Xiao Ban Xia Jia Fu Ling Tang ( stopping vomiting)
Fu Ling BanXia Sheng Jiang
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• Treatment
• Excess Type
• 2) Fluid retention in St. transform to heat
• Signs Symptoms
• Main Sym. Rigidity, fullness pain sensations
  in the epigastrium abdomen, sustained rigidity
  and fullness despite having a normal urination,
  or water moving sound in the intestines,
  abdominal fullness, constipation, dry mouth
  tongue
• Concurrent sym.
• Tongue greasy, or white or yellow
  coating
• Pulse deep, taunt pulse
• Treatment Protocol
• Purging water retention

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• Formula
• Modifications
• Fullness of chest or epigastric
• -- Zhi Shi, Hou Pu

Gan Sui Ban Xia Tang ( fluid in St.) Gan Sui Ban Xia Tang ( fluid in St.) Gan Sui Ban Xia Tang ( fluid in St.) Gan Sui Ban Xia Tang ( fluid in St.) Gan Sui Ban Xia Tang ( fluid in St.) Gan Sui Ban Xia Tang ( fluid in St.)
Gan Sui Ban Xia Bai Shao Honey Gan Cao
Ji Jiao Li Huang Pill ( Fluid in intestine) Ji Jiao Li Huang Pill ( Fluid in intestine) Ji Jiao Li Huang Pill ( Fluid in intestine) Ji Jiao Li Huang Pill ( Fluid in intestine) Ji Jiao Li Huang Pill ( Fluid in intestine) Ji Jiao Li Huang Pill ( Fluid in intestine)
Fang Ji Jiao Mu Ting Li Zi Da Huang
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• Treatment
• Excess Type
• 3) Fluid retention in the Hypochondrium
  (Pleurisy)
• (Always due to Lu Def. season evils invasion)
• Signs Symptoms
• Main Sym. Distending pain over the chest
  hypochondrium, aggravated by coughing, even
  breathing or turning round body, fullness in the
  hypochondrium on the affected side.
• Concurrent sym. Alternate attack of chills
  fever in most case, or tidal fever, bitter taste,
  dry throat. After long illness night
  sweating(Yin def.)
• Tongue First stage white or yellowish
  coating Last stage red tongue with less
  coating
• Pulse taunt rapid pulse
• Treatment Protocol
• Purging Lung heat
• Expel excessive fluid

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• Formula
• Modifications
• Excessive Phlegm-damp Sym Fullness of chest
  greasy coating
• -- Xie Bai, Xing Ren,
• No appetite weakness
• -- Ling Gui Zhu Gan Tang

Jiao Mu Gua Lou Tang Jiao Mu Gua Lou Tang Jiao Mu Gua Lou Tang Jiao Mu Gua Lou Tang Jiao Mu Gua Lou Tang Jiao Mu Gua Lou Tang
Jiao Mu Sheng Jiang Chen Pi Ban Xia Sang Bai Pi GuaLou
Fu Ling Su Zi Ting Li Zi Da Huang
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• Treatment
• Excess Type
• 4) Fluid retention in the chest ( Zhi Ying )
• Signs Symptoms
• Main Sym. cough, dyspnea, orthopnea, profuse
  white foamy sputum
• Concurrent sym. puffiness in the face and the
  ankle part in severe cases. Could see cold or
  heat exterior symptoms.
• Tongue white greasy coating
• Pulse taunt tense pulse
• Treatment Protocol
• Warming Lung
• Remove fluid retention

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• Formula
• Modifications
• Sticky sputum
• -- Bai Jie Zi, lai Fu Zi
• In severe case more fluid retention, less
  exterior syn., severe dyspnea, cough, inability
  to lie flat
• -- Ting Li Da Zao Xie fei tang
• Warm Yang regular Qi
• -- Gui Zhi, Chen Pi
• Warm Yang Desending Qi
• -- Su Zi, Ban Xia, Da Fu Pi, Xing Ren
• Eliminate water retention
• -- Zhu Ling, Fu Ling

Xiao Qing Long Tang Xiao Qing Long Tang Xiao Qing Long Tang Xiao Qing Long Tang Xiao Qing Long Tang Xiao Qing Long Tang
Ma Huang Gui Zhi Bai Shao Gan Cao Gan Jiang Xi Xing
Ban Xia Wu Wei Zi
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• Treatment
• Excess Type
• 4) Fluid retention in the four limbs ( Yi Ying
  or Anasarca)
• Wind-cold attacking Lu Sp def.
• Signs Symptoms
• Main Sym. Joints pain, heaviness sensation
  edema in the four limbs, aversion to cold, no
  sweating
• Concurrent sym. puffiness in the face and the
  ankle part in severe cases.
• Tongue white greasy coating
• Pulse taunt tense pulse
• Treatment Protocol
• Expel the exterior
• Remove fluid retention

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• Formula
• Modifications
• Sticky sputum
• -- Bai Jie Zi, lai Fu Zi

Xiao Qing Long Tang Xiao Qing Long Tang Xiao Qing Long Tang Xiao Qing Long Tang Xiao Qing Long Tang Xiao Qing Long Tang
Ma Huang Gui Zhi Bai Shao Gan Cao Gan Jiang Xi Xing
Ban Xia Wu Wei Zi
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• Treatment
• Def. Type
• 1) Weakness of Sp. Yang
• Hypofunction of sp in transportation
  transformation dampness
• Signs Symptoms
• Main Sym. fullness discomfort in the chest
  and hypochondrium, being comfortable if the
  abdomen pressed or warmed. Frequent vomiting thin
  fluid or sputum, thirsty but no desire for
  drinking
• Concurrent sym. dizziness, palpitation,
  shortness of breath, no appetite, loose stools,
  weakness, water shaking sound in the abdomen,
  eyelid puffiness after getting up in the morning,
  lower limb edema in the afternoon.
• Tongue white slippery coating
• Pulse taunt, thread slippery pulse
• Treatment Protocol
• Warm reinforcing Sp
• Remove fluid retention

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• Formula
• Modifications
• Yin hyperactivity due to Yang def.
• -- Fu Zi, Wu Zhu Yu, Rou Gui
• Vomiting thin fluid thin sputum
• -- Gui Zhi, Bai Zhu, Fu Ling, Zhu Ling, Ze Xie
  ( Wu Ling San)
• Fullness in the chest hypochondrium
• -- Mu Xiang, Sha Ren, Chen Pi

Li Zhong Wan Li Zhong Wan Li Zhong Wan Li Zhong Wan Li Zhong Wan Li Zhong Wan
Ren Sheng Bai Zhu Gan Jiang Zhi Gan Cao
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• Treatment
• Def. Type
• 2) Weakness of Kid. Yang
• Aged people or patient with impairment of the
  kidney due to chronic disease
• Signs Symptoms
• Main Sym. chills, cold limbs, cramping
  numbness sensation or tremor in the lower
  abdomen, rapid breathing, shortness of breath,
  worsening on exertion, vomiting, abundant sputum
• Concurrent sym. dizziness, vomiting of foamy
  fluid.
• Tongue enlarged body with white
  slippery coating or white greasy coating
• Pulse thready slippery
• Treatment Protocol
• Warming Kid.
• Remove fluid retention

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• Formula
• Modifications
• Sp Kid yang def.
• -- Jing Gui Sheng Qi Wan Ling Gui Zhu Gan
  tang
• Bad appetite
• -- Chen Pi, Ban Xia
• Fluid retention
• -- Wu Ling San

Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang Zheng Wu Tang
Fu Zi Bai Zhu Bai Shao Fu Ling Sheng Jiang
JIng Gui Sheng Qi Wan JIng Gui Sheng Qi Wan JIng Gui Sheng Qi Wan JIng Gui Sheng Qi Wan JIng Gui Sheng Qi Wan JIng Gui Sheng Qi Wan
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• Case History
• 1. Male 72 years
• Medical History patient has suffered panting
  with abundant sputum for several years.
• First visiting
• Main complain panting with abundant
  sputum
• Coughing with abundant foamy sputum, breath
  with mouth open and shoulders elevated, inability
  lie flat in whole day, even couldnt get into
  sleep, exhausted. Patient even cant talk longer
  which will cause panting symptoms worse. Face
  legs edema.
• Tongue white greasy coating
  Pulse taunt slippery
• TCM diagnose
• Fluid retention in the chest lung Sp yang
  Def.
• Treatment protocol
• Removing water retention Warm up yang
• Formula
• Ting Li Zi 9, Bai Zhu 9, Sheng Jiang Pi 5,
  Gui Zhi 5, Su Zi 12, Xing Ren 12, Fu Ling 12, Zhu
  Ling 12, Fang Ji 12, Ban Xia 6, Chen Pi 6, Dong
  Gua Ren 12