Herbal Remedies

Herbal Treatment

There are several techniques that are immediately applicable for symptomatic treatment of very high fever. They include the following.

Zi Xue Dan (Purple-Snow Pill): 3 g by mouth three times daily.

Niuhuang Qing Xin Wan (Bovine Gallstone Sedative Tablet): one tablet by mouth three times daily.

Chaihu (Bupleurum) Extract: 4 ml by intramuscular injection —four to six times daily.

Sponge bath with decoction prepared from jingjie (Schizonepeta) 10 g and bohe (Mentha) 15 g; this is suitable for high fever due to Wind-Cold.

Sponge bath with 20% decocted shigao (gypsum); this is suitable for high fever due to Heat invading the interior.

Retention enema: prepared as follows. Decoct dahuang (Rheum palmatum) 10-15 g, mangxiao (Mirabilite) 9g, gancao (Glycyrrhiza) 6g and xuanshen (Scrophularia) 15 g. Let cool and adjust the decoction to 500 h with cool water.

1 High Fever of Defensive Level

i Wind and Cold

Main Symptoms. High fever, chills; headache, body aches; and nasal congestion. The tongue is pale, with thin white coating. The pulse is floating and tight.

Therapeutic Principle. Dispel Wind, disperse Cold, release the exterior and reduce fever.

Treatment. Modified Jing Fang Bai Du San (Schizonepeta-Saposhnikovia Detoxifying Powder). The modified composition is as follows: jingjie (Schizonepeta) 6g, fangfeng (Saposhnikovia) 6g, qianghuo (Notopterygium) 6g, chaihu (Bupleurum) 6 g, bohe (Mentha) 6 g, zhiqiao (Poncirus trifoliata) 6 g, qianhu (Peucedanum) 6 g, jiegeng (Platycodon) 6 g, duhuo (Angelica) 6 g, chuanxiong (Ligusticum) 6 g, fuling (Poria) 6 g, and gancao (Glycyrrhiza) 3 g.

If Cold in the exterior is severe, add mahuang (Ephedra) and guizhi (Cin-namomum) to enhance the actions of dispelling Cold and releasing the exterior. Alternately, use Mahuang Tang (Ephedra Decoction).

ii Wind and Heat

Main Symptoms. High fever, mild or no chills; thirst, sore throat; thin white or yellow tongue coating; and floating and rapid pulse.

Therapeutic Principle. Cool Heat, extinguish Wind and release the exterior with acrid-cool herbs.

Treatment. Yin Qiao San (Lonicera and Forsythia Powder).

If Heat is particularly strong, add huangqin (Scutellaria), banlangen (Isatis) and qinghao (Artemisia).

If thirst is marked, add tianhuafen (Trichosanthes).

If there is chest fullness, add huoxiang (Agastache) and yujin (Curcuma) to regulate Qi and prevent further invasion by exogenous pathogenic evils.

2 High Fever of Qi Level

i Lung-Heat

Main Symptoms. High fever; cough, dyspnea, viscid, purulent or blood-streaked sputum; chest pain; and thirst. The tongue is red, with yellow coating. The pulse is slippery and rapid.

Therapeutic Principle. Cool Heat, detoxify poisons, clear the lung and dissipate Phlegm.

Treatment. Ma Xing Shi Gan Tang (Ephedra, Almond, Gypsum and Licorice Decoction).

If it is necessary to enhance the formula’s ability to cool Heat and detoxify poisons, add jinyinhua (Lonicera), lianqiao (Forsythia), huangqin (Scutellaria) and yuxingcao (Houttuynia).

ii Stomach-Heat

Main Symptoms. High fever, heat-aversion; thirst, much drinking; coarse respiration; halitosis; restlessness; and sweating. The tongue coating is yellow or yellow and dry. The pulse is surging and rapid.

Therapeutic Principle. Purge stomach-Heat and generate fluids.

Treatment. Bai Hu Tang (White Tiger Decoction).

If there is constipation as well, add dahuang (Rheum palmatum).

If there is Dampness in addition to Heat, add cangzhu (Atractylodes lanced).

iii Heat in Intestines

Main Symptoms. High fever, especially in the afternoon; abdominal distention and pain; constipation or fecal impaction with encopresis; or agitation and delirium. The tongue is yellow and dry, with prickles. The pulse is deep, replete and forceful.

Therapeutic Principle. Unblock the intestines and purge Heat.

Treatment. Da Cheng Qi Tang (Potent Purgation Decoction)

If Heat has gelled and Yin damaged, add shengdihuang (Rehmannia), maimen-dong (Ophiopogon) and xuanshen (Scrophularia).

iv Heat in Gallbladder

Main Symptoms. Alternating chills and fever; chest and subcostal tightness or pain; or nausea, vomiting; or jaundice. The tongue is red, with yellow greasy coating. The pulse is slippery and rapid.

Therapeutic Principle. Cool Heat and restore gallbladder function.

Treatment. Da Chaihu Tang (Major Bupleurum Decoction).

If subcostal or abdominal pain is severe, add yanhusuo (Corydalis) and chuanlianzi (Melia).

For jaundice, add yinchenhao (Artemisia capillaris) and zhizi (Gardenia).

If Heat poisons are strong, addjinyinhua (Lonicera), qinghao (Artemisia annua) and lianqiao (Forsythia).

v Dampness-Heat

Main Symptoms. Persistent high fever; band-like heaviness of the head; chest and epigastric fullness; heaviness in the body; and anorexia. The tongue coating is yellow and greasy. The pulse is taut, slippery and rapid.

Therapeutic Principles. Cool Heat and dissipate Phlegm.

Treatment. Gan Lu Xiao Du Dan (Sweet Dew Detoxification Pill). It has the following composition: huangqin (Scutellaria) 10 g, lianqiao (Forsythia) 4g, huashi (talcum) 15 g, mutong (Akebia quinata) 5g, yinchenhao (Artemisia) 10 g, shichangpu (Acorus) 6 g, huoxiang (Agastache) 4 g, and bohe (Mentha) 4 g.

If Heat is especially intense, add huanglian (Coptis) and huangbai (Phelloden-dron).

For Dampness-Heat in the bladder, with urinary frequency, urgency, dysuria and dark urine, add Ba Zheng San (Eight-Herb Rectification Powder), with modifications as appropriate.

If Dampness and Heat are in the large intestine, with abdominal pain, tenesmus and burning anus, use Gegen Qin Lian Tang (Pueraria-Scutellaria-Coptis Decoction) with modifications as appropriate.

vi Summer Heat Injuring Qi

Main Symptoms. Heatstroke, high fever, extreme thirst, profuse sweating; dysphoria, flushed face; and coarse respiration. The tongue is red, with greasy yellow coating. The pulse is surging and rapid.

Therapeutic Principle. Dissipate Summer Heat, augment Qi and generate fluids.

Treatment. Qing Shu Yi Qi Tang (Summer Heat-Dissipating Qi-Augmenting Decoction). It has the following composition: xiyangshen (Panax quinquefolium) 10 g, maimendong (Ophiopogon) 10 g, shihu (Dendrobium chrysanthum) 10 g, huanglian (Coptis) 10 g, hegeng (Nelumbo nucifera, stalk) 10 g, zhuye (Phyllostachys nigra) 10 g, zhimu (Anemarrhena) 10 g, gancao (Glycyrrhiza), jingmi (Oryza sativa) 10 g, and xiguapi (Citrullus vulgaris) 10 g.

If Summer Heat is extreme, add shigao (gypsum).

If Yin injury is not prominent, remove xiyangshen and maimendong.

3 Intense Heat in Nutritive and Blood Levels

Main Symptoms. High fever worst at night; dysphoria, restlessness; or clouded mind, delirium; or convulsion, cutaneous ecchymosis and petechiae. The tongue is deep red or deep crimson. The pulse is threadlike and rapid.

Therapeutic Principle. Purge the Nutritive Level of Heat, cool the Blood Level and detoxify poisons.

Treatment. Qing Ying Tang (Nutritive-Clearing Decoction).

If there is bleeding, add mudanpi (Paeonia suffruticosa), baimaogen (Imperata) and cebaiye (Biota orientalis).

For clouded mind and delirium, use An Gong Niuhuang Wan (Gallstone Palace-Calming Pill), one tablet three times daily.

4 High Fever due to Internal Injury

Fever due to internal injury is usually low grade. A few patients, however, do have prolonged fever above 39°C (102.2°F).

Two pathological mechanisms lead to high fever in internal injury, and both involve functional impairment of the visceral organs. One leads to Qi stagnation and blood stasis, so that Dampness gels, causes blockage and transforms into Heat. The other leads to deficiency of Qi, blood, Yin or Yang, with imbalance of Yin-Yang, so that endogenous Heat develops. Functional impairment of the viscera may result from improper diet, the passions being pent-up, excessive fatigue, unrestrained sexual activity or protracted severe illness.

Qi Deficiency. Fever fluctuates widely, but is generally worsened by fatigue. In addition, there are such symptoms of Qi deficiency as lassitude, shortness of breath, spontaneous sweating, decreased appetite and loose feces. Apply the therapeutic principle of using sweet-warm formulas to cool Heat. Use Bu Zhong Yi Qi Tang (Middle-Restoring and Qi-Augmenting Decoction).

Blood Insufficiency. This may come about because of massive bleeding or protracted illness. In addition to high fever, the typical symptoms are pallor, a pale tongue and a threadlike and feeble pulse. Treat with Gui Pi Tang (Spleen-Restoring Decoction).

Yin Deficiency. In this case, there is recurrent fever that is highest in the afternoon and at night. In addition, the typical symptoms include hotness in the palms and soles, dry mouth and throat, a red tongue with little coating, and a threadlike and rapid pulse. Treat with Qing Gu San (Bone-Cooling Powder). It has the following composition: yinchaihu (Stellaria dichotoma), zhimu (Anemarrhena), huhuanglian (Picrorhiza scrophulariflora), digupi (Lycium), qinghao (Artemisia), qinjiao (Gentiana), biejia (Amyda), and gancao (Glycyrrhiza).

Yang Deficiency. Several typical symptoms accompany high fever in this case. These include chills, coldness of the body, shortness of breath, aches and weakness in the limbs and knees, a pale plump tongue that may be indented, a moist white tongue coating, and a deep, threadlike and forceless pulse. Treat with Jin Gui Shen Qi Wan (kidney-Qi Pill from the Golden Cabinet).

Qi Stagnation. The fever fluctuates with changes in the emotions. In addition, there are a bitter taste, subcostal distention, agitation, irascibility, and a taut and rapid pulse. Treat with Dan Zhi Xiao Yao San (Carefree Powder with Paeonia and Gardenia).

Blood Stasis. Here, high fever comes in the afternoon or at night. There are accompanying dry mouth and throat but little drinking, pain with fixed location or mass on the limbs or body, cyanotic tongue speckled with petechiae and a taut and impeded pulse. Treat with Xue Fu Zhu Yu Tang (Decoction for Releasing Blood Stasis).

Dampness. For high fever due to Dampness gelling in the interior and transforming into Heat, treat with San Ren Tang (Three-Seed Decoction).

Herbal Treatment

Several prepared formulas are convenient for emergency treatment of convulsions.

Zhi Jing San (Spasm-Relieving Powder): 3 g three times daily for seizures involving all four limbs. It has the following composition: quanxie (Buthus) and wugong (Scolopendra).

An Gong Niuhuang Wan (Gallstone Palace-Calming Pill): one pill three times daily for seizures due to extreme Heat giving rise to Wind.

Zi Xue Dan (Purple-Snow Pill): 3 g three times daily, also for seizures due to extreme Heat giving rise to Wind.

Hupo Bao Long Wan (Amber Dragon-Embracing Pill): one pill three or four times daily. This formula has the ability to extinguish Wind, stop convulsion, dissipate Phlegm and cool Heat. Hupo Bao Long Wan has the following composition: niuhuang (Bos taurus domesticus, gallstone), renshen (Panax), gouteng (Uncaria), hupo (amber), xionghuang (realgar), tianzhuhuang (Bambusa textilis), shexiang (Moschus), baijiangcan (Bombyx mori), fuling (Poria), zhusha (cinnabar), and bile-treated nanxing (Arisaema erubescens).

Extreme Heat Giving Rise to Wind

Main Symptoms. In addition to convulsion, there are opisthotonos, trismus, teeth-grinding, eyes rolling upward, high fever, thirst with desire for cold drinks, restlessness, abdominal distention and constipation. The tongue is red, with yellow coating. The pulse is taut and rapid.

Therapeutic Principle. Purge Heat and preserve Yin.

Treatment. Xi Ling Bai Hu Tang (Rhinoceros-Antelope White Tiger Decoction). This is Bai Hu Tang (White Tiger Decoction) augmented with the following herbs: shuiniujiao (Bubalus bubalis) 10 g, lingyangjiao (Saiga tatarica) 10 g, gouteng (Uncaria) 10 g, and juhua (Chrysanthemum) 10 g. [The original composition of this formula used rhinoceros horn, hence the name. This is now replaced by the horn of the water buffalo, which is equally efficacious.]

For trismus and gurgling in the throat from sputum, add bile-treated nanxing (Arisaema consanguineum).

For loss of consciousness or delirium, prescribe An Gong Niuhuang Wan (Gallstone Palace-Calming Pill) to open orifices and resuscitate.

For constipation and abdominal distention and pain, add dahuang (Rheum palmatum), mangxiao (Mirabilite) and zhishi (Citrus aurantium) to facilitate defecation of Heat-purging.

If Heat attacks the Nutritive and Blood Levels, with eruption of macular rash, add shengdihuang (Rehmannia) and mudanpi (Paeonia suffruticosa) to help cool blood and purge Heat.

Hyperactive Yang Transforming into Wind

Main Symptoms. A patient with constitutional hyperactivity of liver-Yang suddenly develops headache and vomiting, followed by loss of consciousness and seizure. In addition, the face is flushed and there may be loud snoring. The tongue is red, with yellow coating. The pulse is taut, tight and forceful.

Therapeutic Principle. Nourish Yin, subdue Yang, calm the liver and extinguish Wind.

Treatment. Zhen Gan Xi Feng Tang (Liver-Sedating and Wind-Extinguishing Decoction). Since their purpose is to unblock the liver yinchenhao and maiya may be removed from this formula.

To enhance the formula’s ability to calm the liver and extinguish Wind, add tianma (Gastrodia) and gouteng (Uncaria).

For intense headache, add lingyangjiao (Saiga tatarica), xiakucao (Prunella) and kudingcha (Ilex cornuta, latifolia).

If there is gurgling in the throat from sputum, add Zhejiang beimu (Fritillaria), tianzhuhuang (Bambusa textilis), zhuru (Phyllostachys nigra) and bile-treated nanxing (Arisaema consanguineum) to dissipate Phlegm.

Wind Stirring due to Yin Deficiency

Main Symptoms. Chorea-like movements of the hands and feet; low fever, flushed cheeks; dry mouth, dry tongue; lassitude; and shortness of breath. The tongue is crimson and denuded. The pulse is threadlike and rapid, or depletive and rapid.

Therapeutic Principle. Nourish Yin and extinguish Wind.

Treatment. Da Ding Feng Zhu (Major Wind-Extinguishing Pearls).

If there is insufficiency of Qi and blood as well, add huangqi (Astragalus), dangshen (Codonopsis) and danggui (Angelica) to augment Qi and nourish blood. Alternately, prescribe Ba Zhen Tang (Eight Treasures Decoction).

Interior Invasion by Wind Poisons

Main Symptoms. Following physical trauma the patient develops headache, dizziness, restlessness, grimacing, opisthotonos, and recurrent seizures involving all four limbs. The tongue coating is greasy, and the pulse taut and tight.

Therapeutic Principle. Dispel Wind, detoxify poisons and relieve convulsion.

Treatment. Yu Zhen San (Fairy Powder). It has the following composition: tianma (Gastrodia) 10 g, baiprocessed processed fuzi (Typhonium giganteum) 10 g, nanxing (Arisaema erubescens) 10 g, fangfeng (Saposhnikovia) 10 g, baizhi (Angelica dahurica) 9 g, and qianghuo (Notopterygium) 9 g.

To enhance the ability to relieve convulsion, quanxie (Buthus), wugong (Scolo-pendra) and baijiangcan (Bombyx) may be added.

Exogenous Evils Blocking Meridians

Main Symptoms. Convulsion involving all four limbs; opisthotonos; trismus, inability to speak; chills, fever; no or slight sweating; headache; and heaviness of limbs. The tongue is pale red, with thin white coating. The pulse is floating and tight.

Therapeutic Principle. Dispel Wind, disperse Cold, dry Dampness and harmonize the Nutritive Level.

Treatment. Modified Qianghuo Sheng Shi Tang (Notopterygium Dampness-Defeating Decoction). It has the following modified composition: qianghuo (Notopterygium) 10 g, duhuo (Angelica pubescens) 10 g, gaoben (Ligusticum sinense) 10 g, fangfeng (Saposhnikovia) 10 g, gancao (Glycyrrhiza) 6 g, chuanxiong (Ligusticum) 10 g and manjingzi (Vitex trifolia) 9 g.

If Cold is stronger than the other exogenous evils, with headache, no sweating and tense pulse, release the exterior and induce sweating with Gegen Tang (Pueraria Decoction). It has the following composition: gegen (Pueraria), mahuang (Ephedra), guizhi (Cinnamomum), baishaoyao (Paeonia) and gancao (Glycyrrhiza).

Sometimes Dampness and Heat enter the channels and produce such symptoms as muscle spasm, fever, epigastric fullness, thirst without desire to drink, dark urine, yellow and greasy tongue coating and slippery and rapid pulse. For this illness, prescribe San Ren Tang (Three-Seed Decoction) augmented with dilong (Pheretima), sigualuo (Luffa cylindrica) and weilingxian (Clematis) to enhance its ability to unblock channels.

Herbal Treatment

Qi-Shock

Main Symptoms. Pallid complexion; profuse sweating; shortness of breath; shut eyes, open mouth; incontinence of urine and feces; plump tongue; and forceless pulse.

Therapeutic Principle. Augment Qi and reverse collapse.

Treatment. Du Shen Tang (Lone Ginseng Decoction).

If renshen is not available, huangqi (Astragalus) or baizhu (Atracty lodes) may be used as substitute.

If sweating persists, add huangqi (Astragalus) and wuweizi (Schisandra) to supplement Qi augmentation and to astringe sweat.

Blood-Shock

Main Symptoms. Pallid, lusterless complexion; dizziness, blurred vision; palpitations, restlessness; short, shallow respiration; and gray, cold limbs. In severe cases, there is dull sensorium or loss of consciousness. The tongue is pale white. The pulse is hollow or indistinct and on the verge of collapse.

Therapeutic Principle. Augment Qi, replenish blood, support genuine Qi and reverse collapse.

Treatment. Danggui Bu Xue Tang (Angelica Blood-Replenishing Decoction). It has the following composition: huangqi (Astragalus) 30 g (five parts) and danggui (Angelica) 6 g (one part).

If there is concern that the blood loss will lead to Qi-shock as well, use Du Shen Tang (Lone Ginseng Decoction) first.

If bleeding persists, add ejiao (Equus), xianhecao (Agrimonia pilosa), cebaiye (Biota orientalis) and other herbs that nourish blood and stop bleeding.

If palpitation and restlessness are prominent, add suanzaoren (Ziziphus), yuanzhi (Polygala) and wuweizi (Schisandra) to nourish blood and calm the mind.

Yin-Shock

Main Symptoms. Flushed face; sweating, fever, thirst, desire to drink, or agitation, restlessness; dry lips, dry mouth; and dark urine, dry feces. The tongue is denuded and dehydrated or dark red. The pulse is threadlike and indistinct or indistinct and on the verge of collapse.

Therapeutic Principle. Nourish Yin, generate fluids, augment Qi and reverse collapse.

Treatment. Sheng Mai San (Pulse-Generating Powder).

If necessary, processed processed fuzi (Aconitum) and ganjiang (Zingiber) may be added to prevent Yang from depletion and becoming uprooted.

If the cause is fluid loss due to vomiting or diarrhea, it is appropriate first to use Si Ni Tang (Frigid-Extremities Decoction) to rescue Yang and reverse collapse, then follow with herbs to nourish Yin and augment Qi.

If sweating is profuse, add shanzhuyu (Cornus), longgu (fossil bone) and muli (Ostrea) to astringe sweat and reverse collapse. Note: longgu and muli are decocted first.

Yang-Shock

Main Symptoms. Pallid complexion; profuse sweating; shallow respiration; cold body, limbs; and dull sensorium. The tongue is pale but moist. The pulse is indistinct and on the verge of collapse.

Therapeutic Principle. Rescue Yang and reverse shock.

Treatment. Shen Fu Tang (Ginseng-Aconitum Decoction). Its composition is as follows: processed processed fuzi (Aconitum) 10 g and renshen (Panax) 10 g.

If the face and lips are cyanotic, add danshen (Salvia), danggui (Angelica) and chishaoyao (Paeonia) to relieve stasis and unblock the channels.

Note. When Yang-shock develops, it requires immediate treatment. If available, certain solutions for injection may be used. These include Renshen Injection (made from renshen, Panax), Sheng Mai Injection (made from Sheng Mai San, Pulse-Generating Powder), Shen Fu Injection (made from Shen Fu Tang, Ginseng-Aconitum Decoction), Zhishi Injection (made from zhishi, Citrus aurantium), and Qingpi Injection (made from qingpi, Citrus tangerina).

Herbal Treatment

Strength Type of Qi Syncope

Main Symptoms. Sudden fainting precipitated by emotional stimulation, loss of consciousness, coarse respiration, tight jaws and fisted hands; or cold limbs. The tongue coating is thin and white. The pulse is deep and taut or deep and sunken.

Therapeutic Principle. Regulate Qi and release stagnation to open orifices.

Treatment. For resuscitation, force-feed Suhexiang Wan (Storax Pill). Follow with Wu Mo Yin Zi.

If there is much sputum causing impeded respiration, add bile-treated nanxing (Arisaema consanguineum), zhuli (Phyllostachys nigra) and beimu (Fritillaria) to eliminate sputum.

If there are dizziness and headache, with flushed face and red eyes, add gouteng (Uncaria) and shijueming (Haliotis) to calm the liver and suppress Yang.

For patients with a history of similar attacks, use such formulas as Xiao Yao San (Carefree Powder) as a preventive.

Deficiency Type of Qi Syncope

Main Symptoms. Weak constitution; precipitating symptoms such as overwrought emotions, excessive fatigue, hunger or intense pain; dizziness, fainting; pallid complexion; sweating, cold limbs; and weak respiration. The tongue is pale. The pulse is deep and infeeble.

Therapeutic Principle. Augment Qi and revive Yang.

Treatment. For resuscitation force-feed Shen Fu Tang (Ginseng-Aconitum Decoction). Alternately, inject Sheng Mai Solution (Pulse-Generating Solution) intravenously pre-prepared from Sheng Mai San (Pulse-Generating Powder).

Follow with Si Wei Hui Yang Yin (Four-Ingredients Yang-Rescue Drink). It has the following composition: renshen (Panax) 10 g, processed fuzi (Aconitum) 6g, ganjiang (Zingiber) 10 g, and gancao (Glycyrrhiza) 6g. Note: renshen is decocted first.

If sweating is profuse, add huangqi (Astragalus), baizhu (Atractylodes), longgu (fossil bone) and muli (Ostrea) to firm the exterior and stop sweating. (Note: longgu and muli have to be decocted first.)

Strength Type of Blood Syncope

Main Symptoms. Frequent dizziness; sudden fainting, often precipitated by emotional upset; tight jaws, flushed face, and purple lips. The tongue is dark red. The pulse is taut and forceful.

Therapeutic Principle. Open the orifices, mobilize blood and regulate Qi.

Treatment. For resuscitation force-feed Suhexiang Wan (Storax Pill). Alternately, use Qing Kai Ling intravenously by push or drip.

Follow with Tong Yu Jian (Stasis-Resolving Decoction). It has the following composition: danggui (Angelica) 10 g, honghua (Carthamus) 3g, shanzha (Crataegus) 6g, qingpi (Citrus tangerina) 10 g, wuyao (Lindera) 10 g, muxiang (Aucklandia) 10 g, xiangfu (Cyperus) 10 g, and zexie (Alisma) 10 g.

For agitation and irascibility, with dizziness and headache, add shijueming (Haliotis), gouteng (Uncaria), longdancao (Gentiana), juhua (Chrysanthemum) and shichangpu (Acorus) to calm the liver and the mind.

Deficiency Type of Blood Syncope

Main Symptoms. Sudden fainting, pallid complexion, lusterless lips, limb tremor, spontaneous sweating, cold limbs and weak respiration. The tongue is pale. The pulse is hollow or threadlike, rapid and forceless.

Therapeutic Principle. Augment Qi and nourish blood.

Treatment. For resuscitation force-feed Du Shen Tang (Lone Ginseng Decoction) or give Renshen Solution or Sheng Ma Solution by intravenous drip or push.

Follow with modified Renshen Yang Ying Tang (Ginseng Nutritive-Supporting Decoction). It has the following composition: renshen (Panax) 10 g, huangqi (Astragalus) 10 g, danggui (Angelica) 10 g, shudihuang (Rehmannia) 10 g, baishaoyao (Paeonia) 10 g, wuweizi (Schisandra) 10 g, baizhu (Atractylodes) 10 g, fuling (Poria) 10 g, yuanzhi (Polygala) 10 g, gancao (Glycyrrhiza) 10 g, rougui (Cinnamomum) 10 g, shengjiang (Zingiber) 10 g, dazao (Ziziphus) 10 g, andchenpi (Citrus tangerina) 10 g.

For spontaneous sweating and cold limbs, with weak respiration, add processed processed processed fuzi (Aconitum) and ganjiang (Zingiber) to warm Yang.

For dry mouth with insufficient fluids, add maimendong (Ophiopogon), shashen (Adenophora tetraphylla) and yuzhu (Polygonatum) to nourish Yin.

Summer Hert Syncope

Main Symptoms. Sudden fainting on a hot summer day; fever with cold limbs; and flushed facet. In some cases, there may be delirium. The tongue is red and dry. The pulse is surging and rapid.

Therapeutic Principle. Cool Summer Heat, augment Qi, open orifices and stimulate the mind.

Treatment. For resuscitation force-feed Niuhuang Qing Xin Wan (Gallstone Mind-Clearing Pill) or Zi Xue Dan (Purple-Snow Pill). Alternately, give Qing Kai Ling intravenously. General measures include moving the patient to a shaded and cool place, oxygen inhalation, intravenous fluids and an effective cooling measure.

Follow with Bai Hu Jia Renshen Tang (White Tiger plus Ginseng Decoction).

If there are convulsion and delirium, add lingyangjiao (Saiga tatarica), gouteng (Uncaria) and juhua (Chrysanthemum) to cool Heat, regulate the liver, dispel Wind and stop convulsion.

Phlegm Syncope

Main Symptoms. There is a history of habitual overindulgence in fatty and sweet foods, with much sputum. Sudden fainting precipitated by rage; gurgling in the throat with sputum; spitting of sputum or saliva; and coarse respiration. The tongue coating is white and greasy. The pulse is deep and slippery.

Therapeutic Principle. Mobilize Qi and eliminate Phlegm.

Treatment. Dao Tan Tang (Phlegm-Dissipating Decoction).

To enhance the formula’s actions to eliminate Phlegm and regulate Qi, add zisuzi (Perilla) and baijiezi (Brassica).

If Phlegm and Dampness have given rise to endogenous Heat, with viscid yellow sputum and greasy yellow tongue coating, add zhuli (Phyllostachys), zhizi (Gardenia) and huangqin (Scutellaria) to cool Heat and dissipate Phlegm.

Food Retention Syncope

Main Symptoms. Sudden fainting, suffocating sensation and epigastric fullness. The tongue coating is thick and greasy. The pulse is slippery and replete.

Treatment. If syncope occurs shortly after eating, induce vomiting with salt solution and follow with Shen Zhu San (Leaven-Atractylodes Powder) and Bao He Wan (Harmony-Preserving Pill). The combined composition is as follows: shanzha (Crateagus), shenqu (medicated leaven), laiprocessed processed fuzi (Raphanus), huoxiang (Agastache), cangzhu (Atractylodes lanced), houpo (Magnolia), sharen (Amomum), banxia (Pinellia), chenpi (Citrus tangerina) and fuling (Poria).