As we move into the winter months, it is important for clinicians to have a solid working knowledge of effective herbal protocols for treating and managing clinical cold and flu presentations.It is commonplace to have patients referred to me by other clinicians due to complications in cold and flu scenarios and in almost all of these cases the respective patient was previously administered the patent medicine Yin Qiao San. Upon questioning if they were experiencing Wind Heat symptoms appropriate to Yin Qiao San, the majority of the patients reply: "I don't remember, I was just told this was a good formula for colds or flu regardless of what I was feeling." In my personal clinical opinion, the patent medicine Yin Qiao San is perhaps the most misused and over prescribed medicine of Traditional Chinese Medicine eclipsed only by Xiao Yao San in incorrect administration. I want to present some important patent medicines in the treatment and management of cold/flu presentations, which are often underutilized by practitioners and clinicians.
Ren Shen Bai Du San
This is an important patent medicine which dispels wind-cold-damp, resolves the exterior and tonifies the qi. Perhaps the most common presentation I see in the clinic is a patient with cold/flu symptoms due to various types of wind invasion with a chronic underlying qi vacuity. In these cases, simply handing out Yin Qiao San will not adequately address the presentation and may actually allow the situation to worsen. This patent is an excellent fit for patients with an underlying qi vacuity suffering from chronic allergies; this presentation creates a "perfect storm" for wind invasion complications. This patent is also wonderful for post-partum deficiency syndromes coupled with wind invasion as well as elderly patients contracting cold/flu symptoms. It's important to also remember that this patent can and should be combined with appropriate heat clearing formulas as needed. I often combine this patent medicine with Echinacea and Elderberry extract for more effective symptom resolution.
Nei Xiao Luo Li Wan
This patent medicine is a vastly underutilized formula which clears heat, resolves toxins, disperses swelling, transforms phlegm, softens hardness and dissipates nodules. This formula is a key addition for patterns of wind heat which include infected or swollen lymph glands and severe swollen throat. It can also be used to resolve recalcitrant phlegm in the respiratory system with cold and flu complications. I often combine this patent medicine with the patent medicine Bai Hu Tang in cases of extreme heat and or high fever, as this combination can quickly address aggressive acute presentations. The herb Echinacea makes a perfect addition to this formula as well. I also use this formula in cases of wind heat invasion with an underlying sinus infection due to chronic allergies. I often have patients take this formula with Ju Hua or chrysanthemum tea as an "anupana" or "vehicle" to enhance the medicinal effects.
Pu Ji Xiao Du Yin
This patent medicine clears heat, resolves toxins, dispels pathogenic wind, cools the blood and moistens the throat. This is one of the most effective formulas for bacterial and viral issues in general and strep throat, tonsillitis and lymphatic swelling in particular. In presentations of wind heat invasion which rapidly progress to more severe symptoms, always keep this formula in mind. In most cases of wind heat invasion which I see in the clinic, the patient has already been experiencing prodromal symptoms for a week before they seek help. In these cases, a simple patent of Yin Qiao San will not work and Pu Ji Xiao Du Yin can provide key actions to resolve the pattern presentation and can easily be combined with other appropriate patents as needed.
Chuan Xin Lian
This patent clears heat, resolves toxins, cools the blood and disperses swelling. An elegant simple three-herb formula, Chuan Xin Lian is a wonderful adjunct to add to various other formulas when a stronger action is needed to clear heat. This formula is key for sore throats and lymphatic issues related to heat and is also an excellent adjunct for heat in the liver and can be used effectively in presentations of herpes simplex, oral or genital, and herpes zoster, shingles. The common cold or flu presentations which exacerbate quickly into blood heat or toxic heat can be addressed with this formula in combination with the appropriate differential diagnosis. This patent can also be used to clear secondary bacterial infections resulting from lingering cold and flu symptoms as it addresses heat toxins affecting the lymph, blood and organ level of the body.
Gan Mao Ling
This formula clears heat, resolves toxins, dispels wind, relieves cough, and opens the nasal orifice. This patent particularly targets pathogenic wind heat in the Shao Yang and Yang Ming stages expressed via symptoms such as fever with chills, sore throat, red eyes, stiff muscles/general aching, nasal discharge and or swollen lymph glands. Gan Mao Ling can easily be combined with other wind heat formulas such as Sang Ju Yin or Yin Qiao San for more effective symptom resolution. I often encourage patients to have this patent formula on hand to take at the first sign of standard cold and flu symptoms which express as wind heat invasion. It is a wonderful combination with Elderberry syrup and should be dosed frequently at the first sign of cold/flu symptoms, ideally every 3 to 4 hours in combination with Elderberry extract in syrup form.
Zhong Gan Ling
This patent medicine dispels pathogenic wind, clears heat, resolves toxins, cools the blood, and moistens the throat. It is a key formula for cold and flu presentations with fever, chills, headache, body aches, sore throat and swollen lymph glands. It can easily be combined with Yin Qiao San, Gan Mao Ling, Bai Hu Tang, or Chuan Xin Lian as needed depending upon the pattern presentation and severity of symptoms.
I hope this quick overview of these important patent medicines broadens the clinician's view of treatment options for cold and flu presentations. I have written in past articles about important ideas when using Echinacea and respiratory issues as complications of cold and flu issues, so I encourage reader's to refer back to these articles in conjunction with the material presented for the acute treatment of cold and flu challenges.
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