During the cold and flu season it is not uncommon to hear of clinicians prescribing such patent remedies as Gan Mao Ling, Yin Chiao Jie Du Pian, or Ge Gen Wan for acute presentations of the predictable symptoms of early-stage viral infection. The patient's initial symptoms often may resolve or lessen; so rather than resting adequately, the patient will continue with an active lifestyle due to family and/or work responsibilities. This is an extremely common clinical scenario, and in such cases the patient can suffer from lingering low-grade post-wind-invasion syndromes.
When such scenarios occur, I have found the most common issues to be low-grade lingering symptoms of the respiratory tract. The TCM pattern presentations I most commonly encounter with these lingering issues are lung qi deficiency and lung yin deficiency.
With that said, let's discuss various patent medicines that are highly effective when treating lingering respiratory symptoms which present following viral infection; as well as a simple herbal tea patients can use in conjunction with the TCM patent medicines to efficiently clear lingering respiratory concerns. This is a particularly important area of therapy, as allopathic medicine does not have much to offer for low-grade, lingering symptoms.
Lung Qi Deficiency
One of my favorite formulas for treating the pattern of lung qi deficiency post-viral infection is Bu Fei Wan. This patent medicine is a highly effective option for deficiency presenting with chronic cough with mostly clear, thin sputum, breathlessness on exertion, wheezing, spontaneous sweating, and excessive fatigue. The tongue can be pale to normal with thin coating; pulse can be weak or even normal.
A simple, yet highly effective patent medicine, Bu Fei Wan contains herbs to boost spleen qi, nourish lung yin, stop sweating and calm cough. This is an extremely gentle formula that can easily be combined with other spleen qi patent medicines such as Bu Zhong Yi Qi Tang or Shen Qi Da Bu Wan if the qi deficiency is severe – usually indicated by signs such as loose stool and poor appetite in addition to the expected signs of fatigue.
Patients can increase the dose of Bu Fei Wan in the initial stages of treatment and gradually lower the dose as the cough clears and other deficiency signs resolve.
This is one of my all-time favorite formulas for treated lingering respiratory symptoms coupled with fatigue following viral infection. It is not uncommon for patients to be prescribed antibiotics when viral infections progress to more serious respiratory symptoms; as a result, patients often experience chronic fatigue and gastric symptoms even when the respiratory symptoms clear. In such cases, Bu Fei Wan is a highly effective option.
Lung Yin Vacuity
In cases of lingering low-grade symptoms of the respiratory tract, it is extremely common for the lung viscus to become dry and irritated, leading to the pattern of yin deficiency. This typically presents as a chronic dry, irritating cough (usually worse at night); dry lips and mucous membranes; low-grade fever; night sweats; heat in the palms and soles; and potentially dry stools with constipation. The tongue is typically dry with no coating or geographic coating and red body; pulse is usually rapid and thin.
In these cases, the patient may also experience a chronic dry sore throat and dry mouth that are not improved by drinking fluids and show no signs of inflammation upon examination.
The patent medicine Bai He Gu Jin Wan is an excellent choice for such cases. One important factor to keep in mind when using this patent medicine is that it contains some yin-enriching ingredients that are rich and cloying, and may aggravate any patterns of underlying dampness or spleen deficiency. If there are signs of dampness or spleen deficiency, the formula can be taken along with spleen tonics or with small doses of Bao He Wan (mentioned in my last Planetary Herbalism column – February issue).
If the patient has significant weak digestion and a history of spleen deficiency, you can use Sha Shen Mai Dong Wan, which targets lung yin deficiency and stomach yin deficiency, and contains much less rich or cloying herbs. I find Sha Shen Mai Dong Wan particularly effective for patients suffering from low-grade respiratory symptoms post-viral infection who are also chronic smokers of cannabis or tobacco; and for patients who live in extremely dry climates. If dry signs are a significant part of the pattern presentation along with qi deficiency signs, Sha Shen Mai Dong Wan can be combined with the patent medicine Sheng Mai San Wan.
A tea I also use regularly with patients suffering from lingering post-viral infection respiratory symptoms is mullein leaf tea. This tea can be found at herb stores and brewed easily at home. Patients can brew a quart of tea and sip throughout the day, and use this tea in conjunction with the above-mentioned TCM patent medicines. Mullein tea gently nourishes lung yin, calms coughs, and is very spleen-friendly.
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