I have a patient with 10 months of coughing fits and intermittent wheezing. He’s seen about a dozen doctors and been on 5 rounds of antibiotics with no improvement. His last round was after this thing was finally diagnosed as a pneumonia superbug. It was a 21-day course of ABX that didnt’ help. Coughing is productive, with thick yellow-green phlegm, and he showed me a picture of the expectorate that looked like a friggin poached egg. Crazy that it came out of his lungs. He also has a lot of neck stiffness and gets crazy muscle spasms in his upper body–mainly torso but can affect different muscles over a pretty large part of his body in a single 30 second episode. He often gets these as a response to needling (fun) within a second or two of needle insertion. He has a dusky tongue with greasy yellow tongue coat, and to top this all off, he has bilateral deviated pulses. On the left hand I can feel it between the lung and LI channels. On the right, I can’t find it for the life of me. He has significant varicose veins in his feet and dry cracked skin on the distal part of the spleen channel of his feet. My treatments have been somewhat scatter-minded. We’ve done variations on XXXT with XB, ZS. I’ve tried mixing that with SYGCT (to stop bronchiole and skeletal muscle spasms) and GZFLW (for the obvious blood stasis in his feet, and thinking blood circulation in his chest may be related to fluid accumulation in the chest?). It’s been about a month now with no improvement. I was reading about Da Xianxiong Wan, where there is chest bind with neck rigidity and mild convulsions. This all sounds like my guy, but he does not have pain on palpation of his chest and abdomen. Should I abandon this line of thinking? And if it’s worth considering, where does one get Gansui? Or how do we substitute?
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