Home Forums Diplomate Discussion Hi All

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      Hi All: I’ve been working with GZQSYJMHFZXXT this autumn/winter more so than usually for sinus issues. This is a bit of an off label use as it is indicated in the text for epigastric hardness. Also, though we don’t have a standard pulse per se, we tend to go off something like a ZWT pulse for it, though here I’ve been using it more off the cuns, going more off herb methods.I hope these cases are helpful to some, and if anyone has any critiques or any other ideas about what could’ve been done better or differently, it’d be great to discuss it. Case 1: 14 yr old femaleMain complaint – sinus congestion & very dry painful nose following an anaphylactic shock several months previouslyAlso has dryness of the eyesNumbness & tingling of upper lipDry mouthFrequent urinationBowels are normalL – 1st superficial thin wiry faint, 2&3 deep faintR – 1st superficial very tight, 2&3 deep faintGZ 9SJ 9DZ 6GC 6MH 6FZ 30XX 6 Did 12 days bulk, and sinus congest and nose dryness improved by 85%, then she caught a cold and slipped back to 65%.Numbness & tingling of the upper lip resolved. She was then harmonised and treatment was continued with ZWT+XX with continued improvement. My thought process went thusly:Upon hearing her symptoms my thoughts naturally went to GGT, but then when feeling the faintness of the L side of the pulse I felt this could be a GZJFZT, and if the R side of this pulse didn’t show much this is where I would have gone. However the superficial tight R cun brought cold/closure of tai yin into the equation, and if the R guan has also shown size then this could have still been a weak GGT with a FZ formula as a followup, or if there had been some upward moving yang then even GZJNT mod could’ve come into the equation, but the rest of the R side was deep faint, so they were all eliminated from the process. If the R 1st had been more mid depth or deeper tight then a ZWT could’ve come into the equation, but that wouldn’t account for the left, nor would a LGWWJXT. If the pulse had not been so faint then L 1st up and R 1st up and tight could fit XQLT, which would have MH to open tai yin to allow the congested fluids to descend and XX to open the nose, again if the R 2nd had the appropriate findings XQLT+GG could have been considered, but the pulse over all was too faint for a XQLT. Another thought was that if only the R 1st was there then the faintness would point to MHFZXXT, which had all the elements I wanted but still didn’t attend to the L 1st. At this point GZQSYJMHFZXXT came to mind as a formula that ticked all the boxes. I have since used it in a few more cases where the pulse indicated the need for a GZ&MH combination with cold fluids in the picture, and I’ve also wanted XX to open the nose, but overall it has been too faint for something like Xiao Qing Long Tang (used more for sinuses than cough, a bit like a LGWWJXT with a finding on the L too), I’ve come to use it as a deficient XQLT, a Xu Qing Long Tang if you will. Case 2: late 20’s femaleMain complaint – hay fever with sinus congestion, headaches, facial pain, runny nose, very dry eyesAsthma with shortness of breathAcid reflux with epigastric painBowels – 2xday, tends to looseL 1st superficial faint, tight, 3rd deep tightR 1st superficial, very tight, 3rd deep tight GZQSYJMHFZXXT was prescribed in granules for 3 weeks; headaches, facial pain, sinus congestion, dry eyes, shortness of breath, and epigastric pain has all significantly lessened, reflux had only occurred once.She was beginning to get some restlessness and poor sleep. The cun positions had dropped away, ZWT+XX, GJ, XR was prescribed as a followup. Case 3: early 50’s femaleMain complaint – loss of sense of smell and taste after surgery for nasal polyps. Sense of smell and taste return slightly with the use of steroids and when she goes running.Clear runny noseEasily gets sinus congestion and pain. Initially ZWT+XX was prescribed and the sense of smell returned on and off, then ZWT+XX was re-prescribed but with the addition of Shi Chuang Pu in an attempt to strengthen the effect of the formula, and Zhi Shi as the bowels were slowing down. On these modifications the sense of smell and taste disappeared again and did not come back when restarting the original formula. Following this she was harmonised, then her pulse showed the following:L 1st superficial faint, 2&3 deep faint wiry/tightR 1st superficial, very tight, 2nd deep tight, GZQSYJMHFZXXT was prescribed in granules for 3 weeks and the sense of smell and taste began to return constantly, but at a low level. The pulse was largely unchanged and a repeat was prescribed.

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