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Bensky & Barolet's F & S defines the actions of RSBDS as releasing

the exterior wind-cold-damp pathogen, and augmenting the qi. The

formula is used for patients with pre-existing vacuous qi with a

w-c-d external invasion, where the qi is insufficient to expel the

pathogen. However, the main symptoms are given as " high fever and

severe chills with shivering ... absence of sweating ... " . I'm

interested in seeing if anyone has a good explanation for this

apparent inconsistency with the general rule of thumb that qi

deficient patients are more likely to have a low grade fever with an

external syndrome. F & S doesn't discuss the issue, and neither does

the one Chinese source I've looked at. My ideas so far are:

 

1. Although the patient has qi vacuity, the wei qi is strong,

(absence of sweating), so the external struggle between defense and

pathogen is strong.

 

2. The pathogen has has become partly internal, and the high fever

represents a yangming stage process, while simultaneously remaining

external.

 

3. The pathogen is more like an epidemic toxin (even though it's cold

damp), and so the fever is strong.

 

4. The formula was written for treatment of children, and children

are more inclined to get high fevers.

 

Does anyone have good explanation, preferably one that has a source

in the literature?

 

TIA

 

Rory

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