Wind-Heat invasions can be of two types: it may be what I call a "simple" Wind-Heat invasion, or it may be a Wind-Heat invasion of the Wen Bing type. For example: an acute mononucleosis would be a Wind-Heat invasion of the Wen Bing type.
From the pathology point of view, they are basically the same, but the Wen Bing Wind-Heat invasions are more severe and potentially more harmful.
The " Clear Metal " remedy can be used for both types of invasions. Whether the Wind-Heat invasion is Wen Bing or not, I always make a diagnosis based on the theory of the "4 levels": Wei, Qi, Ying and Xue. I think that the theory of the 4 levels is absolutely essential for the diagnosis and treatment of acute wind-heat invasions.
At the Wei level, the Wind-Heat is on the outside. The Wei level is characterized by a simultaneous aversion to cold and fever. That is to say, you observe the patient, maybe he is a child in bed, he has a fever and his forehead is very hot, but the child feels cold. This is the classic symptomatology of the acute state of a Wind-Heat invasion, which would be at the Wei level, of the 4 levels. "Clear" Metal "is NOT for the Wei level, I repeat: It's not for the Wei level.
At the Qi level, Heat has penetrated the interior, and the main difference is that the patient no longer has an aversion to cold. He no longer feels cold, but warmth. The child is in bed, you are going to check the child, and you notice that the child is sweating, and has removed the covers. This means that the Heat has penetrated to the next level, that is, to the Qi level, in which the patient still has a fever, but feels hot and thirsty, possibly sweating, and, generally, at this level Qi, the Heat It is in the lungs. So there is, either Heat in Lung, or Phlegm-Heat in Lung, and, then, there would be cough, with or without expectoration. The " Clear Metal " remedy is for this level, for Heat at the Qi level, which would be the second stage of a Wind-Heat invasion.
Another characteristic of Wind-Heat invasions, especially those of the Wen Bing type, is that they progress rapidly. So we have to see the patient more than once a day, because we must change the treatment as soon as the pathogenic factor goes from the Wei level to the Qi level, which is characterized, I repeat, by the fact that the patient is no longer feels cold, but feels hot. When this happens, we can use "Clear Metal", especially if the Heat is pronounced.
" Clear Metal " should be administered in a relatively high dose of, at least, 9 tablets a day. If the patient has clear symptoms of Phlegm-Heat in Lung, that is Heat in Lung with Phlegm, then the remedy to be used, more than "Clear Metal", would be "Ringing Metal" [Resonating Metal]. These two remedies are similar in that they treat the Qi level, but "Clear Metal" is better if the Heat is pronounced: the patient is very hot, thirsty and dry in the mouth. If the patient has cough with expectoration of mucus, then we can use the "Ringing Metal" remedy.
In summary, these two remedies are similar, in the sense that both treat the Qi level, but "Clear Metal" is especially better if the Heat is pronounced, and "Ringing Metal" is better if there is Phlegm-Heat in the Lungs.
By the way, another reason to use " Clear Metal " is that, if the Heat is pronounced, it could also progress to the next level, that is, to the Ying level, which would be a bad progression, because, potentially, there could be serious repercussions in the Ying level or in the Xue level. So it is very important to treat the Heat at the Qi level, and stop it at the Qi level, with the use of " Clear Metal ".
by: Giovanni Maciocia