Case studies

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Case Study #1 M/10, complains that after dinner last night he had discomfort and pain in the epigastrium with fetid belching, acid regurgitation,and abdominal fullness and bloating. He had diarrhea this morning and the symptoms were reduced. T: red: b. food stagnation with heat accumulation
Case study #2 F/35 has chronic eczema, controlled with corticosteriod cream for 5 years. 2 days ago she had a flare up after eating spicy seafood. Now she has eczema on both elbows that is itchy, red and dry with some scaling and blistering. When sh: c. wind-damp-heat invading the skin
Case Study #3 F/49 complains of palpitations and insomnia for 1 month. She is often dizzy and nauseated with a bitter taste in the mouth, dislikes drinking cold water. Her menses is irregular for 1 year. T: greasy yellow coat P: wiry and slippery: a. disharmony between the GB and ST with stirring phlegm-heat
Case Study #4 F/34 infertility for 8 years. Married 12 years with 3 miscarriages. After 1st miscarriage she has irregular periods with lower abd pain during menses. Pain worse with pressure improved with warmth. T: dusky (pale purple) with dry thin: b. strengthen the SP and warm the KD
Case Study #5 F/28 is 3 months pregnant and started having uterine bleeding yesterday with dark red blood. She has lower abd pain worse with pressure. She has a HX of uterine fibroids. T: dark red purplish spots on sides P: wiry and slippery Di: d. Blood stagnation in the uterus
Case Study #5 F/28 is 3 months pregnant and started having uterine bleeding yesterday with dark red blood. She has lower abd pain worse with pressure. She has a HX of uterine fibroids. T: dark red purplish spots on sides P: wiry and slippery Be: b. Gui Zhi Fu Ling Wan (Cinnamomum and Poria Pill)181, Blood stagnation in the uterus, the ONLY blood stagnation formula allowed during pregnancy

a. Wen Jing Tang,179, Chong and Ren empty cold with blood stagnation
c. Tao He Cheng Qi Tang,176,Lower Jiao heat and blood stagnation
d. Gui Pi Tang,145, SP and HT blood deficiency, chronic bleeding due to SP deficiency
Case Study #5 F/28 is 3 months pregnant and started having uterine bleeding yesterday with dark red blood. She has lower abd pain worse with pressure. She has a HX of uterine fibroids. T: dark red purplish spots on sides P: wiry and slippery he: a. Dan Gui
Gui Zhi Fu Ling Wan, Cinnamomum and Poria Pill
Gui Zhi, Fu Ling
Mu Dan Pi
Chi Shao Yao
Tao Ren, Feng Mai
Case Study #6 F/48 with continuous menstruation for 10 days. High job stress for 2-3 months. Last month menses was early and lasted 10+ days. This month repeat scenario. The bleeding alternates light trickle to heavy flow that is bright/dark red wit: c. nourish Yin, clear heat and stop bleeding to treat metorrhagia
Case study #7 M/40 caught a cold last week (chills/fever/headache). No he complains of a cough with wheezing and rapid breathing. He also has congestion with thick yellow phlegm. He has chest oppression with tightness. T: red yellow greasy coating P: c. exterior syndrome with phlegm-heat
red tongue with greasy yellow coating
pulse is slightly floating, slippery
Case study #7 M/40 caught a cold last week (chills/fever/headache). Now he complains of a cough with wheezing and rapid breathing. He also has congestion with thick yellow phlegm. He has chest oppression with tightness. T: red yellow greasy coating: b. Zi Su Ye/ Xing Ren neither of them are in the formula

Ding Chuan Tang
Ma Huang, Zi Su Zi
Xing Ren, Ban Xia
Kuan Dong Hua, Sang Bai Pi
Huang Qin, Gan Cao
Case study #8 F/44 complains of hiccups and nausea that have been going on for over 1 month. Symptoms started after hysterectomy 6 weeks ago. Symptoms are worse after eating spicy food and improve with drinking water. T: red with scanty coating P: r: a. Stomach deficiency with heat
Case Study #9 M/36 has chronic cholecystitis for over 3 years. Symptoms include pain in the right hypochondrium, sour belching, nausea, distension and oppression in the chest and abd. The symptoms are worse when eating oily foods. T: red, greasy yel: a. Circulate the Qi and remove stagnation
Case study #10 F/68 diagnosed with emphysema five years ago. She complains of shortness of breath, wheezing with much watery sputum and a heavy tight feeling in the chest. Her legs often feel weak and her ankle are swollen. TCM diagnosis?: d. phlegm-damp stagnation in the LU with KD Qi deficiency.
Case study #10 F/68 diagnosed with emphysema five years ago. She complains of shortness of breath, wheezing with copious watery sputum and a heavy tight feeling in the chest. Her legs often feel weak and her ankles are swollen. What would the t: b. T: greasy white coating P: weak and slippery

a= damp and heat no heat signs
c= Yang deficiency signs this is Qi deficiency
d= blood stagnation, no signs
Case study #10 F/68 diagnosed with emphysema five years ago. She complains of shortness of breath, wheezing with much watery sputum and a heavy tight feeling in the chest. Her legs often feel weak and her ankle are swollen. Best Formula? a: b. Su Zi Jiang Qi Tang (Perilla Descend the Qi Dec.) LU phlegm damp and KD Yang def. with LU Qi rebellion, excess above with deficeincy below causing wheezing or cough

a. Ding Chuan Tang, LU phlegm-heat and external wind-cold with LU Qi rebellion T: red, greasy yellow coating P: slippery, rapid or slight floating
c. Ma Xing Shi Gan Tang, LU heat with or without external wind-heat causing wheezing T: red tip and border thin white or yellow coating P: slippery rapid, floating if external wind-heat
d. Ju Pi Zhu Ru Tang, ST heat with middle jiao def. causing ST Qi rebellion
Case study #10 F/68 diagnosed with emphysema five years ago. She complains of shortness of breath, wheezing with much watery sputum and a heavy tight feeling in the chest. Her legs often feel weak and her ankle are swollen. Which herbs ARE part: a. Rou Gui / Dang Gui

b. no Sang Bai Pi / no Huang Qin
c. no Ma Huang / no Yin Xing (Goa Ben)
d. no Gui Zhi / no Xing Ren

Su Zi Jiang Qi Tang
Zi SU Zi,Ban Xia
Hou Po, Qian Hu
Zi Su Ye, Sheng Jiang
Rou Gui
Dang Gui, Zhi Gan Cao
Da Zao
Case study #11 M/60 diagnosed with chronic congestive heart failure. Symptoms include chest pain, shortness of breath, worse after exertion, cough with scanty sputum difficult to expectorate and spontaneous night sweats. T: dusky (pale purple) thin: d. LU Qi and Yin deficiency

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