Formulas Case Studies Flashcards
A 35 year-old male patient has severe stiffness of his neck and back and is sweaty. He feels like staying inside with the windows closed. His pulse is floating on the left cun and wiry on the right cun.
- DRY
- COLD
- EXTERNAL
Li : Taiyang zhongfeng stepping into Yangming
Fang : Guizhi Tang, Guizhi jia Gegen Tang
A 49 year-old female patient presents with a weak cough, a runny nose, sneezing, chills and shoulder and neck pain for 3 days. She developed diarrhea and then panting, and has a tendency to develop panting and wheezing. Her pulse is floating on the left cun, and tight on the right cun.
- DAMP
- COLD
- EXTERNAL
Li : Taiyang zhongfeng in chuanjia (asthma pt)
Fang : Guizhi Tang or Guizhi jia Houpo Xingren Tang
- A 28 year-old male patient presents with severe body pain and stiffness. He initially felt sweaty all over, and has had a fever with chills. He is no longer chilled and his sweating is diminishing, but his thirst has increased. His pulse is floating, weak, soft and slightly rapid on the left cun, and his tongue is dry.
- DRY
- HOT
- EXTERNAL
Li : Taiyang Wenbing
Fang : Guizhi Tang or Gualou Guizhi Tang
A 62 year-old patient presents with chronic but mild loose stool, a poor appetite, and a severe sense of cold, cold hands and feet and with a palpably cold abdomen. Also upon palpation of the abdomen, you notice strong pulsations around the area of Shuifen (Ren 9). His pulse is deep and weak, and his tongue is swollen and wet.
- DAMP
- COLD
- INTERNAL
Modification :
Qu - Bai Zhu
Jia - Gui (pulsations over Ren 9)
Li : Taiyin yang xu with heart yang xu
Fang : Lizhong Wan
A 14 year-old female patient presents with history of a dry, sore throat, a fever and mild aversion to cold, painful limbs and aching joints, and slight retching with a poking feeling under her heart that lasted for 7 days. She has no nausea and the retching stopped on the 8th day, but she developed chest vexation. Then her menstrual cycle began and her fever diminished. Her pulse is slow, floating on the left cun, and wiry on the left guan, and big, weak and wiry on the right guan. She feels generally chilly, and has fullness under her rib-sides. She has intense menstrual cramping pain.
- DRY
- COLD
- EXTERNAL
Modification :
Qu - HQ, BX, RS
Jia - Gua Lou Gen
Li : Taiyang-Shaoyang Zhongfeng entering the blood chamber
Fang : Chaihu Guizhi Tang
A 9 year-old male patient presents with a rattling, deep cough, a runny nose, sneezing, chills and shoulder pain for 3 days. He has not had any sweating. He complains that his cough is painful and distressing, and that he is very thirsty. Upon palpation and observation, you notice that his breathing is very rapid and the upper shoulders are lifting and falling quickly, indicating panting. He is very agitated. He has no nausea. His pulse is floating and wiry on the left chi, floating and wiry on the right cun, and is rapid. His tongue is wet with a red tip.
- DAMP,
- HOT
- EXTERNAL
Modification :
Qu - Banxia (no nausea, phlegm)
Jia - Tian Hua Fen (thirst)
Li : Taiyang Zhongfeng with Lung heat
Fang : Xiao Qinglong jia Shigao Tang
A 35 year-old female presents with fatigue, a dry throat, dry eyes, a dry cough, a stuffy nose, thirst, and a fever of 102°. She explains that she does not have time to be sick since she has a very important deadline approaching. She says that she has stayed up a few nights working very late, and has not been eating well. Her pulse is floating and rapid, and her tongue has a thin white coat.
- DRY
- HOT
- EXTERNAL
Modification : n/a
Li: Yangming/ Qi layer dry heat afflicting Lung
Fang: Sang Ju Yin
A 72 year-old female patient presents with a dry throat, a dry mouth, thirst, and a severe dry cough with shortness of breath. She has a fever of 99°, night sweats, deep body aches, fatigue and weakness. Her pulse is deep, thready and rapid, and her tongue is dry and red.
- DRY
- HOT
- INTERNAL
Modification : Maimendong, Chuan Xiong, (maybe bai shao)
Li : Sever Yin Xu with trapped heat / steaming bone
Fang : Qinghao Biejia Tang
A male in his mid-30s presents with a chief complaint of fevers of unknown origin that have persisted for six weeks. His fever began in the afternoon, and then subsided, and then again woke him around 3-4 am, when his Advil “wore-off”. He went to urgent care complaining of elevated temperature (102°) and chills, severe headache at the temples and occiput that was worse lying down, a sore throat, and sinus pain and pressure with nasal congestion. He was given Augmentin, which caused him to vomit. After four days of vomiting and feeling generally worse he was told to stop the Augmentin and given a second antibiotic, Azithromycin. Two days later his condition worsened and his fevers climbed to 104°F. He ended up in the emergency room where he had elevated liver enzymes (possibly from the Augmentin), normal CBC (including WBC), and was suspected to have left lobe pneumonia. He was given IV antibiotics and fluids and remained in the hospital for 8 days while they ran a battery of tests. Nothing conclusive was found. The patient had severe fatigue (unable to work), fever and chills, no sensation of heaviness, no thirst, no dryness of the lips or mouth, and the stools had recently become drier. They were characterized by a strong sensation of shivering cold. After multiple courses of antibiotics, a loss of 25 lbs. (he was not overweight), and $72,000 in hospital bills, he was discharged. Although his fevers had decreased he had no diagnosis, and within days of being discharged his fevers started to return. Prior to the fevers he had been overworked and had not been sleeping much. For the last few years he had been taking Metformin for diabetes and Pepcid for acid reflux.
Previous to the last few days he generally felt cold with the fevers. Currently he has aversion to heat with the fevers. He is taking eight Advil a day to control the fevers (4 every 12 hours). When the Advil wears off the fever spikes and he starts to sweat. He is thirsty now. His pulse is slippery, floating, and rapid on the right side. His tongue has cracks, no coat, and is slightly red with small purple spots on the underside.
- DRY
- HOT
- EXTERNAL
Modification : Lu Gen
Li : Taiyang Shanghan cold transforming to heat
Fang : Yin Qiao San
A 16 year-old presents with nausea, a headache and a cough. He has no thirst. His cough is productive with thin, very sticky, dry and white phlegm. His tongue has a thin white coat, and his pulse is floating and slightly tight.
- DRY
- COLD
- EXTERNAL
Modification : frontal HA = Bai Zhi
Li : Taiyang - Yangming disease with cold dryness in Lung, Dampness in Spleen
Fang : Xing Su San
A 12 year-old male patient presents with a swollen sore throat, fever, chills, aversion to cold, and no thirst that has lasted for 2 days. He has slight sweating and a productive cough with yellow, sticky phlegm. It hurts him to cough. His pulse is floating and slippery (slightly rapid), and his tongue has a thin yellow coating.
- PHLEGM
- HOT
- EXTERNAL
Modification : Xiao Xian Xiong Tang (knot/pain in the chest due to phlegm)
Li : Taiyang Zhongfeng with heat
Fang : Suzi Lihou Tang
A 52 year-old male presents fatigue, a headache, dry throat, and a dry, hacking cough. He has a fever of 100° and is very thirsty. He says that he has been going through a very difficult emotional time dealing with the death of his mother, and managing her estate while trying to find time to grieve. He says that he feels intense anxiety and discomfort at times. He has not been able to sleep due to this anxiety. His pulse is floating, rapid and thin. His tongue is dry with a red tip.
- DRY
- HOT
- EXTERNAL
Modification : Kuan dong hua + Xuan fu hua
Li : Lung qi and yin deficiency; Lung grief
Fang : Sang Xing Tang
A 32 year-old male patient presents with painful, white and red, foul-smelling diarrhea. He described shreds of mucous in the stool, stabbing pain around Huangshu (Ki 16), nervousness, irritability, thirst and an inability to eat or drink. The pulse was deep, wiry and rapid and the tongue was red with a yellow coating in the back.
- DAMP
- HOT
- INTERNAL
Modification : Huang Qin Tang (for severe pain)
Li : Jueyin blood heat; stasis heat in the Chongmai
Fang : Baitouweng Tang
A 27 year-old female patient presents with a facial boil for 6 days and a fever for 3 days. The lesion began as a grain-sized papule on Juliao (ST 3). It was mildly itchy but not tender. She squeezed it, and it gradually enlarged, becoming inflamed and tender, and extended to the right cheek. She was treated with penicillin, and since then she has had a fever, a bitter taste in her mouth, and a poor appetite. Her temperature is 101. The papule is red, with redness spreading across her cheek and up to the lower eyelid. Her pulse is slippery and rapid and her tongue is red with a yellow coating.
- PHLEGM
- HOT
- Internal
Modification : Banzhilian + Huanglian ( For pronounced hot tumors: add)
Li : Trapped heat in the Yangming pifu (skin region)
(displaced digestive process
Fang : Wuwei Xiaodu Yin both internally and externally
A 68 year-old female patient presents a large boil on the inside of her thigh near Ziwuli (Lv 10). She says that it just came up 2 days ago in the middle of the night. She had had an intense meeting the previous evening. Last night she developed a fever of 103 and said she was “losing it” in the sense of anger and rage. She has an intense fear that her fever will spike again tonight and she won’t be able to handle it. She is overweight and has a deep red complexion and small, red-tinged eyes. She tells you that she has been going through a very stressful time. She is the head administrator at a school and there are accusations against her of tyrannical control of the school. She says that nothing would get done if she didn’t maintain control, but that many of the board members, parents and teachers don’t understand how important her work there is. She has a lot of anger and frustration around the conflicts that she says have been “brewing”. She is very thirsty, has dark urination, and severe insomnia. Her boil is deep purple and about the size of a golf ball. It is very painful and itchy. Her pulse is forceful, slippery and rapid, and her tongue is red with a yellow coating.
- DRY
- HOT
- INTERNAL
Modification : add Dandouchi (zhi zi zhi tang)
Li : Fire toxins trapped in the Jueyin (skin region), YM and Shaoyang (in the sanjiao and fu organs)
Fang : Huanglian Jiedu Tang
(with Wuwei Xiaodu Yin externally)
