Minister Wang’s Clinical Experience 2000.6.28

Minister Wang’s Clinical Experience 2000.6.28

Patient Wang suffered from excessive fatigue, improper diet, and post-exposure diarrhea, which improved after antibiotic treatment. However, the patient now exhibits agitation, severe insomnia, loss of appetite, palpitations, excessive sweating, fatigue, dry and bitter mouth, red tongue with thick yellow greasy coating, and a large, wiry yet weak pulse.

Prescription: bupleurum, scutellaria, pinellia, codonopsis, licorice, ginger, jujube, raw dragon bone, oyster shell, cinnamon, huanglian, rhubarb, fermented soybeans, gardenia, zhishi, atractylodes, ho xiang, peilan, salvia, agarwood, white peony. Decocted in water and taken orally.

Second visit: After taking four doses, the patient greatly improved, sleep improved, appetite returned, and spirits slightly improved. The previous formula was adjusted by removing ho xiang, peilan, and sea cucumber, adding qianghuo, duhuo, xiangru, raw coix seed, horsetail, weilingxian, fried sour jujube seeds, chuanxiong, and zhimu.

Third visit: After taking six doses, sleep was good, spirits gradually stabilized, but the tongue remained yellow and thick, with palpitations still present, and the pulse was rapid and wiry (100 beats per minute). Upon further inquiry, the patient’s ultrasound showed 2–3 liver cysts of moderate size, with a white blood cell count of 20×10^9^/L. The previous formula was adjusted by removing qianghuo, duhuo, horsetail, weilingxian, fried sour jujube seeds, zhimu, and chuanxiong, adding angelica, white peony, atractylodes, poria, and peppermint, adopting the concept of Danzhi Xiaoyao San; the patient reported continued blurred vision, so this formula was modified to enhance the effects of soothing the liver and improving eyesight.

Fourth visit: All symptoms have eased, except for palpitations, shortness of breath, and poor sleep. The previous formula was adjusted by adding Guipi Tang, Danzhi Xiaoyao San, Huanglian Jiedu, and Gui Zhi Chuan Ge Sheng Shi Cao, to further improve the condition.