Inferring Internal Injuries from Forehead Pain
In December of last year, a female patient consulted me, asking about the cause of her forehead pain. I mentioned that it was not easy to determine, as it could be related to the stomach, possibly caused by the liver affecting the stomach, or it could be due to external wind. She said she would go to the hospital for an examination.
On February 13, 2020, the patient returned for a follow-up consultation. The 38-year-old female patient reported that she had been experiencing forehead pain for several years. Previously, the pain would come and go, but now it was almost daily. Although the pain was tolerable, it caused dizziness and hindered her ability to think. After consulting me last year, she went to the hospital for an examination and was diagnosed with chronic gastritis, but no liver issues were found. The hospital prescribed stomach medication for her to take for a month, but after taking it for over 20 days, she felt uncomfortable, and her symptoms worsened, sometimes experiencing acid reflux, which made her reluctant to eat.
Currently, her appetite varies; sometimes she feels very hungry, while at other times she has no appetite and experiences bloating. She has a bowel movement almost every day, but the amount is small, and she feels unsatisfied after defecation. She also has a slight cough, with a dry throat. Her urine is yellow and scant. Occasionally, she feels a pulling pain in her sides. She is easily irritable, has difficulty falling asleep, and does not sleep soundly, often dreaming and snoring, sometimes waking up in the middle of the night. In the morning, she feels unrefreshed, has a dry mouth, and experiences a bit of a bitter taste. Her menstrual cycle is 30 days and relatively regular, but in the past year, her menstrual flow has decreased significantly. She does not experience menstrual pain but feels some bloating. The menstruation lasts for 4 to 5 days, and she experiences breast tenderness a week before menstruation. The tongue shows a small amount of yellow coating in the center, a deep tongue body, and distended veins at the tongue’s base. The pulse is thin and rapid, with a slightly weak heart pulse, a tight liver pulse, a weak and thin kidney pulse, a slightly weak lung pulse, a floating and weak spleen pulse, and a slightly weak and small life pulse. I informed her that although the hospital found no liver issues, traditional Chinese medicine (TCM) suggests otherwise. I prescribed a formula of 7 doses: Chai Hu (Bupleurum), Zhi Gan Cao (Honey-fried Licorice), Huang Qin (Scutellaria), Huang Lian (Coptis), Ren Shen (Ginseng), Da Zao (Jujube), Qing Ban Xia (Pinellia), Jiao San Xian (Fried Three Immortals), Ji Nei Jin (Chicken Inner Gold), and Gan Jiang (Dried Ginger).
On February 23, 2020, the patient returned for a follow-up visit. She reported that her forehead pain had mostly disappeared, and she no longer felt dizzy when thinking. She felt much lighter, although she still had a slight dry cough and a bit of throat irritation, but it was much improved compared to before. Her appetite was good, her abdomen was not bloated, and she no longer experienced acid reflux. She had a bowel movement daily, with more volume than before. Her urination was generally normal, though occasionally yellow. The pulling pain in her sides was less frequent and not noticeable unless she paid attention to it. She was sleeping much better, no longer snoring, and felt more refreshed in the morning, though she still experienced some dry mouth but no bitter taste. The tongue had almost no coating, and the veins at the tongue’s base were prominent. The pulse was much more relaxed, with a thin and slightly weak heart pulse, a slightly tight liver pulse, a very weak and thin kidney pulse, a weak lung pulse, a slightly thin spleen pulse, and a slightly weak life pulse. I adjusted her formula to include Chai Hu (Bupleurum), Gui Zhi (Cinnamon Twig), Huang Qin (Scutellaria), Gan Jiang (Dried Ginger), Tian Hua Fen (Trichosanthes Root), Duan Mu Li (Calcined Oyster Shell), Jiao San Xian (Fried Three Immortals), and Wu Wei Zi (Schisandra).
A few days ago, she provided feedback that after taking the medicine and observing for more than ten days, all her symptoms had disappeared. During the last consultation, I felt that her Qi and blood were somewhat weak, and she planned to continue with consolidation treatment.
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