20250104, Female, 74 years old, height 150 cm, weight 120 Jin.
Medical History: Bronchitis. Diabetes. Herpes, no longer itchy. Mild tricuspid regurgitation. Experienced diarrhea six to seven times a day during hospitalization. Hospitalized in December 2024.
Medication History: Antidiabetic medication. During hospitalization, took An Gong Niu Huang Wan (安宫牛黄丸).
Chief Complaint: Fatigue while walking, heavy breathing sounds.
Physical Examination: Pulse is knotted and intermittent. Tongue is red with little coating, thin and moist at the root, sublingual veins are coarse and purple. Hands are warm, dry, and cracked with peeling. Eyelids are pale with red edges. Abdomen is distended. Lower limbs are dry with peeling and blood vessels visible, sock marks present.
Detailed Diagnosis: Exterior: Fear of heat. Sweating is possible, does not fear wind after sweating. Wind causes blurred vision and easy tearing. Sore throat last night. Pain in the right groin upon palpation for three days. Sleep is possible. Painful twitching on the dorsum of the left foot with numbness in the toes (post-cyst surgery).
Interior: Dry mouth and thirst, drinks a lot, both warm and cool are acceptable. Appetite is okay, stomach is fine, does not want salty or spicy food, finds even a little salty, prefers bland food. Bowel movement once a day, well-formed. No nighttime urination.
Pattern Differentiation Analysis: Severe fluid deficiency, hence the little coating, fear of salty and spicy, dry mouth and thirst, skin cracking. Fluid is essential; deficiency not only affects nourishing functions but also the pushing function of Qi. Yin damage affects Yang, hence fatigue while walking and heavy breathing sounds. The knotted and intermittent pulse indicates a serious condition, with a risk of sudden death (I did not mention this at the time, fearing to scare them; a physician must always give patients hope).
Clearly a case of Mai Men Dong Tang (麦门冬汤), according to the theories of Hu Lao, Xiao, Huang, and Lou, it is a specific formula pattern. Clinically, specific formula patterns are relatively rare (as original patterns are few, modified formulas cannot be called specific patterns). The Mai Men Dong Tang pattern is also relatively rare, hence this record. Prescription: Mai Men Dong Tang, “Mai Men Dong (Mai Men Dong) 7 Sheng, Ban Xia (半夏) 1 Sheng, Ren Shen (人参) 2 Liang, Gan Cao (甘草) 2 Liang, Jing Mi (粳米) 3 He, Da Zao (大枣) 12 pieces. For counteracting rebellious Qi, throat discomfort, and stopping rebellious Qi, Mai Men Dong Tang is the main treatment.” Clear heat, tonify fluids, and protect the middle Jiao, half dosage, 7 doses. Even at half dosage, this lady could not tolerate it, felt throat discomfort, and gave up after one dose, despite my prior warning that it might cause throat discomfort and that it should be simmered longer, 50 minutes would be fine. What a pity.
I have taken this formula; it is the best for tonifying fluids, with exquisite compatibility and remarkable effects, as it moistens and descends fluids, providing immediate relief for insomnia. Once, when I lay down at night with dry hands and feet unable to sleep, I took one-sixth of the dose, drank a small bowl, and fell asleep, truly a case of “覆杯而愈” (recovery at the turn of a cup), and the taste is sweet, extremely friendly for those with fluid deficiency and dry heat insomnia, though it is costly (large quantity, high-quality authentic medicinal materials are expensive, plus my shrinkage after sun exposure), even half dosage costs over forty per dose. Of course, as a physician, the primary pursuit is to cure diseases in a closed loop.