Record of Classical Formulas Diary | Issue 1258 2022.02.06
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Today marks the 1257th day of my diary writing.
Documenting a case of treatment for an aunt.
Main Symptoms:
Dizziness, weakness in the waist and legs, feeling like there are snowflakes moving in the eyes.
Dry nose with blood at night, dry mouth, dry eyes, not during the day, slightly yellow complexion, no desire to drink, but can eat.
Poor digestion, sometimes formed stools, cannot eat fried or cold foods; if eaten incorrectly, blood pressure rises and heart rate increases.
Usually blood pressure is 145 over 90, has not taken antihypertensive medication, poor sleep, cannot fall asleep in the first half of the night, sweats when lying on the side, but not when lying flat.
The tongue has tooth marks on the sides, is red, has petechiae, and there are blue veins on the underside.
I confirm again, is there nasal congestion and runny nose?
Is there dry mouth and bitter taste? Is there throat itchiness?
Does the cough worsen significantly when the throat itches?
Aunt: I sneeze and have a runny nose in the morning, but it stops after a while; I have had allergic rhinitis for a long time.
Last year I had repeated colds, had a fever last month, and after drinking ginger water and taking Xiao Chai Hu Decoction twice, the fever subsided.
Later, I developed a cough, which was bronchitis-like, with no throat itchiness, and in the morning, I would rinse my mouth and expel yellow phlegm, with no bitter taste in the mouth.
Currently, the main symptoms are:
Feeling weak while walking, somewhat like being drunk; I had two episodes of benign paroxysmal positional vertigo last year, which improved significantly after repositioning; actually, I have felt dizzy for the past ten years and have seen many doctors without improvement.
Analysis: The aunt’s main symptoms are fatigue, dizziness, insomnia, and repeated visits to doctors, with no significant improvement after treatment.
The main complaints are numerous; since this is an online consultation, there is no pulse diagnosis. Based on symptoms and tongue appearance, I attempt to analyze:
Dry nose with blood, dry mouth, dry eyes, indicating heat above.
Slightly yellow complexion, no desire to drink, tooth marks on the tongue, red tongue, petechiae, and blue veins on the underside, indicating blood deficiency and water retention.
Comprehensive consideration: Jueyin disease, blood deficiency and water retention.
Proposed formula: Chai Hu Gui Zhi Gan Jiang Tang, Dang Gui Shao Yao San with added Fu Zi, Xian He Cao, Tian Ma, and Niu Xi.
Second Consultation:
Director Lin! Good evening!
Tomorrow there is still one dose of medicine left; after drinking the medicine for six days, dizziness, anxiety, and limb weakness have improved a lot, the face color has improved significantly, and the eyes are no longer swollen. Now I can fall asleep in the first half of the night, but I wake up and cannot sleep in the second half.
Currently, the symptoms are: the nose is still dry with nasal crust, dry mouth with no desire to drink, sneezing and runny nose in the morning, stools are somewhat unformed, and there are signs of poor digestion.
When lying on the side, I still sweat a bit, and when lying on my side, I sweat; I am afraid of wind and cold, with shoulder and neck soreness, and lower back weakness. Overall, there has been significant improvement, about 80%.
Based on the clinical symptoms and tongue appearance, I added 10g of Huang Qi and 30g of Ye Jiao Teng to the original formula.
Third Consultation:
Director Lin! Happy New Year!
Thank you for helping me treat many symptoms; the dizziness, overall weakness, and anxiety symptoms have disappeared. I now feel much more relaxed and energetic.
There are still some symptoms remaining, such as sneezing and runny nose when exposed to cold, dry nose at night but with nasal crust blocking the nostrils, and tearing slightly in the wind. Occasionally, I feel like there are snowflakes in my vision.
After taking the second consultation’s medicine, my face itches, with a few red spots near the eyes and nose, but nothing else.
I consider this to be a sign of the pathogen exiting from the surface. On the 4th, the aunt sent me a message:
Director Lin: It itches less now, and I have a bit of dry mouth at night, but it is much better than before. I can eat, but I am afraid to eat too much, fearing poor digestion. I eat until I am about 70-80% full. Now I think that a few days ago, I seemed to not feel sweat when lying on my side.
Last night, when lying on my side, I had a bit of sweat on my upper back and neck, which is much better than before. I am not as afraid of wind and cold, and the symptoms have significantly reduced.
I added 10g of Jing Jie and 10g of Fang Feng to the original formula.
This case’s online consultation record shows that the condition is not severe, but it has troubled the aunt. Through TCM treatment, relatively good results have been achieved.
The reason for documenting this is mainly to share that during the recovery process, skin itching may occur, and I want to share with everyone that during the use of warming yang herbs, skin itching or even rashes may appear. Is this a clinical symptom response or a sign of the pathogen exiting?
I consider it may be a manifestation of the disease exiting from the surface after warming yang.
I have encountered many such manifestations in clinical practice, such as gout, where using warming yang herbs may cause more pain than before treatment, or urticaria, which may become more pronounced and itchy than before treatment. When symptoms are expelled, they may lessen.
However, how to judge this can sometimes be a problem, mainly relying on the doctor’s experience and judgment. Everyone can also continuously observe and experience in clinical practice, summarizing their clinical experience.
Lin Jiaming, Associate Chief Physician
Studied under the famous national TCM master Li Ke, a direct disciple of Professor Ruan Yongdui, a renowned TCM physician in Guangdong Province.
Engaged in the inheritance of Six Meridians and Classical Formulas diagnosis and treatment, currently, I have conducted 12 sessions of introductory classical formula inheritance classes with Teacher Li Cheng.
Students come from all over the country, utilizing weekends to provide free consultations in elderly universities and grassroots communities, which are well received by the public.
Advocating Zhang Zhongjing’s medicine, Six Meridians differentiation, using classical formulas to treat common and frequently occurring diseases, becoming a successor of classical formulas.
Skilled in using TCM classical formulas to treat common diseases, frequently occurring diseases, and difficult and severe diseases such as acute cerebrovascular diseases (stroke) and sequelae, recurrent dizziness, stubborn insomnia, dementia, epilepsy, Parkinson’s disease, depression, anxiety, headaches, psychological disorders, and other difficult miscellaneous diseases.
Proficient in using pure TCM to treat stroke, dizziness, insomnia, depression, headaches, diabetes, cough, fever, asthma, wheezing, stomach pain, bloating, irregular menstruation, dysmenorrhea, infertility, and post-operative tumors, dizziness, headaches, tremors, cough, wheezing, chest obstruction, and unexplained fever, etc. Formulated a classical formula and Six Meridians differentiation, focusing on the application of invigorating yang, warming yang, and supporting yang academic thoughts.
Welcome to add me on WeChat; I will update a study note every morning in my Moments.
Please follow the Classical Formulas Diary public account, and together we will steadfastly continue on this path. Every day I interpret a section of the Treatise on Febrile Diseases. For me, it is both pressure and motivation. No matter what, I hope that through ten or twenty years of repeatedly studying the Treatise on Febrile Diseases, I can gain something.
Although I am not yet interpreting it well, I hope to try. May my persistence influence many TCM practitioners, continuously striving for improvement, every day, accumulating small efforts into great achievements.
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