Acupuncture Cases Study

Male, age 30

CC: Fever

Fever Two-day history of fever. The patient was exposed to cold in the course of a business trip. He felt cold and had an aversion to cold. His temperature was 38.6°C. There was nasal obstruction with watery nasal discharge, an absence of sweating, no sore throat but a slight cough with some white sputum, and generalized aching. He was not thirsty. His appetite was poor. Urination and bowels were normal.

Tongue: Slightly red body, thin, white, rather moist coating

Pulse: Floating and a little tight

Male, age 26

CC: Sore throat

One-day history of sore dry throat with some hoarseness. The patient felt feverish and was sweating slightly with a temperature of 37.8°C. He had some aversion to wind and cold, and there was nasal obstruction but no cough. He also had a headache with dizziness. His appetite and food intake were normal, but he drank more fluid than usual. Sleep, bowels and urination were all normal.

Tongue: Red tip, thin, slightly yellow coating

Pulse: Slightly rapid

Female, age 32

CC: Headache and fever

One week ago the weather became colder and the patient neglected to dress warmly. She developed a fever of 38°C with intermittent sweating. When she sweated the temperature went down, but when the sweating ceased the temperature rose. She had an aversion to cold, nasal obstruction with watery discharge, and a headache with a heavy sensation around the head. Her limbs felt heavy and sore. She was not thirsty. Her appetite was poor and she felt nauseated and vomited once after experiencing fullness in the epigastrium. Her stools were unformed, bowel movement once or twice per day, and urination was normal.

Tongue: Pale body with a white, greasy coating, slightly yellow on the root

Pulse: Soft

Female, age 43

CC: Bad cold

One month ago the patient had a bad cold and has not recovered. She has a feeling of being always cold, with an aversion to wind, and spontaneous sweating. She has a cough with a little sputum but no sore throat or fever. She has general lassitude and fatigue and cold extremities. She is not thirsty. Food intake, bowels, and urine are normal.

The patient has a weak general constitution, easily catches cold, always feels cold, and prefers to wear more clothes than other people.

Tongue: Pale body, white moist coating

Pulse: Sunken (Hidden), thin, and forceless

Female, age 19

CC: Cough

Two month history of cough, but the symptoms became much worse over the last four days. Originally the symptoms were sore throat and slight cough with white sputum, but four days ago the symptoms changed to severe cough with profuse yellow sputum and chest pain on the right side. The chest pain became worse when she coughed or breathed deeply, and she was admitted to the hospital. When the patient was admitted she had a temperature of 39.5°C. She had no aversion to cold and had a feverish sensation around her entire body. The patient had completely lost her appetite and developed abdominal distention with dryness in the mouth which she relieved by drinking cold water. She felt mentally restless. She had not had a bowel movement for four days, and had yellow urine. Her complexion was red.

Tongue: Red body, yellow and dry coating

Pulse: Slippery and rapid

Female, age 60

CC: Cough

The patient has a recurrent cough of four years' duration. Last week the symptoms returned. Four years ago bronchitis was diagnosed, the main symptom being an non asthmatic cough, onset normally in the winter or when the patient catches cold. One week ago after exposure to cold the symptoms returned. The main symptoms are severe cough, worse during the night, and the patient can only sleep 3-4 hours per night. There is excessive white sputum; the patient has a feeling of being cold without a fever, and there is a stifling sensation in the chest. She has a poor appetite and loose stools, with 4-5 bowel movements per day.

Tongue: Light red body, white, greasy coating

Pulse: Thin, slippery

Male, age 40

CC: Cough

The patient complained that since yesterday he has suffered from very severe bouts of coughing. The cough is immediately followed by wheezing and a distending sensation which radiates upwards from the Lung. The cough causes chest and hypochondriac pain, and the cough becomes more severe when he lies flat on the bed. When he coughs he brings up thick sputum, sometimes containing a small quantity of blood clots. He is thirsty, likes to drink water, and has a bitter taste in the mouth. The other symptoms include poor appetite, general lassitude, yellow urine, and constipation for two days, red eyes and a hot feeling on the skin over the entire body.

Tongue: Red body, yellow coating

Pulse: Surging (Full) and forceful. The right distal region is stronger.

Female, age 41

CC: Cough

This patient has had a recurrent cough for over two years. When it recurs it can be either mild or severe. The cough is accompanied by thick, yellow, sticky sputum which is both scanty in quantity and difficult to bring up. The patient is thirsty and has a dry, hoarse throat. She has a feeble voice, poor appetite, and prefers not to speak. In the afternoon she develops a slight fever (37.5°C- 37.8°C). She also has a malar(颊的)flush, night sweats, and dream-disturbed sleep. In addition, there is a history of lower back pain and soreness and weakness of the lower limbs. Over the past six months there has been no menstruation.

Tongue: Deep red tongue body, very thin tongue coating

Pulse: Thin, rapid

Female, age 63

CC: Drowsiness and dizziness

The patient's symptoms first began two months ago. They were episodic and mild in nature, and were occasionally accompanied by slight, lateral headaches. She had no idea as to the cause of her condition, which did not deteriorate over the two month period. One week ago, after an emotional upset, the dizziness, headache, and drowsiness all became worse. The other main symptoms in this case were dream-disturbed sleep, palpitations, general lassitude, and distention in the intercostal, hypochondriac, epigastric, and abdominal regions. The patient has a poor appetite and bitter taste in the mouth. She does not complain of being thirsty. She has a dry stool every other day. Urination is normal.

Tongue: Dark pale body; thick, greasy, slightly yellow coating

 Pulse: Wiry, slippery, and slightly rapid

Female, age 44

CC: Dizziness

The patient has a history of dizziness for just one week. There was no obvious causative factor. She has nausea but no vomiting. She does not have any whirling or spinning sensation with the dizziness, but occasionally has mild tinnitus. She complains of a poor appetite and mild pain in the epigastric and abdominal regions. She does not like to drink water and avoids cold foods. Her urination and stool are normal.

Tongue: Pale and flabby body with small purple spots, thin tongue coating, middle and back is white and moist

Pulse: Slippery

Male, age 35

CC: Dizziness

This patient has a history of episodic dizziness for the last two years, and around the same time was diagnosed with hypertension. His blood pressure is very unstable, and dizziness occurs each time the blood pressure rises. The dizziness has been relieved by Western medicine.

This young man was very hot-tempered and irritable. After each fit of anger the hypertension and dizziness became worse. The most recent onset began two weeks ago, and again the symptoms were caused by an outburst of anger, but this time the Western medicine did not relieve his dizziness. It is so severe that it affects his ability to walk. He sleeps fitfully and suffers from general lassitude. The patient's appetite is unaffected by his main complaint. He has a red complexion and red eyes.

Tongue: Red tongue body, thin and yellow coating

Pulse: Wiry and thin

Male, age 57

CC: Dizziness

Nine years ago the patient developed very severe dizziness. He experienced a whirling sensation as if he were on a small boat in rough seas. Sometimes the onset was so severe that he could hardly walk. The accompanying symptoms were vomiting, high-frequency tinnitus, and low blood pressure. He has had two relapses of a similar pattern over the past nine years. Two months ago the dizziness recurred, and the patient found that whenever he read, the dizziness became worse. His balance was very poor, his appetite diminished, and there was nausea and a tendency to vomit. There was an abnormal sensation in the abdominal and epigastric regions. He expectorated small quantities of phlegm. The patient has also noticed that his weight has decreased; he belches a lot, and frequently passes gas. Bowel movements are normal, but his rectum is slightly prolapsed. The patient has slight urinary frequency. Over the past few days he developed urticaria (skin rash caused by wind) around the entire body, accompanied by pruritus, which makes it very difficult to sleep. He also has nightmares.

Tongue: Pale body, white and thin coating

Pulse: Wiry, thin, and forceless

Female, age 52

CC: One-sided headache

The patient has a two year history of episodic, one-sided temporal headaches with no obvious precipitating cause. Three days ago she developed a right-sided headache following a family bereavement. The headache is fixed in the right temporal region and the pain becomes worse in spasms, especially when she feels particularly sad or upset. The pain interferes with sleep. Her throat is dry and she feels thirsty and likes to drink. Her appetite is good but when she eats sweet things she has a feeling of distention in the epigastric region. She feels hot around the body and sweats easily. She has occasional chest pain, primarily on the left, but this is not severe. Her right upper arm feels uncomfortable, but there is no actual pain or limitation of movement.

Tongue: Dark red body with a yellow, slightly thick, greasy, and rather dry coating

Pulse: Sunken and wiry

Male, age 34

CC: Headache

Two weeks ago the patient was exposed to wind and cold and developed a headache. The pain was centered in three areas: the medial extremity of both eyebrows, the bridge of the nose, and the occipital region. The nape of the neck and the upper back were also stiff. Later, pain also developed on the right side of the head. The pain is now worse than before and is continuous, the patient becoming nauseous when the pain is severe. Analgesics have had no effect. Whenever the patient goes out in the cold the pain intensifies. There is sensitivity and tenderness in the frontal region, the right side of the head, and the occipital region.

Tongue: Body is normal, coating is white

Pulse: Sunken, slightly slow, and forceful

Female, age 29

CC: Headache

The patient has a recurrent history of forehead pain of over ten years' duration.

Over the years the pain has gradually become more severe. When the headaches began there was no obvious cause. In the last year the headaches have become much more frequent and severe. The accompanying symptoms in the head region are dizziness and a feeling of cold. The patient always wears a hat, even during the summer, because of sensitivity to cold. She also complains of a sticky white discharge from the nose and nasal obstruction. (Eight years ago X-rays revealed chronic sinusitis.) She has been treated with Western drugs and Chinese herbs, but the only result was temporary relief from the pain. The frequency of headaches has remained unchanged. At present the patient has a very bad headache which has caused insomnia and loss of appetite for the past few days. She has no desire to drink and her urination is normal. She passes two loose, unformed stools per day. Her complexion is slightly pale.

Tongue: Slightly red body (i.e., normal), tongue coating is white

Pulse: Sunken and forceless

Male, age 32

CC: Headache

The patient has a seven year history of headaches, dating from an injury suffered when he fell from a height and struck the back of his head. He was unconscious for a short time, and upon regaining consciousness had severe headache and dizziness. The diagnosis at that time was cerebral concussion and he was treated symptomatically. After recovering he had only occasional occipital headaches.

Six months ago while he was working extremely hard without adequate rest the headaches became more frequent and severe. They were always occipital and he felt that the pain was similar to that which he experienced at the time of the injury. He also had dizziness, insomnia, and general lassitude. He returned to the hospital where he was diagnosed with sequelae from the head injury. At present the patient complains that reading causes the symptoms to become very severe and his concentration is impaired. His appetite, bowel movements, and urine are normal. His complexion is sallow and dry.

Tongue: The body is slightly red with obvious ecchymosis (Red spots) at the extreme tip. The coating is normal.

Pulse: Sunken (Hidden) and slightly thin

CC: Migraine for five years

Five years ago, the patient suffered from hepatitis and was jaundiced. She also complained of nausea, poor appetite, abdominal distention, and pain in the liver region. She simultaneously developed headache in the occipital region, which was continuous for one month. When she recovered from hepatitis all the symptoms disappeared except for the headache, which recurred on the right temporal area and was often induced by eating cheese or sweet foods. The headache was also aggravated by menstruation. The weather did not affect it in any way. The headache was very sharp, usually accompanied by nausea and vomiting, and the patient became hypersensitive to noise. The headache could last for a few hours or even a few days. The pain was sometimes relieved by analgesics.

In recent months the migraines have become more frequent. For the last seven days the patient suffered a continuous migraine which was not relieved by analgesics. She has abdominal distention, difficulty in sleeping, and no appetite. Bowel movements and urination are normal. Her menstrual cycle is extremely irregular.She is presently taking hormones in an attempt to regulate the cycle. In the last two years her body weight has increased markedly (over 15kg) even though she eats very little food.

Tongue: Body is normal in color, white, with a slightly thick coating

Pulse: Sunken, slightly wiry

Male, age 23

CC: Headache

The patient has a five-year history of recurrent headaches which have become more frequent and severe during the past year. There is no obvious precipitating factor and the headaches are unpredictable in onset. There is no association with changes in the weather. The pain is mainly on the forehead, eyebrows, and orbit, while the occiput feels stiff and tense. He has severe photophobia(畏光) during the headaches, accompanied by violent nausea and vomiting, and his face becomes pale. The headaches last from 1-3 days during an attack. They interfere with sleep and affect the appetite. When he has no headache his appetite is good, but he often has a dry mouth and foul breath. His urine and bowels are normal.

Tongue: Slightly red tip; the body is soft and flabby with a thin, white, moist coating

Pulse: Sunken and thin

Male, age 29

CC: Lower back pain

The patient has a two-year history of recurrent lower back pain. The main symptoms in the lower back are coldness, pain, and heaviness. The symptoms worsen on cloudy or cold days, and are alleviated by warmth. Sometimes the lower back pain radiates forward to cause discomfort in the lower abdominal area. The patient has no recollection of any obvious causative factors. He has a very slight reduction in appetite and is not thirsty. The urine is yellow and normal in quantity. He has a bowel movement only once every two or three days, the stools being normal. The patient has no problem with sleeping.

Tongue: Pale body, white, greasy coating

Pulse: Sunken (Hidden), thin pulse

Female, age 42

CC: Pain in left lower back and lower limb

Pain in left lower back and lower limb for ten days with no recent trauma. The patient has a history of recurrent episodes of the same problem. There is also a feeling of coldness, soreness, weakness, numbness and abnormal feeling over the same area, these symptoms becoming worse when the weather is cold, and the pain becoming more severe. The pain is relieved by warmth and there is no exacerbation of the pain with movement.

There is general lassitude and poor memory, but the patient's appetite is good.

She does not sleep soundly and does not feel refreshed on wakening. Bowel movements and urination are normal. The patient has a sallow complexion.

Tongue: Light red body with dry coating, yellow and thick at the root

Pulse: Wiry and forceless

Male, age 67

CC: Soreness in the lower back

Four days ago the patient developed a slight fever and an aversion to cold; the symptoms are still present. The patient has distention in the epigastrium and abdomen, and also complains of nausea and a complete loss of appetite. There is excessive saliva in the mouth accompanied by a diminished sense of taste. There is pain and soreness of the back, especially in the lumbar area, and the patient also complains of a sensation of heaviness and restriction of movement in the lower back. The head, spinal column, shoulders, and knee joints all feel heavy and restricted, but to a lesser degree.

Tongue: Slightly dark red body, thin, moist, and slightly yellow coating

Pulse: Slippery and slightly floating, thin on the left side proximal position

Male, age 41

CC: Lower back pain

This patient overexerted himself at work. After lifting a heavy object he developed severe pain in the lower back. At the time movement in the lower back was unaffected, but the following morning the pain was very severe and his movement was severely restricted. Every movement caused sharp pain, making it difficult for the patient to walk. The pain radiated downwards over the buttocks and both legs. Besides the pain the patient did not feel any other discomfort. He received several tui na treatments without effective relief and came for acupuncture the third morning after the injury. His general health is good.

The tongue and pulse are normal.

Female, age 41

CC: Joint pain in the fingers, wrists, and elbows

This woman worked as a cleaner in a small factory for over ten years where she had contact with cold water. Two months ago she began to get pains in all the small joints of her fingers, particularly severe at the finger tips. The pain worsens in cold weather and towards the end of each working day, but eases in warm surroundings. When the pain is aggravated, it radiates from the fingers to the wrists and elbows. Recently the pain in the wrists and elbows has become as bad as that in the fingers. She also complains of poor sleep, palpitations, and a stifling sensation in the chest. Her appetite, bowels, and urination are normal. Her finger nails have recently become flatter than usual and have lost their luster. Her energy level is poor, especially during menstruation, but the period is otherwise normal. Sometimes she feels a slight soreness and weakness in the lower back, and the knee joints have a mildly uncomfortable feeling when she walks, especially when descending stairs.

Tongue: Slightly pale body, two areas of ecchymosis出血斑(middle and right side), coating is thin and white

 Pulse: Sunken(Hidden) and moderate

Male, age 28

CC: Joint pain

The patient has a history of rheumatoid arthritis with episodes of pain and swelling of joints. This disease began six years ago with symptoms primarily of the knees and ankles, but also occasionally involving his elbows and wrists.

One week ago he developed a bad cold with aversion to cold, fever, and a sore throat. Three days ago his left knee and ankle joints became swollen, painful, and locally hot and red. The pain moved around and became worse on pressure. Yesterday the right knee also became red, painful, and swollen. He developed redness and nodularity in the region of both knees. The rash is not itchy and waxes and wanes (变暗淡).

At present both knee joints are swollen and movement is limited by pain, the right knee being worse than the left. His temperature is 38.2°C and he has a very mild aversion to cold. The patient also complains of headache, sore throat, anorexia, sweating, thirst with a desire to drink, scanty yellow urine, and dry stools. He has been constipated for three days.

Tongue: Red body with a slightly yellow coating

Pulse: Rapid and slightly floating

Male, age 46

CC: Pain in right shoulder

Three-year history of pain in the right shoulder which has gradually become worse. He was diagnosed as suffering from periarthritis肩周炎of the shoulder joint. The symptoms worsen with exposure to cold, especially in winter and when the weather is cloudy and damp. Physical labor also exacerbates the pain, and the patient always has difficulty in dressing and undressing. He has tried various remedies including physiotherapy, Western drugs, and Chinese herbs, but with very little success.

Because the weather recently turned cold and the pain more severe, he decided to try acupuncture treatment. The patient has no previous health problems and indeed his general health remains good. On examination there was general tenderness of the deltoid muscle, especially the anterior and upper lateral aspects. There was reduction in the shoulder's range of motion, especially in abduction and internal rotation. There was some atrophy of the muscles of the shoulder girdle on the right.

Tongue: Normal body with a thin white coating

Pulse: Wiry and tight

Female; age 41

CC: Joint pain and palpitations

The patient has a ten-year history of recurrent episodes of pain in the joints of the upper and lower limbs, especially the small joints of the hand and wrist. The pain in her hands is sometimes so severe that she is unable to move the joints. More recently she has also had pain in the spine. Even though Chinese herbs or acupuncture have controlled the symptoms during each exacerbation, her problem has gradually worsened. During the last year she has had low energy and developed palpitations and dyspnea on exertion. She has no chest pain but does have a stifling sensation in the chest. Her symptoms improve with rest. At times when all the symptoms are severe, she has edema of the lower limbs with some pitting at the ankles. The edema is absent in the mornings and becomes more obvious during the day. She sleeps poorly and does not like to drink, but her appetite is normal. Her urine is reduced in quantity, but her bowels are normal.

Tongue: Normal body color with a thin, white, moist coating

Pulse: Soft and rather rapid

Male, age 14

CC: Pain on the left lower neck and shoulder

This child had two cycling accidents in recent years. Three months ago he was taking part in a race and again fell off his bicycle onto his left side while cycling at high speed. He felt pain on the left side of his neck and the posterior and upper aspects of the left shoulder. The pain was worse on moving the shoulder joint, and the symptoms were still present after three months. When he tries to cycle he has aching from the shoulder to the wrist with some numbness of the anterior aspect of the forearm.

At the time of the accident he was X-rayed and there was no bone injury or displacement. The diagnosis was cervical spine injury with soft tissue injury to the shoulder. He was treated with physiotherapy and local cortisone injections. He also saw a chiropractor and took homeopathic remedies, but the symptoms persisted. His general health is good.

On examination there was slight swelling on the left side of the neck with tenderness on the left side of the spinous process of C7. The posterior and superior aspects of the left shoulder were tender. He was unable to raise his left arm anteriorly more than 140°. His right shoulder movements were normal.

Tongue: Normal body, thin white coating

Pulse: Slightly wiry

Female, age 46

CC: Pain in both elbows

This patient has a rural background. She is accustomed to hard physical labor and to carrying heavy loads for a considerable distance. Four months ago she carried a heavy weight of books for several hours to reach a bus-stop. The same evening both her elbows became very painful. The symptoms did not improve with rest, and since that time she has been unable to carry anything without severe pain, especially in the right elbow. The original injury occurred during the winter but she does not associate the symptoms with cold weather. Local heat and massage have no effect on the pain. The patient is obese but has previously enjoyed excellent health. Her appetite, sleep pattern, bowels, and urine are normal. On examination there is obvious tenderness on the lateral epicondyle of the Humerus, worse on the right side, with bilateral local muscle tenderness.

Tongue: Normal color with a thin and slightly yellow coating

Pulse: Sunken and moderate

Female, age 49

CC: Deviation of mouth and eye

One week ago after sleeping in a draft, the patient awoke with this problem which was accompanied by the following symptoms: right-side headache, discomfort at the top of the head, sore, pounding sensation in the right eye, inability to close the right eye and copious watery discharge from the eye. On examination, when the patient attempts to close her right eye, a small gap of 2mm remains. Wrinkles on the right side of the forehead have disappeared. The right side nasolabial fold has become distinctly less pronounced and the right angle of the mouth has dropped. When the patient was asked to smile in order to reveal her teeth, four were visible on the left but only two on the right. The patient's blood pressure was 90 over 60mmHg. Since onset of the paralysis she has also had episodic palpitations, difficulty in falling asleep, and a bitter taste in the mouth. The patient is not thirsty and has slightly dry stool. Her appetite and urination are normal.

Tongue: The body of the tongue is slightly redder than normal, the coating is very light yellow and is a little bit thicker than usual.

Pulse: The pulse is soft on both sides, but the right side is a bit more sunken.

Female, age 52

CC: Numbness and motor impairment on the left side of the body

The patient's symptoms developed suddenly, and she came for treatment after just one day. On that day she had awakened with numbness down the left side of her face, arm, and leg. She also experienced frequent episodes of muscular weakness of the limbs. Each episode was of 2-3 minutes' duration. The patient recalled that in the past she had experienced numbness on the tips of the fingers of the left hand, but she had ignored his and had never received treatment. Prior to her latest problem she caught &bad cold, and after a family dispute became angry and emotionally upset. At-present, except for a stifling sensation in the chest, she has made a good recovery from her cold. She had recently experienced other problems with her general health, including dizziness, restlessness, insomnia, and dream-disturbed sleep, a feverish sensation on the upper half of her body, excessive sweating, dry throat, and thirst with a strong desire to drink. She reported that her lower back and limbs had felt weak, sore, and cold for a longtime. The patient's blood pressure was normal. Her complexion was quite red, and her eyes were bloodshot.

Tongue: Dark red tongue with a white, greasy coating

Pulse: Right side is sunken and rapid, left side is sunken, thin, and rapid. Both pulses are forceless.

Female, age 39

CC: Unconsciousness and hemiplegia

This patient had a long history of severe hypertension with dizziness and headache. She was prescribed appropriate Western medication, but took it only occasionally. Two days ago, while physically laboring, she suddenly lost consciousness and was admitted to hospital while still unconscious. Her eyes were tightly closed, her jaw was tightly clenched, and her breathing was very rough with aloud gurgling sound from the throat. She had severe hemiplegia down the left side of the body. Since the onset of symptoms she had no bowel movements. Her temperature was 38.8°C, her body was very hot to the touch, and her face was red.

The tongue body is deep purple and curled up as a result of increased muscular tension, the coating is thick, greasy, dry, and yellow. (Note: Because the patient was unconscious and her jaw was clenched, a special mouth-gag was used to open the mouth.)

Pulse: Slippery, wiry, and forceful

Female, age 59

CC：Hemiplegia

The patient suffered a cerebral vascular accident (CVA) one month ago. At that time she suddenly lost consciousness and had obvious hemiplegia on the left side. After twenty-four hours in intensive care she regained consciousness.

She was first seen for acupuncture three weeks after the stroke. At that time her mental state was clear but she complained of weakness and numbness on the left side of the body and could not stand. There was deviation of the mouth to the right with salivation, and her speech was slurred. Her muscular strength was grade II to III. She felt that her tongue was very stiff. She had no appetite and no abnormal thirst. Her stools were dry with a bowel movement only once every several days.

Tongue: Dark with red spot. The coating was thick, yellow, and greasy.

 Pulse: Sunken (hidden), thin, and forceless

Male, age 54

CC: Insomnia

One-year history of insomnia. The patient usually wakes between 3and 4A.M. and finds it difficult to fall back to sleep. He occasionally remembers his dreams. The patient feels that his level of mental energy during the day is poor, feels drowsy, and suffers from dizziness and poor memory. His food intake is less than average and he has abdominal distention after eating. He has general lassitude but is not restless and has no feelings of fever or cold. He is not thirsty. Urination and bowel movements are normal.

Tongue: Pale body with a thin white coating

Pulse: Thin

Female, age 32

CC: Insomnia

Two months ago this patient was studying hard, with considerable mental strain, and began to suffer from insomnia. She had great difficulty in falling asleep and tossed and turned in bed. When she did sleep she dreamed a lot and had a tendency to wake with a start during a dream. Her memory became poor. She also suffered from palpitations, restlessness, shortness of breath, and was reluctant to speak to anyone. She had night sweats, general lassitude, and her appetite was sometimes poor and sometimes normal. Bowel movement and urination were normal. Her menstrual cycle was regular, but the quantity of blood loss was reduced.

Tongue: Red at the tip, thin, yellow, greasy coating

Pulse: Wiry, thin, and rapid

Male, age 39

CC: Insomnia

This patient has suffered from recurrent insomnia for several years. During the past week the insomnia has returned with difficulty in falling asleep and many dreams. The patient usually feels restless and has a sensation of heat in the chest. He also suffers from dizziness, poor memory, and a weak appetite. His mouth is dry and he likes to drink water. He has slight soreness and weakness in the lower back and the knee joints. Bowel movement and urination are normal.

Tongue: Light red body with a thin yellow coating

Pulse: Sunken(Hidden), thin, and slightly rapid

Male, age 39

CC: Insomnia

Frequent insomnia for the past two years. It is not difficult to fall asleep initially, but he has many dreams and wakens easily, after which he finds it difficult to go back to sleep. The patient feels very restless and sometimes has a hot, feverish sensation with sweating when the restlessness becomes severe. In addition, he sometimes wakes up to find that he has been sweating during sleep. In Chinese medicine this is referred to as night sweats'. The patient has dizziness in the morning with a heavy sensation around the head, and high frequency, 'cicada-like' tinnitus. He also complains of poor memory, severe general lassitude, and feels cold all the time, with cold extremities. He is very sensitive to temperature changes and has an aversion to heat and cold alike, being unable to adapt quickly. His appetite is poor and he has very bad digestion. He has a dry mouth, likes to drink water, and complains of urinary frequency, getting up 3-4 times a night-to urinate.

He has loose stools with a bowel movement once per day. He also complains of pain and coldness of the knee joints. His complexion is pale.

Tongue: Dark red body with a yellow, dry, greasy .coating, thick in the middle and at the root

Pulse: Right side: Slippery and forceless. The proximal position is thin.

Male, age 45

CC: Palpitations

The patient has complained of episodic palpitations with a rapid heartbeat for over one year. Initially they occurred only rarely, but now they occur every few days, whenever he works too hard or does not take enough rest. During the onset, severe restlessness sets in, accompanied by shortness of breath and a stifling sensation in the chest. When he rests the symptoms gradually disappear. Since the palpitations have developed his appetite has decreased and his sleep is poor. Bowel movements and urination are both normal. His complexion is dusky, lusterless, and pale.

Tongue: Slightly red body, thin and white coating

Pulse: Forceless

Female, age 51

CC: Palpitations and toothache

The patient has a history of palpitations for several years. The toothache began last week. Her general constitution is weak, as she has general lassitude, frequent bouts of episodic palpitations, and shortness of breath. Last week she developed painful, swollen gums. There is no bleeding from the gums, but the pain radiates to the neck. She has a dry mouth and throat and a desire to drink. Food intake is normal, but she has not defecated for three days, which is a new development.

The patient has chronic sensations of cold and pain in the lower back and knee joints.

Tongue: Pale body, white, greasy tongue coating

 Pulse: Wiry and slippery

Female, age 46

CC: Palpitations and shortness of breath

This woman has a history of chronic heart disease. The Western diagnosis was aortic insufficiency. She has a two-year history of frequent episodes of palpitations and shortness of breath. When she lies down the palpitations and shortness of breath are still severe. The heart rate exceeds 130 per minute. The patient cannot take any physical exercise, and the slightest exertion causes severe discomfort and loss of breath; even when seated she has great difficulty in breathing. She has been hospitalized many times with heart failure.

At present her breathing has become even worse with frequent wheezing when she attempts to move. She has both a cold appearance and cold limbs, and catches cold very easily. She complains of aching around the entire body. Her sleep is poor and she wakes easily during the night for no apparent reason. She has scanty, clear urine and constipation. Her bowel movements are only once every few days, but the stools are moist. Her complexion is dark and without luster.

Tongue: Pale, purplish body, white, greasy coating

Pulse: Thin and rapid

Female, age 63

CC: Palpitations with anxiety

This patient has had recurrent anxiety attacks accompanied by palpitations for the past two years. Besides palpitations the patient has also experienced episodes of irritability, a stifling sensation in the chest, and shortness of breath.

Ten days ago after an emotional upset the symptoms recurred, but this time they were worse than usual. The patient complains of an episodic feverish sensation rising upwards to the head and accompanied by sweating. She is not thirsty and prefers cold food, but her appetite is poor. There is no abdominal discomfort. The restlessness makes it difficult for her to fall asleep. She complains of coldness and pain in the lower back. Urination and bowel movements are normal.

Tongue: Slight red body, thin and white coating

Pulse: Thin