Case Studies from Chinese Acupuncture Experts

Female 22

CC: Dysmenorrhea for eight years

This patient’s first menarche was at the age of 14; it was painful. She did not have treatment because the pain was not serious at that time. Four years ago, after being caught the rain during her period the pain became worse. She took western medicine which stopped the pain, but when menstruating she would still have severe abdominal pain. Her lower abdomen felt cold; she had scanty menstrual flow that was dark in colour with clots. Recently, her menstrual pain was unendurable. Her limbs were cold and there was a cold pain in her lower abdomen. So, she came in for treatment.

Examination

Slim build, with a pained expression on her face, sweating from the head

Tongue: slightly dark, with a thin coating

Pulse: wiry

Female 23

Female, 43

CC: Amenorrhea for half a year

This patient usually has normal menstrual cycles, color, quantity and quality of the blood is normal. Half a year ago, while she had her cycle she went swimming, and the period suddenly stopped. She had accompanying soreness of the low back, feeling of limb weakness, aversion to wind, headache, and a cold sensation in the lower abdomen. Vaginal discharge is without smell.

Examination:

Pale tongue with a thin white coating, deep and slow pulse

Female 40

CC: Amenorrhea for two years

Two years ago, the patient had a quarrel with someone during her menses, prior to this she had been depressed and her periods were becoming increasingly irregular. There were accompanying symptoms of lower abdominal distention, cold pain in the loins that radiated to the back, fullness in chest, sighing, irritability, limbs numbness and loose stools 2 to 3 times a day.

Examination:

Patient’s cheeks and lips is dark purple, tongue is purplish with a thin yellow coating, and pulse wiry, proximal (Chi) position is weak

Female 31

Prolonged menstruation for 14 days

Fourteen days ago this patient’s menstrual flow began, it was light in colour and accompanied by soreness in the lumbar region. She took some Chinese medicine but it was not effective. She had her first period at the age of 14. The cycle, colour and quantity of her menstruation were all normal. She got married at the age of 27, and has had two abortions within her two years of marriage. She was always tired, afraid of cold, mentally fatigued and does not like to talk.

Pale complexion, pale tongue with a thin coating, and a deep thready pulse  

Female, 24

[Chief Complaint)

Irregular menstruation accompanied by Beng Lou (uterine bleeding) for seven years

(Present Medical History)

This patient was 15 at menarche初潮. The cycle, colour and quantity of her menstruation were all normal. She is introverted and was depressed for a long time. 6 years ago, the cycle became disordered; she would have it once every two or three months, even up to six months between periods. The flow was profuse, even after she had bled for seven days and contained big clots. Hundreds of doses of herbal medicine, hormone therapy, and three D&C's (Dilation and Curettage) failed to have any effect. Presently she had irregular cycles that lasted for more than seven days with scanty dark flow, distending pain in lower abdomen, large clots, accompanied by dizziness, headache, and palpitations.

[Examination)

Sallow complexion, yellow and slight greasy tongue coating, thready and rapid pulse

Female 40

Breast pain with nodules for six years

Six years ago, this patient had an abortion after which her menstrual cycle became erratic (irregular) and she started to have breast swelling and pain. By taking Chinese herbal medicine the pain could be relieved, but it would start again when she stopped taking the herbs. In the past three years 15 days before the onset of her menstrual flow, she would feel numbness on the tip of the tongue and stiffness of the tongue root. At night on the 2^nd to 3^rd days of the menses, she had a salty taste in her mouth and spit out about 10ml of blood. She is irritable, usually had a hot temper, late onset of her period along with scanty, pale flow and breast pain that was worse before the period and when she was anger or tired. Additionally, she had symptoms of a fontal headache, difficulty in falling asleep, dream disturbed sleep, blurred vision, tinnitus, bitter taste in the mouth, and throat dryness.  

She is thin with a pale complexion. Her breasts are normal in appearance, no exudation from nipples. Patchy, movable and smooth masses, 4.5cmX3.5cm, with medium hardness, clear margins, and significant tenderness, were felt in the later superior parts of her breasts. The cervical and subaxillary lymph nodes were enlarged. Her tongue is red, not moist, with a thin white coating, and a wiry thready pulse.   

Female 25

Distending pain in breasts for eight months

Eight months ago, after getting angry with someone, she began to have a distending pain in the breasts. Afterwards the pain repeatedly appeared and got worse before menstruation. Masses were felt in the breasts. Recently, she had delayed menstruation which was accompanied by distending pain in the abdomen.

Examination: A patch-like 3.5cmX3,5cm mass is felt in the later superior part of the right breast, and  a 2.5cmX2.5cm mass is felt in the later superior part of the left breast. They are movable, smooth and tender. The subaxillary lymph nodes are not examined. She has a little red tongue, and wiry pulse. Infrared scanning showed hyperplasia of the mammary glands.

Female 22

CC: swelling and redness at the tip of the right middle finger

Yesterday in the evening the patient noticed that there was swelling and redness near the nail. The following morning it was worse as the colour changed from fresh red to blue purple and had white pus filled top. Pain radiated down the medial side of forearm to the elbow, the pain is unendurable. She had chill and nausea

Examination:

Clear consciousness, sallow complexion, normal voice and respiration, thin white tongue coating, thready rapid pulse

Female 40

CC: Numbness of left palm for half a day

This morning the patient felt numbness and pain of her left hand, chills, irritability and nausea

Examination:

Pale complexion, emaciation, and swelling of the left hand around HT8 with a dull sensation, no change in skin color. Red tongue, Yellow coating, thready rapid pulse

Female 18

Many white patches all over the body for seven years

Seven years ago, she began to have 1 cm white patches on the lateral side of her left lower limb. One year ago, her wrists, ankles and right hypochondrium began to have white patches too.

Examination:

The biggest patch is 5x7 cm. Red tongue with tooth marks on the borders, thin white coating, and thready pulse.

Male 30

CC: White patch on the dorsum of the left hand for hale a month

Half months ago the patient noticed a white patch on the dorsum of his left hand after a quarrel with somebody    

Examination:

The white patch 3cm X 6cm in size, red tongue, thin white coating, rolling pulse

Male 60

CC: Tinea 癣 with itching at neck and palms toe years

Two years ago the patient began to have tinea with itching at the palms, afterward the nape and elbows became involved. The patient was diagnosed with neurodermatitis神经性皮炎and treated with various therapies, but the itching was not relieved. He could not sleep at night because of the itching.

Examination:

The skin of the dorsum of the hands and elbows was rough like cowskin, red tongue, white coating, wiry pulse.

Female, 24

Female 30

CC: The nape of her neck and the left elbow had thickened skin with serious itching for three month

The patient began to have a thick of the skin with serious itching at the nape and elbow in the past three months. She tried many kinds of treatment, but all no effect 

Examination:

The skin of the nape in an area 4cmX8cm and the left cubital fossa in an area 3cmX5 cm became thick, dry and chapped, and with serous itching. It was made worse by warmth, and a pink granule –like fluid come out after scratching

Female 16

CC: Swelling and pain of the right ankle joint for one day

This patient sprained her right ankle, the joint swelled up and turned black and blue; it was extremely painful. She could not walk at all and could not sleep either because of the pain

Examination:

Severely swollen right ankle, unable to put any weight on it at all, There were no fractures or dislocated bones.

Pale tongue, thin white coating, and superficial tight pulse