3/22/2023 Cases

1.
36 Y.O. FEMALE COMPLAINING OF GENERAL FATIGUE AND WEAKNESS

She appears quite wan

and thin. Visual exam
She feels depressed and She can’t walk very far She can feel her heart
reveals her eyes as
has trouble getting out of without having to rest and beating in her chest she
slightly bulging and she
bed. she is often out of breath. complains.
complains that her eyes
feel gritty.

She reports feels of

You notice mild tremors
She is thirsty and her vexation and agitation as
Her complexion is pale of the hands when you
mouth feels dry with a well as insomnia
and lusterless. take her wrist to feel the
pasty taste in her mouth characterized by difficulty
pulse.
falling asleep.
1.
36 Y.O. FEMALE COMPLAINING OF GENERAL FATIGUE AND WEAKNESS

She also reports a

When this occurs, her
feverish sensation that
Her knees and back are face becomes bright red,
appears in the early Her appetite is poor.
sore. but then returns to
afternoon and spikes and
normal.
then recedes.

Her tongue is red with a

She reports bloating and Her bowel movements
thin coat and her pulse is
fatigue after eating. tend to be soft.
weak and rapid.
  2.56 Y.O. Female complaining of intermittent issues with
her digestion. She reports pain and distension in her
stomach and abdomen. She can’t stand the sight of food at
times. She experiences dry heaves and nausea. She has a
tendency to soft stool. She reports that her flatus is quite
malodorous. She also tends to belch quite frequently. She

CASE 2 also experiences insomnia when all of these issues are

readily apparent. She has been previously diagnosed with
hyperthyroidism and has been treated with both western
biomedicine and with herbs and acupuncture. Initially she
experienced a strong emotional trauma which her
practitioner explained as creating phlegm which
manifested as a goiter. She remembers being fidgety and
anxious back then.
  . She also noted feelings of heat and also increased
appetite. Despite eating voraciously she could not gain
weight. She discontinued her TCM treatment as she
could not afford both modalities. Recently her issues
revolve more around feeling cold and fatigued most of
the time. She is now a little overweight, whereas in the
past she was always quite thin, almost too thin. She
CASE 2 also complains of low back and knee soreness and
weakness and ringing in the ears. At this time she is
experiencing the digestive complaints and insomnia
rather significantly. Her tongue fur is thick and slimy
and her pulse is slippery.
  
  3.60 Y.O. female complaining of general fatigue and
weakness. She feels depressed and has trouble getting
out of bed. She can’t walk very far without having to
rest and she is often out of breath. She can feel her
heart beating in her chest she complains. She appears
quite wan and thin. Visual exam reveals her eyes as
CASE 3 slightly bulging and she complains that her eyes feel
gritty. You notice mild tremors of the hands when you
take her wrist to feel the pulse. Her complexion is pale
and lusterless. She reports feels of vexation and
agitation as well as insomnia characterized by
difficulty falling asleep. She is thirsty and her mouth
feels dry with a pasty taste in her mouth
  Her knees and back are sore. She also reports a
feverish sensation that appears in the early afternoon
and spikes and then recedes. When this occurs her face
becomes bright red, but then returns to normal. Her
CASE 3 appetite is poor. She reports bloating and fatigue after
eating. Her bowel movements tend to be soft. Her
tongue is red with a thin coat and her pulse is weak and
rapid.
 ◦ 70 Y.O. male. CC is severe itching. Patient has
been diagnosed with NIDDM for several years.
The itching has increased over the course of the
last several years. Initially it started in cold dry
weather that is in midwinter
◦ Dry skin and scratch marks are clearly visible over
Case 4 the body, especially on the antero-tibial surfaces.
There are no lesions, however, evident. The patient
reports that the itching is quite severe. Visual
examination reveals the patient has a dark, “sooty”
complexion and rather dry earlobes, like slices of
dried apple
 ◦ The patient reports poor sleep especially because of
frequent need to arise and urinate. In general the
patient urinates quite frequently with a large
volume. The urine appears cloudy as well. The
patient experiences dry mouth and tends to be
thirsty.
Case 4 ◦ The patient complains of a chronic weak dry cough
as well. In addition the patient complains of
tinnitus and low back soreness and weakness. The
tongue body is red and dry with a thin coat. The
pulse was found to be fine and wiry.
 ◦ 63 Y.O. Female. Previously diagnosed with
essential hypertension. Other significant data is a
total cholesterol reading of 320 with triglycerides
of 400. Over last few years she developed some
Case 5 new issues for which she is consulting you. Her
most pressing issue is a sense of fullness and
pressure in her chest. Her mouth is dry and she is
thirsty and drinks frequently- more than previously
 ◦ She reports dizziness. She also reports being
extremely hungry, but only able to eat small
portions. She reports a feeling of heat in her upper
body which makes her a little annoyed and
Case 5 “squirm”. This feeling of heat seems to contribute,
but not totally to her sleep problems, which are
characterized mostly by difficulty falling asleep
and sometimes not sleeping at all or very lightly.
 ◦ She feels weak and tired. She also complains of a
new issue with what have been diagnosed as
‘lipomas” by her dermatologist. Her tongue is dark
Case 5 red with slimy, white fur which was yellow in the
center. Her pulse was slippery and wiry.
 ◦ 47 Y.O. Male. The patient complained of feelings
of abdominal distension and fullness accompanied
by burping and occasional nausea. This, he reports
has occurred over the last couple or three weeks.

Case 6 This has been accompanied by decreased appetite.

He complained that his lower legs were heavy,
tired and sore. He also felt fatigued and weak. His
urine was normal, however his bowel movements
were more frequent and soft.
The patient reported significant alcohol and tobacco use since the age of 17. He reports that he
was pretty slim until about 10 years ago when he started to gain weight and become
overweight. His total cholesterol was 340 with a triglyceride reading of 380.

His BP was fairly normal with a slightly raised diastolic figure. The patient’s tongue was
slightly dark with slimy, white fur which was yellow at the root. The pulse was fine and
slippery

Case 6