Dr. Di Case Studies, #1

Sample or Course Materials

 

Cases covered include Wei, Qi, Ying, and Xue (Blood) level febrile diseases and several types of dysentery. This course covers the treatment of chicken pox, jaundice, Yangming excess heat, damp-heat pox of the head and face, parasites, stress induced fear, overstrain leading towards an early death, tuberculosis, excessive drinking, excessive dreaming and spirit travel at night, edema, phlegm stagnation, chronic diarrhea and many other disorders.

 

  

1. True cold and false heat: cold and heat repel each other

A seventeen year-old male had chills and fever, body aches and a headache. He had been prescribed a heavy dosage of Ma Huang Gui Zhi Tang for a few days but his symptoms did not change. The herbal formula did not bring on sweating. Instead, the patient became severely thirsty and irritable, and his fever climbed even higher in the afternoon. One doctor diagnosed him as having a Yang Ming organ excess and prescribed a Da Cheng Qi Tang and Bai Hu Tang modification. After drinking tea made from two bags of herbs per day for two days, his excessive thirst was relieved, but he began speaking loudly with manic behavior throughout the night until the next morning. His hands and feet were cold and his tongue was bright white and puffy. His pulses were full and floating at the sky level and were imperceptible at the earth level.

 

Diagnosis
Wei level wind-heat trapped at the Yang Ming Qi and organ level resulting in exhaustion of the Yang. True cold battles heat on the surface.

Treatment plan
Warm and strengthen the Kidney Yang and calm the Heart

 

Formula: Jin Gui Shen Qi Wan modification.

Fu Zi (Aconiti Radix Lateralisa preparata) 6g.
Rou Gui (Cortex Cinnamomi Cassiae) 10g.
Pao Jiang (Toasted Zingiber Officinale Rosc) 6g.
Fu Zi, Rou Gui and Pao Jiang join to warm the Kidneys and the interior. Fu Zi is stronger and it stays in the blood for a longer period. Fu Zi must be boiled for at least one hour to reduce the toxicity of the herb. It is appropriate to ask the patient for permission before including it. Rou Gui is fast moving, while Pao Jiang warms the Lungs, Stomach, Spleen and Kidneys. Compared to Rou Gui, Pao Jiang is more stable and it supports the actions of Fu Zi.

Ba Ji Tian (Radix Morindae Officinalis) 12g.
Bu Gu Zhi (Fructus Psoraleae Corylifoliae) 12g.
Ba Ji Tian and Bu Gu Zhi warm the Kidney Yang. Ba Ji Tian expels wind-damp bi-pain and has a strong yang fortifying action. Bu Gu Zhi warms the Spleen and Kidney Yang.

Fu Shen (Sclerotium Poriae Cocus Pararadicis-part around root) 10g.
Yuan Zhi (Semen Tritici Aaestivi Levis) 6g.
Fu Shen and Yuan Zhi calm and clear phlegm from the Heart. Fu Shen drains dampness and Yuan Zhi clears phlegm blocking the Heart orifice.

Niu Xi (Radix Achyranthis Bidentatae) 10g.
Niu Xi strengthens the Liver and Kidneys and promotes blood circulation and urination. It guides the blood to flow to the lower body while expelling wind-damp and alleviating bi-pain.

Shu Di Huang (Radix Rehmanniae Glutinosae Conquitae) 6g.
Shu Di Huang nourishes the Blood, Jing and Yin.

Shan Yao (Radix Dioscoreae Oppositae) 15g.
Shan Yao is astringent and strengthens the Spleen and Kidneys.

Shan Zhu Yu (Fructus Corni Officinalis) 10g.
Shan Zhu Yu is astringent and strengthens the Kidneys and Liver.

Fu Ling (Sclerotium Poriae Cocoa) 15g.
Ze Xie (Alismatis Rhizoma) 10g.
Fu Ling and Ze Xie promote urination. Fu Ling is a neutral substance that balances water in the body. Ze Xie eliminates Kidney excess and clears deficient heat.

Mu Dan Pi (Cortex Moutan Radicis) 10g.
Mu Dan Pi cools heat and promotes blood circulation.

 

Resolution
He took one bag of this formula and slept for twenty-four hours. After taking the herbal formula for four days, he recovered.

 

 

2. Yang Ming organ excess heat.

A seventy year-old male had a common cold and was drinking copious amounts of water. He had fullness in both his chest and abdomen. He was delirious and manic, and also suffered from scanty yellow urination and constipation. His tongue was red with a dry coating, and his pulses were full and strong.

 

Diagnosis
Yang Ming organ excess

Treatment plan
Purge heat from the Yang Ming

 

Formula: Da Cheng Qi Tang

Da Huang (Radix et Rhizoma Rhei) 15g.
Hou Po (Cortex Magnoliae Officinalis) 12g.
Mang Xiao (Mirabilitum) 12g.
Zhi Shi (Fructus Immaturus Citrii Aurantii) 10g.
Da Huang is a strong purgative. It also promotes Blood circulation and clears heat-toxins. Because of its strength, it is the dominant herb in this formula. Mang Xiao softens hard stool to help purge the bowel. Zhi Shi and Hou Po break up stagnant Qi and cause the Qi to descend. Although Zhi Shi is a stronger Qi mover, Hou Po also disseminates the Qi and resolves stagnation.

After taking the formula for half a day, he expelled smelly dry stool. The fever and other symptoms were ninety percent improved by nightfall. He was still experiencing fatigue the next day but his fever was gone. His tongue was red and dry, and his pulse was small and rapid.

Diagnosis: Qi and Yin deficiency.
Formula: Yin Qiao San & Zeng Ye Tang modified.
Function: To clear the residual heat, augment the qi, generate fluids and lubricate the Yin.

Sheng Di Huang (Radix Rehmanniae Glutinosae) 10g.
Mai Men Dong (Tuber Ophiopogonis Japonici) 10g.
Xuan Shen (Radix scrophulariae Ningpoensis) 6g.
Zhi Mu (Rhizoma Anemarrhenae Asphodeloidis) 6g.
All of the above herbs clear heat and nourish the Yin. Sheng Di Huang is the strongest ingredient. It moistens the Blood and Jing while clearing heat from the blood. Mai Men Dong cools the Stomach, Lung and Heart Yin. Xuan Shen and Zhi Mu also clear heat from the blood. Xuan Shen clears heat toxins and moistens the fluids. Zhi Mu clears Qi level heat.

Huang Qin (Radix Scutellariae Baicalensis) 6g.
Huang Qin clears Upper Jiao heat.
Jin Yin Hua (Flos Lonicerae Japonicae)10g.
Lian Qiao (Fructus Forsythiae Suspensae) 10g.
Jin Yin Hua and Lian Qiao clear heat toxins and release surface heat. Jin Yin Hua is stronger in its ability to move and relieve the surface. Lian Qiao is stronger in its ability to clear heat toxins and to treat hot phlegm nodules.

Tian Hua Fen (Radix Trichosanthis Kirilowii) 6g.
Tian Hua Fen clears hot phlegm and moistens the dry throat.

Chai Hu (Radix Bupleuri) 3g.
Chai Hu smooths and spreads the Qi.
Chen Pi (Pericarpium Citri Reticulatae) 6g.
Chen Pi regulates the Middle Jiao Qi and dries phlegm.

Fu Ling (Sclerotium Poriae Cocoa) 12g.
Fu Ling promotes urination and balances water in the body.

Dang Gui (Radix Angelicae Sinensis) 3g.
Dang Gui promotes blood circulation and nourishes the blood.

Gan Cao (Radix Glycyrrhizae Uralensis) 6g.
Gan Cao harmonizes the ingredients function and clears heat toxin.

Resolution
He took this formula for seven days, after which time he recovered.

 

 

 

3. Excess in Wei Level and Yang Ming organ with Yin deficiency.

A sixty year-old female suffered from delirium and excess fullness of the abdomen after having a cold for three months. She presented with a dark red tongue and face, and her pulses were deep, small, hard and strong.

 

Diagnosis
Wind-heat common cold moving into the Yang Ming organ and Blood levels.

Treatment plan
To eliminate heat in the Wei, Qi and Blood levels. Purge heat from the Yang Ming organ.

 

Formula: Tiao Wei Cheng Qi Tang, Yin Qiao San & Zeng Ye Tang modification.

Xuan Shen (Radix scrophulariae Ningpoensis) 10g.
Mai Men Dong (Tuber Ophiopogonis Japonici) 12g.
Sheng Di Huang (Radix Rehmanniae Glutinosae) 12g.
Zhi Mu (Rhizoma Anemarrhenae Asphodeloidis) 12g.
All the above herbs clear heat and moisten the fluids. Xuan Shen, Sheng Di Huang and Zhi Mu cool heat in the Blood. Xuan Shen clears heat toxins and moistens dryness. Sheng Di Huang nourishes the Blood and Yin. Zhi Mu sedates heat at the Qi level and moistens the fluids.

Di Gu Pi (Cortex Lycii Radicis) 12g.
Mu Dan Pi (Cortex Moutan Radicis) 12g.
These two herbs clear heat from the Blood. Di Gu Pi treats steaming bone disorder. Mu Dan Pi promotes blood circulation. 

Jin Yin Hua (Flos Lonicerae Japonicae) 12g.
Lian Qiao (Fructus Forsythiae Suspensae) 12g.
Qing Hao (Herba Artemisia Annuae) 6g.
These three herbs release heat from the surface. Jin Yin Hua and Lian Qiao clear heat toxins. Jin Yin Hua is stronger in its ability to relieve wind-heat. Lian Qiao is stronger at clearing heat toxins and dissolving hot phlegm nodules.

Xi Yang Shen (Radix Panacis Quincquefolii) 10g.
Xi Yang Shen clears heat while concurrently strengthening both the Qi and the Yin.

Bai Shao (Radix Peoniae Lactiflorae)12g.
Bai Shao regulates the Liver Qi, harmonizes the Ying and Wei, and nourishes the Yin and the Blood.

Da Huang (Radix et Rhizoma Rhei) 15g.
Da Huang purges heat and promotes blood circulation.

Lu Gen (Rhizoma Phragmitis Communis) 12g.
Lu Gen promotes urination, generates fluids and clears heat.

Dang Gui (Radix Angelicae Sinensis) 3g.
Dang Gui promotes blood circulation and nourishes the blood.

Gan Cao (Radix Glycyrrhizae Uralensis) 6g.
Gan Cao harmonizes the ingredients in the formula.

Feng Mi (honey) 15g.
Feng Mi moistens dryness and smooths bowel movements.

 

Resolution
She took one bag of this formula and then had excess watery diarrhea. Her fever was relieved and her temperature dropped back down to normal. She had no more delirium or fullness of the abdomen. After continuing the same formula without Da Huang for a few days, she fully recovered.

 

 

4. Wind-heat transmits to the Shao Yang and Blood levels. Menstruation flows from the nose instead of from the uterus.

A seventeen year-old female had chills and a high fever. The fever was higher in the morning and she was delirious at night. She had severe bleeding from the nose during the time of menstruation for a few days but no uterine bleeding. She had a red, purple and dry tongue. Her pulses in the Kidney and Liver positions were deep, slippery and wiry. The Lung pulse was floating and rapid.

 

Diagnosis
Wei level heat moves inward to the Yang Ming, Shao Yang and Blood levels. The blood that comes out through the nose does not reside comfortably in the uterus of the Kidney system. The heat causes the hot blood that should flow from the uterus to rise to expel through the nose.

 

Treatment plan
To smooth and clear Shao Yang and Blood heat. Clear heat trapped in the Shao Yang between Wei Qi and Blood levels. Cool the Blood and smooth the Qi.

 

Formula: Xiao Chai Hu Tang modification

Chai Hu (Radix Bupleuri) 12g.
Chai Hu regulates the Liver Qi, harmonizes the Shao Yang, and releases heat from the surface.

Ban Xia (Rhizoma Pinelliae Ternatae) 3g.
Huang Qin (Radix Scutellariae Baicalensis) 12g.
Ban Xia dries phlegm and descends Stomach Qi. Huang Qin clears Upper Jiao damp-heat. As a pair, they clear Liver and Gall Bladder damp-heat.

Dang Shen (Radix Codonopsitis Pilosulae) 10g.
Dang Shen strengthens the Qi.

Sheng Di Huang (Radix Rehmanniae Glutinosae) 12g.
Mu Dan Pi (Cortex Moutan Radicis) 12g.
Chi Shao (Radix Paeoniae Rubrae) 12g.
These three herbs cool heat in the Blood. Sheng Di Huang nourishes the Blood, Yin and Jing. Mu Dan Pi and Chi Shao promote Blood circulation. Mu Dan Pi is strongest in its ability to cool the Blood. Chi Shao is stronger at promoting Blood circulation.

Wang Bu Liu Xing (Semen Vaccariae Segetalis) 6g.
Wang Bu Liu Xing breaks through Blood stagnation to promote menstruation.

Zhi (honey-fried) Bie Jia (Carapax Amydae Sinensis) 10g.
Zhi Bie Jia cools heat and promotes Blood circulation to dissolve clots.

Gan Cao (Radix Glycyrrhizae Uralensis) 6g.
Gan Cao harmonizes the other ingredients in the formula.

After she took two bags of formula, her fever reduced, the nosebleed resolved, and the delirium stopped. Her tongue was red, but it was less dry and purple. Her Kidney and Liver pulses returned at the middle level with a slippery, floating and full quality. A new diagnosis was made and formula to fully resolve the condition:

 

Diagnosis
Shao Yang and Blood heat

Formula: Xiao Chai Hu Tang & Qing Gu San modification

Function
To regulate Shao Yang, cool the heat in the Blood, and lubricate the Yin.

 

Chai Hu (Radix Bupleuri) 3g.
Chai Hu regulates the Shao Yang and relieves the surface.

Ban Xia (Rhizoma Pinelliae Ternatae) 3g.
Huang Qin (Radix Scutellariae Baicalensis)15g.
Ban Xia dries dampness and decends the Qi. Huang Qin clears Gall Bladder and Liver damp-heat. As paired, these herbs clear damp-heat in the Shao Yang.

Xi Yang Shen (Radix Panacis Quincquefolii) 12g.
Xi Yang Shen clears heat and strengthens the Qi and Yin.

Sheng Di Huang (Radix Rehmanniae Glutinosae) 12g.
Sheng Di Huang clears heat in the Blood and lubricates Yin, Blood, Jing and body fluids.

Mu Di Pi (Cortex Moutan Radicis) 12g.
Di Gu Pi (Cortex Lycii Radicis) 12g.
Yin Chai Hu (Stellaria Dichotomae Herba) 12g.
Bai Wei (Radix Cynanchi Baiwei) 12g.
Zhi Bie Jia (honey-fried Carapax Amydae Sinensis) 30g.
This group of herbs cools the heat in the Blood. Mu Dan Pi promotes Blood circulation. Di Gu Pi and Yin Chai Hu treat steaming bone syndrome. Di Gu Pi flows to the surface. Yin Chai Hu clears Middle Jiao damp-heat. Bai Wei cools acute and chronic deficient heat. Zhi Bie Jia promotes Blood circulation and penetrates clumps.

Gan Cao (Radix Glycyrrhizae Uralensis) 3g.
Gan Cao harmonizes the ingredients of the formula.

 

Resolution
After taking two bags of this formula, she fully recovered.

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