Responses

    1. Ask and you shall receive! (See my post here)
      I apologize for the delay, I was traveling over the last 5 days and didn’t get a chance to get this uploaded until this morning.

  1. Case Study Class 25 Sept 2024
    Gender: female
    Age: 36
    Height: 5’ 8”
    Weight: 135 lb
    Ethnicity: American/European
    Occupation: self-employed/part-time NGO

    Chief complaint: tired, stressed
    Symptoms: feels exhausted, tired upon waking
    Brief history: patient has 3 children (2, 4, 7 yo), is a single mom. Menarche at 14. History of trauma (sexual and psychological abuse).
    Diet and Lifestyle: Cooks most meals, eats a well-rounded diet. Non-smoker, rarely drinks alcohol. Gets regular exercise. Lots of stress with children who are young and needy, normal stuff. Has help from parents, which allows her to work.
    Sleep: sleeps very well and deep but wakes with the children at night and is tired in the morning.
    Energy: very good, except when it’s not. She feels like she has lots of energy some times but mostly is tired/exhausted.
    Appetite: good, cooks most meals with good attention to diet.
    Stool: 1 X/day, slightly dry with occasional diarrhea if she eats heavier foods like diary
    Thirst: doesn’t drink enough water, not thirsty or just “forgets” to drink.
    Urine: 6–9 X/day, sometimes darker, mostly unremarkable
    Menstruation: regular (28–30 days), scant with occasional heavy flow. Some but few clots, often none. Minor abdominal pain/discomfort, weepy or irritated pre-menstrual time.
    Basic observations: Patient is in good physical health, gets regular exercise, often with the kids, walking to wild-harvest herbs and seaweeds. Patient has a classic “single mom” lifestyle and is simply fried from doing it along with the drama that came with the dad of the youngest two kids (won’t take his meds and has psychotic episodes – needed to get a restraining order)
    Pulse: n/a
    Tongue: slightly red, thin white coat

    Dx: kidney vacuity
    Explanation: This is a simple pattern of exhausted kidney qi, which really means that there is exhaustion of qi, yin, yang, and potentially essence. Not mentioned in the case above (hopefully someone will ask but should have been included) is that the patient has a “grainy” voice that lacks qi. She has no sex drive and generally is worn out.
    Exhaustion/tiredness: this patient has had three children in the span of less than 5 years without much support. Additionally, she has a history of emotional and sexual abuse, which strongly taxes the kidney qi. Her exhaustion is very significant and impeding her ability to function in the world, both at work and with her children. Her apparent good energy is short-lived and fleeting.
    Menstruation scant with occasional flooding while her menstruation appears to be well ordered, her flow is scant except when she is particularly exhausted, then there is flooding. This suggests that the qi is unable to control the amount of flow and simply can’t “hold it up.” Remember, kidney governs opening and closing.
    Occasional diarrhea is similar to the menstruation issue noted above, when she over-taxes her digestion, it simply cannot handle the load. The reality is that, when asked about specifics, the “over-taxing” is actually a very reasonable amount of food and she never had any issues with dairy until a couple years ago when she started having problems with fatigue. Remember, kidney governs opening and closing.
    The slightly red tongue and white coating, are common in this pattern. The reddening suggests that there is some heat developing from kidney yin and qi vacuity.
    Formula: Unnamed Formula
    baizhu (柴胡) atractylodes, white 30g
    huangqi (黃芪) astragalus 30g
    baishao (白芍) white peony 30g
    shu dihuang (熟地黃) rehmannia, prepared 30g
    huangqin (黃芩) skullcap, Chinese 10g
    huangbai (黃柏) phellodendron 10g
    zhishi (枳實) bitter orange, mature 15g
    meiguihua (玫瑰花) rugosa rose 15g
    yejiaoteng (夜交藤) polygonatum, stem 10g
    suanzaoren (酸棗仁) ziziphus, kernel 10g
    gancao (甘草) licorice 5g