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  2. Unknown Member

    I have a friend who makes and sells vegan walnut meat. It is amazing! and infinitely variable depending on what spices are used. She makes taco meat, sloppy joe meat and more. She won’t share her precise recipe bc she sells her products in the highly competitive Atlanta market. You can search vegan walnut meat recipes and come up with great ideas. Most recipes include walnuts, mushrooms (essential for taste and texture) and flavorings and use a food processor. I plan to experiment with making this. She uses onion, garlic, and possibly turmeric that I know of. If you are in the Professional Herbalist Course, check out Thomas’ post on turmeric. Let us know your favorite recipes!

  8. Thomas July 23, 2024

    For: Advanced Students working on Case Studies. If you are not actively working on the advanced lessons and case Studies, you can still attend, but please stay in listen only mode, unless called upon.

    Preparation:

    1. What other questions might you ask?

    2. A diagnosis using Chinese medicine or Western Herbal Medicine

    3. A treatment strategy based on the diagnosis

    4. An appropriate formula

    【Case Study Class 19 June 2024 】

    Gender: male

    Age: 62

    Height: 192 cm

    Weight: 115 kg

    Ethnicity: white American

    Occupation: US government

    Chief complaint: GERD*, type II diabetes, coronary artery disease, acute myocardial infarction, hypertension, difficulty sleeping (*diagnosed by dietician but patient doesn’t think it is good diagnosis.)

    Symptoms: occasional heart burn after eating, wakes many times during night, prefers cold drinks and foods (and winter)

    Brief history: Formally got a lot of exercise, but over the last decade that has declined significantly for a variety of reasons.

    Diet and Lifestyle: eating better now with lots of room for improvement. Still eating sweets after lunch and dinner.

    Sleep: poor, needs to get up to pee 4–5 times a night, struggles to fall asleep as well

    Energy: not very good but seems to be able to work and get on with his day, even though he clearly has fairly low energy

    Appetite: strong, recently trying to reduce sweets/snacks, eating more healthy

    Stool: 1 X/2–3 days, hard and difficult

    Thirst: often thirsty

    Urine: 7–10 X day

    Basic observations: Patient is in fair to poor physical health, although mentally he seems to be is average or above health, this is a good thing because he clearly wants to work on his health, even if it is obvious that he is a little down about his current situation. Patient has been trying lots of things by trying to learn from the internet but finally realized that he needed to talk to a professional because he wasn’t getting the results that he desired and he finally realized that it was more complex than he might have thought.

  10. Thomas September 9, 2024

    Here is the case for this Wednesday’s class: (please be prepared to address #s 1-4 below)
    1. What other questions might you ask?
    2. A diagnosis using Chinese medicine or Western herbal medicine.
    3. A treatment strategy based on the diagnosis.
    4. An appropriate formula.

    Case Study Class 11 September 2024
    Gender: female
    Age: 50
    Height: 5’ 6”
    Weight: 158 lbs
    Ethnicity: American/European
    Occupation: non-profit

    Chief complaint: menopause/sore throat
    Symptoms: sore throat with redness and a yellow patch at back of throat. Hot flashes, night sweats, heart palpitations, anxiety, gained 20+ lbs in last couple years
    Brief history: been pregnant once with miscarried twins, chronic fatigue (dx in the 1990s), multiple kidney stones, tinnitus, migraine headaches, IBS with alternating diarrhea and constipation (more constipation since menopause started)
    Diet and Lifestyle: eats pretty well, lots of veggies, some meat, perhaps too much starch.
    Sleep: difficultly falling asleep
    Energy: OK, varies, mostly tired but seems to power through the day without the use of stimulants
    Appetite: OK, eats and generally enjoys food
    Stool: dry, strained, small pcs.
    Thirst: doesn’t drink much water, no real thirst
    Urine: 4–6 X/day, sometimes darker
    Basic observations: Patient is in reasonably good physical health. She is trying a number of different things to find a path to health. Has some inappropriate fears around things like electricity (EMFs), and similar pop-culture health concerns.
    Pulse: n/a
    Tongue: slightly red, thin white coat, thicker toward the back

    1. Thomas September 24, 2024

      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.

  13. Thomas September 24, 2024

    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

  18. Thomas October 7, 2024

    Hi All,
    Here is the case for Wednesday.

    Case Study Class 9 Oct 2024
    Gender: female
    Age: 52
    Height: 5’ 7”
    Weight: 145 lb
    Ethnicity: Chinese
    Occupation: self-employed/retired

    Chief complaint: pain in the ribside
    Symptoms: occasional cough, sensation of and ability to expel phlegm from the throat
    Brief history: patient had 2 children (25 and deceased). Menarche at 13.
    Diet and Lifestyle: Cooks almost all meals, eats very healthy diet, occasional alcohol consumption, over last year or so not getting much exercise (moved to the US from China 2 years ago).
    Sleep: sleeps very well, can sleep for 8-12 hours, generally feels rested in the morning.
    Energy: generally good.
    Appetite: good, but can be low occasionally, cooks most meals with good attention to diet.
    Stool: 1-3 X/day, occasional diarrhea, generally loose and sometime difficult. Usually stinky with regular farting
    Thirst: forgets to drink water, not thirsty
    Urine: 6–9 X/day, mostly unremarkable
    Menstruation: regular (32–40 days), scant with occasional heavy flow. Few, if any, clots, often none. Little of no menstrual pain or discomfort of any kind. (Mom menstruated until she was 59)
    Basic observations: Patient is in reasonable physical health, has started to get regular exercise but irregular to this point. Patient is slightly over-weight, holding most of this in her stomach area. Patient often as skin issues, particularly in the summer when itchiness can lead to scratching and open sores. Stopped eating dairy products, which seems to have cleared her skin.
    Pulse: n/a
    Tongue: slightly red with red “prickles,” moderately thick white coat

  19. Thomas October 10, 2024

    Here is the entire case presented last night:

    Case Study Class 9 Oct 2024
    Gender: female
    Age: 52
    Height: 5’ 7”
    Weight: 145 lb
    Ethnicity: Chinese
    Occupation: self-employed/retired

    Chief complaint: pain in the ribside
    Symptoms: occasional cough, sensation of and ability to expel phlegm from the throat
    Brief history: patient had 2 children (25 and deceased). Menarche at 13.
    Diet and Lifestyle: Cooks almost all meals, eats very healthy diet, occasional alcohol consumption, over last year or so not getting much exercise (moved to the US from China 2 years ago).
    Sleep: sleeps very well, can sleep for 8-12 hours, generally does not feel rested in the morning.
    Energy: generally good.
    Appetite: good, but can be low occasionally, cooks most meals with good attention to diet.
    Stool: 1-3 X/day, occasional diarrhea, generally loose and sometime difficult. Usually stinky with regular farting
    Thirst: forgets to drink water, not thirsty
    Urine: 6–9 X/day, mostly unremarkable
    Menstruation: regular (32–40 days), scant with occasional heavy flow. Few, if any, clots, often none. Little of no menstrual pain or discomfort of any kind. (Mom menstruated until she was 59)
    Basic observations: Patient is in reasonable physical health, has started to get regular exercise but irregular to this point. Patient is slightly over-weight, holding most of this in her stomach area. Patient often has skin issues, particularly in the summer when itchiness can lead to scratching and open sores. Stopped eating dairy products, which seems to have cleared her skin.
    Pulse: bowstring and slippery
    Tongue: slightly red with red “prickles,” moderately thick white coat

    Dx: liver constraint with spleen/lung qi vacuity leading phlegm accumulation
    Explanation: This is a relatively straightforward case of liver constraint with a confounding phlegm accumulation pattern due to spleen and lung qi vacuity.
    Ribside pain: this is a classic liver qi symptom. When the liver qi is constrained, it does not flow normally and there can be distention and pain in the ribside.
    Cough with phlegm: The coughing and expectoration of clear to white phlegm is a clear indication of lung qi vacuity.
    Frequent stool with occasional diarrhea: This is a clear sign of spleen qi vacuity. The spleen is vacuous and can not hold the stool. Additionally, this has led to accumulation of dampness that has transformed into phlegm.
    The slightly red tongue with prickles and moderately thick white coating, are common in this pattern. The reddening suggests that there is some heat developing from the liver constraint, the prickles suggest liver constraint with some blood stasis, and the coating shows the dampness/phlegm accumulation.
    Formula: Unnamed Formula
    houpo (厚朴) magnolia bark 12g
    qingpi (青皮) immature tangerine peel 10g
    baishao (白芍) white peony 12g
    chaihu (柴胡) bupleurum 6g
    skullcap (北美黃芩) Scutellaria lateriflora 10g
    fuling (茯苓) poria 12g
    elecampane (土木香) Inula helenium 10g
    zhi yuanzhi (製遠志) polygala, prepared 10g
    gancao (甘草) licorice 6g

  20. Thomas October 21, 2024

    This week we will focus on HOW to do an intake as well as some principles of treatment. Please read (or review) the first three pages of Lesson 31 (31-1,2,3). It’s OK if you are not there yet in the course, just read those three pages. Additionally, please read section 13.2 (pages 765-770) of Chinese Medicine: Theories of Modern Practice. See you on Wednesday evening.

    1. Christelle November 7, 2024

      Hi Thomas , I take it there’s no recording for this one? Busy catching up , had a two month break due to illness so trying to get back into things.

      I found some of the other recordings which I’m working through. We heading for summer in South Africa so I want to join one of the sessions soon.

      Thanks!

  22. Thomas November 11, 2024

    Good Morning Everyone,
    Below is the case study for Wednesday. Please be prepared for #1-4 that precede the case study.

    1. What other questions might you ask?
    2. A diagnosis using Chinese medicine or Western herbal medicine.
    3. A treatment strategy based on the diagnosis.
    4. An appropriate formula.

    Case Study Class 13 November 2024
    Gender: female
    Age: 77
    Height: 5’ 2”
    Weight: 135 lbs
    Ethnicity: Portuguese American
    Occupation: retired
    Chief complaint: insomnia and palpitations
    Symptoms: recent weight loss, feeling hot all the time, anxiety/nervousness, palpitations, insomnia, difficulty focusing/double vision
    Brief history: historically cold and damp constitution, struggle with excessive weight entire life, seesaw dieting (liposuction), both knees have been “replaced”
    Diet and Lifestyle: Prepares regular meals for family with a moderately healthy diet; pretty standard with some sugary foods on occasion.
    Sleep: not good, wears A CPAP (continuous positive airway pressure) machine (12 years)
    Energy: fair to poor, although more lately but short lived
    Appetite: good
    Stool: 1–2 X/day
    Thirst: thirsty, sometimes very thirsty
    Urine: 8–10 X day
    Basic observations: Patient is in fair health, overweight, doesn’t really exercise
    Pulse: rapid
    Tongue: red, very little coating, has the appearance of chopped meat

  25. Thomas November 18, 2024

    Good Morning Everyone. Here is the case for Wednesday’s case study. Please remember to be prepared with questions to further your understanding of the case, suggestions for assessment and treatment strategies, as well as herb and formula suggestions.

    Case Study Class 20 November 2024
    Gender: male
    Age: 36
    Height: 6’ 0”
    Weight: 215 lbs
    Ethnicity: American
    Occupation: VC/consulting
    Chief complaint: anxiety, nervousness, sense of tension as if curled up in a ball
    Symptoms: difficulty staying focused, general anxiety, mental and physical tension
    Brief history: traumatic childhood with a raging father, over-achiever, high-stress occupation
    Diet and Lifestyle: Eats a pretty healthy diet, alcohol occasionally, but previously used it to “help social interactions” or to avoid feeling bad. Gets some exercise, recently has lost ~75 lbs (actively trying to lose weight via dietary choices and exercise). Recently filed for divorce to get away from a toxic relationship.
    Sleep: fair to poor (5-6 hours). Wakes frequently, dreams, difficulty falling asleep, wakes early in the morning.
    Energy: good, in spite of challenging sleep quality, seems to have good energy
    Appetite: no hunger
    Stool: 1 X/day (occasionally misses a day)
    Thirst: “normal”
    Urine: 3–4 X day
    Basic observations: Patient is in good health, overweight but losing weight appropriately, health improving with dietary and exercise modifications. Also seeing an acupuncturist and therapist.
    Pulse: deep, thin, difficult to find in all by the upper burner positions
    Tongue: stiff, pointed, reddish/purple, thin whitish-yellow coating

  26. Gabriela Gioacchini November 18, 2024

    I am not sure if I understand what the point of this conversation was. I was always taught here that I need to “treat what I see” based on patterns of Chinese medicine diagnosis… so I saw Yin deficiency fire/heat and thought of Anemarrhena Phellodendron Rehmania formula ( the same as you suggested) with addition of Chamomille, Hops and lemon balm for the sleep. Why would this be considered a malpractice? I thought that herbalists are not to “diagnose or treat a disease”; and the conversation was all about ” how we did not recognize Grave’s disease” instead of finding the correct pattern for the symptoms? I mean Bob Flaws in his book ” The Treatment of Modern Western Medical Diseases” lists a few patterns under Grave’s disease and Yin vacuity heat is one of them… so this approach is not “wrong”. Thank you for your clarification.

    1. Thomas November 18, 2024

      Hi Gabriela,
      Thank you for this question and a chance to explain in a concise manner what my point was for this class.
      First, it’s great that you made the correct pattern diagnosis and settled on the same Chinese medicine formula, well done! And, I think your Western herb suggestions are also good, although I don’t think I would want to give this person hops.
      I’m not saying that making the right pattern diagnosis is wrong or malpractice. Instead, I am trying to stress the importance of understanding when there may be something more happening than you should try, at least initially, to treat with herbs and when to refer a client to see a physician. You don’t need to be able to identify every disease, but you should be able to identify some and also be able to recognize when something is potentially serious, even if you don’t fully understand what’s happening. This is both for the client and for you. We, unfortunately, live in a very litigious society (protect yourself) and I believe it is ethically important (protect the client) that you can meet at least a minimum understanding of both normal and patho- physiology. These are things you would need to know if you wanted to become an registered herbalist with the AHG and they are things I strongly believe you should know if you want to be a professional herbalist.
      With regards to the book reference, keep in mind that that book was written for professional Chinese medicine practitioners or advanced students who are in a rigorous degree program. It is assumed that they know how to recognize red flags and refer appropriately because it is taught at those schools. It is simply out of the scope of that text to discuss a “red flag,” but all those practitioners and advanced students know how to recognize them, including Graves disease.

  28. Thomas January 6, 2025

    Good Morning Everyone,
    Here is the case for this Wednesday. This case was presented just over a year ago but there is some follow-up, so we will look at it again from the start.
    Gender: female
    Age: 26
    Height: 155 cm
    Weight: 68 kg
    Ethnicity: white
    Occupation: office work
    Chief complaint: diagnosed uterine fibroids
    Symptoms: excessive menstrual bleeding, break-through bleeding, extreme pain prior to and during menstruation
    Brief history: Patient has been suffering from extreme pain and sometime embarrassing situations due to extreme bleeding. Frequently needs to take time off work. Wants to get pregnant but needs to resolve current health issues.
    Diet and Lifestyle: Diet is fair, lots of carbs and sugar, some junk food. Usually skips breakfast or has a pastry and coffee. Does not get any regular exercise.
    Sleep: fair; generally, wakes very tired/groggy; sometimes has difficulty falling asleep.
    Energy: low energy
    Appetite: appetite swings between ravenous and no hunger at all
    Stool: 3+X every day, pre-menstrual diarrhea or constipation
    Thirst: doesn’t really drink water; sips on a soft-drink with lots of ice most of the day
    Urine: 8-10X day, sometimes much more, clear to yellow, often has odor
    Basic observations: Patient is over-weight, consumes excessive sugar, does not consume many veggies, and gets no exercise. Facial complexion pale and flesh very soft and doughy. Hand and feet cold (as observed on the table at the time of applying acupuncture/moxibustion).
    Pulse: thin, slippery, and slightly rapid
    Tongue: pale, swollen, thick greasy coating

  29. Thomas January 13, 2025

    Students please be prepared with the following:
    1. What other questions might you ask?
    2. A diagnosis using Chinese medicine or Western herbal medicine.
    3. A treatment strategy based on the diagnosis.
    4. An appropriate formula.

    Case Study Class 15 January 2025
    Gender: male
    Age: 33
    Height: 168 cm
    Weight: 65 kg
    Ethnicity: French Canadian
    Occupation: small business owner
    Chief complaint: cold/flu symptoms with lower abdominal fullness and vomiting
    Symptoms: heat effusion; aversion to wind and cold, spontaneous sweating, thirst but vomits after drinking, inhibited urination (comes but not smoothly, seems less than amount of water consumed)
    Brief history: patient exercises occasionally and is in reasonably good health.
    Diet and Lifestyle: Diet is eating out for most every meal often low-quality/fast food. Smokes and consumes alcohol and occasionally to excess.
    Sleep: fair, dreams a lot, recently of drowning
    Energy: good to low, often tired, very busy with work
    Appetite: OK, occasionally very strong appetite
    Stool: 1-2 X/day
    Thirst: very thirsty (see above)
    Urine: 3-5 X day, stream not strong, light to darker yellow
    Basic observations: Patient is in fair physical health. Patient is concerned, rightly, by the vomiting and retching, distention and fullness in his lower abdomen, and his lack of a strong urinary function, which have just started after feeling like he was catching a cold.
    Pulse: floating and rapid

    See you Wednesday evening.

  34. Thomas February 11, 2025

    Hello Everyone, Here is the case for Wednesday
    As always, be prepared to answer the following questions or provide input for any of the following:
    1. What other questions might you ask?
    2. A diagnosis using Chinese medicine or Western herbal medicine.
    3. A treatment strategy based on the diagnosis.
    4. An appropriate formula.

    Case Study Class 12 February 2025
    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

  40. Thomas February 24, 2025

    Good Morning everyone,
    Here is the case for Wednesday evening:
    Case Study Class 26 January 2025
    Gender: female
    Age: 25
    Height: 168 cm
    Weight: 62 kg
    Ethnicity: white/Eastern European
    Occupation: retail/student
    Chief complaint: “hormonal acne” on face
    Symptoms: facial acne breakouts just after ovulation
    Brief history: Patient has been suffering from acne problems since she started to menstruate. Previously the outbreaks were not confined to her face but also covered her upper back and some on her upper chest area. Upper chest and back acne has mostly gone away but facial, particularly on the jaw line (stomach channel), has continued with little change. The patient recently purchased a variety of “cooling” and “anti-toxin” herbs and made some “formulas” to try to self-treat the condition. While she saw initial improvement, over several months found that she felt cold and realized she may have cooled herself off and thought it best to seek professional advice.
    Diet and Lifestyle: Generally, doesn’t eat breakfast, is not hungry. Instead, has herbal tea and espresso and, perhaps, some fruit. The rest of her diet is rather good as she likes to cook and prepares a wide variety of foods, prepared from scratch.
    Sleep: goes to bed late but gets 8-10 hours of sleep daily. Tired in the morning.
    Energy: slow to start but good energy through the day, tapering off in the evening. Previously, she was very active/athletic but more recently has not been as active.
    Appetite: good, except in the morning
    Stool: 1 to occasionally 3X every day
    Thirst: 2-3 glasses of water per day and 3-8 cups of herbal tea throughout the day
    Urine: reasonable for water intake
    Menstruation: menarche at age 14. Cycle 28-30 days. Used to be longer with more blood, but after taking the self-prescribed herbs, the duration has changed to ~5 days and she feels as though it has improved by being a little less painful and a little less bleeding.
    Basic observations: Patient is energetic and strong-willed. She is very excited to use herbs to treat her acne and is very motivated to do it with the guidance of a professional after realizing that she had made some mistakes.
    Pulse: N/A
    Tongue: red with red prickles, narrow, thick white coating

    As always, be prepared with questions about the case, potential diagnosis’s, potential formula(s), etc.

  43. Thomas March 17, 2025

    Hi Everyone,
    Here is the case for Wednesday afternoon. See you this afternoon for materia medica.
    Case Study Class 19 March 2025
    Gender: female
    Age: 6
    Height: 95 cm
    Weight: 14 kg
    Ethnicity: Middle Eastern
    Occupation: n/a
    Chief complaint: eczema, constipation
    Symptoms: outbreaks on arms (inside elbows), neck (front), and two bald spots on head
    Brief history: Patient has been suffering with these issues for a 2-3 years. This is a particularly bad outbreak after nearly a year without any significant issues. Child is generally happy, energetic, a good eater, and has no “potty” issues.
    Diet and Lifestyle: Generally, good appetite and eats what she is given. Family eats a reasonably good diet with some sweets, but not excessive (this outbreak may have been triggered by the classic “uncle came over the fed the kids a bunch of sweets” syndrome.
    Sleep: generally good, more problematic with outbreak
    Energy: generally good, less energy with this outbreak
    Appetite: good
    Stool: 1 every 1-3 days
    Thirst: drinks when offered, sometimes doesn’t ask, but other times asks for water.
    Urine: reasonable for water intake
    Menstruation: n/a
    Basic observations: Patient appears in good spirits, nothing noteworthy.
    Pulse: N/A
    Tongue: somewhat pointed, red tip, prickles, thicker coating in the middle and toward the back

  44. Thomas March 25, 2025

    Hello Everyone,
    I apologize for the late upload. We are revisiting a case that was done about a year ago but we lost the recording. So, it might be a review for some of you.
    Gender: male
    Age: 38
    Height: 172 cm
    Weight: 72 kg
    Ethnicity: American/European
    Occupation: teacher

    Chief complaint: swelling in the legs
    Symptoms: problems with urination (not smooth), headache, anxiety, shortness of breath, and diarrhea
    Brief history: patient is in reasonably good health, had a recent cold with slight fever but only lasted a few days…treated with OTC medication (“western”).
    Diet and Lifestyle: Cooks some meals, mostly eat out. Non-smoker, social drinker. Gets regular exercise.
    Sleep: good, not remarkable
    Energy: generally good but recently not very good
    Appetite: generally good but recently not strong
    Stool: 2–5 X/day
    Thirst: thirsty
    Urine: 5–7 X/day, stream not strong, has been getting darker recently
    Basic observations: Patient is in good physical health. Patient is concerned about swelling. Saw a GP and they prescribed a diuretic, which didn’t help very much.
    Pulse: floating and rapid
    Tongue: slightly red, white coat

  46. Thomas April 21, 2025

    Good Morning Everyone,
    Please find Wednesday’s case below:
    Please remember to be prepared with the following:
    1. What other questions might you ask?
    2. A diagnosis using Chinese medicine and/or Western herbal medicine.
    3. A treatment strategy based on the diagnosis.
    4. An appropriate formula.

    Case Study Class 23 April 2025
    Gender: male
    Age: 58
    Height: 182 cm
    Weight: 105 kg
    Ethnicity: Euro/American
    Occupation: university professor
    Chief complaint: palpitations and fatigue
    Symptoms: palpitations, stuffiness in the chest, shortness of breath, easily fatigued, spontaneous sweating, lack of motivation
    Brief history: patient is a tenured professor who has lived a, more or less, standard American lifestyle. Has been feeling most of these symptoms for the last couple years, but the palpitations have gotten much worse recently. Cardiologist says there’s nothing wrong with his heart and recommended regular walks and a heart monitor. Patient wore the heart monitor but no abnormalities were found.
    Diet and Lifestyle: Wife does the cooking but meals are often out of a can or package. Eats out regularly. Drinks 2-3 cups of coffee a day but has started to drink more to help energize him and push through the day. Alcohol 2-4 times a week, rarely more than 1-2 glasses of wine.
    Sleep: fair, but never feels rested
    Energy: low, often tired
    Appetite: OK but not as strong as he thinks it should be
    Stool: 1x/day
    Thirst: nothing significant, drinks several glasses of water per day, but not particularly thirsty
    Urine: 7-10x/day, stream not strong, occasional dribbling
    Basic observations: Patient seems in fair health but very weak and slightly over-weight. Seems a little depressed, but says he’s only really down because he doesn’t seem to have much energy. Facial complexion is pale and eyes seem to lack a strong spirit.
    Pulse: weak/vacuous
    Tongue: pale with a thin white coat

  47. Thomas April 23, 2025

    Hi All,
    As we discussed in our last session, we have a guest case today. So, instead of the case I posted on Monday, we will address this case from Donna.

    Gender: Male
    Age: 58
    Height: 177 cm
    Weight: 84 kg
    Ethnicity: Caucasian
    Occupation: Project Engineer (works with plastic molding)
    Chief Complaint: Immediate histamine response after eating. (98% of the time)
    Symptoms: Sneezing, runny nose (usually starts before meal is over), can turn into gagging, frequently followed by diarrhea and stomach pain. Sometimes this is in conjunction with heart palpitations, an increase in blood pressure, and body trembling, especially in the hands. Can have the palpitations, BP increase, and shakes without the stomach issues as well. Does have irregular heart beat at times. (diagnosed through a heart monitor) Will also randomly start sweating for no apparent reason.
    Brief History: Stressful work + home environment for many years, previously diagnosed with Leukemia (treated with monoclonal antibodies – has been in remission for 3 years), gall bladder was removed years ago, had severe acid reflux resulting in a fundoplication in 2018.
    Diet and Lifestyle: Typically eats one meal a day; dinner. Usually cooked at home with good quality meat and vegetables. Uses nicotine (pouches), trying to quit. (previous smoker) May have an occasional beer, but the carbonation can bring on the same histamine response. Difficulty burping since the surgery in 2018. Is active at work, then will walk, work outside, etc. when weather allows.
    Sleep: Ok. Can’t seem to sleep more than 6 hours. Frequently has night sweats and he will wake wet and cold to the point of shivering.
    Energy: Good during the day, dies off in the evening.
    Appetite: Wants to eat, but is hesitant due to feeling bad afterwards.
    Stool: Frequent diarrhea
    Thirst: Often very thirsty, drinks a lot of water.
    Urine: Irregular, some days seems normal, other days can go every 20 minutes, at times it’s difficult to hold.
    Basic Observations: Has overexerted himself for 20+ years. Has made health improvements in the last 5 years. (lost weight, stopped smoking, dealt with past grief, etc) Frustrated with these issues that he has not been able to resolve. Has a tic in his left eye from a bells palsy episode many years ago. Complexion is normal. Holds extra weight only in his belly.
    Pulse: Best guess: floating, firm, strong
    Tongue: No coating to very light white coating, crack in the middle, slightly red tip

    See you later today!

  48. Thomas June 10, 2025

    We will have a student presentation this week (tomorrow) for the case study. Please review the case and be

    Initial Consultation Date 12/9/24
    Case Study Details Gender: F Age: 47 Height: 5’6” Weight: 150 Ethnicity: European Occupation: Licensed acupuncturist and RN
    Primary Complaint: Peri-menopause symptoms including hot flashes, weight gain, sweating, hair thinning, dryness, bloating, and fatigue. Brief History: Symptoms began in 2021, when she was still in acupuncture school. Client lives in humid Texas. Stress at work. Recently, she hired a colleague, who prescribed a custom formula, resulting in the client feeling a little better. But significant relief was elusive. The client stopped working with that colleague and is now taking an herbal supplement called “Gleefull Hormone Supplement” (a Yang tonic), which is helping with the sweating and weight gain. Secondary Complaint: none Diet and lifestyle: Client eats fairly healthy and mostly avoids processed foods. She eats a lot of nuts and has two glasses of wine in the evening. Sweating: At night in the early morning Sleep: 8-9 hours per night. Difficulty falling asleep (sometimes racing thoughts, worries). Doesn’t feel rested when she wakes up. Energy: 4 out of 10 Pain: Lower back aching and soreness (doesn’t call it pain). Stabbing menstrual pain in low belly and low back pain. Urination: Pale and clear, occasionally smelly, cough/sneeze incontinence Stool: Pencil-thin and loose, once daily Appetite: Low appetite Mental State: Depression & anxiety. Client tends to be more depressed than irritated. Irritation happens during menses. Temperature: She lives in very humid Texas. Her body feels Hot, but hands and feet are cold. Dislikes the cold. When she was younger, she was always cold. Hearing: no issues Thirst: Thirsty but only desire to drink small sips Other: Two months ago, she had all thyroid labs run (TSH, free T3, free T4, reverse T3, Thyroid Peroxidase Antibodies, Thyroglobulin Antibodies); they came back normal-low but ALL within normal limits. Phone consultation (client lives in a different state). I’ve met her once in person. Client speaks in
    a quiet, measured way. She looks pale in photos. Experiencing stomach fullness and sleepiness after meals. Hypochondriac stiffness/tightness. Stuffiness of chest or epigastrium. Feeling of heaviness. Dry mouth especially in the morning. Swollen breasts before period. Menstrual blood is “gooey” and red. Undigested food in stools when she’s extremely stressed approximately once per month. A little vaginal discharge always. Poor memory. Low libido. Medical History: C-section – 28 yo. Childhood tonsillectomy & ear tubes, lumpectomy – 2017. Family Medical History: Mom – emphysema, aFib, HBP. Dad – lung cancer, HBP, alcoholic. Grandparents – cancer, stroke, HBP. Medications: None Supplements: Gleefull Herbal Hormone Supplement (contains vitamins and epimedium, dang gui, ashwagandha, catuaba bark, damiana leaf, ginger root, maca root, mucuna pruiens, muira puama, sarsaparilla, tribulus terrestrius, black pepper). Also takes collagen powder and NAC powder. Tongue: swollen, mostly pale, red edges, scallops, depressed areas in the front and middle/back, purple sublinguals especially in the back Pulse: Rapid, thin, slippery, weak and deep in left rear position (pulse was taken by one of her colleagues) ANALYSIS: Yang and Yin Vacuity (Yang predominant), Liver Invading Spleen TREATMENT STRATEGY: Supplement Kidney Yang and Yin, Subdue and Course Liver and Supplement Spleen HERBAL RECOMMENDATIONS: Variation on You Gui Wan with epimedium and Jia Wei Xiao Yao San Explanation: Client shows predominantly Yang Vacuity symptoms with poor libido, some incontinence, lassitude, subdued and quiet manner, clear urination, pale tongue with white fur. Yin Vacuity symptoms include hot flashes at night and early morning, dry mouth, hair loss, mental restlessness and anxiousness at night (tends to run hot, poor memory, dryness). Liver Yin vacuity has led to a disharmony of the Liver’s function to order the Qi, which has led to irregular menstruation. Irritability is related to the Liver Yin Vacuity and the Vacuity Heat.
    Herb
    Pin Yin / Pao Zhi
    Amount
    Epimedium
    Yin yang huo
    30g
    Prepared rehmannia
    Shu di huang
    12g
    Lycii, dry fried
    Gao qi zi, chao
    12g
    Chinese Wild Yam, dry fried
    Shan Yao, chao
    12g
    Cornus, dry fried
    Shan zhu yu, chao
    12g
    American ginseng
    Xi yang shen
    12g
    Eucommia
    Du zhong, dry-fried w/ginger juice
    12g
    Herb
    Pin Yin / Pao Zhi
    Amount
    Bupleurum root
    Chai hu
    9g
    Angelica sinensis, dry fried slightly
    Dang gui, chao
    15g
    White peony
    Bai shao
    9g
    White atractylodes
    Bai zhu
    9g
    Poria
    Fu ling
    9g
    Baked licorice
    Zhi gan cao
    4.5g
    Moutan peony
    Mu dan pi
    9g
    Gardenia fruit, dry fried
    Zhi zi, chao
    9g
    Codonopsis
    Dang shen
    9g
    Vitex berry
    Vitex agnus-castus
    9g
    Motherwort herb
    Leonurus cardiaca
    9g
    Dietary and lifestyle recommendations: Focus on meat protein, whole grains and legumes (legumes contain phytoestrogens), cooked vegetables including dark leafy greens, a little cooked fruit in season. A little seaweed is beneficial, and fermented foods support the gut microbiome responsible for metabolizing estrogen. Avoid nuts and nut butters, avocados, alcohol, caffeine, chocolate, greasy fatty foods, and dairy (as they congest the Liver) with the exception of walnuts, flaxseed, black sesame seeds. Avoid foods that are cool and damp in nature like juices, raw foods, cooling foods like bananas, melons, cucumbers, and soy milk. Evening primrose and borage oils are good for dryness. Vitamin E (300-600 IU daily) can reduce hot flashes, vaginal dryness, breast tenderness. Walnuts, flaxseeds (contains phytoestrogens), black sesame seeds, and honey make a nice snack.
    Gentle movement – yoga or Qi gong – can be beneficial. Expression through writing and/or spending time in nature can be beneficial.

    January 10, 2025 – Update She has been taking herbs for two weeks, but isn’t taking vitex. Can’t tolerate the vitex in tincture form; it’s too bitter. She will switch to a vitex capsule. Can only take herbs twice daily. I recommended that she increase morning and evening dose, since she’s only taking twice daily. Also recommended increasing motherwort from 10 drops twice daily to 30 drops twice daily. Please retake photo (blurry and drank coffee). weight gain – no hot flashes (3 out of 10 – occasionally) Sweating (2 to 10) hair thinning (5 to 10) Dryness (8) Itchy skin and scalp is worse. Suggested Vitamin E (300-600 IU daily). Bloating (4) Fatigue (6 to 10) holidays were very stressful Last period? Now 21 days late. Irritable. Motherwort 10 drops twice day. She had two episodes of “burning butt diarrhea” (ate chicken & veg, fish and veg – not spicy). Fire hot and foul smelling. Happened hours after taking herbs. No glass of wine with dinner. No recurrence. Holiday stress was very high. Diet and lifestyle: Reduced nut intake Sweating: At night in the early morning Sleep: 8-9 hours per night. Difficulty falling asleep on occasion. Wakes up not feeling rested. Energy: 4 out of 10 Pain: No lower back pain. Urination: Pale and clear, occasionally smelly, cough/sneeze incontinence Stool: More formed Appetite: Poor until 3pm, then hungry. Mental State: Depression & anxiety. Client tends to be more depressed than irritated. Irritation happens during menses. Temperature: Same. Her body feels Hot, but hands and feet are cold. Dislikes the cold. When she was younger, she was always cold. Hearing: no issues Thirst: Same. Thirsty but only desire to drink small sips.

    Jan 31, 2025 update Client finally had a period on 1/15. It was 21 days late and had cramps for the first 2 of the 3 days. Bled for 2-3 days. After the onset, her anger/irritability was greatly improved. Client is pleased with her progress.
    Increased the Motherwort to a full dropper twice a day. She gave the Vitex tincture another try and was able to tolerate 20 drops twice daily in hot water. She started taking evening primrose capsules at least once a day. She admits that the evening dose of all her herbs has been inconsistent. She typically forgets the evening dose on the weekends when she is out of her normal routine.
    Client ran out of the Si Jun Zi Tang on 1/24. She placed an order for the tincture and is awaiting its arrival to resume. She just ran out of the Custom Formula this morning and reordered. weight gain – no hot flashes – none Sweating – same
    hair thinning – same Dryness – no improvement. Hasn’t been taking herbs and evening primrose consistently. Bloating (4) Fatigue (4 out of 10 ) less fatigued Last period? Jan 17. Two days of bleeding. One day spotting. (when she was younger she had 5 days bleeding) No more diarrhea. Diet and lifestyle:Reduced nut intake Sweating: At night in the early morning Sleep: 8-9 hours per night. Difficulty falling asleep on occasion. Wakes up not feeling rested. Energy: 4 out of 10 Pain: No lower back pain. Urination: Pale and clear, occasionally smelly, cough/sneeze incontinence Stool: Still more formed. She has improved her diet. Appetite: Feeling hungry in the morning. Mental State: Feeling a bit better. Irritation is much more in check. Less depression & anxiety. Temperature: Same. Hearing: no issues. Thirst: More thirsty. Waking up with a dry mouth. Drinking more.

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