I understand from this that Ye’s first take on the patient was anger and liver constraint. This may not have been the complaint the patient was seeking relief for — it seldom is. I think the major complaint was insomnia with the choppy pulse signifying blood deficiency. The yellow complexion really brings the damaged Spleen strongly into the picture. It sticks out so strongly as the 2nd or 3rd observation that it makes me wonder, — how yellow looking was this patient? In any case damage the predominant symptoms together with insomnia very obviously points to Gui Pi tang — however it does not negate the possible usefulness of Jiao Wei xiao yao san which could be prescribed concurrently but would not have treated all the Spleen related conditions and insomnia.

What this points out for me is that despite observing liver constraint — I don’t think that Ye believed that relieving insomnia and all the damaged blood and spleen issues with Gui pi tang would adversely affect the liver constraint. In other words he rightly kept his eye on the goal and didn’t allow himself to be sidetracked from relieving what he saw as the core first issue.