Cheng,  an older woman, presented with a wiry and choppy pulse, with external cold and internal heat. She had teeth pain, dry tongue, and insomnia. This is Liver and Spleen constraint and clumping.

Herbal prescription:

yu jin (Curcumae, Tuber)
gou teng (Uncariae cum Uncis, Ramulus)
mu dan pi (Moutan, Radicis Cortex)
xia ku cao (Prunellae, Spica)
sheng xiang fu (Unprocessed Cyperi, Rhizoma)
bo he (Menthae, Herba)
chen pi (Citri Reticulatae, Pericarpium)
fu ling (Poriae Cocos, Sclerotium)

Chinese: 程(妪) 脉弦涩。外寒内热。齿痛舌干。无寐。乃肝脾郁结不舒。郁金 钩藤 丹皮 夏枯草 生香附 薄荷广皮 茯苓

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Showing 3 comments
  • Jason Blalack

    As with many of Ye Tian-Shi’s case studies, things are a little vague. We can extrapolate a couple important things from this case.
    1. A wiry and choppy pulse is fairly significant in diagnosing constraint.
    2. It is not uncommon for obvious symptoms to just not be listed. For example, there could easily be rib side pain.
    3. We see a pattern of Liver and Spleen constraint. This is a bit different from a typical Liver invading Spleen (with a deficient Spleen). Notice the formula contains no tonifying herbs (except the mild fu ling). The first six herbs address the Liver, the last two address the Spleen. Contrast this to xiao yao san (which by the way will show up in a future Ye Tian-Shi case study– soon).
    4. Five herbs are cooling.

    Any other ideas or questions?

  • Steve Bonzak

    Hi Jason-

    Thanks for starting this project. I think the translation of cases with commentary into English is extremely important and really appreciate you sharing these.

    So one question that pops to mind when I read a case like this and the formula written, is what was the rationale? Certainly if I had read lots and lots of Ye Tian-shi case studies I would be able to see his method a bit more clearly. Do you have insights for use as to why these particular liver qi coursing and blood regulating herbs were chosen and not others?


  • Jason Blalack


    Thanks for the comment. Your questions are not easy to answer. Ye Tian-Shi’s cases are notoriously terse. However, since you are interested in Ye Tian-Shi I will start posting more constraint cases that use similar herbs. From this, together, we can start to make sense of why he picks certain herbs versus others. As you know, one of these cases it is not very helpful, but as we amass similar cases I think things will become clearer. Please feel free to ask a specific question about a given herb and I will try to find an answer for you.

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