Examples of Cases

    Case 1: Li XX, male, 18yr, a senior middle school student, and his father is an expert on thoracic surgery and his mother is a gynecologist. On Oct. 10th, 1978, his father invited me to make a house visit for his son. When I came to his house, I saw the patient sleeping soundly so I forced him to wake up. The patient was still not quite clear, with dull eyes and disinclination to speak.

    When the pulse diagnosis was over, he fell asleep again immediately. His mother told me that he had already been sleeping for 5 days. After the college entrance examination, the patient was exhausted and then was caught in the rain on his way home. It triggered the disease. He was diagnosed as neurasthenic at the People’s Hospital. After 4 days of taking western medicines, no improvement was observed but the somnolence even became worse. He kept sleeping day and night, accompanied with anorexia, no defecation for 3 days, deep-colored urine, dark tongue with white and greasy coating.
　
i. Etiology and pathogenesis: Excessive thinking and anxiety resulted in the deficiency of vital qi; after the rain encounter, the turbid dampness invaded the body to block the lucid orifices and caused somnolence.

ii. Treatment principles: resolving dampness with fragrant medicine, activating spleen and inducing resuscitation.

iii. Prescription: “Xing Pi Kai Qiao Decoction” plus Folium Perillae, Herba Schizohepetae and Radix Stephaniae Tetrandrae.

    After 3 doses, the symptoms of somnolence was relieved and the patient could have three meals a day regularly and could talk with his parents, though feeling a little tired when speaking. After another 6 doses of the previous prescription plus Radix Astragari 15 g and Radix Atractylodes Macrocephalae 12 g, the patient completely recovered.

   His parents were so glad that their long-frowned eyebrows began to stretch out. His father said that, “I had never expected that TCM is so miraculous that it has cured my son within such a short period! I am so thankful!” One year later, when the father came back with another patient, I asked him about his son. He told me that his son was going very well that there was no more of his old illness. And he was studying at college in Beijing.

Case 2: Li Jingwen, female, 22yr, a freshman of Beijing Foreign Studies University
　She came to my clinic in Aug. 2004. The patient said that as early as grade 8, she began to feel sleepy from the very beginning of every class. No matter how hard she tried to control herself, it was of no use. She could fall asleep only ten minutes into the class. She had once gone to hospitals for examinations but no organic pathological changes was discovered. And the final diagnosis was somnolence. She had tried several kinds of drugs but none had been proved to be effective.

   Fortunately she was clever enough to catch up with other students by taking her classmate’s notes. Being a freshman, she still felt sleepy in classes and even when having meals. Now it was in her summer vacation, she could even sleep 16 to 20 hours per day. In addition, her amenorrhea had lasted for three months and she caught cold frequently. Her family was rather worried about her. Symptoms: diminishing and yellowish complexion, emaciation, general lassitude, fatigue, qi deficiency with disinclination to talk, anorexia, pale tongue with thin and white coating, thready, feeble and forceless pulse.　

i. Etiology and pathogenesis: The typical manifestations of the weakened functions of spleen and stomach resulted in the deficiency of qi and blood. It became inadequate for the body’s normal functions. As a result, amenorrhea and frequent cold were induced. Due to the failure of qi and blood to go up to the head, somnolence occurred.

ii. Treatment principles: replenishing qi and enriching blood, activating spleen and inducing resuscitation.

iii. Prescription: “Xing Pi Kai Qiao Decoction” plus Radix Astragari, Radix Angelicae Sinesis, Radix Ginseng and etc.

    After 10 doses, the patient had her mental spirits elevated and appetite boosted. Her symptoms of somnolence had also been relieved. She just felt a little sleepy during the daytime and had regular sleeps at night. After another 20 doses of the primary prescription plus Radix Panacis Quinquefolii 15 g, her symptoms of somnolence disappeared, her intake of food was greatly increased, her menstruation became regular and her complexion also became ruddy. Since she had to go back to school in Beijing, she could not continue to take decoctions. I suggest her continue to take the finished TCM preparation of Guipi Pill for another month to consolidate the therapeutic effects.

Case 3: Sun XX, 50 yr, a chief engineer of the 4th Architectural Department of Hebei Province
    The patient had the disease for 3 years. He may fall asleep in humdrum environment; especially when attending meetings, he could fall asleep in a few minutes and snore loudly. He was frequently criticized by his boss. He had been had a separate bedroom from his wife for many years. In May 1997, he came to visit me in my hospital.

    Symptoms: obesity, short of breath on exertion, dull looks in his eyes, and slow speech. He said he did not like doing exercises but with extremely good appetite. Within his diet structure, meat took up a high proportion; drink liquor occasionally, lassitude in the four extremities, dizziness, feeling sleepy, sticky and greasy stools, depressed and oppressed sensation in the chest and abdomen; despite the somnolence, the sensation of sleepy and lassitude could be relieved after waking up, pale and purple tongue with yellow and greasy coating, soft and moderate pulse.　

i. Etiology and pathogenesis: based on the TCM theories, the obese people often have excessive dampness. The patient preferred sweet and greasy food, which made it much easier for dampness production. The middle-jiao was blocked by the turbid dampness, the spleen-qi failed to transform food and the lucid yang could not ascend, which had resulted in dizziness and somnolence.

ii. Treatment principles: eliminating dampness, invigorating spleen and inducing resuscitation.
iii. Prescription: “Xing Pi Kai Qiao Decoction” plus Rhizoma Atractylodis, Rhizoma Pinelliae, Semem Arecae and etc.

    After 10 doses，his dizziness was alleviated, his bowel movements became normal, and the depressed and oppressed sensation in the chest and abdomen disappeared. After another 10 doses, his symptoms of somnolence had basically disappeared. He was energetic every morning and unexpectedly, the snoring almost disappeared. He was very happy.

Case 4: Chen XX, female, 55 yr, a villager from Nantongye Village of Huolu County, Shijiazhuang.
　In 1973，I came to work at a healthcare institute in Huolu County, and the patient came to visit me in mid-September. The patient said she had somnolence for about one year. She didn’t feel sleepy when working while standing, but when she sat down to work, especially in humdrum environment, she was quite easy to fall asleep. Once she fell asleep while cooking, which made her meal get burnt.

    Another example, her brother whom she had not seen for three years came to visit her from the army, but she fell asleep again after saying few words. Such examples happened frequently. Two years ago, her husband was severely injured by fall and became disabled. From then on, she had always been in a bad mood and the disease developed. Symptoms: depression, emaciation, distention in her chest and hypochondrium, loss of appetite, dark and purple tongue, stringy and thready pulse.

i. Etiology and pathogenesis: the long-term anxiety, thinking and depression resulted in the dysfunction of spleen and stomach. The spleen failed to transport and transform, and the splenic dysfunction triggered the development of somnolence.

ii. Treatment principles: soothing liver, activating spleen and inducing resuscitation

iii. Prescription: “Xing Pi Kai Qiao Decoction” plus Radix Codowopsis Pilosulae, Radix Bupleuri, Fructus Aurantii and etc.

Case 5: Wang XX, male, 40 yr, a driver at a provincial department
    The patient said he had been suffering from uncontrollable sleepiness during the last half a year. Being as a driver, it was very dangerous. More than once he discovered that his car was only a dozen of centimeters away from the front one.

    He was quite worried. One week ago, his car carrying his boss even collided into another one on the way to a meeting. This was caused by his strong feeling of sleepiness. His boss suggested him take a rest for a period of time and come back to work only after a complete recovery. He paid a visit to me in March 2005 by following his friends’ advice. Symptoms: slight obesity, darkish complexion，normal appetite，discomfort in defecation, abdominal distention, dark and purple tongue with thick and greasy coating, soft pulse.

i. Etiology and pathogenesis: As a driver, he often took meals outside and did little physical exercises, which led to indigestion and the stagnation of dampness in the middle-jiao. The spleen-qi failed to transport and transform, the lucid yang failed to ascend, the upper orifices were blocked by the turbid dampness, which had resulted in somnolence.

ii. Treatment principle: dissolving dampness and activating spleen, ascending lucidity and descending turbidity.

iii. Prescription: “Xing Pi Kai Qiao Decoction” plus Rhizoma Cimicifugac, Rhizoma Alismatis, Radix Pucrariac, Radix Aucklandiae.

    After 10 doses, the symptoms of somnolence improved significantly. The tongue coating was reduced much thinner and the bowel movement became regular. After another 15 doses of the primary prescription with little alteration, the patient had already gone back to work with good recovery. Then 5 more doses were prescribed to consolidate the therapeutic effects.

Case 6: Yang XX, female, 24 yr, a commentator in a medical exhibition
    As a commentator, her explanation was quite clear and accurate. She often helped others to do the explanation work so that she won high praises from both her boss and visitors.

    Her first visit was in June 2000. She said she would fall asleep quickly when attending meetings or group discussions. Although her colleague gave their advices and she had determined to control this feeling, she failed repeatedly so as to make her quite worried. Once at a meeting, she tried her best to open up her eyes but she still fell asleep. Her colleague believed this was a disease and suggested her go to see a doctor.

    I diagnosed it as somnolence. During inquiry, I discovered that her mother-in-law came to live with her recently. Since their living habits were quite different and she could not become accustomed to this new situation and dare not to speak out directly. She had been in a bad mood with constant bouts of depression. Then the conditions stated above occurred.

i. Etiology and pathogenesis: Due to the depression, the stagnation of liver-qi led to the restriction of spleen, which resulted in the deficiency of spleen and the failure of lucid yang to ascend. I suggested her deal rationally with the relationship and communicate this with her husband, take it easy and try to regulate her own emotions.

ii. Treatment principles: soothing liver and dissolving depression, activating spleen and inducing resuscitation.

iii. Prescription: “Xing Pi Kai Qiao Decoction” plus Radix Gurcumae，Rhizoma Cyperi, Fractos Citri and etc.

    After 10 doses，the symptoms of somnolence basically disappeared. Another 15 doses of the primary prescription plus Raix Paeoniae Alba 20g were prescribed to consolidate the therapeutic effects.

Case 7: Wang XX, male, 14 yr, a student, the only child of a well-to-do family. His first visit was in April, 2003. He was 1.5 meters in height and 74 kilograms in weight with a healthy reddish complexion. He always fell asleep in class even when sitting in the first row and his performances were very poor,. He had been frequently criticized by his teachers. The teachers told his parents about this and suggested him go to see a doctor.

    Symptoms: excessive intake of food, halitosis, abdominal distention, difficulty in defecation, acidic and rotten smell of the stool, thick and greasy tongue coating. It was diagnosed as food stagnation in spleen and stomach, which resulted in the transportation and transformation failure of the spleen-qi.

i. Treatment principles: promoting digestion and removing the stagnated food, activating spleen and inducing resuscitation.

ii. Prescription: “Xing Pi Kai Qiao Decoction” plus Fructus Crataegi, Fructus Hordei Germinatus, Massa Fermentata Medicinalis, Semen Arecae and Endothelium Corneum Gigeriac Galli.

   After 5 doses, improvement was observed and after 15 doses, recovery was achieved.

Case 8: Zhang XX, male, 40 yr, a private businessman.
    His first visit was on Mar. 15th, 2000. Chief complaints: after a business trip to Guangzhou, he slept for 20 hours and even wanted sleep more. At first, he thought he was so tired that he needed rest. But after 3 days and nights of sleep, he found that the more he slept the sleepier he felt. Symptoms: dizziness, loss of appetite, thick and greasy tongue coating, oppressed sensation in the chest, anorexia, thirty but without any desire to drink.

i. Treatment principles: eliminating dampness, invigorating spleen and inducing resuscitation.

ii. Prescription: “Xing Pi Kai Qiao Decoction” plus Semen Coicis, Medulla Tetrapanacis, Herba Pogostemonis.

    After 10 doses, improvement was observed. And after another 15 doses of the primary prescription with little alteration, recovery was achieved.