frequent, his stools were loose and his sexual energy was weak. He was prone to colds and other
respiratory infections.
His tongue was of a normal colour and slightly swollen on the whole of the right side. His pulse
was Wiry on the left side and Weak on the right Front positions (Lung).
Diagnosis This case is similar to the previous one. Here too, some symptoms and
signs (frequent urination, loose stools, knee ache and weak sexual
energy) seem to point to Kidney-Yang deficiency. However, the pulse
and tongue contradict this. In this case too, most of the symptoms are
due to stagnation of Liver-Qi, similar to the previous case. In addition,
this young man shows a long-standing, underlying deficiency of
Lung-Qi. This is evident from the Weak Lung pulse, his being prone to
colds and the swelling on the whole right side of the tongue. In fact, on
questioning, it emerged that he had had a long attack of glandular fever
(mononucleosis) when he was 14, and that when he was 21 he had had a
cough for 6 months and was suspected of having TB (which he did not).
Thus, in this case the fatigue is primarily due to stagnant Liver-Qi
impeding the proper flow of Qi. On trying to investigate the possible
cause of Liver-Qi stagnation, in transpired that he felt "desperate" and
"frustrated". His father had died when he was 14 and his mother when
he was 22. Normally, bereavement tends to dissolve Qi and cause
deficiency of Qi. However, people react emotionally to life's events in
different ways. In the case of this young man, the sadness from the
bereavement had probably given way to anger about losing both parents
in a few years.
Treatment principle The treatment was aimed again primarily at soothing the Liver and
relieving stagnation, and, secondarily at tonifying Lung-Qi. Only herbal
medicine was used.
Herbal treatment Initially he was prescribed a decoction of Yue Ju Wan
Gardenia-Ligusticum Pill with the addition of only Zhi Gan Cao Radix
Glycyrrhizae uralensis praeparata and Wu Wei Zi Fructus Schisandrae
chinensis to tonify Lung-Qi. He reacted to this decoction with a
dramatic improvement and after repeating another course, he was given
the same prescription as a patent remedy for 3 months, producing a
complete recovery.
Case History 12.6
Tiredness: Stagnation of Liver-Qi-Male, Age 74
A 74-year-old man complained of extreme tiredness and poor appetite. He did not have any other
symptoms and had always been in good health. He was a keen gardener and had always been
busy in the garden and the home. In the past year, however, he was always tired and mentally he