had more energy, she felt angry, still had pre-menstrual tension, did not

sleep well and was confused. I concluded that the treatment emphasis

should have been, as is often the case, on eliminating first rather than

tonifying. In this case, the premature tonification had probably created

more stagnation affecting the Mind and Ethereal Soul, hence the anger,

insomnia and mental confusion. I therefore changed the treatment

principle to concentrate on pacifying the Liver, eliminating stagnation,

calming the Mind, opening the orifices and settling the Ethereal Soul,

and chose to use a variation of Xiao Yao San Free and Easy Wanderer

Powder:

Bo He Herba Menthae 3 g

Chai Hu Radix Bupleuri 9 g

Dang Gui Radix Angelicae sinensis 9 g

Bai Shao Radix Paeoniae albae 12 g

Bai Zhu Rhizoma Atractylodis macrocephalae 9 g

Fu Ling Sclerotium Poriae cocos 15 g

Gan Cao Radix Glycyrrhizae uralensis 6 g

Sheng Jiang Rhizoma Zingiberis officinalis recens 3 slices

Shu Di Huang Radix Rehmanniae glutinosae praeparata 9 g

Xiang Fu Rhizoma Cyperi rotundi 6 g

He Huan Pi Cortex Albizziae julibrissin 6 g

Shi Chang Pu Rhizoma Acori graminei 6 g

Explanation The first 8 herbs constitute the Xiao Yao San which pacifies the Liver
and nourishes Liver-Blood.

Shu Di was added to tonify the Kidneys.

Xiang Fu, He Huan Pi and Chang Pu pacify the Liver, eliminate

stagnation, lift depression and open the orifices.

This decoction had a much better effect, improving the pre-menstrual

tension, calming her and dispelling the confusion. She continued to be

treated with variations of this decoction for about 3 months, after which

the treatment principle was changed again to tonify Kidney-Yang

primarily. After another 4 months, she felt much better all round and her

pre-menstrual tension had gone.

Prognosis

Both acupuncture and herbs, singly or in combination, give excellent results for pre-menstrual
tension. It could be said that there is hardly a case that cannot be helped, although those caused
by Phlegm-Fire harassing upwards will take longest to treat. As with all menstrual problems, it