started seeing a psychotherapist and then a psychiatrist who prescribed tranquillizers (diazepam
and temazepam) and anti-depressants of the MAOI kind.
He started having acupuncture with a colleague who referred him to me for herbal treatment.
His main symptoms when he came to me were epigastric pain, alternation of constipation and
diarrhoea, ache in the joints, burning eyes and a hot feeling at the back of the head.
On a mental level his main manifestations were severe anxiety, insomnia, bouts of crying, poor
memory and concentration, depression and a lack of confidence and self-esteem.
His eyes lacked glitter and looked scared, his body was overweight and his complexion was very
dull and sallow.
His tongue was dark-Red, Swollen, with a Heartcrack, without coating and dry. The tip of the
tongue was redder and the root had no spirit (Plate 9.3(262)). His pulse, however, was slightly
Rapid, quite Full and Slippery.
Diagnosis This is an extremely complex condition. As far as patterns are
concerned there are basically two main patterns: severe Yin deficiency
of the Heart and Kidneys (Red-peeled tongue with red tip and root
without spirit, mental restlessness, anxiety, insomnia, burning eyes, a
hot feeling on the occiput, lack of confidence and self-esteem) and
Phlegm-Heat misting the Mind (crying without reason, poor memory
and concentration). There are a few other patterns but these can be
considered secondary. For example, there is Stomach-Yin deficiency
causing the epigastric pain, Damp-Heat causing the joint pain, some
stagnation of Liver-Qi causing the alternation of constipation and
diarrhoea and some Spleen deficiency causing him to be overweight and
generally tired. It is this underlying Spleen deficiency which, over the
years, led to the formation of Phlegm, later transformed into
Phlegm-Heat.
If there is Phlegm, why does the tongue not have a thick-sticky coating?
This is because there is an underlying severe deficiency of Yin which
caused the coating to fall off. Thus, although not shown on the
tongue-body colour, Phlegm does manifest in the swelling of tongue
body (which in such a severe case of Yin deficiency should have been
Thin) and in the symptoms and the pulse which is Full and Slippery.The Yin deficiency obviously derived from the time of his severe
influenza. A constant temperature for a month burned the body fluids
and injured Yin. The deficiency of Yin over the years led to the
formation of Empty-Heat which harasses the Mind. On the other hand,