She felt very tense and irritable and often had a pain under the right rib-cage. She also suffered
from pre-menstrual tension.
Her tongue was Red, redder on the sides, with a yellow coating (Plate 9.5(269)). Her pulse was
Weak on the right and Wiry on the left.
Diagnosis The main problem in this case is Liver-Qi stagnation leading to
Liver-Fire. Prolonged stagnation of Qi over many years often leads to
Fire. Liver-Fire can overflow into the chest and obstruct the descending
of Lung-Qi causing asthma. This type of asthma starts later in life (i.e.
not during childhood) and is clearly related to emotional strain as it is in
this case. Liver-Fire is evident from the Red sides of the tongue but not
many other symptoms: this is because it did not arise independently but
from stagnation of Liver-Qi. Hence the symptoms of stagnation of
Liver-Qi such as the hypochondrial pain, the irritability, the
premenstrual tension and the Wiry pulse on the left.
Treatment principle When Liver-Fire develops from Liver-Qi stagnation it does not require
draining with bitter-cold herbs or purging, but only clearing with a
combination of pungent herbs to open and move Qi and some
light-bitter herbs to clear.
Hence the treatment principle is to move Qi, clear Liver-Fire, restore the
descending of Lung-Qi, calm the Mind and settle the Ethereal Soul.Acupuncture LU-7 Lieque, LU-1 Zhongfu, G.B.-34 Yanglingquan, LIV-3 Taichong,
LIV-14 Qimen, P-7 Daling, P-6 Neiguan, ST-40 Fenglong. All with
even method.
Explanation LU-7 and LU-1 restore the descending of Lung-Qi.
G.B.-34, LIV-3 and LIV-14 move Liver-Qi. LIV-14, in particular, will
move Liver-Qi in the chest.P-7 and P-6 calm the Mind, settle the Ethereal Soul, indirectly move
Liver-Qi, restore the descending of Lung-Qi and open the chest.ST-40, especially in combination with P-6, opens the chest and eases
breathing.Herbal treatment The formula used was a variation of Si Ni San Four Rebellious Powder:
Chai Hu Radix Bupleuri 6 g
Bai Shao Radix Paeoniae albae 9 g
Zhi Shi Fructus Citri aurantii immaturus 6 g
Zhi Gan Cao Radix Glycyrrhizae uralensis praeparata 6 g