Constraint – Migraine (JB)

Case by: Jason Blalack

The patient presented with a chief complaint of chronic migraines, which were preceded by a sensation of heat rising to the head. She also felt warm overall, had red eyes that could easily become swollen with yellow discharge, painful and bleeding gums, difficulty falling asleep and would wake up with her mind racing, a long history of menstrual cramps and pain with clots, alternating bowels (constipation and loose) that had a tendency towards a strong smell that were occasionally sticky. Her abdomen was sore to the touch, her pulse was deep, wiry, and jumpy, and her tongue had a yellow coat.

She had tried many formulas in the past including tian ma gou teng yin as well as bitter, cold, descending and purging methods with no success. This is a pattern of fire due to Liver constraint. The treatment method was to follow the Inner Classic’s “when there is fire from constraint discharge it (火郁发之)”

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Constraint – Heart, Spleen, Wood Fire (YTS)

Original Case by: Ye Tian-Shi (叶天士)

Constraint damaging the Heart and Spleen nutritive aspect with internal heat

Ji was a 69-year-old elderly person whose emotions were unwell (felt down). When there is constraint then lesser fire transforms into vigorous fire. The appetite was intact but the gastric cavity was uncomfortable. The mouth and tongue were eroded and putrid.

Diagnosis: This was damage to the Heart and Spleen nutritive aspect with wood fire scorching and removing the essence by force.

The muscles were becoming smaller day by day. Only when the patient became joyous would the overall condition begin to lighten, indicating that the internal arising of heat from constraint could potentially be balanced. However implementing a method of clearing fire with bitter cold medicinals is wrong for regulating the emotions that are internally causing heat from constraint.

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Constraint – Gui Pi Tang (YTS)

Original Case by: Ye Tian-Shi(叶天士)

The patient had anger with Liver constraint. [In addition,] thought and preoccupation had damaged the Spleen. There was a yellow complexion, choppy pulse, and (s)he was [often] awake with an inability to go to sleep. Ancestor Xue’s method of treatment was used.

rén shēn (Ginseng Radix)
huáng qí­ (Astragali Radix),
shú bái zhú (steamed?? Atractylodis macrocephalae Rhizoma)
fú shén (Poriae Sclerotium pararadicis)
dà zǎo (Jujubae Fructus)
lóng yǎn ròu (Longan Arillus)
dāng guī (Angelicae sinensis Radix)
zhì gān cǎo (prepared licorice root)
hēi shān zhī zǐ (black gardenia)
mǔ dān pí (Moutan Cortex)
yuǎn zhì (Polygalae Radix)

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Constraint (Liver / Spleen) Sinus (YTS)

Original Case by: Ye Tian-Shi (叶天士)

Wu (40 years old) was exhausted and angry which led to damage. The disease was located in the Liver and Spleen. There was chronic brain leakage and the bone marrow has been secretly damaged. The patient was to take [the below prescription] that resolves constraint for a short time, and then continue with a diffusing and tonifying one.

gōu téng (Uncariae Ramulus cum Uncis)
shēng xiāng fù (unprepared cyperus)
mǔ dān pí (Moutan Cortex)
sāng yè (white mulberry leaf)
shén qū (medicated leaven)
bái sháo (Paeoniae Radix alba)
fú líng (Poria)
chén pí ­ (Citri reticulatae Pericarpium)

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Diarrhea- Gui zhi jia shao yao tang (LDZ)

Original case: Liu Du-Zhou

A 52 year old male came in for a diagnosis on July 18, 1994. He had diarrhea that had been going on for more than one year and had used many kinds of antibiotics with no avail. Every day he had diarrhea 3 to 6 times, and at the time of the intake it was a watery type with small amount of pus and blood. There was also tenesmus, abdominal tenderness, which was especially severe on the lower left quadrant. There was also a fear of cold and a fever (approx 37.5C / 99.5F).

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