Clinical Cases

A 46-year-old woman presents with a 1-year history of episodic headaches. The pain is distending and worsens with emotional stress. Recently, she has experienced dizziness, tinnitus, irritability, and difficulty sleeping. She denies strong thirst. Tongue is red on the sides with scanty coating. Pulse is wiry and slightly rapid. What is the most likely diagnosis?

A 42-year-old woman presents with 8 months of fatigue, loose stools, poor appetite, and a sensation of heaviness. Symptoms worsen on rainy days and after overwork. She reports mild abdominal distention, a sticky taste in the mouth, and no strong thirst. Tongue is pale and enlarged with a white greasy coating. Pulse is soft and slippery. What is the most likely pattern?

A 57-year-old man presents with 2 weeks of cough producing thick yellow sputum after an initial cold. He now has chest oppression, mild fever, thirst, and a red tongue with greasy yellow coating. Pulse is slippery and rapid. What is the most likely pattern?

An 11-year-old boy catches colds easily. He sweats spontaneously, speaks softly, becomes short of breath on exertion, and his tongue is pale with a weak pulse. What is the most likely pattern diagnosis?

A 24-year-old woman feels depressed and sighs often. She has distending hypochondriac pain and irregular menstruation that worsens with stress. Tongue edges are slightly red; pulse is wiry. What is the most likely pattern diagnosis?

A 32-year-old woman has palpitations, insomnia, dream-disturbed sleep, poor memory, poor appetite, and fatigue. Tongue is pale; pulse is thin and weak. What is the most likely pattern diagnosis?

A 67-year-old man has aversion to cold, cold limbs, low back soreness, and frequent night urination. Tongue is pale and swollen; pulse is deep and slow. What is the most likely pattern diagnosis?

A 73-year-old woman has palpitations, insomnia with many dreams, forgetfulness, pale lips, and a thin pulse. Appetite is fair and fatigue is mild. What is the most likely pattern diagnosis?

An 11-year-old boy has had recurrent colds for six months. He sweats easily with mild activity, speaks with a low voice, and is easily fatigued. Over the last two weeks he has morning nasal congestion with clear discharge but no obvious sore throat. Tongue is pale with a thin white coat. Pulse is weak. What is the most likely pattern?

An 18-year-old young man has coughed for one month after an exterior illness. The cough is short and dry with scant sticky sputum, worse in the afternoon with throat dryness and occasional hoarseness. He has no obvious aversion to cold or fever. Tongue is red with scant coat. Pulse is thin and rapid. What is the most likely pattern?

A 24-year-old woman has had palpitations and difficulty falling asleep for three months. She becomes dizzy with slight exertion, and her menses are scanty and pale. Her complexion is lusterless and lips are pale. Tongue is pale. Pulse is thin and weak. What is the most likely pattern?

A 29-year-old woman has had poor appetite for six months, abdominal distention after meals, loose stool, and fatigue of the limbs that worsens after work. Her complexion is sallow. Tongue is pale and slightly swollen with white coat. Pulse is slow and weak. What is the most likely pattern?

A 32-year-old woman has had premenstrual breast distention and hypochondriac fullness for six months. Symptoms worsen with emotional upset and she often sighs. Menses are irregular. Tongue edges are slightly red. Pulse is wiry. What is the most likely pattern?

A 36-year-old man has had sore low back and knees for eight months. Dry throat is worse in the afternoon and evening, with night sweating during sleep and occasional tinnitus. He feels heat in the palms and soles. Tongue is red with scant coat. Pulse is thin and rapid. What is the most likely pattern?

A 41-year-old man has recurrent distending headaches with red eyes, bitter taste, irritability, constipation, and dark urine. Tongue is red with yellow coat. Pulse is wiry and rapid. What is the most likely pattern?

A 45-year-old man presents with chest oppression, abundant phlegm, a heavy cloudy head sensation, slowed speech and response, and restless sleep. Tongue coat is thick and greasy. Pulse is slippery. What is the most likely pattern?

A 52-year-old woman developed palpitations, poor memory, insomnia with many dreams, reduced appetite, loose stool, and sallow complexion after prolonged overwork. Tongue is pale. Pulse is thin and weak. What is the most likely pattern?

A 58-year-old man has had pronounced aversion to cold for one year, sore low back and knees, cold legs, frequent clear nocturia, and low energy. Tongue is pale and swollen with white coat. Pulse is deep and slow. What is the most likely pattern?

A 63-year-old woman has had low-grade afternoon fever for two months with night sweating, dry mouth and throat, and heat in the palms and soles, but no high fever or intense thirst. Tongue is red with scant coat. Pulse is thin and rapid. What is the most likely pattern?

A 68-year-old woman has had dizziness, blurred vision, and occasional limb numbness for six months. Her complexion is pale and her nails are light in color. Tongue is pale. Pulse is thin. What is the most likely pattern?

A 73-year-old man has had recurrent distending headaches, vertigo, and tinnitus for half a year. He is irritable and sleeps poorly, but has no clear bitter taste or constipation. Tongue is red with scant coat. Pulse is wiry, thin, and slightly rapid. What is the most likely pattern?

A 14-year-old girl has coughed for two months, worse in the afternoon, with scant sputum, dry throat, and a preference for sipping warm water. She occasionally has malar flush. Tongue is red with little fluid. Pulse is thin and rapid. What is the most likely pattern?

A 34-year-old man develops poor appetite, abdominal bloating, unformed stool, fatigue, and dull complexion after long-term sedentary overwork. Tongue is pale with white coat. Pulse is weak. What is the most likely pattern?

A 47-year-old woman developed insomnia, dream-disturbed sleep, forgetfulness, palpitations, poor appetite, and fatigue after years of caregiving stress. Her menses are also scanty. Tongue is pale. Pulse is thin and weak. What is the most likely pattern?

A 56-year-old overweight man reports chest oppression, abundant phlegm, a heavy wrapped-head sensation, restless sleep, and a sticky mouth on waking. Tongue coat is thick and greasy. Pulse is slippery. What is the most likely pattern?

A 65-year-old woman has recurrent tinnitus, sore low back and knees, dry mouth at night, and occasional tidal heat with night sweating. Tongue is red with scant coat. Pulse is thin and rapid. What is the most likely pattern?