This afternoon is not busy, so Dr. Li would like to share with everyone a story about a patient from the morning clinic.

He reported symptoms such as chest tightness and shortness of breath, mental fogginess, irritability, a short temper, and being easily angered by situations. Additionally, he experiences strong desires but physical weakness, along with dampness in the scrotum. Many people, when encountering such symptoms, might immediately think of Chaihu Shugan Wan (Bupleurum Liver-Soothing Pills). However, for this patient, the effect was not significant. While there was slight improvement in the dampness and itching of the scrotum, long-term use instead led to increased discomfort.

Let's take a look at his tongue presentation:

The edges of the tongue are swollen, and the entire tongue surface exhibits a convex shape—this indicates liver qi stagnation. Simultaneously, he also experiences symptoms such as distension and fullness in the chest and flanks, insomnia with excessive dreaming, dry eyes, and belching.

Upon closer observation, the edges of the tongue are red and lack a tongue coating. This is due to excessive heart fire, which evaporates the body fluids, preventing the heart fire from descending and causing it to accumulate in the upper body. This leads to symptoms such as mouth ulcers, yellow urine, and palpitations.

Additionally, cracks in the center of the tongue indicate that the patient has issues with spleen deficiency, qi and blood deficiency, spleen and stomach deficiency, as well as depletion of yin fluids. This results in poor appetite, abdominal distension, fatigue, and lack of strength.

A thick, greasy tongue coating indicates heavy phlegm-dampness due to kidney yang deficiency. His symptoms of cold limbs, soreness and weakness in the lower back and knees, oily face, and heavy dampness are all manifestations of kidney yang deficiency and insufficient yang qi to warm and transform dampness.

It is crucial to note that his liver-soothing treatments were ineffective because the heat was not resolved. Many stagnant qi spots in the front of the tongue suggest the need to invigorate blood and remove stasis. Additionally, he also suffers from liver blood deficiency and intense heart-liver fire, so simply soothing the liver would only intensify the heart fire, leaving the cold-dampness unresolved.

While ingredients like Akebia caulis, Alismatis rhizoma, and Plantaginis semen in Longdan Xiegan Pills have some dampness-expelling effects, they can also bring greater harm.

Therefore, for this patient, the key to treatment lies in soothing the liver, fortifying the spleen, expelling dampness, warming kidney yang, clearing heart fire, and harmonizing the heart and kidney. Only in this way can his body be fundamentally regulated.

After a period of treatment, his symptoms have shown significant improvement.