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Question about difficult case


Hello all. I have a question about a difficult case. That case is me. I’m not a practitioner but have received training in ayurveda and am familiar with basic concepts and diagnostic methods of TCM. I live in an area with no Chinese medicine practitioners and would like to educate myself while I find a way to get to one. Any help would be greatly appreciated.

First, I have chronic pain, difficulty breathing, a stiff neck and shoulders, dry eyes/eye pain, and depression. These symptoms have been going on for about five years and I’ve gotten some limited relief from various methods (staying physically active helps, and certain herbs will also cause a small improvement), but not a full solution.

I had an acupuncturist confirm that I had liver qi stagnation and heat. He told me to take American ginseng and it gave some relief for a while, until it stopped working. I can do a basic self-diagnosis using tongue and pulse and have experimented with many herbal formulas. Anything containing bupleurum (chai hu), such as xiao yao wan or jia wei xiao yao wan, will create heat symptoms within the first couple doses, though it also creates some relief of the other symptoms. I seem to have a stagnant liver that is also too hot and dry (blood deficient) to handle herbs for qi stagnation.

I also have reason to believe that there is qi deficiency. For a couple weeks earlier this year my digestion went out (very strange for me since I can usually stomach anything), and I also generally have a flabby tongue with teeth marks. Overly “yin” foods and herbs make me feel congested. Therefore it seems impossible to deal with the blood deficiency, qi stagnation, and qi deficiency all at the same time. How on earth do you address this?

The herbs that help me have properties of being sweet, bitter, and cooling. I’ve tried many herbs and that’s the specific combo that works. Other examples in addition to the American ginseng are rhodiola and tai zi shen (though it’s not as good as the others). Sweet herbs alone make me feel worse. Bitter ones alone improve symptoms, but make me overheat. I thought a combo of jia wei xiao yao wan plus an yin tonic (liu wei di huang wan) would work, but I still overheated.

Apologies for the long message, but if you are a practitioner, how would you deal with this if I showed up at your clinic? I am in Mexico where there are no TCM practitioners so would much appreciate any feedback.


When you say chai hu creates heat symptoms what exactly are those symptoms? Same with digestion went out - what specifically do you mean? What is your current activity/exercise level? How is your sleep?

In general using single herbs is not going to be effective especially without the guidance of a practitioner. If you came into our clinic I would probably have you stop taking any herbs and focus on your diet as a first step. People very often overlook how important the diet is to our health.


Thanks, Stephen. Anything with chai hu in it will make my face flush and my eyes go red. When I say my digestion went out, for a few days I could literally feel the food sitting in my stomach, and not to go into too detailed of a description, but it would pass mostly undigested. My body also felt very chilled. I’m not sure why this happened but I’ve dealt with a lot of weird psychosomatic symptoms. I’m fairly active - I walk and do yoga every day. Of all the issues I’ve had, sleeping has never been one of them. I get enough sleep and don’t have trouble falling asleep.

What would you suggest I do with my diet? Thanks again for any advice.


I’d suggest eating foods that are well cooked. Avoid using a lot of spices and definitely avoid hot/spicy foods like hot sauces or hot peppers. Try not to eat both high carb and high protein foods at the same time. So for example don’t eat a stake with a few rolls or bread. Eat steak with some vegetables instead. Don’t drink a lot of water with your meals, especially ice water. It would be better to wait 20-30 minutes after a meal before drinking more than a sip or two. Try to eat some broth or soup for a meal once a day for a week or two. And finally do not drink soda or energy drinks.


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