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    Worked Clinical Examples

    Three fully worked, anonymised cases showing exactly what Medi-Chi produces — intake, differentiated patterns with classical citations, treatment principle, points, herb direction, Western overlay, and red flags. No cherry-picking, no marketing gloss.

    Last updated: 19 July 2026 · Read the methodology

    For registered practitioners and students. These worked examples are teaching artefacts, not clinical directives. Herbal formulas are named in Pīnyīn as prescribing direction only — use within your registered scope and jurisdiction (AHPRA / TGA in Australia).

    Western condition
    TCM pattern feature
    Showing 3 of 3 cases
    Medi-Chi embossed hero for worked example: Perimenopausal insomnia with night sweats
    Case 01

    Perimenopausal insomnia with night sweats

    48-year-old woman, wakes at 3am most nights, drenching night sweats, irritable by late afternoon, tongue red with a peeled centre, pulse thin and rapid.

    Intake summary

    Chief complaint
    Sleep-maintenance insomnia (3–4am waking), 6+ months
    Cycle
    Irregular, 40–60 day intervals, scanty flow
    Heat signs
    Night sweats, five-palm heat, thirst for cold drinks
    Emotional
    Irritability, sighing, low frustration tolerance
    Tongue
    Red body, peeled coat centrally, slightly cracked
    Pulse
    Chi thin and rapid; Guan wiry on the left

    Pattern differentiation

    Kidney Yin Deficiency with Empty Heat(Shèn Yīn Xū, Xū Rè)Primary

    3am waking, night sweats, red peeled tongue and thin-rapid chi pulse all point to depleted Kidney Yin failing to anchor the Shen and control Empty Heat rising at night. The Kidney–Heart axis (Shuǐ Huǒ) is uncoupled.

    • "When Kidney Water fails to ascend to meet Heart Fire, sleep is disturbed and the spirit is unsettled."— Sù Wèn, Chapter 46 (paraphrased clinical synthesis)
    • "Yin deficiency generates internal heat; heat harasses the Heart and produces vexation and insomnia."— Jīn Guì Yào Lüè, Ch. 6 (Zhang Zhongjing)
    Liver Blood Deficiency with Liver Qi Constraint(Gān Xuè Xū jiān Gān Qì Yù)Secondary

    Scanty menses and left Guan wiryness suggest Liver Blood is not being reinforced and Qi is stagnating — a common perimenopausal pattern that layers on top of the Yin deficiency.

    • "The Liver stores Blood; when Blood is insufficient the Hún is not housed and dreams are disturbed."— Líng Shū, Chapter 8

    Treatment plan

    Treatment principle
    Nourish Kidney Yin, clear Empty Heat, calm the Shen, soothe the Liver.
    Point prescription
    KI 3 Tài Xī, KI 6 Zhào Hǎi, HT 6 Yīn Xī, HT 7 Shén Mén, SP 6 Sān Yīn Jiāo, LR 3 Tài Chōng, Ān Mián (extra). Even technique on Yin points, light dispersing on LR 3.
    Herbal direction
    Base formula direction: Zhī Bǎi Dì Huáng Wán modified — add Suān Zǎo Rén and Bǎi Zǐ Rén for Shen-calming, He Huan Pi for Liver Qi constraint. Prescribe only within your registered scope.
    Lifestyle
    Wind-down window 90 min before bed, no screens after 9:30pm, cool bedroom, magnesium-rich evening meal, gentle Yin yoga or Qì Gōng.
    Western overlay

    Consistent with perimenopausal vasomotor symptoms and HPA-axis dysregulation. Consider FSH/LH, TSH and ferritin if not already screened; refer for menopause review if severity warrants.

    Red flags — refer

    Weight loss > 5%, new headaches, night sweats without hormonal context, or heavy irregular bleeding warrant medical work-up before continuing.

    Medi-Chi embossed hero for worked example: Post-viral fatigue with brain fog
    Case 02

    Post-viral fatigue with brain fog

    34-year-old, 5 months post-COVID, wired-but-tired, worse after minimal exertion, loose stools most mornings, pale swollen tongue with teeth marks, pulse soggy and weak.

    Intake summary

    Chief complaint
    Fatigue, PEM after activity, cognitive fog
    Digestion
    Loose stools AM, bloating after meals, sugar cravings
    Sleep
    Falls asleep easily, unrefreshing
    Tongue
    Pale, swollen, teeth-marks lateral, thin white coat
    Pulse
    Overall soggy and weak, right Guan especially deficient

    Pattern differentiation

    Spleen Qi Deficiency with Dampness(Pí Qì Xū jiān Shī)Primary

    Post-viral depletion has hit the middle Jiāo. Fatigue worse after eating, loose AM stools, teeth-marked pale tongue and soggy right Guan pulse are textbook Spleen Qi failing to transform and transport, with Damp accumulating.

    • "The Spleen governs transformation and transportation; when Spleen Qi is deficient, Dampness is generated internally."— Pí Wèi Lùn (Lǐ Dōng-yuán), Ch. 1
    • "After a warm-disease pathogen retreats, the Qi and fluids are consumed; recovery must nourish the Middle first."— Wēn Bìng Tiáo Biàn (Wu Jutong), Wei-Qi stage discussion
    Latent Pathogen in Shào Yáng(Fú Xié zài Shào Yáng)Differential

    Consider if fatigue oscillates with low-grade fever, alternating chills/heat, or bitter taste — would shift the plan toward a Shào Yáng harmonising strategy (Xiǎo Chái Hú Tāng family).

    • "Alternating cold and heat, bitter mouth, dry throat — this is Shào Yáng disease."— Shāng Hán Lùn, Line 96 (Zhang Zhongjing)

    Treatment plan

    Treatment principle
    Tonify Spleen Qi, resolve Dampness, gently lift Yang, protect the Middle Jiāo.
    Point prescription
    ST 36 Zú Sān Lǐ, SP 3 Tài Bái, SP 9 Yīn Líng Quán, CV 12 Zhōng Wǎn, CV 6 Qì Hǎi, BL 20 Pí Shū, BL 21 Wèi Shū. Moxa on ST 36 and CV 6 (if no heat signs).
    Herbal direction
    Direction: Liù Jūn Zǐ Tāng or Shēn Líng Bái Zhú Sǎn depending on Damp burden. Prescribe only within your registered scope.
    Lifestyle
    Pacing / heart-rate ceiling for PEM, warm cooked foods, cut raw/cold and refined sugar, protein at breakfast, 20-min midday rest.
    Western overlay

    Overlaps with ME/CFS and long-COVID phenotypes. Screen ferritin, B12, vitamin D, TSH, coeliac. Refer if PEM is severe or symptoms progressing.

    Red flags — refer

    Chest pain on exertion, new shortness of breath, unexplained fevers, or neurological deficits — refer urgently before continuing TCM management.

    Medi-Chi embossed hero for worked example: Right-sided cyclical migraine, worse premenstrually
    Case 03

    Right-sided cyclical migraine, worse premenstrually

    29-year-old, migraines 2–3 days pre-period, right temple, throbbing with nausea, breast distension in luteal phase, tongue slightly dusky with red edges, pulse wiry.

    Intake summary

    Pain quality
    Throbbing, right temple → behind right eye
    Cycle correlation
    Onset 2–3 days before menses, resolves by day 2
    PMS
    Breast distension, irritability, clotted flow first day
    Tongue
    Body slightly dusky, red edges, thin coat
    Pulse
    Wiry overall, wiry-choppy on left Guan

    Pattern differentiation

    Liver Qi Stagnation transforming to Fire, with Blood Stasis(Gān Yù Huà Huǒ jiān Xuè Yū)Primary

    Unilateral temporal migraine follows the Shào Yáng / Liver channel. Premenstrual timing, breast distension, red tongue edges and wiry pulse show Liver Qi constraint generating Heat; the dusky tongue and clotted flow show Blood Stasis has joined in.

    • "The Liver channel ascends through the diaphragm... connects with the eye system and meets the vertex."— Líng Shū, Chapter 10 (Channel Pathways)
    • "When Qi moves, Blood moves; when Qi stagnates, Blood stagnates. Persistent Qi constraint always injures the Blood."— Yī Lín Gǎi Cuò (Wang Qingren), Blood Stasis chapters

    Treatment plan

    Treatment principle
    Course the Liver, clear Heat, invigorate Blood, unblock the channel.
    Point prescription
    GB 20 Fēng Chí, GB 8 Shuài Gǔ, Tài Yáng (extra), LR 3 Tài Chōng + LI 4 Hé Gǔ (Four Gates), SP 10 Xuè Hǎi, SP 6 Sān Yīn Jiāo. Strong dispersing technique on right side during luteal phase.
    Herbal direction
    Direction: Xiāo Yáo Sǎn base, moving toward Jiā Wèi Xiāo Yáo Sǎn if Heat signs are strong; add Chuān Xiōng and Yán Hú Suǒ for channel-moving analgesia. Prescribe only within your registered scope.
    Lifestyle
    Consistent sleep timing across the cycle, reduce alcohol and aged cheeses in luteal phase, magnesium glycinate trial, cycle-tracking to pre-empt treatment 5 days before onset.
    Western overlay

    Fits menstrual / oestrogen-withdrawal migraine phenotype. If aura is new, pain sudden and worst-ever, or associated with focal neurology — image before continuing.

    Red flags — refer

    Thunderclap onset, first migraine after age 40, fever with neck stiffness, or new focal signs = urgent medical review.

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