“I always have something in my throat and I feel heavy all day.”
Mucus that will not clear
The persistent throat sensation, heaviness and fatigue have gradually affected her routine over recent months.
- Patient
- Woman, 34
- Occupation
- Primary school teacher; talks eight hours a day
- Medication
- Antihistamine in spring. Nothing regular.
- Allergies
- Grass pollen
- History
- Smoker until eight years ago. No admissions.
- Habits
- Breakfast standing up, almost always cold. Late dinners.
- Vitals
- Afebrile · stable weight · no dyspnoea
1 · The consultation
You have 16 minutes. Each question or examination costs 2. Choose carefully what to ask.
Questions
Examination
2 · The tongue
3 · The pulse
Describe the pulse on each axis.
4 · The pattern
5 · Differential diagnosis
You're torn between two patterns. Which is it?
Which finding decides it?
6 · Case twist
Patient update“Oh, and I have a sore on the edge of my tongue that will not go. Three weeks unchanged, and it does not hurt.”
Mark the warning signs present:
What do you do?
7 · The treatment
Principle
Strategy
Points (choose 4)
Case solved
Reasoned solution
Pattern: Phlegm-damp from Spleen deficiency. Supporting signs: Thick mucus in the throat, Heaviness in the head and legs, Bloating after eating, Thick, greasy coating, Slippery pulse.
The deciding clue: Thick, greasy coating: Dense, sticky and with an oily sheen: it looks like it could be scraped off..
Safety: Correct. A painless tongue ulcer that has not closed in two weeks is not a sign on this map: it gets referred. The phlegm pattern was well built, and the rest of the treatment can continue afterwards.
Treatment: Tonify the Spleen and dry the damp, Transform phlegm and free the throat; Warm, cooked food; no more cold breakfast, Moxa over the middle floor. Points: ST40, SP9, ST36, CV12.
More patients are waiting in the app, with voice, a real timer and a history of your decisions.
See the solution without playing
Pattern: Phlegm-damp from Spleen deficiency. Supporting signs: Thick mucus in the throat, Heaviness in the head and legs, Bloating after eating, Thick, greasy coating, Slippery pulse.
The deciding clue: Thick, greasy coating: Dense, sticky and with an oily sheen: it looks like it could be scraped off..
Safety: Correct. A painless tongue ulcer that has not closed in two weeks is not a sign on this map: it gets referred. The phlegm pattern was well built, and the rest of the treatment can continue afterwards.
Treatment: Tonify the Spleen and dry the damp, Transform phlegm and free the throat; Warm, cooked food; no more cold breakfast, Moxa over the middle floor. Points: ST40, SP9, ST36, CV12.
Teaching case. Fictional patient for study purposes. If you have real symptoms, consult a healthcare professional.
