(chapter36)Overthinking Damaging Spleen, Phlegm-Dampness Disturbing Heart

Case Record of Madam Li Beisan

While visiting Mr. Li Beisan’s residence, his wife suddenly fell ill. Madam Li was known for her poetry, painting, and exceptional embroidery skills, with a lively, confident personality and eloquent speech. During our conversation in the parlor, other officials were playing a card game similar to poker, which I chose not to join. Just as dinner was being served, an elderly maid rushed out and said, “Madam is suddenly experiencing palpitations and nausea, unable to sit still. She’s heard of Dr. Wang’s medical expertise and requests your immediate assistance!”

Following Mr. Li into the bedroom, I saw two maids supporting Madam Li. She was sweating profusely and clutching her chest. I promptly checked her pulse: ​the pulse at the spleen position (spleen qi reflection point on the wrist) ​was thin and weak, while ​the left cun position (heart/lung pulse zone) ​felt slippery (hua) and rapid (shu). I diagnosed her condition as ​​“Spleen Deficiency with Phlegm Retention Syndrome”​ and explained:

“This illness stems from chronic overthinking damaging the spleen, leading to poor digestion. Madam likely experiences forgetfulness and anxiety regularly. Now, phlegm-dampness has accumulated around the Heart Protector Meridian , causing palpitations and nausea.”

I outlined the (used in traditional contexts) plan:

​First Phase – Clear Phlegm: Use ​Lianzi Qingxin Yin

​Formula:
Baical Skullcap Root (Huang Qin )
Dwarf Lilyturf Tuber (Mai Dong )
Chinese Wolfberry Root Bark (Di Gu Pi )
Plantain Seed (Che Qian Zi )
Licorice Root (Gan Cao )
Stone Lotus Seed (Shi Lian Zi )
Ginseng (Ren Shen )
Mongolian Milkvetch Root (Huang Qi )
Poria Mushroom (Fu Ling)

Second Phase – Strengthen the Spleen: Prescribe ​Renshen Guipi Wan ( Ginseng Spleen-Restoring Pills).
“This condition developed gradually and requires progressive recovery—it cannot be cured overnight.”

Treatment Timeline:

• ​Days 1–2: After taking Lianzi Qingxin Yin, her palpitations and nausea subsided.
• ​Days 3–12: Switched to Renshen Guipi Tang (Spleen-Restoring Decoction). After four follow-up visits within ten days, all symptoms vanished completely.