The following cases present variations of this condition. Afer familiarizing yourself with the possible common patern presentations and appropriate formulas for treatment, use the following exercises to test your overall understanding of the condition.

1. Female, 49 years old. Lacrimation in both eyes when facing into the wind with no redness or pain. Her face was pale and she was dizzy. The tongue was pale with a thin coating. The pulse was thready and weak.

Select the most appropriate formula below:

A. Modified Bā Zhēn Tāng (Eight-Gem Decoction)

B. Modified Zuŏ Guī Yĭn (Left-Restoring Beverage)

C. Modified Sì Wù Tāng (Four Substances Decoction)

D. Modified Zhĭ Lèi Bŭ Gān Săn (Tear-Checking and Liver-Supplementing Powder)

E. Modified Yòu Guī Wán (Right-Restoring Pill)

2. Female, 66 years old. Persistent lacrimation in both eyes with clear watery discharge and an inability to see for long periods. Her face was pale. She had fatigue, forgetfulness, palpitations and a poor appetite. The tongue body was pale with a thin coating. The pulse was thready and weak.

Select the most appropriate formula below:

A. Modified Bā Zhēn Tāng (Eight-Gem Decoction)

B. Modified Zuŏ Guī Yĭn (Left-Restoring Beverage)

C. Modified Sì Wù Tāng (Four Substances Decoction)

D. Modified Zhĭ Lèi Bŭ Gān Săn (Tear-Checking and Liver-Supplementing Powder)

E. Modified Yòu Guī Wán (Right-Restoring Pill)

1. D

2. A

The two study cases can be discussed together, as both are variations of blood deficiency. For the first case, the patient exhibits symptoms of wind, therefore the best formula selection is modified Zhĭ Lèi Bŭ Gān Săn. It is a statement of fact that blood dryness produces wind. The formula tonifies the blood, eliminates liver wind and stops tearing which matches the root and the branch patterns of this case.

The second case scenario is similar, albeit she has a weaker constitution. Her face is pale. She is fatigued, along with forgetfulness, palpitations and a poor appetite. This is a classic presentation of spleen qi and heart blood defciency; therefore the patient is treated with modifed Bā Zhēn Tāng (Eight-Gem Decoction).