TCM Clinical Simulator

The Book of Modules: Interactive Case Study 3

Patient Clinical Intake File
Demographics 67 y/o Male
Chief Complaint (Biao)

Repeated episodes of severe, sharp facial pain and numbness tend to last a few minutes. Pain is relieved by warm towels, gets worse in cold/wind.

Secondary Presentation & History

Face has a pale and puffy appearance. Diagnosed with trigeminal neuralgia; Tegretol causes severe fatigue, nausea, and cognitive fog.

Objective Physical Diagnostic Markers
Tongue Evaluation Pale tongue with white greasy coat

Indicates constitutional phlegm, dampness, and Spleen Qi deficiency.

Pulse Diagnostics Soggy (Ru Mai)

Confirms internal dampness obstructing the vessels with underlying Qi deficiency.

Book of Modules Reference Quick-Sheet
Gao Ben/Bai Zhi: Warm, dispel wind-cold from face
Chuan Xiong: Move blood, dispel facial wind
Tao Ren/Hong Hua: Core blood activation pair
Xi Xin/Fu Zi: Deep warming, disperse channel cold
Ban Xia/Chen Pi: Er Chen Tang phlegm base
Cang Zhu/Hou Po: Ping Wei San Spleen damp drier
Phase 1 of 5

Diagnostic Assessment & Pattern Identification

Analyze the patient's severe trigeminal pain, history, tongue, and soggy pulse. What is the correct underlying pattern of disharmony according to traditional diagnostic criteria?

Phase 2 of 5

Formulating the Treatment Strategy

Every successful modular prescription balances Root and Manifestation. Map each clinical presentation block to its correct treatment strategy.

Presentation A

Sharp, severe facial pain attacks triggered by wind-cold and relieved by heat.

Presentation B

Deep congealing cold inside the collaterals causing stabbing pain and localized stasis.

Presentation C

Pale, puffy facial appearance, greasy tongue coat, soggy pulse, and drug fatigue.

Phase 3 of 5

Herb Cabinet: Module Selection

Consult the *Book of Modules*. Select the optimal combinations to relieve trigeminal neuralgia facial pain, activate stagnant blood, warm the channels, dry dampness, and strengthen the Spleen.

1. Dispel Wind-Cold & Alleviate Facial Pain Required

2. Activate Blood & Resolve Stasis Required

3. Warm the Channels & Scatter Cold Required

4. Transform Phlegm-Damp & Strengthen Spleen Required

Phase 4 of 5

Dosing Decisions & Customizations

Dosing is where raw modular theory matches clinical complexity. Select the correct logical dosing weights, and decide whether to enable overlap optimization.

Module 1 & 2 (Chief Complaint)

Directly addresses the acute, agonizing facial neuralgia and localized stasis.

Module 3 (Warm Channels)

Warms deep collaterals. Contains Ma Huang and highly toxic Xi Xin.

Module 4 (Phlegm & Spleen)

Constitutional support for resolving underlying soggy, damp terrain.

Check this box to apply advanced modular formulation rules. This will merge duplicate ingredients in the draft (omitting the duplicated *Chuan Xiong* from the Blood Activation block and consolidating the dual *Chen Pi* entries into a single 6g dose).

Phase 5 of 5

Final Formula Prescription & Clinical Summary

Below is the complete compound herbal prescription compiled from your modular choices. Review the final dosage adjustments and clinical rationale.

Composite Prescription (Decoction) 1 Bag Daily (Divided Doses)

Module 1: Facial Pain due to Wind-Cold

Gao Ben (Rx. & Rz. Ligustici): 9g
Bai Zhi (Rx. Angelicae Dahuricae): 9g
Chuan Xiong (Rx. Ligustici): 9g

Module 2: Activate Blood Chuan Xiong Merged

Tao Ren (Sm. Persicae): 9g
Hong Hua (Flos Carthami): 9g
Dang Gui (Rx. Angelicae Sinensis): 15g
Chuan Xiong (Rx. Ligustici): 9g (Duplicated!)

Module 3: Warm the Channels & Scatter Cold

Ma Huang (Hb. Ephedrae): 6g
Xi Xin (Hb. Asari): 2g
Fu Zi (Rx. Aconite): 9g

Module 4: Phlegm, Dampness, & Spleen (Er Chen + Ping Wei) Chen Pi Consolidated

Ban Xia (Rz. Pinelliae): 6g
Cang Zhu (Rz. Atractylodis Lancea): 6g
Hou Po (Cx. Magnoliae Officinalis): 6g
Chen Pi (Per. Citri Reticulatae): 6g (Consolidated)
Chen Pi (Per. Citri Reticulatae): 6g (From Er Chen)
Chen Pi (Per. Citri Reticulatae): 6g (From Ping Wei)
Fu Ling (Poria Cocos): 9g

Clinical Takeaway:

  • Herb Consolidation Rule: The warm blood activator *Chuan Xiong* belongs to both the facial pain and blood moving modules. Writing it once in the chief pain block is sufficient.
  • Spleen Damp Strategy: Combining *Er Chen Tang* and *Ping Wei San* targets both phlegm and the damp-spleen root. Their dual *Chen Pi* entries are consolidated to 6g to avoid over-drying the patient.
  • Channel Warming Precautions: Dosing toxic *Xi Xin* gently at 2g and *Fu Zi* at 9g provides safe warming coverage.