Repeated episodes of sharp, boring epigastric pain. The pain is relieved by eating, but made worse by stress and emotions.
Acid reflux, exceptionally strong appetite (hungry again soon after eating), highly restless/energetic. Often bad tempered and angry.
Reddish-purple indicates stasis; red sides suggest Liver heat; dry yellow coat confirms Stomach fire.
Slippery/full shows excess heat & dampness; wiry confirms Liver fire constraint and intense pain.
Diagnostic Assessment & Pattern Identification
Evaluate the clinical data. The combination of burning epigastric pain, immense hunger, acid reflux, emotional anger/wiriness, and dry yellow tongue coat points to which underlying disharmony?
Formulating the Treatment Strategy
Every successful clinical protocol links specific symptom groups directly to their appropriate strategic healing targets.
Presentation A
Insatiable appetite, hungry soon after eating, acid reflux, with dry yellow tongue coat.
Presentation B
Sharp, boring epigastric pain relieved by eating, red sides, with reddish-purple tongue.
Presentation C
Bad temper, angry episodes, high restlessness, and severe reflux regurgitation.
Herb Cabinet: Module Selection
Consult the *Book of Modules*. Pick the most precise herbal combination to clear the fire, relieve sharp pain, calm anger, and arrest acid backup.
1. Drain Stomach Fire Required
2. Drain Liver Fire Required
3. Epigastric Pain (Blood Activation) Required
4. Anger & Acid Reflux Combined Required
Dosing Decisions & Customizations
Dosing dictates clinical efficacy. Formulate the correct target weights for the patient's acute boring pain and excess fires, and manage overlapping ingredients.
Module 3 (Boring Epigastric Pain)
Primary Chief Complaint: sharp, boring pain congealed by blood stasis.
Modules 1 & 2 (Stomach & Liver Fire)
Underlying excess heat pathogens generating insatiable hunger and red tongue sides.
Module 4 (Anger / Reflux Support)
Secondary emotional tension and heavy mineral shell acids.
The acid reflux stopper *Hai Piao Xiao* operates in a module containing *Shi Jue Ming* and *Mu Li*. Since *Shi Jue Ming* and *Mu Li* are already written inside the Anger module, checking this box merges them so they do not duplicate in the prescription.
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.
Module 1: Drain Stomach Fire
Module 2: Drain Liver Fire
Module 3: Epigastric Pain (Chief Complaint priority)
Module 4: Calm Shen (Anger) & Acid Reflux Overlaps Consolidated
Clinical Takeaway:
- Consolidation Synergy: *Shi Jue Ming* and *Mu Li* serve double-duty as heavy anchors to subdue angry Liver Yang and as alkalizing calcium shells that coat the stomach and relieve acid regurgitation. Listing them once keeps the prescription pristine.
- Targeted Blood Invigoration: Epigastric pain characterized as "sharp" and "boring" is congealed blood stasis. Satiating this complaint requires the highest dosage range of the *Wu Ling Zi / Yan Hu Suo* pair (9g each).
- Anger & Acid Feedback: Uncontrolled anger generates constrained Liver fire, which immediately stimulates severe Stomach acid secretions. Calming the mind with *He Huan Pi* is key to stopping the physiological root of reflux.