Huang, 65-year-old male, 171cm/75kg.
Initial consultation on January 29, 2019.
History: Superficial gastritis with ulceration for over 10 years. Patient reported that he often experienced abdominal pain after taking western medications as well as abdominal discomfort after eating fruit. He felt a sticky sensation in his umbilicus, and also experienced abdominal distention, belching, poor appetite, difficulty falling asleep, and had no issues with his bowel movements. He was worried that his digestive disease will develop into cancer, and therefore, his mood was quite poor.
Signs: Robust build, double eyelids, frowning eyebrows, lively facial expressions, a red face, and dusky red lips. In addition, he procrastinated when he spoke. His abdomen was soft, there were purple stasis marks below his tongue, his throat was red, tongue coating slightly greasy, and his pulse was slippery.
Prescription: jiangbanxia 15g, houpo 15g, fuling 15g, sugeng 15g, zhike 15g, zhizi 15g, lianqiao 30g, huangqin 10g; 9 packets; 3 days on, 2 days off.
Second consultation on February 26, 2019: After taking the formula, his symptoms had improved. However, once stopping them, the symptoms returned, yet this time there was no abdominal pain, and only a feeling of discomfort, plus the location of the pain had now changed. He was also belching, had subcostal distention, and his sleep was reduced. 9 packets of the same formula with chenpi 20g was given; 3 days on, 2 days off.