Bringing evidence-based insights into clinical practice should be the central aim of every medical doctor and herbalist. One of the greatest challenges in Chinese herbal medicine is bridging the gap between theory and application. Within the tradition of TEAM™, as in other medical sciences, case studies are a powerful tool for this transformation: they demonstrate how theoretical knowledge is tested against the patient’s presentation and refined through careful observation and examination.

The TEAM™ methods used to identify herbs and formula structures are systematic and structured to ensure accuracy. For example, when observing how questions are applied in the case study below, think of the identification process like the classic board game Guess Who: clear, precise, closed yes/no questions are asked to eliminate herbs that do not align with the response, and to confirm those that do. To access the truth, questioning must be directed in this way to strip away the patient’s personal opinions and assumptions, reducing the disease presentation to a single formula–disease pattern, which can then be verified through the pulse, tongue coating, and abdominal examination.

Question: Does your person have blonde hair?

Answer: No.

Action: Eliminate all the people with blonde hair.

This case study illustrates that same process. A patient presents with acute influenza - alternating chills and fever, profound fatigue, and a yellow tongue coating. Applying TEAM™ methods - abdominal and pulse palpation, tongue observation, and targeted questioning - we follow step-by-step reasoning that confirms the appropriate formula structure: Minor Bupleurum Blend (Xiao Chai Hu Tang).

Step 1.

We first need to identify which herb is connected to the presentation of acute alternating chills and fever. Our first consideration is Bupleurum Root (Chai Hu):

Bupleurum Root (Chai Hu).

Pulse: Left Middle (Guan) position tight-wiry on or above the gas-level depth (qi-depth) - Yes

Abdominal: Responsive tightness and fullness below the hypochondrium – Yes

Questioning: Fullness in the chest – Yes. Responsive stiffness and tightness of the nape and upper back – Yes

Bupleurum Root (Chai Hu) is confirmed according to the primary indication of responsive tightness and fullness below the hypochondrium and a tight-wiry pulse above the gas-level depth on the left middle position, with secondary fullness in the chest and responsive stiffness and tightness of the nape and upper back.

Step 2.

Next, we identify which herb connects with Bupleurum Root (Chai Hu) according to TEAM™ formula structures. Our first consideration is Scutellaria Root (Huang Qin), which is always paired with Bupleurum Root (Chai Hu) when the tongue coating is yellow from the middle to the back.

Scutellaria Root (Huang Qin).

Tongue coating: Tongue coating yellow – Yes

Questioning: Sore throat – Yes. Sticky-soft stools – Yes

Scutellaria Root (Huang Qin) is confirmed according to the primary indication of the yellow tongue coating with secondary sticky-soft stools and a sore throat.

We now have two confirmed herbs—Bupleurum Root (ChaiHu) and Scutellaria Root (Huang Qin). The following formula structures must be considered: Minor Bupleurum Blend (Xiao Chai Hu Tang), Bupleurum plus Mirabilite Blend (Chai Hu Jia Mang Xiao Tang), Bupleurum minus Pinellia plus Snakegourd Root Blend (Chai Hu Qu Ban Xia Jia Tian Hua Fen Tang), Bupleurum and Cinnamon Twig Blend (Chai Hu Gui Zhi Tang), Bupleurum, Cinnamon Twig, and Dried Ginger Blend (Chai Hu Gui Zhi Gan Jiang Tang), Major Bupleurum Blend (Da Chai Hu Tang), Major Bupleurum plus Mirabilite Blend (Da Chai Hu Jia Mang Xiao Tang), and Bupleurum plus Fossilized Bone and Oyster Shell Blend (Chai Hu Jia Long Gu Mu Li Tang).

Step 3.

A common indication to help identify and eliminate some formula structures is the presence and severity of thirst. Formulas with Snakegourd Root (Tian Hua Fen) present with excessive thirst compared to formulas with Pinellia (Ban Xia), which present with no thirst.

Snakegourd Root (Tian Hua Fen).

Questioning: Large thirst – No. Normal to no thirst – Yes

The confirmation of normal to no thirst indicates that formula structures with Snakegourd Root (Tian Hua Fen) are inappropriate for this formula-disease pattern.

 Pinellia (Ban Xia).

Abdominal: Nonresponsive fullness in the upper epigastrium – Yes

Questioning: Normal to no thirst – Yes. Poor appetite or nausea  – Yes. Throat obstruction (fullness in the throat) – Yes

We can confirm that Pinellia (Ban Xia) is confirmed according to the primary indication of nonresponsive fullness in the upper epigastrium with secondary normal to no thirst, poor appetite, with a full sensation in the throat.

We now have three confirmed herbs - Bupleurum Root (Chai Hu), Scutellaria Root (Huang Qin), and Pinellia (Ban Xia). Candidate formulas are further narrowed to: Minor Bupleurum Blend (Xiao Chai HuTang), Bupleurum plus Mirabilite Blend (Chai Hu Jia Mang Xiao Tang), Major Bupleurum plus Mirabilite Blend (Da Chai Hu Jia Mang Xiao Tang), Bupleurum and Cinnamon Twig Blend (Chai Hu Gui Zhi Tang), Major Bupleurum Blend (Da Chai HuTang), and Bupleurum plus Fossilized Bone and Oyster Shell Blend (Chai Hu Jia Long Gu Mu Li Tang).

Step 4.

We next check the abdomen for pulsations above the umbilicus. Cinnamon Twig (Gui Zhi), Unripened Bitter Orange (Zhi Shi), and Oyster Shell (Mu Li) are each associated with distinct pulsation patterns, ranging from superficial to deep and extending from just above the umbilicus to the xiphoid process.

Abdominal: Pulsations above the umbilicus – No

Questioning: Sweating – No. General aches and pains – No

Step 5.

Because no pulsations above the umbilicus are found, we can exclude formulas with Cinnamon Twig (GuiZhi), Unripened Bitter Orange (Zhi Shi), and Oyster Shell (Mu Li) - namely Bupleurum and Cinnamon Twig Blend (Chai Hu Gui Zhi Tang), Bupleurum, Cinnamon Twig, and Dried Ginger Blend (Chai Hu Gui Zhi Gan Jiang Tang), Bupleurum plus Fossilized Bone and Oyster Shell Blend (Chai Hu Jia Long Gu Mu Li Tang), Major Bupleurum Blend (Da Chai Hu Tang), and Major Bupleurum plus Mirabilite Blend (Da Chai Hu Jia Mang Xiao Tang).

Since abdominal examination and tongue coating are more objective than questioning, we now turn to Rhubarb Root (Da Huang), Peony Root (Bai Shao), and Mirabilite (Mang Xiao).

Rhubarb Root (Da Huang)

Abdominal: Responsive fullness in the upper epigastrium – No. Responsive irregular stadium shaped object in the upper epigastrium – No

Pulse: Right Middle (Guan) position is deep-slippery - No

Rhubarb Root (Da Huang) is eliminated.

Peony Root (Bai Shao)

Abdominal: Responsive tight-tense rectus abdominals – No

Questioning: Restless legs – No. Muscular cramping – No

Peony Root (Bai Shao) is eliminated.

Mirabilite (Mang Xiao)

Abdominal: A large responsive hard sphere shape in the upper epigastrium – No

Mirabilite (Mang Xiao) is eliminated.

Step 6.

Now that we have thoroughly investigated each herb with questioning and abdominal examination, we can be certain that any formula structure with Rhubarb Root (Da Huang), Peony Root (Bai Shao), and Mirabilite (Mang Xiao) are inappropriate. These include Major Bupleurum Blend (Da Chai HuTang), Major Bupleurum plus Mirabilite Blend (Da Chai Hu Jia Mang Xiao Tang), and Bupleurum plus Mirabilite Blend (Chai Hu Jia Mang Xiao Tang).

We can now investigate and confirm the remaining herbs: Panax Ginseng Root (Ren Shen), Fresh Ginger (Sheng Jiang), Licorice Root (Gan Cao), and Chinese Red Date (Da Zao) in the final formula structure, Minor Bupleurum Root Blend (Xiao Chai Hu Tang) for this disease presentation.

Panax Ginseng Root (Ren Shen).

Abdominal: A nonresponsive hard sphere shape in the upper epigastrium – Yes

Panax Ginseng Root (Ren Shen) is confirmed.

Fresh Ginger (Sheng Jiang).

Questioning: Poor appetite or nausea – Yes. Nausea after eating – Yes

Fresh Ginger (Sheng Jiang) confirmed.

Licorice Root (Gan Cao).

Abdominal: Urgency – Yes

Licorice Root (Gan Cao) is confirmed.

Chinese Red Date (Da Zao).

Abdominal: Responsive submerged pulsations below the umbilicus – Yes

Chinese Red Date (Da Zao) is confirmed.

With these confirmations, Minor Bupleurum Blend (Xiao Chai Hu Tang) is established beyond doubt as the correct formula structure for this particular disease pattern.

Conclusion.

Through systematic questioning, tongue observation, and precise abdominal and pulse examinations, we added or eliminated inappropriate herbs and formula structures step by step until only one possible formula structure remained. This case demonstrates how the TEAM™ approach bridges theory and clinical reality: by stripping away assumptions and focusing on concrete, testable signs, the practitioner can align the patient’s presentation with the correct formula–disease pattern, ensuring both accuracy and therapeutic effectiveness. Importantly, this same structured method can be applied to any disease presentation or formula structure, providing a reliable pathway from symptoms to treatment.

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