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Cheng, female, 23 years old. Due to emotional distress and increasing depression, she suddenly experienced confusion, tightly closed eyes, and although she responded when called, her voice was faint, and her limbs were unable to move voluntarily. Her complexion was pale and bloodless, with palpitations and insomnia. Her heart rate was over 120 beats per minute. This condition occurred several times a day or once every few days. She was previously diagnosed with "paroxysmal tachycardia" at a hospital. Initial treatments with Qingjie and Bupleurum formulas were ineffective.

Later, when the patient was not experiencing an episode, further inquiry revealed that she had not had a bowel movement for six or seven days. She felt a burning sensation and fullness in her chest, often tearing her clothes and pounding her chest, describing a sensation as if her throat was on fire. When asked why her eyes were tightly closed, she said she was afraid to open them because she saw people around her bed "with two heads." I suddenly realized that these were hallucinations and visual illusions. Upon further examination, her tongue was red at the edges with a thick, greasy yellow and black coating. Her pulse was thin, rapid, and hurried. The syndrome was identified as yangming interior excess combined with phlegm heat stagnation and thoracic accumulation. I decided to try Minor Purgative Decoction combined with Minor Chest Bind Decoction, adjusting the formula as follows:
Rhubarb Rhizoma 15g, Immature Orange Fruit 12g, Magnolia Bark 12g, Whole Trichosanthis Fruit 30g, Coptis Rhizome 10g, Pinellia 6g, Acorus 12g, Raw Iron Filings 30g (to be decocted first), Liquorice Root 9g

. After taking three doses of the above formula, she had a large amount of black, sticky, foul-smelling stool, and the frequency of her episodes decreased. During the episodes, all symptoms were reduced, and her condition significantly improved. After taking three more doses, her condition continued to improve, with clear consciousness, open eyes, and clear speech. Based on the original formula, 30 grams each of raw Longgu and raw Muli were added, and three more doses were taken. Her condition gradually improved, and with further adjustments based on her symptoms, she fully recovered after half a month.