Mr. H.K. Part 1

Mr. H.K. is a 33 year old Cantonese gentleman who presented to the clinic with tiredness, dizziness, generalized weakness, pains in the upper back, a sensation of heaviness in his feet, 20 pound weight loss, and insomnia of 6 months duration. He denied any emotional complaints. Past medical history was noncontributory. Medical evaluation was unrevealing, except that the patient seems anxious and depressed. Mr. H.K. denied feeling anxious or depressed, and initially reftised to speak with a mental health counselor until it was agreed that he would receive medications as part of the therapy. He stated that talking therapy would not help.

During the course of his illness, Mr. H.K. had consulted with his family and with traditional Chinese experts. He believed he was suffering from "wind" (fling) and "not enough blood" (m-kau-huet). He had begun treating his illness with traditional Chinese herbs and diet therapy, and was planning to visit an acupuncturist. He had frequently been told by Chinese friends and neighbors that Western medicine could not help his illness, and indeed he had been disappointed by his clinic visit because, despite the lengthy work-up, almost nothing had been explained to him and he had received no medications.

The patient was born into a family of educated farmers and teachers in Kwangtung Province. His family moved to Canton when he was young, and then to Hong Kong after his father was killed. He had been in the U.S. for 10 years. His wife has had two miscarriages and no children, and two years ago he lost most of his savings. His symptoms of anxiety, fearfilness, and irritability began around the time of his wife's second miscarriage and their financirj problems. The symptoms were attributed to "not enough blood.