Name: Parmod.

Sex: Male.

Age: 47 years.

0ccupation: An engineer.

Chief Complaint: Edema of both lower extremities for 1 week.

History of Present Illness: About 1 week ago, the patient' s lower extremities got edema without any obvious causes. It's pitting edema and occurred in the areas below both knee-joints, especially two ankle joints swollen severely. After the illness came on, he got slight fatigue and lassitude, but no fever or aching-pain of waist and legs. There were palpitation and a bit shortness of breath. He once went to the local hospital and was treated with intravenous dripping some antibiotics for 1 week, but it's not effective against the illness, then he came to me for treatment on October 10,1997.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and rapid, the tongue was red with a thin layer of white fur. The lungs were all normal. HR was 120beats/min. The cardiac rhythm was regular. There weren't systolic murmur and diastolic murmur. There was obvious pitting edema below both knee-joints. The abdomen was normal. There was not other abnormal sign.

Lab Test: Routine urine examination was normal.

Examination of Electrocardiogram: It indicated there was sinus tachycardia.

Diagn0sis: Idiopathic Edema.

Differentiation: This disease, in TCM, belongs to the category of¡°ShuiZhong"(edema). It was caused by deficient spleen-qi and heart-qi. The deficiency of spleen-qi caused there was insufficiency of splen0gastric qi, which couldn't normally govern blood-flowing and transport body fluid, then some parts of them were washed away from their normal channels and accumulated together in the subcutaneous layer, so that the edema was caused; as for the deficiency of heart-qi, it directly caused the palpitation and shortness of breath.

Therapeutic Principle: It's cardinal therapy to strengthening middle energizer to nourish qi, it's auxiliary therapy to promote blood circulation and induce diuresis.

Recipe: Modified Decoction for Strengthening middle qi to nourish qi and Decoction of Six Drugs Including Rehmannia.

DangShen,Pilose Asiabell Root 30g

BaiZhu,Bighead Atractylodes Rhizome 15g

FuLing,Tuckahoe 12g

ShengMa,Cimicifuga Rhizome 3g

ChaiHu,Bupleurum Root 3g

ChenPi,Tangerine Peel 10g

ShengHuangQi,Raw Milkvetch Root 30g

Danggui,Chinese Angelica Root 10g

ShanYao,Chinese Yam Rhizome 18g

ZeXie,Oriental Water Plantain Rhizome 12g

MuDanPi,Tree Peony Bark 10g

DanShen,Red Sage Root 25g

ChuanXiong,Chuanxiong Rhizome 15g

ShanZhuYu, Dogwood Fruit 12g

ZhiaanCao,Prepared Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking,2 doses were prescribed. Vegetable and low-fat food were suggested as daily diet.

Effect Observation: After taking 1 dose, the edema of lower extremities disappeared at once, the palpitation disappeared too. The patient then came to me for expressing his thanks, he was to1d to continue taking the 2nd dose in order to get complete curative effect, addtionally he was told to have a rest to nurse himself well. After 1 month's follow up, the illness didn't recur, then it's ending.