Case 1

Name: Shao.

Sex: Female.

Age: 24 years.

0ccupation: A worker.

Chief Complaint: Abdominal pain and diarrhea for 3 years.

History of Present Illness: Three years ago, the patient got severe diarrbea from a contaminated diet. At that time it was diagnosed as " Acute Enteritis" and she was treated by intravenous dripping antibiotics in a hospital, the diarrhea was relieved. But since then, she hadn't dared to eat fruit and meat, otherwise she would get a immediate diarrhea, the stool was like yellow soup without red and white mucus in it. Sometimes similar attack came back due to a cold or weariness. In the past several years, she had been treated by many times of taking "Norfloxacin, Berberine Hydrochloride" and Chinese herbs in a hospital, but there was no obvious effect on her. Recently, she had an abdominal pain, which was followed by a immediate diarrhea. The diarrhea occurred 4 or 5 times a day, it caused she dared not eat fruit and meat at all. Then she came to our hospital for treatment on September 5,1998. Since the illness came on, her appetite, urination and sleeping had been all normal. There was not other complaint.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and soggy. The tongue was red with a thin layer of white fur. The chest was normal. The abdomen was soft and flat. There was no tenderness all over the abdomen. There was not other abnormal sign.

Diagnosis: Chronic Enteritis.

Differentiation: It was caused by the failure of the middle-Jiao to take charge of digesting food and transporting fluid, which caused the up-flaming of deficiency-fire while the pathogenic water-dampness was retained in the lower-Jiao.

Therapeutic Principle: Invigorating spleen to activate middle Jiao; clearing away heat evil and eliminating pathogenic water-dampness.

Recipe: Modified Decoction of Pinelliae for Purging Stomach fire Formulated by Dr. Zhang Zhongjing.

DangShen,Pilose Asiabell Root 30g

BaiZhu,Bighead Atractylodes Rhizome 15g

FuLing, Tuckahoe 12g

HuangLian,Coptis Root 9g

HuangQin, Scutellaria Root 12g

OanJiang,Dried Ginger Root 3g

FaBanXia,Pinellia Tuber 5g

YiYiRen,Coix Seed 30g

ShanYao,Chinese Yam 25g

ZeXie,Oriental Water Plantain 15g

QinPi,Ash Bark 12g

BaiTouWeng,Pulsatilla Root 18g

GanCao,Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. Hot and greasy food was forbidden during the treatment.

Effect Observation: After taking the 5 doses, the patient came back for reexamination on September 10,1998. She told me the diarrhea had been relieved from 4 or 5 times to 1 or 2 times a day, the stool became formed and soft. But the abdominal pain was as same as before, which accompanied with dryness of mouth. Physical examination showed the pulse was thready and uneven, the tongue was red with a map-like layer of white fur. All these signs showed the middle-Jiao had been activated, but there was deficiency of stomach-Yin. So that the followed therapeutic principle should be invigorating spleen and nourishing stomach-Yin.

Recipe:

DangShen,Pilose Asiabell Root 30g

BaiZhu,Bighead Atractylodes Rhizome 15g

FuLing, Tuckahoe 10g

ZhiMu,Anemarrhena Rhizome 12g

YuZhu,Fragrant Solomonseal Rhizome 18g

MaiDong,Ophiopogon Root 20g

DanShen,Red Sage Root 20g

WuMei,Black Plum 20g

QianShi,Gordon Euryale Seed 20g

C-eGen,Pueraria Root 9g

ShanYao,Chinese Yam 15g

YiYiRen,Coix Seed 25g

BaiTouWeng,Pulsatila Root 15g

TuSiZi,Dodder Seed 18g

GanCao,Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. Fat and greasy food was forbidden during the treatment.

After taking the 5 doses, she came back for reexamination on September 17. She told me dryness of mouth had disappeared, the abdominal pain was relieved. Her defecation occurred 1 or 2 times a day, the stool was formed and soft. But there was a paroxysmal abdominal pain before her defecating. Physical examination showed the pulse was thready and uneven, the tongue was red with a thin layer of white fur, and the vena profunda linguae was purplish blue in colour. All these signs showed the patient's spleen and stomach had gotten substantial. However, as a result of a long time of illness, the blood stasis had been formed in the meridian. Because the qi of spleen and stomach had been much more plenty, so that some attacking drugs should be used to have amopping-up operation against the blood stasis which lurked in the meridian deeply. By this way, the functional activaties of internal organs would get coordinated well. Recipe: Modified Decoction of Removing Blood Stasis in the Chest Formulated by Dr. Wang Qingren.

ShengDiHuang,Dried Rehmannia Root 12g

MuDanPi,Tree Peony Bark 9g

ChuanXiong,Chuanxiong Rhizome 10g

ChiShao,Red Peony Root 10g

HongHua, Safflower 10g

TaoRen,Peach Seed 9g

DangGui,Chinese Angelica Root 12g

ZhiHuangQi,Moxa-prepared Milkvetch Root 30g

ZhiKe,Fruit of Citron 8g

HuangLian,Coptis Root 9g

ChaiHu,Bupleurum Root 8g

DanShen,Red Sage Root 20g

DangShen, Pilose Asiabell Root 30g

YiYiRen, Coix Seed 18g

ZhiGanCao,Prepared Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. She was told to take the decoction out of her intermenstrual period. The diet was not limited.

After taking the 5 doses, the patient came back for reexamination on October 3. She told me the abdominal pain had disappeared, defecation occurred 1 time a day, the stool was soft and formed. There was not uncomfortable sensation any more. All these signs showed the patient had been cured completely. After half a year's follow-up, the illness didn' t recur. Then it' s ending.

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