Name: Ruan.

Sex: Female.

Age: 75 years.

Occupation: A retired teacher.

Chief Complaint: Palpitation and chest oppression for a week.

History of Present Illness: A week ago, the patient got cough, rhinorrhea and fever due to a cold, accompanied with palpitation, chest oppression and weakness of whole body. In the local clinic, it was diagnosed as "common cold" and she was treated by intravenous dripping some anti-inflammatory agents, then her fever disappeared and rhinorrhea and cough were relieved greatly, but palpitation and chest oppression got worse and worse, which occurred from paroxysmally to continuously, furthermore, she got extremely lassitude and fatigue in recent days, which prevented her from steping upstairs to the 2nd floor and doing any daily working as normal. Then she came to our hospital for treatment on December 11,1999. After the illness came on, she kept her appetite, urination and defecation normal all along, but she got bad sleeping, which was full of dreams throughout night. There were not dim eyesight, amaurosis, and coma during her illness.

Physical Examination: The patient was weak with a normal general condition. The pulse was thready, uneven, abrupt and irregular. The tongue was red with a thin layer of white fur. The respiratory sounds in both lungs were all clear. Some scattered big rales could be heard occasionally. HR was 87 beats/rain. The cardiac rhythm was regular. There were premature beats, which occurred 6 to 8 times a minute. There weren't systolic murmur and diastolic murmur. The abdomen was normal. There was not other abnormal sign.

Examination of Electrocardiogram: HR was 87 beats/min.

There were frequent atrial premature beats, which occurred 6 to 8 times a minute.

Diagnosis: Viral Myocarditis; Arrhythmia: Atrial Premature Beats.

Differentiation: This disease, in TCM, belongs to the category of "XinJi, ZhengZhong" (palpitation). It's caused by attack of exogenous pathogenic wind and cold, which invaded the chest and caused the initial qi's flowing became slow and unsmooth. So that the heart-collaterals were obstructed. Additionally, because the patient was in old age and poor health, her deficient heart-qi could not effectively resist the invasion of the exogenous evil, therefore, the exogenous evil could directly attack the heart. So that the heart-Yin was hurt and there were blood stasis and stagnation of qi in heart, the patient then got palpitation and chest oppression.

Therapeutic Principle: Invigorating qi and promoting blood-circulation, nourish Yin and regulating the initial qi; tranqulizing the mind with heavy material, eliminating phlegm-evil and smoothing chest oppression.

Recipe:

DangShen,Pilose Asiabell Root 30g

BaiZhu,Bighead Atractylodes Rhizome 12g

FuShen,Poria with Hostwood 25g

BaiJieZi,White Mustard Seed 15g

MaiDong,Ophiopogon Root 15g

ChuanXiong,Chuanxiong Rhizome 12g

GuiZhi,Cinnamon Twig 10g

WuWeiZi,Schisandra Fruit 18g

DanShen,Red Sage Root 25g

TanXiang, Sandalwood 9g

ShuiZhi, Leech 5g

GuaLouPi,Trichosanthes Fruit 30g

ZhiShi,Immature Bitter Orange 18g

XieBai, Macrostem Onion 15g

BaiLongChi, Dragon's teech 30g (to be decocted in water earlier. )

All the above drugs were to be decocted in water for oral taking, 7 doses were prescibed. Greasy, hot and fat food was forbidden during the treatment. In the same period, she was told to take the capsule for wrecking mass. Recipe:

A' Wei, Asafetida

HuPo, Amber

Each herb should be taken just the right amount.

All the above drugs were to be ground into fine powder and mixed together, filling the large-sized capsules with the mixed powder, taking 2 pieces each time,3 times a day.

Effect Observation: After 3 days' treatment, her palpitation and chest oppression disappeared, no premature beat could be heard through hearing examination on heart. After taking the 7 doses of decoction, all discomfort disappeared, she slept well throughout night. Reexamination of Electrocardiogram showed normal. All the signs indicated the premature beat disappeared already, the illness was cured. But because the patient was in old age and poor health, it's necessary for her to reinforce the curative effect. Then she was told to take 5 doses of the above prescription once more. After taking the ,5 doses, the patient restored completely, she could step upstairs to the 6th floor without any uncomfortable sensation. Then she was told to take the pills of heaven-king for nourishing heart in order to nurse herself better. After a year's follow-up, there was not recurrence of the illness, then it' s ending.