Name: Ye.

Sex: Male.

Age: 37 years.

Occupation: A self-employed driver.

Chief Complaint: Rigidity of left knee-joint for 1 year after fracture of left thigh.

History of Present Illness: Two years ago, the patient was knocked down by a car. At that time, he was sent to a hospital in Nanjing for treatment. Through immediate roentgenogram examination, it was confirmed as "Comminuted Fracture of Lower End of the Left Femur," then he was treated with an operation named as "internal fixation of fracture of lower end of the left femur with steel plates. "1 year later, the fractured bone was healed, then he had another operation in the hospital again in order to take out the fixed steel plates. After the operation, he found there was rigidity of the left knee-joint, which caused he lost the function of the left leg to bend the knee. Then he went to other hospital in Nanjing again for treatment. The doctors in the hospital decided to treat the illness with the 3rd operation again in order to relax the regional adhesion of the affected part. But after the operation, he found the left knee-joint was as rigid as before, the left knee-joint couldn't bend at all. Although he had many days of functional training, it couldn't get better a little. Because he was a driver originally, he had lost his ability for working since he got this illness. Then he came to me for treatment on May 20,1996.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and uneven, the tongue was dark red with a thick layer of white fur. The left knee-joint couldn't bend at all. The left popliteal fossa and the region 15cm above the superior border of the left knee cap became as hard as stone without elasticity. An operative scar which was 12cm long could be found in the lateral region of the left thigh. There wasn' t other abnormal sign.

Diagnosis: Traumatic Rigidity of Knee joint.

Differentiation: It's accumulation of blood stasis and patho-genic dampness-phlegm in the left knee-joint, which obstructed the regional meridian steadily and caused the meridian qi couldn't pass through the affected region. So that the knee-joint couldn' t bend normally. In addition, the patient had several times of 0peration,which hurted his healthy qi and blood severely. So that healthy qi and blood became so deficient that the knee joints could not be nourished effectively.

Therapeutic Principle: Invigorating qi and nourishing blood, activating blood to resolve stasis; eliminating the dampness-evil and the phlegm evil in order to dredge the obstructed meridian passage. In addition, it's necessary to apply some external drugs onto the affected region in order to remove the blood stasis, soften the sclerotic tissue and dredge the obstructed channel passage. Only by this way, could this illness be cured completely.

Recipe:

ZhiHuangQi,Moxa-prepared Milkvetch Root 25g

DangGui,Chinese Angelica Root 12g

BaiShao,White Peony Root 15g

YiYiRen,Coix Seed 30g

CangZhu, Atractylodes Rhizome 25g

GuiZhi,Cinnamon Twig 10g

DuHuo,Pubescent Angelica Root 15g

ChuanXiong,Chuanxiong Rhizome 15g

ChiShao,Red Peony Root 12g

ShuDiHuang,Prepared Rehmannia Root 25g

MuGua,Chaenomeles Fruit 12g

ShenJinCao, Club-moss 15g

SangZhi,Mulberry Twig 15g

BaiJieZi,White Mustard Seed 15g

GanCao,Liquorice Root 12g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. In the same period, he was told to apply the external drugs onto the left popliteal fossa and the region 15cm above the superior border of the left knee-cap, cover the external drugs with a layer of gauze and put a hot-water bag onto the layer of gauze to have a fomentation.

Recipe:

DingXiang, Cloves 20g

XiaoHuiXiang,Common Fennel Fruit 20g

HongHua, Safflower 30g

ChuanXiong,Chuanxiong Rhizome 30g

ChuanWu,Sichuan Aconite Root 50g

CaoWu,Wild Aconite Root 50g

All the above drugs were to be ground into fine powder. He was told to mix the powder together, add them into some 75% alcohol to make herb plaster. He should apply the plaster onto the affect region once a day. In addition, the patient was told to do functional training named as "RuFengSiBi (as if sealing and closing--one action of TaiJi). "He should do it 300 times a day in morning, afternoon and evening separately.

Effect Observation: After 5 days' treatment, the tongue became dark red with a thin layer of white fur, the pulse was uneven and thready. All these signs showed the pathogenic dampness-phlegm was removed while there was blood stasis yet. So that it's necessary to strengthen removing the blood stasis and clearing away the obstruction from the meridian.

Recipe:

ZhiHuangQi,Moxa-prepared Milkvetch Root 15g

DangGui,Chinese Angelica Root 6g

JiXueTeng,Spatholobus Stem 15g

QianNianJian, Sargentgloryvine 10g

YiYiRen,Coix Seed 15g

MuGua,Chaenomeles Fruit 8g

DuHuo,Pubescent Angelica Root 8g

ShuDiHuang,Prepared Rehmannia Root 25g

GuiZhi,Cinnamon Twig 10g

SuMu,Sappan Wood 8g

TuFuLing,Smilax Glabra Rhizome 12g

SangZhi,Mulberry Twig 8g

RuXiang, Frankincense 5g

MoYao, Myrrha 5g

GanCao,Liquorice Root 6g

All the above drugs were to be decocted in water for oral taking. 20 doses were prescribed. In the same period, applying the external drugs and doing the functional training were as before.

After 20 days of the above treatment(it took 25 days to treat the illness totally), the patient could bend his left knee-joint freely, the left knee-joint could bend more than 90¡ã. In addition, the left popliteal fossa and the 15cm long region above the superior border of the left knee-cap became as soft as normal, the elasticity renewed. The patient got the ability for working again. He could drive his car as before from Nanjing to Maanshan City. Then he was told to nurse himself well and continue doing the functional training. After 4 years' follow up, the illness didn' t recur. Then it' s ending.