Case 1

Name:Yao.

Sex: Female.

Age: 63 years.

0ccupation: A peasant.

Chief Complaint: Dizziness, numbness of shoulders and aching-pain of waist and knee-joints for more than 20 years.

History of Present Illness : More than 20 years ago, the patient slowly got dizziness, numbness of shoulders and an aching pain of waist and knee joints without any obvious causes. At the beginning, she thought it was maybe caused by overworking, then she went to the local clinic and was separately treated by acupuncture, massage and resting, the illness could be relieved within a short time, several days later it would come back soon, furthermore, the symptoms slowly became more and more serious. Then she went to a hospitals in Changzhou City for treatment. Through roentgenogram examination, the illness was confirmed as "Cervical Spondylosis; Retrograde Affection of Lumbar Vertebraes and Knee joints. "She then was treated with acupuncture, massage, traction and Chinese herbs. The symptoms became sometimes mild and sometimes serious, sometimes it could be aggravated by weather changing or over-working, but the aggravated symptoms could be relieved soon under the above treatment. In the recent 5 years, the dizziness occurred frequently, accompanied with a progressively aggravated numbness of shoulders, which sometimes got so severe that she felt her shoulders were too limp to hold up, it's difficult for her to put on clothes or comb her hair. Only under someone's assisting, could such daily action be finished. In addition, she got an aching pain in her waist and knee-joints, which caused she got a sensation of rigidity, aching and heaviness in her waist and legs when she walked about. For such reason, she usually dare not bend forward or backward. In the recent years, the curative effect of the above treatment became more and more faint. Then she was treated with some western medicine such as "Brufen, Ibuprofen, "but the symptoms couldn't be relieved yet. Then she came here for treatment on December 12, 1999 through somebody. After the illness came on, her urination, defecation and appetite, sleeping were all normal. There wasn't other complaint.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready, deep and uneven, the tongue was light red with a thin layer of white fur. There was muscular tension in the shoulders and the back of neck. There was fixed tenderness in the cervical vertebras. There was percussion pain in the lumbosacral portion. Bending and straightening of knee-joints were all limited. There wasn't other abnormal sign.

Roentgenogram Examination: The X ray films showed there were spurs of the 3rd to the 6th cervical vertebras, each affected intervertebral space became more narrow than normal; there were spurs of the 2nd to the 4th lumbar vertebras; there were spurs of the both tibial plateaus and the both entocremial parts. All these signs indicated there were cervical spondylosis, retrograde affection of lumbar vertebraes and knee-joints.

Diagnosis: ¢Ù Cervical Spondylosis. ¢Ú Osteophytosis of Lumbar Vertebraes and Knee-joints.

Differentiation: It's deficiency of kidney which caused there was a failure of kidney to control the bone' s normal growing, the bone couldn't be nourished well and the spurs were formed. The spurs prevented the meridian qi from flowing through the affected regions, then there were blood stasis and stagnation of qi in the affected regions. So that the movement of the affected 0ints was limited and the patient got the sensation of aching, heaviness and rigidity in the affected regions. Furthermore. The cervical spurs pressed the cervical blood vessels and prevented the blood from flowing upward to the brain, then the brain couldn't be nourished well as normal, as a result of it, the patient got a continuous dizziness.

Therapeutic Principle: Nourishing kidney in order to strengthen the bone, activating blood to resolve stasis, dredging the obstructed channel and keep the channel unobstructed.

Recipe:

QiangI.ang, Dung Beetle 5g

ShuiZhi, I.eech 5g

JiuXiangChong, Aspongopus 15g

DiBieChong,Ground Beetle 5g

XuDuan,Teasel Root 90g

NiuXi,Achyranthes Root 30g

guSuiBu,Drynaria Rhizome 90g

JiXueTeng,Spatholobus Stem 80g

ZhiHuangQi,Moxa-prepared Milkvetch Root 150g

DangGui,Chinese Angelica Root 60g

ShouWuTeng,Fleece-flower Stem 80g

QianNianJian, Sargentgloryvine 80g

ShuDiHuang,Prepared Rehmannia Root 60g

YiYiRen,Coix Seed 30g

BaiBianDou, Hyacinth Bean 30g

ZiRanTong,Calcined Pyrite 20g

DiLong, Earthworm 15g

BaiJiangCan, Batryticated Silkworm 15g

SangZhi,Mulberry Twig 60g

GuiZhi,Cinnamon Twig 50g

QiangHuo,Notopterygium Root 40g

GaoBen,Ligusticum Root 50g

All the above drugs were to be ground into fine powder, filling some large-sized capsules with the powder sepe. She was to1d to take 5 pieces of the capsules each time,3 times a day in morning, afternoon and evening separately, fat and greasy food was forbidden during the treatment.

Effect Observation: After half a month of the above treatment, all the symptoms were all relieved greatly, the dizziness was greatly relieved, the numbness of shoulders disappeared, the movement of waist and knee joints wasn't limited, there wasn't the sensation of rigidity, aching and heaviness in the legs. After 1 month' s treatment, all the symptoms disappeared. Then she was told to continue taking the

capsules in order to keep a long curative effect. After 1 year's

fo11ow-up,the illness didn't recur. Then it's ending.

Case 2

Name: Hua.

Sex: Female.

Age: 49 years.

0ccupation: A peasant.

Chief Complaint: Pain of lumbosacral portion for half a month.

History of Present Illness: Half a month ago, the patient got a pain in the lumbosacral portion without any obvious causes. It' s a severe prickling-like pain and caused she dare not turn over on bed, bend the waist forward or backward. In addition, she usually felt there was a sudden lightning pain radiating to the buttocks. Then she went to the local hospital and was treated with oral taking analgesic agent for half a month, the pain remained unchanged. Then she came to our hospital for treatment on June 20,1999. After the illness came on, her sleep, appetite, urine and stool were all normal all along. There wasn't other complaint.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and uneven, the tongue was red with a thin layer of white fur. The chest and the abdomen were all normal. There was percussion pain in the lumbosacral portion. The raising test of the straight-leg on both sides showed positive. There wasn't other abnormal sign.

Roentgenogram Examination: The X-ray film showed there were spurs of superior borders of the 2nd to the 4th lumbar vertebraes. It indicated there was retrograde affection of the lumbar vertebraes.

Diagnosis: Osteophytosis of Lumbar Vertebrae.

Differentiation : It' s deficiency of kidney-qi, which caused there was a failure of kidney to control the bone's normal growing, and the bone couldn't be nourished well and the spurs were formed. In addition, the spurs obstructed the meridian qi' s passage. As a result of it, there were blood stasis and stagnation of qi, which caused the patient got the severe prickling-like pain.

Therapeutic Principle: Activating blood to resolve stasis; nourishing kidney in order to strengthen the bone; neurishing qi and nourishing blood, dredging the obstructed channel passage.

Recipe:

ZhiHuangQi, Moxa-prepared Milkvetch Root 30g

DangGui,Chinese Angelica Root 12g

RuXiang, Frankincense 10g

MoYao, Myrrha 10g

HongHua, Safflower 10g

TaoRen,Peach Seed 15g

GouJi,Cibot Rhizome 18g

XuDuan,Teasel Root 25g

NiuXi,Achyranthes Root 18g

WuShaoShe,Black tail Snake 15g

ShuDiH uang, Prepared Rehmannia Root 15 g

BaiShao,White Peony Root 15g

HuangLian,Coptis Root 6g

HuangQin,Scutellaria Root 6g

ShengGanCao,Raw Liquorice Root 9g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed.

Effect Observation: After taking the decoction, the patient came back on June 28, 1999 for reexamination. She told me the pain was relieved greatly after she took the 1st dose, it disappeared at all after she took the 5th dose. Now she could bend her waist forward or backward freely. Then she was told to take 3 doses of the above prescription once more, grinding all the herbs into powder and mixing the powder with some water together to make pills. In order to keep a long term of curative effect, she should take 6g of the pills each time, 3 times a day.

After half a year's follow up, the illness didn't recur. Then it's ending.

Case 3

Name: Lu.

Sex: Female.

Age: 41 years.

0ccupation: A worker.

Chief Complaint: Pain of left knee-joint for 1 year.

History of Present Illness: One year ago, the patient got a pain in the left knee-joint without any obvious causes. At the beginning, it occurred mostly during the overcast or raining days. At last it became a constant pain, which affected her normal walking. Sometimes the severe pain prevented her standing for a long time. Sometimes she couldn't freely bend the left knee joint because of the severe pain. She had been to local hospitals for treatment. After taking "Ibuprofen, Pills for strengthening the bones and the joints "and "Oral liquid for treating wind-dampness syndrome," there was not obvious curative effect on her. The pain was as same as before, she couldn't freely bend her left knee yet. Then she came here for treatment on May 4,1996.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and uneven, the tongue was light red with a thick layer of white fur. Bending and straightening the left knee-joint were all limited. There was not tenderness in the affected region. There was not other abnormal sign.

Roentgenogram Examination: The X ray film showed there were spurs of the left tibial plateau and the left entocremial part.

Diagnosis: Osteophytosis of Left Knee joint.

Differentiation : It' s deficiency of kidney qi, which caused there was a failure of kidney to control the bone' s normal growing, then the bone couldn't be nourished well and the spurs were formed. The spurs caused the blood stasis and the stagnation of qi in the affected part. In addition, the exogenous cold-dampnesss took advantage of this chance and got into the affected region. Then the patient got the knee joint pain, which was always aggravated easily by overcast and raining weather.

Therapeutic Principle: Nourishing kidney in order to strengthen the bone, warming the channel in order to eliminate the cold evil, activating blood to resolve stasis, invigorating spleen and eliminating the dampness evil.

Recipe :

RuXiang, Frankincense 8g

MoYao, Myrrha 8g

ZhiChuanWu, Prepared Sichuan Aconite Root 5g (to be decocted earlier)

ZhiCaoWu, Prepared Wild Aconite Root 5g (to be decocted earlier)

XuDuan,Teasel Root 15g

NiuXi,Achyranthes Root 20g

GuSuiBu, Drynaria Rhizome 15g

YiYiRen,Coix Seed 30g

CangZhu,Atractylodes Rhizome 20g

HongHua, Safflower 12g

TaoRen,Peach Seed 12g

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.

Effect Observation: After taking the decoction, the pain of left knee was relieved greatly, she could bend and straighten the left knee-joint freely. Then she was told to continue taking 5 doses of the above prescription in order to consolidate the curative effect. After half a year' s follow up, the illness didn' t recur. Then it' s ending.