Name: Zhou.

Sex: Female.

Age: 61 years.

0ccupation: A peasant.

Chief Complaint: Swelling pain of right neck for 3 months.

History of Present Illness: Three months ago, the patient got a swelling-pain in her right neck without obvious cause. She took some anti inflammatory medicines by herself, but there was no effect on her. Furthermore, the swelling pain got worse and worse, it prevented her from holding up the right arm, and the right cheek got swollen severely, so that it's difficult for her to speak, chew and turn her head. The movement of raising and lowering her head could aggravate the swelling-pain. Then she separately went to some local hospitals for treatment. During almost 3 months' treatment, she was treated with intravenous dripping some antibiotic drugs and oral taking some Chinese herbs, but the swelling pain couldn' t be relieved yet. Meanwhile there was a toruloid node with a sharp tenderness on the right neck near the right ear. Then she came to me for treatment on November 20,1998 through somebody. In the past 5 years, the patient got a same illness in every autumn. As a rule, it must take 1 and a half months to have intravenous dripping some antibiotic drugs to relieve it. Usually she had a good appetite, urination, defecation and sleep. There was not other complaint.

Physical Examination: The patient was conscious with a painful complexion. The right cheek was swelling, if touched upon, there was tenderness. The right mastoid lymph nodes were swelling with sharp tenderness too, they were toruloid in size and tenacious in texture. The movement of the head and neck was limited. The pulse was taut and uneven. The tongue was red with a thin layer of yellow fur. There was not other abnormal sign.

Diagnosis: Chronic Lymphnoditis.

Differentiation: This disease, in TCM, belongs to the category of "TanDu" (syndrome caused by phlegm-evil). It's entangle ment of the wind-heat and the phlegm-heat, which accumulated in the ShaoYang meridian and caused the stagnation of qi and blood stasis. So that the toruloid node was caused.

Therapeutic Principle: Activating blood to resolve stasis; eliminating the pathogenic phlegm and exterminating the hardness, clearing away heat to remove toxin. In addition, it's necessary to apply some external drugs onto the affected region to soften the mass and resolve the swelling, dredge the obstructed meridian.

Recipe:

ShengDiHuang,Dried Rehrnannia Root 18g

MuDanPi,Tree Peony Bark 12g

BanBianLian,Radical Lobelia 18g

BanZhiLian,Barbat Skullcap 18g

LianQiao,Forsythia Fruit 10g

GeGen, Pueraria Root 10g

YeJuHua,Mother Chrysanthemum 20g

RenDongTeng, Honeysuckle Stem 25g

ShuiZhi, Leech 5g

JiangHuang,Turmeric Rhizome 15g

ChanYi, Cicada Slough 12g

DiLong, Earthworm 18g

BaiJiangCan,Batryticated Silkworm 15g

GuiZhi,Cinnamon Twig 10g

ShengDaHuang,Raw Rhubarb 12g (to be decocted later)

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. Greasy and hot food was forbidden. In the same period, she should apply the external drugs onto the affected region.

Recipe:

ShengDaHuang, Raw Rhubarb

SheXiang, Musk

HuangLian, Coptis Root

ChanSu, Toad Venom

BingPian, Borneol

Xi0ngHuang, Realgar

(Each herb was taken just the proper amount.)

All the above drugs were to be ground into powder, she should mix the powder together and add them into some white vinegar and honey to make herb-plaster, applying some plaster onto the affected region, once a day.

Effect Observation : After 1 day' s treatment, the swelling-pain was relieved greatly. After 2 days' treatment, the toruloid nodes disappeared. After 3 days' treatment, there wasn't swell on the right cheek any more. After 5 days' treatment, the sickness was cured completely. The movement of her head and neck was freely. She could speak and chew normally. After 1 year' s follow-up, the sickness didn' t recur. Then it' s ending.