Name: Wang.

Sex: Female.

Age: 40 years.

0ccupation: A worker.

Chief Complaint: Insomnia for 8 months after artificial

abortion.

History of Present Illness: Ten months ago, the patient got an artificial abortion. 2 months later, she got insomnia, headache and dizziness. Furthermore, her leukorrhea became like strong nasal discharge. After many days' rest, the insomnia was unchanged as before, then she separately went to the local hospitals for treatment. In the past months she had been often treated with blood-nourishing drugs and mind tranqilizing drug, but there was no curative effect on her. Then she had to be treated with some sleeping pills such as "Diazepam" and "Meprobamatum. "During the period of taking the pills, she could get a half-ameliorated sleeping in the nighttime. While she got an aggravated headache with lassitude and fatigue in the daytime. Sometimes the severe headache involved her nose got an aching sensation. After many days of taking the pills, the curative effect became more and more faint. In the nighttime, she slept less than 1 hour. While in the daytime, the headache became more and more severe accompanied with lassitude and fatigue. For such reason she was often so overwhelmed with the suffering that she hardly wished to live. Then she came here for treatment on August 1.5,1996 through somebody. Since the illness came on, her appetite, urination and defecation had been all normal. There was not other complaint.

Menstrual and Obstetrical Histories : 15¡Á[(6-7)¡Â28]¡Á(1996-8-2);2-0-1-2.

Physical Examination: The patient was tired with a sallow eomplexion. Her cheeks were purplish red in colour. The pulse was thready and taut, the body of the tongue was red with a thin layer of white fur, the edge of the tongue was pale, swollen and teeth-printed. The chest and abdomen were all normal. There was not other abnormal sign.

Diagnosis: Refractory Insomnia After Artificial Abortion.

Differentiation: It's deficiency of qi and blood, disharmony between nourishing-Qi and defensive-Qi, which were all caused by the artificial abortion. As a result of it, the deficient qi couldn't control the leukorrhea's secretion as normal and then the patient's leukorhea became strong nasal discharge; the deficient blood could not support the brain's functional activities as normal and then the patient got the insomnia, headache and dizziness. In addition because there was imbalance between the defensive mechanism and the constructive mechanism, the patient was tired with a sallow complexion and the expectant therapy couldn't cure the illness easily.

Therapeutic Principle: Invigorating qi and nourishing blood; regulating nourishing-Qi and defensive Qi.

Recipe:

DangShen,Pilose Asiabell Root 30g

ZhiShouWu,Prepared Multiflower Knotweed Root 20g

ZhiHuangQi,Moxa-prepared Milkvetch Root 30g

DangGui,Chinese Angelica Root 12g

YuanZhi,Polygala Root 20g

ShiChangPu,Grassleaved Sweetflag Rhizome 20g

GuiZhi, Cinnamon Twig 15g

BaiShao,White Peony Root 20g

ShengJiang,Ginger 5 pieces

HongZao,Chinese-date 5 pieces

SuanZaoRen,Wild Jujuba Seed 15g

YeJiaoTeng,Fleece-flower Stem 15g

BaiZhu,Bighead Atractylodes Rhizome 15g

FuShen,Poria with Hostwood 20g

LongGu,Dragon's Bone 15g (to be decocted earlier)

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 patient came back for reexamination, she told me she felt more energetic than before and her spirit got better obviously, her sleeping got more smooth and steady than before, but it was less than 2 hours yet. The leukorrhea became normal. Physical examination showed the middle of the tongue was fresh red and the edge of the tongue was light red with a thin layer of white fur, her complexion became ruddy and lustrous. All these signs showed the defensive mechanism and the constructive mechanism had been effectively regulated while there were stagnation of liver-qi and stagnated heat evil in the internal organs, which flamed up and disturbed the brain's functional activities. So that the patient got the obstinate insomnia. This clinical phenomenon showed that not all the puerperant syndromes belong to the category of deficient syndrome. Then the followed therapeutic principle should be expelling heat by purgation, dispersing the stagnated liver-qi, nourishing qi and tranqilizing the mind.

Recipe:

DangShen,Pilose Asiabell Root 30g

BaiZhu,Bighead Atractylodes Rhizome 20g

FuLing, Tuckahoe 25g

HuangOin,Scutellaria Root 15g

HuangLian, Coptis Root 12g

ChaiHu,Bupleurum Root 15g

LongGu,Dragon's Bone 25g (to be decocted earlier)

MuLi,Calcined Oyster Shell 25g (to be decocted earlier)

ShengDiHuang,Dried Rehmannia Root 20g

BaiShao,White Peony Root 20g

GuiZhi,Cinnamon Twig 10g

YuanZhi,Polygala Root 10g

ShiChangPu,Grassleaved Sweetflag Rhizome 10g

ShengGanCao, Liquorice Root 10g

ShengDaHuang,Raw Rhubarb 15g (to be decocted later)

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 decoction, her sleeping became smooth and steady very much, it's more than 5 hours in every night, the headache and dizziness disappeared completely, the leucorrhea normalized. Then she was told to take some qi invigorating, blood-nourishing drugs in order to nurse herself. After 2 months' follow up, the illness didn't recur. Then it's ending.