Name: Cui.

Sex: Female.

Age: 23 years.

0ccupation: A college-student.

Chief Complaint: Profuse leukorrhea with a foul smell for more than 1 year.

History of Present Illness: More than 1 year ago, the patient got profuse leukorrhea without any obvious causes, it's just like yellowish water, accompanied with a foul smell. Usually there were aching-pain and distending sensation in her lumbosatral regions and she often got lassitude and fatigue. In addition, her menstruation occurred every 28 days and usually persisted almost 15 days, it was less in amount, dark red in colour and occurred in drops with much more difficulty, but there was no blood clot in it. She had separately been to a hospital in Nanjing for treatment. After physical examination it was diagnosed as "Chronic Pelvic Inflammation," and she had been treated by many kinds of western medicine and Chinese herbs, but the syndrome couldn't be relieved effectively. Then she came here for treatment on February 20, 1998. Since the illness came on, her appetite, sleeping, urination and defecation had been all normal. There was not other complaint.

Menstrual and Obstetrical Histories: 14¡Á£¨15¡Â28£©¡Á£¨1998-2-18£©; 0-0-0-0.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and soggy, the tongue was pale with a thin layer of white fur, but the root of the tongue was covered with a greasy layer of yellow fur. The chest and abdomen were all normal. There was not other abnormal sign.

Diagnosis: Chronic Pelvic Inflammation.

Differentiation: This disease, in TCM, belongs to the category of "DaiXia"(leukorrhagia). It was caused by deficiency of spleen qi and downward flow of dampness-heat evil. The deficient spleen-qi could not normally control the leukorrhea's secreting, then the leukorrhea' s secreting could not be controlled within the normal limits and the patient then got the profuse leukorrhea; furthermore, the downward flow of dampness-heat evil directly caused the leukorrhea became like yellowish water with a foul smell. In addition, there was blood stasis in her uterus, which was clearly reflected by her abnormal menstrua-tion(The menstruation was less in amount, dark red in colour and occurred in drops with much more difficulty, they are all typical character of blood stasis in the uterus).

Therapeutic Principle: Invigorating spleen-qi and regulating the qi, activating blood to eliminate stagnation; clearing away heat evil and expelling dampness.

Recipe:

DangShen,Pilose Asiabell Root 30g

BaiZhu,Bighead Atractylodes Rhizome 15g

FuLing, Tuckahoe 18g

QiYeYiZhiHua,Windpipe Trachea 18g

ZhiHuangQi,Moxa-prepared Milkvetch Root 30g

DangGui,Chinese Angelica Root 6g

XiangFu,Nutgrass Flatsedge Rhizome 6g

LongDanCao, Gentian Root 15g

XuDuan,Teasel Root 25g

DanShen,Red Sage Root 15g

ChiShao,Red Peony Root 12g

ZhiKe,Fruit of Citron 9g

PuGongYing,Dandelion Herb 15g

BaiJiangCao, Patrinia 15g

ZhiGanCao,Prepared Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 10 doses were prescribed. She was told to oral take the 10 doses after her present menstruation. In addition, I was transferred from Nanjing to Jiangyin Hospital of TCM for another position on February 21,1998.

Unfortunately, the patient was so anxious for a quick success that she didn't take the decoction according to my advice, she took the 10 doses during her present menstrual period.

Effect Observation: When she was taking the decoction, her present menstruation disappeared quickly and the yellowish leukorrhea with the foul smell disappeared too. But 1 week later, some dark brown juice flowed out from her vagina, which was thick in texture and less in amount but occurred continuously all days. At the beginning, she took it for granted that the juice would disappeared slowly by itself. But in the next 40 days, the dark brown juice had been flowing continuously every day. At last she had to write a letter to me on May 15,1998 and phoned me on May 30,1998 in order to tell me what had happened and ask me how to do for it.

After attentive asking her condition, I thought it had been caused by the raising strength of DangShen (Pilose Asiabell Root) and ZhiHuangQi (Moxa prepared Milkvetch Root), which invigorated the qi greatly and the invigorated qi prevented her menstruation from flowing smoothly and normally because she had taken the 10 doses during her menstrual period. So that the obstructed menstruation was kept in her uterus and then there was blood stasis in the uterus. The corresponding therapeutic principle should be activating blood to resolve stasis. The prescription is Modified Decoction for Removing Blood stasis in the Chest.

Recipe:

ShengDiHuang,Dried Rehmannia Root 15g

MuDanPi,Tree Peony Bark 15g

TaoRen,Peech Seed 12g

HongHua, Safflower 12g

ChaiHu,Bupleurum Root 6g

FoShou,Finger Citron 9g

ChiShao,Red Peony Root 12g

JiaoShanZha,Prepared Hawthorn Fruit 12g

YiMuCao, Motherwort 15g

DanShen,Red Sage Root 18g

ZhiKe,Fruit of Citron 12g

ChuanXiong,Chuanxiong Rhizome 9g

DangGui,Chinese Angelica Root 10g

NiuXi,Achyranthes Root 12g

ShengDaHuang,Raw Rhubarb 9g (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, the patient phoned me and told me that the dark brown juice had disappeared completely, her menstruation and leukorrhea became all normal, there was no foul smell too. Then she was told to take pills of Red Sage Root and pills of spleen-strengthening in order to nurse herself well. After half a year's follow-up, the patient was in good health all along. Then it's ending.