Name: Zhang.

Sex: Male.

Age: 22 years.

Occupation: A college student.

Chief Complaint: Red maculopapules and strong itching of whole body after having a bath for half a year.

History of Present Illness: Half a year ago, the patient got many pieces of maeulopapules all over the body after having a bath, accompanied with strong itching sensation. The maculo-papules' shapes varied, the big ones looked like coins, the small ones were like mung beans. They were all dark red in colour. At the beginning of the illness, they're mostly restricted to the chest, the back, limbs and both sides of groins. After the treatment of using the " VitC, VitBco, Chlor-trimeton and Tabellae Astemizoli" in local polielinic, not only the symptom was not relieved but also the maculopappules extended the affected region to all the patient's body after the patient had a bath, accompanied with strong itching-sensation. Then he came to me for treatment on June 30,1997. After the illness came on, he kept his appetite, sleeping, urination and defecation normal all along. There was not other complaint.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and soggy. The tongue was dark red with a thin layer of white fur. Under normal eondition,the skin all over the body was normal. There was not other abnormal sign.

Diagnosis: Chronic Urticaria.

Differentiation: It' s called "YinZhen" ( hidden eruption) in TCM. It's caused by exogenous wind-heats, which hid into interstices and accumulated together in the middle Jiao. Then as a result of act from inside in coordination with evils attacking from outside, this sickness became intractable. Under normal condition, the skin and interstices was close so that the lurked evilc0uld not play its pathogenous effect, when the patient was having a bath, the skin and interstices was open in a warm environment so that the lurked evil could play its pathogenous effect. This is the reason why the illness must come back after having a bath.

Therapeutic Principle: Simultaneous appearance of pathogenic factors from the exterior and interior, inducing diaphoresis and relieving superficies to expell the evils which lurked in interstices; purging to expell the evils which :cumulated in the middle-Jiao.

Recipe: Miraculous Bolus of Ledebouriellae.

FangFeng,I.edebouriella Root 15g

JingJie, Schizonepeta 15g

LianQiao,Forsythia Fruit 15g

MaHuang, Ephedra 15g

BoHe,Peppermint Herb 15g

ChuanXiong,Chuanxiong Rhizome 15g

DangGui,Chinese Angelica Root 15g

BaiShao,White Peony Root 15g

BaiZhu,Bighead Atractylodes Rhizome 15g

JiaoZhiZi,Parched Capejasmine Fruit 15g

JiuDaHuang,Rhubarb (fried with spirit) 15g

MangXiao, Mirabitite 15g

ShengShiGao, Gypsum 30g

HuangQin,Scutellaria Root 30g

JieGeng,Platycodon Root 30g

HuaShi, Talc 50g

GanCao,Liquorice Root 30g

The above drugs were ground together into powder and mixed with water to make pills. 6g of pills were taken each time, 3 times a day. Greay and fat food was forbidden during the treatment.

Effect Observation: After 6 days of the above treatment, the maculopapules couldn't appear after the patient had a bath. Then the patient was told to take all the pills. After half a year of fo11ow-up, the sickness didn't recur. Then it's ending.