Name: Zhang.

Sex: Female.

Age: 21 years.

0ccupation: A college-student.

Chief Complaint: Red maculae and strong itching of whole body for 3 days.

History of Present Illness: Three days ago, the patient got many large pieces of red maculae and itching sensation on the skin of whole body without any obvious causes, there were many groups of crowded papules in the affected region. At the beginning, they appeared only on the skin of both hands and arms, quickly they extended the affected regions to the head, neck, trunk and the back, accompanied with strong itching sensation. Then the patient went to the local clinic and was treated by 2 kinds of drug named as "Tabellae Astemizoli" and "Prednisone Acetate Tablets. " After 3 days' treatment, there was no effect on her. The regions of the red maculae became more and more than before, the colour of the affected skin got darker and darker, the itching sensation was too severe for her to bear. Then she came to our hospital for treatment on September 5,1997. After the illness came on, her appetite, urination and defecation were all normal, but she got a bad sleeping because of the strong itching. There was not other complaint.

Physical Examination: The patient was conscious with a normal general condition. The pulse was floating and rapid, the tongue was red with a thin layer of white fur. There were many large pieces of red maculae on the skin of whole body, in which there were many groups of crowded papules. The papules were all corn-sized. There wasn't blister or erosion in the affected regions. There was not other abnormal sign.

Diagnosis: Eczema.

Differentiation: It's caused by exogenous wind-heat, which attacked the body from exterior and tangled with the endogenous damp-heat and then accumulated together under the skin. So that the blood stasis was formed under the skin and the blood stasis caused the red maculae and papules all over the body. As for the strong itching, it was directly caused by wind getting into the blood.

Therapeutic Principle: Cooling the blood and activating blood, dispelling wind and expelling superficial evils. Clearing away heat and removing the blood stasis by purgation.

Recipe:

ShengDiHuang,Dried Rehmannia Root 15g

MuDanPi, Tree Peony Bark 15g

ShanZhi,Capejasmine Fruit 12g

HuangLian,Coptis Root 9g

TaoRen,Peach Seed 8g

ShuiZhi,Dried Leech 5g

BaiXianPi,Dittany Bark 15g

DiGuPi,Wolfberry Bark 9g

FangFeng,Ledebouriella Root 10g

ChanYi,Cicada Slough 10g

YeJuHua, Mother Chrysanthemum 12g

JingJieSui,Schizonepeta Spike 9g

GanCao,Liquorice Root 6g

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

BoHe,Peppermint Herb 10g (to be decocted later)

All the above drugs were to be decocted in water for oral taking. 3 doses were prescribed. Hot and greasy food was forbidden during the treatment.

Effect Observation: After taking the decoction, the strong itching sensation was relieved greatly, most of red maculae and papules on the skin of head, neck, chest, back and both hands and arms all disappeared. But the affected skin of lower abdomen, groins and both legs was as same as before. It showed that wind was mostly expelled while damp-heat attacked lower-Jiao. Then it was necessary to induce diuresis, eliminate the dampness-evil inthe lower-Jiao and remove blood stasis by purgation.

Recipe :

ShengDiH uang, Dried Rehmannia Root 15 g

ZhiMu,Windweed Rhizome 12g

ShanZhi,Capejasmine Fruit 9g

LongDanCao, Gentian Root 15g

HuangQin,Scutellaria Root 10g

HuangBai,Phellodendron Bark 10g

FuLing, Tuckahoe 12g

BaiXianPi,Dittany Bark 12g

CangZhu, Atractylodes Rhizome 12g

HuaShi, Talc 15g

QinPi,Ash Bark 12g

ChiXiaoDou,Red Bean 12g

MuDanPi, Tree Peony Bark 15g

ShengDaHuang,Raw Rhubarb 10g (to be decocted later)

All the above drugs were to be decocted in water for oral taking. 3 doses were prescribed. Hot and greasy food was forbidden during the treatment.

After taking the decoction, the affected skin of lower abdomen, groins and legs became as same as normal. After half a month of follow-up, the illness didn' t recur, then it' s ending.