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7. Pigmentary Degeneration of Retina

Name : Zhou.

Sex: Female.

Age: 21 years.

Occupation: A college-student.

Chief Complaint: Night blindness for 15 years.

History of Present Illness: Fifteen years ago, the patient could scarely see things after it's in the dusk without any obvious causes. When it was in the dusk, the things in the distance could be seen approximately with difficulty; but the things around her couldn't be seen at all. While in the daytime or in strong light, she could seen things clearly. In the past 15 years, she got innumerable treatment, usually she was treated with "VitA, VitD, sheep' s liver, pig' s liver" and "bolus of six drugs including Rehmannia" and so on, but there was no obvious effect on her. In the recent 3 years, her night blindness got worse and worse, so that she couldn't see anything in the dark, even someone was nearing her, she couldn't see it either. Then she came here for treatment on December 20,1996.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and soggy. The tongue was pale, tender and teeth-printed with whitish fur. The complexion was pale, the eyes were lusterless. There wasn't other abnormal sign.

Diagnosis: Pigmentary Degeneration of Retina.

Differentiation: It belongs to the category of "Gao Feng Que Mu"(pigmentary degeneration of retina with the pupil golden in color) in TCM. It's deficiency of innate essence, which caused the deficiency of spleen-Yang and kidney Yang.

Therapeutic Principle: Warming and reinforcing kidney-Yang and spleen-Yang; invigorating spleen qi and eliminating patho-genic dampness.

Recipe:

DangShen,Pilose Asiabell Root 30g

BaiZhu,Bighead Atractylodes Rhizome 25g

FuLing, Tuckahoe 15g

ZhiFuZi,Prepared Aconite Root 6g

GanJiang,Dried Ginger 6g

ShanYao,Chinese Yam Rhizome 20g

YiYiRen,Coix Seed 20g

TuSiZi,Dodder Seed 30g

CangZhu,Atractylodes Rhizome 30g

ShaYuanZi,Flatstem Astragalus Seed 20g

JueMingZi,Cassia Seed 25g

GouQiZi,Wolfberry Fruit 25g

ZhiGanCao,Prepared I.iquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 10 doses were prescribed. Cold and greasy food was forbidden during the treatment.

Effect Observation: After taking the 10 doses, the patient told me she could see things clearer than before in the dusk, but she couldn't see the adjacent things very clearly in dark. After physical examination, the pulse was deep and thready, the tongue was pale and tender with a thin layer of white fur. All these signs showed that the pathogenic dampness had been eliminated mostly, the deficienty of spleen got better slowly, while kidney Yang remained deficient. Then the followed therapeutic principle should be to strengthen reinforcing kidney-Yang, invigorating qi and activating blood. So that the deficiency in interstices resulting from a long term of illness could be nourished well.

Recipe :

ShengHuangQi,Raw Milkvetch Root 30g

DangGui,Chinese Angelica Root 10g

HongHua, Safflower 12g

ChuanXiong,Chuanxiong Rhizome 20g

DanShen,Red Sage Root 15g

TaoRen,Peach Seed 15g

BaJiTian, Morinda Root 20g

GouQiZi,Wolfberry Fruit 25g

TuSiZi,Dodder Seed 20g

ShanYuRou, Dogwood Fruit 15g

ShuDiHuang,Prepared Rehmannia Root 15g

ShanYao,Chinese Yam Rhizome 15g

CangZhu,Atractylodes Rhizome 20g

RouGui, Cinnamon Bark 10g

ZhiGanCao,Prepared Liquorice Root 6g

All the above drug were to be decocted in water for oral taking. 25 doses were prescribed. Dietetic restraint was idem.

After taking the decoction, the tongue got red with a thin layer of white fur, she told me she could see things clearly in the dusk, especially the things around her could be seen clearly, she could have a walk in the dusk by herself. In order to keep a long time of curative effect, then I told her to take 5 doses of the above prescription, and grind the drugs into powder, taking the powder 5g each time,3 times a day. In the same period, she should take bolus of six drugs including Rehmannia. After 1 year's follow-up, the sickness didn't recur. Then it's ending.

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