Name: Xu.
Sex : Male.
Age: 42 years.
0ccupation: An officer.
Chief Complaint: Erosion and swelling-pain of feet for half a month.
History of Present Illness: Half a month ago, the patient had a strong itching sensation between his toes caused by attacking of "Tinea on Pedes. "The skin of the affected region was ulcerous and erosive due to his severe scratching. Lots of thin soaking liquid oozed out from the surface, accompanied by a foul smell, the dorsum pedis and the affected part between the toes became very swelling. Then the patient went to the local clinic and was treated by intramuscular injecting "Benzylpenicillin" and external applying "Ung. Clotriomazoli" for 1 week, but there was no obvious curative effect on him, then he was treated by intravenous dripping "Benzylpenicillin" for 1 week again, it was no effect on him either, furthermore, his feet were so severe swelling that he couldn' t wear socks and shoes. The soaking liquid continuously oozed out from the affected surface with a special foul smell. In addition, the patient had too much greasy, rich food and drinking during his illness, so that there appeared many large pieces of red maculae and strong itching on the skin of the neck, groins, lower abdomen and the medial regions of the thighs, moreover, the penis and the scrotum became severe swelling too. Then the patient came to our hospital for treatment on November 4, 1996. Since the illness came on, his appetite, urination and defecation had been all normal. But his sleeping was not smooth and steady because of the suffering from the illness. There was not other complaint.
Physical Examination: The patient was conscious with a normal general condition. The pulse was floating and taut. The tongue was red with a thin layer of white fur. Both dorsa of both feet were hill-like swelling, the affected skin between the toes was erosive, wet And soaked with some white decayed materials on it. Many irregular large pieces of red maculae were seen on the skin of neck, lower abdomen, groins and the medial regions of the thighs. The penis and the scrotum were severe swelling. There was no abnormal sign else.
Diagnosis: Tinea on Pedes(the erosive type).
Differentiation: It's caused by dampness evil and heat evil that lurked in interstices. When they gathered together, they caused the affected regions swelling. When they played their pathogenous effect, they caused the affected surface was erosive, wet and socked. In addition, YangMing hollow-organ was full of the greasy and rich food during the illness, it prevented the damp heat from being expelled in YangMing channel, and then they were transferred into the JueYin channel. So that many large pieces of red maculae appeared on the skin of lower abdomen, the penis and scrotum got swelling. (The lower abdomen, penis and scrotum are all the regions controlled by JueYin meridian)
Therapeutic Principle: Clearing away heat and tome material, inducing diuresis with bland drugs, removing the blood stasis by purgation.
Recipe :
ShengDiHuang,Dried Rehmannia Root
ZhiMu,Windweed Rhizome
CheQianCao,Plantain Herb
LongDanCao,Gentian Root
MuDanPi,Tree Peony Bark
NiuXi,Aehyranthes Root
BaiXianPi,Dittany Bark
TuFuLing, Smilax Glabra Rhizome
HuangQin,Seutellaria Root
HuangBai,Phellodendron Bark
ZeXie,Oriental Water Plantain Rhizome
ShengDaHuang,Raw Rhubarb
QinPi,Ash Bark
GanCao,Liquorice Root
HanFangJi,Fangji Root
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 1st dose, the severe itching sensation disappeared, the swelling of the affected regions mostly disappeared. The colour of the affected skin became lighter than before. After taking the 2nd dose, the illness was cured completely, then he was told to take the 3rd dose in order to remove the remnant of the damp-heat in the blood. In addition, he was told to aviod eating greasy and fat food and purify his mind and reduce his desires in order to have a good rest. After 1 month of follow-up, the illness didn't recur. Then it's ending.
