Name: Wang.

Sex: Male.

Age: 7¡Á£¨8¡Â12£©years.

0ccupation: A pupil.

Chief Complaint: Redness of dextral eye for half a month.

History of Presint Illness: Half a month ago, the patient's dextral eye became red suddenly, accompanied with high fever and chill. It's not followed by photophobia and lacrimation. There were unsmooth and dry sensation of the dextral eye with much secretion. Then he was led to the local policlinic and then was treated by intramuscular injecting "Benzylpenicillin" and using the "eye drops of anti inflammatory, chlorotetracycoline eye ointment" for 1 week. The chill and high fever disappeared, but the dextral eye remained red as before. Then he was sent to hospital in Nanjing for treatment, the hospital ' s treatment was just like before. After 1 week's treatment, there was no effect on the eye. Then his mother led him to our hospital for treatment on June 22,1996.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready, floating and rapid. The tongue was fresh red with a thick layer of white fur. The lateral part of the dextral eye was severely congestive and fresh red in colour, where there were some congestive radial intersticess. In addition, there were some grey-yellow miliary nodes which were all various-sized on the bulbar conjunctiva and the edge of the cornea. There wasn't other abnormal sign.

Diagnosis: Herpetic Conjunctivitis.

Differentiation: It belongs to the category of "JinGan" (follicular conjunctivitis) in TCM. It was caused by attack of exogenous wind-heat, which got into the meridian, and caused liver failed to bear the dipersive effect, so that the stagnated pathogenic fire which flamed upwards to the eye was caused. In Western medicine, it belongs to the category of delayed allergic reaction.

Therapeutic Principle: Relieving the superficies syndrome with pungent flavored and cool-propertied herbs, expelling wind and clearing away heat, cooling blood and eliminating toxic material.

Recipe:

ShengDiHuang,Dried Rehmannia Root 15g

ZhiMu,Windweed Rhizome 5g

HuangLian,Coptis Root 4g

HuangQing,Scutellaria Root 5g

LongDanCao,Gentian Root 6g

CheQianZi,Plantian Seed 8g

JueMingZi,Cassia Seed 8g

Boric,Peppermint Herb 8g (to be decocted later)

ChanYi,Cicada Slough 8g

FuLing, Tuckahoe 10g

YinChen,Oriental Wormwood 6g

ShengGanCao,Raw Liquorice Root 6g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. Greasy and hot food was forbidden.

Effect Observation: After taking the decoction, the military nodes on the bulbar conjunctiva and the edge of the cornea disappeared, the red eye got better than before. But the pulse remained thready and deep, the tongue was dark red with a thick layer of white fur. All the signs showed that the pathogenic heat had been eliminated greatly, but the remnant of the pathogenic heat lurked in the blood and was waiting for an opportune moment to go into action. So that it's important to reinforce clearing away the pathogenic heat and toxic material, expelling dampness and promoting diuresis. Then 10g of ChiXiaoDou (Red Bean), 10g of TuFuLing (Smilax Glabra Rhizome) and 10g of CangShu(Atractylodes Rhizome) were used instead of 6g of YinChen(Oriental Wormwood) and 10g of FuLing(Tuckahoe) in the original recipe, and I told them to take 3 doses of this recipe continuously. But the boy's mother was a nurse, who knew about medical theory superficially, she took it for granted that the remnant of the evil would disappeared by themselves without using the recipe because the evils had been mostly eliminated. Then she didn't take the 3 doses of the changed recipe.

In the next daybreak, the patient got a sudden high fever, and the both eyes became red. Then he was quickly sent to a hospital of Jiangsu province, and was treated by taking drugs of anti-inflammatory, dripping "Guttae Kanamycini Sulfatis" and "erythromycin eye ointment. "After 2 days' treatment, the high fever disappeared while both eyes remained red, then his mother led him to me again for treatment. After physical examination, the pulse and the tongue were as before. Then the treatment should be as before, but it's necessary to reinforce elimilating toxic material and dampness evil and promoting diuresis.

Recipe:

ShengDiHuang,Dried Rehmannia Root 15g

ZiCao,Arnebia Root 10g

HuangQing,Scutellaria Root 8g

YeJuHua, Mother Chrysanthemum 15g

QinPi,Ash Bark 10g

BoHe,Peppermint Herb 12g (to be decocted later)

LianQiao,Forsythia Fruit 12g

JueMingZi,Cassia Seed 12g

ChanYi,Cicada Slough 10g

CangZhu,Atractylodes Rhizome 10g

ChiXiaoDou,Red Bean 12g

CheQianZi,Plantian Seed 12g

TuFuLing,Smilax Glabra Rhizome 8g

LongI)anCao,Gentian Root 8g

ShengGanCao,Raw Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. Hot and greasy food was forbidden.

After taking the decoction, the both eyes became bright as normal. The pulse was normal. The tongue was light red with a thin layer of white fur. After 1 week's follow-up, the sickness didn't recur. Then it's ending.