History of Present Illness: Three days ago, the patient got sore throat without obvious cause. It got worse and worse progressively, accompanied with odynophagia and hoarseness. Quickly, she lost her normal voice. Then she had to go to the local policlinic for treatment. After 2 days of intravenous dripping "Benzylpenicillin," oral taking some antibiotics, and blowing "Watermelon Frost" onto the affected part, there was no obvious curative effect on her, and the illness became severer than before. Furthermore, the patient got chest distress and dyspnea, which caused she could not speak as normal. Then she came to TCM Department for treatment on July 9,1997.
Physical Examination: The patient was conscious with mouth breathing. Her lips were purple-coloured. The mucous membrane of the retropharyngeal wall became dark red and congestive. The epiglottis was congestive and swelling. Both tonsils were swelling . The pulse was thready and rapid. The tongue was red with a thin layer of white fur. There wasn't other abnormal sign.
Diagnosis: Acute Laryngitis.
Differentiation: It was caused by upward attack of exogenous wind heat, which accumulated together in the throat and then caused there appeared qi stagnation and blood stasis in the throat. It caused the functional activities of the lung qi became disorderly, then the patient lost her voice and got chest distress. Therapeutic Principle: Clearing away heat to remove toxin, dispelling pathogenic wind and expelling superficial evils. Activating blood to resolve stasis to relieve the congestion in the throat. In addition, expelling toxic materials by purgation. (In TCM, this method was called taking away the firewood from under the cauldron)
Recipe: Modified Decoction for Regulating Ascending and Descending Function and Decoction for Promoting Production of Body Fluid.
XuanShen,Scrophularia Root 15g
ShengDiHuang,Dried Rehmannia Root 12g
XiaKuCao,Prunella Spike 15g
PuGongYing,Dandelion Herb 12g
ChanYi,Cicada Slough 10g
BaiJiangCan,Batryticated Silkworm 9g
NiuBangZi,Arctium Fruit 15g
ShanDouGen,Subprostrate Sophora Root 15g
JieGeng,Platycodon Root 20g
ShuiZhi,Dried Leech 12g
JinQiaoMai,Fagopyrum Cymosum Rhizome 15g
ShengDaHuang,Raw Rhubarb 12g (to be decocted later)
All the above drugs were to be decocted in water for oral taking. 2 doses were prescribed. Hot and greasy food was forbidden during the treatment, avoiding speaking to relieve the congestion of the throat.
Effect Observation: After taking the 1st dose, the patient excreted some loose, dark and foul stool, and then the soreness of throat and hoarseness disappeared at once. The patient could speak normally, then I decreased the ShengDaHuang (Raw Rhubarb) from 12g to 6g,and told her to go on taking the 2nd dose.
