Name: Wang.

Sex: Female.

Age: 32 years.

0ccupation: A worker.

Chief Complaint: Dry mouth and vexation for 2 and a half years.

History of Present Illness: Two and a half years ago, the patient got dry mouth without any obvious causes. It caused he didn't dare speak to other ones, otherwise he would feel his mouth was severely dry and rough as if the tongue would be cracked. Then he was often annoyed at it. He could be vexed by some trivialities easily. Meanwhile, he didn' t want to drink water. In addition, he usually got bad sleeping. In the past years, he had gotten many kinds of lab tests from the local hospitals. The results of relative hormones were all in normal limits. Then he went to local hospitals for treatment. The asked doctors treated his illness with heat-clearing, dampness-eliminating and Yin nourishing therapy, but all treatments could not be effective against his illness. Furthermore, the illness became worse and worse in recent half a year, the patient became indifferent and lost interest in everything, he was used to standing lonely and sick of social intercourse, he could hardly say a word all a day due to the severe dry mouth, additionally he was often irritated unaccountably. Then he came to our hospital for treatment on october 7,1998 through somebody. After the illness came on, the appetite, urine and stool were all normal, but be got bad sleeping, which was full of dreaminess throughout night. There was not other complaint.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and uneven. The tongue was red with a thin layer of white fur. There was not other abnormal sign.

Diagnosis: Melancholia.

Differentiation: It's retention of blood stasis in the interior and a failure of the qi to take charge in distributing the clear fluid all over the body normally. So that the thin and clear body fluid couldn't be distributed upward and the mouth and tongue couldn't be moistened effectively as normal. Then the patient got dry mouth without thirst. The original doctors didn't recognize the syndrome correctly, and treated the illness incorrectly with heat-clearing, dampness-eliminating and Yin-nourishing therapy. It was just like what a set phrase said "try to go south by driving the chariot north--act in a way that defeats one's purpose. "So their treatments ended in failure.

Therapeutic Principle: Activating blood to resolve stasis; nurishing qi and relieving stagnation.

Recipe: Modified Decoction of Removing Blood Stasis in the Chest Formulated by Wang Qingren.

ShengDiHuang,Dried Rehmannia Root 15g

MuDanPi,Tree Peony Bark 12g

DangGui,Chinese Angelica Root 9g

ChuanXiong,Chuangxiong Rhizome 6g

TaoRen,Peach Seed 9g

ZhiKe,Fruit of Citron 5g

ChaiHu,Bupleurum Root 6g

ZhiHuangQi,Moxa-prepared Milkvetch Root 30g

DangShen,Pilose Asiabell Root 30g

ChiShao,Red Peony Root 8g

H0ngHua, Safflower 8g

NiuXi,Achyranthes Root 9g

ZhiZi,Capejasmine Fruit 6g

HuangLian,Coptis Root 5g

ShiChangPu,Grassleaved Sweetflag Rhizome 9g

YuanZhi,Polygala Root 12g

ShengGanCao,Raw I.iquorice Root 6g

All the above drugs were to be decocted in water for oral administration. He was told to take 5 doses of the above prescription. Greasy and hot food was forbidden during the treatment.

Effect Observation: After taking the 5 doses, he came back for reexamination on October 13,1998. He told me dry month had been relieved greatly, vexation disappeared, he could have a talk with somebody for half an hour, but there were chest distress and shortness of breath. All these signs showed that the blood stasis had been removed greatly while qi in middle Jiao was deficient yet. So that the next therapeutic principle should be activating blood to resolve stasis, invigorating qi and soothing the chest oppression. Recipe :

ShengDiHuang,Dried Rehmannia Root 15g

MuDanPi,Tree Peony Bark 6g

DangGui,Chinese Angelica Root 9g

ChuanXiong,Chuanxiong Rhizome 9g

TaoRen,Peach Seed 9g

ChaiHu,Bupleurum Root 8g

ShengHuangQi,Raw milkvetch Root 25g

DangShen,Pilose Asiabell Root 30g

ChiShao,Red Peony Root 8g

YuanZhi,Polygala Root 12g

ShiChangPu,Grassleaved Sweetflag Rhizome 15g

QuanGuaLou,Trichosanthes Fruit 18g

DanShen,Red Sage Root 15g

TanXiang, Sandalwood 8g

ZhiGanCao,Prepared Liquorice Root 9g

All the above drugs were to be decocted in water for oral administration. He was told to take 5 doses of the above prescription. Dietetic restraint was idem. In the same period, he was t01d to take the bolus for strengthening middle Jiao and benefiting qi, 8g a time,3 times a day.

After taking the 5 doses, the patient came back for reexamination on October 20,1998. He told me the chest distress and shortness of breath disappeared while there were dizziness and dry mouth sometimes. The tongue was red with a thin layer of white fur, the pulse was taut and thready. There was not other uncomfortable sensation. All these signs indicated there was interior-beat and the clear body fluid was still deficient. Then it's necessary to change the recipe in order reinforce the curative effect. Recipe :

ShengDiHuang,Dried Rehmannia Root 30g

XuanShen,Scrophularia Root 25g

MaiDong,Ophiopogon Root 25g

GeGen,Pueraria Root 10g

WuMei,Black Plum 20g

JieGeng, Platycodon Root 15 g

DangShen,Pilose Asiabell Root 30g

TaoRen,Peach Seed 12g

ChiShao,Red Peony Root 15g

DanShen,Red Sage Root 20g

HuangLian,Coptis Root 12g

ZhiZi,Capejasmine Fruit 10g

ZhiMu,Windweed Rhizome 12g

ShengGanCao,Raw Liquorice Root 10g

ChuanXiong,Chuanxiong Rhizome 15g

All the above drugs were to be decocted in water for oral administration. He was told to take 5 doses of the above prescription, taking the bolus for strengthening middle-Jiao and benefiting qi continuously.

After taking the 5 doses, the patient came back to express his thanks to me, he told me the dizziness and dry mouth disappeared, he could have a long talk with his friends or his family members as normal as before. After half a year's follow up, the patient was in good health all along, the illness didn't recur. Then it' s ending.