Name: Sha.

Sex: Male.

Age: 8 years.

0ccupation: A pupil.

Chief Complaint: Dark streaks of face for 1 year and a half after being injuried.

History of Present Illness: One and a half years ago, the patient's face was injured by other boy's scratching when they were fighting. At that time the wounds were deep with more bleeding. Then the patient was sent to hospital and treated by partial debriding. 1 month later, the wounds were healed. But since then, there had been 4 black scratched streaks on his dextral face without pain and itching, the sense of the affected surfaces was normal. Then his parent led him to the department of dermatology of hospitals in Nanjing for treatment. After 1 and a half years of the above treatment, the affected surfaces were as dark as before. His parent were afraid that the sickness which damaged their son's face would affect their son's living and working in the future. Then they led their son to me for treatment on May 22,1997.

Physical Examination: The patient was conscious with a normal general condition. 4 longitudinal scratched streaks were seen on the patient' s dextral face, whose lengths were separately lcm,3cm,2cm,1.5era from the lateral part to the median part, they were all black in colour without tenderness, scar and other uncomfortable sensation. The pulse, tongue and viscera were all normal.

Diagnosis: Traumatic Facial Melanosis.

Differentiation: This disease, in TCM, belongs to the category of "MianGanZeng" (blackish patch on the face), it was caused by injury, which caused the skin and the partial meridian were damaged, so that blood stasis and stagnation of qi were caused in the affected part, then the melanin granule was accumulated in the affected part and the black spots were formed.

Therapeutic Principle: Activating qi and removing blood stasis, dispelling wind and resolving the black spots, keeping the sweat pores of the affected skin unobstructed. Because the sickness was in the partial skin and interstices, then the efficacy of oral taking decoction couldn't reach the affected part, so that it's necessary to use the external drugs.

Recipe:

GanSong, Spikenard 50g

ShanNai,Resurrection I.ily Rhizome 15g

DanShen,Red Sage Root 30g

TaoRen,Peach Seed 20g

RuXiang, Frankincense 15g

MoYao, Myrrha 15g

BaiJi, Hyacinth Bletilla 20g

BaiLian,Ampelopsis Root 20g

BaiZhi,Dahurian Angelica Root 30g

BaiJiangCan, Batryticated Silkworm 15g

BaiFuPian,Prepared Aconite Root 12g

BaiJiLi,Tribulus Fruit 30g

All the above drugs were to be ground into powder. I mixed the powder with some egg white together to make herb paste. The herb-paste should be put into icebox ordinarily. As it was used, his father was told to take a soup-ladle of the paste and put it in the indoor temperature more than 15minutes, he should wash the affected surface clean with water, apply the herb paste onto the affected surface, cover the paste with a layer of gauze and then put a hot towel onto the layer of gauze to have fomentation, he should do it more than 30minutes each time, 2 times each day.

Effect Observation: After 1 month of the above treatment, 3 streaks whose lengths were separately lcm, 2cm, 1.5cm disappeared, the colour of them became as same as normal while the streak whose length was 3cm got slightly black, its colour was darker than normal. Then the patient was told to go on the treatment. 1 month later, the longest streak disappeared too, the patient's face became as same as normal in colour. After 1 year's fo11ow-up, the sickness didn't recur. Then it's ending.