Name: Lü.

Sex: Female.

Age: 49 years.

0ccupation: A peasant.

Chief Complaint: Difficulty in opening eyes for 2 months, abdominal pain for half a year, intermittent diarrhea for 1 year.

History of Present Illness: One year ago, the patient got an intermittent diarrhea without any obvious causes, it occurred 4 or 5 times a day, the stool was loose and formless. After many times of treatment in the local policlinic, it became sometimes mild and sometimes severe, and was usually aggravated by catching a cold or overexertion. Half a year ago, she got a paroxysmal abdominal pain, which was followed by an immediate diarrhea. Furthermore she often felt very weak. 2 months ago, she couldn' t open her eyes, accompanied with frequent dizziness. Especially in every morning, she felt aching-pain in her forehead, it seemed that her upper eyelids were weightier than one thousand jin, so that it was difficult for her to open the eyelids. Only by someone's rubbing, could the eyes be opened with a great difficulty. When the eyes were opened, she could see the things around her with narrowing eye. In the past 2 months, she got several times of treatment from several hospitals, but there was no effect on her at all. Then she came to our hospital for treatment on October 12,1998 through somebody. 1 and a half years ago, she got menopause already. Since the illness came on, her appetite and sleeping had became worse than before, the urination was normal all along. There wasn't other complaint.

Physical Examination: The patient was conscious with a weak general condition. The pulse was thready and uneven, the tongue was dark red with a thin layer of white fur. The V. profunda was variciform and was dark blue in colour. The patient narrowed her eyes into a line. The upper eyelids could be moved upward. There was no tenderness in the affected part. There was no abnormal sign else.

Diagnosis: ? Blepharoptosis. ? Chronic Enteritis.

Differentiation: It's deficiency of qi of the middle-Jiao due to a long time of diarrhea, which caused the blood circulation and the flowing of qi became weak and unsmooth, so that there was blood stasis, which obstructed the meridian of spleen. Because spleen is responsible for the normality of the eyelids through the collaterals of TaiYin spleen channel, then the eyelids couldn't open as normal when the collaterals of spleen channel were obstructed by the blood stasis. It was just like what a set phrase said: with the skin gone, what can the hair alhere to? (it means everything can not exist without its basis) This disease, in TCM, is a typical case of the evils hiding into the collaterals due to a 10ng time's illness.

Therapeutic Principle: Nurishing qi of middle Jiao and activating blood to resolve stasis from the collaterals.

Recipe: Modified Decoction of Removing Blood stasis in the Chest Formulated by Dr. Wang QingRen.

ShengDiHuang,Dried Rehmannia Root 18g

MuDanPi,Tree Peony Bark 9g

ChuanXiong,Chuanxiong Rhizome 10g

TaoRen,Peach Kernel 9g

HongHua, Safflower 9g

DangGui,Chinese Angelica Root 9g

ChiShao,Red Sage Root 9g

NiuXi,Achyranthes Root 9g

DangShen,Pilose Asiabell Root 30g

ZhiHuangQi,Moxa-prepared Milkvetch Root 25g

ChaiHu,Bupleurum Root 12g

ChuanLian,Coptis Root 9g

YiYiRen,Coix Seed 18g

ShengGanCao,Raw Liquorice Root 8g

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

Effect Observation: After taking the decoction, the patient came to me for reexamination on October 19,1998. She told me the abdominal pain had disappeared, the stool was moved 1~2 times a day, she could open her eyes freely, the dizziness became better than before. But she felt weak yet. All these signs showed the blood stasis had been removed mostly while the qi of middle- Jiao was still deficient. Then she was told to begin taking the pills for strengthening middle-Jiao and benefiting qi, 6g a time,3 times a day. In the same peroid, she was told to add 9g of ShanZhi(Capejasmin Fruit) and omit 12g of ChaiHu(Bupleurum Root) in the original prescription. She was told to take 5 doses of this changed prescription.

After 5 days of the above treatment, all the uncomfortable sensation disappeared. The patient got vigorous, the stool was moved once a day, she could open her eyes freely. After 10 months' follow-up, the illness didn' t recur, then it' s ending.