朱明中医大夫主治来自英国Slaughter先生皮肤干燥瘙痒综合症之住院病历。
Record of Hospitalization
Name: Jonathan Slaughter Gender: Male
Age: 38 Marital State: Married
Profession: Ballet Dancer Address of Birth: Worthing, UK
Nationality: British Current Address: see below*
Date of Hospitalization: August 1, 2004. Record Date: August 1, 2004
Major complaint: Dry skin for 38 years, severe itching, 24 hours scratching everyday, multiple skin ulcers, past treatments no help.
Disease history: Jonathan complained that when he was born, mother found cuts on his arms and dry skin. So his mother tried to use western cortisone and steroid external use cream for him to relieve the dryness of the skin. When he was 18 years old, he went to Central Ballet School in London and studied Ballet techniques for two years. During this period, he still was using the cream, pills and injections.
*Chibashi Chuouku
Aoba Cho 1269
Aoba Cho No Mori
Koen Dori 7-401
Japan
When he was 25 years old, he tried to stop steroid, then he felt pretty much worse. The symptoms are fatigue, sorness of the joints, joint stiffness, thick skin, even could not turn his neck.. When he was 32 years old, he went to Tokyo, Japan to teach the local people the techniques of Ballet. He used quite a lot herbal treatment in Japan for two years, yet no obvious improvement was found; he was given fire-purging Chinese herbal medications and this even made him feel cold in hot summer.
Currently, the major complaint is dry sense of the skin which feels like hard paper, fatigue, itching very severely, and has to scratch all the time, falling off of the skin flakes at most parts of the body skin. The two hands, two feet and the back part of the knees have obvious ulcers, especially the swelling of the two feets and ankles is severe. Thirst and liking much water of normal temperature, constipation often.
Five years ago, he felt irregular beats of the heart. But right now, this feeling has disappeared. Asthma lasted all the time till recent four years, during which no onset of asthma was found. When asthma happened, it is three or four times every week. He feel always blockaded nose, nasal excretion is yellow.
Jonathan is allergic to horse, any other animal with body hair, sometimes honey and alcohol. He also said the right kidney is bigger than the left kidney, but no nephritis or kidney stone or infection was found.
The total body check is carried out. T37.1C, P 90 beats/per minute, BP 120/70 mmHg.
The left pulse is thready and string-like, right pulse soggy. The tongue is enlarged, moist and without tongue coating.
Diagnosis: Yin deficiency, fulminant fire, external wind disturbing, blood dryness, the skin fails to be nourished.
Treatment strategy: Moistening yin, clearing heat, expelling wind, stopping itching, enriching blood.
So the formula for oral use is as follows. Take 200 milliliters in the morning 10:00 AM, and another 200 milliliters in the afternoon 4:00 PM.
glehnia root 12g ophiopogon tuber 12g Solomon’s seal root 12g
scrophularia root 12g honeysuckle 15g wild chrysanthemum flower 15g
xanthium 10g cnidium seed 10gschizonepata 1 0g ledebouriella 10g
ligusticum root 12g peach kernel 12g tangkuei root 10g
The second formula is for external use for bathing, soaking, washing the skin for twenty minutes in 11:00 AM and 5:00 PM for another twenty minutes.
schizonepata 30g ledebouriella 30g licorice root 50g
honeysuckle 80g xanthium 50g stemona 50g salvia root 30g
cnidium seed 50g glehnia root40g ophiopogon tuber 40g
Solomon’s seal root 40g scrophularia root 40g rhubarb 20g
Prescribed by Dr. Ming 2004.8.1
August 2, Jonathan said he could get used to the internal use herbal tea and external use soup. Washing and soaking the skin for 15 minutes. It is too early to say if there is good change. But it seems to him that he feel the skin on the arms is less itching. The ulcer on the feet is less itching and would like to have some cream to moisten the local skin.
Dr. Ming, 2004, 8, 2.
August 3, Jonathan said the taste of the herbal tea is acceptable, not too much bitter and not too much cold in nature. Yesterday afternoon after coming back from exposing to strong sunlight for two hours, itching is even stronger, and the feet feel hurting stronger. But if exposing too strong sunlight in the past, he has to scratch strongly, but this time he did not need to scratch. This morning he feels the skin seems to be a little bit moist. I checked the total body skin, dry indication and flakes could be found. It is obvious that the ulcers at the back of the two knees are disappearing. The ulcers of the feet are still obvious. So the internal use herbal formula is as follows:
glehnia root 12g ophiopogon tuber 12g Solomon’s seal root 12g
scrophularia root 12g trichosanthes root 10g honeysuckle 15g
wild chrysanthemum flower 15g xanthium 10g cnidium seed 10g cicada molting 10g
schizonepata 1 0g ledebouriella 10g tangkuei root 10g anemarrhena root 10g
arctium seed 10g
Two dosages: 200 ml in the morning, another 200ml in the afternoon.
The external use formula is as follows:
schizonepata 30g ledebouriella 30g licorice root 50g honeysuckle 80g
xanthium 50g stemona 50g cnidium seed 50g glehnia root40g
ophiopogon tuber 40g Solomon’s seal root 40gscrophularia root 40g
trichosanthes root 40g phellodendron bark 40g anemarrhena root 40g
rhubarb 20g cicada molting 40g flavescent sophora root 40g
arctium seed 40g
Two dosages: washing externally once in the morning 11:00AM, 5:00PM.
Offer external use ointment, Meibao Moist Scalds Ointment to use external on the feet to moisten the local skin, twice a day.
Dr. Ming, 2004.8.3
August 4, Slaughter said yesterday from the morning till 9:30 PM, rare feel itching sense. In the past, the whole daytime and night are of severe itching. But after 9:30, he feels itching and has to scratch, sleep is relatively relaxed. This morning the itching of the face is relatively more compared to other part of the total body skin. I found that the ulcers of the two feet are getting better, swelling is reduced 20%.
Dr. Ming, 2004.8.4
August 5, Slaughter is feeling that itching degree is reduced 50% percent in the daytime and 90% percent reduced at night. I found that the skin is becoming little bit moist and the ulcers on the feet are continuing to heal.
Dr. Ming, 2004.8.5
August 6, the skin itching degree is continuing to decrease. The feet itching is reduced obviously. Now the upper part of the body including the face, neck, chest, upper back is still dry and itching. More skin flakes come down. Advice the patient to use Meibao Moist Scalds Ointment on these severe parts of skin for two to three days to see the result. I tried to touch the skin; the skin feels like hard paper. So the internal use formula is trying to strengthen the effect of moistening the skin.
glehnia root15g ophiopogon tuber 15g Solomon’s seal root 15g
scrophularia root 15g asparagus tuber 15g trichosanthes root 10g
honeysuckle 15g wild chrysanthemum flower 15g xanthium 10g cnidium seed 10g
cicada molting 10g schizonepata 1 0g edebouriella 10g
tangkuei root 10g anemarrhena root 10g arctium seed 10g
The external use formula also strengthens the effect to moistening the skin.
schizonepata 30g licorice root 100g honeysuckle 80g xanthium 50gstemona 50g cnidium seed 50g glehnia root60g ophiopogon tuber 60g Solomon’s seal root 60g scrophularia root 60g trichosanthes root 60g asparagus tuber 60g phellodendron bark 40g anemarrhena root 40g rhubarb 20g cicada molting 40g
flavescent sophora root 40g arctium seed 40g
In addition offer another tube of Meibao Moist Scalds Ointment, use on the upper part of the body skin.
Dr. Ming, 2004.8.6
August 7, the general condition is continuing to be improved. The crispy and hard skin which touches like hard paper is becoming moist. The scratching is much less, and itching degree reduced obviously. Sleep is calm, appetite good, spirit good. Jonathan used cream on the top part of the body skin twice yesterday. The ulcers on the feet are being improved.
Dr. Ming, 2004.8.7
August 8, the skin is becoming obviously moist. Only the skin of the neck is still dry apparently. The itching is still from time to time, but much relieved. The spirit and sleep are quite good. Yesterday, some friends in Huaihua and our hospital accompanied Jonathan to our local park. Since the weather is too much hot, so when coming back after 5 hours sightseeing, the itching worsens a little bit, but compared to before, the itching is much slighter.
So almost continue the same treatment strategy, put some blood quickening herbs to improve the slight swelling of the feet.
So the oral use formula is as follows:
glehnia root15g ophiopogon tuber 15g Solomon’s seal root 15g
scrophularia root 15g asparagus tuber 15g trichosanthes root15g
honeysuckle 15g wild chrysanthemum flower 15g xanthium 10g cnidium seed 10g
cicada molting 10g schizonepata 1 0g ledebouriella 10g tangkuei root 10g
anemarrhena root 10g arctium seed 10g carthamus flower 10g
The external soaking formula is
schizonepata 30g icorice root 100g honeysuckle 80g xanthium 50g
stemona 50g cnidium seed 50g glehnia root60g ophiopogon tuber 60g
Solomon’s seal root 60g scrophularia root 60g trichosanthes root 60g
asparagus tuber 60g phellodendron bark 40g anemarrhena root 40g
rhubarb 20g cicada molting 40g flavescent sophora root 40g arctium seed40g
tangkuei root 40gcarthamus flower 40g peach kernel 40g
August 9, the skin continues to become moist. The feet itching are still there sometimes. The itching at the upper part of the body is reduced greatly.
Dr. Ming, 2004.8.9
August 10, all the conditions continue to improve. The skin is becoming moist and itching is reduced greatly. Now the major task is to promote the recovery of the feet swelling. So strengthen the blood quickening to reduce the swelling of the feet.
The internal use formula two dosages as below:
glehnia root15g ophiopogon tuber 15g Solomon’s seal root 15g
scrophularia root 15g asparagus tuber 15gtrichosanthes root15g
honeysuckle 15g wild chrysanthemum flower 15g xanthium 10g cnidium seed 10g
cicada molting 10garctium seed 10g tangkuei root 10g igusticum root 10g
peach kernel 10g carthamus flower 10g anemarrhena root 10g sparganum 8g
zedoary 8g
The external use formula is changed to the following:
licorice root 100g honeysuckle 80g xanthium 50g temona 50g
cnidium seed 50g glehnia root60g ophiopogon tuber 60g Solomon’s seal root 60g
scrophularia root 60g trichosanthes root 60g asparagus tuber 60g
phellodendron bark 40g anemarrhena root 40g rhubarb 20g cicada molting 40g
flavescent sophora root 40g arctium seed 40g tangkuei root 40g
carthamus flower 40g peach kernel 40g sparganum 50g zedoary50g
Dr. Ming, 2004.8.10
August 11, the skin is becoming moist. Yesterday massage half an hour of the legs. The feet swelling are reduced very well. Even we could see the veins now.
Dr. Ming, 2004.8.11
August 12, Jonathan said yesterday is the best day that he feels so good, almost no itching. The mind and body are totally relaxed. The swelling on the feet is almost gone. Add cnidium 10g in the internal use formula. Add cnidium 50g in the external use formula.
Dr. Ming, 2004.8.12
August 13, the general condition is steady. The skin is more moist. While yesterday feels very itchy. This is due to the purpose we wish to promote the final blood stasis on the feet.
Dr. Ming, 2004.8.13
August 14, tomorrow Jonathan will leave Huaihua back for Tokyo by taking flight from Zhang Jiajie to Shanghai. He said that he could find and feel 90% recovery, this is the fastest recovery compared to any other treatments in the past, and also he said that we could not imagine the nightmare he experienced in his 38 years, so he was very pleased. Continue to former formulas for one day.
In general, the TCM treatment is very effective and safe, and good recovery has been obtained to Jonathan's case. After 14 days treatment, the itching is almost gone, the skin becomes moist, skin flakes very little, the multiple ulcers are cured. The critical point for this successful treatment is accurate Syndrome Identification and different Treatment Determination. Chinese medicine is curing the root of this disease. So hope he could continue to use the formula in Japan for a period to consolidate the result so that 100% recovery can be got. Try to avoid spicy foods, alcohol, beer, fishy foods, relax the mind, keep the happy emotion.
Dr. Ming
August 14, 2004.