The patient Mrs. Kim, from America.
Brief Summary: The patient Mrs. Kim, from America, has suffered from inflexibility of the right hand, asthenia of the left hand, and general joints asthenia accompanied by a staggering gait for one and a half years. After three-month treatment here, her condition has been improved quite a lot.
Records of Hospitalization
Name: Kim Sex: Female
Age: 34 Profession: Civil servant
Nationality: America Marital status: Married
Onset Season: Summer Date of Admission: Oct. 2nd, 2006
Complainer of history: The patient herself Reliability: Reliable
Chief complaint: The patient has suffered from inflexibility of the right hand, left-hand asthenia, and general joint asthenia accompanied by a staggering gait for one and a half years.
Present illness: One and a half years ago the patient began to have right-hand inflexibility, left-hand asthenia, and general joint asthenia evidenced by her inability to walk for more than five minutes, without any obvious cause. Because she hadn’t done anything about her illness due to ignorance, it progressively grew worse. Then she could no longer juxtapose the right-hand fingers closely and had no extension in the atrophic middle finger. She had muscular atrophy and jitters (small irregular movements) in her right hand; therefore, it could not carry anything without the help of the left one. She had poor ability in making fine movements evidenced by her inability to use her right or left thumb to touch other fingers of the same hand or to write stably with a pen or pencil. When she had only the tip of her foot on the floor, she had shaking in her knees. And sometimes she had spasmodic pain in her toes. She couldn’t stand on one foot and had a duck gait in walking due to poor sense of balance. However, the MRI and the blood test she had in a local hospital showed no abnormality. After her condition was aggravated, she came to a local hospital for acupuncture.
Past history: No history of typhoid, tuberculosis and hepatitis. No history of medicine or food allergy. No operation or transfusion history. No history of preventive vaccination provided.
Personal history: She was born in US, living in a dry environment. No contact history of schistosomiasis. She has been smoking for 15 years, a packet of cigarettes by day. No addiction to alcohol or special food. She was gentle.
Menstrual history: Moderate and red menses without peculiar smell.
Marital history: She was married at 27 and had given birth to a son and a daughter. Her husband and children are all healthy.
Family history: Her parents are both healthy. No family history of special disease.
Physical examination
T 37℃，P 80bpm, R 20bpm, BP: 100/70mmHg
She was mid-nourished and normally developed. Her mind was clear. She was in a positive position and cooperative in examination. Her skin was moist. No jaundice in the sclera. No superficial lymph-node enlargement. Bilateral pupils were round and equal in size and sensitive to light. No thoracic deformity. Sound of breath was bilaterally normal on auscultation. No respiratory rales or pleural friction rubs. Heart border was normal. Heart beat 80bpm. Cardiac rhythm was regular. No pathological murmurs of heart on auscultation. Abdomen was flat and soft without tenderness or rebound tenderness. Liver and spleen were not palpable. No percussion pain on renal region. Bowel sound wasnormal. No Spinal and pelvic deformity or tenderness. The development of the anus or pudendum was normal. Her tongue was dull with thin and yellow coating, and her pulse is threadlike and weak. (The condition of four limbs will to be elaborately discussed in special examination of four limbs.)
Special examination of four limbs: The patient’s right-hand was inflexible and has poor ability in making fine movements evidenced by her inability to write stably. Her right hand had mild amyotrophy and muscular jitters. She could not juxtapose the right-hand fingers closely and had no extension in the atrophic middle finger. Her left hand was weak. She had general asthenia of joints and muscles. When she had only the tip of her foot on the floor, she had shakings in her knees. Sometimes she had spasmodic pain in her toes. And she couldn’t stand on one foot and had a duck gait in walking due to poor sense of balance. The myodynamia of her hands was bilaterally grade IV.
Diagnostic examination: Not provided.
First diagnosis:
TCM diagnosis: Wei-syndrome (flaccidity syndrome)
Symptom diagnosis: stagnation of qi and blood; liver and kidney asthenia; liver and spleen asthenia.
WM diagnosis: ALS
First Medical Record
6:30p.m. Oct. 31st 2006
Kim, a 34-year-old female, has suffered from right-hand inflexibility, left-hand asthenia, and general joint asthenia accompanied by staggering gait for one and a half years. She was met by our translator in Zhijiang Airport and arrived in Huaihua Red Cross Hospital at 5: 30p.m Oct. 31st 2006.
Essentials for diagnosis:
1. The patient has suffered from a right-hand inflexibility, left-hand asthenia, and general joint asthenia accompanied by staggering gait for one and a half years.
2. One and a half years ago the patient began to have right-hand inflexibility, left-hand asthenia, and general joint asthenia manifested as inability to walk for more than five minutes, without any obvious cause. As she hadn’t done anything about her illness, it grew worse progressively. Three months later, she had involuntary movements in the right thumb, and she had muscular atrophy and jitters (small irregular movements) in her right hand. Due to this, she could not carry anything without the help of the left one. She had poor ability in making fine movements evidenced by her inability to use her right or left thumb to touch other fingers of the same hand or to write stably with a pen or pencil. She felt weakness in the left hand and shoulder pain, if she turned the body. When she had only the tip of her foot on the floor, she had shaking in her knees. Sometimes she had spasmodic pain in her toes, and she couldn’t stand on one foot. She also had a duck gait in walking due to poor sense of balance. However, the MRI and blood test she had in a local hospital showed no abnormality. After her condition was aggravated, she had been in a local hospital for acupuncture before she came here. Her tongue was dull with thin and yellow coating, and her pulse was threadlike and weak.
3. She was mid-nourished and normally developed. Her mind was clear. She had languid face. She was in a positive position and cooperative in examination.
4. T 36.8℃，P 80bpm, R 20bpm, BP: 90/60mmHg
5. No thoracic deformity. Chest percussion noted resonance. Sound of breath was bilaterally clear on auscultation. No pleural friction rubs.
6. The patient’s right-hand was inflexible and has poor ability in making fine movements evidenced by her inability to write stably. She had mild amyotrophy and muscular jitters in her right hand. She could not juxtapose the right-hand fingers closely and had no extension in the atrophic middle finger. Her left hand was weak. She had general asthenia of joints and muscles. When she had only the tip of her foot on the floor, she had shaking in her knees. Sometimes she had spasmodic pain in her toes, and she couldn’t stand on one foot. She also had a duck gait in walking due to poor sense of balance. The myodynamia of her hands was bilaterally grade IV.
7. Diagnostic examination: Not provided
Diagnostic basis
TCM: Wei-syndrome (flaccidity syndrome) refers to the flaccidity and weakness of extremities leading to muscular atrophy and less liberty in movement. In clinics, amyotrophy and weakness of lower extremities always leads to failure in walking. There are also cases in which the patient has amyotrophy and weakness of both upper and lower extremities. At the advanced stage, some victims may even be unable to stand or to hold an object. As the disease worsens, the patient becomes so atrophic that he or she will be paralysed.
The external cause of Wei-syndrome is mainly pathogenic warmth or damp heat. If the pathogenesis is damp heat, the disease is always caused by an attack of pathogenic dampness, due to prolonged stay in humid environment or exposure to water or rain, after which stagnant dampness accumulate in human body and transform into heat. It could also be caused by impairment of spleen and stomach because of irregular diet. In this case, the accumulated dampness and heat invade the meridians and block the circulation of qi and blood, which causes insufficient nourishment of sinews, vessels and muscles, finally leading to amyotrophy.
The internal cause, on one hand, refers to deficiency of the liver and kidney, asthenia of the spleen and stomach, and deficiency of blood essence and body fluid, which all lead to insufficient nourishment and affection by pathogenic warmth or toxin of sinews, vessels and muscles; on the other hand, it is that the pathogenic heat, not completely removed in the treatment of Heat-Disease, burns and scorches the lung(Jin-viscera), leading to the lack of production and transformation of body fluid and qi which further causes insufficient nourishment of sinews and vessels. Finally both of these two causes lead to Wei-syndrome manifested as the dysfunction of the limbs. Asthenia of spleen and stomach, weakness due to chronic illness, or the impairment of the liver and kidney due to excessive sexual activities, can also cause insufficiency of body fluid and blood, leading to the insufficient nourishment of sinews, vessels and muscles, thus, the gradual wasting away of muscles will finally lead to dysfunction of limbs. In conclusion, the external cause of Wei-syndrome is invasion by pathogenic warmth, heat, dampness, or toxin, while the internal one is gastrosplenic asthenia and hepatonephric deficiency due to chronic illness or excessive sexual activities, for those will cause severe consumption of body fluid and blood. The pathogenesis is lacking nourishment for sinews and vessels. The Zang-Fu organs most affected are liver, kidney, lung, stomach and spleen, especially liver and kidney.
Western medicine: The patient’s right-hand was inflexible and has poor ability in making fine movements evidenced by her inability to write stably. She had mild amyotrophy and muscular jitters in her right hand. She could not juxtapose the right-hand fingers closely and had no extension in the atrophic middle finger. Her left hand was weak. She had general asthenia of joints and muscles. When she had only the tip of her foot on the floor, she had shaking in her knees. Sometimes she had spasmodic pain in her toes, and she couldn’t stand on one foot. She also had a duck gait in walking due to poor sense of balance. The myodynamia of her hands was bilaterally grade IV.
Diagnostic differentiation
TCM: The patient’s Wei-syndrome should be differentiated from Bi-syndrome. Although they both fall into the category of limb disease, they are different in pathogeny, pathogenesis and clinical manifestations. Wei-syndrome is characterized as limp, weak and emaciated limbs with shriveled muscles. A patient suffering from Wei-syndrome may even become unable to hold an object or to stand without support. Besides, the patient’s lower limbs are more often affected, though he or she usually has no joint pain. On the contrary, Bi-syndrome is generally characterized as aching pain, fixed heaviness and inflexibility of sinews and bones, muscles and joints, with occasional numbness or swelling, though, no paralytic manifestations. The pathogenesis of Wei-syndrome is that the essence and blood in five-fu organs is insufficient to travel through the whole body leading to malnourish of the meridians and collaterals; while that of Bi-syndrome is that the obstruction of meridians and collaterals by pathogenic qi blocks the circulation of qi and blood.
WM: The patient’s ALS (amyotrophic lateral sclerosis) should be differentiated from SM (syringomyelia) which occurs typically between ages 10 and 35. Men are about two times more affected as women are. The onset of the disease is unpredictable, and it had a long developmental course. Its clinical manifestation is caused by neural lesion of affected spinal segments, characterized by dissociated sensory disturbance, that is, degeneration or loss of pain and warm sense without loss of deep senses, accompanied by dyskinesia and neural dystrophy due to impairment of fasciculus of spinal cord, amyotrophia, myasthenia, cutaneous and articular dystrophy, deformity of spine, and cavus.
First diagnosis
TCM diagnosis: Weizheng (flaccidity syndrome)
Symptom diagnosis: stagnation of qi and blood; liver and kidney asthenia; liver and spleen asthenia.
WM diagnosis: ALS
Plan of treatment and care
1. On routine care of traditional Chinese internal medicine
2. On grade II care
3. Regular diet
4. Herbal tea: one dosage a day and drink by twice
5. Acupuncture and massage: once a day
6. Have a positive and optimistic attitude towards your disease
7. Have more medical examinations if necessary
Date: 3rd of October 2006 Time: 9:00 a.m.
The patient complained to Dr. Yan about her right-hand inflexibility and poor ability in making fine movements evidenced by her inability to use her right or left thumb to touch other fingers of the same hand or to write stably. She had a weak left hand, general asthenia of joints, and involuntary muscular jitters. Sometimes she had spasmodic pain in her toes. No aversion to cold. No fever. No nausea or vomit. No headache or dizziness. Her spirit and sleep were good. Her bowel movement and urination were normal. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak.
Dr. Yan’s analysis:
1. The treatment of Wei-syndrome should be focused on stomach meridian of foot-yangming, which means treating Wei-syndrome by nourishing the spleen and stomach. The spleen and stomach are the source of the pulmonary fluids, and also governs the transformation of the vital essence and blood of liver and kidney; therefore, one should nourish yin and stomach when gastric thin fluid is deficient, replenish qi and invigorate spleen when spleen and stomach are deficient. Only if the patient’s spleen and stomach are full of vigor can he or she have enough food to ensure the supply of qi, blood and body fluids, which in turn will keep the Zang-Fu organs functioning vigorously, so the sinews and vessels will have sufficient nourishment which is beneficial to the recovery of the patient. The treatment of deficiency syndrome should be focused on nourishing healthy qi, while that of liver and kidney asthenia should be focused on nourishing liver and kidney. The treatment of excessive syndrome should be focused on expeling pathogenic qi and activating collaterals. The treatment of lung heat attacking thin fluids should be focused on clearing heat and dryness, that of pathogenic damp heat on clearing heat and removing dampness through diuresis, that of stasis blocking the meridians and collaterals on activating blood circulation and removing stasis. If it is deficiency-excess complication, the treatment should not be focused on only one aspect.
2. Principle of TCM treatment: Strengthening the spleen and supplementing qi; Tonifying the liver and nourishing yin essence. Herbal tea prescribed for three days included Astragalus, Dipsacus, Cooked Rehmannia, Eucommia, Ovate Atractylodes, White Peony, Poria, Cornus, and so on. A daily dosage should be decocted twice.
Date: 4th of October 2006 Time: 9:00 a.m.
The patient complained that she had an inflexible right hand, a weak left hand and general asthenia of joints. No aversion to cold. No fever. No nausea or vomit. No headache or dizziness. She was presented with a good spirit. Her sleep was good. Her bowel movement and urination were normal. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak.
Date: 5th of December 2006 Time: 9:00 a.m.
Today the patient had some improvement in the right-hand flexibility and had more extension in the right middle finger. She was still unable to juxtapose the right-hand fingers closely or to write without difficulty. She had a weak left hand and general asthenia of joints. She still had muscular jitters in her hands now and then, though the spasmodic pain in her toes became less. No aversion to cold or fever. No nausea or vomit. No headache or dizziness. She was presented with a good spirit. Her sleep was good. Her bowel movement and urination were normal. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak.
Date: 8th of December 2006 Time: 9:00 a.m.
The patient complained that she had two red swellings on her neck, itching and a little aching, which may be caused by an insect creeping across her neck last night. No headache or dizziness. No aversion to cold or fever. No nausea or vomit. We gave her Fuyangshuang to treat the swellings.
Examination: T 37℃，P 80bpm, R 20bpm, BP: 100/70mmHg
Today the patient’s right-hand flexibility was better. She had full extension in the right middle finger. She became able to juxtapose the right-hand fingers closely or wrote with less difficulty. She had more stability to use her thumb to touch other fingers of the same hand. She had pain and obvious tenderness in the metacarpophalangeal joint of her right thumb when she used her right hand. The weakness in her left hand and joints was less. Her muscular tension was increased. Her hands had obviously less muscular jitters, and her toes also became less painful. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak.
Date: 11th of October 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. She was presented with a good spirit. Her sleep was good. Her bowel movement and urination were normal. The patient’s right-hand flexibility was better. She could fist and open it easily. She had more stability to use her thumb to touch other fingers of the same hand. She had more muscular strength, but her right hand trembled obviously when she spread her palm. It was still difficult for her to hold a pen without the left hand’s support and to write without twisting. She had poor ability to make fine movements. When she used her right hand, she had pain and obvious tenderness in the metacarpophalangeal joint of her right thumb. The weakness in her left hand and joints was less. Her muscular tension was increased. She still had unobvious muscular jitters in her hands, though the spasmodic pain in her toes became less. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. The herbal tea had been benefit, so the patient was asked to take another five dosages.
Date: 14th of October 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. She was presented with a good spirit. Her sleep was good. Her bowel movement and urination were normal. The patient’s right-hand flexibility was better. She could fist and open it easily. She had more stability to use her thumb to touch other fingers of the same hand, and she had more muscular strength. But her right hand trembled slightly when she opened the fist. It was still difficult for her to hold a pen without the left hand’s support and to write. She had poor ability to make fine movements. When she used her right hand, she had pain and obvious tenderness in the metacarpophalangeal joint of her right thumb. She had a little weakness in her left hand and joints, and her muscular strength was increased. And she had clear improvement in her gait. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to take five dosages of herbal tea of the same prescription.
Date: 17th of October 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were a little bad. Her appetite was good. Her urination was normal but she had no bowel movement in the latest three days. The patient’s right-hand flexibility was better. She could fist and open it easily. She had more stability to use her thumb to touch other fingers of the same hand, and she had more muscular strength. But her right hand trembled slightly when she opened the fist. It was still difficult for her to hold a pen without the left hand’s support and to write. She had a little improvement in writing. She had much difficulty in making fine movements. When she used her right hand, she had pain and obvious tenderness in the metacarpophalangeal joint of her right thumb. She had a little weakness in her left hand and joints. Her muscular strength was increased a bit. Her gait was much better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s Requirement: to do more functional trainings for the right hand. Main herbs used in the new prescription are Shudi (Cooked Rehmannia), Duzhong (Eucommia), Shengqi (Fresh Astragalus), Xuduan (Dipsacus), Danggui (Tangkuei), Huainiuxi (Achranthes), Zaopi (Cornus), Guijiao (Tortoise Planstron), Lujiao (Deerhorn glue), Baishao (White peony), etc.
Date: 20th of October 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were a little bad. Her appetite was good. Her urination and bowel movement were normal. The patient’s right-hand flexibility was better. She could fist and open it easily. She had more stability to use her thumb to touch other fingers of the same hand, and she had more muscular strength. But her right hand trembled slightly when she opened the fist. It was still difficult for her to write or to hold a pen without the left hand’s support. She had a little improvement in writing. She had much difficulty to make fine movements. When she used her right hand, she had less pain in the right-thumb metacarpophalangeal joint than before. She had a little weakness in her left hand and joints. Her muscular strength was increased a bit. Her gait was much better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to do more functional trainings for the right hand.
Date: 23rd of October 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were good. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better. She had more stability to use her thumb to touch other fingers of the same hand, and she had more muscular strength. But her right hand trembled slightly when she opened the fist. Her right hand shook obviously when she stretched her right hand. Her grasping ability was better, though she still needed the help of the left hand to hold a pen. She had a little better ability to make fine movements. Her gait was better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: strengthen functional training.
Date: 26th of October 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were good. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better. She had no difficulty in using her thumb to touch other fingers of the same hand, and her right hand had more muscular strength. Her right hand shook involuntarily less obviously when she stretched her right hand. Her grasping ability was better, though she still needed the help of the left hand to hold a pen. She had a little better ability to make fine movements. Her gait was better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: strengthen functional training.
Date: 29th of October 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were good. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better. She had no difficulty in using her thumb to touch other fingers of the same hand, and her right hand had more muscular strength. Her right hand shook involuntarily less obviously when she stretched her right hand. Her grasping ability was better, though she still needed the help of the left hand to hold a pen. She had a little better ability to make fine movements. Her gait was better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 2nd of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better. She had no difficulty in using her thumb to touch other fingers of the same hand, and her right hand had more muscular strength. Her right hand shook involuntarily less obviously when she stretched her right hand. Her grasping ability was better, though she still needed the help of the left hand to hold a pen. She had a little better ability to make fine movements. Her gait was better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 3rd of November 2006 Time: 9:00 a.m.
Yesterday the patient had gone to Guangzhou for a four-day travel.
Date: 6th of November 2006 Time: 6:30 p.m.
Today the patient came back from Guangzhou at 5:30 p.m. She had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. She was a little tired. Her appetite was normal. Her bowel movement and urination were normal.
Examination: T 37℃，P 80bpm, R 20bpm, BP: 100/70mmHg Her heart and lungs were normal. Her abnormal was flat and soft.
The patient’s right-hand flexibility was better. Her right hand strength increased. She had no difficulty in using her thumb to touch other fingers of the same hand, and her right hand had more muscular strength. The involuntary shake of her right hand was less than before when she stretched her right hand. She still needed the help of the left hand to hold a pen. She had a little better ability to make fine movements. Her gait was better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 9th of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her appetite was normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better. She had no difficulty in using her thumb to touch other fingers of the same hand, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. Her ability of grasping a pen and writing was better. She had a little better ability making fine movements. Her gait was better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 12th of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her appetite was normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better. She had no difficulty using her thumb to touch other fingers of the same hand, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. Her ability of grasping a pen and writing was better. She had a little better ability making fine movements. Her gait was better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 15th of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her appetite was normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. Her ability of grasping a pen and writing was better. She had a little better ability making fine movements. Her gait was better. Her tongue was dull with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 18th of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her appetite was normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better. She had no difficulty in using her thumb to touch other fingers of the same hand, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. Her ability of grasping a pen and writing was much better. She was able to write slowly. She had much better ability making fine movements. Her gait was much better. Her tongue was red with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training of affected limbs. The main herbs used in the herbal tea include Shengqi (Fresh Astragalus), Zaopi (Cornus), Baishao (White peony), Xuduan (Dipsacus), Baji (Morinda), Danggui (Tangkuei), Lujiao (Deerhorn glue), Tubei (Wingless Cockroach), Duzhong (Eucommia), Shudi (Cooked Rehmannia), Dayun (Cistanche), Guijiao (Tortoise Planstron), and so on.
Date: 21st of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her appetite was normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. She was able to write slowly. She had much better ability making fine movements. Her gait was much better. Her tongue was red with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 24th of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her appetite was normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better. She had no difficulty in using her thumb to touch other fingers of the same hand, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. She was able to write slowly. She was able to write slowly. She had much better ability making fine movements. Her gait was much better. Her tongue was red with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training of affected limbs and take herbal tea of the same prescription.
Date: 27th of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. She was able to write slowly. She had much better ability making fine movements. Her gait was much better. Her tongue was red with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 30th of November 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. She was able to write slowly. She had much better ability making fine movements. Her gait was much better. Her tongue was red with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 3rd of December 2006 Time: 9:00 a.m.
Today the patient had no discomforts such as headache, dizziness, nausea, vomit, fever or aversion to cold. Her spirit and sleep were normal. Her bowel movement and urination were normal. The patient’s right-hand flexibility was much better, and her right hand had more muscular strength. The involuntary shake of her right hand was obviously less than before when she stretched her right hand. She was able to write slowly. She had much better ability making fine movements. Her gait was much better. Her tongue was red with thin and yellow coating. Her pulse was fine and weak. Doctor’s requirement: to strengthen functional training and take herbal tea of the same prescription.
Date: 6th
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