bubble_chart Content

Zhang, female, 42 years old, farmer. Generally healthy, in the autumn of 1978, while pulling a cart to deliver fertilizer, she accidentally stumbled and fell. The cart slid down, and one of its wheels ran over her abdomen. She immediately felt

abdominal pain, lumbago, and hematuria, and was subsequently admitted to the surgical department of our affiliated hospital for treatment. After examination, it was found that one of her kidneys was damaged, but not severely. She was given medication to resolve stasis and stop bleeding. The next day, the hematuria stopped, her back pain ceased, and her spirits improved. However, the patient experienced continuous sweating on her hands, feet, chest, and abdomen, prompting a consultation with me.

Upon examination, the patient had dull pain in her abdomen, a slow pulse, and persistent spontaneous sweating on her palms, soles, and chest, with no other complaints. Initially, this was diagnosed as disharmony between nutrient and defensive qi. She was prescribed Cinnamon Twig Decoction, two doses, but it was ineffective. During a follow-up consultation, I inquired about her bowel movements and learned that she had not defecated for four days since the injury. Reflecting on the "Cold-Damage Disease Treatise," which states: "When cold-damage disease shifts to yangming, the person will have profuse sweating." And, "Not changing clothes, internal fullness, and difficulty in defecating are signs of yangming." This patient had continuous sweating on her hands, feet, chest, and abdomen, along with difficulty in defecating and abdominal pain, indicating the main symptoms of yangming. The slow pulse was due to the stagnation of pathogenic factors inside, blocking the pulse pathway. The previous diagnosis of disharmony between nutrient and defensive qi was incorrect. Therefore, the treatment was changed to Stomach-Regulating Purgative Decoction, with the addition of Peach Kernel and Carthamus to resolve blood stasis. The prescription was:

Rhubarb Rhizoma 9g, Mirabilite 18g (to be taken with water), Prepared Liquorice Root 6g, Peach Kernel 9g, Carthamus 9g, Tail of Chinese Angelica 12g, Red Peony Root 9g
. After taking one dose, her bowel movements normalized, and the sweating completely stopped. She was then given medication to nourish and activate blood, and after three days of treatment, she fully recovered.

In this case, the spontaneous sweating after the injury was initially considered as disharmony between nutrient and defensive qi, and Cinnamon Twig Decoction was prescribed without success, indicating a misdiagnosis. Upon re-evaluation, by questioning the patient and analyzing the symptoms, the key signs of profuse sweating on the hands and feet and difficulty in defecating were identified as yangming disease. After taking one dose of the correct medication, her bowel movements normalized, and the sweating stopped, leading to a full recovery after further treatment.