Brief Summary: June 7,
2006, Abdulrahman, a little boy, from Oman, arrived in our
hospital. The boy has suffered from Brain problem.
Record of
Hospitalization
Name:
Abdul
Sex: male
Age:
7
Nationality: Oman
Date of
Hospitalization: June 5, 2006
Major
complaints: Sudden faintness with
loss of
consciousness. Foaming at the mouth. His eyes turn up.
Twitching the right side of his body for 1-5 minutes. He will
become normal after waking up.
Disease History: The patient was in hospital for treatment in
March 2004 because of the asphyxia and twitch. He was diagnosed
with brain fever in Oman. He took
antiviral remedy for one
year after leaving hospital. In
January 2006, the
disease repeated twice lasting one and five minutes
respectively. He has the symptoms of
faintness with
no consciousness, shouting, eyes turning up, foaming at the
mouth,
twitching the right side of his body,
spasm of both hands and enuresis. Then he became normal after
waking up. He was once again in hospital and diagnosed with
Brain Problem.
Physical examination: Weak physical condition. No disease
history of tuberculosis and hepatitis. Normal growth of his body
and common nutrition level. Clear consciousness and cooperative.
No yellow stain of the skin sclera. No swelling of lymph nodes.
Normal growth of his head and five sense organs. Sensitive to
the light reflection. Normal size of the pupillae. No hyperaemia
in the throat. No swelling of the tonsil and thyroid gland. No
varix. Thoracic cage is symmetrical. Normal breath sound in the
lungs. The heart rate is 85 times/minutes and no cacophony. The
abdomen touches even and soft. No pressing pains and no rebound
tenderness. Normal intestinal gurgling sound.
Diagnosis:
Brain
Problem (congenital defect, deficiency of spleen and kidneys)
June
6, 2006
Sleep
well. Clear mind. Good spirit. Deep and fine pulse. Enlarged
tongue and whitish tongue body. The center of the tongue is a
bit yellowish and greasy.
June
7, 2006
Good
spirit. Normal appetite. Deep and fine pulse. Thin and whitish
tongue coating.
June
8, 2006
Runny
nose but no fever. No headache. Fine pulse. Whitish tongue
coating. Doctor asks him to drink more warm water.
June
10, 2006
Very
good sleep. Deep and fine pulse. Thin and whitish tongue
coating.
codonopsis root 10g£¬
ovate
atractylodes root 7g£¬
pinellia 7g£¬
root
poria 10g, etc.
June
13, 2006
Good
appetite and sleep. No dizziness and no headache. Deep and fine
pulse. The tongue coating is thin and whitish.
June
17, 2006
Good
spirit and appetite. No dizziness and no headache. Pulse is
deep and fine and a bit slippery. Thin and whitish tongue
coating. The treatment strategy mainly focuses on boosting qi
and resolving phlegm.
astragalus root 12g£¬
gastrodia tuber 7g£¬
poria
7g£¬
ovate
atractylodes root 7g£¬
etc.
June
21, 2006
His
father tells us that the little boy has good sleep and spirit
during the treatment. But the father request us increase his
food intake so that the boy could become more fat and strong.
Pulse is deep and fine and a bit slippery. Thin and whitish
tongue coating.
codonopsis root 10g£¬
poria
7g£¬
ovate
atractylodes root 7g£¬
pinellia 7g£¬
etc.
June
26, 2006
Recently his food intake increased. Good sleep. No any other
discomfort. Pulse is deep and fine and slippery. Thin and
whitish tongue coating.
codonopsis root 10g£¬astragalus
root 12g£¬
peach
kernel 6g£¬
red
peony root 6g£¬
etc.
July
1, 2006
His
father asks us to change the herbal tea because of the bitter
and strong taste. The patient¡¯s complexion looks much better
now. Deep and fine pulse. Tongue coating is thin and whitish.
Now we will mainly focus on fortifying his spleen.
codonopsis root 10g£¬
ovate
atractylodes root 7g£¬
root
poria 10g£¬
polygala root 7g, etc.
July
5, 2006
Good
spirit and appetite. He feels well with the herbal tea.
July
9, 2006
Very
good spirit. No headache and no dizziness. Increased food
in-take. Moderate pulse. Slightly reddish of the tongue body.
Thin and whitish tongue coating. We will fortify his spleen and
boost qi and resolve phlegm.
licorice root 4g£¬
codonopsis root 10g£¬
ovate
atractylodes root 7g£¬
pinellia 5g£¬
etc.
July
14, 2006
No
change of his condition. We advice him keep on with the formula.
July
18, 2006
The boy has an overall test and will be leaving
hospital on July 20. We prescribe 60 dosages of herbal tea for
him after he returns home. During the treatment, the patient has
daily treatment including herbal tea, acupuncture and massage.
After one more months treatment, he has a better constitution
than before and the food intake is also increased. In our
hospital his condition is stable. ¡¡
