1. What is the prognosis of this disease?

2. What are the manifestations of qi and blood insufficiency and lingering pathogenic dampness present on his second visit?

3. In terms of prevention and nursing, what should one pay atention to?

1. The patient had a recurrent disease for five years. It was a case of mixed defciency and excess with its root in defciency and branch excess. If diferentiated and treated properly, the disease may be cured, but a full recovery and prevention of recurrence would require a longer course of treatment than simply eliminating the present symptoms. If differentiated incorrectly, and treated improperly, such as considering the case pure damp-heat, overuse of bitter and cold medicinals could aggravate the damage of stomach and spleen and makes it difficult to resolve the condition.

2. The patient’s itching was substantially relieved with reduced eye secretions but he still had a sallow complexion, thin body, irritated conjunctiva, a light red tongue with a thin white and slightly greasy coating, and a wiry, weak pulse. These symptoms show his relatively deep insufciency of qi and blood, the tongue coating being the main indication of lingering pathogenic dampness.

3. The incidence of this disease is closely related to the patient’s constitution and seasonal changes. At the onset of symptoms it is important to avoid exposure to wind, sand, dust, smoke and strong light. It is recommended to wear sunglasses to protect the eyes and avoid direct irritation. Avoiding spicy, fatty or cold foods will prevent additional overwhelming of the spleen, and accumulation of dampness, and the formation of damp-heat. During the remiting stage, it’s important to secure the root by fortifying the spleen, boosting qi, and nourishing the blood to prevent the reoccurrence of the condition.