The 5th form – Hypersensitive constitution form

       The liver is the largest organ in the human body.  Its function is important and complicated and if injured, the influence is wide and it can cause a series of physiologic or pathologic changes.  Liver is a detoxification organ; impairment of liver function can cause abnormality of metabolism and excretory disturbances.  If the liver cannot detoxify metabolites, then, the respective metabolites would retain in the blood and further more the body cannot normally obtain substances required for nutrition.  In severe cases, the laboratory examination results would show significant abnormalities which indicate that the liver disease has produced metabolic disturbances and accumulation of abnormal substances in the blood (called by TCM as wetness-heat).  If the attack is acute and severe, the result may be hepatic coma and death.

         Metabolic substances may retain in the body, if hepatic detoxification function is impaired.  Clinically, hypercholesterolemia may induce cardiovascular disease, high blood uric acid may induce gout, hypoproteinemia and hepatic edema may lead to imbalance of auricular fluid and the production of vertigo.  These conditions may be cured without special treatment if systemic TCM therapy is administered.

According to our observation, many symptoms caused by the response of immune system are usually mild.  These symptoms are often recognized by physicians as local symptoms and diagnosed as:

•           Nasal hypersensitivity (nasal obstruction, nasal discharge, repeated sneezing, especially occurring in the morning);
  
•           Tracheal hypersensitivity (itching and soreness of throat, cough, abundant expectoration, shortness of breath, asthma, sensation of foreign body in the trachea and chest, inability to expectorate or swallow, named by TCM as globus hystericus);
  
•           Gastrointestinal hypersensitivity (loss of appetite, nausea, belching, distension of abdomen, stomache ache, constipation or diarrhea, indigestion of food containing heterologous protein, high lipids and certain food made from protein or inability of taking certain common protein containing food such as fresh milk, eggs etc.);
  
•           Dermal hypersensitivity (dryness of skin, hyperkeratosis, ichthyosiform desquamation, pruritus, repeated attacks of German measles, eczema and acne).  So, attention is usually paid on treatment of the superficial and not the fundamental, and the chronic hepatitis condition would become worse and the patient could not be treated in time.

The above mentioned symptoms caused by hypersensitive conditions are in fact described in the respective systems.  Its pathogenesis is closely related to hepatic metabolism, but in clinical practice, they are often considered as disease entities and not given treatment according to liver disease; their treatment are superficial and not fundamental.  Therefore, when the child has the above symptoms, further examination by physician is advisable so as to avoid neglect of diagnosis and treatment of chronic hepatitis.

  Introduction of cases – Hypersensitive constitution form

Case 5-1:   male, age 4-1/2 yrs, repeated nasal hypersensitivity and asthma for over 2 yrs.

Case 5-2:   Wong sisters, elder sister age 5 yrs, history of nasal hypersensitivity and asthma.    Younger sister age 16 months suffering from common cold, roseola and varicella, parents being sufferers of chronic hepatitis.

Case 5-3:   male, age 1 yr, pediatric eczema, malnutrition, poor development, grandfather and grandmother being sufferers of chronic hepatitis.

Case 5-4:   male, age 8 yrs, repeated rubella since infancy, susceptible to common cold, sorethroat, hyperhidrosis, fatigue and paleness of skin.

Case 5-1

Chan – (Computer No. 358) male, age 4-1/2 yrs.  The mother said that her child had repeated nasal hypersensitivity and asthma for 2 years.  He frequently suffered from loss of appetite, distension and pain of abdomen, vomiting diarrhea, dryness and pruritus of skin.  Physical examination revealed a thin stature with pale skin, scanty subcutaneous fat, poor nourishment and development, soft and distended abdomen and hepatomegaly of 1.5 cm.  After taking 13 parcels of TCM drugs, the liver was normal and the bowl movements smooth.  Medication stopped after 3 weeks of systemic TCM treatment.  He was re-examined half a year later and no hepatomegaly was found.

Wong sisters, parents were sufferers of chronic hepatitis.  Her mother had history of acute icteric hepatitis during infancy (about 8-10 years of age) and was not systematically treated.

Her father had history of hepatitis preventive injection two years ago.  On visiting, he complained of severe loin pain for two weeks and he was susceptible to fatigue and also had symptoms of chronic hepatitis such as repeated abdominal pain, diarrhea, exopathy and cough.  Physical examination revealed a hepatomegaly of 4.5 cm, bradycardia (48/min).  He was clinically cured by systemic TCM therapy.

Elder sister Wong – (Computer No. 507), female, age 5 yrs.  She had history of nasal hypersensitivity and asthma which occurred repeatedly.  In the recent 2 days, she was attacked by fever, cough and varicella.  Her first visit was on 30 October 1997.  Physical examination: scantly varicella eruptions over skin of whole body, part of them formed scabs; hepatomegaly of 1.5 cm.  After taking 9 parcels of TCM drugs, the liver was normal and varicella eruptions also healed.  Medication continued for 4 weeks.

Younger sister Wong – (Computer No. 508), female, age 16 months.  Her first visit was on 30 October 1997.  Her mother said that the child had otitis media two months ago and was hospitalized because of pneumonia and high fever for 5 days.  She was discharged after 12 days of hospitalization after which she again suffered from common cold, bronchitis roseola and varicella, associated with diarrhea and nocturnal crying.  She asked for TCM treatment.  Physically examination: skin of chest and back scanty varicella marks, hepatomegaly of 1.5 cm.  After taking 9 parcels of TCM drugs, the varicella healed, cough stopped and the liver returned to normal.  A total of 27 parcels of TCM drugs were administered and the child achieved clinical cure.  A return visit was made 3 months later because of common cold and fever but the liver was still normal.

Yuan – (Computer No. 314), male, age 1 yr.  His grandmother and his parents all had chronic hepatitis and were treated in this clinic.  First visit: 23 March 1997.  The mother said that the child had dermal lesions 10 more days after birth and it was diagnosed as pediatric eczema, but although it was repeatedly treated by specialists, the effect was still not significant.

Physical examination revealed that the infant was poorly nourished and developed; on the face, axilla, wrist and ankles there were erosions, erythema and multiple small eruptions; the abdomen was soft and distended; the liver enlarged to 1.5 cm.  TCM therapy was not given for the time being because the parents could not bear the pain of the child in taking the medicine.  TCM treatment was accepted on 16 July 1997 because the child was attacked by generalized eruptions dermal, erythema, dryness and fissures; he also had a hot temper, poor sleeping, nocturnal crying and frequent bowl movement, 4-6 times a day.  He could only take soybean milk, his abdomen still soft and distended and hepatomegaly still 1.5 cm.

After taking 8 parcels of TCM drugs, the child’s liver was normal, the skin erosions and pruritus decrease, the skin over the face and limbs slightly reddish, dry and desquamated.  TCM treatment stopped 4 weeks later, at which time his urine was till yellowish, appetite poor and the skin at the flexor surface of the articulations of the extremities still slightly reddish and desquamated.

Eight months later (April 1998) the child was hospitalized because of tonsilitis and fever.  After subsidence of fever, the pediatric eczema relapsed and he made a return visit to the clinic.  He was found to have flush of face, maculopapular eruptions of the left facio-buccal skin.  He was thin looking, his abdomen soft and distended.  After 4 days of TCM treatment and it was found that the facio-buccal flush subsided, the eruptions disappeared and the liver retracted to 1.5 cm.  He took another 4 days of medicine and his mother said that no more skin eruptions were found, the liver was normal but nocturnal dermal pruritus was still present.  Medication stopped after 4 weeks of systemic therapy.

On 12 January 1999, his father had a return visit to the clinic and said that the child’s skin was smooth but his appetite was not so good.

Dong (Computer No. 2136), male, age 8 yrs.  First visit: 25 May 2000.

The mother said that the child had repeated attacks of German measles since infancy and when severe, he had to be sent to the emergency department.  He was susceptible to common cold, sorethroat, hyperhidrosis, fatigue, loss of appetite, ozostomia, constipation, bowl movements often once in a week.  He frequently suffered from insomnia, difficulty in falling asleep and could be easily awakened.  Physical examination: skin palish yellow, tongue normal, abdominal wall showing prominent subcutaneous veins, percussion tenderness of liver hepatomegaly of 3 cm.

After taking 3 parcels of TCM drugs, the liver was normal.  He continued the TCM therapy and constipation gradually improved.  There was some oral ulceration and occasional scanty rubella eruptions.  Sleeping was good one week later.  After 2 weeks of TCM therapy, he could feel hungry, his appetite improved and bowl movement became once a day.  After 3 weeks, there were still occasional rubella eruptions, hyperhidrosis and loss of hair.  The chest and abdominal wall and lower limbs still showed prominent veins.  When TCM drugs were taken for one month, sometimes he was still not able to have bowl movement daily.  A total of 64 parcels of TCM drugs were taken to complete the systemic course of therapy.  He was followed up.

Half a year later, he suffered from common cold, constipation, loss of appetite, fatigue and hyperhidrosis and returned for medication.  Physical examination revealed a hepatomegaly of 3 cm (being the first relapse).  After taking 3 parcels TCM drugs, the liver was normal.  During systemic TCM therapy, the patient had fever, sorethroat, cough and redness of tongue.  Then he stopped the TCM drugs by himself and turned to WM treatment for two weeks.  When he returned for TCM treatment, the liver was found to be enlarged 1.5 cm (being the second relapse of hepatomegaly).  After taking 3 parcels of TCM drugs, the liver returned to normal and TCM therapy was continued.  But 10 days later, he suffered from abdominal pain, diarrhea and cough because of eating raw fish.  He took WM drugs and felt sleepy after the treatment.  WM drugs were taking for 7 times and the liver was enlarged 3 cm (being the third relapse of hepatomegaly).  He was given 3 parcels of TCM drugs and the liver was again normal.

A return visit was made in February 2001.  The mother said that the child was given WM drugs because of severe coughing and expectoration.  The patient’s liver enlarged 1.5 cm (being the fourth relapse of hepatomegaly).  After taking 3 parcels of TCM drugs, the liver returned to normal.  TCM therapy was continued until a 4 week systemic course was completed.  He was clinically cured in April, then medication was topped and he was followed up.  In the following 2 years, there were nine episodes of relapse.  He had nasal hypersensitivity, rubella, constipation and hemorrhoids which required TCM therapy; in the time following, several times of physical examination did not reveal any abnormality.

translated by Professor ZHENG Hua En in April 2006