Foreword
For thousands of years, the “concept of wholism” penetrated through the channel of recognization of diseases in traditional Chinese medicine. We apply this concept together with the method of “treatment according to syndrome differentiation” to explain (1) the development of hepatophilic virus disease, the different symptoms occurring in different stages after invasion of the body by the virus, and (2) the characteristics of simultaneous multiple visceral injuries caused by damage to different visceral organs, and all these have been considered exceedingly appropriate. Invasion of hepatophilic virus, as a kind of pestilential evil, may originate at the infantile stage of human life in the form of persistence of virus infection to affect the function of various visceral organs. “From shallow to deep layer, form the exterior to the interior”, these are the actions of the disease at different stages whereby various symptoms may be gradually initiated.
For the sake of facility in introduction, we attempt to describe systematically the six forms of chronic virus hepatitis as classified by traditional Chinese medicine. They include:
| (1) | liver stagnation and lung dryness form ; |
| (2) | wetness-heat evaporation form ; |
| (3) | weakness of energy and blood deficiency form ; |
| (4) | channel blockage and stasis of blood form; |
| (5) | abnormal rise of liver-yang form (this form should also include the three kinds of results produced by itself, namely, yin deficiency of liver and kidney, deficiency of yin and domination of yang, deficiency of both in and yang); and |
| (6) | deficiency of both liver and kidney form. |
But this so called classification is only for facility in description and is therefore artificial. In fact, patients in different stages of disease and different times, may have different symptoms or have simultaneously symptoms belonging to two forms or above. Actually, there is no strict borderline between the forms, but on the other hand, in the course of treatment, the rule of “treating the foundation” is absolutely the same for all forms.
Chronic hepatitis liver stagnation and lung dryness form, its cause, development
and characteristics and case reports
(1) The case of liver stagnation and lung dryness
According to the explanation of traditional Chinese medicine, “Hepatophilic virus” acting as a kind of pestilential evil, after invasion into the human body, will hinder vital energy resulting in stagnation of liver and stasis of Qi. Prolonged stagnation may change into heat; the fire of heat evil not only hides in the liver and difficult to be eliminated, but also the liver is full of blood which communicates with blood circulation so that the heat evil may hide in the blood. Liver heat is also heat of the blood; if it flares up to the lung, it may case lung dryness, the early stage of which may show a series of virus disease prodromal symptoms of repeated nasal hypersensitivity and common cold, that is , upper respiratory tract catarrhal symptoms. Among the acute phase of Hepatophilic virus infection, it is usually associated with severe prodromal symptoms (especially in infants) such as chill, fever, general muscular-ache, headache, fatigue, loss of appetite, etc. They are then followed by respiratory infection symptoms of the liver stagnation and lung dryness for. If the liver stagnation and lung dryness cannot be timely and systematically treated by TCM, often, stubborn and unclassified exogenous insult symptoms may remain with predominance. Such condition usually occurs in infants and premenstrual or postmenstrual women; and the illness may relapse and aggravate.
Liver stagnation and lung dryness may also appear in the late stage of Hepatophilic virus disease. Because of deficiency of liver and kidney and lack of kidney water, yin deficiency of the lung is produced, and it may lead to the appearance of repeated dryness of the mouth and tongue, sensation of foreign material and itching in the throat, severe paroxysmal coughing, scanty sputum, quickness and shortness of breath, hot sensation of palm, hyperhidrosis, perspiring during sleep, etc. Although upper respiratory tract infection may be caused by different bacteria and viruses, but invasion of Hepatophilic virus is often associated with the characteristic abnormality of the region of liver dullness.
Marked symptoms of liver stagnation and lung dryness indicate high rate of duplication of the viruses and distinct activity of the chronic Hepatophilic virus disease. Characteristically it is different from common cold, tonsilitis or bronchitis, and generally, these may be continuous severe coughing, shortness of breath, profuse sputum, bloody sputum or even repeated hemoptysis and often times, misdiagnosed as chronic bronchitis, pulmonary tuberculosis, bronchiectasis, asthma, and even pulmonary carcinoma. After infection of hepatophilc virus, liver stagnation and lung dryness form patients, because of paroxysmal severe coughing, prolonged course and repeated attacks of illness, may mislead clinicians to apply chest X-ray or sputum examinations, blood sedimentation test, bacterial incubation to find Mycobacterium tuberculosis or even repeated bronchoscopy, but these efforts will usually yield normal results.
According to the statistical data of 2000 cases of abnormal margin of liver dullness classified by TCM, those having the liver stagnation and lung dryness symptoms occupied 49.7% (993:2000); there were 1286 female patients in which the form occupied 47.8% (616:1286); there were 181 young and adolescent patients under 16 years old and this form occupied 70.2% (127: 181). We can see that in the young patients with Hepatophilic virus disease, the symptoms in the early stage of disease are mostly of the liver stagnation and lung dryness form.
Figure 1- Male and female patients
Figure 2 – Female patients Figure 3 – Young and adolescent patients
The above statistics may not be scientific enough, but it points out a fact: in the vast majority of medical and pediatrical upper respiratory tract infection patients seeking for medical help, really, how many of them are infected by Hepatophilic virus and suffering form virus hepatitis that have initiated the liver stagnation and lung dryness symptoms. Therefore, if patients are finally diagnosed as chronic hepatitis or found to have abnormal area of liver dullness by physical examination, it is appropriate to give them systemic TCM therapy with the hope of achieving early clinical cure.
By WONG Kwok Hung
7th November 2000
(translated by Professor ZHENG Hua En)