Acute upper respiratory tract infection is a frequently encountered disease of the respiratory system in clinical practice. The disease is collectively referred to as upper respiratory tract inflammation; the affected parts are mainly nose, nasopharynx and pharynx and therefore we often us the terms acute rhinitis, acute nasopharyngitis (common cold), acute pharyngitis, acute tonsillitis in diagnosis. The disease in adults is often called “common cold” and when it occurs repeatedly, it is called “exogenous evils inhabiting the interior”. Various viruses and bacteria can evoke upper respiratory tract infection and clinically these are the most common diseases seen in pediatrics. But 90% of the primary infection are caused by viruses and often times, these are the prodromal symptoms of hepatophilic virus disease and common viral infections (such as virus hepatitis, measles, German measles, small pox, parotitis, etc).
Repeated attacks of common cold are the most common manifestations of patients having Hepatophilic virus diseases. In fact, these symptoms of exogenous insults are only part of the common symptoms seen in the TCM liver stagnation and lung dryness form of chronic hepatitis, especially in infants, children, premenstrual and postmenstrual periods of women, post-parturient and postoperative periods when the body is weak and disease may easily relapse. If the patient is confirmed to have virus hepatitis or found to have abnormal margin of liver dullness associated with repeated attacks of common cold, one must consider it a sign of liver stagnation and lung dryness form of hepatophilic virus disease and should not discard it lightly as a common attack of exogenous pathogens.
Hepatogenic upper respiratory tract infection symptoms are often the result of frequent reproductions of hepatophilic viruses which evoke immunologic responses of the body. When the disease is clinically cured by systemic TCM treatment, repeated common cold attacks may be stopped usually.
At the end of last year, we made a summary on 2000 cases of abnormal margin of liver dullness in Hong Kong and found that patients diagnosed as hepatic upper respiratory tract infection amounted to 47.6% (951: 2000), ranging second according to the western medical category of hepatic virus disease. (as shown in Fig 1, Part of common symptoms in hepatophilic virus disease, disease statistics).
- In these patients, 533 were male, and those having the history of repeated common cold symptoms occupied 45.2% (241: 533);
- 1286 were female and 46.3% of them (591: 1286) had repeated common cold symptoms;
- 181 patients were under the age of 16 and 114 of them had repeated common cold symptoms, occupying 63.0% (114: 181) and these symptoms were often the chief complaint of the patients.
Hence it is reasonable to consider that in our general clinics, not few of the upper respiratory tract infection patients seeking for medical help are, in fact, suffering from the “liver stagnation and lung dryness” form of chronic hepatitis and they visited the clinic because of repeated attacks. If they are discovered early and treated by systemic TCM, the symptoms can be controlled, the course of disease shortened and clinical cure can be attained.
By WONG Kwok Hung
5th December 2000
(translated by Professor ZHENG Hua En, February 2002)