Last week, we introduced hepatogenic exopathy (upper respiratory tract inflammation) with a case report. This week we continue the introduction with typical cases of different ages. Repeated common cold attacks are generally the symptoms most frequently seen in Hepatophilic virus disease patients and these extremely common symptoms are manifestations of the TCM liver stagnation and lung dryness form classification of chronic hepatitis.
| Case 2
Pang (code no. 686), male, age 53, British, first visit was in October 1995. He received hernial operation in a certain large hospital in Hong Kong and in the post-operative days, he had attacks of exogenous insults with profuse sputum, pain the throat and chest, insomnia, abdominal distention, diarrhea and water like stools for more than on month. He came to the clinic because medical therapy was not effective. Physical examination: a tall and strong man, face brilliant, tongue swollen with teeth pitting, the forearms and dorsal surface of hands showing senile pigmentation patches. The abdomen soft and distended, liver enlarged to costal margin. The impression was chronic hepatitis “liver stagnation and lung dryness” form and therefore TCM therapy was instituted. After taking the drugs, the liver margin was normal, vomiting ceased, and TCM therapy was proposed to treat the liver disease. The patient did not have liver disease before and he could not accept the diagnosis of chronic hepatitis. So he visited a western doctor whom he knew and had a liver function test. The result showed an increase of transaminase A year more later, he had coughing again which appeared usually in the morning and scanty sputum and he had also edema of the legs. On February 1997, he came back to Hong Kong for examination and his liver was found enlarged down to the costal margin. Coughing decreased after taking two parcels of TCM and he carried 21 parcels of drugs at his return to India. One month after the TCM treatment, he came back to Hong Kong and he had not hepatomegaly, the lower margin of liver dullness being 1.5 cm above the costal margin. Coughing disappeared and his only complaint was poor sleep occasionally.
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Case 3
Fong (code no. 2092) female, age 22.
Her father had type a hepatitis with jaundice, her mother had hepatomegaly and myoma of uterus. They were both treated in our clinic.
On March 2000, she was first seen in our clinic with the complaint of a past history of tracheal hypersensitivity, repeated sore-throat, hoarseness, obstinate coughing, facial acne, menstrual disorders and a history of dysmenorrhea. On visiting, she complained of tiredness, somnolence, pain and itching of throat, coughing without sputum for 2 weeks. Medical treatment did not give an effective result.
Physical examination revealed a pale yellowish face, pale lips, tongue with thin white coating and reddish tip, the bilateral ribs showing anomaly, the liver 1.5cm below costal margin with percussion tenderness.
After 3 parcels of TCM, the amount of stools increased, being 2-3 times a day, loose and brownish in color. After treatment, hoarseness disappeared, coughing was relieved and sleeping was good, but the tip of tongue remained reddish; the liver was 1.5 cm above costal margin, yet percussion tenderness was still present. During systemic TCM treatment, coughing was relieved and finally disappeared and acne was also cured. Her menstruation delayed and premenstrual symptoms were marked. She complained of chest distention, cramps of the lower abdomen, anxiety, but dysmenorrhea disappeared and the amount of menstrual blood decreased, the color being bright red and no blood clots were seen. The course of treatment was four weeks, after which all symptoms disappeared. Due to the attainment of clinical cure, medical treatment was stopped and patient was told to take some medicine at premenstrual periods.
| Case 4
Lee (computer no. 026), male, age 27. His first visit was in November 1993 with the chief complaint of repeated common cold since childhood associated with hoarseness, sore-throat, abdominal distention, diarrhea, oral erosions, painful swelling of gingivae, right costal pain. Tonsillectomy was done on the advice of doctor, but the above symptoms still persisted. In the week before, he had high fever and sore-throat and he took anti-inflammatory drugs. On visiting, the fever had subsided but oral eruptions, sore-throat, headache, abdominal distention and diarrhea were present. Physical examination: big in stature, fat but not tough, showing also abdominal distention, intestinal tympanites, percussion tenderness of hepatic region, lower margin of liver 3 cm above costal margin, indicating decrease of area of liver dullness. After taking 5 parcels of TCM, although he still had headache, abdominal distention and diarrhea, the lower margin of liver in percussion discended to 1.5 cm below costal margin. After 24 parcels of TCM, the liver margin was 1.5cm above costal margin, through 7 weeks of treatment, clinical cure was attained and treatment was stopped for observation. In the following years, the patient visited the clinic occasionally and found at times to have oral ulcers or gastrointestinal discomfort and was treated with TCM drugs. More than once, physical examination showed normal findings including the liver and relapse of disease was not seen.
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Case 5
Kwok (computer no. 284), male, age 34, first visit in February 1996.
He was found to be a carrier of type B hepatitis virus for two more years by blood examination and often had nasal obstruction, sneezing, pain and dryness of throat, oral ulcers and fatigue. On physical examination, percussion tenderness was found over the hepatic region and the liver enlarged to 1.5cm below costal margin.
After 8 parcels of TCM administration, hepatic upper respiratory tract inflammation symptoms disappeared and the lower margin of liver retracted to the costal margin. Another 7 parcels were given and the liver margin returned to 1.5cm above costal margin. Systemic TCM treatment was stopped after 4 weeks administration and relapse did not occur thereafter.
By WONG Kwok Hung
12th December 2000
(translated by Professor ZHENG Hua En, March 2002)