Hepatogenic pulmonary disease is the pulmonary pathologic changes or complications caused by hepatophilic virus during virus hepatitis. In the process of chronic active hepatitis, the viruses, which cause the chronic infection, are in a state of continuous generation, and the respective immune response of the human body can uninterruptedly evoke clinical symptoms attributable to respiratory tract infection.
Clinically, besides nasal hypersensitivity and repeated common cold symptoms caused by liver stagnation and lung dryness, there are often comparatively severe chronic throat itching, paroxysmal choking cough, profuse sputum, globus hystericus [“méi hé qì”] (a subjective symptom as if a foreign body stuck in the throat, unable to cough it out or swallow down) and fatigue of variable degrees. The patient often feels shortness of breath, heaviness in the chest, headache, dizziness and numbness of extremities, sluggishness in locomotion (shortness of breath in going upstairs or doing exercises).
Hepatogenic trachitis and bronchitis and also interstitial pneumonia were introduced previously, together with two case reports. Here, we continue to introduce other typical cases.
Typical Case Study
Case 3
Lee (code number 2120) male, age 74 years. His first visit was in April 2000 with the chief complaint of repeated attacks of exogenous evils and chronic cough with profuse sputum, nasal catarrh, costal pain and occasional blood tinged sputum for 30 more years. Sputum examination was negative, and he was diagnosed as chronic bronchitis but repeated western medical and TCM therapy was ineffective. For 20 more years, he repeatedly suffered from constipation, anal fistula (肛漏) and anal prolapse (肛門垂脫) which had to be replaced manually each time after passing stool. Often times he had insomnia and usually had to take sedatives (鎮靜劑). Five years ago, he showed redness of face and ear, and had feverish sensation in the five viscera at which time physical examination revealed hypertension, fluctuation between 150-170/90-100 mmHg and anti-hypertensive drugs were prescribed thereafter.
Physical examination: face red, marked costal anomaly, percussion tenderness over hepatic region, hepatomegaly of 1.5 cm below costal margin, “+” pitting edema of lower extremities, left forearm showing patchy subcutaneous telangiectasis (毛細血管擴張) , color fading on pressure, no pruritus (騷癢) and skin eruptions.
After taking 3 parcels of TCM, the stools were normal being once a day and large in amount; there was no abdominal pain. Treatment caused significant decrease of coughing. The sputum became less and was slightly yellow in color. The liver was normal and edema of the lower extremities was relieved. The blood pressure was 170/100 mmHg (under treatment of anti-hypertensive drugs (降壓藥物)).
Another two weeks of TCM treatment caused regression of redness of the face. There was some ophthalmic discharge (眼垢); coughing was significantly less, the sputum was white, watery and somewhat transparent. He still felt headache but sleeping was good and the liver normal. There was slight pitting edema over tibia. Blood pressure was 150/80 mmHg. It was estimated that the liver fire was controlled; the administration of anti-hypertensive drugs had coordinate effect in lowering the blood pressure.
After 3 weeks of TCM treatment, the body weight dropped 3 pounds (from 172 lbs down to 169 lbs). Coughing at night stopped, but headache was still present. The liver was normal. After 4 weeks of treatment, besides some tiredness, poor mental status and some ophthalmic discharge, the patient did not have any discomfort. The facial outlook was normal and there was no redness or hot feeling. The degree of anal prolapse (肛脫) was reduced by half and edema of lower extremities disappeared. The stools passed smoothly and the blood pressure was stabilized at 146/86 to 160/90 mmHg. Treatment was stopped afterwards and the patient was under follow-up observation.
Case 4
Lee (code number 792) female, age 68 years, married.
Her first visit was on 15th May 1997 with the chief complaint of acute type A hepatitis for 30 years. She had repeated tiredness associated with edema for a long time. In the recent 3 weeks, she had fever, chest pain, cough, fatigue, weakness and diarrhea (腹瀉). She was treated with western medicine and also TCM but with no avail. Physical examination revealed a thin woman with pale yellowish skin, thick white tongue coating and deep redness of tongue proper, hepatomegaly of 3 cm below costal margin, and marked percussion tenderness of hepatic region.
Two parcels of TCM drugs were administered. Two days afterwards, the fever subsided and chest pain disappeared. Occasionally, there was coughing and the tongue coating was yellow. The liver retracted to 1.5cm below costal margin and returned to normal after 8 parcels of drugs. There was occasional coughing, the extremities were painful and the tongue coating thick and yellowish white. She continued TCM medication and the symptoms gradually disappeared. Clinical cure was obtained after 28 parcels of TCM drugs. Her liver function test was normal.
By WONG Kwok Hung
9th January 2001
(translated by Professor ZHENG Hua En in April 2002)