Preface
Chronic virus hepatitis can be classified into six forms according to traditional Chinese medicine, they include
(1) liver stagnation and lung dryness form,
(2) wetness-heat vaporization form,
(3) deficiency of energy and blood form,
(4) blockage of channels and stasis of blood form
(5) flaring up of liver yang form
(6) weakness of liver and kidney form.
The first form “liver stagnation and lung dryness” was mentioned previously and from now on, the second form “wetness-heat vaporization” is introduced. Patients belonging to this form are even more in number, and the clinical symptoms manifested are very commonly seen and it is the top form among the six.
This so called classification is really artificial and is done only to facilitate description, actually, patients in different stages and times, may have different symptoms or have symptoms belonging to two or more forms. In fact, there is no strict boundary among the forms, but on the other hand, in the course of treatment, the rule of treating the primary cause is absolutely unchanged.
Pathogenesis of wetness-heat vaporization form
The hepatophilic viruses enter the human body as pestilential evil which, from the point of traditional Chinese medicine, is a kind of wetness evil (yin evil 陰邪), capable of producing the following changes:
Wetness can easily surround the spleen and also liver stagnation easily suppresses the earth spleen causing weakness of the latter. Internal wetness is consequently produced and prolonged stagnation is changed into heat, so that wetness-heat gathers and stays inside the body and is difficult to be eliminated. It then inhibits and they yang-energy of the body, penetrates deeply into the nutritious blood, viscera and channels, producing significant symptoms and signs of wetness-heat vaporization.
On account of the presence of wetness-heat which leads to occupation of heat evil inside the lung and stomache, the heat evil can be transmitted to the yang ming channel (陽明經) and then released through the skin to form various kinds of skin diseases.
If the liver flares up in the liver, and the spleen becomes inactive, the energy embedded in wetness-heat may run down to indwell in the lower-jiao (下焦) and induce wetness-heat of the urinary bladder, uterus and large intestine.
Wetness-heat is comparatively concealed, difficult to be discovered and eliminated and often part of the wetness-heart vaporization patients were infected at the infantile period; they ere easily neglected at that time and were diagnosed and treated only after growing up into the adult age. Therefore, the course of disease is often prolonged and full of relapses and the course may extend to several years or even several decades. The clinical symptoms may persist for a long time with aggravations and remissions. The wetness-heat manifestations, therefore, often times, guide the chronic Hepatophilic virus disease patients to think that their constitutions are quite similar to the wetness-heat group.
Statistical data of 2000 cases
The manifestations of Hepatophilic virus disease are complicated and the clinical symptoms are varied. Most of the patients present, at the same time, symptoms of different degrees of severity coming form different systems, and if you ask about his past history, you may find that it coincides with the manifestations of wetness-heat of chronic hepatic disease as classified by TCM.
The symptoms of wetness-heat vaporization form are the most frequently seen and most typical symptoms among the six forms classified by TCM in chronic hepatitis. This clinical behavior often times runs through the entire course of chronic hepatitis until the achievement of clinical cure by the management of systemic TCM. According to the statistical data form 2000 cases of abnormal liver dullness in Hong Kong, it is shown : among the forms classified by TCM, those have wetness-heat vaporization symptoms amount to 69.20% (1384:2000) and among 1286 female patients, those having wetness-heat vaporization symptoms amount to 68.27% (878:1286), and in 181 cases under 16 years of age, those belonging to the children group amount to 58.56% (106:181). From here, we can see in hepatophilic virus disease patients those with wetness heat vaporization form symptoms are the most common and they occupy the first range in all forms (see fig 1).
Symptoms of other forms combined with those of wetness-heat vaporization form are extremely common (see figure 2). These combinations may be the following:
| Wetness-heat vaporization (type 2) and blockage of channels and stasis of blood (type 4) symptoms | amount to 30.95%
(619 :2000) |
| Wetness-heat vaporization (type 2) and liver stagnation and lung dryness (type 1) symptoms | amount to 30.15% (603 : 2000) |
| Wetness-heat vaporization (type 2), liver stagnation and lung dryness (type 1) and blockage of channels and stasis of blood (type 4) symptoms. | amount to 12.75% (225 : 2000) |
Written by Wong Kwok Hung
published on 6th February 2001
(translated by Professor ZHENG Hua En in August 2002)