“Virus gastroenteritis” means the attack of the stomache and intestinal mucosa by virus producing acute or chronic infectious disease of the gastrointestinal tract.
At the present time, most physicians accept that liver disease can involve any site of the gastrointestinal tract. In traditional Chinese medicine, it is called “wetness-heat of the stomache and intestines”. “So Wen” (The Plain Questions of Huangdi’s Internal Classic”) (素問) stated :”if wetness overcomes, there is leakage of water”, indicating that wetness evil is the main cause of gastrointestinal wetness-heat and actually, it is the usual manifestation of virus gastroenteritis in Hepatophilic virus disease patients. In the previous sections, we have introduced oral ulcers, virus labial mucosa disease, hepatogenic gastric disease and portal hypertensive gastric disease, and , for continuance, the small intestines and large intestines should be mentioned.
In fact, all hepatophilic viruses which cause virus hepatitis complicated by gastroenteritis symptoms, should be included in the pathogens of “virus gastroenteritis” because the pathogens of the latter are very widely ranged. But, in the past, it was considered that “virus enteritis” occurred only in infants under 2 years of age, and the onset of disease was usually acute, associated with abdominal pain, diarrhea or upper respiratory tract infection or even symptoms like chilliness and fever. There are numerous commonly encountered pathogenic viruses, such as nocardial virus (諾澳克樣病毒), rotavirus (輪狀病毒), adenovirus (腺病毒), astrovirus (星狀病毒), corona-virus (冠狀病毒), etc. Actually, the above mentioned viruses should be included in the pathogens of “virus gastroenteritis”; besides the production of infantile acute “virus enteritis”, more attention should be paid to the symptoms of “virus gastroenteritis” which are the chief manifestations of chronic hepatitis.
The statistical data of 2000 cases of abnormal margin of liver dullness in Hong Kong revealed that clinical symptoms showing “virus gastroenteritis” amounted to 1031:2000, reaching 52%, in which a certain amount of cases presented with these symptoms as chief complaint.
Introduction of cases
| Case 1
Cheung (code number 1525), male, age 33 years. He had his first visit at the end of May 1993, with the complaint of repeated gastrointestinal discomfort, marked ozostomia (口臭), intention of defecation after meal, frequent flatus, abdominal distention, passing several times of stools a day, wetness-heat stools, dryness of mouth and pharynx, thirst, intermittent yellowish color of urine in the recent years. Because of recurrent affection due to exogenous pathogenic factors, he had hoarseness of voice, coughing, profuse sputum and generalized pain of the body. Physical examination: liver enlarged to costal margin with percussion tenderness. After taking 18 parcels of TCM drugs, the liver returned to normal. Medication was stopped after another 2 weeks of drug administration, but in less than one month later, he was repeatedly attacked by common cold, abdominal pain and diarrhea and therefore he visited the clinic again. It was found that the liver did not show any enlargement. Four weeks of systemic TCM medication was instituted and at the end of which, he obtained clinical cure and then TCM treatment was stopped for observation.
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| Case 2
Lee (code number 494), male, age 33 years. He first visited the clinic on July 1994 which the chief complaint of fatigue, repeated abdominal discomfort, and pain of abdomen after meal for 4 to 5 years. The pain aggravated recently with diarrhea three to four times a day; the stools were tarry, loose and abundant in amount. Physical examination: a lean patient, tongue enlarged with thin yellow coating, liver 1.5 cm below costal margin. After taking totally 12 parcels of TCM drugs, the abdominal pain was gradually relieved and the liver dullness returned to normal, the lower margin of liver being 1.5 cm above costal margin. Another 20 parcels of TCM drugs caused recovery of the stools. Clinical cure was obtained and TCM treatment was stopped temporarily for observation. Re-examination was done 3 months later, the liver was normal in size and there was no relapse of gastrointestinal symptoms.
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Case 3 Yip (code number 1580), female, age 11 years. Her first visit was on August 1999. Her mother substituted her for the complaint, saying that the girl had a very poor health condition, and could easily get stomache ache due to diet upset, abdominal distention, diarrhea, poor mental status and occasional constipation. In the recent days, she experienced nausea, vomiting, vertigo, poor appetite, abdominal distention, vomiting right after meal and passing loose and watery stools 2-3 times a day. Western medicine was given with no avail. Physical examination, revealed a lean, poorly nourished and underdeveloped girl, her skin palish yellow, tongue without coating, positive percussion tenderness of hepatic region, liver 1.5 cm below costal margin. Two parcels of TCM drugs were given, resulting in cessation of nausea and vomiting. She had a marked sensation of hungriness and her appetite recovered. The stools were 1-2 times a day, but still loose inform. Percussion tenderness over hepatic region was still present but the liver was normal in size. Systemic treatment was given for 4 weeks, after which, therapy was stopped for observation.
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By Wong Kwok Hung
published on 3rd April 2001
(translated by Professor ZHENG Hua En in September 2002)