Characteristics of wetness-heat of stomache and intestines
As we understand deeper the clinical symptoms of chronic virus hepatitis classifies by traditional Chinese medicine, it is clear the symptoms of wetness-heat of stomache and intestines, a part of the wetness-heat vaporization form, have its own characteristics:
| 1. The course of disease is prolonged and full of relapses; if not treated with effective systemic TCM medication, the symptoms are extremely difficult to be eradicated. 2. It is often associated with marked generalized symptoms of chronic hepatitis; the patient usually complains of extreme fatigue, generalized soreness of body, heaviness of lower extremities, loss of appetite, weakness, vetigo (眩暈), anxiety, dreamful sleep, insomnia, palpitation, shortness of breath and unstable sleeping. Because of gastrointestinal dysfunction, the patient may have anemia, hepatogenic malnutrition and underdevelopment, or even hormonal disturbances, thinness or puffiness. The patient may be vulnerable to exogenous evils, or have menstrual disorders, hypermenorrhea (經量過多) or dysmenorrhea (經痛) in women. 3. In physical examination, the patient is often shown to have abnormality of margin of liver dullness or percussion tenderness over hepatic region. 4. Some patients had definite history of hepatitis and hepatitis “antigens” and “antibodies” were positive in blood examinations or their liver function presented abnormality. Some patients may also have hepatomegaly under ultrasonic or CT scan. 5. Gastrointestinal wetness-heat symptoms can easily relapse and usually the causes are unclean drinks and food or ingestion of raw, cold, pungent or dry-heat food. Recent clinical observation shows that ingestion of virus carrying food like raw fish or not well cooked mussel, the disease may relapse. The incubation period is extremely short and at the first appearance of symptoms, it may simultaneously expose an enlarged area of liver dullness. Ordinarily, after taking 3 parcels of the effective TCM drug ”QuGanDu”, the enlarged liver can return to normal. 6. The clinical symptoms of “irritable bowel syndrome” are completely identical with the gastrointestinal symptoms of chronic virus hepatitis. Some physicians consider the former a disease entity of intestinal dysfunction. Clinical practice demonstrates that if these patients show abnormal margin of liver dullness and are treated with effective systemic TCM drugs, it is easy to obtain clinical cure. |
In the past, not few physicians, as well as patients, had mistaken the symptoms of “gastrointestinal wetness-heat of Hepatophilic virus disease for other disease. They neglected the fundamental “virus hepatitis” condition and therefore, it was extremely easy to make the wrong diagnosis, miss the diagnosis or to give the wrong management.
Common symptoms
The patient may have prolonged dryness of throat, nocturnal thirst and drinking, ozostomia (口臭), morning nausea, vomiting sensation in teeth brushing, poor appetite, fullness of stomache and abdominal distention. After meal, abdominal distention becomes worse, the patient may have to pass stools after eating, and diarrhea alternates with constipation. Occasionally, the stools were scanty in amount but wetness-heat in nature; the patient may have tenesmus (里急後重) and burning sensation of the anus and a small number of patients may see blood tinges toilet paper after defecation, and even more, there may be dripping of blood.
Some patients may have gastrointestinal hypersensitivity ingestion of some kinds of food may evoke nausea, vomiting, borborygmus (腹鳴), abdominal distention, frequent passing of flatus (多屁), abdominal pain, diarrhea and dyspepsia. Few patients may have dull right hypochondriac pain, exacerbating in the presence of fatigue or overworking.
Although some patients do no have any change in the appearance of stools, but they frequently experience wetness-heat abdominal pain or even repeated paroxysmal abdominal cramps, and if severe in intensity, emergent hospitalization may be the only way. On account of the severity of abdominal pain, it may be easily misdiagnosed as acute gastroenteritis, stomache illness, acute appendicitis (急性闌尾炎), cholecystitis (膽囊炎), cholelithiasis (膽石症), etc. Physical examination usually reveals thinness, pale yellowish or darkish color of skin, malnutrition, underdevelopment or puffiness, and appearances due to hypoalbuminemia (血白旦白減少), like teeth prints of enlarged tongue, palish white or redness of tongue or yellowish or white tongue coating. Few patients may have thick and fixed coating of tongue which can hardly be eliminated if not treated by systemic TCM medication. Some patients may show edema of lower extremities (marked pitting by finger pressing on front of tibia), coarseness and desquamation of skin, etc.
Introduction of cases (continued)
| Case 4
Xie (code number 1502), male, age 6 years. His father suffered from type A hepatitis with jaundice five years ago and he still experienced tiredness, edema, palpitation, abdominal pain and distention. His mother was a carrier of type B hepatitis virus and had history of menstrual disorder. On July 1999, the parents and the child came to the clinic and all were found to have hepatomegaly. The mother had physical examination several months before and was found to have rise of liver ferment. Their child had repeated paroxysmal abdominal pain, diarrhea, constipation, enuresis, nasal sinusitis (鼻竇炎) and otitis media (中耳炎史).
On the first visit, the child showed palish yellow skin, abdominal distention, prominent veins over the chest and abdominal wall and hepatomegaly of 1.5 cm below costal margin. After 7 parcels of TCM drugs, the liver became normal. Medication was stopped after 6 weeks of systemic treatment. His return visit was on November 1999 when his mother said that he had taken some cakes in the school a week before together with about ten classmates. They all vomited after that. The vomiting of her son was associated with diarrhea and it was followed by cough, profuse sputum, and abdominal distention, western medicine was given with no avail. The child was examined physically and found, for the first time, relapse of hepatomegaly, being 1.5 cm below costal margin. One half parcel of TCM drug was administered, once daily for 6 days, after which, the liver was found to be normal. There was relief and disappearance of symptoms and therapy was stopped after 4 weeks of systemic treatment.
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By Wong Kwok Hung
published on 10th April 2001
(translated by Professor ZHENG Hua En in September 2002)