TA KUNG PAO - < Talks about Hepatitis from elderly physicians >
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TA KUNG PAO - < Talks about Hepatitis from elderly physicians > |
43
:Hepatophilic virus disease - TCM classification as
“Wetness-heat vaporization form”
Common symptoms (10):
Wetness-heat of lower-jiao - Stranguria, turbid urine, leukorrhea (I)
(下焦濕熱)
The
various symptoms of “wetness-heat vaporization form” are the most common and
typical symptoms of TCM classification of chronic hepatitis.
These symptoms appear during the entire course of chronic hepatitis up to
the time of clinical cure of the disease by TCM treatment.
The mechanism and pathology of wetness-heat vaporization form not only
can produce different disease and lead to different clinical symptoms but,
promoted by infection of hepatophilic virus, it can also cause accumulation of
“wetness-heat” in the body, and further, downward flow of
“wetness-heat”, rendering the body to form “wetness-heat of lower-jiao”
(下焦).
Attack from wetness-heat is enhanced by liver dysfunction which causes
abnormal metabolism and poor detoxication ability and also by direct affection
of pestilential evil on various organs of the body causing inflammatory reaction
of mucosal tissues and consequently clinical symptoms of lower-jiao
wetness-heat. These clinical
manifestations are “stranguria”, “turbid urine”, “leucorrhea” and
difficulties in urination and defecation; they all belong to the field of
“wetness-heat of lower-jiao” disease in TCM.
Clinically,
the so called lower-jiao heat in TCM is caused by accumulation of heat through
the flaring of fire in the gate of life as well as heat in the urinary bladder;
the respective symptoms are difficulty in mieturition, dark urine, constipation,
hematuria, dribbling urination and anuria.
The patient, although weak, has heat in the body and if the heat gues up,
it becomes fire and if it runs down, it causes spermatorrhea.
The most common symptoms are urinary bladder wetness-heat, dysfunction of
urinary bladder and leukorrheal disease.
(1) Urinary bladder wetness-heat.
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The symptoms include :
¨
frequent urination (loss of control of urinary bladder, frequent
alternation of shutting and opening of bladder sphincter);
¨
dribbling and unclear urination (loss of gasification function in the
kidney, kidney damaged by prolonged existence of five types of stranguria and
turbid urine, dripping of urine in voiding, unsmooth urination);
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pain in micturition;
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burning sensation of urethra;
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post-urination dribbling,
¨
distensive pain of lower abdomen, ¨ dysuria and in severe cases even hematuria and anuria. |
Late
stage liver disease patients mostly have damaged of yin and
therefore, if there is urinary turbidity, toxin should be eliminated.
In case of stranguria, yin should be supplemented.
There is also difference in clinical management, but the TCM systemic
treatment of “soothing the liver and relieve stagnation together with clearing
of wetness-heat” in chronic hepatitis is indispensable.
If the liver is not completely detoxicated and wetness-heat not
abolished, treatment of the fundamental cannot be attained and wetness-heat of
lower-jiao would not be eradicated.
(2)
Dysfunction
of urinary bladder
This is due to weakness of kidney causing
exhaustion of body fluid and invasion of evil upon the urinary bladder where
heat is accumulated and it reaches to an excessive height and finally turns into
dysfunction of urinary bladder. The
symptoms include tenderness of the lower abdomen and the urinary bladder.
If
the patient drinks water, the amount of urine is small and there is difficultly
in urination, enuresis or appearance of a clear discharge.
If the gasification ability of kidney and urinary bladder is impaired,
there may be anuria, obstruction of urinary passage and dribbling urination.
Prostatic disease in the male should also be classified in the field of
lower-jiao wetness-heat.
(3)
Leukorrheal
disease:
This is also caused by wetness-heat.
The formation of leukorrheal disease in women is mostly due to the
invasion of virus evil and if it persists for a long time, the belt channel is
hurt causing wetness-heat to flow down to the uterus.
Another cause is injury of the liver that affects the spleen.
If the energy of spleen is not protected, it cannot regulate body
metabolism as well as blood nutrition so that wetness is formed and it flows
down to become whitish discharge. Whitish
substances may therefore flow out from the vagina from time to time and may take
the form of nasal discharge or sputum, and because the illness runs a prolonged
course, it is called leukorrheal disease. The
treatment of leukorrheal disease aims at clearance of liver and stoppage of
stranguria; therefore, hepatophilie virus infection is also an important cause
in the formation of gynecologic diseases.
Case 1
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Lee (code number 1124) male, age 37 years.
He
took his first visit on November 1994, having a history of type B
hepatitis virus carrier for 10 years.
He also suffered from hemorrhoids with bleeding for nearly 20
years. Recently, he was found
to have chronic nephritis confirmed by biopsy and also positive B. coli in
urine culture. He felt weak
and had also insomnia, repeated sorethroat, frequent micturition and
distensive pain over the loins and lower abdomen.
Physical
examination: tongue margin multiple ecchymotic patches, thin and whitish
tongue coating, (+) pitting edema of lower extremities, abdomen distended,
soft and tympanitic, lower margin of liver dulness 3cm above costal
margin. The tentative
diagnosis was type B hepatitis, type B hepatic nephritis, wetness-heat of
lower-jiao (stranguria, hemorrhoids complicated with bleeding).
After
taking 3 parcels of TCM drugs, the lower margin of liver dulness was found
to be 4.5 cm above costal margin; sleeping improved and frequency of
urination decreased. After
another 3 parcels of TCM drugs, percussion of liver revealed hepatomegaly
of 1.5 cm. Abdominal distension improved, hemorrhoidal bleeding stopped
and there was marked regression of edema of lower extremities. Another 15 parcels of TCM drugs (total 21 parcels) brought the liver dulness to normal. In the meantime, clinical symptoms disappeared. Clinical cure was attained after systemic TCM treatment for chronic hepatitis and thereafter TCM therapy was discontinued.
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By WONG Kwok Hung
published on 10th July 2001
(translated by Professor ZHENG Hua En in March 2003)