Hepatophilic Viral Diseases
Classification according to Traditional Chinese Medicine Method
Introduction
For thousands of years, the “Concept of Entirety”[1] has been adopted in the treatment of diseases in traditional Chinese medicine (“TCM”). It is appropriate to take this concept as the basis for explaining the onset of diseases: from the development of chronic hepatitis to the various symptoms at different hepatitis stages, to the damages of the body organs caused by hepatitis viruses and simultaneously the characteristics of various internal organs.
As an introduction, we shall classify the types of chronic hepatitis in accordance with the viewpoint of the traditional Chinese medicine. Hepatophilic virus diseases can be classified into six syndromes namely:
- The Stagnation of the liver qi (vital energy) and lung-dryness form
- The Wetness-heat vaporization form
- The Deficiency of both qi (vital energy) and the blood form
- The Blood stasis in the meridians and collaterals form
- The Exuberance of yang (vital function) of the liver
- The Deficiency of liver and kidney
However, this way of classification is only for the sake of convenience. Actually, a patient may have different symptoms or may have more than two types of classification at the same time. In fact, there is no distinct boundary among the five types of classification. In the course of treatment, the method of effecting a permanent cure is absolutely the same no matter which syndromes of classification.
Type 1: The Stagnation of the Liver qi (vital energy) and Lung-Dryness Form
The main clinical symptoms are various symptoms found in common diseases like repeated nasal sensitivity, common cold, tonsillitis, tracheitis, and asthma. Other common symptoms are: bleez, having a running and stuffy nose, bleeding in nose, dryness in month, thirst, dryness of the nasal cavity and pharynx, sore throat, dry cough, hemoptysis, globus hystericus, hoarseness, abdominal pain, short of breath, yellowish urine, stubborn constipation, hematochezia, etc.
For this type of classification, when the hepatitis viruses (i.e. the viruses of epidemic diseases) invade into the body, the flow of vital energy will be blocked and the liver qi will be stagnated which will then be transformed into a kind of “pathogenic heat”. The heat will hide in the liver and is difficult to be removed. The blood in the liver is heated and the pathogenic heat is subsided and hided in the blood system. The heat in the liver is the heat in the blood system. When the heat moves up to the lungs, it will cause dryness of the lung. At the early stage, a series of symptom on common cold can be resulted. Dryness of the lungs can be seen at a later stage of hepatophilic viral diseases where the liver and kidneys become deficient. It is because the body fluid is inadequate and it leads to the deficiency of yin (vital essence) of the lungs.
The resulting symptoms are: dry throat and dry tongue, marked by globus hystericus or itchy throat. Patients will suffer from choking with sputum, short of breath, hot in the palms, sweating, night sweating. Although various viruses and bacteria may also infect the upper respiratory system, the hepatitis viruses once invade into the body system and cause dryness of the lungs and stagnation of the liver would indicate that the duplication of viruses is frequent. This means the hepatophilic viral diseases is obviously active. It is different from common cold, tonsillitis or tracheitis. Sometimes because of the existence of symptoms like coughing, short of breath, abundant expectoration or repeated hemoptysis, it may be misdiagnosed as pulmonary tuberculosis or bronchiectasis.
The symptoms caused by stagnation of the liver qi and lung-dryness form are as follows:
- The symptoms occur continuously on the entire body and over long period of time. These include headache, ache all over the body, loss of energy, agitated, insomnia, dreamfulness (dream-disturbed sleep), weak eyes with red eyeballs, red and dry lips, reddened tongue with yellowish and white coating, often accompanied by anorexia, halitosis, nausea, abdominal distension, diarrhea after eating. Sometimes a patient may have stomachache caused by the wetness-heat, or may have interchangeable diarrhea and constipation, sudden pain around the ribs, taut pulse, generally no high fever, creeping chills. These symptoms will be exaggerated and recurring when the patients are over-exhausted or after menstruation for female.
- In case a patient receive western medicines treatment and was diagnosed as having common cold or tracheitis, the result is not satisfactory in general; the effect will not be good and the symptoms will recur again and again unless the wetness-heat inside the patients’ body is cleared thoroughly. If antibiotics and anodyne are used without care, the situation will be intensified. Therefore, many patients usually take western medicines at the acute stage in order to take control of the situation (e.g. to bring down a fever). Then they would consult Chinese practitioners for TCM treatment in order to clear away the wetness-heat and relieve the stagnancy of qi (vital energy) of the liver. The possibility of recurring is obviously reduced.
- Generally, the laboratory test and X-ray test usually show no positive result (i.e. negative). However, when the patients undergo blood tests for liver, only some of them may find antigen or antibody inside their bodies. Nor would liver function tests result change to positive. If they do ultra-sound test, the result may show that the livers are inflamed (hepatomegaly) and there are waves of hepatitis. Although many patients even go through blood tests and ultra-sound tests, the diagnosis for hepatophilic viral diseases cannot be concluded.
- When undergo physical check-up, that is by percussion to examine the liver, the patient may feel painful around the percussion zone. It is often found that the liver is inflamed – bigger than normal size. In clinical terms, the liver size is a decisive factor to determine the existence of hepatophilic viral diseases and a careful examination is required. On the other hand, it is important to note that if the size of the liver is not inflamed, it does not mean that the patient is free from hepatophilic viral diseases. This is because the liver may undergo to cirrhosis stage and therefore the size of the liver is reduced. Or may be the patient is suffering from abdominal distension, and much gas is retained inside the body which affect the accuracy of percussion. Therefore, it is necessary to examine again and again, to apply the Chinese medicines, and to observe the patient’s situation before making diagnosis.
- Hepatophilic viral diseases is an epidemic disease that affects the entire body. The past history and family history of a patient is important and helpful in making a diagnosis. The patient’s state of health, past symptoms, diseases relating to hepatophilic viral diseases, the spouse’s state of health or whether immediately family members have liver cancer or hepatitis are all important and useful information. It is not easy to make a doubtful diagnosis or incorrect diagnosis if the information of the past history, family members’ liver history, clinical symptoms, result of body examination, inflamed liver, percussion result, blood test results on antigen and antibody, liver function test, etc can be supplied and relied on.
(translated in February 2002)