Jaundice
General
Introduction
Jaundice is a disease and
syndrome, marked mainly by yellow in eyes, the body and urine. Generally, it is
divided into 3 kinds, Yang jaundice, Yin jaundice and acute jaundice. Yang
jaundice is more often seen and a part of them is of in-fectivity.
Jaundice in traditional Chinese
medicine and western medicine has same meaning, so jaundice in infectious
hepatitis, cholecystitis, diseases of biliary tract, cirrhosis, hemolysis, acute
or subacute yellow atrophy of liver, leptospirsis etc. All can refere the
treatment based on differentiation of symptoms and sings in the chapter.
Causes
of disease and pathogenesis.
Causes of disease and jaundice
have internal cause and exopathic cause. The exopathic cause is mainly affection
by exopathogenic factors or improper diet and the internal cause is more related
with deficiency-cold of the spleen and stomach, and internal injury. The
internal and external causes are correlated often. They are discussed
respectively in the following.
Ⅰ. Affection by
external pathogens: affection by damp-heat, fulminant pathogens, from superface
to interior, stagnation in the middle-Jia, dysfunction of the spleen and stomach
in transport and transformation, accumulation of dampness and heat pathogens in
the liver and gallbladder, induce impairment of dispelling function of the
liver, bile overflowing and infusing into the muscle and skin, flowing down to
the urine bladder, so yellow body, eyes and urine appear. Invasion of excessive
dampness, heat and epidemic pathogens with acute or infectivity very quickly
manifests as sevious phenomenon of invading the Yin-blood, which is called as
acute jaundice.
Ⅱ. Impairment due to
improper diet: Improper diet, often hunger or full, or over drinking, over
eating fat, sweet ,greasy food, all can impaire the spleen and stomach, even
lead to dysfunction of transport and transformation, accumulation of dampness
pathogen in the body. Excessive Yang-Qi in the interior, damp-heat is formed due
to dampness easily producing heat, and attacking the liver and gallbladder, bile
does not circulate in bile tract, infusing into the muscle and skin, so Yang
jaundice appears; improper diet, over
cold and cool impairing Yang-Qi of the spleen and stomach, or deficiency-cold in
the spleen and stomach, dysfunction of the spleen in transport, so dampness
pathogen easily produces from cold, and stagnation of cold-dampness in the
middle-Jiao, stagnation of bile, failure of normal circulation, flowing into the
muscle and skin to induce Yin jaundice.
Ⅲ. Internal injury due
to tiredness: Overwork, weakness of the spleen and stomach can induce jaundice.
It is mainly divided into two aspects: Firstly,
injury of the spleen-Yang or deficiency-cold of the spleen and stomach, failure of transport of water and
dampness, dampness produces from cold, leading to stagnation of cold-dampness in
the middle-Jiao, blockade of bile excretion, flowing into the muscle and skin to
form Yin jaundice. This is caused by deficiency of the spleen and internal
excess of cold-damp pathogens; Secondly, failure of pruducing
Qi and blood due to deficiency of the spleen, deficiency of Qi and blood,
so results in jaundice. This jaundice is also caused by deficiency, so it is
called as jaundice due to deficiency.
Ⅳ. Obstruction of
biliary tract by gallstones and ascaris: due to specificity of constitution, or
invasion of damp-heat forming gallstones, leaving in the gallbladder,
obstructing the biliary tract, or internal accumulation of damp-heat,
dysfunction of the spleen and stomach, obstruction of the biliary tract by
roundworm induces bile overflowing, forming jaundice.
Ⅴ.protracted abdominal
mass: stagnation of biliary tract by blood stasis, bile overflows to form
jaundice.
To sum up, dampness pathogen is
a key of occurrence of jaundice, and there are damp-heat and clod –dampness pathogens. From the point of view of
Zhanand Fu-organs, it is mainly involved in the spleen, stomach, liver and
gallbladder, and often from the spleen and stomach to the liver and gallbladder.
The spleen has the function to transport and transform nutrients, and it is
aversion to dampness, both affection by dampness pathogen or improper diet and
production of dampness pathogen in the interior all impair firstly functions of
the spleen and stomach. Dysfunction of the spleen in transport, stagnation of
dampness pathogen in the middle-JIao, dysfunction of the spleen and stomach in
ascending and descending, and failure of the spleen-Qi fails in ascending,
leading to stagnation of the liver-Qi, failure of scending down stomach-Qi
induces disturbance of transport
and excretion of bile. Stagnation of dampness pathogen leads to failure of bile
in biliary tract and bile seeping into blood, and then infusing into the muscle
and the skin, forming jaundice. It is the difference of Yang jaundice and Yin
jaundice that the patient of Yang jaundice has excessive Yang and more heat,
more excessive stomach-fire, prduction of dampness pathogen due to heat,
inducing stagnation of damp-heat, because dampness and heat are often excessive,
so there is difference of dampness over than heat or heat over than dampness in
pathogenesis of Yang jaundice. Extremely excessive fire-heat is called as toxin,
as excess of heat toxin, the pathogenic factor attacking Ying-blood, and
invading pericardium, often forming acute jaundice. The patient of Yin jaundice
has excessive Yin and severe cold, insufficiency of the spleen-yang, dampness
pathogen is caused by cold, forming cold-dampness; and protracted Yang jaundice,
or orver taking drugs of cold in nature, damaging the spleen-Yang, dampness
produces from cold pathogen, also forming Yin jaundice. In addition, at once the
jaundice caused by obstruction the biliary tract by gallstones and roundworn,
symptoms of the liver and gallbladder will be seen, manifesting often heat as
main, belongs Yang jaundice. In he patient of the jaundice caused by protracted
abdominal mass, stagnation of blood stasis in the biliary tract, Yin jaundice or
Yang jaundice is formed often due to consititution of cold and heat.
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