Discussion on Recurrence of Chronic Hepatitis, August 2, 1977

Discussion on Recurrence of Chronic Hepatitis, August 2, 1977

Patients with chronic hepatitis often experience recurrent flare-ups, which is one of the most challenging issues in the medical community. Over recent years, the author has carefully observed the course of this condition and has gained some insights, which are presented below. The recurrence of chronic hepatitis is caused by the following three factors: ① colds; ② diet; ③ fatigue.

1. Colds. Most cases are habitual colds; due to prolonged illness, the immune system of hepatitis patients gradually weakens, making them susceptible to invasion by wind-cold and wind-heat pathogens. The “Yellow Emperor’s Inner Canon” states: “Wherever pathogenic factors gather, the qi must be deficient,” which perfectly explains this phenomenon. Many patients mistakenly believe that a cold is a recurrence of hepatitis and excessively take hepatitis medications, some even receiving continuous intravenous drips of 10% glucose, resulting in worsening conditions. Ultimately, the cold leads to a recurrence of hepatitis, effectively turning a simple cold into a serious liver disease. In the summer of Ding Si, the author’s wife fell ill, and upon returning home from Lanzhou, the author found her pulse floating, accompanied by headache, nasal congestion, liver pain, nausea, chest pain, and fatigue. She had previously suffered from chronic hepatitis, and this time she thought it was a liver attack, so she self-administered liver medications, which only made the condition worse. The author said: “This is a severe cold.” He then prescribed Xiao Chai Hu Tang combined with Gui Zhi Tang, and after ten doses, her condition greatly improved. Later, he switched to Chai Hu Shu Gan San to further enhance the effect.

2. Diet. Recurrence of this disease is often caused by dietary indiscretion. In the spring of Ding Si, the author treated a patient named Li, who had chronic hepatitis but had been improving in recent years. Ten days ago, he ate a large amount of fermented rice cakes, causing discomfort in the stomach and immediately triggering pain in the liver area, along with bitter taste and dry throat. Other doctors mistakenly believed it was a recurrence of hepatitis and prescribed liver medications, but to no avail. Upon examination, the author found her pulse sinking, with both guan pulses being string-like and especially pronounced on the right side, concluding that the root cause was food stagnation, with liver depression as the manifestation. This is a case of earth overcoming wood, not wood overcoming earth. From a Western medical perspective, the problem lies in the stomach rather than the liver. The author then prescribed Yue Ju Wan combined with Dan Shen Yin and Xiao Chai Hu, which successfully cured the condition.

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3. Fatigue. Fatigue is an important factor leading to the recurrence of hepatitis. For individuals with pre-existing liver disease, the first symptom triggered by fatigue is usually liver pain. The primary treatment for liver pain should be Chaihu Shugan San. At this stage, liver function is still normal; however, if accompanied by fatigue and loss of appetite, it may indicate a change in liver function, in which case Qianggan Tang should be the main treatment.