Jaundice

Jaundice is mainly manifested by yellow discoloration of the sclera , skin and urine , resulted from the dampness in the spleen and heat in the stomach , leading to abnormal circulation of the bile which spreads to the skin surface . It is divided into yang jaundice and yin jaundice according to its nature .

Etiology and Pathogenesis

The seasonal and epidemic pathogenic factors accumulate in the spleen and stomach , leading to internal formation and collection of damp heat . Dampness after mixed with heat is apt to penetrate deeper , while heat mixed with dampness is apt to get more exuberant . The liver and gallbladder are steamed by the heat in the spleen and stomach , leading to overflow of the bile to the skin surface , thus jaundice appears .

Irregular diet injures the spleen and stomach , causing disturbance in transportation and transformation and internal formation of dampness , which transforms into heat . Damp heat stains the skin yellow .

Overstrain or general weakness of the spleen qi may give rise to hypoactivity of the yang in the middle jiao , leading to failure in transportation and transformation and stagnation of cold dampness , thus yin jaundice results . As said in A Guide to the Clinic Treatment The cause of yin jaundice is the dampness produced from cold water . If the spleen yang fails to resolve the dampness , the normal distribution of bile is impaired , affecting the spleen , soaking into the muscles , and spreading to the skin which turns yellow as if it were smoked .

Yin jaundice can also result from an improperly treated yang jaundice which leads to injury of the yang qi , hypoactivity of the spleen yang , and internal collection of cold dampness .

Differentiation

Yang jaundice :

Main manifestations : Lustrous yellow skin and sclera , fever , thirst , scanty dark yellow urine , heaviness of the body , fullness in the abdomen , stuffiness of the chest , nausea , yellow , sticky tongue coating , string - taut , rapid pulse .

Analysis : Steaming of the damp heat makes the bile spread to the skin surface . Heat being a yang pathogenic factor , makes the yellow discoloration of the skin lustrous . Fever , thirst , scanty dark yellow urine are due to excessive damp heat , which damages the body fluid , and disturbs the activity of the bladder . When the dampness is collected , the pure yang fails to be distributed and heaviness of the body results . In case of obstruction of the qi in the fu organs , fullness in the abdomen occurs . Stuffiness of the chest and nausea are due to the steaming of damp heat , leading to upward perversion of the turbid contents of the stomach . Yellow sticky tongue coating is due to accumulation of damp heat , and string - taut , rapid pulse due to excessive heat in the liver and gallbladder .

Yin jaundice :

Main manifestations : Sallow skin , heaviness of the body , weakness , loss of appetite , epigastric stuffiness , lassitude , aversion to cold , absence of thirst , pale tongue , thick , white tongue coating , deep slow pulse .

Analysis : The stagnation of cold dampness in the spleen and stomach impedes the distribution of yang qi , leading to overflow of the bile , thus the skin is sallow . In case the dampness stays in the spleen , the spleen yang is hypoactive and the transporting and transforming function is impaired , therefore , heaviness of the body , weakness , loss of appetite and epigastric stuffiness occur . Aversion to cold and lassitude are due to weakness of the yang qi . Since this case is of cold - damp nature , thirst is absent . Pale tongue , thick white tongue coating are due to deficiency of yang failing to resolve dampness . Deep , slow pulse is a sign of cold dampness staying in the yin system .

Treatment

Method : The points of Taiyin , Yangming and Shaoyang Meridians are selected as the principal points . Reducing is applied to remove heat and dampness in yang jaundice , while even movement with moxibustion is used to warm the middle jiao and resolve dampness in yin jaundice .

Prescription : Yinlingquan ( Sp 9 ) , Zusanli ( S 36 ) , Ganshu ( B 18 ) , Danshu ( B 19 ) , Zhiyang ( Du 9 ) . Supplementary points : Yang jaundice : Taichong ( Liv 3 ) , Yanglingquan ( G 34 ) .

Yin jaundice : Moxibustion to Pishu ( B 20 ) , Yanggang ( B 48 ) .

Explanation : Yinlingquan ( Sp 9 ) and Zusanli ( S 36 ) are used to strengthen the spleen and resolve dampness . Ganshu ( B 18 ) , Danshu ( B 19 ) and Zhiyang ( Du 9 ) are important points to treat jaundice . Since the damp heat resides in the gallbladder , Yanglingquan ( G 34 ) is selected to reduce heat , and used in combination with Taichong ( Liv 3 ) to regulate the flow ofqi in the liver and gallbladder . Moxibustion to Pishu ( B 20 ) and Yanggang ( B 48 ) may resolve cold dampness by warmth and treat jaundice .

Remarks

This condition is seen in acute icteric hepatitis , obstructive jaundice and hemoly - tic jaundice . Acupuncture and moxibustion are more effective to treat hepatogenic jaundice .