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Liver-gallbladder damp-heat
肝胆湿热 〔肝膽濕熱〕gān dǎn shī rè
Also damp-heat brewing in the liver and gallbladder (湿热蕴结肝胆 shī rè yùn jié gān dǎn).
A disease pattern chiefly characterized by distension and pain in the rib-side; aversion to food; abdominal distension; alternating cold and heat; yellowing of the body and eyes (jaundice); in men, genital damp-itch or painful swollen testicles; in women vaginal discharge or pudendal itch; damp-heat signs.
Description: Distending pain in the rib-side; aversion to food; bitter taste in the mouth; short voidings of yellow urine; upwelling and nausea; abdominal distension; stool irregularities (thin sloppy stool or dry bound stool); in some cases, alternating cold and heat; in some cases; yellowing of the eyes and body (jaundice); in men, scrotal itch/genital damp itch or and painful swollen testicles; in women, fetid yellow vaginal discharge and pudendal itch. Note that gallstones were never traditionally detectable, they are attributed to liver-gallbladder damp-heat (just as urinary stones are treated mostly attributed to bladder damp-heat).
Diseases: Sores; pudendal itch; vaginal discharge; alternating cold and heat; rib-side distension.
Biomedical correspondence: Mostly seen in acute icteric hepatitis or biliary tract infections.
Pathogenesis: This repletion pattern arises when damp-heat brewing in the spleen affects the liver and gallbladder. The damp-heat
- is externally contracted;
- arises from excessive consumption of rich sweet or fatty foods; ordevelops when impaired movement and transformation of the fluids creates dampness that lies depressed and forms heat.
The damp-heat spreads to the liver, to obstruct free coursing. This is described as congested earth rebelling against wood
(土壅侮木 tǔ yōng wǔ mù).
- When impaired free coursing affects the gallbladder, it can affect the lesser yáng (shào yáng) (shào yáng) channel
pivot,
where right and evil engage in a struggle that manifests is alternating cold and heat. - When damp-heat steams upward, bile is carried by it and spills out into the skin, giving rise to yellow eyes and body (jaundice).
- The damp-heat can also pour down through the liver channel to rise to cause genital conditions.
Comparison Between Damp-Heat Brewing in the Spleen and Liver-Gallbladder Damp-Heat | ||
---|---|---|
Damp-heat Brewing in the Spleen | Liver-Gallbladder Damp-Heat | |
Common Signs | Heat effusion, slimy yellow tongue fur, a pulse that is slippery and rapid | |
Differences | Abdominal distension, torpid intake, nausea and vomiting, and stool irregularities | Rib-side pain, jaundice, genital itch |
Analysis of signs
- Earth rebelling against wood: Aversion to food, upwelling and nausea, and abdominal distension. There are also stool irregularities: if dampness is predominant, the stool is sloppy; if heat is predominant, the stool is dry and bound.
- Inhibited qì dynamic in the liver and gallbladder channel: Distending pain sometimes associated with scorching heat in the rib-side area.
- Depressed damp-heat steaming upward and gallbladder qì ascending counterflow: Bitter taste in the mouth.
- Lesser yáng (shào yáng) (shào yáng) : The lesser yáng (shào yáng) is the pivot, half exterior half interior. When invaded by damp-heat, there may be alternating heat effusion and aversion to cold.
- Bile spilling outward: Yellowing of the eyes and body.
- Liver-gallbladder qì pouring downward through the liver channel: Short voidings of reddish urine, scrotal itch, genital damp itch, or painful hot swollen testicles in males or fetid vaginal discharge and pudendal itch in females.
- Tongue: Red with slimy yellow fur.
- Pulse: Rapid and stringlike or slippery.
Comparison
- Damp-heat brewing in the spleen does not manifest in jaundice unless the damp-heat spreads to the gallbladder. See table.
- Bladder damp-heat is associated with urinary signs.
Treatment
Medicinal therapy: Course the liver and disinhibit bile; clear and drain damp-heat. Use medicinals such as virgate wormwood (Artemisiae Scopariae Herba,
Acumoxatherapy: Base treatment mainly on CV and the three yīn channels of the foot. Select