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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

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).

Comparison Between Damp-Heat Brewing in the Spleen and Liver-Gallbladder Damp-Heat
Damp-heat Brewing in the Spleen Liver-Gallbladder Damp-Heat
Common SignsHeat effusion, slimy yellow tongue fur, a pulse that is slippery and rapid
DifferencesAbdominal distension, torpid intake, nausea and vomiting, and stool irregularitiesRib-side pain, jaundice, genital itch

Analysis of signs

Comparison

Treatment

Medicinal therapy: Course the liver and disinhibit bile; clear and drain damp-heat. Use medicinals such as virgate wormwood (Artemisiae Scopariae Herba, 茵陈蒿 yīn chén hāo), bupleurum (Bupleuri Radix, 柴胡 chái hú), curcuma (Curcumae Radix, 郁金 yù jīn), unripe bitter orange (Aurantii Fructus Immaturus, 枳实 zhǐ shí), scutellaria (Scutellariae Radix, 黄芩 huáng qín), phellodendron (Phellodendri Cortex, 黄柏 huáng bǎi), gardenia (Gardeniae Fructus, 山栀子 shān zhī zǐ), rhubarb (Rhei Radix et Rhizoma, 大黄 dà huáng), gentian (Gentianae Radix, 龙胆 lóng dǎn), isatis root (Isatidis Radix, 板蓝根 bǎn lán gēn), bushy knotweed (Polygoni Cuspidati Rhizoma, 虎杖 hǔ zhàng), and hanging stonecrop (Sedi Herba, 石指甲 shí zhǐ jiǎ). Virgate Wormwood Decoction (茵陈蒿汤 yīn chén hāo tāng) is used for damp-heat jaundice. Major Bupleurum Decoction (大柴胡汤 dà chái hú tāng) is mainly used for liver-gallbladder damp-heat characterized by high fever or alternating heat and cold, distending pain in the rib-side, severe pain the upper abdomen, bitter taste in the mouth, nausea and vomiting of bitter fluid, constipation, or jaundice.

Acumoxatherapy: Base treatment mainly on CV and the three yīn channels of the foot. Select BL-18 (Liver Transport, 肝俞 gān shù), BL-19 (Gallbladder Transport, 胆俞 dǎn shù), LR-14 (Cycle Gate, 期门 qī mén), GB-24 (Sun and Moon, 日月 rì yuè), LR-3 (Supreme Surge, 太冲 tài chōng), TB-6 (Branch Ditch, 支沟 zhī gōu), GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán), and SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán); needle with drainage. Where heat is predominant, add GV-14 (Great Hammer, 大椎 dà zhuī) and LI-11 (Pool at the Bend, 曲池 qū chí). Where dampness is predominant, add SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo) and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ).

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