bubble_chart Content

Mr. Han, male, 33 years old, first consultation on September 24, 1964. Since August 1963, he has experienced loss of appetite, aversion to greasy food, fatigue, and weakness. At the same time, he noticed yellow urine and yellowing of the eyes. Liver function tests showed a jaundice index of 13 units, with all other indicators normal. He was diagnosed with cholangiolitic hepatitis. Over the past year, every half month or so, the yellowing of the eyes and urine has recurred, without complete resolution.

Current symptoms: loss of appetite, aversion to greasy food, lack of strength, occasional pain in the right hypochondrium, abdominal distension and fullness, loose stool, yellow urine. Tongue coating is thin and white, pulse is wiry, thin, and slippery.
Pattern identification: dampness-heat not cleared, spleen yang deficiency. Prescription:
Virgate Wormwood 15g, Polyporus 9g, White Atractylodes Rhizome 9g, Alisma 9g, Dried Ginger 3g, Cinnamon Twig 5g, prepared common monkshood daughter root 6g, Shiny Bugleweed 12g, Plantain Seed 12g
Second consultation: After taking 4 doses of the above prescription, bitter taste in the mouth, dry throat, dark yellow urine, red tongue texture, and a rechecked jaundice index of 14 units. Further detailed pattern identification revealed dampness-heat not cleared, stasis obstructing the middle jiao, dysfunction of spleen in transportation, and long-term illness leading to qi deficiency and blood stasis. The previous method was adjusted to focus on clearing heat and dispelling dampness, aromatic transformation and activating blood, supplemented by tonifying qi and nourishing blood. Prescription:
Virgate Wormwood 60g, raw 15g, charred White Atractylodes Rhizome 10g, Villous Amomum Fruit 6g, Bitter Apricot Seed 10g, red tangerine exocarp 10g, Patchouli 15g, wine-processed Scutellaria 10g, Dandelion 15g, Cyperus 10g, Shiny Bugleweed 15g, Hangzhou Peony Root 30g, Chinese Angelica 14g, Ricepaperplant Pith 3g, Plantain Seed 12g

Third consultation: After taking dozens of doses of the above prescription, physical strength improved, appetite increased, abdominal distension and fullness disappeared, urine cleared, and stool normalized. Rechecked jaundice index dropped to 5 units. Later, raw was used in larger doses for further regulation, achieving clinical recovery with no recurrence upon follow-up.

Note: In this case, the persistent jaundice resembles yin jaundice. However, there are also signs of residual dampness-heat, such as yellow urine and a thin, slippery pulse. Therefore, although the primary approach was clearing heat and draining dampness, it was supplemented with strong warming yang agents like ginger, cinnamon, and monkshood, with only 15g of Virgate Wormwood, which was relatively insufficient in dosage and strength. This not only failed to achieve the desired effect but also aggravated heat and damaged the body's vital energy, leading to bitter taste in the mouth, dry throat, dark yellow urine, red tongue texture, and an increased jaundice index, with dampness-heat becoming more intense. Consequently, the pungent and hot ingredients were removed, and Dandelion, wine-processed Scutellaria, Shiny Bugleweed, Ricepaperplant Pith, and Plantain Seed were used instead, with an increased dosage of Virgate Wormwood, focusing on clearing heat, removing toxins, activating blood, and draining dampness, with an emphasis on clearing and draining damp-heat. The key points in treating yin jaundice are: the main symptoms should be pudendal coldness and dampness, with no obvious heat signs, or symptoms like cold limbs, clear and long urine, deep and thin pulse, and pale tongue texture. Caution should be exercised with strong warming yang agents like cinnamon and monkshood, especially in stages of deficiency and excess mixed, cold and heat interwoven, and deficiency-type pathogen excess. The formulation and use of medication should be approached with caution.