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Hepatitis : Diagnosis
   
Western Medicine Chinese Medicine

Hepatitis A
Hepatitis A is diagnosed by testing blood for the presence of the virus. After an acute infection with the hepatitis A virus, most people recover uneventfully with no long-term effects but recovery generally takes a long time. Once a person recovers from the infection, the person develops immunity to the virus and cannot be infected again.

Hepatitis B
Hepatitis B virus infection can result in an acute or chronic condition. The disease is diagnosed by testing blood for the presence of the virus. A person is usually diagnosed with hepatitis B virus if they have had the virus present in their blood for more than six months. The severity of liver disease can be determined from A liver biopsy - a procedure used to obtain a small amount of liver tissue that is examined under a microscope.

Biopsy of the liver

Hepatitis C
As with hepatitis A and B, diagnosis of hepatitis C can be made by testing blood for the presence of the virus. The severity of liver disease can be determined from performing a liver biopsy.

A fasting plasma glucose (FPG) of 140 mg/dl (7.8 mmol/l) or greater
A 2-hour plasma glucose (2-h PG) post 75-gm of oral glucose tolerance test (OGTT) level of 200 mg/dl (11.1 mmol/l)
Both of the above

However, the latest American Diabetes Association (ADA) expert committee finds that there is a greater degree of hyperglycemia amongst patients who have FPG of 140 mg/dl or higher than those who have 2-h PG of 200 mg/dl or higher. Almost all patients with FPG 140 mg/dl or higher have 2-h PG levels of 200 mg/dl or higher. However, not all patients with 2-h PG of 200 mg/dl or higher have FPG of 140 mg/dl or higher. Therefore, the ADA currently recommends the diagnosis of diabetes be based on a lower level of FPG.
A patient is diagnosed with diabetes if he has typical hyperglycemic symptoms with a random plasma glucose of 200 mg/dl (11.1 mmol/l) or greater, confirmed on a subsequent day by one of the following criteria:
Typical symptoms of diabetes plus a random plasma glucose of 200 mg/dl (11.1 mmol/l)
A fasting (at least 8 hours of no caloric intake) plasma glucose of 126 mg/dl (7 mmol/l) instead of 140 mg/dl
A 2-hour post load glucose level of > 200 mg/dl (11.1 mmol/l) after a 75-gram anhydrous glucose load.


 
 

Through the four techniques a variety of symptoms and signs will be used to identify the individual's disharmony pattern. This is crucial because at the various stages of a disease, a variety of disharmony patterns are present which require different types of therapy. This is why individuals with the same disease may be treated very differently by their TCM practitioner.

As described earlier in the definition section, hepatitis is not directly diagnosed using TCM methods. Instead its symptoms will be grouped according to the disharmony pattern the individual displays. The following describes the disharmony patterns most commonly seen in person's with viral hepatitis.

1. Stagnation of dampness-heat evil in middle-burner
  This condition causes fever, bright yellow coloring on the face, eyes and skin, as well as poor appetite, vomiting, nausea, and yellow or dark-colored urine. Additional symptoms may include constipation, and a feeling of oppression over the central abdomen after eating meals. The tongue is red and coated with greasy and yellow fur. The pulse is faint and stringy or stringy and rapid.
 
 
Tongue exhibits thick greasy fur
   
2. Stagnation of liver-qi and spleen deficiency
  Symptoms are not always obvious, but can be seen by poor appetite, nausea, dark yellow urine, a dry mouth, discomfort over the central abdomen after meals, and distended pain in the upper lateral region of the abdomen. However these symptoms are less obvious than the symptoms listed in the above type. The tongue appears red or pink, and is covered with a thin coating of fur and appears greasy. The pulse sign is small, faint and thready.
   
3. Yin deficiency in liver and kidney
  Individuals feel fullness or dull pain in the upper lateral region of the abdomen. They also experience dizziness, ringing in the ear, fatigue and soreness in the limbs. The skin complexion appears yellow in color, and the skin especially around the eyes and throat appears wrinkled and dry. Mental depression and insomnia may arise and lead to malaise and fatigue. Poor appetite and abdominal distention can also occur. Males may suffer from premature ejaculation, and females may have irregular menstruation. The tongue is pale and covered with thin greasy fur, and the pulse is faint.
   
4. Obstruction of the meridians by blood stasis
  Symptoms include lassitude, soreness of limbs, poor appetite, dull pain in the upper lateral region of the abdomen, and abdominal distention. The face appears gray or dark gray, the skin complexion yellow, palms appear dark red and there is nasal bleeding. Dilatation of small blood vessels may find on the face, chest or upper part of body. The tongue appears dark red and is covered with pettechaie that are small pinpoint purple bruised looking spots or appears greasy. The pulse sign is faint or thready and slight.
   
5. Excessive heat and toxins
  This type of syndrome occurs suddenly or results from persistent hepatitis. The individual suddenly becomes feverish, and the yellow coloring of the skin steadily deepens. Subsequent symptoms include drowsiness, confusion, swelling, body fluid that leaks into the abdominal cavity (ascites), passing bloody stool, and nasal bleeding. Finally, the individual vomits blood and slips into a coma. Death is usually the ultimate result. The tongue is dark red and is covered with fur that appears filthy and greasy or scaled. The pulse sign is thready and rapid or thready and rolling.

Note: If a TCM practitioner suspects there might be a serious problem that Chinese medicine alone cannot treat, he or she will recommend the individual see a western doctor for further follow up.