The Treatment of Modern Western - Biblio.nhat-nam.ru

14CHOLECYSTITIS/CHOLELITHIASISCholecystitis means inflammation of the gallbladder, whilecholelithiasis means stones within the gallbladder and bileduct. Modern methods of imaging have now shown thatgallstones obstructing the bile duct are the most commoncause of cholecystitis. Therefore, we are discussing these tworelated conditions under a single heading. The symptoms ofacute cholecystitis are severe, acute, colicky pain localized inthe upper right quadrant which often radiates around to thelower right scapula. This pain is typically accompanied bynausea and vomiting. Approximately, 75% of patients haveexperienced these symptoms one or more times before.Typical episodes improve in 2-3 days and resolve within aweek. Risk factors include being obese, female, and over 40years of age, the so-called three F’s of gallbladder disease.The Western medical diagnosis of this disease is based on thepatient’s presenting signs and symptoms, their history, andeither hepatobiliary scintigraphy or ultrasound. The Westernmedical treatment of this condition consists mainly of fasting,rehydration with IV fluids and electrolytes, and the prescriptionof antacids and anticholingerics. Antibiotics maybe prescribed if cholecystitis is complicated by infection.Cholecystectomy is routinely used for the management ofacute cholecystitis and is considered the treatment of choiceby many MDs. Noninvasive methods of lithotripsy, such asthose using sonic pulses, are only sometimes used.CHINESE DISEASE CATEGORIZATION: Cholecystitisand cholelithiasis are mainly categorized as xie tong, rib-sidepain, fu tong, abdominal pain, and huang dan, jaundice.Accompanying nausea and vomiting are categorized as e xinand ou tu respectively.DISEASE CAUSES: Unregulated eating and drinking,internal damage by the seven affects, aging, and wormsDISEASE MECHANISMS: Over-eating oily, slimy foodsmay damage the spleen and engender dampness internally. Ifevil dampness transform heat, dampness and heat may bind,forming damp heat which then obstructs the free flow of qiand blood and the qi mechanism. Inhibited flow of the qiand blood results in rib-side and abdominal pain, while inhibitionof the qi mechanism results in nausea and vomiting.It is also possible for damp heat brewing and binding toengender or transform worms which also inhibit both theflow of qi and blood and the qi mechanism with the sameresults. If dampness and heat spill over from the center intothe skin, jaundice may appear.On the other hand, unfulfilled desires and anger may bothdamage the liver which then loses control over coursing anddischarge. Qi stagnation results in rib-side and abdominalpain. If the liver assails the stomach, the stomach qi maybecome disharmonious, thus leading to nausea and vomiting.If liver depression endures for a long time, it maytransform into depressive heat. If qi stagnation endures, itmay engender blood stasis, since the qi moves the blood,and, if, the qi stops, the blood stops. If the liver invades thespleen, the spleen typically becomes vacuous and weak andloses its control over movement and transformation.Therefore, there may be food stagnation and/or dampaccumulation. If internally engendered dampness due tospleen vacuity combines with depressive heat due to liverdepression, this may also give rise to damp heat obstructingthe center.If either internally engendered or dietarily caused damp heatbrews internally, it may produce heat toxins burning andblazing. Because enduring damp heat damages and consumesboth the qi and yin, qi and yin vacuity symptoms maybe seen, especially in older patients.