Quite the Quiet Epidemic, The Liver and Oriental Medicine

Hepatitis C is called the "Shadow Epidemic" because one can carry the virus and pass it on for 20 years without any outward signs of infection. The invasion of Hep C and the pathological damage created by the virus is the number one reason for liver transplantation in the United States.

Hep C is contracted the same way as Hepatitis B and HIV are through contact with body fluids of an infected person, through sex with an open wound, tainted b1ood products, shared items of intimate use such as razor blades, toothbrushes and used syringes.

Hepatitis C has a greater immune camouflage than the HIV virus. This means the virus can create its damage upon the liver while avoiding attack by specialized killer cells. Most Hep C carriers are healthy looking and give no outward signs of infection.

This often comes much to the surprise of patient and physician alike. Some patients display a history of a vague dull nagging pain around the liver area or blood work shows a rise in liver enzyme levels. When this occurs a viral count is usually ordered confirming the presence and level of infection. Presently, there is NO known cure for Hepatitis C infection.

According to the World Health Report published by the World Health Organization in October 1996 Hepatitis B has infected 2,000 million people, of whom 350 million are chronically infected and therefore at risk of death from liver disease. About 100 million are chronically and incurably infected with Hepatitis C and are similarly at risk.

In a Fact Sheet published in June 1997 WHO estimates that a proportion in the order of 3% of the world population has been infected with HCV and that there are more than 170 million chronic carriers who are at risk of developing liver cirrhosis and/or liver cancer.

Unfortunately, unlike Hepatitis B, which becomes chronic at a rate of about 17.5% of the number of people infected, Hepatitis C turns into a chronic disease in over 70% of the people infected. The 170 million figure is probably an under-estimate, for a number of reasons. Consider the people who do not go to see a doctor, mostly in under-developed countries, and therefore are not registered as being ill or are asymptomatic and have not been tested yet.

Considered together the figures for both Hepatitis B and C, there is an astronomical figure of almost 2.2 billion people alive infected with a serious infectious disease of the liver. Of these, 450 million have developed chronic hepatitis.

By any standards, to have 170 million people infected with Hepatitis C, 3% of the world population, means we are facing a very serious problem. If we consider the total number of people infected with both Hepatitis B and C, almost 2.2 billion - nearly half the world population, then we can only agree with the World Health Report 1996: "Hepatitis is emerging as a global health issue".

Underfunding of research seems to be the biggest hurdle in finding a cure for Hepatitis C. In terms of numbers in the whole world there are 8.5 times more people infected with Hepatitis C Virus than people infected with HIV at 20 million according to the WHO Report in 1996.

The research funds are disproportionately smaller for Hepatitis C. This despite the fact that for each person who dies of AIDS four persons die of Hepatitis C. For example, in the USA, one of the most developed countries of the world, the research funds for Hepatitis C are 255 times smaller than the ones for HIV. According to the Centers for Disease Control, Hep C affects 5 times more people than HIV. 3.5 million Americans are known to have HCV vs. 700,000 with HIV.

The National Institute of Health spends $1.15 billion a year on HIV and AIDS research and only $4.5 million a year on HCV. There is no funding for the treatment of chronic hepatitis, but $500 million is spent annually for AIDS treatment. This is not to say that there should be a reduction in the funds allocated for HIV.

The comparison is used in order to illustrate that Hepatitis C is almost ignored by the authorities, despite the huge spread of this illness. The goal is to see a substantial increase in the funds allocated for the research and treatment of Hepatitis C.
The Liver: Master Organ for Optimal Nutrition.

The liver is the master organ for creating optimal nutrition for all the 50 trillion cells in your body. The liver is the body's largest organ, weighing three to five pounds in adults. It uses 12 - 20% of the body's total energy, and it must generate this energy to it's own cells.

The liver routinely performs over 500 known functions to regulate your cell's metabolism. It is the "alchemical wizard" of the body, transforming toxins into harmless chemicals for excretion, and digestively absorbed nutrients into the proper biochemical forms your cells can use to function.

Yet the liver is probably the organ most assaulted by toxic modern lifestyles, full of pollution, stress, junk foods, drugs, etc. In the US 40,000 deaths a year are due to liver disease. Yet most people will never suffer from hepatitis, cirrhosis, or jaundice, the "classic" liver diseases.

Toxic modern lifestyles may however promote subclinical liver dysfunction. As this review will make clear, no matter how good your diet and digestion, if your liver does not perform its many jobs properly, your cells can still be grossly malnourished.
Optimal nutrition is a function, not just of what we eat and digest, but of how well the liver bio-transforms incoming food nutrients into forms that the bloodstream can transport to all the body's cells, and that the cells can use to perform their metabolic functions.

Key Liver Functions

The liver converts the thyroid hormone thyroxine (T4) into its more active form tri-iodothyronine (T3). Thyroid hormones act as the body's thermostat, regulating the rate at which virtually all biochemical reactions occur in the body.

Inadequate conversion of T4 to T3 by the liver may lead energy-depleting hypothyroidism, leading to chronic fatigue, weight gain, poor memory and a host of other problems. The liver creates Glucose Tolerance Factor (GFT) from chromium, niacin and possibly glutathione.

GFT is needed for the hormone insulin to properly regulate blood-sugar levels. Due to its critical role in facilitating amino acid entry into muscle cells, GFT empowered insulin is also a necessary co-factor for Growth Hormone to be effective in promoting muscle growth in response to athletic training programs.

The liver manufactures bile salts. These are used to emulsify fats and the fat soluble vitamins A,D,E and K for proper digestive absorption. The liver also removes some fat-soluble toxins from the body by first dissolving them in bile salts, then dumping the bile and toxin mixture into the intestine for eventual fecal excretion.

The liver activates B vitamins into their biologically active coenzyme forms. The plant vitamin A precursor beta carotene must be turned into real vitamin A. Other nutrients, such as iron and copper, must be changed by the liver into their appropriate bloodstream transport or storage forms, such as ferritin or ceruloplasmin.

Virtually every nutrient, whether it be vitamin, mineral or amino acid, must be biotransformed into its proper biochemical form in which the nutrient may be stored, transported or used in cellular metabolism. If the liver does not properly activate nutrients into their bioactive forms, then even the most well-absorbed, high potency, broad spectrum supplement will be useless at best and possibly even mildly toxic.

The forms in which nutrients are found in supplements and foods are not the final, active biochemical forms used by the cells. If you do get the active coenzyme form of a nutrient from a food or supplement, it will usually be broken down during digestion. There's no getting around the critical role of the liver in bio-activating the nutrients we get from foods or supplements.

The liver stores various nutrients, especially A, D, B12 and iron for release as needed. The liver manufactures carnitine from lysine and other nutrients. Carnitine is the only known bionutrient that can escort fats into the mitochondria, where the fats may be burned to generate ATP bio-energy.

The mitochondria are microscopic power plants found in each of the body's 50 trillion cells, as many as 1000 per cell! These mitochondria generate 90% of the ATP bio-energy that powers every aspect of our life at the cellular level. The heart muscle burns fats to make ATP almost exclusively, and is extremely sensitive to cellular carnitine deficits. The muscles of well trained endurance athletes will burn fats to supply up to 70% of their fuel needs.

The liver converts lactic acid from a toxic waste to an important storage fuel. Lactic acid is produced when glucose (sugar) is metabolized through physical activity and may irritate nerves and muscles if it accumulates to excessive levels. However, a healthy liver will extract lactic acid dumped into the bloodstream by hard-working muscles and convert it into the important reserve endurance fuel glycogen.

The liver serves as the main glucose buffer, preventing high or low extremes of blood sugar. It is the key regulator of blood sugar between meals, due to its manufacture, storage and release of glycogen. Glycogen is the starch form of glucose in which the body can store a half days sugar supply.

When the blood sugar is low, a healthy liver converts stored glycogen into glucose, releasing it into the bloodstream to raise blood sugar levels. When blood sugar is too high, the healthy liver will remove much of it, converting the excess into stored glycogen or fat.

The liver can make glucose from dietary or body derived amino acids. This process ensures adequate brain and muscle carbohydrate fuel supplies even when the diet provides little or no carbohydrates. The liver is the chief regulator of protein metabolism. It converts different amino acids into each other as needed.

The liver produces cholesterol and packages it into different forms for blood transport HDL and LDL. Essential fatty acids, such as linoleic acid, GLA, EPA, and DHA, must also be properly packaged by the liver into appropriate lipoprotein forms to allow transport through the blood to the 50 trillion cells using the fatty acids.

The liver is the main poison detoxifying organ in the body. It must break down virtually everything toxic to the body from metabolic wastes, to insecticide residues, drugs and alcohol industrial and food processing chemicals. Failure of this liver function will usually cause death in twelve to twenty-four hours.

The liver uses a relatively small number of enzyme systems to detoxify the 10,000 or more chemicals polluting modern food, air, and water. Ironically, in metabolizing some toxic chemicals through its standard limited repertoire of detoxifying processes, the liver may inadvertently convert a toxic substance into an even more damaging toxin.

The liver must dispose of ammonia, an extremely toxic byproduct of protein metabolism. The amino acids arginine and orthinine are used by the liver to control ammonia levels. Ammonia can cause brain irritation and even death, at surprisingly low levels. The liver is the main organ for breaking down hormones after they have served their messenger function to their target cells.

For example, if the liver does not break down insulin quickly enough, hypoglycemia results as the still circulating insulin continues to lower blood sugar. If the liver does not metabolize estrogen properly, PMS will result. Failure to dispose of adrenaline, the "fight" or "flight" hormone, after it has outlived its usefulness may lead to chronic irritability and temper explosions.

This brief review, which has not even touched on other key liver functions, such as immune functions and blood clotting protein manufacture, should make clear the central role of the liver in promoting optimal cellular nutrition.

A survey of mild liver dysfunction symptoms sounds like a description of "normal" modern life. These might include chronic fatigue and feeling tired after meals. Depression, mood instability, and irrational anger and temper flare-ups may be liver related. PMS symptoms, including breast soreness and sensitivity, depression, hypoglycemia and irritability, may be liver related.

People routinely consuming large amounts of overheated, hydrogenated, junk food fats, coffee drinkers, regular alcohol users, smokers, people regularly driving on crowded, exhaust-filled roads and highways, women using birth-control pills, candida patients, workers routinely exposed to heavy metals, hydrocarbon solvents and those on long term prescription drug therapy are all considered to be at risk of subclinical liver dysfunction.

Fortunately modern nutritional science has discovered many nutritional measures to promote optimal liver function and detoxification, even in the presence of unavoidable toxins. A major liver protecting nutrient is vitamin E. E is generally recognized as the major lipid fat soluble antioxidant in human tissue.

As early as 1973, N.R. Diluzio published studies demonstrating that many liver toxic compounds caused their damage through creation of lipid peroxides (rancid fats) in liver cells. This damage could be offset by supplementary vitamin E. Fatty infiltration, in which streaks of fatty material interpenetrate the liver's structure, is a common feature in alcoholism and in various liver diseases.

What Is Hepatitis?

Hepatitis is an inflammation of the liver. The word comes from a combination of two Greek words: "Hepatos-" liver, and "-itis" inflammation. The inflammation of the liver, hepatitis, can be caused by several factors. If inflammation and necrosis of hepatocytes persist for more than 6 months then it is considered chronic hepatitis.

Based on histological criteria, chronic hepatitis classification is as follows: chronic persistent; chronic lobular and chronic active hepatitis. Chronic Persistent Hepatitis and Chronic Lobular Hepatitis usually follow acute hepatitis B or C. These disorders may persist for years, but are mild and rarely progress to chronic active hepatitis or cirrhosis.

Clinical features for both are vague or no symptoms such as anorexia, weakness and nausea the clinical signs are absent. Sometimes liver enlargement can be detected through persistently high transaminase values.

Hepatitis C is a form of hepatitis caused by an RNA (Ribo Nucleic Acid) virus, and accounts for most of the hepatitis cases previously referred to as non-A, non-B hepatitis. The Hepatitis C Virus (HCV) was first identified in 1988 and a Hepatitis C antibody test (anti-HCV) to identify individuals exposed to HCV became commercially available in 1990.

In 1995 the hepatitis C virus was seen for the first time by using an electron microscope. The hepatitis C virus has a high mutation rate. These ongoing changes in the virus make it difficult for the body's own immune system to fight off, as by the time the immune system figures out the virus, it has changed to look different. For the same reason it is very difficult to develop a vaccine.

There are cases of hepatitis C with no evidence of blood to blood exposure (receiving blood transfusions or products, needle sticks or needle sharing), where it is unknown how these individuals became infected. Hepatitis C Virus (HCV) infection becomes chronic in about 50-80% of cases, therefore HCV is known to cause the most cases of Chronic Active Hepatitis.

Chronic hepatitis C behaves differently from hepatitis B. The disease is generally milder and most people are asymptomatic or have vague or no symptoms. Nevertheless, 10-15 years and even more, from the infection, the complications of cirrhosis appear in about 20-30% of patients, sometimes unexpectedly.

The percentage of patients who develop cirrhosis is much greater than in chronic hepatitis B, while primary liver cancer appears to be much less common. About 80% of patients have abnormal aminotrasferase values. A characteristic feature of chronic hepatitis C is the fluctuation in aminotrasferase values seen in approximately 50% of cases. Fluctuations seem to represent effects of mutations in the virus or episodic immune reactions. Transaminase values don't correlate well with histological features of disease.

About 20% of patients with positive diagnostic tests for HCV have persistently normal liver enzymes. Some of them progress to more advanced disease, in others infection appears to remain quiescent. Chronic liver injury caused by Chronic Active Hepatitis can lead to cirrhosis and hepatocellular carcinoma. About 20% of patients with chronic hepatitis C and 25% of those with chronic hepatitis B progress to cirrhosis after 15-20 years from onset of the infection.

The scar tissue that forms in cirrhosis replaces the normal liver cells, making the flow of blood through the liver increasingly difficult. The loss of normal liver tissue slows the processing of nutrients, hormones, drugs, and toxins by the liver, as well as the production of proteins and other substances made by the liver.

Liver cirrhosis is associated with development of Hepatocellular carcinoma and therefore it can be considered a pre-cancerous lesion. Approximately 5% of chronic HBV and 10% of chronic HCV carriers develop HCC. Hepatocellular carcinoma HCC can also be found in patients with chronic hepatitis but without cirrhosis. This situation is more frequent in patients with chronic hepatitis B than in chronic hepatitis C.

Chronic hepatitis is frequently asymptomatic, therefore it is often discovered casually, during routine blood tests. The first element of suspicion is the elevation of transaminase levels a sign of liver injury. Chronic hepatitis can be distinguished from an acute form because it persists and gives no sign of recovery as blood tests are persistently abnormal.

Positivity for anti-HCV does not necessarily mean presence of chronic hepatitis C, because this antibody persists for some months after recovery from an acute form. Diagnosis of chronic hepatitis C can be posed only after the detection of HCV in patient's blood with PCR, which can detect minute amounts of viral genome RNA.

If chronic hepatitis is present a liver biopsy should be performed to assess the degree of liver inflammation and extent of fibrosis for hepatitis staging and grading. In fact, if cirrhosis is present, treatment requires caution and, in some cases, cannot be applied. The two most common screening tests to establish the presence of Hep C are:

ELISA - Enzyme Linked Immunosorbent Assay. First introduced in 1991, searches the blood sample for certain biochemical sequences which are associated with the presence of antibodies to Hep C. ELISA 1 searched only for the presence of one particular genetically specific to HCV, and was not very reliable.

In 1993 it was replaced by ELISA 2, a more comprehensive and reliable test, but still fell short of being accurate. Now ELISA 3 is available, easy to perform, inexpensive and far more accurate, which makes it usually the initial test recommended by physicians.

RIBA - Recombinant Immunoblot Assay was developed as a better alternative to ELISA 1, and went through three generations of refinement. It incorporates a search for two different sets of patterns in combination with checking for the presence of a control substance. RIBA 3 is relatively accurate, but being more expensive than ELISA 3 it is used to confirm the ELISA 3.

One Persons Struggle

Anthony Defontes used Oriental Medicine to deal with a 10-year hepatitis C infection. Anthony first found out he had Hepatitis C through a routine insurance examination about nine years ago and was told to keep tabs on it by receiving blood tests at six-month intervals to see if the liver enzyme levels were being affected by the disease.

There are three or four enzymes that are indicative of the severity of the disease along with triglycerides levels. He hadn’t contracted it in a conventional manner. Two things that he had never been involved with were intravenous drug use or blood transfusion. Basically it boiled down through more research that being a hairdresser, he could have contracted it from having an open cut on his finger and come in contact with the open cut of a client’s head.

Anthony has been a subscriber of Family Health News for as long as he’s had the disease and consequently is an advocate of oxygen products, antioxidants and colloidal silver. He was treating himself that way for the disease for years really thinks that it kept the Hep C at bay for the last nine years.

He went without any of the tiredness or jaundice or liver pain that’s associated with hepatitis C. Then he noticed that the enzyme levels started to climb and made some inquiries into where to get treatment. He got a referral to an acupuncturist and herbalist.

Anthony feels that people should go the alternative route before they pursue the conventional medical route. Conventional doctors told him they wanted to put him on interferon and perform a liver biopsy. Neither of which did he want anything to do with. So he figured he’d try an alternative method first being that the disease wasn’t that far along.

It has been one year since he started acupuncture and herbs and his enzyme levels are almost completely back to normal. His triglycerides, which were as high as 800 at one time, and usually averaged around 450, are now in the normal range of 150. He feels that he’s managing his Hep C.

He’s just about at the end of the treatment with oriental herbs and the acupuncture and is considering going for chelation therapy afterward to see if he can totally knock the disease out of his blood. It’s barely detectable at this point.

A TRADITIONAL CHINESE MEDICINE TREATMENT FOR HEPATITIS

Traditional Chinese Medicine (TCM) does have treatment protocols that are virucidal. There are also liver protecting and immune enhancing herbs as well as acupuncture. This protocol is used to try to heal the damaged liver tissue and build the body’s own immune system. The intention is that a bolstered immune system will recognize and attack the virus. The long range goal is to bring the body back to homeostasis.

TCM has a long and thoroughly researched history for the treatment of hepatitis of all forms. Since China has some of the poorest sanitation infrastructure per population base, they have ample opportunity to accumulate medical experience treating hepatitis.   This particular protocol has been developed by Dr Robert Gaston at the Quan Yin Medical Center in Miami, FL (305) 758-7011.

Treatment Protocols are broken down into three 3 month periods or trimesters. Before beginning treatments, a blood profile is needed with 1iver enzyme levels and preferably a viral count as well. These numbers are used as a base to chart the effect of the treatments.

1st trimester: Acupuncture and herbal treatments are applied once a week for a period of three months, after which a Second blood test is done. If the liver enzymes drop, treatment will be every 2 weeks. Acupuncture and herbs are applied every two weeks for the next 3 months. Then another blood test is drawn.

If improvement continues the protocols are herbs only every two weeks. In the 3rd trimester herbs only are given every two weeks. During this period the herbal formulas are adjusted to deal with any specific enzymes that are slow to return to normal. After the 3rd trimester, if enzymes are normal the patient is released from treatment.

Then the patient needs to have blood work done every three months. If the enzyme levels start to rise herbal treatments must resume.

The reason TCM has such a positive effect on health of people with incurable diseases is its ability to deal with each human being as an individual. The presence of the Hep C virus is only one part of a larger picture, which includes excess or weakness created by life in this culture, genetic predisposition to the way the infection is affecting the individual and the life style that person is living.

According to Dr. Gaston the following is an overview of the disease and a recommended treatment protocol for Hepatitis C with Traditional Chinese Medicine. TCM offers the most comprehensive treatment protocol we currently have for combating Hepatitis C and Hepatitis in general. Current western therapy against the Hepatitis C virus is still under development and consists of generic anti-viral therapy and supportive maintenance. We currently have no vaccine.

Hepatitis C is a dangerous, usually chronic disease that is blood borne and easily transmitted via sexual contact, perinatal exposure and by sharing infected needles. Unfortunately most carriers seem to be totally asymptomatic in the early stages of infection and over 85% of infected patients develop a chronic infection.

Serious liver disease occurs in about 70% of infected patients and is a leading indicator for liver transplantation after complete hepatic failure. The CDC reports that somewhere between 36,000 and 230,000 new infections of HCV (Hepatitis C Virus) occur in the United States alone.

Hepatitis C is caused by HCV, an RNA flavivirus. The basic symptoms of the active disease are jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea and vomiting. There is currently no vaccine available to prevent HCV infection and therefore prevention is based on counseling and education to reduce high-risk exposure.

Since various forms of hepatitis are epidemic in China and other developing countries, considerable effort has been spent in China to control the disease. Traditional Chinese Medicine (TCM) has been used quite successfully in conjunction with western antiviral therapy to suppress HBV and HCV in chronically ill patients.
Recent research by Han Jinghuan showed very promising results using old TCM herbal formulae. Several studies indicated a range of effectiveness between 70 and 93 percent, with actual sero conversion rates of 40-50% reported for HVB carriers.

TCM Etiology and Pathogenesis

Traditional Chinese Medicine views Hepatitis in general, as caused by an epidemic external pathogen and/or pathogenic heat and damp that has accumulated in the interior of the body. Epidemic pathogens infect the liver and gallbladder, which results in heat or damp-heat accumulations that affect the normal flow of liver Qi and secretion of bile and leads to jaundice, nausea, anorexia, and malaise.

Improper diet or abnormally damp and/or hot weather can cause a dysfunction of the spleen’s transportation and transformation function, leading to retention of damp-heat in the spleen and the stomach, leading to further injury of the liver and gallbladder.

Exuberant pathogenic damp-heat accumulated in the interior of the body for a long time impairs the body’s vital essence. As a result, deficiency of Yin, Yang, Qi, and/or Blood syndromes may occur. In serious cases, epidemic pathogens and/or damp-heat may invade the pericardium and cause coma or other central nervous system symptom

TCM Differentiation of Symptoms

Yang versus Yin Jaundice.

Affection due to damp-heat is known as Yang Jaundice. It is characterized by a lustrous yellow discoloration of the skin and the sclera of the eyes, fever, anorexia, nausea, dryness, and bitter taste in the mouth, pain in the right hypochondrium, a yellow greasy tongue coating and a taut, slippery, rapid pulse.

Affection due to cold-dampness is known as Yin Jaundice and is marked by a dark yellow discoloration of the sclera and smoky-colored skin, lassitude, poor appetite, pale tongue with a thick, greasy coating and a deep, small, weak or slow pulse. Yang Jaundice is usually seen in acute viral hepatitis. Yin jaundice usually occurs in chronic hepatitis.

Determination of the preponderance of heat versus damp. Damp-heat is the most common pathogenic influence in jaundice. However, damp-heat invades the body in different ways, so that some patients experience more heat symptoms and others exhibit a preponderance of damp symptoms.

Fever, thirst, constipation, and scanty dark yellow urine, reddened tongue with yellow coating and rapid pulse mark cases of preponderant heat. Cases of preponderant damp, on the other hand, are characterized by a heavy sensation in the body, anorexia, nausea, fullness and distention in the abdomen, stuffiness in the chest, loose stool, whitish, thick and greasy tongue coating and a slippery pulse.

In protracted cases, pathogenic damp-heat may consume the Yin of the Liver and the Kidneys, leading to Yin deficiency of both organ systems. The symptoms of this condition are feverish sensation in the palms and feet, thirst, dizziness, tinnitus, insomnia, lumbago, weakness of the legs, reddened tongue with little or no coating and a fine, rapid pulse (in addition to the general characteristics of damp heat enumerated above).

Recognition of deficiency versus excess

Most acute hepatitis cases are of the excess type, while a majority of chronic hepatitis patients are in a condition of deficiency and excess. This is usually manifested as weakness, lassitude, poor appetite, nausea and loose stool.

In some cases, exuberant damp-heat remains in the interior of the body or virulent epidemic pathogens affect the body attacking the pericardium and producing yin and blood deficiency. This condition is marked by fever, progressive jaundice, restlessness, delirium, distention and fullness in the abdomen, edema, and even hepatic coma. The tongue is usually dry and reddened, covered with a yellow greasy coating and the pulse is small, weak and rapid. This syndrome is mostly seen with fulminant hepatitis or subacute hepatic necrosis.

Determination of stagnation of Qi versus Blood stasis

In the early stage of the disease, Liver Qi stagnates, which affects the function of the spleen and the stomach and leads to a disturbance between the liver and the stomach manifested as anorexia, abdominal distention, hypochondriac pain varying with emotional changes and irritability.
In some cases, stagnant liver qi leads to blood stasis, manisfested as hepatomegaly with stabbing pain, tenderness, dark purplish complexion and vascular spiders. Stagnant liver qi may cause dysfunction of the spleen in transporting and transforming, thus causing water to accumulate. In addition, blood stasis may also disturb water metabolism and consequently cause edema and ascites.

Herbal Treatment Strategies

Clear away Damp-Heat.

If heat is preponderant, Yin Chen Hao Tang (Oriental Wormwood Decoction) is used to clear away damp-heat. Modifications to strengthen the effect of clearing toxic heat typically include: Huang Qin, Ju Hua, and Ban Lan Gen. For severe nausea and vomiting: add Ban Xia, and Zhu Ru. For hypochondriac pain, add Yu Yin and Yan Hu Suo. If damp is preponderant, the formula of choice is Yin Chen Wu Ling San (powder of oriental wormwood and five herbs with poria).

Warm the Middle Burner and eliminate damp.

This treatment principle is used to treat Yin Jaundice. The formula used is Yin Chen Zhu Fu Tang (decoction of Oriental wormwood, white atractylodes, and aconite). For cases with spleen deficiency, add: Dang Shen, and Huang Qi to replenish middle burner Qi.

Relieve repressed Liver Qi and Invigorate the Spleen.

The best formula here is: Chai Hu Shu Gan San (Bepleurum Powder for relieving Depressed Liver Qi) and Si Jun Zi Tang (Four Gentlemen Decoction).

Nourish Yin of the Liver and Kidneys.

For yin deficiency of the Liver and Kidneys, the best choice is Yi Guan Jian (Ever effective decoction). For cases with afternoon fever, add: Mu Dan Pi, or Zhi Mu. For cases with thirst and poor appetite, add: Shi Hu, Shan Sha, and Ji Nei Jing.

Regulate Liver Qi and Remove Blood Stasis.

Xue Fu Zhu Yu Tang (Decoction for removing blood stasis in the chest) is used to treat stagnant liver qi and blood stasis. In severe cases, with stabbing pain in the abdomen, high fever, eruptions and hemorrhages, use Xi Jiao Di Huang Tang (Rhinoceros Horn Decoction – where water buffalo horn may be substituted).
These treatment principles may be used alone or in combination depending on the presentation of symptoms. Acute or subacute hepatic necrosis requires combined TCM and western medicines.

Acupuncture Treatment

The principal points are: BL-18, Gan Shu, the back-shu point of the Liver, BL-19 Dan Shu, the back-shu point of the Gallbladder, BL-20 Pi Shu, the back-shu point of the Spleen, ST-36 Zu San Li, to replenish strength and regulate the GI tract, GV-9,Zhi Yang

The supplementary points are: 1) For accumulation of damp-heat: GB-34, LV-3, DU-14, PC-5, LI-11 2) For accumulation of cold-damp needle and apply moxa at: BL-48, SP-9, SP-6 3)For deficiency of yin: LV-3, KD-3. 4)For stagnation of qi and blood stasis: LV-3, GB-40, BL-17, SP-6, LI-4

In conclusions, the application of Traditional Chinese Medicine herbal and acupuncture therapy in the treatment of Hepatitis and specifically Hepatitis C requires extensive clinical experience. Patients should consult an experienced practitioner of TCM before attempting dangerous self-medication. Current research tends to show that the best results are obtained when TCM and Western medicine are applied simultaneously. Hepatitis C is a relatively newly discovered disease and long-term studies have just barely begun. TCM has the longest and most extensive history of clinical experience with hepatitis in general and should be one of the major alternative therapies applied to ameliorate the symptoms of HCV infection. Much research needs to be done to obtain a cure.