Case 1

Name: You.

Sex: Female.

Age: 42 years.

Occupation: A private pedlar.

Chief Complaint: Distending-pain of right hypochondriac region for half a year.

History of Present Illness: Half a year ago, the patient got a distending pain in the right hypochondriac region without any obvious causes, accompanied with dizziness and lassitude, but there weren't anorexia, nausea and so on. Then she went to a hospital for treatment. After some relative medical examination, it was diagnosed as "Chronic Persistent Hepatitis B, "and she was treated with some liver-protecting drugs and some antidotic drugs. After half a year's treatment, the patient still got intermittent distending pain in the right hypochondriac region. Then she was led to me for treatment on December 15,1998. Physical Examination: The patient was conscious with a normal general condition. The tongue was red with a thin layer of white fur. The pulse was thready and taut. The abdomen was flat and soft, there was slight tenderness in the right hypochondrium. The liver and the spleen couldn't be palpated in the both inferocostal region. There wasn't other abnormal sign.

Lab Test: HBsAg (+), HBeAb (+), HBcAb (+); the result of liver function was in normal limit.

Diagnosis: Chronic Persistent Hepatitis B.

Differentiation: It's caused by pestilence, which got into the blood and lurked into the sub-collaterals of liver so deeply that it couldn't be removed easily.

Therapeutic Principle: Having a mopping-up operation against the pestilence lurked in the sub-collaterals of liver by some insect drugs; activating blood to resolve stasis in order to reinforce clearing away the pestilence from liver. In addition, it' s necessary to use some liver-protecting drugs and some antidotic drugs. By these

ways, liver-the office of storing up blood would be cleaned.

Recipe: Decoction for Cleaning liver Formulated by myself.

ZhiHuangQi,Moxa-prepared Milkvetch Root 30g

DangGui,Chinese Angelica Root 15g

ChuanXiong,Chuanxiong Rhizome 15g

WuLingZhi,Trogopterus Dung 20g

TaoRen,Peach Seed 15g

ChiShao,Red Peony Root 12g

ShuiZhi, Leech 5g

DiBieChong,Ground Beetle 5g

YuanHu,Corydalis Tuber 9g

XiangFu,Nutgrass Flatsedge Rhizome 10g

ZhiKe,Fruit of Citron 8g

XiaKuCao,Prunella Spike 25g

YiYiRen,Coix Seed 20g

All the above drugs were to be decocted in water for oral taking. 25 doses were prescribed. In the same period, she was told to take the pills for Protecting liver Formulated by myself as follow:

ShengDiHuang,Dried Rehmannia Root 20g

MuDanPi,Tree Peony Bark 15g

I.ongDanCao,Gentian Root 18g

QiYeYiZhiHua,Windpipe Trachea 30g

DanShen,Red Sage Root 25g

JiangHuang,Turmeric Rhizome 15g

DaQingYe, Isatis Leaf 15g

BaiHuaSheSheCao, Oldenlandia 30g

YinChen,Oriental Wormwood 20g

HuZhang,Giant Knot-weed Rhizome 30g

BanLanGen,Isatis Root 15g

WuWeiZi,Schisandra Fruit 30g

WuMei,Black Plum 25g

ZhiZi,Capejasmine Fruit 20g

ShengDaHuang,Raw Rhubarb 12g

All the above drugs were to be ground into fine powder, mixed together and filled into some medium-sized capsules separately, taking 5 pieces each time,3 times a day. Acid, greasy and hot food was forbidden during the treatment.

Effect Observation: After 25 days' above treatment, the patient came back for reexamination. She said the distending pain in the right hypochondriac region had disappeared, there was no uncomfortable sensation. Results of reexamination of lab test was as follow: HBsAg (--), HBeAb (--), HBcAb (--).It showed the pestilence had been eliminated completely. Then it's necessary to stop the treatment and begin having follow-up. During 1 year's follow-up, she had 2 times of reexamination of lab test, the results were all normal. It indicated the illness had been cured. Then it' s ending.

Case 2

Name: Zhou.

Sex: Female.

Age: 49 years.

0ccupation: A worker.

Chief Complaint: Abnormal liver function for 2 months. History of Present Illness: Two months ago, the patient had physical examination, the antigen and antibody systems of hepatitis were abnormal, it showed the results were as follow: HBsAg(+), HBeAg(+), HBcIgMAb(+), HBcIgGAb(+). In addition,the result of liver function was abnormal too. However, the patient didn't get a distending pain in the liver region, and there weren't aversion to greasy food and acid regurgitation too. 0nly dark yellowish urine was there. After the physical examination, the patient herself separately went to some local hospitals for treatment. After 2 months' treatment, the results of radio-immunity test were all as same as before, the illness remained unchange. Then she came to our hospital for treatment on August 22,1997.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and taut. The tongue was red with a thin layer of white fur. The heart and lungs were all normal. The abdomen was flat and soft, there was slight tenderness in the right hypochondrium. The liver and the spleen couldn't be palpated in the both inferocostal region. There was not other abnormal sign.

Lab Test: The results of radio-immunity test were as follow: HBsAg(+), HBcAb (+), HBcIgMAb (+) ; the result of liver function was as follow: ALT was 168U/L. There was not other abnormal result.

Diagnosis: Chronic Active Hepatitis B.

Differentiation: It was caused by pestilence, which got into the blood and lurked into liver. Furthermore, it hurted Yin and got entangled with damp pathogen together. So that it' s difficult to remove it completely.

Therapeutic Principle: Clearing away heat to counteract toxin, activating blood and nourishing Yin, counteracting pestilence and elimination of foulness.

Recipe: Decoction for Protecting liver Formulated by myself

ShengDiHuang,Dried Rehmannia Root 20g

MuDanPi, Tree Peony Bark 15g

LongDanCao,Gentian Root 18g

QiYeYiZhiHua,Windpipe Trachea 30g

DanShen,Red Sage Root 25g

JiangHuang, Turmeric Rhizome 15g

DaQingYe,Isatis Leaf 15g

BaiHuaSheSheCao, Oldenlandia 30g

YinChen,Oriental Wormwood 20g

HuZhang,Giant Knot weed Rhizome 30g

BanLanGen, Isatis Root 15 g

WuWeiZi,Schisandra Fruit 30g

WuMei,Black Plum 25g

ZhiZi,Capejasmine Fruit 20g

ShengDaHuang,Raw Rhubarb 12g (to be decocted later)

All the above drugs were to be decocted in water for oral taking. 20 doses were prescribed. Greasy and hot food was forbidden. Each dose should be decocted in water 3 times a day for 0ral taking in morning, afternoon and evening separately.

Effect Observation: After taking the decoction, the result of the reexamination of liver function was as follow: ALT was 16U/L. The results of the reexamination of radio-immunity test were as follow: HBsAg (+), HBeAg (--), HBcAb (+), HBclgMAb(--), HBcIgGAb (+). All these signs showed that the patient had become an virus carrier. Then she was told to nurse herself by taking some patent medicine for protecting liver. After 1 year' s follow-up, the patient was an virus carrier all along. Then it' s ending.

Case 3

Name: Ding.

Sex: Male.

Age: 49 years.

0ccapation: A peasant.

Chief Complaint: Distending pain of right hypochondrium for 2 months, accompanied with lassitude, fatigue, poor appetite and bitterness of mouth.

History of Present Illness: Two months ago, the patient got a distending pain in the right hypochondrium without obvious causes, accompanied with lassitude, fatigue, poor appetite and bitterness of mouth. Then he went to the a hospital for treatment,the antigen and antibody systems of hepatitis were abn0rmal: HBsAg (+), HBeAb (+), HBcAb (+), HBcIgMAb(+). The results of liver function examination were all normal. There wasn't other abnormal sign. He came to our hospital for

treatment on June 15,1998 through somebody. Since the illness came on, his urine, stool and sleeping had been normal all along. In addition, there weren't fever, vomiting, jaundice and aversion to greasy food during the illness.

Physical Examination: The patient was conscious with a normal general condition. The pulse was taut and unslippery. The tongue was red with a thin layer of white fur. The heart and lungs were all normal. The abdomen was flat and soft. There wasn't tenderness in the right hypochondrium. The liver and the spleen couldn't be palpated in the both inferocostal region. There wasn't other abnormal sign.

Lab Test: The results of antigen and antibody systems of hepatitis were as follow: HBsAg(+), HBeAb(+), HBcAb(+), HBcIgMAb(+). The results of liver function were all in normal limit. There wasn't other abnormal sign.

Diagnosis: Chronic Persistent Hepatitis B.

Differentiation: It's caused by pestilence, which got into the blood and lurked into the sub-collaterals of liver so deeply that it couldn't be eliminated easily.

Therapeutic Principle: Removal of toxic materials and elimination of foulness, clearing away heat to countact toxin, activating blood and removing blood stasis.

Recipe: Decoction for Protecting liver Formulated by myself.

ShengDiHuang,Dried Rehmannia Root 20g

MuDanPi,Tree Peony Bark 15g

LongDanCao,Gentian Root 18g

QiYeYiZhiHua,Windpipe Trachea 30g

DanShen,Red Sage Root 25g

JiangHuang,Turmeric Rhizome 15g

DaQingYe,Isatis Leaf 15g

BaiHuaSheSheCao, Oldenlandia 30g

YinChen,Oriental Wormwood 20g

UuZhang,Giant Knot-weed Rhizome 30g

BanLanGen. Isatis Root 15g

WuWeiZi,Schisandra Fruit 30g

WuMei,Black Plum 25g

ZhiZi,Capejasmine Fruit 20g

ShengDaHuang,Raw Rhubarb 12g (to be decocted later)

All the above drugs were to be decocted in water for oral taking. 30 doses were prescribed. Greasy, hot food was forbidden during the treatment.

Effect Observation: After 30 days' treatment, the results of antigen and antibody systems of hepatitis were as follow: HBsAg (+), HbeAb (--), HBcAb (+), HBclgMAb (--), HBcIgGAb (+). The results of liver function examination were all normal. All these signs showed the patient become an virus carrier, and resistant to the hepatitis virus. Then he was told to take 3 doses of the above prescription once more, and all the drugs were to be ground into powder, he was told to mix the powder and water together to make pills, taking 6g of the pills each time,3 times a day. In the same period he should take the pills for strengthening spleen. After 1 year's follow-up, the patient was an virus carrier all along. Then it' s ending.

Case 4

Name: Li.

Sex: Male.

Age: 22 years.

0ccupation: A college-student.

Chief Complaint: Distending pain of right hypochondrium for 1 year.

History of Present Illness: One year ago, the patient got a distending pain in the right hypochondrium without obvious causes, it occurred paroxysmally. After having lab test in the local policlinic, it was found that liver function was abnormal. Then he was sent to a hospital in Nanjing for reexamination, the results of lab test were abnormal too: ALT was 58U/L, HBsAb(+), HBeAb(+). There wasn' t other abnormal result. The doctors in the hospital considered that it's restoration stage

of chronic hepatitis which couldn't affect his health too much. Then they treated the illness with some liver-protecting drugs, antiviral drugs and some patent medicines of TCM, but there was a constant distending pain in the right hypochondrium all along. Furthermore, in the past 1 year, it was found that ALT was persistently higher than normal and HBsAb, HBeAb were all persistently positive through many times of lab test. In addition, there were fatigue, abdominal fullness and bitterness of mouth in the recent 9, months. Then he came to our hospital for treatment on September 16,1997.

Physical Examination: The patient was conscious with a normal general condition. The pulse was rapid and thready, the tongue was dark red with a thick layer of white fur. The heart and lungs were all normal. The abdomen was flat and soft. There wasn't tenderness in the right hypochondrium. Ascites sign was negative. The liver and the spleen couldn't be palpated in the both inferocostal regions. There wasn't other abnormal sign.

Lab Test: The results of antigen and antibody systems of hepatitis were as follow: HBsAb(+) HBeAb(+). The result of liver function was as follow: ALT was 58U/L.

Diagnosis: Chronic Persistent Hepatitis B.

Differentiation : It was caused by pestilence, which attacked the body from the exterior and lurked in liver deeply. As a result of a 10ng term of it, there was an entanglement between dampness evil and heat evil, which prevented liver from taking charge of dispersing function as normal. Then the patient got the distending pain of right hypochondrium, bitterness of mouth and so on.

Therapeutic Principle: Clearing away heat and expelling dampness, removal of toxic materials and elimination of foulness, activating blood to resolve stasis.

Recipe: Decoction for Protecting liver by myself.

ShengDiHuang, Dried Rehmannia Root 20g

MuDanPi, Tree Peony Bark 15g

LongDanCao,Gentian Root 18g

QiYeYiZhiHua,Windpipe Trachea 30g

DanShen,Red Sage Root 25g

JiangHuang, Turmeric Rhizome 15g

DaQingYe, Isatis Leaf 15g

BaiHuaSheSheCao, Oldenlandia 30g

YinChen,Oriental Wormwood 20g

HuZhang,Giant Knot-weed Rhizome 30g

BanLanGen,Isatis Root 15g

WuWeiZi,Schisandra Fruit 30g

WuMei,Black Plum 25g

ZhiZi,Capejasmine Fruit 20g

ShengDaHuang,Raw Rhubarb 12g (to be decocted later)

All the above drugs were to be ground into powder and mixed with water together to make pills, taking 6g of the pills each time, 3 times a day. Hot and greasy food was forbidden during the treatment.

Effect Observation: After 45 days' treatment, reexamination of lab test showed the sickness had been cured, the results were as follow: ALT was 28U/L, HBsAb (+), HBeAb ( -- ). There weren't fatigue, lassitude, bitterness of mouth and distending pain in the liver region. Then he was told to nurse himself with some spleen-kidney strengthening drugs. After 3 months' follow up, the patient was well all along. Then it' s ending.