An excess of bilirubin in blood can produce jaundice, is a yellowish discoloration of skin, tissues and sclera ‘white of eyes’ caused by high levels in blood of the chemical bilirubin. It results from an increased amount of bilirubin, a reddish-yellow pigment in blood, when bilirubin level is mildly elevated; they are yellowish but tends to brown when level is high. Jaundice is mainly manifested by yellow discoloration of the sclera, skin, urine, normally resulted from dampness in spleen and heat in stomach, leading to abnormal circulation of bile, which spreads to skin surface. It is further divided into Yin ‘Homo’ and Yang ‘Hetero’ jaundice per it’s nature.
Bilirubin is formed by breakdown of hemoglobin, a pigment in RBC. Liver removes bilirubin from the blood stream and discharges it in bile. The chemical that remains in blood after iron is removed becomes bilirubin. Thus, jaundice results from either excessive production of bilirubin or reduced discharge of bile. Jaundice is not a disease but a symptom of various diseases.
Haemolytic jaundice results from an increased breakdown of red blood cells, which cause greater concentration of bilirubin in blood.
Hepatocellular jaundice occurs when the liver is diseased, as in hepatitis, so that it cannot secrete enough bile.
Obstructive jaundice is caused by blocking of bile ducts.
Gallstones may also cause such a blockage.
Many babies are born with physiologic jaundice, which occurs if body cannot process all the bilirubin it produces. In most cases, it disappears within two weeks after birth.
Bile a fluid secreted by liver helps the body digest and absorb fatty foods. It also rids body of certain waste products. Bile flows from the liver into a tube called the hepatic duct. It connects with common bile duct, which leads to small intestine. Except after meal most of the bile does not proceed directly to intestine. Rather, it enters in gall-bladder, a pouch attached to common bile duct. There, bile is stored and concentrated until needed. It contains various waste products that eventually become part of the feces (solid body wastes). One of these waste products, bilirubin, is formed from breakdown of red blood cells. Bilirubin gives bile its color, which ranges from brown to greenish-yellow. Other waste matter in bile includes excess cholesterol and certain poisons that the liver removes from bloodstream.
The seasonal and epidemic factors accumulate in spleen and stomach, leading to internal formation and collection of damp heat. Dampness after mixed with heat is apt to penetrate deeper, while heat mixed with dampness is apt to get more exuberant. The liver and gallbladder are steamed by the heat in spleen and stomach, leading to overflow of the bile to skin surface, thus jaundice appears.
Irregular diet injures the spleen and stomach, causing disturbance in transportation and transformation and internal formation of dampness, which transforms into heat. Damp heat stains the skin yellow.
YANG Jaundice ;
Main manifestations: abdomen distended, body heaviness, chest stuffiness, fever, nausea, pulse rapid, skin lustrous yellow and sclera, string taut, thirst, tongue yellow sticky coating, urine scanty dark yellow. If spleen yang fails to resolve the dampness, normal distribution of bile is impaired, affecting spleen, soaking into muscles and spreading to skin which turns yellow as if it were smoked. Basically, steaming of damp heat makes the bile spread to skin surface. Heat being a yang factor, makes yellow discoloration of skin lustrous. Fever, thirst, scanty dark yellow urine are due to excessive damp heat, which damages the body fluid and disturbs the activity of bladder.
YIN Jaundice ;
Main manifestations: appetite lost, aversion to cold, body heaviness, epigastric stuffiness, lassitude, pulse deep slow, skin sallow, thirst absence, tongue pale, tongue thick-white coating, weakness. Yin jaundice can also result from an improperly treated yang jaundice which leads to injury of yang qi, hypo-activity of spleen yang, and internal collection of cold dampness. Basically, the stagnation of cold dampness in spleen and stomach impedes distribution of yang qi, leading to overflow of bile, thus the skin is sallow. In case the dampness stays in spleen, then spleen yang is hypo-active and transporting-transforming function is impaired, therefore heaviness in body, loss of appetite and epigastric stuffiness occurs.
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