Therapeutic method: Activating the function of the spleen, inducing diuresis and warming yang.

Recipe: Modified Decoction of Oriental Wormwood and Bighead Atractylodes and Prepared Aconite.

Ingredients:

Herba Artemisiae Capillaris 30g

Rhizoma Atractylodis Macrocephalae 12g

Radix Codonopsis Pilosulae 12g

Poria 15g

Semen Coicis 30g

Radix Aconite Praeparata 6g

Pericarpium Citri Reticulatae 10g

Fructus Crataegi 10g

Fructus Hordei Germinatus 10g

Massa Fermentata Modicinalis 10g

Administration: All the above drugs are to be decocted in water to get 200--300ml of decoction. Take equal shares in the morning and in the evening.

Modification: In case of aversion to cold and cold limbs, add

Rhizoma Zingiberis 10g

In case of hepatosplenomegaly, add

Radix Salviae Miltiorrhizae 15g

Carapax Triengcis 15g

In case of ascites, add

Pericarpium Arecae 15g

Semen Plantaginis 15g (wrapped in a piece of cloth during decocting)

2. Anicteric Hepatitis:

(1)Dampness and Heat in the Liver and Gallbladder

Clinical manifestations: Chest stuffiness, dysphoria with feverish sensation, pain in the hypochondrium, abdominal dis-tension, lassitude and weakness, anorexia with aversion to greasy food, bitter taste and dry mouth, scanty dark urine, dry stools, reddened tongue with yellow and greasy fur, taut and rapid or smooth and rapid pulse.

Therapeutic method: Removing pathogenic heat and dampness.

Recipe: Modified prescriptions of Oriental Wormwood Decoction combined with Decoction of Gentian for Purging Liver-fire.

Ingredients:

Herba Artemesiae Capillaris 30g

Fructus Gardeniae 10g

Radix Scutelariae 10g

Radix Gentianae 10g

Radix Isatidis 30g

Herba Patriniae 30g

Radix Curcumae 12g

Semen Plantaginis 10g(wrapped in a piece of cloth during decocting)

Radix Salviae Miltiorrhizae 12g

Poria 10g

Cortex Magnoliae Officinalis 10g

Administration: All the above drugs are to be decocted in water to get 200--300ml of decoction. Take equal shares in the morning and in the evening.

Modification: In case of prominent pain in the hypochon-drium, add

Fructus Meliae Toosendan 12g

Rhizoma Corydalis 10g

In case of obvious epigastric distension and stuffiness, add

Fructus Aurantii 10g

Fructus Amomi 10g

In case of poor appetite, add

Fructus Crataegi 15g

Endothelium Corneum Gigeriae Calli 10g

(2) Stagnation of the Liver-Qi with Deficiency of the Spleen:

Clinical manifestations: Dull pain in the right-sided hypochondrium, general debility, anorexia, loose stools, thin and whitish fur of the tongue, deep and taut pulse.

Therapeutic method: Relieving the depressed liver-Qi and reinforcing the function of the spleen.

Recipe: Modified Ease Powder.

Ingredients:

Radix Bupleuri 10g

Radix Angelicae Sinensis 10g

Radix Paeoniae Alba 10g

Radix Codonopsis Philosulae 12g

Rhizoma Atractylodis Macrocephalae 10g

Poria 10g

Radix Curcumae 12g

Pericarpium Citri Reticulatae 10g

Radix Salviae Miltiorrhizae I2g

Rhizoma Dioscoreae 15g

Fructus Crataegi 15g

Massa Fermentata Medidnalis 12g

Radix Glycyrrhizae Praeparata 6g

Administration: All the above drugs are to be decocted in water to get 200--300ml of decoction. Take equal shares in the morning and in the evening.

Modification: If the disease is characterized by dryness of the eyes, dizziness, dull pain in the hypochondrium, hot sen-sation in palms and soles, soreness and weakness in the loins and knees, dry and red tongue coated with a little fur or no fur at all, taut and thready pulse, which is caused by deficiency of the liver-yin, nourishing the liver-yin should dominates the treatment. The given recipe is Decoction for Nourishing the Liver and Kidney with additional ingredients:

Ingredients:

Radix Glehniae 12g

Radix Ophiopogonis 12g

Radix Rehmanniae 12g

Fructus Lycii 15g

Radix Angelicae Sinensis 10g

Fructus Meliae Toosendan 10g

Carapax Trionycis 15g

Radix Curcumae 12g

Herba Dendrobii 12g

(3) Stagnation of Qi and Blood Stasis :

Clinical manifestatinos: Gloomy complexion, stabbing pain in the right hypochondrium, hepatomegaly or splenomegaly, abdomi-nal distension, anorexia, some telangiectases in the skin of face and neck with vascular spiders, liver palms, dark purple tongue sometimes marked with ecchymoses, taut and uneven pulse.

Therapeutic method: Promoting blood circulation, re-moving blood stasis and softening hard hepatomegaly or splenomegaly.

Recipe: Modified Decoction of Peach Kernel and Safflow-er with Other Four Ingredients.

Ingredients:

Radix Angelicae Sinensis 12g

Radix Paeoniae Alba 12g

Rhizoma Ligustici Chuanxiong 10g

Semen Persicae 10g

Flos Carthami 10g

Radix Salviae Miltiorrhizae 20g

Carapax Trionycis 15g

Squama Manitis 6g

Rhizoma Zedoariae 10g

Caulis Spatholobe 30g

Rhizoma Cyperi 10g

Fructus Cirri Sarcodactylis 10g

Radix Glycyrrhizae Praeparata 10g

Administration: All the above drugs are to be decocted in water to get 200--300ml of decoction. Take equal shares in the morning and in the evening.

Modification: In case of symptoms of lassitude and weak-ness, add

Radix Codonopsis Pilosulae 12g

Radix Astragali seu Hedysari 15g¢Ù

For all types of clinical manifestations mentioned above, if SGPT is higher than normal, Fructus Schisandrae may be tak-en at the same time, 3g are taken each time and 3 times a day; or additional intake of Herba Sedi Sarmentosi 50mg are taken each time and three times a day; or choose any of the appropri-ate amount of the following ingredients for extra intake: Rhi-zoma Bistortae, Rhizoma Polygoni Cuspidati and Herba Hy-perici Japonici.

Prevention

Both feces and blood from patients with hepatitis A con-tain virus during the prodromal and early icteric phases of the disease. Raw shellfish concentrate the virus from sewage pollu-tion and may serve as vectors of the disease. General hygienic measures should include handwashing by contacts and careful handling, disposal, and sterilization of excreta and contaminat-ed clothing and utensils. Close contacts of patients with hep-atitis A should receive immune serum globulin (ISG) as soon as possible but no later than 6 weeks after exposure. Travelers to endemic areas where sanitation facilities are poor may be protected by prior administration of ISG or by using hepatitis

¢Ù Note: Generally, a decoction should be taken in two separate doses a day, one ,n the morning and the other in the evening. The whole course of treatment covers 3¡«6 successive days, or depends on the pa-tient's condition. This principle is applicable to all the recipes that are mentioned in this book. A vaccines. The use of such vaccines in other high-risk groups is currently under study.

Hepatitis B is rarely transmitted by body finds other than blood, but nonetheless one should avoid contact with the excreta of patients. Far more important is the meticulous disposal of contami-nated needles and other blood-contaminated utensils.

Efforts at preventing hepatitis B have involved the use of ISG enriched in anti-HBs [ hepatitis B immune globulin (HBIG)]and the recombinant hepatitis B vaccine. Postexpo-sure prophylaxis with HBIG after blood or mucosal exposure(e.g., needlestick, eye splash, sexual contacts of acute hep-atitis B patients, neonates born to mothers with acute or chronic infection) should be given within 7 days and subse-quently with hepatitis B vaccine. Preventive vaccination is cur-rently recommended for high-risk groups and individuals (health care professionals, patients undergoing dialysis, pa-tients with hemophilia, residents and staff of custodial care in-stitutions, sexually active homosexual men) and is advocated universally for children.

No accepted prevention strategies are available for HCV. Because ISG does not contain HCV-neutralizing antibodies, it is of no use for postexposure prophylaxis. However, evidence indicates that early treatment of acute hepatitis C with agents such as interferon-a may significantly reduce the development of chronic infection. The advent of widespread blood product screening for anti-HCV has significantly reduced the incidence of post-transfusion hepatitis.