Biliary tract infection includes acute and chronic cho-lecystitis and cholangitis; cholelithiasis includes cholelithi-asis, choledocholithiasis and calculus of intrahepatic duct. Biliary tract infection and cholelithiasis often exist simul-taneously and are responsible for each other. Chronic cho-lecystitis usually occurs after cholelithiasis and is often the sequela of acute cholecystitis, clinically marked by pain in the upper or right upper abdomen. According to the clini-
cal symptoms, biliary tract infection and cholelithiasis pertain to the conceptions of hypochondriac pain, jaundice in TCM. This problem is usually caused by exogenous pathogenic factors, emotional changes and improper diet that lead to interior accumulation of damp-heat and failure of the liver and gallbladder to disperse; or by prolonged accumulation of damp-heat that condenses bile into stone. The clinical manifestations are either of sthenia syndrome or of heat syndrome.
1. Stagnation of liver and gallbladder qi
Oppression and distension in the right upper abdo-men, colic at intervals, migratory pain, mental depres-sion, belching and sighing, dysphoria and susceptibility to rage, thin and yellow tongue fur, taut and rapid pulse.
2. Damp-heat in the liver and gallbladder
Acute onset, fever, bitter taste in the mouth and dry throat, yellow coloration of eyes and body, yellow urine, constipation, red tongue with yellow and greasy (or dry) fur, taut and rapid pulse.
3. Accumulation of heat-toxin
Chills and fever, flushed cheeks and yellow coloration of body, restlessness, scanty and brown urine, constipa-tion, even delirium and coma, cold limbs, deep-red or purplish tongue with yellow and dry or prickly fur, slip-pery and rapid or deep and latent pulse.
1. Body acupuncture
Modification: For stagnation of liver and gallbladder qi, Qimen (LR 14) and Yanglingquan (GB 34) are added; for damp-heat in the liver and gallbladder, Yinlingquan (SP 9) and Xiaxi (GB 43) are added; for accumulation of heat-toxin, Quchi (LI 11), Neiting (ST 44) and Xiaxi (GB 43) are added; for high fever, Dazhui (GV 14) and Erjian (TE 2) are added; for colic of gallbladder, Yang-lingquan (GB 34) and Hegu (LI 4) are added; for nausea and vomiting, Neiguan (PC 6) and Zusanli (ST 36) are added; for jaundice, Zhiyang (GV 9) and Zusanli (ST 36) are added; for constipation, Zhigou (TE 6) and Tianshu (ST 25) are added; for coma and prostration, Shuigou (GV 26), Baihui (GV 20), Neiguan (PC 6), Hegu (LI 4) and Zusanli (ST 36) are added.
Performance: Riyue (GB 24) and Qimen (LR 14) are needled obliquely lateral along the costal space, vertical needling should be avoided. Zhongwan (CV 12) is needled obliquely downward to the right hypochondrium to enable the needling sensation radiate to the affected region. Ver-tical needling should not be too deep. Dazhui (GV 14) and Erjian (LI 2) are pricked for bloodletting. All the acu-points are needled with reducing techniques. At the same time electropuncture can be applied with continuous wave and high frequency for 40 - 60 minutes of strong stimulation.
2. Ear acupuncture
Performance: Each time 3 - 5 acupoints are selected and needled with routine procedure. Strong stimulation is required for acute syndrome (bloodletting from the tip of ear), while moderate stimulation is required for chronic syndrome. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear pressure.