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Acupuncture Today – October, 2002, Vol. 03, Issue 10

Hepatitis C Virus: The Silent Epidemic, Part Two

The Hepatitis C Help Program: An East-West Comprehensive Approach - Chinese Diagnosis and Treatment with Acupuncture, Moxibustion and Massage

By Misha Cohen, OMD, LAc

Chinese Differential Diagnosis

The organ patterns primarily disturbed in hepatitis C virus (HCV) are the liver organ patterns and the spleen organ patterns.

These organ patterns affect a person's digestion and energy. According to Chinese traditional medicine, acute viral hepatitis is generally associated with excess damp heat or damp cold conditions.

While in a few cases a person infected with HCV may have or notice acute symptoms, it is rare. Therefore, the TCM stages at which one is diagnosed with hepatitis C are often the chronic stages of qi stagnation, and the qi and yin deficiency stages. Advanced chronic disease includes a development of the patterns of xue (blood) stagnation and deficiency.

All HCV is associated with the li qi (pestilence/epidemic factor) toxic heat:

Toxic Heat

Symptoms: Itching, sensations of heat, agitation

Tongue: Red spots and body

Pulse: Rapid

In addition, there are 10 syndromes specifically associated with viral hepatitis.

The following excess syndromes are associated generally with acute hepatitis and increased liver enzymes. However, these may persist in chronic hepatitis (along with additional syndromes that develop as liver disease progresses).

1. Liver /Gallbladder Damp-Heat

  • bright yellow face/eyes
  • fever
  • costal pain
  • jaundice
  • nausea
  • pulse: wiry
  • tongue: red, with yellow greasy fur

2. Spleen Damp-Heat

  • bright yellow face
  • abdominal pain
  • nausea
  • jaundice
  • fever
  • decreased appetite
  • pulse: slippery
  • tongue: red, with yellow greasy fur

3. Spleen Damp-Cold

  • sallow yellow face
  • abdominal pain
  • nausea
  • feels cold/often has fever
  • decreased appetite
  • pulse: slippery
  • tongue: pale, with greasy white fur

The following excess syndrome is generally associated with chronic hepatitis.

4. Qi Stagnation

  • fatigue
  • costal pain
  • fullness in abdomen
  • nausea
  • flatulence/bloating
  • often increased liver enzymes
  • swollen liver and spleen
  • pulse: wiry
  • tongue: purplish or normal, with thin white coat

The following deficiency syndromes are associated generally with chronic hepatitis:

5. Spleen Qi Deficiency

  • fatigue
  • abdominal tenderness
  • nausea/queasiness
  • lack of appetite
  • muscle weakness
  • loose stools
  • pulse: deficient
  • tongue: pale, swollen with toothmarks

6. Liver Yin Deficiency

  • dryness of eyes, nails, throat and mouth
  • fatigue
  • blurry vision
  • dizziness
  • muscle spasms
  • reddish cheeks and eyes
  • numb limbs
  • quick temper
  • pulse: thin, deficient, wiry, rapid

7. Qi Deficiency (General)

  • fatigue
  • bleeding (such as purpura)
  • leg edema
  • ascites
  • pulse: deficient
  • tongue: pale, swollen

8. Yin Deficiency (General)

  • fatigue
  • reddish cheeks
  • night sweats
  • afternoon fevers or hot flashes
  • restlessness
  • waking up during night
  • pulse: thin, deficient, rapid

The following deficiency syndrome is often associated with cirrhosis.

9. Xue (Blood) Deficiency

  • pale and lusterless face
  • general dryness
  • enzymes often normalize
  • shrunken liver
  • pulse: deficient and thready/hollow if loss of blood
  • tongue: pale

The following excess syndrome is often associated with liver cancer (and is in addition to deficiency syndromes).

10. Xue (Blood) Stagnation

  • sharp, stabbing costal pain
  • abdomen hurts with movement
  • pulse: choppy or wiry (with pain)
  • tongue: purple or purple sides

Treatment with Acupuncture, Moxibustion and Massage

General Chronic Hepatitis Treatment

  • Special points - .75 cun from du channel at the level of T10/T11/T12, along with UB 18/19/20
  • With deficiency, add St36, Sp6
  • Four gates: Liv3, LI4
  • Costal (liver) pain: Liv14, GB24
  • Costal (spleen) pain: Liv13

For Specific Chinese Patterns:

  • damp-heat liver/gallbladder: GB34, Liv3, Ren12, Sp6, Ear-Liv, Ear-GB
  • damp-heat spleen: Sp9, Sp6, Ren12
  • damp-cold spleen: Use moxa on Sp 6, Sp9, UB 20, Ren12
  • liver qi stagnation: Liv3, LI4, UB18
  • qi and xue deficiency: St36, Sp6, UB20, 21, 23
  • xue stagnation: Sp10, LI11
  • gallbladder pain: gallbladder (Special point about 1 cun below GB34)


Moxibustion may be used in HCV to stimulate specific acupuncture points. This warms the channels and expels cold and dampness; creates a smooth flow of qi and xue; strengthens yang qi; prevents disease; and maintains health.

For hundreds of years, moxibustion has been partnered with acupuncture. According to the Chinese text, Introduction to Medicine, "When a disease fails to respond to medication and acupuncture, moxibustion is suggested."

For chronic hepatitis, whenever there are increased AST and ALT levels, you may use the following points:

  • special points - .75 cun from du channel at the level of T10/T11/T12
  • also include UB18/19/20

Additional points for various conditions include:

  • for dampness and treating digestive problems associated with cold, use Ren12 - halfway between the navel and the tip of the sternum; effective in dispelling cold and dampness
  • for diarrhea associated with pharmaceutical treatment or chronic spleen deficiency, use salt and loose cone moxa treatment over the navel at Ren8
  • for weak energy and lack of appetite, use St36, Sp6
  • with nausea, moxa Ren12, Ren14 and Sp6
  • for liver/costal pain, use stick moxa at Liv14 and GB24


I instruct the client to perform self-acupressure at the following points:

  • for nausea, press P6 and Ren12
  • for weak energy, massage St36, Sp6 and Sp4
  • for loose stools and abdominal cramping, massage St37, St25

Abdominal massage is helpful to harmonize the large and small intestine, liver, spleen, stomach and gallbladder. To increase the massage's effectiveness, warm the abdomen first with a hot pack or ginger compress. You may also massage using warming oil infused with cinnamon essential oil.

Click here for previous articles by Misha Cohen, OMD, LAc.

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