OBJECTIVETo investigate the essence of dampness and heat, the two main etiological factors of jaundice, to seek the objectified indices for syndrome typing of jaundice.

METHODSNinety-five adult in-patients with icteric viral hepatitis B were eligible, 61 of them were free from bacterial or fungal infection, while 34 with secondary bacterial or fungal infection. The serum biochemical indexes, and clinical features such as the color of jaundice, tongue picture and pulse frequency were observed.

RESULTSDark-yellow colored skin, red or normal tongue proper with white tongue fur appeared in most patients with dominant elevation of direct bilirubin, in whom the ratio of direct bilirubin to indirect bilirubin (DBIL/IBIL > or =1). The color of tongue proper often turned pale in patients with cirrhosis due to the complicated anemia caused by hyperactivity of spleen, while the quick pulse and yellow tongue fur always presented in patients accompanied with infection. On the contrary, bright-yellow colored skin, red tongue with yellow fur appeared in patients with dominant elevation of indirect bilirubin, in whom DBIL/IBIL <1.

CONCLUSIONDBIL/IBIL ratio can exactly reflect the syndrome types of jaundice, when it is equal to or above 1, the type is mostly of dampness dominant, whereas it is less than 1, heat dominant. If quick pulse and yellow tongue fur appeared in patients with DBIL/IBIL > or =1, it indicates that the presence of heat conversion of the dampness stagnancy.