Acute hepatic failure is a critical disease caused by multiple causes of acute massive necrosis of hepatocytes or severe dysfunction of organelles in hepatocytes, resulting in short-term progression to hepatic encephalopathy and even life-threatening. The disease is dangerous, jaundice occurs 12~24 hours after the onset of jaundice, jaundice progressively aggravated, 2~4 days after coma, and bleeding tendency, most common in fulminant viral hepatitis, acetaminophen poisoning, halothane anesthesia poisoning, acute fatty liver in pregnancy, etc., and the case fatality rate is as high as 80%~90%. This disease belongs to the category of Chinese medicine “acute yellow”, also known as “epidemic yellow”, “plague yellow”. I. Identification and typing 1, the evil in the qi: the onset of acute, body and eyes yellow, gradually deepen, urine deep yellow, high fever and thirst, face also gas thick, restlessness or delirium, nausea and vomiting, dry mouth, bitter, abdominal distension and dystocia, constipation, the tongue is deep red, the moss is yellow and greasy, and the pulse is slippery. 2, the evil into the blood: the body is yellow, also called “epidemic yellow”, “plague yellow” category of traditional Chinese medicine, also known as “epidemic yellow”, “plague yellow”. 2, evil into the camp blood: body heat at night, body and eyes as yellow as gold, short urine, drowning dark yellow, coercive and rib distension and pain, delirium, drowsiness and drowsiness, or vibration and convulsion, or epistaxis, vomiting blood, urinary blood, blood in stool, skin rash, or abdominal distension with water, tongue reddish-red, moss yellow and dry, pulse string and fine number. Evil in the qi division [Treatment] Clearing away heat and removing toxins, inducing diuresis and eliminating yellowness. [prescription] Yin Chen artemisia soup (” jin gui yao liu “) plus flavor: the main drug: Yin Chen artemisia, gardenia, rhubarb, can add antelope horn, the big green leaf, soil poria, dandelion, honeysuckle to strengthen the effect of clearing heat and detoxification. If the evil heat is blazing, high fever does not go down, add gypsum, Zhimu clear heat and fire; Evil heat inside closed heart orifices, dizziness, transferring the service Angong Niuhuangwan to open the orifices to wake up the spirit; Stomach gas upward vomiting, add bamboo, Huanglian and stomach and lowering the reversal; Right coercive pain, is the dampness-heat condensation, stagnation of collateral veins, add Chaihu, Yuanhu, yujin to dredge the liver and gallbladder, eliminate stasis pain; Epigastric distension and stuffiness, for the internal organs of the air is not passable, add hedgehog, Houpaku to move the gas and pass through the internal organs. 2, the evil into the camp blood [treatment] clean camp cool blood, detoxification to save Yin. [prescription] rhinoceros horn scattered (“a thousand jin Yao Fang”) and rhinoceros horn dihuang Tang (“a thousand jin Yao Fang”): the main drug: rhinoceros horn (water buffalo horn generation), Huanglian, ascending hemp, gardenia, chen, raw rhubarb, peony dandanpi, red peony. Serving the above does not work, can be changed to take the clear plague and poisonous drink; If the body and eyes yellow, agitation such as madness, gradually to coma, breathing air thick, phlegm in the throat, tongue red moss yellow thick and greasy, pulse slippery, for phlegm and fire internal disturbance, the treatment is suitable for clearing away heat and detoxification, cleansing phlegm to open up the orifices, prescription rhinoceros and antelope three juice drinks (“re-editing the theory of wide warmth and heat”). Third, the appropriate technology 1, acupuncture therapy (1) the main points: ① liver Yu, gallbladder Yu, Xingma, foot Sanli; ② large vertebrae, to Yang, medical Ming, Neiguan; ③ liver Yu, spleen Yu, Taichong, Yanglingquan. A group of points is chosen daily, with strong stimulation, without leaving needles. Matching points: coma: Renzhong, Hegu, Yongquan, Shixuan (bloodletting); irritability: Neiguan, Shenmen; uh-oh: Neiguan, Hegu, Shusanli, diaphragm Yu, in the epigastric region (available atropine 0.5 mg for acupoint injections); abdominal distension: Shusanli (can be injected into the acupoints vitamin B1100 mg), can also be used to Wu Juzhu fried hot to cloth wrapped in hot compresses around the umbilicus. (2) Main points: Renzhong, Shixuan, Hegu, Taichong, with the use of large vertebrae, Neiguan, Fenglong, Yongquan, strong stimulation, do not leave the needle, with diarrhea, used for Shenxiao closed evidence; main points: Sousi, Taibi, Fuxuyao, with the use of Hegu, Laogong, foot Sanli, flat tonic and diarrhea, and the addition of moxibustion Baihui, Neiguan, Qi Hai, used for Shenxiao off the evidence. (3) To reduce yellowness, choose Da Shi, Liver Yu, He Gu, Nei Guan; to stop bleeding, choose Blood Sea, Shui Quan; to open the orifices, choose Ren Zhong, Shixuan, Bai Hui; to clear heat and detoxification, choose Quchi, He Gu, Da Shi. Manipulation: use the diarrhea method, get the feeling of needles, leave the needle for 10 minutes. 2. Patch therapy (1) with 30 grams of chen, two slices of ginger, with the pounding, patch chest, removed after 24 hours. (2) 10 grams of garlic root, castor beans 3 grams, pounded together as mud, paste the Yongquan points, fixed with gauze. The main treatment of acute yellow with dropsy. (3) with buttercup stems and roots 10-20 grams, pounded, applied to the Lechu point for 24 hours, so that the local blisters. If the blister is too large, the liquid in the blister can be drained. (4) 5 snails, a little salt, mashed as mud, paste Shi Men acupoint, long cover gauze, treatment of acute yellow with vomiting. 3.Enema therapy: use Da Cheng Qi Tang or Niu Huang Cheng Qi Tang, thick decoction to 60 ml, retained enema, once every 6 hours. 4.Nasal drip therapy (1) Drabanemerosa hebecarpa 10 grams, 15 grams of jujube, 30 grams of Qiancao, 5 grams of Erzhuang, 3 grams of Daxue, 5 grams of Qiangwu, decoction nasal feeding. Treatment of acute yellow with coma. (2) with a bitter melon, mashed, cloth bag twisted juice, storage bottle spare, each time 1 ~ 2 drops, drops into the nose. (5) Wine therapy (1) Prescription: 120 grams of cordyceps root. Usage: half of the roots with wine, water, into the vessel to cook for half a day; dew overnight, depending on the amount of wine. The wine juice should be taken warmly in several times. Mainly treats damp-heat jaundice. (2) Prescription: 5 loofah roots, appropriate amount of yellow wine. Usage: the loofah root mashed, a bowl of water to fry a few boiled, remove the slag, take the juice and wait for the temperature, with yellow wine to serve. 6, convulsive nose therapy: 10 grams of melons, research powder convulsive nose, several times a day, yellow water flow is healed. 7.Application method: a handful of Artemisia capillaris, a piece of ginger, pounded, rubbed on the chest, limbs. 8, proprietary Chinese medicine (1) Angong Niuhuang Pills: one pill each time, three times a day. (2) Zhi Bao Dan: one pill each time, three times a day, orally or nasally. (3) Ganluo Sterilization Dan: 9 grams per dose, 3-4 times daily. (4) Huanglian Shangqing Pill: 6 grams per dose, 3 times daily. (5) Cow musk powder: 3 parts of artificial oxalis, clove, calamus, one part of musk, 10 parts of antelope horn powder, 7 parts of saffron, all the above medicines are finely ground and become. Each time to serve 0.85 grams, twice a day (every 3 hours in severe cases), served 2 to 5 days. (6) Shen Rhinoceros Dan: It is suitable for those who are suffering from severe heat and toxicity and delirium. Take 9 grams orally each time, twice a day. (7) Zixue Dan: For those with convulsions of the limbs and delirium. Take 1~2 grams orally each time, twice a day. (8) Suhexiang Pill: For those with closed orifices and delirium with cold. Take one pill orally each time, twice a day. (9) Jade Pivot Pill: It contains musk, crocus sativus, chrysanthemum cream, andrographis, halberd, vermilion sand, and five times seed, etc. It functions in detoxification and elimination of obscenity. Applicable to frequent vomiting more than. 9, Chinese medicine injection (1) Qing Kai Ling injection: 80 milliliters add 5% glucose liquid 300 milliliters, intravenous drip, 1~2 times daily. (2) Yin gardenia yellow injection: 40~100 ml add 5% glucose liquid 250 ml, intravenous drip, once a day. (3) Wake up the brain still injection: 20 milliliters add 10% dextrose injection 200 milliliters, intravenous drip, 1~2 times a day. (4) Shuanghuanglian powder injection: 3~4. 2 grams added to 5% dextrose injection in 500 ml of intravenous drip, once a day. (5) Calamus and tulip gold injection: each milliliter contains 2 grams of calamus and tulip gold, commonly used 10-20 ml of this drug, added to 250 ml of 10% dextrose solution, intravenous drip, twice a day; or 2 ml of intramuscular injection, 4-6 times a day. (6) Clears the liver injection solution: by the Yin Chen, the gardenia, the rhubarb, the tulip gold, the woolly dongqing and so on the preparation and become. Commonly used 20~40 ml of this drug, add 10% glucose solution 250 ml, intravenous drip. (7) Clearing injection: it is prepared by Artemisia, Fritillaria, Ginkgo biloba, Panax quinquefolium, Dandelion and so on. Each time, 80~100 ml of this drug should be added into 250 ml of 10% glucose solution and injected intravenously, 1~2 times a day. (8) Compound Danshen Injection: 40 ml of this drug should be added into 5% dextrose solution or low molecular dextrose 1000 ml and injected intravenously. It can also be injected intramuscularly with 2~4 ml, 3 times a day. (9) Chuanxiongxizine injection: function of activating blood circulation and removing blood stasis, with anti-platelet aggregation effect, and the aggregated platelets have depolymerization effect; also can dilate small arteries, improve microcirculation and cerebral blood flow, and produce anti-thrombosis and thrombolytic effect. Each time 40 ~ 80 mg, divided into two intramuscular injection, or add 10% glucose solution 500 ~ 1000 ml in intravenous drip, once a day. 10, diet therapy (1) chicken bone grass boiled red dates: chicken bone grass 60 grams, red dates 8, decoction tea. Applicable to Yang Huang, acute yellow. (2) Xihuangcao Boiled Pork Liver: 60 grams of Xihuangcao, 50 grams of pork liver, decoction. Applicable to Yang Huang, acute yellow. (3) Dan Shen Lingzhi Boiled Chicken: 30 grams of Dan Shen, 15 grams of Ganoderma lucidum, chicken (frog) 250 grams. The chicken will be peeled and cleaned with the soup, salt seasoning, drink soup and eat meat. Applicable to Yin Huang.